December 15, 2023 • 11 mins
What if you could fully comprehend that nagging foot pain and finally get on the road to a pain-free life? This week on the LMD Podiatry podcast, we're unwrapping the mystery of plantar fasciitis - a common foot ailment that has left many puzzled. Our host, Dr. Lauren Dabakaroff, and co-host, Jeremy Wolf, take on the mission of helping you understand this condition - from its root causes, like tight calves and hamstrings or ill-fitting footwear, to the role your biomechanics play in its development.
Imagine knowing exactly what to do when that first painful step hits you in the morning or when discomfort creeps in at the end of the day. Dr. Lauren guides us through the critical steps in getting a precise diagnosis, highlighting why it's crucial not to ignore those pesky symptoms. We also take a detour into the world of proper footwear and discuss the potential hazards of taking your feet for granted. This episode is a treasure trove of information for anyone keen on keeping their feet in top-notch shape. Don't miss it!
To learn more, visit: LMDpodiatry.com or contact (954) 680-7133
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Welcome to the LMD Pediatry podcast.
Trust us to get back on yourfeet.
Here's your host, Dr LaurenDevakaroff.
Jeremy (00:15):
Hello, welcome back everyone to another episode of
the LMD Pediatry podcast.
I'm your co-host, Jeremy Wolfe,and I am here with your host,
Dr Lauren Devakaroff.
How you doing, Dr Lauren?
How's it going?
I'm chilling.
Dr. Lauren (00:32):
It's the holiday season.
Jeremy (00:34):
Tis the season.
Dr. Lauren (00:35):
as they say, yeah a little bit of Hanukkah, a little
bit of Christmas, a little bitof, you know whatever.
Everybody else is celebratingGetting the gifts, lighting the
candles, looking at trees.
Jeremy (00:50):
All the fun stuff, all the fun stuff.
So I've been getting signs fromthe universe I've been hearing
a lot about.
A friend of mine recently toldme he was going to get a
myofascial massage.
And then I heard on anotherpodcast because as you know,
I've been running a lot latelySomebody was talking about the
myofascial this and that and Isaid to myself I've also heard
(01:14):
planter fasciitis before and Iknow we actually talked about it
briefly on another segment whenwe were going over some topics
about sports injuries and thingslike that.
And I know this is a commonailment that folks have and I
imagine a lot of people outthere are like me and really
don't know much about.
They've heard it before.
They don't know really what itis.
So what exactly is planterfasciitis?
(01:35):
What are their common symptomsassociated with the condition?
Dr. Lauren (01:39):
Sure.
So planter fasciitis a lot ofpeople hear it and they have no
idea what it actually means.
But what the planter fascia?
It's the band that holds upyour arch.
So when you say planterfasciitis, it means inflammation
(01:59):
of the band that holds up yourarch.
That's the itis part.
Why is it caused?
There's a couple of differentreasons.
The most common cause of planterfasciitis is when your calves
and your hamstrings are tootight.
It's very biomechanical and whatthat means is if your calves
(02:20):
and hamstrings are tight orshort, what happens is your heel
or your planter fascia, whichholds up your arch, works extra
hard to reach the floor when youwalk.
So if my legs or if my calvesare super tight, when I try to
put my foot down, and it worksextra hard to put the foot down,
(02:43):
I create an abnormal tug andpull on the planter fascial band
and it creates little microtears in there.
And because it tears or sprains, that's when people start
getting pain there, because yourbody's trying to heal the
sprain and it doesn't get betterbecause you keep walking on
your foot.
So that's kind of thehistorical biomechanical
(03:09):
progression of how planterfasciitis typically happens.
Another common cause of it isjust not wearing the right shoes
, Even if you're not tight.
If you're older and you'relosing some of your fat pad or
the cushion underneath your foot, underneath your heel, if
you're walking barefoot or notwearing soft, supportive shoes,
(03:31):
that can also irritate the bandor the planter fascia, creating
that inflammation that's causingyou pain.
