Central Florida Foot and Ankle Center - Sports and Running

Billups Out for Season with Achilles Tear

2012-02-09T15:54:00.000-05:00

Chauncey Billups will be forced to sit out the rest of theNBA season with a torn Achilles tendon. The injury came in Monday night’s game against the Orlando Magic, asBillups’ Clippers went on to beat the Magic 107-102 in overtime. Billups, who is 35 years old, reports that hehad not previously had any pain in his Achilles tendon. The tear, however, was confirmed with MRI onTuesday. Billups will undergo surgery torepair to torn tendon, and promises to return to the league.

Achillles tendon tears can often occur just like they haveto Chauncey Billups, with no real history of pain in the area. However, what is common in Achilles tendontears is that there is degenerative disease in the tendon that precedes thetear. This degenerative disease isusually appreciated in the operating room under direct visualization when thetendon is repaired, even when the MRI reads the tendon as normal. This is because the changes can often be toosubtle to pick up MRI. The degenerativecondition is referred to as tendinosis of the Achilles tendon, and when thereis an acute incident of pain without a rupture, it is called tendinitis.

Surgical repair of Achilles tendon tears and rupturesinvolves cleaning up the ends of the tendon and removing any scar tissue thatmay be present in the tendon. A morenormal shape and appearance of the tendon is achieved using strong sutures toand strength to the tendon as it heals. Post-operatively, the patient is placed in a cast and remains non-weightbearing for several weeks. Followingremoval of the cast, aggressive physical therapy is initiated forrehabilitation. The timeline forcomplete healing of the surgical site is usually between three and six months,and a return to full strength may come after complete healing hasoccurred. In a professional athlete suchas Chauncey Billups’ case, this usually means the season ends early.

Billups, a five-time NBA All-Star, will certainly be missedon the court. He is considered one ofthe strongest leaders in the league, and has a way of boosting team morale bothon and off the court. He was picked upby the Los Angeles Clippers from the New York Knicks, and has become a key rolein the team’s ascent to the top of the Western Conference. They are in serious contention for thechampionship this year, in part due to Chauncey Billups. Hopefully he will be back on the sidelinessoon, his presence giving the Clippers motivation to win.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
www.FLFootandAnkle.com

Gronkowski Expected to Play in Super Bowl

2012-01-24T12:02:00.000-05:00

The New England Patriots’ victory on Sunday over theBaltimore Ravens sends the Pats to the Super Bowl, but a scary moment came inthe third quarter when tight end Rob Gronkowski went down with what looked likea serious injury. After catching a shortpass, Gronkowski was tackled and had his left ankle trampled in theprocess. The injury looked bad at first,and Gronkowski was helped off the field. He later returned to the game in the fourth quarter, but was seenwearing a boot after the game.

The Boston Herald is reporting that Gronkowski’s ankle is“fine”, and that he’ll be ready to play in two weeks when the Patriots take onthe New York Giants in the Super Bowl. This news comes as a relief to Patriots fans everywhere.

Ankle injuries in football and other sports are a commonoccurrence. The anatomy of the ankle issuch that a number of different structures may be injured following trauma tothe ankle. The most common types ofinjuries are sprains of the lateral ankle ligaments. These include the anterior talofibularligament (ATFL), calcaneofibular ligament (CFL), and the posterior talofibularligament (PTFL). The medial ankleligaments include the superficial and deep deltoid ligaments, which are lesscommonly affected by rotational ankle injuries.

Fractures of the ankle can also occur, including fracturesof the lateral malleolus (outside ankle bone), and the medial malleolus (insideankle bone). The talus, which sitsbetween these two structures in the ankle joint, can also be affected. Most commonly, the talus may have anosteochondral lesion, which is a chip in the joint surface.

High ankle sprains are injuries to the syndesmosis of theankle, and can be very slow healing injuries that are prone tocomplications. These can be quite severeinjuries, and may be associated with the development of long-term instabilityof the ankle.

A number of tendons cross the ankle joint, and can alsobecome damaged in an injury. Mostnotably, the peroneal tendons, which run along the outside of the ankle, maybecome strained or even dislocated in a rotational-type of injury.

Fractures of some of the bones of the foot may also be seenin rotational-type ankle injuries, including the fifth metatarsal, the cuboid,the navicular, and the anterior process of the calcaneus. A thorough work-up with x-rays is almostalways warranted.

While it is not clear what anatomic structures RobGronkowski’s injury involves, it is good news that the medical staff isanticipating his return for the Super Bowl. He is certainly a major asset to the Patriots, and plays a vital role intheir offense.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW. Winter Haven, Fl. 33881
863-299-4551
www.FLFootandAnkle.com

DeMarco Murray out for Season with Broken Ankle

2011-12-12T10:28:00.000-05:00

DeMarco Murray, running back for the Dallas Cowboys, will beout for the rest of the season with a broken ankle. The injury came this Sunday night in thefirst quarter of the game against the New York Giants, as Murray was pulleddown at the end of an eight-yard gain. His ankle was pinned against the turf, and the injury is being reportedas an ankle fracture and a high ankle sprain.

The rookie was a key asset to the Cowboys’ offense thisseason in their search for a playoff spot, but will sit the rest of the seasonas the injury heals. He had run for 25yards already in the game, giving him 899 for the season. The combination of ankle fracture and highankle sprain will certainly require some attention from the Dallas medicalstaff and trainers.

Ankle fractures are a common pathology during sports, andcan occur from either direct or indirect mechanisms. Indirect mechanisms imply a twisting forceplaced across the ankle when the foot is held in place. This is particularly common in football, asis the diagnosis of a high ankle sprain.

A high ankle sprain refers to damage to the anklesyndesmosis, which is a structure that keeps the tibia and fibula in closecontact, helping to create and stabilize the ankle joint. An injury to the syndesmosis can often leadto long-term damage and instability in the joint. These sprains are often treated with surgery,where a screw is placed across the syndesmosis to prevent it from moving whilethe tissues are allowed time to heal. Inthe case of DeMarco Murray, it is uncertain whether surgery will benecessary.

Ankle fractures canbe treated conservatively, often immobilizing the ankle and leg in a short legcast or a removable boot and keeping weight off of the leg while it heals. For ankle fractures that have becomedisplaced, meaning that the ends of the broken bone do not line up with eachother, surgery may become necessary to achieve a favorable outcome. Surgery forankle fractures involves the use of screws and plates, which may be necessaryto use on both sides of the ankle. Inthe case of ankle fracture combined with high ankle sprain, it becomes veryimportant to stabilize the ankle sprain with a screw across the tibia andfibula, the leg bones that create the ankle joint. Without this stabilization, motion across thescrew will cause the screw to fail, and the fracture fragments will be allowedto move apart.

As for DeMarco Murray, he will hopefully be able to heal hisinjury rapidly, and return to a productive career. The rookie running back was having a greatseason before the injury, rushing for 293 yards in October, the seventh-most inthe history of the NFL.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
www.FLFootandAnkle.com

Despite Sprained Foot, Roethlisberger Gets It Done

2011-10-10T09:47:00.000-04:00

Earlier in the week, it looked like Steeler’s quarterbackBen Roethlisberger may have broken his foot. He hobbled all week in practice, and was nowhere near full speed. While the team never released details ofexactly what the injury was, it looked like a sprain in his foot.

That sprain didn’t slow him down one bit on Sunday, as heand the Steelers roled over the Tennessee Titans, with a final score of38-17. Roethlisberger threw for 228yards and five touchdowns.

While there was no diagnosis released to the press, the painwas reported as being across the forefoot, and Big Ben hobbled noticeably attimes during the game. With the painbeing localized around the metatarsophalangeal joints, the possibility of aplantar plate injury, tendinitis, irritation of the capsular ligaments of theMTP joints, and many other conditions become possibilities.

Of his foot, Roethlisberger told the press “I told ya, I wasjust faking it, I’m a wimp.”

Over the next week, fans will have to keep an eye onRoethlisberger during practice to determine the fate of his left foot.

Most likely, it seems as though Roethlisberger may havesprained one of the capsular ligaments of one of the lesser metatarsophalangealjoints. These injuries are typicallyminor, and will resolve with rest, ice, and compression. If that is the case, he should be fine fornext week, when the Steelers face the Arizona Cardinals.

Sprains of the foot are treated conservatively. This involves PRICE therapy, with protection,rest, ice, compression, and elevation. Depending on what joint is affected, various types of braces may beused. Sprains of the rearfoot and anklecan be particularly worrisome, and will usually require various splinting andbracing techniques.

A sprain happens when a ligament of a joint is extended pastits normal range of motion. Extra stressis placed on the ligament as it is brought through an abnormal range of motion,and this creates a painful situation that is quickly followed by inflammationaround the joint. This inflammation addsto the pain, and is the reason that a sprain can last several weeks and is slowto get over. In order to fight theinflammation, non-steroidal anti-inflammatories are often added to thetreatment protocol, as well as compression and elevation.

Roethlisberger performed strongly on Sunday, but may not beout of the woods yet. He is a playerthat performs strongly when he’s hurt, but he’ll have to practice smart overthe next week.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
www.FLFootandAnkle.com

Kevin Williams will play despite plantar fasciitis

2011-09-02T10:28:00.001-04:00

Kevin Williams, the All-Pro defensive tackle of theMinnesota Vikings, said that he will play through his plantar fasciitis in theopening day matchup against San Diego. “It’s a situation where I feel it’s not going to go away until maybe theoffseason,” Williams said to the press. “We’re just going to deal with it and try to grin and bear it”. It sounds as though Williams knows that hisleft foot won’t be feeling much better any time soon, but he’s willing to shakeit off and continue on with practice and with the beginning of the season.

Amongst athletes both professional and amateur, thisreaction to plantar fasciitis is quite common. Many people will chose to perform through the pain, and eventually itmay even stop.

The plantar fascia is a strong piece of fibrous tissue,organized into an aponeurosis, that runs along the bottom of the foot. It attaches the heel bone (calcaneus) to thedigits. An increase in pressure andforce along the plantar fascia can often create a painful sensation, mostcommonly in the bottom of the heel. Thepain is especially strong with the first few steps out of bed in the morning,or after a long period of sitting.

Plantar fasciitis is extremely common, and accounts forapproximately 15% of all podiatry visits. It is the most common cause of heel pain in adults, and accounts forroughly 9% of all running injuries. Between 1995-2000, there were over 1 million patient visits to U.S.hospitals and hospital-based outpatient centers that were diagnosed withplantar fasciitis. It is easy to seethat professional football players and other athletes are not the only onesaffected by plantar fasciitis. It isalso commonly associated with obesity, flat feet, poorly fitting shoes, andexcessive periods of walking, standing, or running.

The vast majority of plantar fasciitis cases are treatedconservatively. This will generallyincludes such things as rest, ice, various taping methods, orthotics, steroidinjections, and night splints, as well as a change in shoegear. Rarely do these cases go on to surgicalintervention.

As for Mr. Williams, it may be quite accurate that his heelpain does not totally resolve until the season is over. Will it hinder his ability on the field? That is something for Vikings fans to waitand see. However, it is quite possiblethat with aggressive conservative therapy, which he is likely alreadyreceiving, he will be just fine to continue with the season.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
www.FLFootandAnkle.com

Titus Brown out with High Ankle Sprain

2011-08-29T10:01:00.003-04:00

Cleveland Browns’ linebacker Titus Brown will be sidelined with a high ankle sprain. The Browns have been pummeled with injuries this preseason. Titus Brown will join teammates Eric Steinbach (tackle) and Brandon Jackson (running back) and Jordan Norwood (wide receiver) on the injured list. With a season opener on September 11 against the Cincinnati Bengals, things are not looking good for Cleveland.

A high ankle sprain is an injury to the syndesmosis between the tibia and fibula. The ligaments that attach the tibia to the fibula aid in stabilizing the ankle joint. These ligaments can become sprained or even torn when the leg is forced to rotate outwards with a planted foot. This is a common injury in contact sports, football in particular.

The syndesmosis is composed of the anterior and posterior inferior tibiofibular ligaments. In a sprain, usually only one of these ligaments is injured. The syndesmosis can also be injured in ankle fractures, where the fibula is destabilized and allowed to rotate.

The diagnosis is usually suspected through history and physical examination, and may be confirmed with x-rays and an MRI. MRI may not be necessary for everyone, but can help differentiate between a sprain and a tear of the ligaments. For high-level athletes, MRIs are typically ordered swiftly.

Once the diagnosis is confirmed, high ankle sprains are treated with a period of immobilization in a cast for about 6 weeks. Anti-inflammatory medications and pain relievers may also be used in conjunction with immobilization to relieve the symptoms. Following immobilization, a period of rehabilitation will begin. This generally involves aggressive stretching and strengthening exercises, with a slow return to full weight bearing and activity.

For cases requiring surgery, a screw may be placed across the syndesmosis from the fibula to the tibia. This screw helps immobilize the joint while the ligaments heal, and is left in place for about three months. Patients are instructed not to walk on the leg while the screw is in place, as it could break with motion. The screw is taken out once the ligaments have healed, and an aggressive physical therapy rehabilitation program begins.

As for Brown, no surgery has been scheduled, and he’s been placed in a cast. For Cleveland Browns fans, this is good news, as the linebacker will likely return later in the season. While he won’t be ready for the regular season opener, he may be ready to return to play mid-season.

Central Florida Foot and Ankle Center, LLC.101 6TH St. NW. Winter Haven, Fl. 33881 863-299-4551http://www.FLFootandAnkle.com

Lions’ Leshoure Out with Achilles Rupture

2011-08-15T09:43:00.004-04:00

Detroit Lions rookie running back Mikel Leshoure will be out for the season following an Achilles tendon rupture sustained during practice on Monday. The Lions drafted Leshoure in the second round from the University of Illinois, and were hoping to have him take turns carrying the ball with Jahvid Best. Of Leshoure, Coach Jim Schwartz said "He’ll have surgery very soon, probably tomorrow, and he’ll be back. He won’t be back this year, but he’ll be back. And he was doing very well."

Achilles tendon injuries can be a career-ending injury, which certainly takes some air out of the tires of the Detroit Lions, who sports pundits are predicting to have a turn-around year. In a systematic review of statistics from the NFL, Parekh et al showed that 36% of skill-players (running backs, wide recievers, defensive backs, cornerbacks, and linebackers) never returned to play professionally.

The study analyzed the power ratings of the players who did return to play professionally. Power ratings are statistics used to measure a player's level of play, such as rushing and passing yards. Of the 64% who returned to play (21 players total), all showed a significant decline in their power ratings as well as the number of games played. This 64% is slightly lower than the previously reported 71% of patients returning to full activity following surgical repair of Achilles tendon ruptures. This difference may be attributed to size, weight, strength, and overall physical demand of professional football players when compared to the average young athlete.

The study by Parekh et al looked at the three seasons before injury and the three seasons following injury, and averaged statistics for the players over those three years. It was found that the power ratings fell by average of almost 50%, and that the amount of games played fell from 11.67 to 6.17. This suggests that even if a player is able to recover from the injury and return to their previous level of play, they may never regain their original quality of play.

