Dr. Berg's Foot Facts
By Dr. Rion Berg
March 22, 2021
Category: Heel pain
Tags: Untagged

father and son feet on the beachMany people (about 10%) experience heel pain or plantar fasciitis at some point in their life. This common foot condition develops due to many contributing factors. You may have wondered whether this condition can be inherited.

The answer is, sort of.

It turns out that while the condition itself is not inherited, the foot type and other body mechanics that contribute to its development are genetic.

What Is Plantar Fasciitis?

Plantar fasciitis is the most common type of heel pain. It develops when enough force is placed on the plantar fascia which runs along the bottom of the foot. If you experience pain in the heel of your foot when you first get out of bed in the morning, you most likely have this condition.

Hereditary Factors in Developing Plantar Fasciitis

Foot Type

While a person with any foot type can develop plantar fasciitis, people with flat feet or very low arches are most at risk. That’s because people with flat feet tend to overpronate, causing the plantar fascia to overstretch. When this foot structure overstretches small tears occur at the bottom of the heel causing the inflammation and pain of plantar fasciitis.

People with high arches are also more prone to developing plantar fasciitis.

Equinus or Tight Calf Muscles

Equinus or tight calf muscles can also be inherited. It is also a common contributing factor to development of plantar fasciitis. People with tight calf muscles end up altering the way they move to compensate for limited ankle motion. Most often this leads to flattening the arch which puts stress on the plantar fascia. However, in addition to heredity a shortened or tight calf muscle can also develop from wearing high heels.

This means even a person with a neutral foot type can develop plantar fasciitis if they also have tight calf muscles.  

Other Risk Factors for Developing Plantar Fasciitis

Other risk factors for developing this painful condition include:

  • Runners and other athletes – people who are involves in high impact sports also place a lot of stress of the plantar fascia.
  • Women tend to develop it more often then men
  • Overweight or obesity – extra weight also places more strain on the plantar fascia.
  • Pregnancy – due to rapid weight gain
  • Poor footwear – wearing unsupportive shoes

Treatment of Hereditary Factors

Fortunately both flat feet and tight calf muscles can be treated.

Flat feet are often discovered in early childhood around age five or six. Before then flat feet are considered normal. Even young children can be treated with orthotics to correct the way they walk and prevent pain from developing.

While over-the-counter orthotics can sometimes help with mild plantar fasciitis, most commonly patients will need to be cast for custom orthotics. The latter type of orthotics will more fully correct faulty foot mechanics.

Tight calf muscles are treated by taking on a fairly aggressive stretching program. While many providers advocate wall stretches, our office provides an Achilles splint that can be used during the day for stretches lasting 30 mins. The latter type of stretching program is much more effective in alleviating tight calf muscles.

For more information about heel pain in runners download our eBook, "The Complete Guide to Stopping Heel Pain in Runners".

For chronic heel pain, download our eBook, "Stop Living With Stubborn Heel Pain".

To get relief from plantar fasciitis, call our office at 206-368-7000 or request an appointment today.


Running shoesWhat a year we’ve had! Most of us are happy that 2020 is behind us and we’re looking forward to making 2021 one of our best.

For many of us that means losing weight we’ve gained after being stuck at home behind a desk and a Zoom camera. Perhaps you’ve vowed to take up running or you’ve decided to take it up after some time off.

Either way, running is great sport as long as you can do it safely. Here are my top 5 tips for preventing foot and ankle injuries when you run.

Buy Running Shoes To Match Your Foot Type and Running Style

If you’re just starting out, don’t resort to wearing any old pair of tennis shoes. Go to a reputable running store like Super Jock N Jill or Brooks and buy a running shoe. Running shoes are designed to support your feet when pounding the pavement. Regular tennis shoes won’t cut it.

If you used to be a runner and have an old pair laying around, make sure they aren’t worn out. Turn the shoes over and check out the treads. If you see uneven wear patterns, buy yourself a new pair.

Also, running shoes should match your particular foot type and running style. For more information about buying running shoes read my previous blog, “How to Buy Running Shoes”.

