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
The posterior tibial tendon is located on the inside of your ankle and plays a major role in supporting and maintaining the arch on the bottom of the foot. Due to the high demands of the tendon with every day life, it can result in overuse of the tendon. This overuse is referred to as posterior tibial tendon dysfunction. When this occurs, patients will eventually develop a flat foot deformity and loss of arch height due to the weakened tendon no longer being able to support the arch. This condition is commonly seen in middle-aged women. Those with diabetes also have an increased risk.
The major problem with posterior tibial dysfunction is that it is a progressive disorder. This means that it will get worse overtime. The initial symptoms of the condition are pain and tendonitis; however there is normally no decrease in strength of the tendon or loss of arch at this stage. As it worsens, the tendon will develop tears and the patient will eventually end up with a decrease in the arch height and a flat foot. With early diagnosis, the progression can normally be slowed, or halted, through the use of orthotics, bracing, immobilization and physical therapy. If the dysfunction is left untreated, or progresses, then it may eventually have to be treated with surgical intervention.
–Dr. Colleen Law
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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
If your child or adolescent develops heel pain, chances are it’s due to Sever disease, which is also known as calcaneal apophysitis. Sever disease is one of the most common sources of heel pain in adolescents and most commonly affects children between the age of 6-13 who are active and involved in sports. Sever is an irritation or inflammation of the heel bone growth plate which is a result of the heel bone growing faster than the surrounding muscles and tendons. Along with repetitive microtrauma, these tight tissues cause increased pull on the growth plate, which results in pain. It is commonly seen in soccer players. Traditionally Sever used to be more common in boys; however, due to the increasing number of girls involved in organized sports, it is becoming more common in the female population.
Sever disease will eventually resolve on its own without any long-term complications. All treatments are symptom based and some children may have to decrease or take off some time from sports until the pain goes away. In some severe cases, children may have to be immobilized in a walking boot for a couple of weeks until the pain subsides. Sever patients commonly have a tight Achilles tendon, so stretching exercises are very important to help try to decrease some of the pull on the growth plate. Anti-inflammatories and ice are also recommended. Return to activity is based on relief of symptoms and should be done gradually. When returning to play, gel heel cups can be used in the cleats or sneakers in order to help provide some cushion.
—Dr. Colleen Law
Thanks to all our patients who continue to support and appreciate our office. You all make us all enjoy what we do everyday.
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Here is the latest copy of the APMA Newsletter “Footprints”. Focus on Foot Injury: Identification, management and protection tips from future injury.
Blue Ridge Foot and Ankle Clinic is pleased to announce Dr. Elaine Allen will be joining our practice. Dr. Allen is Board Certified in Foot Surgery by the American Board of Foot and Ankle Surgery. Dr. Allen has been actively practicing podiatry and foot & ankle surgery in Virginia and Georgia for 8 years. She will be seeing patients in our newly built Fishersville office beginning September 14, 2015.
Call our Fishersville office at (540) 949-5150 or schedule and appointment online at Schedule Appointment to consult with Dr Allen on your foot and ankle injury or concern.
WELCOME DR ALLEN !!!
Custom Functional Orthotics
Custom orthotics are the best decision people can make to improve their foot health and function. Custom orthotics are unique and specially made to your feet. Orthotics treat and correct individual foot ailments. Proper shoes fitted with custom foot orthotics are the best insurance that we can give ourselves to protect our feet.
Your orthotics are manufactured by a state-of-the-art fabrication facility utilizing the latest advancements in machinery and technology available today. The fabrication starts with an analysis of your feet and a laser casting. The image produced from this scan is sent to our lab where your device is “born”. The technicians analyze these scans and make subtle adjustments to ensure a precise fit and form. Exact models of your feet are created on an automated CAD/CAM milling machine. These models are used to form your orthotics with a high temperature pressure fit system. Then they are assembled by hand and laminated. The result is a set of orthotics made to your feet with Dr. Murray’s or Dr. Chang’s specific instructions and modifications to optimize your foot function. This process typically takes 2 weeks and you will be called when they are ready.
