What is Plantar Fasciitis

Plantar fasciitis is the most common foot problem in the world.  Plantar fasciitis is an inflammation within the ligament on the bottom of the foot that connects the heel and the toes.  The inflammation is usually worse first thing in the morning when getting out of bed, or getting up from a seated position after 15 minutes of rest. The condition may appear to resolve after walking for a few minutes but may manifest as an aching and throbbing pain in the evening.  

What causes plantar fasciitis?

The root cause of plantar fasciitis is a result of excessive tightness of the calf muscles.  A normal foot will have 15° of dorsiflexion, or upward motion at the ankle while in a seated position with the knee straight. This motion is necessary to walk normally without tripping over our toes.
When the calf muscles are too tight, then too much tension within the plantar fascia. The plantar fascia is unable to withstand the tension and its fibers will tear. This tearing causes pain and inflammation most often at its attachment on the heel.  Less commonly, plantar fasciitis can manifest in the central arch area of the foot.

Another cause for plantar fasciitis is excessive collapsing of the arch while standing. Those with flat feet are at higher risk for plantar fasciitis.  As the arch collapses, tension on the plantar fascia will increase, leading to the tearing of fibers.

What are common treatments for plantar fasciitis?

The number one treatment for plantar fasciitis is stretching exercises. These exercises address the tightness of the calf muscles. If the calf muscles are no longer tight, then there is less tension on the plantar fascia and the tearing and inflammation will resolve.  Another technique to stretch the calf muscles is to use a dorsal night splint while sleeping. This will stretch the calf muscles during rest and helps with compliance to stretching exercise regimens.

Arch supports are useful to resolve plantar fasciitis. They help decrease the collapsing of the arch and therefore reduce tension on the plantar fascia. Custom arch supports made by your InStride Gaston Foot Specialist are most beneficial as they will match the contour of a person’s foot perfectly. Over-the-counter arch supports can also be helpful if they are firm and support the arch.

Other methods of treatment are aimed at resolving the inflammation of the plantar fascia. These include anti-inflammatory medications, steroid injections and deep heating techniques like ultrasound.

Most podiatrists will employ several treatment options to resolve plantar fasciitis.  If a patient fails conservative treatment for plantar fasciitis, a surgical option may be necessary. Surgical management of plantar fasciitis involves cutting two thirds of the plantar fascia to remove the excessive tension. When the tension is gone, the inflammation caused by plantar fasciitis quickly resolves.

The longer one suffers from plantar fasciitis, the longer it usually takes to resolve.  With multiple options for treatment and predictable results, there is no need to suffer. 

Contact InStride Gaston Foot & Ankle Associates at 704-861-0425 to schedule an appointment today!

By: Dr. Randall Contento  |




Did you know that toenails are just a specialized type of skin? They no longer serve any function. Because the average person takes 3000 to 6000 steps per day,  your toenails are subject to micro-trauma just by hitting against the toe of your shoe thousands of times per day! This damage to the nails will cause discoloration and thickening. Other reasons your toenails are ugly may be caused by infection or physical deformities of your foot.

When toenails are thickened and discolored, the best recommendation is to see a foot and ankle specialist. In order to give an accurate diagnosis, the nail plate must be sampled and sent to a lab for several detailed tests. The results of the tests will conclude whether there is a bacterial infection, fungal infection, yeast infection or just damage. From there, your Gaston Foot and Ankle Podiatrist will customize a treatment plan ranging from topical medication that is brushed onto the infected nail, oral medication, surgery, or laser treatment. The skin of the sole of the foot may be a source of the infection. Fungus infections such as athlete’s foot and sweaty feet will create recurring toenail fungus. Left untreated, the fungal infection will return 50% of the time.

Ugly toenails can also be formed by foot type or possible foot or ankle deformities. These deformities will put extra pressure on the toenails which causes them to be damaged and prone to infection. Hammertoes, cross over toes, bunions, flat feet, high arches all put pressure on the toenails. A foot and ankle specialist can address the deformity with shoe modification or custom made orthotics. 

