Walk This Way

Comprehensive evaluation reveals root cause of chronic heel pain.

During his 26 years in the Air Force — the last two serving as a chief advisor to a general — Edward Slavin followed a regimented daily routine that included plenty of exercise. Years ago, he carried that routine with him into civilian life.

After two or three treatments, Edward’s heel pain began to disappear

Now 85, Edward still makes a point of exercising regularly. Some of that exercise comes from working in his yard, where Edward still cuts the lawn and trims the hedges. Most of the rest comes from jogging.

“I say jogging but what I do is more like speed-walking,” Edward confesses. “Either way, I jog or speed walk about a mile every other day. I’m usually out there for a little more than half an hour. It helps keep me in good shape.”

Last October, a stabbing pain that ran from his right heel to his right big toe slowly derailed Edward’s jogging routine. After trudging through the intensifying pain for two weeks, Edward finally gave in to it.

“I couldn’t even walk anymore,” he laments. “And I’m not talking about just speed-walking. It hurt to walk anywhere. It was sheer pain just to get up and walk into the kitchen or go to the bathroom. I tried everything I could think of to get rid of it. I tried ice and heat, and when that didn’t work I bought an arch support and put that in my shoe.

After a couple of weeks with no improvement, Edward went to a podiatrist, who determined the pain was due to plantar fasciitis, an inflammation of the band of tissue that connects the heel to the toes, and a heel spur, a calcium deposit that causes a bony protrusion on the heel.

For the plantar fasciitis, Edward received a steroid injection that provided little to no relief. For the bone spur, the podiatrist recommended surgery but suggested that Edward first visit Regional Rehab in Spring Hill.

Assessing the Whole Patient

At Regional Rehab, Charles C. Donley, PT, and Paul Ernandes, PT, PhD, perform a very comprehensive evaluation of every patient, taking into consideration the individual’s entire well-being, not focusing purely on one specific complaint.

“Once we’ve each evaluated a patient, Paul and I will then collaborate and discuss the findings of our individual comprehensive assessments,” Charles clarifies. “We believe the comprehensive evaluations and collaborations are the keys to our success.”

It was for Edward. As Paul explains, the assessments revealed that the root cause of Edward’s heel pain was elsewhere in his body.

“Edward had the heel pain and plantar fasciitis, but it was the way he presented himself that told me his posture was the origin of his problem,” Paul reports. “With the way he stood and walked, he was putting a lot of extra unnecessary pressure on his feet.”

Edward stood with what is known as an anterior pelvic tilt, where the shoulders slouch downward while the belly protrudes forward. This kind of a stance can cause a muscle imbalance throughout the body that puts undue stress on the feet.

In Edward’s case, the stress resulted in the development of the bone spur and plantar fasciitis, which were treated with three advanced modalities: the Class IV deep tissue therapeutic laser, the HIVAMAT® 200 deep oscillation therapy device and iontophoresis.

The laser uses specific wavelengths of red and near-infrared light to stimulate the body’s natural ability to heal cells. It works by releasing nitric oxide, which removes congestion and swelling, promotes rapid healing and reduces discomfort while increasing blood circulation.

The HIVAMAT 200 creates gentle impulses that relax muscles and penetrate all tissue layers to remove the inflammatory byproducts that cause pain in cells.

With iontophoresis, a medication is delivered through the skin, typically with a patch that allows the drug to be absorbed slowly. In Edward’s case, his foot was placed on a small mat that allowed acetic acids to dissolve the bone spur and correct the plantar fasciitis.

“Helpful and Friendly”

At the same time, the team at Regional Rehab worked to correct Edward’s posture by stretching his tightened muscles, strengthening his weakened muscles and monitoring an exercise program designed to develop stability.

“His tight muscles were in the calf, thigh, low back, hips, pectorals and chest,” says Louis Arevalo, PTA, who monitored Edward’s treatment. “The weak muscles were the ones between the shoulder blades.”

“For the posture, we basically did gait training. In doing that, our goal is to correct the body’s mechanics, so Edward walks with the proper posture. That way, there is no common deviation that leads to pain in the future.”

“Now I have no pain in my heel whatsoever. The treatments worked great!” – Edward

Edward visited Regional Rehab for treatment 10 times. During each visit, his heel and posture were treated. After just two or three visits, Edward’s heel pain began to dissipate. After seven treatments, he felt well enough to resume jogging.

“Now, I have no pain in my heel whatsoever,” Edward exudes. “The treatments worked great! I’m telling you, visiting Regional Rehab was the best move I could have made. I’m really glad my podiatrist suggested it because the people there are great.

“From Charles, Paul and Louis on down, they’re all truly professional, helpful and friendly. They’ve got outstanding expertise, but the thing that really makes them stand out is how much they care about their patients. These people really care, and they’re exceptional.”

© FHCN article by Roy Cummings. Photo by Jordan Pysz. mkb
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    • Regional Rehab

      Regional Rehab's ultimate goal is to enrich people’s lives by helping to enhance their physical and mental well being, creating an atmosphere of quality care and optimum healing with a loving touch.... Read More

    • Charles C. Donley, PT

      Charles C. Donley, PT, is the owner of Regional Rehab. He earned his Bachelor of Science degree in physical therapy, graduating cum laude, from the University of Pittsburgh. He served on the board of the Hernando County United Way, is a d... Read More

    • Paul Ernandes, PT, PhD

      Paul A. Ernandes, PT, PhD, joined Regional Rehab in April 2018. He previously was director of physical therapy at Vitality Physicians and Rehab and spent 10 years as director of rehabilitation at Oak Hill Hospital in Brooksville. He has also ... Read More