Use this search box to search our site


Haga clic aqui Espanol


achilles tendonitis

AUTHOR: Marc Mitnick DPM

REVIEWED BY: Podiatric Medical Review Board

--> achilles tendonitis

Although I have a discussion on tendonitis elsewhere on this site, I thought I would devote a whole discussion to Achilles tendonitis as it is probably the most common tendonitis occurring on the foot and one of the most common tendon diseases occurring in the body in general.

It is estimated that Achilles tendinopathy pain accounts for upwards of 20 percent of all athletic injuries. Typical of most athletic injuries, the range of severity is wide, but there is always the chance that a minor injury will transform into a major injury if adequate measures are not taken or the patient tries to “run” through the injury. Men, over the age of 40, are more prone to damage to the Achilles tendon, even rupture of the tendon due to the fact that as we age the structure of the tendon becomes more rigid and therefore more prone to tearing.

WHAT IS ACHILLES TENDONITIS

This tendonitis can occur in one of three places:

  • the uppermost portion of the tendon where it originates from the gastrocnemius and soleus muscles (top arrow)
  • the mid portion of the tendon between the muscle and the heel bone (middle arrow)
  • the attachment of the tendon into the back of the heel (bottom arrow).


three areas of pain in Achilles tendonitis


The anatomical make-up of the Achilles tendon is somewhat different than most tendons in that instead of having a “synovial sheath” which is a covering surrounding the tendon, the Achilles tendon is surrounded by a loose fatty layer of tissue known as the paratenon.

Two problems with this type of anatomical arrangement is that the paratenon supplies the Achilles tendon with most of its blood supply, so healing of the Achilles tendon is very much dependant on the integrity of the paratenon and secondly, the paratenon itself is subject to injury. Many people will sustain injury to both the paratenon and the Achilles tendon resulting in adhesions (scarring) between the two structures that will lead to further reduction of motion and an increase in pain.



CAUSES OF ACHILLES TENDONITIS



The most common causes of Achilles tendonitis are poor training techniques particularly by older athletes. Inadequate warm-up, a rapid increase in mileage, or rapid increase in intensity of other sports will put excessive tension on the tendon.

For runners the type of surface used for running can have a negative impact on the Achilles tendon. Concrete surfaces do not allow for any shock absorption on impact and thus the shock of the foot hitting the ground results in damage to the posterior musculature including the Achilles tendon. Running on uneven surfaces such as sand or a “banked” road results in more expenditure of energy by the lower leg muscles making the Achilles tendon more prone to injury. Running uphill applies more strain to the Achilles tendon increasing the possibility of injury.

Poor athletic shoe selection can also create Achilles tendonitis. A shoe that constantly rubs and irritates the back of the heel may eventually lead to irritation of the tendon. A poor shock absorbing athletic shoe will put more strain on the Achilles tendon. An athletic shoe that does not adequately hold the heel bone (calcaneus) in place may also put unnecessary strain on the Achilles tendon.

Foot structure will also play a role in the development of Achilles tendonitis. A foot that over pronates causes the Achilles tendon to overwork and may lead to injury. A foot that over supinates is a poor shock absorbing foot and this too may lead to inflammation of the tendon.

Tight Achilles tendon is probably the biggest cause for pain in the tendon. Many people unfortunately have a tight tendon, meaning when they bend their foot upwards (with their knee locked in extension), they simply cannot bend their foot more then 90 degrees relative to the lower leg. This inability to bend their foot further than 90 degrees puts tremendous strain on the tendon.

SYMPTOMS OF ACHILLES TENDONITIS



The main complaint by patients is pain in the back of the heel. This pain needs to be distinguished from retrocalcaneal bursitis (see bursitis) or retrocalcaneal bone spur, along with some less common causes such as gout or Rheumatoid arthritis.

The pain is most pronounced, when initially walking, after periods of inactivity such as sleeping or sitting for a long period. Walking around will generally decrease but not eliminate the amount of pain. When exercising the pain is most prevalent when jumping or pushing off.

