Foot and Ankle Stress Fractures – Treatment and Prevention

Originally posted April 2011 – Updated Jan 3 2018

foot and ankle stress fractures

What do people who jog, basketball players, dancers, gymnasts, and tennis players have in common?

All of them are at an increased risk of foot and ankle stress fractures.

What Is A Stress Fracture?

A stress fracture is caused by a small crack in the bone.

Overuse is the most common reason they develop: high-impact sports contribute to the fractures, as do running and basketball. Also, people with osteoporosis or other diseases that weaken bones can develop a stress fracture from performing everyday activities.

When the muscles of the foot and/or ankle are over-tired, they have a harder time absorbing the shock of repeated impacts.

When they are fatigued enough, the muscles begin transferring the stress of the impact to the bones of the foot or ankle: this is when stress fractures can occur.

foot metatarsals

The most common areas for foot and ankle stress fractures are the second and third metatarsals of the foot and in the heel.

Other common places for stress fracture are the outer bone of the lower leg (the fibula), and a bone on the top of the midfoot called the navicular.

Improper sports equipment, such as shoes that are too worn or stiff, can also contribute to stress fractures.

Foot and Ankle Stress Fracture Symptoms

  • Pain that develops gradually, increases with weight-bearing activity, and diminishes with rest
  • Pain that becomes more severe and occurs during normal, daily activities
  • Swelling on the top of the foot or the outside of the ankle
  • Tenderness to touch at the site of the fracture
  • Possible bruising

Treatment of Foot and Ankle Stress Fractures

  • Stop the activity and rest if you suspect a stress fracture.
  • Apply ice to the injured area 3-4 times a day for 10 minutes each time, and elevate your foot or leg.
  • Try not to put weight on the injured leg until you have seen a doctor.
  • Rest approximately 6-8 weeks from the activity that caused the injury. Do non-aeorbic exercise, such as swimming or cycling until the injury has healed.
  • Your doctor may recommend protective footwear to reduce stress on your leg or your foot until it has healed. A full contact orthotic is used to treat stress fractures, as it supports the metatarsals better than a weight bearing cast.
  • In some cases, you may need to have a cast applied or may need surgery to heal properly.

Prevention of Stress Fractures

  • Don’t wear old or worn-out running shoes. Use ICON Full Contact Orthotics that match your arch exactly, and immediately control the movement of your foot to give you the most
    amount of support and correction. A full contact orthotic is the only device that fully supports the metatarsals the instant weight bearing begins.
  • Alternate your activities (example: alternate swimming with jogging) so you don’t cause a repetitive stress injury.
  • Gradually increase time, speed, and distance when starting a new sport; a 10% increase per week is fine.
  • Strength training can help prevent early muscle fatigue and the loss of bone density that comes with aging.
  • Stop the activity if pain or swelling comes back. If pain continues for a few days after resting, see your doctor.

For more information about foot and ankle stress fractures, please contact Dr. Marc Klein or call his office at 561-447-7571 today.

Are Orthotics Good or Bad For Flat Feet?

flat feet

A question I am often asked in my podiatry practice is “Would orthotics be good for my flat feet?”

The short answer is “Yes” but like any good consumer, you should understand why.

Flat Feet and Fallen Arches

The terms “flat feet” and “fallen arches” are used to describe the same problem. They are often used interchangeably but for the sake of this article I’ll just be using Flat Feet.

I instruct my patient to remember that flat feet are caused by the foot not functioning properly. A flat foot has an arch that has collapsed due to the collapse of different bones in the foot.

There are two types of Flat Feet

Rigid Flat Feet (RFF) – someone with RFF has an almost solid foot with no arch. So, if someone with RFF were to put their foot in cement while they were sitting or while they were standing, the imprint would be the same.

Flexibile Flat Feet (FFF) – this type of flatfoot is the more common one. Someone with FFF has an arch while they are sitting, but when they put weight on the foot by standing, the foot becomes flat.

