All

Your Feet Deserve Our Support

Arch supports, inserts, insoles, and orthotic devices -- what’s the difference and what do I need? Like any building or machine, the foundation of support is essential. Think how annoying it is to sit at a table that rocks back and forth because the base is out of balance. A simple packet of sugar or folded napkin under a table leg can make all the difference. The human body is no different - and that support and balance begins with your feet. The best place to start is with your shoes. Finding the right shoe is more than pinching them to find the big toe. Aligning the heel, arch and toe length will ensure proper fit and function. The goal is make the shoe work with the foot-- not against it. A simple test is to pick up a shoe and bend it. The break point - or where it bends -  should be where the toes bend. If it bends anywhere else, there could be a functional mismatch between the shoe and the foot. Once shoes have been selected, attention can then be focused on what is inside the shoe. Many shoes are made with removable insoles - the lining inside the shoe. These insoles are often soft, thin, and offer little to no support. This can frustrate many people who are in search of the perfect shoe. That’s why it is often necessary to replace what is inside the shoe with either an over the counter insert or custom orthotic devices. This is where there are similarities between your eyes and your feet. Glasses - frames and lenses - accommodate for your vision problems and help you see better. Shoes and inserts accommodate your feet and help you walk and feel better. Taking this analogy one step further, some people do well with over the counter, non prescription glasses, but many need prescription glasses in order to adjust for the differences between their eyes or because the simple corrections that the non prescription glasses offer are not sophisticated enough. The same is true with your feet. There are lots of different over the counter inserts available in stores and online. However, not only are everyone’s feet different, but there are often significant differences between the feet of one person. That is why prescription orthotic devices are often necessary. Made from impressions of your feet, orthotic devices are made to fit you and no one else. Taking into consideration all of your biomechanical issues, including the way in which your feet function, the way you walk (or run), your alignment  -- and whether there are other contributing factors such as a leg length difference - custom devices are designed and made in order to accommodate all of your unique characteristics. Helping to provide symmetry, function, and postural balance, will not only be more comfortable -- but custom orthotic devices will also go a long way in reducing pain or problems that may have led you down this path in the first place. The first step in this direction is to visit a podiatrist with Foot & Ankle Specialists of the Mid-Atlantic for an examination and guidance on what will make your feet feel and function the best that they possibly can. Shoe recommendations and orthotic devices are a great way to help make that happen. Make an appointment today.   Podiatrist Dr. David LevineDr. David Levine works in our Frederick, MD (Thomas Johnson Dr) office. The information on this site is provided for your assistance only; this site does not provide podiatric advice. You should never diagnose or treat yourself for a podiatric condition based on the information provided herein, and the information is not provided for that purpose. Likewise, you should never determine that treatment is unnecessary based on this information. The information contained herein is not a substitute for podiatric care provided by a licensed podiatric professional. The information provided herein is not podiatric, medical or professional advice. This site does not create a doctor-patient relationship. Dr. David Levine and Foot & Ankle Specialists of the Mid-Atlantic, LLC expressly disclaims all warranties of any kind, whether express or implied, related to any products offered for sale on this web site. Dr. David Levine and Foot & Ankle Specialists of the Mid-Atlantic, LLC further expressly disclaims any product warranties of effectiveness or fitness for any particular purpose or use. You are solely responsible for your use of, or reliance on, any products offered for sale herein, and any consequences arising out of such use or reliance. In no event will Dr. David Levine and Foot & Ankle Specialists of the Mid-Atlantic, LLC be liable for any damages resulting from use of or reliance on any such products, whether based on warranty, contract, tort or any other legal theory. This website, and the information contained herein, is provided to you as a service for use at your sole risk.

