Sunday, August 28, 2011
Simple Tips Help Runners and Walkers Avoid Problems
Simple Tips Help Runners, Walkers Avoid Foot Problems
Here are the “do’s & don’ts” of running and walking for fitness.
Proper training and preparation can mean the difference between enjoying healthy exercise and developing debilitating foot pain.
All too often, people who start walking or running for exercise make the common mistake of going too far, too fast, and too hard during their workouts, instead of building up training times gently and gradually.
As a result, they can experience problems such as Achilles tendinitis, stress fractures or shin splints. In fact, an estimated one million runners a year develop heel pain, which is most commonly caused by plantar fasciitis — an inflammation of the soft tissue at the bottom of the heel.
Plantar fasciitis may be triggered by faulty body mechanics or excessive pronation, in which the arch of the foot “flattens” too much while walking or running.
Stretching exercises, shoe inserts or changing shoes may help relieve this type of heel pain as will icing or anti-inflammatory drugs. Custom orthotics and physical therapy might be recommended if heel pain persists. For those with chronic pain, surgery may be recommended. Surgery may also be appropriate for those who develop bunions or hammer toes from running.
The foot problems that arise from running or vigorous walking can often be avoided when common sense training guidelines such as these are followed:
•Generally, runners should increase the distance they travel by no more than 10 to 20 percent per week. (Example: A person who runs 20 miles within a seven-day period, should not add more than two to four miles per week.)
•Introduce only one new training element a week — so do not increase mileage and start running up hills at the same time. Do one or the other to prevent injuries.
•When training on inclines, practice running part of the way up the hill and walking the rest, then gradually build up to running the whole hill.
•Rest one day per week.
•Practice proper stretching techniques — paying particular attention to calf stretches. (Example: put both hands against a wall with one leg behind the other; feet flat on the floor. Lean forward to stretch the rear leg. Then switch to the other leg.)
•Purchase properly fitting shoes since an improper fit and worn out shoes can lead to injuries. Running and walking shoes should provide ample room in the toe box (about 1⁄2 inch).
•Foot, knee or back pain may signal that shoes or orthotics need replacing.
•See a doctor if pain limits workouts or does not disappear within two days after a training run.
•Finally, instead of focusing on the competitive aspects of races, learn to enjoy the experience of running or walking — and the benefits of exercise, which includes but is certainly not limited to reducing the risk of obesity, diabetes and high blood pressure.
Visit us at Lyon Foot & Ankle Clinic, PC.. Schedule an appointment Today: (630) 495-1240
Convenient locations for foot and ankle care at:
Lombard
Wood Dale
Warrenville
Elgin
Cary
Elmhurst
Heel Pain from Running
The most common cause of heel pain from running is plantar fasciitis which occurs in the undersurface of the foot. Plantar fasciitis occurs because the plantar fascial ligament is excessively stretched beyond its normal extension point causing small tears of the ligament fibers, especially where the ligament connects to the heel bone. In other words, when your foot over pronates and the arch drops in the running position, the foot is unstable. During the critical time of running, the plantar fascia ligament, which is connected to the heel bone, is over stretched and is torn. This over stretching causes tears and the severe pain and swelling.
The cause of heel pain from running is due to abnormal motion called excessive pronation. Excessive pronation is when too much lowering of the arch occurs. During the long distance running or walking activity, the foot strikes the ground on the heel, then the foot rolls forward toward the ground. If the arch then drops due to abnormal foot biomechanics, then your foot is overpronating. The abnormal motion of the heel and arch often causes the pain, inflammation, and burning sensation under the arch.
TREATMENT for Plantar Fasciitis
Icing
Stretching before getting out of bed in am and before activity, including walking
Night splints, worn to bed and during inactivity, ie watching TV, reading, cruising the internet and checking out www.LyonFootandAnkleClinic.net
Decreasing running and incorporating weight lifting, swimming, biking into routine until heel pain subsides
Wearing Custom Orthotics from Lyon Foot and Ankle Clinic, PC
If severe pain and not resolving, cryoablation may be the best to get you on track again, refer to blig posts below for more info on cryoablation
Plantar Fascial Release is last resort surgical procedure, yet is great procedure for the severe cases of plantar fasciitis.
Questions, schedule an appointment with Dr Esther Lyon, DPM (630) 495-1240.
Sunday, March 6, 2011
Sever's Disease: A Common Cause of Heel Pain in Children
What is Sever's disease?
Sever's disease occurs in children when the growth plate (which is the growing part of the heel) is injured. 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 can injure the heel and cause Sever's disease.
When is my child most at risk for Sever's disease?
Your child is most at risk for this condition when he or she is in the early part of the growth spurt in early puberty. Sever's disease is most common in physically active girls 8 years to 10 years of age and in physically active boys 10 years to 12 years of age. Soccer players and gymnasts often get Sever's disease, but children who do any running or jumping activity may also be at an increased risk. Sever's disease rarely occurs in older teenagers because the back of the heel has typically finished growing by 15 years of age.
How do I know if my child's heel pain is caused by Sever's disease?