Custom Orthotics For Flat Feet

Do custom orthotics work? Well, now that you are aware that there are different types of flat feet you can see that having custom orthotics vs. over the counter ones would be more beneficial in the long run.

With differences in the type of flat feet problems you may have and the differences in the overall structure of your feet, a custom orthotic would be the best product for the best results.

A good orthotic (I recommend Full Contact orthotics) is supportive enough to control the body weight and as a result are excellent for flat feet.

The material in the Full Contact orthotics will give you the support that you need.

You may be tempted to use a soft, cushiony foot orthotic but these types cannot support the body weight so they cannot give you the full support you need. They may feel good temporarily, but in the long run, will stop working and can actually contribute to back pain.

Patients also need to remember that if they are casted for orthotics and they are standing during the casting then the cast is giving the lab an impression of a flat foot not an impression of a corrected foot.

When I take an impression for foot orthotics, the patient is sitting down and the foot is put through a simulated gait cycle allowing for correction of the foot which is then captured in the impression. When it’s done in this manner the lab is getting a corrected foot to make the orthotic from.

In my opinion, Full Contact orthotics are the best orthotics made.

If you have any questions about custom orthotics or problems with your flat feet, call me, Dr Marc Klein at 561-447-7571 or email me today.

Full Contact Orthotics For Shin Splints

Originally posted April 2011 – Updated December 21, 2017

full contact orthotics for shin splintsShin splints are very common – in fact, 13% of all running injuries are caused by tibial stress syndrome (more commonly known as shin splints).

Most athletes, dancers, and runners will get them on occasion and non-athletes can get them just from doing something they are unaccustomed to doing, such as jogging to catch their runaway dog.

shin splintsShin splints result from inflammation and damage of the tendons and muscles that run up the shin.

They aren’t a true medical condition, but they are symptomatic of an underlying problem.

Shin splints come from the overuse of the involved muscle and tendon.

But it’s important to note that shin pain does not necessarily mean that you have shin splints.

In fact, there are two other conditions that oftentimes are mis-diagnosed as shin splints.

  1. Compartment Syndrome – pain on the outer part (anterior) of the lower leg.
  2. Stress Fracture – an incomplete crack in the bone.

Shin Splints Can Result From Any Of The Following

  • Repetitive movements such as those involved in running
  • Stress fractures (tiny, hairline breaks in the lower leg bones)
  • An increase in exercise levels
  • Over-pronation or arch flattening which occurs when you take a step: the arch flattens to absorb the impact and instead of the muscle and tendon stretching, it pulls the muscle away from the bone. Take enough steps (as when running) and the overworked tendons and muscles will cause pain and inflammation. Full contact orthotics for shin splints that offer arch support are very helpful in preventing over-pronation.

Shin splints cause a dull, achy pain down the front of the affected lower leg. The pain may be intermittent or constant and the area may be sore to the touch.

It is even possible that the swollen muscles can press on the nerves in the foot, causing a numb or tingly feeling or weakness in the foot.

You can treat shin splints by decreasing pain, inflammation or swelling, and by addressing the underlying cause of the condition:

  • Exercise to stretch and strengthen the muscles in the lower leg. Exercises that make your muscles stronger are usually effective in preventing a recurrence once your shin splints have healed.
  • Take anti-inflammatory medications, such as ibuprofen or aspirin, and/or use ice applied directly to the painful areas of your shin. Also, wrapping your lower leg with an elastic bandage can be helpful if there is any swelling. Keep in mind that these treatments do not heal the underlying causes of your shin splints.
  • Rest and avoidance: Rest is often recommended to reduce inflammation and swelling. You may want to decrease your training time or distance until your shins have a chance to heal. You may also want to avoid impact activities such as running until your shin has healed. Remember that, although rest may decrease your pain temporarily, it does not address the cause of your shin splints.
  • Use Custom Full Contact Orthotics for shin splints: Properly designed biomechanical orthotics (the kind that actually change the way your foot functions) are often the most effective treatment of shin splints.