Actually pressing on the Achilles tendon may also elicit pain and you may be able to feel swelling along the course of the tendon.

DIAGNOSIS OF ACHILLES TENDONITIS



Most cases of Achilles tendonitis is diagnosed by proper history and physical examination. Squeezing the tendon may yield pain. Bending the foot upwards with the knee in a locked position will usually also cause pain. In individuals where there is Achilles tendonitis the patient will usually demonstrate a lack of dorsiflexion (the ability to bend the foot upwards beyond ninety degree relative to the lower leg with the knee locked).

It is also recommended to test the strength of the tendon to rule out rupture of the tendon particularly if the pain occurred while exercising and a "pop" was felt. They also describe the rupture as if someone kicked them in the heel. Keep in mind that the tendon can rupture even with no history of exercise or trauma.

You should attempt to stand up on your toes. If there is a tear in the tendon you will not be able to perform this test, or at the very least it will be very painful.

Many times in a Achilles tendon rupture, you can actually feel a gap in the tendon where the tear has occurred.

When the pain on the Achilles tendon is at the level where it attaches into the heel bone, an x-ray may be helpful to rule out other problems such as bone spurring on the heel bone and/or calcification of the tendon itself.

In situations where the tendon does not respond to treatment or a tear is suspected, an MRI can be very helpful in evaluating for minor and major tears within the tendon, along with other problems such as calcification of the tendon.

WHAT IS INSERTIONAL CALCIFIC ACHILLES TENDINOSIS?



This condition has been described as an overuse injury particularly in long distance runners as well as jumping sports, skating and skiing. It is typically described by patients as pain at the point where the Achilles tendon inserts into the heel bone (calcaneus).

The most notable finding in these cases is calcification of the Achilles tendon where it inserts into the heel bone. If the calcification is severe enough it can extend well into the Achilles tendon. This creates a functional shortening of the tendon, essentially because the calcified portion of tendon is no longer able to function as tendon.

From a medical standpoint this is known as an enthesopathy which a disease process of the enthesis, which by definition is the insertion of tendon, fascia, muscle or articular cartilage into bone.

The calcification of the Achilles tendon is due primarily to inflammation of the tendon. The Achilles tendon is under tremendous stress as it functions to help move the foot forward in gait. Athletic activities further stress the tendon at its insertion. Abnormal biomechanical function at the talo-calcaneal joint (the subtalar joint located just below the ankle joint) will also exacerbate the problem.

Along with partial loss of function of the Achilles tendon, the actual calcification of the tendon will be irritated by shoe pressure. (see yellow arrow on x-ray)

insertional calcific achilles tendinosis




TREATMENT FOR ACHILLES TENDONITIS



In determining treatment for Achilles tendonitis it is important to first determine the cause. Elimination of factors that are exacerbating the problem such as poor athletic shoes, lack of adequate warm up or poor running surfaces all need to be addressed.

orthotics for Achilles tendonitis

If it is determined that a particular foot structure is the causative agent then an orthotic should be tried. An orthotic will do a couple of things:

  • It raises the heel slightly thus decreasing the tension on the Achilles tendon. Reducing tension reduces pain.
  • An orthotic will also help absorb shock particularly in those with high arched feet.
  • In people with flatter feet, an orthotic will create better alignment and better function of the Achilles tendon. This is an important point to note, because people with a tight Achilles tendon, will tend to have feet that flatten out. By pronating, this decreases the distance, ever so much, between the origin of the tendon and its insertion into the heel bone. By decreasing the distance, you decrease the tension.

In order to reduce the complications associated with this condition conservative treatment should be instituted immediately.

  • Icing the area will help reduce the inflammation and pain. In mild cases where you are still participating in athletics, I would advise ice both before and after exercise.
  • Stretching of the Achilles tendon is also mandatory, however, it should be pointed out that for most people stretching will relax the tendon slightly but does not actually stretch it.
  • Short term use of anti-inflammatory medication is also helpful. This type of medication is indicated for acute tendon problems and should be limited in chronic forms of tendinopathy because in chronic tendon problems there is no longer inflammatory cells within the tendon and therefore anti-inflammatory medication will be of limited value.

