A common condition of heel pain, plantar fasciitis affects about 2 million people per year.
Its painful, but in most cases, can be treated with out surgery or non-invasive procedures.
Marco Ucciferri, DPM , discusses common causes of plantar fasciitis, symptoms and treatment as well as how to prevent the occurrence of this condition.
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How to Heal the Pain in Your Heel -- Plantar Fasciitis
Featured Speaker:
Dr. Ucciferri has practiced with Foot and Ankle Care Associates of New Jersey since 2003. His hospital appointments have included Hoboken University Medical Center, Somerset Medical Center, and Surgicare of Central Jersey.
Born in Italy and raised in the United States, Dr. Ucciferri says, "I became a doctor so that I can make patients feel better and help the community." He adds, "I believe in preventive health care to preempt problems before they happen."
Dr. Ucciferri is a member of the American Podiatric Medical Association and New Jersey Society of Podiatric Medicine. He is a fellow of the American College of Foot and Ankle Surgery.
Marco Ucciferri, DPM
Marco Ucciferri, DPM, expertise includes child, adolescent, and adult foot and ankle medicine, foot and ankle trauma, and reconstructive surgery.Dr. Ucciferri has practiced with Foot and Ankle Care Associates of New Jersey since 2003. His hospital appointments have included Hoboken University Medical Center, Somerset Medical Center, and Surgicare of Central Jersey.
Born in Italy and raised in the United States, Dr. Ucciferri says, "I became a doctor so that I can make patients feel better and help the community." He adds, "I believe in preventive health care to preempt problems before they happen."
Dr. Ucciferri is a member of the American Podiatric Medical Association and New Jersey Society of Podiatric Medicine. He is a fellow of the American College of Foot and Ankle Surgery.
Transcription:
How to Heal the Pain in Your Heel -- Plantar Fasciitis
Melanie Cole (Host): A common condition that causes a great deal of heel pain, plantar fasciitis, affects about two million people per year. It’s painful but in most cases, can be treated without surgery and noninvasive procedures. My guest today is Dr. Marco Ucciferri, podiatrist, with Summit Medical Group, whose expertise includes child, adolescent, and adult foot and ankle medicine, foot and ankle trauma, and reconstructive surgery. Welcome to the show, Dr. Ucciferri. Tell us about plantar fasciitis. What is it and what causes it? It’s such a painful condition that so many people suffer from.
Dr. Marco Ucciferri (Guest): Yes, plantar fasciitis is a very common disorder of the ligament on the bottom of the foot. Basically, a ligament is a structure that goes from one bone to another bone to create stability to the foot. This ligament basically goes from the heel bone to the ball of the foot, and what can happen is if overused, improper shoe gear, improper mechanics of the foot creates stress on the ligament which creates pain and basically walking on your foot with continued pain to the areas, this does not let it resolve. It continues to get inflamed and painful. It seems to snowball as time goes on.
Melanie: Let’s start with some of these causes in the list. How involved are shoes and what you do in causing plantar fasciitis?
Dr. Ucciferri: Well, shoes can definitely cause the issue in the sense of having improper support to the shoes. If the shoe is an older shoe, sometimes shoes are very flat, shoes that don’t have good support can create this problem. Even walking barefoot, like a lot of patients will come in and say, “Well, I’m home, but running here and there, I’m home all day.” You put miles on your foot with no support. That can create inflammation to the ligament itself.
Melanie: Now, when you’re dealing with this kind of pain it first starts to come out, what’s the first line of defense that you recommend people do? Because it’s very specific, you hobble around in the morning. Tell us some of the symptoms and what you recommend people do, right off the bat when they start to experience them.
Dr. Ucciferri: Sure, some of the symptoms, usually and most commonly is that they’re getting up first thing in the morning and start having pain at first weight bearing on the foot. The pain usually subsides as you get going. The reason that happens is because you’re basically lengthening or stretching up the ligaments, which is the tightness which makes it feel better. Basically as you continue to walk, it reduces the pain. It can happen throughout the day, getting out of the car, getting out of a chair, watching the TV, so you’re getting off the couch you get significant pain. The first few things you can do for that is just an oral anti-inflammatory such as ibuprofen, resting it, obviously giving a good support of shoe and putting on a pair of sneakers which could be very helpful if they are fairly new, and also resting and icing it.
