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Pros and Cons of Custom Orthotics for Plantar Fasciitis

Custom Orthotics Whether you’ve been newly diagnosed with plantar fasciitis or have been struggling with heel pain for months, chances are you have wondered whether or not you need custom orthotics.

Let’s take a look at the pros and cons of custom shoe inserts that can help you make your decision!

Will Custom Orthotics Help Plantar Fasciitis?

A quality pair of custom orthotics can make a big difference in improving your plantar fasciitis, by supporting your arch and cushioning a sensitive, deteriorating heel pad. That’s why orthotics are one of the top-recommended conservative treatments for plantar fasciitis!

Unfortunately, just one set of custom orthotics can cost upwards of $200. Is the price worth it? Keep reading to learn more about the benefits, drawbacks, and alternatives to custom orthotics!

Benefits of Custom Orthotics

In the past, custom orthotics had to be created by a podiatrist. However, now it’s quite a bit easier to get a pair of custom orthotics without even leaving your home.

Several companies will send you a footprint imprint kit, along with a short questionnaire online, to determine where you’re feeling pain, the exact width and length of your foot, and any other particular needs you may have (e.g., correcting overpronation).

Within less than a month, you’ll get a pair of custom orthotics.

Drawbacks of Custom Orthotics

While custom orthotics can make a big difference in heel pain, there are a few drawbacks that you should know about before you decide to buy!

High Prices

One of the biggest drawbacks to custom orthotics is the high prices. For just one pair, your starting price is about $230 on the low end. While this isn’t nearly as high as many medical interventions, it is one of the highest priced conservative treatments for plantar fasciitis.

Accessibility

Because of the high prices of custom orthotics, they aren’t exactly accessible for people with a tight budget. And because of the turnaround time needed to ship you a kit, take your foot imprint, send the imprint back, plus time for creating the orthotics themselves, it’ll be about a month before they arrive at your door — which can feel like a long time if you’re suffering.

Minimal Evidence to Justify Custom Inserts

While there’s a good deal of evidence to show that orthotics can improve plantar fasciitis, there’s not much evidence to show that custom orthotic inserts do a superior job. In fact, a recent landmark meta-analysis of 20 studies shows that custom orthotics and prefabricated orthotic inserts perform pretty much identically.

So, Are Custom Orthotics Worth It?

Custom orthotics can be a lifesaver for some people, especially if you have several different foot issues you’re trying to beat. However, for most people, the benefits of high-quality non-custom orthotics, like Heel Seats are identical to custom orthotics (the main difference being that higher price tag!).

Still can’t decide? Test out a pair of 5-star, non-custom orthotics that come with a money-back guarantee (like Heel That Pain!). If you still wonder what you might be missing with a pair of custom orthotics, test drive a brand that offers a money-back guarantee (several do!). That way, you can make sure you love your custom orthotics before you get stuck with the cost. And at the end of the day, you’ll be able to rest assured that you have the best fit for your foot–and your wallet!

Alternatives to Custom Shoe Inserts

If you aren’t ready to drop more than $200 on a pair of custom orthotics, the good news is that you have some fantastic alternatives. Clinically proven orthotic inserts like Heel Seats cost about as much as lunch out on the town, which means that you can afford to outfit every pair of shoes in your closet for less than one pair of custom orthotics.

If you spend most of your summer in sandals, there’s also alternatives that can be worn with bare feet, such as Heel Seat Wraps, which lift and align the arch like an orthotic insert, but can be worn with open-toed shoes and sandals.

Have you tried custom orthotics? Tell us in the comments below — we love hearing from you!

 

 

How to Find a Foot Doctor Near Me

How to Find a Foot DoctorIf you’re suffering from chronic or severe symptoms of plantar fasciitis, the question, “How do I find a heel pain doctor near me?” is at the very top of your list.

And while that question might seem easy enough to answer in the information age, it can be surprisingly difficult to know where you should start in your search for an amazing plantar fasciitis doctor near you. Save yourself time and frustration with these helpful tips!

Tips for Finding a Plantar Fasciitis Doctor Near Me

Finding the right plantar fasciitis doctor near you is one of the most important steps you’ll take toward healing, particularly if your symptoms are severe or have not responded to conservative heel pain care.

