New Stem Cell Studies are Promising

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Here at the Heel Pain Institute, we have been pioneering the use of mesenchymal stem cells for the treatment of conditions like plantar fasciitis. In a recent Consumer Update, the U.S. Food and Drug Administration announced some encouraging findings in their research into mesenchymal stem cells. The researchers working for the FDA are making great strides in the use of stem cells for regenerative medicine, traveling a path parallel to the world-class doctors here at the Heel Pain Institute. And, although our methods have produced some remarkable results, the work being done at the FDA could mean that patients throughout the country can enjoy the same benefits that our patients get from our stem cell therapy, and for applications beyond heel pain.

Stem Cell Therapy

Here at the Heel Pain Institute, our stem cell therapy method utilizes tissue harvested from your own bone marrow, then treats it and reintroduces it to the damaged tissue in your plantar fascia. The FDA’s aims are much wider. First, the researchers at their labs are looking at differences between stem cells on a large scale. They want to see if there are differences between stem cells harvested from people of varying ages and genders. So far, the research has found no significant biological differences between stem cells from different groups. The goal of these studies is to determine if stem cells could be grown in a lab and distributed on a mass scale. In fact, in the near future, we may be able to offer stem cell therapy using FDA-approved stem cells from a pharmaceutical company, rather than harvested from your own body.

The ultimate promise of these studies lies in the possibility of replacing organs using stem cells. Degenerative brain diseases, spinal cord injuries, and liver failure – to name just a few conditions – could all be reversed if these researchers are successful. We have seen the promise of stem cell therapy for plantar fasciitis; let’s hope it can give people with other conditions similar results.

Plantar Fasciitis is No Match for Jairus Byrd

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Despite being limited to just nine starts last season (eleven games total) by plantar fasciitis, NFL safety Jairus Byrd was one of the most sought-after free agents on the market this offseason. He signed a six-year, $54 million deal with the New Orleans Saints, a sure sign of their faith in his athletic abilities despite last season’s injury. In fact, the talented defensive back is expected to make a huge impact for the Saints this coming season.

ESPN analysts have noted some concerns over Byrd’s plantar fasciitis, which kept him off the field for the first five games last season. In fact, some have even dubbed him “speed deficient.” As far as injuries go, plantar fasciitis can be especially disconcerting for those already dealing with speed challenges.

The plantar fascia runs along the bottom of the foot along the arch. It can be injured by repetitive strain, especially running on hard surfaces. Although the grass or turf of a football field isn’t the worst surface to run on, the level of training that athletes like Byrd undertake can still leave them prone to this condition.

As a foot injury, plantar fasciitis can obviously put a damper on your speed. Although Byrd recovered last season, the risk of recurrence is still on the minds of many analysts. If he were to reinjure his foot, it could keep him from the training needed to keep his speed up on the field.

Fortunately, professional football players have access to a number of medical and physical therapy resources to keep them healthy. With the proper treatment – which may have included custom orthotics and novel treatments like PRP – getting over plantar fasciitis is a very attainable goal. While no one knows what the future will hold, it seems like Byrd will make a positive contribution to the Saints on the field.

Can Jeter Maintain a Healthy Plantar Fascia?

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A recent article in Sports Illustrated highlighted the injuries in Derek Jeter’s lower body as he enters his final season for the New York Yankees. Last season, Jeter played only 17 games after injuring his ankle, quadriceps, and calf. Fans and team management are hoping that Jeter can make a full recovery and deliver a championship-caliber performance this season, a la Mariano Rivera’s final season last year. However, given his history of injuries, there are some areas where Jeter fans should be particularly concerned.

Jeter Plantar Fascia

Charlie Neibergall/AP

In the same article, doctors expressed concern about Jeter’s plantar fascia and Achilles tendons. These large, thick tendons serve essential functions for the movement of the feet. But they are also subject to the most wear and tear over time. Couple that fact with the relative lack of blood flow in the region, and you have a recipe for injury, especially in a professional athlete on the cusp of his 40th birthday.

