Exercises For Posterior Heel Pain

Athletes will often experience posterior medial heel pain because of degenerative changes to the plantar fascia, known as plantar fasciopathy. Without a properly functioning plantar fascia, the joints of the big toe, ankle, and hip do not move properly and posterior medial heel pain will develop. Here are three exercises that will help ease your pain:

1. Big toe stretch. Cross your right ankle over your left knee when you are sitting. Take your right big toe and and push it towards your shin. Attempt to push your big toe back into your hand, holding the position for five to seven seconds. Relax and push the toe further back to your shin. Repeat the exercise three to five times and switch legs. 
2. Goblet squat. This squat trains the hip and the ankle to reduce stress on the foot. It will align the arch of the foot and use the muscles of the hip to control foot and ankle actions. Take a kettleball with both hands and hold it at chest level against your body. Your feet should be shoulder-width apart and your toes slightly pointing out. Now shift your weight to the outside of your foot to pop your arch. Squat down, keep the arch in your foot, and return to standing. Repeat up to three set for ten repetitions.
3. One leg lateral anti-rotation press. The hip reduces stress on the posterior medial heel by preventing total collapse of the kinetic chain and the stresses on the body afterwards. Stand with your shoulders perpendicular to a cable column with one foot furthest from the cable column. The cable should be even with your rib cage. Press the cable in front of you and resist the weight pulling you toward the cable column. Do ten repetitions and switch sides. Repeat up to four sets. 

Reference: Livestrong
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 like our page on Facebook.

Rays' Longoria Suffering With Plantar Fasciitis

Tampa Bay Devil Rays slugger Evan Longoria has been starting at designated hitter because he is suffering

from plantar fasciitis in his left foot.
"Just a little plantar issue," said Longoria. "It's probably been bothering me for two weeks now. But it kind of gets to a point where I don't feel like I'm doing any good to go out there and run around on it. So I can DH and still be effective.
"... It's just standing around, really. It feels pretty good at the beginning of the game. And by the time the end of the game comes around, if I've been in the field, it gets pretty sore."
The Rays have been playing some long games recently, and Longoria believes this is partly to blame for the plantar fasciitis flare-up. 
"Some of those games in the Boston series, I was hurting by the end of the game," Longoria said. "My hope is that with a couple of DH days, stay off the turf here and then get the off-day going into Boston, that should give it enough time to be fine and I should be back out there."
This is the first time Longoria has dealt with the plantar fasciitis devil.
"It's something I haven't dealt with before. And it's pretty painful, so I can understand what Albert (Pujols) is dealing with over there in Anaheim. It's kind of a weird deal. But it's not going to keep me off the field. Whether it's DH or in the field, I feel like I should be over it by the off-day (on Monday)," Longoria said. 
We love your enthusiasm and your positive attitude, Evan, really we do, but it's highly unlikely you'll "be over it" any time soon. You've clearly never had plantar fasciitis before, and don't realize how long it's going to take for you to feel 100% again. Only with time, rest, and rehabilitation will you feel better! Have a chat with Albert Pujols, who has been suffering from plantar fasciitis for more than seven years!
Kelly Johnson has been filling in defensive for Longoria while he's playing DH.
Reference: MLB
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 like our page on Facebook.

What Is Plantar Fasciosis?

You've likely heard of plantar fasciitis before. Plantar fasciitis is characterized by the inflammation of the plantar fascia, a strong connective tissue in the sole of your foot. But what is plantar fasciosis?
Plantar fasciosis, like plantar fasciitis, has symptoms of heel pain and pain in your plantar fascia, but this condition involves degeneration, micro-tears, and cell death of the plantar fascia. It typically affects active men between the ages of 40 and 70. 
Plantar fasciosis usually affects those who have a high arch or are flat footed. Those with the condition will have pain or discomfort at the point where your plantar fascia connects to your heel bone. Plantar fasciosis can also be known as calcaneal spur syndrome or calcaneal enthesopathy and involves stretching, tearing, and degeneration of your plantar fascia at its attachment site. 
Your podiatrist will perform X-rays to determine the cause of your heel pain. If they discover a bone spur at the site of the pain, is it not the cause of your pain, but is indicative that your plantar fascia has been exerting excessive force on your heel bone. 
One of the causes for plantar fasciosis is inappropriate footwear. Shoes that have a tapered toe box hold your toe in an adducted and extended position. When your toe is in this position, it pulls on a part of the foot called the flexor retinaculum and restricts the blood flow to your posterior tibial artery, the artery that carries blood to the bottom of your foot. The tissues in the sole of your feet will start to deteriorate as the blood supply to this area is decreased.
Other conditions that cause plantar fasciosis are:

