Common Foot Problems in Men

By: Williette Nyanue - June is the month that we celebrate Father’s Day! This coming Sunday, many of us will celebrate the day set aside to honor the men in our families for all of the hard work they do for us. How fitting is it then that June is also Men’s Health Month? In case you did not know:

Men’s Health month is celebrated across the country with screenings, health fairs, media appearances, and other health education and outreach activities. The purpose of Men’s Health Month is to heighten the awareness of preventable health problems and encourage early detection and treatment of disease among men and boys.[1]

Men are notorious for neglecting their health. Dr. Weil Jr. has even seen it with his male patients. He states, “Men neglect their feet more than women because we can be stubborn. When they do show up at my office, their problems are usually worse off.” Men’s health month is celebrated the entire month of June, with special emphasis this month on June 11^th-17^th, which is Men’s Health Week. We have been celebrating Men’s Health Week by filling our Twitter and Facebook pages with facts, statistics and solutions to common men’s health problems. In honor of Father’s Day, Men’s Health Month and the culmination of Men’s Health week, we have put together a list of common foot problems that we see here at the Weil Foot and Ankle Institute and ways to solve these problems.

Common Foot Problems in Men

•  Excessive Sweating/Foot Odor – Did you know that there are over 250,000 sweat glands on your feet alone? While excessive sweating doesn’t cause foot odor, areas affected by excessive sweat can be the breeding ground for odor causing bacteria. 
• The first step in controlling foot odor is taking proper care of your feet. Talk to your Weil Foot and Ankle physician about proper foot hygiene to control and prevent the development of odor causing bacteria.
•  Wash your feet daily with warm water and a mild soap, and dry them completely.
• Change your socks frequently, at least once a day.
•  Invest in an odor absorbing foot powder and/or a foot antiperspirant if you suffer from excessive sweating.
• Allow your shoes to dry completely before wearing them. This will help to stunt the growth of odor causing bacteria.
•  The SteriShoe Ultraviolet Sanitizer is a shoe sanitizer that works to kill off the germs that cause foot infections and offensive shoe odor.
•  Fungal Infections/Athlete’s Foot –Fungal infections occur when fungus grows on your feet. Fungi usually grow in warm, moist environments, so if you suffer from excessive foot sweating take special precaution. Athlete’s Foot, one of the most common fungal infections, is contagious and can be transferred by the sharing of socks and shoes or through a wet gym or pool floor. It is estimated that 1 in 5 people have Athlete’s foot, with men accounting for the majority of cases.[2]  Fungal infections can also spread to your nails and cause them to become thick and discolored. Symptoms of Athlete’s Foot include red, itchy skin, burning and/or pain and blisters. 
• If you suffer from Athlete’s foot or any other fungal infection, contact your Weil Foot and Ankle physician, who will be able to prescribe you a medication that will clear up the source of the fungal infection.
• For tips on how to prevent fungal infections, refer to our Guide to Summertime Foot Care.
•  Blisters – A blister is a liquid filled bubble or pocket on the skin that is usually caused by friction between the skin and another material. Blisters are most commonly the result of shoes that are too tight or improper socks. While a blister will usually heal on its own, if your blister becomes painful or you see signs of an infection, be sure to contact your Weil Foot and Ankle Institute physician. To prevent blisters from occurring:
• Wear shoes that fit properly and offer enough room.
• Wear proper fitting socks.
• Invest in blister prevention patches that you can put in your shoes to decrease friction against your blister prone areas.
•  Corns and Calluses – Corns and calluses are thick layers of skin that form when there is too much pressure or friction to the skin. They can also be caused by deformities like bunions and hammertoes. Corns usually appear on the toes and calluses on the bottoms of the feet. [3] If not addressed, they can become extremely uncomfortable. To prevent corns and calluses, 
• Wear comfortable shoes that fit properly.
• Regular pedicures will also help to slough off dead skin that accumulates over time.
• The Weil Foot and Ankle Institute offers corn and callus pads to alleviate some of the discomfort that may arise.
• Because there are many different products on the market and different procedures used to treat corns and calluses, be sure to talk to your Weil Foot and Ankle physician, who will suggest the most appropriate products and line of treatment for your individual case.
•  Ingrown Nails – An ingrown nail, as we mentioned in Dr. Klein’s May post, is “a toenail that has curved in at the medial and lateral sides of the nail. It digs into and can cause a break in the skin.” This break in the skin is susceptible to infection. Ingrown toenails can be the result of wearing poorly fitting shoes, but are usually the result of improper cutting of the toenail. Teenagers/young adults and older men and women are most at risk for ingrown toenails, and men are usually affected more than women.[4] Symptoms of an ingrown toenail include pain, tenderness, swelling and redness around the area. An infected ingrown toenail may also ooze pus.[5]
• If you have symptoms of an ingrown toenail, see your Weil Foot and Ankle physician.
• As mentioned in Dr. Klein’s post, physicians can usually take care of ingrown and even infected ingrown toenails relatively easily with either trimming or debridement in the office, or a small in-office procedure.
•  Gout – Gout is a form of arthritis that occurs when there is excess uric acid in the body. Gout is nine times more prevalent in men than it is in women.[6] People with gout suffer from gout attacks, which usually occur at night and in the big toe first. The symptoms of gout or a gout attack are: pain, swelling, warmth and stiffness in the toe joint.[7]
• If you have symptoms of gout, be sure to see one of our podiatrists here at the Weil Foot and Ankle Institute so that you can be properly diagnosed.
• After you have been diagnosed, your Weil Foot and Ankle physician can provide you with anti-inflammatory medication that will help alleviate your symptoms.
• If symptoms continue, consult your podiatrist and your primary care physician for information about further treatment options such as additional medication and possible surgery.

