Common foot and ankle injuries

I am planning to do several talks to local shoe stores to inform the staff about certain common foot and ankle injuries and how to approach them. Here is a handout of what I talk about:

PLANTAR FASCIOSIS
• Arguably the most common foot complaint
• When first seeing a podiatrist, it has progressed from fasciitis to fasciosis
• Fasciitis is an inflammatory condition of the fascia on the bottom of the foot
• Fasciosis is collagen degeneration with no inflammatory cells present
• Seen in all types of people, but common thread is usually a sudden increase in activity; pain after a period of rest that goes away after 5-10minutes and at the end of the day
• Treatment involves: rest, supportive shoegear in conjunction with therapy that causes an inflammatory response, i.e., aggressive stretching, self-massage, injection (cortisone/anesthesia mixture or just anesthesia)
• Orthotic therapy maintains the healed/healing plantar fascia, along with prevention of any biomechanical abnormalities that caused the condition

ACHILLES TENDONOSIS
• Has become common, especially for individuals who have worn high-heeled shoegear for a long period of time and want to start wearing flatter shoes
• When first seeing a podiatrist, it has progressed from tendonitis to tendonosis
• Tendonitis is an inflammatory condition of the tendon about ¾ inch from the back of the heel bone
• Tendonosis is collagen degeneration with no inflammatory cells present
• Pain is present after a period of rest that goes away after 5-10 minutes and with increased activity
• Treatment involves: rest, supportive shoegear in conjunction with therapy that causes an inflammatory response, i.e., Alfredsson stretching protocol, aggressive cross friction massage
• Orthotic therapy maintains the healed/healing Achilles tendon and may incorporate a heel lift to decrease stress upon it

CAPSULITIS
• A condition mostly due to biomechanical abnormalities
• It is an inflammatory condition of the capsule (sheath surrounding the joint with nerve and artery supply)
• Pain usually in the ball of the foot, is mild in the morning, but increases as the day continues and is usually sharp in nature with no radiation.
• Mostly like to compensatory overload of the second metatarsalphalangeal joint, due to inadequate functioning of the first ray (i.e., too short, too long, too stiff, etc.)
• Treatment, involves rest, supportive shoegear and use of adequate orthotic therapy that restore normalcy to the first ray joint.

Happiness and good health!