While the name is new, the condition itself is not. Rock G. Positano, DPM, MSc, MPH, DSc, Director of the Non-surgical Foot and Ankle Service at HSS, and the Heel Pain Center at HSS, has seen similar cases for years among patients who experienced dramatic weight loss following bariatric surgery. "The heel relies on a protective fat pad to absorb shock with every step," said Dr. Positano. "When that cushioning is lost too quickly, the heel can become extremely sensitive and painful, making even routine movement difficult." Understanding the symptoms and seeking appropriate treatment early can help patients stay active while continuing their weight-loss journey.

Read the full article at usnews.com. 

Research has found that many women wear shoes that are too small and may need a larger size as they age. Dr. Positano refers to this as the “Cinderella complex”: trying to fit a larger foot into a smaller shoe size.

“It is unlikely that your shoe size at age 20 is going to be the same at age 50,” said Dr. Positano.

Wearing ill-fitting shoes can contribute to foot pain, tendonitis, blisters, ankle swelling, and even discomfort in the knees, hips, and lower back. Instead of expecting shoes to "break in," Dr. Positano advised choosing footwear that feels comfortable from the start, with adequate support in the heel, arch, and forefoot.

Read the full article at nypost.com. 

Dr. Positano noted that improperly fitting shoes can contribute to issues such as tendonitis, blisters, ankle swelling, and knee, hip, and back pain. While many people do well in traditional footwear, he said customized shoes may be particularly beneficial for those with unique foot structures or other specific needs.

“People often neglect the importance of their feet until they develop a problem,” Dr. Positano said. “Foot and ankle pain may not be life threatening — but it certainly is lifestyle threatening.”

Read the full article at nypost.com. 

Dr. Positano notes that extended wear—especially during summer months when people tend to walk more—can increase the risk of foot pain, slips, and injury. Supportive footwear is key, particularly for those spending long hours on their feet.

Read the full article at vogue.com. 

Dr. Positano said that for people who have issues with their feet or ankles, boots in summer can be salutary. For anyone with plantar fascia, Achilles’ tendon or heel and knee issues, they’re actually a good idea.

“The boot provides stability in these areas and often protects against overuse injuries,” Dr. Positano said. Especially if the boot has a one- to two-inch heel.

He calls this the “Cinderella complex” of footwear and advises avoiding it. Test the fit of boots in the mid- to late afternoon, when swelling is usually at its height.

Further risks: If your feet sweat a lot in the summer heat, you are at risk for athlete’s foot and contact dermatitis. “Perspiration in a closed boot in a warm climate may actually cause chemicals in the boot material to leach out and cause skin inflammation,” Dr. Positano said.

Read the full article at nytimes.com. A subscription is required to access. 

She was treated by Rock G. Positano, DPM, MSc, MPH, DSc, Founder and Director of the Non-surgical Foot and Ankle Service and the Heel Pain Center at HSS. 

Read the full article at ew.com.

She was cared by Rock G. Positano, DPM, MSc, MPH, DSc, Founder and Director of the Non-surgical Foot and Ankle Service and the Heel Pain Center at HSS. 

Read the full article at newsweek.com. 

“With the possibility of a winter storm approaching this weekend, it’s important for every New Yorker to be cautious of the foot and ankle problems that can be caused or worsened by wearing snow boots,” said Dr. Positano. 

“Since there are more risks than rewards with snow boots, these shoes certainly aren’t made for walking.”

Dr. Positano noted that while snow boots appear “safe,” they offer little to no orthopedic support.

“This leads to tendon and ligament overuse, which can cause painful injuries, especially when making long treks in the snow or in the rain,” he explained.

“An influx of knee and back problems can also arise from the lack of support, mixed with the presence of underlying orthopedic problems,” said Dr. Positano. 

Read the full article at nypost.com. 

A recognized innovator in non-surgical treatment for complex foot and ankle issues, Dr. Positano has been on staff at HSS since 1991 and is founder and director of Non-Surgical Foot and Ankle Service and the Joe DiMaggio Heel Pain Center.

Dr. Positano, a 1989 graduate of what is now Touro University’s New York College of Podiatric Medicine (NYCPM), has served as the editor of 12 medical textbooks ranging from foot and ankle orthopedics and heel disorders to sports medicine. His thesis on foot health was approved “with Honors” and “with Distinction” by the faculty of the Yale School of Medicine. He’s also a contributing writer to U.S. News & World Report.