    A full contact orthotic will address both the current painful condition and will prevent re-occurrence of the problem over the long term. An ICON Full Contact Orthotic will completely support your arch to relieve the stress and pulling of the muscle in your leg that you have damaged.

    This is most effective in correcting the structural origin of the problem: loss of arch height. A combination of foot orthotics (to address the cause of your shin splints) and therapies (to decrease the inflammation) is the most effective strategy.

By correcting the cause of your problem with ICON Full Contact Orthotics for shin splints, you can expect to have 50-80% relief in 3 weeks and 80-100% relief in 6-8 weeks.

For more information about ICON Full Contact Orthotics for shin splints, please contact Dr. Marc Klein by phone at 561-447-7571 or email him today.

Causes and Treatments For Heel Pain

From the Florida Podiatric Medical Association

Heel Pain Has Many Causes

In our pursuit of healthy bodies, pain can be an enemy.

In some instances, however, it is of biological benefit.

heel pain

Pain that occurs right after an injury or early in an illness may play a protective role, often warning us about the damage we’ve suffered.

When we sprain an ankle, for example, the pain warns us that the ligament and soft tissues may
be frayed and bruised, and that further activity may cause additional injury.

Pain, such as may occur in our heels, also alerts us to seek medical attention. This alert is of utmost importance because of the many afflictions that contribute to heel pain.

Heel Pain

Heel pain is generally the result of faulty biomechanics (walking gait abnormalities) that place too much stress on the heel bone and the soft tissues that attach to it. The stress may also result from injury, or a bruise incurred while walking, running, or jumping on hard surfaces; wearing poorly constructed footwear; or being overweight.

The heel bone is the largest of the 26 bones in the human foot, which also has 33 joints and a
network of more than 100 tendons, muscles, and ligaments. Like all bones, it is subject to outside influences that can affect its integrity and its ability to keep us on our feet. Heel pain, sometimes disabling, can occur in the front, back, or bottom of the heel.

Heel Spurs

A common cause of heel pain is the heel spur, a bony growth on the underside of the heel bone.

The spur, visible by X-ray, appears as a protrusion that can extend forward as much as half an
inch. When there is no indication of bone enlargement, the condition is sometimes referred to as “heel spur syndrome”.

Heel spurs result from strain on the muscles and ligaments of the foot, by stretching of the long
band of tissue that connects the heel and the ball of the foot, and by repeated tearing away of
the lining or membrane that covers the heel bone.

These conditions may result from biomechanical imbalance, running or jogging, improperly fitted or excessively worn shoes, or obesity.

Plantar Fasciitis

Both heel pain and heel spurs are frequently associated with an inflammation of the band of fibrous connective tissue (fascia) running along the bottom (plantar surface) of the foot, from the heel to the ball of the foot. The inflammation is called plantar fasciitis. It is common among athletes who run and jump a lot, and it can be quite painful.

The condition occurs when the plantar fascia is strained over time beyond its normal extension,
causing the soft tissue fibers of the fascia to tear or stretch at points along its length; this leads
to inflammation, pain, and possibly the growth of a bone spur where it attaches to the heel bone.

The inflammation may be aggravated by shoes that lack appropriate support, especially in the
arch area, and by the chronic irritation that sometimes accompanies an athletic lifestyle.

Resting provides only temporary relief. When you resume walking, particularly after a night’s sleep, you may experience a sudden elongation of the fascia band, which stretches and pulls on the heel.

As you walk, the heel pain may lessen or even disappear, but that may be just a false sense of relief.  The pain often returns after prolonged rest or extensive walking.

Excessive Pronation

Heel pain sometimes results from excessive pronation. Pronation is the normal flexible motion and flattening of the arch of the foot that allows it to adapt to ground surfaces and absorb shock in the normal walking pattern.

As you walk, the heel contacts the ground first; the weight shifts first to the outside of the foot, then moves toward the big toe. The arch rises, the foot generally rolls upward and outward, be-coming rigid and stable in order to lift the body and move it forward.

