Heel Pain Stretch of the Week: Adductor Stretch

Sit on the floor with your back against a wall, keeping your back straight. Put the soles of your feet together and your hands on your knees. Push your knees down towards the floor until you feel a stretch in your inner thigh.
Hold 30 seconds. Repeat 5 times a day.
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 It Hurt? Cortisone Shot in the Heel

The answer to that question, is unfortunately, yes, for most people, getting a cortisone shot in the heel will hurt. However, the relief the shot provides outweighs any pain associated with the injection.
Cortisone is an anti-inflammatory medication, not a pain-killer. The injection is designed to disrupt the chemical process that leads to inflammation, the actual cause of the pain in heel pain. By reducing inflammation, pain often subsides. Cortisone injections are very safe to perform. Side effects tend to be very rare and minor. However, there are a few potential side effects of a cortisone injection that patients should know about.
Systemic side effects occur as a result of a small amount of the cortisone entering the bloodstream and affecting your entire body, not just the location where the cortisone was given. Unlike taking oral steroids, or having cortisone injected directly into the bloodstream, only a small amount of a local injection is absorbed by the body. And since the body actually produces cortisone naturally, most people do not experience systemic effects. Those who do may experience:
Elevated blood sugar
The most common systemic reaction is seen in diabetic patients. Patients with diabetes should carefully monitor their blood sugar as cortisone can cause a temporary rise in their levels. Patients taking insulin should be especially careful, checking their blood sugar often and adjusting the insulin doses, if necessary.
Facial flushing
Patients may experience flushing sensation and redness of their face. This reaction is more common in women and is seen into up to 15 percent of patients. This can begin within a few hours of the injection and may last for a few days.
Local side effects
Local side effects are those that are only experienced in one area of the body. The local side effects of a cortisone injection are also rare.
Pain
Some patients have discomfort after the injection and may experience an increase in pain 24 to 48 hours after being treated. This usually subsides quickly and can be aided with an ice pack and anti-inflammatory medication.
Infection
Whenever there is a break in the skin, like when a needle is used to administer cortisone, there is a chance of infection. Your doctor will sterilize the skin to minimize the risk of infection.
Skin pigment changes
Patients with darker skin should be aware that cortisone may cause skin around the injection site to change. This is not harmful.
Loss of fatty tissue
High doses of cortisone can have detrimental effects on some tissues in the body. When injected into fatty tissue, cortisone can lead to a problem called fat atrophy. Fat atrophy causes loss of fatty tissue, which can lead to dimpling of the skin or the thinning out of fat. Patients who get cortisone shots in the heel to treat plantar fasciitis may find walking painful as fat that cushions their steps may thin out.
Tendon rupture
Cortisone can also cause weakening of tendons. This is one reason your podiatrist will limit the number of cortisone injections administered. Cortisone can also lead to tendon rupture.
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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Jay Ratliff Still Suffering From Plantar Fasciitis, Not An Excuse

Cowboys nose tackle Jay Ratliff is still suffering with the plantar fasciitis that plagued him in the preseason. 
He says he'll have to deal with it all year. Ratliff has also been dealing with the recovery from a high ankle sprain last season and a normal ankle sprain a few weeks ago. 
"Any time you get hurt, yes, it's frustrating, but I've been down this road before," he said last Friday at Valley Ranch. "From experience, you can't really sit here and dwell on that. All you can do is just move forward, even if the injury is fresh. It's still behind you, you just got to figure out a way to get it done and adapt. In this business, being hurt is not an excuse." 
Ratliff is 13th on the team with 17 tackles, one for loss, and has seven quarterback pressures despite playing just four games. He missed the first four healing from the worst pain of his plantar fasciitis and suffered an ankle sprain right before halftime last week but returned for the second half. He returned to practice last Friday on a limited basis.
"I've got a love for the game. I just want to do the best that I can. Even if you're hurt, there's no excuses," Ratliff said.
He talked about the effect of his injuries on his left leg. "If you hurt a part of your body, the rest of your body is going to compensate. Unfortunately, I had a few things go wrong on this leg. The plantar fasciitis, the high ankle sprain, and now just the regular ankle sprain. But that's nothing that's going to stop me."
When asked if the plantar fasciitis was completely cleared up, Ratliff replied, "It's just one of those nagging things that you have to play with through the year. So it's really nothing, you know what I mean? You really want to hear about that? I really don't want to talk about it." 
Ratliff laughed. "It's all good." Hope you're doing your stretches, icing, and keeping off it as much as you can, Jay! 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 Stretch of the Week: Piriformis (Trunk Twister) Stretch

Sitting on the floor, cross your left leg over the right thigh. The left foot should be on the floor outside of the right knee. Place your right elbow on the outside of the left knee. Gently stretch by pushing the elbow into the knee, keeping your back straight. Reverse legs and repeat.
Hold for 30 seconds. Repeat 5 times for each leg, 1 time per day.
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

• Heel Pain Stretch of the Week: Quad/Hip Flexor Stretch

  ---

• Heel Pain Stretch of the Week: Towel Crunches

  ---

• Heel Pain Stretch of the Week: Seated Hamstring Stretch

  ---

• Heel Pain Stretch of the Week: Seated Calf Stretch

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• Heel Pain Stretch of the Week: Standing Calf Stretch

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Cutting Calf Muscle To Cure Heel Pain: Too Extreme?

