Demystifying Plantar Fasciitis: Causes, Diagnosis, and Prevention with Dr. Lauren Dabakaroff

What if you could fully comprehend that nagging foot pain and finally get on the road to a pain-free life? This week on the LMD Podiatry podcast, we're unwrapping the mystery of plantar fasciitis - a common foot ailment that has left many puzzled. Our host, Dr. Lauren Dabakaroff, and co-host, Jeremy Wolf, take on the mission of helping you understand this condition - from its root causes, like tight calves and hamstrings or ill-fitting footwear, to the role your biomechanics play in its development. 

Imagine knowing exactly what to do when that first painful step hits you in the morning or when discomfort creeps in at the end of the day. Dr. Lauren guides us through the critical steps in getting a precise diagnosis, highlighting why it's crucial not to ignore those pesky symptoms. We also take a detour into the world of proper footwear and discuss the potential hazards of taking your feet for granted. This episode is a treasure trove of information for anyone keen on keeping their feet in top-notch shape. Don't miss it!

To learn more, visit: LMDpodiatry.com or contact (954) 680-7133

Transcript

Speaker 1: 0:01

Welcome to the LMD Pediatry podcast. Trust us to get back on your feet. Here's your host, Dr Lauren Devakaroff.

Jeremy: 0:15

Hello, welcome back everyone to another episode of the LMD Pediatry podcast. I'm your co-host, Jeremy Wolfe, and I am here with your host, Dr Lauren Devakaroff. How you doing, Dr Lauren? How's it going? I'm chilling.

Dr. Lauren: 0:32

It's the holiday season.

Jeremy: 0:34

Tis the season.

Dr. Lauren: 0:35

as they say, yeah a little bit of Hanukkah, a little bit of Christmas, a little bit of, you know whatever. Everybody else is celebrating Getting the gifts, lighting the candles, looking at trees.

Jeremy: 0:50

All the fun stuff, all the fun stuff. So I've been getting signs from the universe I've been hearing a lot about. A friend of mine recently told me he was going to get a myofascial massage. And then I heard on another podcast because as you know, I've been running a lot lately Somebody was talking about the myofascial this and that and I said to myself I've also heard planter fasciitis before and I know we actually talked about it briefly on another segment when we were going over some topics about sports injuries and things like that. And I know this is a common ailment that folks have and I imagine a lot of people out there are like me and really don't know much about. They've heard it before. They don't know really what it is. So what exactly is planter fasciitis? What are their common symptoms associated with the condition?

Dr. Lauren: 1:39

Sure. So planter fasciitis a lot of people hear it and they have no idea what it actually means. But what the planter fascia? It's the band that holds up your arch. So when you say planter fasciitis, it means inflammation of the band that holds up your arch. That's the itis part. Why is it caused? There's a couple of different reasons.

Dr. Lauren: 2:09

The most common cause of planter fasciitis is when your calves and your hamstrings are too tight.

Dr. Lauren: 2:15

It's very biomechanical and what that means is if your calves and hamstrings are tight or short, what happens is your heel or your planter fascia, which holds up your arch, works extra hard to reach the floor when you walk.

Dr. Lauren: 2:34

So if my legs or if my calves are super tight, when I try to put my foot down, and it works extra hard to put the foot down, I create an abnormal tug and pull on the planter fascial band and it creates little micro tears in there. And because it tears or sprains, that's when people start getting pain there, because your body's trying to heal the sprain and it doesn't get better because you keep walking on your foot. So that's kind of the historical biomechanical progression of how planter fasciitis typically happens. Another common cause of it is just not wearing the right shoes, Even if you're not tight. If you're older and you're losing some of your fat pad or the cushion underneath your foot, underneath your heel, if you're walking barefoot or not wearing soft, supportive shoes, that can also irritate the band or the planter fascia, creating that inflammation that's causing you pain.

Jeremy: 3:38

Well, you know I got my brooks now, so, yes, I'm in good shape with the footwear. So how is planter fasciitis diagnosed and why is it important for individuals that are experiencing these types of symptoms to go and seek professional help and go see if it died?

Dr. Lauren: 3:58

What was the first part of your question?

Jeremy: 4:01

No, how is it? How is planter fasciitis diagnosed?

Dr. Lauren: 4:04

Oh, how the why it's important.

Jeremy: 4:05

if you're, if you're experiencing what you think might be symptoms, the best way to diagnose it, the best way to diagnose it.

Dr. Lauren: 4:13

If the patients are saying I have pain with the first step of the morning and pain at the end of the day, that's usually, like you know, light bulb probably planter fasciitis. And then when I examine the foot and I have, if there's pain on one specific area of the heel, I know that that's planter fasciitis. And then I just confirm it with imaging Right. So I always want to take an x-ray, make sure there's no stress, fracture or any other issue in the foot that could be causing the heel pain. And then usually I do ultrasonography or sonogram and I take a look at the arch and I want to see how severe the plantar fasciitis is. Sometimes the patients have a really bad sprain within the band and needs more aggressive treatment, and I find too into their issue.