Melanie: What about some of those treatments that people see on TV late at night that holds your foot in that flexed position to keep stretched out so you don’t have that pain in the morning? Do any of those things work, like wrapping your feet at night?
Dr. Ucciferri: Some of them do, but when you have an acute inflammation, they’re sometimes stretching the foot. There’s a night splint, a device that you put on your foot to stretch out the ligament itself. Sometimes they actually can create over-extension of a ligament which creates more pain and does not really resolve the issue. Taping the foot, supporting the foot, sometimes over-the-counter devices like a Dr. Phil’s insert are a helpful first line of defense to aid to get better. But a lot of times it doesn’t resolve it, so I advise the patient to try to get ahold of a physician before it gets much worse.
Melanie: Is there a way to prevent plantar fasciitis? Is stretching before you get out of bed in the morning or stretching before a workout or if you get up from your seat? You’ve been sitting at work all day and doing some kind of stretches, and if they do work, tell us what those stretches to do are.
Dr. Ucciferri: Yes, definitely stretching is very helpful to prevent issues. Stretching is important for all activities in your lifestyle. You should definitely stretch before and after exercise. With your first few steps in the morning, if you are having some discomfort, stretching can be helpful in the initial portion of having the pain, and especially if they include stretching the foot toward the top of your body so basically you’re dorsiflexing a foot and then you’re going to feel the pull on the back of the leg on the bottom of the foot so you know you’re stretching it correctly.
Melanie: How hard should you stretch? Should you hold the stretch for a while? Do you just move it and dorsiflex it back and forth? How hard should you do that?
Dr. Ucciferri: It should be enough that you feel the tension on the back of the leg. But it’s very individual to the person. Some patients can really stretch and you feel the pull on the back of the leg. Some patients stretch a little bit and still feel the pull. Once you feel the pulling, you’re definitely doing a stretch.
Melanie: What about arch support, Dr. Ucciferri? If people wear orthotics or they put the Spenco or Superfeet in their shoe, does that help to prevent plantar fasciitis or help with the symptoms?
Dr. Ucciferri: Definitely. I explain to patients it does help to prevent plantar fasciitis, and then the custom-mold orthotics is something that is also many times covered by insurance companies. Basically, it’s the device that supports the ligament so that there’s no overworking of the ligament. There’s no overstretching of the ligament which can create damage which causes the pain. Superfeet and Spenco are such great devices as an enflamed type of issue, and I explain to patients that they’re not very custom to your foot really, but they can help to take some of the pressure off it. Even cushioning the foot makes a big difference.
Melanie: When would a plantar fascia injection come into play? When would any other kind of intervention come in when your plantar fascia is bad?
Dr. Ucciferri: Well, even the patients that come to the office have tried multiple types of treatment at home via taping or sneakers, over-the-counter inserts, anti-inflammatories with no resolution of the pain, and that’s where we go ahead and do an injection of cortisone. The cortisone basically goes into the area, and initially we just reduce the inflammation allowing the patient to stretch and be able to tolerate an orthotic which can help them to resolve most of the pain.
Melanie: How long does it last?
Dr. Ucciferri: Hopefully, doing the injection can last indefinitely. Basically, it’s based on getting the patient over that threshold of having consistent pain and being able to use an orthotic or sneaker to prevent the problem from reoccurring. The injections are an adjunct to the all-round therapy of getting the patient better with plantar fasciitis, but they’re very necessary to reduce that inflammation so the patient can tolerate those other things that we do.
Melanie: In what situation would it affect other things? If you have plantar fasciitis, Dr. Ucciferri, are there other complications, things that are going to start to happen as we look at the base of support, which are our feet, going back up to the knees and the hips and the back if you’re hobbling around with pain?
Dr. Ucciferri: Correct. When patients do have pain in their foot, be it plantar fasciitis or bunion or hammertoes or some type of deformity, you compensate and you can get leg pain, knee pain, hip pain, IT band syndrome. Basically, your body will compensate for the pain that you’re having and will compensate to other joints and therefore kind of move up even to a lower back pain.
