Cowboy's injury woes continue. Marion Barber dislocated his right little toe in the first half against Seattle on Nov. 27 and did not practice all week. Team sources say it hurts too much for him to run on it. He did not join the team for the trip to Pittsburgh this weekend, so he is definately out for the game. All from a toe???? What's with the Cowboys? First Tony Romo is out with a pinky finger then Barber with a pinky toe!! Are they wimps?? What happened to being a tough football player? I remember Emmitt Smith playing with a seperated shoulder!
In all seriousness, a pinky toe injury can really hamper the running style of a running back. And, if you have ever broken your pinky toe; you know that it is almost impossible to wear a shoe comfortably. Toe dislocation with or without an accompanying fracture can take 4 to 8 weeks to heal. The treatment is to strap the toe to the next one and immobilize the foot. Very rarely do these need surgery and the worst case scenario is a enlarged toe that may develop a corn in a tight shoe. Life conitnues as we know it.
So, if my patients can survive broken and dislocated toes, why can't Marion Barber play? It's cold in Pittsburgh and his toe would be numb anyway!! Suck it up! Who gets to play running back this week? Felix Jones is out. Marion Barber is out. Guess it's time to pull someone from the practice squad. What a mess!! All from broken pinkies!
Sunday, December 7, 2008
Monday, December 1, 2008
Holiday Foot Pain
Well our house had a great Thanksgiving holiday filled with turkey and way too much stuffing. But instead of putting up Christmas decorations like many others did, we decided to paint our living room. Why I don’t know, but after standing on a 10 foot ladder for hours I realized why foot injury and pain is so common this time of year. I would describe the pain in my feet as very uncomfortable and I found myself walking around the kitchen like a “burnt-toed chicken” as my friends from Georgia would describe it! My toes were numb and my arches were on fire. The only relief I found was making my husband do the ladder work.
This time of year everyone is going to put their feet through a grueling ritual of mall walking, Christmas shopping and house decorating. And come January 1st, the resolution to get back in shape and lose those holiday pounds will disappear quickly due to foot pain and the inability to exercise. This happens because we dramatically increase our activity this time of year without thought to what we are doing to our feet and legs. The pain comes from multiple factors: muscle fatigue in those small muscles of the foot, arch strain from wearing inappropriate shoes while walking for hours, shin splints, increasing walking time from 30 minutes a day to 5 hours in one weekend! And let’s not forget those 4 inch shoes that look great with that holiday outfit, but cause all your toes to go numb 30 minutes after wearing them!
The most common things we see during this season are heel pain or plantar fasciitis, neuromas, shin splints and Achilles tendonitis. All are due to fatigue and overuse. Pain can occur in the arches and heels as well as along the front of the legs. With neuromas, there is pain in the ball of the foot with a sensation of walking on a rock or a rolled up sock. Usually, the pain described will subside once the walking event is over and you can get off your feet and rest.
Follow these helpful tips for a pain free holiday experience:
1. Wear a good supportive shoe for long walking, standing or increased activity. A really good tennis shoe is just the thing to keep those feet comfortable and reduce foot and leg muscle fatigue.
2. Take frequent breaks during the activity and get off those feet. Give them a rest!
3. Stretching reduces muscle pain after a long day of walking. Good calf and arch stretches will keep you from walking with a limp the next day.
4. Roll, baby, Roll! When you are done with your day, roll your feet across a frozen bottle of water. Not only does this feel great, but it decreases the swelling along the arches and heels.
5. If you plan on hanging Christmas lights, remember safety is the key. Never do this alone! Wear stiff soled boots or tennis shoes to reduce arch strain from ladder rungs and give you a better standing surface.
6. Wear those nice heels to Christmas parties, but don’t stand all night! Wear comfortable shoes on your way to the party, then switch right before making your grand entrance. If you like dancing and want to wear heels, expect pain!
If you find that your foot, ankle or leg pain is not going away with rest, ice and a simple shoe gear change, then there may be something more serious going on that needs to be treated as soon as possible. Have a safe and happy holidays!
