Posts for tag: plantar fasciitis

Although the right shoes can ameliorate certain problems, sometimes foot pain is caused by biomechanical issues. One common condition nurses experience is plantar fasciitis, or inflammation of the thick band of tissue that connects the heel bone to the toes, said podiatrist Julia Overstreet, DPM, director of the American Foot Care Nurses Association in Bellevue, WA.
Dr. Julia Overstreet
A tell-tale sign of plantar fasciitis is stabbing pain in the heel with the first few steps in the morning, and the pain may return after long periods on the feet. The discomfort is usually the result of pressure placed on the plantar fascia. Wearing arch supports for four to six weeks can often remedy the problem — as long as nurses wear them at all times except in bed or in the shower, Overstreet said.
Source: nurse.com [10/9/18]
Courtesy of Barry Block, editor of PM News.
Brought to you by Doctor John A. Hardy, owner of Toronto's foot clinic, Academy Foot and Orthotic Clinics.


Plantar fasciitis is a very painful condition where your heel may hurt, feel hot or swell. The pain is a result of inflammation or microscopic tears of the plantar fascia. The fascia is a thin layer of tough tissue supporting the arch of the foot.

Often when you have plantar fasciitis, the pain is at its most intense when you first get out of bed. Sometimes it is noticeable at the beginning of an activity and then gets better as the body warms up. Prolonged standing may cause pain, as well.

Severe plantar fasciitis pain can cause loss of time from work and may lead to partial or total disability. Common surgical procedures used for the treatment of chronic plantar fasciitis may also lead to permanent disability.

There are two phases of the condition.  Fasciitis is inflammation.  Inflammation alone can be treated with numerous conservative treatments.  Anything that addresses rest and inflammation can be helpful.  The chiropodist may use strapping, taping, orthotics, or lasers in this phase.  If the condition has moved on to phase 2, the tissue is damaged (microtearing), and needs to be repaired.  For Phase 2 or chronic plantar fasciitis (fasciosis), high energy ESWT is the only FDA approved device proven to create this repair without surgery.

E.S.W.T treats a variety of conditions using shock waves, or Extracorporeal Shock Wave Therapy (ESWT), outside the body. The treatment is non-surgical and non-invasive. This quick, effective procedure harnesses intense but very short energy waves to heal many chronic painful orthopedic conditions.

Shockwaves are applied via hand piece and held against the skin. In the initial phase of the treatment it may cause some pain, however, this indicates correct targeting of the problem area. Many patients receive pain relief in just 8-10 days after the first treatment. This ESWT treatment can eliminate heel pain in as few as 6 treatments. Although, depending on your condition you may require 6 to 10 treatments, the average is 6. 

Academy Foot and Orthotics Clinic offers this treatment to patients to help improve signs and symptoms of painful conditions including: plantar fasciosis.

Brought to you by Doctor John A. Hardy, owner of Toronto's foot clinic, Academy Foot and Orthotics Clinic. 


“Plantar fasciitis is a fairly common and treatable overuse injury,” John Powers, DPM, a podiatrist with Northwest Allied Foot & Ankle, said. Left untreated, it can become a chronic condition that prevents you from maintaining your activity level. It can also cause knee, hip, and back problems. It can even change the way you walk. Footwear with proper arch and heel support is the best way to try to prevent foot pain and injuries, but if you find yourself with a diagnosis or suspected case of plantar fasciitis, there are some steps you can take at home.
Drs. John Powers and Timothy Short
“First, consider keeping weight off your foot until the initial inflammation subsides and applying ice to the painful area in 20-minute intervals,” said Timothy Short, DPM, a podiatrist at Northwest Allied Foot & Ankle. “Stretching exercises for your Achilles tendon and plantar fascia are by far the best treatments to address the injury and prevent recurrence.
Source: Tucson Arizona Daily Star [4/8/18]
Courtesy of Barry Block, editor of PM News.
Brought to you by Doctor John A. Hardy, owner of Toronto's foot clinic, Academy Foot and Orthotics Clinic.



As long as we participate we consider ourselves athletes and maybe we all are. From the man who after his heart attack is on a treadmill daily, to the woman who jogs every morning, to the child who plays soccer ultimately to the marathon runner, each are capable and usually run into injury or problems many of them foot related. 

