NEW HAVEN, Conn. (WTNH) – People of all ages, shapes and sizes have plantar fasciitis – chronic heel pain. A common problem among millions.
Noted foot and ankle surgeon Dr. Peter Blume with Yale New Haven Hospital — answers frequently asked questions.
He says, “Plantar Fasciitis is inflammation of plantar fasciitis ligament. It’s a ligament that originates on the heel bone, on the calcaneal tubercle, which then inserts all the way up into the forefoot.”
And goes onto say, “It’s really repetitive walking and standing. It’s the stress on the ligament. And we don’t really understand where that comes from but it’s a very common problem.”
Can you prevent plantar fasciitis?
Dr. Blume responds, “Stretching, a simple over-the-counter orthotic, good sneakers, tie shoes, padding, some of the foam mats that you can stand on. There are some preventative things you can do, if you first note there is pain in that region.”
Treatment for plantar fasciitis? Dr. Blume says “it starts with conservative steps, such as stretching, an over the counter type orthotic device, accommodative shoes, changing your shoe, some anti-inflammatories, Motrin, Advil, Aleve.”
Bill from Windsor asks – Why do some patients respond to cortisone shots and others don’t?
Dr. Blume says, “Because depending upon whether is really significant amount of fluid or inflammation of the ligament and how tight that ligament is, some ligaments when we do an MRI are two to three times thick that they should be. So the ligament should be a couple of millimeters thick but sometimes that ligament can be 5, 6, 8 millimeters thick, sometimes cortisone doesn’t penetrate that. And if the underlying cause of the heel pain is not plantar fasciitis and it’s a tumor or a growth or it’s a nerve problem, again they are not going to respond.”
This question also from Bill – What’s causing additional pain in the ankle and knee?
He answers, “You don’t realize you start to compensate. If you can’t put that heel down, you’re going to walk on your forefoot, you’re going to shift your gait pattern.”
Why does the pain become worse after prolonged sitting?
“Why? Because that ligament contracts because fibrous fills up with fluid. The minute you step down again, that ligament has to re-stretch out,” says Dr. Blume.
Stacy from Norwalk says she generally goes barefoot at home and wants to know what shoes to wear indoors?
“The one thing we tell patients is, do not walk barefoot. In the house, put on a simple sneaker,” says Dr. Blume, “If you’re not comfortable in a sneaker, wear a soft slipper, wear something with memory foam.”
Dr. Blume says physical therapy also plays an important role, along with certain devices to stretch that ligament.
He says 90 percent of patients get better with standard care with 10 percent requiring surgery.
He highly recommends not ignoring that heel pain.
Get it thoroughly checked out – because while it could be plantar fasciitis — Dr. Blume says there are other underlying causes such as a bone tumor or stress fracture.
Have a health question? Specialists like Dr. Blume will answer it.
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