Plantar Fasciitis Relief

Orthotics and Your Feet

Orthotics are devices which fit into the shoe to aid the foot. "Functional orthotics" are rigid and designed to control motion and correct the function of the foot. Individuals with flatfeet, tendonitis, plantar fasciitis, certain foot deformities, knee, hip and back problems may benefit from functional orthotics. "Accommodative orthotics" are soft and designed to reduce pressure and prevent excess friction. Diabetics and those with a loss of sensation or circulation in their feet will benefit from accommodative orthotics. Both types of orthotics are custom made by taking a mold of the foot.

Functional Orthotics

The goal of the functional orthotic is to improve the mechanics of the foot, control the abnormal motion in the foot, decrease the pain in the foot, ankle, knee, hip or backand to add support. The orthotic should make standing, walking, jogging or running more comfortable. The orthotic must be rigid to help control the motion in the foot and add support. If the orthotic is soft, the weight of the body would collapse the device and it would no longer function.

Abnormal motion is typically in the form of pronation. Pronation is the rolling in of the foot and collapse of the arch. The motion starts at the rearfoot, or heel area. When the heel turns in, it allows the arch to collapse. This puts undue stress on the ligaments and tendons in the arch area and contributes to the development of tendonitis, plantar fasciitis, bunions and hammertoes. The functional orthotic helps to control the abnormal motion in the rearfoot. This is accomplished by taking a mold of the foot in its neutral position. The neutral position is the position the foot should be in when walking. When standing, the over-pronated foot is in the uncorrected position. The mold of the foot should be taken with the patient sitting so the foot can be placed in the neutral position.

The molds are sent to a lab and scanned into a computer. A reverse image is produced and the computer generates an image of the foot in neutral position. The computer adjusts the image based on the corrections recommended by your podiatrist. A model of the foot is then cut out, in some cases out of wood. The orthotic material is pressed over the foot model and the orthotic is created. The most common material is polypropylene, but other materials, such as graphite are used. In some cases, hand-made molds are created out of plaster. This was the classic way orthotics were made until newer technology made the process much less labor intensive.

Functional orthotics are a successful treatment for many problems affecting the lower extremity. In a recent article in the Journal of the American Podiatric Medical Association, 75% of patients surveyed had good to excellent results from functional orthotics. This includes 17% who felt the orthotics "cured" their pain. Less than 10% had no relief. The most commonly treated condition in the study was a painful heel. Over 20% of patients surveyed were treated for a painful heel and 20% were treated for a painful arch. Fourteen percent of the individuals were using orthotics for flatfeet. Other conditions treated with orthotics were knee, hip and back pain, foot arthritis, bunions and high arches. Tendonitis was not specifically evaluated.

Individuals with plantar fasciitis (heel and arch pain) who also have flatfeet usually respond best to orthotics. The plantar fascia is a ligament type structure on the bottom of the foot which helps to hold up the arch. When the foot collapses, the weight of the body stresses the ligament and results in tearing and inflammation. This results in plantar fasciitis. These individuals typically respond well to orthotics in combination with other treatments. Certain types of tendonitis respond well to orthotics and other types require orthotics. Posterior tibial tendonitis is the tearing and inflammation of the tendon that helps to hold up the arch. When this tendon is overstressed by arch collapse it cannot heal. Orthotics are essential in the treatment of this condition.

Individuals with high arches may require orthotics as well, but they do not respond as well. Orthotics can help slow the progression of bunions and hammertoes, but they will not prevent this process. Orthotics may help with some pain at a bunion, but they will not "cure" the bunion. When the motion in the foot is contributing to the problem, orthotics are generally recommended. If the foot is stable and does not require support, the bunion, hammertoe, neuroma, tendonitis or even plantar fasciitis may not require custom made orthotics for treatment. These individuals may do well with a pre-fabricated orthotic.

Accommodative Orthotics

Diabetics can develop numbness and loss of circulation in the feet. This numbness and circulation loss puts them at risk for developing open sores on the feet called ulcerations. To help prevent excess rub and friction in certain areas on the feet, accommodative orthotics are recommended. Diabetics who do not have numbness or circulation loss (as diagnosed by their doctor) do not need to have accommodative orthotics. If the foot has a deformity, like a bunion or hammertoe, then accommodative orthotics are necessary.