Excessive pronation—excessive inward motion—can create an abnormal amount of stretching and pulling on the ligaments and tendons attaching to the bottom back of the heel bone.

Excessive pronation may also contribute to injury to the hip, knee, and lower back.

Disease and Heel Pain

Some general health conditions can also bring about heel pain.

Rheumatoid arthritis and other forms of arthritis, including gout, which usually manifests itself
in the big toe joint, can cause heel discomfort in some cases.

Heel pain may also be the result of an inflamed bursa (bursitis), a small, irritated sack of fluid;
a neuroma (a nerve growth); or other soft-tissue growth. Such heel pain may be associated with
a heel spur or may mimic the pain of a heel spur.

Haglund’s deformity (“pump bump”) is a bone enlargement at the back of the heel bone, in the
area where the achilles tendon attaches to the bone. This sometimes painful deformity generally is the result of bursitis caused by pressure against the shoe and can be aggravated by the height or stitching of a heel counter of a particular shoe.

Pain at the back of the heel is associated with inflammation of the achilles tendon as it runs behind the ankle and inserts on the back surface of the heel bone.

The inflammation is called achilles tendinitis.

It is common among people who run and walk a lot and have tight tendons.

The condition occurs when the tendon is strained over time, causing the fibers to tear or stretch along its length, or at its insertion on to the heel bone. This leads to inflammation, pain, and the possible growth of a bone spur on the back of the heel bone. The inflammation is aggravated by the chronic irritation that sometimes accompanies an active lifestyle and certain activities that strain an already tight tendon.

Bone bruises are common heel injuries. A bone bruise or contusion is an inflammation of the
tissues that cover the heel bone. A bone bruise is a sharply painful injury caused by the direct
impact of a hard object or surface on the foot.

Stress fractures of the heel bone also can occur, although infrequently.

Children’s Heel Pain

Heel pain can also occur in children, most commonly between ages 8 and 13, as they become
increasingly active in sports activity in and out of school.

This physical activity, particularly jumping, inflames the growth centers of the heels; the more active the child, the more likely the condition will occur. When the bones mature, the problems disappear and are not likely to recur.

If heel pain occurs in this age group, podiatric care is necessary to protect the growing bone and to provide pain relief. Other good news is that heel spurs do not often develop in children.


A variety of steps can be taken to avoid heel pain and accompanying afflictions:

  • Wear shoes that fit well—front, back, and sides—and have shock-absorbent soles,
    rigid shanks, and supportive heel counters.
  • Wear the proper shoes for each activity.
  • Do not wear shoes with excessive wear on heels or soles.
  • Prepare properly before exercising. Warm up and do stretching exercises before and
    after running.
  • Pace yourself when you participate in athletic activities.
  • Don’t underestimate your body’s need for rest and good nutrition.
  • If obese, lose weight.

Podiatric Medical Care

If pain and other symptoms of inflammation—redness, swelling, heat—persist, you should
limit normal daily activities and contact a doctor of podiatric medicine.

The podiatric physician will examine the area and may perform diagnostic X-rays to rule out
problems of the bone.

Early treatment might involve oral or injectable anti-inflammatory medication, exercise
and shoe recommendations, taping or strapping, or use of shoe inserts or orthotic devices.
Taping or strapping supports the foot, placing stressed muscles and tendons in a physiologically
restful state. Physical therapy may be used in conjunction with such treatments.

A functional orthotic device may be prescribed for correcting biomechanical imbalance, controlling excessive pronation, and supporting of the ligaments and tendons attaching to the
heel bone. It will effectively treat the majority of heel and arch pain without the need for

Only a relatively few cases of heel pain require more advanced treatments or surgery. If
surgery is necessary, it may involve the release of the plantar fascia, removal of a spur,
removal of a bursa, or removal of a neuroma or other soft-tissue growth.

