Plantar fasciitis common cause of heel pain in runners

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By KENNETH GERSZBERG, M.D.
Special to Palms West Monthly
Posted July 3, 2018

There are numerous reasons patients with foot & ankle issues come into our offices. The following questions are representative of the types of injuries and ailments we treat:

Question 1: I recently twisted my ankle playing pickleball. I went to an urgent care center and they said it was only a sprain. What are my treatment options and when can I get back to playing the game? 

Answer: If your ankle feels 100 percent better, it should be safe to continue playing. Most of the time these injuries are treated with a supportive brace, physical therapy and activity modification for a period of time. For more severe injuries, a walking boot might be used. 

The time to return to pickleball depends on the severity of the injury, but typically between two to four weeks (usually with a brace during play). You know your body best and need to use good judgement when deciding whether to return to any activity. 

Remember, every body and every injury is different. If there is any lingering swelling, pain, stiffness and/or instability, an evaluation by an orthopedic foot and ankle specialist would likely be warranted.

Question 2: I have suffered from arthritis for years and was recently diagnosed with arthritis in my feet. Why is it so uncommon to hear about arthritis in the feet and/or ankles?

Answer: Arthritis is a very common diagnosis throughout the body and is usually most debilitating in the hips and knees. There tends to be less severe symptoms in the foot and ankle region. 

Some people, though, do have severe arthritis in this area. Most of the time it’s treated with anti-inflammatory medications, shoe modifications or braces. For arthritis that is resistant to conservative treatment options, surgery is sometimes warranted. 

If the pain has started to limit your daily activities, you should see an orthopedic foot and ankle specialist for further evaluation and treatment options.

Question 3: I’m a runner and I recently increased my distance to 3-6 miles daily. I’ve been experiencing a lot of pain on the bottom of my foot and back of my heel. Do you have any suggestions for how to treat this and should I see a doctor?

Answer: The two main structures in this area of the foot that are commonly affected in runners are the Achilles tendon and plantar fascia. They are connected, and usually a lack of stretching and sudden increase in activity precipitates this painful condition. 

Plantar fasciitis is one of the most common causes of heel pain, especially in runners. The longer this problem lingers, the harder it becomes to treat. Plantar fasciitis is typically treated conservatively at first. I would recommend icing the area, rest, thoroughly stretching the foot and ankle, use anti-inflammatory medications and occasionally a night splint. 

Another possible cause of this pain could be running with old sneakers! As a rule, your tennis shoes should be replaced every six months. 

If these options do not provide relief, make an appointment with an orthopedic foot and ankle specialist as soon as possible for a complete evaluation to nip this in the bud so you can continue to enjoy running pain free. 

Kenneth Gerszberg, M.D. completed extensive fellowship training in foot & ankle surgery at Icahn School of Medicine at Mount Sinai in New York City. He is dedicated to giving each patient a personalized plan to treat their condition including both surgical and nonsurgical options. Dr. Gerszberg treats patients in two locations in West Palm Beach and Wellington. For more information, visit PBOI.com. 

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