Liam Horner was an average 22 year old who liked to play football (soccer in the US). But a nagging pain in his heel developed into a serious and debilitating condition that caused him to give up his game.
"I also had to give up my job in the building trade because I was on my feet all day," said Horner. "Even to get out of the house I had to bathe my left foot in hot water to loosen up the muscles.
Heel pain affects one in every ten people in their lifetime, 75% of which are women. For most, stretching and wearing orthotics relieve the pain. Others will find relief in shockwave therapy or cortisone injections. But many still suffer in pain.
Horner's doctor prescribed orthotics and sent him to physical therapy, but those options give him little relief. He tried acupuncture as well, but that had little effect. Turns out the root cause of Horner's pain was not in his heel, but in his calf muscle.

"Some people have particularly tight muscles which means the heel is pulled upwards in the same position as when you point your toes," explains Matthew Solan, consultant orthopaedic surgeon at the London Foot and Ankle Center. "The plantar fascia which is the tendon in the heel is never able to relax and becomes highly inflamed."
The solution for Horner was a gastrocnemius release, which involves carefully cutting the calf muscle during surgery to create greater flexibility. "If you imagine the lower leg as a rasher of bacon, the calf muscle is the bacon meat but like the rasher it is covered by a rind. You can only stretch the bacon itself so far because the rind remain tight and limits flexibility. If we carefully cut the rind then the rasher can be stretched further," says Dr. Solan, who learned the technique in France and now performs more of these procedures in the United Kingdom than any other physician.
"This small operation is a way of stretching the tight calf muscle in a very controlled way to allow the release of the strain from the affected heel area." This procedure is typically carried out as a day case with the surgeon making a small incision behind the knee to access the calf muscle.
"I had my surgery at around 8am and by lunchtime I was able to walk up and down the hospital stairs so was discharged by the afternoon," said Horner. "The recovery was very quick indeed. There was very little pain, no more than the occasional tweak if I over-stretched during the first week. I was able to go for a short run within two and a half weeks of surgery. I noticed a difference in my heel pain almost straightaway. By six weeks I was playing football again and within two months I was fully recovered. Most people with heel pain find other treatments help them but if like me you are left with long term, intractable pain it has a very significant impact on your life. I had to change my job and give up sport."
"It was only when I was seen in a specialist center that my problem was properly assessed and effectively addressed. I do hope this treatment will become available to more people," said Horner.
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.

Radiation Therapy May Help Heel Pain Sufferers

Those suffering from plantar fasciitis, or heel pain, experienced significantly less pain and improved quality of life following a treatment of external beam radiation therapy, a new study published in July in the International Journal of Radiation reports.
Between 8 to 10 percent of the population has severe heel spurs, and common treatments include icing, heat, and anti-inflammatory drugs. Most injections, like steroids and local anesthetics, only provide short-term relief for the patient.
The new study demonstrated that 80% of standard cases experienced complete pain relief with radiation therapy, with 64% having marked or constant pain relief during the 48 weeks following treatment.
Radiation therapy has been used for 60 years because of its anti-inflammatory effects, but the mechanism of action is unknown. Marcus Niewald, MD, PhD, a radiation oncologist at Saarland University Medical Center in Homburg/Saar, Germany came up with a randomized trial to compare the effect of standard dose radiation therapy with low dose radiation therapy among patients with plantar fasciitis.
There were 66 participants in the study and they were evaluated every six weeks until the 12 month clinical trial was over. Four patients were secondarily excluded once the trial began, 29 patients received the standard regimen, and 33 patients received the low dose regimen.
"After treatment of these 62 patients the difference between the effects of radiation therapy in the two arms became very clear in the clinical impressions, this urged us to perform an interim analysis, and finally, led to the decision to prematurely close the trial," wrote Niewald.
Five of the 29 patients in the standard dose group were retreated and had improved results. Researchers did not note acute side effects or long-term toxicity.
Limitations to the study included the facts that there was no placebo group, patients nor physicians were not blind to the dose group, and statistical power may be limited to the early closure of the trial. "Radiation therapy yields important pain relief in patients with painful heel spur (plantar fasciitis) compared with very low doses, and this could be proven at a high level of evidence for the first time," wrote Niewald.
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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