This time of year everyone is going to put their feet through a grueling ritual of mall walking, Christmas shopping and house decorating. And come January 1st, the resolution to get back in shape and lose those holiday pounds will disappear quickly due to foot pain and the inability to exercise. This happens because we dramatically increase our activity this time of year without thought to what we are doing to our feet and legs. The pain comes from multiple factors: muscle fatigue in those small muscles of the foot, arch strain from wearing inappropriate shoes while walking for hours, shin splints, increasing walking time from 30 minutes a day to 5 hours in one weekend! And let’s not forget those 4 inch shoes that look great with that holiday outfit, but cause all your toes to go numb 30 minutes after wearing them!
The most common things we see during this season are heel pain or plantar fasciitis, neuromas, shin splints and Achilles tendonitis. All are due to fatigue and overuse. Pain can occur in the arches and heels as well as along the front of the legs. With neuromas, there is pain in the ball of the foot with a sensation of walking on a rock or a rolled up sock. Usually, the pain described will subside once the walking event is over and you can get off your feet and rest.
Follow these helpful tips for a pain free holiday experience:
1. Wear a good supportive shoe for long walking, standing or increased activity. A really good tennis shoe is just the thing to keep those feet comfortable and reduce foot and leg muscle fatigue.
2. Take frequent breaks during the activity and get off those feet. Give them a rest!
3. Stretching reduces muscle pain after a long day of walking. Good calf and arch stretches will keep you from walking with a limp the next day.
4. Roll, baby, Roll! When you are done with your day, roll your feet across a frozen bottle of water. Not only does this feel great, but it decreases the swelling along the arches and heels.
5. If you plan on hanging Christmas lights, remember safety is the key. Never do this alone! Wear stiff soled boots or tennis shoes to reduce arch strain from ladder rungs and give you a better standing surface.
6. Wear those nice heels to Christmas parties, but don’t stand all night! Wear comfortable shoes on your way to the party, then switch right before making your grand entrance. If you like dancing and want to wear heels, expect pain!
If you find that your foot, ankle or leg pain is not going away with rest, ice and a simple shoe gear change, then there may be something more serious going on that needs to be treated as soon as possible. Have a safe and happy holidays!
Tuesday, November 11, 2008
Tony Parker Blows Out His Ankle
Did you see the video of Tony Parker’s ankle injury in the game against the Miami Heat? Nasty! It made my ankle hurt! Looks like the San Antonio Spurs will be without him for a while. Ankle sprains can take 4 to 8 weeks to heal; and that’s assuming he doesn’t need his ligaments repaired and didn’t break anything. Preliminary reports say bad sprain, but that could mean anything. Watch the video and you will wonder if 4 weeks is enough to recover from that!
Ankle sprains are actually one of the most common sports injuries, especially in basketball. Many players actually suffer from chronic instability due to multiple ankle sprains over a period of years and little or no true rehab. Many younger athletes return to sport as soon as the swelling goes down and they can get their shoes back on and laced up. This is way too early! An ankle sprain actually messes up the proprioception in your ankle so your brain has trouble understanding where your ankle is in space. This makes you more unstable and prone to reinjury.
If you have an ankle sprain, you should be evaluated by a sports medicine podiatric foot and ankle surgeon if you have localized pain, swelling and bruising, as well as inability to walk more than 5-7 steps comfortably. Many a foot fracture has been missed in the emergency room when x-rays were taken only of the ankle and not the foot. The fifth metatarsal is often broken with the same mechanism of injury of an ankle sprain, so the foot should be evaluated as well. If severe ligament injury is suspected, an MRI can evaluate the grade of injury. This is really what decides whether surgery is needed for full recovery.
Treatment for ankle sprains really depends on the degree of severity, which can only be determined by your doctor. Initial treatment always includes “R-I-C-E” therapy – Rest, Ice, Compression, and Elevation. Pain and edema is usually controlled with NSAID’s (non-steroidal anti-inflammatories) like ibuprofen. Bracing or casting coupled with non-weightbearing on crutches may be needed in more severe injuries to rest and stabilize the ankle while it heals. Return to pain-free ROM and stability is the goal. Surgery is only recommended in Grade 3 severe injuries in athlete’s or in those patient’s who have had multiple ankle sprains and suffer from chronic ankle instability. Long-term ankle instability can often be avoided with an aggressive physical therapy program. Bracing should only be used in the short-term during rehabilitation because long-term bracing actually causes atrophy and decreased ROM.