Please bring the shoes you plan on using the orthotics with so one of our assistants can check for a proper fit. You will be given instructions to use with the orthotics during the “breaking-in” period. A follow up appointment will be made to discuss with the doctor how the orthotics are working for you. Some patients may need more time to get used to their orthotics and some orthotics may require adjustments. Although most patients are happy with their devices immediately, we want you to appreciate the uniqueness of the human body and understand this process can sometimes take time to make the proper adjustments. Our goal is to help treat and correct your ailment so you can live a healthy and active lifestyle. Therefore, we include free adjustments for 90 days.
One set of orthotics may suffice for many of our patients, but different activities require different accommodations. Therefore, some of our more active patients order multiple pairs of orthotics. Here are a few of the reasons why:
“I need a second set of orthotics for when my other pair gets wet.” – Local runner
“I need orthotics for standing on a concrete floor all day and another pair for hiking with my family.” – Factory worker
“My orthotics really help in my athletic shoes. I wish they worked in my dress shoes.” – Local business woman (we offer the Cobra, which is an orthotic designed to work with many casual and dress shoes)
Most of our orthotics are designed to last 5 to 10 years. Depending on your particular ailment, activity, and amount of use, your orthotics may need to be refurbished (re-covered) during this time period.
First set – $395.00
Additional set – $300.00
These are the prices for non-covered orthotics; when covered by insurance, the prices are predetermined by the terms of the insurance plan.
Insurance coverage: Please verify with your insurance company that custom orthotics are a covered benefit and how your deductible and coinsurance apply.
Welcome to the Blue Ridge Foot and Clinic team. We look forward to helping you stay healthy and active.Blue Ridge Foot and Ankle Clinic LIKE US ON 887 A Rio East Court Charlottesville, VA 22901 434-979-8116 417 South Magnolia AveWaynesboro, VA 22980 540-949-5150 New office in Fishersville will open early 2015 @ 66 Parkway Lane Suite #102 Fishersville, VA 22939 Blue Ridge Foot and Ankle Clinic has been a part of the Waynesboro and Charlottesville communities for over 20 years. Podiatrists Dr. Kevin Murray and Dr. Stewart Chang offer services in sports podiatry, foot and ankle problems and diabetic foot care. Our friendly, accommodating team of Certified Podiatric Medical Assistants look forward to welcoming you to our practice.
- Posted in Achilles Tendon, Ankle Surgery, Athletic Injury, Bunions, Children, Cycling, Dr. Kevin Murray, Dr. Stewart Chang, Foot Doctor, Foot Pain, Heel Pain, Leg pain, Orthotics, Our Community, Our Team, Plantar Fasciitis, Podiatrist, Podiatry, Running, Shin Splints, Shoes, Shoes and Socks, Uncategorized
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Orthotics are commonly suggested aides to recovery and injury prevention. Orthotic shoe inserts control the motion between the forefoot and the rear foot, evenly distributing the weight and pressure exerted on the foot. They reduce excessive motion that may occur in certain feet, they can act as a binding force that absorbs strain as pressure is exerted on them, and they can accommodate and cushion painful or injured areas. “While not everyone needs orthotics,” Dr. Murray notes, “they are a highly successful conservative treatment strategy for certain types of feet and foot conditions.” For problems ranging from structural deformities, such as bunions, to conditions such as posterior tibial tendonitis, orthotics are an economic way to both treat pain and prevent further injuries.
Through their forty years of combined experience in working with Charlottesvillian feet, Dr. Murray and Dr. Chang have found resounding success in prescribing and fitting orthotics to fit a variety of foot types and injuries. The process for getting orthotics takes some time, primarily because Dr. Murray and Dr. Chang want to make sure that orthotics are right for the health of your feet.
