DR. HOOK- Step to it: Lots at risk for plantar fascia

Jewish dance master Steve Weintraub gave a workshop on Yiddish dance to Klezmer music. When I entered the Beth Israel Synagogue for the very first time, I had no idea what Klezmer music was, but I did have some idea of Yiddish dancc– well, only because I was Motel the tailor in Fiddler on the Roof.  (And trust me, I was a great Ashkenazi Jew! L'chiam!)

   Our beloved nurse practitioner and her rabbi hubby invited me to come dance. I was a little nervous because even though I ice dance, I have some difficulty learning new moves. I don't take aerobics classes because what can be more humiliating than watching yourself in a big mirror doing everything the opposite of the rest of the class? No Saturday Night Fever for me!

   And, yes, as Michele Kwan graceful as I am, I tend to also step on people's feet when I dance. And I did step on everyone's feet at the Yiddish dance class– all 75 people. I gave enough "flat tires" to keep Firestone in business forever. Do you think I'll get plantar fasciitis from all the bouncing on my toes?

   Plantar fasciitis is a painful foot condition involving the deep layer of the plantar fascia. What's that? Fascia is a fibrous, pearly white looking tissue, like that goo covering a raw chicken breast. Plantar is not a peanut, but the sole of the foot (dorsal is the top side). You know– it's like when you plant your foot into the ground (isn't it great when everything comes together?).  

   The plantar fascia runs from the heel to all five toes. It supports the arch of the foot, in particular when pushing off the foot during walking. So activities that put stress on the arch of the foot can lead to plantar fasciitis.

If you're a Jumping Jack Flash with either high arches or flat feet, it's easier to get plantar fasciitis. Obesity does more than give a lead foot; the extra weight puts more stress on the fascia. So I wonder if being barefoot and pregnant can cause plantar fasciitis?

Standing on hard floors all day is another risk factor. Heel spurs are associated with plantar fasciitis. You can't nudge along your horse with heel spurs. They're bony projections on the heel bone around where the fascia connects.  

   Have you ever seen a ballet dancer's feet? Oy, vey! Beautiful as they are on stage, their poor feet are at risk for plantar fasciitis. But so are folks who do high-impact aerobics. So good support shoes are important to reduce the stress on the feet. 

   It's pretty easy to diagnose plantar fasciitis by physical exam. Pressing on certain spots of the feet makes the patient jump several feet, like Carl Lewis in the long jump. Sometimes an X-ray is useful to see if there's a heel spur.

   A good podiatrist is needed if the plantar fascia ruptures, hurts just too darn much, or if the fasciitis compresses on nerves in the foot. Steroid injections can help, but usually good arch supports and stretches suffice in helping the feet heel– er, heal.  

   Resting the aching foot is important, but in our busy lives, who has time? Like in My Fair Lady, "I could have danced all night and still have begged for more." I'm so ready to dance at my next Jewish wedding reception. In the meantime, I'm going to take care of my plantar fascia, because I never will become a fascist.

Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice. Email him with your questions.