Monday, August 20, 2012

Insertional achilles tendonitis

Insertional achilles tendonitis is characterized by inflammation and pain surrounding the point where the achilles tendon and heel connect. This area experiences extreme stress during any movement that involves excessive stretching of the tendon or repetitive high-impact sports, producing either severe inflammation or possibly even the tearing or rupturing of the tendon. 
The symptoms of insertional tendonitis usually involves tenderness directly over the Achilles tendon insertion area--around the back of the heel where the tendon joins the bone. Without proper treatment, this area experiences a gradient of discomfort during repetitive activity, resulted in constant tenderness and/or severe discomfort as the inflammation progresses.

Conservative treatment can resolve most cases of achilles tendonitis. The following treatments below can help treat and prevent this painful foot condition.
1) Ice twice a day with a frozen gel pack or water bottle for twenty minutes.
2) Calf stretching exercises before and after activity three sets for 30 seconds
3) 1/4 inch heel lifts placed in the back of shoes to take tension off of the back of the heel where the achilles tendon inserts.
4) Avoiding explosive activity (jumping, bootcamp) activities for a few weeks.
5) Rest to allow the inflammation to reduce
6) Topical and oral anti-inflammatory medication to reduce inflammation
7) Physical Therapy with ultrasound to reduce inflammation
8) Cross training via lower impact exercises
9) Achilles night splints which help to stretch the achilles tendon at night.
10) Custom foot orthotics with heel lift built into the orthotic and a top cover that incorporates shock absorption for the heel.

Wednesday, August 1, 2012

Preventing foot pain by finding the right sandal for summer

During the summer months it is important to wear the most supportive sandal or flip flop to help prevent various foot ailments. When looking for the right shoe first and foremost, the more surface area contact there is between the foot and the sandal, the more support the foot will have. This means the wider the sandal and the higher the arch, the better the support as this will provide more of a foundation especially for people who suffer from low arches.
The next consideration is stability. This is best accomplished by finding sandals that are adjustable as opposed to sliding on. Adjustable straps or Velcro fasteners are keys to a stable fit.  Wide straps are preferred compared to narrow straps.
We suggest the Chaco sandals, which tend to be wide, have a high arch and have fully adjustable straps. FitFlop sandals are also wide with a high arch in addition to a thick, cushioned midsole with wide upper straps. Orthaheel has a great selection of styles, many with adjustable straps, high arches and cushioned heel supports.  Birkenstock is another nice option for summer sandals.

Wednesday, July 25, 2012

Plantar fascial night splints

Plantar fascial/achilles night splints are devices that we are able to dispense in our practice that aid in stretching out the achilles tendon and plantar fascia. We have a good number of patients that have resolution in heel pain with the use of just stretching exercises, night splints, and icing. Night splints are generally used while sleeping or resting at home. The night splints that we dispense are preset at 5 degrees and after a week we have our patients reset the splint to 10 degrees. Typically heel pain patients will use the night splints for 4-6 weeks.
A majority of insurances cover plantar fascial/achilles night splints. It is easy to use and is a nice conservative treatment option for heel pain.

Tuesday, July 17, 2012

Golf shoes for Plantar fasciitis

Where To Buy

The best golf shoes for heel problems can be purchased at any pro golf shop, athletic store and many shoe stores. Golf shoes can even be purchased online from the retailer.


The best golf shoes for heel problems can be purchased for $100 to $250 a pair. It is important for your health to buy a shoe based on your specific needs, rather than for the price.


A good pair of golf socks that have arch support are best to wear with golf shoes for heel problems. Look for acrylic golf socks which help to wick away moisture from the feet and prevent blister formation. A good golf sock will also have more cushioning which can help to cushion the heels.


Be sure to try on golf shoes at the end of the day, or after a 20-minute walk so your feet are at their largest, and you will get the best fit. Look for ECCO, Foot Joy's, and Adidas brand golf shoes. Dr. Brown and Dr. Saffer's favorite specific line of golf shoes are the ECCO BIOM golf shoe and the Adidas 360 ATV.

