Abstract:
An orthotic device for treating heel pain associated with Plantar Fasciitis is disclosed, comprised of a flexible heel cup shoe insert with a bar-shaped member extending laterally across the bottom sole portion of the device and located under the heel-arch connection of a person&#39;s foot when worn by the person in order to apply continuous accupressure to the calcaneus-midtarsal connection area and thus alleviate pain.

Description:
BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present invention relates to a novel orthotic device for use in relieving heel pain. In particular, the present invention relates to an orthotic device involving the continuous placement of pressure to a certain area of the foot in order to alleviate pain resulting from Plantar Fasciitis. 
     2. Description of the Related Art 
     Plantar Fasciitis is the most common cause of heel pain, debilitating countless people of both active and sedentary lifestyles. The condition is caused by overstressing and subsequent inflammation of the plantar fascia, which is the dense, fibrous sheath of muscle tissue located longitudinally on the bottom of the foot, stretching from the calcaneus bone at the rear of the foot to the metatarsal heads leading to the toes in the front of the foot. Heel spurs, which consist of calcinaceous deposits that grow on the front of the calcaneus and point into the plantar fascia, can exacerbate the pain to an unbearable extent. Patents&#39;s complaints of heel pain often originate in the first step they take out of the bed in the morning, when the plantar fascia is stretched violently out of the natural contraction that occurs during a state of sleep. This pain may ease gradually throughout the day, only to return the next morning. 
     Sufferers of heel pain due to Plantar Fasciitis and/or heel spur commonly seek treatment through physical therapy, corticosteroid drugs, surgical procedures, and a myriad of orthotic devices, cushions, and gels. The complexity of treating this ailment is supplemented by other biomechanical factors, such as pronation (rolling in of the feet), supination (rolling out of the feet), weakened ankles, extra body weight, improper footwear, loss of the body&#39;s natural shock absorbers, flattened or dropped arches, and weakened high arches. 
     The prior art includes several orthotic devices intended to treat heel pain of various types. Devices exist to hold, immobilize, and/or support the heel and/or leg of the user. Patents have been issued for inventions that involve L-shaped leg braces with various immobilization features, elastic footwraps which provide compressive forces on the bottom of the foot, and orthotic insoles to be worn with shoes for arch support and heel cushioning. The existing devices claim to alleviate heel pain by cushioning and cradling the heel, applying accupressure to various foot locations using gel platforms, and placing a softer material surrounded by a more resilient one to treat pain originating from the calcaneous. While these devices provide some temporary relief, they have not typically resulted in a pain-free experience for patients. There is, therefor, a need for a device and method of treatment which relieves the pain associated with Plantar Fasciitis to a greater extent than is provided by current treatment protocols. 
     SUMMARY OF THE INVENTION 
     The inventor&#39;s experiences as a podiatrist treating patients led to the discovery that accupressure applied at the calcaneous-midtarsal connection on the bottom of the foot temporarily alleviated the pain associated with Plantar Fasciitis. The calcaneous-midtarsal connection is the point on the bottom of the foot where the heel meets the arch. Further, the inventor discovered that accupressure continually applied to this location, using a specially constructed orthotic device, could provide the key to pain relief, as indicated by many patient trials, often resulting in a completely pain-free experience for many patients. 
     While standard orthotic inserts often comprise a flexible heel cup, the present invention provides heel pain relief associated with Plantar Fasciitis using a raised bar which extends above the surface of such a standard orthotic insert. This “Fasciitis bar” extends laterally across the sole portion of the cup, in a position located beneath the calcaneous-midtarsal connection of the foot when the orthotic device is worn. The flexible heel cup serves to locate the Fasciitis bar in precisely the proper location to apply moderate accupressure force when the patient walks or stands. 