• Calf muscle shortening
• Obesity
• Rheumatoid arthritis
• Corticosteroid injections
• Plantar fascia contracture
• Reactive arthritis
• Psoriatic arthritis

Signs and symptoms of plantar fasciosis include mild swelling and redness in the affected area, impaired ability to move, and tenderness on the bottom on your heel.
Your podiatrist will recommend you wear different shoes that do not constrict your feet and keep them in your natural position. You should look for shoes with a flat heel, wide toe box, no toe spring, and have flexible soles. They will also recommend stretching exercises to rehabilitate your foot. Dietary changes and aerobic exercises are important for those who are overweight. They may find that water aerobics helpful. Physical therapy may also be part of your podiatrist's treatment plan.
Reference: Northwest Foot and Ankle
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 like our page on Facebook.

Pressure Sores On the Heel

Are you experiencing pain in your heel due to a sore? Decubitus ulcerations are pressure sores that develop

on the back of the heel. These are typically seen in people who are bedridden and are unable to shift or transition in a bed or chair. Pressure sores are common in those who are hospitalized for long periods of time, wheelchair users, frail elderly, or critically ill patients.
Our skin can unfortunately only withstand increased pressure for a short period of time, and when pressure is applied to soft tissue at the back of the heel for hours or days, this results in partially or total obstructed blood flow to the soft tissue. The skin will begin to breakdown and a wound or ulceration will develop.
Usually the ulcerations happen over a bony prominence. These areas are very tender and can become infected if untreated. Ulcerations can also occur because of protein-calorie malnutrition, microclimate, diseases that reduce blood flow to the skin, such as atheriosclerosis, or paralysis and neuropathy. 
Treatment of decubitus ulcers will involve cleaning the wound and offloading the sore. When pressure is relieved from the skin, the wound responds well and the wound will heal.  Healing of pressure sores may be slowed by the age of the person, medical conditions, smoking, or anti-inflammatory medications. 
Treatment may also include a few pillows under the calf and verbal instructions on offloading for patients who are light, mobile, and have good protective sensation. Patients who are obese, immobile, and bedridden will do better with rigid ankle brace offloading devices, like Pressure Relief Ankle Foot Orthosis (PRAFO).
Reference: Texas Heel Pain Center and Podiatry Today. 
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 like our page on Facebook.

Bone Tumors In the Heel

Bone tumors in the heel are extremely rare and can be one of the causes of heel pain. 
There are three types of tumors in the heel: intraosseus lipoma, osteoid osteoma, and unicameral bone cyst. 

An intraosseus lipoma is a benign tumor made of lipose or fat tissue that develops inside the bone. On an X-ray, it would look like a hole in the bone. Males are affected more than females and it can occur in people ages 5 to 85. Treatment for this type of tumor is through surgical excision and using a bone graft to fill in the space. 
An osteoid osteoma is also a benign tumor that appears like a centralized hardened bone surrounded by soft tissue. Men are twice as likely to be affected as females, but it is most common in children and young adults between the ages of 10 and 19. The pain from this tumor is usually worst at night and can be relieved with aspirin and other non-steroidal anti-inflammatories. Pain will usually subside after two and a half years, but if the pain worsens or the patient cannot endure the pain, surgical excision will be performed. 

A unicameral bone cyst is a fluid filled cyst that is found in children. This cyst is found near the edge of the heel bone, making the bone prone to fracture. The cyst is usually removed and filled with bone graft. 
None of these bone tumors in the heel are life threatening, but they can cause failure fractures and severe pain in some patients. X-rays are typically prescribed to rule out bone tumors in heel pain patients. 
Reference: FAANT
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 like our page on Facebook.

