Christine’s “Homage to the Foot” is a wonderful article. It elucidates the importance of our feet, not just for running, but for the most basic activities we are tasked with on a daily basis. For me, an orthopaedic foot and ankle surgeon, this article also humbles me. It is a gentle reminder of the foot’s mysteriousness, complexity, and need for treatment plans that are unique to each patient and that transcend the algorithms put forth in textbooks.
Although the 28 bones and 33 joints in the foot and ankle can pose diagnostic and treatment dilemmas, it is important to remember that common things are common; “when you hear hoofbeats, think horses, not zebras!” In other words, your heel pain is probably just plantar fasciitis, and not a calcaneal stress fracture. And your Achilles is likely inflamed, not torn. With this mindset, you will be empowered to treat your ailments without spending countless hours in my office (or another provider’s!).
If you have pain, the first step is activity modification. Stop running! Taking some time off and see if a little activity modification helps. This can go a long way. As the pain subsides, slowly begin to run again. Gradually increase your intensity, using NSAIDs (i.e.-Advil, Motrin, Aleve) as needed. I cannot overstate the importance of stretching as well. Working on the gastrocnemius-soleus complex by stretching your Achilles can help to offload pressure on the bottom of your foot. Exercising your foot’s intrinsic muscles by picking up marbles or scrunched up socks with your toes will help with your balance and stride. Balancing on one leg at a time will enhance your proprioception, strengthening the ankle’s static and dynamic stabilizers (the lateral ligaments and peroneal tendons, respectively). And when these seemingly easy but effective strategies fail, it’s time to seek formal help!
Dr. Andrew Rosenbaum is an orthopaedic doctor at the Bone & Joint Center specializing in the ankle, foot, minimally invasive foot and ankle surgery (including bunions, flatfoot reconstruction), general orthopaedics, total ankle replacement & revulsion, trauma, percutaneous fasciotomy and tenotomy for plantar fasciitis. He is also the Director of Orthopaedic Research at Albany Medical College. He has presented his research both nationally and internationally.