Jeter plays short stop, arguably the most physically demanding position on the field. The quick movements and direction changes required at this position could be potentially dangerous when it comes to developing a condition like plantar fasciitis. However, experts feel that if anyone can make a full recovery and play at the top of his game, it’s Jeter.

Given the treatment he has already received, Jeter has a good chance at staying healthy throughout the 2014 season. However, not everyone has access to the kind of medical care he receives. Many common foot and ankle injuries, including plantar fasciitis, are brought on by chronic straining on the tendons. Unlike Jeter, most of us don’t make a living playing sports. If your body is telling you there’s an injury, you should seek medical treatment rather than force the issue.

Reach The Finish Line with Gait Assessment and Marathon Training

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Running a marathon takes passion, endurance and most of all training. Even consistent runners agree that without proper preparation you will likely suffer an injury. Here at the Heel Pain Institute we want to help you succeed and cross the finish line proudly without any injuries. Our experienced podiatrists have the tools to help you develop a customized approach to your race, whether you are a beginner or veteran runner you will feel at ease after learning from the best.

Running Gait Assessment

An individual’s running gait is the way in which he or she runs. Our experienced podiatrists utilize the latest computer software to analyze and assess our patient’s running gait which will help determine the style of shoes to wear as well as learn how well the athlete’s efficiency of motion.

Every runner has areas of weakness and inflexibility which can lead to poor quality running and at worse cause severe long-term injuries. A running gait assessment specialist can uncover an athlete’s weaknesses and help the runner perform their best without causing damage to healthy joints.

Training Plans

Starting off on the right foot involves a good training plan for any marathon participant. A typical marathon training plan should cover about 12 to 16 weeks prior to race day. However, many first-time runners do not have a solid foundation to start from, even if they spend the better part of their day at the gym. There are a number of training methods to follow, the experienced-based plans from Runners World is a great place to start. However, you may need some guidance along the way, so to help some of our specialists are leaving you with these safety tips for your journey:

  • Do not retry a failed workout, rest for a day and then restart

  • Run only the miles you set for yourself

  • Avoid running fast

  • Mix up your workouts with strength training

  • If ankles, knees, heels or joints hurt while training, see a podiatrist

At Heel Pain Institute we recommend you follow this plan to help you finish your marathon, pain-free. Schedule a consultation with our running gait assessment specialists to help you analyze your running motions before training commences. Gait assessment is critical for the marathon participant, as well as keeping to a consistent training program. The Heel Pain Institute at University Foot and Ankle Institute is ready to help you cross the finish line all year long. Contact us today.

Plantar Fasciitis Catches Gary Neal Off Balance

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The bright side for Milwaukee Bucks organization is that they have time to rebuild their game plan for the NBA’s second half of the season as we edge closer to Christmas. Unfortunately they have to make due without the third-year shooting guard Gary Neal.

Neal who is struggling to ward off the pain from a plantar fasciitis injury sat out of Wednesday night’s game when he aggravated his foot last week against the Dallas Mavericks. Primarily he is a key backup guard coming off the bench to chip in an average 10.5 points a game for the ailing Bucks.

The reserve guard was seen walking in a boot on his way with the team to face the Cleveland Cavaliers in Friday night’s matchup. He has battled plantar fasciitis all season as he is on his way to miss even more games this season, slipping in and out of the lineup.

What is Plantar Fasciitis?

The structured band of tissue, the plantar fascia connects the heel to the ball of the foot. In order to stabilize pressure across the foot when striking the ground, the plantar fascia must be able to absorb impact when healthy. If the structure becomes strained the excess pull or force results in small tears and swelling.

Plantar fasciitis, is documented soft tissue trauma in acute and chronic levels. The acute stage is during the first three to six months of injury to the area. Chronic plantar fascia develops after the initial six months which is the body’s natural response to poor healing from chronic injury.