Physical therapy is needed for all ankle sprains. The goals of physical therapy should be to regain full ROM, strength and yes, your friend and mine: proprioception. Regaining strength as well as overall balance training are the keys to successful rehabilitation of an ankle sprain. A maintenance program of ankle strengthening, stretching, and proprioception exercises helps to decrease the risk of future ankle sprains, particularly in individuals with a history of multiple ankle sprains or of chronic instability.
Bottom line: if you happen to try to imitate Tony Parker and fall down and go “Boom” playing basketball or any other sport, have your ankle sprain evaluated by a podiatric foot and ankle surgeon. Delaying treatment and rehabilitation can lead to life-long instability and a really bad jump shot!
Ankle sprains are actually one of the most common sports injuries, especially in basketball. Many players actually suffer from chronic instability due to multiple ankle sprains over a period of years and little or no true rehab. Many younger athletes return to sport as soon as the swelling goes down and they can get their shoes back on and laced up. This is way too early! An ankle sprain actually messes up the proprioception in your ankle so your brain has trouble understanding where your ankle is in space. This makes you more unstable and prone to reinjury.
If you have an ankle sprain, you should be evaluated by a sports medicine podiatric foot and ankle surgeon if you have localized pain, swelling and bruising, as well as inability to walk more than 5-7 steps comfortably. Many a foot fracture has been missed in the emergency room when x-rays were taken only of the ankle and not the foot. The fifth metatarsal is often broken with the same mechanism of injury of an ankle sprain, so the foot should be evaluated as well. If severe ligament injury is suspected, an MRI can evaluate the grade of injury. This is really what decides whether surgery is needed for full recovery.
Treatment for ankle sprains really depends on the degree of severity, which can only be determined by your doctor. Initial treatment always includes “R-I-C-E” therapy – Rest, Ice, Compression, and Elevation. Pain and edema is usually controlled with NSAID’s (non-steroidal anti-inflammatories) like ibuprofen. Bracing or casting coupled with non-weightbearing on crutches may be needed in more severe injuries to rest and stabilize the ankle while it heals. Return to pain-free ROM and stability is the goal. Surgery is only recommended in Grade 3 severe injuries in athlete’s or in those patient’s who have had multiple ankle sprains and suffer from chronic ankle instability. Long-term ankle instability can often be avoided with an aggressive physical therapy program. Bracing should only be used in the short-term during rehabilitation because long-term bracing actually causes atrophy and decreased ROM.
Physical therapy is needed for all ankle sprains. The goals of physical therapy should be to regain full ROM, strength and yes, your friend and mine: proprioception. Regaining strength as well as overall balance training are the keys to successful rehabilitation of an ankle sprain. A maintenance program of ankle strengthening, stretching, and proprioception exercises helps to decrease the risk of future ankle sprains, particularly in individuals with a history of multiple ankle sprains or of chronic instability.
Bottom line: if you happen to try to imitate Tony Parker and fall down and go “Boom” playing basketball or any other sport, have your ankle sprain evaluated by a podiatric foot and ankle surgeon. Delaying treatment and rehabilitation can lead to life-long instability and a really bad jump shot!
Monday, October 27, 2008
Crazy Bony Growths Under the Toenails
Osteochondromas
Have you noticed your big toenail growing funky? Have you noticed a pain or bump at the end of your big toe? Is your nail changing but you don't think its fungus? There could be a really easy answer and solution for these symptoms!!
A lot of times people will walk around their entire life with big toenails that look and feel different than the rest of the toenails on their feet. If your big toenail has always been thickened or is painful when you touch it you could be suffering from what is called a subungal exostosis.
What is a subungal exostosis??
A subungal exostosis is a growth that most commonly occurs on the distal phalanx of your big toe, or at the end of your big toe directly under the nail. This type of lesion is a combination of both bone and cartilage and usually can easily be seen on X-rays.
How do I know if I have a subungal exostosis?
Many times these lesions are asymptomatic, but if you are having pain in your toenail, or your toenail grows weird then you need to have it looked at.