Stress Fractures

The fall season is a time where many of us are outside hiking, running or enjoying other exercise. With this increased exercise, problems may develop. Any time there is a sudden onset of pain and swelling of the foot or ankle without any recent known injury or trauma a stress fracture has to be considered-- a stress fracture is a small crack in the bone. Stress fractures are very common in the weight-bearing bones of the lower extremity with the 2nd metatarsal bone the most common.  Repetitive stress of these bones being the causative factor. Bone remodeling is the process where mature bone is removed and replaced by new bone.  This is a process occurring continually throughout our lives. If this process is not in balance a stress fracture can occur.   A rapid increase in activity (a new running or walking program, training for a race, increase in exercise frequency), a job requiring  standing and walking (nurses, teachers, factory workers), elderly patients whose bone strength has diminished are all common causes of stress fractures. Improper shoe wear may also play a role in the development of a stress fracture.  

Symptoms and Diagnosis

Pinpoint pain and swelling that increase with activity and as the day progress are often the initial complaint.  Stress fractures are usually diagnosed with x-rays. Stress fracture cannot be seen on x-ray until the bone begins to heal itself by forming new bone.  This is usually takes 2 - 3 weeks after the onset of pain. Infrequently, a bone scan or MRI is needed to help with the diagnosis.  

Treatment and Prevention

Stress fractures usually heal in 6 - 8 weeks provided proper care is given.  Most of the time a walking boot combined with reduced activity will lead to uneventful healing. Continued high activity can lead to a complete fracture of the bone and nonunion. In most cases once you have healed from a stress fracture normal activity may resume.  Wearing a good supportive shoe with adequate shock absorption should help in preventing this from happening again.  A gradual increase in activity when starting or resuming exercise is important in prevention as well. Podiatrist Dr. Kevin MurrayDr. Kevin Murray works in two offices for your convenience: Charlottesville, VA (Rio East Ct) and Fishersville, VA. The information on this site is provided for your assistance only; this site does not provide podiatric advice. You should never diagnose or treat yourself for a podiatric condition based on the information provided herein, and the information is not provided for that purpose. Likewise, you should never determine that treatment is unnecessary based on this information. The information contained herein is not a substitute for podiatric care provided by a licensed podiatric professional. The information provided herein is not podiatric, medical or professional advice. This site does not create a doctor-patient relationship. Dr. Kevin Murray and Foot & Ankle Specialists of the Mid-Atlantic, LLC expressly disclaims all warranties of any kind, whether express or implied, related to any products offered for sale on this web site. Dr. Kevin Murray and Foot & Ankle Specialists of the Mid-Atlantic, LLC further expressly disclaims any product warranties of effectiveness or fitness for any particular purpose or use. You are solely responsible for your use of, or reliance on, any products offered for sale herein, and any consequences arising out of such use or reliance. In no event will Dr. Kevin Murray and Foot & Ankle Specialists of the Mid-Atlantic, LLC be liable for any damages resulting from use of or reliance on any such products, whether based on warranty, contract, tort or any other legal theory. This website, and the information contained herein, is provided to you as a service for use at your sole risk.

What is the Cause of My Heel Pain?