Causes and Risk Factors

Plantar fasciitis is caused by overuse of the plantar fascia. When an athlete, such as Neal, encounters such an injury it is likely due to poor running in poorly supported footwear. Since Neal is a basketball athlete, avoiding quick and repetitive movements with constant impact on the heels and arch is virtually impossible. Besides basketball players, other athletes at risk of this injury, include runners and joggers, tennis, volleyball and racquetball players.

Elderly men and women are also at risk of injury when ligaments and bone tissue become weaker.

Overweight and obese people also have this common injury due to the excessive stress from extra weight bearing. Also those who are prone to stand or walk long hours at work can develop cases of plantar fasciitis.

Plantar Fasciitis Treatment

Fortunately for athletes like Neal, there are a variety of options to treat this condition. From the acute phase the options of treatment include:

  • Arch support or orthotics

  • Physical therapy

  • Cortisone injections

  • Anti-inflammation medication

  • ReleF, radio frequency technology

There are a number of options to help you or superior athletes such as Neal make a full recovery without the need of invasive treatment. Chronic plantar fasciitis can be avoided when treated early, and when you experience throbbing pain our foot and ankle specialists can recommend the right form of treatment for relief. Don’t be afraid to make the call to the University Foot and Ankle Institute to help you ease the pain, book your consultation today.

Running Barefoot and Heel Injuries

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Running Barefoot Too Often Increases Risk to Heel Injuries

Our ancestors walked barefoot for millions of years, so why can’t we do it? There have been many of us who convert to training barefoot, and many agree with the experts that running barefoot has improved running mechanics. Running barefoot helps build a natural footstrike that relieves stress and knee pain, by training our body to land midfoot instead of on the heels or toes. Though plenty foot experts agree that combining footwear and barefoot training in the beginning stages help enhance the transition without increasing the risk of heel injuries or stress fractures.

The barefoot style becomes increasingly popular, but so do the injuries, reports a study from Brigham Young University. Earlier this year, researchers had examined 36 participants who wore barefoot shoes, a brand of footwear opposite of running shoes which have less cushion and support. These experienced runners were running a regular 15 and 36 miles per week in regular shoes. Half of the runners were told to increase their mileage while wearing Vibram Five Fingers barefoot shoes for 10 weeks of training.

Each runner was scanned with an MRI and more than half of those wearing the barefoot shoes showed indications of heel injuries and stress fractures on the bones of their foot. As a result, researchers concluded that runners who transition to barefoot running should do so very slowly. Otherwise, the chances of stress injuries in feet are more likely to occur.

Slowly and Surely Build Up Strength

Everyone who transitions into barefoot running needs to build up strength in their feet in order to increase the speed in running. In order to withstand the forces of striking the ground the individual needs to acquire enough strength in each foot to absorb the pressure. The ankle joint needs to roam freely to adjust to landing position. If both function properly, the knee is free to hinge back and forth without any disruption. If you cannot do it slowly then you should not increase speed.

Our heel specialist, Dr. Bob Baravarian told the San Francisco Chronicle that there has been a number of heel injuries and stress fractures among first-timers who are unfamiliar with the variations of forefoot striking.

“All of a sudden, the strain going through your foot is multiplied manifold,” said Dr. Baravarian about the beginner who develop pain from barefoot running. Heel injuries occur when people do not ease into running barefoot, so those attempting to convert should take it lightly, as if they were learning how to run as they were when they were children.

Before your feet sink into deeper stress and pain, ease into barefoot running. Whether it is using barefoot running shoes or running without any footwear, your feet need to adjust to the force of impact. The number of injuries can decrease if runners refrain from pushing their feet past their limits upon the first signs of pain. Runners who increase the speed of barefoot running too quickly are likely to develop heel injuries. Build up strength and rest as much as possible to avoid heel pain, then build up speed comfortably.

