According to The American College of Foot and Ankle Surgeons:

Don’t Ignore Your Kid’s Heel Pain
Address Pain Early, Avoid Long Recovery
The American College of Foot and Ankle Surgeons stresses that athletes should never “play through the pain” in their feet. Left untreated, heel pain can lead to difficulty in walking that will require complicated therapy.

The number of pediatric patients reporting heel pain increases with fall and winter sports seasons. Obesity is emerging as another prominent cause of heel pain--even with students in physical education class activities, says Karl Collins, DPM, FACFAS, a St. Louis-based foot and ankle surgeon.

The good news is that kids are good healers and treatment may be simple if it is done quickly.

“Put in a little time to address the problem early because if you wait, you might be in a cast or boot later for a long time,” Dr. Collins says.

Kids undergoing growth spurts are especially susceptible to heel pain starting at age 8 until around age 13 for girls and age 15 for boys. The source of the pain is usually the growth plate of the heel bone, a strip of soft tissue where new bone is forming to accommodate adolescents’ lengthening feet. Overuse, repeated pounding, or excessive force on the Achilles tendon can cause inflammation and pain.

For many teenagers, the growth plate has completely closed, and heel pain is caused by other conditions such as plantar fasciitis, tendonitis, bursitis, bone bruises or fractures.

Sometimes, the simple RICE strategy--Rest, Ice, Compression, Elevation--resolves pain, but when healing does not happen soon, it’s time for clinical evaluation. Anti-inflammatory medications, physical therapy, or other treatments tailored for patients may be necessary. Trauma injury to the foot requires immediate consultation.

“People have a tendency to give it time and see if the pain goes away on its own, and sometimes that happens. But if symptoms persist, it’s time to see a specialist in order to make sure the foot is healing properly and avoid complications,” said Tim Swartz, DPM, FACFAS, a Maryland-based foot and ankle surgeon.

Dr. Swartz said parents often bring their kids to the pediatrician or the emergency room first, but need to follow up with a foot and ankle surgeon. With extensive experience in foot and ankle therapies, foot and ankle surgeons are uniquely qualified to diagnose and treat foot problems in young people through examination and imaging beyond basic x-rays, which don’t always reveal the cause of the pain.

Preparation and recognition of warning signs can help prevent or reduce the severity of heel pain.

Supportive shoes are a must, but it’s not always obvious when to switch shoes or adapt them for the best fit. Consider these guidelines:
• Use inserts to raise the heel, especially in flat-footed cleats
• Discard shoes that caused pain. Don’t use them for another sport
• Wear well-constructed shoes designed for specific sports
• Switch cleats often because they are not supportive shoes.

Don’t skip warm-up or cool-down exercises, Dr. Swartz added. Stretching helps prevent heel pain, especially when sports call for explosive sprints that pull quickly on tendons.

Several things should tip parents off that their child needs attention, including limping, complaining, walking on toes, and pain the morning after a game. Parents should never push their children to play when their feet hurt, even if it is “the big game.”

Dr. Collins said one tenet always applies, “Foot pain is never normal and you should never play when you are in pain.”

At Foot Care Centers we will use a combination of stretching/icing regimen with shoe gear modification and heel inserts as a concominant therapy to resolve your child's heel pain. Tags: children, heel pain, calcaneal apophysitis

Last week Woods had to back out of a tournament secondary to Left Achilles tendon pain.  This problem was the cause of two missed majors last year.  It was the second time in 10 months that Woods had to withdraw from a tournament because of his Achilles. 

Woods is scheduled to play the Arnold Palmer Invitational at Bay Hill, which starts March 22.

Achilles tendinitis is inflammation of the Achilles tendon, the band that starts out as the calf muscle and twists as it passes the behind the ankle joint and inserts into the back of the heel bone.

Pain and swelling is relieved by rest and sometimes immobilization in a removable cast boot.  Other treatment includes, ankle taping, ice, oral anti-inflammatory medications, and stretching. 

Please click on the link below for additional information and stretching exercises from the University of Illinois.

 http://www.mckinley.illinois.edu/handouts/achilles_tendinitis/achilles_tendinitis.html

 

Tags: Achilles tendon stretching, Achilles tendon, Tiger Woods, Achilles tendinitis

Heel Pain: Hands-on Physical Therapy and Stretching Prove Effective for Treating Heel Pain
DOI: 10.2519/jospt.2011.0501




Here is an article recently published in the Journal of Orthopedic and Sports Physical Therapy in regards to manual stretching and therapy techniques for heel pain (plantar fasciitis)

J Orthop Sports Phys Ther 2011;41(2):51-51. doi:10.2519/jospt.2011.0501



DO YOU EVER WAKE UP WITH PAIN IN THE HEEL OF YOUR FOOT FIRST THING IN THE MORNING? If so, you may have plantar fasciitis, the most common type of heel pain. People with heel pain typically report a sharp pain under their heel that may spread into the arch of the foot. The pain is often worse when the person stands after lying down or following a period of sitting—for example, taking the first couple of steps in the morning or standing up after watching TV. Although the pain may actually decrease with activity, such as walking, it tends to return at the end of the day.

