Robert Rosenstein, DPM
Jennifer Zienkowski, DPM
Michael Coppers, DPM
Plantar fasciitis is the term commonly used to refer to heel and arch pain traced to an inflammation on the bottom of the foot. More specifically, plantar fasciitis is an inflammation of the connective tissue, called plantar fascia, that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone. Overpronation is the most common cause of plantar fasciitis. As the foot rolls inward excessively when walking, it flattens the foot, lengthens the arch, and puts added tension on the plantar fascia. Over time, this causes inflammation.
Also known as heel spur syndrome, the condition is often successfully treated with conservative measures, such as the use of anti-inflammatory medications, ice packs, stretching exercises, orthotic devices, and physical therapy. Note: Please consult your physician before taking any medications. In persistent cases, Extracorporeal Shock Wave Treatment (ESWT) may be used to treat the heel pain.
Extracorporeal Shock Wave Therapy (ESWT) is used to treat chronic heel pain (plantar fasciitis). "Extracorporeal" means "outside of the body." During this noninvasive procedure, sonic waves are directed at the area of pain using a device similar to that currently used in nonsurgical treatment of kidney stones.
Extracorporeal Shock Wave Therapy is prescribed for patients who have experienced plantar fasciitis for an extended period of time -- six months or more -- and have not benefited from other conservative treatments. The brief procedure lasts about 30 minutes and is performed under local anesthesia and/or "twilight" anesthesia. Strong sound waves are directed at and penetrate the heel area to stimulate a healing response by the body. ESWT is performed on an outpatient basis. Although there are no bandages, someone will need to drive the patient home.
People who are not candidates for ESWT include pregnant women and individuals with neurological foot disease, vascular foot disease, pacemakers, or people taking medications that interfere with blood clotting (such as Coumadin).
This therapy is a safe and effective alternative treatment for heel pain and only requires a short recovery time. Clinical studies show a 70 percent success rate for treatment of plantar fasciitis using Extracorporeal Shock Wave Therapy.
According to the American Academy of Orthopaedic Surgeons, doctors have noticed an increase in the number and severity of broken ankles since the 1970s, due, in part, to the Baby Boomer generation being active throughout every stage of their lives.
The ankle has two joints, one on top of the other, and three bones. A broken ankle can involve one or more of the bones, as well as injury to the surrounding connecting tissues or ligaments.
There are a wide variety of causes for broken ankles, most commonly a fall, an automobile accident, or sports-related trauma. Because a severe sprain can often mask the symptoms of a broken ankle, every ankle injury should be examined by a physician.
Symptoms of a broken ankle include:
- Bruising.
- Swelling.
- Immediate and severe pain.
- Inability to put any weight on the injured foot.
- Tenderness to the touch.
- Deformity, particularly if there is a dislocation or a fracture.
The treatment for a broken ankle usually involves a leg cast or brace if the fracture is stable. If the ligaments are also torn, or if the fracture created a loose fragment of bone that could irritate the joint, surgery may be required to secure the bones in place so they will heal properly.