Use these handy resources to quickly find the right podiatrist near you:

Talk to Your General Practitioner

While your GP might not be the right fit for specialized podiatric care, here or she is very likely to be connected with doctors in many different specialties, and be familiar with the experiences that other patients who have been referred to that doctor have fared!

Search the APMA

The APMA (American Podiatric Medical Association) allows you to search for a podiatrist near you, using either a zip code search or a mile radius search (since the podiatrist closest to you might have a different zip code). Using this tool also allows you to find out whether your potential podiatrist has been board certified in different specialties (like surgery), which may be important to you.

Use the APMA Search Tool to Find a Foot Doctor Near You

Check Out Your Insurance Provider Network Online

If your insurance network is choosy, and you want to make sure that the foot doctor you choose is going to be fully covered, you may want to check your provider’s online network. Most providers offer a searchable database of in-network doctors that can be narrowed by speciality and location.

Use RateMDs.com (and Cross-Reference with Google!)

The right bedside manner, and positive outcomes from other patients are (understandably!) important factors from patients. RateMds.com allows you to read reviews from patients in your area, and can help you find a doctor with high reviews. More than 2 million providers can be found on this site alone. Make sure to cross-reference your findings with Google reviews, especially when there are only a few experiences shared on RateMds.com.

Use Local Social Media

While Facebook and Instagram aren’t much help in finding a plantar fasciitis doctor, local forms of social media, like Nextdoor.com can connect you with people in your neighborhood and district. The site allows you to post questions, asking for recommendations about which podiatrist in the area comes highly recommended, or to search other people’s questions about finding a foot doctor.

What Kind of Foot Doctor Should I Look For?

In general, if you have chronic or severe plantar fasciitis, you’ll want to start by meeting with a podiatrist. He or she can help you explore many different medical treatments for your condition, and in many cases may be certified to perform surgery, should you decide on that option.

If you are pretty sure, based on your medical history and research, that you are headed toward a surgical procedure, you may want to look for an orthopedic surgeon, who will typically have additional surgical expertise — but may be more difficult to make an appointment with. Depending on your condition and the success of more conservative medical interventions, a podiatrist may refer you to an orthopedic surgeon.

Will I Need a Referral for a Plantar Fasciitis Doctor?

It can be confusing to know whether or not you need a referral for a specialist like a plantar fasciitis doctor.

For the most part, you do not need a referral to make an appointment with a podiatrist. However, you should still check with your insurance provider, since some carriers have more complex rules about coverage for specialized medical care.

Getting a referral can also be helpful in other ways. If you have had a good relationship with your family doctor or general practitioner, he or she will often be willing to send an introductory letter to the podiatrist they recommend, along with a patient history (including injuries, treatments you have already tried, and medications you may be taking).

How did you find your foot doctor? Share your experience and tips in the comments below!

Tenex Procedure for Plantar Fasciitis

Tenex for plantar fasciitis blog imageThe idea of removing scar tissue to treat soft-tissue injuries isn’t new. But there is a new, minimally invasive method of scar tissue removal that’s generating a lot of buzz!

The Tenex procedure, which was created in partnership with the Mayo Clinic as an alternative to surgery, has become an increasingly popular method for resolving chronic cases of plantar fasciitis. If you’re considering the Tenex procedure for plantar fasciitis, keep reading to learn everything you need to know about Tenex!

What Is the Tenex Procedure?

The Tenex procedure is a minimally-invasive, non-surgical medical treatment that uses high-frequency vibrations and a specialized tool to remove accumulated scar tissue from a damaged tendon (or in cases of plantar fasciitis, a damaged plantar fascia ligament)..

Tenex can be used to treat many different kinds of tendon and soft-tissue injuries, including rotator cuff tendonitis, Achilles tendonitis, and patellar tendonitis (jumper’s knee). Tenex can also be used to treat plantar fasciitis. By removing scar tissue, Tenex helps restore mobility and circulation to the injury site, as well as encouraging regrowth of healthy tissue.

Is the Tenex Procedure Effective in Treating Plantar Fasciitis?

Since Tenex was approved in 2013, more than 80,000 procedures have been performed. And the results, so far, are pretty promising. Clinical studies, as well as several years of followup research on post-treatment outcomes, are impressive — although some of the clinical studies are not specific to plantar fasciitis, but rather Achilles tendonitis or rotator cuff injuries.