In Sever's disease, heel pain can be in one or both heels. It usually starts after a child begins a new sports season or a new sport. Your child may walk with a limp. The pain may increase when he or she runs or jumps. He or she may have a tendency to tiptoe. Your child's heel may hurt if you squeeze both sides toward the very back. This is called the squeeze test. Your doctor may also find that your child's heel tendons have become tight.
How is Sever's disease treated?
First, your child should cut down or stop any activity that causes heel pain. Apply ice to the injured heel for 20 minutes 3 times a day. If your child has a high arch, flat feet or bowed legs, your doctor may recommend orthotics, arch supports or heel cups. Your child should never go barefoot.
If your child has severe heel pain, medicines such as acetaminophen (one brand name: Tylenol) or ibuprofen (some brand names: Advil, Motrin, Nuprin) may help
Will stretching exercises help?
Yes, stretching exercises can help. It is important that your child performs exercises to stretch the hamstring and calf muscles, and the tendons on the back of the leg (see pictures 1, 2 and 3). The child should do these stretches 2 or 3 times a day. Each stretch should be held for about 20 seconds. Both legs should be stretched, even if the pain is only in 1 heel.
Your child also needs to do exercises to strengthen the muscles on the front of the shin (see picture 4). To do this, your child should sit on the floor, keeping his or her hurt leg straight. One end of a bungee cord or piece of rubber tubing is hooked around a table leg. The other end is hitched around the child's toes. The child then scoots back just far enough to stretch the cord. Next, the child slowly bends the foot toward his or her body. When the child cannot bend the foot any closer, he or she slowly points the foot in the opposite direction (toward the table). This exercise (15 repetitions of "foot curling") should be done about 3 times. The child should do this exercise routine a few times daily.
2.Hamstring stretch.
1. Heel cord (Achilles tendon) stretch.
Are there any problems linked with Sever's disease?When can my child play sports again?
With proper care, your child should feel better within 2 weeks to 2 months. Your child can start playing sports again only when the heel pain is gone. Your doctor will let you know when physical activity is safe.
No long-term problems have been linked with Sever's disease. However, call your doctor if your child's heel pain does not get better with treatment, gets worse or if you notice changes in skin color or swelling.
Can Sever's disease be prevented?
Sever's disease may be prevented by supporting the foot structure with orthotics from Lyon Foot & Ankle Clinic, PC and maintaining good flexibility while your child is growing. The stretching exercises pictured here can lower your child's risk for injuries during the growth spurt. Physical therapy may also be required if the tissue structures are too inflamed. Good-quality shoes with firm support and a shock-absorbent sole will help. Your child should avoid excessive running on hard surfaces until condition is under control.
If your child has already recovered from Sever's disease, orthotics, stretching and putting ice on the heel after activity will help keep your child from developing this condition again.
Lyon Foot & Ankle Clinic, PC. www.LyonFootandAnkleClinic.net
Call Today to Schedule an appointment: (630) 495-1240.
--Heel Pain
--Ankle Pain
--Bunions.
--Calluses
--Ingrown Nails
--Fungal Nails
--Old Ankle Injuries
--Ball of Foot Pain.
What is Sever's disease?
Sever's disease occurs in children when the growth plate (which is the growing part of the heel) is injured. 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 can injure the heel and cause Sever's disease.
When is my child most at risk for Sever's disease?
Your child is most at risk for this condition when he or she is in the early part of the growth spurt in early puberty. Sever's disease is most common in physically active girls 8 years to 10 years of age and in physically active boys 10 years to 12 years of age. Soccer players and gymnasts often get Sever's disease, but children who do any running or jumping activity may also be at an increased risk. Sever's disease rarely occurs in older teenagers because the back of the heel has typically finished growing by 15 years of age.
How do I know if my child's heel pain is caused by Sever's disease?
In Sever's disease, heel pain can be in one or both heels. It usually starts after a child begins a new sports season or a new sport. Your child may walk with a limp. The pain may increase when he or she runs or jumps. He or she may have a tendency to tiptoe. Your child's heel may hurt if you squeeze both sides toward the very back. This is called the squeeze test. Your doctor may also find that your child's heel tendons have become tight.
How is Sever's disease treated?
First, your child should cut down or stop any activity that causes heel pain. Apply ice to the injured heel for 20 minutes 3 times a day. If your child has a high arch, flat feet or bowed legs, your doctor may recommend orthotics, arch supports or heel cups. Your child should never go barefoot.
If your child has severe heel pain, medicines such as acetaminophen (one brand name: Tylenol) or ibuprofen (some brand names: Advil, Motrin, Nuprin) may help
Will stretching exercises help?
Yes, stretching exercises can help. It is important that your child performs exercises to stretch the hamstring and calf muscles, and the tendons on the back of the leg (see pictures 1, 2 and 3). The child should do these stretches 2 or 3 times a day. Each stretch should be held for about 20 seconds. Both legs should be stretched, even if the pain is only in 1 heel.
