Feb
22
2012
It should come as no surprise that athletes’ feet and ankles are prime candidates for foot and ankle injuries. The repeated pounding that athletes’ feet receive on paved surfaces and side-to-side motion can cause numerous injuries.
Whether you’re an athlete, participate in sports regularly or are just a weekend warrior, you need to know some of these common athletes’ foot injuries.
(picture by northbayfamilycompoundingpharmacy.com)
Ankle sprains are one of the most common sports injuries. Prompt treatment by a foot and ankle doctor is important because “sprain” could actually be an ankle fracture.
Treatment for sprains and fractures is two conditions is very different. An ankle that has not been properly healed and strengthened is more likely to suffer repeated sprains, leading to chronic ankle instability.
Achilles tendonitis, an inflammation of the tendon that runs down the back of the lower leg, can turn into the degeneration of the tendon (Achilles tendonosis). A sudden increase of a repetitive and/or athletic activity, leading to injury of the tendon fibers, can cause serious problems.
Heel pain is most often caused by plantar fasciitis, although it may also be caused by stress fractures. While faulty foot structure is the most common cause of plantar fasciitis, it can also result from wearing shoes that are worn out or not designed for the sport in which you’re participating.
Keeping the Achilles tendon stretched can help get rid of this pain, but continued pain should be checked out by a foot and ankle doctor to rule out a fracture or other cause.
In Morton’s neuroma, also called “intermetatarsal neuroma,” there is a thickening of nerve tissue in the ball of the foot resulting from pressing on and irritating the nerve.
Causes of Morton’s neuroma include activities that involve repetitive irritation to the ball of the foot, such as running or court sports.
Symptoms start gradually and may come and go when the nerve is irritated due to activity. But it’s important to have it looked at by an experienced foot and ankle doctor before the damage becomes more severe.
These are just some of the foot and ankle injuries that happen to athletes and people who participate in sporting activities; there are many more.
Remember, any type of foot pain is never normal. A foot and ankle doctor can examine your feet and give you the best course of action.
Please call 626-447-2184 (Arcadia) or 310-551-1711 (Century City) to speak to a foot and ankle specialist about your foot and/or ankle needs.
Feb
18
2012
In previous posts, we have talked about common foot and ankle injuries that happen to men and women. Now, we’re going to talk about common foot problems in children.
(picture by associatedpodiatristsny.com)
As with adults, pain in a child’s foot or ankle is never normal. Contrary to popular belief, there is no such thing as “growing pains.”
In fact, any pain that lasts more than a few days, or is severe enough to limit a child’s walking, should be checked by a foot and ankle doctor.
Here are some of the foot and ankle conditions commonly experienced by kids.
Most children with flat feet have no symptoms. However, sometimes they may have trouble participating in physical activities or sports, or appear to walk or run awkwardly. Some kids complain of pain or cramping in their feet, legs or knees.
Any pain with a child’s feet should be evaluated by a foot and ankle doctor.
Calcaneal apophysitis, also known as Sever’s Disease, is a painful inflammation of the heel’s growth plate. It typically happens to children between the ages of 8 and 14 years old.
This is because the heel bone (calcaneus) is not fully developed until at least age 14. Until then, new bone is forming at the growth plate (physis), which is a weak area located at the back of the heel. If there is too much repetitive stress on the growth plate, maybe through kids playing sports, then inflammation can develop.
Tight shoes or socks, or incorrect nail trimming, are some of the most common causes of ingrown toenails in children, although sometimes the tendency for nails to curve inward is inherited. When a child, or adult, has an ingrown toenail, the nail breaks the skin and serious infections can result.
If their child has an ingrown toenail, parents should never try to dig the nail out at home. They should contact a foot and ankle doctor.
A plantar wart can develop anywhere on the foot, but they usually appear on the bottom (plantar side) of the foot. Plantar warts are caused by the human papilloma virus (not playing frogs), which is the same virus that causes warts on other parts of the body. Plantar warts commonly occur in children and adolescents. These warts grow deep into the skin, and can make walking or standing painful.
Remember, any type of foot pain is never normal. A foot and ankle doctor can examine your feet and give you the best course of action.
Please call 626-447-2184 (Arcadia) or 310-551-1711 (Century City) to speak to a foot and ankle specialist about your foot and/or ankle needs.
Feb
15
2012
In an earlier post, we talked about common foot and ankle injuries that happen to women. Now. we’re going to cover the foot and ankle injuries that often occur with men.