One study, which followed 34 patients for more than three years after their Tenex procedure, found that even 3.5 years post-procedure, 70% were still satisfied with their procedure. Another larger study, specific to plantar fasciitis, evaluated 53 patients who underwent the Tenex procedure, and found that at 6 months post-procedure, the vast majority (96%) were pleased with their results and would recommend Tenex to a friend. The same study showed that patients’ average FADI (foot and ankle disability index) score improved from 59% to 90% by 24 weeks post-procedure (100% is the best possible score on the FADI).

What to Expect During the Tenex Procedure

After you arrive for your scheduled Tenex procedure, your doctor will use local anesthesia to numb your foot.

Once your foot is numb, your doctor will use ultrasound imaging to precisely locate the scar tissue that he or she will remove with the Tenex Procedure. Your doctor will then create a tiny incision on your heel, and insert a specialized instrument (the Tenex Tissue Removal System, which has a needle-like tip) that releases high-frequency vibrations to destroy scar tissue while leaving healthy tissue unharmed.

The entire Tenex Procedure should take less than 30 minutes, and should not be painful with the local anesthesia. Once completed, your incision will be bandaged, and you will be able to leave the treatment facility (many patients can drive themselves home, but you may want to plan for a ride just in case!).

Post-Procedure Care After Tenex

Expect up to 6 weeks of total healing time that includes extra rest, NSAIDs as needed, and icing for any swelling or tenderness. Your doctor may recommend the use of a walking boot for the first one or two weeks of recovery.

After your incision has fully healed and you are back on your feet (and hopefully feeling incredible!) you’ll want to take steps to keep your feet healthy — and keep your heel pain from returning. For instance, if your plantar fasciitis was caused by the repetitive strain of long days on your feet for work, or the stress of high-impact sports, consider wearing heel cups to support your plantar fascia, and making a new commitment to giving your feet enough rest throughout the day or activity.

Benefits of the Tenex Procedure

The Tenex procedure offers some unique benefits for people who struggle with chronic plantar fasciitis, especially in comparison with surgery:

  • Fast relief from heel pain following the procedure
  • Shorter healing time, compared to surgery (many people recover in as little as three weeks)
  • Small incision that doesn’t require stitches
  • No scarring, and very few potential side effects
  • Precise tool that, when used with guided ultrasound imaging, can destroy only damaged tissue while leaving healthy tissue intact
  • Promising results in clinical studies
  • Local anesthesia, instead of general anesthesia
  • Typically covered by insurance, making the procedure less expensive
  • Good alternative for patients who haven’t had success with conservative treatments, physical therapy, surgery, or cortisone shots

Possible Side Effects and Risks of the Tenex Procedure

There are very few documented side effects of the Tenex procedure, and all are minor and temporary.

As you recover, you may experience pain, redness, tenderness, or swelling in the foot that has been treated. You may also notice some bruising or minimal trauma to the treatment area. You can manage these symptoms with ice packs and NSAIDs as needed. Follow your doctor’s instructions about when to remove the bandage, rest the foot often, use your walking boot as needed, and keep the wound clean as directed for the fastest healing time.

How Much Does Tenex Cost?

The cost of a Tenex procedure will depend on whether or not it’s covered by your particular insurance company (most providers do cover the Tenex procedure), whether the procedure is performed in a hospital setting or a doctor’s office, and whether local anesthetic or sedation is used (most people just need local anesthetic).

Without insurance, Tenex can cost anywhere from $1,600-$5,000 according to representatives from Tenex Health.

What Type of Doctor Performs the Tenex Procedure?

Several different kinds of specialists are trained in the Tenex procedure, including orthopedic surgeons, podiatrists, radiologists, and sports medicine providers. You can find a provider trained in Tenex by using the Tenex locator.

Before you schedule or undergo the Tenex procedure, make sure you verify with your insurance that the procedure will be covered by your chosen provider, and find out whether or not you need a referral.

If you do need a referral as required by your insurance provider, talk to the podiatrist or general practitioner who has treated you for plantar fasciitis.

Have You Tried Tenex?

Have you undergone (or are thinking about undergoing) the Tenex procedure? We want to hear all about it. Tell us about your experience in the comments below!

