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Foot Notes

Picture a world where instead of treating pain with drugs and surgery, it is successfully treated through enhancing your body’s own power to heal itself. This is regenerative therapy, a technology that is catching on quickly. Thanks to strides in the field of regenerative therapy, athletes around the world are already benefitting from these innovative techniques.

“Regenerative medicine is a game-changer in modern medicine. By harnessing and enhancing the body’s own innate ability to heal, athletes are recovering quicker, with less down time, and with less pain, naturally.” Dr. Kellen Cohn, DPM, First Step Foot Care.

According to Dr. Cohn there has been an abundance of new modalities in the field of regenerative medicine.

“There has been an evolution of regenerative therapies from its infancy of platelet-rich-plasma, to the exploding field of placental amniotic stem cells, to needleless Extracorpeal Shockwave Therapy. There are so many new options available to patients that are safe and effective today,” Says Dr. Cohn.

At First Step Foot Care we are proud to offer and be fully equipped with the most innovative techniques. Even with out-of-pocket expense; considering the minimal down time, easy recovery, and absolute minimal risk, you find that there are amazing new treatments coming to the market. Regenerative therapy has potential to be curative in many cases, preventing need for surgery.

“Through the use of regenerative medicine, we are seeing patients recover well and heal faster,” said Dr. Cohn.

If you are suffering from a debilitating pain or injury, Dr. Cohn suggests you contact your primary care physician to find out if you may be a good candidate for a regenerative medicine protocol.

First Step Foot Care specializes in Platelet-Rich-Plasma, Amniotic Stem Cell injections, and Extracorpeal Shockwave Therapy. You can learn more by visiting

What is PRP? PRP, or “Platelet Rich Plasma” is a portion of your very own blood that has been separated from your red blood cells that can be used to treat and heal ailing tendons, ligaments, bones, and joints.

How does PRP work? Your body’s first response to injury is to deliver platelets to the site of injury. It is these platelets that initiate repair through the initiation of growth factors and by attracting more of their healing counterparts to come assist in the healing process. PRP injections help intensify your bodies natural efforts by increasing the platelet concentration around the area in need.

How is PRP obtained? PRP used for injections is obtained from a sample of blood taken from the patient, which is then centrifuged and prepared in office. Because it is obtained from the patient in whom it is to be given, there is very little risk of infection or allergic reaction.

What can PRP be used to treat? The ultimate goal of PRP injections is to resolve pain through healing. For this reason, PRP has a broad range of practical uses, including but not limited to chronic plantar fasciitis, ankle ligament sprains, tendonitis (as commonly seen in avid runners), Achilles tendon injuries, bursitis and more. 

Why should you consider PRP? This treatment is gaining in popularity, and for very good reason. Not only are PRP injections quick and performed in office, but also in utilizing your body’s own healing factors, PRP is of natural origin to your system and provides very few adverse effects. This high-tech modality has been utilized in professional sports for years. Chicago Bull Joakim Noah frequently used the injections for plantar fasciitis to help him stay game ready. Research has showed strong correlation with PRP’s ability to assisting in healing of soft tissue and bone injuries. For individuals struggling with chronic ailments of the foot and ankle, significant reduction in pain can be seen in 2-4 weeks!

Ask us today is PRP might be good option for YOU!

Are you experiencing bad foot odor? Don’t worry, it’s not uncommon. About 36 million people in their adult life experience this problem. Why is that the case? Our skin is home to many types of harmless bacteria that is part of our normal flora. Normally, when we sweat it is odorless. However, if the sweat is contained in an environment it can’t escape, such as when wearing socks and shoes, it creates a perfect environment for that bacteria to react with the sweat. The waste that is excreted from the bacteria is actually what causes the bad odor.

So how do you stop it? Before heading to your doctor’s office, try some easily accessible remedies and see if they work.