    If these simple measure do not seem to be helping, then cessation of the athletic activities (rest) is also mandatory. Remember, our goal here is to minimize damage and not let the condition worsen.

  • Night splints for Achilles tendonitis is another means to reduce Achilles pain and aid the tendon in healing. This is accomplished through wearing a night splint during sleep. This keeps the Achilles tendon in its proper position while sleeping. In more severe cases a cam walker, or walking cast may be necessary to keep the tendon immobilized all day as well. The less the tendon is forced to stretch and over work, the quicker it will heal.

  • In situations where these simple procedures have not helped then physical therapy may be necessary. This consists of a program where the physical therapist works on reducing the inflammation while at the same time tries to increase the flexibility of the Achilles tendon.

We generally do not give cortisone injections for Achilles tendonitis particularly at the insertion of the heel because this has been shown to increase the chance of Achilles tendon rupture. If injectable cortisone is to be used it should be injected underneath the skin and not directly into the tendon.



NEWER THERAPIES FOR TREATMENT OF ACHILLES TENDONITIS



Other conservative treatments include extracorporeal shockwave therapy (ESWT) particularly in chronic forms of Achilles tendon problems.

(PRP) or Platelet-rich plasma injections have been used for tendon repair in many parts of the body, however, most studies that I have read have not found the same degree of success in the Achilles tendon.

In cases of rupture of the Achilles tendon, surgery is generally the indicated treatment. This is primarily true for younger active individuals. The exception would be in those individuals who lead a very sedentary life style or are not good surgical candidates. In these cases the patients are usually put in a cast for upwards of several months.

is surgery the only option for a ruptured Achilles tendon?

Interestingly enough, a study, albeit it a small one was conducted whose purpose was to measure outcomes of those who had complete open reconstruction Achilles tendon surgery vs. those with percutaneous tendon repair (small incision repair) vs. those that had conservative management.

Three years post treatment, the subjects Achilles tendon was measured for calf muscle volume (a poorly functioning Achilles will cause the muscle belly to atrophy or shrink), cross sectional area of the tendon through MRI imaging, to measure the length of the tendon. They were also questioned about time lost from work or activity.

Essentially the results showed no significant difference in calf muscle volume, Achilles length, and time lost from significant activity among the three different treatment approaches.

This study is not large enough to suggest the best treatment option for Achilles rupture, but does suggest that whichever approach one takes, the end result will be the same.1

running with Achilles tendonitis

During the acute phase of Achilles tendonitis, it would be wise to refrain from running as you are only looking for problems, one of which is rupture of the tendon. At this point you should be looking at other exercise options such as an exercise bike where you can still burn calories but the stress on the tendon is minimal.

Once you are at least fifty percent improved and would like to try and resume running, here are a few suggestions:

  • make sure you have some device in your running shoe, either an orthotic or at the very least, a heel lift to take some of the tension off of the Achilles tendon.
  • avoid running up hills as this increases the tension on the Achilles tendon and can aggravate the condition.
  • try and run on softer surfaces like a high school track and avoid sidewalks and streets as they put stress on the Achilles tendon.
  • if you can tolerate them, take an anti-inflammatory 30 minutes before you go out to run.
  • ice the Achilles tendon both before your run and immediately after.
  • if you feel the pain worsening during your run, stop immediately.

It is also worth noting that a class of antibiotics known as Fluroquinolones, more commonly known as Cipro and Levaquin, have an FDA warning attached to them, suggesting that these antibiotics can increase the risk of tendon rupture. Those individuals taking these antibiotics should be aware of this side effect.

