Summer Ends, Heel Pain Begins

It's a common occurrence in podiatry practices every September: we will get a multitude of phone calls of patients calling because they have foot pain. It's so common that we can often pinpoint exactly when the phone calls are going to start poring in- right after Labor Day.
What people are experiencing is not just average foot pain, it's heel pain, or plantar fasciitis. And the reason they are having such difficulties in the month of September is because their feet are shocked into wearing actual shoes. Think about it: people will spend their entire summers in flop-flops, sandals, and the like. All of these shoes are flimsy, floppy, and unsupportive. So when you've been walking around in unsupportive shoes, what do you think happens? You feet become used to these shoes, your gait changes, and problems are bound to arise.
When people switch back to shoes that have more structure and are more supportive, their feet cry out in pain! Your feet are not used to structure and support and the problems that were lurking are now coming out. It's like when you haven't gone to the gym in a while and overdo it when you go back- your muscles ache.
Heel pain is the most common complaint from summer shoe wearers because of the shoe's inherent design. Your feet need support when walking and running, and that support comes from shoes. Without proper support, your feet pronate in or supinate out, your arches begin to collapse, and there is pressure on the wrong parts of the foot. With flip-flops, your feet struggle to keep the shoes on your feet, causing an unnatural gripping. That flip-flop sound is the shoes pounding against your heels. No wonder people get heel pain!
So what can you do if you're having heel pain in the fall? First, stop wearing unsupportive shoes. You are not doing your feet any justice by wearing flimsy shoes. If it means spending a little more on fewer pairs of shoes, then do so. Second, call a podiatrist for an appointment. We are able to treat your heel pain conservatively and effectively with stretching, orthotics, shoe recommendations, and sometimes injections. Surgery is rarely required for heel pain sufferers.
Next summer remember: if you want to wear flip-flops and unsupportive shoes, think of the pain you went through in the fall. You may just reconsider!

If you are experiencing heel pain, call our Rocky Hill or Middletown office to make an appointment.
Jeffrey S. Kahn, DPM
Connecticut Foot Care Centers
Heel Pain Doctor in CT
Podiatrist in Rocky Hill and Middletown, CT
Visit our website, follow my tweets on Twitter, and friend or like our page on Facebook.

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Does A Night Splint Help My Heel Pain?

If you wake up every morning and can barely get out of bed because your feet hurt so much, you probably have heel pain, or plantar fasciitis. Plantar fasciitis is the inflammation of the plantar fascia, the long band of ligament that runs from your toes to your heel.

There are many treatment options for heel pain, but one of the options that has the best success rate is the night splint. Night splints work by providing a constant stretch to the plantar fascia ligament overnight. While we sleep, our feet often go into a passive position, meaning they relax. When a ligament is relaxed for too long, stretching it, like after a night's sleep, causes the pain. This is a proven, effective method of treating heel pain. You will notice relief when you wake up in the morning and can walk with less pain! When wearing the night splint consistently you will notice a progressive relief of your heel pain.
The type of night splint we prescribe for our patients is the Active Innovations Dorsal Night Splint. It is designed to hold the foot in a neutral position during sleep, thereby helping to alleviate the morning pain and discomfort associated with plantar fasciitis. The overall benefits of this night splint are: low profile, less/bulk/weight, less heat retention, increased comfort during sleep, increased usage by patient, and easy night-time mobility.
If you are experiencing heel pain, call our Rocky Hill or Middletown office to make an appointment.
Jeffrey S. Kahn, DPM
Connecticut Foot Care Centers
Heel Pain Doctor in CT
Podiatrist in Rocky Hill and Middletown, CT
Visit our website, follow my tweets on Twitter, and friend or like our page on Facebook.

Flat Feet and Heel Pain

Flatfoot is often a complex disorder, with diverse symptoms and varying degrees of deformity and disability. There are several types of flatfoot, all of which have one characteristic in common: partial or total collapse (loss) of the arch.
Other characteristics shared by most types of flatfoot include:

• "Toe drift", in which the toes and front part of the foot point outward.
• The heel tilts toward the outside and the ankle appears to turn in.
• A tight Achilles tendon, which causes the heel to lift off the ground earlier when walking and may make the problem worse.
• Bunions and hammertoes may develop as a result of a flatfoot. 

Flexible flatfoot is one of the most common types of flatfoot. It typically begins in childhood or adolescence and continues into adulthood. It usually occurs in both feet and progresses in severity through the adult years. As the deformity worsens, the soft tissues (tendon and ligaments) of the arch may stretch or tear and can become inflamed.
The term "flexible" means that while the foot is flat when standing (weight-bearing), the arch returns when not standing.
Symptoms, which may occur in some persons with flexible flatfoot include:

• Pain in the heel, arch, ankle, or along the outside of the foot.
• "Rolled-in" ankle (over-pronation).
• Pain along the shin bone (shin splint).
• General aching or fatigue in the foot or leg.
• Low back, hip, or knee pain.

