One of the most common causes of heel pain on the bottom of your foot is plantar fasciitis. Plantar fasciitis is pain along your heel and arch due to inflammation of the plantar fascia. The plantar fascia is a large band on the bottom of your foot that goes from the heel bone and attaches to each of the toes. This band helps support your arch as you walk. Plantar fasciitis can affect a variety of people including athletes or those who spend a lot of time on their feet at work. The pain is typically described as severe with the first couple of steps out of bed in the morning or with the first couple of steps after sitting for a long period of time. The pain generally starts to feel better as you start to take more steps, but some people also develop worsening pain or feeling of fatigue in their foot as the day goes on.
There are several different types of treatments for plantar fasciitis. One of the most important things when dealing with plantar fasciitis is supportive shoe gear. Flip-flops and flexible shoes without much support can exacerbate the condition. Also calf stretches, anti-inflammatories, and ice at the end of the day or after activities are helpful to try and calm down the inflammation. Freezing a water bottle and rolling it along your arch is a good option when it comes to icing. If these basic measures fail than steroid injections, arch supports, or night splints can also be utilized.
–Dr. Colleen Law
Stress fractures differ from regular fractures in that they are cracks in the bone opposed to a complete break through the bone. Stress fractures are very common in the foot and lower extremity due to the mechanical load from our bodies. In the foot they are most commonly seen in the second and third metatarsals. Overuse and repetitive forces cause stress fractures. This overuse can be from a runner who increases their mileage too quickly or from any increase in activity or change in activity.
People who suffer from stress fractures generally have pain in a very specific spot on their foot, ankle, or leg. Diagnosis can be a little tricky in that stress fractures are not seen right away on x-rays. This takes a couple of weeks to visualize and by the time it is seen on x-ray, the stress fracture has already started to heal. The healing of the stress fracture seen on x-ray is called callus formation. To get more of a definitive diagnosis of a stress fracture right away your doctor can order an MRI or bone scan.
Treatment for stress fractures is rest. If a patient was to continue their increased activity while having a stress fracture this could result in a complete fracture and would increase the recovery time. Sometimes your doctor may put you in a surgical shoe or walking boot in order to decrease the stress. Ice and elevation are also important for the recovery process. For those who wish to keep their conditioning up while recovering from a stress fracture, aqua jogging and swimming can be good options.
–Dr. Colleen Law
Lateral ankle sprains are the most common type of ankle sprains. These sprains happen after an inversion injury or inward rolling of your foot on your ankle and affect the ligaments on the outside of your ankle. They most commonly occur in sports, especially seen in basketball and football, but also can occur in everyday activity. The lateral ankle is composed of three major ligaments, the anterior talofibular ligament (ATFL), the calcaneal fibular ligament (CFL), and the posterior talofibular ligament (PTFL). There are varying degrees of severity of ankle sprains, but the most commonly injured ligament is the ATFL.
Certain people are more prone to ankle sprains than others, especially those with a higher arch foot or those who have had a severe or multiple sprains in the past. It is normal after suffering from a sprain to have varying levels of swelling and bruising. The most important thing following a sprain is over the first 24-72 hours to practice the pneumonic RICE. RICE stands for rest, ice, compression, and elevation. Studies also show that initiation of early range of motion is key in the recovery process. Once the swelling goes down, then strengthening of the muscles around the ankle joint should be initiated to help prevent chronic ankle instability. Taping, bracing, and balancing exercises also can help in preventing re-injury. Most people start to feel better after a sprain over a couple of days, but in the case of severe sprains this could take several weeks to recover. If you develop a sprain that is not improving over a couple days, especially if you have followed the pneumonic RICE, then make sure you schedule an appointment with your doctor.
-Dr. Colleen Law
If you begin to develop a nagging pain without significant change in your mileage or training, you must consider your shoe gear. Running shoes typically are good for about 300-500 miles depending on running surfaces, experience, and size of the runner. These first few signs of a nagging pain is usually a way of your body telling you that you need a new pair of sneakers.
