Dr. David DeFries

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Achilles Tendonitis Plantar Fasciitis Heel Spurs Shin Splints

Pain related to the lower leg is often related to issues higher up in the body. The feet and lower leg are charged with keeping us stable when standing and also must work together when we walk. When our weight is not distributed properly, improper pressure is transferred down the leg and through the foot. Patients presenting with heel spurs, bunions, plantar fasciitis, shin splints and Achilles tendonitis are often found to have pain and or tenderness in the knees, groin, hip, low back and or neck. 
As with most conditions, the key is to determining whether the problem is acute or chronic.

An example of an acute injury is a traumatic injury to the ankle due to a misstep off a curb. When the ankle twists beyond the normal range allowed by the muscles an injury results in the muscle and tendons and in worse cases the ligaments may be affected and a fracture may occur. This initial injury is considered acute and the pain, while intense at first, is expected to subside as the normal healing process takes place.

A chronic presentation relating to the foot / ankle / lower leg presents as discomfort which has been experienced for longer than ten days and is not the result of a recent injury. Chronic pain may be due to an old injury that did not heal properly or to bad biomechanics that contribute to improper stress on the lower leg and foot. Examples of this are: plantar fasciitis, heel spurs, frequent ankle strains and in some cases bunions. 

It is very important to always look at the  cause  of a  symptom  as well as the symptoms itself. Without addressing the  cause , the  symptom  is likely to return and the condition may worsen.


CAUSE could be the twisting of the foot in a hole in the ground.

DAMAGES are a strain to the muscles and tendons as well as irritation to the joint.

SYMPTOMS are pain in the ankle.

In this case we know the cause and only have to recommend that the patient stop stepping in holes! In order to reduce the SYMPTOMS we must address the DAMAGE caused by the injury which calls for ice, elevation, laser therapy to reduce pain and speed healing and kinesio taping to afford stability and improve lymph flow. Treating a SYMPTOM only, such as taking medication or over the counter pills, does not treat the DAMAGE and in some instances can lead to slowed healing, additional pain, scar tissue formation and ultimately a chronic condition.


CAUSE A previous injury that did not heal correctly or faulty biomechanics which lead to improper weight distribution to the foot and ankle.

DAMAGES may include scar tissue in the Achilles tendon, heel spurring, plantar fasciitis.

SYMPTOMS may present as pain in the heel, arch of the foot, calf tenderness.

Procedures typically recommended for an acute and chronic ankle/foot/toe conditions are laser therapy and kinesio taping.
Laser therapy rapidly speeds the healing of the tissue while at the same time decreases the pain. Kinesio taping helps to stabilize the area while also allowing the tissue layers a degree of mobility which prevents scar tissue and promotes fluid exchange. 

High power laser therapyEvery day for three days then every other day until resolved.

Kinseio Taping to the affected area: Typically taping is applied and left in place for three to four days and then reapplied as needed.

The combination of these two therapies does a tremendous amount in reducing pain and speeding recovery.

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