Your child also needs to do exercises to strengthen the muscles on the front of the shin (see picture 4). To do this, your child should sit on the floor, keeping his or her hurt leg straight. One end of a bungee cord or piece of rubber tubing is hooked around a table leg. The other end is hitched around the child's toes. The child then scoots back just far enough to stretch the cord. Next, the child slowly bends the foot toward his or her body. When the child cannot bend the foot any closer, he or she slowly points the foot in the opposite direction (toward the table). This exercise (15 repetitions of "foot curling") should be done about 3 times. The child should do this exercise routine a few times daily.
2.Hamstring stretch.
1. Heel cord (Achilles tendon) stretch.
Are there any problems linked with Sever's disease?When can my child play sports again?
With proper care, your child should feel better within 2 weeks to 2 months. Your child can start playing sports again only when the heel pain is gone. Your doctor will let you know when physical activity is safe.
No long-term problems have been linked with Sever's disease. However, call your doctor if your child's heel pain does not get better with treatment, gets worse or if you notice changes in skin color or swelling.
Can Sever's disease be prevented?
Sever's disease may be prevented by supporting the foot structure with orthotics from Lyon Foot & Ankle Clinic, PC and maintaining good flexibility while your child is growing. The stretching exercises pictured here can lower your child's risk for injuries during the growth spurt. Physical therapy may also be required if the tissue structures are too inflamed. Good-quality shoes with firm support and a shock-absorbent sole will help. Your child should avoid excessive running on hard surfaces until condition is under control.
If your child has already recovered from Sever's disease, orthotics, stretching and putting ice on the heel after activity will help keep your child from developing this condition again.
Lyon Foot & Ankle Clinic, PC. www.LyonFootandAnkleClinic.net
Call Today to Schedule an appointment: (630) 495-1240.
--Heel Pain
--Ankle Pain
--Bunions.
--Calluses
--Ingrown Nails
--Fungal Nails
--Old Ankle Injuries
--Ball of Foot Pain.
Tuesday, March 1, 2011
HEEL PAIN
Plantar Fasciitis is the most common painful foot condition that causes heel pain. Plantar Fasciitis is due to irritation and inflammation of the ligament that forms the arch of the foot.
What is PLANTAR FASCIITIS?
Plantar Fasciitis is an inflammation of the plantar fascial ligament that starts at the heel and goes along the bottom of the foot. It attaches to each of the bones that form the ball of the foot. The Plantar Fascia works like a rubber band between the heel and the ball of the foot to form the arch of the foot. A pad of fat in the heel covers the Plantar Fascia to help absorb the shock of walking. Damage to the Plantar Fascia can be a cause of heel pain.
What causes the heel pain?
As a person gets older the plantar Fascia becomes less like a rubber band and more like a rope that does not stretch very well. The fat pad on the heel becomes thinner and can’t absorb as much of the shock caused by walking and being active. The extra shock damages the Plantar Fascia and may cause it to swell, tear, or bruise. You may even notice swelling and or bruising on the heel.
How will I know if my pain is caused by Plantar Fasciitis?
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 pin sticking into the bottom of the foot or heel. After you have been standing for a while, the pain becomes more a dull ache. If you sit down for any length of time, the sharp pain will come back when you stand up again. Examination by Dr. Esther Lyon, DPM will confirm the diagnosis and then treatment can begin.
What can I do about the Heel Pain?
Custom made orthotics prescribed by your podiatrist
Cut back on walking or running
If you are overweight, losing weight can help lessen the pain
If you job involves standing on a hard surface, place some type of padding on the floor where you stand
Avoid flat shoes and bare feet
Stretching exercises for the feet are important. (Ask the doctor for stretching exercises)
Physical Therapy
What if your feet still hurt after taking these measures?
If your pain is severe and or conservative care is not sufficient Dr. Lyon can suggest other treatments.
Dr. Esther Lyon, DPM is a heel pain specialist and who typically uses a less invasive option called Cryo-surgery to treat chronic and or severe heel pain. Dr. Esther Lyon, DPM is one of the leading Cryo-surgeons of the foot and ankle.
What is Cryo-surgery?
Cryo-surgery is a minimally invasive procedure, and is often preferred to more than traditional kinds of surgery because Cryo-surgery has minimal pain, scaring, and down time. In most cases where cryo-surgery is used to treat heel pain, the results are usually permanent relief.
Dr. Esther Lyon, DPM is one of the few heel pain specialists nationwide performing the Cryo-surgery procedure for pain relief of the foot, ankle, and heel. Foot Cryo-surgery is a procedure utilizing controlled cooling temperatures. The cryo surgical procedure creates a nerve block by stopping the pain of tiny sensory nerve tissue.
Foot, ankle, and or heel Cryo-surgery indications:
-Heel Pain
-Neuromas
-Arthritis heel pain
-Neuropathy
-Plantar Fibroma
-General foot, ankle, or heel pain
Advantages to foot, ankle, or heel Cryo-surgery:
-Minimally invasive procedure
-Walking the day of procedure
-Minimal down time from work/activities
Call Today to schedule an appointment
Lyon Foot & Ankle Clinic, PC
www.LyonFootandAnkleClinic.net
Plantar Fasciitis is the most common painful foot condition that causes heel pain. Plantar Fasciitis is due to irritation and inflammation of the ligament that forms the arch of the foot.
