Foot, Ankle and Heel Pain Treatment

The human foot/heel/ankle complex integrates an amazing group of muscles, bones, nerves and connective tissue that can withstand and generate enormous force loads and provide balance and stability for the entire body. Given the stress this region is subjected to on a daily basis, it is no wonder that pain and injury sometimes occur. Foot and ankle pain is often the result of mechanical deficiencies in gait, caused by muscle imbalances and weakness.

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Common Causes of Heel, Ankle and Foot Pain

Many things can contribute to foot, heel and ankle pain and injury:

  • Sedentary lifestyle with too much sitting
  • Weakened foot core muscles
  • Poor postural habits
  • Unsupportive footwear
  • Muscle weakness or tightness
  • Overtraining during sports or exercise
  • Obesity
  • Pregnancy

In most cases, the solution to resolving foot and ankle pain lies in physical therapy aimed at resolving the underlying causes.

Common Injuries to the Foot, Heel and Ankle

While injuries to the foot and ankle complex sometimes occur from an acute traumatic injury, they are more likely to result from repetitive overuse during standing, walking, running or jumping.

Common types of foot and ankle pain and injury include:

  • Achilles tendonitis/tendinosos
  • Plantar fasciitis
  • Bursitis at the back of the heel and ankle
  • Stress fractures to bones of the foot, heel and ankle
  • Metatarsalitis (pain in the ball of the foot)
  • Foot arch pain
  • Ankle instability
  • Foot arthritis

Diagnosis of Foot, Heel and Ankle Pain

Because of the complexity of the structures of the foot, accurate diagnosis is key to fast and effective treatment. Foot and ankle pain is often misdiagnosed, costing the patient time and money without finding relief. While a clinical exam and medical history are part of any diagnostic session, failure to rule out uncommon or complex issues can slow healing and even lead to more pain. At NYDNR, we use diagnostic ultrasound to view the structures of the foot, heel and ankle in motion, in real time.

This enables us to see how the various structures interact while moving so we can pinpoint the specific source of pain. Our clinical director, Dr. Kalika, is an expert clinician trained and certified in diagnostic ultrasonography.

Treatment for Foot, Heel and Ankle Pain

Traditional treatment approaches for foot pain often include steroid injections, orthotic shoe inserts and over-the-counter analgesics. However, treatment methods that focus primarily on pain management often fail to correct the underlying dysfunction that led to pain and injury in the first place.

At NYDNR, we take a multi-modal approach to foot pain treatment that combines a variety of innovative treatment methods,

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ESWT (extracorporeal shock wave therapy)

High frequency shock waves have been proven effective for speeding up healing and promoting new tissue growth in tendons and muscles with a limited or impaired blood supply. Shockwave therapy is painless, non-invasive and fast.

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Gait Analysis and Retraining

Mechanical deficiencies in walking or running gait can lead to foot, ankle, knee, hip and back pain. We use 3D motion capture video and force plate technology to measure joint angles and forces acting on the body during walking and running. We then use virtual feedback to correct deficiencies and retrain your gait to improve efficiency and prevent injury.

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Exercises for the Lower Kinetic Chain

Imbalances in muscle tension at any point in the lower body can interfere with foot and ankle movement and lead to pain and injury. Through strengthening and stretching exercises that target the specific needs of the individual patient, we are able to restore balance and reduce wear and tear on the structures of the feet and ankles.

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Real-Time Ultrasound

Not only is ultrasound an accurate diagnostic tool, it also helps us monitor the rate and degree of healing, ensuring that our treatment plan is effective. The ability to monitor the body’s structures in motion, in real time, makes ultrasound an invaluable tool in our rehabilitation toolbox.

At NYDNR, all treatment plans are individualized, based on sophisticated diagnostic results. Our goal in treatment is to restore optimal function, so you can walk, run, jump and play with pain-free confidence and low risk of re-injury.

Foot and Ankle Pain

Foot, Ankle and Heel Pain Treatment

The human foot design is unique in the animal world. From the evolutionary standpoint human foot is a highly innovative anatomical structure that had developed to serve as the main weight receptor of the newly achieved bipedal support base. It evolved to be the most durable anatomical formation in the entire human body. Aside from the time of infancy when the body is horizontally aligned, the foots intricate structures provide, in conjunction with the ankle bones and powerful connective ligaments, the perfect biomechanical apparatus for ambulation or bipedal locomotion. Read more

Heel Pain and Plantar Fasciitis Treatment

Many people deal with heel pain on a regular basis. Although there are many different causes of heel pain, plantar fasciitis is the most common cause. Plantar fasciitis results when the plantar fascia, or the ligaments that connect the heel to the bones in the foot and provide support to the arch, become strained. A strained plantar fascia causes weakness, swelling, and inflammation as well as thickening, which leads to a great deal of pain. Plantar fasciitis occurs most often in individuals 35 and over, however, those who regularly participate in activities that requires a great deal of standing, or runners, might experience this condition way in advance of middle age. Read more

Heel Pain, Runners Heel and Plantar Fasciitis Treatment

Typically plantar fasciitis is pain in the heel, especially during the initial few steps after waking up. Some other symptoms are: sensitivity and tightness in the heel or the he arch while walking or running.

Patients who suffer from this condition still use old medical terminology, which is no longer used by medical professionals. It was believed previously that heel pain is caused by formation of heel spur. However, this has been disproved a long time ago. Since it is visually appealing for patients to imagine that they step on a sharp bony outgrows, patients still believe that the heel spur is what is causing their heel pain. Read more

Ankle Instability and Ankle Sprain Treatment

Every day 25,000 people sprain their ankle and more than 1 million people a year visit the emergency room due to an ankle injury. Although half of all ankle sprains are caused by athletic activity ankle injuries can happen to anyone at any age not just athletes or weekend warriors. There are different kinds of ankle injuries including sprain, ankle strain, and ankle fracture. Read more

Ankle Instability/Sprain

Ankle instability is a common issue for many people. They may be athletes like basketball players who have stretched their ligaments with regular athletics, or they may be people who discovered their weak ankles aren’t supporting new activities like walking on broken New York sidewalks, or uneven trails. This may be a result of use, limber ligaments, or heredity. This can lead to a lack of support on the foot and high risk of an ankle sprain. For many cases, there are a number of nonsurgical treatments for ankle sprain here at NY Dynamic Neuromuscular Rehabilitation. In extreme cases, surgery may be required. The purpose of rehabilitation exercises within the ankle sprain treatment is to improve muscle strength, range of movement, and sensorimotor control, which are commonly impaired after ankle sprain. Read more

New evidence based and award winning test for ankle stability. Courtesy Maarteen Prins PT PHD


Testimonials

130 West 42 Street Suite 1055, New York NY 10036
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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

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Complete tear of rectus femoris
with large hematoma (blood)

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Separation of muscle ends due to tear elicited
on dynamic sonography examination

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