Is Plantar Fasciitis a Hereditary Condition?

Is Heel Pain Hereditary blog imageAt first glance, the question of whether or not common sources of heel pain, including plantar fasciitis and heel spurs, are genetic looks like a firm “no.”

There is no such thing as a “plantar fasciitis gene,” or a DNA marker for heel spurs.

However, on closer inspection the question of whether or not plantar fasciitis or heel spurs are hereditary is a little more complex (and interesting!) We dug into the research on heel pain and genetics, as well as consulting some of the leading foot care experts to give you the full scoop!

Is Plantar Fasciitis Genetic?

Again, nobody has a “plantar fasciitis gene” hidden in their genetic makeup. However, there is a strong correlation between plantar fasciitis and other genetic factors.

Dr. Bela Pandit says, “Heel spurs and plantar fasciitis can certainly have a hereditary link. Both obesity (which places excessive stress on the plantar fascia) and foot type (particularly flat feet with tibial tendon weakness) are two significant factors that contribute to plantar fasciitis and have a strong genetic link.”

The Genetic Link Between Plantar Fasciitis and Flat Feet

Flat feet, which leads to pronation (and causes an excessive inward roll as the foot hits the ground), is a homozygous recessive genetic trait shared by about 10%-20% of the general population. If you have one parent with flat feet, your chances of having flat feet too are about 50%. If both of your parents have flat feet, all of their children will have flat feet.

The Genetic Link Between Plantar Fasciitis and Body Weight

Body weight is another significant risk factor for plantar fasciitis, since greater weight places greater strain on the plantar fascia ligament. And while most people tend to think of body weight as a result of caloric intake and expenditure, new research shows that genetics play a strong role in how the body stores and releases fat. Newer studies show that about 50 genes play a crucial role (about 40-70%) in whether or not a person will be overweight.

The Genetic Link Between Plantar Fasciitis and Plantar Fascial Disorder

Plantar fascial disorder, which develops as a combination of plantar fasciitis and plantar fibromatosis (a rare condition that results in excessive connective tissue), has a genetic link as well. Some studies have shown that genetics play a role in how likely a person is to have plantar fibromatosis and plantar fascial disorder.

How Significant Are Genetic Risk Factors for Developing Plantar Fasciitis?

It’s important to remember that genetics are complicated — and just a slice of the pie in determining whether or not a person actually develops plantar fasciitis or heel spurs.

While understanding your genetic risk factors can help you be more proactive in seeking treatment for heel pain or recognize warning signs you might have otherwise missed, genetic risk factors aren’t a surefire diagnosis.

Dr. Robert Kornfeld says, “There’s no simple answer to questions about genetics and heel pain. Diet, lifestyle, and environment (or epigenetics) will always interact with genetic factors like foot biomechanics. Meaning, two people with the exact same foot structure can have very different experiences with heel pain.”

In other words, even someone with “imperfect” feet can avoid heel pain. Dr. Kornfeld says, “Someone might inherit a structural predisposition for plantar fasciitis, but poor diet or lifestyle choices that put the tissues under stress will ultimately be the determining factors on whether or not the condition develops.” He adds, “This is exactly why preventative care is such an important part of modern medicine. We can catch structural or functional deficiencies that stem from genetics, while also intervening on behalf of different lifestyle factors to help prevent these painful and often chronic conditions.”

Are Heel Spurs Hereditary?

In most cases, heel spurs aren’t a result of genetics but rather a symptom of plantar fasciitis. A deteriorating, thinning heel pad combined with inflammation and pressure on the plantar fascia ligament can lead to these painful bone growths that dig into foot tissue.

However, there are also many cases in which heel spurs can develop separately from plantar fasciitis and ultimately cause heel pain. And there is some evidence that genetics play a role in such cases. Arthritic disorders like ankylosis spondylitis and reactive arthritis as well as diffuse idiopathic skeletal hyperostosis have a strong genetic connection — and a strong correlation with the growth of heel spurs.

The takeaway? Make sure to give your doctor a full accounting of your family medical history — even if you’re not sure the condition relates to foot pain!

Lifestyle Choices, Heredity, and Heel Pain

It’s also important to consider that lifestyle choices (like our line of work, hobbies, or activity level), while not genetic, are often tied to our family of origin. Understanding these factors, and making changes as needed, can help avoid plantar fasciitis or heel spurs.

