However, you don’t have to let heel pain keep you down. Dr. Silverman has been helping patients manage their heel pain for decades, and he can do the same for you. In today’s blog, he shares some of his professional advice on managing and preventing heel pain.

Five Ways To Combat Heel Pain

If you’re hoping to prevent or treat heel pain, here’s what we recommend:

1. It Starts With Your Shoes – First and foremost, you need to get your feet into comfortable and supportive shoes. If your shoes have little protection in the heel area, or if they have an elevated heel that is shifting how stress is dispersed across your foot, it’s a recipe for heel pain. Reevaluate your footwear and look into shoes that provide a little more protection for your heel area.

2. Limit The High-Impact Exercise – We love that you want to be active, but don’t always do the same high-impact activities, especially if your heels are the first area striking the ground during these exercises. Many runners, especially those who ramp up their mileage too quickly, will find that their heels start hurting. We don’t want you to be inactive, but swap out some high-impact exercises for activities that are less stressful on your heel, like biking or swimming.

3. Work Towards A Healthy Weight – Our feet and our heels bear the stress of our body weight, so the more you weigh, the more stress they feel with each step you take. Working to shed just a few pounds can take an immense amount of repetitive strain off your feet. Staying active and making healthier dietary choices can take a big burden off your heels.

4. Stretch – Get in the habit of stretching before athletic activity. This will help a lot of the soft tissues that help support the heel prepare for the activity to come. Stretching can help the calf, the Achilles and key muscles in the foot respond more naturally when stressed, which keeps your gait and your athletic form ideal. Better bodily mechanics ensure our heels aren’t overstressed when we’re active, so be sure to stretch before exercise and other physical activities.

5. Connect With A Doctor – Finally, one of the best ways to treat heel pain is by connecting with a physician if you’re dealing with new or worsening heel pain. There are plenty of different issues that could be causing your discomfort, and sometimes it’s best to have a professional take a closer look and pinpoint your diagnosis. From there, an individualized treatment plan can be tailored to your needs and personal goals. You don’t have to fight heel pain on your own!

For more tips on managing and preventing heel pain, or for assistance overcoming a different type of foot or ankle issue, connect with Dr. Silverman today!

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Causes Of Fat Pad Degeneration

Expedited loss of the fat pads in our heels can lead to a few different foot issues, including fat pad syndrome and bone spurs in the heel. To prevent these issues and ensure every step remains comfortable, we want to shine a spotlight on four activities that may be putting excessive strain on your heel fat pads.

1. Unsupportive Shoes – We didn’t come out of the womb wearing shoes, so you certainly don’t need to wear shoes all the time in order to protect your heels. However, wearing the wrong shoe or a shoe that doesn’t provide the right support for the activity can lead to extra strain on your heel fat pad. High heels or unsupportive athletic shoes can either put added stress on certain areas of your feet or fail to provide enough protection during high-intensity activities, increasing your risk of heel fat pad loss.

2. Being Overweight – The more you weigh, the more stress that is channeled to your feet with each step you take. If you’re overweight or obese, your fat pads may degenerate faster as a result of this extra strain.

3. High-Impact Activities Without Ample Rest – We want you to exercise and challenge your body, but if you gravitate towards high impact activities and don’t give your feet enough time to recover after activity, you may be at risk of affecting the health of your heel fat pad. Box jumps and running can put additional pressure on our heels, and while they are a great way to physically challenge your body, be sure you give it some time off to recover after intense activity.

4. Watch Your Surfaces – It’s also wise to consider what surfaces you are exercising on. We understand that you’re not going to be able to take your basketball game outside to a grass surface, but harder surfaces naturally absorb less stress when we move, which puts more strain on your feet. If you’re training for a marathon or simply going for a run, consider running on a softer track surface as opposed to running on the sidewalk or road. Also, be sure to keep the above tip in mind and give your feet plenty of rest after intense activity on a hard surface as well.

The post Four Activities That Wear Down Your Heel Fat Pad appeared first on Lance Silverman, MD - Orthopedic Foot & Ankle Surgeon.

What Is Sever’s Disease?

Sever’s disease is a condition that occurs when the Achilles tendon ends up pulling on the growth plate of the heel bone. This repeated stress on the growth plate of the heel can lead to pain and inflammation, making movements like standing, walking and running quite uncomfortable. It tends to occur in physically active children between the ages of 8 and 14 years old, and discomfort typically increases during physical activity or a period of rapid growth. During a growth spurt, the bones grow faster than the tendons, increasing the pull of the tendon on the heel.

