Bursitis Of The Feet Treatment

Overview

Bursitis is the inflammation of a bursa within the body. A bursa is a fluid-filled sac that cushions some of the major joints, allowing bones, gliding muscles, and tissues to exist together without harming each other. It aids in reducing the friction between bones and the soft tissues above it. Though there are bursae all over the body, the main ones are located in the knee, elbow, shoulder, hip, and heel. These are also the ones that are the most often injured. Still, however, when you hear the word ?bursitis?, the person is usually referring to their shoulder, but it could also refer to any of the preceding areas–such as the second most common one, the hip.

Causes

Bursitis, tendinitis, and other soft tissue rheumatic syndromes typically result from one or more factors. These include: Play or work activities that cause overuse or injury to the joint areas Incorrect posture Stress on the soft tissues from an abnormal or poorly positioned joint or bone (such as leg length differences or arthritis in a joint) Other diseases or conditions (rheumatoid arthritis, gout, psoriasis, thyroid disease, or an unusual drug reaction) Infection.

Symptoms

You might have Retrocalcaneal Bursitis if you notice any of the following symptoms. You have pain or tenderness at the back of the heel where the Achille’s tendon attaches. Have swelling near the attachment of the tendon to the heel bone. You have noticed a slowly growing bump on the back of the heel. The back of the heel turns red after getting rubbed in shoes. The back of the heel hurts worse when you run, walk up hill or wear high heels.

Diagnosis

Diagnosis of heel bursitis can be made by your health practitioner and is based on the following. Assessing the location of the pain by palpating the back of the heel. Assessment of any inflammation at the back of the heel. Assessment of biomechanics and foot function. Ultrasound or MRI can reveal inflammation of the retro calcaneal bursa.

Non Surgical Treatment

Rest and apply cold therapy or ice. Ice should not be applied directly to the skin as it may cause ice burns but wrap in a wet tea towel. Commercially available hot and cold packs are often more convenience than using ice. Taping the bursa with a donut shaped pad to take some of the pressure from footwear may help. A doctor may prescribe anti-inflammatory medication e.g. ibuprofen to reduce the pain and inflammation. Applying electrotherapy such as ultrasound may reduce inflammation and swelling. A steroid injection followed by 48 hours rest may be given for persistent cases. If the bursitis is particularly bad and does not respond to conservative treatment then surgery is also an option.

Prevention

Maintain proper form when exercising, as well as good flexibility and strength around the ankle to help prevent this condition. Proper stretching of the Achilles tendon helps prevent injury.

Hammertoe Treatments

Hammer ToeOverview

A hammertoe is a deformity in the foot, causing the second, third, or fourth toe to be permanently bent in the middle joint, causing the toe to resemble a hammer (hence, its name!) or a claw. They are most commonly found in women who wear narrow shoes, such as high heels, that cause the toes to bend unnaturally for extended periods of time. A hammertoes may be difficult or painful to move, and the skin may become callused from rubbing against the inside of the shoe. In fact, there are two types of hammertoe: flexible and rigid. Flexible hammertoes can still move at the joint and are indicative of an earlier, milder form of the problem. Rigid hammertoes occur when the tendon no longer moves, and at this stage, surgery is usually necessary to fix the problem.

Causes

But what causes the imbalance of the tendons and muscles in the first place so that they begin to pull and bend the joint? A bad fitting shoe could be the cause but it usually isn?t the primary cause. Many people are genetically predisposed to hammertoe, and the condition begins to progress more quickly when they wear shoes that fit poorly, for example pointy toes, high heels, or shoes that are too short. Hammertoe may also be caused by damage to the joint as a result of trauma.

Hammer ToeSymptoms

Here is a look at some of the symptoms hammertoe can cause. They include hammer-like or claw-like appearance of the toe. Pain when walking or moving the foot. Difficulty moving the toe. Corns may form on top of the toe. Callus may form on the sole of the foot. During the initial stages, you may be able to manually straighten your toe. This is called a flexible hammertoe. But as time passes, the toe will not move as easily and will continue to look like a hammer. Pressure and irritation over the joint can cause a blister to develop and become a corn over time. These corns have the potential to become infected and cause additional symptoms such as redness, bleeding, and difficulty wearing shoes and socks. Corns are the main cause of pain when hammertoes are developing.