(image by myoptumhealth.com)
Men’s feet and ankles take a beating, with jobs that often require long hours standing or walking. Of course, men can also get from leisure foot and ankle injuries from activities involving running and jumping.
However, men tend to ignore foot and ankle problems until pain starts slowing them down. It’s important for men to know that pain is not normal, and most foot and ankle conditions are easier to fix early on.
Participating in sports activities is a big way for men can get a sprained ankle. But even day-to-day activities such as walking on an uneven surface or slipping on an icy sidewalk can mean painful stretching or tearing of the ankle ligament. If an old sprain hasn’t completely healed, the ankle may repeatedly get sprained, resulting in chronic ankle instability.
While some foot types of men are more prone to get Hallux Rigidus, painful stiffening of the big toe joint, more than others, it can also be cause by overuse. Golfers may develop it as a result of the motion of the foot during the follow-through of the swing. Men may have jobs that increase the stress on the big toe, such as those requiring frequent stooping or squatting.
Tendonitis and tendonosis of the Achilles tendon are usually caused by repetitive activity. Participation in athletics can cause this. Last week, we reported on Chauncey Billups who suffered a torn Achilles tendon injury.
However, those men who are less conditioned and participate in athletics only on weekends are also at risk for getting injuries of the Achilles tendon. These problems are also common in men whose work puts stress on their ankles and feet, such as laborers.
Toe and metatarsal fractures, also known as broken toes, are common among men as well. Some people say that “the doctor can’t do anything for a broken bone in the foot.” This is usually not true. In fact, if a fractured toe or metatarsal bone is not treated correctly, serious complications may develop and a man should contact a foot and ankle doctor as soon as possible.
Remember, any type of foot pain is never normal. A foot and ankle doctor can examine your feet and give you the best course of action.
Please call 626-447-2184 (Arcadia) or 310-551-1711 (Century City) to speak to a foot and ankle specialist about your foot and/or ankle needs.
Feb
9
2012
Los Angeles Clippers basketball player Chauncey Billups suffered a season-ending Achilles tendon tear on February 6th and is expected to miss at least eight months of play.
“I will be back,” Billups told Yahoo! Sports by phone. “I’m not done. I’m not retiring. I will definitely be back. This has been the story of my career, coming back, fighting, scrapping and I will play again.”
(picture by sbnation.com)
Hopefully, he is consulting an experienced foot and ankle surgeon who can treat his Achilles tendon injury.
What exactly is an Achilles tendon tear? A tendon is a band of tissue that connects a muscle to a bone. The Achilles tendon runs down the back of the lower leg and connects the calf muscle to the heel bone. The Achilles tendon aids us in walking by helping to raise the heel off the ground.
We don’t know exactly how bad Billups’ tear is, but an Achilles tendon rupture is a complete or partial tear that happens when the tendon is stretched beyond its capacity. Jumping or pivoting, or running, can overstretch the tendon and cause a tear. An injury to the tendon can also result from falling or tripping.
In diagnosing an Achilles tendon rupture, a foot and ankle surgeon will ask questions about how and when the injury occurred and whether the patient has previously injured the tendon.
The foot and ankle doctor will examine the foot and ankle, feeling for a defect in the tendon that suggests a tear. Range of motion and muscle strength will be evaluated. If the Achilles tendon is ruptured, the person will have less strength in pushing down (as on a gas pedal) and difficulty rising on the toes.
Treatment for an Achilles tendon rupture include surgical and non-surgical approaches. The decision of whether to proceed with surgery or non-surgical treatment is based on the severity of the rupture and the person’s health and activity level.
Non-surgical treatment is for minor ruptures and people with medical conditions that prevent them from undergoing surgery. Non-surgical treatment includes a cast, walking boot, or brace to restrict motion and allow the torn tendon to heal.
Surgery often increases the patient’s push-off strength and improves muscle function and movement of the ankle. Various surgical techniques are available to fix the rupture. The foot and ankle surgeon can say which procedure best for the person.
Remember, any type of foot pain is never normal. A foot and ankle doctor can examine your feet and give you the best course of action.
Please call 626-447-2184 (Arcadia) or 310-551-1711 (Century City) to speak to a foot and ankle specialist about your foot and/or ankle needs.
Feb
7
2012
Women are generally more vulnerable to certain foot problems than men.
A big cause is walking in stylish, narrow-fitting shoes that can crunch the toes, especially high-heel shoes that cramp the forefoot and can cause arch and ankle problems.