Jeremy (03:38):
Well, you know I got my brooks now, so, yes, I'm in good
shape with the footwear.
So how is planter fasciitisdiagnosed and why is it
important for individuals thatare experiencing these types of
symptoms to go and seekprofessional help and go see if
it died?
Dr. Lauren (03:58):
What was the first part of your question?
Jeremy (04:01):
No, how is it?
How is planter fasciitisdiagnosed?
Dr. Lauren (04:04):
Oh, how the why it's important.
Jeremy (04:05):
if you're, if you're experiencing what you think
might be symptoms, the best wayto diagnose it, the best way to
diagnose it.
Dr. Lauren (04:13):
If the patients are saying I have pain with the
first step of the morning andpain at the end of the day,
that's usually, like you know,light bulb probably planter
fasciitis.
And then when I examine thefoot and I have, if there's pain
on one specific area of theheel, I know that that's planter
fasciitis.
(04:33):
And then I just confirm it withimaging Right.
So I always want to take anx-ray, make sure there's no
stress, fracture or any otherissue in the foot that could be
causing the heel pain.
And then usually I doultrasonography or sonogram and
I take a look at the arch and Iwant to see how severe the
(04:55):
plantar fasciitis is.
Sometimes the patients have areally bad sprain within the
band and needs more aggressivetreatment, and I find too into
their issue.
Jeremy (05:09):
So what are the available treatment options for
the salement?
I mean both in terms of medicalinterventions and also
self-care strategies.
Dr. Lauren (05:21):
So first thing is stretching, because if you have
the most common thing that'scausing it, which is the tight
cap and hamstring, the numberone thing you have to start
incorporating into your dailyroutine is stretching your calf
and your ankle.
You could, you know, if you'relazy, you get a night's splint
(05:42):
that stretches your calf for you.
I actually have a really coolstretching splint that you could
sit in for an hour a day and goall the way up your leg.
Some people just they're toolazy to stretch, so we have
things like that.
But really it's just like therun or stretch and calf
(06:02):
stretching and all these typesof things.
You do them a couple times aday, hold each leg for 20
seconds and alternate and do acouple reps and that should help
kind of stretch out your calfand your hamstring.
And patients do see that assoon as they do that, they can
see when they put their footdown there's not as much
pressure on their heel.
So that's number one, super,super conservative.
(06:25):
And then the next step is basicrest and ice.
Okay, again, it hurts becauseit's inflamed, so I always
recommend icing and avoidinghigh impact activities for a
couple weeks until the areaheals and goes back to normal no
running, no jumping, nobarefoot walking, only low
(06:45):
impact, like walking in goodsneakers, like you do, swimming,
swimming, biking only lowimpact.
And then, if it's very, verypainful, sorry about that.
If it's very, very painful, Iusually offer a steroid
(07:05):
injection and all that does isit delivers an anti-inflammatory
medication directly to theproblem area.
So I insert the needle right tothe area of pain and basically
there's steroid in there andwhat the steroid does is gets
rid of the inflammation that'scausing the pain.
Some patients need like two orthree of them, together with
(07:28):
some anti-inflammatorymedications, such as an
ibuprofen, for example.
And when you do all that at thesame time, your plant
infrecyitis resolves within amonth and a half tops.
Jeremy (07:39):
Are there ever any?
I'd imagine there are extremecases of plantar fasciitis that
go beyond just the injections,that require actual surgery and
things like that.
Dr. Lauren (07:52):
So when plantar fasciitis goes untreated okay or
doesn't respond to treatmentany of the treatment options
that I just laid out for you youfall into a chronic plantar
fasciitis category.
And then some patients dorequire surgery.
The surgery for that is aplantar fasciotomy, in which I
(08:17):
go into the operating room andyou go to sleep and I go in and
I make a little incision and Ijust release that fascia and
that actually gives patients allthe relief in the world and
it's not a bad recovery processbut it really does help.
It's really reserved for peoplethat fail all those other
(08:38):
treatment options Okay.