Diagnosis

First push up on the bottom of the metatarsal head associated with the affected toe and see if the toe straightens out. If it does, then an orthotic could correct the problem, usually with a metatarsal pad. If the toe does not straighten out when the metatarsal head is pushed up, then that indicates that contracture in the capsule and ligaments (capsule contracts because the joint was in the wrong position for too long) of the MTP joint has set in and surgery is required. Orthotics are generally required post-surgically.

Non Surgical Treatment

Apply a commercial, nonmedicated hammertoe pad around the bony prominence of the hammertoe. This will decrease pressure on the area. Wear a shoe with a deep toe box. If the hammertoe becomes inflamed and painful, apply ice packs several times a day to reduce swelling. Avoid heels more than two inches tall. A loose-fitting pair of shoes can also help protect the foot while reducing pressure on the affected toe, making walking a little easier until a visit to your podiatrist can be arranged. It is important to remember that, while this treatment will make the hammertoe feel better, it does not cure the condition. A trip to the podiatric physician?s office will be necessary to repair the toe to allow for normal foot function. Avoid wearing shoes that are too tight or narrow. Children should have their shoes properly fitted on a regular basis, as their feet can often outgrow their shoes hammertoe rapidly. See your podiatric physician if pain persists.

Surgical Treatment

Surgical correction is necessary in more severe cases and may consist of removing a bone spur (exostectomy) removing the enlarged bone and straightening the toe (arthroplasty), sometimes with internal fixation using a pin to realign the toe; shortening a long metatarsal bone (osteotomy) fusing the toe joint and then straightening the toe (arthrodesis) or simple tendon lengthening and capsule release in milder, flexible hammertoes (tenotomy and capsulotomy). The procedure chosen depends in part on how flexible the hammertoe is.

The Facts About Over-Pronation

Overview

Foot types can be divided into three major groups: the flat foot (Pes Planus), the high arched foot (Pes Valgus) and the normal to low arched foot. A true ‘flat foot’ is very rare. In fact, less than 5% of the population have flat feet i.e. a foot with no arch present whatsoever and the entire bottom surface of the foot being flat on the ground. About 5-10% of people have a high arched foot. The majority of the population have a normal to low arch. Even though the arches appear to be normal most of us suffer from over-pronation during walking, running and standing, due to the hard, flat unnatural surfaces we walk on, combined with wearing unsupportive footwear. With every step we take the arches flatten and the ankles roll inwards. Pronation itself is not wrong because we need to pronate and supinate as part of our natural gait cycle. Pronation (rolling in) acts as a shock-absorbing mechanism and supination (rolling out) helps to propel our feet forward. Over-pronation occurs when the foot pronates too deep and for too long, not allowing the foot to ‘recover’ and supinate. Over-pronation hampers our natural walking pattern. It causes an imbalance and leads to wear and tear in several parts of the body with every step we take.Over-Pronation

Causes

Overpronation often occurs in people with flat feet, whose plantar fascia ligament is too flexible or too long, and therefore unable to properly support the longitudinal arch of the foot. People tend to inherit the foot structure that leads to overpronation. In a normal foot the bones are arranged so that two arches are formed, the longitudinal and the transverse. Ligaments hold all the bones in their correct positions, and tendons attach muscles to bones. If the bones are held together too loosely, they will tend to move inwards as this is the easiest direction for them to go. Over time the soft tissue structures will adjust to the misalignment and the foot will become permanently over-flexible, with a flat arch.

Symptoms

Not all foot injuries affecting runners are necessarily down to a particular running gait; it is rarely that simple to diagnose how a foot problem developed . Simply being an overpronator does not mean that a foot injury has been caused by the running gait and it could be due to a number of factors. However mild to severe overpronators tend to be at a higher risk of developing musculoskeletal problems due to the increased stresses and strains which are placed on the body when the foot does not move in an optimum manner. The following injuries are frequently due to overpronation of the feet. Tarsal tunnel syndrome. Shin splints. Anterior compartment syndrome. Plantar fasciitis. Achilles tendonitis. Bunions. Sesamoiditis. Stress fractures. Back and hip pain. Ankle pain.