Another important way to prevent injuries when it comes to running shoes is to find a type of shoe that is most compatible with your foot structure. Everyone’s feet are different so a type of shoe that works well for your friend, may not work as well for you. People who have a flatter arch and overpronate need more of a motion controlled stability type shoe, whereas those who have a high arch and underpronate do better with more cushioned and neutral type shoe. Especially if you are new runner, I would recommend going to your local running store to help you find a pair of sneakers. These stores typically have experienced runners who will evaluate your foot type as well as running goals to help find you a shoe that would work the best for you. Once getting your new sneakers, make sure you take a couple of days walking around in them prior to running in order to help break them in. Also, another good tip is to buy two pairs at once and alternate running in them every other day in order to slow down the wear of an individual pair.
-Dr. Colleen Law
I am very excited to be joining Dr. Murray, Dr. Chang, Dr. Baglio, and Dr. Schustek and the rest of the team at Blue Ridge Foot and Ankle Clinic in July! I graduated from Temple University School of Podiatric Medicine in Philadelphia, Pennsylvania and completed my residency at St. Luke’s University Health Network in Allentown, Pennsylvania. While at St. Luke’s, I had experience training in both the inpatient and outpatient setting, as well surgical training in elective and non-elective foot and ankle surgery, and experience with wound care and diabetic limb salvage.
I am interested in treating a variety of different pathologies in the foot and ankle, but one area that I am particularly interested in is sports medicine. In college, I competed on the cross country and track teams at Lehigh University. After suffering from a foot injury, which required surgery during my freshman year, I was introduced to the field of podiatry. I really like that I can relate my love for running with my job as a podiatrist and understand what it is like recovering from an injury and returning to activity.
In my free time I like to spend time with my husband Matt and viszla, Zoey. We enjoy running and other outdoor activities and look forward to getting involved with the Charlottesville community.
I am really excited about the move to the Charlottesville area and am eager to start meeting and working with patients in July!
-Dr. Colleen Law
Common Running Injuries-Plantar fasciitis
Plantar fasciitis is a common injury that many runners experience. Below is a brief description of the injury, and what you may be able to do to prevent plantar fasciitis.
Plantar fasciitis (arch pain)—Arch Pain is often caused by frequent stress on the plantar aspect, or the bottom of the foot. When the plantar fascia, a supportive, fibrous band of tissue running from the heel to the ball of the foot, becomes injured, pain on the bottom results. Forefoot or rear-foot instability with excessive pronation may result in plantar fasciitis. Overtraining may contribute. Shoes with good mid-foot stability may prevent plantar fasciitis. If pain persists, visit us at Blue Ridge Foot & Ankle!
Here is the latest copy of the APMA Newsletter “Footprints”. Focus on Foot Injury: Identification, management and protection tips from future injury.
There are a few things that come into play when deciding if it is time to replace your athletic shoes. Three ways to determine if they need to be replaced are amount of usage, signs of wear, and the age of the shoe. The components of an athletic shoe that can break down and wear out are the outer sole, midsole, and heel.
The outer sole is typically made of carbon rubber, which is very abrasion resistant and also consists of 2 components. Most athletic shoes will have a harder and more resilient rubber in the heel of the shoe since this is where most of the wear will occur.
The mid-sole is normally composed of a foam material, such as ethylene vinyl or polyurethane, sometimes even a blend of these materials. This area of the shoe is intended to be shock absorbing and in some shoes, controls excessive foot motion. The midsole will begin to compress over time, because of the repetitive load that is placed on that area. The shoe will no longer absorb shock, or control the foot as well as it did when new. Sometimes the midsole can compress and deform unevenly which can create alignment changes in the foot. This can ultimately lead to injuries associated with over-use, such as achilles tendinitis, stress fractures, plantar fasciitis, and metatarsalgia.
Midsoles should be considered worn out if any of the following occur:
- After 300-500 miles of running or walking.
- Shows signs of unevenness when placed on a flat surface.
