Watch & Learn: Brighton Foot & Ankle YouTube

Dr. Castelein explains that heel spurs are bony projections that form over years when tight structures like the plantar fascia or Achilles tendon repeatedly pull on the heel bone. Despite being a common diagnosis, the spur itself is rarely the source of pain — the inflammation in the surrounding tissue is. For most patients with plantar fasciitis or Achilles tendonitis, the spur can be left alone entirely. Surgery to remodel the bone is only considered when the spur is large enough to rub against footwear or when tendon repair is needed, and even then the underlying cause must be addressed to prevent recurrence.

Dr. Castelein explains low ankle sprains, focusing on the ATFL (anterior talofibular ligament), the most commonly injured ligament in the ankle and the equivalent of the ACL for the knee. He covers how the injury occurs from landing on uneven surfaces or another player’s foot, common in skill position players like running backs and wide receivers, and why imaging like X-ray and MRI is important to rule out cartilage damage and tendon involvement. Treatment ranges from physical therapy, taping, and bracing to surgical reconstruction depending on the severity of the sprain.

Dr. Castelein explains how foot arch type, whether flat, high, or neutral, directly impacts stability, weight transfer, and consistency in your golf swing. Low arches cause the foot to pronate and the leg to rotate inward, leading to a swaying swing and arch or knee fatigue, while high arches create a rigid, smaller base that reduces shock absorption and can cause ball of foot pain and ankle instability. He recommends calf stretching and custom orthotics to stabilize either arch type and improve performance on the course.

Dr. Castelein breaks down what amateur golfers can learn from three tour superstars: Tiger Woods’ dedication to 40+ minutes of stretching and core strength training before ever touching a club, Rory McIlroy’s focus on hip and thoracic spine rotation using resistance bands, and Scottie Scheffler’s signature foot shuffle technique that improves hip mobility and rotation consistency. The takeaway for everyday golfers is to prioritize flexibility, rotation, and body prep over equipment.

Dr. Castelein discusses the three most common foot and leg injuries he sees in golfers: plantar fasciitis, Achilles tendinitis, and anterior tibial tendinitis (shin splints). He explains that all three are connected to tight calf muscles and hamstrings, and recommends focusing on flexibility and stretching before, during, and after rounds to prevent pain and stay on the course.

Dr. Castelein breaks down which conservative bunion treatments are worth trying and which aren’t, explaining that bunion braces and splints don’t address the underlying joint instability. He recommends silicone toe spacers for cushioning and padding, along with rigid supportive insoles and mesh shoes that don’t put pressure on the bunion. When pain, sores, or shoe fit become a problem, he suggests it may be time to consider surgical correction.

Dr. Castelein explains first MPJ arthrodesis, a procedure that fuses the big toe joint to correct severe bunions paired with joint arthritis or damage. He describes it as a reliable “gold standard” option, especially for older patients or those with conditions like osteoporosis, with patients able to walk immediately in a surgical boot and a full recovery timeline of 6-8 weeks.

Dr. Castelein breaks down the Lapiplasty procedure, a modern update to the century-old Lapidus bunion correction. He explains how the first metatarsal joint shifts and rotates to cause bunions, and how 3D/4D correction techniques fuse and stabilize that joint to reduce recurrence rates to 5% or less, compared to older methods.

Dr. Castelein explains how tight calf muscles (the gastrocnemius and soleus) place extra strain on both the Achilles tendon and the plantar fascia, often causing heel pain and Achilles discomfort at the same time. He recommends calf stretching as a first step to relieve pressure on both structures.

Dr. Castelein covers lateral ankle sprains and the anterior talofibular ligament (ATFL), the most commonly injured ligament in ankle injuries. He explains the difference between partial tears and full ruptures, when an MRI is needed, and when treatment may require bracing versus surgical repair (the Brostrom procedure).

Dr. Castelein explains anterior tibial tendinitis, commonly called shin splints, a frequent overuse injury in runners and track athletes. Treatment focuses on stretching the calf muscles, supportive orthotics, and anti-inflammatory care to relieve pressure on the tendon.

Dr. Castelein and Toni Reese of The Running Lab discuss the evolution of running shoe design, from the minimalist/barefoot trend to today’s high-cushion and carbon-plated performance shoes. They cover how stack height, stability, and shoe engineering affect injury prevention and running efficiency.

