Plantar Fasciitis Explained By Chattanooga's Foot Surgeon

Of all complaints seen by podiatrists, heel pain is the most common. But just because it is common, does not mean that it isn't a real pain. Most people suffering from plantar fasciitis symptoms describe a sharp pain in the bottom of the heel first thing in the morning when they step out of bed. Many others will also get pain after getting up off the couch watching TV or after sitting and working at a computer. There is almost never any recollection of an injury. It usually just seem to come on gradually. The inflammation gradually gets worse over time. Although some patients do have bone spurs or heel spurs associated with the inflamed plantar fascia, the spur isn't usually the problem. The good news is that most people with pain in the bottom of the heel can get better quickly and without surgery. There are many simple and effective treatments available. Dr. Christopher Segler of the Ankle & Foot Center of Chattanooga (a heel pain specialist) discusses the treatment options so that you can get relief from your heel pain.




Dr. Christopher Segler is an author, award winning foot surgeon and heel pain specialist who says heel surgery can (and should) be avoided in most cases of plantar fasciitis or heel spurs. He recommends simple and effective treatment or advanced non-surgical therapies for chronic heel pain. Don't let someone talk you into heel surgery! His surgical podiatry practice is at the Ankle & Foot Center of Chattanooga. If you or someone you care about has heel pain, you can request a FREE copy of Dr. Segler's book "No More Heel Pain; A Guide to Understanding Heel Pain Causes and Treatments" at http://www.AnkleCenter.com.

Small Problems, Big Obstacles After Foot Surgery

Whenever planning for foot or ankle surgery, it is important to consider how extensive the surgery will be, and whether or not you will be able to walk. Many people underestimate the difficulties of not being able to walk while recovering after foot surgery. Although most people tend to worry about the pain that they have after foot or ankle surgery, this is not typically the biggest problem.

One patient explained that after having foot surgery, she can get around to be very difficult. She said that her doctor did explain that she would have to be non-weightbearing that she underestimated the difficulty and discovered that even minor tasks that could seem challenging.

She explained that even the simplest tasks take a LOT longer when you do it on crutches or in a wheelchair. Even though she has a ranch style home, which has no stairs, she still famished needed help.

Like most homes, some doorways are not quite big enough to get through with a wheelchair. This makes it difficult to move from room to room.

Other things that she previously took for granted like getting a bowl from a high cabinet like the one below is virtually impossible without help.

Because she has a stacked washer and dryer, she found the same is true of doing laundry. Getting anything out of the basement is impossible.

Moving from the kitchen to the dining room with a plate of food is a real challenge as well. . Fortunately, she has recruited the help of her husband without any difficulty. For anyone living alone, all of these tasks can prove to be very difficult.

Because of this it is important to make sure that you discuss what your living situation is like, prior to foot surgery. Many people don’t even think about one or two stairs in a split level home as much of an obstacle, until they have foot surgery.

As long issue plan ahead, even more extensive surgeries requiring crutches or a wheelchair can go smoothly. But it’s important to be realistic about your expectations in the amount of help, you will have while recovering.


Dr. Christopher Segler is an author, inventor and award winning foot doctor with a surgical podiatry practice in Chattanooga. He invented the patented surgical instrument that simplifies flatfoot surgery and bunion surgery. He publishes articles and teaches other surgeons about his unique methods to decrease pain after foot surgery. You can order a FREE copy of his informative book about common causes of foot pain at http:www.anklecenter.com.

What is a Bunion?

A bunion is a nothing more than a bump or enlargement of the bone and joint at the base of the big toe. This joint is called the first metatarsophalangealjoint (MPJ). A bunion forms when the joint becomes misaligned and the bone or soft tissues at the big toe joint start to move out of place. What happens is that the big toe starts to bend over toward the other toes. This causes the bone to stick out. The soft tissues that are covering that bone Denbigh come irritated red and inflamed. This causes a painful knot of bone. Because this joint carries the majority of the body´s weight while walking, bunions can become extremely painful. Eventually the big toe joint itself may become arthritic, stiff and sore. This can make walking and fitting into shoes extremely difficult.


Dr. Christopher Segler is an award winning foot and ankle surgeon with a podiatry practice in Chattanooga. He is the inventor of a patented surgical instrument designed to simplify bunion surgery and flatfoot surgery. He publishes articles teaching other surgeons about his techniques and how to decrease pain after foot surgery. You can order a FREE copy of his informative book about common causes of foot pain at http://www.anklecenter.com.

Do I Need Surgery for Arthritis in my Big Toe Joint?

Today I had a question from an active 28 year-old named Jennifer. She has a very active 3 year old son she chases about, but she gets pain and stiffness in the big toe joint. She says its worse when she crawls around on the floor kneeling, squatting, and playing with her little boy. She says he's into everything, but she loves watching him learn.

