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.

Sore Legs and Back While Pregnant? Blame Your Feet!

sore back and legs while pregnant

Sore legs and back while you’re pregnant is stressful and may be unnecessary.

Among the many discomforts women have during pregnancy, aching feet and back pains tend to top the list.

As the fetus grows and gains weight, the expectant mother often finds that her legs ache and her feet have enlarged and are frequently swollen by the end of the day.

In addition, her back becomes sore as her center of gravity changes and she shifts to support the growing baby.

Foot Changes in Pregnancy

During pregnancy, it is often difficult for expectant women to wear the same types and width of shoes they formerly did. It can be challenging for them to be comfortable exercising, being active, or even simply walking around due to leg and back pain.

Many of these foot, leg, and back problems happen in conjunction with an increase in the hormone Relaxin early in the pregnancy. The body amplifies relaxin production to make the pelvic ligaments more flexible in preparation for the birth of the baby.

In addition to loosening the pelvic ligaments, Relaxin also affects other ligaments throughout the body, including those in the feet.

Accordingly, the plantar calcaneonavicular or spring ligament in the arch of the foot becomes more amenable to stretching, as do other foot ligaments. This ligament stretch, combined with the expectant mother’s weight increase due to the baby she is carrying, allows the foot to collapse and roll inward (pronate) under pressure from walking or running.

Consequently, lower back pain during pregnancy often comes from the rapid collapsing and over-pronation of the women’s foot arch as she strides or jogs and not just from “pregnancy posture”.

Full Contact Orthotics End Foot and Lower Back Pain

Biomechanically correct foot orthotics, such as the ICON Full Contact Orthotics I use in my practice, give stability to the ligaments of the foot and offer overall foot support.

Fabricated from a direct impression of your foot, full contact orthotics provide better shock absorption of the pressures exerted when walking, cessation of over-pronation, and a marked decrease in back, foot, and leg pain.

Pregnancy provides a great opportunity to address underlying foot problems while your foot is malleable and able to adapt to a new position. Using the time while you are pregnant to support your foot in a new corrected position will allow proper functioning and decreased pain for years to come.

Dr. Marc Klein is an Illinois-trained podiatric surgeon. His practice is dedicated to biomechanics and sports medicine. He believes in addressing his patient’s underlying problems as well as their symptoms. He lectures nationally about the Icon orthotics technology and trains other podiatrists in the newer casting techniques. He has been interviewed by ABC, NBC, CBS and Comcast newsmakers, all of which can be viewed on his website at www.dmarcklein.com.

Dr. Klein’s office is located in The Garden Shops of Boca Raton, at 7050 W. Palmetto Park Rd. Suite 18, Boca Raton, Florida.  Map and Directions
Office phone number is 561-447-7571.

Are Heel Pain and Back Pain Related?

Heel pain and back pain can be related secondary to the abnormal functioning of the foot.

A heel pain can cause back painpronated or collapsed foot can cause heel pain as well as back pain.

If you tend to walk with more weight on the inside of your foot, then you may have a pronated foot. This abnormality can contribute to back pain.

In other words, if the way you walk is abnormal or at least not optimal, then that will cause you to have an altered gait (an altered way of walking). This can easily force your muscles, including your back muscles, to be altered which in turn could cause you back pain.

Whether your foot pain is in your heel or arch or toes or any other part of your foot, if the pain causes you to walk abnormally in any way, this could cause you back pain.

Truth be told, just about any problem you have with your feet can cause or contribute to pain throughout your body including your legs, your back, your shoulders and even your neck. After all, the entire body is connected with tissues and muscles and when one is affected, this can easily spread to others.

Sciatica Heel Pain

Your heel pain can be a result of problems with your Sciatica which results from pressure on the L5-S1 nerve root. Most people think of leg pain when they think of Sciatica issues but in addition to any pain in the leg you can also feel pain in your heel and in your back.

Pinched Nerve Foot Pain

Another common foot or heel pain that can cause back pain is a “pinched nerve” which is essentially a thickened nerve tissue, oftentimes called a neuroma. A common one is Morton’s Neuroma.

These are often a result of an injury to the foot, repetitive stress, a deformity in the foot or, most commonly for women, ill fitting shoes or high heels.

A pinched nerve, or neuroma in your foot will cause you to walk differently and as a result, it will pull your back muscles which in turn will cause you back pain.

How To Prevent Back Pain Due To Foot Problems?

Treatment of course depends on the specific foot problem but I can say that for most people suffering from this problem, the answer is usually foot orthotics. These days there are many off the shelf orthotic products but if you’re serious about the best treatment for your pain, I recommend custom Icon “full contact” orthotics.

We would create a mold of your foot, send it off to the lab to get a custom orthotic made specifically for you.

