Podcasts about hammer toe

(00:00-9:32) Rodgers and Hammertoe just doesn't miss. Tim is red hot with the mouth noises. Did Jackson tune out for a second? (9:40-29:43) Robert Thomas joins us ahead of Game 1 against Winnipeg. Putting conspiracy theories to rest. Getting some rest yesterday and feeling better today. Wanting to close the game out early against Utah. This team is a good mix of youngsters and veterans. Big steps taken from last year to this year. The schedule for the series. The fans in Winnipeg. Robert puts Jackson on the spot. Jobu's flying the plane. (29:52-41:44) Late period Lupe Fiasco. May is sundress season. Drops of the Week. Stand By Me. What's a Hahn Bomb? Learn more about your ad choices. Visit podcastchoices.com/adchoicesSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

(00:00-9:32) Rodgers and Hammertoe just doesn't miss. Tim is red hot with the mouth noises. Did Jackson tune out for a second? (9:40-29:43) Robert Thomas joins us ahead of Game 1 against Winnipeg. Putting conspiracy theories to rest. Getting some rest yesterday and feeling better today. Wanting to close the game out early against Utah. This team is a good mix of youngsters and veterans. Big steps taken from last year to this year. The schedule for the series. The fans in Winnipeg. Robert puts Jackson on the spot. Jobu's flying the plane. (29:52-41:44) Late period Lupe Fiasco. May is sundress season. Drops of the Week. Stand By Me. What's a Hahn Bomb? Learn more about your ad choices. Visit podcastchoices.com/adchoices

(00:00-40:13) Analysis and insight peppered in throughout the program. Dougs a ball knower. E-Mail of the Day controversy from yesterday. Audio from our co-host and part-time Billiken Coach Josh Schertz talking about the loss last night at Dayton. Billikens gonna have to get hot to win this baby. Jordan Walker left yesterday's game with an apparent knee injury yesterday. Pestus has some opinions on the EMOTD controversy, an apology for Jackson, and appreciative of his prize pack. Sargent Major Rose is next up and has high praise for Design Aire. (40:21-1:08:51) Rogers and Hammertoe is at it again with a Blues banger. Jeremy Rutherford in The Athletic alluding to Schenn maybe being on the move here shortly. How will this new song affect things? Would Schenn waive his no-trade? Doug's skeptical on what you could get in return. It's snowing sideways. (1:09:01-1:34:51) What does Rick Roll mean? Jackson's not cut out to run for office. Sometimes to feel alive, you gotta die a little. If you enjoy sleeping indoors, you're not rooting for the Chiefs or Cubs. Martin doesn't wanna break Neighbor Bill's heart. Quitting the NFL. Cork Ball. Doug likes Girl Scout Cookies. The Plumber is on the line with a snow question for Doug. Learn more about your ad choices. Visit podcastchoices.com/adchoicesSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

(00:00-40:13) Analysis and insight peppered in throughout the program. Dougs a ball knower. E-Mail of the Day controversy from yesterday. Audio from our co-host and part-time Billiken Coach Josh Schertz talking about the loss last night at Dayton. Billikens gonna have to get hot to win this baby. Jordan Walker left yesterday's game with an apparent knee injury yesterday. Pestus has some opinions on the EMOTD controversy, an apology for Jackson, and appreciative of his prize pack. Sargent Major Rose is next up and has high praise for Design Aire. (40:21-1:08:51) Rogers and Hammertoe is at it again with a Blues banger. Jeremy Rutherford in The Athletic alluding to Schenn maybe being on the move here shortly. How will this new song affect things? Would Schenn waive his no-trade? Doug's skeptical on what you could get in return. It's snowing sideways. (1:09:01-1:34:51) What does Rick Roll mean? Jackson's not cut out to run for office. Sometimes to feel alive, you gotta die a little. If you enjoy sleeping indoors, you're not rooting for the Chiefs or Cubs. Martin doesn't wanna break Neighbor Bill's heart. Quitting the NFL. Cork Ball. Doug likes Girl Scout Cookies. The Plumber is on the line with a snow question for Doug. Learn more about your ad choices. Visit podcastchoices.com/adchoices

