• Healthy Living Series, video #3 of 4: Plantar Fasciitis

    by Dr. Don Pelto
    on Sep 18th, 2017

Here is Dr Pelto's Healthy Living Video series #3 of 4. This video is about plantar fasciitis. 

If you would like a free 14 day course on heel pain I send to my patients just click below.

14 Day Heel Pain Mini-Course

 

Transcript Below

Hello and welcome to healthy living I'm
Dr. Donald Pelto I'm a foot doctor in
Massachusetts and I'm answering
some of the common questions I get every
summer for my patients about their feet
the first question is how can I get rid
of my heel pain to start out I want to
explain a little bit about what heel
pain is heel pain has another name
that's kind of complex
it's called plantar fasciitis now what
is the plantar fascia the plantar fascia
is a ligament that goes from the ball of
the foot all the way to the heel it's
about this thick and it's a secondary
support structure of the foot well
meaning secondary because it's not
really supposed to bear your weight
what's the primary support structure
well those are the bones tendons and
muscles and ligaments that are in your
foot so if the bones aren't doing their
job or if the tendons aren't doing their
jobs then what happens is the plantar
fascia has to take care of all of the
the weight-bearing and taking away all
the pressure on the foot this area tends
to get inflamed it gets painful the most
common problem that people have is pain
when they get out of bed in the morning
so imagine if you get out of bed in the
morning and you're starting to limp
around as you go to the bathroom you
probably have plantar fasciitis also if
you sit down at work for about an hour
or two and then you get up and it starts
to hurt you probably have plantar
fasciitis but you may ask don't I just
have a heel spur well here's a picture
of a heel spur you can see the large
spur that's in the bottom of the heel
the spur usually isn't the problem in
the past we used to remove the heel spur
surgically we used to go in there make
an incision and rasp off some of the
bone thinking that that would resolve
the problem sometimes it did but many
times it didn't that spur is actually
caused because of the tight pressure and
pull from the plantar fashion if you
pull in a bone long enough it's going to
develop a spur in that direction and one
of the areas is on the bottom of the
heel so how do you treat plantar
fasciitis
once you determine what you have then
you have to do three things you have to
reduce the inflammation you have to
reduce the tightness and you have to
stabilize the foot so let's first talk
about reducing the inflammation
inflammation is the pain that you feel
when you get up in the morning
inflammation is the pain that you have
on one foot and not the other the
inflammation has to get calmed down and
before you see a doctor you've probably
taken anti-inflammatories you've
probably iced the area and some people
even take a bottle of water put it in
the freezer and roll it on the bottom of
the foot that's all fine but your paint
your foot still hurts by the time you
come to the doctor's office we actually
take something we inject a steroid in
there called cortisone now you may think
steroids are dangerous well it's not
that type of a steroid a steroid you can
use it up to three times in the bottom
of the heel and that's going to reduce
the inflammation because right now your
foot is stopped is stuck in a chronic
pain cycle you get up in the morning and
it hurts you start to walk and things
loosen up and it feels better but then
when you sit down and get up again it
hurts and you have to use the cortisone
to reduce that inflammation the second
type of treatment is to reduce the
tightness on the bottom of the heel
before you come to see the doctor you've
probably tried the runner stretch where
you push against the wall you may have
tried going off the side of a step and
loosening up the Achilles all those are
good but by the time someone comes to
the doctor you probably need some
physical therapy and there are some
special tools you can use in this
picture you're going to see a foam
roller and also something called trigger
point tools both of these are guided
towards reducing the tightness in the
back of the calf they can be very
helpful and there's also one of the
technique called the grasped and
technique and that's used by the
physical therapist that's actually where
they take a hard piece of metal and they
rub it down the back of the Achilles
tendon to reduce the inflammation that's
the second thing you have to do and the
third aspect is you have to stabilize
the heel and support the foot most
people they use the worst shoes for the
hardest activities and if you're wearing
improper shoes or shoes that are too
old and you do a lot of walking are you
wearing a flip-flop that doesn't have
any support many times you can aggravate
the plantar fasciitis so to start with I
would say go to a very good sneaker
store and get a good shoe preferably a
running shoe but you may say I'm not a
runner I'm a walker but I still say get
a running shoe because it has the best
technology in that type of a shoe and
you can also try an over-the-counter
insert many people buy them
over-the-counter I don't really
recommend the soft ones so let me
explain here's an example of an orthotic
this one's made with carbon graphite
it's very rigid but it has some give to
it and if you look at the arch the arch
can't be pushed down by my finger you
want something that's stable if you find
that the device that you're using you
can bend it or it collapses it's not
really doing anything you need a device
that can support the heel of your foot
and support the arch of your foot and
allow the foot to relax and rest it's
going to do the work for the foot not
everyone needs orthotics what orthotics
can help you especially if you do a lot
of walking and if you do a lot of
standing at your work but let's say you
don't want to go to the doctor what are
some of the home treatments you can do
you can ice it you can take the
anti-inflammatories you can try the
stretching you can try to take a insert
and put it into your shoe those all can
be helpful but if you have heel pain for
over six months or over a year don't
wait it's probably not going to get
better I people come in that frequently
say if I just wait a year it's going to
go away well if it's not better probably
in a couple of months it's probably not
going to get better and some people they
need some advanced treatments let's go
over some of the advanced treatments for
plantar fasciitis one of them is called
platelet-rich plasma therapy that's
where you draw some blood from your arm
and you spin it down and you take only
the platelets and you inject those
platelets into the area of the plantar
fascia what those do is those actually
reduce the inflammation and bring the
healing components that you need for the
plantar fascia to get better now we
don't do this right away many times
we've already tried three cortisone
injections we've done physical therapy
we've done
orthotic and if none of those work then
we do this as an advanced therapy
another type of a therapy the second one
is called shock wave therapy shock wave
therapy is very similar to something
called lithotripsy if you've ever had
kidney stones it actually uses sound
waves to hit the area of the plantar
fascia that's thickened and inflamed and
it allows more blood vessels to go there
and it helps to heal the plantar
fasciitis and then the third type of
treatment it actually uses stem cells
and you take the stem cells inject them
to the area of inflammation and it can
help with healing all of these are used
after the other traditional treatments
aren't being effective so I hope you
found this helpful and if you want to
learn more about plantar fasciitis you
can go to www.drpelto to learn more
Author Dr. Don Pelto

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