Plantar fasciitis is a painful and often frustrating condition – and one that becomes chronic in many cases. Painful heel syndrome, as it’s sometimes called, affects the heels of the feet and occurs in up to ten percent of the population at some point. It’s particularly prevalent among runners and people who walk or stand on their feet all day. When plantar fasciitis doesn’t respond to conservative therapy, some doctors recommend shockwave treatment for plantar fasciitis. Is this an effective way to treat the symptoms?
Shockwave Therapy for Plantar Fasciitis: How Does It Compare?

Shockwave therapy for plantar fasciitis involves hitting the heels with focused waves of energy. These waves “shock” the feet, which stimulates the body’s natural healing response. Shockwave therapy may involve high-energy waves or low-energy ones. Most doctors recommend low-energy shock wave therapy, because high-energy shockwaves are painful enough to require anesthesia.

Consider saving your money if your doctor recommends low-energy shockwave therapy to treat plantar fasciitis. In a recent study comparing low-energy shockwave treatment to three times daily stretching exercises, stretching solidly beat out low-energy shockwave therapy for symptom reduction. Only 29% of people experienced relief after shockwave therapy compared to 65% of those who used stretching exercises to treat plantar fasciitis.

Other types of therapy for that are better options for plantar fasciitis include platelet rich plasma (PRP) or orthotics. With PRP, the plasma that gets injected contain hundreds of proteins called growth factors which are very important in the healing of injuries. The platelets are then separated from other cells and the concentration is increased through a process known as centrifugation. Then when ready, the increased amount of platelets is combined with the remaining blood to promote healing.

Orthotics is another great way to heal plantar fasciitis. Rigid orthotics can realign the foot and provide long-term arch support which can help to promote healing without surgery or other injections. Finally applying ice to the heels twice a day are also good drug-free ways to relieve the symptoms of plantar fasciitis.
Shockwave Treatment for Plantar Fasciitis: The Bottom Line?

Don’t be too quick to sign up for low-energy shockwave treatment for plantar fasciitis. Other types of treatments like PRP, orthotics or stretching to increase flexibility of the ligaments may be more effective – and it’s certainly less expensive and more convenient.

Determining if you require orthotics is often a tough diagnosis to determine without seeing a doctor first. Orthotics can resolve a number of issues with the body including foot and ankle pain, knee pain and even lower back pain. Orthotics can also help with improving posture and reducing the strain on your body’s joints.

how to tell if i need orthoticsOrthotics are inserts that are put inside of the footwear that you already own to help support the foot during walking, running or any sort of activity. Very few individuals were born with perfect feet, which means that the rest of us have feet that can result in painful pressure points, or uneven arches to support our bodies.
Talk With A Doctor About Custom Orthotics

When it comes to determining if you need orthotics for your feet, we recommend that you schedule an appointment with Dr. Pedram Aslmand. Dr. Aslmand will be able to properly diagnose the pressure points with your feet and if orthotics are necessary, take the proper measurements and testing to get your a custom orthotic built specifically for your feet.

Orthotics are recommended at our office as a way to successfuly and conservatively treat many lower extremity conditions. So contact our office to schedule a convenient consultation to determine the best course of action for your specific foot and ankle ailments.

A bunion is a deformity of a joint at the base of the big toe. Bunions develop when the metatarsal bone turns outward, forcing the big toe to point inwards which can cause pain and discomfort as pressure is placed on the foot caused by swelling in the joint.

Bunions are more common in women than men and can be a result of repeatedly squeezing the foot into narrow footwear or shoes that have a pointed toe. Additionally, other factors can contribute to bunion pain including having low arches, loose joints and tendons or hereditary conditions. Bunions can also become painful and irritated when individuals have to remain on their feet for extended periods of time throughout the day such as teachers, construction workers, nurses and dancers.

At Advanced Foot & Ankle Center, we provide conservative treatment options in lieu of surgery. We want our patients to avoid surgery if possible and by supplying personalized, conservative bunion care we can often treat bunion pain without surgery.

Our conservative approach includes determining if the patient is wearing a show that properly fits and contains support in the area of the painful joint. Shoes that can relieve bunion pain should have a wide front and flexible sole to support the arch and cushion the foot. We also recommend gel-pads that can be inserted into shoes to provide stability and cushions to protect again repetitive blows on that area.

Therapeutic options include soaking the foot in warm water and alternating that with a cold ice pack & compression to alleviate pain. Over the counter anti-inflammatory drugs such as aspirin can also reduce pain and swelling in the area, but should not be relied upon as a permanent solution to reduce pain.

If a conservative approach to rehabbing a painful bunion does not result in a decreased amount of pain, then a bunionectomy can be scheduled and performed with minimal downtime and sometimes without the need for crutches or a cane to assist the patient with walking while they recover. For more information about diagnosing and treating bunion pain, schedule an appointment with Dr. Pedram Aslmand by using the ZocDoc widget at the top of the webpage.