Build Up Your Training Slowly
Even if your best friend is pushing you to run your first race in three weeks, it’s more important for you to train and be ready before taking on your first challenge. You’re much more apt to injure yourself if your body and feet aren’t prepared. Talk to your physician before beginning any new training program. Runner’s World suggests running three days per week to give your body time to recover in between runs. Read their article “How to Run When Your Just Getting Started” to get more details.

Warm Up Before You Begin

Your body needs to warm up before you stress it to avoid injury.  Although many people warm-up by doing short wall stretches, you’ll get more benefit from your stretch when your muscles are warm. I highly recommend starting out with some  Dynamic Warm-ups for Runners . These warm-ups help increase the temperature of your muscles and elongate them. You’ll be much more ready to put your legs and feet through their paces, enhance your performance, and prevent injury.

Moisturize Your Feet

You wouldn’t think this would be at the top of my list, but moisturizing your feet is essential. If your feet are so dry they crack, you’ll soon be in plenty of pain when you run. Dry feet can also make you more prone to blisters. There are many options out there. Try one of the following: Gold Bond Ultimate Softening Foot Cream with Shea ButterCurel Foot Therapy, or Aveda Foot Relief. For more severe cracking, I’d recommend Gormel Cream. It contains 20% Urea, a sure-fire way to soften up and repair your feet.

Buy Socks That Wick Away Moisture

The right socks will help prevent blisters. Avoid cotton socks that retain moisture and instead choose brands that contain Merlino wool, nylon, acrylic, polypropylene, or polyethylene fibers. It may seem ironic that with one stroke of the pen I say to add moisture to your feet and the other stroke says to avoid it. But the truth is that while your feet need moisture to stay supple and avoiding cracking, too much moisture will lead to chafing and blisters.

Try one of these highly rated brands: Nike, Asics, Injiji, Belega, Swiftwick, and Feetures.

Other Safety Ideas

Also, because we’re in the middle of a pandemic and its winter there are a few other things you should consider before leaving your house.

  • Wear a mask. Yes, I know you’re outside. But if you’re going to be coming within six feet of anyone, it’s important to mask up.
  • Make sure you’re visible. Our dark, rainy afternoons and evenings can be a deadly combination for runners. Wear gear that is bright and neon colored. Purchase bright yellow, turquoise, and even white clothing at Brooks or Road Runner Sports. You should also consider purchasing a reflective vest, belt, lights or snap bands. These items are available at REI and other sports stores.

Call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

For more information about heel pain in runners download our eBook, "The Complete Guide to Stopping Heel Pain in Runners".

For chronic heel pain, download our eBook, "Stop Living With Stubborn Heel Pain".

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Pinterest.


Foot laying on it's sideAs an athlete you know you're prone to injury. You're familiar with many of the more common foot pain problems such as plantar fasciitis and Achilles tendonitis. But recently you've experienced pain on the outside of your foot where your little toe is.

Now you're wondering what that could possibly be.

As your Seattle podiatrist I'm here to let you know that every part of your foot is vulnerable to injury particular when you stress it--including the outside of your foot. It's important to curtail any sports activities until your foot is properly evaluated by a podiatrist to prevent any further injuries.

Pain on the outside of the foot can be a sign and symptom of the following conditions:

Stress fracture

Stress fractures are tiny, hairline cracks in the bone associated with overuse. If ignored, these cracks can turn into breaks so important to get them treated.

Cuboid syndrome

Cuboid syndrome occurs when the cuboid bone goes out of alignment with the heel bone. Pain increases when weight is placed on the arch or side of the foot.

Peroneal tendonitis

The Peroneal tendons are located on the outside of the ankle. When these tendons become inflamed (peroneal tendonitis) they may cause pain around the backside of the ankle, over the outside of the heel where they run under the bump in your heel bone.  

Jones fracture

Jones fracture is a fracture of the 5th metatarsal bone on the outside of the foot. It can occur through forceful impact to the outside of the foot, through overuse, or following an ankle sprain.

Sinus tarsi syndrome

The sinus tarsi is a small bony canal located just in front of the protruding side ankle bone. Injury to the sinus tarsi is caused by overuse or an ankle sprain. Symptoms often include:

  • Pain can be experienced on the side and the front of the ankle.
  • Pain can develop over time or follow a period of increased physical activity
  • Symptoms often worsen  when standing, walking, or running around a curve
  • This syndrome is often associated with flat feet.