(image by webmd.com)
Here are some of the foot and ankle injuries commonly experienced by women. These conditions should be checked by an experienced ankle and foot specialist.
A neuroma is a thickening of nerve tissue. A neuroma is the result of compression and irritation of the nerve. This compression creates enlargement of the nerve, eventually leading to permanent nerve damage.
The most common neuroma in the foot is a Morton’s Neuroma, which happens between the third and fourth toes. One of the most common causes of Morton’s Neuroma is wearing shoes that have a tapered toe box, or high-heeled shoes that can cause the toes to be forced into the toe box.
A bunion is often described as a bump on the side of the big toe. The visible bump actually reflects changes in the bony framework inside the front part of the foot. Bunions start with a leaning of the big toe, gradually changing the angle of the bones and slowly producing the characteristic bump, which becomes increasingly larger.
Bunions are most often caused by an inherited faulty mechanical structure of the foot. While wearing shoes that crowd the toes won’t actually cause bunions, it sometimes makes bunions get progressively worse.
Heel pain is most often caused by plantar fasciitis, a condition that is sometimes also called “heel spur syndrome.” Plantar fasciitis is an inflammation of the band of tissue (the plantar fascia) that extends from the heel to the toes. The fascia first becomes irritated and then inflamed, resulting in heel pain.
The most common cause of plantar fasciitis relates to faulty structure of the foot. Wearing non-supportive footwear on hard, flat surfaces puts abnormal strain on the plantar fascia and can also lead to plantar fasciitis.
Because there are several potential causes, it is important to have heel pain properly diagnosed. A foot and ankle surgeon is able to find the cause of your heel pain.
An ankle sprain is an injury to one or more ligaments in the ankle, usually on the outside of the ankle. Ligaments are bands of tissue that connect one bone to another and bind the joints together.
Sprained ankles often result from a fall, a sudden twist, or a blow that forces the ankle joint out of its normal position. Ankle sprains commonly occur while participating in sports, wearing inappropriate shoes, or walking or running on an uneven surface.
Remember, any type of foot pain is never normal. A foot and ankle doctor can examine your feet and give you the best course of action.
Please call 626-447-2184 (Arcadia) or 310-551-1711 (Century City) to speak to a foot and ankle specialist about your foot and/or ankle needs.
Jan
27
2012
Tibial Hemimelia is not a city in Tibet. It is a leg and foot condition where there is a partial or total absence of the tibia (also known as the shinbone).
It is the rarest form of lower limb deficiency (present at birth) and only happens in one in a million births. This is a big deal because the Tibia is the strongest weight bearing bone in the body.
(photo by rbelding.org)
There are two long bones in the lower leg, the thicker one is called the Tibia and the thinner one is the Fibula. When a baby has Tibial Hemimelia, the Fibula is there, but the Tibia is either missing or misshapen.
There is often a foot deformity and the foot may even have additional toes. If that wasn’t enough, the knee may also be twisted inwards.
Most legs affected by Tibial Hemimelia will look unusual and it can happen in either in one leg or both legs. Thirty percent of the time with Tibial Hemimelia, both legs have it. Sometimes the Fibula may also be deformed or unaffected.
Tibial Hemimelia may be discovered when the baby is born or during a routine ultrasound. Treatment of the Tibial Hemimelia by a foot and ankle surgeon really depends on how severe it is.
For a mild form of Tibial Hemimelia, the Ilizarov apparatus may be used to lengthen the baby or child’s leg and improve the position of the foot.
In more severe cases of Tibial Hemimelia, amputation may be the best option, followed by a prosthetic limb (fake leg), which may be placed above or below the knee depending on the condition of the knee joint.
Some attempts at reconstruction of the Tibia have been made using the Fibula, but this rarely provides a functioning limb because of instability at the knee and problems with the quadriceps (thigh) musculature.
Tibial Hemimelia is a type of Lower Limb Deficiency (LLD). The options for treatment of Tibial Hemimelia will vary depending on which bones are present, the size and shape of them and any problems in other structures such as muscles and ligaments.
When considering Tibial Hemimelia treatment options for your child, it is important to remember there is not one ‘right’ or ‘wrong’ decision. Parents should never feel pressured into making any quick decisions, but should always have clear unbiased information.
If you child suffers from Tibial Hemimelia, then you need to contact a foot and ankle surgeon who can give you the best course of action for your child.
