Dr. Berg's Foot Facts

Posts for: March, 2011

By By Rion A. Bertg, DPM
March 29, 2011
Category: foot care


Up to 10% of the population suffers from heel pain, plantar fasciitis. Millions of dollars are spent per year in health care to resolve this problem. Many common treatments including cortisone injections, physical therapy, orthotics, and surgery are available, but the advantages of one over the other are not necessarily proven in randomized studies.

I’ve been in practice for thirty years, and I continue to utilize the latest techniques in resolving heel pain. My heel pain patients in Seattle are happily running, walking, skiing and enjoying the active lifestyle the Northwest offers. I continue to hope that some of these techniques will resolve your heel pain faster, with less down time, and provide more lasting relief.

Speaking of lifestyles, with the passing of the infamous, Elizabeth Taylor, passes a time when high heels are required as part of the work "uniform" for women. Save the stillettos for evening. To keep your feet happy and healthy in the long term, wear lower heels with work attire and consider a dress flat to wear with slacks.

1.   So what is plantar fasciitis?

  • It is the inflammation of the attachment of a long flat ligament, the plantar fascia, at it’s attachment to the heel or along its course to the base of your toes.
  • It becomes inflamed when it is over pulled from the heel to the toes. If the process continues it pulls on the bone and a spur can develop.

2.  What are the most important factors contributing to heel pain?

Self Assessment

Your Weight             Overweight?  Yes     No
Your Work                Prolonged Standing?  Yes     No
Your Play                  Runner?  Mileage/wk  _____ Court Sports______ Other___________
Your Foot Type        Flatfoot?  Yes    No    Very High Arches   Yes      No
Your Shoes              Slip On?  Yes    No     Stable?    Yes    No   

                                    Stable = Bends at ball, not in the middle
                                                  and doesn't twist easily from side to side

Barefoot/stocking feet/house slippers at home?   Yes     No

3.  Where do you start when it comes to treatment?

Begin by being honest with yourself and deciding how long you have been having your heel pain.  1-4 weeks, 1-3 months, 3-6 months, 1 year or longer

What is your pain level on a scale of 0-10?

Divide this up_______AM pain level

_______During the day

_______Pain only at end of day

_______Pain during athletic activities

_______Pain when you are off your feet

4. First Steps to Self Help

Don’t go barefoot/slippers at home

If you have a house rule of no shoes, buy Crocs for in house only


For acute pain >6/10, short duration

(1-4weeks) with no Hx of injury

Begin icing ten minutes/day, if tolerant and no GI issues/or other contraindications, oral anti-inflammatory per your physician’s recommendation


Check your shoes for stability

Generally an athletic shoe with slight heel is preferred. Remove insole of the shoe and replace with a good OTC support such as Powerstep or Superfeet


Before rising

Stretch your calf, flexing your ankle 20 reps, stretching against the wall.



Stop running until symptoms are subsiding.


Heel pain can prevent you from enjoying your dailing life as well as leisure time at the parks and urban trails we have right here in Lake City, Shoreline, Ravenna and Kenmore. Take care of your feet and get outside to enjoy the beginning of Spring!

If you have signs of heel pain, call us today for an appointment at 206-368-7000 or request an appointment online.







By Rion A. Berg, DPM
March 22, 2011
Category: Uncategorized

Spring often brings hope and sometimes the motivation towards improved health through exercise. For those who enjoy exercising in a group, (and who enjoy dancing), aerobic dancing can be a great choice to help you get in shape. Aerobic classes have been around for over 30 years and are offered in many locations in and around Seattle.

Aerobic dancing is a workout set to music, usually for about an hour, following a specific routine to warm up, peak heart rate and cool down. The benefits of aerobics are multiple – strengthening heart and lungs, lowering cholesterol levels and decreasing stress. Unless they are designed as “low impact,” most aerobic programs are quite strenuous.

If you have never taken an aerobics class or have been away a long time, it's a good idea to have an exam to assess the risk of injury to your feet.

Take Care Of Your Feet!

Impact forces from aerobics can reach up to six times the force of gravity, which is transmitted to each of the 26 bones in the foot. 

Proper shoes are crucial to successful, injury-free aerobics. Shoes should provide sufficient cushioning and shock absorption to compensate for pressure on the foot many times greater than found in walking. They must also have good medial-lateral (side-to-side) stability.

If your ankles turn inward or outward too much (e.g., excess pronation or supination) you may want to call the Foot and Ankle Center of Lake City about custom orthotics, custom because they will be designed for your feet and correct problems that could contribute to an injury.

Don’t be tempted to wear your running shoes for aerobic exercise. Running shoes lack the necessary lateral stability and lift the heel too high to be considered acceptable for aerobics.

Prevention of Injuries

Injuries from aerobics usually result from improper shoes, surfaces, or routines, and overuse of muscles through too vigorous a regimen. Take classes from a certified instructor and give yourself time to learn the program correctly. If you can, start at a low-impact level and work your way up as you become fit and more confident of the routine.

If you exercise at home with a video, be very careful. Read the label to determine whether the video is produced by certified aerobics instructors and whether you can handle the degree of impact. While it's safe to do low-to-moderate impact aerobics on the living room carpet, that's not a proper surface for high-impact routines.

Don't under estimate the importance of the cool-off period. It burns off lactic acid (which makes muscles feel tired) and adrenalin, while keeping blood from pooling in the extremities.

The Pain Factor

If you feel pain in your feet, stop. Don't attempt to exercise through pain, or you may aggravate an acute injury into a chronic or even permanent one. If you continue to be bothered by pain in your feet or ankles for more than 24 hours after exercising, contact our office for an appointment.

Common Aerobics Injuries

Plantar fasciitis (arch pain) -- Arch pain is often caused by frequent stress on the plantar aspect, or bottom of the foot, in an aerobics routine.

Heel spurs -- Heel spur syndrome, related to plantar fasciitis, occurs after calcium deposits build up on the underside of the heel bone.   


Sesamoiditis --. Incredible forces are exerted on the sesamoid bones during aerobics, and inflammation and fractures can occur. Proper shoe selection and custom orthotic devices can help avoid sesamoiditis.

Stress fractures -- Probably the most common injuries to aerobics instructors, stress fractures are caused by poor shoe selection, hard surfaces, and overuse. When swelling and pain surface, call for an appointment. X-ray evaluation and early treatment can prevent a disabling injury.

The Bottom Line

Remember, foot pain is not normal, so don't ignore it. Chances are, a successful aerobics regimen will bring out the body you've always dreamed of, and a better feeling about yourself both physically and mentally!

By Rion Berg, DPM

Please visit our on-line library for more information on keeping your feet happy and healthy!