Mar 02 2010
Botox injections at the heel improve pain and function in patients with chronic plantar fasciitis, according to a new study in the Journal of Rehabilitation Medicine. Fifty patients with chronic heel pain and a diagnosis of plantar fasciitis were divided into two groups. Continue Reading »
Dec 01 2009
Plantar fasciitis is the tearing, inflammation and subsequent degeneration of the plantar fascia, a broad ligament-type structure which extends across the bottom of the foot. The plantar fascia supports the arch and increases the rigidity of the foot, aiding the calf muscles in propelling the body forward during walking. Excess stress on the plantar fascia can cause microscopic tears within the fascia resulting in pain, typically at the inside of the heel. Continue Reading »
Nov 06 2009
It is well documented that musculoskeletal conditions, such as carpal tunnel syndrome, Dupuytren’s contracture and trigger finger, occur in association with thyroid disease. Most disorders occur with hypothyroidism, but there have been occurrences with thyrotoxicosis as well. Although there is limited research to support a clear association between hypothyroidism and plantar fasciitis, it is theorized that low thyroid levels will increase the susceptibility for the development of plantar fasciitis. Continue Reading »
Oct 30 2009
Pain under the heel at the first step in the morning is the most characteristic symptom associated with plantar fasciitis. Plantar fasciitis is the tearing, inflammation and degeneration of the plantar fascia, an important connective tissue structure in the bottom of the foot. The plantar fascia is similar in structure to a ligament and is composed of collagen, elastin, glycosaminoglycans (GAGs), fibroblasts and water. 
Type I collagen adds to the fascia’s considerable strength and the elastin increases elasticity, as the name implies. Glycosaminoglycans are long chains of repeating sugar units which attract water and function to resist pressure. Continue Reading »
Oct 29 2009
The plantar fascia is a thick, fibrous, connective tissue band which extends along the bottom of the foot. The structural make up of the plantar fascia consists of collagen, elastin, glycosaminoglycans and water. The primary cells are fibroblasts, which synthesize collagen. The primary component of the fascia is type I collagen which adds to the strength of the structure. Elastin is a protein which gives the fascia some elasticity as well as increasing it’s function in dynamic arch support when walking. Glycosaminoglycans, GAGs, are long chains of repeating sugar units that attract water and add resiliency to the ligamentous structure. Continue Reading »
Oct 28 2009
Plantar fasciitis is a condition which results from microscopic tears within the plantar fascia. The plantar fascia, a ligament-type structure in the foot, is one of the most important structures in the foot due to it’s role in supporting the arch. Despite it’s strength, excess stress in combination with abnormal mechanics of the foot can result in small tears within the fascia. In the illustration to the left, a tear in the plantar fascia is highlighted. An up-close view shows a microscopic image of the tearing in the ligamentous structure. Continue Reading »
Oct 27 2009
The plantar fascia is a connective tissue band which extends from the heel bone to the ball of the foot. The plantar fascia is designed to support a tremendous amount of weight. Continue Reading »
Oct 26 2009
Plantar fasciosis is the degeneration (deterioration) of the plantar fascia as a result of repetitive stress. The plantar fascia is a broad, thick, fibrous band that extends from the base of the calcaneus (heel bone) to the base of the toes. The fascia is composed of a dense network of highly organized collagen fibers, which gives it the strength necessary to support the tremendous force placed through the arch when walking. During the push off or propulsive phase of walking, the plantar fascia tightens like a cable, increasing the arch height, shortening the foot and helping to create a rigid lever which increases the efficiency of motion as the body is propelled forward. Continue Reading »
Oct 12 2009
Last week it was questionable whether Eli Manning, the quarterback for the New York Giants, would start in yesterday’s game against the Raiders. Not only did he start his 83rd straight game for the Giants, he led the Giants to an easy 44-7 victory over the Raiders. Manning took at seat on the sidelines midway through the second quarter after completing 8 of 10 passes for 173 yards and connecting for 2 touchdowns. Continue Reading »
Oct 08 2009
Eli Manning, the quarterback for the New York Giants, has been diagnosed with an injury to his plantar fascia. Manning limped off the field early in the 4th quarter of last Sunday’s game with a painful right heel. An MRI has confirmed inflammation of his plantar fascia, a strong, web-shaped ligament-type structure in the bottom of the foot. Continue Reading »
Sep 29 2009
Calf stretching is an universal treatment recommended for patients with plantar fasciitis, the most common cause of heel pain. In a study from the University of Western Sydney in Australia, calf stretching using a wooden wedge was evaluated as a specific treatment for plantar fasciitis. Plantar fasciitis is the tearing and resultant inflammation of a long connective tissue structure in the bottom of the foot. In this trial, 92 patients with plantar fasciitis were randomly divided into two groups. The treatment group was given a specific calf stretching regime using a wedge block, in addition to sham ultrasound treatment. The placebo group was given the sham ultrasound treatment only. Both groups were evaluated after two weeks of therapy and no statistically significant difference in pain or function was found.
This study is of interest because it contradicts the use of one of the most commonly prescribed therapies for plantar fasciitis. But, this study only used one method for calf stretching and evaluated patients after two weeks of treatment. Additional stretches for plantar fasciitis are not studied in this clinical trial and the therapy was only given over a period of two week. In conclusion, this study found that calf stretching with a wedge block is not beneficial for plantar fasciitis when utilized for two weeks.
More information on heel pain and plantar fasciitis.