Seattle Seahawks Avril Has Injured Plantar Fascia

Seattle Seahawks defensive end Cliff Avril has not been participating in team workouts since he suffered an injury to his plantar fascia five week ago. 
Coach Pete Carroll said last week that Avril was progressing in his recovery and would start running again the end of last week. He said Avril won't be able to participate in team practices for "another couple weeks at least."
When asked if Avril's injury was serious, Carroll replied, "Well, it hurts. You could ask him about it. The plantar fascia thing is a real uncomfortable thing. You just have to wait it out. It's something that you can come back from. It's not a problem. But you just have to wait it out. He's real anxious to go, and he's doing very well in his rehab. And he runs some this week for the first time. So it will take another couple weeks at least."
Avril signed a two year $15 million contract with the Seahawks this offseason after playing five seasons with the Detroit Lions. Avril had 9.5 sacks last season and was signed this season with Michael Bennett to boost their pass rush and provide insurance for defensive end Chris Clemons, who tore his ACL in the team's playoff victory against the Washington Redskins. 
Participating in the OTAs is not a necessity for veterans like Avril. It is likely he will also be held out the rest of the offseason, including next month's minicamp. 
Reference: Pro Football Talk
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 like our page on Facebook.

Joakim Noah Looking To Avoid Surgery

Joakim Noah tried rest (well, what he called rest- we saw him on the court a lot more than he probably

should have been) to calm his plantar fasciitis, but that didn't seem to work. 
With the Chicago Bulls now eliminated from the NBA playoffs, it's now a question if more rest and rehabilitation is what he needs. Should Noah have surgery for his plantar fasciitis?
According to the Chicago Sun Times, both Noah and the Bulls would prefer Noah avoid surgery. "That hasn't been determined," said head coach Tom Thibideau. "Obviously we'd like to avoid the surgery. He has responded a lot better. He has found something that has worked. We want him to get completely healthy. That will be the focus, getting him back to 100 percent. He needs some rest, as most of the guys do. Same thing with Luol Deng. We have to get him completely healthy again. Those are two players that we'll be on top of right away."
Surgery for plantar fasciitis is for the cases that are the worst of the worst. This is not a treatment course we recommend for the average case, as conservative treatment usually clears up the condition. If you visit a podiatrist and they recommend surgery as their first course of treatment, you need to get a second opinion. Most cases clear up with conservative treatment. 
Noah may indeed be one of those cases that truly needs surgery, but we have to wonder if he has dedicated enough time to resting and following conservative treatment. Now that he won't be pounding the floor several times a week, and wearing those horrid, unsupportive shoes he wears when playing, perhaps he has a chance of healing on his own. But what he needs to do is stay off the court, stretch, ice, find a better basketball shoe, and make getting better his priority. 
Reference: Slam Online
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 like our page on Facebook.

Nuggets Guard Lawson Out Weeks With Heel Injury

If we've learned anything from this NBA season, it's that if you have a plantar fasciitis problem, don't try to

be a muscle man and power through the injury. It's not an injury that gets better with repeated exercise- it gets worse. 
Now, here's another plantar fascia tear casualty- Denver Nuggets guard Ty Lawson has a plantar fascia tear in his right heel and while it was expected he would be out several weeks, last Tuesday he practiced with the team.
Lawson suffered the injury on March 19th in a 114-104 victory over the Oklahoma City Thunder and he missed the next four of five games.
There was no official timetable for Lawson's return, but the Nuggets seem to be optimistic about his prospects for the rest of the season. Coach George Karl told Nuggets.com, "I have a feeling that he had somewhat of a partial tear in his plantar fasciitis (sp), and that's untreatable. But popping it creates a situation where now once the soreness goes away, he probably should be able to be pain-free. It could come in a couple of weeks.
"His job and our job is to figure out how to get him feeling 100% and having some confidence playing the game of basketball. I think it's a situation where it's going to work out. I'm optimistic about how it's going to work out."
After practice last Tuesday, Karl told The Denver Post, "I don't think he took many chances, but he did run up and down the court. He doesn't seem like he was confident. Knowing Ty, he probably won't try overly aggressive game until he's in the game."
Lawson leads Denver in scoring at 16.7 points per game and 6.7 assists. The team has already clinched a playoff berth.
Lawson says his foot feels better than it did, but it's still not 100%. Does anyone else feel like Lawson is being rushed back? Yes, he is the team's best player, but has no one learned from the Pau Gasol debacle? An injury like a plantar fascia tear, whether it's partial or complete, does take time to heal. The few games he sat out are not nearly enough to keep further damage from occurring.
Reference: SB Nation
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 like our page on Facebook.