Bunionette or Tailor's Bunion

A Tailor's bunion is located on the outside of the little toe. Just like a regular bunion it's caused by having faulty foot structure, such as flat feet.

Treatment for Pain On the Outside of the Foot

Treatment for this type of pain depends on the diagnosis, however, there are many commonalities.

  • RICE - rest, ice, compression, and elevation are always recommended for acute injuries.
  • Stop physical activity - many side of foot pain conditions are brought on as a result of participation in sports.  Ceasing these activities gives the foot time to heal.
  • Reduce inflammation - inflammation is always a concern with an injury. Reducing that inflammation is essential to start the healing process. Anti-inflammatory medication, cortisone shots and MLS laser therapy can both help in your recovery.
  • Foot immobilization - in addition to stopping your physical activity your podiatrist may also put your foot in a walking boot to give your injury a better chance of healing properly.
  • Special padding - in some cases specialized padding will assist in off-loading weight from the affected area such as the pad used to treat the Cuboid Syndrome.
  • Stretching tight calf muscles - tight calf muscles often play a big role in causing foot and ankle injuries. When the calf muscle is too tight the foot and ankle can't move properly. The stress gets transferred to areas of the foot that aren't designed to handle it. We recommend going beyond wall stretches for calf muscles. Instead we recommend using an Achilles splint during the day.
  • Custom orthotics - many people have poor foot mechanics.  This can lead to injuries particularly when someone is active in sports. Custom orthotics are designed to prevent the foot from pronating or supinating and are recommended when either of these problems are seen.
  • Appropriate footwear - wearing footwear designed for the sport the person engages in can help prevent side of foot injuries. A shoe with a wider toe box is recommended to accommodate the foot with certain conditions such as a Tailor's bunion.

If you're experiencing pain on the side of your foot, give us call at 206-368-7000 to set up an appointment or request an appointment online.


athlete with ankle injuryPresident Elect Biden needs to be more careful. Over the Thanksgiving holiday he slipped and twisted his ankle while playing with Major, one of his German shepherds. Initially he thought the injury was just a sprain since an X-ray didn’t reveal a break.  However, a follow-up CT scan found hairline fractures in the lateral and intermediate cuneiform bones in his midfoot. Fortunately, Biden won’t need crutches, but he will need to wear a walking boot for several weeks to ensure his foot heals properly.

What can this incident tell us?

So many of us sprain our ankles and don’t think much of it. We put some ice on it or take a few ibuprofen and hope for the best. This is particularly true of my male patients. For many of them, running to the doctor at the first sign of an injury or symptom seems unmanly. Or they just assume their injury will heal on its own.

While this may be true some of the time, often this type of thinking is a mistake. Not treating a injury can lead to foot and ankle problems down the road that may only be resolved with surgery.

Here are some common foot and ankle injuries that will likely get worse if you don’t treat them in their early stages.

Stress Fractures

Hairline fractures or stress fractures like the type Joe Biden experienced can turn into much larger breaks if not adequately treated. Runners, underweight women, people with osteoporosis, and people with flat feet are all at risk for developing this condition. While this condition is easily treated in the early stages, if it progresses to a break, surgery may be needed to repair it.

Plantar Fasciitis

Plantar fasciitis is not typically caused by an acute injury but develops overtime. Runners and other athletes often develop this condition through overuse and ramping up their training too quickly. Waiting to treat this condition or continuing to engage in sports activities will prolong the recover from this painful condition. If you do develop sudden onset of heel pain during exercise and there are signs of bruising, this indicates a tear has occurred. You should seek immediate attention from a podiatrist. 

Achilles tendonitis

Like plantar fasciitis, Achilles tendonitis also develops overtime. When this condition is inadequately treated it can lead to Achilles tendonosis, a progressive and degenerative condition. The tendon becomes weaker and prone to re-injury and rupture. Treatment will require immobilization of the foot and ankle and treatment with regenerative medicine.

Ankle sprains

Ankle sprains that go untreated or do not adequately heal can turn into a condition called Chronic Ankle Instability. While the first line of treatment is physical therapy, if the instability is not resolved, newer advances in surgery now require much less recovery time.