What is PLANTAR FASCIITIS?
Plantar Fasciitis is an inflammation of the plantar fascial ligament that starts at the heel and goes along the bottom of the foot. It attaches to each of the bones that form the ball of the foot. The Plantar Fascia works like a rubber band between the heel and the ball of the foot to form the arch of the foot. A pad of fat in the heel covers the Plantar Fascia to help absorb the shock of walking. Damage to the Plantar Fascia can be a cause of heel pain.
What causes the heel pain?
As a person gets older the plantar Fascia becomes less like a rubber band and more like a rope that does not stretch very well. The fat pad on the heel becomes thinner and can’t absorb as much of the shock caused by walking and being active. The extra shock damages the Plantar Fascia and may cause it to swell, tear, or bruise. You may even notice swelling and or bruising on the heel.
How will I know if my pain is caused by Plantar Fasciitis?
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 pin sticking into the bottom of the foot or heel. After you have been standing for a while, the pain becomes more a dull ache. If you sit down for any length of time, the sharp pain will come back when you stand up again. Examination by Dr. Esther Lyon, DPM will confirm the diagnosis and then treatment can begin.
What can I do about the Heel Pain?
Custom made orthotics prescribed by your podiatrist
Cut back on walking or running
If you are overweight, losing weight can help lessen the pain
If you job involves standing on a hard surface, place some type of padding on the floor where you stand
Avoid flat shoes and bare feet
Stretching exercises for the feet are important. (Ask the doctor for stretching exercises)
Physical Therapy
What if your feet still hurt after taking these measures?
If your pain is severe and or conservative care is not sufficient Dr. Lyon can suggest other treatments.
Dr. Esther Lyon, DPM is a heel pain specialist and who typically uses a less invasive option called Cryo-surgery to treat chronic and or severe heel pain. Dr. Esther Lyon, DPM is one of the leading Cryo-surgeons of the foot and ankle.
What is Cryo-surgery?
Cryo-surgery is a minimally invasive procedure, and is often preferred to more than traditional kinds of surgery because Cryo-surgery has minimal pain, scaring, and down time. In most cases where cryo-surgery is used to treat heel pain, the results are usually permanent relief.
Dr. Esther Lyon, DPM is one of the few heel pain specialists nationwide performing the Cryo-surgery procedure for pain relief of the foot, ankle, and heel. Foot Cryo-surgery is a procedure utilizing controlled cooling temperatures. The cryo surgical procedure creates a nerve block by stopping the pain of tiny sensory nerve tissue.
Foot, ankle, and or heel Cryo-surgery indications:
-Heel Pain
-Neuromas
-Arthritis heel pain
-Neuropathy
-Plantar Fibroma
-General foot, ankle, or heel pain
Advantages to foot, ankle, or heel Cryo-surgery:
-Minimally invasive procedure
-Walking the day of procedure
-Minimal down time from work/activities
Call Today to schedule an appointment
Lyon Foot & Ankle Clinic, PC
www.LyonFootandAnkleClinic.net
Tuesday, February 8, 2011
Cryosurgery for Heel Pain
Cryosurgery
For more information about Cryosurgery, call Lyon Foot & Ankle Clinic, P.C. at (630)495-1240 for an appointment.
What is Cryosurgery?
Cryosurgery is the specialized field of using extremely low temperatures to destroy pathological tissues. Cryosurgery is not a new concept in the elimination of pain. Hippocrates recognized the analgesic and anti inflammatory of ice on injuries in the year 430BC. In the past few decades, cryo-technology has been used in the treatment of malignant tumors of the prostrate, liver and other organs. Moreover, cryosurgery is gaining acceptance in dermatology, plastic surgery, urology, pain management and podiatry.
The application of cryo-technology in podiatry has been increasing since it first became approved by the FDA in late 2003. Common foot conditions that can be treated with cryosurgery are plantar fasciitis, infracalcaneal bursitis, neuromas, neuritis, and plantar fibromas.
How Does Cryosurgery Work?
Cryoanalgesia or cryoablation as it is also called is a minimally invasive procedure that uses extremely cold temperatures to selectively destroy nerve endings. Nitrous oxide if forced under pressure between 600 and 800 psig between the inner and outer tubes of the cryoprobe. The gas is released through a small opening into the chamber at the tip of the probe . As the pressurized gas is released into the chamber it expands and results in a rapid drop in temperature. This is referred to as the Joule- Thompson effect and results in an ice ball forming at the uninsulated tip of the probe. The temperature can reach -70C and the size of the ice ball can range from 3.5mm to 10 mm depending on the amount of the tube that is uninsulated. This is a closed system therefore no gas escapes from the system.
What is a Typical Cryosurgical Procedure?