If you have questions about heel pain, ask podiatrist Dr Marc Klein.

Podiatrist For Sports Injuries in Boca Raton

foot sports injuriesIf you are looking for a podiatrist who specializes in treating sports injuries, you should visit us at High Performance Podiatry.

Our top-notch Boca Raton podiatrist, Dr. Marc B. Klein, provides innovative therapies for effective treatment of sports injuries.

If you have suffered some type of sports injury, and need the treatment of a Boca Raton podiatrist who specializes in the field, you will benefit from seeing our podiatrist who uses the most modern treatment at our podiatry practice to treat sports injury problems.

At our office we use the most advanced equipment and procedures for both the diagnosis and treatment of sports injuries.

Our digital x-ray imaging allows our podiatrist to often be able to provide an immediate and complete diagnosis. This equipment allows our patients to experience less radiation exposure.

If you need stem cell therapy for fast recovery, we are able to provide you with this treatment which stimulates the growth of normal tissue formation. This type of treatment also has the benefit of resulting in less scar tissue.

We also offer platelet rich plasma treatment to aid in the recovery from tendon and ligament injuries. This treatment accelerates healing and can even help patients avoid needing to have more aggressive surgery. Our podiatrists can treat all aspects of athletic foot, ankle, and lower leg conditions. Whether y

ou need advanced reconstructive foot care, or other treatment, you will be treated by a doctor who is highly trained in podiatry-related biomechanics and sports medicine.

Among the conditions that we commonly treat are: shin splints; tendon tears; Achilles tendon ruptures; dramatic bursitis; plantar fasciitis; stress fractures; strains and sprains; trauma; foot and ankle reconstruction; gait and arch analysis; and Achilles tendinitis.

Our doctors will always try all conservative treatment methods before recommending surgery.

For an appointment to meet with our Boca Raton podiatrist regarding treatment of your sports injury problem, contact us today at 561-447-7571 or request an appointment online.

Treating Foot Neuromas in Boca Raton Florida

treating neuromas south floridaIf you have a foot neuroma, you will want to visit us at High Performance Podiatry.

Our top-notch foot doctor in Boca Raton Florida, Dr. Marc B. Klein, will be able to provide you with excellent treatment for your foot neuroma.

When a person has a neuroma, they have a painful foot condition also referred to as a pinched nerve, or a nerve tumor.

A foot neuroma is a benign growth of nerve tissue.

It can frequently occur between the third and fourth toes.

When a patient has a neuroma, they may experience pain, a burning sensation, tingling or numbness between the toes and the ball of the foot.

The most troublesome symptom of the foot neuroma is generally pain felt between the toes while you are walking.

Oftentimes, patients with neuromas find that if they rub the affected area when it is bothering them, it will feel better for a while.

Sometimes a patient may even feel as though they have a stone in their shoe.

What Causes Foot Neuromas?

It is unclear as to exactly what causes neuromas.

Some factors which can contribute to the development of neuromas include: biomechanical deformities such as a highly arched foot; foot trauma; wearing footwear that causes your toes to be squeezed together; or repeated stress in a specific area of the foot.

At the earliest sign of pain, we hope you will contact our foot doctor in Boca Raton Florida for treatment.

If a neuroma is left untreated it tends to become worse.

Our podiatrist will diagnose your foot problem and provide appropriate treatment for you which can include: orthotics; anti-inflammatory medicines; or padding and taping.

When the more conservative treatments fail, our podiatrist may recommend surgical treatment of the neuroma.

For an appointment to visit our foot doctor in Boca Raton Florida, for treatment of common foot problems as well as specialty podiatry issues such as foot neuromas, contact us today at 561-447-7571 during business hours or email us.

Treating Bunions in Boca Raton

foot bunionsBunions are a very common foot problem, and one that we are highly qualified to treat here at High Performance Podiatry.

Just as you would see a specialist if you had digestive difficulties or back pain, so too should you seek out our foot doctor as the experienced expert when it comes to treating foot Bunions.

The photo to the right shows you what a bunion would look like on your foot.

Of course, there are varying degrees of bunions, some are small, some are large.

Foot bunions can be very painful.  The reason is that when your foot develops a bunion, your body weight rests on it every time you take a step.

If your shoes are tight (which often happens) then it will probably rub against the bunion and cause calluses to form.

So you see, you should never ignore the issue of foot bunions.  We encourage you to see your podiatrist, or if you do not have one, come in to see Dr Marc Klein in Boca Raton.

His expertise and many years in practice will help you with your foot pain due to bunions.

What Are Bunions?

A bunion is a bony (often painful) hump at the base of the big toe on your foot.

The part of your toe where the joint is attached to the rest of your foot is where bunions form.

