Plantar Fasciitis

What is it?

The plantar fascia is a broad band of fibrous tissue that runs along the bottom surface of the foot, attaching at the bottom of the heel bone and extending to the toes. Plantar fasciitis is an inflammation caused by excessive stretching of the plantar fascia causing micro-tears in the tissue.

Individuals who suffer from plantar fasciitis often complain that their first steps out of bed in the morning are very painful. The pain may subside with activity, but worsen again at the end of the day or after sitting for a period of time and then getting up again.

With Plantar fasciitis, the bottom of your foot usually hurts near the inside edge where the heel and arch meet. You may also commonly experience pain along the inside edge of your foot between the heel and the ball of your foot.

What causes it?

Plantar fasciitis is usually an overuse injury that can be caused by:

  • Over-pronation (which results in the arch collapsing upon weight bearing and over-stretching the fascia);
  • A foot with a high arch (which results in an inflexible foot that does not absorb shock well);
  • A sudden increase in physical activity;
  • Excessive weight on the foot (sudden weight gain as in pregnancy);
  • Tight calf muscles (which decreases the ankle’s flexibility and increases the strain on the plantar fascia);
  • Poor footwear (which does not help to control the foot’s mechanics or is too rigid).

How can a pedorthist help?

The key for the proper treatment of plantar fasciitis is determining what is causing the excessive stretching of the plantar fascia. When the cause is over-pronation (common with a low-arched foot), an orthotic with rearfoot posting and longitudinal arch support is an effective device to reduce the over-pronation and allow the condition to heal.

If the cause is your unusually high arches, an orthotic that provides cushioning and stability to the foot as well as footwear that will complement your rigid foot type (a good shock absorbing shoe) will be of most benefit.

Stretching of the calf muscle is, surprisingly, a key component to helping treat plantar fasciitis. It is particularly useful in reducing the early morning pain or pain when getting up from rest. The calf should be stretched gently before getting up in the morning to reduce daily re-injury.

Other common treatments include plantar fasciitis night splints and shoes with strong heel counters to control the amount of pronation and provide good cushioning to the foot. A shoe with a good rocker sole at the toes can also be helpful in reducing the strain on the plantar fascia. Heel pads can help to provide extra comfort and cushion the heel, but do not address the biomechanical abnormality that may be causing the pain and is often not a good long-term solution.

Avoid running on hard or uneven ground, lose any excess weight through a balanced exercise program.

Pedorthic Association of Canada

Heel Spur

What is a Heel Spur?

A heel spur is a decidedly uncomfortable situation in which a bony prominence develops off the heel bone, which is also known as the calcaneus bone. Its primary cause of discomfort is the inflammation it can produce in the surrounding tendons, as it can irritate the muscles, tendons and other tissue layers nearby. These heel spurs generally form over several months, with symptoms slowly developing. Often these heel spurs may exist for a long time without causing symptoms.

What Causes Heel Spurs?

These spurs are caused by calcium deposits which build up underneath the calcaneus bone. This may be a long process, or it may be accelerated by repeat strains or damage to the heel muscles, tendons, or membranes which cover the foot. These heel spurs often occur for athletes who do large amounts of repetitive jumping or continuous running.

 More Information about Heel Spurs coming soon.


What is it?

Diabetes is a serious disease that can lead to devastating complications related to the feet and legs. Diabetes is a condition where the body does not produce insulin or when the insulin that it produces cannot adequately perform its normal functions. Insulin is a substance produced in the body that helps process the food we eat and turn it into energy.

Diabetes is classified into two different types: Type 1 and Type 2. Type 1 is usually associated with juvenile diabetes and is often linked through heredity. Type 2 is commonly referred to as adult-onset diabetes.

Diabetes disrupts the vascular or circulatory system which can affect how our body heals itself. Persons affected by diabetes may also lose sensation in their feet and this is called diabetic neuropathy. It can be very dangerous to lose the sensation in your feet, as you may not notice a “sore” until it is too late. Amputation in the population of persons affected by diabetes is much higher than in the general population because of these complications.

It is essential that persons affected by diabetes take special care of their feet in order to avoid these complications.

What causes it?

Foot problems caused by diabetes develop from a combination of causes including poor circulation and neuropathy.

Poor Circulation Vascular disease in persons affected by diabetes causes a narrowing of the arteries that can lead to significantly decreased circulation in the lower part of the legs and the feet. This decreased circulation reduces the body’s ability to heal itself and persons affected by diabetes often develop sores or ulcers that can take months or even years to heal. The longer a sore is present, the more likely it is that infection can enter the body causing more serious problems.