In honor of Men’s Health Month and Father’s Day, be sure to take special interest in your health this month and all the months to come. Schedule appointments with your doctors and get all of the necessary tests and screenings. Become aware of your health status. If you suffer from any of the foot ailments that are listed here, be sure to make an appointment so that one of our physicians can help you address the issue.

Looking for a great Father’s Day gift? Here a few health-related gifts that I am sure your dad would love whether or not he suffers from any of the above ailments.

Health related gifts:

 Athletic/ Walking Shoes – Does your dad do a lot of walking or working out? Get him a pair of athletic or training shoes to keep him supported during his activity.

•  Men's Athletic Tie-Less Lace Closure White Mesh
•   Men's White Strap-N-Lace Leather Athletic Shoes

Custom made inserts

•   Call today and request and appointment to have your dad fitted for our custom made inserts.

Sandals – The summer is here and dad could probably use a pair of new sandals. Give him comfort and support with this option.

• Vasyli Malibu Sandals For Men - Healthy & Stylish Sandals
• Men's Fisherman Leather Sandals-Light Brown

Shoes – How many of your fathers are like mine and buys a new pair of shoes only when his old ones are completely broken down? Do him a favor, throw those old ones away and buy him a new pair!

•  Orthofeet Men's Leather Lace - Brown
•  Orthofeet Men's Leather Strap - Black

If you don’t want to get any foot related gifts, Dr. Weil has given a list of good gifts your dad may like! (Hint, hint if any of his kids are reading this ;))

Dr. Weil’s Father’s Day Gift Guide!

• Gift certificate for a clothing store—ex: Nordstrom. Contrary to popular belief, men do like to shop too…sometimes.
• Golf balls: You can never have enough golf balls. They always seem to disappear...
• Grilling stuff: Men like to cook with fire. It brings out the caveman in all of us.
•  Personalized gifts from the kids: Anything that kids make themselves is always special for dads.

I think everyone knows that when compared to Mother’s Day, Father’s Day can be a little underwhelming. Let’s not make that the case this Father’s Day. Let’s show our dads how much we really appreciate them by making this Father’s Day really special. Have fun celebrating with your families!