Here are five over the counter remedies to relieve foot odor:

  1. Washing your feet with antibacterial soap
    This method will reduce the bacteria on your feet, killing the colonies and decreasing the smell they produce. It’s an easy add to your hygiene routine.

  2. Sprinkle baking soda into your socks
    This simple fix can be found in your kitchen cabinets. Baking soda contains sodium bicarbonate, which basically neutralizes the environment the bacteria is living in, therefore reducing the odor on your feet. On the plus side, it also softens the skin.

  3. Putting antiperspirants on your feet
    Antiperspirants that contain aluminum chloride will reduce and dry the sweat on your feet, thereby diminishing the environment where the bacteria thrive in. Simply purchase an armpit spray antiperspirant, it works well.

  4. Creams such as Lavilin foot cream
    This particular cream contains active ingredients to kill the bacteria while also keeping skin smooth and comfortable.

  5. Wearing moisture-wicking socks
    Wool socks are really effective at reducing odor. These socks will diminish the sweat and keep your feet feeling breathable.

These five OTC remedies are a great way to start an end to your foot odor, and these methods are very simple and easily accessible. However, if this problem persists with no avail talk to a podiatrist to see what can be done. There are advanced techniques that can be prescribed by your podiatrist, such as iontophoresis, that reduce sweating and foot odor.

Is your heel causing you pain? Well you’re not alone, more than 2 million
Americans seek treatment for heel pain each year. The most common cause of
pain is plantar fasciitis. Typically plantar fasciitis is most painful with
your first step out of bed, and this is termed post-static dyskinesia.
Although it is the most common cause of heel pain, it is certainly not the
only one.

To elaborate, here are five less common reasons you may have heel pain.

  1. Tarsal tunnel syndrome:

    Similar to carpal tunnel syndrome in the wrist, tarsal tunnel syndrome is an agitation of the largest nerve in the foot as it passes across the ankle. This nerve, named the tibial nerve, provides sensation to the bottom of the foot. When this nerve is compressed in the tarsal tunnel by a band of tissue known as the flexor retinaculum, a number of things could happen. There may be shooting pains in the foot, numbness, or a tingling/ burning sensation. Most of the time patients will exhibit a flattened arch, and this pathological pronation of flattened arches tightens the tarsal tunnel causing the pinched nerve. Symptoms are correlated with activity, worse at the end of the day, and sometimes cause pain at night. The first line of treatment includes arch supports to reduce pathological pronation, anti-inflammatory modalities, and stretching.

  2. Arthritis:

    Unfortunately, arthritis is a common but poorly understood disease process. Common arthritic joint symptoms include swelling, pain, stiffness and decreased range of motion. The most common type of arthritis is degenerative joint disease also known as osteoarthritis. It is simply the wear and tear of joints over time. This can be accelerated by injury to the joint. Arthritis in the joint between the heel bone and the ankle bone may refer pain to the heel. An x-ray is diagnostic. Treatments for arthritis include immobilizing braces, physical therapy, and cortisone injections.

  3. Stress fracture: 

    Stress fractures in the heel bone are common in running athletes. Stress fractures are overuse injuries from repetitive stress. In the heel, a stress fracture causes pain that is spread out along the heel and can be reproduced when the heel is squeezed together, side-to-side. Limitation of activity is a must until the fracture heals, and full non weightbearing may be necessary. Luckily, once healed, the bone is stronger than it started, and the stress fracture is less likely to reoccur. However a specific plan of action to slowly progress back to full activity is needed. Stress fractures are easily missed if not seeing a specialist as they do no regularly show on plain x-ray films. If misdiagnosed cortisone injections can be disastrous to recovery.

  4. Fat pad atrophy:

    Atrophy is the medical term for wasting away. Fat pad atrophy describes the loss of healthy fat between the heel bone and the ground it contacts. This fat helps protect the heel by absorbing shock while we move. Without it, there is increased stress at the heel, and sometimes a prominent heel bone can be felt through the skin. Overtime everyone loses fat padding to some degree, but only where we need it most, including the heel and the ball of the foot. This occurs in older patients, and they will complain of heel pain especially when walking on hard floors or without shoes. Patient’s do well with customized soft cushioned orthotics with deep heel cups designed to hold the remaining fat pad under the heel bone.

