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Posts for: July, 2013

July 15, 2013
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Many of us are welcoming the warmer weather sporting flip-flop sandals, however, their popularity among teens and young adults is responsible for a growing epidemic of heel pain in this population.

More heel pain is being seen in patients 15 to 25 years old, a group that usually doesn’t have this problem.  A major contributor is wearing flip-flop sandals with paper-thin soles every day. Flip-flops have no arch support and can accentuate any abnormal biomechanics in foot motion, and this eventually brings pain and inflammation.”

Especially for girls and young women, thicker soled sandals with supportive arches might not be considered stylish, but if you want to wear sandals most of the time, you’ll avoid heel pain if you choose sturdier, perhaps less fashionable styles.  

It is estimated that 15 percent of all adult foot complaints involve plantar fasciitis, the type of heel pain caused by chronic inflammation of the connective tissue extending from the heel bone to the toes. Being overweight and wearing inappropriate footwear are common contributing factors.

The pain is most noticeable after getting out of bed in the morning, and it tends to decrease after a few minutes and returns during the day as time on the feet increases. Not all heel pain, however, is caused by plantar fasciitis. It also can occur from inflammation of the Achilles tendon, bursitis, arthritis, gout, stress fractures, or irritation of one or more of the nerves in the region. Therefore, diagnosis by a foot and ankle surgeon to rule out other causes is advised.

Initial treatment options for heel pain caused by plantar fasciitis should include anti-inflammatory medications, padding and strapping of the foot and physical therapy. Patients also should stretch their calf muscles regularly (Stretching), avoid wearing flat shoes and walking barefoot, use over-the-counter arch supports and heel cushions, and limit the frequency of extended physical activities.

Most patients with plantar fasciitis respond to non-surgical treatment within six weeks. However, surgery is sometimes necessary to relieve severe, persistent pain.

For further information about heel pain, please contact 1 of our 3 offices (Our Offices     )

Although rest and relaxation are the goals for most vacations, they usually involve a lot of walking and a lot of walking usually involves sore feet.

Walking is great exercise and one of the most reliable forms of transportation.  But if your feet aren’t in the best shape or you don’t have the right shoes, too much walking can cause foot problems.

Good foot care is essential if you plan to subject your feet to long periods of walking. Some simple foot care tips include:

  • Wear thick, absorbent socks (acrylic instead of cotton).
  • Dry feet thoroughly after bathing, making sure to dry between toes. Use powder before putting on shoes.
  • Nails should be cut regularly, straight across the toe.
  • Bunions, hammertoes or any other serious foot problems should be evaluated by a foot and ankle surgeon.

The right shoe is also important to healthy walking.  The ideal walking shoe should be stable from side to side, and well-cushioned, and it should enable you to walk smoothly. Many running shoes will fit the bill. (Athletic Shoe Guidelines)

Warming up exercises to help alleviate any muscle stiffness or pulled muscles are also advised before walking. Loosening up the heel cords (Achilles and calf) and thigh muscles before a walk is especially effective. (Stretching)

If you’re not accustomed to long walks, start slowly and rest if your feet start hurting. And above all, have fun!


Each day, with every step you take, your big toe bears a tremendous amount of stress, a force equal to about twice your body weight. Most of us don't realize how much we use our big toe. We tend to take it for granted, unless a problem develops.

One problem that afflicts the big toe is called hallux rigidus, a condition where movement of the toe is restricted to varying degrees. This disorder can be very troubling and even disabling, since we use the all-important big toe whenever we walk, stoop down, climb up or even stand. If you have pain and/or stiffness in your big toe, you may have this condition.

Hallux rigidus is a disorder of the joint located at the base of the big toe. It causes pain and stiffness in the big toe and with time it gets increasingly harder to bend the toe. "Hallux" refers to the big toe, while "rigidus" indicates that the toe is rigid and cannot move. Hallux rigidus is actually a form of degenerative arthritis (a wearing out of the cartilage within the joint that occurs in the foot and other parts of  the body).

Early signs and symptoms include:

-Pain and stiffness in the big toe during use (walking, standing, bending)

-Difficulty with certain activities (running, squatting)

-Swelling and inflammation around the joint

As the disorder gets more serious, additional symptoms may develop, including: 

-Pain, even during rest

-Difficulty wearing shoes because bone spurs (overgrowths) develop

- Limping (in severe cases)

Common causes of hallux rigidus are faulty function (biomechanics) and structural abnormalities of the foot that can lead to osteoarthritis in the big toe joint. This type of arthritis—the kind that results from "wear and tear"—often develops in people who have defects that change the way their foot and big toe functions. In some people, hallux rigidus runs in the family and is a result of inheriting a foot type that is prone to developing this condition. In other cases, it is associated with overuse, especially among people engaged in activities or jobs that increase the stress on the big toe, such as workers who often have to stoop or squat. Hallux rigidus can also result from an injury or an inflammatory diseases, such as rheumatoid arthritis or gout.

Treatment for mild or moderate cases of hallux rigidus may include one or more of these strategies:

-Shoe modifications: Shoes that have a large toe box should be worn, because they put less pressure on the toe. Stiff or rocker-bottom soles may also be recommended.

-Orthotics: Custom may improve the function of your foot.

-Medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be prescribed to help reduce pain and inflammation. Supplements such as glucosamine-chondroitin sulfate and some vitamins and minerals may also be helpful.

-Injection therapy into the affected toe can help to reduce the inflammation and pain.

-Therapy: Ultrasound therapy or other physical therapy modalities may be undertaken to provide temporary relief.

In some cases, surgery is the only way to eliminate or reduce pain. There are several types of surgery that can be undertaken to treat hallux rigidus. These surgical procedures fall into two categories.

-The first category of procedures consists of reconstructing and "cleaning up" the joint. The arthritic damage from the joint as well as any accompanying bone spurs are removed, preserving and restoring the normal alignment and function of the joint, as well as reducing or eliminating pain.

-The second category of procedures consists of more aggressive procedures.These procedures include fusing the joint or removing part or all of the joint and replacing it with an implant, such as is done for the hip or knee.


If you or someone you know is suffering from this condition please contact one of Our Offices for a consultation.