I love to run.  Running is my favorite way to relieve stress and spend time outdoors.  I am fortunate to live in Ormond Beach, Florida, where the scenery is breathtaking and the weather is amazing.  The hard-packed sandy beaches are great for running with an ocean view.  The bridges offer uphill challenges in an otherwise flat landscape.  I consider myself the typical hard-headed runner; I have over-trained and am suffering the consequences.  Luckily, I happen to work for an incredible group of foot and ankle physicians at Atlantic Foot and Ankle Associates with four offices located in Daytona Beach, Port Orange, Palm Coast, Orange City, Florida.

A few months ago, I began to experience heel pain, especially when I first got out of bed in the morning.  I learned that I was suffering from Plantar Fasciitis, a condition common to runners.  I went in to see Dr. James Rust in our Daytona Beach location, who carefully listened to what I had to say and took the time to explain my treatment options.  He explained that the physicians at Atlantic Foot and Ankle Associates initially treat patients with heel pain as conservatively as possible recommending: 

• rest or periods of immobilization
• icing the painful area
• heel stretching exercises 
• night splints to stretch the injured fascia and allow it to heal
• wearing shoes with good support and cushions
• non-steroidal or steroid-type medicines 
• steroid shots or injections into the heel
• in severe cases, surgical treatment may be necessary release the tight tissue

Dr. Rust recommended custom orthotics, stretching and icing.  The heel pain slowly began to decrease and I was able to continue running and interval training.  If you are suffering from symptoms such as heel pain, please do not hesitate to contact one of our podiatrists.  You do not have to suffer any longer!

By Marisa Aitken

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

Having never considered myself much of an athlete, let alone spent any time running, in 2004 I strangely convinced myself to run a half marathon.  The Detroit Free Press Marathon really appealed to me because it offered what no other marathon does: two international border crossings and an underwater mile through the Detroit-Windsor Tunnel.  With less than two months to train, I hit the pavement. 

Autumn in Michigan is nothing short of breathtaking.  Vibrant colors of changing leaves helped take my mind off the pain I was experiencing in just about every part of my body.  I did most of my training at a beautiful park with a scenic eight-mile pathway winding through hills and woods, often with views of the lake the path surrounded (which inevitably sparked my on-and-off-again love affair with running).  The cool temperatures were ideal, and two months later, I ran the half with an overall time of 2:13.  Being a novice runner, I had no idea if that was good or bad – I was just happy I finished.

The experience of participating in such an amazing event had me convinced; next year I was going to run the full marathon!  I was going to keep training throughout the year so I would be prepared and ready for next fall’s event!  And then winter set in.  Snow, sleet, slop.  Yuck.  As much as I despise the cold (and running in snow), my disdain for treadmills is even stronger.  

Fast-forward seven years.  The on-and-off-again love affair continues.  Although running has consistently been a part of my exercise regimen, there has been no distance training to speak of.  I now live in Florida where the weather is optimal for outdoor activities.  I had heard about a small group of runners that trained a few times a week, and decided to give it a whirl.  Within a couple of months, I’m back up to eight-mile distance runs on the on the beach (talk about beautiful scenery), and the rest is an up-hill battle at the bridge. 

I’ve always had some knee issues when running distance, but for the first time I’m finding other pains creeping in (maybe I’m just getting old).  As the Director of Marketing and Community Relations at Atlantic Foot and Ankle Associates, I have full access to five of the best podiatrists in Daytona Beach, Port Orange, Palm Coast, and Orange City.  A runner’s dream! 

When I began experiencing heel pain, (especially when I first got out of bed in the morning), I learned that I was suffering from Plantar Fasciitis, a condition common to runners.  Being the typical hard-headed runner, I wasn’t willing to hang up my shoes just yet.  With the help of custom orthotics made at our office, I have been able to continue training and have run three 5k’s, and a 10k (that is a picture of me getting my 2^nd place award at the Daytona Speedway 5k race).   My heel pain is going away and I am looking forward to the next event!

By Marisa Aitken

A-Rod has ventured into the world of ‘Orthobiologics’.  In December of 2011 he flew to Germany where his knee and shoulder were treated with PRP (Platlet-rich plasma).

Orthobiologics is cutting edge technology which augments the body’s healing potential and in the case of PRP, it allows for healing proteins known as growth factors to aid in the repair process.  This treatment initially originated in the dental community where it was used with mandibular reconstruction.  The process for PRP is fairly simple where a small sample of blood is withdrawn from the patient, placed into a centrifuge and separated into its components. The platelets are then injected into the site of injury.  Other notable athletes who have used PRP include Tiger Woods and Cliff Lee.

PRP has been used to treat a variety of foot and ankle pathology including but not limited to plantar fasciitis (heel pain),  peroneal and Achilles tendonopathy.  Additional options include but are not limited to ankle bracing, custom orthotics, physical therapy, cross-training, activity modification and/or surgical intervention. The treatment plans for the particular problem are based on the pathology, diagnosis and clinical presentation of the patient.

From the professional athlete to the weekend warrior, our goal is to keep you on your feet at Atlantic Foot and Ankle Associates.  With four offices conveniently located in Palm Coast, Daytona Beach, Port Orange, and Orange City, Florida, we are able to provide a wide variety of both conservative and surgical options to keep you pain free.

Don’t suffer from foot or ankle pain any longer… have your feet evaluated by one of our five physicians at Atlantic Foot and Ankle Associates.  To make an appointment online visit our appointment request page or call our office and speak with one of our friendly staff members.

By Dr. Sona Ramdath Jr.  

“Doctor, my heel hurts and I can’t understand why?  It is definitely worse in the morning or after I sit and try to stand up.  It is a sharp pain that is causing me to limp.  I’ve tired different shoes and pads from the foot care isle and nothing is working.”  This is a daily complaint we treat at Atlantic Podiatry Associates in Palm Coast, and is without a doubt one of my favorite things to treat as a podiatrist.  

Our approach to heel pain is simple and effective.  After listening to our patients describe their pain, a thorough lower extremity physical examination is done.  A radiograph allows us to visualize the foot bones to see how the bones and joints interact with the ground.  Radiographs should always be weight bearing.  If there is pain while the toes are bent up and simultaneous pressure of the inner heel, an ultrasound will be performed.  If the ultrasound reveals a thickened plantar fascia, the patient is diagnosed with plantar fasciitis.

To start treatment, our doctors prefer to decrease inflammation of the plantar fascia with an oral anti-inflammatory (Advil or Motrin) or an injectable anti-inflammatory (cortisone) when pain is moderate to severe.  By using an ultrasound, we are certain to inject precisely where the fascia is inflamed using an ultrasound guided technique.  

Stretching the foot after periods of rest is crucial.  A night splint may be worn during leisure times or while sleeping to assist with stretching the foot.  Wearing arch supports, or orthotics, can help stabilize the foot and relieves the pressure of the plantar fascia.  It is very important to be sure the arch supports are somewhat hard or made from a plastic material that may be covered with a softer material.

It is common for athletes with sports injuries to be diagnosed with plantar fasciitis, including pros like Kobe Bryant and Eli Manning.  Sometimes patients need more than one injection, aggressive physical therapy, orthotics, and sometimes surgery.  

As the summer months continue, we love to kick off our running shoes and throw on our sandals.  However, prolonged sandal wearing is a major cause of plantar fasciitis and we encourage everyone to evaluate your shoes of choice.  Match them appropriately to your activity of the day and you may be able to avoid the “summertime” heel pain also known as plantar fasciitis.

By Dr. Dennis McBroom