It is important to note that circulation to the toes is limited compared to everywhere else in the body as the toes are the furthest from the heart; therefore it takes longer to treat a toenail problem than it does a fingernail problem. Patience is needed to understand that no matter what treatment is adopted, it usually involves treatment for the lifecycle of the toenail: 6-12 months.

Do you want your ugly toenails clear and beautiful in time for summer? Contact InStride Gaston Foot & Ankle Associates at 704-861-0425 to schedule an appointment today and you will have your feet perfect by summer!

By: Dr. Ryan Meredith  |




As a practicing podiatrist for over 12 years, I am asked about arch supports thousands of times. Most people would benefit from the "right kind" of arch supports. No two feet are alike, so the "right kind" of arch support is based on the height of ones arch. The foot has supportive ligaments and tendons that maintain the height of an arch. There are three categories of arches: low, high and medium.

Low Arch Foot Type.

Those with low arches will usually have more flexibility in their ligaments and tendons. The excessive flexibility causes the arch to collapse while standing. When the arch collapses, it creates strain on the ligaments and tendons which causes injury. As the foot is supported by the arch support, the arch remains rigid and is no longer at maximum strain. Those with excessively flat feet will often suffer from injuries to these tendons and ligaments if an arch support is not being used such as tendonitis and plantar fasciitis.

High Arch Foot Type.

The supportive ligaments and tendons are naturally tighter with less flexibility which creates a high arch foot type. High arches make adapting to uneven terrain and absorbing shock more difficult. Those with higher arches tend to suffer overuse injuries like stress fractures, frequent sprains and heel pain. A custom arch support will fit the contour of a high arch foot perfectly, increasing the stability between the flat ground and a curved foot. The support will distribute the pressure equally through the entire foot rather than just the heel and ball of the foot which will prevent injury and strain.

Medium Arch Foot Type.

Medium arch height people will likely have less foot pathology than a higher or lower arch type. Our arch height can lower with age, weight gain, pregnancy and with activities like running. An arch support can be used to prevent lowering of the arch due to these challenges.

There are major differences between over-the-counter or store-bought arch supports and custom arch supports made by a medical professional. A mass-produced device will never provide a perfect fit. The arch of the device must be more flexible to accommodate different arch heights and weight. This flexibility will lead to bottoming out of the arch support within 6 months and it will need to be replaced. A custom arch support is made from a cast of ones feet. This process will produce an arch support that can last a decade or more without collapse. It will support ones feet more completely and can be modified for specific pathology or problems.

By: Dr. Randall Contento, DPM
InStride Gaston Foot & Ankle Associates

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 It’s that time of year again in Gaston County. Even the stragglers are turning on their heat in their houses. Just the other day I was reaching for my chapstick – thinking – It’s too soon! I’m not ready for winter!

A very common ailment that we hear in the office of InStride Gaston Foot & Ankle is dry cracked heels. But how does it happen? Why? Here are some common factors:

1. You may be suffering from eczema or psoriasis (dry skin conditions)
2. You may be overweight 
3. You may have diabetes (autonomic neuropathy leading to less sweating) or a less active thyroid (lowers the body’s metabolic rate which decreases sweating)
4. You might be standing long periods of time on hard surfaces
5. You may wear open heeled shoes, like sandals, that don’t allow proper foot protection

Most people find cracked heels to be a cosmetic problem, but when the cracks begin to deepen – many complain of pain and bleeding.  

What you shouldn’t do:

 Don’t cut the skin with scissors or a blade.  Cutting too much skin can lead to complications and a potential infection – leave it to the podiatrists at Gaston Foot & Ankle to remedy the cracked heels.

What you should do: 

Moisturize, moisturize, moisturize!
Our podiatrists recommend moisturizing at least twice a day. Try applying moisturizer before going to sleep and putting on cotton socks to keep the moisture in.
Drink plenty of water
Hydration is key to keeping not only your heels from cracking but also your skin (elbows, lips, legs) from chapping or flaking. Once the central heat kicks on in your home, you are subjecting your skin to drying out.
Use a pumice stone
For mild dry skin on the heel, where a callous has formed and has the potential to crack, try using a pumice stone to cautiously remove the dead/dry skin. Make sure that the pumice stone is clean before using. If there are deep fissures or cracks, consult your podiatrist before.
For the winter months, Gaston Foot & Ankle has Idonia Cream on special – buy one get one free – it is the most ideal moisturizer for cracked heels.
Wear shoes in the house
I know it sounds like a bummer but when your feet are dry and calloused; your skin lacks the elasticity to stretch while you are walking or standing.  Walking around the house barefoot or sockfoot isn’t going to cut it. Invest in a decent pair of house shoes that support your heels and have them the dedicated house shoes. 

