Plantar Fasciitis: Guest Blog by Dr. Scott Torness
I recently had a bout of heel pain for the first time in my Podiatric career. I have been advising people that suffer from this on ways to alleviate the pain for many years, despite not having had this personally. My pain was caused by shoes that I actually picked out for myself.
I am not brand specific, but actually, I am shoe-construction specific for treating patients. There is not one shoe out there that will be perfect for every person. Shoes are built for foot types and picking the right shoe is extremely important. None-the-less, I tried the shoes first without an orthotic, then with an over the counter orthotic, and finally with my prescription orthotics. My heel continued to hurt despite the different orthotics in the shoe.
I diligently iced and stretched, went back to wearing my other shoes and prescription orthotics. I now have an appreciation for people that suffer from this pain.
The technical term is plantar fasciitis. Frequently called heel spur syndrome, this is probably one of the most frequent problems we see at the clinic.
I have an approach for treating heel pain that begins with conservative treatment options. I have subscribed to the theory that the spur does not hurt, it’s the inflammation caused by the pathology. My initial approach is to obtain x-rays to evaluate the bone structure and make sure there is no stress fracture of the heel. Once the x-rays have been evaluated, a physical exam of the foot is done to determine where the patient is having the most pain. Many people that suffer from plantar fasciitis may not have a spur at all on x-ray. I examine bilateral feet to make sure that the “good” foot does not have similar pains or symptoms. I then engage the patient in a treatment plan to address the pain.
I advise icing to help with inflammation. We give instructions on icing and to protect the skin from a frost-bite injury. We advise stretching and range of motion and provide instructions on what to do. I am a firm believer that a tight calf muscle is the driving force behind plantar fasciitis. There are other pathologies that can contribute and x-rays are needed to evaluate the structure of the foot.
Shoes are advised and I do recommend that they make sure the shoe is comfortable in the store. I have started to tell people that shoes break down, and they don’t necessarily break in.
There are several different over the counter orthotics that are available. There are good and bad, but these are mass-produced orthotics that are not patient or pathology specific. Some over the counter orthotics can be heated up to better fit a foot, which could provide a more “custom” application. Then, there are prescription orthotics that are made specifically for the patient. None are perfect. When evaluating for a prescription orthotic, I try to have the patient use an over the counter first and then if we have to modify the over the counter, it becomes a template for the prescription orthotic. I have had prescription orthotics for about 17 years now. I do use over the counter orthotics at times in boots or waders to help support my foot better though.
Other treatment options that are available are physical therapy, steroids, amniotic/chorionic tissue injections, platelet rich plasma injections, avoiding barefoot (cheap flip flops, house slippers, etc) and immobilization.
Some patients, even after having tried conservative treatment, have to have surgical correction.
Trav’s Outfitter has always treated my patients with concern and care. They help direct the patient to the orthotic and shoes we’ve advised to work best for their foot structure. They also have a shoe return policy that is extremely generous. If you happen to get a shoe that just doesn’t work for you, as long as you’ve only worn the shoe in the house, they will exchange it, NO QUESTIONS ASKED!
I appreciate all that Trav’s has done to help my patients get back to the activities they enjoy without having to worry about their feet!
If you have had these symptoms or pain in the feet that has been causing an interruption in your daily activities, or if you just don’t feel like doing things because your feet hurt, I encourage you to set up an appointment in the office to have an evaluation and x-rays of the feet to help you get back to those activities that you want to enjoy!
Scott Torness, DPM FACFAS
Brown Clinic Watertown (main office)
Milbank and Webster (outreach offices)
Ortonville, MN (outreach office)
You can also see:
Dr Eric Woolley DPM AACFAS
Brown Clinic Watertown (main office)
Dawson, MN (outreach office)
Madison, SD (outreach office)