Melanie: When that happens, you know that it’s pretty bad. Please, in the last few minutes here, give your best advice for listeners who might be suffering from plantar fasciitis and why they should come to Summit Medical Group for their care.
Dr. Ucciferri: Sure. I explain to patients – most patients come in, the first thing they say when they get better, they say, “I wish I didn’t wait.” The patient suffering for more than a month with plantar fasciitis, there’s no reason why he shouldn’t go see a physician. It’s very, very minimally invasive. Pain is very minimal with cortisone injections. There’s a technique to do an injection. A lot of patients are afraid to get injections but it is very much a turning point for them to get better. I explain to patients, “Try not to be afraid to come in and we have some in our group who do a very good job with patients who are afraid to get injections or afraid of treatment. Once they get better, they are always saying, “Why did I wait so long? I wish I had come in much sooner.”
Melanie: Well, it certainly is really good advice. Thank you so much. You are listening to SMG Radio. For more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks for listening.
How to Heal the Pain in Your Heel -- Plantar Fasciitis
Melanie Cole (Host): A common condition that causes a great deal of heel pain, plantar fasciitis, affects about two million people per year. It’s painful but in most cases, can be treated without surgery and noninvasive procedures. My guest today is Dr. Marco Ucciferri, podiatrist, with Summit Medical Group, whose expertise includes child, adolescent, and adult foot and ankle medicine, foot and ankle trauma, and reconstructive surgery. Welcome to the show, Dr. Ucciferri. Tell us about plantar fasciitis. What is it and what causes it? It’s such a painful condition that so many people suffer from.
Dr. Marco Ucciferri (Guest): Yes, plantar fasciitis is a very common disorder of the ligament on the bottom of the foot. Basically, a ligament is a structure that goes from one bone to another bone to create stability to the foot. This ligament basically goes from the heel bone to the ball of the foot, and what can happen is if overused, improper shoe gear, improper mechanics of the foot creates stress on the ligament which creates pain and basically walking on your foot with continued pain to the areas, this does not let it resolve. It continues to get inflamed and painful. It seems to snowball as time goes on.
Melanie: Let’s start with some of these causes in the list. How involved are shoes and what you do in causing plantar fasciitis?
Dr. Ucciferri: Well, shoes can definitely cause the issue in the sense of having improper support to the shoes. If the shoe is an older shoe, sometimes shoes are very flat, shoes that don’t have good support can create this problem. Even walking barefoot, like a lot of patients will come in and say, “Well, I’m home, but running here and there, I’m home all day.” You put miles on your foot with no support. That can create inflammation to the ligament itself.
Melanie: Now, when you’re dealing with this kind of pain it first starts to come out, what’s the first line of defense that you recommend people do? Because it’s very specific, you hobble around in the morning. Tell us some of the symptoms and what you recommend people do, right off the bat when they start to experience them.
Dr. Ucciferri: Sure, some of the symptoms, usually and most commonly is that they’re getting up first thing in the morning and start having pain at first weight bearing on the foot. The pain usually subsides as you get going. The reason that happens is because you’re basically lengthening or stretching up the ligaments, which is the tightness which makes it feel better. Basically as you continue to walk, it reduces the pain. It can happen throughout the day, getting out of the car, getting out of a chair, watching the TV, so you’re getting off the couch you get significant pain. The first few things you can do for that is just an oral anti-inflammatory such as ibuprofen, resting it, obviously giving a good support of shoe and putting on a pair of sneakers which could be very helpful if they are fairly new, and also resting and icing it.
Melanie: What about some of those treatments that people see on TV late at night that holds your foot in that flexed position to keep stretched out so you don’t have that pain in the morning? Do any of those things work, like wrapping your feet at night?
Dr. Ucciferri: Some of them do, but when you have an acute inflammation, they’re sometimes stretching the foot. There’s a night splint, a device that you put on your foot to stretch out the ligament itself. Sometimes they actually can create over-extension of a ligament which creates more pain and does not really resolve the issue. Taping the foot, supporting the foot, sometimes over-the-counter devices like a Dr. Phil’s insert are a helpful first line of defense to aid to get better. But a lot of times it doesn’t resolve it, so I advise the patient to try to get ahold of a physician before it gets much worse.