I only do that surgery maybeonce a year because I always
tell my patients if you don'tvisit me, I have to take you to
the operating room.
But there are some patients thatcome to me when it's too late
and I can look on the ultrasoundand see that they have all the
scar tissue in their plantarfascia and it's just like I
(08:59):
always tell them you may or maynot respond to my treatment.
Sometimes they do, sometimesthey don't.
One other trick I do have up mysleeve for preventing patients
from going to the operating roomis I do regenerative medicine
and I basically use these stemcell injections and what the
(09:19):
stem cells do.
Is they actually correct?
They actually reheal the area,kind of regenerate the scar
tissue back to normal plantarfascia and they take away the
pain at the same time.
And for some patients it doeswork and I have been able
successfully able to getpatients out of the operating
room just by getting one or twoof those injections.
Jeremy (09:43):
Very interesting.
So, as always, my number onetakeaway and I say this out loud
, have to reinforce it to myself, but also to share it with
listeners Everything goes backto preventative measures, like
you said, stretching, takingcare of yourself, doing the
things that are necessary toavoid these issues from
(10:05):
happening in the first place andwe're all guilty of it.
Right, like you said many times.
But if you take one thing awayfrom this, it's take care of
yourself, be kind to your bodyand put in a little hard work
and go and be a littleuncomfortable, because it will
pay out dividends in the longrun, that's right.
Dr. Lauren (10:23):
That's right.
If you feel a little littleheel pain, you know the number.
First thing you got to do getyourself some fixed salt
sneakers or some nice cushymemory memory foam slippers at
home.
You know, stretch a little bitand you it'll prevent it from
getting worse.
It's really all about just kindof being conscious of what your
(10:46):
body's trying to tell you andknowing how to, you know, attack
it before it gets too worse.
And then you have to come andsee me.
That's anything I can impartwisdom on my patients and all
people with heel pain.
Jeremy (11:01):
All right, sounds good.
Dr Debaker off.
Always a pleasure, so niceseeing you.
I wish you and your family awonderful holiday season, if we
don't cross paths before then,so take care of a great week.
Dr. Lauren (11:16):
Thank you, you too.
Jeremy (11:18):
I shall, I shall, and thanks to our listeners for
tuning in and we will catch younext time.
Everyone, take care and have awonderful holiday season.
Speaker 1 (11:30):
Thank you for listening to the LMD podiatry
podcast.
For more information, visit LMDpodiatrycom that's
LMDPODIATRYcom or call954-680-7133.
Welcome to the LMD Pediatry podcast.
Trust us to get back on yourfeet.
Here's your host, Dr LaurenDevakaroff.
Jeremy (00:15):
Hello, welcome back everyone to another episode of
the LMD Pediatry podcast.
I'm your co-host, Jeremy Wolfe,and I am here with your host,
Dr Lauren Devakaroff.
How you doing, Dr Lauren?
How's it going?
I'm chilling.
Dr. Lauren (00:32):
It's the holiday season.
Jeremy (00:34):
Tis the season.
Dr. Lauren (00:35):
as they say, yeah a little bit of Hanukkah, a little
bit of Christmas, a little bitof, you know whatever.
Everybody else is celebratingGetting the gifts, lighting the
candles, looking at trees.
Jeremy (00:50):
All the fun stuff, all the fun stuff.
So I've been getting signs fromthe universe I've been hearing
a lot about.
A friend of mine recently toldme he was going to get a
myofascial massage.
And then I heard on anotherpodcast because as you know,
I've been running a lot latelySomebody was talking about the
myofascial this and that and Isaid to myself I've also heard
(01:14):
planter fasciitis before and Iknow we actually talked about it
briefly on another segment whenwe were going over some topics
about sports injuries and thingslike that.
And I know this is a commonailment that folks have and I
imagine a lot of people outthere are like me and really
don't know much about.
They've heard it before.
They don't know really what itis.
So what exactly is planterfasciitis?
(01:35):
What are their common symptomsassociated with the condition?