---

[1] http://www.menshealthmonth.org/

[2] http://www.webmd.boots.com/skin-problems-and-treatments/tc/athletes-foot-how-common-is-it

[3] http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002212/

[4] http://www.emedicinehealth.com/ingrown_toenails/article_em.htm

[5] http://www.weil4feet.com/common_ingrown_toenail.html

[6] http://www.weil4feet.com/common_gout.html

[7] http://www.weil4feet.com/common_gout.html

Foot and Ankle Specialist: Obesity, Feet, and the Impact on Health Care

Dr. Weil Jr., who also serves as the editor of Foot and Ankle Specialist, wrote an editorial entitled, Obesity, Feet, and the Impact on Health Care, for the publication's latest issue. We have provided a sample of the article here on the blog, but be sure to head over to our site or the Foot and Ankle Specialist to read the full publication.

Over the last year, my Fellow Erin Klein, decided to take on projects looking at how Body Mass Index (BMI) influences several common foot and ankle problems.  Our data base includes BMI measurements for all patients dating back to before 2000.  She was able to isolate thousands of patients with diagnoses of plantar fasciitis, Achilles tendonapathy and adult onset flatfoot deformity.  She created a control group of patients whose diagnosis would not typically be associated with increased BMI (toenail conditions, neuroma, ankle sprains).  Comparisons were made between the control groups and the conditions that would be associated with increased BMI.  Additionally, the BMI measurements were assessed to evaluate success of treatment in the study groups.  Many conclusions were made from the research including: 1. Patients in the plantar fasciitis, Achilles tendonapathy, and adult onset flatfoot had higher BMI than control group, 2. Patients with higher BMI had less success with typical conservative alternatives, and 3. Our patients, as a whole, had a high BMI. Obesity in the United States is reaching epidemic proportions.  Statistics on the growth of obesity are staggering.  This was once considered a problem of the United States but other countries around the globe are starting to have similar problems and in India, the second most populous country in the world, their obesity rates are increasing at a much higher rate than in the U.S. Obesity is often associated with lower socioeconomics due to poor nutrition and healthcare.  However, our practice is heavily weighted toward middle to upper middle class.  This is not a problem of a certain class but a problem with all society. We looked at some common foot and ankle conditions and the influence of obesity.  Clearly these are not the most important problems associated with the disease, but illustrate the influence that obesity has on people’s lives.  Diabetes, heart disease, hypertension, and cancer are examples of critical medical problems associated with obesity.  There are few medical conditions that cannot be negatively associated with obesity. As we treat foot and ankle problems, we are in the trenches of how obesity affects people.  We illustrated how common foot and ankle problems are associated with increased BMI.  With these foot and ankle problems, people are unable to exercise due to the pain of the condition.  Lack of exercise often results in increased BMI and now we get a downward spiral.  This all leads to worsening of the patients overall health and we see it in advanced diabetic problems (neuropathy, PVD, wounds, Charcot) and worsening deformities that require surgical intervention, but that surgery becomes more difficult and risky with increased BMI and their co-morbidities.

The Weil Foot and Ankle Institute’s Comprehensive Guide to Summertime Foot Care!

By: Williette Nyanue - According to the almanac, the official start of summer this year will not be until June 20^th. However, with the celebration of Memorial Day this past weekend, many of us are already fully immersed in the summer season.

Because each season brings with it its own set of challenges for our bodies, many of us change our health routines to reflect the change in season. In the fall and winter months the temperature drops and the air gets drier leaving us with dry skin, hair and nails. To combat this drop in temperature and humidity, many of us switch to heavier creams and maybe even shorter, cooler showers. The winter months also have their own uniform: sweaters, thermal underwear and boots to combat the snow. When the summer season starts, this winter routine is almost completely reversed. With longer days, and therefore longer exposure to sun, and higher temperatures, we use lighter creams with a higher SPF, and drink more water to prevent dehydration. As for the summer attire, well, we all know that there is more skin, more skin, and then more skin.

As we change our health routines to adapt to the changing weather, we must not forget that our foot care routines will also require some slight changes. The summer months bring specific problems for our feet that you may not be aware of. Just as you would switch your skincare regimen and wardrobe for the summer, be sure to switch your foot care regimen…or at least implement one if you haven’t already!