Please call 626-447-2184 (Arcadia) or 310-551-1711 (Century City) to speak to a foot and ankle specialist and find out which is the best option for your child.
Jan
25
2012
Fibular Hemimelia is when someone is born with a partial or complete absence of the fibula, which makes their leg shorter and may include deformities the femur, knee, tibia and other foot and ankle conditions.
We don’t know what causes Fibular Hemimelia, but it is not considered to be genetic (passed down from the parents).
(image by orthobullets.com)
For many years amputation has been considered the standard treatment. If someone has a serious lack of ankle stabilization and significant limb length difference, then amputation is still recommended. There are two types of amputation methods used: the Boyd procedure and the Symes procedure.
However, advances in ankle reconstruction and limb lengthening are now an option for less sever cases of Fibular Hemimelia. There are many factors that decide which treatment option is the best choice.
When trying to decide between amputation or limb lengthening, parents would be wise to consult a foot and ankle specialist.
Basically, the main question to ask is: “Is the foot functional?”
If the foot is not functional, then amputation and prosthetic fitting may be the best course. As horrible as that may sound to parents, keep in mind that even athletes have had this procedure and gone onto the Olympics.
That said, patients with less severe Fibular Hemimelia may undergo successful lengthening and stabilization procedures. Complex surgery for lengthenings is required to protect the foot from further deformity.
There have been studies that demonstrate that children who undergo early amputation are more active, have less pain, are more satisfied, have fewer complications, undergo fewer procedures, and incur less cost than those who undergo lengthening.
There were fewer hospital admissions, clinic visits, and periods of absence from school in children who had the amputation procedure done.
When it comes to limb lengthening, families often have unrealistic expectations of the surgical and prosthetic technology available and may refuse amputation, when this has been recommended, and instead choose limb lengthening.
The good news is that Fibular Hemimelia can be discovered via ultrasound while the baby is still in the mother’s uterus. This gives the parents and their foot and ankle doctor time to prepare for amputation after birth or bone lengthening surgery.
Here are a few interesting facts about Fibular Hemimelia:
- Partial or total absence of fibula is one of the most frequent abnormalities in the legs.
- It is most common long bone deficiency and is the most common skeletal deformity in the leg.
- It most often is present only on one leg.
- Males have it twice as often as females.
If you suspect your child has Fibular Hemimelia, then a foot and ankle surgeon can give you the best course of action.
Please call 626-447-2184 (Arcadia) or 310-551-1711 (Century City) to speak to a foot and ankle specialist and find out which is the best option for your child.
Jan
21
2012
Has this ever happened to you? Your ankle gives out and it collapses under your body weight. You hit the ground hard with an ankle injury.
People tell you to get up and walk it off. Others are telling you to put ice on it. Others examine it with their unprofessional gaze and then tell you not to worry: “If you can walk on it, it’s not broken.”
(image by thesportsphysiotherapist.com)
So you manage to limp home and get off your foot. A couple of days later, the ankle has become very swollen and painful. It’s all “black and blue.”
Maybe you go to the emergency room or an urgent care center to have you are ankle injury checked and/or X-rayed.
You are told it’s not fractured and not to worry, it is only an ankle sprain. They put an Ace bandage on it.
You spend the next couple of months dealing with swelling, pain, stiffness, muscle spasms and pain. You tape it, you tie it, you wrap it, you soak it. And finally, it “heals.” Or has it?
In reality, this an ankle that has never properly healed and is left with weakened support, making you vulnerable to chronic ankle sprains and a life of chronic pain.
So why would something like a simple ankle sprain wind up creating chronic ankle instability? An ankle sprain can lead to an over-stretched ligament that can cause bleeding in the “pulled-open” spaces of the tissue, it can cause a partial tear of the ligament and can cause the ligament to be pulled off of its bony attachment and/or a complete tear of the ligament.
Since there are numerous ligaments supporting the ankle on both sides there can be multiple ligaments involved in the injury. The mistaken notion that if it’s not broken, it does not require treatment could not be further from the truth.
Ligaments have no direct blood flow from an artery. They receive oxygen and nutrients from microscopic circulation. So blood flow to ligaments is somewhat restricted. Since the healing of all injuries depends on good blood circulation, ligaments are at a disadvantage due to their poor blood supply.
Most important would be compression and immobilization. Using an Ace bandage may limit some swelling, but it does not immobilize the ankle. Movement and the stress of weight-bearing on these tissues makes it that much more difficult for the ligament to heal.