Current treatment regimens hinge on surgical repair of the ruptured tendon. While studies have shown promising reults with conservative non-surgical treatment combined with aggressive rehabilitation protocols, the incidence of re-rupture is lower in surgically repaired Achilles tendons, and the time to full recovery is also faster. Surgeons are trending towards earlier, aggressive physical therapy regimens following surgery instead of the six to eight weeks of immobilization previously set as the standard of care.

Central Florida Foot and Ankle Center, LLC.

101 6TH St. NW.

Winter Haven, Fl. 33881

863-299-4551

www.FLFootandAnkle.com

Better Workout – Running or Walking?

2011-08-05T12:43:00.004-04:00

Whether walking or running provides a better workout is a debate that could go either way, and could be discussed for hours. Advocates of each can point out the benefits of their exercise method of choice. In the end, the truth is that either form of exercise is generally good for you, and the choice should come down to which you are more comfortable with. Regardless of which side you’re on, here are some tidbits about each that might help you make up your mind.

Yes, running will burn more calories that walking. However, this is only true when you compare them based on the amount of time each activity is performed. When you compare them based on distance, the amount of calories burned is the same. For example, running for twenty minutes will burn roughly twice as many calories as walking for twenty minutes. However, running three miles and walking three miles will burn the same amount of calories.

Running or jogging can work different muscles than walking, and can work them harder. This is because more force and strain is placed on the muscles while running. However, walking allows your body to be a state of elevated cardiovascular demand for a longer period of time, which will actually help improve cardiovascular health over time, perhaps even more so than running.

Generally speaking, runners are more prone to injury because of the increased demand on the muscles of the lower extremity during activity. This can lead to overuse injuries such as tendinitis and stress fractures. But, for young and healthy people, running provides a great source of exercise and can help train for other sports. It also provides the “runner’s high” that avid runners talk about, which you won’t be able to get from walking.

For many people, though, walking is a great source of exercise. Particularly in older populations and overweight people beginning an exercise program, walking is generally the first form of exercise initiated. It is often recommended for weight loss in obesity, to prevent arthritis, and as an adjunct treatment to osteoporosis. Of course, speak with your doctor before starting any new exercise or walking program.

Walking and running can both be incorporated into a successful exercise program. Podiatrists can be a great source of information for those beginning a walking or running program, particularly if you are experiencing any foot or ankle problems. Sometimes the use of orthotics or even simple exercises for the lower extremities can help prevent some of these problems.

Central Florida Foot and Ankle Center, LLC.

101 6TH St. NW.

Winter Haven, Fl. 33881

863-299-4551

www.FLFootandAnkle.com

Accessory Bones of the Foot

2011-06-07T11:13:00.003-04:00

The normal human foot contains twenty-eight bones. These bones help to give shape and function to the foot, and help provide the framework for shock absorption and mechanics that make movement possible. Sometimes, though, a foot contains more than twenty-eight bones. A number of accessory bones may be present in the foot as well, which may or may not be pathologic.

Accessory bones can be divided into two categories – ossicles and sesamoids. Sesamoids are small, round bones found within tendons in the foot. The two common sesamoids are within the flexor hallucis brevis, and help comprise the sesamoid apparatus. The sesamoid apparatus aids in function of the first metatarsophalangeal joint.

Some of the more common accessory sesamoids include:

Os peroneum – located within the tendon of the peroneus longus, commonly seen near the peroneal notch of the cuboid.
Os interphalangeus – Located within the long flexor tendons, adjacent to the interphalangeal joints of the digits.
Capsular sesamoids – these are located within the tendons crossing the metatarsophalangeal joints, typically in the long flexors

Accessory ossicles differ from sesamoids in the way they develop. They develop from a separate center of ossification in close proximity to the normal anatomy. Some of the more common accessory ossicles include:

Os Trigonum – develops as a separate ossicle posterior to the lateral tubercle on the posterior surface of the talus. When the ossicle is fused, it is known as a Steida’s process. These can often become pathologic as they can cause friction on the tendon of the flexor hallucis longus, which can cause irritation and pain.
Os tibiale externum – located on the medial side of the foot in close proximity to the navicular. There are several variations of this accessory bone that exist, including those that have fused to the navicular. These are often symptomatic, and may also be referred to by some clinicians as a pre-hallux
Os supranaviculare – also referred to as os talonavicular dorsale, it is found on the dorsal aspect of the talonavicular joint.

A number of accessory bones exist in the foot, which may or may not become symptomatic. Clinically, accessory bones can often appear as fractures on x-ray, and may even mimic them in their symptoms. Sesamoids may appear as bipartite, meaning they are split in two pieces, or tripartite, meaning they are split into three pieces. Bipartite and tripartite sesamoids can often resemble fractures on x-ray.

Accessory bones, when symptomatic, can be treated by offloading the area, debridement of callus that forms over them, or even surgical resection for some.

Central Florida Foot and Ankle Center, LLC.

101 6TH St. NW.

Winter Haven, Fl. 33881

863-299-4551

www.FLFootandAnkle.com

Oilers’ Hall Goes Down with Ankle Injury

2011-03-17T10:00:00.002-04:00

Edmonton Oilers rookie sensation Taylor Hall was injured in a fight in Thursday’s game against the Columbus Blue Jackets, when he went up against Derek Dorsett. The injury came as the two went down to the ice, when Hall twisted his ankle.

The Oilers announced that Hall would be getting an MRI on Friday afternoon. Hall will be unable to travel with the team as they begin a five-day road trip this weekend.

Lucky for hall, there doesn’t appear to be a fracture of the ankle at this time. The MRI was most likely ordered to check for a high ankle sprain or any other type of injury to the soft tissues of the leg and ankle.

A high ankle sprain involves an injury to the tissues connecting the two bones of the leg, the tibia and the fibula. This tissue, known as the syndesmosis, helps keep the ankle joint in line and plays a critical role in stabilizing the ankle. The syndesmosis can be strained or torn in an ankle injury, and can be a particularly difficult injury to heal. They typically take longer to heal than a normal ankle sprain.

A high ankle sprain is typically treated with a cast for 6 weeks, so long as the injury is stable. When the injury is unstable, surgery may be necessary to place a screw through both the tibia and fibula, holding the syndesmosis together while it heals. These screws are typically left in for 3 months. Patients are instructed not to walk on the injured leg while the syndesmotic screw is in place. There is normally some motion between the two bones when walking, and this motion may break the screw.

Another surgery may be required after the syndesmosis is healed to remove the screw, while some doctors will let the patient begin to walk on the leg until the screw breaks. The reason for this is that there are very few reported problems with a broken screw. If there is a problem, then the screw can be removed as it would have been anyway. This way, the patient is saved an extra surgery until they need it.

If Taylor Hall is shown to have a high ankle sprain or a serious sprain or tear of the ankle joint, he will have to miss a few months of the season until he can heal.

Hall is leading his team with 22 goals this year, along with 20 assists. He is in contention for rookie of the year. Thursday’s game against the Blue Jackets gives Hall his first career “Gordie Howe Hat Trick”, in which a player scores a goal, an assist, and gets in a fight all in the same game.

Central Florida Foot and Ankle Center, LLC.

101 6TH St. NW.

Winter Haven, Fl. 33881

863-299-4551

www.FLFootandAnkle.com

Negative Pressure Wound Therapy

2011-02-21T14:59:00.003-05:00

Negative pressure wound therapy (NPWT), also known as topical negative pressure, sub-atmospheric pressure or vacuum sealing technique, has become a topic of much interest in the area of acute and chronic wound healing. Particularly in the diabetic population, where chronic wounds run rampant, this technology has been explored as a potentially promising therapy.

NPWT is just one of several technological advances in wound care therapy that has emerged in the past several decades. This list also includes bioengineered skin equivalents, bone marrow-derived stem cell therapy, and growth factor therapy. However, the science behind Negative Pressure Wound Therapy is quite interesting.

The vacuum sealing technique involves placement of a special device, sometimes referred to as a wound-vac, on the chronic or acute wound. This device consists of a foam or gauze dressing applied directly to the wound, then sealed tight with a clear, plastic-wrap-like dressing. The dressing is then attached to an electronic device that creates a negative pressure in the newly created seal, similar to a vacuum. This negative pressure ranges anywhere from 50-175 mmHg.

The system created turns an open wound into a controlled, closed wound while removing cellular debris and excess fluid from the wound. This allows the wound to be well-controlled in terms of exudate management. Granulation tissue, the tissue that indicates the ability for the wound to heal, is stimulated to generate within the wound. There is also a decrease in the bacterial load of the wound, reducing the incidence of infection, as well as increased blood flow to the wound.

Published case-studies and small cohort studies have shown negative pressure wound therapy to be effective in the treatment of diabetic foot ulcers. However, a Cochrane review pointed to the fact these trials consisted of too few enrolled subjects to be considered significant evidence to support the use of wound-vacs. However, the growing popularity of the device may lead to more extensive research in the area, as well as better designed studies.

Another area of concern for the use of negative pressure wound therapy is the cost associated with its use. However, several studies have looked at the cost-effectiveness of NPWT, and have found that the decrease in staff required for dressing changes not only balances, but exceeds the cost-effectiveness of standard wound care therapy. Because the NPWT dressings only need to be changed after 48-72 hours, there is less maintenance required for the wound. Therefore, the staff demands are decreased in the management of chronic wounds using NPWT.

Negative pressure wound therapy remains a promising choice for the treatment of diabetic foot ulcerations. The diabetic population is particularly prone to chronic wounds, and NPWT may be a useful technology.

Central Florida Foot and Ankle Center, LLC.

101 6TH St. NW.

Winter Haven, Fl. 33881

863-299-4551

www.FLFootandAnkle.com

New York Giants Plagued with Injuries Late in the Season

2010-12-29T14:07:00.002-05:00

New York Giants’ wide receiver Hakeem Nicks will most likely sit out in week 17 with a broken toe. The news was released today that the injury was in fact a broken big toe on his left foot. It is not clear whether the injury occurred during the game on Sunday against Green Bay. The Giants lost that game 45 to 17.

Injuries to the great toe are extremely common in turf sports such as football. The combination of flexible shoes on a hard surface creates the perfect combination for the development of turf toe, which is a hyperextension injury to the first metatarsopahalangeal joint (MTPJ). This joint connects the great toe to the rest of the foot.

Fractures of the great toe may also be due to a single traumatic event, or to repetitive stress to the bones. In Nicks’ case, it is unclear whether the injury occurred during a game or during practice.

Nicks’ injury comes at an awful time for the New York Giants, whose playoff hopes are dwindling fast. Their injury report is crowded with players already, some of which are other foot and ankle injuries.

Center Shaun O’Hara has missed nine games this season due to Achilles, ankle, and foot injuries. O’Hara was also picked for the NFC Pro Bowl roster, a decision which many sports fans see as ill-advised. O’Hara will also be doubtful for week seventeen, as his Achillles condition has flared up in the past few days.

Running back Ahamad Bradshaw is also questionable for this week’s game with an ankle injury that limited his production in week sixteen. The official report has him listed with a sprained ankle. Lateral ankle injuries are often very difficult to rehab, as we’ve written about before. The key to non-operative treatment is adding to stability to the joint with the use of braces.

Other players on the Giants’ injury report include Will Blackmon (knee), Chris Canty (neck), Antrel Rolle (ankle), Dave Tollefson (knee), Justin Tuck (chest), Osi Umenyiora (knee), and Corey Webster (ribs).

Injuries like those plaguing the Giants, many of which are injuries to the lower extremity, can be extremely common in football. Especially late in the season, when fatigue and inclement weather start to play a greater factor, lower extremity injuries start popping up everywhere, effecting nearly every team. Proper training and conditioning is essential to avoiding these types of injuries, not only in the professional athlete, but in the casual athlete as well.

Central Florida Foot and Ankle Center, LLC.

101 6TH St. NW.

Winter Haven, Fl. 33881

863-299-4551

www.FLFootandAnkle.com

Microfracture Surgery for Greg Oden

2010-11-22T11:51:00.003-05:00

Greg Oden, of the Portland Trailblazers, will be forced to miss the rest of the NBA season this year. The center, who was the #1 pick in the 2007 draft, has just recievd microfracture surgery of his left knee. Oden received a similar surgery on his right knee during his rookie year, which postponed his professional start.

Microfracture surgery is a treatment for an osteochondral lesion, which is damage to the articular cartilage within a joint. The knee is a common place for these types of injuries to occur, as well as the ankle. The surgery involves making tiny holes in the damaged cartilage, which allows for blood to access the area more easily. This brings in healing and growth factors, which can promote the generation of cartilage in the area. The new cartilage that forms is fibrocartilage, which not quite the same as the hyaline cartilage that forms the cartilage of the joint. However, this fibrocartilage does allow for a more normal range of motion postoperatively, and often can reduce the pain associated with an osteochondral lesion. In podiatry, it is common to see an osteochondral lesion of the talus following an ankle injury, which sometimes may be corrected with microsurgery.

A study out of Drexel University College of Medicine studied NBA players that received microfracture surgery of the knee between 1997and 2006. The study looked at a number of factors, and analyzed the player efficiency ratings (PER) of the NBA players both before and after the surgery. The study found that twenty-percent of the players did not return to the NBA. It also found that of the players that did return, only 17 of 24 players continued to play for more than two years, and that universally all players saw a reduction in their player efficiency rating as well as the number of minutes played.

What will be the fate of Greg Oden following his second microfracture surgery? There’s no way to know for certain, but the NBA is hopeful that he will recover and have a successful career. Certainly he will be able to have a normal life after the surgery, but will his knees be able to withstand the high impact of an NBA player? The high forces placed through the lower extremity during running and jumping, as well as the sheer forces place on the knees during cutting and pivoting moves may prove to be to much for the Portland Trailblazers’ center.

Central Florida Foot and Ankle Center, LLC.

101 6TH St. NW.

Winter Haven, Fl. 33881

863-299-4551

www.FLFootandAnkle.com

Platelet-Rich Plasma Therapy

2010-10-11T12:01:00.005-04:00

In the world of sports injuries, healing time is of the utmost importance. The difference in a week for full recovery can mean the difference between making the playoffs and ending the season early. Because of this need for fast-tracking healing times, different innovations have become more popular in medicine. One of these innovations is the use of platelet-rich plasma.

Platelet-rich plasma (PRP) had been used previously as an adjunct to healing in spinal surgeries and in plastic surgeries with extensive soft tissue damage. The process involves drawing a small amount of blood from the patient (between 30mL and 60mL), putting the blood into a centrifuge, and spinning it down to separate the blood components. The plasma is separated from the cells, but the platelets are kept in the plasma. This platelet-rich plasma can then be injected back into the same patient, in the area that healing is needed. PRP has gained popularity, and has been used to treat tendon injuries, ligament injuries, cartilage injuries, muscle injuries, and for chronic wounds.

Part of PRP’s recent surge in popularity is due to its use in treating sports injuries. Professional athletes like Tiger Woods, Troy Polamalu, and Hines Ward have all received media attention from PRP therapy. Recently, Houston Texans wide receiver Andre Johnson has made the news for receiving platelet-rich plasma treatment. As more and more professional athletes use PRP therapy, it becomes more common for amateur athletes and weekend warriors to ask their doctors about the treatment.