“The foot is the most ignored part of the body,” said Dr. Positano, 66. “Foot and ankle problems may not be life threatening, but when they occur, they are certainly lifestyle threatening.”

Read the full article at nycpm.touro.edu. 

If suddenly, your knee, ankle or big toe starts throbbing. It can be so sensitive that even touching the top of your bedspread is painful. After a night of suffering, you get out of bed, and your feet only feel worse. They’re throbbing, swollen, hot to the touch – and you can forget about putting your full weight onto it.

If any of these symptoms apply to you, there’s a heavy chance you suffer from gout.

Read the full article at usnews.com. 

Read the full article at huffpost.com. 

According to Dr. Positano, your feet never go on holiday. When traveling, your feet are constantly working – even if you're on vacation. A foot in pain or suffering from an injury can “make or break” a vacation that you spent time and money planning. The best “travel insurance” isn’t the dollars spent to secure your deposit back in case of any emergency. Instead, it’s having healthy feet.

In the stress of planning and the excitement of traveling, people often ignore how important their feet are, especially when going on vacations that require a tremendous amount of walking or standing, climbing hills or having to handle difficult and uneven terrain. That is, until they start to feel foot pain or discomfort. There may be nothing more stressful or baffling than when a patient comes to my office at the Hospital for Special Surgery complaining of foot and ankle pain a few days, or even one day, before they leave for their trip (which happens far too frequently). If this pain had been a recurring issue, the smarter option would be for the patient to come to me four to eight weeks before their trip.

Read the full article at usnews.com. 

They may be far away from your major organs, but your feet can hold major clues about your health — especially if you’re dealing with one key symptom that’s frequently brushed off.

“Heel pain is the great imposter,” Dr. Positano explained, meaning it can be masking other more serious conditions.

For one thing, agony in the foot and heels could be related to disorders that affect the joints and muscles.

“Many rheumatologic conditions such as psoriasis, lupus, rheumatoid arthritis and blood clots may also present as heel pain,” Dr. Positano added.

Read the full article at nypost.com. 

“Plantar fascia injuries are very prevalent post-marathon,” said Dr. Positano. The plantar fascia, which connects your heel to your toes, acts as the body’s major shock absorber. Its fat pad has a low blood supply, he explained.

“The marathon stress can accelerate degeneration of the fascia and lead to partial and, in some cases, complete tearing,” Dr. Positano said, noting that this can cause sharp, stabbing or aching pain in the heel or arch.

Read the full article at nypost.com. 

“Your feet never go on vacation. They are constantly working and never on holiday,” was his latest bit of wisdom. “The best travel insurance is healthy feet.”

According to Dr. Positano, a painful foot can ruin a $40,000 vacation even before it starts, so why aren’t people more proactive when it comes to protecting the “Michelin tires” of the body?

“People often ignore and underestimate how important the feet are, especially when going on vacations that often require a tremendous amount of walking and standing, climbing hills, and uneven terrain,” he says. “What baffles me is the patient who comes to see us at our center at HSS, complaining of foot and ankle pain, the week or even the day before they are leaving on their voyage.”

Read the full article at forbes.com. 

In the segment, Dr. Positano explains what turf toe is, how it occurs, and the impact it can have on athletes’ performance and recovery.

Watch the video at youtube.com. 

On the court, they endure grueling matches and quick turnarounds under intense pressure. Off the court, athletes juggle recovery, injury prevention, media appearances, sponsor obligations and late-night events.

Rock G. Positano, DPM, MSc, MPH, DSc, Founder and Director of the Non-surgical Foot and Ankle Service and the Heel Pain Center at HSS joined “Mornings On 1” to explain how players keep their bodies in top shape during one of the sport’s toughest stretches.

Watch the full segment at ny1.com.

Watch the segment at fox5.com. 

People are prone to toe injuries big and small in the summer because they’re playing outside more, wearing less-protective footwear, such as sandals and flip-flops, and walking barefoot on hot surfaces like pavement and sand.

A broken toe might seem like a minor inconvenience, but dismissing it means you’re left with the dreaded, red and swollen “sausage toe” — and must banish those toe-tally cute kitten heels and wedges to the back of the closet for now.

In the long term, you face the risk of persistent aches and pains, trouble walking, arthritis and even deformity.

The Positanos recommend seeing a doctor as soon as the injury occurs to undergo medical imaging.

Read the full article at nypost.com. 

The study found that pedestrians in New York, Boston and Philadelphia are picking up the pace compared to years past. That come as New York was also just named the fourth most walkable city in the world by Time Out.