When performing cryosurgery it is extremely important to identify the area or areas of greatest pain. This becomes the target point for the cryoprobe. The area is injected with local anesthesia. A 3mm percutaneous incision is made and a trocar is inserted to separate tissue. Afterwhich, the cryoprobe is inserted and depending on the foot pathology the area is treated with 2 cycles of 2-3 minutes with a defrost cycle of 30 seconds in between.
What Happens After Surgery?
Activity should be reduced for about three days. The bandage is changed the next day by the patient. The patient puts on bacitracin ointment and a new bandage. The incision heals in 3-4 days. A patient may take an oral anti-inflammatory for 3-4 days postoperatively if needed.
When is Cryosurgery of the Foot Needed?
Cryosurgery is used when previous treatments such as non steroidal anti inflammatory medications, orthotics, night splints, physical therapy and injection therapy have failed. Our patient a 56 year old male presented with chief complaint of right heel pain on and off for 10 years. The patient had tried all of the above with lessening of symptoms but no resolution of symptoms. The patient described his pain as 9 out of 10 with 0 being no pain and 10 being the worst amount of pain. We performed cryosurgery on his right heel. One week after surgery the patient had a pain level 4 out 10. On the patient’s next visit the patient reported pain of 1/10. Six weeks after the procedure the patient was completely asymptomatic.
Overall, cryosurgery is an effective procedure where conservative methods have failed. The procedure is minimally invasive with a very short postoperative course.
For more information about Cryosurgery, call Lyon Foot & Ankle Clinic, P.C. at (630)495-1240 for an appointment.
What is Cryosurgery?
Cryosurgery is the specialized field of using extremely low temperatures to destroy pathological tissues. Cryosurgery is not a new concept in the elimination of pain. Hippocrates recognized the analgesic and anti inflammatory of ice on injuries in the year 430BC. In the past few decades, cryo-technology has been used in the treatment of malignant tumors of the prostrate, liver and other organs. Moreover, cryosurgery is gaining acceptance in dermatology, plastic surgery, urology, pain management and podiatry.
The application of cryo-technology in podiatry has been increasing since it first became approved by the FDA in late 2003. Common foot conditions that can be treated with cryosurgery are plantar fasciitis, infracalcaneal bursitis, neuromas, neuritis, and plantar fibromas.
How Does Cryosurgery Work?
Cryoanalgesia or cryoablation as it is also called is a minimally invasive procedure that uses extremely cold temperatures to selectively destroy nerve endings. Nitrous oxide if forced under pressure between 600 and 800 psig between the inner and outer tubes of the cryoprobe. The gas is released through a small opening into the chamber at the tip of the probe . As the pressurized gas is released into the chamber it expands and results in a rapid drop in temperature. This is referred to as the Joule- Thompson effect and results in an ice ball forming at the uninsulated tip of the probe. The temperature can reach -70C and the size of the ice ball can range from 3.5mm to 10 mm depending on the amount of the tube that is uninsulated. This is a closed system therefore no gas escapes from the system.
What is a Typical Cryosurgical Procedure?
When performing cryosurgery it is extremely important to identify the area or areas of greatest pain. This becomes the target point for the cryoprobe. The area is injected with local anesthesia. A 3mm percutaneous incision is made and a trocar is inserted to separate tissue. Afterwhich, the cryoprobe is inserted and depending on the foot pathology the area is treated with 2 cycles of 2-3 minutes with a defrost cycle of 30 seconds in between.
What Happens After Surgery?
Activity should be reduced for about three days. The bandage is changed the next day by the patient. The patient puts on bacitracin ointment and a new bandage. The incision heals in 3-4 days. A patient may take an oral anti-inflammatory for 3-4 days postoperatively if needed.
When is Cryosurgery of the Foot Needed?
Cryosurgery is used when previous treatments such as non steroidal anti inflammatory medications, orthotics, night splints, physical therapy and injection therapy have failed. Our patient a 56 year old male presented with chief complaint of right heel pain on and off for 10 years. The patient had tried all of the above with lessening of symptoms but no resolution of symptoms. The patient described his pain as 9 out of 10 with 0 being no pain and 10 being the worst amount of pain. We performed cryosurgery on his right heel. One week after surgery the patient had a pain level 4 out 10. On the patient’s next visit the patient reported pain of 1/10. Six weeks after the procedure the patient was completely asymptomatic.
Overall, cryosurgery is an effective procedure where conservative methods have failed. The procedure is minimally invasive with a very short postoperative course.
Wednesday, December 24, 2008
HEEL BONE PAIN AND HEEL PAIN CAUSES. HEEL PAIN TREATMENTS, HEEL PAIN EXERCISES FOR HEEL PAIN IN MORNING AND AFTER REST. Plantar Fasciitis the Cause?
By Dr. Esther Lyon D.P.M.
Heel pain causes many patients to needlessly limp for months. Effective heel pain treatments are available for heel pain, commonly referred to as plantar fasciitis.