Diagnosis

A quick way to see if you over-pronate is to look for these signs. While standing straight with bare feet on the floor, look so see if the inside of your arch or sole touches the floor. Take a look at your hiking or running shoes; look for wear on the inside of the sole. Wet your feet and walk on a surface that will show the foot mark. If you have a neutral foot you should see your heel connected to the ball of your foot by a mark roughly half of width of your sole. If you over-pronate you will see greater than half and up to the full width of your sole.Over-Pronation

Non Surgical Treatment

Adequate footwear can often help with conditions related to flat feet and high arches. Certified Pedorthists recommend selecting shoes featuring heel counters that make the heel of the shoe stronger to help resist or reduce excessive rearfoot motions. The heel counter is the hard piece in the back of the shoe that controls the foot?s motion from side-to-side. You can quickly test the effectiveness of a shoe?s heel counter by placing the shoe in the palm of your hand and putting your thumb in the mid-portion of the heel, trying to bend the back of the shoe. A heel counter that does not bend very much will provide superior motion control. Appropriate midsole density, the firmer the density, the more it will resist motion (important for a foot that overpronates or is pes planus), and the softer the density, the more it will shock absorb (important for a cavus foot with poor shock absorption) Wide base of support through the midfoot, to provide more support under a foot that is overpronated or the middle of the foot is collapsed inward.

Prevention

With every step we take, we place at least half of our body weight on each foot (as we walk faster, or run, we can exert more than twice our body weight on each foot). As this amount of weight is applied to each foot there is a significant shock passed on to our body. Custom-made orthotics will absorb some of this shock, helping to protect our feet, ankles, knees, hips, and lower back.

Will Severs Disease Need To Have Surgical Procedures?

Overview

Sever?s disease occurs in children when the growing part of the heel is injured. This growing part is called the growth plate. The foot is one of the first body parts to grow to full size. This usually occurs in early puberty. During this time, bones often grow faster than muscles and tendons. As a result, muscles and tendons become ?tight.? The heel area is less flexible. During weight-bearing activity (activity performed while standing), the tight heel tendons may put too much pressure at the back of the heel (where the Achilles tendon attaches). This may injure the heel.

Causes

One of the most common causes of heel pain in adolescents, Sever’s disease is an overuse injury to the growth plate of the calcaneus (heel). It is commonly seen in growing, active children 8-12 years of age. Soccer players, gymnasts, and children who do any sort of running or jumping activity have an increased risk of developing Sever’s disease. Occurring in one or both feet, Sever?s disease occurs at the back of the heel (also known as the apophysis or the insertion of the Achilles tendon).

Symptoms

The most prominent symptom of Sever’s disease is heel pain which is usually aggravated by physical activity such as walking, running or jumping. The pain is localised to the posterior and plantar side of the heel over the calcaneal apophysis. Sometimes, the pain may be so severe that it may cause limping and interfere with physical performance in sports. External appearance of the heel is almost always normal, and signs of local disease such as edema, erythema (redness) are absent. The main diagnostic tool is pain on medial- lateral compression of the calcaneus in the area of growth plate, so called squeeze test. Foot radiographs are usually normal. Therefore the diagnosis of Sever’s disease is primarily clinical.

Diagnosis

Sever’s disease is based on the symptoms reported. To confirm the diagnosis, the clinician will examine the heels and ask about the child’s activity level and participation in sports. They may also squeeze the back part of the heel from both sides at the same time to see if doing so causes pain and also ask the child to stand on tiptoes to see if that position causes pain. There may be tightness in the calf muscle, which contributes to tension on the heel. Symptoms are usually worse during or after activity and get better with rest. X-rays generally are not that helpful in diagnosing Sever’s disease, but they may be ordered to rule out other problems, such as fractures. Sever’s disease cannot be seen on an X-ray.