(00:00-18:53) Story out of Texas on the Houston Texans and relocation. Can Jackson name all the UFL teams? Don't couch your passions. What if the winter of discontent leads to a Blues Stanley Cup and a Cardinals World Series? (19:01-32:46) New Cardinals Jam bringing us back from break. Shout out Rogers and Hammertoe. Let's Go Youngry Birds. Audio from the 2Fox talking with Denny Hoskins. Matt McGloin has resigned from the job he started on Monday at Boston College. Audio of Mike Francesa having some trouble with McGloin's name. Are you fan page material? (32:56-36:57) Marshy Marsh can spit. People are offering themselves and their wives to Marsh. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Today's episode comes from a runner who asked me a very interesting question during a surgical second opinion webcam call. She seemed to be really confused because the doctor had recommended performing hammertoe surgery in the doctor's office, and not an operating room.  She thought that was weird. She was also confused because the surgery would be performed using only a needle and not a scalpel. Can a doctor really do a hammer toe surgery using nothing but a needle?  Well, that is what we're talking about today on the Doc On The Run Podcast.

If you are a runner and you got diagnosed with a plantar plate sprain, you probably already figured that out plantar plate sprains can be frustrating. The plantar plate ligament is on the bottom of the foot, at the base of the second toe and it helps hold the toe down against the ground.  What is crossover toe deformity?  Well, if you look at the foot from the top, typically crossover toe deformity means the big toe tilts this way and the second toe forms a hammer toe and tilts that way and goes over the big toe. When you have the second toe over the big toe, it causes lots of problems.  Today on the Doc on the Run podcast, we're talking about when a plantar plate tear can cause or contribute to the development of a thing called crossover toe deformity. 

This week the hilar Connor Wood (Fibula) is on Long Winded! The conversation derails many times but we cover his new found brotherhood with his dog (idk), his standup career (booming!), and new hawt movie "The Challengers" (am back in tennis lessons). I hope you enjoy!Sponsors:AG1: Try AG1 and get a FREE 1-year supply of Vitamin D3K2 AND 5 free AG1 Travel Packs with your first purchase at drinkAG1.com/windedBetterHelp: Visit BetterHelp.com/WINDEY today to get 10% off your first monthPlease note that this episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct or indirect financial interest in products or services referred to in this episode.Produced by Dear Media.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Ever wished you could understand the nuanced world of bunions from a specialist's perspective? Brace yourself for a riveting discussion with Dr. Mark Sheehan, a foot and ankle connoisseur from the Kayal Orthopaedic Center, as we dissect the anatomy of the foot, focusing specifically on the big toe joint and the bones of the forefoot. Dr. Sheehan masterfully guides us through the essence of foot alignment and gait, their crucial role in diagnosing bunion deformities, and the potential for other deformities like flat foot to coexist.With Dr. Sheehan's expertise, we delve into the labyrinth of diagnosing bunions and the interplay of two essential angles. Get ready to gain valuable insights into the typical presentation of this condition and the myriad surgical options available for bunion deformity. Be it a simple medial eminence resection, a distal metatarsal head osteotomy, or foot fusion, the chosen procedure depends on the severity of the bunion, and this is something we'll dissect in-depth. As we advance, we plunge into the rare condition of juvenile bunion deformities and the significance of their conservative treatment. Dr. Sheehan provides enlightening details on the prevalence of this condition, the need for more education on surgical treatments, and the potential for secondary problems arising from bunion deformities. Join us on this thrilling journey into the realm of bunions, where understanding these deformities paves the way for more effective treatments. Don't miss out on this captivating conversation; it's sure to change the way you view bunions forever. Support the show