While heredity can make you more prone to getting these small bony protrusions, the more concerning risk factors include…

  • having flat feet
  • wearing poor-fitting shoes
  • and walking in a way that puts excessive pressure on the big toe joint

For those reasons, women tend to suffer from bunions more often than men do as a result of the effects of high heels, which are typically tight in the toe area and by their very design put more pressure on the toes.

Treating Bunions

Treating bunions can vary based on the severity of your symptoms.

Mild to moderate cases may be corrected simply by wearing more comfortable and roomy footwear, or adding bunion pads or arch supports to your shoes. Their purpose is to alleviate the pressure on the toe joint by redistributing your weight with respect to your feet.

If you have a bad case of bunions or the more moderate treatments do not provide the desired results, surgery may be an option to consider.

Besides dealing directly with what you’re experiencing right now, our foot doctor will also provide you with valuable tips to prevent recurrences in the future.

Walking or even standing can be painful when you have a bunion. And engaging in athletic activities might be close to impossible until you get relief.

Our office is prepared to help you in every way possible. Call us at 561-447-7571 and schedule an appointment to have your bunion evaluated and treated.

Or complete our online appointment request form today.

Treating Hammertoes In Boca Raton

treating hammertoes delray beachAre you seeking a Boca Raton foot doctor to help you resolve any painful podiatric issues that have gone untreated?

Whether you need sports medicine or treatment for your hammertoes, you can find the gentle podiatric care you need at High Performance Podiatry, where our staff of kind and seasoned professionals is dedicated to getting our patients back on their feet so they can participate in their favorite physical activities.

At High Performance Podiatry, our team of specialists takes pride in offering top tier podiatric care to our fellow members of the Boca Raton community and beyond.

We offer a wide range of treatments to alleviate an even wider range of symptoms and conditions.

These include custom foot orthotics, laser toenail fungus treatment, foot and ankle surgery, sports injury surgery, sports orthotics, and a variety of other treatments for foot/heel pain, ball of foot pain, bunions, fungal toenails, warts, ingrown toenails, leg/ankle pain, Morton’s neuroma, hammertoes, and acute/chronic wounds.

In other words, if you’re suffering from hammertoes and hoping to be paired with a highly skilled podiatrist that can set you on a personalized treatment path towards recovery, you’ve come to the right place!

Hammertoes are caused by a bending deformity of one or both joints of the second, third, fourth, or fifth toes (all toes excluding the big toes). This can put pressure on the toes while the patient wears shoes, eventually causing long-term issues.

Muscle and tendon imbalance is generally cited as cause for the development of hammertoes.

Symptoms include…

  • pain or irritation of the affected toe or toes while the patient wears shoes
  • the development of corns and calluses on the toe – between toes – or on the ball of the foot
  • an inflamed, burning sensation
  • visible contracture of the toe
  • and even the formation of open sores

Give us a call at High Performance Podiatry to ensure that your condition is treated by a Boca Raton foot doctor before your symptoms progress.

With our help, you can breathe a little easier knowing the future of your feet is in good hands!

Foot Care in Boca Raton FL

deerfield beach podiatristAt High Performance Podiatry, our Boca Raton, FL podiatrist offers a wide variety of podiatry foot care. Our doctor, Dr. Marc Klein, is experienced in treating common foot problems and sports related injury, as well as more severe and specialized foot issues. We perform techniques such as gait analysis, provide custom orthotics where needed and use advanced Icon technology. We help patients feel pain free again by correcting foot alignment, relieving heel pain and pain in the hip, spine, ankles, shins and knees. Voted best podiatrist in the area in 2015, our offices remain a well loved place for patients to find excellent foot care. We serve not only the Boca Raton area but also Delray Beach,  Deerfield Beach, Fort Lauderdale, West Palm Beach, Miami and Boynton Beach.

Some of the surgical treatment our team of professionals provide is correction for bunion, hammer toe and flat feet. We also perform surgery on ankle fractures and instability, ruptures of the Achilles tendon, fractures and surgery on neuromas. Neuromas can be extremely painful if not treated right away, and can cause deformities of the foot. Hammertoes and bunions can do the same. They cause the big toe to turn inwards, becoming painful and putting stress on the joints. The stress can make walking hard and wearing shoes painful. Our custom made foot orthotics can help ease the pain of bunions and hammertoes. Ask our podiatrist about custom icon orthotics and diabetic foot care as well.

Our comprehensive foot exams involve a look at the entire foot, checking for any foot ailments like heel spurs, fungal toenails, ingrown toenails or warts on the feet. Also, an arch analysis will be taken, which helps understand the motion of the foot. Each foot is different, and the arch analysis can help us understand how you walk and how you fit into shoes and how it affects your body.