Tuesday, June 26, 2012

Cracked heels

Dry, cracked heels are a very common problem. It is also a difficult problem to treat because, not only is the skin dry in this area, but it is also thickened or callused making it difficult for moisturizers to penetrate deep. A pumice stone or foot file may also help to reduce some of the thick, callused skin. Hydrostat cream is a product that Dr. Brown and Dr. Saffer offer in the practice for our patients. It is a product that contains Urea and it helps to soften and smooth rough, dry or cracked heels. Hydrostat cream is used once a day and is made just for the feet. A good heel cup will also help prevent your heel from spreading when bearing weight which will help control the cracking or fissuring. If you have diabetes, poor circulation or if the cracks are deep and bleed, you should consult with Dr. Saffer or Dr. Brown.

Wednesday, June 20, 2012

Summer sandals to prevent heel pain

As summer approaches one of the keys to preventing heel pain is having the proper shoe gear. It is not practical to wear sneakers all of the time especially during the hot summer months. We would like to recommend some various lines of sandals for women that not only provide support but are fashionable.

1) Dansko sandal
2) Fit flops
3) Tsubo Sandals
4) MBT women Kisumu sandals
5) MBT women Habari
6) Orthaheel talia Sandal

It is worth it to spend just a little more money on the right shoe which may help to prevent various forms of heel pain.

Tuesday, June 12, 2012

Plantar fasciitis in Professional basketball player

 Greg Stiemsma a professional basketball player for the Boston Celtics has been suffering from a chronic case of plantar fasciitis. He does not participate in running drills during practice and only is able to play during games.

Plantar fasciitis is not only found in recreational athletes but also found in professional sports. Typical treatment consist of aggressive physical therapy, cortisone injections, custom foot orthotics, and sometimes immobilization with a walking boot.

If you suffer from plantar fasciitis with pain in the heel or bottom of the foot it is important to be diagnosed as early as possible in order for conservative treatment to be effective.

For more information on plantar fasciitis please refer to our website at

Wednesday, June 6, 2012

Stress fracture of the heel

If you experience heel pain it may not always be the typical case of Plantar fasciitis. Stress fractures are common and can occur in healthy individuals without a history of any trauma to the foot. We most commonly see stress fractures in runners from over training. We also see stress fractures in middle age women who may have osteoporotic bone.
Pain presents in the inside and outside of the heel with swelling and pain. On examination there is pain upon compression of both sides of the heel bone.
Diagnosis of stress fractures starts with clinical examination and x-ray evaluation. In our offices we have digital x-ray technology that can quickly rule out a stress fracture of the heel bone.
Treatment involves immobilization in a cam walker boot for a period of 6-8 weeks.

Please keep in mind that if you do suffer from heel pain make sure you have your foot evaluated as soon as possible in order that you can be properly diagnosed and treated.

For more information please refer to our website at

Tuesday, January 10, 2012

Professional basketball player suffers from Plantar fasciitis

Dwayne Wade professional basketball player for the Miami Heat has been suffering from an acute case of plantar fasciitis over the past several weeks. In the shortened season he does not have much time to rest his foot because of back to back games being more frequent.
He more likely will be treated with immobilization with a walking boot, physical therapy, orthotics, ice, and rest. Lesser invasive surgical techniques for a quicker recovery time may be Shockwave treatment, Topaz, and PRP treatment. We have touched upon PRP treatment in our last posting. Kobe Bryant recently had PRP for a wrist injury and is still recovering but his treatment has enabled him to continue playing at a high level.
Look out for future post on the progression of Dwayne Wade's injury and the treatments that he has had.
Our practice offers various conservative options for heel pain in the recreational and serious competitive athlete. We are also board certified in Foot Surgery if surgery is an option.