Heel pain is a frequent ailments that podiatrists treat. One of the most common causes of heel pain is due to plantar fasciitis. The plantar fascia is a large ligament that extends from the heel to the toes and is a big supporter of the arch. When this ligament becomes inflamed and irritated, we refer to this as plantar fasciitis. One of the main symptoms of plantar fasciitis is pain that is worse when someone first gets up out of bed in the morning or gets up after a period of rest. This pain will initially start to improve after a few steps of walking, but then will reoccur again after getting up from another period of rest. Symptoms can also occur after long periods of standing and also can worsen following exercise. Plantar fasciitis can occur in a variety of age groups. Some of the factors that can make patients more prone to developing plantar fasciitis are:
  • Those with a flat foot type
  • Those with tight calf muscles
  • Those who have a high arch foot type
  • Certain athletes such as distance runners
  • People who have occupations that require them to be on their feet all day long
  • Certain shoegear and spending a lot of time barefoot can also trigger plantar fasciitis. Flip-flops are one of the most common culprits of plantar fasciitis in the summertime and shoes that are highly flexible with little support can also trigger it.
There are a variety of treatment options for plantar fasciitis and your doctor will be able to provide you with treatment options that could best suite you. The majority of plantar fasciitis cases can be resolved with conservative care without surgical intervention. Here are some of the treatment options that your doctor may suggest: Shoe gear: Your doctor will likely examine and discuss the shoes that you wear on a daily basis. It is important to wear shoe gear that has a good arch support and to avoid spending a lot of time barefoot. Your doctor will be able to suggest certain brands and styles to help you find supportive shoe gear for work, exercise and leisure. Sometimes even just changing the shoe gear can lead to significant improvement in plantar fasciitis symptoms. Arch Supports/Custom Orthotics: There are a variety of different arch supports that are marketed today. Some are better than others and your doctor will be able to provide you with a list of which ones to try. Your doctor may also discuss with you the option of custom orthotics, where an insert is made specifically for your foot and is superior to over-the-counter inserts. Some insurance plans will cover custom orthotics, while others do not. Ask your doctor if custom orthotics would be a covered benefit under your plan. Anti-inflammatories and Ice: Anti-inflammatories and ice can both help to reduce inflammation, which can help relieve pain. Sometimes your doctor can write you a prescription strength anti-inflammatory to help further reduce inflammation. It is recommended to ice your foot after any activity, and at the end of the day when dealing with plantar fasciitis. Some patients prefer freezing a water bottle and rolling it along the bottom of the foot. Calf Stretches or Physical Therapy: Having tight calf muscles can be a trigger for plantar fasciitis. If you do have tight calf muscles it is important to do daily calf stretches. Your doctor will be able to provide you with a list of stretches. Sometimes if calf stretches are not enough, your doctor may suggest wearing a splint at night that can stretch the calf while you are sleeping. Physical therapy is another option that your doctor may suggest to further help you with your flexibility. Injections: For patients that have significant pain and inflammation, your doctor may suggest a cortisone injection. The injection is given typically right where the plantar fascia attaches to your heel bone and helps to reduce inflammation in the area. Typically the injection given is a long acting steroid and can take a few days to start working. Even if the injection gets rid of all the pain, it is still important to make sure you continue to wear proper shoe gear, stretch and use the inserts your doctor suggested-- otherwise the plantar fasciitis can reoccur in the future. Extracorporeal Shockwave Therapy (EPAT): EPAT is a treatment option for those that suffer from chronic plantar fasciitis. EPAT is a non-invasive procedure which works by using pressure waves to increase blood flow and metabolism to the injured area in order to help accelerate the healing process. Most patients will undergo 3 different treatment sessions, over 3 consecutive weeks, with each treatment lasting about 10 minutes. During this treatment period your doctor will have you stop taking any anti-inflammatories and icing because this can interfere with the EPAT’s effectiveness. The best results from the treatment are usually seen about 6 weeks following the last treatment. Foot and Ankle Surgeon Dr. Colleen LawDr. Colleen Law works in 4 offices for your convenience: Charlottesville, VA (Abbey Road), Charlottesville, VA (Rio East Ct), Culpeper, VA, and Fishersville, VA. The information on this site is provided for your assistance only; this site does not provide podiatric advice. You should never diagnose or treat yourself for a podiatric condition based on the information provided herein, and the information is not provided for that purpose. Likewise, you should never determine that treatment is unnecessary based on this information. The information contained herein is not a substitute for podiatric care provided by a licensed podiatric professional. The information provided herein is not podiatric, medical or professional advice. This site does not create a doctor-patient relationship. Dr. Colleen Law and Foot & Ankle Specialists of the Mid-Atlantic, LLC expressly disclaims all warranties of any kind, whether express or implied, related to any products offered for sale on this web site. Colleen Law and Foot & Ankle Specialists of the Mid-Atlantic, LLC further expressly disclaims any product warranties of effectiveness or fitness for any particular purpose or use. You are solely responsible for your use of, or reliance on, any products offered for sale herein, and any consequences arising out of such use or reliance. In no event will Colleen Law and Foot & Ankle Specialists of the Mid-Atlantic, LLC be liable for any damages resulting from use of or reliance on any such products, whether based on warranty, contract, tort or any other legal theory. This website, and the information contained herein, is provided to you as a service for use at your sole risk.