Dr. Lauren (01:39):
Sure.
So planter fasciitis a lot ofpeople hear it and they have no
idea what it actually means.
But what the planter fascia?
It's the band that holds upyour arch.
So when you say planterfasciitis, it means inflammation
(01:59):
of the band that holds up yourarch.
That's the itis part.
Why is it caused?
There's a couple of differentreasons.
The most common cause of planterfasciitis is when your calves
and your hamstrings are tootight.
It's very biomechanical and whatthat means is if your calves
(02:20):
and hamstrings are tight orshort, what happens is your heel
or your planter fascia, whichholds up your arch, works extra
hard to reach the floor when youwalk.
So if my legs or if my calvesare super tight, when I try to
put my foot down, and it worksextra hard to put the foot down,
(02:43):
I create an abnormal tug andpull on the planter fascial band
and it creates little microtears in there.
And because it tears or sprains, that's when people start
getting pain there, because yourbody's trying to heal the
sprain and it doesn't get betterbecause you keep walking on
your foot.
So that's kind of thehistorical biomechanical
(03:09):
progression of how planterfasciitis typically happens.
Another common cause of it isjust not wearing the right shoes
, Even if you're not tight.
If you're older and you'relosing some of your fat pad or
the cushion underneath your foot, underneath your heel, if
you're walking barefoot or notwearing soft, supportive shoes,
(03:31):
that can also irritate the bandor the planter fascia, creating
that inflammation that's causingyou pain.
Jeremy (03:38):
Well, you know I got my brooks now, so, yes, I'm in good
shape with the footwear.
So how is planter fasciitisdiagnosed and why is it
important for individuals thatare experiencing these types of
symptoms to go and seekprofessional help and go see if
it died?
Dr. Lauren (03:58):
What was the first part of your question?
Jeremy (04:01):
No, how is it?
How is planter fasciitisdiagnosed?
Dr. Lauren (04:04):
Oh, how the why it's important.
Jeremy (04:05):
if you're, if you're experiencing what you think
might be symptoms, the best wayto diagnose it, the best way to
diagnose it.
Dr. Lauren (04:13):
If the patients are saying I have pain with the
first step of the morning andpain at the end of the day,
that's usually, like you know,light bulb probably planter
fasciitis.
And then when I examine thefoot and I have, if there's pain
on one specific area of theheel, I know that that's planter
fasciitis.
(04:33):
And then I just confirm it withimaging Right.
So I always want to take anx-ray, make sure there's no
stress, fracture or any otherissue in the foot that could be
causing the heel pain.
And then usually I doultrasonography or sonogram and
I take a look at the arch and Iwant to see how severe the
(04:55):
plantar fasciitis is.
Sometimes the patients have areally bad sprain within the
band and needs more aggressivetreatment, and I find too into
their issue.
Jeremy (05:09):
So what are the available treatment options for
the salement?
I mean both in terms of medicalinterventions and also
self-care strategies.
Dr. Lauren (05:21):
So first thing is stretching, because if you have
the most common thing that'scausing it, which is the tight
cap and hamstring, the numberone thing you have to start
incorporating into your dailyroutine is stretching your calf
and your ankle.
You could, you know, if you'relazy, you get a night's splint
(05:42):
that stretches your calf for you.
I actually have a really coolstretching splint that you could
sit in for an hour a day and goall the way up your leg.
Some people just they're toolazy to stretch, so we have
things like that.
But really it's just like therun or stretch and calf
(06:02):
stretching and all these typesof things.
You do them a couple times aday, hold each leg for 20
seconds and alternate and do acouple reps and that should help
kind of stretch out your calfand your hamstring.
And patients do see that assoon as they do that, they can
see when they put their footdown there's not as much
pressure on their heel.
So that's number one, super,super conservative.
(06:25):
And then the next step is basicrest and ice.