     Made of a resilient, dense material, the Fasciitis bar provides sufficient accupressure to the calcaneous-midtarsal connection to stretch the plantar fascial tissues and prevent collapse of the calcaneal bone, thus relieving pain. The Fasciitis bar places the center of accupressure mid-way across the width of the patient&#39;s foot. This is distinct from the arch support portion of standard orthotics, which apply upward pressure against the inside of the patient&#39;s foot, further forward toward the ball of the foot. In fact, the Fasciitis bar of the present invention is located to provide pressure between the heel and the arch of the foot, along the centerline of the foot. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     FIG. 1 is a side elevation view looking toward the inside of a human left foot, including the major bones of the foot and ankle; 
     FIG. 2 is a top plan view of the orthotic heel cup of the present invention, including the Fasciitis bar; 
     FIG. 3 is an isometric view of the orthotic heel cup with the Fasciitis bar; 
     FIG. 4 is a sectional view of the orthotic heel cup taken along a line as shown in FIG. 3 which lies along the length of the orthotic device just inside the edge which underlies the inside (arch side) of the patient&#39;s foot; 
     FIG. 5A is a sectional view of the orthotic heel cup taken along a line as shown in FIG. 3 which lies along the length of the orthotic device at the mid-point thereof which underlies the middle of the patient&#39;s foot; 
     FIG. 5B is a sectional view similar to that of FIG. 5A showing an alternate embodiment of the orthotic heel cup; 
     FIG. 6 is a sectional view of the orthotic heel cup of FIG. 3 taken along a line as shown in FIG. 3 which lies along the length of the orthotic device just inside the edge which underlies the outside of the patient&#39;s foot; 
     FIG. 7 is a side elevation view of a human left foot similar to the view of FIG. 1, including the major bones of the foot and ankle, along with a sectional view of the orthotic heel cup, in section, as shown in FIG. 5A, and illustrating the proper location of the orthotic heel cup and its Fasciitis bar; 
     FIG. 8 is a perspective view of a second alternative embodiment of the orthotic device of the present invention; and 
     FIG. 9 is a view, similar to that of FIG. 7, but showing the second alternative embodiment of FIG.  8   
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
     FIG. 1 diagrammatically illustrates a typical human foot  24  along with the lower end of the tibia  11 . This view shows the inside, or arch side, of the foot in outline, along with an outline of the major bones which would be seen on that side of a skeletal foot. Below the tibia  11  is the talus  13 , or “ankle bone”. Positioned below and rearwardly of the talus  13  is the calcaneus  26 , or “heel bone”. Positioned moderately below and forward of the talus  13  is the navicular  15 . Immediately behind the navicular  15 , and not shown in the illustration of FIG. 1, is the cuboid, which occupies a position similar to that of the navicular  15 , but on the outside of the foot. The area between the calcaneus  26  and the navicular  15  and cuboid is the calcaneus-midtarsal connection  28  where the heel meets the arch of the foot  24 . 
     Forward of the navicular  15  and cuboid are the cuneform bones  17 . Extending forwardly from the cuneform bones  17  are the metatarsals  30  and the phalanges  32 . Though not shown, the plantar fascia joins the calcaneus  26  to the MTP joints  34  between the metatarsals  30  and the phalanges  32 , generally along the arch  36  of the foot  24 . 
     Illustrated in FIGS. 2 through 6 is the orthotic device  10  in accordance with the present invention, provided to relieve pain in the heel of a person&#39;s foot  24  when worn. The orthotic device  10  is comprised of a cup-shaped heel portion  20  which is adapted to surround the heel and adjacent areas of a person&#39;s foot  24  when worn, and to properly position the orthotic device  10  beneath the patient&#39;s foot  24 . The orthotic device  10 , including the heel portion  20 , is preferably formed as a single piece, and may comprise a material that can be manufactured in the illustrated configuration through thermo-forming or injection molding. Such materials include but are not limited to plastics, gels, foams such as P-lite® or polypropylene, visco-elastic polymer, Softsole®, polyurethane, and combinations thereof. Regardless of the material used, the preferred hardness is between 20 to 80 durometers. This hardness has been found to apply appropriate pressure to the patient&#39;s foot, without causing discomfort. 