Jeremy: 5:09

So what are the available treatment options for the salement? I mean both in terms of medical interventions and also self-care strategies.

Dr. Lauren: 5:21

So first thing is stretching, because if you have the most common thing that's causing it, which is the tight cap and hamstring, the number one thing you have to start incorporating into your daily routine is stretching your calf and your ankle. You could, you know, if you're lazy, you get a night's splint that stretches your calf for you. I actually have a really cool stretching splint that you could sit in for an hour a day and go all the way up your leg. Some people just they're too lazy to stretch, so we have things like that. But really it's just like the run or stretch and calf stretching and all these types of things. You do them a couple times a day, hold each leg for 20 seconds and alternate and do a couple reps and that should help kind of stretch out your calf and your hamstring. And patients do see that as soon as they do that, they can see when they put their foot down there's not as much pressure on their heel. So that's number one, super, super conservative.

Dr. Lauren: 6:25

And then the next step is basic rest and ice. Okay, again, it hurts because it's inflamed, so I always recommend icing and avoiding high impact activities for a couple weeks until the area heals and goes back to normal no running, no jumping, no barefoot walking, only low impact, like walking in good sneakers, like you do, swimming, swimming, biking only low impact. And then, if it's very, very painful, sorry about that. If it's very, very painful, I usually offer a steroid injection and all that does is it delivers an anti-inflammatory medication directly to the problem area. So I insert the needle right to the area of pain and basically there's steroid in there and what the steroid does is gets rid of the inflammation that's causing the pain. Some patients need like two or three of them, together with some anti-inflammatory medications, such as an ibuprofen, for example. And when you do all that at the same time, your plant infrecyitis resolves within a month and a half tops.

Jeremy: 7:39

Are there ever any? I'd imagine there are extreme cases of plantar fasciitis that go beyond just the injections, that require actual surgery and things like that.

Dr. Lauren: 7:52

So when plantar fasciitis goes untreated okay or doesn't respond to treatment any of the treatment options that I just laid out for you you fall into a chronic plantar fasciitis category. And then some patients do require surgery. The surgery for that is a plantar fasciotomy, in which I go into the operating room and you go to sleep and I go in and I make a little incision and I just release that fascia and that actually gives patients all the relief in the world and it's not a bad recovery process but it really does help. It's really reserved for people that fail all those other treatment options Okay. I only do that surgery maybe once a year because I always tell my patients if you don't visit me, I have to take you to the operating room.

Dr. Lauren: 8:47

But there are some patients that come to me when it's too late and I can look on the ultrasound and see that they have all the scar tissue in their plantar fascia and it's just like I always tell them you may or may not respond to my treatment. Sometimes they do, sometimes they don't. One other trick I do have up my sleeve for preventing patients from going to the operating room is I do regenerative medicine and I basically use these stem cell injections and what the stem cells do. Is they actually correct? They actually reheal the area, kind of regenerate the scar tissue back to normal plantar fascia and they take away the pain at the same time. And for some patients it does work and I have been able successfully able to get patients out of the operating room just by getting one or two of those injections.

Jeremy: 9:43

Very interesting. So, as always, my number one takeaway and I say this out loud, have to reinforce it to myself, but also to share it with listeners Everything goes back to preventative measures, like you said, stretching, taking care of yourself, doing the things that are necessary to avoid these issues from happening in the first place and we're all guilty of it. Right, like you said many times. But if you take one thing away from this, it's take care of yourself, be kind to your body and put in a little hard work and go and be a little uncomfortable, because it will pay out dividends in the long run, that's right.

Dr. Lauren: 10:23

That's right. If you feel a little little heel pain, you know the number. First thing you got to do get yourself some fixed salt sneakers or some nice cushy memory memory foam slippers at home. You know, stretch a little bit and you it'll prevent it from getting worse. It's really all about just kind of being conscious of what your body's trying to tell you and knowing how to, you know, attack it before it gets too worse. And then you have to come and see me. That's anything I can impart wisdom on my patients and all people with heel pain.

Jeremy: 11:01

All right, sounds good. Dr Debaker off. Always a pleasure, so nice seeing you. I wish you and your family a wonderful holiday season, if we don't cross paths before then, so take care of a great week.

Dr. Lauren: 11:16

Thank you, you too.

Jeremy: 11:18

I shall, I shall, and thanks to our listeners for tuning in and we will catch you next time. Everyone, take care and have a wonderful holiday season.

Speaker 1: 11:30

Thank you for listening to the LMD podiatry podcast. For more information, visit LMD podiatrycom that's LMDPODIATRYcom or call 954-680-7133.