The theory behind how PRP therapy works is somewhat simple. Platelets in the blood normally release chemical signals to promote healing at a specific site. These signals attract more platelets to the area, which increases the amount of signal being release, and thus the healing process continues. By removing blood from a person and concentrating the amount of platelets in a particular area, the healing time is theoretically increased.

In podiatry, common uses for PRP therapy include plantar fasciitis and Achilles tendon tears/ruptures. Both of these areas are prone to chronic injuries that can be very difficult to heal, and can often take a very long time for the symptoms to go away. Therefore, platelet-rich plasma therapy becomes an interesting option for these patients. These areas of injury can also have a relatively low blood supply, which may be why they are prone to injury in the first place. Injecting platelet-rich plasma into these areas can promote healing in an area that may be difficult for platelets to reach on their own.

While platelet-rich plasma seems to be a great therapy to boost the healing of certain types of injuries, there are certain limitations to its use. The studies that have been performed show inconsistencies in the method of use, as well as small sample sizes and a lack of control subjects. Additionally, there are many studies that show inconclusive results as to the efficacy of PRP. This takes away from the studies that show PRP to be an effective method of treatment, as the results may not be able to be repeated.

While there may be some controversy over its efficacy, PRP is still becoming a popular method of treatment for chronic injuries, particularly among professional athletes. This is due to a vast amount of resources for this patient group, as well as the desire to fast-track recovery time. As more studies are performed on the topic, watch for more solid results to be shown.

Central Florida Foot and Ankle Center, LLC.

101 6TH St. NW.

Winter Haven, Fl. 33881

863-299-4551

www.FLFootandAnkle.com

Metatarsalgia (Forefoot Pain)

2010-10-07T11:59:00.003-04:00

The term metatarsalgia translates to “pain in the metatarsals”. It is most commonly used to describe pain in the metatarsal heads, at or near the ball of the foot. Though it is sometimes used as a discrete diagnosis, the term metatarsalgia is a very general term that does not offer a reason for the pain. There are a number of different conditions that can cause metatarsalgia, and many others that may mimic the findings.

True metatarsalgia results from increased pressure in the metatarsal heads. This is most commonly the result of biomechanical deformities such as hallux valgus or an elevated first ray. Conditions like this may also be associated with bunion formation. Most frequently it is associated with a flatfoot, or a foot that is prone to pronation syndrome. However, increased pressures through the metatarsal heads may also be seen in a high-arched foot, or pes cavus.

Another common cause of metatarsalgia is a thinning of the fat pads at the bottom of the foot. Fat pads are normally found underneath the heel and at the ball of the foot. These well-organized structures help to cushion the forces applied to the foot while walking. In older people, the fat pads can thin as a normal part of aging, a component of some disease processes, or with the use of some drugs such as oral steroids. When the fat pad at the ball of the foot thins, the cushioning underneath the metatarsal heads is lost, and metatarsalgia may ensue.

Pain in the metatarsal heads is also commonly seen with hammertoes, as the contracted digits force the metatarsal heads into the ground with excessive force. Over time, this can create a painful situation.

Other conditions of the foot may appear as metatarsalgia, but may actually be a different pathological process. Neuromas, particularly those found between the metatarsals such as Morton’s neuroma, can appear at first as metatarsalgia. Stress fractures of the foot may also lead to pain in the ball of the foot or at the metatarsal heads.

Rheumatoid arthritis may appear initially as metatarsalgia, and should be ruled out as a part of the clinical exam. This may include x-rays as a diagnostic study, which can also look for avascular necrosis of the metatarsal heads as a cause of the pain. Tendinitis, bursitis, and capsulitis (a swelling of the joint capsule) can also appear as metatarsalgia. It is up to the clinician evaluating the patient to differentiate between these pathologies.

The best treatment, therefore, for metatarsalgia, is to address the underlying cause of the condition. If it is a biomechanical etiology, such as from over-pronation, conservative therapy may address correcting the deformity. The use of custom orthotics or another type of shoe insert is commonly employed as a first-line treatment. Simply resting and icing the area while taking anti-inflammatory medications may alleviate the pain, but can also delay the proper and necessary treatment. Custom orthotics, specialized shoe inserts, a change in shoes, and possibly shoe modifications will all help the person with a loss of the protective fat pads found on the bottom of the foot as well.

Central Florida Foot and Ankle Center, LLC.

101 6TH St. NW.

Winter Haven, Fl. 33881

863-299-4551

www.FLFootandAnkle.com

Pes Cavus

2010-08-26T11:39:00.003-04:00

A high-arched foot, referred to medically as pes cavus, is a foot in which there is a large opening of the inside of the foot when bearing weight. A high-arched foot is the opposite of flat feet, and is considerably less common than flat footedness.

Pes cavus may be an asymptomatic foot type, and may actually be beneficial in sports such as long distance running. The foot is fixed in a downward position, or plantar flexed, and is often quite rigid.

In the symptomatic patient, there may be difficulty in shoe fitting. Custom orthotic devices for the foot are often necessary, and children with high-arched feet may have difficulty walking. Some common complaints of symptomatic pes cavus patients include metatarsalgia, ankle instability, and corns and calluses of the feet where ill-fitting shoes may be rubbing.

The causes of pes cavus are as varied as people with the foot type. There is often no identifiable underlying cause, most commonly observed in the asymptomatic patient. There are a number of neurological disorders that can lead to pes cavus, including Charcot-Marie-Tooth, cerebral palsy, and multiple myeloma. Pes cavus may also be seen in some cases of diabetes and following stroke.

When being evaluated by your physician for pes cavus, there are a number of questions you may be asked. Some topics might be:

Progression: Have your feet always had a high arch, or is it a new development?
Location: Is the high arch on both feet? Is it noticeably higher on one side? Have you noticed any changes to your hands?
Associated Symptoms: Have you had any burning, tingling, numbness or pain in the hands or feet? Have you recently been sick or been caring for an ill person? Have you had any previous injuries to the foot?

Generally, the treatment for high-arched feet is to accommodate any injuries, prevent further injuries with the use of orthoses, and to use properly fitting shoes. This conservative treatment is effective in most.

Surgical treatment is only used for severely symptomatic feet, and only after conservative treatment has failed. The goal of surgical treatment in pes cavus is to bring the foot flat to the ground, thus allowing for weight to be distributed evenly through the foot. A number of different surgical procedures and techniques exist, and each patient should be considered unique. Often there is a combination of soft tissue and bony procedures that are required, and a joint fusion (arthodesis) may be necessary for proper function.

Central Florida Foot and Ankle Center, LLC.

101 6TH St. NW.

Winter Haven, Fl. 33881

863-299-4551

www.FLFootandAnkle.com

Hammer Digit Syndrome

2010-07-23T12:52:00.005-04:00

Hammer digit syndrome refers to a group of deformities of the toes that causes the toes to be in a fixed position. Depending on the type of deformity, this fixed position may be flexed (where the toes are pointed downwards) or extended (where the toes are pointed upwards). The deformities come in a wide range, with names like mallet toe, claw toe, and hammertoes. Of these types of digital deformities, hammertoes are the most common form.

Types of Deformity: The lesser digits of the foot (all but the hallux, or great toe) consist of three bones called phalanges, which are connected to a longer bone called a metatarsal. The joints between theses bones are named for the bones they connect, referred to as metatarsophalngeal joints, and the proximal and distal interphalangeal joints.

With hammertoes, the deformity is seen across all of the joints. This causes the toes to curl up in a predictable pattern, as seen in the picture above. The metatarsophalangeal joint will be fixed in an extended position (with the joint bent upwards) and the proximal interphalangeal joint will be fixed in a flexed position (with the joint bent towards the ground). The distal interphalangeal joint will commonly be bent in an extended position as well.

Mallet toes show a flexed joint only at the distal interphalangeal joint (the joint furthest down the toe, closest to the nail). Claw toes will show a flexion deformity at both the distal and proximal interphalangeal joints, which will curl the toe in the shape of a claw. Hence the name, claw toes.

Causes of the deformity: Normally, the toes are kept in their straight position by a balance from the muscles the insert into the digit. These include both intrinsic and extrinsic muscles of the foot. The extrinsic muscles the insert into the lesser digits are the extensor digitorum longus on the top (dorsal surface) of the foot, and the flexor digitorum longus on the bottom (plantar surface) of the foot. The intrinsic muscles include the lumbricales and interossei muscles, as well as the flexor digitorum brevis and the extensor digitorum breivs. Together, all of the muscles will help to balance the toes, keeping them straight.

When the muscular balance of the digits is lost, it can cause hammer digit syndrome to develop. Most commonly, this will result in the hammertoe variety. There are several different ways that this imbalance can occur.

· Flexor Substitution: The extrinsic flexors of the foot and toes all originate from the back of the leg, or the posterior compartments. These muscles insert into the foot , and act to bring the bones of the foot, including the toes, towards the ground. This is known as plantarflexion. When these muscles become weakened, particularly the soleus muscle, the other flexors are forced to substitute for the soleus. When the flexor digitorum longus substitutes for the soleus, it causes the toes to curl. This can contribute to hammer digit syndrome.

· Extensor Substitution: This is essentially the same mechanism as flexor substitution, but the problem originates with the extrinsic extensors of the foot. The extensors are located in the anterior compartment of the leg. In particular, when the tibialis anterior becomes weakened, the extensor digitorum longus will increase its pull on the toes. This will cause the toes to curl up.

· Flexor Stabilization: This is a problem with the intrinsic muscles of the foot, in particular the interossei and the lumbricales. These two groups of muscles function to stabilize the toes. When the muscles become weakened, such as in flat feet, the relative pull from the flexor digitorum longus increases. This will cause the toes to curl.

High-Heeled Shoes and how they contribute to Hammertoes: It is commonly accepted among podiatrists and other foot and ankle specialists that high-heeled shoes can help contribute to the development of hammertoes. This is due to the position that the foot is put in when wearing high-heels. When a foot is placed in a high heeled shoe, the foot is in a plantar-flexed position. This lengthens the extensor muscles of the foot (especially the tibialis anterior), which effectively weakens the pull of the muscle on the foot. Thus, extensor substitution is allowed to take place. Similarly, when a person wears high-heeled shoes all day, the flexors and intrinsic musculature is not functioning in its optimal motion. The long flexors of the toes can be over-worked, causing further curling of the toes. Therefore, he use of high-heeled shoes creates the perfect situation for hammertoes and other varieties of hammer digit syndrome to develop.

Complications of Hammer Digit Syndrome:

Because the toes are no longer straight in hammer digit syndrome, they may no longer fit properly into shoes. A toe that is curled up inside a shoe may be forced to rub up against the shoe, causing pain and hotspots to develop. These areas of friction can quickly develop into corns and calluses. The areas of friction are commonly seen on the top of the toes, at the joints.

Additionally, when the toes are curled up, weight can no longer be placed on the toes in the proper way. Therefore, the weight is shifted more onto the ball of the foot, which can cause large calluses to develop on the bottom of the feet.

Treatment: There are a number of factors that play into the treatment of the different varieties of hammer digit syndrome. Most commonly a conservative approach is taken first. This would include things like trimming of the corns and calluses, a change in shoe gear to accommodate the deformity, and different padding techniques to help alleviate some of the pain. All of these measures will help relieve the pain associated with hammertoes, but will not correct the deformity.

The only way to truly correct the deformity is to have surgery on the toes. Depending on the extent of the deformity, the surgery may address only the soft tissues of the toes (the ligaments and tendons influencing the deformity) or it may include the removal of some of the bone in the toes.

Central Florida Foot and Ankle Center, LLC.

101 6TH St. NW.

Winter Haven, Fl. 33881

863-299-4551

www.FLFootandAnkle.com

The Barefoot Running Debate

2010-06-22T09:16:00.005-04:00

Barefoot running is a topic of much debate. The trend of runners shedding their bulky running shoes for lighter weight shoes or even no shoes at all as been progressively getting bigger over the past several years. More and more runners are joining the movement, and the shoe companies are responding. Nike’s Free series of running shoes have different gradients of cushioning depending on the level of barefootedness that a runner desires; Vibram makes a shoe that looks more like a glove for the foot, with individual toes and a durable rubber sole, but virtually no support or cushioning.

Advocates of the barefoot running movement point to the natural biomechanics of the body as the reason to follow suit. With barefoot running, the tendency to strike with the heel first is erased. The foot hits the ground in the midfoot area first, allowing forces to be displaced more evenly and to allow for the natural shock absorbing mechanisms of the body to work. Barefoot runners claim that this causes less overuse injuries like tendonitis and arthritis, as well as a decrease in knee and hip pain.

The other side of the argument points out that there are many hazards to running barefoot, particularly in a city on pavement. Foreign objects like rocks, glass, and metal may find their way into the runner’s feet, causing injury and possibly infection. Furthermore, the opposition to barefoot running points out that there are very few “perfect” feet out there, and that most people will require some level of cushioning and support.

The truth most likely lies somewhere in between these two extremes. There are many runners out there that would benefit from strengthening of the muscles of the foot, which may be achieved from running barefoot. However, this population is limited – not everyone will reap the benefits. For many athletes, particularly the less serious and beginners out there, the risks of barefoot running outweigh the advantages.

There is a ton of information on barefoot running, whether it is coming from the Internet or from a published book or from “expert” opinions. If you are one of the many that is considering or currently participating in barefoot running, it is important to be skeptical about this information, and to ease into any new exercise program. Running long distances barefoot takes a long time to work up to, and it may be difficult to achieve for the average runner.

Central Florida Foot and Ankle Center, LLC.

101 6TH St. NW. Winter Haven, Fl. 33881

863-299-4551

www.FLFootandAnkle.com

Is it Athlete’s Foot, or Something Else?

2010-06-07T12:02:00.004-04:00

That dry, itchy, burning feeling on your feet hasn't gone away in weeks. Is it athlete’s foot, or could it be something else?

Athlete’s foot is a common presentation to the podiatric physician. It is a fungal infection of the superficial skin layers, usually of the fungal genus Trychophyton, and is also called tinea pedis or ringworm of the foot. It causes flaking and scaling of the skin, which can lead to itching and other unpleasant sensations. It is common for tinea pedis to spread to other parts of the body, most notably the toenails. When the fungal infection spreads to the toenails (or it may originate at that location) it is known as onychomycosis. Tinea pedis and onychomycosis are a very common combination.

Athlete’s foot may be treated with a number of different pharmaceuticals, including over-the-counter medications as well as prescriptions. Over-the-counter medications include tolnaftate (sold as Tinactin), miconazole nitrate, and terbinafine (sold as topical Lamisil). Oral medications are available by prescription. Regardless of the type of medication used, however, the timeline for curing tinea pedis can often last more than six weeks.

The fungal infection is transmitted via contact, typically in damp environments such as locker rooms and bathhouses. Preventative measures against tinea pedis can be taken by preventing contact with public surfaces. Wearing sandals or bath-shoes in areas like this can help, as well as washing the feet with soap and water, drying completely, and wearing absorbent cotton socks. Excessive sweating of the feet, or hyperhidrosis, is often associated with tinea pedis, due to the increase in moisture in the area.

