What is Plantar Fasciitis?

Written by admin on January 16, 2013 – 7:02 am -

Plantar fasciitis is the progressive degeneration of the plantar fascia of the foot and is a common Orthopaedic complaint. . Plantar fascia is the medical term for the fibrous connective tissue that comprises and creates the arch of the foot by connecting the calcaneus (heel bone) to each of the phalanges (toes). The plantar fascia is located along the bottom side (plantar surface) of the foot, and is amongst the densest fascia in the body. Originally presumed to be an inflammatory disorder of this tissue, we now know that inflammation is only rarely the culprit. Numerous men, women, and even world-class athletes suffer from plantar fasciitis. Marcus Camby of the New York Knicks and Derrick Favors of the Utah Jazz are two NBA players currently battling the condition.

Plantar fasciitis is most prevalent in men between the ages of forty and seventy but is also frequently seen in women. The most common complaint of plantar fasciitis is a sharp pain in the heel or arch of the foot. Others include a ‘pulling’ sensation, a sharp or dull ache, or a burning sensation. Someone suffering from plantar fasciitis may complain of pain during or after intense exercise, or after standing for long periods of time; however, the classic report is pain in the morning when getting out of bed but subsiding throughout the day, or a gradual onset of dull pain which then turns into sharp pain as the day progresses. Individuals with pes planus (flat feet/no arch) or pes cavus (very high arch) are more prone to plantar fasciitis (albeit for different reasons) than individuals with normal arches. Other causes or risk factors for plantar fasciitis are sudden weight gain or obesity, long distance running, and poor arch support in shoes.

Initial treatment begins with rest, ice massage (freezing a water bottle and rolling the bottle back and forth under the foot), OTC anti-inflammatories, and stretching the foot and heel throughout the day–especially before getting out of bed– by rolling over a tennis ball, wearing shoes with the appropriate amount of support, shoe inserts, and wearing night splints while sleeping to keep the foot and fascia stretched throughout the night, preventing contraction (tightening) of the fascia tissue. If conservative treatment fails, PRP or steroid injections and/or surgery may be considered. We have had excellent results with the emerging technique of Platelet Rich Plasma (PRP) injections.

Plantar fasciitis symptoms may take anywhere from days to years to subside. Prevention of plantar fasciitis is best ensured by optimizing the flexibility of the ankle joint, Achilles tendon, and calf muscles (gastrocnemius and soleus)

References

A.D.A.M. Medical Encyclopedia. (2012, March 1). Plantar fasciitis. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004438/

Dr. Mark Galland is a Board Certified Orthopaedic Surgeon specializing in sports medicine, practicing in Wake Forest and North Raleigh. He serves as team physician and Orthopaedic consultant to the Carolina Mudcats, High-A Affiliate of the Cleveland Indians of Major League Baseball, as well as several area high schools and colleges. Dr. Galland can be reached at (919) 562-9410 or by visiting www.orthonc.com or www.drmarkgalland.com.

Caitlin Davis, LAT, ATC is a post graduate fellow at GOSM. For more information, visit us at www.atcfellowship.com


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Injuries and Preventative Measures for Young Soccer Athletes

Written by admin on September 13, 2012 – 5:35 am -

Soccer is the most popular sport in the world with up to 230 million amateur participants. In the U.S. alone 3 million are registered in either high school or youth programs with an estimated growth of 21.8% annually.

As a result, soccer-related orthopedic injuries are more and more common. In 2006 alone, the CPSC (The US Consumer Product Safety Commission) estimated 186,000 soccer-related injuries. Up to 45% of those injuries reported occurred in athletes ages 15 years or younger.

The lower extremity is the most common location of injury. The ankle is the most common area injured, followed closely by the knee. In addition, Sever’s disease is perhaps the most common over-use injury seen in younger soccer athletes.

Sever’s disease, or calcaneal apophysitis, typically occurs in physically active youth between the ages of 8 to 15. The name sounds bad, but it is really not serious. Not really a “disease,” it is an inflammatory response at the growth plate of the heel bone where the Achilles tendon attaches. For soccer athletes, it usually results from excessive running on hard surfaces (not every pitch is covered in soft cushiony grass, too often the field is hard-packed earth) in cleats lacking proper fit, heel or arch support. Common symptoms include pain at the back of the heel and a limp that are aggravated during running. In severe cases, the pain may also be present with walking. As with many overuse injuries, the best treatment is to dramatically decrease activity. Severe cases may warrant complete non-weight-bearing for a period of time. Additional measures include rest of the injured area, providing a heel lift or heel cup for support, and stretching the calf and hamstring muscles 2-3 times per day. Prevention of Sever’s disease requires maintenance of flexibility of the calf and hamstring muscles, wearing well-fitted shoes that allow proper support throughout the entire foot, and adoption of a reasonable training regime that will not allow extensive amounts of vigorous activity for young developing athletes (particularly during growth spurts).

While Sever’s disease is among the most common soccer-related injuries, there are a number of other conditions to which soccer players are prone. Ankle and knee injuries account for over half of all injuries in soccer athletes regardless of the age. The major concern for all parents and athletes is the complete rupture of the anterior cruciate ligament (ACL) in the knee. Fear not, mom and dad! Help is on the way. A recent study published in the American Journal of Sports Medicine reported that the implementation of an injury prevention program resulted in 21% fewer injuries. Proper warm-up and cool-down, taping unstable joints, and exercises designed to improve the core stability, coordination, reaction time, and endurance were all incorporated into the training regime. The researchers also included a process of educating the coaches on proper training and the promotion of fair play.

While athletic participation will always carry the inherent risk of injury, Taking the proper steps towards injury care and prevention can be the difference between staying healthy and missing a number of games or even an entire season.

Orthopaedic Specialists of North Carolina partner with a number of youth athletic organizations in the greater Raleigh area. Dr. Mark Galland and his colleagues at OSNC are specialists in orthopedic surgery and sports medicine and are eager to assist any and all young athletes injured on the playing field. For immediate needs, our Wakefield and Knightdale locations have an urgent care clinic open 7 days a week from 9:00am to 9:00pm, no appointment needed.
www.orthonc.com

Article by Dr. Mark Galland with Matt Rongstad, ATC/LAT


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