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Lions' Kicker Hanson Retires Because of Heel Problems

There are times when you want to continue, but your body tells you it can no longer go on.

That's how Detroit Lions' kicker Jason Hanson felt after this last season. He pondered returning for one last season, but problems with his heels made it impossible for him to come back. He recently made the decision to retire after 21 years of playing in the NFL, all 21 seasons with the Lions. 
"It's time. I gave serious thought and consideration to playing in 2013. While the determination and willpower are still there, the wear and tear on my body, especially the issues I had and still have with my heel, have convinced me that it's time to retire," said Hanson.
Hanson was the first player in NFL history to play 300 games with one team, finishing with 327. He set a record last season when he played his 21st season with the same franchise. Hanson was a record-making player: he had 52 field goals from at least 50 yards, is third in career scoring list at 2,150 points and third in field goals with 495. He is also the only player with 2,000 points for one team.
"Jason Hanson is the gold standard," said Lions president Tom Lewand. "He had an exemplary, Hall of Fame-worthy career on the field, and for those of us fortunate to know him well, he is an even better person, teammate, friend, husband, and father."
Hanson joins Jerry Rice, George Blanda, Morten Anderson, Gary Anderson, and Vinny Testaverde with 21 pro seasons. He joined the Lions in 1992, the year after they reached the NFC Championship game. He played in six postseason games, which were all losses, and went through the team's terrible 0-16 season in 2008. He was rewarded in 2011 when the Lions made the playoffs for the first time in a dozen years. 
Hanson was looking forward to the press conference, when he could "publicly thank so many people who have played such a big part in my career. You all helped me along this journey and I am forever grateful." 
And Lions fans everywhere are grateful for you, Jason Hanson. Wishing you the best in the future. 
Reference: ESPN
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 like our page on Facebook.

Lateral Plantar Nerve Entrapment

Lateral plantar nerve entrapment causes pain in the inner, lower heel, and inner ankle area. The lateral plantar nerve is a branch of the posterior tibial nerve which passes through the tarsal tunnel. This nerve provides the skin of the fifth toe and the lateral half of the fourth, as well as most of the deep muscles. It is also sometimes called Baxter's nerve, for Dr. Donald Baxter, a Houston orthopedist who described the condition in 1984. An entrapment may occur between the abductor hallucis muscles and the quadratus planus muscle. 
Lateral plantar nerve entrapment is often seen in athletes, as it is a repetitive stress injury. 
Symptoms include pain that radiates from the inner, lower heel to the inner ankle area. Numbness is not common in this condition. Baxter's nerve entrapment is often confused with plantar fasciitis. So how do you tell the difference? Plantar fasciitis is worst in the morning when you take that first step out of bed. Pain from a Baxter's nerve entrapment gets worse as you put weight on your foot throughout the day. You'll still feel pain when you're off your feet when you have an entrapment- with plantar fasciitis, the pain is relieved. 
Treatment includes rest, anti-inflammatory medications, supporting the arch of the foot with tape, orthotics to correct the overpronation, cortisone shot, and if those options fail, surgical release. 
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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Joakim Noah To Return Tomorrow From Plantar Fasciitis