Okay, again, it hurts becauseit's inflamed, so I always
recommend icing and avoidinghigh impact activities for a
couple weeks until the areaheals and goes back to normal no
running, no jumping, nobarefoot walking, only low
(06:45):
impact, like walking in goodsneakers, like you do, swimming,
swimming, biking only lowimpact.
And then, if it's very, verypainful, sorry about that.
If it's very, very painful, Iusually offer a steroid
(07:05):
injection and all that does isit delivers an anti-inflammatory
medication directly to theproblem area.
So I insert the needle right tothe area of pain and basically
there's steroid in there andwhat the steroid does is gets
rid of the inflammation that'scausing the pain.
Some patients need like two orthree of them, together with
(07:28):
some anti-inflammatorymedications, such as an
ibuprofen, for example.
And when you do all that at thesame time, your plant
infrecyitis resolves within amonth and a half tops.
Jeremy (07:39):
Are there ever any?
I'd imagine there are extremecases of plantar fasciitis that
go beyond just the injections,that require actual surgery and
things like that.
Dr. Lauren (07:52):
So when plantar fasciitis goes untreated okay or
doesn't respond to treatmentany of the treatment options
that I just laid out for you youfall into a chronic plantar
fasciitis category.
And then some patients dorequire surgery.
The surgery for that is aplantar fasciotomy, in which I
(08:17):
go into the operating room andyou go to sleep and I go in and
I make a little incision and Ijust release that fascia and
that actually gives patients allthe relief in the world and
it's not a bad recovery processbut it really does help.
It's really reserved for peoplethat fail all those other
(08:38):
treatment options Okay.
I only do that surgery maybeonce a year because I always
tell my patients if you don'tvisit me, I have to take you to
the operating room.
But there are some patients thatcome to me when it's too late
and I can look on the ultrasoundand see that they have all the
scar tissue in their plantarfascia and it's just like I
(08:59):
always tell them you may or maynot respond to my treatment.
Sometimes they do, sometimesthey don't.
One other trick I do have up mysleeve for preventing patients
from going to the operating roomis I do regenerative medicine
and I basically use these stemcell injections and what the
(09:19):
stem cells do.
Is they actually correct?
They actually reheal the area,kind of regenerate the scar
tissue back to normal plantarfascia and they take away the
pain at the same time.
And for some patients it doeswork and I have been able
successfully able to getpatients out of the operating
room just by getting one or twoof those injections.
Jeremy (09:43):
Very interesting.
So, as always, my number onetakeaway and I say this out loud
, have to reinforce it to myself, but also to share it with
listeners Everything goes backto preventative measures, like
you said, stretching, takingcare of yourself, doing the
things that are necessary toavoid these issues from
(10:05):
happening in the first place andwe're all guilty of it.
Right, like you said many times.
But if you take one thing awayfrom this, it's take care of
yourself, be kind to your bodyand put in a little hard work
and go and be a littleuncomfortable, because it will
pay out dividends in the longrun, that's right.
Dr. Lauren (10:23):
That's right.
If you feel a little littleheel pain, you know the number.
First thing you got to do getyourself some fixed salt
sneakers or some nice cushymemory memory foam slippers at
home.
You know, stretch a little bitand you it'll prevent it from
getting worse.
It's really all about just kindof being conscious of what your
(10:46):
body's trying to tell you andknowing how to, you know, attack
it before it gets too worse.
And then you have to come andsee me.
That's anything I can impartwisdom on my patients and all
people with heel pain.
Jeremy (11:01):
All right, sounds good.
Dr Debaker off.
Always a pleasure, so niceseeing you.
I wish you and your family awonderful holiday season, if we
don't cross paths before then,so take care of a great week.
Dr. Lauren (11:16):
Thank you, you too.
Jeremy (11:18):
I shall, I shall, and thanks to our listeners for
tuning in and we will catch younext time.
Everyone, take care and have awonderful holiday season.
Speaker 1 (11:30):
Thank you for listening to the LMD podiatry
podcast.
For more information, visit LMDpodiatrycom that's
LMDPODIATRYcom or call954-680-7133.
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