As warmer weather invites even more foot traffic, one doctor is urging people to take better care of their feet.

Rock G. Positano, DPM, MSc, MPH, DSc, founder and director of the non-surgical foot and ankle service at HSS, joined “Mornings On 1” to discuss ways to prioritize your foot health.

Watch the full episode at youtube.com. 

The foot by itself [without a sock] in a shoe, plastic or not, provides a perfect milieu for fungal growth,” explained Dr. Positano. “It is moist, dark and there is heat. The combination of those three things make a foot inside a shoe a dangerous place.” Isn’t danger just another way of saying… “temptation?” 

Read the full article at vogue.com.

Read the full article at ilmessaggero.it.

If you feel like you’ve just been kicked in the bottom of your heel, but turn around to see nobody there, you may be experiencing an issue with your Achilles tendon or plantar fascia. Ever since the coronavirus pandemic hit in 2020, there has been a rise in heel and Achilles injuries. There are many factors contributing to the rise in these foot injuries:

-Lack of exercise from being confined at home

-Lack of proper conditioning before any form of physical activity

-Wearing little to no footwear, which provides no support to your feet. Yes, this even goes for being barefoot at home. People would be shocked at the mileage one can walk while being at home.

The above issues can result in what's been coined by myself as “pandemic foot” in an article with The New York Times, a term created due to the increase number of foot and ankle pain during and post-pandemic explained Dr. Positano.

Read the full article at usnews.com. 

“Achilles injuries are different,” said Dr. Positano. They may be healed physically, but there’s a significant psychological component as well. Every time an athlete coming off a recent Achilles injury moves, somewhere in their mind they could be wondering whether they’ll re-injure it. It takes time to overcome that and often the timeframe for true recovery is closer to two years.”

Read the full article at athlonsports.com. 

Listen to the full episode at podcasts.apple.com.

“It has to do with where you wear them. The whole purpose of a shoe is to protect the foot. We found that in cases where people are doing excessive walking or standing, it's probably not a good idea. There is no protection,” explains Dr.  Positano.

“The foot is the most important shock absorbing part of our body. Flip flops do absolutely nothing for shock absorption,” says Dr. Positano.

Watch the segment at fox5ny.com.  

Estimates show that by the time a person reaches age 65, approximately 90% of the population will have suffered a foot and ankle condition at some point. The foot is a complicated body part – home to 26 bones, 33 joints and a complex matrix of ligaments, tendons and muscles.

Due to the physiological complications that come with aging - such as decreased muscle mass, poor circulation and longer healing times - foot problems and injuries in older people can have complications on their overall health and mobility. Your feet really are your base of support.

According to Dr. Positano, one of the most common conditions across all generations is plantar fasciitis, also known as “heel spur syndrome.” Affecting nearly 2 million Americans each year, plantar fasciitis is caused by an inflammation and degeneration of the plantar fascia, the tendon band located on the bottom of the foot. The plantar fascia is responsible for maintaining the structure and stability of the arch.

Read the full article at health.usnews.com.

Read the full article at usnews.com. 

“Pickleball has become a musculoskeletal pandemic. We have seen a crazy increase in the amount of people hurting themselves while playing pickleball,” says Dr. Positano.

“It's great workout, but what people don't realize even though it's a smaller court, there's bigger injuries. We have seen a large increase in the number of people hurting their Achilles tendons or their heels, plantar fasciitis, fractures, etc. The reason why is it's a very quick game.  Your instinct is to make a move a lot quicker than you would on a paddleball court or tennis court,” explained Dr. Positano.

“If it last more than a day or two and you're not able to weight bear, then you really should have it looked at,” said Dr. Positano.

Watch the segment here at fox5ny.com. 

“The blood supply for that Achilles tendon will decrease by almost one third after age 30. That means less blood which translates into less elasticity, less strength, and more of a likelihood of a person who is around 35 to 45 injuring their Achilles tendon,” explained Dr. Positano. 

This segment aired on New York 1 on September 12. 

So much of what we see at the US Open looks full of strength and athleticism and at many times so effortless and graceful. But we have seen several players retire early as a result of injuries they have experienced during matches due to stress and strains. 

“I think the most important thing is not to overdo something. Everyone gets inspired around Wimbledon or the US Open to go out and play a lot of tennis. And of course it makes people feel good because they watched these tennis players on the court and they think they can just go out there and start full force. We find that many of these injuries involving the foot and ankle are really because these people are not conditioned. Particularly in the areas of heel pain and achilles pain," said Dr. Positano. 