Accommodative orthotics are made from many different types of material. Some are made of a foam type material, others made from cork and others have covers ranging from soft spongy material to leather. The type of material depends on the type of foot. Many accommodative orthotics, made for diabetics, have two or more layers that form around the foot once they are worn. Three pairs are dispensed every year and they are replaced every 4 months. Other materials are longer lasting. A mold of the foot is taken by stepping into a foam box. In this case, it is important to take the mold standing, so that the orthotic can be made to form around the foot.

The Cost

Many insurance companies cover orthotics for certain diagnoses. The most commonly covered diagnoses are plantar fasciitis (heel and arch pain), flatfeet and diabetes. Many insurance companies cover the orthotics at 80%. This means the patient is responsible for 20% of the cost unless they have a secondary insurance. If the deductible has not been met, then the amount is applied to the deductible and the patient must pay the full amount. Orthotics are not cheap. They range from $250 to $600.

Medicare covers orthotics for diabetics with neuropathy (numbness of the feet). Medicare does not cover orthotics for any other type of foot problem. Secondary insurance will not cover orthotics if Medicare does not cover them.

Podiatrists most commonly prescribe orthotics, but pedorthotists, orthotists, physical therapists and sometimes orthopedists will also provide orthotics.

Author: Christine Dobrowolski, DPM

Christine Dobrowolski is a podiatrist and the author of Those Aching Feet: Your Guide to Diagnosis and Treatment of Common Foot Problems. To learn more about Dr. Dobrowolski and her book visit http://www.skipublishing.com For more information on prefabricated orthotics visit http://www.northcoastfootcare.com

Article Source: http://EzineArticles.com/?expert=Christine_Dobrowolski,_DPM

More information can be found on the following pages: Plantar Fasciitis Relief – Plantar Fasciitis Treatment – Chronic Plantar Fasciitis & Exercise – Plantar Fasciitis Surgery & Cure – Plantar Fasciitis Splint – Shoes & Plantar Fasciitis Running – Foot Pain Symptoms – Plantar Fasciitis Orthotics – Fasciitis Treatment.

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Running And Plantar Fasciitis

Runners often complain about heel pain. Actually, most people have endured heel pain at some point in their lives. 40% of all visits to U.S. podiatrists are due to heel pain. Of all the different causes of heel pain, the majority is due to a condition known as plantar fasciitis, which is an inflammation in the band of tissue, known as the plantar fascia, that runs from the heel to the toes.

Plantar faciitis is most often caused by a tight Achilles tendon or poor foot structure, such as overly flat feet or high arches. Wearing non-supportive footwear on hard surfaces, spending long hours on your feet, and obesity are also causes of plantar faciitis.

Plantar fasciitis usually causes a sharp, stabbing pain on the inside of the bottom of the heel that can feel like an ice pick jabbing into your heel. Pain from plantar fasciitis is usually most severe when you first stand on your feet in the morning.

Many people complain that the first step out of bed is the worst. Many also have pain as they get up and start to walk after sitting for a period of time while working at a desk or computer. This heel pain will usually subside as you walk, but can return with prolonged standing, walking or running.

For runners, the plantar fascia may become inflamed after a period of running hilly courses or running in excessively worn shoes or the wrong type of shoe for your foot type. Once this happens, a cycle of inflammation ensues.

There is a nerve (called the medial calcaneal nerve) that runs along on the inside of the heel bone and actually curves down around the bottom of the heel between the bone and the plantar fascia. As you walk and place stress on the plantar fascia, the tugging of this ligament where it attaches to the heel bone stimulates inflammation.

The inflammation results in fluid being collected around the nerve between the bone and the plantar fascia. The nerve gets compressed by the collection of fluid when you get up and step on the heel. This causes the sharp pain. By stepping on the heel, some of the fluid is pushed out of the area and away from the nerve. The second step may also hurt less as even more fluid is pushed away from this space around the nerve. Once you get moving, the pain then usually subsides. Once you go to sleep the whole cycle begins again.