However, not all that looks like athlete’s foot is tinea pedis. Blisters of the bottom of the foot, particularly diffuse blisters from chronic friction, can often look like tinea pedis. These friction blisters may come from poorly fitting shoes or sandals, and are often seen in runners.

Erythrasma is a bacterial infection of the skin between the toes that can look like tinea pedis. The two diagnoses are differentiated with the use of a Wood’s Lamp, as well as a culture of the area.

Some other conditions that may mimic athlete’s foot include psoriasis, candidiasis (also a fungal infection, but of a different genus), and allergic reactions.

Additionally, there are several different forms that tinea pedis may take. The inflammatory form of tinea pedis may show as small blister-like lesions on the foot, which are filled with either a clear or slightly opaque fluid. The blisters may pop and ooze, causing more pain. This form of tinea pedis should be dealt with aggressively, as the discontinuities of the skin can lead to infection.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW. Winter Haven, Fl. 33881
863-299-4551
www.FLFootandAnkle.com

Analyzing the Marcus Thames Injury

2010-05-26T09:13:00.003-04:00

Marcus Thames, of the New York Yankees, suffered an ankle injury in Wednesday’s game against the Rays. He is now listed as day-to-day, as the X-rays have reportedly come back negative.

The injury came after Thames stepped on his own bat after a single to left field. Footage of the play can be seen on the MLB.com website, which you can check out here.

After watching the footage, the injury appears to have been an inversion injury of the ankle. Incidents like this can lead to ligament strains and ruptures, tendon tears, and even fractures of the fibula or tibia. The X-rays ordered following Thames’ injury was likely to rule out fractures.

Being listed as day-to-day is likely an indication that Thames’ injury is not very severe. A possible ligament strain or partial tear is possible, particular of the anterior talo-fibular ligament. This structure composes part of the ligamentous support of the lateral ankle, and is susceptible to injury.

Another diagnosis that is highly possible is an injury to the peroneal tendons. There are a number of different ways for a tendon to be injured, most of which are classified by which layer or area of the tendon is injured, or by whether the etiology is acute or chronic. In this situation, the etiology would be acute (from the incident of the injury) and the area injured would most likely be in the tendon close to the insertion into bone. If we were looking for a fracture, it would most likely be found at the base of the fifth metatarsal (where the peroneus brevis inserts) or at the base of the first metatarsal and medial cuneiform (where the peroneus longus inserts).

Since the X-rays were “negative”, a fracture of this nature is not likely. This should come to good news to Thames and the Yankees, who have seen a plague of outfielder injuries this spring.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW. Winter Haven, Fl. 33881
863-299-4551

www.FLFootandAnkle.com

David Beckham Tears Achilles Tendon

2010-03-25T13:25:00.006-04:00

David Beckham returned to Britain on Monday after being sidelined with an injury last week in Finland. The soccer superstar suffered a total tear of the Achilles tendon during the game, and will be sidelined for several months to recover. This comes as a huge blow to Beckham, who was hoping to play in the World Cup this June. This would have been Beckham’s fourteenth consecutive appearance in the World Cup.

The injury occurred last Sunday, in an AC Milan game. Beckham has been on loan to AC Milan from the Los Angeles Galaxy. Beckham came to Major League Soccer’s L.A. Galaxy in 2007 when he signed a $250 million dollar deal, a record for soccer players, and throwing him into the ranks of some the biggest sports contracts ever.

Following the injury, Beckham was brought to Turku, Finland where he was operated on.

According to Dr. Sakari Orava, the surgeon who performed the procedure, Beckham will be in a cast for three to four weeks, followed by months of rehabilitation. In general, the time it takes for a complete recovery takes around six months. This is likely to be minimum amount of time it will take for David Beckham to return to playing.

The Achilles tendon is a continuation of the gastrocnemius and the soleus muscles, which are collectively considered to be the muscles of the calf. The muscles combine to form the Achilles tendon, with then inserts into the calcaneus (heel bone).

With tight calf muscles, there is extra strain put on the tendon. With enough downward force, such as from landing on the foot from a jump, can tear the tendon. The calf muscles play a huge role in most sports, as they help us run, jump. Pivot, and maneuver in many different activities.

In Beckham’s case, and in many other cases, the tendon can be completely ruptured. When this happens, there are both surgical and non-surgical options. Surgically, the tendon is sewn together with durable sutures. The foot is then put into a cast for three to four weeks, or until the tendon can heal itself.

In non-surgical treatment, the foot may be put into a cast without any repair of the tendon itself. The tendon will actually heal itself over time. Studies show that after one year, the results of both surgical and non-surgical care are about the same.

Surgical intervention, however, has been shown to provide results faster than non-surgical options. There is also a slightly greater chance of a second tear or rupture when the tendon is not repaired surgically. For these reasons, it is understandable that David Beckham and his trainers and doctors opted for surgical treatment.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

The Battle at Marathon

2010-03-16T16:21:00.002-04:00

As the spring approaches, we are entering into the marathon-training period (if you haven’t begun training already, that is). The arduous task of running 26.2 miles is taken on by thousands of people every year. The training is an intense process, usually lasts about three months, and is topped off with the physically, mentally, and emotionally draining challenge of running a marathon. You may be asking yourself at this point, “Why would anyone want to do this?”

Well, it all begins with the Greek legend of Pheidippides. The story goes that at the Battle of Marathon, the messenger Pheidippides was sent to Athens to report that the Persians had been defeated. After running the entire distance without stopping, Pheidippides burst into assembly to exclaim “Nenikekman”, which is translated as ‘We Have Won’. Pheidippides then collapsed and died.

The distance that Pheidippides had just completed is where the distance of a marathon run comes from. The Greek messenger, in travelling from Marathon to Athens, would have had to either crossed or ran around Mount Penteli. If he had travelled South around the mountain, which he presumptively had done, he would have completed a distance of just over 26 miles. There is some debate as to whether Pheidippides ran South of the mountain, or if perhaps he ran through the mountain, crossing straight rather than around. If he had done this, the original distance that Pheidippides ran would be significantly less than 26 miles.

The modern marathon evolved from more recent events. The marathon was first introduced during the 1896 Summer Olympics in Greece. The event was not designed with a set distance in mind, but rather with the route extending from Marathon to Athens. This was a distance of 24.85 miles. Spiridon “Spiros” Louis was the first winner of the marathon, with a time of 2 hours 58 minutes and 50 seconds.

The Olympics committee would use the idea of connecting two points on a map together as a design for the marathon event for the next six Olympic games. It wasn’t until the 1924 Olympics that the set distance of 26.22 miles was adopted. The official distance, set by the International Amateur Athletic Federation (IAAF) measures exactly 26 miles and 385 yards. This is now the distance that is used as a standard for marathon runs.

There are over 800 marathons that are organized every year. Of the most prestigious are the Boston, New York, Chicago, London, and Berlin marathons. The Boston Marathon is the longest standing of any of the annually held marathons. The tradition was started in 1897, following the popularity of the event from the 1896 Olympics. It is held every year in April, and attracts an average of about 20,000 registrants. The record for registrants was set in 1996, with 38,000 people registered to run. Time trials for the event make it difficult to enter, and it sets the scene for a very competitive event. Winners receive cash prizes, with first place overall in both men’s and women’s receiving $500,000 each.

The marathon experience has come a long way since its beginnings. What was once a Greek legend has turned into a rite of passage for serious runners. It is a distance that once attained warrants a bumper sticker, showing a glimpse of history in a strong symbol of modernism.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Highlights from the Winter Olympics

2010-03-01T10:47:00.004-05:00

The Vancouver games have come and gone, and with them came great athletes into our homes and onto our televisions. The spotlight is on skiing, snowboarding, skating and hockey, the last of which has desperately tried to reach out to fans from the professional level. Well this past February, that light has shone in attention for the NHL and more.

Al Michaels and Bob Costas handled most of the NBC broadcast, guiding us through the world that is the Olympics. Stories of the highs and lows of tremendous athletes’ careers were told to us.

There was Joannie Rochette, the Canadian figure skater won the bronze medal just days after her mother died of a heart attack.

And Nodar Kumaritashvili, the Georgian luge slider that died in a horrendous crash while practicing.

And there was the USA-Canada hockey rivalry in the women’s division followed by the same set-up in the men’s division, of which both gold medal games went to the Canadians, in Canada.

Names like Bode Miller, Lindsey Vonn, and Shani Davis are etched into our memories, their gold medals gleaming.

Certainly, the drama was thick.

Through all of the back-stories and interviews, through the kiss-and-cry area in figure skating, and through the entire Olympics backdrop, there were some incredible displays of athletic performance.

Apollo Ohno, the U.S. speed skater that came into the games a heavy favorite demonstrated his strength both on and off the ice. NBC aired footage of Ohno working out on dry-land, stretching and warming up for the race. The stretches put so much weight on the lateral ligaments of the ankle, that the commentary mentioned the “do not try this at home” cliché.

The lateral ankle, of course, is a site of common pathology. Strains, sprains, tears and fractures all occur frequently at this site.

The exercise Ohno was performing demonstrated his strength and balance necessary for speed skating.

Shaun White showed us how to fly through the air, flipping around on a snowboard and landing a gold medal with an incredible performance. White’s signature move, the Double McTwist, had to wait to be displayed until after the official event in an encore run. The trick was deemed to be too dangerous for the Olympic games, and was thus banned from Vancouver.

Yes, the Winter Olympics is a grand affair. They bring us sports that we would otherwise rarely see. Curling, Nordic freestyle skiing, Biathalon, and ice dancing all become a part of our vernacular, if only for a brief time.

In addition to the athleticism on display, the theatrics of the Olympics holds nothing back. The grand finale: Michael Buble on a float in the arena that houses hockey and ice skating, singing ‘O Canada” with an amazing amount of Canadian celebrities and Mounties and dancers in a parade. It is an impressive event, and it fit well within the Vancouver 2010 Winter Olympics.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

South Korea Take First Gold Medal, Canadian Women Dominate Hockey

2010-02-26T14:41:00.003-05:00

The Favorite Kim Yu-Na of South Korea grabbed the gold medal in figure skating last night, shattering her former record of point totals and beating the silver medalist by a 23-point margin. The 19-year-old Kim, who is known as “Queen Yu-Na” by her fans, sealed the deal with a total score of 228.56. That is a new record for Kim, and it gives South Korea their first gold medal in the Winter Olympics.

Japan’s Mao Asada took home the silver medal, and bronze went to Canada’s Joannie Rochette, who was skating just days after her mother died tragically of a heart attack.

Kim Yu-Na skated to Gershwin’s “concerto in F”, which she performed nearly flawlessly. That performance gave her a score of 150.06 points, which brought her total to 228.56.

In women’s hockey news, the Canadian team defeated the U.S. team 2-0 to win the gold medal. The match-up paired the only two serious contenders in women’s hockey against each other, setting up a fiery rivalry.

Two early goals from Canada’s Marie-Phillip Poulin in the first period would put the Canadians on top, a deficit that the American would never come back from. The shutout was held intact by a sensational performance by Canadian goalie Shannon Szabados, who made 28 consecutive saves in the game.

"We played a great game and this is an incredible moment," Szabados said. "It was unbelievable. I just had to be calm and poised. I just tried to relax and have fun. You always want to be confident out there."

The U.S.-Canada rivalry in hockey extends back to 1998 when the sport was introduced to the Winter Olympics. The Americans won the first gold medal in 1998, followed by Canadian victories in 2002 and 2006. With 2010 under their belt, that makes three gold medals in a row for the Canadian women. With the exception of the 2006 games when the U.S. was upset early by Sweden, the Canadians and Americans have met in every single gold medal game.

Of course, that rivalry also extends to the U.S. and Canada’s men’s hockey teams. In the semifinal games today, the U.S. will play Finland and Canada will play Slovakia. It is very likely that the U.S. and Canada will both win their games today, setting up a final game in men’s hockey for Canada to play the United States. Not only would this an interesting parallel to the women’s hockey tournament, but it would set up a rematch for the early round upset when the U.S. beat Canada.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Olympics Update – Men’s Hockey Quarterfinals

2010-02-25T11:29:00.003-05:00

Maybe it was the fact that they lost to the fifth-seeded U.S. team in the first round. Maybe it came from playing in their home country, with over 17,000 people watching. Whatever the motivation, the Canadian men’s hockey team came out swinging last night, and beat the Russians in the quarterfinals 7-3.

The first period was a blistering attack on Russian goalie Evgeni Nabokov. Canadian Ryan Getzlaf was the first to score in the game, followed by back-to-back goals from Dan Boyle and Rick Nash, opening up the game with a three to nothing run.

The Russians would never recover from that deficit, and superstar Alex Ovechkin was effectively taken out of the game by the Canadian defense keeping him up against the boards for much of the game. A frustrated Ovechkin broke three sticks through the first two periods of play.

Russian goalie Ilya Bryzgalov summed up the game nicely by saying that the Canadian team “came out like gorillas out of a cage.”

The other games of the quarterfinal round were less thrilling, but still showed impressive talent to move the winning teams on to the semifinals. The United States shutout Switzerland 2-0, with a pair of goals in the third period from Zach Parise. Finland topped Czech Republic with a score of 2-0 as well, and Slovakia beat Sweden with a score of 4-3.

This sets up a semifinal round for Canada to play Slovakia, and the United States to play Finland. The winners of each of the games will face each other in the finals for the gold medal.

The U.S.-Finland game will be a rematch of a feud between the two teams. At the 2006 winter Olympics in Turin, Italy, Finland earned the silver medal after defeating the Americans 4-3 in the quarterfinal round. This is the game in which U.S. forward David Backes and Finnish defensemen Anssi Salmela got into a brawl at the buzzer, with Salmela’s face by smashed by Backes.

The Canadians in last night’s game had a similar revenge match with the Russians. Russia knocked Canada out of the 2006 Olympic tournament in the quarterfinal round. Canada finished in seventh place that year, a dismal position for a team that is generally a favorite for a medal.

Semifinal games will take place on Friday, February 26. The U.S.-Finland game is scheduled for 12:00pm PST, and the Canada-Slovakia game is scheduled for 6:30pm PST. Both games should prove to be excellent hockey, with a lot at stake for the competitors.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

U.S. Hockey Team Upsets Canada

2010-02-22T16:52:00.004-05:00

Last night in a huge upset, the young United States Men’s Hockey team defeated the heavily favored Canadian team 5-3. This marks only the second time that the U.S. team has beat the Canadian team – the last time was in 1960. The United States came out wearing the throwback 1960’s sweaters, an homage to that last victorious team.

Now, as the United States heads into the 12-team tournament as the #1 seed, they have set the standard for what is to come from the young team.

Coached by Ron Wilson (head coach of the Toronto Maple Leafs), the Americans took the lead early in the first period with a goal from Brian Rafalski (of the Detroit Red Wings) within the first minute of play.

That goal would then be answered by Ryan Getzlaf (of the Anaheim Ducks) on the Canadian team, which would then be followed by another goal from Rafalski.

The player of the game, however, was certainly Ryan Miller, the goalie for the United States. Miller stopped 42 of 45 shots from the Canadians, an impressive game from the Buffalo Sabre.

