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As I See Fit: Determining the cause of foot and heel pain

Q: "While walking in my yard, I suddenly got a sharp pain in the bottom of my foot. It felt like Velcro ripping. The same foot has been bothering me for a while and is now bruised on the bottom. I thought it was plantar fasciitis but my doctor said I ruptured my PL. What's the difference?" Laura K., Eldersburg

A: With 26 bones — one quarter of all bones in the human body — 33 joints and more than 100 muscles, tendons and ligaments, the foot and ankle is one of the body's most complex structures and, therefore, a multitude of conditions could be to blame for bruising and a tearing, burning or ripping sensation on the bottom of the foot.

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According to the Mayo Clinic, plantar fasciitis, one of the most common causes of heel pain, is the "inflammation of a thick band of tissue, called the plantar fascia, which runs across the bottom of your foot and connects your heel bone to your toes."

Repeated small injuries to the fascia are thought to cause plantar fasciitis, symptoms of which, such as pain in the heel and arch of the foot, tend to be worse in the morning and are felt most keenly where the fascia attaches to the heel bone.

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Though plantar fasciitis can strike anyone at any age, it is most common in athletes and people between the ages of 40 and 60, and it is twice as common in women as it is in men. It is estimated that 1 in 10 people will get plantar fasciitis at some time in their life.

Methodistorthopedics.com describes the peroneus longus tendon as wrapping down and under the foot and angling forward under the sole of the foot where it connects to the bottom of the main bone of the big toe. The peroneus longus tendon stabilizes the arch of the foot when walking.

Common causes of peroneal tendon problems include repetitive ankle motions, which can cause wear and tear on the tendon; a high arch, which puts extra tension on the peroneal tendons; ankle sprains, which can tear the ligaments that support the lateral part of the ankle; and, in some patients, the problem is caused by degenerative changes in the tendons themselves rather than by inflammation around the tendons, causing the tendon to become abnormal, a condition called tendonosis.

A peroneal tendon rupture is a complete tear in one of the two peroneal tendons on the outside of the ankle. According to sw.org, symptoms of a peroneal tendon rupture include a "pop" or rip felt behind the outer part of the ankle; pain and weakness when moving the foot; tenderness, swelling, warmth and redness around the outside of the ankle; and bruising in the area of injury.

If you suspect you have a foot or ankle injury, it is always best to consult with your doctor to determine the proper course of treatment for your injury.

Please email your fitness and health questions to me at leimlite@gmail.com or mail to:

As I See Fit

c/o The Advocate

115 Airport Drive, Suite 170

Westminster, MD 21157

Sherri Leimkuhler is from Eldersburg and is an Ironman triathlete with extensive experience in fitness and health. Her column appears on the second and fourth Wednesday of the month.

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