Non Surgical Treatment

Sever?s disease will go away on its own with rest or after heel bone growth is complete, usually within 2 to 8 weeks after the heel pain or discomfort appears. Sever?s disease is not expected to cause long-term problems, though symptoms may linger for up to several years in severe cases. Certain conservative care measures may be helpful in treating this health problem, including avoiding activities that provoke pain or discomfort, elevating the leg while at rest, performing hamstring and calf muscle stretches two to three times per day, undergoing physical therapy, using cold therapy, using an elastic wrap or compression stocking, Avoiding footwear with heel elevation, toe spring, and toe taper, and instead favoring footwear that?s completely flat and widest at the ends of the toes. More aggressive treatment measures, including over-the-counter anti-inflammatory medication (e.g. ibuprofen), steroid injections, and surgery, may be indicated in certain cases. Addressing the footwear component of this health problem is an important part of a well-rounded Sever?s disease treatment plan. Optimal footwear for preventing or treating this problem is flat, wide (widest at the ends of the toes), and flexible in the sole. Open-back footwear (such as certain Crocs models) may be particularly helpful for kids and teens with Sever?s disease.

Adult Aquired FlatFoot Do I Suffer AAF?

Overview

Acquired adult flatfoot deformity (AAFD) is a progressive flattening of the arch of the foot that occurs as the posterior tibial tendon becomes insufficient. It has many other names such posterior tibial tendon dysfunction, posterior tibial tendon insufficiency and dorsolateral peritalar subluxation. This problem may progress from early stages with pain along the posterior tibial tendon to advanced deformity and arthritis throughout the hindfoot and ankle.Flat Foot


Causes

Damage to the posterior tendon from overuse is the most common cause for adult acquired flatfoot. Running, walking, hiking, and climbing stairs are activities that add stress to this tendon, and this overuse can lead to damage. Obesity, previous ankle surgery or trauma, diabetes (Charcot foot), and rheumatoid arthritis are other common risk factors.


Symptoms

Your feet tire easily or become painful with prolonged standing. It’s difficult to move your heel or midfoot around, or to stand on your toes. Your foot aches, particularly in the heel or arch area, with swelling along the inner side. Pain in your feet reduces your ability to participate in sports. You’ve been diagnosed with rheumatoid arthritis; about half of all people with rheumatoid arthritis will develop a progressive flatfoot deformity.


Diagnosis

Looking at the patient when they stand will usually demonstrate a flatfoot deformity (marked flattening of the medial longitudinal arch). The front part of the foot (forefoot) is often splayed out to the side. This leads to the presence of a ?too many toes? sign. This sign is present when the toes can be seen from directly behind the patient. The gait is often somewhat flatfooted as the patient has the dysfunctional posterior tibial tendon can no longer stabilize the arch of the foot. The physician?s touch will often demonstrate tenderness and sometimes swelling over the inside of the ankle just below the bony prominence (the medial malleolus). There may also be pain in the outside aspect of the ankle. This pain originates from impingement or compression of two tendons between the outside ankle bone (fibula) and the heel bone (calcaneus) when the patient is standing.


Non surgical Treatment

Nonoperative treatment of posterior tibial tendon dysfunction can be successful with the Arizona AFO brace, particularly when treatment is initiated in the early stages of the disease. This mandates that the orthopedist has a high index of suspicion when evaluating patients to make an accurate diagnosis. Although there is a role for surgical management of acquired flat feet, a well-fitted, custom-molded leather and polypropylene orthosis can be effective at relieving symptoms and either obviating or delaying any surgical intervention. In today’s climate of patient satisfaction directed health care, a less invasive treatment modality that relieves pain may prove to be more valuable than similar pain relief that is obtained after surgery. Questions regarding the long-term results of bracing remain unanswered. Future studies are needed to determine if disease progression and arthrosis occur despite symptomatic relief with a brace. Furthermore, age- and disease stage-matched control groups who are randomized to undergo surgery or bracing are necessary to compare these different treatment modalities.

Flat Foot


Surgical Treatment

For patients with a more severe deformity, or significant symptoms that do not respond to conservative treatment, surgery may be necessary. There are several procedures available depending on the nature of your condition. Ligament and muscle lengthening, removal of inflamed tendon lining, transferring of a nearby tendon to re-establish an arch, and bone realignment and fusion are examples of surgical options to help with a painful flatfoot condition. Surgery can be avoided when symptoms are addressed early. If you are feeling ankle pain or notice any warmth, redness or swelling in your foot, contact us immediately. We can create a tailored treatment plan to resolve your symptoms and prevent future problems.