Next on the agenda for the U.S. team is the winner of the Switzerland-Belarus qualifying game set for Tuesday. The Americans beat Switzerland last week 3-1, but the victory did not come easy. If the United States is to play Switzerland, who is the favorite, expect the Swiss to come out with a vengeance.

The United States is not alone in receiving a bye into the quarterfinals. They are joined by Russia, Sweden, and Finland in that qualification. Other teams that will have to fight it out for a position in the quarter finals are the fifth-seeded Czech Republic vs. No. 12 Lativa, Canada (No. 6) vs. Germany (No. 11), Slovakia (No. 7) vs. Norway (No. 10), and Switzerland (No. 8) vs. Belarus (No. 9).

If you’ll be one of the millions watching Men’s Hockey in the Olympics, pay attention the footwork involved in the game. Think of how hard it is do move quickly in shoes, now try that on the ice. That should give you an appreciation of the difficulty of the sport. Many professional hockey players, including the Olympians, opt for functional orthoses to be put into their skates. This helps them get optimal function out of the foot-skate interface, allowing for quick stops and pivots. It will be quick footwork that wins the game – stay tuned for more updates on the 2010 Winter Olympics from Vancouver!

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Olympics Update – Marit Bjoergen Wins Gold

2010-02-22T08:10:00.002-05:00

In an incredible display of endurance, Norway’s Marit Bjoergen has won the gold medal in the Ladies’ 15km Pursuit with a time of 39:58.1. Sweden’s Anna Haag will bring home the silver, and Poland’s Justyna Kowalczyk narrowly edged out Norway’s Kristin Sotermer Steira in a photo finish for Bronze.

Bjoergen’s gold medal performance in the 15km Pursuit adds to her list of medal-earning performances at the 2010 Vancouver Olympics. She also won a gold medal in the Ladies’ Individual Sprint Classic, and earned the bronze in the Ladies’ 10km freestyle.

The 15km pursuit exemplifies the difference between classic and freestyle cross-country skiing. In classic skiing, the skis used are long and thin, sometimes referred to as “skinny skis”. This allows for speed, but does not offer much for lateral movement. In freestyle cross-country skiing, also known as skating, the skis are slightly wider, and curved on the edges. This allows for more lateral motion, or a motion that more closely resembles ice-skating.

During the combined pursuit event, the Olympians exchange their skis halfway through the race. They begin with classic skis, and exchange them in the middle for the freestyle skis. This exchange proves to be a pivotal point in the race, as Bjoergen’s smooth transition allowed her to keep pace as the leader.

In both types of cross-country skiing, the boot is attached to the ski at the toe, but not at the heel. This allows for a gait that can closely resemble walking, especially when the skiers are racing up hill. It is clear to see that the heel is coming off of the ski during the race, which is characteristic of cross-country skiing. Cross-country skiing in general consists of both uphill and downhill movement, and the heel lift is essential for the uphill portions of the race.

The event is truly a test of endurance, as the 15km race is roughly equally to almost 9.5 miles! You can see while watching the event that the skiers grab water and sports drinks during the race, much like a runner in a marathon. This is to keep hydrated and keep a steady supply of energy, as muscle glycogen stores (the way that our bodies keep a reserve of fast-acting energy) can become depleted very quickly during such a long event.

The men’s pursuit race, which is a distance of 30km (15km classic and 15km freestyle) is scheduled for February 20 at 1:30pm PST.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Shaun White Repeats Gold, Torah Bright takes Women’s Gold

2010-02-19T13:21:00.003-05:00

Wednesday night proved to be Shaun White’s night as he took the gold medal in the men’s halfpipe event. White won with a score of 48.6 following an incredible display of athleticism and agility.

The 23 year old athlete came into the Olympics defending the gold medal in the same event, and successfully repeated. He has also previously won the vert competition in skateboarding at the 2007 X Games.

The silver medal in men’s halfpipe snowboarding went to Peetu Piiroinen of Finland, and the Bronze went to the United States’ Scott Lago.

In the women’s halfpipe snowboarding competition, Australia’s Torah Bright took the gold medal home with a score of 45.0. Torah Bright, also 23 years old, helped to break the long-standing U.S. domination of women’s halfpipe snowboarding. Americans Hannah Teter and Kelly Clark took the silver and bronze medals home, with scores of 42.4 and 42.2, respectively.

The amount of force placed on the body during an event such as snowboarding is incredible. Seeing the heights that Shaun White, Torah Bright, and the other snowboarders reach during the event shows just how much impact they are coming down with. While the forces placed on the body while snowboarding have never been studied and published, the forces during skateboarding have. While skateboarding, ground reactive forces can reach up to 10-20 times the skateboarder’s body weight. It would be very interesting to see exactly what the forces are being placed on the feet, ankles, knees and hips during snowboarding.

Non-professional snowboarders are likely to be familiar with these forces. Going off of a jump, it is important to land with the knees slightly bent, bringing the entire body down closer to the ground while landing. This helps lessen the impact on the body. Landing with a straight knee joint and rigid ankle joint can seriously injure the participant.

Snowboarding injuries that are typically seen include ankle sprains and knee ligament injuries. These occur from the twisting motions of the body over a stationary knee and ankle. Without the proper attention to detail, the amateur snowboarder can find himself or herself in an immense amount of pain following this type of injury.

Keep watching the Olympics to see how your favorite athletes prepare their bodies for the impact with the ground. Notice how they move their legs, knees and feet when landing in snowboarding and ski jumping. Ski jumping is set for February 22, with several rounds being televised.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Winter Olypmics 2010 and Foot Health

2010-02-18T10:57:00.004-05:00

No matter what you’re favorite Olympic event, there’s bound to be something to keep your interest in the 2010 Winter Olympics from Vancouver. Whether it is hockey, figure skating, or the biathlon, the Winter Olympics give us an opportunity to watch some of the most elite athletes in the world compete in their sport.

Foot health is something that the Olympian, just like all other athletes, must be aware of. In sports such as snowboarding, alpine skiing, and ski jumping, there is an incredible amount of force that is applied to the feet, ankles, and knees in particular. This force is many times the normal force of walking, and can lead to serious injury and fracture if the proper measurements are not taken. Athletes must be aware of their form and technique, as well as the feet that they are landing on.

Many skiers and ice skaters wear orthotic devices in their ski boots and ice skates. This is a common practice among downhill skiers and hockey players, from Olympic athlete to amateur. The reason for this is that a custom orthotic can make an otherwise uncomfortable boot much more comfortable, as well as add a significant amount of function to the clunky footgear.

The Olympic games, which began on February 12, is an exciting time to watch the world come together in Vancouver. The games will continue through February, with the closing ceremony on February 28.

You can follow the games online at www.vancouver2010.com, where you can get updates on medal counts, event schedules, and lots of other information.

Check back here for updates on the Olympic games and foot health, and plenty of other information on podiatry and related topics!

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Born to Run?

2010-01-20T15:26:00.005-05:00

Were we, as human beings, born to run? The anatomy and physiology of our bodies certainly indicates that the answer to this question is yes.

There are twenty-eight bones in the human foot alone, making up joints designed to absorb and distribute the forces associated with walking and running evenly through our bodies. Moving up the leg, our ankle, knee and hip joints help us absorb these forces, carrying them through our spines all the way up into our neck and head. Our movement is studied in terms of biomechanics by podiatrists, pedorthists, orthopedists, and other professionals.

Biomechanically speaking, we are in fact born to run. When studying the gait cycle, or the movements we make while running and walking, it has been shown that running is a much more efficient process than walking. That is, more of the energy that gets put into running gets translated into forward motion. While walking, much of the energy that gets put into walking gets translated into up-and-down motion, as well as motion from side-to-side. In the biomechanical world, this is referred to as frontal plane and transverse plane motion, respectively.

Additionally, our muscles are designed for longer strides and greater forces than we usually use them for during walking. Take for example the gluteus maximus. The gluteus maximus is one of the largest muscles of the lower extremity, yet is barely used at all in walking. When we pick up the pace and begin running, our gluteus maximus becomes more active. This is especially apparent when running up-hill.

Consider the shape of the foot. The ball of the foot is a muscular and well-padded area, designed to absorb impact and keep us steady. In proper running form, the ball of the foot is where we ideally want to land, which propels us into the next stride. When we strike with our heel first, it can set us up for a number of running-related problems. Many running purists are turning to barefoot running, which embraces the natural design of the foot as a running tool.

A number of other factors come in to play when discussing the idea of running as human nature. Our body’s chemistry allows us to run for long distances at a moderate pace, whereas most other mammals sprint short distances followed by periods of rest. This is made possible by our storage of energy, which we can readily use. We store carbohydrates simply for the purpose of burning them for energy when we need them, such as in intense exercise.

Of course, running in the modern human is more exercise and less necessity. We don’t necessarily have the need to run away from a predator anymore, or chase down our dinner in a field. The evolutionary traits, however, are still around from our Caveman ancestors.

So the next time you are struggling through that run, just remind yourself of this: You were born to do this!

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Which Running Shoes to Buy?

2010-01-05T08:52:00.000-05:00

Have you ever browsed through a running store looking for the right pair of shoes? It can be a daunting task, given all the options available to the consumer. Any good running store will have at least five or six brands heavily stocked. Within each brand, there may be a dozen or so choices, so how do you know which one to pick for yourself?

The easiest thing would be to have a trained salesperson help you decide which shoe is right for you. They may watch you walk, try to analyze your gait, and put you in a shoe that they think will be most appropriate for you. However, a trained salesperson may not always be available. With that in mind, there are a few things you’ll want to look for in a shoe.

1. First thing’s first – you’ll need to know what type of shoe to get. Breaking down the various types of running shoes most generally, you’ll find two basic types; shoes that are meant for cushioning and shoes that are meant for controlling the motion of your foot.

A shoe that controls the motion of your foot, or a “motion-control” shoe is usually used for someone that over-pronates, has a very flexible foot, or generally has a lot of movement in their gait. They may have a lower arch, which can be measured by stepping with a wet foot onto a piece of paper.

If you tend to put a lot of pressure on the lateral, or outside portion of your foot, you’ll be more likely in need of a cushioning shoe. These shoes are meant to support the natural movement of your foot, while giving it extra padding through the stresses of running.

Within each running shoe brand, there are various levels of support and motion control-type shoes. Think of it as a sliding scale. There are several places to read reviews of particular styles of both types of shoes, available through magazines like Runner’s World, and online reviews such as http://www.motioncontrolrunningshoes.info/ and http://www.cushionrunningshoes.com/. You may also find that experienced and well-trained salespeople, where available, will have opinions regarding some styles, brands, and types of shoes.

2. Get the right size. Find out how to pick the right size HERE.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Running Through the Cold

2009-11-23T17:20:00.000-05:00

Looking to keep running when the weather gets cold? It may not be an issue in the warm-weather states, but if you live in a place where the weather gets chilly, here are a few steps to keep you comfortable:

· Wear clothes made of a moisture-wicking material. This includes material such as polypropylene and wool. Avoid cotton, as this tends to hold moisture next to the skin. Keeping your skin dry is probably the most important step in staying warm when the weather is not. Fleece hats and gloves will work as well, and will let your skin breathe.

· Wear lots of layers. Wearing several layers of clothes will allow you to move easier than when wearing one bulky layer. Try different weights of clothes in combination, including base layers (the layer against the skin), mid-weight layers over that, and a wind breaking layer on top. Wearing layers also allows you to peel off the layers if you get too warm.

· Dress for twenty degrees above the actual temperature. If you are warm when you walk outside, imagine how warm you will be once you start running! Dressing for weather that is twenty degrees warmer than it actually is will help you avoid this problem. You’ll want to be a little cold when you walk outside, but not too cold.

· Wear the right kind of socks. Running socks come in all different shapes, sizes and weights. There are socks made of polypropylene, and socks made of wool, as well as other materials. A thick wool sock will help keep your feet warm in cold weather, and will also help wick the moisture away. Moisture held next to the foot by a cotton sock can make your feet cold, as well as cause blisters a major pain.

· Gortex shoes can keep the weather out. Gortex is a breathable material that is water resistant. This is great in a cold rain or snow. It also offers extra warmth for your feet.

· Stretch inside. This will get your blood flowing, so you will be less cold once you walk outside. You can also try running down stairs or jumping in place a few times. Don’t get so warm that you start to sweat, just warm enough to get your blood moving.

· Beware of snow and ice. If it gets snowy in your town, there is always the possibility of black ice that you won’t see until it’s too late. There are products you can buy to put on the bottom of your shoes to give you extra traction in the snow and ice, such as products like STABILicers or YakTrax.

· Take off sweaty clothes when you’re done. Keeping your sweaty running clothes on after running outside in the cold will not only give the people around you a whiff of your stench, but it will make you very cold. Take off your running clothes right away when you come inside.

Keep in mind that frostbite and hypothermia can set in pretty quickly in temperatures below twenty degrees. Its great to run outside in the cold, but it is important to prepare yourself properly. You can always check out our online store for new running products at www.FLFootandAnkle.com.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Nate Robinson Suffers Early Season Ankle Injury

2009-11-23T09:12:00.003-05:00

On Sunday’s game against the Philadelphia 76er’s, New York Knicks guard Nate Robinson had to leave in the fourth quarter because of an ankle sprain. The Knicks star sprained his right ankle, which will certainly be a drawback for the already 0-3 Knicks.

Robinson won the Sprite Slam Dunk Contest at last year’s All-Star Game, when he jumped over teammate Wilson Chandler, and then later over Dwight Howard. Nate Robinson is listed at five feet nine inches.

The ankle sprain will likely sideline Robinson for at least two weeks as he recovers. Depending on the extent of the injury, it could be longer.

Until he returns, guards Larry Hughes and rookie Toney Douglas will fill in for Robinson.

The lateral ankle is composed mainly of three ligaments that hold the foot bones to the fibula, which is the leg bone that helps form the ankle. The foot bones involved are the talus and the calcaneus (the heel). The ligaments that hold these structures together are called the anterior talofibular ligament, the calcaneofibular ligament, and the posterior talofibular ligament.

Often in a lateral ankle sprain, these ligaments can become stretched out or even torn. Most commonly, the anterior talofibular ligament and the calcaneofibular ligament are the two that are affected.

It has not been reported yet the extent of Robinson’s injury, but he will likely get an MRI to determine if the ligaments have been effected. If the ligaments are intact, two weeks should be enough time for him to be back to normal. If they aren’t, it could be a longer recovery.

Basketball is one of the most common sports for athletes to suffer from lateral ankle sprains. One of the reasons for this is that the players are jumping up and down so often, and they may be landing on an uneven surface, like another player’s foot. When landing on an uneven surface, it becomes very easy to roll the ankle laterally, causing the sprained ankle.

To prevent ankle injury during basketball, the proper footwear is recommended. A high-top basketball shoe will offer additional support for the lateral ankle, helping to prevent rolling the ankle. At any level of competitive basketball, especially the NBA, it would be hard to find a player without the proper shoe gear. But on playgrounds and gyms, it’s pretty easy to find a pick-up basketball game filled with players wearing improper shoe gear.

Updates are sure to come once the extent of Nate Robinson’s injury is determined. After leaving the arena on crutches this Saturday, Knicks fans and fantasy basketball players will be waiting for the news.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Lacing Patterns!