In diagnosing flatfoot, the foot and ankle surgeon examines the foot and observes how it looks when you stand and sit. X-rays are usually taken to determine the severity of the disorder. If you are diagnosed with flexible flatfoot but you don't have any symptoms, your surgeon will explain what you might expect in the future.
If you experience symptoms with flexible flatfoot, the surgeon may recommend non-surgical treatment options, including:

• Activity modification. Cut down on activities that bring you pain and avoid prolonged walking or standing to give your arches a rest.
• Weight loss. If you are overweight, try to lose weight. Putting too much weight on your arches may aggravate your symptoms. 
• Orthotic devices. Your foot and ankle surgeon can provide you with custom orthotic devices for your shoes to give more support to the arches. 
• Immobilization. In some cases, it may be necessary to use a walking cast or to completely avoid weight-bearing.
• Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce pain and inflammation.
• Physical therapy. Ultrasound therapy or other physical therapy modalities may be used to provide temporary relief. 
• Shoe modification. Wearing shoes that support the arches is important for anyone who has flatfoot.

In some patients whose pain is not adequately relieved by other treatments, surgery may be considered. A variety of surgical techniques is available to correct flexible flatfoot, and one or a combination of procedures may be required to relieve the symptoms and improve foot function.
In selecting the procedure or combination of procedures for your particular case, the foot and ankle surgeon will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors. The length of recovery period will vary, depending on the procedure or procedures performed.
If you are experiencing heel pain from flat feet, call our Rocky Hill or Middletown office to make an appointment.
Jeffrey S. Kahn, DPM
Connecticut Foot Care Centers
Heel Pain Doctor in CT
Podiatrist in Rocky Hill and Middletown, CT
Visit our website, follow my tweets on Twitter, and friend or like our page on Facebook.

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High Arched Feet and Heel Pain

Cavus foot, or high-arched foot, is a condition in which the foot has a very high arch. Because of this high arch, an excessive amount of weight is placed on the ball and heel of the foot when walking or standing. Cavus foot can lead to a variety of signs and symptoms, such as pain and instability. It can develop at any age, and can occur in one or both feet.
Cavus foot is often caused by a neurologic disorder or other medical condition such as cerebral palsy, Charcot-Marie-Tooth disease, spina bifida, polio, muscular dystrophy, or stroke. In other cases of cavus foot, the high arch may represent an inherited structural abnormality.

An accurate diagnosis is important because the underlying cause of cavus foot largely determines its future course. If the high arch is due to a neurologic disorder or other medical condition it is likely to progressively worsen. On the other hand, cases of cavus foot that do not result from neurologic disorders usually do not change in appearance.
The arch of a cavus foot will appear high even when standing. In addition, one or more of the following symptoms may be present:

• Hammertoes (bent toes) or claw toes (toes clenched like a fist).
• Calluses on the ball, side, or heel of the foot.
• Pain when standing or walking.
• An unstable foot due to the heel tilting inward, which can lead to ankle sprains.
• Heel pain.

Some people with cavus foot may also experience foot drop, a weakness of the muscles in the foot and ankle that results in dragging the foot when taking a step. Foot drop is usually a sign of an underlying neurologic condition.
Diagnosis of cavus foot includes a review of the patient's family history. The foot and ankle surgeon examines the foot, looking for a high arch and possible calluses, hammertoes, and claw toes. The foot is tested for muscle strength, and the patient's walking pattern and coordination are observed. If a neurologic condition appears to be present, the entire limb may be examined. The surgeon may also study the patterns of wear on the patient's shoes.
X-rays are sometimes ordered to further assess the condition. In addition, the surgeon may refer the patient to a neurologist for a complete neurologic evaluation.
Non-surgical treatment of cavus foot may include one or more of the following options:

• Orthotic devices. Custom orthotic devices that fit into the shoe can be beneficial because they provide stability and cushioning to the foot.
• Shoe modifications. High topped shoes support the ankle, and shoes with heels a little wider on the bottom add stability.
• Bracing. The surgeon may recommend a brace to help keep the foot and ankle stable. Bracing is also useful in managing foot drop. 

If non-surgical treatment fails to adequately relieve pain and improve stability, surgery may be needed to decrease pain, increase stability, and compensate for weakness in the foot.
The surgeon will choose the best surgical procedure or combination of procedures based on the patient's individual case. In some cases where an underlying neurologic problem exists, surgery may be needed again in the future due to the progression of the disorder.
If you are experiencing heel pain from high arches, call our Rocky Hill or Middletown office to make an appointment.
Jeffrey S. Kahn, DPM
Connecticut Foot Care Centers
Heel Pain Doctor in CT
Podiatrist in Rocky Hill and Middletown, CT
Visit our website, follow my tweets on Twitter, and friend or like our page on Facebook.