Mike interviews Dr. Ray McClanahan (Podiatrist) about common foot problems & what causes them. Dr. McClanahan's practice, Northwest Foot & Ankle in Portland, Oregon, allows him to care for those who find their highest joy when in motion. In his 26 years as a podiatrist, he has learned that most foot problems can be corrected by restoring natural foot function. He is also the inventor of Correct Toes, silicone toe spacers. His professional goal is to provide quality natural foot health services with an emphasis on sports medicine, preventative and conservative options, and education on proper footwear. Northwest Foot And Ankle Website: https://www.nwfootankle.com/ Correct Toes Website: https://correcttoes.com/ Shoe List: https://correcttoes.com/foot-help/shoe-list/ Time Stamps 0:00 Intro Song 0:08 Dr. Ray McClanahan Introduction 0:49 Dr. McClanahan Background 7:00 Northwest Foot & Ankle Center 10:03 Optimal Shoes for Foot Health 19:29 Transitioning to Minimalist Shoes 23:25 Fixing Bunions 32:10 Correct Toes – Toe Spacers 38:33 Common Causes of Heal Pain – Plantar Fasciitis Vs Plantar Fasciosis 51:33 Common Causes of Hammer Toe 55:02 Flat Feet & Arch Strengthening 57:22 How Most Podiatrists Treat Patients Vs Dr. McClanahan's Approach 60:35 Shin Splints Causes 64:42 Footwear & Ankle Injuries 66:53 Cleats for Athletes 68:18 Last Remarks --- Support this podcast: https://anchor.fm/bobandbrad/support

Christopher McDougal's 2009 book, Born to Run, brought minimal footwear and the importance of healthy feet to the forefront of fitness conversations internationally. At the time, there were just a couple minimal-style shoe companies in existence, today there are dozens. If you're like most people, you've likely been squishing your feet into narrow toe box shoes with arch support and an elevated heel for most of your life. The result? Plantar fasciitis, bunions, hammertoe, and overlapping toes are just a handful of the many problems that can arise from this modern foot binding practice. The good news is that there are solutions and this week's guest is here to talk you through them. Listen and learn Why your toes should be the widest part of your foot What “zero drop” means and why it's important How to decide between surgical or natural interventions for foot problems The importance of strong, limber feet Learn More Chris' Site ABOUT OUR GUEST Christopher Ioannou is a sports scientist who specializes in foot health, minimal shoes, and fixing feet. He has a great YouTube channel called “Exercising Health”. Like the Show? Leave us a review Check out our YouTube channel Visit www.yogabody.com

Motivated by a passion to help African American Women remove foot pain and unsightly scars, Dr. Yolanda Ragland shares how to have healthy feet. As founder of “Fix Your Feet ®” focuses on the surgical correction of painful and embarrassing forefoot deformities, including bunions and hammertoes, using the Tiara-Toe™ technique is the brainchild of Dr. Yolanda Ragland, AKA Queen of Toes™.Topics CoveredAre high heels safe to wear all the time?A unique reason Dr. Ragland loves Kanye's shoes (and it's not what many may think)What is Tiara Toe TechniqueHow her practice is different than any other podiatry practice in the worldMore on Dr. Yolanda RaglandAs a Doctor of Podiatric Medicine, Yolanda Ragland is a Podiatric Surgeon.She maintains offices on Park Avenue in New York City and the Washington Metro area, Bowie, Maryland. The focus of her practice is bunion and hammertoe correction. Her trade secret Tiara ToeTM technique leaves patients with “sandal-ready feet” and little to no visible scarring aftertheir surgical procedure.Dr. Ragland's goal is to help women be successful by supporting them with a strong foundation.Support the show: https://www.steveharveyfm.com/See omnystudio.com/listener for privacy information.

Motivated by a passion to help African American Women remove foot pain and unsightly scars, Dr. Yolanda Ragland shares how to have healthy feet. As founder of “Fix Your Feet ®” focuses on the surgical correction of painful and embarrassing forefoot deformities, including bunions and hammertoes, using the Tiara-Toe™ technique is the brainchild of Dr. Yolanda Ragland, AKA Queen of Toes™.