What Are The Most Obvious Key Treatment And Cause Of Achilles Tendonitis Suffering ?

Overview

Achilles TendonitisAchilles tendonitis is a condition wherein the Achilles tendon, at or near its insertion to back of the heel, becomes inflamed and causes pain. The Achilles tendon is one of the longest and strongest tendons in the body. It is avascular (not supplied with blood vessels) so it can be slow to heal. The Achilles tendon is formed in the lower third of the leg. Two muscles join to form the Achilles tendon, the Gastrocnemius and the Soleus which are commonly referred to as the calf muscle. The Achilles tendon works as an anti-pronator which means it helps to prevent the foot from rolling inward.

Causes

Achilles tendinitis is caused by repeated stress to the tendon, not a direct injury. Often times, this can happen from doing too much too soon and not giving your body enough time to rest or adjust to the increase in intensity or amount of exercise. Another contributing factor can be tight calf muscles. Having tight calf muscles and starting an activity can put added stress on the achilles tendon.

Symptoms

The primary symptom of Achilles tendon inflammation is pain in the back of the heel, which initially increases when exercise is begun and often lessens as exercise continues. A complete tear of the Achilles tendon typically occurs with a sudden forceful change in direction when running or playing tennis and is often accompanied by a sensation of having been struck in the back of the ankle and calf with an object such as a baseball bat.

Diagnosis

During the physical exam, your doctor will gently press on the affected area to determine the location of pain, tenderness or swelling. He or she will also evaluate the flexibility, alignment, range of motion and reflexes of your foot and ankle. Your doctor may order one or more of the following tests to assess your condition, X-rays. While X-rays can’t visualize soft tissues such as tendons, they may help rule out other conditions that can cause similar symptoms. Ultrasound. This device uses sound waves to visualize soft tissues like tendons. Ultrasound can also produce real-time images of the Achilles tendon in motion. Magnetic resonance imaging (MRI). Using radio waves and a very strong magnet, MRI machines can produce very detailed images of the Achilles tendon.

Nonsurgical Treatment

More often than not, Achilles tendonitis can be treated without surgery. However, recovery may take a few months. The following will can help you recover and get back in the game. Rest is always the most important thing when recovering from an injury. Your body needs a break to heal. While taking time off from exercise is recommended, if you just can?t ditch all physical activities, switch to more low-impact ones while you?re recovering. When resting your Achilles, try biking, swimming or using an elliptical machine until you?re fully healed. Icing the injured area of your Achilles tendon throughout the day can help to reduce the swelling and pain. However, try not to ice it for more than 20 minutes at a time. Non-steroidal anti-inflammatory medication is recommended to help reduce the swelling and pain associated with Achilles tendonitis. These include such drugs as ibuprofen and naproxen. While they will reduce swelling, the do not reduce the thickening for the tendon. If you find yourself taking these medications for more than a month, speak with your doctor.

Achilles Tendonitis

Surgical Treatment

Open Achilles Tendon Surgery is the traditional Achilles tendon surgery and remains the ‘gold standard’ of surgery treatments. During this procedure one long incision (10 to 17 cm in length) is made slightly on an angle on the back on your lower leg/heel. An angled incision like this one allows for the patient’s comfort during future recovery during physical therapy and when transitioning back into normal footwear. Open surgery is performed to provide the surgeon with better visibility of the Achilles tendon. This visibility allows the surgeon to remove scar tissue on the tendon, damaged/frayed tissue and any calcium deposits or bone spurs that have formed in the ankle joint. Once this is done, the surgeon will have a full unobstructed view of the tendon tear and can precisely re-align/suture the edges of the tear back together. An open incision this large also provides enough room for the surgeon to prepare a tendon transfer if it’s required. When repairing the tendon, non-absorbale sutures may be placed above and below the tear to make sure that the repair is as strong as possible. A small screw/anchor is used to reattach the tendon back to the heel bone if the Achilles tendon has been ruptured completely. An open procedure with precise suturing improves overall strength of your Achilles tendon during the recovery process, making it less likely to re-rupture in the future.