- Display noticeable creasing
The heel counter of the shoe helps hold the heel on top of the midsole and prevents excessive heel motion. This area is considered broken down when it feels flexible, when compressed side to side, or appears to lean to one side or the other when viewing from the rear of the shoe.
It is typically best to replace athletic shoes that are over a year old, whether they are worn out or not. Replacing athletic shoes when necessary may be costly in the short term, but can help prevent injuries and keep you active in “the long run”.
The Achilles Tendon, sometimes called the “heel cord,” is the band of tissue that connects the calf muscle to the heel bone. If you’ve ruptured it, most likely you’d know it. When the tendon is stretched beyond its capacity due to forceful jumping or pivoting or sudden acceleration when you’re running, it can tear. At Blue Ridge Foot & Ankle Clinic, we often see this injury in “weekend warriors,” those less-fit adults who decide to go full force running, exercising, or participating in a sport. The tendon can also rupture as the result of tripping or a fall. If you’ve ruptured your Achilles Tendon you will probably experience one or more of the following:
- Sudden stabbing pain in the back of the ankle or calf that may subside to a dull ache
- A popping or snapping sensation
- Swelling between the heel and the calf
- Difficulty walking (especially upstairs or uphill) and an inability to rise up on your toes
If you believe you have ruptured your Achilles Tendon, call our Fishersville office at 540-949-5150 or our Charlottesville office at 434-979-8116 immediately. Prompt medical attention is necessary to prevent further damage. Until you are able to see the doctor, follow the RICE (Rest, Ice, Compression, Elevation) regimen.
Our board certified podiatrists, Dr. Stewart M. Chang and Dr. Kevin P. Murray will conduct a thorough examination of the foot and ankle, which will involve checking for range of motion and comparing the injured foot to the uninjured one. Our podiatrists will also want to know how the injury occurred and, in some cases, may order an MRI or other advanced imaging tests.
There are both non-surgical and surgical treatment options for a ruptured Achilles Tendon. Your podiatrist will determine the best treatment plan for you, based on the severity of the injury and your level of activity.
How many times have you heard it said, when someone thinks they may have broken a toe, “No sense going to the doctor, there’s nothing they can do for a broken toe.” That’s a myth! In fact, not treating a fractured toe correctly can lead to serious complications including: a deformity of the bone structure which may limit mobility or make it hard to find comfortable shoes, arthritis, chronic pain, and possibly long-term dysfunction requiring surgery to correct. At Blue Ridge Foot & Ankle Clinic, we want you to know the facts about toe fractures. Toe fractures, or breaks fall into two categories.
Also known as acute fractures, traumatic fractures are the result of a direct impact or blow, such as dropping something heavy on your toe or stubbing it really hard—you usually know when it happens. You may hear a breaking sound at the time the incident occurs and have serious pain on impact that lasts a few hours (the pain may go away after several hours but that does not mean the toe isn’t fractured). There may be bruising and swelling the next day and the toe may appear misshapen or out of place.
Stress fractures may not be so obvious. These small, hairline breaks have symptoms that can come and go. There may be pain at the site when touched and swelling of a particular area without bruising. Pain usually comes after activity but goes away when resting. Oftentimes stress fractures result when athletes over do it and try to increase their activity level too quickly. They can also be caused by improper footwear, deformities in foot structure, or certain diseases like osteoporosis.
Diagnosis and Treatment
Just because you can still walk on your foot is not proof that your toe isn’t broken. If you experience any of the symptoms above, it’s important that one of our board certified podiatrists examine your toe promptly. Dr. Kevin P. Murray and Dr. Stewart M. Chang will first conduct a thorough exam of your toe and foot, which may include digital x-rays. Depending on the type and severity of the fracture, several treatment options are available:
- Splinting the toe to keep it in a fixed position until it heals
- “Buddy taping” the broken to another toe is sometimes appropriate
- Wearing rigid or stiff-soled shoes to protect the toe from further damage and keep it in the proper position
- Surgery may be required if the break is severe or the bone is badly displaced.
If you believe you may have a fractured toe, don’t delay. Make an appointment today at one of our two conveniently located offices in Fishersville or Charlottesville.