Mike Struwin is a local singer songwriter who has been playing and writing songs since he was 13.  He has been involved in bands such as Hammertoe and Steamboat, but is keeping it simple with his latest band called the Mike Struwin Band (which JSS interviewees Mike Nelson [Ep 8] and Matt Sypian [Ep 1]).  Check him and the band out at the Livery on April 29 and also at the Acorn Theater on July 20.

You get home from work and take off your shoes. As you relish the moment of your feet being free, you notice that the second toe on your right foot is curled up. After a few moments, it straightens. Over the next several days, this keeps happening. What's going on? Why does your toe keep doing it? How can you get it to stop?

In this episode, Drs. Quinn and Donovan discuss their experiences with various approaches to hammertoe surgery, along with the importance of the first ray, the plantar plate, and conservative approaches in an overall treatment plan.

The far more censored version of the award-winning and unparalleled "A Mediocre Time with Tom and Dan." - "A Corporate Time" is a daily companion and terrestrial radio show heard nationally on iHeartRadio. It's silly.

The Gentlemen of Crypto EP - 740 Check us out on Talkshoplive, Sundays at 3PM PT/6PM ET: https://talkshop.live/channels/thegentlemenofcrypto ********************************** Connect with us online at the following places: KRBE Digital Assets Group • Website: https://thegentlemenofcrypto.com • TGoC Podcast: http://pca.st/hdVR SOCIAL • KRBE Twitter: https://twitter.com/krbecrypto • KRBE Facebook: https://www.facebook.com/krbecrypto/ • KRBE Instagram: https://www.instagram.com/krbecrypto/ • King Twitter: https://twitter.com/KingBlessDotCom • Bitcoin Zay Twitter: https://twitter.com/bitcoinzay COOL CRYPTO GEAR • Amenhotep Designs: https://www.adesignuk.com/ • No Keys No Cheese Gear: https://www.bitcoinmovement.com   Business Inquiries: krbe@krbecrypto.com Support "The Gentlemen of Crypto" by using our referral link to download the Brave Browser. https://brave.com/krb666 Donations welcome, but not necessary! ********************************** **This is not financial advice. The expressed opinions in the video are of the speakers. You can lose all your money in the cryptocurrency market, so be sure to do your own research before investing.** The Gentleman of Crypto is a daily live broadcast that explores Bitcoin and cryptocurrency market. We discuss international topics, news updates, and future innovations in blockchain, digital currencies and assets, fintech, and more.

Join us as Susan shares her experience of recuperating from hammertoe surgery. She shares some lessons that apply to more than medical and physical realities, but give a vivid picture of what happens when we have something wrong with even a small part of our spiritual life. It's great to have Susan back in action! Enjoy! You can also read more about her experience here: "Susan: A Trip to the Burrito Factory." 

In this episode, we review the high-yield topic of Hammer Toe from the Foot & Ankle section. --- Send in a voice message: https://anchor.fm/orthobullets/message

Maidman SD, Nash AE, Manz WJ, Spencer CC, Fantry A, Tenenbaum S, Brodsky J, Bariteau JT. Comorbidities Associated With Poor Outcomes Following Operative Hammertoe Correction in a Geriatric Population. Foot Ankle Ortho. 2020;5(4)1-6. https://doi.org/10.1177/2473011420946726  

See omnystudio.com/policies/listener for privacy information.

Maidman SD, Nash AE, Fantry A, Tenenbaum S, Daoud Y, Brodsky J, Bariteau JT. Effect of Psychotropic Medications on Hammertoe Reconstruction Outcomes. Foot Ankle Ortho. 2020;5(3):1-6. https://doi.org/10.1177/2473011420944133

MQTA S3 E60… Learn how to crack an egg properly… Now we learn about a curvy squirrel with large breasts… Possum Love and boobs…. Llama Man loves the new plush Llama plush toy with extra parts… Foot Fetish people rejoice. Now from Sex Robot Company you can get silicone feet with built in Vaginas… Don’t get Hammer Toe or Corn on the Knob… Find Big ‘Gina Foot….