1.Long Term Outcomes of Muscle Volume and Achilles Tendon Length after Achilles Tendon Rupture Rosso C., et al.(University Hospital Basel, Basel, Switzerland; University of Basel, Basel Switzerland; Harvard School of Public Health, Boston, MA; Rennbahn Clinic, Muttenz, Switzerland; Cantons Hospital Fribourg, Fribourg, Switzerland)
Knee Surg Sports Traumatol Arthrosc. 2013 Jun;21(6):1369-1377



REFERENCES

Mayo Clinic

Orthoinfo

University of Michigan Medicine



Want more information? CLICK HERE



ESPANOL

Para traducir esta pagina, ve al boton de traduccion de Google en las esquina superior derecha de la pagina


translate page

ORTHOTICS for multiple types of foot pain
best buy in a pre-made orthotic
click link below


SuperStepOrthotics


ORTHOTICS for heel and arch pain for those who must wear dress shoes
click link below


redithotics





I've been doing some aggressive research lately (it's how I found your incredible website) and realize now that my symptoms are not consistant with the diagnosis. Jennifer

Hunterville, NC
….after reviewing your amazing site (great for the avg. jill). So thank you very much!!!

Liesbeth

NY
I am really, really impressed with your plain-speak explanations for the various conditions.

Jacqueline

NJ
This was an extremely helpful site. I have an appointment on the 18th and your info. Was right on target…..

Jack

Fla
A well organized site containing much information written in a manner that the average reader can comprehend.

Jean

Ontario, Canada
I found your website and articles most interesting.

Andrew

Fla.
Thank you for a quick response. I think your site is the best information site on foot pain and I have viewed many.

Judy

(location unknown)
I came to your website, footspecialist.net via www.foot-pain explained .com which I think is also your website? I thought explanations for different types of problems were well addressed and thoughtfully stated for the patient in mind.

L.W.

New York
You have an amazing and extremely informative site. I enjoyed looking through all of the data and stats.

Yvette

Memphis, TN
Thanks again so much for the information in the article. Very interesting.

Anna

Scotland
Great article. I have had plantar fasciitis since I was in high school……..

J. Simmons

(location unknown)
Dear Dr. Mitnick, The orthotics arrived four days ago and I slipped them into my shoes immediately. I was skeptical as to the usefulness of the item, they really didn't look very exotic. I have to say though, after using them for just four days, I have experienced grand relief from my foot pain. Even the very first day, I was able to do a lot of work while on my feet with at least a 75% reduction of pain. It has only gotten better every day, and I go nowhere without my shoes with the orthotics. I had been experiencing extreme heel and sole pain for about six months and had to take extended breaks off my feet many times a day as well as regular doses of Ibuprofen. Since getting the orthotics, my life has returned to normal and I feel good again. Just wanted to say thanks for the recommendation for a very effective item, I had no idea what a change this item could affect.

Yours truly,

J.C. Forbes

Tennessee
Thanks for the Response, you hit it on the head.

Steve

Redondo Beach, CA
Thank you for your time and expertise in answering my question…..

LH

(location unknown)
First, thanks for putting together this website. Its the most informative site I have found dealing with foot problems. Last June I started having pain and swelling at …….

Joe

(location unknown)
First of all, thank you for having all this useful information available in one place. I've been through most of your website and based on my research, pain and evaluations I think I've narrowed things down quite a bit.

Pete M.

(location unknown)
Thank you for the best site I have found when researching foot pain.

Glenda B.

Madison, Alabama
Thanks for replying so quickly. I was a bit concerned. I think your website is great, and chock full of info.....

Carol

Denison, TX
Dr. Marc, Thank you so much for your reply which seemed to be right on. I have researched many sites but you put me on the right path to the possible answer. My foot pain may not rule the rest of my life after all! I believe I'll make a sign that reads, "THE END IS NEAR!" Thanks Very Much,

Dawn

West lafayette, IN
Dear sir...no doubt you get positive comments re your site...May I please be added to the list of your admirers. In all of my years of web surfing I would say your site is right there with the very best. Thank you for taking the time to write the terrific info you provide and for putting things into laymen terms for us mere mortals. I pray you have much on going success and thank you again for a deed well done. As for me I did not find much help for my symptoms and will continue on my quest. Were you anywhere in the South I would make and appointment...Thanks again dear sir...m.e.

Michael E.

Tampa, Florida 33624
Hi. This is a great site! I'm a healthy middle aged woman who is in good health, but.....

