HJBR-2020-jul-aug

36  JUL / AUG 2020 I  HEALTHCARE JOURNAL OF BATON ROUGE COLUMN ORTHOPEDIC COMMON OVERUSE INJURIES OF THE FOOT Given the current COVID-19 pandemic, I decided to discuss the musculoskeletal problems I have seen most as the nation comes back to life. Like most of the coun- try, my practice changed drastically during the lockdown, and I found myself at home more, and at work less. I also found myself being more active than I usually am—lon- ger walks with my dogs, spending more time outside, and getting to exercise a lot more. Looking around my neighborhood, it seemed a lot of people had the same idea. People who have relatively sedentary office jobs were suddenly at home, and the weather was perfect, so they were outside with their kids and animals, with a drastic increase in activity level. Now, as people are leaving their homes and getting more minor problems addressed, my office has been flooded with overuse injuries—tendi- nitis, plantar fasciitis, and stress fractures. The most common overuse injury is, by far, plantar fasciitis. It is common even without a lockdown, but with the increased walking (sometimes in not so supportive shoes), the incidence went way up. This is characterized by heel pain, most common- ly right at the insertion to the calcaneus. It is worse in the morning, or after rest, but can be relieved with walking. Historically called a bone spur or a stone bruise, stud- ies have shown that the heel bone itself re- ally has nothing to do with plantar fasciitis. It is caused by tightness of the Achilles and hamstring. Stretching is the mainstay of treatment with heel lifts, icing, and anti-in- flammatories helping relieve pain, while the patient stretches out. Patients can still be active while they have plantar fasciitis, as long as they stretch a lot. On the differential of plantar fasciitis, but much more detrimental, is the calca-