Dr. Castelein explains metatarsal fractures, which make up 35-40% of all foot fractures. He covers the difference between acute trauma and stress fractures, which metatarsal bones are most commonly affected, and when treatment requires surgery versus a walking boot.

Dr. Castelein explains the Jones fracture, a specific break in the fifth metatarsal that occurs in a low blood-flow area, making it prone to slow healing. He discusses conservative treatment with a bone stimulator versus surgical repair with a screw, and typical recovery timelines.

Dr. Castelein breaks down common fracture terminology, including displaced versus non-displaced, intra-articular versus extra-articular, and simple versus comminuted fractures. Understanding these terms helps patients know what their diagnosis means for treatment and healing time

Dr. Yara Tinawi discusses the historical practice of foot binding in China, explaining its cultural origins and the lasting structural damage it caused, including chronic fractures and gait abnormalities. She uses it as an example of how altering the foot’s natural structure has lasting consequences.

Dr. Castelein gives a general overview of foot and ankle fractures, which make up 25% of all adult fractures. He explains when imaging like x-ray, CT, or MRI is needed, when surgery is required versus conservative treatment with a boot, and what recovery typically looks like.

Dr. Castelein discusses common causes of foot, ankle, and leg swelling, including medications, limited mobility, and chronic conditions like heart, kidney, or liver disease. He covers practical solutions like elevation, compression, and ankle pumps to help reduce fluid buildup.

Dr. Castelein explains why swelling after foot and ankle surgery is a normal part of healing, especially since the foot and ankle have less room to absorb extra fluid than larger joints. He recommends elevation, ice, massage, and compression to manage swelling during recovery.

Dr. Castelein explains the three types of gangrene affecting the foot and ankle: gas gangrene (a fast-moving bacterial infection requiring emergency surgery), wet gangrene (an infected, draining wound needing antibiotics and wound care), and dry gangrene (a stable condition often tied to poor blood flow, managed with a vascular surgeon). He covers common causes like diabetes, smoking, and circulation issues, and stresses that any form of gangrene needs prompt medical attention.

Dr. Castelein discusses Raynaud’s disease (also called Raynaud’s phenomenon), a condition where small blood vessels in the feet overreact to cold by constricting, causing numbness, tingling, or a burning sensation. He covers risk factors like age, smoking, and diabetes, along with treatment options ranging from keeping feet warm and dry to prescription creams or oral medication for more persistent cases.

Dr. Castelein explains why feet feel cold, discolored, or numb in winter, breaking it down into two causes: blockages in large blood vessels (often tied to cardiac history, diabetes, or aging, and linked to calf cramping while walking) versus issues in small blood vessels at the toes, like Raynaud’s disease. He recommends getting circulation checked and staying active to support healthy blood flow.

Dr. Tinawi and medical assistant Sophie demonstrate proper wound care technique, covering antibacterial creams like Silvadene and antiseptics like Betadine, along with correct gauze application, cling wrap, and Coban self-adherent wrap. The video walks through wrapping technique around the toes and ankle to keep dressings secure without being too tight.

Dr. Tinawi and medical assistant Sophie demonstrate how to apply a 4-inch ACE bandage for swelling and inflammation, starting at the base of the toes and overlapping each wrap by 50%. They cover the figure-eight technique around the ankle for secure support and tips on positioning the Velcro to avoid pressure points.

Dr. Castelein talks with Dr. Josh White, medical director for Ortho Feet, about what makes a shoe diabetic-friendly, including proper depth, multiple widths, a removable insert, and closed-toe design to prevent pressure sores and ulcerations. They also cover specialty options like pickleball shoes, golf shoes, and styles designed to accommodate ankle braces, all available for fitting at Brighton Foot and Ankle.

Dr. Castelein discusses how icy Michigan winters lead to a spike in slip-and-fall ankle fractures, especially among adults 65 and older. He covers why fibula fractures are the most common type from these falls, when an x-ray is needed (especially if pain lasts more than 2-3 days), and how more severe bimalleolar fractures involving both the fibula and tibia require surgery.