00:26 – Intro 02:09 – You need an Architect 05:28 – Health checking – running – Time for a half marathon 12:00 – I think they call that Hammer Toe 14:15 – Shake Weight 15:46 – Layer 8 conference 18:00 – Live pickpocketing 23:00 – Time for a webinar! 23:28 – Re-reading the Harry Potter […]

Dr. Wallace provides expert information and advice on what seniors and others should know and do about their feet and toes.

Dr. Wallace provides expert information and advice on what seniors and others should know and do about their feet and toes.

While Heavy and Ty are off doing stuff, Professor Brad joins Gustav to discuss parenting, seventies shows and hammer toe. Check out Professor Brad on Below the Belt and his new podcast with KJ called Our Texas (about Texas history.  Send in your podiatry and skin problems, thoughts about parenting and regretful tattoos to canyouhearmepod@gmail.com Follow us on Twitter @canyouhearmepod @realgustav @tywebb3000 @heavylongmire and Brad is @bitsarefun Find us on Tumblr and Instagram @canyouhearmepod The post Professor Brad Part 1 – Hammer Toe appeared first on Can You Hear Me?.

Welcome Back From The Weekend!!!! Today We Talked About How June Bugs Are Little Bitches, Bug Bites And Stings – Google: ‘Horrible Wasp Stings’, Sam’s ‘Hammer Toe’, A Library Book That Was Returned 47 Years Late, A Bouncy House That Blew Away… With A Kid In It, Bullying Senior Citizens – ‘Raise Up Off That Tapioca’, LeBron Not Being Concerned With Game One Loss – Although Everyone Else Seems To Be, Gimpy Got Pissed ‘Cause He Couldn’t Get It Up, That #PenisPuppy, A Live Tiger Being Taken To Prom, System Of A Down Is Apparently NOT Recording A New Album - #Bummer, Jeff Hensley Stopped By Again, Hanson Was Here To Talk About Hop Jam This Weekend, Best & Worst Of The Weekend, Our Listeners Are Awesome!!!!!! Should We Build A Wall To Keep Out All Them Damn Dirty Canadians??????

Welcome Back From The Weekend!!!! Today We Talked About How June Bugs Are Little Bitches, Bug Bites And Stings – Google: ‘Horrible Wasp Stings’, Sam’s ‘Hammer Toe’, A Library Book That Was Returned 47 Years Late, A Bouncy House That Blew Away… With A Kid In It, Bullying Senior Citizens – ‘Raise Up Off That Tapioca’, LeBron Not Being Concerned With Game One Loss – Although Everyone Else Seems To Be, Gimpy Got Pissed ‘Cause He Couldn’t Get It Up, That #PenisPuppy, A Live Tiger Being Taken To Prom, System Of A Down Is Apparently NOT Recording A New Album - #Bummer, Jeff Hensley Stopped By Again, Hanson Was Here To Talk About Hop Jam This Weekend, Best & Worst Of The Weekend, Our Listeners Are Awesome!!!!!! Should We Build A Wall To Keep Out All Them Damn Dirty Canadians??????

DOWNLOAD: PSB Ep. 64 “Sproing” Tonight, Ferguson and me the ~Z~ discuss the fun computer crashing during recording, the excitement of Hammer Toe, the wonderful world of “Shrimp Pimp”, and the premier of Pretentious Podcast Classic with Joe Borowski! Enjoy!  

DOWNLOAD: PSB Ep. 64 “Sproing” Tonight, Ferguson and me the ~Z~ discuss the fun computer crashing during recording, the excitement of Hammer Toe, the wonderful world of “Shrimp Pimp”, and the premier of Pretentious Podcast Classic with Joe Borowski! Enjoy! … Continue reading →

DOWNLOAD: PSB Ep. 64 “Sproing” Tonight, Ferguson and me the ~Z~ discuss the fun computer crashing during recording, the excitement of Hammer Toe, the wonderful world of “Shrimp Pimp”, and the premier of Pretentious Podcast Classic with Joe Borowski! Enjoy! … Continue reading →

MQTA S2 E115….  Human Toe in Yukon has gone missing.  Perhaps someone drank it!!... Stop…. Hammer Toe... Rub your root if you want good luck and happiness…  This dress will help you commit crimes and many people have helped create it….   Also, this is the best (or worst) cup of coffee anyone has ever made – it comes with extra protein!!!   But you may face time in jail if you make it yourself!!!