Aside from heel pain that comes and goes and may be worsened by activity, other symptoms of Sever’s disease include:

• Limping
• Walking on toes to avoid pressure on the heels
• A feeling of pressure on the back of the heel
• Swelling
• Redness

And while Sever’s disease is not all that serious, try telling that to a kid who just wants to run around with their friends without pain, or to a parent who wants to help their child find relief from their discomfort. Fortunately, with targeted treatment, many children and teens can find the pain relief they seek.

How To Treat Sever’s Disease

Treatment is pretty simple on paper, but every parent knows that it’s not always easy to get kids to follow through with commitments like physical therapy or to adhere to restrictions that have been put in place. It will take a concentrated effort from both parent and child to help them successfully overcome this condition. Odds are your foot specialist will recommend a combination of the following treatments:

Rest/Activity Avoidance – You’ll want to cut back a little on activities to provide a better healing environment for the tendon and heel. That’s not to say that children should just sit on the couch for weeks, but limit physical activities that include tasks like running and jumping, especially if symptoms start to develop.

Ice – Icing the back of the heel and the lower Achilles tendon for 15-20 minutes after activity or when symptoms develop can help to calm inflammation and swelling that could be prolonging discomfort.

Footwear Changes – Cushioned and supportive shoes are a must. Shoes that are too tight or unsupportive options can put more strain on the Achilles tendon and in turn the heel.

OTC Pain Relievers – Over-the-counter pain relievers and anti-inflammatory medications may also prove useful for calming irritation caused by activity.

Physical Therapy and Stretching – Stretching and physical therapy exercises are very important in helping your child find long-term pain relief. Stretching will help to loosen a tight Achilles tendon to decrease the pull of the tendon on the growth plate. Calf stretches through toe pointing or flexing, or by stretching up against a wall can help to take pressure off the heel’s growth plate.

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What’s Causing My Chronic Heel Pain?

If you’re dealing with chronic heel pain, especially if the discomfort is worse right away in the morning when you take your first few steps, you may be dealing with one of these three conditions:

Heel Bursitis – Heel bursitis, also classified as heel inflammation, is a common cause of heel discomfort. If chronic stress causes the bursa sac in the area to become inflamed or irritated, you’ll deal with pain, discomfort and localized swelling in the heel area. Switching to a more comfortable shoe, re-examining your activity habits and stretching before movement can all help to take stress off the heel and protect the bursa sac. Be wary of increasing your activity load too quickly, as too much stress in a short time of time is the most common reason for heel bursitis.

Achilles Tendinitis – Achilles tendinitis can develop when the large tendon that runs down the back of your leg become irritated or inflamed. This inflammation is typically the result of overstress to the area, but it could also be caused by your gait and the way pressure is applied to the tendon. Overuse is the most common cause of Achilles tendonitis, and it is treated much the same as heel bursitis, with activity modification, footwear changes and short-term rest to allow the inflammation to subside.

Plantar Fasciitis – Plantar fasciitis is another condition that is ultimately caused by inflammation or irritation of a structure, but this time it is housed in the connective tissues that run on the underside of your foot that connect your heel to your toes. When this thick band of tissue becomes inflamed or irritated, movement and pressure on the area can become painful. You’ll typically notice this with the first few steps after inactivity or as you get out of bed in the morning. Footwear changes and activity modification are helpful in combating plantar fasciitis, but physical therapy to help strengthen structures and take pressure off the plantar fascia is also immensely helpful. Surgery to correct the problem can also be performed, but most people respond well to conservative treatment.

The post Three Causes Of Nagging Heel Pain appeared first on Lance Silverman, MD - Orthopedic Foot & Ankle Surgeon.

Heel Pain Won’t Go Away

Here’s a look at some of the reasons why your heel pain isn’t going away.

1. Too Much Stress – We’ll get to some of the possible underlying causes in a bit, but regardless of what’s causing your heel pain, the simple fact may be that it’s not going away because you continue to put too much stress on your feet. You need to give your heels time to rest and heal, and if they are constantly absorbing stress with each step, they can’t easily do that. We understand that it’s easier said than done to remain off your feet for a while, but do what you can and talk to your foot specialist about walking boots or other weight-bearing orthotics.

2. Bad Shoes – Your shoes could actually be contributing to your heel pain, and if you keep sticking your feet in the same pair every day, odds are that discomfort is going to linger. High heels and unsupportive flats like sandals can put abnormal stress on different areas of your feet, including your heels. Make sure your shoes are comfortable and that the inside provides amble cushioning. Otherwise consider switching shoes or adding an orthotic insert.

3. Your Weight – Being overweight can also put more stress on your feet and the natural cushioning in your heels. Over time, this added stress can lead to heel pad height loss and make bearing stress more uncomfortable. Striving to eat right and work towards a healthy weight can also help to alleviate heel discomfort.