Nene Sits Out Basketball Games in Olympics

Washington Wizards basketball player Nene, playing for the Brazilian team in the Olympics, sat out the final game of pool play with plantar fasciitis in his left foot.
Nene is expected to be able to play today when Brazil plays Argentina in the quarterfinals. Brazilian coach Ruben Magnano rested Nene in the game against Spain, which the Brazilians won 88-82. In winning this game, it may have made the path to the medal podium more difficult for the Brazilians, who haven't won a medal since 1964.
The Wizards have been monitoring Nene's heel pain and believe it will not be a problem when training camp begins on October 2.
After playing the first game in London, Nene said the plantar fasciitis that had bothered him shortly after he joined the Wizards was flaring up again. With the Olympics coming to a conclusion on Sunday, the Wizards expect Nene to have enough time to rest his injury. He had missed 10 consecutive games in April due to the pain from plantar fasciits, but returned for the final 5 games.
In the games, Nene is averaging just 6.5 points and 7.0 rebounds in 4 games.
Nene will have to rest, ice, and stretch his injured foot so he can play properly and without problems in the coming basketball season. Let's hope he's seeing a podiatrist who is giving him the treatment he needs!
If you are experiencing heel pain, call our Rocky Hill or Middletown office to make an appointment.
Jeffrey S. Kahn, DPM
Connecticut Foot Care Centers
Heel Pain Doctor in CT
Podiatrist in Rocky Hill and Middletown, CT
Visit our website, follow my tweets on Twitter, and friend or like our page on Facebook.

Heel Pain in Women

Women are notoriously hard on their feet. From a very small age they seek the most fashionable, yet painful shoes to wear. Women will spend long hours on their feet, walk long distances, and run errands in inappropriate shoes. Women are always on the go, whether it's for work, home, or family, and their feet bear the brunt of that busy world.
The most common type of foot pain women are likely to endure is heel pain, or plantar fasciitis. Plantar fasciitis is the inflammation of the plantar fascia, which runs from your toes to your heel. It is a thick, fibrous ligament. If you are waking up in the morning and are experiencing a lot of foot pain, this is one sign that you have heel pain. This is because the plantar fascia contracts in the night and once you start moving in the morning, you stretch it out again.
Causes of heel pain in women are slightly different from men. They include:

• Too much physical activity. Women who run, jog, or exercise a lot place a lot of stress on your heel bone and the soft tissue around it. 
• Faulty foot mechanics. If you have a high arch or a flat arch, supinate or pronate, you are more likely to have heel pain because of how your foot is designed. 
• Shoes that don't fit properly. As mentioned before, women will stuff their feet in too small shoes just so they can have that perfect pair of Jimmy Choos, no matter the consequences later. Thin soled and loose shoes make your feet work harder and flap your heels. 
• Being middle aged or elderly. As we age, our feet loose fat pads and the arch begins to fall. A sagging arch means foot pain.
• Being overweight. Unfortunately, the more you weigh, the more stress you place on your feet.

Just because you have heel pain does not mean that you have to live with it. There are many conservative treatments we prescribe so you will be able to get back to your busy life. Your podiatrist may prescribe either over-the-counter or custom molded orthotics, which will help with the faulty mechanics of your feet and provide the support that is lacking. With consistent use many people feel relief from orthotics. Stretching exercises will also be prescribed. Stretching the plantar fascia is one of the best methods of ridding yourself of heel pain. Finally, for those who are suffering from severe heel pain in the morning, a night splint may be provided to stretch your plantar fascia during the night.
If you are experiencing heel pain, call our Rocky Hill or Middletown office to make an appointment.
Jeffrey S. Kahn, DPM
Connecticut Foot Care Centers
Heel Pain Doctor in CT
Podiatrist in Rocky Hill and Middletown, CT
Visit our website, follow my tweets on Twitter, and friend or like our page on Facebook.

Related articles

• Dr. Oz and High Heels

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Phillies' Player Carlos Ruiz Battling Heel Pain

The 2012 Philadelphia Phillies team has certainly had its share of injuries and now their key player is battling plantar fasciitis.
According to manager Charlie Manuel catcher Carlos Ruiz is battling plantar fasciitis. The 33 year old woke up several weeks ago during a series against the Los Angeles Dodgers and felt the stabbing pain in his heels. Right now Ruiz is playing about half of the games for the Phillies.
Recently Ruiz pinch-hit against the Milwaukee Brewers wearing sneakers instead of cleats.
Ruiz says that the pain is subsiding, but at its peak it was "a knife in the back of my foot." He is receiving treatment and performing different kinds of stretches in an attempt to improve. The Phillies have not placed him on a disabled list, which is a good sign.
2012 has been Ruiz's year. He is batting the best of his career, .343, with 14 home runs, 56 RBIs, and was named to the All-Star team for the first time.
While Ruiz sits, Erik Kratz is being used- backup Brian Schneider is on the DL with an ankle sprain.
If you are experiencing heel pain, call our Rocky Hill or Middletown office to make an appointment.
Jeffrey S. Kahn, DPM
Connecticut Foot Care Centers
Heel Pain Doctor in CT
Podiatrist in Rocky Hill and Middletown, CT
Visit our website, follow my tweets on Twitter, and friend or like our page on Facebook.