Most of the time these lesions are completly benign but because they cause discomfort the treatment for them is most often excision.
If they are disturbing the nail bed and causing your nail to grow funny then a podiatrist can easily remove the growth in an out patient surgery setting. The recovery from a surgery like this is quick and easy. Afterwards your nail will usually grow much more normal than before and be pain free!! So dont wait, if you are sick of your funny looking toenails have them checked out. You could be walking around with painful ugly toenails when there is an easy fix!
Have you noticed your big toenail growing funky? Have you noticed a pain or bump at the end of your big toe? Is your nail changing but you don't think its fungus? There could be a really easy answer and solution for these symptoms!!
A lot of times people will walk around their entire life with big toenails that look and feel different than the rest of the toenails on their feet. If your big toenail has always been thickened or is painful when you touch it you could be suffering from what is called a subungal exostosis.
What is a subungal exostosis??
A subungal exostosis is a growth that most commonly occurs on the distal phalanx of your big toe, or at the end of your big toe directly under the nail. This type of lesion is a combination of both bone and cartilage and usually can easily be seen on X-rays.
How do I know if I have a subungal exostosis?
Many times these lesions are asymptomatic, but if you are having pain in your toenail, or your toenail grows weird then you need to have it looked at.
Most of the time these lesions are completly benign but because they cause discomfort the treatment for them is most often excision.
If they are disturbing the nail bed and causing your nail to grow funny then a podiatrist can easily remove the growth in an out patient surgery setting. The recovery from a surgery like this is quick and easy. Afterwards your nail will usually grow much more normal than before and be pain free!! So dont wait, if you are sick of your funny looking toenails have them checked out. You could be walking around with painful ugly toenails when there is an easy fix!
Tuesday, October 21, 2008
LaDainian Tomlinson Slowed By Turf Toe
The San Diego Chargers star running back, LaDainian Tomlinson, has been hampered all season by an early turf toe injury. This injury can be devastating and has ended many NFL careers. What is turf toe really? How can we avoid this pain in the toe?
What is turf toe?
Turf toe is a condition of pain in the base of the big toe. This usually caused from either traumatically jamming the toe, or pushing off repeatedly when running or jumping. The most common complaints are pain, stiffness and swelling. The pain can be so severe that pushing off in football is virtually impossible.
This injury is especially common among athletes who play on artificial turf, hence the name “turf toe”. The hard surface combined with running, jumping and cutting in football and soccer, make turf toe a frequent injury. Some also blame the choice of athletic footwear. The more flexible shoes, especially used in competition, provide less support to the forefoot joints, possibly contributing to the incidence of turf toe.
How does turf toe occur?
When a player sustains a turf toe injury they are actually tearing the capsule that surrounds the joint at the base of the big toe. Tearing this joint capsule can be extremely painful. Furthermore, tear of the joint capsule can lead to significant instability and even dislocation of the joint at the base of the toe. This may lead to accelerated cartilage wear and arthritis of the big toe known as Hallux limitis or rigidus. This wear-and-tear arthritis can end a promising career prematurely.
How is turf toe diagnosed?
Turf toe is diagnosed based primarily on the physical examination of the patient. X-rays may be taken to ensure there is no fracture or evidence of arthritis. Occasionally an MRI is needed to evaluate the surrounding tendons or to rule out an occult stress fracture.
What is the treatment of turf toe?
Treatment of turf toe consists of trying to control the inflammation of the joint capsule. Treatment protocol can include:
1. Rest
2. Ice
3. Elevation
4. Taping or padding to off-weight the toe joint
5. Anti-inflammatories
6. And in chronic cases steroid injections to the joint may be helpful
7. Long term use of a functional foot orthotic to balance the forefoot in the cleats is quite helpful.
Athletes diagnosed with turf toe should avoid stress to the joint for about three weeks to allow the joint capsule to heal. Once returning to activities, functional orthotics can be used to limit the motion of the big toe and prevent further damage to the joint capsule.
Will turf toe return?
