Feeling the Blues from Heel Pain?

March Madness is coming underway, basketball fever is beginning to set in, and excitement is in the air! Before you take the court though, make sure that heel pain isn’t going to slow you down! One of the most common conditions that I treat as a podiatrist is something called Plantar Fasciitis. It is by far the number one cause of heel pain.

The plantar fascia is a band of connective tissue along the bottom of the foot. It stretches from the heel to the toes, and its purpose in the body is to support the arch of the foot. The plantar fascia can become strained, inflamed, and swollen. This is what causes the immense pain on the bottom of the foot! Things that contribute to plantar fasciitis include feet that roll in too much (pronation), high arched or flat feet, walking, running or standing for long periods (especially on a hard surfaces such as concrete), obesity and improper shoes. Most people find the most extreme pain to be at its worst when they have been sitting for a long period of time and then walking, or after getting up in the morning and then taking their first few steps. There is actually a word created to describe this exact condition, called "post-static dyskinesia." The theory as to why the pain is the worse at these times is because the fascia tightens up when we sleep and sit for long periods. It has lost the ability to stretch. When we walk small micro tears occur to allow the arch of the foot to flatten out.

This condition is easily diagnosed, because of the specific areas of sharp pain that are usually present. An x-ray will most likely be taken to rule out any trauma or stress fracture or bone tumor of the heel bone (calcaneous). Sometimes on x-ray a heel spur can be seen coming off the bottom of the heel bone. Although the literature says as high as 85% of people with heel pain have a heel bone spur, it is very rare that it is ever surgically removed. This is because of the great deal of research that has been put in to treating this condition conservatively.

Treatment options for plantar fasciitis are focused mainly around rest and stretching! The area is inflamed, so it needs some time to relax! To speed up healing, an anti-inflammatory pill such as ibuprofen (Motrin) or a steroid injection can help. Calf stretching will help release the pull of the calf muscle, which in turn causes the calf muscles not to pull on the fascia as much. Ice and physical therapy can also help with stretching/strengthening exercises, as well as pain relief. Night splints are very helpful as they keep the fascia stretched throughout the night. Orthotics are very important as they accommodate the deformity of the foot and support the arch, preventing the constant stretching of the fascia when we walk. These are used as a long term treatment to prevent any reoccurrence. If all these measures are unsuccessful, do not worry as other options still exist! These include, but are not limited to, minimally invasive endoscopic surgery, Extracorporeal Shockwave Therapy, which uses sound waves to stimulate healing and injection of blood platelet concentrate into the inflamed fascia. Most patients are encouraged to walk after these procedures. Once you start to notice the heel pain, you should try to see your podiatrist before it gets worse! The earlier you treat it, the quicker you can get back in the game, pain free!


The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com

Diabetes and Proper Foot Care!

Diabetes is one of the most prevalent diseases in the world, affecting at least 220 million worldwide. It is broken down into two different types; type one requiring daily injections of insulin, and type two from ineffective use of insulin by the body. Over 90% of diabetics are in the type two category and obesity and inactivity are major contributing causes!

Insulin is needed by the body to break down sugar and store it as energy in the body. Whether your body doesn’t produce enough insulin, or your cells don’t respond to the insulin your body produces, it causes the sugar in your blood to rise. This is why diabetics need to check their blood sugar frequently!

Diabetes can have a devastating effect on certain areas of the body, including blood vessels, eyes, kidneys, nerves, and feet! This is what makes proper foot care so important for our diabetic population. Insurance companies are realizing the dangers of diabetes and are covering more frequent doctor’s visits to ensure that problems are identified as soon as possible. In between these visits I recommend you do the following.

First and foremost, keep your blood sugar as close as you can to normal values and exercise and diet as long as you are cleared by your primary care physician! This will keep your blood vessels and nerves in the best working order. Your PCP can help you determine your best blood sugar level.

For foot care, make sure to wash your feet daily with warm water and soap. Dry them thoroughly, especially between your toes. It is important to apply a mild moisturizing lotion or cream on your dry skin, especially your heels, daily. Never go barefoot, and look into having special diabetic shoes custom made for your feet. Medicare provides this as a benefit for diabetics. Make sure to check your feet daily for any cracks, open lesions, redness or swelling. Also, if you have pain that doesn’t go away or numbness you should be concerned. If any of these develop, make an appointment with your podiatrist! Make sure that you do not treat any calluses, corns, or perform nail care by yourself without consulting with your podiatrist first. It is probably better to have these tasks performed by your podiatrist! Make sure to check inside your shoes, as many diabetics have neuropathy (little or no feeling in their feet), and even a small rock inside a shoe can create an open lesion that can progress to an ulcer, or worst case scenario an amputation! Regular visits to your podiatrist, as well as doing your part in between visits, are the best way to maintain good foot health.


The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com

Toe Nails Turning Colors?