Heel Pain Tips

  • If you have experienced painful heels, try wearing your shoes around your house in the
    evening. Don’t wear slippers or socks or go barefoot. You may also try gentle calf stretches
    for 20 to 30 seconds on each leg. This is best done barefoot, leaning forward towards a wall
    with one foot forward and one foot back.
  • If the pain persists longer than one month, you should visit a podiatrist for evaluation and
    treatment. Your feet should not hurt, and professional podiatric care may be required to help relieve your discomfort.
  • If you have not exercised in a long time, consult your podiatric physician before starting a new exercise program.
  • Begin an exercise program slowly. Don’t go too far or too fast.
  • Purchase and maintain good shoes and replace them regularly.
  • Stretch each foot and achilles tendon before and after exercise.
  • Avoid uneven walking surfaces or stepping on rocks as much as possible.
  • Avoid going barefoot on hard surfaces.
  • Vary the incline on a treadmill during exercise. Nobody walks uphill all the time.
  • If it hurts, stop. Don’t try to “work through the pain”.

Your podiatric physician/surgeon has been trained specifically and extensively in the diagnosis and treatment of all manner of foot conditions. This training encompasses all of the intricately related systems and structures of the foot and lower leg, including neurological, circulatory, skin, and the musculoskeletal system, which includes bones, joints, ligaments, tendons, muscles, and nerves.

10 Tips For Good Diabetic Foot Care

tips for diabetic foot care

Part of podiatry care is helping patients with diabetes to care for their feet.

Because diabetes causes damage to nerve and blood vessels, neuropathy is a very common symptom of a diabetic diagnosis.  Approximately 70% of people with diabetes develop neuropathy in their feet and hands.

As responsible physicians, we care about our patients and want to help them to help themselves in preventing as many problems as possible.

We provide them with educational information and material to help them. One of our sources of information is from the National Diabetes Education Program which has a wealth of information for those suffering from diabetes.

Below are their recommendations for the caring for your feet if you are a diabetic.

10 Tips For Good Diabetic Foot Care

  1. Check your feet every day (evening is best) for cuts, blisters, red spots, swelling, and
    sore toenails. If you have trouble bending over to see your feet, use a plastic mirror or ask
    a family member or caregiver to help.
  2. Wash your feet every day in warm water, and be sure to dry well between the toes.
  3. Rub a thin coat of skin lotion on the tops and bottoms of your feet, but not between
    your toes.
  4. Trim your toenails carefully and straight across when needed. See your podiatrist if
    you need help.
  5. Never walk barefoot, and wear comfortable shoes that fit well and protect your feet.
  6. Nerve damage can cause loss of feeling. Look and feel inside your shoes before putting
    them on. Ask your team about getting special shoes.
  7. Keep the blood flowing to your feet by wiggling your toes and moving your ankles up
    and down for 5 minutes, two or three times a day.
  8. Plan a physical activity program with your health care team.
  9. Take your shoes and socks off at every check up and have your doctor look at your
    feet. Tell your health care team right away about any foot problems.
  10. Let your doctor know right away if you have loss of feeling in your feet, changes in
    the shape of your foot or foot ulcers or sores that do not heal.

Get your free copy of Take Care of Your Feet for a Lifetimeclick here.

If you have any questions about diabetic foot care or if you are in need of a skilled podiatrist in the Boca Raton, Fl area, contact Dr Marc Klein by phone at 561-447-7571 or email him today.

Breaking The Foot Pain Cycle With Custom Foot Orthotics

Originally posted March 2011 – Updated November 30, 2017

Sore Feet

The food server, retail worker, and nurse all have one thing in common: they spend most of their day standing.

They, along with thousands of others, suffer from foot pain that they assume is a normal condition of their occupation.

One patient of mine admitted that “for too long I accepted my sore, achy feet, and the overall body fatigue they caused, as the natural consequence of getting older… it seemed natural to me to have foot pain after more than a half century of running, playing sports and otherwise racking up foot mileage.”

Understanding Foot Pain

Most people don’t realize that foot pain isn’t a result of stress from standing or walking, but rather from inappropriate, standardized footwear.

If you need eyeglasses, you wouldn’t wear a pair without customizing them to your prescription because your eyes would hurt and you’d experience headaches.