Dr. Castelein talks with Brock, a foot and ankle sales representative with over 10 years of OR experience, about trends in surgical products including soft tissue fixation, plates and screws, and biologics. The conversation touches on newer approaches to joint preservation in foot and ankle surgery.

Dr. Castelein discusses the benefits of walking barefoot on sand, including increased calorie burn, calf and foot muscle engagement, and natural exfoliation, while also cautioning that too much can lead to Achilles or heel fatigue. He also explains how footprints in the sand can reveal foot arch type, with high, flat, and neutral arches each leaving a distinct imprint pattern.

Dr. Castelein talks with Kevin, a surgical industry rep with over 18 years of experience, about advances in bunion surgery. They discuss the shift toward minimally invasive techniques that allow earlier weight-bearing and faster recovery, along with how modern approaches have dropped recurrence rates from around 72% with older procedures down to roughly 98% success.

Dr. Castelein breaks down ankle fracture dislocations using a recent example of a football injury, explaining how a single fracture can sometimes be treated conservatively, but a fracture involving two bones (a bimalleolar fracture) or torn stabilizing ligaments requires surgery. He also covers how surgeons check cartilage health during the procedure to help prevent long-term arthritis and support a full return to activity.

Dr. Castelein answers a common question on whether socks and compression sleeves make a difference for plantar fasciitis. He explains that while targeted compression can reduce swelling and provide support, the bigger factors for relief are a supportive orthotic in the shoe and consistent calf stretching, such as with a night splint, to take pressure off the plantar fascia.

Dr. Castelein explains why skin cancer checks shouldn’t skip the feet, since 5-15% of melanomas appear there. He walks through the ABCDE rule for evaluating spots and moles, asymmetry, border, color, diameter, and evolution, as a way to catch warning signs early and know when to see a dermatologist.

Dr. Castelein shares foot and leg health tips for air travel, including wearing knee-high compression socks (20-30 mmHg) to reduce swelling, choosing breathable shoes with mesh, and watching salt and sugar intake before flying. He also notes that compression socks are especially important for travelers with circulatory issues or a history of blood clots.

Dr. Castelein and Toni Reese from Brighton Running Lab break down four shoe options for different needs, the cushioned New Balance Fuel Cell Rebel for energetic runs, the more stable New Balance 880 for long miles or walking, the natural-fit Altra Via for all-day comfort, and the motion-control Saucony Echelon for stability and arch support. Each shoe is suited to a different foot type or activity level.

Dr. Castelein shares recovery tips for athletes and people on their feet all day at work, including wearing 20-30 mmHg compression socks to improve circulation, using calf and hamstring stretching tools, and incorporating massage guns or foam rollers to relieve muscle tension. He also recommends staying hydrated, aiming for roughly half your body weight in ounces of water daily.

Dr. Castelein discusses plantar fascia tears, using a recent sports injury as an example to explain the difference between minor tears (common, often treated conservatively with a boot, ice, and physical therapy) and more severe tears affecting over a third of the tissue, which may require surgical repair. He notes that most plantar fascia injuries heal well and don’t keep athletes out for long.

Dr. Castelein and Toni Reese from Brighton Running Lab discuss two major trends in running footwear: high-stack foam shoes like the Glycerin Max for everyday comfort and rehab, and carbon fiber plated “super shoes” like the New Balance Super Comp Trainer and Saucony Endorphin Elite for competitive racing. They explain how carbon plates stabilize soft, high-performance foam to boost running efficiency by up to 8%, while noting these race-day shoes aren’t meant for everyday training.

Dr. Castelein and Toni Reese from Brighton Running Lab walk through how a proper shoe fitting works, covering gait analysis, foot scanning for pressure points and arch type, and matching customers to shoes based on heel-to-toe drop and toe box width. They discuss how wider, natural-fit shoes like Altra can benefit people with forefoot pain conditions like metatarsalgia, neuromas, or bunions.

Dr. Castelein and Toni Reese from Brighton Running Lab discuss why getting properly fitted for popular shoes like Hoka matters more than following a friend’s recommendation, since fit and foot shape vary person to person. They also cover moisture-wicking running socks (including a plantar fasciitis-specific sock), recovery tools like foam rollers and massage sticks, and tips for keeping white shoes clean with water-repellent spray.

