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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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
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
Colleen Law graduated from Temple University School of Podiatric Medicine in Philadelphia, Pennsylvania and completed her residency at St. Luke’s University Health Network in Allentown, Pennsylvania. At St. Luke’s, she underwent extensive training in elective and reconstructive forefoot, rearfoot, and ankle surgery, as well as experience in wound care and diabetic limb salvage.
Prior to her medical education, Dr. Law attended Lehigh University, where she was a member of the cross country and track and field teams. Through this experience, she developed an interest in sports medicine, which led her to pursue a career in podiatry. In addition to her interest in sports medicine, she is also interested in elective and reconstructive foot and ankle surgery and diabetic limb salvage.
During her free time, Dr. Law enjoys spending time running and hiking with her husband Matt and vizsla.
Dr. Law is accepting new patients beginning July 17, 2017.