Heel pain in the morning? How about heel bone pain when you stand after sitting or resting for a few minutes? More people needlessly suffer from heel pain than any other foot ailment. Fortunately, much can be done to alleviate this heel pain. Patients often have heel pain first thing in the morning or after getting up to stand after sitting. The heel pain can be a sharp, searing pain or present as a tearing feeling in the bottom of the heel. As the condition progresses there may be a throbbing pain after getting off your feet or a soreness that radiates up the back of the leg or arch of the foot.
To understand the cause of the heel pain one must understand the anatomy of the foot, the heel bone, the ligament structure and some basic mechanics in the function of the foot. A thick ligament, called the plantar fascial ligament helps form the arch of the foot. The plantar fascial ligament attaches from the heel bone to the ball of the foot, providing the supportive architecture for our feet.
The plantar fascial ligament is made of dense, fibrous connective tissue that will stretch very little. It act something like a shock absorber. As the foot impacts the ground with each step, it flattens out lengthening the foot. This action pulls on the plantar fascia, which stretches slightly. When the heel comes off the ground during walking or running the tension on the ligament is released.
Anything that causes the foot to flatten excessively will cause the plantar fascia to stretch greater than it is accustomed to doing. One consequence of this is the development of small tears where the ligament attaches to the heel bone. As the foot overpronates during walking the excessive tension on the plantar fascial ligament causes tears from its attachment into the heel bone.
Excessive flattening of the arch is termed pronation. If there is excessive pronation of the foot during walking or standing, the plantar fascial ligament is strained. Over time, this will cause a weakening of the ligament where it attaches into the heel bone, causing pain. When a person is at rest and off their feet, the plantar fascial ligament attempt to mend itself. Then, with the first few steps the ligament re-tears, causing pain. A cycle of pain is begun. If you find yourself with this cycle of pain, it is time to have it addressed. Chronic inflammation of the heel may result if this condition goes untreated.
Diagnosis
The diagnosis of heel pain is made by a thorough history of the course of the condition and by a physical examination. Weight bearing x-rays are useful in determining if a spur is present and to rule out rare causes of heel pain such as a stress fracture of the heel bone, the presence of bone tumors. A sonogram is utilized to look at the soft tissue structures around the heel and measures the inflamed tissues.
Treatment
A newer treatment called cryoablation has assisted many patients with heel pain. These procedures allow the patient able to walk the same day.
If your heel pain has become too much to bare, it is time to take a closer look. The good news is that heel pain can often be relieved quickly and with little discomfort to get patients back on their feet. Foot and ankle pain is our specialty.
Dr. Esther Lyon is a Board Certified Podiatrist by the American Board of Podiatric Surgery. She practices in the Western Suburbs of Chicago, Illinois. The four offices are located in Lombard, Warrenville, Wood Dale, and Elgin. Dr. Lyon and her staff are well known for their expertise and kindness. Caring about patients is priority number one.
Dr. Esther Lyon treats foot and ankle pain, with heel pain being the most common ailment treated. We treat patients in the Western Suburbs of Chicago including Glen Ellyn, Wheaton, Addison, Bartlett, West Chicago, Naperville, Aurora, North Aurora, South Elgin, Schaumburg, Elk Grove Village, Elmhurst, Downers Grove, Westmont and Carol Stream.
CALL LYON FOOT & ANKLE CLINIC AND SCHEDULE AN APPOINTMENT TODAY: (630) 495-1240.
Heel pain causes many patients to needlessly limp for months. Effective heel pain treatments are available for heel pain, commonly referred to as plantar fasciitis.
Heel pain in the morning? How about heel bone pain when you stand after sitting or resting for a few minutes? More people needlessly suffer from heel pain than any other foot ailment. Fortunately, much can be done to alleviate this heel pain. Patients often have heel pain first thing in the morning or after getting up to stand after sitting. The heel pain can be a sharp, searing pain or present as a tearing feeling in the bottom of the heel. As the condition progresses there may be a throbbing pain after getting off your feet or a soreness that radiates up the back of the leg or arch of the foot.
To understand the cause of the heel pain one must understand the anatomy of the foot, the heel bone, the ligament structure and some basic mechanics in the function of the foot. A thick ligament, called the plantar fascial ligament helps form the arch of the foot. The plantar fascial ligament attaches from the heel bone to the ball of the foot, providing the supportive architecture for our feet.
The plantar fascial ligament is made of dense, fibrous connective tissue that will stretch very little. It act something like a shock absorber. As the foot impacts the ground with each step, it flattens out lengthening the foot. This action pulls on the plantar fascia, which stretches slightly. When the heel comes off the ground during walking or running the tension on the ligament is released.
Anything that causes the foot to flatten excessively will cause the plantar fascia to stretch greater than it is accustomed to doing. One consequence of this is the development of small tears where the ligament attaches to the heel bone. As the foot overpronates during walking the excessive tension on the plantar fascial ligament causes tears from its attachment into the heel bone.