So you don’t know where to start? Have no fear! I contacted Dr. Weil, Jr. and he has given me some great information in order to help me create a comprehensive guide for your summer foot care needs. Follow the points on this guide and you’ll be sure to keep your feet healthy throughout these summer months.

Temperature and Sun Exposure

The elevated temperatures of the summer months bring a unique set of challenges for your feet including increased sweating, which can lead to odor and fungal and bacterial infections, and exposure to the sun's harmful rays. Here are a few ways to adjust your routine to combat these issues.

Elevated temperatures

• Invest in a foot antiperspirant/deodorant if you suffer from foot odor or sweating. 
• Make sure that whatever shoes you are wearing allow your foot to breathe. For all of the runners and athletes out there, this is really important if you must wear closed to shoes during the warmer months. See a few options for athletic shoes here and here. 
• Wear lightweight socks when you wear closed toe shoes, and change them regularly. We offer a sock on our website that you may want to check out. It efficiently transfers heat and eliminates bacteria, fungi and odor.
•  If you develop excessive sweating, foot odor or any fungal/bacterial infections, be sure to contact one of the physicians at the Weil Foot & Ankle Institute for an evaluation.

Sun Exposure

• Don’t forget to put sunscreen on your feet! You can use the same sunscreen that you use for your body. Remember that feet burn easily because they are not regularly exposed to sun, so don’t increase the risk by neglecting them with sunscreen. 

What to wear, what to wear?

Just like we need to change our wardrobes for the warmer months, it is important that we make the proper changes to our footwear. Here are some things to consider when buying shoes in the summer.

•  Invest in the footwear of the season: open toe sandals. Open toe sandals, allow our feet to breathe and stay dry. This prevents sweating, odor and bacterial growth.
• Make sure that your sandals provide good arch support. They should not be flat. Higher heels are better.
• Invest in sandals with a stiffer sole, which offer more support for you than flexible soles.
•  Make sure the sandals provide comfort. Do not sacrifice comfort for style because you will regret it in the long run. Believe it or not, there are fashionable sandals that also provide comfort.

To flip-flop or not to flip-flop?

The ease and convenience of flip-flops make them the summer shoe of choice for many of us. Flip-flops, however, lack arch and heel support. The gripping that your toes have to do when walking in flip-flops also puts tension and strain on your shins. When buying and wearing flip-flops:

• Do not wear flip-flops when engaging in strenuous activity such as running, walking for long distances, playing sports, etc.
•  Make sure that your flip-flops are made with a flexible but firm material to prevent foot injuries that may come from excessive bending.
• Make sure that your flip-flops offer good arch and heel support. A great option for a flip-flop would be our Orthaheel sandals. They are cute and supportive and were recommended by Dr. Oz on a recent video segment from his show.

Going barefoot?

Summer is the time when you’re most likely going to be barefoot. Who doesn’t like to feel the grass beneath their feet or the sand between their toes? If you do not have pain, going barefoot is ok, but keep in mind there are many problems associated with barefootedness including heel pain and metatarsalgia. When walking barefoot:

• Beware of foreign bodies and things that can injure the skin including glass, branches, cans, rocks, etc.  
• Limit exposure to moist surfaces that are shared by multiple people. This includes pool decks, locker rooms, etc. This will limit the chances of fungal infections and warts.
•  Be careful of hot sand, which can burn feet. This is especially true for diabetics who don't have good feeling in their lower extremities. 

Prepare yourself for activity

Common foot and ankle injuries due to increased activity in the summer include shin splints, ankle sprains, tendinitis, blisters and bruises, stress fractures of the toes or ankle, and plantar fasciitis. Make sure to take a few simple precautions to prevent these injuries.

• Build up activity progressively. In other words, don't sit all winter and go out and try to run a 5K without training properly and building up your muscles.
• Make sure you stretch properly before and after training.
•  Invest in good athletic shoes and make sure to change them frequently. Athletic shoes that are in good shape will have less than 400 miles of wear.
•  Invest in insoles to properly support your feet and ankles while engaging in athletic activity. We offer insoles on our site, and we also make them custom in our office. If you would like a set of our custom made orthotics, be sure to request an appointment for a consultation today!