Marathon Training

Since winter is officially over (it never really happened in Southern California), that means there’s no excuse for not getting outside and enjoying the beautiful weather. One of the best ways to get into shape is to set a goal for the not-too-distant future and design a plan for achieving this goal. Try a marathon race, for example. Running is a great sport to get into. Outside of proper running shoes, which are essential for avoiding injury, there’s virtually no cost. Running a marathon may seem completely out of reach, yet thousands of people from old to young, fit to not-so-fit do it all of the time. Getting into marathon condition is much like the act of running itself—it’s all about pacing.

Pain is Not Gain

Before beginning any sort of physical activity, you have to be realistic about your capabilities. If necessary, consult your doctor to safely determine your fitness level. Once you’re ready to run, go easy on yourself. It’s better to get out and do many, shorter, easier runs, than to do a small number of knee-busting, ankle-twisting exercises. The idea is get into a routine that maximizes time spent exercising and minimizes injury. The old idea that pain is gain is outmoded. Be good to your body, it’s gotten you this far.

Make Resting a Priority

Running requires resting. That’s all there is to it. You don’t train for a marathon by running a marathon every day, or even every week. Often, the actual marathon will be the only time you run the full length of the race. Everything else is about building endurance and avoiding injury. The body, especially the muscles used in running, is a lot like any other piece of complex machinery. There is a very real threat of overloading and overworking yourself. This is why when you draft a workout plan you need to include days of rest. Multiple and frequent rest days, not just when you think you might be exhausted.

Carbs

Runner’s World Magazine reminds us of one of running’s most glorious aspects—it allows us to indulge in carbs without feeling guilty. Carbs are fuel and when you’re running, you need the energy. This may fly in the face of proponents advocating for a zero-carbohydrate diet, but when you’re training for a marathon ignore the carb haters. Of course, you need to be smart about your diet. This is not an excuse to eat a bag of greasy potato chips. Choose your carbs wisely and plan your intake around periods of high calorie burn.

As we enter our 30s, 40s, and 50s, life seems to get busier than ever. Between professional and family obligations, not to mention taking a little time for ourselves and our sanity, it seems like there is always less and less time to get that doctor-recommended 30 minutes of exercise every day. It can be even more difficult if you are suffering from any number of common foot injuries. But the truth is, the busier you are, the more you need to go for that daily run/walk. Here’s why:

Exercise Improves Brain Function

With all the demands placed on you every day, it can be easy to feel overwhelmed. This is compounded by that foggy feeling that many people get in the early morning or after lunch. But what if you could get more done at work in a shorter amount of time? What if you could leave on time most, if not every, day? Well, a little cardiovascular exercise can help with that.

Walking and, especially, running get your heart and lungs working overtime. They have to work extra hard to get more oxygen to your muscles so they can keep up with this increase in activity. But the increase in oxygen-rich blood pumping blood also affects your brain. It can even stimulate the creation of new nerve cells and blood vessels within the brain, effectively reversing some of the aging process within the brain.

Running Can Help Relieve Stress

While a little stress is good for us, pushing us to excel in certain situations, too much can be downright deadly. Fortunately, running and walking stimulate the production of endorphins within the brain. These relaxing chemicals help put you in a better mood and can relax you after a stressful day of work and errands. For best results, try running in a natural setting with fewer people around.

Walking Can Be a Great Group Activity

Looking for a little quality time with the family? Maybe you want to get to know your neighbors better. Taking a nightly walk or jog after dinner can be a great way to spend time with those around you and get that much-needed exercise. It’s a great example of multi-tasking and the kids won’t have the opportunity to get distracted by their phones or tablets.

Weight Loss Can Reduce Other Health Risks

Here at Advanced Foot and Ankle Center, we regularly treat patients with diabetic foot problems. Type 2 diabetes is one of those diseases that are more prevalent in individuals who are overweight. Going for regular walks or runs can help you keep your weight in the healthy range, reducing your risk of developing obesity-related conditions. This can create a positive feedback loop, where healthy living leads to lower risk of disease, making it easier to continue exercising. This also means less time away from work and home for medical treatments.

Exercise Boosts Your Energy

Finally, if you feel like your life is too busy now, imagine how much harder it will be to keep up as you age. Fortunately, exercise helps give you more energy in the long run, even if you feel a little drained at first. Regular runs or walks mean more restful sleep and increased energy throughout the day. The boost in productivity alone will more than make up for the 30-60 minutes you spend exercising every day.

It is important to take the proper precautions before starting any new exercise plan. You should consult with a doctor to make sure you are healthy enough to engage in your planned activity. We can also recommend the right equipment and even make custom orthotics to cushion and protect your feet and ankles.