Chicago Bulls center Joakim Noah has missed the last few games because of plantar fasciitis.
Nick Friedell of ESPN Chicago tweeted, "Noah has plantar fasciitis in his right foot. He had it in his left foot three years ago. He isn't sure when he'll return to the lineup."
Noah missed 18 games when his left foot was affected in 2009-10 and eventually had shockwave therapy to help him with the pain. "The one in 09-10, I just kept playing through it. I probably played with it for a month until I couldn't anymore. This time, I stopped a lot earlier. I probably played on it for five or six games. I just knew what direction it was going in. In 09-10, I just tried to act like it wasn't there and played through it. That was a mistake. With a couple more days of treatment I'm hoping to be OK," Noah said.
Noah was smart this time to stop soon after he started to feel pain. Too often this basketball season we've seen players be out just a few days, return to the game, then have to be out for several weeks because they didn't rest and rehabilitate properly.
Noah said on Monday that he was hoping to return by Thursday to play against the Denver Nuggets. "I'm moving in the right direction. Give it a couple more days and try to go on Thursday," Noah said.
The center said he got some shots on the Bulls' day off on Sunday but did no running or jumping. He is resting the injury and treating it with ice and laser treatments (stretching!). "You definitely learn from your experiences," Noah said. "I've been through this before. I know what to expect. I've gotten all these treatments before. I'm hoping with a couple more days rest I'll be back at 100 percent and I won't have to deal with this anymore."
Noah has missed just one game so far this season. He is averaging 12.1 points, 11.3 rebounds, 4.2 assists, 2.1 blocks, and 1.3 steals per game, all of which are career highs. He is also averaging 38 minutes per game, 10 minutes higher than last year, which could be a contributing factor to the heel pain. Noah was also selected as a reserve for the NBA All-Star game on February 17th.
However, his production since his injury has declined. Noah shot just 42 percent during the month of January and his scoring was down, even though his rebounding was up.

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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Fat Pad Atrophy

Between our skin and heel bone, we have a one inch thick pad which acts as a shock absorber and cushion. This cushion is called a fat pad because it's mostly made up of fatty tissue. The pad is divided into sections by ligamentous baffles which keep the fat pad from spreading out and keeping the pad where it belongs- under the heel.
Over time, this fat pad can stretch out, causing us to lose some of that cushion and creating pain in the heel. Weight bearing is often very uncomfortable when this occurs. Typically, fat pad atrophy happens to the elderly, but runners and athletes who run a lot suffer from this condition. Also, if you've landed hard on a surface while barefoot, jumped in dress shoes with a hard heel, stepped on a stone, or work on a surface that is concrete, tiled, or hardwood, you may also experience this pain.
Symptoms of this condition include:

• Pain in the middle of the heel. This is different from plantar fascia or bone spur pain, which would be present at the front of the heel. 
• A deep, dull aching pain that feels like a bruise.

Fat pad atrophy may or may not improve over time, so it is important to allow the heel to rest while it is healing. This will allow the inflammation to decrease. Talk with your podiatrist about a heel cup, which is inserted in your shoes and provides cushioning in the heel area. If this does not work, a heel insert may be added to your shoes to keep the fat pad in place. Other treatment options include icing after exercise or activity, wearing well-cushioned shoes, and avoiding walking barefoot on hard surfaces.
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.

Calcaneal Fractures

Calcaneal fractures, or fractures of the heel bone can be disabling, severe, and long-term injuries. 
The calcaneus is the most frequently fractured tarsal bone and account for 2% of all adult fractures. 60% of these fractures are calcaneus fractures. 
This injury typically occurs when a person has been in a motor vehicle accident or falls from a great height. In instances of car accidents, 10% of patients will also sustain another fracture- either in the spine, hip, or other foot. 
Injuries to this bone often damage the subtalar joint and cause the joint to become stiff, making it difficult to walk on uneven or slanted surfaces. 
There are several different types of calcaneal fractures, including:

• Stable fracture. This is a nondisplaced fracture. The broken ends of the bone meet correctly and are aligned, and therefore will stay in place to heal properly. 
• Displaced fracture. This type of fracture means that the parts of the bone do not meet up and therefore it will not heal properly on its own. Surgical intervention is often required to correct this fracture.
• Open fracture. This is a broken bone that comes through the skin, also known as a compound fracture. This is a complex injury because not only does it break the bone, it causes damage to the tissue, tendons, skin, and ligaments. Open fracture require a long time to heal.
• Closed fracture. With this injury, the broken bones do not pierce the skin, but still may damage soft tissues internally. 
• Comminuted fracture. This type of break is very unstable because the bone breaks into multiple pieces. 

