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Medical & Surgical Treatment of Foot & Ankle

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Category Archives: Heel Pain

Peyton Manning-Bad Plantar Fasciitis vs Partial tear?

Dr. Holdren Otis

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The plantar fascia is a ligament on the bottom of the foot that goes from the heel bone to the bases of the toes

Manning is currently listed on the injury report as right shoulder, rib and left foot injury. There are differing reports about what caused him to leave the game Sunday after throwing 5 passes and 4 interceptions again the Kansas City Chiefs. Peyton Manning has struggled with plantar fasciitis over the season. Plantar fasciitis, also known as heel spur syndrome, is the most common cause of heel pain. It is seen in individuals who are physically active or have increased their daily activity. The plantar fascia itself is a thick band of tissue attaching to the heel bone, the calcaneus. Tugging and pain are usually felt at this attachment, but pain can be in the arch as well. This tugging can cause microtears or worse a partial rupture of the fascia itself.  Pain in the morning and when getting up to walk after sitting for a period of time are common complaints. The heel is often painful when a person has to push off on the toes.

Treatment for microtears of plantar fasciits is much different from treatment of a partial or complete tear of the fascia. Microtears are treated with a decrease in activity, especially what causes the pain. The foot and arch itself needs to be supported with an arch strap or insert in the shoes so that the fascia doesn’t have to stretch so much with each step. The longer the symptoms have been around the longer it takes to make the pain go away. If the pain is not going away with diligent care for 6 months then a surgical procedure can be done through a scope to lengthen the fascia.

A partially torn plantar fascia is an uncommon injury but can be done with one forceful planting of the foot. Sometimes a pop is felt or heard with associated pain.  It is not possible to repair the plantar fascia surgically. Time and rest with gentle stretching are the main treatments.  Soft tissue, such as the plantar fascia, can take up to 8 weeks to fully heal. Immobilization with a walking boot or cast can help to heal it faster and is recommended for a fully ruptured plantar fascia. Once the fascia is healed light stretching and slowly getting back into activities is the best way to prevent a re-rupture. Peyton’s brother Eli Manning tore his fascia completely in 2009. There is no genetic link to pathology of the plantar fascia but they may have a similar foot type, along with high level athletics that would predispose them both to this issue.

Peyton Manning broke the record for the most passing of all time earlier in the game. For the sake fans of the Broncos and Peyton Manning hopefully microtears of the fascia along with the shoulder and ribs kept him out of the game and not something more serious like a partial or complete rupture.

What your runnning shoes are not giving you.

Dr. Holdren Otis

I have spoken with many runners and their trials of trying to find the correct running shoe for their build, running gait, mileage, terrain and foot type. There are many, many types of shoes to choose from and the task can be daunting. Let me start with what a running shoe can offer for you. The first is protection from the road below your feet. Why wear shoes in the first place? The reason is to allow you to run on anything from icy paths, rocky dirt roads, a smooth river trail or a grassy field. The second a running shoe will offer is cushioning to take away a little shock from your body falling to the ground with every step at six times your body weight. Some shoes like the Hoka brand have a very thick sole and offer what many of my running friends call a “smooth ride.” Other shoes are for more efficient “ball of the foot” runners like the Nike Free, offer less between you and the miles ahead.

Ok now let’s discuss what a running shoe is not going to give you. Arch support. That insert in your shoe is usually colorful and soft, but little else. It is flexible and may have a little more material where the arch of your foot is but it is not support. If I can bend the insert with my hands then you can definitely do it with your body weight. I have heard from many runners “I bought these shoes because they have good arch support.” The shoes you have purchased may have stability, they don’t bend in the midfoot, which is a good quality of a shoe but they don’t support your arch. Any shoe that offers memory foam may feel good and squishy but it is not arch support either.


Note the flexibility of the standard shoe insert.

Inserts pulled out of running shoes.

Inserts pulled out of running shoes.


Shoe inserts all look about the same. These are from Asics, Addidas, Fila, Sketchers, Nike, Saucony, Mizuno and New Balance. I have run in about every major shoe brand.



A normal arch height foot on a standard shoe insert.


The same normal arch height foot on a custom molded semi rigid orthotic that fits the arch and heel very well.



Not absolutely everyone needs arch support but if you have had foot pain, plantar fasciitis, heel pain, arch pain, very high or low arched feet, a custom molded orthotic made to your exact arch is an excellent way to support your arch and foot. If you have tried orthotics in the past but they were too rigid or painful for you there is an answer for that too. An orthotics doesn’t need to be made out of a hard material to be effective. A semi rigid device can be made so the main structure has a little give to it and it is covered with a soft material to make it comfortable to wear. With anything made specific for you and your foot, Dr. Hirt and I want to make sure that you love wearing it. Given time you will not even notice that you are wearing your orthotics, but will become aware if you forget to put them in a pair of shoes. Both Dr. Hirt and I wear orthotics in all of our shoes.


A high arched foot on a standard shoe insert.


A high arched foot type in an over the counter semi rigid insert.


A high arched foot type in an excellent fitting rigid custom molded orthotic device.


An orthotic can turn an okay pair of shoes into a great pair and searching for just the right pair of shoes may become a little bit easier. If arch support is what you are looking for, look no further than Fenton Foot Care and Brighton Family Foot Care or your local podiatrist.

Heel Pain=Plantar fasciitis, Well Not Necessarily.