Preventing Foot and Ankle Injuries

The best thing to do is to prevent foot and ankle injuries from occurring in the first place. Because so many of the conditions described above are more prevalent in athletes, the recommendations I’m giving will focus on those involved in sports. 

Wear Appropriate Footgear

It’s important to wear footgear designed for the sport you engage in. Athletic shoes are designed to help prevent injuries based on the type of moves the athlete makes while engaged in their particular sport. For example, basketball players regularly jump and twist during play. Basketball shoes rise up around the ankle to help prevent ankle sprains which occur when that much twisting force is placed on the body.

Build Up Training Time Gradually

Oftentimes when we start a new sport or engage in a sport after a long period of time, we want to ramp up as quickly as possible.  While keeping up with friends and colleagues seems like a good idea, participating at a new or old sport at the same level is a recipe for injury. Our bodies take time to accommodate changes, including increases in sports activity. Start off slowly and build up by 10% each week.

Stretch and Condition Sufficiently

Stretching is also key to preventing injuries. Many of the conditions named above are in part caused by having tight calf muscles. Stretching your calf muscles enough to prevent these conditions from occurring will often require more than just a static wall stretch. If you know you have tight calf muscles, consider using an Achilles splint to stretch them during the daytime. It’s also important to keep the rest of your body in condition so that less stress transfers to your feet and ankles during play.

If you've injured yourself while running or playing sports, give our office a call at 206-368-7000 or request an appointment online.



By Dr. Rion Berg
November 23, 2020
Category: diabetes
Tags: diabetes   gout   Thanksgiving  

food being deliveredFor most of us Thanksgiving is all about food. Each year we look forward to eating our favorites  including turkey, stuffing, and pumpkin pie. But for many of us Thanksgiving is filled with many pitfalls, particularly if we have diabetes or gout.  Eating the wrong thing or too much of our favorites can elevate our blood sugar or cause foot pain.

This year we have the added problem of a pandemic.  While we might normally be able to ask our families to cook special treats to meet our dietary needs, this year there is already a lot of stress and strain on everyone. We may not want to bother those who are already going out of their way by making special home deliveries during Covid.

If you are doing the preparation and you have people with these health conditions in your family it doesn't need to take more effort, just more forethought.  If you're the one with diabetes or gout, there are some steps you can take to avoid pushing your health into the red zone this holiday season.

Making Healthier Turkey

While turkey is usually a healthy food for anyone, there are ways to make it healthier. Try this turkey recipe by Eating Well to benefit those who want to reduce their fat and salt intake.

Limit Foods that Contain Purines

Foods with purines can cause those prone to gout to experience pain, particularly in their big toes. It's not the purines themselves that are the problem but the uric acid they turn into to.  Foods high in purine are: mussels, scallops and tuna, red meat, and liver. Drinks with high levels of purines are red wine and beer and drinks containing fructose.  Drinking lots of water can help flush the uric acid from your system.

Cut Back on Sugar

Most of us eat way more sugar then we need to make our food taste good. Many of our Thanksgiving foods are full of them. Consider the classic yam dish with marshmallows on top. Yams already contain sugar which is what makes them super delicious. If you want to make them special without the added sugar, add spices such as cinnamon, nutmeg, and cloves. You may also consider substituting white sugar with Splenda or Stevia, both better options for people with diabetes.

Choose Your Carbs Wisely

Besides turkey, most of us relish eating mashed potatoes, sweet potatoes, dressing, and gravy. Carbs can be a minefield for someone with diabetes. Eating too much of them can lead to a sharp increase in blood sugar.

You have a couple of choices this Thanksgiving. Either you can eat small amounts of each of your favorite foods or decide upfront which foods are a must have.  Then ask your host to only deliver those foods. Another idea is to apportion these favorites out over several days.

Eat Ahead of Time

One way to moderate how much you eat on Thanksgiving is to eat ahead of time. Don't skip breakfast. Instead make your morning meal one with protein like eggs instead of having your usual coffee and toast. Protein is more satisfying and lasts longer in the body.

If you're a diabetic or experiencing foot pain due to gout, call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Follow Dr. Berg on Facebook, Twitter, and Pinterest.



This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.