Avoiding Overstride: Michael Vick and Running Injuries

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Avoiding Overstride: What Michael Vick can Teach Us About Running Injuries

Avoiding Overstride Running Injuries

If you are like every other fitness junkie or weekend warrior, you expose yourself to the risks of running injuries. Running can provoke the potential strain of hamstring injuries, which can make even the most avid runner question their running strides. Anyone who has ever flipped on their television on a Sunday can see the brawlers of the NFL as they sprint for the end zone to score a touchdown. Philadelphia Eagles Quarterback Michael Vick is one of the many players sidelined with a hamstring injury due to his excessive habit of overstriding while running. Vick, like many others, do what they can to nurse injured hamstrings, heel pain and knee issues back to health, but the full strength is never regained until they stay off of it and adjust their running stride.

Vick, and other runners recuperating from hamstring issues encounter hamstring pain due to their improper heel-strike overstride style. The overstride is when runners over extend their stride and with each strike they land with their heel not their midfoot while running. The more that the runner continues the overstride running motion, the more the hamstring muscles increase the tearing of individual muscle fibers, called microtraumas. Microtraumas can occur in anyone, even without overstriding during running, but microtraumas that repeat over and over do not allow proper healing and leads to pain during high levels of activity.

Proper Stride Supports Muscle Health & Prevents Running Injuries

Finding the proper stride to run with efficiency and protection from injury is up to the runner decide how much they are willing to change their range of motion. Experts say that discontinuing the heel strike overstride is the best option to prevent running injuries. Changing their running form to midfoot strike or forefoot are the alternative landing options, but finding the midfoot and forefoot can be challenging.

No single running technique is suitable for everyone, but with training and practicing proper motion the legs and feet remain comfortable. Runners’ feet should land not very far in front of their hips with every stride. This makes it possible for them to alternate the landing to their midfoot or forefoot. As each strike is made the landing should feel gentle, relaxed and compliant. Runners can find their midfoot or forefoot form by attempting the following:

  • Run barefoot, or minimal footwear covering
  • Avoid landing on heels
  • Stand up straight and shorten stride
  • Gradually adjust to the new form
  • Relax and rest to avoid strain

According to a report from Harvard University, forefoot and midfoot striking can help avoid and relieve repetitive stress injuries in leg muscle groups as well as fractures and syndromes. Midfoot strikes and forefoot strikes lead to lower impact forces and lower rates of injury. A good way to tell if the feet are landing properly is by running barefoot on hard and smooth surfaces free of debris.

The midfoot strike provides equal balance and casual form for frequent runners. After repeating running injuries, the athlete should take steps in preventing further injury and convert to proper striking distance with each step. Heel striking, or over striding increases the potential for impact and forefoot striking increases potential stress on lower legs. The best option for runners may be to adjust and change their running form to midfoot striking.

Darius Miller’s Stress Fracture

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The Elements of Stress Fractures and its Effects on NBA’s Darius Miller

As the National Basketball Association is on the cusp of tipping-off for its 2013-14 season, NBA fans once again unite only to hear the bad news of some of their favorite stars. Second-year forward, Darius Miller of the New Orleans Pelicans is likely to be out for most of the preseason treating a stress fracture that required surgery in his left foot in early September. Coming off a poor rookie season, Miller was set to redeem himself in his second year after showing tremendous improvement in summer league play with the Pelicans, when he scored a team-high 23 points on July 18. After undergoing surgery, the former University of Kentucky star does not have a set timetable to make his return for this upcoming season as he continues to rehabilitate the stress fracture.

Stress Fracture of the Heel:

Just as the name indicates, a stress fracture is small crack, or fracture, in the bone usually caused by chronic stress and overuse from repeatedly jumping up and down or running long distances. The fracture in the bone does not occur right away in most cases, although it can be caused by a one-time high stress injury. A stress fracture commonly can’t be seen on a standard x-ray, and it may require MRI scans of the foot to properly determine diagnosis. Most patients are able to make a full recovery after rest and use of a boot to continue walking, but for professional athletes such as Miller, surgery may be necessary to ensure complete healing, especially in areas with poor blood supply.