Georgia Podiatry, Inc. Today, Schwegman and I sat down to learn about Georgia Podiatry, Inc. Dr. Evan Brody founded Georgia Podiatry after practicing several years in a large multi-site group. He has since added two more locations to provide more convenient access to the care of their foot and ankle specialists. Dr. Brody sees […] The post Georgia Podiatry Inc – Top Docs Radio appeared first on Business RadioX ®.

Plantar fasciotomy. This is the cutting of the plantar fascia. This can be done either through an open incision in which the plantar fascia is exposed during the cutting process or endoscopically, using small fiberoptic instruments. The effect is the same. It is effective. Most clinical studies cite an 80-95% success rate. His treatment has never set well with me. For all the reasons that I have listed above, the plantar fascia is a very important structure and cutting it can have dire consequences. And when plantar fasciotomies go wrong, they can go very wrong. Some of the most unhappy, painful patient’s that I have seen have been people with failed plantar fasciotomies. The loss of this guidewire to the arch can lead to pain in the joints along the outside of the foot, stress fractures, and I believe, eventually, arthritis within the middle portion of the foot. There have been other methods that have come and gone. Over the last 15 years, I have seen many of them. Orthotripsy or extracorporeal shock wave treatment is the application of repeated high energy shockwave is generated in a water bladder using a spark plug and concentrated onto the heel. This was approved by the FDA in 2000. There was a lot of initial enthusiasm for it. The initial studies showed a 65% success rate with one treatment and an 85% success rate with 2 treatments. However, a later study published in the Journal of the American Medical Association (JAMA) seemed to place the send out. Then, one of the companies most active in manufacturing the machines used for this treatment became embroiled in a false advertising lawsuit. Even though many articles seemed to continue to support this form of treatment, it has become very difficult to get it approved by insurance and to get the machines to do the treatment. Platelet rich plasma is perhaps the one that is most up in the air. During this procedure, blood was taken from the body and spun in a centrifuge. This separates the blood into components. There is the watery plasma which contains soluble proteins and electrolytes. There is the red blood cells which settle to the bottom. Finally, there is the in between layer, which contains platelets, full of growth factors. The problem is that the type and concentration of these growth factors varies from person to person and from technique to technique. Not all of these growth factors are likely to be helpful. So a “soup” of growth factors is used, but it is impossible to tell whether it is the best combination. Some encouraging clinical studies have been published, but a number of them have been discouraging. Botulism toxin is made by bacteria. When it is injected in small doses, it has been used to paralyze muscles in the face, to give a more youthful, wrinkle free appearance. Injection of doses of this protein have been shown to give relief of the plantar fasciitis pain. It is unclear whether this is because it has paralyzed key muscles or because it has some direct pain relieving effect. The dosages that are used can be quite expensive ($2000 or more) Coblation is the burning of small areas of tissue using a radiofrequency probe that has a lower temperature than standard cautery techniques in the operating room. This is passed through the damaged tissue several times. Some good results have been published, but despite the fact that the technique has been around for over 10 years it has not met with widespread acceptance. My own experience with this technique has been somewhat unpredictable. The FAST procedure has been recently introduced. FAST stands for “focused aspiration of scar tissue”, but I’m sure that this abbreviation is used to imply that the technique has a quick recovery. It uses an ultrasound probe to liquefy the damaged tissue within the plantar fascia. Certainly the manufacturer’s and doctor’s in vault in its development have been enthusiastic about its results. Personally, I am still waiting for published results of this procedure. The problem with all of these procedures is that they focus on the scar tissue within the plantar fascia and not the underlying problem, the weakness in the arch muscles. To some extent, without addressing the underlying problem, the procedure may be doomed to fail. In practice, these procedures work a surprisingly large percent of the time. However, often their hype does not live up to the results. In conclusion, the plantar fascia is a key structure in the foot. The foot in turn is an amazing and delicate mechanism. Plantar fasciitis itself is a sign of a weak foot, a condition that is, in place given our shoewear choices, Western lifestyle with its obesity, diabetes, and other medical problems, and increased lifespan. Current surgical management is not adequate, but in the worst cases may be all that we have. Fortunately, in practice, it seems to be largely successful. Unfortunately, they’re too many situations in which it does not give adequate pain control or leads to complications that are worse than the initial problem. Hopefully, new treatments are on the horizon which will give better results and fewer complications. http://www.wholefoot.com/plantar-fasciitis-surgery/feed/ 0