It’s the same with orthotics.

The Most Common Cause of Foot Pain

The most common cause of general foot pain occurs because the muscles in the bottom of the foot are stretching abnormally due to an improper arch in your shoes. If your arch is not properly supported as you walk, your foot muscles become stretched and fatigued because they are not being held up by your skeletal structure.

How Custom Foot Orthotics Can Help

Using Icon Full Contact Technology, I mold high performance custom foot orthotics, making a precise match for your arch. This changes how your foot functions during everyday activities, allowing it to re-form into a normal shape that permits pain-free function.

This is a breakthrough from the old-fashioned techniques most podiatrists use which don’t allow for full contact of the arch, thereby making the foot collapse as you walk. Those types of orthotics only alleviate a portion of the pain, rather than fixing the problem completely.

One patient of mine testifies that “the Icon orthotics Dr. Klein made for me didn’t just mitigate my problems, they virtually solved them.” Another states that “in less than one week after getting your custom Icon orthotics all pain and discomfort left me” and he felt ten years younger. It’s also important to understand that your feet affect other parts of your body.

Most patients who experience relief from foot pain also find pain disappearing in their knees, hips, spine, and more, which makes our high-performance custom foot orthotics life-enhancers rather than just pain relievers.

For more information about how custom foot orthotics can help break your foot pain cycle, please contact Dr. Klein online or call his office at 561-447-7571 today.

Full Contact ICON Orthotics Treat More Than Foot Pain

Originally posted February 2011 – Updated November 2017

andy roddickWhen U. S. Open Tennis champion Andy Roddick was 15 years old, he came to my office requesting a replacement pair of old-fashioned technology orthotics. He had been using them for about a year for generalized foot pain and he had outgrown them.

I made him the pair that he requested and also recommended to him and his dad that he needed a lot more support than he was getting.

They decided to try the High Performance Full Contact Technology ICON Orthotics.

Andy told his dad that within one week of using his new ICON orthotics, his back pain, which he had been dealing with for almost 18 months, had disappeared.

High-performance podiatric orthotics had corrected the functioning of his entire leg, thus relieving his back pain, whereas Andy’s older technology orthotics had not. The improvement was so dramatic that his father and his coach ordered a couple of pairs for themselves.

What Are Orthotics?

Orthotics are shoe inserts/arch supports, which can be purchased over-the- counter or can be custom-made.

Custom made orthotics can be made using old technology or the new High-Performance Full Contact Technology, which gives the most amount of support and correction.

Who would benefit the most from High-Performance Podiatric Orthotics? 

We are now able to relieve not only foot pain and heel pain, but also ankle, knee, hip and lower back pain. People who stand on their feet all day can also benefit from ICON orthotics. Pregnant women experience back pain due to the changes in their feet: they too can be helped.

What is the difference between High-Performance Full Contact Podiatric Orthotics and older orthotics? 

Full Contact technology is the main difference.

If you hold an old-fashioned technology orthotic up to your foot, you would see that it doesn’t quite match YOUR ARCH.

Full Contact ICON orthotics match your arch, exactly. The difference is that when you are using the Full Contact technology it immediately controls your foot, whereas the old-fashioned technology requires your foot to collapse first and then it begins to help.

Read more about ICON Orthotics.

Patients should also be aware that the shoes and sneakers they are presently wearing can give a tremendous amount of information to a podiatrist. I always ask that my patients bring in their sneakers so I can see poor wear patterns, which again are usually due to abnormal functioning of the foot.

One of the most important things for patients to be aware of is the proper fit of most of their shoes. Shoes with laces should be fit larger than a regular dress shoe and should have approximately a thumbnail’s width in front of the longest toe.

For more information about ICON Orthotics and how they can help you, please contact Dr. Klein or call his office at 561-447-7571 today.

Heel Pain and Plantar Fasciitis Treatment

Originally posted February 2011 – Updated Nov 2017

Charlie Alexander, a triathlete, came to my South Florida podiatry office for plantar fasciitis treatment after not being able to participate in his favorite pastime for over a year and a half due to constant foot and heel pain.