Prevention

To lower your risk of Achilles tendonitis, stretch your calf muscles. Stretching at the beginning of each day will improve your agility and make you less prone to injury. You should also try to stretch both before and after workouts. To stretch your Achilles, stand with a straight leg, and lean forward as you keep your heel on the ground. If this is painful, be sure to check with a doctor. It is always a good idea to talk to your doctor before starting a new exercise routine. Whenever you begin a new fitness regimen, it is a good idea to set incremental goals. Gradually intensifying your physical activity is less likely to cause injury. Limiting sudden movements that jolt the heels and calves also helps to reduce the risk of Achilles tendonitis. Try combining both high- and low-impact exercises in your workouts to reduce stress on the tendon. For example, playing basketball can be combined with swimming. It doesn?t matter if you?re walking, running, or just hanging out. To decrease pressure on your calves and Achilles tendon, it?s important to always wear the right shoes. That means choosing shoes with proper cushioning and arch support. If you?ve worn a pair of shoes for a long time, consider replacing them or using arch supports. Some women feel pain in the Achilles tendon when switching from high heels to flats. Daily wearing of high heels can both tighten and shorten the Achilles tendon. Wearing flats causes additional bending in the foot. This can be painful for the high-heel wearer who is not accustomed to the resulting flexion. One effective strategy is to reduce the heel size of shoes gradually. This allows the tendon to slowly stretch and increase its range of motion.

What Can Cause Painful Heel And Ways To Prevent It

Plantar Fascia

Overview

Plantar fasciitis is a common foot disorder that affects more than two million people every year, especially runners. It is inflammation of the plantar fascia, a thick band of tissue on the bottom of the foot. The most common area of pain is directly on the bottom of the heel, although some people may only have pain in the arch of the foot. Diagnosis of plantar fasciitis is typically done through a physical examination, which includes listening to the patient history, palpation of the heel and possibly x-rays.


Causes

Although plantar fasciitis may result from a variety of factors, such as repeat hill workouts and/or tight calves, many sports specialists claim the most common cause for plantar fasciitis is fallen arches. The theory is that excessive lowering of the arch in flat-footed runners in­creases tension in the plantar fascia and overload­s the attachment of the plantar fascia on the heel bone (i.e., the calcaneus). Over time, the repeated pulling of the plantar fascia associated with excessive arch lowering is thought to lead to chronic pain and inflammation at the plantar fascia’s attachment to the heel. In fact, the increased tension on the heel was believed to be so great that it was thought to eventually result in the formation of a heel spur.


Symptoms

Plantar fasciitis which usually occurs on one foot at a time typically develops slowly. Some cases can be sudden and severe. If you suspect that you have plantar fasciitis, you should feel a sharp, stabbing heel pain, usually in the inside bottom part of the heel. The pain will likely be worse when you take the first steps after long periods of rest (especially after sleep). The pain may also worsen as you stand, climb stairs, or tiptoe. You typically will not feel a lot of pain during exercise, but will feel the ache after. In some cases, the affected heel may even swell.


Diagnosis

Your doctor will ask you about the kind of pain you’re having, when it occurs and how long you’ve had it. If you have pain in your heel when you stand up for the first time in the morning, you may have plantar fasciitis. Most people with plantar fasciitis say the pain is like a knife or a pin sticking into the bottom of the foot. After you’ve been standing for a while, the pain becomes more like a dull ache. If you sit down for any length of time, the sharp pain will come back when you stand up again.


Non Surgical Treatment

Check your shoes to make sure they offer sufficient support and motion control. They should bend only at the ball of the foot, where your toes attach to the foot. This is very important. Avoid any shoe that bends in the center of the arch or behind the ball of the foot. It offers insufficient support and will stress your plantar fascia. The human foot was not designed to bend here and neither should a shoe be designed to do this. You may also strengthen the muscles in your arch by performing toe curls or “doming”. Toe curls may be done by placing a towel on a kitchen floor and then curling your toes to pull the towel towards you. This exercise may also be done without the towel against the resistance of the floor. Plantar fasciitis is usually controlled with conservative treatment. Besides surgery and cortisone injections, physical therapy modalities such as electrical stimulation and ultrasound can be used. Often the foot will be taped to limit pronation. Following control of the pain and inflammation an orthotic (a custom made shoe insert) can be used to control over-pronation.