What does plantar fasciitis feel like? Not one of my patients would be in my office if they weren’t experiencing pain. The pain is usually worse for the first couple of steps after getting out of bed or getting up from a seated position. The description attached to this is “The first step is the worst step!”. What is happening is that the muscles in the calf and arch are contracting during rest because of the foot is allowed to relax. The stretching that occurs on the first step increases the force within the plantar fascia and the sensitive plantar fascia becomes painful. This pain often radiates into the calf and forefoot. The location of the pain is very characteristic. It is usually found on the inside and front of the weight-bearing heel. Pain is found in other locations usually have other underlying problems besides plantar fasciitis. This often leads people to conclude that they do not have enough padding under their heel, that they strike heel too hard. This is not the case. When we look at the tissue of plantar fasciitis under a microscope, as we can do after surgery, what we find is both interesting and counterintuitive. First, we do not find inflammation in the tissue. We also don’t see that the tissue damage is located on the spur. What we find is that the damage consists of small tears within the ligament that do not completely heal, leading to blood vessel proliferation and deterioration of the tissue. Who gets it? Certainly, it is more common in people that are overweight. You would expect this because the more that you weigh, more pressure that you are putting on the plantar fascia. People that have restricted ankle range of motion either naturally or after an injury or surgery, also seem to develop it more frequently. So impaired flexibility seems to be an issue. I also see up frequently in athletes and in people with sedentary occupations. So where doesn’t all go wrong? Well, my belief is that plantar fasciitis is rooted in a poorly functioning and weak arch muscles. The weakened muscles fail to protect the plantar fascia, which gradually weakens and tears. The underlying problem is our shoe wear. Our feet were designed without shoes in mind. Our natural state is to walk, shoeless, on rocks, tree roots, and uneven surfaces on the forest floor. In this state, our feet are asked to do a different job than when they are in shoes. When we walk barefoot, our toes are flexing and grasping for purchase in the mud and dirt. This conditions our feet, especially the small arch muscles. In addition, our feet are constantly twisting to adjust to the uneven surfaces. This twisting and torquing of the arch is also a function of the small muscles. When we walk in shoes, the jobs that are feet are asked to do is much more crude. The toes really do nothing. The foot hits the floor as one unit, never allowing the muscles to work much. It would be really much like taking a small child and never allowing them to use her hands without any snug pair of mittens on. By the time that child was an adult, the muscles in their hands may be a capable of grasping and doing fine manipulation of objects. That child’s hand would most likely be permanently impaired from this development. Why would we expect our feet to develop differently? Finally, our sedentary lifestyle contributes by allowing us to be heavier and in worse condition. In many ways, plantar fasciitis can be a sign of overall poor body conditioning. Other contributing factors include the fact that we as a Society are getting older. In some cases, changes in activity and stress to these for structures can precipitate an episode of plantar fasciitis. This is a factor in many forms of tendinitis and stress injury. There was a great man, named Julius Wolff, who came up with a very simple principal that underlies this. Dr. Wolff was one of the first professors of orthopedics in Berlin. He was examining heel bones and noted that this small bony spicules within the bones lined up with the force within the bone. He correctly guessed that the loading of a bone causes it to become stronger over time. However, this remodeling requires time. If the stress overload to the bone, then it can go on to injury before it strengthens. Therefore, training errors during athletics in which a person “overdoes it”, can lead to injury. Other general medical problems can also contribute such as diabetes, atherosclerosis, and inflammatory conditions such as rheumatoid arthritis. So, how do we treat it? Whatever we do, this seems to work 85-90% of the time. Many of the treatments that have been suggested include heat, cold, wrapping with an