Dr. DuCasse 02:42
Okay. So we want to jump into this heel pain. First of all, I think heel pain has been the bane of, you know, the existence of many podiatrists and podiatric surgeons, figuring out the etiology of the heel pain. Most of the patients we see, in our practice, have heel pain, you’ve certainly seen a lot of heel pain. How did you get into managing heel pain? When you first started out? How did you evolve?
Dr. Barrett 03:11 discusses the evolution of the treatment of heel pain in the last 30 years and how EPF (endoscopic plantar fasciotomy) was integrated into the profession. The 652 patient multi surgeon study LINK is discussed as well as the early patient responses to EPF. The meta-analysis by Anderson and Foster comparing fasciotomy to fasciotomy with spur resection. LINK
Dr. Barrett 08:22 discusses the profession’s fixation on the heel spur.
Dr. Barrett 08:41 talks about the early push back against EPF.
Drs. DuCasse and Barrett 11:23 is plantar fasciitis really inflammatory?
Dr. Barrett 13:28 discusses the early integration of Diagnostic Ultrasound into the management of heel pain.
Dr. Barrett 15:34 illustrates the staging and grading of plantar fasciitis.
Dr. Barrett 17:31 does heel pain need to really be treated 6 months with failed conservative care?
Dr. DuCasse 17:47 Plantar Fasciopathy versus Fasciitis
Dr. Barrett 18:31 talks about multiple etiology heel pain syndrome (MEHPS) and ruling out neurogenic heel pain. Differential diagnoses for heel pain and how important the HPI is in formulating an accurate diagnosis.
Dr. Barrett 20:25 What about Equinus?
Dr. DuCasse 23:39 Has the treatment of heel pain overall really gotten any better over the last 3 decades?
Dr. Barrett 24:53 discusses the ability of practitioners to really be able to accurately place injections without ultrasound.
Stephen Barrett 26:48 Can you really hold yourself out as an expert in heel pain if you do not implement diagnostic ultrasound in your work up of the heel pain patient?
Dr. DuCasse 29:20 The court of last resort.
Dr. Barrett 31:33 Is it a mouse or elephant?
Dr. DuCasse 33:25 discusses the literature.
Dr. DuCasse 36:13 talks about the reluctance of some physicians to integrate new ideas and understanding to their clinical regimens.
Dr. Barrett 36:47 goes over the early history of PRP. The efficacy and safety of using PRP and other injectables.
Dr. Barrett 38:11 Peptides—BPC 157
Dr. DuCasse 40:54 How can you change one’s central theory
Drs. DuCasse and Barrett 42:22 What about X-rays—are they valid? The Li and Muehleman study LINK
Dr. Barrett 44:46 The Dunning Kruger effect LINK
Dr. Barrett 45:32 Staying off Mt. Stupid
Dr. DuCasse 46:59 but those are kind of the ones you fixate on the ones that you can’t figure out exactly what’s happening, right.
Dr. Barrett 47:04 The Surgeon Heuristic