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BMJ Research: Ultrasound guided corticosteroid injection for plantar fasciitis: randomised controlled trial|
Objective: To investigate the effectiveness of ultrasound guided corticosteroid injection in the treatment of plantar fasciitis.
Participants: 82 people with a clinical and ultrasound diagnosis of plantar fasciitis unrelated to systemic inflammatory disease.
Conclusion: Our findings show that a single ultrasound guided dexamethasone injection is a safe and effective short term treatment for plantar fasciitis, providing better pain relief than placebo at four weeks. The treatment also reduces abnormal swelling of the plantar fascia soon after treatment, and continuously for several months. These findings are important for clinical practice as they indicate that an appropriately administered dexamethasone injection is efficacious in the short term for plantar fasciitis and that such an injection may lead to beneficial longer term physiological changes to the affected plantar fascia. Clinicians offering this treatment should also note that significant pain relief did not continue beyond four weeks.
News Medical - Foot and ankle injuries among athletes rise since 2003: Report. Published on September 3, 2010
Athletes who return to their sport before they are completely healed may suffer long-term consequences. Sports-related injuries are part of the game, and as athletes are becoming stronger, faster, and better conditioned, higher-energy injuries are becoming common. Foot and ankle injuries are especially concerning because they are increasing in number and severity and are often misunderstood.
Athletes, along with the general population, are bothered by the ever-common, plantar fasciitis. This may be prevented and treated with regular plantar fascial and heel cord stretching, as well as strengthening the intrinsic muscles of the foot.
A major concern right now is artificial field surfaces and how they may factor into lower extremity injuries. Certain molded-bottom shoes perhaps lessen injury on these surfaces, and yet the player may have reduced traction and performance because of it. It is a fight between performance and risk of injury, and players often take the side of performance.
News Medical - Researchers suggest bare-foot dancing to avoid plantar fasciitis. Published on September 17, 2010
With ballroom dancing once again on our screens, all eyes are on the sequins and steps. British and Chinese scientists have found that that bare-foot dancing spreads the force evenly between heel and toe, but the higher the shoe heels, the more the force is thrown forward on to the toes. Under controlled testing conditions, dancing in 10 cm high-heels can lead to pressures three times that of the atmosphere being applied to the toes.
The shift of the high-pressure region from heel to forefoot when dancing in high-heels can lead to discomfort of the foot and a condition known as plantar fasciitis after prolonged periods of dancing. This finding underlines the importance of the cushioning properties under the forefoot region.
From The New York Times - Sports Section
The ignoble status that injured feet have among athletes is puzzling, because foot troubles aren’t just debilitating;
in many sports they’re also common....
A small but compelling 2003 study done in Brussels looked at the impact of running for 30 minutes a day for one week. The 10 subjects were new to the sport. Three showed slight signs of foot damage before the study. At the end of the week, half of the runners had either new or increased fluid accumulation in their bone marrow. After only seven days, the newbie joggers had pounded their feet into the earliest stages of stress fracture.
The foot is at such high risk for injury largely because it has so many small, frangible parts — 26 bones, 33 joints and more than 100 tendons, ligaments and muscles, any of which can fail. Nevertheless, under ideal conditions, feet are built to handle the abuse of even high-impact sports.
“A healthy foot, like a car, has two ways to absorb pressure: it has pads and it has springs,” says Carol Frey, the director of orthopedic foot and ankle surgery in Manhattan Beach, Calif. The pads are the cushiony pillows of fat beneath the heel and the ball of the foot. The springs are its tendons and ligaments, which flex and bend as the foot moves. Strong tendons and ligaments can withstand several times a person’s body weight — the force with which a foot can hit the ground while jumping or running downhill.
Injuries to the plantar fascia and connected tissues are the most common foot ailment in athletes over 30. Many people, feeling the first stabs of heel pain from an injured fascia, switch to softer, looser athletic shoes, thinking that will cosset the foot and correct the problem. It does the opposite. “Adding soft cushioning beneath your feet increases instability,” says Douglas Richie, a podiatrist in Seal Beach, Calif. The unsupported foot rolls too much, and the tight tissues get pulled even tighter.
From The New York Times - FEET; Think of Your Poor Feet
THE average person walks the equivalent of three times around the earth in a lifetime. That is an enormous amount of wear and tear on the 26 bones, 33 joints and more than 100 tendons, ligaments and muscles that make up the foot.
The most common foot conditions that occur as you get older are arthritic joints, thinning of fat pads cushioning the soles, plantar fasciitis (inflammation of the fibrous tissue along the sole), bunions (enlargement of the joint at the base of the big toe), poor circulation and fungal nails.
From The New York Times - VITAL SIGNS: TREATMENTS; Heel Pain: A Step Backward
In recent years, people suffering from the painful heel ailment known as plantar fasciitis have been turning for help to an ultrasonic method also used to treat kidney stones and gallstones. But a new study, published in The Journal of the American Medical Association, reports that the method, shock wave therapy, appears ineffective against the heel problem.
To measure the effectiveness, the researchers divided their volunteers into two groups. One received shock wave therapy, the other a mere simulation. Earlier studies reported that shock wave therapy was beneficial. But at 6 and 12 weeks, the researchers in this study found, patients in the two groups were reporting almost identical levels of improvement. The report concluded that the therapy 'was not better than a placebo.'