Symptoms and Causes of Stress Fractures

Stress fractures are most common in the weight-bearing bones of the lower leg and foot. Podiatrists urge athletes to pay attention to any pain as catching on to the signs early will help prevent further damage. Common symptoms of stress fractures include:

  • Pain
  • Swelling: Increased during activity, decreased with rest
  • Continued pain when the foot is at rest
  • Tenderness in specific locations

Stress fractures are also commonly seen in patients suffering from osteoporosis as the bone has become weaker and even normal levels of force can cause small breaks in the bone.

If the individual constantly places the foot under unaccustomed force without enough time for recovery, the stress on the foot can result in bone fatigue. This will eventually lead to cracks in the fatigued bones, thus resulting in stress fractures.

Treatment and Surgery for Stress Fractures

Brace Used for Stress Fractures

Brace Used for Stress Fractures

After evaluation of injury, a podiatrist can determine which form of treatment is necessary to repair the stress fracture. In mild cases, they may suggest anti-inflammatory medication, such as ibuprofen or aspirin to reduce pain, as well as plenty of rest and reducing weight on the affected area. A boot, splint and/or cast will also immobilize the foot to help in the healing and recovery process.

After swelling decreases, the patient will notice improvement in skin creases and gradually be allowed to slowly put weight on the area. Use of crutches or a cane may be necessary for at least two weeks after diagnosis.

Crutches and Cane

Crutches and Cane

According to WebMD, a patient should avoid activity that introduced the stress fracture for a minimum of six to eight weeks. If the foot is exercised too soon after initial symptoms the healing process could be delayed and the damage may not heal correctly. The most severe stress fractures that do not heal on their own require surgery, full recovery can be within several months to years.

Darius Miller had corrective surgery to repair the stress fracture and underwent his rehab program in the days following the procedure. Since then he has not been at liberty to return to the basketball court, and is expected to miss a minimum of eight to 12 weeks.

Those who are suffering from stress fractures or experience continued pain in heels even after resting should make an appointment at the University Foot and Ankle Institute. They are internationally recognized specialists who can diagnose patients properly for any foot and ankle condition. Call now and book your consultation today.

Heel Pain and Custom Orthotics

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Heel Pain Treatment: Custom Orthotics

Summer is in full swing, and there is no better time to go hiking than now, but walking in your hiking shoes has been starting to feel more painful than usual. Then, the pain starts to creep up even when wearing tennis shoes out to the mall. Even your high heels give off an unfamiliar strain in the heel. The heel pain persists and nothing seems to make it feel better. Although tight, narrow shoes can cause heel pain from the strain and lack of proper support, heel pain can be a symptom of an underlying condition your podiatrist can diagnose.

Heel Pain

Heel pain can be caused by extensive walking, standing, running or jumping. Improper footwear can also cause heel pain. However, if you are experiencing pain for any length of time where rest and/or a change of shoes has not relieved pain, it is time to see a foot doctor. There are conditions such as heel bone spurs and plantar fasciitis that can cause a great deal of pain and damage if not treated.

Custom Orthotics

Heel pain can be treated with custom orthotics to correct alignments and relieve pressure in the ankle and foot to relieve pain.

Custom Orthotic Dress Shoe Insert Los Angeles

Custom Orthotic for Dress Shoes

Custom orthotics are shoe soles that are inserted into a shoe or integrated in the sole of the shoe. Orthotics are molded pieces of rubber, leather, metal, plastic, or synthetic material that are designed to fit a patient’s foot. They balance the foot in a neutral position and cushion the foot from impact on hard surfaces. Custom orthotics control the pain to specific problems including unusual shaped feet or when feet roll toward the arch (pronation).

Custom Orthotic Insert for Athletic Shoes Los Angeles

Custom Orthotic Insert for Athletic Shoes

Sole inserts can be bought at any store today, but custom orthotics are shaped to an individual’s foot. Store bought orthotics are not designed for people who have an existing foot or ankle condition and therefore cannot offer the same type of pain relief that a custom made orthotic would. These devices can be prescribed by the orthotic specialists at the University Foot and Ankle Institute. There a foot doctor will examine the heel and determine a diagnosis and treatment plan tailored to you.