BMC Musculoskelet Disord 19;8:36, Apr 2007
Sep 14 2009
A new study in this month’s issue of the Clinical Journal of Sports Medicine evaluated the biomechanics, arch height, impact load, maximum load and ankle dorsiflexion in women runners, during running and while standing. The researchers divided 50 age and mileage matched women runners into two groups, a plantar fasciitis group and a control group. The plantar fasciitis group had a history of plantar fasciitis, while the control group had no history of plantar fasciitis. The women were evaluated during standing and running and the data was collected using a force plate and a motion capture system. Continue Reading »
Aug 13 2009
A pneumatic lithotripter is a device which uses pressurized gas to pass shock waves through water to break up hardened tissues into smaller fragments. Classically the device has been used for kidney stones, but the use of shock wave therapy for chronic musculoskeletal conditions has become more popular in the past decade. For kidney stones, the device is inserted into the upper urinary tract. Internal use is referred to as intracorporeal and in the past has been reserved for kidney stones. Continue Reading »
Jul 15 2009
Sharp pain at the inside of the heel at the first step in the morning is a classic sign of plantar fasciitis. Plantar fasciitis is the tearing and resultant inflammation of the plantar fascia, a ligament-type structure in the bottom of the foot. The pain is not limited to the bottom of the heel, the pain may extend through the arch or to the back of the heel. The pain experienced at the first step in the morning tends to work itself out after 15-20 minutes, but usually returns during the day or with activity. Continue Reading »
Jun 09 2009
Platelet rich plasma injections are becoming a more common and popular treatment for chronic musculoskeletal conditions. Chronic foot and ankle conditions, such as plantar fasciosis and Achilles tendinosis typically begin with the classic inflammatory process. Initially, the area becomes red, inflamed and swollen. Patients will describe a sharp, stabbing pain with weight bearing and tenderness to palpation. After a repetitive stress injury, it’s normal for the body to increase blood flow to the injured area and send cells to clean up damaged tissues and initiate the healing process. Continue Reading »
May 30 2009
Carlos Quentin of the Chicago White Sox went on the 15-day disabled list yesterday for plantar fasciitis of his left heel. Quentin complained of a sore heel mid-May and was sidelined for a week with hopes of recovering and avoiding the disabled list. He returned to the lineup last week. Manager Ozzie Guillen was disappointed Quentin hadn’t mentioned the painful heel earlier, as it is clear his performance has suffered as a result. Quentin started the season hitting .302, with 7 home runs and 13 RBIs and is now hitting .229 with 8 home runs and 20 RBIs. After his diagnosis in mid-May, he was placed in a protective boot, he had a steroid injection and was given custom orthotics. Continue Reading »
May 28 2009
A new study in the Journal of the American Podiatric Medical Association (JAPMA) evaluated the safety and efficacy of ultrasound-guided plantar fascia release for treatment of chronic plantar fasciitis. Forty-one patients were selected for the study and forty six feet underwent endoscopic plantar fascial release. Continue Reading »
Apr 18 2009
Many individuals have flatfeet and never have foot problems. In fact, all of us are born with flatfeet and some of the greatest athletes have flatfeet. But, flatfeet are a problem when complete arch collapse is combined with excess inward rotation of the foot and ankle (pronation). This type of flatfoot causes excess stress on the joints, ligaments and tendons in the foot and ankle and if not treated appropriately, tendon and joint problems may develop. Catching the condition early and initiating treatment can help prevent future problems. All infants have flat feet, so this makes it difficult to assess early on if an infant’s flatfeet will become a problem later on in life. Between the age of two to three, the child’s foot starts to develop into a more characteristic shape as the bones grow and become more prominent. Continue Reading »
Apr 08 2009
Haglund’s deformity is an enlargement of the bone on the back of the heel that typically leads to an inflammed bursa, the fluid-filled sac between the Achilles tendon and the heel bone. The condition typically occurs in young, active individuals and those with high arched feet because the heel bone (calcaneus) tilts back in a high arched foot. As the heel bone tilts back, the bump on the back of the heel becomes more prominent. Continue Reading »
Apr 02 2009
At the 94th Scientific Assembly and Annual Meeting of the Radiological Society of North America in December, Italian radiologists presented results from their study of a novel treatment for plantar fasciitis. Dr. Luca M. Sconfienza and his research team evaluated 44 patients with plantar fasciitis who were unresponsive to therapy. Each patient had a Continue Reading »
Mar 26 2009
Orthotics are devices designed to control abnormal motion in the foot. Custom orthotics are made by taking a mold of the foot, while prefabricated orthotics are based on foot size. Orthotics are a common treatment for patients with plantar fasciitis, the most common cause of heel pain. The research to support the use of orthotics in the treatment of plantar fasciitis has been mixed. Below are a few articles evaluating the role of orthotics in the treatment of plantar fasciitis. Continue Reading »
Nov 14 2008
Plantar fasciitis (Plan – TAR fash – ee – I – tis) is the medical term used to describe the most common cause of heel pain. Plantar means bottom of the foot. Fascia is defined as a band of connective tissue, similar in composition to a ligament, which sits below the skin and separates different layers of tissue. Itis means inflammation. The plantar fascia originates on the bottom of the heel bone and extends towards the bases of the toes. Plantar fasciitis has been classically described as microscopic tearing and subsequent inflammation of the plantar fascia.
May 27 2008
Stretching has always been a part of the treatment regimen for plantar fasciitis, but not all stretches are equal. Research in the past few years has shown that specifically stretching the plantar fascia is more effective than general calf stretching in the short term and has also shown overall pain reduction in the long term. Continue Reading »
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