ASK THE EXPERT
“HEEL PAIN IN THE RUNNER” DON’T LET IT SLOW YOU DOWN
H
eel pain in active adults is most commonly related to having “the worse pain levels when walking first thing in the morning or after long periods of sitting.” It is essential to quickly care for and treat heel pain to avoid further misalignments and complications. While several factors may be in play when it comes to heel pain, they can only be correctly diagnosed by a foot and ankle specialist. Runners with heel pain typically complain of arch pain, pain on the bottom of the heel, swelling on the bottom of the heel, and sometimes even bruising if symptoms are severe. If arch pain persists beyond a few days, treatment is needed to prevent the condition from becomFig: 1 ing worse. The most common cause of heel pain is a condition known as plantar fasciitis (Fig.1). Plantar fasciitis occurs secondary to one wearing non-supportive footwear on hard surfaces, overuse/
By Dr. Warren Windram D.P.M.
increased activity, improper training habits, and even possibly a faulty foot structure (flatfeet). Plantar fasciitis is an inflammation of the band of tissue (the plantar fascia) that extends from the heel to the toes. In this condition, the fascia first becomes irritated and then inflamed, resulting in heel pain. Another cause of heel pain commonly seen in runners is a calcaneal stress fracture (Fig. 2). If not treated appropriately prolonged symptoms of heel pain (generalized pain in the heel area that develops slowly (over several days to weeks)) will be experienced, including noticeable redness, swelling, and bruising to the areas of the heel bone. Treatment efforts plantar fasciitis such as stretching, limiting activity, shoe modifications/ orthotics, oral medications/steroid injections, night splints, taping/strapping, physical therapy, stretching exercises (plantar fascia/Achilles tendon), and simply avoiding barefoot walking can all help relieve pain symptoms. Although a relatively small amount of patients will require surgical intervention, your foot and ankle surgeon can discuss the most appropriate surgical treatment if necessary. Surgical treatment for chronic cases include percutaneous Platelet Rich Plasma injections, Topaz Coblation therapy, extra corporal shockwave therapy, and endoscopic plantar fasciotomies.
Fig: 2
If diagnosed with a stress fracture of the heel bone, treatment will include rest and immobilization of the effected foot. Stress fractures in the heel bone occur mostly due to overuse injuries or an underlying issue related to bone quality/bone mass (osteoporosis). A foot and ankle specialists can utilize diagnostic imaging to appropriately diagnose and treat the stress fracture. In some cases, surgery may be required to stabilize the stress fracture or to repair a stress fracture that has progressed to a complete bone fracture. To prevent heel pain, it’s key for active individuals to run on soft surfaces, keep mileage increases to less than 10 percent per week, and wear the proper shoes for your foot type and gait.
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Dr. Windram specializes in foot & ankle reconstructive/trauma surgery, with a particular interest in total ankle joint replacement surgery. He is involved with podiatric surgical training, working as the podiatric surgical residency director at Memorial Health Care System. Dr. Windram is the current director of the Foot and Ankle Fellowship program at Westside Regional Medical Center and is a clinical instructor at Westside & Memorial Health Care System’s podiatric surgical residency programs. South Florida Institute of Sports Medicine 209 S.W. 84th Avenue, Plantation, FL 33324
New Plantation Location
South Florida Institute of Sports Medicine Foot, Ankle & Leg Specialists
SAME DAY APPOINTMENTS
2021
2020
Fractures, Arthritis and More
Pediatric & Sports Medicine
therapists, and staff provide patients The Foot, ankle, and leg specialists with the latest medical technology at South Florida Institute of Sports and surgical procedures. Medicine (SFISM) have moved to a new location off Pine Island Road Expanded Access to Care near the Westfield Broward Mall. Dr. SFISM now offers telemedicine Warren Windram and Dr. John Goodner consultations and same-day appointare already seeing patients at the ments. The new space has more exam new, state-of-the-art location, which rooms, giving patients faster opened to accommodate service and greater access to the increasing number care. Families will have peace of patients. of mind knowing injured SFISM provides the loved ones will be seen by most comprehensive, a board-certified surgeon state-of-the-art podiatric, quickly. Dr. Windram and Dr. orthopedic, and rehabiliGoodner, along with their tative care for patients in colleagues Dr. Carlo Messina Scan Here Broward County. and Dr. Michael Cohen, also to Schedule an Their highly trained have offices in Weston and Appointment physicians, physical Pembroke Pines.
⊲ South Florida Institute of Sports Medicine’s new location is 209 S.W. 84th Avenue, Plantation, FL 33324. They accept most health insurance plans and offer discounted rates for self-paying patients. To make an appointment call 954-720-1530 or visit www.SouthFloridaSportsMedicine.com.
⊲ The foot, ankle and leg specialists of South Florida Institute of Sports Medicine are affiliated with Sports Medicine Associates: Dr. Al DeSimone, Dr. Tony Moya, Dr. Alex Bertot, Dr. Franz Jones, Dr. David Shenassa, and Dr. Jorge Gonzalez. Our City Plantation / January 2022 / OurCityMedia.com / 29