How do orthotics help heel pain?

Initially the inserts may feel very odd, but after a week they adjust to the patient’s feet and feel comfortable. As patients continue to walk, their heel pain diminishes within months. This is because the custom orthotics are designed to relieve the pressure on the points which are causing pain. They also are molded to support proper alignment of the bones, tendons and muscles in the foot/ankle. This support allows the user to walk with proper alignment, support and cushion resulting in relieved heel pain.

What shoes can orthotics be used with?

Custom orthotics can be made for nearly any type of shoe. Flats, high heels, tennis shoes or work boots, as long as they can fit inside they will adjust to the feet as the patient puts them in use. Some shoes may be too shallow for orthotics, when purchasing new shoes the individual should insert the orthotics in the shoe and walk in them to decide if they feel comfortable.

What types of orthotics are there?

There are three types of custom orthotics that are prescribed to patients depending on how severe their pain is.

  • Soft – Used for cushioning and padding. Mostly temporary use until pain dissolves.
  • Semiflexible – Used by athletes that allows their feet to remain flexible and maintain firmness while active. These devices will be permanent to maintain the condition at all times.
  • Rigid – Used for non-athletic patients, because the devices are not flexible for activity.

Foot doctors advise athletes to avoid rigid orthotics, because these inserts may contribute to future foot problems such as fractures and neuroma. They will also increase energy consumption in running athletes, diminishing their endurance and stamina.

Heel Pain Treatment in Los Angeles

The podiatrists at the University Foot and Ankle Institute have been treating heel pain in the Greater Los Angeles area with great success. They can design a heel pain treatment plan that may include creating custom orthotics to make walking easy again. For affordable heel pain relief, make the Heel Pain Institute of Los Angeles your choice for healthier feet.

ReleF: Painless Treatment of Heel Pain (Plantar Fasciitis)

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Heel pain (plantar fasciitis) is one of the most common complaints seen in the office today. It occurs not only in the athletic population, but also in those who lead a more sedentary lifestyle. While a majority of patients respond to some combination of rest, ice, anti-inflammatories, stretching, orthotics and physical therapy, some will develop a more chronic condition enduring months of unrelenting pain.

Treating Heel Pain with Cortisone Injections

In the past, cortisone injection was often the default treatment in these more persistent cases. Occasionally surgery was required to relive patients of chronic heel pain. While cortisone still has a place in current practice, and advanced surgical techniques have reduced complications, the deleterious effects of multiple injections and the potential for complications in surgery has led in recent years to newer therapies with less potential for side effects.

Heel Pain (Plantar Fasciitis) Treatment with ReleF

ReleF Machine used to treat chronic heel pain.ReleF by Alpha Orthopaedics is one of the more recent advances in the non invasive treatment of persistent heel pain. ReleF uses radiofrequency technology to deep heat the tissues in and around the plantar fascia. This has the effect of not only initiating a healing response in the plantar fascia itself, but it also has the effect of desensitizing the small nerve endings around the fascia, the combination of which leads to elimination of pain. The procedure is done in the office setting and usually requires two treatments spaced about six weeks apart. There is no anesthesia required, as patient feedback is an important component during the treatment session.

Watch the ReleF Procedure on a Real Patient

ReleF -Painless Treatment of Heel PainWe have seen excellent results with the ReleF procedure in patients who have endured months, and sometimes years, of debilitating heel pain. University Foot and Ankle Institute is considered the foremost group in the treatment of plantar fasciitis and Achilles tendonitis with the use of the ReleF method. Our foot and ankle specialists practicing throughout Southern California are among the best surgeons in the country and specialize in minimally invasive and conservative treatment options for chronic plantar fasciitis and Achilles tendon problems.

Find ReleF from Heel Pain today!