If you are suffering from cracked heels, please do not hesitate to call us at 704-861-0425.

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“Being healthy starts at home.”

How often we have heard that phrase? Often enough to know that we should be stocking our refrigerators filled with kale and lean meats. But what about at work? We munch at desks, take quick stops in the break room, we speed out at lunch time to grab the fastest of foods. What if being healthy starts at work?
At InStride Gaston Foot & Ankle we have started to do just that. We have started a weight loss challenge to become healthier. So don’t worry patients, if you see us slowly shrinking, you’ll know why. We believe that health is very important and we want our patients as well as our team to be the healthiest as possible. 

Coming together as a team and working on a weight loss challenge as an office has its advantages:

1. You are constantly around people that are in your same boat. Encouraging each other throughout the day to be healthier.
2. You swap recipes and work out techniques.
3. When you get HANGRY (hungry + angry) – your colleagues know why.
4. Support. Support. Support. Even when things aren’t going your way and you haven’t lost the weight yet, you have a whole support group that understand and can help pull you through.
5. If you are motivated by competition, then you have other competitors. If you are motivated by goals, you’re with other people with similar goals.

We believe in wellness through mobility and working to become healthier. Rome wasn’t built in a day and your health is not going to magically improve overnight. It takes hard work and dedication but you should be dedicated to your health – because we are too.

Come support us at InStride Gaston Foot & Ankle as we take on this weight loss challenge! While you’re here come have your feet checked out by the best podiatrists in Gaston County! 

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Happy Mother’s Day to all the moms out there! For all of you new mom’s out there, Dr. Kirlin, founder of InStride Gaston Foot & Ankle, has written a post about your new little set of feet on your infant.

Unfortunately many of us are not prepared for all the challenges of parenting. The most important thing we all want for our children is for them to be healthy. When a baby is born it seems that one of the first things we do is to check their little fingers and toes. We want to know how much they weigh, their height and eye color and how much hair they have. After superficial inspection, then we start to look closer to make sure “everything is alright”.

We worry about our baby and want to know that those newborn feet are normal. I wrote this post, so that you the parent or grandparent, might know a little more about what to look for in a child’s foot development, what to expect as your baby grows, begins to walk and eventually runs, plays sports or learns how to dance and eventually leaves you for the big world beyond. Hopefully, your child will never experience any of the conditions we talk about on the website, but at least you may be better prepared if some of these things should occur or you question something that you notice. Having helped raise three wonderful daughters with my wife, I have experienced some of these concerns as a father and most of these as a podiatric physician.

My intention is to allay your fears, offer you some useful information and give you a little peace of mind. At least you will better sense whether your child needs an evaluation for an apparent concern, whether it be with a foot and ankle specialist or your pediatrician.

What to look for and does he or she have normal feet?

A newborn baby is an amazing gift from God. However, as perfect as we would like him to be, occasionally there are flaws in development. Your pediatrician is the first physician to perform an examination on your baby’s feet. He or she will check for a healthy skin color, the circulation and even the sensation and muscle tone. The general foot shape and position and shape of the legs is evaluated and typically all is normal and healthy. If a problem is noticed, prompt attention is obtained for further evaluation.

Normal newborn feet show lots of fat, they are soft with tiny toes straight and pointed forward. There is little or no arch and won’t be seen for over a year or more. If the foot is not straight or is in a position that is curled inward excessively or elevated up towards the leg, there could be a problem.

For more information about your child’s foot development, check out Children’s Foot Problems.

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InStride - Gaston Foot & Ankle Associates

251 Wilmot Drive
Gastonia, NC 28054