Foot Pain


Surgical Treatment

Surgery is usually not needed for plantar fasciitis. About 95 out of 100 people who have plantar fasciitis are able to relieve heel pain without surgery. Your doctor may consider surgery if non-surgical treatment has not helped and heel pain is restricting your daily activities. Some doctors feel that you should try non-surgical treatment for at least 6 months before you consider surgery. The main types of surgery for plantar fasciitis are Plantar fascia release. This procedure involves cutting part of the plantar fascia ligament . This releases the tension on the ligament and relieves inflammation . Other procedures, such as removing a heel spur or stretching or loosening specific foot nerves. These surgeries are usually done in combination with plantar fascia release when there is lasting heel pain and another heel problem. Experts in the past thought that heel spurs caused plantar fasciitis. Now experts generally believe that heel spurs are the result, not the cause, of plantar fasciitis. Many people with large heel spurs never have heel pain or plantar fasciitis. So surgery to remove heel spurs is rarely done.


Stretching Exercises

You may begin exercising the muscles of your foot right away by gently stretching them as follows. Prone hip extension, Lie on your stomach with your legs straight out behind you. Tighten up your buttocks muscles and lift one leg off the floor about 8 inches. Keep your knee straight. Hold for 5 seconds. Then lower your leg and relax. Do 3 sets of 10. Towel stretch, Sit on a hard surface with one leg stretched out in front of you. Loop a towel around your toes and the ball of your foot and pull the towel toward your body keeping your knee straight. Hold this position for 15 to 30 seconds then relax. Repeat 3 times. When the towel stretch becomes too easy, you may begin doing the standing calf stretch. Standing calf stretch, Facing a wall, put your hands against the wall at about eye level. Keep one leg back with the heel on the floor, and the other leg forward. Turn your back foot slightly inward (as if you were pigeon-toed) as you slowly lean into the wall until you feel a stretch in the back of your calf. Hold for 15 to 30 seconds. Repeat 3 times. Do this exercise several times each day. Sitting plantar fascia stretch, Sit in a chair and cross one foot over your other knee. Grab the base of your toes and pull them back toward your leg until you feel a comfortable stretch. Hold 15 seconds and repeat 3 times. When you can stand comfortably on your injured foot, you can begin standing to stretch the bottom of your foot using the plantar fascia stretch. Achilles stretch, Stand with the ball of one foot on a stair. Reach for the bottom step with your heel until you feel a stretch in the arch of your foot. Hold this position for 15 to 30 seconds and then relax. Repeat 3 times. After you have stretched the bottom muscles of your foot, you can begin strengthening the top muscles of your foot. Frozen can roll, Roll your bare injured foot back and forth from your heel to your mid-arch over a frozen juice can. Repeat for 3 to 5 minutes. This exercise is particularly helpful if done first thing in the morning. Towel pickup, With your heel on the ground, pick up a towel with your toes. Release. Repeat 10 to 20 times. When this gets easy, add more resistance by placing a book or small weight on the towel. Balance and reach exercises, Stand upright next to a chair. This will provide you with balance if needed. Stand on the foot farthest from the chair. Try to raise the arch of your foot while keeping your toes on the floor. Keep your foot in this position and reach forward in front of you with your hand farthest away from the chair, allowing your knee to bend. Repeat this 10 times while maintaining the arch height. This exercise can be made more difficult by reaching farther in front of you. Do 2 sets. Stand in the same position as above. While maintaining your arch height, reach the hand farthest away from the chair across your body toward the chair. The farther you reach, the more challenging the exercise. Do 2 sets of 10. Heel raise, Balance yourself while standing behind a chair or counter. Using the chair to help you, raise your body up onto your toes and hold for 5 seconds. Then slowly lower yourself down without holding onto the chair. Hold onto the chair or counter if you need to. When this exercise becomes less painful, try lowering on one leg only. Repeat 10 times. Do 3 sets of 10. Side-lying leg lift, Lying on your side, tighten the front thigh muscles on your top leg and lift that leg 8 to 10 inches away from the other leg. Keep the leg straight. Do 3 sets of 10.