If you suspect that you need orthotics or if you have foot pain, a first visit will include a foot examination, as well as an examination of your shoes. That’s right, bring your shoes to your appointment. The reason being is that the number one cause of foot pain and related injuries is worn out shoes. “Shoes are just not made to be worn forever,” comments Charlottesville shoe guru, Mark Lorenzoni of Ragged Mountain Running. Lorenzoni, a veteran runner and long-time shoe salesman, argues that you should be just as wary of your daily shoes as you are of your athletic shoes. Shoes should be sized properly in regard to the width of the different parts of your foot as well as your gait, your arch, and any propensities your foot may have to pronate. Shoes support your foot by guiding its motion.
If you did not consider which shoes are best for your individual feet, or if you wore out your shoes and kept using them, you may be experiencing a host of problems. Shoes that are too loose can cause blisters or problems with your Achilles tendon; shoes that are too tight could cause plantar fasciitis or aggravate bunions and bursitis; shoes too wide could cause problems in the ankle of people who pronate, and shoes too tight could cause ankle pain in a supinator. So if you come in telling Dr. Chang and Dr. Murray that you have kept working out in over-worn or ill-fitted shoes, they may just send you back to Lorenzoni’s shop. There, a number of trained shoe experts will conduct a gait analysis and draw on their years of expertise in the industry to match your feet to the proper shoe. And a time-saving strategy may be just trying new shoes and replacing your shoes every 200-400 miles, according to the chart below. The good news is that purchasing new shoes is often a complete solution to burgeoning foot pain! The shoe mileage chart below, created by the family at Ragged Mountain Running Shop, can help you sort out when to replace your shoes.
| Shoe Mileage Chart
Over half the injuries runners and walkers experience can be directly attributed to “worn out shoes”. Worn out refers to the midsole (engine) of the shoe, which is the most important component of an athletic shoe. Don’t use the outsole/tread wear as a way of determining how much life is left in your shoes! This midsole component generally lasts about 375-450 miles of athletic use. Cut that mileage rating in half if you choose in addition to use your shoes for anything other than your running or walking exercise (i.e. “wearing around”). Here is a sample mileage chart to determine how often you might need to replace your exercise shoes.
*Created by the family at Ragged Mountain Running Shop*
New shoes, however, may not solve all your foot pain. If you still feel pain after you try out your spiffy new, well-fit shoes, it is time to visit your Charlottesville podiatrist. To get closer to the root of your foot pain problem, Dr. Murray and Dr. Chang are likely to suggest that you wear an over-the-counter shoe insert for a couple of weeks. These inserts cost between $35 and $60, and test whether your foot needs a little extra support or more specific support from an orthotic. If pain still occurs, upon the next visit Dr. Murray, Dr. Chang and their staff will assist you with taping your foot. The tape, in addition to the over-the-counter shoe inserts, will help to redistribute weight throughout the whole foot, binding it in a way similar to an orthotic to test whether a pair of custom-made orthotics will help you. Orthotics last about 5 years (depending on use), they lessen the likelihood of injuries, reduce doctors visits, and relieve pain.
The prescription for your orthotics will depend on your foot type, your condition or injury, and the intended purpose of the orthotic. To this effect, there are different kinds of orthotics. Orthotics are mainly grouped into two categories: functional and accommodative. Functional orthotics correct for excessive motion of the foot, preventing pain during ambulation. Accommodative orthotics are used to distribute weight away from a painful or injured area. Dr. Murray and Dr. Chang will scan your foot and write a customized prescription for your orthotics to fit your orthotics’ purpose and your intended activities. They will consider materials used, the rigidity of the device, and the shape of the heel or head to ensure you go home with the right product.
The process to begin wearing orthotics is gradual. It takes 2-3 weeks to work up to wearing an orthotic full time since the adjustments they make with your foot function could cause initial soreness or pain in the feet, ankles, knees or hips. It takes several months before athletes can run in orthotics comfortably. Be attentive to any pain that may surface in the initial weeks, as adjustments to your orthotics are free under a six-month warranty with the lab that makes them.