If you develop any of the problems mentioned in this post, (foot odor, warts, fungal infection, heel pain, metatarsalgia, plantar fasciitis, etc.) make sure that you call and/or visit the Weil Foot & Ankle Institute so that one of our physicians can get you healed and have you back out enjoying the summer weather as quickly as possible. Now that you have a basic set of guidelines for ensuring your foot health this summer, go out and take advantage of the warm weather. It will be winter again before you know it!

Did we miss anything? Do you have a foot problem relating to summer that you did not see addressed here? Tell us below and we will be happy to provide you with suggestions and solutions!

Joakim Noah: The Real Prognosis

By: Lowell Weil Jr., DPM 

Last Friday, when the Bulls’ starting center Joakim Noah turned his ankle under his leg in a gruesome position, and the typically classless Philadelphia fans (I know...I did my residency there) cheered his injury, the Bulls’ hopes of progressing through the playoffs may have died. Bulls fans around the country held their breaths as they watched yet another star player go down in excruciating pain.

Fortunately, X-rays did not find an ankle fracture, but we can be sure that he suffered a severe sprain.

So, what exactly is a “sprain” you ask?

A sprain occurs when ligaments (tissues that connect bone to bone) are injured.  This injury can take the form of a stretch or a tear.

In Joakim Noah’s case there are many ligaments around the ankle that could have been injured, however, it was most likely the lateral (outside) ankle ligaments and/or the syndesmotic ligament (high ankle sprain). 

Regardless, I know this injury is going to take a while to get better.  While Bulls staff members keep telling the media that whether or not Joakim Noah will play will be a “game time decision,” his chances of playing in the foreseeable future do not seem likely. He is still limping with a walking boot on his foot and ankle.

I have had an opportunity to get to know Joakim a little bit, and I will say that he is a very tough guy.  As most Bulls fans may already know, Joakim will do anything possible to get himself ready to get back on the court and help his teammates win.  I have also found him to be a very nice and thoughtful person.  Once when I saw him, my nine-year-old son was with me and Joakim couldn’t have been nicer to him. My son still talks about it to this day.

You can be sure that under the direction of the Bulls’ head trainer Fred Tedeschi, Joakim is getting around-the-clock care to try and get him ready to play as soon as possible. 

So, here’s hoping that Joakim can make a quick recovery to what appears to be a very tough injury and help propel the Bulls further in the playoffs.  If it doesn’t turn out to happen this year, Joakim will certainly be ready to help the Bulls achieve their goal of an NBA Championship in 2012-2013.

Are You Ready For Pedicure Season?

By: Williette Nyanue

I think that we’ve been tricked here in Chicago. We started off with a beautiful early spring, and the weather was consistently in the upper 70s and 80s. Now it seems we can’t get a day above 70! Nevertheless, we all know that warmer weather is around the corner. As Dr. Weil Jr., noted in his previous blog post, for medical professionals at the Weil Foot and Ankle Institute, spring means the beginning of plantar fasciitis season. However, for most of us ladies, the beginning of warmer weather means that it’s time for us to start getting our feet primed and prepped regularly for open-toe shoe season.

As compared to many of our male counterparts, the amount of time and effort a lot of us women put into getting our feet as close to perfect as possible can seem downright unfair! There’s soaking and scrubbing, washing and massaging, clipping and filing, painting and moisturizing… There are also so many tools needed to get the job done! We use nail files and buffers, pumice stones and brushes, toenail clippers, cuticle clippers, foot scrubs, ointments, oils, lotions, corn pads and nail polish. I’ve even seen what I’m sure was a cheese grater and a machine that I swore you only used to sand uneven surfaces. 