  1. Plantar fasciitis – this is an inflammation of the soft tissue connecting to the heel bone. Most common complaint is extreme heel pain first few steps getting out of bed in the morning or after sitting. There can also be burning pains after standing or walking any extended period of time that can radiate into the long arch. Treatment can include ultra sound, taping and padding, cortisone injections and orthotic devices.
  2. Black discolored toenails – this situation can arise from the trauma of the nails hitting against the top of the shoe, especially in joggers and runners. Sometimes they are painful initially if blood is caught under the nail but usually they are not painful. The reason for the discoloration is the blood under the nail. The treatment depends on whether there is pain involved. There is no discomfort with the nail care.
  3. Knee complaints – many people have knee complaints with activity (skating, running, tennis). This can be due to the foot not functioning properly. For example if the foot rolls inward excessively (pronation) this does affect the knees. Often a properly made orthotic device can be a great help.
  4. Low back complaints – people with a high arch rigid foot that remains high on and off weight bearing can have low back pain because the foot, not being flexible, has a jarring affect on the foot, knee and back. This can occur in sports with running or jumping e.g. basketball. This often can also be helped by a flexible, soft cushion orthotic device, which can absorb the jarring and as a result help the back pain.
  5. Discolored yellow nails – these are discolored because of the fungus that invades the nail. Treatment starts with a test (culture) to determine the fungus organism involved. There are available oral medications such as Lamisil and topical medication, the newest being Penlac that is a clear liquid that is painted on the nail daily. This fungus is acquired walking barefoot at swimming pools or public showers.
  6. Athlete’s foot – is a peeling itching usually found between the toes. Prescription topical medications are usually very effective for this fungus infection.
  7. Stress fractures – this is a fracture of one of the metatarsal bones i.e. one of the small bones in the ball of the foot. It used to be called a march fractures because it was seen in young males in the army when they has to walk long distances with packs in heavy shoes. It is common in young runners, soccer players, etc. There is tenderness and symptoms develop such as arch strain. There is pain on activity, none on rest. Treatment includes mobilizing the area and no active sports.
  8. Morton’s neuroma – this is an inflammation of the nerve usually the one going to the 3rd and 4th toes. The symptoms can be feeling of tingling, numbness or electric shock going to those toes. It only occurs when wearing shoes. Typically when the pain occurs while walking the person takes off his shoes and massages the area to get relief. Treatment is generally an orthotic device, which takes pressure off that metatarsal area and gives relief.
  9. Strains and sprains – can occur in any sports activities. The most common sprain occurs on the outside ankle joint, when one goes over on the ankle during activity. Classically R. I. C. E. (rest, ice compression, elevation) is the best treatment.
  10. Heel bump – a not uncommon complaint, this is bursitis, a bump at the back of the heel near the attachment of the Achilles tendon. This bursitis can get quite tender with the irritation of the boot against the bump, ice skaters and hockey players often suffer from this, as can anyone in an active sport. The bump is genetic and wearing the proper orthotic device can eliminate pressure and give relief. Another bursitis can occur in the ball of the foot just behind the big toe. Often in track athletes a blister can occur in this area. The blister should be opened professionally and pressure should take off the area with padding/orthotic devices.
  11. Blisters – these occur when there is a lot of friction in an area of the foot not uncommonly on the bottom of the big toe and that area of the foot just below it, these can occur in persons that play racquet sports and basketball because participants have to stop and start frequently. These blisters can be filled with clear or dark (blood) fluid. A professional biomechanical examination by a chiropodist can determine the cause and course of treatment.
  12. Corns and callouses – are due to pressure and friction. The most common corns are found on the 5th or smallest toe. These can be most painful when they rub on shoes or boots during activity. Corns can also be found on hammer-toes (toes where the knuckle of the toe sits up). Callouses can be found on the bottom of the big toe, anywhere across the ball of the foot and the heels. Corns and callouses tell us that weight is improperly placed on the foot whenever there is weight bearing. A biomechanical examination by a chiropodist can determine the cause and treatment can follow.
  13. Problems can occur on the top of the foot as well. A jelly-like mass, a ganglion, can be seen on the top of the foot. When pressure is applied to this mass it tends to spread out and if painful should be removed. Also arthritic changes can cause bumps on the top of the feet, which make it difficult to buy comfortable shoes ’ due to the irritation on the area.
  14. Bunions – which are protrusion on the inside of the foot just south of the big toe. These can be painful if they rub against the inside of shoes. A biomechanical examination by a podiatrist can determine the cause and ultimately the treatment. Taylor’s bunions, which are protrusions on the outside of the foot south of the small toe.
  15. Small cysts can occur mainly on the bottom of the foot. A professional should determine the diagnosis. If the cyst is not painful, treatment is not necessary. 
  16. Ingrown toenails – which occur mainly on the big nails, can be painful especially if infected, to someone participating in athletic activities. 
  17. Plantar warts – which are found on the bottom of the feet and can be painful with walking and running.

Brought to you by Doctor John A. Hardy, owner of Toronto's foot clinic, Academy Foot and Orthotics Clinic.


Dr. Michael Saraydarian, a podiatrist at Central Maine Orthopaedics, says plantar fasciitis is the most common condition he and other general foot and ankle doctors see. The plantar fascia is a thick band of tissue on the bottom of the foot. When you have fasciitis, it means the band of tissue is irritated or inflamed. Dr. Saraydarian says repetitively overusing and overstretching the fascia and wearing shoes that don’t fit the activity you’re doing are the most common causes.
Dr. Michael Saraydarian
"Surgery is very, very rare when it comes to plantar fasciitis. Statistics show that less than five percent of people need surgery. Following a treatment plan should include a mix of getting rid of the inflammation, not aggravating it by wearing certain structured shoes or immobilizing the foot, and doing some stretching. Usually, 95 percent of patients are better within weeks.
Source: Diane Atwood, Bangor Daily News [3/22/17]
Courtesy of Barry Block, editor of PM News.
Brought to you by Doctor John A. Hardy, owner of Toronto's foot clinic, Academy Foot and Orthotics Clinic. 


Academy Clinics has a special interest in high quality custom orthotics.



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