Dr. Steven Rosenberg says, “We are certainly a byproduct of our parents. If they struggle with plantar fasciitis because of their body type or foot type (e.g., flat feet), we’re more likely to struggle as well. We’re also likely to follow in our parents’ footsteps when it comes to lifestyle choices (e.g., sports or running) that might make a person more vulnerable to plantar fasciitis.”

Field of Work

Jobs that involve a lot of time standing, especially on a hard surface like cement (like retail, construction, or nursing), can increase your risk of developing plantar fasciitis or heel spurs. Standing is actually a greater risk factor than jobs that require a lot of walking, since standing in steadily taxes the arch of the foot and supporting muscles, instead of the alternating rhythm of impact and rest while taking steps.

Activity Level and Hobbies

While staying active is a good thing (maintaining a healthy weight can help avoid excessive pressure on the arch of the foot), high-impact sports and exercise routines can increase your risk of plantar fasciitis.

So, if you inherited your parents’ love for running marathons, playing basketball, soccer, or even golf (lots of standing!) you’ll want to keep an eye out for the warning signs of plantar fasciitis.

Footwear Preferences

Was it the norm in your house to wear slippers often, or spend the summer in flip-flops? If unsupportive shoes were a hallmark of your childhood, it’s common to continue those habits into adulthood. Wear shoes that support your arch and help distribute impact properly, and avoid problem shoes like slippers, flip-flops, and high heels. For added cushioning and support to the plantar fascia ligament, wear Heel Seats daily.

Staying Ahead of Genetics and Lifestyle Factors

Remember, genetics and lifestyle factors aren’t a sentence of heel pain and plantar fasciitis. But by watching out for common risk factors, you can stay ahead of chronic pain.

Dr. Rosenberg says that, “If your parents had plantar fasciitis or heel spurs, and you know you’re likely to be more susceptible, don’t be afraid to take preventative care by supporting your feet with orthotics.”

Active Release Technique (ART) For Heel Pain

ART for plantar fasciitisActive Release Technique, or ART for short, is a treatment that was initially developed to treat soft-tissue injuries in athletes as quickly as possible.

Since then, ART has gained popularity with doctors and patients to treat microtraumas, tears, and painful scar tissue in a wide variety of injuries — including plantar fasciitis.

In this article we’ll cover how ART therapy works, how this therapy differs from other soft-tissue treatment methods, potential risks and benefits, how much Active Release Technique costs, and whether ART is effective for plantar fasciitis.

What Is Active Release Technique (ART)?

Active Release Technique (ART) is a patented treatment method that targets injuries to soft tissues in the body (like tendons, ligaments, and nerves). The soft tissues of the body (including the plantar fascia) are vulnerable to injuries like tears, bruising, or pulls, as well as chronic deterioration and microtraumas (small tears that accumulate over time).

Scar tissue and adhesions can build up as a result of these injuries and traumas, which places extra strain on tendons, limits range of mobility, and entraps nerves at the injury site. This scar tissue can lead to significant pain and become a big roadblock to healing, especially in areas of the body that don’t naturally get a lot of blood flow (like the heel and arch!).

ART is performed by a trained medical provider, who uses unique movements and manipulations to help break up painful scar tissue, facilitate blood flow to the injured area, and promote healing.

How is ART Different from Other Soft-Tissue Treatments?

While ART might sound very similar to Graston or deep tissue massage at first glance, Active Release Technight is unique in a few different ways. It can be helpful to compare and contrast these common soft-tissue treatments:

ART vs. Graston

Both of these therapies work to break up adhesions and scar tissue while improving circulation. In Graston, a therapist uses instruments instead of the hands to manipulate tissues. These two treatment methods are often used hand in hand.

ART vs. Deep Tissue Massage

Both of these therapies combine pressure with a series of movements. However, unlike deep tissue massage, the movements in Active Release Therapy do a better job of lengthening and applying tension to scar tissue, which helps break that scar tissue up more effectively. ART and deep tissue massage are sometimes used together in therapy sessions.

How Effective Is Active Release Therapy for Plantar Fasciitis?

As of now, there aren’t peer-reviewed studies that can offer conclusive evidence about the effectiveness of Active Release Technique. However, the feedback from patients and providers is encouraging, and the principles of ART are aligned with tried-and-true treatment methods.