Melanie: Is there a way to prevent plantar fasciitis? Is stretching before you get out of bed in the morning or stretching before a workout or if you get up from your seat? You’ve been sitting at work all day and doing some kind of stretches, and if they do work, tell us what those stretches to do are.
Dr. Ucciferri: Yes, definitely stretching is very helpful to prevent issues. Stretching is important for all activities in your lifestyle. You should definitely stretch before and after exercise. With your first few steps in the morning, if you are having some discomfort, stretching can be helpful in the initial portion of having the pain, and especially if they include stretching the foot toward the top of your body so basically you’re dorsiflexing a foot and then you’re going to feel the pull on the back of the leg on the bottom of the foot so you know you’re stretching it correctly.
Melanie: How hard should you stretch? Should you hold the stretch for a while? Do you just move it and dorsiflex it back and forth? How hard should you do that?
Dr. Ucciferri: It should be enough that you feel the tension on the back of the leg. But it’s very individual to the person. Some patients can really stretch and you feel the pull on the back of the leg. Some patients stretch a little bit and still feel the pull. Once you feel the pulling, you’re definitely doing a stretch.
Melanie: What about arch support, Dr. Ucciferri? If people wear orthotics or they put the Spenco or Superfeet in their shoe, does that help to prevent plantar fasciitis or help with the symptoms?
Dr. Ucciferri: Definitely. I explain to patients it does help to prevent plantar fasciitis, and then the custom-mold orthotics is something that is also many times covered by insurance companies. Basically, it’s the device that supports the ligament so that there’s no overworking of the ligament. There’s no overstretching of the ligament which can create damage which causes the pain. Superfeet and Spenco are such great devices as an enflamed type of issue, and I explain to patients that they’re not very custom to your foot really, but they can help to take some of the pressure off it. Even cushioning the foot makes a big difference.
Melanie: When would a plantar fascia injection come into play? When would any other kind of intervention come in when your plantar fascia is bad?
Dr. Ucciferri: Well, even the patients that come to the office have tried multiple types of treatment at home via taping or sneakers, over-the-counter inserts, anti-inflammatories with no resolution of the pain, and that’s where we go ahead and do an injection of cortisone. The cortisone basically goes into the area, and initially we just reduce the inflammation allowing the patient to stretch and be able to tolerate an orthotic which can help them to resolve most of the pain.
Melanie: How long does it last?
Dr. Ucciferri: Hopefully, doing the injection can last indefinitely. Basically, it’s based on getting the patient over that threshold of having consistent pain and being able to use an orthotic or sneaker to prevent the problem from reoccurring. The injections are an adjunct to the all-round therapy of getting the patient better with plantar fasciitis, but they’re very necessary to reduce that inflammation so the patient can tolerate those other things that we do.
Melanie: In what situation would it affect other things? If you have plantar fasciitis, Dr. Ucciferri, are there other complications, things that are going to start to happen as we look at the base of support, which are our feet, going back up to the knees and the hips and the back if you’re hobbling around with pain?
Dr. Ucciferri: Correct. When patients do have pain in their foot, be it plantar fasciitis or bunion or hammertoes or some type of deformity, you compensate and you can get leg pain, knee pain, hip pain, IT band syndrome. Basically, your body will compensate for the pain that you’re having and will compensate to other joints and therefore kind of move up even to a lower back pain.
Melanie: When that happens, you know that it’s pretty bad. Please, in the last few minutes here, give your best advice for listeners who might be suffering from plantar fasciitis and why they should come to Summit Medical Group for their care.
Dr. Ucciferri: Sure. I explain to patients – most patients come in, the first thing they say when they get better, they say, “I wish I didn’t wait.” The patient suffering for more than a month with plantar fasciitis, there’s no reason why he shouldn’t go see a physician. It’s very, very minimally invasive. Pain is very minimal with cortisone injections. There’s a technique to do an injection. A lot of patients are afraid to get injections but it is very much a turning point for them to get better. I explain to patients, “Try not to be afraid to come in and we have some in our group who do a very good job with patients who are afraid to get injections or afraid of treatment. Once they get better, they are always saying, “Why did I wait so long? I wish I had come in much sooner.”
Melanie: Well, it certainly is really good advice. Thank you so much. You are listening to SMG Radio. For more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks for listening.