  5. Calcaneal apophysitis:

    Another complex medical term is apophysitis and it is defined as inflammation of the growth plate. This means those who have calcaneal apophysitis must be growing, so it affects children between the ages of 8 to 14 years old. Calcaneal apophysitis is also known as Sever’s disease. Usually patients that are beginning new sports like soccer or basketball develop this pain. Stretching boots, ice, and padded heel lifts are the mainstay of treatment for this problem. Once the growth plate closes, the disease resolves on its own. Although there are many forms of heel pain, only a specialist is trained to tease out the minute differences on exam and through the patient’s history.

    Stretching and customized shoe inserts are a long term treatment plan for more than one of the diseases, and most the time a good place to start. See our previous post about other benefits of calf stretching too. In the meantime, if you have heel pain it is best to schedule a visit with your podiatrist to be sure to have the right treatment regimen for you.

September 28, 2016
Category: Uncategorized
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We’ve all heard the hype about stretching and the benefits it could potentially have to find a daily stretching routine. But let’s look a little deeper. What about calf-stretching specifically? Why does it matter? What could it alleviate?

The calf is comprised of two muscles. The gastrocnemius begins above the knee, and the soleus lies deep to it, and begins below the knee. These two muscles fuse together to form the Achilles tendon.  Their main function is to plantarflex the foot propelling the body forward during walking, running, and jumping. Excessively tight calf muscles leads to a variety of musculoskeletal conditions, and is termed equinus deformity.

With that in mind, here are six reasons to stretch your calves:

  1. Increased circulation to your lower extremity

    Note:  Increasing the amount of oxygenated blood reaching your foot and ankle can help alleviate minor joint pain and aid in quicker recovery time between workouts or post injury. Promoting circulation also decreases swelling and reduces occurrence of blood clots.
  2. Decreased frequency of leg cramps

    Note: For those who are very active, calf cramping (especially at night) can become all too common. When the calves are excessively tight from exercise, they can develop a tendency to lock up. Stretching will help increase blood flow and decrease those dreaded cramps. Proper hydration may be equally important.
  3. Increased range of motion

    Note: Calves are lever arms for the entire body. When they are more flexible, they have more freedom to move.  Flexible calves can produce more power as well. Stretching the calves improves your ability to walk, bend, twist, climb stairs, ect. Especially in older adults, this can significantly improve ones ability to handle the stresses of daily life with greater ease.
  4. Prevent Achilles tendonitis

    Note: Performing dynamic (active) calf stretches prior to a workout and static (at rest) calf stretches post workout can have significant effects on injury prevention. Dynamic stretching helps warm the muscles up and increases range of motion around the joint, while static stretching help them cool down. Achilles tendonitis is directly correlated to tight Achilles tendons.
  5. Prevent shin splints

    Note: Shin splints are an overuse condition of one of two small muscles originating from the shin. When your calves are too tight behind the leg, the shin muscles in front are over worked to compensate. Calf stretches are a mainstay for prevention of shin splints.
  6. Prevent plantar fasciitis

    Note: Equinus deformity of the calves causes pathological pronation (flatfoot) in the foot when walking. This leads to increased tension on the plantar fascia and is one of the major underlying problems leading to plantar fasciitis. Flexible calves are necessary to allow proper biomechanics of the foot. Reducing pathological pronation decreases incidence of plantar fasciitis.

    The takeaway Â­– No matter your age level of activity, the calves are an important muscle group necessary for daily activity.  Implementing a stretching routine in the morning, before/after your workout, and before bed can improve performance, recovery, and quality of life.  Visit our website to learn some stretching techniques:




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