Common symptoms include: pain, bruising, swelling, heel deformity, and inability to put weight on heel or walk. In some cases, you may be able to walk with a limp, therefore thinking the injury to be minor. You will experience pain in your heel and may think it to be unrelated to your injury.
When you talk with your podiatrist, it is important to tell them the exact details of your injury. How far did you fall? Your podiatrist will look for other injuries and areas where the skin is damaged or punctured. They may test other parts of your body, like your legs and spine to see if damage was done elsewhere. X-rays will be taken to determine what type of calcaneus fracture you have.
In determining your treatment, there are several things your podiatrist will consider:

• Cause of your injury
• Your overall health
• Severity of your injury
• Extent of soft tissue damage

Since most calcaneal fractures cause the bone to widen, the goal of treatment is to restore the normal anatomy of your heel. Nonsurgical treatment will include casting or another type of immobilization. You will not be able to put any weight on your foot until the bone is completely healed, which can take anywhere from six to eight weeks.
Surgical treatment is often required in more complicated cases. If the skin around the fracture has not been broken, your podiatrist will recommend waiting until the swelling has gone down, giving the skin that has been stretched time to heal. Waiting for surgery improves your overall chances for a better recovery from the surgery and reduces your risk of infection. Open fractures require immediate surgical attention, as an open wound invites infection and disease.
There are two different types of surgical procedures a podiatrist may do. An open reduction and internal fixation is used to reposition the bone fragments into their normal alignment. The fragments are held together with special screws or metal plates and screws. A percutaneous screw fixation moves the big bone pieces back into place by pushing or pulling on them without making a large incision.
Complications from a calcaneus fracture may include:

• Small areas of delayed wound healing
• Nerve irritation around the incision
• Tendon irritation caused by the screws
• Joint stiffness
• Chronic pain
• Blood clots
• Failure of the wounds to heal
• Infection
• Collapse of bone
• Arthritis

Seeking immediate attention after this injury is crucial in your recovery.
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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Acupuncture For Heel Pain

A new study concludes that acupuncture is beneficial in treating heel pain. Researchers note that acupuncture treatment is comparable to the use of medications, night splints, and stretching. Results show that acupuncture has more significant improvements in pain relief and restoration of function than a standard treatment plan, which includes anti-inflammatory medications.
Heel pain can be caused by a variety of conditions. Common causes are plantar fasciitis, fat pad atrophy, Achilles tendonitis, stress fractures, and baxter nerve compression. The baxter nerve is on the plantar side of the foot and may become entrapped, causing pain and numbness. Acupuncture is typically applied the relieve the inflammation of surrounding tissues to release pressure on the baxter nerve.
Plantar fasciitis is caused by the inflammation of the tissues around the plantar fascia, creating foot and heel pain. Patients often know when they have plantar fasciitis because they are unable to walk properly after getting out of bed first thing in the morning. Acupuncture helps enhance the micro-circulation of blood to the local region to nourish the tendons and ligaments. This allows for the healing process to decrease the inflammation surrounding the plantar fascia.
Fat atrophy of the heel pad is common in the elderly and those who have a history of steroid injections. Acupuncture helps reduce the inflammation, and therefore providing pain management for this condition.
Achilles tendonitis is a chronic condition to the major tendon that connects the heel to the muscles of the leg. When this tendon is inflamed, it makes walking very painful. Acupuncture can provide rapid relief for this condition and can also help heal the tendon and eliminate the heel pain.
Stress fractures of the calcaneous bone are typically caused by overuse and injuries. Acupuncture is used to relieve the pain by speeding the wound healing process of the fracture. Combined with rest and activity modification, acupuncture helps this type of heel pain.
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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• Home Treatments For Heel Pain