She thought she had a bunion and went to see a foot doctor who told her it was arthritis. And she needed foot surgery right away. Although this assessment was close, it was wrong.

She came in to see me for a second opinion.

Now, I will admit that she does have a little arthritis in the big toe joints. I will admit that one is worse than the other. I will even admit that I (or any foot surgeon) could make it look different on xrays. Maybe even look better on xray. But no guarantee it would feel better. At least not by New Years.

Jennifer has a condition called hallux limitus or hallux rigidus. This happens when there is restricted motion and the big toe doesn't bend up as far as it should. Because of this, the joint starts jamming and develops arthritis. Eventually, bone spurs start to develop on top of the joint. With time it will get worse. The cartilage can even get worn away over time.

Someone recommended that she have joint replacement surgery to put an implant in to replace the worn joint. Good idea, but not when she is committed to taking care of a 3 year old. I recommended she get some super-stiff Dansko Clogs from ZUMFOOT. With these she can walk without pain because the big toe won't be forced to bend and thus it won't jam anymore.

For her this was a good solution. She can can now walk without pain and wait until the timing is better. It won't get worse fast, and she can wait until the little one starts school.

Eventually she will have surgery. But I truly believe that unless the condition is going to get significantly worse, you should have foot surgery when it fits your lifestyle best.

Foot surgery can help many conditions, but the amount of disruption to your daily routine is elective...just like the surgery.


Dr. Christopher Segler is an award winning foot and ankle surgeon with a podiatry practice in Chattanooga. He is the inventor of a patented surgical instrument designed to simplify bunion surgery and flatfoot surgery. He publishes articles teaching other surgeons about his techniques and how to decrease pain after foot surgery. You can order a FREE copy of his informative book about common causes of foot pain at http://www.anklecenter.com.

Mid-Foot Sprains, Pains, and Fractures

The midfoot is a complex area involving 10 different bones coming together to form more than a dozen separate joints. A sprain in this area can result in aching or throbbing midfoot pain, swelling and bruising. Sometimes the pain will start on the top of the foot and go deeper all the way through to the bottom of the arch. This type of injury can interfere with running and has the potential for serious problems if ignored. 

The most common way for an injury of midfoot to occur, is trauma. But it doesn’t have to be the hit-the-foot-with-a-hammer sort of trauma. For a runner, this sort of injury happens when twisting the foot while stepping in a pothole, accidentally stepping off the shoulder, or tripping over a root on a trail run. 

Fortunately, this sort of injury is rare from running. However it is common in other accidents. The classic midfoot injury is sustained in an automobile accident while braking. You have your foot on the brake, smack into the car in front of you and all of the force causes the midfoot joints to be dislocated or fractured.  The area most often injured is actually a collection of joints called Lisfranc’s joint. For trivia buffs, Lisfranc was Napoleon’s surgeon. These injuries are often misdiagnosed as a “midfoot sprain.”

In 2004, I began a research project in order to determine how accurately different doctors are able to diagnose Lisfranc’s injuries. The results of that study were quite frightening. We found that primary care physicians and emergency room physicians were only able to recognize 1.6 % of the identifiable features of these injuries on x-ray. That means that more than 98% of these injuries could be missed if not evaluated by a foot and ankle specialist. 

As a result of this research, I won an award from the American College of Foot and Ankle Surgeons.  Since that time I have seen many patients that came into the office having been misdiagnosed. In most cases they bring their x-rays from the emergency department and the injury is visible. It was just not noticed. In every case, the doctor told the patient that it was just a sprain and would get better.

The difficulty is that we know in fact, these will not get better unless appropriately treated.

Pain and tenderness on the top of the foot is relatively common in runners, but this is more often related to irritation of the tendons on top of the foot. This common problem is not that serious, and is easily treated. 

In contrast, pain that is worse when standing and twisting the foot, or when running, is worrisome. Any associated bruising is always a concern and may signal a much more significant injury. Without appropriate treatment, continued pain and rapid development of arthritis, with associated destruction of the joints in the midfoot, can occur. This can result in significant disability. 

Anytime you have had an injury where you were involved in an accident, stepped off a curb of wrong or stepped into a pothole while running, you should be aware of this possibility. Do not run if you have continued pain. If you are a runner and suspect that you may have a midfoot sprain, it is critical to get evaluated by an expert in foot and ankle care. That way you can get back on the road as quickly and safely as possible.

Dr. Christopher Segler is an author, inventor and award winning foot surgeon with a surgical podiatry practice in Chattanooga. He invented and a patented surgical instrument designed to simplify midfoot fracture surgery and reconstructive flatfoot surgery. He also publishes articles teaching other foot doctors about his methods to prevent pain after foot surgery. You can order a FREE copy of his informative book about common causes of foot pain at http://www.AnkleCenter.com.