But can we help it? During the warmer months, all of the women’s magazines have articles and slide shows with catchy titles such as,“Fix Ugly Feet at Home,” and, “9 Easy Ways to Get Super Soft Feet Just in Time for Summer.” In these magazines we can find all of the great summer nail polish trends for our next pedicure, as well DIY options to make sure that when you’re caught in your open-toe sandals, you have nothing to worry about. The articles all basically remind us of one thing: Having “pretty” feet for the summer should not be an option, it should be a necessity.

Although many women would cite pedicures as relaxing midday or weekend treats, trips to the nail salon can be a hassle with long wait times, expensive prices and did I mention how much that pumice stone tickles?

It may seem that we go through unnecessary lengths just to get ourfeet “pretty” for the warmer months, but all of this effort is not in vain. I’m not just talking about the compliments that you get either. Getting proper, professional pedicures is actually good for the overall health of your feet.  While a podiatrist should look at more serious foot problems such as bunions, hammertoes and infected, ingrown toenails, pedicures can actually play a part in the prevention and aid of some minor and aesthetic foot problems. According to Dr. Weil, Jr., “Pedicurists are trained to manage nails properly. They know how to cut them and the right shape to create because not all nails should be cut the same. Additionally, pedicurists have the proper instrumentation to handle more difficult nails, which are quite common.” Dr.Weil Jr. also notes that getting proper pedicures may be increasingly important for older men and women and those with medical conditions like diabetes. He states, “As we get older, it is more difficult for us to get our hands, and more importantly our eyes, to the level to properly cut a nail. By not being in the right place with our hands or eyes, we could cut the nail incorrectly. This could lead to ingrown toenails, infections, lacerations or wounds.” Pedicurists can also aid in the prevention of painful calluses and corns by sloughing off dead skin that accumulates on your feet over time.

So, as temperatures increase and you think about skipping out on the occasional pedicure because of the inconvenience or hassle that it may cause, remember that not only will pedicures make your feet look pleasing; they can also increase the overall health of your feet. We are constantly abusing our feet. Why not give them a bit of TLC once in a while?

For all of you men out there, you heard it from a doctor himself. Pedicures are good for everyone! Invest in one…just skip the nail polish if you want.

I know we’re ready for the open-toe shoe season here at the Weil Foot and Ankle Institute. Are you?

Are you looking for somewhere to get a professional pedicure? What better place to have one done than a podiatry clinic? The Weil Foot and Ankle Institute offers professional pedicure services throughout the week at our Des Plaines office. If you are in the area, stop by the clinic or call 847-390-7666 to set up your pedicure appointment today! 

Podiatry Today's Current Concepts in Plantar Plate Repair

Current Concepts In Plantar Plate Repair

• Volume 25 - Issue 4 - April 2012
 
• 2867 reads
 
• 1 comments

Author(s): 

 Lowell Weil Jr., DPM, FACFAS, and Erin E. Klein, DPM, MS

Do you find yourself in certain cases choosing between metatarsal realignment and plantar plate repair? Given this dilemma, these authors suggest that combining the Weil osteotomy with a dorsal approach to the anatomic plantar plate may be beneficial in addressing both plantar plate tears and metatarsalgia.

With any surgical procedure, there are problems and complications. The most commonly discussed problem associated with the Weil osteotomy is the “floating toe.” Studies had identified the floating toe to occur 15 to 50 percent of the time following a Weil osteotomy.^1-3 The floating toe does not touch the floor with neutral weightbearing after undergoing a metatarsal osteotomy.

   Additionally, there is weakness and decreased ability to plantarflex the toe actively. Many have theorized as to the cause of floating toe and have suggested modifications to the procedure in order to prevent its occurrence.^4-7 However, most of these changes have not altered the outcome and increased other complications (transfer metatarsalgia, stiffness, edema, etc.) and disability postoperatively.

   For years, we have been trying to find a solution to the problem, whether it is making sure to perform the procedure in the articular surface to prevent plantar translation, performing appropriate dorsal soft tissue release, encouraging early physical therapy (seven days postoperative), and emphasizing plantarflexion strength and night splinting of the toe. Nonetheless, floating toe still occurred, although at rates much lower than cited in the literature. In our most unstable metatarsophalangeal joints (MPJs), we started trying to repair the plantar plate in conjunction with the osteotomy but with limited success due to the difficulty of exposure from the dorsal approach.