Plantar Fasciitis Taping

Often times when patients come in for plantar fasciitis or heel pain, we will tape their foot to ease the pain. Taping the plantar fascia acts like an external splint, but allows the foot to work normally.  But tape doesn't last forever, and when something helps you, you want to be able to replicate it yourself.
A benefit of taping the plantar fascia is you reduce the risk of tearing or rupturing this ligament. Taping provides temporary protection against further injury or progression of pain. Some patients will find taping to be extremely helpful, others will not be able to keep the tape on because of irritation to the skin. If you have diabetes or peripheral vascular problems you should not use tape as a treatment option for your plantar fasciitis.
For tape to stick properly to your foot, your foot needs to be dry and without moisture. If you have lotion on, wash your feet. The foot can also be wiped with milk of magnesia or soaked in tea water. You will need: scissors, a roll of 1 inch tape, and a roll of 2 inch tape.
Here's how to tape:

1. Wrap around the perimeter of the foot from behind the first metatarsal toward the heel, around the heel, and then back toward the fifth metatarsal.
2. Apply the first cross strap and tape across the bottom of the foot. Start just behind the first and fifth metatarsal- just behind the weightbearing ball of the foot. Attach the tape here and bring it up, overlapping the anchor strap on the side. 
3. Apply more cross straps. Overlap the next piece of tape by 50% and continue taping layer by layer toward the heel. You will use 3-4 straps. It is not necessary to cover the heel.
4. Lay another piece of tape over the anchor strap to cover all the unfinished ends on the bottom of the foot. 
5. An optional piece of tape can be wrapped around the forefoot, like the cross straps in step 3. 

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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Lakers' Gasol Diagnosed With Plantar Fasciitis

Los Angeles Lakers' forward/center Pau Gasol has been diagnosed with plantar fasciitis, his latest ailment this season. Gasol's right foot was examined by Dr. Kenneth Jung by MRI, and the Spaniard has continued to play through the pain.
The 11 year veteran missed eight games with knee tendonitis in December, following a loss on December 2nd against the Orlando Magic. After the game, Kobe Bryant told reporters that Gasol needed to put his "big boy pants on". Chris Sheridan of SherdianHoops.com says that Gasol was unfairly blamed by Bryant for the loss. "Pau sat on the bench for the final six minutes of that game. The Lakers were up one when he went to the bench, and Orlando scored 31 points in the final six minutes," Sheridan wrote.
Gasol is a four-time All-Star and two-time NBA champion, and hasn't posted stellar numbers thus far this season. It's likely this plantar fasciitis has been bothering him for quite some time and is affecting his play. Plantar fasciitis can be extremely debilitating if ignored. Gasol has 12.7 points per game with a career low 42.9 percent shooting from the field. Fans are wondering if he's worth the $19 million he's making this season.
He's showing signs of why he's worth that $19 million, most recently on Christmas Day, posting 13 points, 8 rebounds, 6 assists, one block, one steal, and shot 38.5 from the field. With 14.4 seconds remaining he drove to the basket and made a game-winning slam dunk.
Only rest, stretching, icing, and the proper footwear will help Gasol feel better.
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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Tarsal Tunnel and Heel Pain

The tarsal tunnel is a narrow space that lies on the inside of the ankle next to the ankle bones. The tunnel is covered with a thick ligament (the flexor retinaculum) that protects and maintains the structures contained within the tunnel- arteries, veins, tendons, and nerves. One of these structures is the posterior tibial nerve, which is the focus of tarsal tunnel syndrome.
Tarsal tunnel syndrome is a compression, or squeezing, on the posterior tibial nerve that produces symptoms anywhere along the path of the nerve running from the inside of the ankle into the foot.
Tarsal tunnel syndrome is similar to carpal tunnel syndrome, which occurs in the wrist. Both disorders arise from the compression of a nerve in a confined space.

Tarsal tunnel syndrome is caused by anything that produces compression on the posterior tibial nerve, such as:

• A person with flat feet is at risk for developing tarsal tunnel syndrome, because the outward tilting of the heel that occurs with fallen arches can produce strain and compression on the nerve.
• An enlarged or abnormal structure that occupies space within the tunnel can compress the nerve. Some examples include a varicose vein, ganglion cyst, swollen tendon, and arthritic bone spur.
• An injury, such as an ankle sprain, may produce inflammation and swelling in or near the tunnel, resulting in compression of the nerve.
• Systemic disease such as diabetes or arthritis can cause swelling, thus compressing the nerve.