The final straw was when he could not even get out of bed because of the pain in his heels.

Diagnosed with a severe case of plantar fasciitis, Charlie had unsuccessfully tried all classic symptomatic treatments such as stretching, cortisone injections, anti-inflammatory medications and conventional podiatric orthotics.

However, Charlie had never tried High Performance Full Contact Icon orthotics.

He was very skeptical since he had tried orthotics several times before.

I prescribed a pair of Full Contact Icon orthotics for Charlie and within six months, he was again competing in the Ironman triathalon, pain free.

What Is Plantar Fasciitis?

Plantar fasciitis is one of the most common causes of heel pain. It often occurs without any history of trauma.

Patients experience a lot of pain especially when they get out of bed first thing in the morning or after sitting for long periods of time and then standing up.

It is especially common in runners, people who are overweight, pregnant women, and those who wear shoes without adequate support.

The plantar fascia is the thick band on the bottom of the foot that attaches to the heel and extends to the toes. plantar fasciitis

Without this band, the foot would totally collapse each time you stepped on it.

Plantar fasciitis is thought to be an irritation to the plantar fascia or the plantar fascia pulling away from the bone on the inside of the heel. Over time a heel spur appears on x-ray.

There are many common treatments for this problem, which include…

  • stretching
  • night splints
  • motion control shoes
  • physical therapy
  • anti-inflammatory medicines

Patients come into our office for plantar fasciitis treatment after being treated for months with some or all of these treatment methods listed above.

The reason that these modalities do not help is the fact that they are addressing the patient’s symptoms and not the underlying problem.

The underlying problem is the pulling away of the plantar fascia from the heel bone. During the day, the band partially detaches from the medial side, or inside, of the heel. At night, the foot relaxes and the band starts to heal back to the bone.

With only 6 to 8 hours of healing time, when the patient steps down in the morning, the band pulls away from the heel, causing the pain that occurs when first arising.


In summary, plantar fasciitis is due to biomechanical abnormalities, or a breakdown in the structure of the foot.

Poorly functioning feet can also lead to knee, hip, and lower back pain.

Biomechanical issues must be addressed for the long-term resolution of this problem.

The use of High Performance Full Contact orthotics, specifically the ICON ORTHOTIC, allows the plantar fascia to stay in contact with the heel bone while weight bearing. This is the single most important long-term treatment.

If you can keep the plantar fascia close to the bone while standing, it is kept close to the bone when off weight-bearing, and that leaves only the first 30 to 60 minutes every morning when a patient showers and then gets dressed, when the band is pulling away from the heel. This allows the body a significant time advantage to heel the problem by itself.

If you allow the body to heal the problem by itself, it will.

When treating this problem, I explain to my patients that if we can address the underlying causes, we rarely have to treat the symptoms.

I treat less than 5% of my patients with cortisone injections or any of the standard symptomatic treatments.

For more information about plantar fasciitis treatment in South Florida with High Performance Full Contact Icon orthotics, please contact Dr. Klein or call his office at 561-447-7571 today.

Custom Orthotic Solutions Put the Spring Back in Her Step

Originally published September 2013 – Updated November 2017

icon custom orthotics for pain free walking

Kim Rossetti, a multiple marathon runner from Boca Raton, recently came to me after consulting with several doctors and orthopedic surgeons regarding her persistent impacts the bones, tendons and ligaments of her feet with every stride she takes.

Whether you are an athlete or a couch potato, a lifetime of walking or running can result in pain because these stresses flatten the arch of our feet as we age.

And when the arch flattens, it throws off the positioning of the foot, changing the alignment of the knees, hips and lower back, and often leading to persistent pain that can manifest anywhere along this kinetic chain.

The Top 4 Benefits Of Custom Foot Orthotics

  1. Full Support For Your Feet
  2. Reduced Pain
  3. Corrected Pronation
  4. Corrected Supination

These 4 benefits end up allowing you to perform your tasks in the most comfortable method possible, no matter how easy or strenuous the task at hand is.