Excessive flattening of the arch is termed pronation. If there is excessive pronation of the foot during walking or standing, the plantar fascial ligament is strained. Over time, this will cause a weakening of the ligament where it attaches into the heel bone, causing pain. When a person is at rest and off their feet, the plantar fascial ligament attempt to mend itself. Then, with the first few steps the ligament re-tears, causing pain. A cycle of pain is begun. If you find yourself with this cycle of pain, it is time to have it addressed. Chronic inflammation of the heel may result if this condition goes untreated.
Diagnosis
The diagnosis of heel pain is made by a thorough history of the course of the condition and by a physical examination. Weight bearing x-rays are useful in determining if a spur is present and to rule out rare causes of heel pain such as a stress fracture of the heel bone, the presence of bone tumors. A sonogram is utilized to look at the soft tissue structures around the heel and measures the inflamed tissues.
Treatment
A newer treatment called cryoablation has assisted many patients with heel pain. These procedures allow the patient able to walk the same day.
If your heel pain has become too much to bare, it is time to take a closer look. The good news is that heel pain can often be relieved quickly and with little discomfort to get patients back on their feet. Foot and ankle pain is our specialty.
Dr. Esther Lyon is a Board Certified Podiatrist by the American Board of Podiatric Surgery. She practices in the Western Suburbs of Chicago, Illinois. The four offices are located in Lombard, Warrenville, Wood Dale, and Elgin. Dr. Lyon and her staff are well known for their expertise and kindness. Caring about patients is priority number one.
Dr. Esther Lyon treats foot and ankle pain, with heel pain being the most common ailment treated. We treat patients in the Western Suburbs of Chicago including Glen Ellyn, Wheaton, Addison, Bartlett, West Chicago, Naperville, Aurora, North Aurora, South Elgin, Schaumburg, Elk Grove Village, Elmhurst, Downers Grove, Westmont and Carol Stream.
CALL LYON FOOT & ANKLE CLINIC AND SCHEDULE AN APPOINTMENT TODAY: (630) 495-1240.
Relieving Heel Pain with Cryoablation
BioMechanics: Nerve Entrapment Puts The Pinch On Heel Pain
Evaluating patients for nerve problems aids practitioners in treatment decision making
By Gregory Mowen, DPM
Heel pain has been one of the most common presenting complaints that podiatrists, orthopedists, and sports medicine specialists encounter. It is conservatively estimated that two million patients in the U.S. seek treatment annually for heel pain.
Patients have a variety of conservative treatment options, including nonsteroidal anti-inflammatory drugs, physical therapy, cortisone injections, orthoses, and night splints to relieve their heel pain. When these conservative options fail, practitioners often turn to alternative treatments.
Many practitioners do not evaluate their patients with heel pain for nerve entrapment. Those who do test will often first rule out all other factors. Another frequent delay in testing for nerve entrapment is that symptoms may not always be consistent. A Tinel's sign (distally radiating paresthesia in response to gentle percussion) may not always be present as expected in nerve entrapment syndromes.
Pressure-specified sensory testing
A relatively new method for determining peripheral nerve involvement in the upper and lower extremity is pressure-specified sensory testing. The Pressure-Specified Sensory Device (Sensory Management Services, Baltimore), invented by A. Lee Dellon, MD, a pioneer in diagnosing and treating peripheral nerve problems, is noninvasive. It can measure light touch, two-point discrimination, and one- and two-point moving pressure thresholds. Normal levels are preloaded in the system's software and then used for comparison. Diagnosing peripheral nerve problems with PSSD has shown high rates of clinical accuracy.
In a study of 82 patients, Rose et al used pressure-specified sensory testing to evaluate patients presenting with typical plantar fasciitis pain. They concluded that 72.17% of the patients had abnormal sensory function around the heel.
In a sensory testing study, other traditional tests were compared with PSSD and were found to be far less reliable and less sensitive. Using PSSD to identify a peripheral nerve problem was 100% accurate; Semmes-Weinstein monofilaments were only 63% accurate; and vibrometry achieved only 30% accuracy.
Testing each peripheral nerve in the lower extremity for pressure threshold and for two-point discrimination is advised. The results can then help determine a more effective course of treatment. For instance, if there is no neural involvement, then chronic fasciosis should be addressed.
Cryosurgery
If there is isolated nerve entrapment of the MCN (nerve on the inside of the heel) and conservative care fails, then either open decompression of that nerve, endoscopic decompression,or cryoablation would be appropriate. We prefer to use cryosurgery to ablate the terminal branches of that nerve. Cryosurgery is a minimally invasive office procedure that has shown success rates of about 90% among chronic plantar heel pain patients.Typical care for fasciitis/fasciosis may still be needed because of the multiple factors often involved with heel pain.
Most of the common complications associated with an open procedure are not seen in cryosurgery. Typically, after this procedure, the overwhelming majority of patients have less pain and a shorter healing time; they can engage in their activities of daily living immediately. Cryosurgery also can be easily repeated if the patient doesn't achieve complete relief.
Conclusion
Nerve entrapment plays a common role in most heel pain patients. It appears that an incredibly high percentage of people with plantar heel pain may also have nerve entrapments. We need to look for nerve entrapment in these patients much earlier in our evaluations. Knowing more of the factors involved with the patient's pain can lead to more effective treatments.