But it all comes back to shoes. Truth be told, orthotics are only as good as the shoes in which they are inserted. Make sure that your footwear is foot-friendly and accommodates orthotics. It is important to recognize that worn out shoes will negate the work of the orthotic. Note that not all shoes are made to accommodate orthotics, no matter the brand, style, or cost. Consult your podiatrist or local shoe store for more information on which shoes are compatible with orthotic devices. Although one pair of orthotics can be used in multiple pairs of shoes, most patients purchase multiple pairs of orthitcs to fit a variety of shoes.
As sand and dirt can abrade them, reducing their functional period, wash your orthotics every two weeks with mild soap and lukewarm water, letting them dry overnight before reinserting them. If you find that your orthotics squeak, remove them from your shoes and sprinkle talcum or baby powder on them, which should prevent the squeaking.
Your orthotics will work to restore your gait, posture, and to prevent a host of injuries that could be caused by your foot condition. Orthotics are affordable and last for years, and prevent a host of conditions, from runner’s knee to lower back pain. They are a highly effective, cost efficient, non-invasive, and all-around successful treatment technique. Orthotics are only helpful when used, so Dr. Murray and Dr. Chang suggest that you wear orthotics continually to reduce pain and to improve your posture and alignment.Blue Ridge Foot and Ankle Clinic 887 A Rio East Court Charlottesville, VA 22901 434-979-8116 417 South Magnolia AveWaynesboro, VA 22980 540-949-5150 Blue Ridge Foot and Ankle Clinic has been a part of the Waynesboro and Charlottesville communities for over 20 years. Podiatrists Dr. Kevin Murray and Dr. Stewart Chang offer services in sports podiatry, foot and ankle problems and diabetic foot care. Our friendly, accommodating team of Certified Podiatric Medical Assistants look forward to welcoming you to our practice.
- Posted in Athletic Injury, Blisters, Bunions, Children, Cycling, Dr. Kevin Murray, Dr. Stewart Chang, Foot Doctor, Foot Pain, Heel Pain, Leg pain, Orthotics, Plantar Fasciitis, Podiatrist, Podiatry, Running, Shockwave Therapy, Shoes, Shoes and Socks, Stress Fractures
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A neuroma is a growth or thickening in the nerve tissue due to compression or irritation of the nerve. While neuromas can develop in different parts of the body, they are most commonly found in the feet between the third and fourth metatarsals and called Morton’s Neuroma, or intermetatarsal neuromas. Populations who wear restrictive shoes, or have foot abnormalities such as bunions, hammertoes, flat feet, or more flexible feet, are at a higher risk of developing this type of nerve damage. If you suffer from Morton’s neuroma, you probably already know this by the instant relief from the burning and aching toe pain once you take off your shoes. That’s because the width of your shoes often aggravate an already irritated nerve.
Neuromas have a variety of symptoms that vary from pain to tingling, burning or numbness, and even feeling as if something is inside the ball of the foot. Symptoms often have a gradual onset, first only flaming up when wearing shoes with a tight toe box or while engaging in activities that stress the ball of the foot. Initially, symptoms can be relieved by removing a constricting shoe, massaging the tender area, and by avoiding aggravating activities. However, as time passes, symptoms will get progressively worse. If untreated, neuromas can lead to permanent nerve damage, so consult your podiatrist early about your neuroma.
Treatment and prevention vary. First, make sure you have the proper shoes for your feet! Your podiatrist may suggest special padding techniques to relieve the pressure from the affected area. Additionally, icing, using over the counter or custom made orthotics, modifying activities that aggravate the injury, taking NSAIDs, or even cortisone injections can help. In more severe cases, surgery will be a viable option to remove the neuroma altogether.Blue Ridge Foot and Ankle Clinic 887 A Rio East Court Charlottesville, VA 22901 434-979-8116 417 South Magnolia AveWaynesboro, VA 22980 540-949-5150 Blue Ridge Foot and Ankle Clinic has been a part of the Waynesboro and Charlottesville communities for over 20 years. Podiatrists Dr. Kevin Murray and Dr. Stewart Chang offer services in sports podiatry, foot and ankle problems and diabetic foot care. Our friendly, accommodating team of Certified Podiatric Medical Assistants look forward to welcoming you to our practice.