Plantar fasciitis is one of the most common medical diagnoses associated with heel pain and makes up 25% of all foot injuries most noted in runners & athletes. Typically plantar fasciitis is brought on as result of over-training or over-stressing the tissues of your lower extremity. History most likely will indicate a change in level of activity.


You may be at risk for developing plantar fasciitis if you:

v     Participate in endurance sports (running most common)

v     Work in a setting requiring prolonged standing or walking

v     Have a quick change in lifestyle or level of activity

v     Are obese

v     Have calf tightness

You may have plantar fasciitis if you:

v     Experience pain upon standing after period of nonweight bearing

v     Pain with first step most noticeable when arising from bed in the morning

v     Heel pain which slowly reduces with activity

v     Pain in heel region & arch of the foot

You may help rid yourself of plantar fasciitis with:

v     Anti-inflammatory medication (consult with your M.D. to assure you are able to take meds such as Ibuprofen, Aleve, etc)

v     An ice massage to your arch and heel – rubbing frozen water in Dixie cup

v     A deep tissue massage to the inside part of the arch & heel region

v     A disciplined stretching program as shown below:

o       Step 1: Place involved leg over opposite knee

o       Step 2: Grasp ball of foot & dorsiflex* 15-20 times

o       Step 3: Extend toes & dorsiflex 15-20 times

o       Step 4: Maintain stretched position & massage using palm of hand

o       This stretching & massage program should be performed every morning at bedside & after periods of inactivity before setting foot on the ground (should be the first thing you do)!!!

*Dorsiflex- to pull foot upward causing a stretch in the calve/back of heel

v     Physical Therapy to help plan a functional progression to return to a desired level of activity.

Tyler Williams, SPT

Kristi McMahan, DPT






Tendinitis & The Ankle

Tendinitis is an inflammation of the tendon. Tendinitis of the ankle can involve the Achilles tendon, the posterior tibial tendon, or the peroneal tendon. This condition usually results from trauma but can result from underlying inflammatory diseases or illnesses such as reactive arthritis (formerly called Reiter’s syndrome), rheumatoid arthritis, and ankylosing spondylitis. All forms of tendinitis cause pain, swelling, and tenderness in the tendon area involved. The onset may be rapid, such as with an athletic injury.  Immediate treatment involves immobilizing the area, elevation, and limiting weight-bearing, applying ice, and using nonsteroidal anti-inflammatory drugs (NSAIDs) to decrease inflammation.  NSAIDs such as naproxen (Naprosyn) or ketoprofen (Orudis) are commonly used for this purpose.  More severe inflammation can require orthopedic casting. Athletic participation should be limited when the tendon is still inflamed, as there is a significant risk of rupturing or tearing the tendon, especially in the Achilles area, with continued athletic activity. A rupture of the Achilles tendon more frequently occurs in patients who have had previous Achilles inflammation. When the Achilles tendon ruptures, it usually requires orthopedic surgical repair.

Alan Crothers, PT, SCS
Board Certified Sports Clinical Specialist
Downtown Site Manager

If The Shoe Fits…

Foot pain affects over 80% of seniors.  Pain with our feet can be the first sign of more serious medical conditions such as arthritis, diabetes, and nerve and circulatory disorders.  These more serious conditions need to be properly evaluated by a physician and treated medically.  But, a study in 2005 found that a lot of older adults suffered from pressure caused by shoes that don’t fit properly.  Poorly fitting shoes can put pressure on bony prominences, corns and calluses that can cause foot pain and reduce activity levels.  This study showed that most people wear shoes that are too narrow for their feet.  Women also tend to wear shoes that are too short.  Did you know that people over the age of 40 can gain half a shoe size every 10 years?  Over time tissues weaken, muscle mass declines, ligaments become less resilient and our bodies lose that natural spring and bounce.  The result- our feet widen, the arch lowers and the foot becomes a little longer.  So the next time you buy shoes make sure you get properly measured.  You may find out you are wearing the wrong size and have to start looking for wider widths.  A good pair of shoes may relieve some of your foot pain and allow you to increase your level of fitness.

These are a few helpful hints when buying shoes:

  • Try shoes on later in the day, feet may swell as the day wears on
  • Some of us have one foot longer than the other, so fit the longest foot
  • Make sure you have enough depth in the front of the shoe to wiggle your toes
  • You need at least 1/2 inch at the end of your longest toe in the length of the shoe when standing up
  • Make sure the ball of your foot fits comfortably in the widest part of the shoe
  • Consider a lace up shoe, they conform better to the size of your foot
  • For better support look for a shoe with arch support, a firm heel counter and stiff midsole
Carrie Whitted, MPT
Foot and Ankle Specialist

Ankle Sprains and Fractures

Ankle sprains are one of the most common musculoskeletal injuries. Sprains are injuries to the ligaments of the ankle, causing them to partially or completely tear as a result of sudden stretching. They can occur on either or both of the inner and outer portions of the ankle joint. Ankle sprains more commonly happen when there is a pre-existing muscle weakness in the ankle area or a history of previous ankle injuries. The typical injury occurs when the ankle is suddenly “twisted” in a sports activity or by stepping off an uneven surface. The pain is initially severe and can be associated with a “popping” sensation. Immediate swelling over the area of injury often occurs as the injured blood vessels leak fluid into the local tissue. Examination of the area may cause severe pain when the ankle is moved. The degree of pain may not necessarily indicate the degree of damage to the ligament(s). Ligament injuries are often graded from I to III, ranging from partial to complete tears. Partial tears retain some ankle stability, whereas complete tears lose stability because the strapping ligaments no longer brace the ankle joint. After an examination, significant ankle sprains are commonly evaluated with an x-ray test. X-rays can determine whether there is an accompanying break (fracture) of the bone.

Acute ankle sprains are initially treated with ice, rest, and limiting the amount of walking and weight-bearing on the injured ankle. The leg can be elevated to reduce swelling, and crutches are often recommended to avoid further trauma to the injured ligaments. Anti-inflammatory medications can be given to reduce local inflammation. Ice packs help decrease further swelling of the area and can reduce pain. Patients with severe injuries are placed in immobilization casts. Surgical repair of grade III injuries is considered, especially for those patients contemplating future athletic participation. Physical therapy programs are part of the rehabilitation process, incorporating strengthening exercises of the lower leg muscles. Fractures are repaired with casting to immobilize the bone for healing. Depending on the severity, fractures can require orthopedic casting, surgical procedures including pinning, and open repair of the fractured bone.

Alan Crothers, PT, SCS
Board Certified Sports Clinical Specialist
Downtown Site Manager