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.

Is Heel Pain An Epidemic?

We treat a lot of heel pain in our four offices, and it's obviously a diverse enough topic for us to dedicate an entire, weekly blog to it.
But is heel pain an epidemic? Diabetes is certainly an epidemic, but heel pain?
Past president of the American Podiatric Medical Association Michael King, who practices in Fall Rivers, Massachusetts, argues that it is, saying that he "sees 18 to 20 patients a day with plantar fasciitis. Heel pain is epidemic." As for a number of how many people who have this condition he can only guess. "Some people just tolerate the pain and try to get by."
Think about it: if you've had heel pain in the past, how have you dealt with it? Have you immediately made an appointment with a podiatrist, or have you said to yourself, "Well, I'll wait and see if this gets better. It's not that bad right now."? 
We've blogged a lot lately about athletes who have had multiple, recurrent cases of plantar fasciitis and heel pain. Joakim Noah has been in and out of basketball, Pau Gasol tried to ignore it and he ended up tearing his plantar fascia, and Albert Pujols has been suffering for seven years. Seven years!!! 
What frustrates podiatrists most about heel pain and plantar fasciitis is that it can be completely preventable when you take care of your feet and see a doctor right away. Who really wants to wake up in the morning and not be able to get out of bed because they can't move their feet? 
One of the culprits of heel pain is the flip-flop, the podiatrist's nemesis. "Flip-flops seem to be a major source of foot pain. People walk into the office wearing shoes that they should have replaced months ago," says podiatrist Elizabeth Kurtz, who practices in Chicago. 
King sees it too. "I see a lot of people with pain in the fall because they've been wearing cheap flip-flops all summer," he says. 
Heel pain doesn't just affect those who don't wear proper footwear. Runners and walkers are often hit with heel pain if they've recently increased their mileage or pace. It also appears in middle-aged people who live sedentary lives and have a little extra weight. 
If you've tried over the counter products, you'll find that they only provide temporary relief. Some will purchase heel cushions to try to ease the pain, but the source of the pain isn't actually from the heel- it's from the arch. Orthotics, whether over the counter or custom made by a podiatrist, will be the best fix for your heel pain, as they will ease the pain.
When looking to recover from heel pain, remember that it's going to take longer than a week. The damage that created the pain took longer than a week to develop, so it will likely take several weeks up to several months. Don't go barefoot and don't wear flimsy shoes, especially flip-flops. Our Bristol office offers shockwave therapy, which can reduce the inflammation and pain. Traditionally shockwave therapy has been used to break up kidney stones.
Reference: LA Times.
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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