“You can't just go out there and play your heart out because you're not conditioned to do that, which means your muscles, tendons, ligaments are not accustomed to this type of quick escalation,” explained Dr. Positano. 

Listen to the full episode at omny.fm.

"It says a lot about Judge's superior training, his focus, and dedication to be able to come back as fast as he did," said Dr. Positano.

“There's a tremendous amount of stamina and running and pressure that goes on that foot when running. That's the real concern here. When he is able to run the bases and when he is able to field,” continued Dr. Positano. 

“As long as he stays focused, and in the offseason does the right conditioning and rehabilitation, he should be 100 percent next year.” 

“The fact this man is even hitting baseballs is quite remarkable. But people have to appreciate the nature of this injury. This is going to take a significant amount of time and people don't realize how important feet are until they have an injury. Not rehabilitating him properly can have an effect on his long- term career. That's what they should be focused on right now," said Dr. Positano.

This segment aired on New York 1 on July 31st. 

“After looking at what happened with his toe, he made some damage to the ligaments that stabilize that big toe, which is responsible for propulsion, power, catapulting, etc. It will affect all aspects of his game,” explained Dr. Positano. 

"You have to assume this will have an effect on his ability to play defense. It is an injury that has to be dealt with in a very delicate way," said Dr. Positano. 

“I think the best way to handle this injury is do it in a conservative way. Get the joint to heal, get it to become stable again, and of course use an appliance. You make a special orthotic which is something that goes up to the top part of the big toe that stabilizes it.” added Dr.  Positano. 

Listen to the episode at podcasts.apple.com. 

Listen to the podcast at omny.fm. 

According to Dr. Positano, when you are dealing with a tendon or ligament injury in the foot, the blood supply is notoriously low, which means the healing potential is not as good as you'd like to see, there is a loss of strength, and the ability to come back at a rapid pace is impaired.  

If it turns out it is his achilles tendon, that could be a situation where you try not to do a surgical intervention said Dr. Positano. The surgery itself could be done very efficaciously, but the problem is constant force loading which make foot and ankle injuries so difficult.  Unlike other body parts, the foot and ankle have no chance to rest. 

Dr. Positano does not think this injury is career ending, but when an athlete of this caliber has a foot or ankle operation, the long term outcome is not always clear.  

Listen to the episode at omny.fm.

Dr. Positano said we often take our feet for granted until we have an issue. After the pandemic, no part of our body was more important than our feet, for both transportation and safety. Many people developed foot problems after the last 2 years.

“It is important to consider how you treat your feet,” advised Dr. Positano, who suggested the two week rule: if a person has a problem with their foot that has lasted over two weeks, it is time to seek medical attention. 

This segment aired on New York 1 on April 14. 

Read the full article at ny1.com. 

According to Dr. Positano, there is no such thing as a simple ankle sprain.  -Mahomes' has a high ankle injury that is a lot more involved because it deals with bones and ligaments. There is no question he is going to be slightly impaired. 

The most important thing is to stabilize the injury,  bring the swelling and inflammation down, and -try to not overextend what he is doing in terms of his performance and his practice on the field, noted Dr. Positano.

Listen to the episode at omny.fm.

Her physician, Rock G. Positano, DPM, MSc, MPH, DSc, Director of Non- Surgical Foot and Ankle Services at HSS,  helped Brandi get back on her feet. Throughout her rehabilitation process, she came to learn she was not alone, as this condition increased 20-30% post-lockdown. Dr. Positano dubbed this epidemic as the “Pandemic Foot” and is currently completing studies  to quantify the matter. 

“It’s important to not underestimate the severity of symptoms”, explained  Dr. Positano. “Because problems with our feet, though not life-threatening, can be deleterious to one’s quality of life. The inability to move directly influences one’s ability to exercise, socialize, and consequently can be very taxing emotionally as well. During lockdown, routines and habits were forced to change; people who normally would take public transport shifted to walking, for fear of contagion, moving from 2 to 7 km per day. While this degree of exercise is in fact recommended for regulating blood pressure, circulation, bone health, and glucose levels, those not previously accustomed to this degree of activity quickly suffered adverse effects.” 

After the lockdown, there began to be a notable rise in heel pain, which serves as the primary point of shock absorption during the repetitive impact whilst walking. A lack of adequate support compromises its ability to properly function, causing a, rather painful, chain reaction. The issue starts with the heel itself suffering from inflammation, then migrating to the plantar fascia, as well as the fatty tissue that surrounds it. Not long thereafter, a series of repercussions will begin to manifest along the entire body, because when one’s feet begin to fail, the body begins to compensate – and the knees, back, and hips are the first to feel it. 

