Foot Injuries of the Rich and Famous!

Foot Injuries of the Rich and Famous!

New York Giants quarterback Eli Manning may have made plantar fasciitis a household name now. Manning had to leave mid-way during the game against the Kansas City Chiefs to offload a sharp shooting pain in his heel.

The pathology leading to his pain was found to be plantar fasciitis which is essentially inflammation of the ligament that connects your heel bone to the ball of your foot, the plantar fascia. The primary responsibility of this strong, thick plantar fascia is to maintain the arch of your foot.

Plantar fasciitis occurs when the ligament that holds up the arch is irritated. There are a variety of factors that can predispose irritation to the ligament such as flat feet, high-arched feet, poor fitting shoes, standing for long periods of time, lifting heavy weights, and walking on hard surfaces for extended bouts of time.

Plantar fasciitis is an acute condition is and is more well-known known than its chronic counterpart called plantar fasciosis. The difference stems from the presence of inflammation; plantar fasciitis is degenerative plantar fasciosis without inflammation.  Despite the difference, many people broadly use the term plantar fasciitis to cover plantar fasciosis.

The diagnosis of plantar fasciitis is usually made through physical exam.  Radiographs of the foot are taken to eliminate the possibility of other conditions such as heel spurs and fractures. Eli Manning had an MRI of his foot taken in order to rule out a more serious injury such as a stress fracture (stress fractures are not evident on an x-ray). Giants backup QB David Carr was in practice just in case the doctors did not clear Eli Manning for the game on Sunday, and although Eli Manning did not practice on the field with his team for the first time in 3 years before the game on Sunday against the Oakland Raiders, he still threw for 173 yards and 2 touchdowns for the win 44 to 7!

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

APMA demands retraction of Arizona congressman’s statements

John Shadegg, a Republican congressman from Arizona, recently referred to podiatry as an ”esoteric demand that most people don’t have or don’t need,” equating the field to such alternative medicine practices as acupuncture and aromatherapy. The American Podiatric Medical Association has fired back at the congressman, demanding a retraction of the remarks made.

In a press release issued Friday, APMA President Ronald D. Jenson, DPM, said “It is appalling to find someone who serves on the House of Republican Health Care Task Force so uninformed about the podiatry profession and the valuable role of a podiatric physician in the delivery of essential medical and surgical foot and ankle care. We are on the front lines of diabetes management. Without our services and comprehensive diabetes foot care, lower-leg amputations would soar”.

These figures that Dr. Jenson points to include the $19 billion spent in 2007 on the care of diabetic foot ulcers alone. It is estimated that up to 85% of non-traumatic lower extremity amputations could have been avoided by the early detection of such conditions by a podiatric physician.

Podiatrists are often the first to detect diseases such as peripheral vascular disease, deep vein thrombosis, and diabetes, all of which are potentially life-threatening illnesses. To equate podiatry to alternative medicine choices such as acupuncture and aromatherapy is a slap in the face to the thousands of podiatrists in this country who have completed a four-year education in addition to a residency training program. Stumbling through an interview and throwing around rhetoric like this, as Mr. Shadegg has, is a great misstep and epitomizes the misinformation that opponents of healthcare reform have been spreading in the past few months.

Beyond the press release issued on Friday, the APMA has taken further action to set the record straight. APMA president-elect Kathleen M. Stone, DPM, is demanding a personal meeting with Congressman Shadegg, and is sending letters to Arizona newspapers. The APMA will also encourage the podiatric medical school at Midwestern University in Glendale, Arizona to extend an invitation to the congressman to tour the facilities and learn more about the profession.

Healthcare reform has been making prominent headlines all summer. It is important for people following the news to know what is real, and what is not real. Facts are easily blurred by sensationalism and rhetoric. To have a true understanding of what healthcare reform means, it is important to do plenty of research on the topic. A great article was recently published in the New York Times, called “A Primer on the Details of Health Care Reform”. If you are interested in learning more about the topic, this is a good place to start.

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

Back to School Shoes

Stocking up on back-to-school items? You’ll need pencils, paper, notebooks, a new backpack, and other school supplies, but don’t forget a new pair of shoes!

Children’s footwear plays an essential role in the foot health and overall health of your child. They will be exposed to all sorts of different terrain, from the classroom to the playground, and everywhere in between. The right pair of shoes will keep them active and comfortable. Here are a few things to look for in a new pair of shoes for your kids:

· Grab the back heel of the shoe, and press down on both sides. A supportive shoe will not collapse easily.

· Take the shoe and try to flex it at the toes. A good shoe will allow for the toes to flex, but will not bend too easily. A shoe that is too stiff will not allow for the toes to function properly.

