Sunday, April 21, 2024

Secret of Heel pain, plantar fasciitis, heel spur syndrome what you need to know now

 



Plantar fasciitis is a common foot condition characterized by inflammation of the plantar fascia, a thick band of tissue that runs across the bottom of your foot, connecting your heel bone to your toes. This inflammation often leads to intense heel pain, especially with the first steps in the morning or after long periods of rest.

Several factors can contribute to the development of plantar fasciitis, including overuse or repetitive strain on the feet, improper footwear, high arches, flat feet, obesity, and tight calf muscles. Athletes, runners, and individuals who spend prolonged periods on their feet are particularly susceptible to this condition.

The symptoms of plantar fasciitis can vary in intensity, ranging from mild discomfort to severe pain that interferes with daily activities. Without proper treatment, the condition can worsen over time, impacting mobility and quality of life

If you're experiencing persistent heel pain or suspect you may have plantar fasciitis, it's essential to consult with a qualified healthcare professional for an accurate diagnosis and personalized treatment plan. Don't let plantar fasciitis hold you back – with the right approach, you can find relief and get back to enjoying life to the fullest. The Family Foot & Leg Center (FFLC) prides itself on its network of cutting-edge clinics strategically positioned throughout Collier, Lee, Charlotte, and Sarasota Counties, ensuring accessible expert foot and ankle care across Florida. Our goal is to swiftly and effectively address your foot and ankle challenges, enabling you to resume your active lifestyle promptly. Equipped with advanced treatment modalities and staffed by a team of devoted specialists, FFLC is dedicated to delivering top-notch care conveniently situated in your local community.

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Hey guys, Dr. Lam. We are here to talk about plantar fasciitis and surgery for plantar fasciitis. Yes, surgery. You know, a small amount of patients will benefit from surgery. Most -- majority of patients, I will say 85 - 90 percent of our patients do well with conservative care. What is conservative care? Well, you have natural anti-inflammatories, you have stretching techniques, physical therapy is really big, inserts, injections, etcetera, there's also shockwave therapy but let's say all those things fail or you know, you can't afford to pay for shockwave therapy because it is not covered by by insurance but what we have that's a great alternative to that is endoscopic plantar fascial release. I'm gonna show you a little video of that later on of an actual case and I'll talk through it. It's a very short video following this explanation. So you have an idea. This is plantar fasciitis on the bottom of the foot, that's your heel. As you can see, it's nicely marked. So what we're gonna see later in the video, there's a camera going in through one side right about here and it's looking up, it's looking right up at this just as you're looking up but that's what you'd be seeing on the -- there you go, going into zoom so that's what you'd be seeing later on, you'll just be seeing this tissue, this band of tissue and then what you'll also see later on, a blade going in from this side just cutting this right about there, that's what you'll be seeing on the video and why is that important? What is plantar fasciitis? Plantar fasciitis is the inflammation of this rubber band down on the bottom of the foot It actually looks like a rubber band when we go into surgery so that's how I explain to my patients. So why does this cause a problem? Well number one is it's almost like a pinnacle  where your heel strike, number one. Number two, this tissue right here it could be -- you can have little micro tears or macro tears you can have a little tearing of this tissue as you step down wrong or you stepped out on an object, some Legos, anything. Poor choice of shoewear where it's not padded enough and you're getting a lot of injury -- repetitive injury to this, you're not letting it heal. Another theory is you can have some inflammation on the bone inside or what we call venous congestion in there, that's another theory behind that that's why we see a lot of inflammation on an MRI inside the bone or on the plantar fascia or both So obviously, typically we try to do the conservative thing first and if that doesn't work then we move on to more aggressive surgical care. So we're gonna go on to the video of the endoscopic plantar fasciectomy. I'm gonna go ahead and try to talk through it. It's really not much, again, it's a very short video so again you'll see me -- actually the camera is actually inserted on this side on the outside of the foot, 5th metatarsal side the cameras gonna be coming in this way while I cut this side that's what you're gonna see initially I would go in through this side right here to view everything but and then when we come to cutting I reverse the camera, I come in here, the camera's there to look, this is the camera now to look as I take the surgical blade now this is a surgical blade, let's see if I can get another pen here so as not to confuse anyone, this is a surgical blade, again the camera's looking and a surgical blade is right here and you cut, pull back and cut and that is what you're gonna see on the video, any questions let us know. This is a quick procedure, it's about 30 minutes or less from going into the operating room to them prepping, us giving a little anesthesia, to putting in the last stitch which is only about two so go on from there, any comments, concerns let me know. Hopefully this will explain one of our common procedures called endoscopic plantar fasciectomy for chronic plantar fasciitis or plantar fasciosis. Hey guys, this is Dr. Lam. We are going live on the video this is an actual EPF procedure -- endoscopic plantar fasciectomy this is again the camera going in from the outside of the foot, fifth metatarsal side looking at the medial side of the foot as you can see that is a nice curved blade this is all through a couple millimeters incision actually as you can see the fat is underneath on this down side right here and then the blade is cutting the plantar fascia which is this white tissue  right here you see the red underneath that is the muscle belly of the flexor tendon down there so a flexor muscle belly, so we cut until all the white portion is cut which is the plantar fascia we're only cutting a certain amount that is pre measured and you can see I'm moving around the probe just to -- this is just feeling make sure I have every fiber cut as you can see this is a thick fiber right here, this white is the plantar fascia, again the red is the muscle belly underneath there. In chronically inflamed plantar fasciitis you would see that thickened tissue requires a couple passes with that blade again it's all done endoscopically, the incisions are really small we're seeing on the screen as you see right here looks like it's getting a little blurry from the fog so that's it.

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