Plantar heel pain, specifically plantar fasciitis, will be experienced by 10% of the general population at least once in their lifetime. The plantar fascia is a large ligament that connects the bottom of the heel to the toes. The anatomy of the plantar fascia is divided into three bands: medial, central, and lateral. The central band attaches proximally at the medial tuberosity of the calcaneus coursing distally into five separate divisions, those divisions attaching to the sesamoids, as well as the plantar plate of toes two through five. Biomechanical stress of the plantar fascia and its insertion into the calcaneus is the most commonly cited reason this condition occurs. The plantar fascia provides two important functions. Those being supporting the arch of the foot as well as aiding in the re-supination of the foot during propulsion.
Conservative therapy is initially recommended, consisting of non-steroidal anti-inflammatories (NSAIDs), physical therapy, shoe modifications and sometimes injections. These methods work around 90% of the time and patients are quite pleased. In situations where continued pain and discomfort remains there are other options available. Dr. Cottom has been using the latest technology in treating patients with an FDA approved placental derived extracellular matrix injection. This type of injection is similar to STEM cell injections and has proven to be quite effective in certain situations. This type of injection allows the body’s natural cells to attach to the injection material and the body signals its own growth factors to promote healing. The advantage this technique has it that it does not induce an inflammatory response by the body and patients tend to feel better quicker than with PRP injections. It also allows the body to remodel itself and incorporate into the injected placental material. This can be done in the office usually with ultrasound guidance so the injectable can be precisely placed in the most damaged part of the plantar fascia.
In those few cases in which patients do not respond to office-based treatment, Dr. Cottom offers a minimally invasive arthroscopic procedure that has shown excellent results to date. Dr. Cottom has performed this procedure in over 100 patients. He has recently published 2 papers in peer-reviewed surgical journals on the technique and outcomes. (1-2). Please see the heel pain treatment for more information or call 941.924.8777.
1. Cottom JM, Maker JM, Richardson P, Baker JS. Endoscopic Debridement for Treatment of Chronic Plantar Fasciitis: An Innovative Technique and Prospective Study of 46 Consecutive Patients. J Foot Ankle Surg. 2016 Jul-Aug;55 (4):748-52
2. Cottom JM, Maker JM. Endoscopic Debridement for Treatment of Chronic Plantar Fasciitis: An Innovative Surgical Technique. J Foot Ankle Surg. 2016 May-Jun;55 (3):655-8