New Article on Foot and Ankle Football Injuries Is Here

football injuries

As football season is upon us, I have added a new page to my site detailing common foot and ankle injuries found in football.  For those of you who have children playing this season, or those of you young enough to play yourself, this guide may be helpful in guiding you to proper treatment should a foot or ankle injury occur on the field.  Check it out at:

Did you know you can get bursitis in your heel?

heel bursitis pain

While most cases of pain on the bottom of the heel are caused by plantar fasciitis, some are not.  A common alternate cause of heel pain is a condition called bursitis, and it can lead to severe pain directly on the bottom of the heel.

Bursitis is inflammation of a bursal sac, which is a pad of tissue that can be found throughout the body, protecting bony prominences as well as other sensitive tissue.  In the bottom of the heel, the bursa is not necessarily a naturally occurring object.  In general, unlike many other bursas, this bursa is more reactive, meaning that it forms as a result of abnormal pressure and irritation under the heel.  The bursa becomes irritated when the heel bone of a person with a flat foot rotates excessively as it will naturally do during walking, generally exposing the bottom of the heel tissue to a more irritating part of the heel bone that is not usually prominent on the bottom of the heel.  Eventually, a bursal sac will form to protect the irritated soft tissue under the heel bone, and in turn this will become irritated itself.  Other causes for bursitis include walking for extended periods on rocky or bumpy surfaces, high arched feet with poor shock absorption capabilities, as well as poor heel fat pad in older people with a prominent heel bone resulting.  I have even often seen this condition in people who have a more angular shape to the bottom of the heel bone as opposed to a more normal rounded shape.

Bursitis can often be present at the same time as plantar fasciitis.

Treatment of bursitis under the heel is relatively simple.  Steroid injections often take care of the inflammation in and around the bursa, usually more effectively than anti-inflammatory medication taken orally.  Ice helps, as well as increased shock absorption via gel heel inserts or orthotics with soft heel padding.  Surgery is typically not an option, as the attempt to find and remove the bursa can lead to more damage to sensitive tissue such as nerve bundles within the heel, making things worse.

Avoiding Heel and Foot Pain With Sandals


As the weather begins to gradually warm, many people begin the annual migration from enclosed shoes to sandals.  Sandals feel great when the weather is hot, and are very easy to put on and slip off.  Sandals range in build from minimal flip flops to all terrain sports sandals for light hiking  It is an unfortunate fact that some people will gradually injure their feet while in sandals over an extended period, especially the heels.  This injury can take a long time to develop and may not even be noticed until the late summer or early fall, but will cause pain and activity limitation regardless.  This can be avoided by being sensible with one’s choice of sandals, and I would like to offer some advice on how you can still enjoy sandals in the summer without developing pain.

The reality of the situation is that many sandals manufactured today, as in the past, are not very supportive.  Most sandals have flat or thin soles, and flip flop sandals in particular do not stay on the foot well.  Over time, the force applied to the arch of the foot will lead to strain of a ligament on the bottom of the foot known as the plantar fascia.  Once strained, this ligament becomes inflamed and can tear microscopically.  This then leads to more significant pain as the strain continues and the plantar fascia is unable to heal.  People who have lower arches, as well as people who have higher arches tend to more easily injured.  Those with so-called ‘normal’ foot structures can also injure the plantar fascia, just not as easily,

There is a way to avoid this strain altogether and still be able to wear sandals in the summer.  The key is to select sandals that are better constructed to contour the arch and lend more support.  While traditional and fashion sandals do a poor job of this, a newer generation of support-minded sandals are sold in stores everywhere which feature a raised arch bed that cradles the arch and reduces strain to the plantar fascia.  These types of sandals have a much less likelihood of generating strain to the arch, and are much better for the feet.  Traditional strappy flat sandals and inexpensive flip flop sandals should be avoided in general, outside of around the pool or on the beach.  Anyone with a history of heel or foot pain should be especially careful in their selection of sandals.  In central Indiana, there are a number of quality shoe stores that carry these better products, and while they may cost more they will be well worth it in maintaining a foot pain-free summer.

If you happen to develop heel or foot pain after wearing sandals, it is very important you seek treatment.  Plantar fascia injuries and other types of foot pain caused by strain are generally easy to treat, but often will not simply go away on their own.  Many people make this assumption, leading to pain that can last for months to years.  Be sure to see your local podiatrist if you have any questions on what kind of sandal or footwear is right for your foot, or if you start to develop heel or foot pain over the course of this summer.