2009-10-14T07:35:00.000-04:00

The average athletic shoe has 6 pairs of eyelets (12 of those little holes that allow laces to pass through) and with over 2 trillion different ways to run laces through them, you are bound to run into a pattern that accommodates your foot in the shoe! The majority of foot problems that people face stem from shoes – either the shoe is too narrow or too wide, the shoe length is too small so your toes have no room in the toe box, or the toe box is oddly shaped where your toes must scrunch up against each other.

There are instances where the shoe is actually a good a fit, but the top of the shoe is exerting too much pressure on the top of your foot. Or you may find that exercise activities such as running or jogging start to cause pain around your foot as a result of the shoes. Sometimes, all that is required to alleviate the pain is a little adjustment in your lacing pattern. There are a variety of patterns that will allow a decrease in the pressure that the top of the shoe exerts onto your foot, increase ankle stability within the shoe, and even prevent pronation (the excessive inward rolling and flattening of the foot)! And since all that is being changed is way the shoelaces are being threaded through the eyelets, it’s an easy, inexpensive way to gauge whether the pain in your foot is really caused by your shoe or not!

To help with excessive pronation during exercise you may want to lace your shoes higher and tighter (not too tight where you are uncomfortable!). The higher lacing will also help your ankle stay in place and give that joint a little extra stability. Or if you find you have irritation on the top (dorsum) of your foot, there are specific ways that lacing methods can address that problem. For instance, say you have cut on the top of your foot that you’d like to take pressure off of, just rethread your laces off of that site. So instead of your laces crisscrossing at that level of the injury, they’ll be a gap there.

Make an appointment with your podiatrist and have your pain evaluated by them. If your pain is footwear-induced or exercise-induced, make sure to tell your podiatrist that information; and ask them for lacing recommendations. They will be able to show you in person the best technique for you!

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Eli Manning has Plantar Fasciitis

2009-10-13T09:18:00.003-04:00

After leaving the game during the fourth quarter on Sunday, Eli Manning was diagnosed with plantar fasciitis on Monday. This news comes after Giants fans held there breath while watching the star quarterback leave the game complaining of heel pain.

This will not likely keep Manning from playing this coming Sunday against the Oakland Raiders, though it may be painful. He will treat the plantar fasciitis conservatively over the next week, most likely with rest, ice, and massage. The Giants have put him down as a “maybe” for the upcoming game against Oakland.

Plantar fasciitis is an inflammation of the soft tissue that runs along the bottom of the foot. This soft tissue is known as the plantar aponeurosis, and plays a key role in adding stability to the foot. It helps the toes flex during gait, and adds a great amount of integrity to the foot.

The inflammation often comes as a result of improper biomechanics. If the foot is allowed to flatten out while walking or running, this can put stress on the plantar aponeurosis. Repeated stress, such as from running in football cleats, can cause pain, particularly at the bottom of the heel.

This is exactly where Eli Manning reported pain after leaving the game. An MRI was performed to rule out other possible causes, and to assess the amount of inflammation.

Manning said that he felt the pain when he dropped back to throw a pass in the fourth quarter. He stayed in for one more play, where he launched a 54-yard touchdown pass to Hakeem Nicks before coming out fro back up David Carr.

Manning has been a key element to the Giants’ 4-0 start this season. He has thrown for 1,039 yards so far, with 8 touchdowns and just 2 interceptions. He has a 62.3 percent completion percentage, and is the third ranked quarterback in the league. Only his brother, Peyton Manning, and Drew Brees are ranked higher.

Giants fans hope to see Eli Manning at full strength this Sunday against the Oakland Raiders. Oakland is off to a 1-3 start this season following a blowout loss to Houston this past Sunday.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Finding the Right Soccer Cleats

2009-09-14T08:43:00.007-04:00

Soccer can be an incredibly demanding sport, particularly on the feet. During a typical 90-minute professional game a player may cover between 8,000 and 11,000 meters, or between five and seven miles. Around two-thirds of this distance is spent walking or jogging, while the other third is spent sprinting, cruising, or backing. There is a great diversity in the movement involved in playing soccer, not to mention the need to kick the ball. Thus, soccer cleats play a huge role in the effectiveness of the soccer player, and are the most important piece of equipment to the competitor.

While a high school or non-professional athlete may not run as much as the professional soccer player, the athletic demands placed on the feet are great. Companies that make cleats therefore are required to meet the needs of the youth athlete, using designs that were previously only available to elite athletes.

So what should you look for in a soccer cleat? The following is an attempt to introduce some of the different aspects of selecting a soccer cleat.

Control vs. Comfort: The ideas of comfort and control can be thought of as being on opposite ends of a balancing scale. On one side, the player requires control, which is generally obtained with a stiffer, less flexible shoe. On the other side, the more comfortable shoe will be less flexible, and will offer less support. It is thus a balancing act of finding the right amount of control and comfort that is placed in the hands of the manufacturer.

Fit: A soccer cleat should not allow the foot to move too much during play. Excessive movement of the foot within the shoe can lead to blisters and tendonitis, two problems that can easily sideline a player. However, a shoe that fits too tight can lead to pain and trauma to the feet during play. The fit should be snug, but not uncomfortably tight.

The soccer cleat itself has several components that lend to the way it fits. The external last of a shoe is the form on which the shoe is constructed. There are three general types of external lasts – straight, curved, and semi-curved. The external last plays a crucial role in the fit of the shoe. A person with a normal foot type or a flat foot type will probably be most comfortable in a straight lasted shoe. Those with a higher arch generally prefer a curved or semi-curved last.

The internal last is also a very important aspect of the soccer cleat. The internal last is located between the sockliner and the cleats, and serves as the interface between the foot and the cleats. A proper fitting internal last helps support the foot and can prevent sports injuries such as plantar fasciitis.

Upper Materials: One of the key decisions that a soccer player must make when choosing their cleats is what type of upper materials they want in their shoe. The upper is the piece of the shoe that covers the foot, and serves to protect the foot. In soccer cleats, it can make a huge difference for some what type of material is used.

Full grain leather is the standard in soccer cleat uppers. It provides good protection and durability, and will likely last a longer time than kangaroo leather. Kangaroo leather is much thinner, giving less durability to the shoe, but a greater feel for the ball. Kangaroo leather is typically more expensive than full grain leather, and is found in higher end shoes.

Synthetic materials have gained popularity in soccer cleats as well. Synthetics come in a variety of types and thicknesses, and will generally not absorb any water. This makes the shoe durable, but also makes the shoe hotter and less breathable.

Cleat Type: The arrangement of studs and/or blades on the bottom of the soccer cleats can make a huge difference in the interface between the ground and the shoe. Different types of cleats are used depending on field conditions. There are turf shoes, hard ground, firm ground, and soft ground soccer cleats.

· Turf shoes have small rubber studs covering the entire sole of the shoe. These are best for synthetics turf or other extremely hard surfaces. These shoes are designed to be very grippy, but will not dig into the ground.

· Hard ground cleats have short rubber or plastic studs, and the studs are usually arranged in rows. These cleats are designed to be worn on hard, unforgiving surfaces, and help provide grip on fields that are hard for a cleat to penetrate. The studs on hard ground cleats tend to be shorter and firmer than the studs on firm ground cleats.

· Firm ground cleats are the most widely used cleats. They are either made with short studs such as the ones seen in hard ground cleats, but are more commonly made with blades instead. The blades are short pieces of thermal plastic that have been designed to dig into a firm, but somewhat forgiving surface.

· Soft ground cleats have longer studs that are usually detachable. They are designed for use on soft fields, such as a rain soaked field. They come in different lengths, between 12-16mm, and can be adjusted based on the player’s needs.

It is becoming more common for shoe brands to design cleats with interchangeable studs. This facilitates the athlete’s needs without having to buy extra pairs of shoes.

Whether they are for you or for someone you know, it is critical to consider all of these variables when shopping for soccer cleats. The right pair of cleats can be the difference between performing at top potential and sitting on the sidelines with an injury. If you can, shop at a store that specializes in soccer equipment. These store will typically have a wide selection, and will have the knowledge to find the right pair of cleats for you.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Chi Running

2009-09-08T12:21:00.005-04:00

In the running community, the emphasis on proper technique is everywhere. Trainers and coaches stress the importance of running form, and healthcare professionals will often talk about the biomechanics of running, and how it relates to injury. Runners ranging from professionals to weekend warriors can focus on their technique, hoping to become the most efficient runner possible, as well as remain injury-free. Chi Running, a philosophy and technique developed by long time running advocate Danny Dreyer, is no exception to the emphasis on proper form.

In April of 2004, Dreyer release Chi Running: A Revolutionary Approach to Effortless, Injury-Free Running. The book caught on in the running community quickly, and was followed by Chi Walking: Five Mindful Steps to Lifelong Health and Energy in 2006. In Chi Running, emphasis is placed on a midfoot strike during the running cycle as opposed to a heel strike. While the vast majority of runners land on their heels, this can often cause a variety of running injuries, such as iliotibial band syndrome, patellofemoral pain syndrom and even shin splints.

According to the Chi Running website, the philosophy behind Chi Running combines the inner focus and flow of Tai Chi with the power and energy of running. The Chi Running book claims to be the definitive book on running technique, and the Chi Walking book can help apply the same ideas to fitness walking. In an era of increased health problems due to obesity and preventable disease, any book that encourages people to take care of themselves is welcome. Chi Running appears to be a holistic approach to running, helping to focus the mind and entire body on the activity, rather than just simply moving your legs as fast as humanly possible.

The term Chi (pronounced Chee) comes from an ancient Chinese philosophy. The Chi is what unites the mind, body, and spirit. In the Eastern philosophy, Chi is stronger than muscle, and it serves to give energy through the body. At the core of Chi Running is the application of this philosophy. A focused mind, body, and spirit will help the runner become more efficient; less affected by injury, and will make running a more enjoyable experience.

Balance training is a key aspect of Chi Running. With the proper balance of the body, the proper biomechanics of running can be attained. This short YouTube video demonstrates the basics of Chi Running, as demonstrated by a certified Chi Running instructor.

Chi Running is certainly a unique approach to a very common form of exercise, and may help some people with their running form and style. To learn more about Chi Running, check out the website ChiRunning.com.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Sports Medicine and Podiatry

2009-08-18T09:33:00.005-04:00

You may have heard the term “Sports Medicine” before, but do you know what it means? Sports medicine is a subspecialty of medicine that is concerned with the prevention, diagnosis, and treatment of injuries related to sports or exercise. It is an area of medicine that has been getting more attention lately, as an aging baby boomer population is living a very active life. This population, as well as millions of others with an active lifestyle, is prone to injuries of the bones, joints, muscles and ligaments, all of which can be treated by a sports medicine specialist. Podiatrists, as well as orthopedists and physiatrists, can all specialize in sports medicine.

So how big of a deal are sports injuries? In the United States alone, there are approximately 3-5 million sports-related injuries every year, which costs on average about $1 billion. According to information tracked by the National Collegiate Athletic Association (NCAA) the most common sites for sports-related injuries are the ankle, knee, and lower leg. From high school sports statistics, over 53% of reported injuries were of the lower extremity. It’s easy to see how a podiatrist, a doctor specializing in the treatment of the foot and lower extremity, would be very busy if they specialized in sports medicine.

An often overlooked area of concern for many athletes is the preparation before participation in sports. Injuries are often sustained within the first four weeks of training. This is a critical time period for athletes to remain at the top of their game, and to remain injury-free. It is during this time period that prevention becomes extremely important, so as to avoid a serious injury.

Some of the most common sports-related injuries include sprained ligaments, muscle strains, and contusions (bruising). Many of these injuries are due to the enormous forces placed on the lower extremity during sports. When walking, we put roughly 1.5 times our body weight in force on each leg. When running, the forces are equal to roughly three times our body weight on each leg. Jumping increases the force to over six times body weight, and very high impact activities like skateboarding can increase the forces placed on our lower extremities to over seventeen times the body weight!

A podiatrist will usually work with the athlete directly or through the athletic trainer to prevent injury and improve function during activity. In sports medicine, a team approach is often taken with the podiatrist or other physician, the athlete, the athletic trainer, and often the coach. More advanced athletes and professional athletes may also have a massage therapist, a nutritionist, a personal trainer, and even a sports psychologist. The team that helps the athletes may be larger than the team of athletes itself!
Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Rashard Lewis Suspended 10 Games for Steroids

2009-08-07T09:31:00.005-04:00

Orlando Magic forward Rashard Lewis was suspended ten games for testing positive for elevated testosterone levels.

“Toward the end of the season I took an over-the-counter supplement which at the time I did not realize included a substance banned by the NBA,” Lewis said. “I hope every athlete can learn from my mistake that supplements, no matter how innocent they seem, should only be taken after consulting an expert in the field.”

The substance that Lewis referred to is DHEA (Dehydroepiandrosterone), a precursor for human steroid that is commonly found in over-the-counter nutritional supplements. DHEA is a naturally occurring substance in the body, but elevated levels suggest an additional supply, such as that from a nutritional supplement.

"I apologize to Magic fans, my teammates and this organization for not doing the research that should come with good judgment," Lewis said in the statement. "I hope this unintentional mistake will not reflect poorly on our team and its great character.

The news that Rashard Lewis will sit the first ten games of the 2009-2010 season without pay comes as a blow to Magic fans, who witnessed the team go to the NBA finals for the first time since 1995, when Shaquille O’Neal was still on the team.

Lewis had an integral role in leading the Magic to the finals last year, averaging 19.0 points in the playoffs, as well as 6.4 rebounds and 2.6 assists.

Last season marked Lewis’ eleventh in the NBA. He averaged 17.7 points, 5.7 rebounds and 2.6 assists in 79 games.

Steroid and other performance-enhancing supplements have been in the national spotlight for quite some time now. Football players, cyclists, and most notably Major League Baseball players have had their fair share of attention on the topic. But for the NBA, steroid use has been relatively quiet, with many comments hinting at the idea that these types of performance enhancers would not help in basketball. Athletes in other sports have come under heavy questioning on the subject, but basketball players have been saved from this.

With Lewis being indicated, he adds to the list of NBA athletes who have been confirmed as using steroids, a list that already included Darius Miles, Lindsey Hunter, Don MacLean, Matt Geiger, and Soumalia Samake.

The question is, will the NBA begin to be scrutinized as the MLB has been? Should it be? There are undoubtedly more players using similar performance-enhancing products, many of which are slipping under the radar. With Rashard Lewis being added to the list, watch for more names to come.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Cycle with your Feet

2009-08-04T16:18:00.004-04:00

What began as a means of transportation in the 19^th century, the bicycle has evolved into something that has had a tremendous impact on human history and culture. Many have been noticed as contributing to the early design of the bicycle, including John Dunlop who is credited with creating the first air-filled tires. Modern cyclists ride bikes that would look foreign to the original cyclists – racing bikes can be made of carbon fiber and cost upwards of five thousand dollars. Today over 100 million Americans report to riding a bike recreationally, and in many places of the world it is still the primary mode of transportation.