Dr. Castelein breaks down turf toe, an injury to the base of the big toe involving the sesamoid bones and surrounding ligaments, often linked to playing on artificial turf. He explains the three severity levels of ligament injury and the JS classification used to determine whether treatment can be conservative or requires surgical repair, especially for athletes needing full strength and stability in the toe.

Dr. Castelein talks with physical therapist Ryan Mertz about treating ankle arthritis and Achilles tendon injuries, including techniques like dry needling, massage, heat/ice therapy, and balance and strength work to reduce joint compression and pain. They also discuss how treatment plans differ between older patients easing into low-impact activity and younger athletes working back toward high-demand sports.

Dr. Castelein and physical therapist Ryan Mertz demonstrate three key stretches for lengthening the calf muscles and hamstrings, including a gastrocnemius stretch, a soleus stretch, and a seated hamstring stretch, each held for about a minute. These stretches help relieve pressure on the Achilles tendon and plantar fascia, with more advanced options like a yoga down dog stretch recommended for runners training for longer distances.

Dr. Castelein covers two surgical options for the small percentage of plantar fasciitis patients who don’t respond to conservative care: an endoscopic plantar fasciotomy, which releases part of the plantar fascia and requires 2-3 weeks in a boot, and an endoscopic gastrocnemius recession, which lengthens the calf muscle and requires about 4 weeks of recovery. He explains how each procedure is chosen based on whether the pain is more localized to the heel/ball of the foot or also tied to calf tightness.

Sophie interviews Dr. Castelein about his path into podiatry, from his undergraduate degree at the University of Dayton to his doctorate from the Dr. Scholl College of Podiatric Medicine and his surgical residency at Genesis Hospital. He covers his board certifications in foot and rearfoot/ankle surgery, his focus on reconstructive and trauma cases, and acquiring Brighton Foot and Ankle in 2019.

Dr. Castelein talks with physical therapist Ryan Mertz, who shares his background working with the Chicago White Sox and Cubs before returning to Michigan. Ryan explains physical therapy as a collaborative process focused on improving range of motion, strength, and flexibility through manual techniques, exercise, and education, with treatment plans tailored to each patient’s specific goals.

Dr. Castelein breaks down the anatomy behind a bunion, explaining how the first metatarsal shifts and rotates at the joint, pulling the big toe out of alignment and causing pain, swelling, and early arthritis. He also covers hypermobility, a hereditary condition involving excess joint motion, and how the small sesamoid bones are evaluated to help guide which bunion correction procedure is right for each patient.

Dr. Castelein shares foot care tips for weddings, since the long prep and event day can take a toll on your feet. He recommends resting and elevating feet earlier in the day, wearing supportive shoes or orthotics during setup, and packing a comfortable backup pair (like Birkenstocks or APMA-approved shoes) for dancing and standing later on.

Dr. Castelein shares tips on choosing the right hiking socks, recommending materials that reduce friction and manage moisture, with lighter socks for warm, dry climates and thicker wool or cotton blends for colder conditions. He also covers when compression socks (15-20 mmHg, up to the knee) are a good option for circulation, and advises changing socks daily or mid-hike if they get wet.

Sophie interviews Dr. Castelein about growing up in Lake Geneva, Wisconsin, and how tearing both ACLs as a teenager introduced him to orthopedic surgery and eventually podiatry. He shares how he moved to Michigan for residency in 2014, acquired Brighton Foot and Ankle in 2019, and stays active today with skiing, pickleball, and water skiing.

Dr. Castelein explains plantar fasciitis, a common condition affecting at least 10% of adults ages 25-60, describing the plantar fascia as a “bowstring” supporting the foot’s arch that becomes inflamed from overuse. He outlines the three-step conservative treatment approach used in his office: calf stretching to relieve pressure on the fascia, supportive orthotics, and anti-inflammatory medication, noting that 90% of patients improve with this approach.

Sophie interviews Dr. Castelein about his path through podiatry school, from his undergraduate degree in accounting at the University of Dayton to choosing Dr. Scholl College of Podiatric Medicine in Chicago. He shares advice for students considering podiatry, the career’s flexibility in work hours and settings, and what he found most rewarding about the educational journey.