Neuropathy Diabetic Neuropathy is a loss of ability to feel pain, heat and cold. Persons affected by diabetes who have neuropathy can have sores that they are not even aware of due to the insensitivity. Unlike a person who can sense if a stone is in their shoe and take steps to remove it, a person affected by diabetes with neuropathy may walk on the stone all day without noticing. This can cause severe problems. If these injuries are left untreated, complications could arise leading to ulceration and possibly even amputation. Charcot Foot is a common complication of diabetic neuropathy that leads to a massively deformed foot that requires special care to prevent ulceration over unusual pressure points.

It is extremely important for persons affected by diabetes to take the necessary precautions to prevent foot related injuries. It is imperative that the patient affected by diabetes makes daily foot checks a routine, as the consequences of not doing so increases the risk of serious complications. When a patient affected by diabetes takes the necessary preventative foot care measures, it reduces the risks of serious foot conditions such as ulceration and amputation.

How can a pedorthist help?

Footwear and orthotics play an important role in foot care for persons affected by diabetes to help prevent serious injury and help an injury to heal.

The materials used for orthotics for a foot affected by diabetes depend on the history of complications such as ulceration and the presence or absence of sensation on the foot. A person affected by diabetes who has no history of complication and has normal sensation should have an orthotic that will accommodate any abnormal mechanics to alleviate abnormal pressures on the foot. A person affected by diabetes with an ulcer and no sensation requires an orthotic that will redistribute pressure away from the ulcer site and allow it to heal. Plastazote is the most common material used to protect the insensitive foot affected by diabetes.

Footwear for the patient affected by diabetes is also key to preventing complications and should have the following features:

  • Footwear should have toe box that is shaped like the foot and is deep enough to protect the toes from excessive pressure;
  • Removable insoles are preferred for versatility in fitting, as they can be removed to insert orthotics if necessary, or modified themselves to relieve pressure;
  • Rocker soles on the shoes help to reduce pressure in the ball of the foot, an area that is susceptible to pressure sores/ulcers;
  • Firm Heel Counters are recommended for support and stability.

Be sure to call your doctor immediately if a cut, sore, blister or bruise on your foot does not heal after one day.

What can you do to protect you feet on a daily basis?

  • Wear shoes and socks at all times, even indoors.
  • Always check the insides of your shoes before putting them on.
  • Make sure that the lining is smooth and there are no foreign objects in the shoe, such as pebbles.
  • Wear shoes that fit well and protect your feet.
  • Protect your feet from hot and cold temperatures.
  • Keep your skin soft and smooth and trim toenails straight across.
  • Have a professional take care of your nails and skin if you cannot see well.

Pedorthic Association of Canada

Achilles Tendonitis

Pedorthic Treatment for Achilles Tendonitis

What is it?

The achilles tendon is the large tendon located in the back of the leg that inserts into the heel. Achilles tendonitis is an inflammation of that tendon. Achilles tendonitis can develop gradually without a history of trauma or can occur from a sudden injury.

Individuals who suffer from achilles tendonitis often complain that their first steps out of bed in the morning are extremely painful. Another common complaint is pain after steps are taken after long periods of sitting. This pain often lessens with activity.

Achilles tendonitis is aggravated by activities that repeatedly stress the tendon, causing inflammation (such as walking, running or jumping). It is a common problem often experienced by athletes, particularly distance runners. Achilles tendonitis can be a difficult injury to treat due to high levels of activity and reluctance to stop or slow down training.

What causes it?

here are several factors that can cause achilles tendonitis. The most common causes are training too hard/too soon without proper strengthening, biomechanical abnormality such as over-pronation, a high-arch foot type, improper shoes and abnormal stiffness of the calf muscle complex.

How can a pedorthist help?

A person suffering from Achilles tendonitis should incorporate a thorough stretching program to properly warm-up the calf muscles. They should also decrease the distance and intensity of their walk or run, as well as apply ice after the activity. It is best to avoid any up hill climbs, which increases the stress on the Achilles tendon.

An orthotic device should be used to accommodate any biomechanical abnormality and allow the Achilles tendon to function more normally.

A heel lift may be recommended on a temporary basis to elevate the heel and reduce stress on the Achilles tendon. The device should be made with shock absorbing materials.

Shoes that do not place unusual pressure on the Achilles tendon or on its insertion site on the heel will help prevent further injury.

Pedorthic Association of Canada