The arch of your foot and heel are avascular. That means these areas get very little blood circulation naturally. When the arch is injured, strained, or overused the body has a more difficult time sending blood cells to the injury, which are crucial for delivering oxygen, nutrients, and collagen to rebuild the damage. That’s one of the biggest reasons why injuries like plantar fasciitis are slower to heal than say, a cut on your arm.

It’s also the reason why ART’s specialized movements to improve circulation and deliver needed blood supply to the plantar fascia and heel are effective. Each of the movements targets a specific muscle, ligament, or tendon in the foot (there’s more than 100, including the flexor digitorum brevis, abductor hallucis, and the flexor digiti minimi brevis!) and deeply works the tissue using principles of friction, lengthening, and pressure to increase circulation and break up stubborn scar tissue.

Potential Risks and Benefits of Active Release Technique

As with any treatment, ART has unique benefits to offer, along with a few risks that can be summed up as follows:

Potential Benefits of ART

  • Helps improve circulation and blood flow to the avascular plantar fascia
  • Targeted movements break up scar tissue and adhesions
  • Improved blood flow delivers oxygen and nutrients that may speed up healing time
  • Improves the flexibility of the foot and range of motion
  • Relatively inexpensive compared to many medical interventions

Potential Risks of ART

  • The procedure can be moderately painful because of the targeted, intense pressure of the movements that aim to break up scar tissue and adhesions
  • Outcomes haven’t been well documented in studies — but that’s because the studies haven’t been done. (There is promising anecdotal evidence from providers and patients).
  • While ART can be very successful in reducing pain and improving mobility, it isn’t a cure. ART should be done in tandem with lifestyle changes that address why heel pain and plantar fasciitis formed in the first place (like overuse, repetitive stress, or gait imbalance).

What to Expect During an ART Session

Expect your ART session to be part evaluation, part treatment. Your provider will first determine the health, strength, and flexibility of your fascia, ankle, toes, and surrounding muscles and ligaments.

After this evaluation, your provider will use his or her hands to apply pressure, friction, and lengthening techniques to the fascia and surrounding tissues. You will likely be an active participant in your treatment session, moving and standing in different ways to maximally lengthen muscles and ligaments. Keep in mind that these movements can be painful, particularly for individuals who have low pain tolerance; however, most people find that they can tolerate the procedure, and that relief from symptoms occurs within just one to four sessions.

Can I Do ART for Heel Pain at Home?

The movements in ART are extremely specific and deeply work the muscles, tendons, and ligaments in the foot. Without specialized training, trying to apply the necessary pressure and friction to the foot could result in injury.

While there are many easy massage techniques that you can do at home to help improve blood flow, circulation, and break up scar tissue, it’s best to leave Active Release Technique to trained physicians.

Finding an Active Release Technique Provider

If you’re interested in trying ART, there are several different types of providers that offer this therapy. Physical therapists, massage therapists, chiropractors, and doctors are often trained in Active Release Technique.

You can find a certified ART provider in your area by using the directory on the ART website. More than 10,000 providers have been trained worldwide, so chances are high that you have one or several providers nearby!

Cost of Active Release Technique

The cost of ART will depend on your provider, and your insurance coverage. If the therapy is covered by your insurance (and many insurance providers do cover ART if they cover physical therapy), you may only be responsible for a co-pay.

However, even if you are uninsured or your insurance does not cover physical therapy, Active Release Technique is still generally more affordable than many other treatments. Expect to pay similar rates as a chiropractic session or massage visit. You may be able to get a discount for booking several ART sessions upfront (most people need between one and four sessions).

Supplementing Active Release Therapy

While ART is a promising treatment for cases of stubborn or chronic plantar fasciitis, it’s not a miracle cure or a stand-alone treatment. By taking steps to treat the underlying cause of your plantar fasciitis (the reason the condition developed), you can help make sure your arch and heel stay healthy!

Make sure to maintain tried and true conservative treatments that address common causes of plantar fasciitis (like inflexibility and muscle weakness, overuse, and strain to the arch) by regularly stretching and strengthening your arch and surrounding tissues, resting and icing your feet often, and supporting and realigning your arch to a proper height with quality orthotic inserts.

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