   In the fall of 2007, the lead author had given a lecture on the Weil osteotomy at a Podiatry Institute conference in Florida. Immediately following the lecture, Craig Camasta, DPM, gave a lecture on plantar plate pathology and repair. Dr. Camasta was one of the real leaders in discussing the plantar plate and he made a very compelling argument as to the role of the plantar plate in lesser metatarsophalangeal joint problems. Listening to Dr. Camasta’s rationale made the lead author strongly consider the possibility that plantar plate insufficiency may have more to do with the painful metatarsalgia entity and postoperative floating toe problems than previously appreciated. It also made him think that combining the Weil osteotomy with a plantar plate repair would be the best of both worlds...

Read the rest of the article here!  

Hello Spring, Hello Heel Pain??

By: Lowell Weil, Jr., DPM

The baseball season, which marks the unofficial start of spring, is finally here.  Actually, this year in Chicago, spring has started very early with unprecedented great weather in March.  Usually we are still hunkered down with frigid temperatures, hoping and wishing for just a glimpse of spring to arrive.  Spring means many things to different people, but to those who take care of feet at the Weil Foot & Ankle Institute, it means the beginning of PLANTAR FASCIITIS SEASON.

Plantar Fasciitis is that annoying pain to the bottom of our feet, particularly in the heels, that grabs us when we get out of bed in the morning or get up from a rested or seated position.  Oh, it starts out slowly and we think we just have a heel bruise that will go away, but a month or two later we realize not only has it not gone away, your heel pain has actually gotten slightly worse.  Now we are limping a bit in the morning and have cut back on exercise, which is annoying because we know how important exercise is for our overall health.

Why is the onset of plantar fasciitis so prominent in the spring, you ask? The primary reason is that as the weather gets nicer, people want to get out and enjoy it.  Gardeners will take to their gardens for priming, pruning, and planting. Runners and walkers will begin more intense workouts embarking on faster times and longer distances. Golfers will hit the links with more vigor, and many of us will simply get out those sandals that we love, which, by the way, don’t offer much support for our feet.

But why do those things cause heel pain?  Well, heel pain/plantar fasciitis is most frequently caused from tight calf muscles and heel cords.  We get tight calf muscles for several reasons.  One reason is that as we get older, we inevitably get less flexible.  Another reason is that we rarely stretch regularly, even those of us who do yoga. The tight pull of the calf muscles and heel cords causes stress to the plantar fascia, a tissue on the bottom of the foot that connects to the heel bone.  This irritation to the plantar fascia may cause very small tears that result in pain and swelling. When our calf muscles are too tight and we increase our activities, this all results.  Soft surfaces such as grass or sand make heel pain/plantar fasciitis worse by causing our heels to sink downward and putting more stress on the tissues.  To some degree sandals, flip-flops and bare feet do the same thing and do not provide much support.

So now the question you've been waiting for: What do you do if you start getting heel pain?  There are some easy steps you can take to alleviate your heel pain and prevent it from worsening. 

1. Wear shoes that give more support.  A running shoe (I said running shoe, NOT just gym shoe) will provide excellent support and slightly raise the heel to relax the calf muscle.  Wearing shoes with a slight heel can really help.  Look for something that has 1-1.5 inches of heel.
2. Avoid bare feet, slippers, sandals and flats…until your condition gets better.  There are some good sandals, here, that have support that you may want to try out. There are also arch supports (Orthoheel and Powerstep) that can be purchased on line that are better than what is offered in the pharmacy.
3. Increase your stretching. Start stretching your calf muscle 3-4 times a day. See this site for useful stretches.
4. Use conservative treatment to alleviate symptoms. Take over-the-counter anti-inflammatory medicines (Ibuprofen, Aleve, etc.) as directed on the bottle consistently for a week or so.  Putting ice on the area for ten minutes at a time, once or twice a day will also help.