Heel PainDr. Holdren Otis

“You almost want to pee in your bed rather than go to the bathroom. It’s really painful in the morning,” Albert Puljos, a baseball player for the Angels, said it best in an interview with USA today in 2013.  Plantar fasciitis, also known as heel spur syndrome, is the most common cause of heel pain. It is seen in individuals  who are physically active or have increased their daily activity. The plantar fascia itself is a thick band of tissue attaching to the heel bone, the calcaneus. Tugging and pain are usually felt at this attachment, but pain can be in the arch as well. Pain in the morning and when getting up to walk after sitting for a period of time are common complaints.

Although plantar fasciitis is the most common cause of the heel pain, there are other more serious things that can cause pain in the same area. These things include a stress fracture of the calcaneus (heel bone), which occurs with increased activity as well. Also tarsal tunnel, very similar to carpal tunnel of the hand and wrist, can cause shooting pain, tingling and numbness to the foot. In children the closing of the growth plate can cause heel pain when running and jumping. Having your heel pain checked out by a doctor is very important to rule out the other diagnoses. In addition, your pain can be treated quickly and efficiently with all that the medical community has to offer. It is abnormal to have heel pain that does not go away. Call Fenton Footcare today to see one of our doctors.

Miguel Cabrera May Need Surgery

Miguel CabreraDetroit Tigers‘ First Baseman Miguel Cabrera may have to undergo off-season surgery for bone spurs.  Tigers General Manager Dave Dombrowski said: “We’re checking him out from a physical perspective and we’ve already done some of the work on that and we’ll do some more this week. Then we’ll determine what we’re going to do beyond there and that will be more of a doctor’s decision.” Dombrowski said of the injury: “There’s no question that the ankle started to bother him… [i]t hurt him at times worse than others because it was there but if you would do something to jar it, it would hurt him.”

Bone spurs are the result of strain on the muscles and ligaments of the foot.  They usually occur in the heel as a result of stretching of the long band of tissue that connects the heel and the ball of the foot, and by repeated tearing away of the lining or membrane that covers the heel bone. These conditions may result from bio-mechanical imbalance, running or jogging, improperly fitted or excessively worn shoes, or obesity.

Bone spurs can be very painful, but don’t always require surgery. At Fenton Foot Care we have numerous  treatment options, both surgical and non-surgical.  Our philosophy is that the least invasive option is always preferable, and will do all we can to get you back on your feet pain free! If you are experiencing bone and/or heel spurs, make an appointment today.  You don’t have to live with foot pain!

Frank Thomas Inducted Into Baseball Hall Of Fame; Thanks His Podiatrist Amongst Many Others

Frank ThomasFrank Thomas was inducted into the Baseball Hall of Fame, and had many people to thank for it; 138 to be exact. He joked that he had to cut 50 people out of the speech to keep from running over his allotted time. Hitting 521 homeruns over a career that spanned 18 years takes a lot of support, and Thomas made sure to thank everyone he could. He talked about his mother and the support she gave, along with his deceased father whom he credited with instilling in him his tireless work ethic. Fighting back tears Thomas thanked him for “always preaching to me that you can be someone special, if you really work at it”. He also thanked his team podiatrist, Dr. Lowell Weil Sr. for all the work he did keeping Frank on his feet. Over the years, Thomas was treated for a bone spur “half the size of a golf ball in the front of his ankle,” a tarsal coalition (also known as “flat foot”), hallux rigidus (aka “stiff big toe”), a metatarsal stress fracture, navicular fracture, posterior tibial tendonitis and ingrown toenails. There is no doubt without treatment of these foot ailments, Frank Thomas would not have had the stellar career that he did (us Detroit Tigers fans surely remember all the damage he could do in a White Sox uniform…). Proper treatment by a podiatrist allowed Frank to hit towering homeruns into his forties. Your feet literally are the foundation of your body, take care of them and they will take care of you, as Frank Thomas can tell you! Congratulations to Frank Thomas and all of the 2014 class of Hall of Fame inductees from all of us at Fenton Foot Care!

Heel Pain Relief Center Now Open!

Reception Area @ FFC

Reception Area @ FFC

Introducing the Heel Pain Relief Center, now open at Fenton Foot Care!  If you have not experienced heel pain yourself, you probably know someone who has.  As a recent article points out, 85% of adults will develop heel pain in their lifetime.  Without treatment this heel pain will last on average for 3 years, but with expert treatment from our highly-trained doctors, it can usually be resolved in less than a month.  James Hirt, DPM is an expert in treating and preventing heel pain.  Dr. Hirt is a board certified physician with 3 years of surgical training, along with advanced training in Endoscopic Plantar Fascial Release surgery.   Dr. Hirt has performed hundreds of Endoscopic Planter Fascial Release surgeries, and has the expertise and experience to identify and treat your heel pain.  There are multiple causes of heel pain, and no one treatment works for every patient or condition.  Surgery is not necessary in the majority of cases, and our doctors have the philosophy that the least invasive option is always best.

The Heel Pain Relief Center offers:

  • In-office Muscular-Skeletal Ultrasound Diagnostics
  • Custom Functional Orthotics specifically tailored to relieve your heel pain
  • Night Splints
  • Hi-Resolution Digital X-Rays
  • As well as an array of Physician-Selected over-the-counter treatment products

If you are experiencing heel pain, make an appointment today by calling 810.629.3338 [FEET].  Don’t live with heel pain, let our expert doctors help you to get back on your feet again, pain free!