Unfortunately, turf toe can return, often more severe than the initial injury, and rehabilitation may be very slow. LaDainian Tomlinson has been slowed by his injury all season and most likely will not be 100% until he can rest at the end of the season. Most athletes have trouble when they try to come back to sports too soon after sustaining a turf toe injury. Surgery is rarely needed for treatment of turf toe unless this has been a chronic injury and spurs are present in the joint limiting motion. If a bone spur has formed, and severely limits the motion of the toe joint, surgery to remove the spur may be helpful.
Prevention and early treatment is really the key! If you are experiencing pain in the joint after running in practice, your shoes should be evaluated for a functional orthotic to balance your biomechanics and hopefully avoid significant turf toe.
Monday, October 20, 2008
Lumps in Your Feet? May Be A Plantar Fibroma
So, I saw this patient the other day with large lumps on the bottom of her foot. She complained of pain when walking on the lumps and denied any trauma. She said they just “popped up”. After examining the lumps, I diagnosed her with plantar fibromas.
These are thickenings of the plantar fascia or the ligament on the bottom of the foot. They can be genetic, occur from trauma or just appear with no reason. She had tried changing shoes, but this did not change anything.
Conservative care for plantar fibromas includes:
· padding or custom orthotics to offload the lumps
· deep tissue massage
· physical therapy
· injection therapy
· topical verapimil
I explained the surgical treatment was removal of the lump along with a large section of the plantar fascia to reduce recurrence. But this condition has a 20% recurrence rate even with removal of the fascia. So all attempts at conservative care should be made.
If you are experiencing "lumps" in your feet or pain when walking, see a podiatrist today! Not all lumps are fibromas, a small amount are cancer. Early detection is the key! For more information, visit our website! Lots of great foot information!
These are thickenings of the plantar fascia or the ligament on the bottom of the foot. They can be genetic, occur from trauma or just appear with no reason. She had tried changing shoes, but this did not change anything.
Conservative care for plantar fibromas includes:
· padding or custom orthotics to offload the lumps
· deep tissue massage
· physical therapy
· injection therapy
· topical verapimil
I explained the surgical treatment was removal of the lump along with a large section of the plantar fascia to reduce recurrence. But this condition has a 20% recurrence rate even with removal of the fascia. So all attempts at conservative care should be made.
If you are experiencing "lumps" in your feet or pain when walking, see a podiatrist today! Not all lumps are fibromas, a small amount are cancer. Early detection is the key! For more information, visit our website! Lots of great foot information!
Monday, October 6, 2008
Don't Mess around with Ingrown Toenails!
Ouch!! An ingrown toenail hurts! Ingrown toenails hurt because the nail is curving into the skin. This causes a red, swollen, irritated and painful toe. Dont wait till the toenail is dripping pus, you dont need to live with the discomfort or pain.
Before you start performing foot surgery in your bathroom STOP. Remember that most of the time the toenail is ingrown in a place to deep for you to reach. By digging at your toenail you increase the risk of infection and cause yourself more pain.
Here are some tips to determine if your toenail is ingrown:
1. Push on your nail, does it hurt???
2. Is your toe red in color?
3. Is your toe swollen and painful
4. Do you have liquid or pustular drainage present?
Instead of digging at it, have it checked out by a podiatrist who is trained to remove the nail without pain. It may only need to be cut differently or you might need a portion of the nail removed. Even in the worst cases, most people are back to full activity after a couple of hours or at the latest the next day. You might also need an antibiotic to help get rid of the infection. If you think you have an ingrown get it checked out.
Don't mess around with ingrowns! For more information you can go to our website.
Before you start performing foot surgery in your bathroom STOP. Remember that most of the time the toenail is ingrown in a place to deep for you to reach. By digging at your toenail you increase the risk of infection and cause yourself more pain.
Here are some tips to determine if your toenail is ingrown:
1. Push on your nail, does it hurt???
2. Is your toe red in color?
3. Is your toe swollen and painful
4. Do you have liquid or pustular drainage present?
Instead of digging at it, have it checked out by a podiatrist who is trained to remove the nail without pain. It may only need to be cut differently or you might need a portion of the nail removed. Even in the worst cases, most people are back to full activity after a couple of hours or at the latest the next day. You might also need an antibiotic to help get rid of the infection. If you think you have an ingrown get it checked out.
Don't mess around with ingrowns! For more information you can go to our website.
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