Perhaps the most important piece of equipment, besides finding the right type and size of bike, are the shoes one wears when cycling. Cycling shoes are very stiff, with a strong shank through the shoe. This provides a way for the energy from the foot to be transferred into the pedals, providing the most efficient source of energy to spin the wheels. Without a proper shank in the shoe, the arch may collapse while pedaling. This can cause a multitude of foot problems, such as arch pain, tendon problems, or a burning sensation in the bottom of the foot.

It is especially important to select the right cycling shoes if you have a history of foot problems, or if you wear custom orthotic devices. Select a shoe that is specific to your needs, whether that is mountain biking or road biking. For casual riders, the option of a stiff cross training shoe will usually be sufficient. There are also combination biking/hiking shoes that have become more popular in recent years.

If you’re getting more serious with cycling, and want to take it to the next level, you may want to consider bike pedals with toe clips. These are small metal devices that the tip of your shoe fits into, that makes pedaling more efficient. Instead of just pushing with your feet, you can now have a combination pushing/pulling motion more easily. Some may opt for a “clipless” set-up, which are bike pedals that resemble ski bindings. These pedal systems have special shoes that will snap into place, and will be the most efficient way to transfer energy from your lower extremities into the pedals.

Whether you are riding for fun, exercise, or training for a race, it’s important to listen to your body. Many cyclists wind up in a podiatrist’s office with pain in their feet and legs from cycling beyond their limits. The following is a list of common conditions associated with cycling injuries:

· Knee Pain may be caused by improper biomechanics, resulting from a bike that doesn’t fit or poor positioning of the feet while riding. It may present as a clicking, popping, or grinding noise from the joint. Problems with the knee need to be analyzed by a medical specialist right away, as they can quickly progress to more serious and painful situations.

· Achilles Tendonitis is generally seen in riders as an overuse injury, fairly common in serious cyclists. It is a straining or even tearing of the Achilles tendon, and is usually treated with rest, ice, and anti-inflammatory medications.

· Shin Splints may be caused by poor biomechanics while cycling. This is pain on either side of the shin bones, especially when walking.

· Sesamoiditis is a condition of the sesamoid bones, two small bones located under the joint of the big toe. These can become inflamed from too much pressure, usually from a combination of overuse and improper footwear.

· Numbness, especially in the space between the third and fourth toes, may be a sign that the shoes you are wearing to bike in are too tight. Wider shoes may help. Numbness should be evaluated by a sports medicine specialist, as it ma be a sign of a more serious condition known as acute compartment syndrome.

Enjoy that bike ride, but remember to be safe! Pay attention to pain from your legs and feet, and talk to a doctor if you’re having problems. Also, wear a helmet!

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Turf Toe

2009-07-28T11:02:00.007-04:00

You may have heard the phrase before, but what exactly is “turf toe”?

Turf toe refers loosely to a collection of problems that may occur at the big toe. The joint that connects the big toe to the rest of the foot lies between the first metatarsal and the proximal phalange of the big toe. This joint, known commonly as the first metatarsophalangeal (MTP) joint, has two small bones that lie underneath it. These sesamoid bones act as pulleys, allowing the muscles of the foot to have a great pull on the big toe during weight bearing activities.

When something goes wrong with this apparatus, particularly during sports such as soccer and football, the injury may be referred to as turf toe.

Due to the propulsive and pivoting function of the big toe during weight-bearing activities, it is susceptible to injury.

Most commonly, the injury involves an excessive amount of dorsiflexion, or upward motion, of the big toe. This type of injury will lead to a sprain of the ligaments surrounding the joint. This is common in sports where the athlete is wearing cleats, because the cleats cause the foot to maintain a certain position while the body weight is shifting forward. Synthetic turf can create an ideal situation for this type of injury to occur, because the cleats usually stick to the turf easier, and the ground underneath the turf is generally a harder surface.

Since turf toe is a general term, it may also refer to conditions such as sesamoiditis, which is inflammation of the tissue surrounding the sesamoid bones. The sesamoid bones may also be fractured in this type of injury, or the joint capsule surrounding the first MTP joint may be compromised. When evaluating a turf toe injury, the medical professional will work to rule out more serious diagnoses. Turf toe injuries are most frequently handled by a podiatrist, orthopedist, physiatrist, or sports medicine doctor.

Treatment of turf toe, if there are no fractures or other more serious complications, is generally done by resting the foot, icing the area, taking anti-inflammatory medications, and immobilizing the toe. Usually the goal of the treatment is to allow the athlete to return to activity without further complication, and without re-aggravating the injury.

Turf toe is usually a pretty straight-forward injury, and athletes are often able to return to activity in a relatively short amount of time. It is however an injury with a high rate of reoccurrence. Roughly half of the patients that suffer from turf toe will have a reoccurrence within five years of treatment.
Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Low Impact Exercise

2009-07-26T14:45:00.001-04:00

What exactly is low impact exercise? Low impact exercise is determined by the shock that your feet and body experience while doing an activity. Heavy duty sports such as rugby or football are high impact, high intensity exercises. You are literally sending shockwaves through every bone in your body with those types of activities. However, just because an activity is deemed low-impact, does not mean that you cannot burn calories or lose weight through it.

There are some instances and body types where low-impact activities are encouraged as the preferred means of exercise.

- Obese individuals

- Pregnant women

- Individuals with bone or joint injuries (low impact exercise is great for rehabilitation)

- Individuals with chronic health problems like stress fractures , arthritis and osteoporosis

- Individuals new to exercise

If you think that that low impact exercises cannot cause some serious calorie burning, think again. There are so many low impact activities that will require substantial energy to get through: walking, walking up stairs, hiking, cycling, rowing and swimming.

Low impact exercises should be done continuously so that your heart rate gradually increases and stays at a high level. Studies have also shown that 30 minutes of low impact exercising raises your endorphin levels! (Endorphins are pain-reducing compounds within the body) Another plus to losing those calories! Although these exercises are not as intense as sporting activities it is important to start slow and build your way up. These activities can become strenuous and intense if you work hard at them.

Cross-training with different low-impact exercises is the best way to get your body into shape without subjecting it to harsh forces. If you keep your body challenged by varying your exercises, you will burn calories, lose weight and feel good about not sitting on that couch!

How can you add variety to your exercising?

- Try grouping exercises that use different parts of your body for example swimming and stair climbing

- As you gain endurance change the pace or frequency that you do your exercises

- Embellish your exercise movements, for example when swimming take bigger and longer strokes, when marching raise your knees up higher

Before engaging in any exercise regimen, consult your podiatrist for a foot screening.

They will evaluate all aspects of your foot and associated systems such as musculoskeletal, vascular, and neurological to make sure that they all are working together properly. If you encounter any problems or sustain an injury during your workout, stop immediately and talk with your podiatrist.
Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Yao Ming Opts for Pair of Surgeries, Likely to Miss Season

2009-07-23T08:15:00.005-04:00

On Friday, Houston Rockets’ center Yao Ming announced that he will opt for a pair of surgeries on his left foot. The news comes following an injury sustained this past playoff season, when the 7-foot 6-inch professional basketball player hobbled off the court with a broken navicular bone.

After several years of aggravating injuries, Ming will undergo a two-part procedure to fix and strengthen the bone. The first surgery will use a bone graft to help regenerate new bone and surgically repair the hairline fracture of the left navicular. The second procedure will involve realigning the bones of the left foot, thereby lowering the arch of the foot and relieving some of the pressure put on the bones. This procedure may involve attaching a plate to the bones using shallow screws. In February 2008, a similar procedure was done using pins to strengthen the area, but subsequent injuries followed.

This pair of surgeries will likely sideline Yao Ming for the entire season. The Houston Rockets, however, have not released an official statement on the timeline of Ming’s return.

“After much thought and reflection, I have decided to have surgery on my left foot,” Yao Ming said in a prepared statement on Friday. “This surgery will allow me to continue my career playing basketball, and I look forward to returning to the court. I would like to thank everyone who sent me their best wishes. I am very grateful to have the support of teammates, friends and fans as I dedicate myself to making a completely successful recovery.”

The surgery that Yao Ming will be undergoing is similar to a surgery performed on Cleveland Cavaliers center Zyndrunas Ilgauskas in 2001. Ilgauskas recovered well from the surgery, and has since made a great impact on his team and in the league, averaging 74.5 games played since 2001.

The surgery will be performed by Rockets team physician, Dr. Tom Clanton. “This combination of procedures should not only allow healing of his navicular stress fracture but also improve the mechanics of his foot to reduce the stress on that bone and give him the best long-term prognosis,” Clanton said in Friday’s statement.

This season will mark the fifth consecutive season that has been either missed, interrupted, or ended early for Yao Ming, all due to bone injuries. Rockets personnel is standing behind their All-Star center, and has requested to the NBA an exception to the disabled player list.

Others say that it’s just not meant to be – that a man that big was not meant to run up and down a basketball court.
Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Shoe-be-gone!

2009-07-22T13:34:00.005-04:00

Despite all the roles that our feet must play to enable our mobility, to balance our body, to hold up our body weight and to absorb shock, how do we reward them? It’s usually by neglecting the well-being of our feet and confining them in a prison of shoes. We disregard valuable stretching exercises before engaging in physical activities and squish our feet into shoe wear that damages their health. The shoe wear that is being referred to is not just limited to high heels or flip flops, but athletic shoes!

Since when are athletic shoes bad? Tennis shoes themselves are not bad in their entirety – they do provide foot protection from falling objects, significantly assist in shock absorption and redistribute energies in active sporting. However, the constant use of shoes actually inhibits the natural function of feet which can lead to joint and muscle problems elsewhere in the body!

Our feet have evolved to help balance our body and keep us walking upright. The foot is composed of 28 bones which are arranged to form longitudinal and transverse arches. Muscles, tendons and ligaments all help to support the arches. When jogging or running barefoot, our feet are made to land on the ball of the foot to absorb the impact of the ground on our bodies.
Athletic shoes are constructed to cushion and cradle the foot while exercising. The padding that lines those shoes encourages the activist to land on their heels instead of the ball of the foot! As a result, the energies from ground impact traverse right through the heel. The heel is not anatomically equipped to bear such shock. In addition, the heel is in direct line with the ankles, leg, knees, thighs, hips and spine – so any impact the heel experiences distributes right to these bodily areas. Also, the cushioning in the shoes weakens the body’s awareness of foot orientation and contact with the ground which impairs the neurological and muscular feedback that maintains the biomechanics of motion.
It is also important to note that research studies have shown that the quantity of padding is directly related to the amount of impact transferred to the body from the foot. This occurs because the padding interferes with the runner’s ability to feel the ground and as a result the runner strikes their heel more forcefully to the ground leading to increased shock and its transfer to other areas of the body! So remember just because an athletic shoe claims to have the ultimate in comfort and padding, it may not actually be good for your feet!

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Bad Ankles? Try This…

2009-07-13T12:03:00.004-04:00

If you’ve ever sprained an ankle, you know how hard the recovery process can be. Your ankle probably swelled up to the point where you could only wear a certain pair of shoes, and simply walking on it was impossible. It may have taken four weeks or longer until you were able to put full weight on that side of your body, or it may even have been an injury you never fully recovered from. Many ankle sprains can lead to a permanent loss of balance.

It is this loss of balance that is the precisely the focus of studies regarding recurrent ankle sprains. It’s been known for a long time by clinicians that an ankle sprain, particularly a serious ankle sprain, can lead to a recurrence of ankle sprains. Many people who have the problem once will have it again, and an ankle sprain on one side of the body can set you up for an ankle sprain on the other side.

For a long time, it was thought that this was due to a loss of integrity of the ligaments of the ankle. Most commonly a sprained ankle affects the ligaments on the outside of the ankle. In theory, a loss of the integrity of these ligaments would lead to a loss of stability, which could lead to a second, third, or fourth sprained ankle. This theory fits, but it ignores one of the most important aspects of the ligaments.

All of the ligaments in our body are supplied with neuroreceptors. These neuroreceptors send information to the central nervous system about our body’s position in space. This sensory input, known as proprioception, is vital to maintaining balance.

When the ligaments of the ankle are damaged, so are the proprioceptors of the ligaments. The signals being sent to the brain are no longer as they should be, and we therefore lose a lot of the balance that we once had.

There is an answer, however. With balance training, it is possible to retrain the neuroreceptors in your ankle, and increase your balance and stability in your ankles.

Essentially, balance training can be boiled down to this simple exercise: Stand on one foot. Hold it for a minute, and try not to wobble around too much. Now do it again on your other foot.

That’s all there is to it. If you can increase your balance, you can increase the stability of your ankles. If you find it too easy to stand on one foot for a minute, you can close your eyes. You can cross your arms over your chest so you’re not using them to balance yourself. You can stand on a pillow, making the ground underneath you less stable. All of these tricks will help you to increase your balance, and will have a large impact on preventing ankle sprains.

If you’ve suffered from a sprain lately, or have a history of ankle sprains, do this exercise close to a wall or something that you can grab to retain your balance. Of course, do not try this until you are comfortable with putting all of your weight on one foot. With a very recent ankle sprain, this may take close to two months before you’re ready to work on your balance training.
Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Yao Ming’s Foot Injury May Be Career-Ending

2009-06-30T08:50:00.007-04:00

Yao Ming, the 7-foot-6 center for the Houston Rockets, may be looking at a more serious injury than previously believed. The injury came late in the 108-94 loss to the Los Angeles Lakers in game 3 of the Western Conference Finals. Yao Ming left the game, and his left foot was immobilized immediately, pending further medical studies. The fracture to his navicular bone, a bone on the inside of the foot, has expanded rather than healing.

The news comes after team physician, Dr. Tom Clanton told the Houston Chronicle that Yao Ming’s injury “has the potential for him missing this next season and could be career-threatening." Though Yao is not experiencing any pain or tenderness with the injury, a bone scan revealed that the hairline fracture of the navicular had grown larger, and that intervention would likely be necessary.

Specialists are being consulted on the manner, and options are being weighed. One of the options being considered is to surgically fix the broken bone by placing a permanent screw into it. This type of procedure would likely sideline the Rockets’ keystone player for at least the next season. A similar procedure was performed on Cleveland Cavaliers center Zyndrunas Ilgauskas, with good results. Other options include giving the bone more time to heal, using a bone graft, or repositioning the foot to relieve some of the stress on the injury. The important thing to remember is that Yao is not suffering any pain for now, so any intervention will have to take this into consideration.

This injury is the most serious in a series of foot and leg injuries suffered by Yao Ming. Yao missed 21 games in the 2005-2006 season because of an infection in his toe that required surgery. He then broke a bone in his left foot that April, sidelining him once again. Yao sat out another 32 games the following year with a broken right leg, and then had a stress fracture in his left leg in the 2007-2008 that made him miss the playoffs.

The hairline fracture comes as a huge blow to the Rockets, who made it out of the first round of the NBA playoffs this year for the first time since signing Yao. If in fact Yao is done, Rockets general manager Daryl Morey is in for a tough decision. Yao Ming was considered one of the cornerstones of the team, and his presence on the court will certainly be missed. Additionally, Yao Ming has helped bolster the NBA’s international image in China. Over a billion people may be holding their breath right now, waiting to see if Yao will be back for next year’s season.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

What is Osteoporosis?