Patients with tarsal tunnel syndrome experience one or more of the following symptoms:

• Tingling, burning, or a sensation similar to an electrical shock.
• Numbness.
• Pain, including shooting pain.

Symptoms are typically felt on the inside of the ankle and/or on the bottom of the foot. In some people, a symptom may be isolated and occur in just one spot. In others, it may extend to the heel, arch, toes, and even the calf.
Sometimes the symptoms of the syndrome appear suddenly. Often they are brought on or aggravated by overuse of the foot, such as in prolonged standing, walking, exercising, or beginning a new exercise program.
It is very important to seek early treatment if any of the symptoms of tarsal tunnel occur. If left untreated, the condition progresses and may result in permanent nerve damage. In addition, because the symptoms of tarsal tunnel syndrome can be confused with other conditions, proper evaluation is essential so that a correct diagnosis can be made and appropriate treatment initiated.
The foot and ankle surgeon will examine the foot to arrive at a diagnosis and determine if there is any loss of feeling. During this examination, the surgeon will position the foot and tap on the nerve to see if the symptoms can be reproduced. He or she will also press on the area to help determine if a small mass is present.
Advanced imaging studies may be ordered if a mass is suspected or if initial treatment does not reduce the symptoms. Studies used to evaluate nerve problems- electromyography and nerve conduction velocity (EMG/NCV)- may be ordered if the condition shows no improvement with non-surgical treatment.
A variety of treatment options, often used in combination, are available to treat tarsal tunnel syndrome. These include:

• Rest. Staying off the foot prevents further injury and encourages healing.
• Ice. Apply an ice pack to the affected area, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
• Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation.
• 'Immobilization. Restricting movement of the foot by wearing a cast is sometimes necessary to enable the nerve and surrounding tissue to heal.
• Physical therapy. Ultrasound therapy, exercises, and other physical therapy modalities may be prescribed to reduce symptoms.
• Injection therapy. Injections of a local anesthetic provide pain relief, and an injection corticosteroid may be useful in treating the inflammation. 
• Orthotic devices. Custom shoe inserts may be prescribed to help maintain the arch and limit excessive motion that can cause compression of the nerve.
• Shoes. Supportive shoes may be recommended.
• Bracing. Patients with flat foot or those with severe symptoms and nerve damage may be fitted with a brace to reduce the amount pressure on the foot.

Sometimes surgery is the best option for treating tarsal tunnel syndrome. The foot and ankle surgeon will determine if surgery is necessary and will select the appropriate proceudre or procedures based on the cause of the condition.
If you are experiencing heel pain from tarsal tunnel syndrome, 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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• Causes of Heel Pain

I've Got a Pain In My Heel!

A heel bruise is commonly known as a stone bruise, policeman's heel, or a calcaneal fat pad contusion and is caused by sudden impact or repetitive pounding on the bottom of the heel. The fat pad cushions normal heel strikes and prevents the heel bone from serious injury. Repeated pounding of the heel can cause the fat pad to be pushed up against the side of the heel, leaving less of a protective layer, causing heel pain. This is a common injury in sports which require a lot of impact onto the heel. Other common ways people bruise their heel include:

• Jumping and landing from a high place.
• Running with a heel strike instead of forefoot landing, as in barefoot running.
• Stepping on something.

The fat pad can be contused (minor bleeding into the tissue), partially disrupted (split in half), or completely disrupted (torn away from the bottom of the heel bone).
So what can you do about a heel bruise? First, you need to rest and stay off the injured foot. This is the most important course of treatment we can recommend. We know it's difficult to stay off your feet, but when your health depends on it, do the best you can! Begin an icing regimen with 20 minutes on the affected area and 40 minutes off. Those with mild pain should start with putting an insole in their shoes to help with shock absorption. If you are a runner or athletes, change your shoes. Part of your problem could be that your shoes were worn out and did not offer the support you needed. Some patients may improve with a walking boot or cast.
If you ignore the pain and wait for it to get better, you are only causing more damage and preventing your injury from healing. When you have a heel bruise the best thing is to rest and ice right away. By ignoring the pain, your fat pad may become completely destroyed and may never heal. So take care of yourself!
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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