“This trend is most certainly on the rise,” Dr. Positano elaborated. “We have patients in their 30s with the same probability of developing these issues as those in their 80s. Even athletes, who have had to stop their rigorous training as a result of the  pandemic, have displayed signs of this same issue when they picked it back up.”

Read the full article at community.thriveglobal.com. 

Dr. Positano discussed “pandemic foot” in The New York Times article after seeing foot pain increase in many patients due to the COVID-19 pandemic, which caused many to adjust their walking and standing patterns. He saw an increase in patients suffering from pain in their heels and Achilles tendons, noting, “People don’t realize how much mileage they put on walking and standing in their houses.”

Dr. Positano explained, “Foot and ankle problems may not be life-threatening, but they can be ‘lifestyle threatening’. They can affect a person’s ability to exercise, play sports, or even walk.”

Read the full article at Newyorksocialdiary.com.

He encouraged people to be gradual about getting back into an exercise routine – if you aren’t accustomed to a certain amount of activity, you run the risk of overuse problems, particularly in muscle groups in the foot, ankle and back.

Dr. Positano’s tips for getting back into exercising: start slow (as rapid return to activity can be dangerous), feet and back pain are particularly common, and to avoid a self-diagnosis - advising to consult with a doctor about any issues.

This segment appeared during the 8am news hour on May 21, 2021.

“Heel plantar fascia, heel fat pad, Achilles, as well as forefoot problems such as bunion deformities and neuroma are on the rapid rise due to this phenomenon,” noted Dr. Positano. “People don’t realize how much walking they do in their homes. Some of our patients have clocked up to five miles a day in their domiciles using a pedometer. Many of my colleagues are seeing a concomitant increase in knee, hip and lower back problems mainly because of faulty and insufficient shock-absorbing capability caused by being barefoot for significantly longer periods of time.”

Dr. Positano recommended wearing footwear with a semirigid and flexible arch with a small heel indoors.

This article was featured in print on August 31, 2020.

Since the start of the COVID-19 pandemic, Dr. Positano noted people are doubling, even tripling, the amount of time they are walking. He advised to increase your walking gradually. “Don’t go from walking one mile a day to five miles a day. That is a prescription for disaster. The body is not accustomed to that dramatic increase.”

Dr. Positano also recommended wearing supportive footwear. “Wearing flip flops or things that are very soft. Even though they may feel good, they offer no or little support to the arch and the lower leg, which of course will affect the knee, the hip and the back.”

This segment aired during the 9AM news hour on August 4, 2020.

Dr. Positano wrote there has been a recent influx of patients injuring their foot/ankle(s) due to falls, reporting of not being able to see properly due to the mask obscuring their depth of perception, disorienting them in the process, and causing them to misstep and injure themselves. He advised taking a few minutes to ensure your mask is put on correctly to keep yourself safe.

According to experts, the top part of the mask has a wire that runs along its length. Putting the mask on and simply letting it sit on top of one’s eyeglasses, even with the mask right side up will cause the lenses to fog up. Glasses must be taken off first, then as one loops the elastics over the ears, press down on the wire to bend and adapt it so that it will fit tightly over the bridge of the nose and all along the face. This will prevent air from leaking through and allow the mask to fit under the eyeglasses so they won’t fog up. If the mask is not properly positioned and one lens in your eyeglasses gets foggy there will be a loss of stereopsis. This depth perception allows us to intuitively gauge where to place our feet as we walk up or down a flight of stairs for instance, or step off a curb.

Read the full article at Thriveglobal.com.

Read the full article at Popsugar.com. 

Additional coverage: You.co.uk.

This segment aired during the 7am news hour on April 20, 2020.

Dr. Positano adds, "The implications of walking are so important these days because of the psychological benefit. So many people need to be able to get out right now, by practicing social distancing, to release some of their stress, nervousness and anxiety.”

This segment aired during the 9am news hour on April 15, 2020.

Read the article at Publichealth.yale.edu.

He writes that “walking will positively affect your general health, including improving blood pressure, staving off diabetes and regulating blood sugar, losing weight, reducing stress, and, of course, maintaining your mental health".

Read the full article at NYPost.com. This also appeared in the March 28, 2020 print edition.

Additional Coverage:

• Thrive Global