Ace wrap, taping, therapeutic ultrasound, phonophoresis, deep tissue massage such as using the Graston technique, and soaking in Epsom salts. These methods have many things in common. The first is that they don’t do a darned thing to help cure plantar fasciitis, but they do make it feel better for a while. This may be of some benefit. They also all work the same way. The Gate Theory Of Pain was developed by Melzack and Casey in 1968. It suggests that pain is modified in several areas from the source of the pain, in this case in the foot, to where it is perceived in the brain. The pain nerves are stimulated and conduct their impulses to the spinal cord. If enough impulses stimulate the nerve or gate in the spinal cord, this impulse is relayed to the brain, where we would identify and understand that something painful was occurring. If other nerves such as the nerves that sense cold, heat, pressure, vibration, or light touch are stimulated at the same time, these impulses interfere with the gate in the spinal cord, making it less likely that the pain will be noticed by relaying it to the brain. Placing ice on an injury or rubbing it stimulates these nerves and makes it harder to proceed pain. Another way of treating plantar fasciitis is to reduce the stress on the plantar fascia. Wearing a rigid shoe reduces the motion in the front and middle portions of the foot, reducing stress and hopefully allowing the body to catch up with the injury. Similarly, arch supports can eliminate or reduce motion within the arch, reducing pressure and stress from the plantar fascia. But didn’t you that these were bad for feet? Well, I did say that they were bad for healthy feet. Let’s talk about the stages of healing. Nearly every injury occurs and resolves in a pattern. I use this pattern to help guide my treatment and the degree of activity that is appropriate. Stage I is the acute stage. In this stage, pain is present to the point that it interferes with daily function. During this stage, the injured area should be protected and arrested. Palliation or doing things to simply help with pain is really reasonable. Stretching may be helpful at this stage. Strengthening and conditioning however does not make sense when you can barely make it through the day. To some extent a period of time needs to be allowed to get out of this stage. Hopefully, it will be brief. Stage II is the subacute stage. In this stage, the pain is not functionally limiting. Usually, it is primarily morning pain or pain at the onset of activity. The pain can temporarily increases with activity, but the activity should not aggravate it for any prolonged period of time. It is likely that athletics of any significant intensity may be difficult during this stage. The protection that was begun during the first stage should be gradually removed during this stage. This includes such things as supportive shoes and arch supports. The rehabilitative goals are not only improving flexibility but also beginning strengthening on a gradual basis and conditioning. Stage III is the final stage. The pain has resolved. During this stage, the foot should be gradually exposed to increasing stress to allow it to strengthen. Hopefully, with weight loss, and conditioning, the foot can be strengthened above its preinjury level. At a minimum, rehabilitative exercises should focus on flexibility. As it has been documented scientifically, that tight Achilles tendons and muscles and tight hamstring muscles are associated with the development of plantar fasciitis, improving flexibility of these muscles is a key part of rehabilitation. The stretches focused on the Achilles/gastrocnemius complex, the hamstrings, and the plantar fascia. Strengthening and conditioning exercises focus on the intrinsic muscles. I encourage my patients to do these exercises without shoes. One good exercise is to place the front of the foot on a 2 x 4” and to slowly rotate the heel in a circle, shifting the weight on the forefoot from the inside to the outside during the rotation. Begin by doing this for 30 seconds, 3 repetitions, once a day. Gradually, increase the duration to 5 minutes or more, 3 times a day. Other exercises include balance exercises, such as one leg squats or yoga positioning maneuvers. The intrinsic exercises that I think due to most good involve weight bearing (no towel scrunching or picking up marbles with her toes). As resilience increases, hopping or leaping maneuvers are very helpful and may help you get back to sports. http://www.wholefoot.com/what-does-plantar-fasciitis-feel-like/feed/ 0

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