     The orthotic device  10  includes a sole portion  18 , having a bottom surface  40 , which extends throughout the length of the orthotic device  10  and underlies the center of the patient&#39;s heel. Extending upwardly from this sole portion  18  is a rear wall portion  16 , and side wall portions  38 , which together form the heel cup portion  20 . The rim  22  of the rear wall portion  16  and sidewall portions  38  is U-shaped to surround the rear of a patient&#39;s heel in a manner common to orthotics device of the prior art. 
     A raised bar-shaped portion  12 , deemed the “Fasciitis bar”, extends laterally across the orthotic device  10  just forward of the heel cup portion  20 . The raised portion  12  preferably has a semi-cylindrical or pillow shape with tapered sides and extends above the sole portion  18  as a side-to-side bump. The Fasciitis bar  12  is preferably formed as one piece with the sole portion  18  and the heel cup portion  20 , and is preferably constructed of the same material. As discussed above, such materials include but are not limited to plastics, gels, foams such as P-lite® or polypropylene, visco-elastic polymer, Softsole® sheets, polyurethane, and combinations thereof. Regardless of the hardness of the remainder of the orthotic device  10 , the hardness of the Fasciitis bar  12  is preferably between 20 and 80 durometers to provide substantial, comfortable pressure against the sole of a patient&#39;s foot. 
     As shown in the cross sections of FIGS. 4,  5 A and  6 , the Fasciitis bar  12  extends laterally across the orthotic device  10 , blending into the heel cup portion  20  at its extreme ends, but forming a substantial protuberance along the centerline of the orthotic device illustrated in FIG.  5 A. The preferred thickness of the Fasciitis bar  12  at the lateral center portion  48  shown in FIG. 5A may range from 0.0625 inches to 0.375 inches. The length of the bar  12  may range from 0.5 to 2.5 inches, but is preferably centered about the centerline of the orthotic device. In the preferred embodiment shown in FIG. 5A, the Fasciitis bar  12  is generally symmetric from front-to-rear in cross section, with the front and rear surfaces sloping in similar contour. In a first alternate embodiment shown in FIG. 5B, the front surface  46  of the Fasciitis bar  12  slopes more acutely from the peak  48  of the bar  12  to provide a more abrupt pressure differential along the length of the patient&#39;s foot. 
     FIG. 7 illustrates the orthotic device  10  properly sized and positioned in relation to a patient&#39;s foot  24 . As shown, the raised portion or Fasciitis bar  12  is positioned by the heel cup portion  20  directly beneath the calcaneus-midtarsal connection  28  where the heel meets the arch of the foot  24 , at the junction of the navicular  15  and cuboid with the calcaneus  28  (See FIG.  1 ). This placement provides moderate comfortable pressure on this area to provide significant heel pain relief. The bottom sole portion  18  may extend longitudinally forward along the sole of the patient&#39;s foot  24  and against the plantar fascia  36  (FIG. 1) as far forward on the foot  24  as desired, possibly even underlying the metatarsals  30  (FIG.  1 ). 
     Although the preceding description illustrates the Fasciitis bar  12  as a part of a heel cup orthotic device  10 , FIGS. 8 and 9 illustrate a simpler form of the Fasciitis bar  50 . In this form the Fasciitis bar  50  is a stand-alone member, providing a raised portion  52  having a semi-cylindrical shape with a flat bottom  58 . The front portion  54  and back portion  56  of the bar  50  are tapered for increased comfort. In this form of the invention, the Fasciitis bar  50  may include adhesive on its flat side  58  for attachment to a shoe or another orthotic device. Alternatively, the upper surface  52 ,  54 ,  56  may include adhesive for attachment to the sole of a patient&#39;s foot. In either of these cases, the bar  50  is adhesively attached so that it underlies the calcaneus-midtarsal connection  28  where the heel meets the arch of the foot  24 . While adhesive is described herein as the preferred method of attachment of this Fasciitis bar  50  to the sole of a person&#39;s foot or their shoe, strapping or clamping may also be used to hold the device in the proper location.