4. Deep Heel Bruise – You’ve probably experienced the sharp pain that comes with stepping on a hard object squarely with your heel at some point in your life, whether it be a Lego or a small stone. Direct trauma to the heel from stepping on a small object can cause heel bruises, and they can linger if you don’t give the foot time to heal. Heel bruises can also develop as a result of more acute trauma, like if you fall from a great height, because oftentimes your heels are the first thing to hit the ground. We can help treat these heel bruises.

5. Psoriatic Arthritis/Plantar Fasciitis – Psoriatic arthritis can lead to tissue inflammation, and if this occurs in the feet, it can cause symptoms associated with plantar fasciitis. This involves inflammation to a thick band of tissue that connects with your heel. If you don’t actively work to resolve this inflammation, it’s likely going to linger, as will your pain and discomfort. Whether you’re dealing with plantar fasciitis or inflammation derived from psoriatic arthritis, your foot specialist can help.

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Heel Pain Causing Limp

For the sake of this blog, we’re going to focus on some of the more not-so-obvious reasons why you’re experiencing heel pain. Direct trauma from falls or hard contact on the ground can suggest a fracture that would require physician intervention, but the following conditions are a little less obvious, and thus can be trickier to manage.

1. Plantar Fasciitis – Plantar fasciitis is a condition in which the plantar fascia, the tight band of tissue under the arch of your foot, becomes inflamed. This inflammation can lead to severe pain and cause someone to try to avoid putting pressure on the area by limping. It can develop as a result of regular overuse, but can be exacerbated by other factors, like being overweight, being over the age of 40 or having high arches or flat feet. Trying to power through the discomfort tends to inhibit healing, so talk to a foot specialist if you believe you may be dealing with plantar fasciitis.

2. Achilles Tendonitis – Your Achilles tendon attaches to the back of your heel, and if it becomes irritated or inflamed, you may feel it in your heel. Oftentimes this condition develops as a result of overuse, like from running too much or too often, but it can also develop if you have poor fitting shoes that you spend hours in each day. Left untreated, pain can linger, and it can also put you at an increased risk for an Achilles tendon rupture.

3. Tarsal Tunnel Syndrome – We talk more about tarsal tunnel syndrome in this blog, but essentially it’s a condition that involves an impingement of the large nerve at the back of your foot. If pain is housed in both the heel and the front of your foot, odds are a nerve issue is at play. Consider reaching out to a foot specialist if you’re experiencing these symptoms alongside an inhibited gait or localized numbness.

4. Fat Pad Atrophy – Most adults have a nice little fat pad under their heel to help absorb pressure with every step they take. However, over time this heel pad can thin out due to repeated or intense stress. This process can also be expedited in marathon runners or those who are overweight. The lack of natural padding can make each step more painful, leading to a noticeable limp. Treatment varies from patient to patient, and a consultation with a foot specialist can help uncover the best treatment options for you.

With all of the above problems, pain is unlikely to subside if you just try to limp your way through life, so reach out to Dr. Silverman’s office to get set up with a diagnosis and treatment plan.

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Foot Problems Based on Location

Here’s a list of conditions that you might be dealing with based on where in your foot the pain is housed, as well as links to articles we’ve written on the subject.

Pain In The Heel

Cracked Heels

Morning Heel Pain

Heel Spurs

Heel Bruises

Heel Pain in Children

Pump Bump (also known as Haglund’s Deformity)

Pain In The Midfoot and Arch

Midfoot Bone Spurs

Obesity-Related Midfoot Pain

Aching Arches

Plantar Fibroma

Plantar Fasciitis

Pain In The Ball Of Your Feet

MTP Joint Degeneration

Swelling In The Ball of Your Feet

Freiberg’s Disease

Metatarsalgia

Pain In Your Toes

Sprained Toes

Capsulitis

Broken Toenail

Toe Injuries In Children

Chronic Ingrown Toenails

Big Toe Arthritis

Toenail Fungus

Toenail Numbness

Broken Toes

Bunions

The post Common Foot Problems In Different Areas Of The Foot appeared first on Lance Silverman, MD - Orthopedic Foot & Ankle Surgeon.

Causes of Cracked Heels

Heel fissures can affect any person, but they are usually caused by a combination of dry skin and excessive stress on your feet. Because of this, individuals who live in a dry climate, those who are overweight and people who spend a lot of time on their feet are at greatest risk of developing cracked heels. Shoes also work as a layer of protection and climate control, so people who are frequently barefoot are also at risk.

Again, the issue may only seem cosmetic in nature, but severe cracks or untreated fissures can actually be quite painful. They can also act as an entry point for bacteria, increasing your risk of a foot infection which brings with it its own set of issues. Heel fissures can also be quite problematic for individuals with diabetes or those with compromised immune systems, because it can be difficult for those patients to get healthy blood to their extremities, and that can also increase their risk of infection or complications related to their cracked heels.