__________________________________________________________________
__________________________________________________________________
Dr. Esther Lyon D.P.M. is a Board Certified Podiatrist who practices in the Western suburbs of Chicago, Illinois. Heel pain is the most common foot ailment she treats at her offices in Lombard, Warrenville, Wood Dale and Elgin. Cryoablation has been an extremely effective treatment modality in helping patients with foot and heel pain. To schedule an appointment, call (630) 495-1240. We care about our patients.
Suburbs adjacent to Western Suburb locations, include: Glen Ellyn, Wheaton, Elk Grove Village, Schaumburg, Addison, Downers Grove, Elmhurst, Naperville, Aurora, North Aurora, West Chicago, Batavia, South Elgin, Bartlett.
Dr. Lyon D.P.M. started her practice in Lombard in 1997 and is a Board Certified Podiatrist by the American Board of Podiatric Surgery.
Evaluating patients for nerve problems aids practitioners in treatment decision making
By Gregory Mowen, DPM
Heel pain has been one of the most common presenting complaints that podiatrists, orthopedists, and sports medicine specialists encounter. It is conservatively estimated that two million patients in the U.S. seek treatment annually for heel pain.
Patients have a variety of conservative treatment options, including nonsteroidal anti-inflammatory drugs, physical therapy, cortisone injections, orthoses, and night splints to relieve their heel pain. When these conservative options fail, practitioners often turn to alternative treatments.
Many practitioners do not evaluate their patients with heel pain for nerve entrapment. Those who do test will often first rule out all other factors. Another frequent delay in testing for nerve entrapment is that symptoms may not always be consistent. A Tinel's sign (distally radiating paresthesia in response to gentle percussion) may not always be present as expected in nerve entrapment syndromes.
Pressure-specified sensory testing
A relatively new method for determining peripheral nerve involvement in the upper and lower extremity is pressure-specified sensory testing. The Pressure-Specified Sensory Device (Sensory Management Services, Baltimore), invented by A. Lee Dellon, MD, a pioneer in diagnosing and treating peripheral nerve problems, is noninvasive. It can measure light touch, two-point discrimination, and one- and two-point moving pressure thresholds. Normal levels are preloaded in the system's software and then used for comparison. Diagnosing peripheral nerve problems with PSSD has shown high rates of clinical accuracy.
In a study of 82 patients, Rose et al used pressure-specified sensory testing to evaluate patients presenting with typical plantar fasciitis pain. They concluded that 72.17% of the patients had abnormal sensory function around the heel.
In a sensory testing study, other traditional tests were compared with PSSD and were found to be far less reliable and less sensitive. Using PSSD to identify a peripheral nerve problem was 100% accurate; Semmes-Weinstein monofilaments were only 63% accurate; and vibrometry achieved only 30% accuracy.
Testing each peripheral nerve in the lower extremity for pressure threshold and for two-point discrimination is advised. The results can then help determine a more effective course of treatment. For instance, if there is no neural involvement, then chronic fasciosis should be addressed.
Cryosurgery
If there is isolated nerve entrapment of the MCN (nerve on the inside of the heel) and conservative care fails, then either open decompression of that nerve, endoscopic decompression,or cryoablation would be appropriate. We prefer to use cryosurgery to ablate the terminal branches of that nerve. Cryosurgery is a minimally invasive office procedure that has shown success rates of about 90% among chronic plantar heel pain patients.Typical care for fasciitis/fasciosis may still be needed because of the multiple factors often involved with heel pain.
Most of the common complications associated with an open procedure are not seen in cryosurgery. Typically, after this procedure, the overwhelming majority of patients have less pain and a shorter healing time; they can engage in their activities of daily living immediately. Cryosurgery also can be easily repeated if the patient doesn't achieve complete relief.
Conclusion
Nerve entrapment plays a common role in most heel pain patients. It appears that an incredibly high percentage of people with plantar heel pain may also have nerve entrapments. We need to look for nerve entrapment in these patients much earlier in our evaluations. Knowing more of the factors involved with the patient's pain can lead to more effective treatments.
__________________________________________________________________
__________________________________________________________________
Dr. Esther Lyon D.P.M. is a Board Certified Podiatrist who practices in the Western suburbs of Chicago, Illinois. Heel pain is the most common foot ailment she treats at her offices in Lombard, Warrenville, Wood Dale and Elgin. Cryoablation has been an extremely effective treatment modality in helping patients with foot and heel pain. To schedule an appointment, call (630) 495-1240. We care about our patients.
Suburbs adjacent to Western Suburb locations, include: Glen Ellyn, Wheaton, Elk Grove Village, Schaumburg, Addison, Downers Grove, Elmhurst, Naperville, Aurora, North Aurora, West Chicago, Batavia, South Elgin, Bartlett.
Dr. Lyon D.P.M. started her practice in Lombard in 1997 and is a Board Certified Podiatrist by the American Board of Podiatric Surgery.
Subscribe to:
Posts (Atom)