Crossing the Finish Line with Custom Orthotic Solutions

When Kim talks about the life-altering results she’s gotten from using the Icon Full Contact Orthotics I had custom-made for her, she says, “It’s amazing – I can’t believe it!” Kim’s orthotics are comprised of a comfortable hard plastic plate that is molded to make full contact with her foot and support her arch.

Unlike traditional orthotics, these new orthotic solutions are 61% more supportive, constantly holding her feet in the correct position. They don’t allow her arch to collapse, no matter how much running pressure she puts on them, yet they flex as she moves, allowing for proper functioning of her foot structures and accurate alignment of her lower extremities.

With Icon Full Contact Orthotics, Kim now competes totally pain-free and looks forward to running “until I’m 80!” And, my less competitive patients who wear the Full Contact Orthotics are enjoying non-painful, normal feet and the correction of many other problems all the way up their skeletal chain.

For more information about how custom foot orthotic solutions can help break your foot pain cycle, please email Dr. Klein or call his office at 561-447-7571 today.

Laser Therapy Zaps Toenail Fungus

This was originally posted December 2013 and updated November 2017toenail fungus

Onychomycosis is a fancy name for an embarrassing condition: toenail fungus – an unsightly and sometimes painful infection that causes yellowing, discoloring, and thickening of the nail.

Left untreated, it spreads under the nail causing it to become brittle and inflamed, and sometimes resulting in the nail loosening and pulling away from the nail bed.

Although anyone at any age can develop fungal nail infections, it’s generally more common in older adults.

The reason being that as the body (and nails) age, they become brittle and dry. As a result, these small cracks that develop allow fungi to enter the body. Also, older adults tend to develop poor blood circulation to their feet and this can also help to develop toenail fungus.


You can identify whether you may have toenail fungus if your toenails exhibit any or all of the symptoms below are present.

  • Thickened nails
  • Whitish to yellow-brown discoloration
  • Brittle, crumbly or ragged
  • Distorted in shape
  • A dark color, caused by debris building up under your nail
  • Smellling slightly foul

Toenail fungus is surprisingly common – about 35 million of us are walking around with one or more affected nails.

The condition is often caused by…

  • dermatophyte fungi
  • pathogens such as nondermatophyte molds and yeasts (including Candida albicans)
  • humidity
  • or trauma
  • diabetes
  • athlete’s foot

And it’s far from benign: aside from making walking or wearing shoes painful, onychomycosis can cause complications in people with diabetes or compromised immune systems.

Treatment For Toenail Fungus

Until now, toenail fungus has been very difficult to treat: oral prescriptions are only effective about 60 percent of the time and take months to work, while over-the-counter remedies can’t really penetrate as far as the nail bed and are ineffective, at best.

However, there is a new, cutting-edge treatment that has shown an 85 percent effective rate in eliminating toenail fungus in my office: laser therapy.

Our powerful yet gentle, state of the art laser gives us a very safe, pain-free way to kill the organisms at the source – without any downtime for you, and without the potential harmful side effects that oral medications can cause.

The treatment is simple: we pass the laser beam over the infected nail and the adjacent skin several times during the procedure, heating and killing the fungus under the nail.

Treatment takes about 30 minutes, depending on the number of toes involved, and you can go back to your normal activities as soon as you leave our office. You’ll feel a warm sensation in your toe while the laser energy is working and, possibly, a warm “pinch” at the end of the process – that’s it!

There are no health or age restrictions and studies have shown no side effects or negative reactions to laser therapy of infected toenails.

Often, one treatment is enough; however, you may need more than one procedure depending on the severity the fungal involvement. Best of all, you should begin to see new and healthy nail growth within the first four months following your laser therapy.

Note:  Currently, we are not aware of health insurance policies that include this laser treatment for toenail fungus

If you have any questions concerning toenail fungus or our laser treatment, call us today at 561-447-7571 or email us.