Maggie McKay (Host): As kids, you may have heard, "Don't wear flip flops all day long. You need arch support" or "Don't wear high heels all the time. It'll ruin your feet." So, what is the truth about foot health and plantar fasciitis? Today, Dr. Zach Lind, doctor of Podiatric Medicine will fill us in.

Welcome to Stoughton Health Talk. I'm your host, Maggie McKay. Thank you so much for joining us, Dr. Lind.

Dr. Zach Lind: Hi, Maggie. Thanks for having me on.

Host: Absolutely. It is amazing to me how many people suffer from plantar fasciitis that you never knew about until you have it yourself and you start talking to people and you compare notes. So, what exactly is plantar fasciitis and what causes it?

Dr. Zach Lind: Plantar fasciitis, it's an immediate inflammation of the plantar fascia of the foot, which is a thick fibrous band that starts at the heel bone and it makes its way out to all the toes and it has a lot of different attachments in between. This inflammation usually quickly subsides and it just becomes a degenerative type chronic inflammation where it's sort of stuck in this cycle of turnover and tissue damage. As far as we know, there's a couple things that can cause plantar fasciitis, but there's nothing been nailed down in literature. So, high heels, overuse injury, standing all day, obesity, these are some things that can lead to plantar fasciitis.

Host: And what are at-home treatments if there are any?

Dr. Zach Lind: Yeah, there's actually quite a few at-home treatments. We tend to give patients a sheet that has a lot of different exercises and toe stretching. You can use a Dixie cup that's got frozen water in it and massage that area of the foot. It tends to be a very specific area. And most people, it's almost exactly the same presentation. It's sort of that bottom, a little bit on the inside of the heel. It's that pain first thing in the morning when you take steps. It's pain after standing all day or when you get up from a flight or a long car ride. So when you go beyond that for the at-home, it's usually massaging the area that can be with, you know, a hard sort of wood ball, you take anti-inflammatories, and then really just kind of the stretching exercises are what we usually recommend as a first line.

Host: How common is it?

Dr. Zach Lind: It's extremely common. I don't know the specific numbers, but I would hazard a guess that most people that have hit 30 or 40 years old have at least had one episode of it in their life, and some people have been dealing with it for years.

Host: And when should somebody go to the doctor for it? Early on?

Dr. Zach Lind: Yeah. If you have an immediate pain and you know, it's from, you know, maybe you wore high heels or you had a new pair of dress shoes and you're at a wedding dancing all night, and if you have a specific reason why your foot hurts, those tend to go away after a week or two, if you just sort of modified and you're not doing that activity anymore.

If it's people like runners, people who are on their feet all day, factory workers, if you're on cement all day, those are the people that tend to not be able to change that because it's what they do. So, if you've gone a week or two with pain, it's usually better to catch it early. So, those are the people I usually recommend to come in after a week or two of pain and it hasn't gone away.

Host: And what are some treatment options? Are there surgical options?

Dr. Zach Lind: There are. Typically, when we move up the ladder, we have them do the stretching, the anti-inflammatories to really try to knock down that initial inflammatory phase. We have them do, you know, the massage rolling out on a wood ball. Beyond that, we can consider physical therapy. They'll have different options.

There's also good literature on a night splint. And basically, you wear it at night as the name suggests, and it helps hold your foot in a neutral sort of 90 degrees. And some of them will also include a pole on the big toe because dorsiflexing the big toe actually activates that plantar fascia as well. It's called the windlass mechanism. So, a night splint.

Beyond that, we can consider a steroid injection, and that's usually the go to route for people that have been dealing with it for an extended period of time. Typically, anybody that's over a month of pain with plantar fasciitis, we sometimes recommend a steroid injection, which provides sometimes lifelong healing from it and they don't ever need it and they don't ever develop it again. Sometimes it's months to a year. It's really hard to say, everybody's a little different.

Surgical routes, it tends to have a component of equinus or a limited ankle mobility. So, sometimes you can go up in the leg. Kind of in the back of the calf and release the muscle, tendon there a little bit. Otherwise, you can go down into the foot and cut a little bit of the plantar fascia to relieve it.

Host: How long does that take to recover from?

Dr. Zach Lind: It depends on which one you do. Typically, you're in a boot or a surgical shoe. If it's just the plantar fascia release, typically you're off of it for a couple of weeks. If it's up in the leg, usually you're off of it for probably four in a boot, and then usually physical therapy after that.

Host: Is there anything else about plantar fasciitis that we should know?

Dr. Zach Lind: There's been some different sort of opinions online that we've been seeing a lot lately. And I think there's been some newer literature kind of showing the differences, and this is specifically for a minimalist or a barefoot type shoe enthusiast. I think we're still waiting to see how literature pans out on that and whether or not, you know, have we sort of gone too far and over prescribed orthotics and that and kind of seen is it a more flexible, minimal type shoe that actually allows the foot to function the way it was naturally meant to? So, I think we're right now waiting on literature still for that, which could be years, but it's an interesting new avenue.

Host: Well, thank you so much for explaining this because I think a lot of people don't even know they have it. I didn't until I went to the doctor and he said that's what it is. So, this has been very educational and we appreciate your time.

Dr. Zach Lind: Yeah. Thanks for having me on.

Host: Again, that's Dr. Zach Lind. And if you'd like to learn more, you can go to stoughtonhealth.com. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. I'm Maggie McKay. Thanks for listening to Stoughton Health Talk, presented by Stoughton Health.