Remember, any type of ankle pain is never normal. A foot and ankle doctor can examine your ankle and give you the best course of action.
Please call 626-447-2184 (Arcadia) or 310-551-1711 (Century City) to speak to a foot and ankle specialist about your foot and/or ankle needs.
Jan
18
2012
Many people plan to “get more exercise” during the new year, but they need to be careful as Winter is a keen time for foot and ankle injuries.
If people are running or walking on new terrain, they may leave themselves open for a foot and ankle injury.
(image by health.nytimes.com)
Because of the icy or snowy roads, people may change their foot and gait patterns. This can lead to muscle strains, tendon injuries and more.
The front of the ankle is an area that can really take a beating when people move their exercise routine indoors. This is especially true if you’re at the gym and doing doing one motion on an elliptical machine or treadmill.
Even if you change your pace a little bit and/or put your incline up higher, then you are straining the front muscles of your ankle that go across your ankle.
While people may think the greatest danger is running out on icy roads, indoor running tracks have their own risks. When people run consistently in one direction, usually counter clockwise, that can lead to injuries to knees or the Achilles tendon.
It’s a good idea if you can switch to every other day when you run on a track- and run laps in the opposite direction. Also, slow your pace when you take the curves, and save your higher speeds for the straight-aways.
If you are running on potentially slick terrain outdoors, get a pair of those spikes for the bottom of your shoes. Yak Tracks makes them and you put them on the bottom of your shoes and they help you with some traction when you are running.
If you are injured, remember this: the word “RICE.”
Rest- get off your foot/ankle.
Ice- place an ice pack on the injured area for 5-10 minutes- unless specified by a doctor as someone with diabetes or vascular disease.
Compress the area- lightly wrap it with an Ace bandage- not too tight.
Elevation- reduce swelling and pain, elevate the foot or ankle higher than your waist.
The key thing is to listen to your body. If it hurts, other than normal muscle pain, stop doing it. If the pain is persistent, long after your activity has stopped, then you need to see a foot and ankle doctor.
Remember, any type of foot pain is never normal. A foot and ankle doctor can examine your feet and give you the best course of action.
Please call 626-447-2184 (Arcadia) or 310-551-1711 (Century City) to speak to a foot and ankle specialist about your foot and/or ankle needs.
Jan
13
2012
How do you choose a good foot and ankle doctor? You want to look for someone who has the necessary education, certifications, residencies and experience.
If this all sounds complicated, we are going to break it down for you simply.
After completing an undergraduate degree (Bachelors Degree), a foot and ankle doctor should complete four-years of classes at an accredited podiatric medical school and graduate with the degree of Doctor of Podiatric Medicine (DPM). Podiatric medical school classes also provide intensive focus on conditions of the foot and ankle.
After graduation from podiatric medical school, the foot and ankle doctor enters a post-graduate residency in podiatric medicine and surgery approved by the Council on Podiatric Medical Education. These residencies provide training in general medicine, general surgery, and surgical specialties. Currently, the majority of podiatric residency programs are three years in length.
After completing their residencies, foot and ankle doctors may receive additional training in specific areas of foot and ankle surgery through fellowships.
If your foot and ankle doctor is a board Certified foot and ankle surgeon, then that means he or she completed an intensive process leading to certification by the American Board of Podiatric Surgery (ABPS) includes four years of post-doctoral clinical experience, completion of an approved residency, a large number of surgeries representing a diverse range of foot and ankle surgical procedures, successful completion of an extensive two-part certification process and submitting surgical case logs.
Foot and ankle surgeons who have achieved certification by ABPS are eligible to become Fellows of the American College of Foot and Ankle Surgeons (ACFAS). This medical society provides continuing medical education programming to doctors and educates patients and consumers about foot health and the conditions.
Foot and ankle doctors provide medical and surgical care for a wide spectrum of foot and ankle conditions for people of all ages. Foot and ankle doctors are uniquely qualified to detect the early stages of diseases that exhibit warning signs in the feet, such as diabetes, arthritis and cardiovascular disease. They also manage foot conditions which may pose an ongoing threat to a patient’s overall health.
If you are suffering any type of foot or ankle injury, you should consult with a foot and ankle specialist who can provide you with the best course of treatment.
Remember, any type of foot pain is never normal. A foot and ankle doctor can examine your feet and give you the best course of action.
Please call 626-447-2184 (Arcadia) or 310-551-1711 (Century City) to speak to a foot and ankle specialist about your foot and/or ankle needs.