2009-06-17T15:56:00.004-04:00

Osteoporosis, a condition which thins and weakens the bones, is a preventable and treatable disease that increases the risk of bone fractures. It is a disease that can go undetected for many years, and is fairly common, particularly among postmenopausal women. While it is possible for men to develop osteoporosis, an overwhelming majority of those who suffer from osteoporosis are women. According to the National Osteoporosis Foundation, approximately 10 million Americans suffer from osteoporosis, 8 million of which are women.

Women of all ages can be diagnosed with osteoporosis, though the age group that is most at risk is women who have gone through menopause. Additionally, another 34 million Americans are estimated to have low bone mass, which can lead to the development of osteoporosis.

Our bones are living tissues, made up of a bony matrix composed mostly of collagen and hydroxyapatite, which is a mineral compound of calcium and phosphate. The combination of these two components of bone makes them strong and durable, yet flexible enough to withstand stress forces.

Throughout our lives, cells in our bones are constantly remodeling this bony matrix. Cells known as osteoblasts work to lay down new bone, while cells known as osteoclasts work to degrade the old bone.

In a normal individual, this balance is kept in place, with only a slight decrease in bone density over our lives. With osteoporosis, however, this balance is lost, resulting in a thinned and fragile bone.

The areas of the body most affected by the loss of bone density associated with osteoporosis are the hips, spine and wrist. All bones in the body, however, can be affected. In 2005 alone, there were over 2 million reported fractures due to osteoporosis, with over a quarter of them being fractures of the vertebrae. In women with osteoporosis, these fractures are a significant risk.

So how do we treat osteoporosis? What are some steps to prevention? The National Osteoporosis Foundation offers these steps to prevention:

· Make sure you are getting the daily recommended values of vitamin D and calcium. These values are 1,000 mg for calcium and 5 mcg for vitamin D.

· Perform weight bearing and muscle-strengthening exercise on a regular basis.

· Avoid excessive alcohol and smoking, and these can effect the calcium in your body.

· Have a bone density exam performed, especially if you are female and postmenopausal.

· Talk to your health care provider about bone health, and any other concerns.
Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Nordic Walking

2009-05-21T12:02:00.000-04:00

Ever seen anyone walking with ski poles? What they’re doing is something called Nordic Walking.

Nordic walking began as a cross-training activity for cross-country skiers in the summer. It has been practices for decades, and for a while was known as “ski-walking”. It quickly evolved to include backpackers, who could use the poles to lessen the amount of weight on their hips and knees. It has now been marketed as a way to enjoy a more complete workout from fitness walking.

Nordic walking is an effective and practical way to exercise, being as easy to do as walking without poles. It is an exercise that can be done in just about any climate or conditions. It incorporates more muscles into exercise than regular walking, including large core muscles and muscles of the upper body. This creates a more complete workout than regular walking. When using Nordic walking poles, your heart rate is increased when compared to walking at the same pace without the poles, which leads to more calories burned. Using Nordic walking poles also makes it easier to climb hills.

Another advantage of Nordic Walking is that it lessens the impact that walking can have. Using the poles takes a great deal of weight off of the joints of the lower extremity, including the hips, knees, and joints. This can be an important aspect of fitness walking for elderly people, or others that may have a tough time getting around. Walking poles also provide greater balance than walking without poles.

Nordic walking poles may look like ski poles, but they do have some important differences. They are shorter than ski poles used for cross-country skiing, which allows them to be functional. They are very lightweight, and are usually made out of aluminum or carbon fiber. They usually have removable rubber tips for walking on cement or asphalt, and small metal spikes for walking on surfaces like sand, dirt, or snow. Some walking poles are single pieces, while others have a telescoping design that allows for easy adjustment. Some companies that make Nordic walking poles include Leki, Exel, Keytz, and others. A set of poles generally runs somewhere between $20 and $150. They are often sold in sporting-goods stores or stores that specialize in walking and running.

So next time you see some people on the beach or the sidewalk walking with poles, don’t just stare at them wondering what they’re doing…ask if you can join them!

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Marathon Training?

2009-05-19T09:26:00.006-04:00

Thinking about running a marathon? You’re definitely going to want a plan. An essential part of running a marathon is the training that leads up to race day. Whether you are a first time marathoner or seasoned veteran, the 26.2 mile length of the race can be a daunting feat. The proper training schedule is a must.

There has been a vast amount of writing on the subject – a search on Amazon.com for marathon training books will give you over two-thousand results. With so many plans to choose from, how do you know which is the right one for you?

First of all, it’s important to recognize whether or not you are a consistent runner before you start training. Do you run somewhere around 20-25 miles a week? If so, you should be ready to jump into a more serious training schedule. If you’re not running at all, or only running once in a while, its important to be able to get up to that 25 mile per week mark. This will separate you from the less serious runners. If you have a known health condition, or suspect you may have a health condition that would interfere with running this kind of distance, talk to your doctor before starting any type of exercise program.

The next step is to pick a plan that works for you. Do you want to train alone? Would you rather train in a group? Some places may have marathon training groups that start in the spring, leading up to the fall marathon season. You can check with your local running store to see if they know of any training groups in the area. If you’d rather train on your own, you can pick up a book to guide you on your way. Most books offer training programs that run four to six months, depending on the level of runner you are to begin with.

While training for your marathon, you’ll generally start out by running around 20-25 miles in the first week. Many marathon training schedules have you running shorter runs during the week, and saving one day a week for your “long runs”. These will be the runs that will get you used to running marathon distances. You may start out at four or six miles as your long run in the first couple of weeks, and slowly progress to longer distances as the training continues. Eventually, you’ll be running up to twenty miles at a time. There are very few, if any, marathon training programs that have you running the full 26.2 miles before the race –wouldn't you rather save that accomplishment for race day?

A training schedule can be a grueling, but the reward at the end is great. If you’re thinking about running a marathon, think about picking out a schedule that works for you. If you need help, there are lots of resources, and fellow marathoners are usually willing to lend a hand. An excellent resource can be a local running store, where the employees are generally trained to provide you with plenty of information.

Good luck on your training! You can do it!

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.FLFootandAnkle.com

Tim Redding Back on the Mound

2009-03-23T09:51:00.004-04:00

LAKELAND, Fla. - Tim Redding threw off a mound Saturday for the first time since being shut down with discomfort in the back of his right shoulder. The right-hander reported no difficulty and said he remained on track to pitch in his first spring game a week from Sunday.

Redding, who is expected to claim a job as either a long reliever or the No.5 starter, believes the shoulder issue arose because he tried to ramp up activity too quickly upon arriving in camp. He was idle for much of the winter because of Nov.28 surgery to repair a stress fracture in his left, landing foot.

DR’S RESPONSE: A stress fracture is essentially a very small incomplete fracture. It typically is created by repetitive micro trauma. In this athlete’s case, it is most likely due to the constant barrage created by the planting of the left foot on the turf as the ball is released from his right hand. By repeatedly stamping down his left foot, he has created an environment where the bone has been injured.

Another consideration is which particular bone is injured. Although the article doesn’t specify the bone, it is important to understand that different parts of the foot heal differently. This is most often due to the differences in blood flow to different parts of the foot. For example, the outside of your foot receives less blood flow than the heel. A fracture on the outside of the foot would normally take longer to heal than a fracture in your heel.

Stress fractures are treated in a variety of ways. The most common method of treatment involves rest and immobilization. The thought is that removal of the offending repetitive injury will allow the bone in question a good chance to heal. By maintaining a non weight bearing foot, the body’s ability to heal is accelerated significantly because the bone surfaces are not being constantly disrupted, as they would be in normal walking.

Another treatment option is the use of a bone stimulator. This fancy contraption sends micro amounts of voltage several times a day to the bone fracture site. The proven theory behind this is that electricity stimulates the cells in the area of the fracture to respond with more potential. Small amounts of electricity “excite” these cells and spur them into action. By increasing the productivity of these cells, the length of time for a fracture to heal is reduced.

Another treatment option is surgery. Although this is rare, there are a few indications where a surgical approach would be most appropriate. An athlete who has a limited time schedule due seasonal commitments would be a prime example. Other reasons to consider surgery include worsening of the fracture or gaping at the fracture site and lack of improvement secondary to previous treatment methods.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.flfootandankle.com

Durant will miss up to two weeks with a Grade II ankle sprain

2009-03-23T09:50:00.004-04:00

Thunder forward Kevin Durant will miss up to two weeks with a Grade II ankle sprain, according to a team source.

Oklahoma City Thunder guard Kevin Durant (35) holds his leg after injuring himself against the Dallas Mavericks during an NBA basketball game in Dallas, Friday, Feb. 27, 2009. Durant left the game. (AP Photo/LM Otero)

Durant is expected to miss seven to 14 days after rolling his right ankle in Friday’s game atDallas when he stepped on the foot of Mavs forward Josh Howard while driving to the basket with 7:13 left in the first quarter. He remained in the game for about three minutes before walking off the court with a limp.

Team officials said X-rays taken on Durant’s foot were negative, but Durant wore a protective boot on his right foot and walked with the aid of crutches following the Thunder’s 110-108 overtime loss.

Grade II sprains can include damage or tearing of ligaments or a joint capsule and are characterized by swelling, extensive bruising, pain and difficulty bearing weight.

Durant is the NBA’s fourth leading scorer at 26.0 points per game and is averaging 30.6 points in February. Durant had missed only one game this season, a Nov. 12 home game againstOrlando because of a sprained left ankle.

DR’S RESPONSE: Ankle sprains can conceivably ruin your day. Because these are so common and are seen on a daily basis, podiatric physicians have become masters at treating this condition. Let me give a brief overview of this condition.

There are two main kinds of ankle sprains. We can roughly separate them into those on the inside of the ankle and those on the outside of the ankle. The most common type is those that affect the outside of the ankle. This is due to a variety of reasons, the most significant of which is related to the biomechanics of your foot type. Specific types of feet, like high arches, tend to have more of these types of injuries. A sprain that stretches the soft tissues on the outside of your foot is referred to as an inversion type of injury. A sprain which affects the inside of your ankle is far less common and this type of injury is called an eversion sprain. Again, biomechanics has some input regarding this type of injury, but also the fact that these particular soft tissues are stronger and more strategically placed also has a lot to do with making these type of injuries less common.

Let’s discuss the more common type of ankle sprain, the inversion injury. There are three main ligaments on the outside of your ankle. A ligament is a band of soft tissue which connects one bone to another bone. Ligaments are typically placed at certain locations to limit or diminish movement of the local bones. A wider or stronger ligament will resist these forces much better than a smaller or poorly placed ligament.

Looking at the anatomy of an ankle, the three ligaments are pretty much equally spaced around the outside of the ankle. There is one at the front outside, and the middle outside, and one at the back outside of the ankle joint. Let’s call those ligaments 1, 2, and 3 respectively. Conveniently, the order of tearing or rupture of those ligaments is exactly the same as their number. For instance, a grade I sprain indicates that the ligament at the front outside of the ankle joint has been injured. This ligament is the most common one to be injured because when a ankle rolls, there is significant stress applied to this ligament first.

A grade II injury, as in this athlete’s case, refers to an injury that has affected the first AND second ligaments that we previously mentioned. In other words, this athlete has sprained the front and middle outside ligaments but has not affected the back outside one. Finally, a grade III injury is quite rare. This is because the back outside ligament is not only the strongest ligament on the outside of the ankle but also the most strategically placed ligament. It is virtually impossible to rupture without a significant force being applied to it.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.flfootandankle.com

Miller's high ankle sprain explained

2009-02-26T09:55:00.007-05:00

Miller's high ankle sprain explained

BUFFALO, N.Y. (WIVB) - When the Buffalo Sabres take to the ice Tuesday night, it will be without Ryan Miller in the net. When Miller went down, he wasn't able to get back on his skates. The hit produced a particular type of injury called a high ankle sprain.

RESPONSE: High ankle sprains are often painful and debilitating. Any sprain is a rupture or tear of a ligament that connects bones to adjacent bones. Most commonly, ankle sprains occur on the outside and bottom of our ankles where certain ligaments attach the foot to the ankle. This is much more common in nature and the treatment usually consists of rest and immobilization. With a high ankle sprain, the injury occurs to a ligament that courses between and connects the two lower leg bones together. This ligament is much broader in nature and as such, is much more difficult to injure, requiring a significant increase in the amount of force required to produce such an injury. And because it is larger and wider, it takes longer to heal than a typical ankle sprain. Treatment is very similar as a typical ankle sprain, except more prolonged. Ankle sprains are the most common sports injuries. And most happen to amateurs. If you get one, and if you have trouble bearing weight, don't delay, see a podiatrist right away.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.flfootandankle.com

Chris Kaman edges closer to return

2009-02-26T09:48:00.008-05:00

Chris Kaman edges closer to return

The center, who has missed the last 42 games because of plantar fasciitis of his left foot, thinks he could be back in the lineup in about two weeks. Kaman has missed the last 42 games this season with the Clippers because of plantar fasciitis of his left foot.

"At the beginning, it was really frustrating for me," said Kaman, who was averaging 13.9 points and 9.4 rebounds before the injury. "Because I was uncertain when I was going to play. Knowing now what I know, I wish I could have known back then how long it was going to be. "I have to be patient. I can't really complain or do anything about it. Just wait and let it heal and take my time, not overdo it.

"Obviously it [stinks] but there's nothing I can do about it, got to try to get back into shape now and get ready to play. I'm looking down the road and not looking behind me." "I'm a little nervous just because I'm still having some pain down there in my foot," he said. "They're saying it's just scar tissue breaking up. I'm hoping everybody knows what they're talking about and I think they do."

RESPONSE: Any athlete who has missed a large number of games due to plantar fasciitis probably has a very extreme presentation of the condition. It is rare for plantar fasciitis to affect a well conditioned athlete so profoundly. Unless Kaman had a surgical procedure to release the plantar fascia, I’m not sure why he was being told that his “scar tissue” is breaking up. Plantar fasciitis is an inflammation of the plantar fascia, a strong ligament that runs from our heel to the ball of our foot. If indeed he did have a surgical procedure, scar tissue is likely to form as a consequence. Breaking up this scar tissue takes time, as well as proper massage of the fibrous tissues.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.flfootandankle.com

Ankle Injuries

2009-02-26T09:38:00.007-05:00

Well, my first "injury" of the year has arrived. I have this pain in my foot/ankle region right where my foot bends on the top at the ankle. All across there it hurts. It has bothered me a little bit before, but nothing that lasted for more than a couple hours, but on Sunday it acted up enough that made me cut my run short last night.

DR.’s RESPONSE: Ankle pain on the top of the foot could be an indication of more serious problems. Ankle pain is normally perceived on the inside or outside of our ankles. However, pain in the front of the ankle is more difficult to diagnose. Because the foot primarily dorsiflexes at the ankle, I would suspect that the pain probably occurs when the ankle bends, allowing the foot to move upward. I would recommend that you make an appointment with a podiatrist, a physician who is specifically trained to deal with diseases and conditions relating to the foot, ankle, and lower leg. That physician will probably take x-rays and perform a thorough physical exam which should enable them to conclude a specific diagnosis for you.

Central Florida Foot and Ankle Center, LLC.
101 6TH St. NW.
Winter Haven, Fl. 33881
863-299-4551
http://www.flfootandankle.com