Kelly

Texas
Just a wee word of thanks for your wonderful website...It is a terrific service...Thank you for providing your knowledge and help...With highest regards, m ebeling

Michael D. Ebeling

Tampa, Florida 33624


Thanks for a most interesting website, which has helped a lot.

Steve

UK


Dear Dr.Mitnick

I usually do my research on the Mayo clinic website. I think your website is the most informative site I have found when researching foot pain.

I thank you for putting together this incredible website.

Regards,

Dragica W.

Edmonton,Canada


....I have been told that it is not hard enough to be cut off. Please help, I am not sure what to do now! THANKS FOR A WONDERFUL AND VERY HELPFUL SITE!

Roxy

South Africa


You have an unusually clear, informative and well-written website for laypersons. Thank you for that.

Matthew W.

Mansfield Ctr, CT


First, I'd like to thank you for all the information that you provide on your website and the opportunity to write to you.

Steve

Placentia, California


First, I want to let you know that you have the best web site I've found related to foot issues. (The only thing I had difficulty finding was the "ask a question" page.)

Unknown

Unknown location


I received the orthotics Monday afternoon and began wearing them Tuesday. After two days I would say that I have noticed a huge improvement in the discomfort I have been experiencing. My foot feels better than it has in months.

Ric J.

Unknown location


I greatly admire someone like you who would donate and dedicate so much time and effort to helping strangers with no compensation. Truly, it is uncommonly kind. And your site is so intelligently arranged.

Ron R.

Pacific Grove, CA


I used to work for a podiatrist (front desk) back during summers in college years ago, so I know the benefits of good care. Again, I want to thank you for an EXCELLENT website. It was so great to get to your site (top of google search) and actually find all the answers I needed EASILY and QUICKLY! Clearly you put a ton of work into it and I really appreciate it.

All the best,

Victoria

Alameda, California


By the way, millions of websites could use yours as a guideline on how to organize information and make the site user-friendly. Kudos to you!

Anonymous


Thank you for your very interesting and informative site!

Anonymous




Hi. I come to your site often looking for information. It is really informative and I appreciate it very much. I have RA and have been having considerable amount of foot pain...... Dee RN


Thanks very much for the wonderful informative site.

Catherine

New Zealand


Thank You for my answer! I have been schedule for a bone density scan, allingment, and I am in the process of getting orthotics made, and checking out the natural remedies. Thank again! What a great web site!

Sincerely

Josette


Yes I want both pair of orthotics. You don't have an option of ordering 2 at one time so I had to place the order twice. Thanks. My husband likes these and wants to put them in all of his shoes. (referring to Superstep orthotics)

Cindy H.

Arizona
I searched the internet everywhere for a clear description and illustration of my symptoms/problem. https://www.foot-pain-explained.com/ was where I ended my search with answers. If I lived in Jersey (left 30 years ago) and didn't live in Florida I would definetly make an appointment with Dr. Mitnick.

Thanks, Kathy

Florida
1st of all THANKS A LOT for your great site......

Anna

Poland
Thank you so much for your response. I will let you know how I am doing if you would like. Your website is awesome!

M P

South Carolina
Hello! I want to thank you for such an informative website! I found you based on my ankle pain search and am happy to realize that there may be a relatively simple cause and solution....

Natalie

unknown location


...Thanks for your fantastic service.

Gary

Arlington, VA


Thank you so very much, that would be much appreciated. I love those insoles, by the way. (referring to Superstep orthotics)

Kelly W.

San Clemente, CA


Dr Marc is fantastic...He seems to know exactly what you are feeling with the problems you are having. I wish he was in my home town so I could go to him with my problems!!!!!!!!!!!!!

Pam

location unknown


Great insights! Thanks Doc, you're the best.

Glen

location unknown


I have been experiencing foot pain of various sorts and am working to figure out what it is. I found this site and can only say BRAVO!! What an excellent site! The time it must have taken to put all this together must've been a daunting task! I am sure it has helped so many people. Thank you so very much for doing this.

