Boston Celtics Rookie Kelly Olynyk Has Plantar Fasciitis

 Kelly Olynyk a first round draft pick of the Boston Celtics has just recently suffered from an acute case of plantar fasciits. We have recently see a large number of cases of plantar fasciits in professional athletes.

Plantar fasciitis is an inflammation of the fibrous band of tissue on the bottom of the foot which is called the plantar fascia. Plantar fasciitis can presents as pain first step out of bed in the morning in the heel. It can also presents during or after athletic activity. The pain is typically a sharp sensation and can also present on the entire length of the sole of the foot. 

In acute cases rest, NSAIDS, custom orthotics, immobilization with a cam walker boot, night splints, and aggressive physical therapy are initial conservative treatments for plantar fasciitis.

Rarely does this procedure involve surgical intervention.

Topaz and PRP injections are some of the newer minimally invasive procedures for chronic cases of plantar fasciitis that have not resolved with conservative measures.

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Running Injuries & How to Avoid them

Dr. Adam Brown of Carolina Foot Specialists in Charleston, SC explains how running can affect your feet and how you can avoid running injuries in this video.

Plantar Plate Tears

What Is the Plantar Plate?

The plantar plate is a soft tissue structure on the bottom of the foot under the metatarsal head. The plantar plate is composed of type 1 collagen and fibrocartilage. The plantar plate attaches to the base of the toe and the metatarsal

What Is the Function of the Plantar Plate?

The plantar plate cushions the bottom of the metatarsal head while walking and running. In addition, the plantar plate helps bring the toe to the floor while standing.

What Are Causes of Plantar Plate Tears?

The following are causes of plantar plate tears:

• A long first metatarsal, short second metatarsal
• Biomechanical abnormalities ie. Bunions, hammer toes, flatfeet
• Arthritis of the big toe
• Cortisone injection into the area
• Excessive use of high heel shoes
• Trauma

What Are the Symptoms of a Plantar Plate Tear?

The following problems can be symptoms of a plantar plate tear:

• Pain in the ball of the foot that has persisted despite changes in shoes and activities
• A second or third toe that appears to be changing position over time
• A diagnosed ‘neuroma’ that has not been responsive to treatment

How Do You Diagnose a Plantar Plate Tear?

The proper diagnosis of a plantar plate tear as well as any underlying foot deformity starts with a physical exam. Your Carolina Foot Specialists doctor will take a thorough history of your foot problem as well as clinical exam and look for:

• Pain at the metatarsal head typically the 2nd metatarsal
• Swelling in the area of the plantar plate
• Instability of the toes
• Hammer toe deformity
• Previous diagnosis of a neuroma

X-Rays

In house X-rays will be ordered of the feet to assess the quality and alignment of the bones of the foot. X-rays are taken to rule out the possibility of fractures or arthritis in the foot.

Magnetic Resonance Imaging (MRI)

If your Carolina Foot Specialists doctor suspects that you might have a plantar plate tear, they may order an MRI. Magnetic resonance imaging is one of the most sensitive imaging techniques for this particular problem. MRI's are one of the best imaging techniques to evaluate the integrity of the plantar plate and to rule out a tear.

Ultrasound

Ultrasound is another diagnostic test that each of our Carolina Foot Specialists locations offer to evaluate the plantar plate and to rule out a neuroma.

Non-Surgical Treatment Options

Non-surgical treatment options for this pathology are initiated to help alleviate any discomfort in the foot. They include:

• Rest
• Ice
• Anti-inflammatory medication
• Offloading metatarsal padding.
• Cross over taping of the digit to take pressure of the joint
• Custom foot orthotics to accomodate for a biomechanical issue with the feet.
• Changes in Shoes: Avoiding shoes that aggravate this problem (high heels and tight shoes)

When Is Surgical Treatment Necessary?

Surgical treatment is suggested when non-surgical measures fail to alleviate pain and begin to limit your lifestyle.
Surgically this problem is addressed by a direct repair of the plantar plate via a dorsal or plantar incisonal approach, metatarsal osteotomy, and repair of a deviated digit (hammer toe repair).

Aggressive physical therapy and close follow up after surgery are the goals that Carolina Foot Specialists employs to return to activity as quickly as possible after surgery if needed.

Bunions and Your Feet

Bunions—misaligned big toe joints that swell and become tender, causing the first joint of the big toe to slant outward and the second joint to angle toward the other toes. Bunions tend to be hereditary, but can be aggravated by shoes that are too narrow in the forefoot and toe. Surgery is frequently performed to correct the problem. Dr. Andrew Saffer of Carolina Foot Specialists in Charleston, SC explains more in this video. 

Putting Your Feet First in Charleston, SC

Is heel pain ruining your life? Do bunions hinder you from wearing your favorite shoes? Carolina Foot Specialists in Charleston, South Carolina is putting your feet first. Find out how here: 

Recovery after the Topaz procedure

Topaz Coblation for Planter Fasciitis & Heel Pain

Topaz Coblation Procedure

TOPAZ is a quick, simple, procedure that Carolina Foot Specialists offers for chronic heel pain that is unresponsive to conservative treatment. The TOPAZ MicroDebrider utilizes patented Coblation® technology, designed to specifically treat tendons and fascia. The TOPAZ technique has been associated with quick return to daily activities allowing for significant improvement in patient outcomes.

How TOPAZ Works

Through a small incision, approximately and inch long, the TOPAZ MicroDebrider is applied on and around the tendon for half-second duration treatments placed a quarter inch apart to form a grid-like pattern. With every fourth application, the device is inserted deeper into the tendon - approximately a quarter inch in depth. Small amounts of tissue are removed as a light application of radiofrequency energy is guided into the tissue. TOPAZ treatment typically takes less than 20 minutes to administer. Patients are ready to leave the clinic once recovered from local or light sedation.

Patient Selection

• Fascia with partial tears may be at an increased risk of rupture
  
• Patients with chronic heel pain that has been unresponsive to conservative treatment.
  

Patient Preparation

Access can be approached through tiny poke holes made through the skin with the use of a .062 K-wire under IV and local sedation. Procedure takes 20 minutes without the need for skin sutures.

Post Operative Care and Rehabilitation

First week

• Immobilize with cam walker boot or surgical shoe.
• Dressing changes performed by the patient after first postoperative visit

Week 2-Week4

• Passive and active range of motion exercises
• Night splint-Cam walker as appropriate
• Sneaker with custom orthotic

1-3 months

•  Low impact exercising with slow progression into higher impact exercising
• Routine at home or work is okay at the discretion of a surgeon

Carolina Foot Specialists: Neuromas

Neuromas are enlarged benign growths of nerves, most commonly between the third and fourth toes. Neuromas are caused by tissue rubbing against and irritating the nerves. Pressure from ill-fitting shoes or abnormal bone structure can also lead to this condition. Depending on the severity, treatments may include orthotics (shoe inserts), cortisone injections, and, in extreme cases, surgical removal of the growth.

Dr. Andrew Saffer of Carolina Foot Specialists explains more in this video.