Plantar fasciitis is a combination of two separate problems. If your Achilles tendon is too tight, that leads to abnormal tension on the plantar fascia when you run or walk. Second, there is inflammation from all of the tissue damage as the plantar fascia is tearing away at its attachment to the heel bone. You must address both.

The main question I get from patients about treating plantar fasciitis is "will I need surgery?" The answer to this is almost certainly not. Most heel pain sufferers could effectively self-treat their heel pain and get permanent relief without ever visiting a doctor. The reason I know this to be true is that I have tracked the progress of those patients that have been seen in my office. I see several patients with heel pain every single day in my office. In 2007 I only performed surgery on four patients for plantar fasciitis.

My treatment philosophy and practice style is simple. I firmly believe that simple, reliable, cost-effective treatments should always be attempted before expensive and evasive treatments like surgery. Although I am an award winning foot and ankle surgeon (and admittedly love doing surgery) I truly believe that surgery is just a bad idea if any other treatment will work.

The main question I get from runners is "can I run with plantar fasciitis?" The answer is yes, provided it has been diagnosed as plantar fasciitis. As I said earlier, plantar fasciitis is by far the most common form of heel pain, however there are other causes. Certain things can mimic the symptoms of plantar fasciitis, such as stress fractures on the heel bone, bone tumors, and bone cysts, or weak areas.

The difference is that they are usually more painful when you run and will not subside (but instead get worse) while you are walking or running. These can also lead to serious problems such as a fracture of the heel bone. A fractured heel bone will definitely interrupt your training schedule.

Provided that it is plantar fasciitis, the most often effective treatments for plantar fasciitis include stretching, icing, and anti-inflammatory medications. A program of home exercises to stretch your Achilles tendon and plantar fascia are the mainstay of treating the condition and lessening the chance of recurrence.

Achilles tendon stretches are essential to eliminate heel pain. Perform the Achilles tendon stretches morning and evening. Doing this should only take one minute each morning and one minute each night.

Stand upright one large pace away from the wall with your feet parallel and about hip width apart. Place your hands against the wall, at shoulder height. Move your right leg half a pace forward. Try lunging forward on your right leg so that the knee is aligned over the ankle. Stretch your left leg back as far as is comfortable with the foot and heel remaining flat on the floor. Slowly lean forward to stretch the left leg calf muscles and tendon. Hold the stretch for 10 seconds, relax, and repeat on the other leg. Perform each stretch three times per side.

Icing your heel will decrease inflammation that accumulates while you walk during the day, and to prevent more inflammation while you sleep. Ice the bottom of the heel and arch for twenty minutes 2 or 3 times daily in order to relieve your symptoms. Do not go barefoot or wear flip-flops. Only wear shoes with a moderate heel that do not bend through the arch. Always wear shoes when walking, even in the home. If you have custom orthotics, or over-the-counter inserts, wear them in your shoes at all times. The majority of people with plantar fasciitis improve tremendously after just two months of initial treatment.

Keep on running, but seek help if your heel pain gets worse while you run or if the heel pain just won’t go away after trying the treatments described above. Once you get rid of the heel pain, keep stretching your Achilles tendon periodically and you can prevent your heel pain from coming back. No more limping out of bed before your morning run!

By: Dr Christopher Segler

Article Directory: http://www.articledashboard.com

Dr. Christopher Segler is an Ironman Finisher and award winning foot surgeon with a podiatry practice in Chattanooga. He is the inventor of a patented surgical instrument designed to simplify bunion surgery and flatfoot surgery. He specializes in advanced treatments for morning heel pain and bone spurs. You can request a FREE copy of his informative book "No More Heel Pain:a Guide to Heel Pain Causes and Treatments" at www.anklecenter.com.

More information can be found on the following pages: Plantar Fasciitis Relief – Plantar Fasciitis Treatment – Chronic Plantar Fasciitis & Exercise – Plantar Fasciitis Surgery & Cure – Plantar Fasciitis Splint – Shoes & Plantar Fasciitis Running – Foot Pain Symptoms – Plantar Fasciitis Orthotics – Fasciitis Treatment.

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