Plantar fasciitis is a common ailment often heard in the news for its effect on athletes but has the potential to affect non-athletes just as well.   Anatomically, the plantar fascia refers to tissue on the bottom surface (plantar surface) of the foot that spans from the heel all the way to the toes.   The area where the tissue attaches at the heel can become inflamed producing heel pain.  With plantar fasciitis the pain often manifests itself when first standing or walking in the morning.  This is because overnight or even after long periods of sitting, the plantar fascia tenses up so when standing and placing pressure on the fascia the pain is exacerbated.

There are risk factors in the development of plantar fasciitis including certain sports like running where there is continuous stress placed on the plantar fascia.  Obesity is also a risk factor since the increased weight places more pressure on the plantar fascia.  Shoe gear can also influence the development of plantar fasciitis.  Shoes with decreased arch support or a poor fit can increase the stress placed on the fascia.  Another risk factor is the biomechanics of one’s foot.  Pronation is a movement that occurs when the foot is rolled inward towards middle of the body so that the outside of the foot begins to lift off the ground.  When a person overly pronates as he or she walks the arch flattens and lengthens, putting tension on the plantar fascia.

Conservative treatment for plantar fasciitis includes applying ice and taking non-steroidal anti-inflammatory drugs to relieve the pain.  Physical therapy and night splints may help stretch the plantar fascia and relieve the tension.  Orthotic devices and padding can also be made to provide support and accommodation.  Steroid injections are also an option to alleviate pain. 

You don’t have to suffer from heel pain.   The physicians at Atlantic Foot and Ankle Associates take a conservative approach for the treatment of plantar fasciitis.  Make an appointment at one of our four offices conveniently located in Palm Coast, Orange City, Daytona Beach, and Port Orange and we’ll have you back on your feet… pain free!

By Dr. Andrew Green, DPM

Recently several athletes such as Penn State’s Devon Still, Baltimore Ravens’ Ray Lewis and Lardarius Webb, and New Orleans Saints’ Mark Ingram have been suffering from a common injury known as turf toe.  Although turf toe often affects football players, it can happen to anyone.  Turf toe refers to an injury to the ligaments and joint capsule of the first (big) toe.  Often for athletes, this injury occurs when wearing flexible shoes on a hard surface like turf.  The specific injury to the first toe typically involves hyperextension (hyperdorsiflexion) beyond its range of motion.  To explain, when walking the heel lifts up and places pressure on the ball of the foot.  Typically, the toes will then aid in propulsion; however, if the first toe fails to aid in propulsion and remains planted to the ground, then there is a risk of turf toe.   The injury can also occur with jamming or stubbing of the toe.  The symptoms of turf toe are pain which may last for a couple of weeks, swelling, bruising, decreased range of motion of the first toe joint, and sometimes even a pop can be felt or heard upon injury. 

There are three grades of turf toe.  Grade 1 is characterized by stretching of the joint capsule.  Grade 2 has an incomplete tear of these soft tissue structures, and grade 3 turf toe has a complete tear.  Pain, tenderness, swelling, and bruising typically increase with higher grades.  At Atlantic Foot and Ankle Associates, turf toe is treated depending on the grade of the injury, starting with RICE (rest, ice, compression, and elevation).  Often anti-inflammatory medications will be taken as well.  It is extremely important to avoid bearing weight on the toe for approximately 2-4 days and resting an additional 3-4 weeks.  If the injury is more severe and a higher grade, crutches or a cast and toe spica may be needed.  Extremely severe injuries may even require surgery.

If you’ve suffered an injury such as turf toe, do not hesitate to come into one of our four offices located in Orange City, Daytona Beach, Palm Coast and Port Orange.  Remember, this type of injury does not only affect athletes, it can happen to anyone. 

By Dr. Sona Ramdath Jr.