Bre

location unknown


Dr. Mitnick, Thank you so much for your reply. I did let my physician know and they took an x-ray - all is well! Also, thank you for providing this wonderful site, it is very helpful with lots of useful information! I appreciate your gift of time! God bless.

anonymous




Dr. Mitnick, Thank you, you were 100% correct. The pain finally brought me to the ER. I spent 8 days in the hospital. The Doppler you spoke of was able to show that there was no pulse in that foot. This was an arterial clot that split and traveled throughout my leg. My leg was almost amputated. I am in rough shape but have all my parts intact!! You certainly know what you are talking about. Thank you for taking the time to answer. Yours Truly!

anonymous




Staying at home after hallux surgery I spend quite a lot of time seaching info useful for avoiding problems which might come back. Today I found your site and I am .... delighted it happened. It's one of the best site I found last days.

Anna

Poland




Thanks for taking time to read and answer so many questions. It is truly a public service!

Esh

Seattle, WA


I just wanted to say that I am very greatful for this website!!

Bonnie

location unknown




Also, and importantly, just want to praise this web site. Thorough and thoughtfully presented, it certainly must be of considerable assistance to anyone with a foot problem. Terrific -- and very interesting.I trust the address comes up easily for those seeking information.

Bill

New Jersey




Thanks so much for answering my question. You've been more help to me than my own Dr. has been lately. Thanks again....I hope to be able to walk without pain someday.

Debbie

location unknown




Wow, that is exactly the information needed!!! thank you thank you thank you!!! I appreciate this help so very much from Marc Mitnick DPM. Excellent information and help to improve One's life.

Chrissy

location unknown




Thanks so much for this website Dr. Marc! It is so nice that you have this ask the doctor feature..I'm sure I'ts been helpful for alot of people. I will try what you suggested and see if it helps...thanks again!

Tracy

Evansville, IA




Dear Marc

I just want to say thank you for the quick response and the good info. I find it amazing and a super nice thing that you do here by answering medical questions at no charge.

Russ W.

location unknown




Your website is full of a lot of helpful information, and I am very impressed with the time in which you responded to my post. Thank you again for your time and consideration in your response.

-Sunny.

location unknown




Thank you very much for the information, I will consider it. Excellent web site.

Jackie

San Diego, CA




Dr. Mitnick, Just want to say thank you so very much for your quick response and very informative reply! After reading what you had to say, I called the doctor's office and was able to get in and see him the same day as my injury. Toe was x-rayed and luckily, it is not broken or fractured. Very badly bruised and will probably lose the toe nail. And although my toe and toe nail are still very black and blue and very sore, they ARE both starting to feel a little better. So again, thank you! I am so very happy that I came across your website. The service you provide is outstanding and immeasurable!

Rivi,

Albany, NY




Thank you so much for all of your advice. In searching the web for people dealing with this same issue i can tell you that you are a Knight In shining Armor! If I lived in Jersey I would gladly be your Spokesperson. Hopefully next time you hear from me it will be good news. God Bless,

Jill S.

location unknown




THANK YOU SO VERY MUCH FOR YOUR TIME AND EFFORTS, YOU ARE SO VERY APPRECIATED. THANK YOU FOR ALL YOU DO.

Jackie

Whichita, KS




thanks again, this site is very helpful.

mark

Boston, MA




Like others have stated...This site is amazing and I am so thankful that it was created.

....Keep up what your doing. Your a life saver.

Michelle

Colorado




Thanks again for the information provided on your site. It's easy for non-medical folk to understand your writing, and helps provide better communication between patient and doctor.

annielou

Colorado


Wonderful advice

by: Anonymous

This is the best site for foot problem info.


Thank you for this information. This description fits my pain and inflammation behind my 2nd toe perfectly.

by: Max

location unknown
Again, I really appreciate that you responded to my inquiry, and that your mention of Parkinson's helped me to find my way to a diagnosis of this difficult to diagnose disease. Most patients see on average 16 doctors before they are diagnosed. I hope that you can help other people that ask for your expertise in the future.

Barb D.

Canada
I just wanted to say that I am very greatful for this website!! I have had a fusion in my rt foot and am finally getting a little bit better......