Plantar fasciitis is not typically the result of an injury. Instead, this condition usually develops gradually and, if untreated, may get worse over time. By current estimates, 2 million Americans develop heel pain each year, and about 10% of all people will have heel pain at some point in their lives. The February 2011 issue of JOSPT published a research study that provides new evidence that can help people who suffer from heel pain.



NEW INSIGHTS
In this study, 60 patients with heel pain were randomly placed into 1 of 2 treatment groups. One group of patients performed calf and foot stretches and had hands-on therapy provided by a physical therapist (see drawings below), while the other group only performed the stretches. The treatment performed by the physical therapist focused on treating sore points, sometimes called "trigger points." Trigger points are small sections of muscles that feel "knotty" and, when pressed, become more painful. The researchers found greater improvements in patients who both performed the stretches and received hands-on therapy. This finding is important because it suggests that people who are not getting better on their own may benefit from hands-on treatment.



PRACTICAL ADVICE
Although stretching the calf and foot can reduce heel pain, the addition of hands-on physical therapy resulted in better pain relief and greater improvements in function during the first month of treatment. The 3 stretches in this study were performed using a 20-second hold, 20-second recovery time and were repeated 3 times, twice a day. If you have heel pain, you may wish to seek the help of a physical therapist who can instruct you on the proper stretching techniques to perform. The physical therapist can also determine if you are a candidate for trigger point soft tissue techniques applied to your calf muscles, as were used in this study. For more information on the management of heel pain, contact your physical therapist specializing in musculoskeletal disorders.



This JOSPT Perspectives for Patients is based on an article by Renan-Ordine R, et al, titled "Effectiveness of Myofascial Trigger Point Manual Therapy Combined With a Self-Stretching Protocol for the Management of Plantar Heel Pain: A Randomized Controlled Trial." (J Orthop Sports Phys Ther 2011;41(2):43-50. doi:10.2519/jospt.2011.3504)



This Perspectives article was written by a team of JOSPT's editorial board and staff, with Deydre S. Teyhen, PT, PhD, Editor, and Jeanne Robertson, Illustrator.

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Do you experience a sharp pain in your heel when you step out of be in the morning?  If so, don't delay in having this treated! 

You may be suffering from plantar fasciitis, inflammation of the band that supports your arch.  In most cases, heel pain will resolve with conservative treatment.  This includes oral and injectable anti inflammatory medicines, stretching, icing and heel/arch supports.

Roughly 10% of patients continue to suffer from heel pain despite conservative treatment.  Foot Care Centers offers advanced therapies including Extracorporeal Shock Wave Therapy (ESWT) and Autologous Platelet Concentrate (APC +).

ESWT and APC + are both noninvasive, outpatient procedures.  ESWT heals by directing high-energy sound waves to the painful area.   APC + uses the patients own platelets which are injected into the injured site.  Platelets are rich in growth factors which jump start healing.

 If you or someone you know is suffering from heel pain please call 856-691-2152 to make a preferred appointment.

Tags: Shock Wave, Extracorporeal Shock Wave Therapy, APC +, ESWT, heel pain, plantar fasciitis

I was treating a patient the other day and the first question she had when I walked through the door was "What is Plantar Fasciitis?"  She mentioned that while watching an episode of the Deadliest Catch on the Discovery Cannel, one of the veteran crew members couldn't pull his weight on the ship because of heel pain.  Plantar fasciitis is one of the most common causes of heel pain and can be quite debilitating. 

The plantar fascia is a band of connective tissue which supports the arch.  It originates at the base of the heel and inserts into the ball of the foot.  Inflammation of the plantar fascia can be triggered by a change in activity, change in shoes, faulty foot mechanics, weight gain or trauma.  Pain typically occurs with weight-bearing after long periods of rest, most commonly with first steps out of bed in the morning.  Plantar fasciitis responds well to anti-inflammatory medications, stretching and appropriate arch support. 

If you are experiencing heel pain, please call Foot Care Centers for a preferred appointment at 856-691-2152.

Tags: heel pain, plantar fasciitis