Shin splints are one of the most common running injuries that affect marathon runners. They have been plaguing athletes for centuries, so how can you catch a break from them when you are training for your marathon this fall? Workout intensity and hill training are inevitable in the months leading up to the race, but they cannot be avoided in workouts.

A mistake that most runners make is running through the pain. This may cause pain to become more intense in the surrounding bone tissue and last longer than it normally should. The best option for marathon runners is rest, and research shows that use of shock-absorbing insoles are effective when implemented in training months.
What Causes Shin Splints?

The injury is concentrated around the front of the lower legs, between the knee and ankle, which most doctors refer to as medial tibial stress syndrome (MTSS). Mostly affecting people who engage in moderate to heavy physical activity. Sometimes the individual commits to strenuous activity during initial presence which aggravates the condition even further, forcing the individual to stop activity altogether. Shin splints are more likely to occur when leg muscles and tendons are fatigued.

Extreme and excessive force on the shin bone and tissues to muscles surrounding it can swell and cause inflammation. Other causes of shin splints include:

Muscle weakness in thighs and buttocks
Stress reactions to bone fractures
Lack of flexibility
Improper training
Lack of rest
Ill-fitting running shoes
Activities that have multiple starts and stops in running
Running downhill, on slanted surfaces or terrain

How Can I Recover Before the Big Race?

Treatment for the injury first begins by visiting a medical professional to determine the cause of injury and proper recovery methods. Initially, runners should resort to elevating the legs, using ice packs to reduce swelling and anti-inflammatories medication, depending on the level of severity.

Most runners fail to replace their shoes, because they are unaware of when to do so. Marathon runners or amateurs should keep track of the distance their shoes rack up every year. Recommended distance for every runner to replace their shoes is 500 miles, or 800 kilometers. The point of running shoes is to provide support during motion control and when the shoes are no longer in its prime condition, it is time to replace them no matter what their mileage.

According to a study from the National Center for Injury Prevention and Control, the most effective prevention of shin splints involves use of shock-absorbing insoles. Supportive insoles, when used properly align and stabilize the foot and ankle which promote proper running stride. Over the counter or custom-made orthotics are the healthiest investment for runners who suffer from shin splints.

Depending on the severity of pain, shin splints can be corrected before the big race. Every runner alike should rest and recover before engaging in intense activity that requires aggressive foot striking. A medical expert can diagnose symptoms and provide an aggressive approach to correct this type of running injury. Runners with shin splints require rest, proper fitting shoes and supportive insoles or orthotics to make a full recovery just before the marathon.

Evidence suggests that orthotics help relieve painful knee symptoms and possibly help prevent injury in athletes. The key may be pronation control, which in turn affects leg internal rotation leading to improved alignment. Not all knee pain can be attributed to abnormal pronation, as there are other sources to rule out, such as arthritis and ligmanetous damage.

There are several common symptoms that may indicate misalignment of the feet. You may be a candidate for orthotics if:

One side of the sole of your shoe wears out faster than the other.
You frequently sprain your ankle.
You have chronic heel, knee or lower back pain.
Your shins hurt.
Your toes are not straight.
Your feet point inward or excessively outward when you walk.
Your feet hurt in general.

For more information, please contact the office at: (562) 426-0376

Trampoline arenas are popping up everywhere. Although they are very fun for kids, they come with high chance of serious injuries such as foot fracture, ankle fracture, sprains and dislocations.
Obviously, it would be impossible to tell your 10 year old who is dying to go to one of these jumping arenas to sit home and watch TV. But you have to make sure they know about the risks and be very cautious when jumping.

A recent article from USA today about Clippers’ player, Chauncey Billups, and his Achilles injury:

http://www.usatoday.com/sports/basketball/nba/clippers/story/2012-02-08/Chauncey-Billups-vows-to-return-from-injury/53011366/1

Ouch! Achilles injuries don’t just happen to professional athletes. Achilles tendinitis can happen to any active person. Typically people notice swelling in their Achilles tendon and pain with activity. Achilles tendon tears can happen from overuse (think “weekend warriors”) and often require surgery. If you’re having pain in the Achilles tendon, seek help from your podiatrist. To help prevent Achilles injuries, wear shoes with adequate arch support, stretch after activity, and don’t overdo it!

Dr. Erin Kalla is a foot & ankle specialist in Long Beach, CA. She specializes in foot & ankle surgery, sports medicine, and diabetic foot care

We’ve started a new facebook page. It will be a great place to find foot care advice & news about the office. We hope you’ll check it out. Feel free to ask us questions about foot & ankle issues. We also hope to see pictures of our patients enjoying their favorite athletic activities.

https://www.facebook.com/#!/pages/Advanced-Foot-Ankle-Center/321799047856941