So what happens if your heel pain persists?  If your pain does not subside within a week or two, you face the possibility of having a chronic problem.  That is where physicians from the Weil Foot & Ankle Institute come in.  Physicians at the Weil Foot & Ankle Institute are renown for their treatment of heel pain.  The doctors here have done many studies, published papers and books and lectured around the world on heel pain and plantar fasciitis.  They have treated professional athletes from the Chicago Bulls, Chicago White Sox, Chicago Bears and other professional organizations, and Olympic and collegiate athletes from around the country for plantar fasciitis.Weil Foot & Ankle Institute Physicians have pioneered non-invasive and minimally invasive treatments for the treatment of plantar fasciitis. (See treatment options here and here).  They can create a specialized treatment regimen to meet your daily needs and successfully rid you of heel pain.

So as spring creates optimism for our typically disappointing baseball teams, don’t let your heel pain get you down. Protect your heels with the steps we’ve mentioned, and if that heel pain persists, come see one of our doctors at the Weil Foot & Ankle Institute. They’ll have you out and enjoying the weather, free of heel pain, before you know it!

Lowell Weil, Jr., DPM, MBA, FACFAS Fellowship Director, Weil Foot & Ankle Institute

Team Podiatrist, Chicago White Sox 
Dr. Weil Jr. has been on the staff of Weil Foot & Ankle Institute since 1996. His special areas of interest are reconstructive foot and ankle surgery, tendon and ligament reconstruction, radiofrequency techniques, Extracorporeal Shock Wave Therapy and sports medicine.

Treating Heel Pain with ESWT: Our Happy Patients

Hey Doc! I am writing to let you know of my ESWT and office visits from start to finish. When I got there on my first visit I liked the fact that you were straight forward and didn’t try to sell me ESWT and let me know it was not a covered (insurance) item. I had just gotten a shot from my referring doctor so my foot was feeling good. You introduced me to Jennifer and said when and if I decide to do something please call her and she will take care of it from start to finish. She did.

I called several months later and came in and got my first treatment followed by the 3 other two a few weeks apart and we talked every time and I did feel like you were really listening and wanted to let you know I appreciated that. Still and all my foot was not feeling as good as I would have liked. Once again you took the time to listen and we talked about a moving forward game plan. From here is where I really to emphasize my treatment by your staff; in particular Jennifer (She was great!!). The plan was to send in for insurance approval for orthotics. Jen had me get molded so that if they approved them then you get them done and I could come back when complete and be good to go. She said if they say no, we will go to Plan “B” which was using my fourth “freebie” ESWT, and then see how that took and go from there to Plan “C”, which was surgery.

I was called the next day by someone and told that insurance wouldn’t cover the ortoics and if I wanted I would have to pay $550 now. I said to hold them and I will think more on them and get back with them. Then I asked to speak to Jen and schedule the fourth ESWT treatment. I really thought this would be a hassle or was thinking something would be less than before being on you. It was not and you handled it just like normal and one of the things I want to report in this letter is the fourth time was the charm and my foot has felt 100% better since.

Everything seemed great until…I got a bill wanting me to pay approx. $125 for my part of the bill for work that was never done and what the insurance didn’t cover on the orthotics that they did pay for. I called and talked to someone who I’m sure was more than happy to hand this over to Jen to take care of. (I was not happy) The first thing Jen said was will take off everything on this bill that’s not right and make everything right.

She had me come in for another fitting which did not have the office co-pay since I was there before for that. (A cheap guy like me appreciates that). Made the next appointment for the fitting and said if I had any issues on the bill we will finalize them after the fitting. Today after the fitting she walked me out to the waiting area, spoke to Lindsay personally and had her correct the bill to what made sense and then had Lindsay (who was also very nice) go over the bill with me in detail. Then Jen stopped back in and made sure I was a “happy camper”. This was the right thing to do, the professional thing to do, and the nice thing to do. They took a wrong and made it right. Please accept my compliments on your work, Lindsay’s work, and especially Jennifer’s work. She is the best! Please feel free to share this and use me for any reference.

Thanks,
Bob
Franklin Park, IL