Heel Pain: The Latest Answers
To best understand our Heel Pain Center, please read the following article by Dr. Michael Horwitz
You can choose to believe us or come in and have it proven to you. The fact is, our newest surgical procedure for Plantar Fasciitis and Achilles Tendonitis will get you back to work the NEXT DAY.
If I told you right now that I could cure your chronic heel pain with a 30 minute treatment, and have you back to work the next day, would you beleive it? Well you wouldn't run because you can't RUN, in either direction, (towards my office or away), if you truly have chronic plantar fasciitis.
Yes it's true! I can cure your foot pain because I have the resources and experience to do it. In this article, I attempt to plainly spell out exactly how we cure chronic cases of heel pain at Feet for Life. I have even created a new video and website specifically to outline my ground breaking technique.
Unlike other articles, I will not give you a historic perspective of the problem first, and then begin a lengthy justification process in order to convince you of something that I would like you to believe. Instead, I plan on telling you how I will treat you, and then let you determine if it sounds like something you want. Chances are, if you are still reading this, you already have an idea of what your diagnosis entails, and you're looking for some ANSWERS!
Simple. Fast. Effective.
Here is how we do it.
Get the Correct Diagnosis
Use a diagnostic Ultrasound to measure the fascial thickness and look for signs of chronic inflammation. When patients come in with chronic heel pain, they are often aware of the conventional methodsfor diagnosing, but many have yet to have a simple diagnostic ultrasound. This test is simple, fast, and effective. With this data, the diagnosis of "fasciosis" or chronic inflammatory change, can be made.
Getting the Treatment Right
Your feet are yours. They are part of a system that is so uniquely yours, that even if you had a twin sibling with the same problem, treating you both the same would be a mistake. This is because the condition we are treating is related to your biomechanics and activity / footwear preferences. So starting with a program greatly increases the chances for successful long term outcome. Your program should include at least 3 treatment stages – pre, intra and post treatment.
Pre – on your mark
This is the time to evaluate your existing footwear. Most of the time, chronic fasciitis is due to improper footwear use. Restrictive footware and improper use of orthotics are often the culprits. This is footwear that won't let your foot function naturally. I often see patients who have become addicted to certain orthotics and footwear that they believe are helpful, but actually are hurting them. It is the loss of motion and strength of your arch muscles caused by restrictive footwear and orthosis that may be the source of your chronic problem. So during this "pre" treatment phase, we actually need to get you out of your foot prison. Don't worry, if you want to go back to your problem footwear, you can after we cure your faciitis. We often also have to address your weekend footwear vs weekday footwear. See our website for more on this.
Intra – getting set
Here we cure you. That's right. In the most straight forward, logical and simple way, we directly address your inflammation. Believe me when I tell you that we have figured this one out. It was not easy. It took about 15 years, but we have done it. We need 1 day out of your life. You must be willing to have something done for 30 minutes, because this is the time it takes to perform a small procedure on your heel that utilizes both ESWT technology and Radio Cobalation. After 15 years of using ESWT effectively, and 3 years of performing Topaz procedures, we have now got it so right, that I challenge any doctor in the world to come up with a better answer for chronic heel pain that will get a patient back to work and on their feet the very next day.
Post – Go
This stage comes at 4-6 weeks after your ESWT / Cobalaton treatment. Your are now ready to get back into life. Here you are introduced to everything your need to stay out of trouble and get back to high impact activity. Hopefully, during your post treatment period, you have read some materials and have a better understanding of how you got into a chronic state. Now that you are pain free, it's time to start using your knowledge of proper footwear to your advantage. Some of you may even cure yourselves with just this vital information.
Best Game on the planet
"It's great to have that moment of complete recognition of what's right."
I see this every day of my life in the faces of my patients. After years of being treated the absolute wrong way, they come into my environment, get re-educated and leave believing that someone actually got it right. Often times I am barraged with "why" questions. "Why did I not get this treatment and information before?" "Why wasn't I told this?" The answer is that every problem you can possibly have can be solved with the right knowledge of proper treatment. It took a best selling book, "Born to Run", by Christopher McDugal, to truly look at conditions like foot overuse injury and strip away all of the barriers to seeing the problem for what it was, before the problem could be solved. It took me 20 years of treating heel pain, and the humility to see that I did not know everything I needed to know, that got me to the point of finding the truly minimally invasive procedure that is now curing patients and getting them back to full activity in one day.
A closer look at what exactly we are doing
By now you are asking for an appointment to our Heel Pain Center or you are looking for all the answers right now.
It's very simple, we treat the entire heel. We know that chronic heel pain is usually a condition with many sequela. Often, a patient will have prototypical plantar fasciitis for a few months and during this time will start to stand on the outsides of their feet – along to more stable lateral column. This takes the pressure off of the medial fascial insertion and transfers it to the calcaneal cuboid joint, the sural nerve and lateral musculature of the foot. That's why patients will point to both the medial and lateral aspect of the heel. They have 2 different problems. One is related to the original plantar fasciitis and the other is one of the many compensation injuries that occurs because weight shifting. But lets not stop there, next often comes bouts with achilles tendonitis, and even back, neck and knee pain.
So when we perform the 30 minute treatment, we cover two main bases. First, we use high intensity ESWT and lots of it. 4000 pulses will cover all of the main areas that are tender including the cuboid articulations and as far into the arch an necessary. For this we use the Israeli Medispec ESWT machine with it's wide focal diameter. Secondly, we have learned that cobalation of the plantar fascial insertion provides a hands on and very accurate micro fenestration / cobalation of the area that is often time the most tender in chronic cases. Using both of these is what we have found will get patients better fast.
The Topaz Evolution
Here is the point in this paper where any physician worth his salt will take this information and run with it. It would be useful for you to reference the original Topaz procedure publicized on our website. Here we used the wand to create multiple fenestration into the plantar fascia through multiple small stab incisions. This was effective as a treatment, but required 4 weeks of recovery before patients were back in footwear. So the opportunity cost was larger than ESWT, and it was an invasive procedure.
I created the new combination procedure to address both the post op recovery time and invasiveness by using only one incision.
Utilizing the topaz wand and ONE very small incision, we address the plantar fascia directly creating 5 or 6 fenestration points into the medial band of the fascia. The incision is so small that it does not need a stitch. So the trauma is minimal and the patient recovers from the procedure in hours and is ready to get back to regular activity the next day!
What are we actually doing to your foot?
We are actually curing your condition! Everything in life is about flow. Chi is another word for this. When it comes to treatment of inflammation, creating flow is vital. The arthritic is the prime example of a no-flow situation. With no flow comes stagnation and crystallization, like ice – no flow.
With ESWT and Cobalation, we melt the ice. We meat tenderize the tissues to actually create a new blood supply. This isn't simply warming up an area to create better flow, this is making tissue vital. At the same time we are getting rid of stagnant tissue factors that create pain and inflammation. The ESWT covers a large area and is very atraumatic. The Topaz allows us to pin point the treatment right into to area that is the most inflamed. The combination is spot on.
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Please consider reading our FAQ on this treatment on our website. It will hopefully answer even more of your questions. Or, maybe you could come in and see me or one of our physicians. I would very much like to know if you read this article, so please mention it to me.