Bonnie

location unknown
Again, Thank you from the bottom of my heart for taking the time to answer my question....your an angel!

Nancie

Wisconsin
Thank you for your response. You have provided some great insight (to my question)....

Julie

location unknown
Thank-you so very much for responding so quickly and in such detail to my question!! I will give my surgeon a call today!! This website is terrific!!!! Thank-you again!

Renae

North Carolina
Many Thanks Dr Marc!
Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...

KG

location unknown


Thanks again doc for having this website and we STILL need qualified Podiatrists in beautiful sunny Tampa Bay (Bradenton) Florida.

Bessie Mae

Florida
Dear Dr. Mitnick, Thank you so very much for taking your time to answer my question. You have greatly relieved my anxiety related to the continual tingly I feel in my feet. I will share your response with my podiatrist next week. God bless you for having this question and answer page on your website! Most gratefully,

Lynne T.

location unknown
Your webpage is excellent, I commend you on sharing your knowledge to the public.

Robert

New Jersey


Thank you. you were more detailed than what others have told me they finally called from the last xrays and my son is now in a cast for 2 weeks he did have a fracture that was not noticeable.

a mom

location unknown


I have read your website and I have to admit that I am amazed at all the information that is on here. I have learned more than the three years I have been going to several doctors that I have seen!!

Melody

Lenoir, NC


Thank you so much Doc for a quick and thorough response!

Rustam

Bellevue, WA


I cannot thank you enough for your response, opinion, and suggestions! I want you to know how much it means to me, and I'm sure everyone else who has ever asked you a question! I feel like you're a lifesaver and have empowered me to take a stronger role and stand up for myself and my feet!

Jodi

location unknown



Recent Articles

  1. Vitamin D impact on health

    Feb 06, 23 07:17 PM

    Researchers are suggesting that the effectiveness of Vitamin D in fighting and preventing disease is predicated on a persons body mass index (BMI). The thinner the person the greater the positive impa…

    Read More

  2. Foods to speed up healing

    Feb 01, 23 02:41 PM

    One of the best ways to help yourself heal faster after surgery is to eat well. Getting the proper nutrition will provide your body with the essentials it needs to promote healing. Here is a suggestio…

    Read More

  3. Cancer and Type 2 Diabetes

    Jan 25, 23 04:52 PM

    An article revealing that older type 2 diabetics have a higher incidence of cancer then non-diabetics. It is suggested that cancer may surpass CVD as the number one cause of death in older diabetics.

    Read More

  4. Does glucosamine or MSM reduce arthritis pain?

    Jan 22, 23 01:41 PM

    A good review of the possible benefits to taking glucosamine, chondroitin or MSM for arthritis. Always beware of the possible side effects of over the counter supplements.

    Read More

  5. shin splints

    Jan 18, 23 05:12 PM

    A great review on the various causes of shin splints, along with treatment options.

    Read More

  6. Whats new in skin cancer?

    Jan 15, 23 08:32 PM

    A presentation of newer skin protection combinations in an effort to better protect the skin from the hazards of sun exposure.

    Read More

  7. Causes and risk factors of warts

    Jan 14, 23 05:02 PM

    A good review of the causes of warts and protective measures you can take to prevent developing them.

    Read More

  8. Do chronic wounds need to be dressed daily?

    Jan 11, 23 02:18 PM

    Because of supply chain shortages as well as staffing shortages particularly during the pandemic, many institutions extended the time between dressing changes for chronic wounds. Is this really the be…

    Read More

  9. Food choices that raise your risk of type 2 diabetes

    Jan 08, 23 10:07 AM

    A good review of how blood sugars can become elevated and the harm that can do. Certain food groups have a tendency to raise your blood sugars and should be avoided.

    Read More

  10. Outcome stats from Scarf bunionectomy

    Jan 03, 23 03:04 PM

    The Journal of Foot and Ankle Surgery recently reported a meta analysis of outcomes in 1583 Scarf bunionectomies that met their inclusion criteria. Adverse events did not seem to be any better or wors…

    Read More