Treatment and Prevention of Heel Fissures

The good news is that treating and preventing cracked heels is rather straightforward now that you know the risk factors. You can help to prevent and treat heel fissures by:

• Moisturizing your feet
• Avoiding overstressing your feet/standing for extended periods
• Using a pumice stone to gently remove cracked or flaking skin
• Wearing shoes that have extra padding in the heel
• Avoid going barefoot or wearing open-backed shoes
• Losing weight
• Carefully monitoring your feet for fissures, especially if you have other health conditions
• Wearing socks while sleeping

The post The Causes and Treatment Options For Cracked Heels appeared first on Lance Silverman, MD - Orthopedic Foot & Ankle Surgeon.

Heel Pain In The Morning

Heel pain in the morning can be caused by a number of different conditions, but the most common cause is plantar fasciitis. Heel bruises and calcaneal fractures could be underlying problems if you suffered an acute moment of injury, like you feel off a ladder or stepped hard on a pebble, but most people who have heel discomfort in the morning can’t cite a specific moment when pain started. They just woke up one morning, stepped out of bed, and noticed some heel pain.

Plantar fasciitis involves a problem with your plantar fascia, which is a strong, thick band of fibrous tissue that runs from your heel to the base of your toes. It helps to provide stability and flexibility to the midfoot while also providing critical support to your arch. Problems can develop if the plantar fascia becomes inflamed or irritated, which can result in microtears of the fascia fibers. This leads to pain, which is often centered in the heel.

Plantar fasiciitis can set in for a number of reasons, and they can occur in both the active and the sedentary. For example, some of the risk factors for developing plantar fasciitis are being overweight or being overly active. This is why we see the condition in older individuals whose arch may be under stress from weight gain to young athletes who are stressing the fibers during athletic activity. Young or old, active or sedentary, heel pain that is not caused by acute trauma can typically be traced back to plantar fasciitis.

Treating Morning Heel Pain

One of the reasons why the plantar fascia is painful with the first few steps in the morning is because these fibers are transitioning from hours of inactivity to an active, load-bearing state. So how can you limit heel pain in the morning and also work to prevent it long term?

To limit pain each day, do some foot and toe stretches first thing in the morning before you get out of bed. Crunch your toes then flex your feet, as this will help loosen up the fascia before it’s asked to shoulder your weight. Also, be sure to stretch your foot arch, as this too will help ease those muscles into activity for the day.

As for long term plans to curb plantar fasciitis, those begin by working with a foot specialist. They’ll take a look at your heel and the plantar fascia and determine what factors are likely contributing to the condition. Some people may be asked to cut back on activity, while others may be given an exercise plan. Most patients will be asked to do four things:

• Targeted physical therapy
• Stretching exercises
• Maintain a healthy weight
• Eat a healthy diet

Your doctor can provide you with a specific plan, but if you follow those four treatment techniques, odds are you’ll see a reduction in morning heel pain. For more information, reach out to Dr. Silverman’s office today.

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5 Tips For Plantar Pain Relief

Here are five things to try if you’re dealing with pain in your heel.

1. Change Your Shoes – Your shoes may not be giving your heel and arch the support it needs, and that could be stressing your plantar fascia. Find a shoe the contours to your arch and has plenty of support, and consider having them fitted by a professional. If you have high arches, you may also benefit from wearing these supportive shoes inside your home, as walking barefoot doesn’t offer much support.

2. Stretch and Rest – One of most common agitators of plantar heel pain is stress and overuse, which can be countered with some good old fashioned rest and relaxation. However, don’t just keep your foot idle while it’s resting. Pair rest from exercise or activity with a stretching routine that you complete a couple of times each day. This will help keep the plantar fascia from pulling or tightening up, which prevents against pain and discomfort when you are moving.

3. Ice – Ice or cold treatment can help prevent against inflammation in the area that is causing pain. You can put an ice pack on the floor and rest your foot on top of it, or you can freeze a water bottle and roll your foot back and forth over the bottle for 5-10 minutes. This second technique also helps to stretch the fascia a little, which helps to keep it loose.

4. Night Splints – In more extreme cases, a night splint may help. These devices help to stretch your plantar fascia when you’re in bed to help keep the fascia from contracting.

5. Visit A Foot Specialist – If the above conservative care techniques fail to provide you with adequate relief, contact a foot specialist in your area. They’ll be able to take a closer look at your foot and figure out exactly what’s causing your heel pain. They may be able to prescribe some more hands-on conservative care techniques, or they can perform a minimally invasive operation to take care of the problem.

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