While you are sitting at home enjoying the Winter Olympics, have you noticed that your toenails are beginning to change colors? Instead of the healthy, light color the nail bed used to be, they have now become more of a yellowish or brownish color? Have you noticed that your nails are somewhat brittle with underlying debris? If this sounds like some or all of your toes you probably have something called onychomycosis। One of the contributing factors causing these ugly nails are tight shoes which crowd your toes, keeping them warm, moist and tight. Exercise can also cause repetitive micro-trauma, allowing for fungus to invade the nails. Using community showers without shower sandals or spending a lot of time around locker rooms and swimming pools can expose your feet to fungus. In addition, systemic conditions such as Diabetes can also make it easier for fungal infections to develop.

Fungal nails can be diagnosed by your local podiatrist, with the use of a few simple tests such as a KOH test or fungal culture। These tests involve taking a sample from under the nail, after the nail is trimmed back। Other conditions can cause the nail to look as if it has a fungal infection, so the condition must be diagnosed before it can be treated। There are several options available for treatment। There are topical agents, which include antifungal creams, lotions, gels and polish that are applied directly to the affected area। Oral antifungals are usually more effective at killing the fungus, but may cause side effects। The worse of which can be liver damage। Blood work is usually drawn before you start to make sure your liver enzymes are normal। Topical agents are used on superficial fungal conditions. Whereas, the orals are used for more severe, thickened nails.

Exciting new technology is now being researched for the treatment of mycotic (fungal) nails, including the use of lasers and UV light। Much of this data and research is currently undergoing FDA trials, so keep checking with your podiatrist on new available technology! A new fungal polish has been approved by the FDA but will not be available until the fall of 2010.

Ways to prevent from getting fungal nails can include avoiding tight fittings shoes, staying away from certain athletic surfaces, always wearing clean socks, washing and drying feet daily, and switching between a few different pairs of shoes। Fungus loves warm, dark and damp environments, so try to provide dryness, light for your feet। Take care of your toes, and they will take care of you! If you are worried you may have fungal nails, call your local podiatrist before summer and sandal season begin!

The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com

Ankle Sprain Causing You Pain?

Are ankle sprains are one of the most common lower extremity ankle injuries for both athletes and the rest of us. The literature states that inversion (when the foot turns inward) ankle sprains are most common, happening about 85% of the time. This is because increased range of motion in the “inverted” (turned in) and “plantarflexed” (downward pointed) position can also tear ligaments in the ankle, with a severe sprain. One of the most common sports ankle sprains are encountered in is basketball. This is usually caused by a player jumping and landing awkwardly on another player’s foot, leg, or twisting their ankle. Other things that can cause ankle sprains include stepping on an uneven surface or in a hole, especially when wearing shoes with a platform or heel.

Ankle sprains can be a debilitating injury, and sometimes people never truly recover from one if not treated properly. They are usually graded in three different stages, ranging from a mild strain of the ligaments, to a full rupture. Symptoms of ankle sprains include severe pain, feeling or hearing a pop/snap, swelling, bruising, and an inability to walk. Dwight Freeney suffered a severe ankle sprain, but was able to play in the Super Bowl because his medical staff performed round-the-clock treatment and rehabilitation. Kobe Bryant also suffered a severe ankle sprain, causing him to unfortunately miss the NBA All-Star game. Athletes usually have fewer problems rehabbing an ankle sprain because they have an extensive medical support team. Those not fortunate enough to be in the same position must take their future ankle stability into their own hands. As the saying goes, a bad ankle sprain can sometimes be worse than a clean break! With this in mind, it is important that you receive immediate medical attention so a proper treatment plan can be started. This could include ice, elevation, compression, bracing, physical therapy, and rest. Future complications of an untreated ankle sprain can include ankle instability, recurrence of ankle sprains, decreased range of motion, swelling that remains forever, and arthritis. If you feel you may have suffered an ankle sprain, do yourself a favor and see your local podiatrist!

The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com

Kids in high heels causing early bunions?

Fashions newest controversial topic surrounds young children, and believe it or not, the wearing of high heels. These so coined “kiddie” or “kitten” heels have been spotted all across America, and these girls aren’t playing dress-up. It is a growing trend for celebrities and the general public alike to put their children in high heels, some as young as three months old! Having your children follow in the current trend can be very detrimental to the permanent structure of their feet. I strongly encourage all parents to not let their children participate in such behavior! Although formal studies with children have not yet been conducted, this is because there has never been such a trend until recently.

Women across the world know that high heel shoes can be very uncomfortable, especially when wearing them for extended periods of time. They can lead to many common foot conditions, including: calluses, corns, neuromas, bunions, and most importantly foot pain! Although it has been said that high heels are not the only cause of bunions, they are definitely a contributing factor. Putting a child in high heels can potentially do a great deal of damage, mainly for the reason that their foot is still growing. Since their bones are still growing, the point of the shoe can cause bunions, and the heel in the back increases pressure to the toes. This is not the right recipe for future adult happy feet! Realistically speaking, fashionable shoes are necessary at times. They should definitely be used in moderation when possible. Parents, don’t let your children grow up too quickly!


The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com

The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com

Welcome!

Greetings!

Welcome to the first blog for Dr. Isidore Steiner, DPM.  Dr. Steiner is a podiatrist in Michigan, who has been serving Oakland and Livingston Counties since 1980 at five different locations.  The purpose of this blog site is to inform the public of common foot and ankle conditions and ailments.  Please check back frequently, email questions, and leave comments!  Enjoy!