TREATMENT PROCESS

This is my current treatment process for patients with painful Halgund's deformity, please watch the video for full details. 

• 1st Visit - Evaluate your condition, review x-rays, and perform a walking evaluation to determine the cause of your condition. Start working to reduce inflammation, reduce tightness and reduce stress through the back of your heel. 
• 2nd Visit - Will evaluate the initial treatments and if indicated perform an ultrasound examination to evaluate the thickness of the Achilles tendon to help guide further treatments.  
• Shockwave and Amnio Injection - Most of my patients benefit from a series of 3-6 sessions of shockwave therapy to improve blood flow and recovery of the Haglund's deformity and Achilles tendon. After these sessions then patients go through a course of 6 weeks of physical therapy. At times to help speed up the healing an Amniotic injection is beneficial. 
• Orthotics - Orthotics are useful to stabilize the heel position, help with posture and reduce excess movement of the foot that can increase stress in the area of the back of the heel. 
• Physical Therapy - After these sessions of shockwave then patients go through a course of 6 weeks of physical therapy. 

• Daily Rituals: These are the daily rituals that can be used with other office-based treatments. Towel stretch before getting out of bed (30-second stretch 3 times), foam rolling (10 minutes 2x a day), icing or contrast baths (10 minutes 2x a day), anti-inflammatory for 2 weeks at a therapeutic dose (if not doing shockwave), stable shoes and orthotics, Oofos sandals in the house, and avoid going barefoot. 

• Cortisone Injection - Rarely is this indicated in the Achilles tendon due to concern of weakening of the tendon. 
• Brace - At times I recommend an off-loading brace to reduce pressure on the plantar fascia and move the pressure to the lower leg region. 

RESOURCES 

• Shockwave (EPAT) - Information about shockwave therapy.

• Orthotics -  Explanation of how and why orthotics help foot pain.

• Icing and Contrast Bath Instructions - Here is information on how to ice your foot. 

• Oofos - Recovery sandals to wear at home for more support.

• Shoe Recommendations - Here is my shoe recommendation.

• Foam Rolling Exercises - Instructional video for foam rolling. 
• Aerospring Brace - This is a carbon fiber brace that can offload the plantar fascia. 

PRODUCTS 

Here are some of the best recommendations I have found on Amazon to start treatment before you come in to the office.