Treatment for plantar fasciitis and achilles tendonitis

Plantar fasciitis and Achilles tendinopathy are two of the most over-diagnosed conditions for anyone with foot or ankle pain. If you’re experiencing pain on the underside of your foot or on the back of your ankle, just above your heel, it’s likely that you’ve irritated the fascia or tendon, likely through over-use or improper biomechanics.

Due to the damage of the connective tissue, resting it or buying an over-the-counter brace are not enough to correct the problem. Consequently, it often goes mis-treated and becomes a chronic complaint.

One of the most effective treatments is to remodel the tissue through controlled load and rehab, strengthen the intrinsic muscles of the foot, and manual therapy throughout the kinetic chain and the small joints of the feet.

It is so important to get this pain evaluated by a professional who understands the rehab necessary to correct it. It is not something that you want to attempt to self-diagnose or self-prescribe treatments based on the internet alone. This includes utilizing kinesiotape and orthopedic braces that you are able to purchase over-the-counter. Not to say these tools are never appropriate, but that should be the decision of the medical professional.

Depending on bracing long-term, even for just athletic performance, can have detrimental effects on our biomechanics and can allow our muscles and surrounding tissues to get weak and become dependent on the brace for support, causing more issues.

Common Issues We Treat

• Bullet points for the plantar fasciitis page as well:
• Foot pain while walking/running
• Flat feet/ Pes Planus/ Arch collapse
• Metatarsalgia
• Heel pain
• Arch pain
• Achilles tendinitis
• Sprain/Strain

WHAT IT IS

Plantar fasciitis and Achilles pain are often mechanical in nature, meaning that it’s a result of how we move and use our body. To fix a mechanical problem, you need a mechanical solution. The rehab that we provide, both in-office and teaching the patient to do themselves, aims to restore full and pain-free ranges of motion and then strengthen the surrounding muscles and tissues to better tolerate load and stress.

If you were to break your arm and not seek treatment or casting, the bone would eventually heal itself. You would lose function and range of motion, but it would eventually stop hurting on its own.

Connective tissue damage is a bit more complicated than that. Left alone to just “rest” or restricted to a splint or soft cast, the tendon and tissue will not be remodeled, will not heal on its own, and the pain will persist for long after the initial injury or incident. This is why seeking appropriate treatment is so important.

WHAT IT ISN’T

Plantar fasciitis and Achilles tendon pain can be frustrating to deal with due to its chronic nature and unresponsiveness to most other treatments. That doesn’t mean that you must live with the pain forever or even that it would take dozens of visits to correct.

No matter how chronic the complaint, there is usually still improvement to be made, if not full resolution, however, the sooner you get a connective tissue problem like these evaluated and treated, the better the prognosis and the faster the recovery.

Have Questions? We’re here to help!

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October 25, 2018

Is that a rock in my shoe? Overuse injuries can cause heel and foot pain. Weekend warriors, aerobics enthusiasts and even folks who are just getting back into exercise are no strangers to pains and strains. When it comes to foot pain, there are two common issues:

• Pain in the back of the heel may be the result of Achilles tendonitis, which can be caused by an overuse injury.
• Pain on the bottom of the foot may be caused by plantar fasciitis – a result of inflammation in the fascia, a connective tissue, which in this case stretches between your heal and toes.

In both cases, the pain is a culmination of irritation over time, rather than an acute injury, like a sprain. “The expression ‘no pain, no gain’ can be dangerous,” said Dr. Adam Ferguson, an orthopaedic surgeon specializing in the foot and ankle at the Connecticut Orthopaedic Institute at MidState Medical Center. “You should always listen to your body. If something doesn’t feel right, give it some rest.” In about 35 percent of cases, these injuries occur in people who exercise a few days a week, but body mechanics, shoe fit, age, gender, foot shape, your occupation and your weight can also play a role. It is rare for an Achilles tendon or the fascia in the foot to rupture, but cortisone injections can increase the risk of rupture. Both tendonitis and fasciitis can cause bone spurs – bumps of extra bone that grow in an injured area. Bone spurs are not usually the cause of the pain. Instead, they are typically the result of the irritated soft tissues. Removing bone spurs rarely fixes the issue. Fortunately, Achilles tendonitis and plantar fasciitis can be prevented, or at least mitigated. In both cases, rest, stretching and non-steroidal anti-inflammatory medications (NSAIDs) are common treatments. In difficult-to-treat cases, physical therapy, bracing or, in cases resistant to all other forms of treatment, surgery may be required. Splints and orthotics may also be helpful in treating both conditions. “Patients with pain in the back of the heel or the bottom of the foot that doesn’t go away with rest and NSAIDs after a couple of weeks should call their doctor,” said Dr. Ferguson. “There are effective treatments outside of surgery that can be used to manage overuse injuries of the foot. If surgery is required, the Connecticut Orthopaedic Institute is uniquely positioned to not only treat the problem, but also provide an exceptional experience geared toward the unique needs of each patient.” Gradually increasing your activity, wearing properly fitting shoes, incorporating stretching in your routine, maintaining a healthy weight, and alternating activities are effective ways to prevent overuse injuries. Sometimes, foot pain caused by overuse injuries can take up to six months to resolve. Dr. Adam Ferguson is an orthopaedic surgeon at the Connecticut Orthopaedic Institute at MidState Medical Center. His focus is on foot and ankle care. To learn more about the Institute, click here. 

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