· Hold the shoe in the front with one hand and at the back of the shoe with the other hand. Try to twist the shoe. If the shoe twists easily in the middle, it is not supportive enough.

· Bring your kids with you. If you let your children have a say in their footwear, it will help promote a healthy lifestyle in the future.

· After your child has been wearing the shoes for a while, check the bottoms of the shoes. Uneven wear patterns, especially in the heel, can indicate a biomechanical problem, which should be evaluated by a podiatrist.

· Bring a pair of socks when you go shopping. Sure, you can use the socks that they have in the store, but they may not be the socks that your child wears. Different socks can have different thicknesses, which may alter the fit of the shoe.

· Look for the APMA seal of acceptance. This seal is awarded by the American Podiatric Medical Association for shoes that fit the guidelines for acceptable footwear. You can look at a complete list of these shoes here.

Keep in mind that the right shoes for your children will allow them to participate in a number of activities in school. If they are playing sports after school, it is also important that they wear sport-specific footwear. Cleats are for soccer or baseball, and running shoes are absolutely necessary for running. Taking care of your children’s feet and having them take care of themselves is the first step towards a long, healthy lifestyle.

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

Sports Medicine and Podiatry

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

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Pregnancy and Your Feet

During pregnancy, a woman goes through a lot of changes to her body.  Physiologically speaking, things are working differently.  Hormonal and metabolic functions are altered, blood flow is changed, and weight gain has an effect on the mother-to-be biomechanically.  The healthy weight-gain associated with pregnancy causes a change in the center of gravity, which leads to a condition known as lordosis, or sway-back.  This change in posture can have a strong effect on the lower extremities, including the feet.

Some of the conditions that can be caused by the changes involved in pregnancy include flat feet/pronation syndrome, a change in foot size, swollen feet, plantar fasciitis, and cramps in the legs and feet.  The following is a list of some of the conditions, their causes, and what a podiatrist may do to help with the symptoms.  If you are pregnant and experiencing foot and leg pain, your obstetrician or gynecologist should refer you to an APMA member podiatrist.

• Swollen Feet/Increased Foot Size: This is often caused by edema, or excess fluid collecting in the tissues of the foot.  Extra blood may also accumulate in the legs and feet during the third trimester, which contributes to the swelling and change in foot size.  It is very common for an increased foot size to be a permanent change following pregnancy.  A podiatrist may recommend wearing support stockings to avoid some of the swelling.  Also, elevating the feet whenever possible allows some of the excess fluid to flow out of the feet.  If you’re pregnant, have your feet measured to see if they have increased in length and/or width, and buy comfortable shoes.
• Flat Feet/Overpronation: The increase in body weight causes an increase in stress on the feet, which can lead to the arches flattening out.  Once the arches begin to flatten, you may notice that you are walking more on the insides of your feet.  This is known as overpronation syndrome, and can be dealt with usually by wearing over-the-counter shoe inserts, or prescription orthotic devices prescribed by your podiatrist.  Overpronation syndrome can cause pain and inflammation in the heels, which may be dealt with by wearing a more shock-absorbing shoe.
• Plantar Fasciitis: This is a condition that is often linked to overpronation syndrome.  Basically, the tissue on the bottom of the foot is stretched beyond its normal limits, causing inflammation and pain on the bottom of the foot, particularly in the heel.  This may be avoided by stretching and exercising daily, as well as wearing shoes that offer an appropriate amount of support.  Walking barefoot or in backless shoes may exacerbate the problem, so try to avoid this when possible.
• Leg and Foot Cramps: This is caused by the increased blood volume in pregnancy and the increased progesterone levels that help avoid high blood pressure during pregnancy.  Unfortunately, the slack blood vessels in the lower extremities combined with the increased weight can cause cramping in the legs and feet due to lowered circulation.  The cramps can be stretched out, particularly by stretching the calves often.  Wear supportive shoes, such as walking or running shoes, and walk off the cramps when you get them.  You may also try rotating your feet in a clockwise rotation 10 times, then switching to counter-clockwise for 10 times.  Repeat this a few times, and do it often to increase the circulation to your feet.

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

Skip the Flip! Part 3

 The flip-flop excels in terms of significantly altering the biomechanics of your gait and the anatomy of your foot. The problem is that this footwear seems so innocuous! Who would have thought that such a simple shoe is the reason for so many pathologies and resultant office visits!?

            This summer footwear alters your gait patterns adversely, provides zero support for your lower extremity, does not offer shock absorption (leaving your poor foot to deal with stress all on its own), yields no traction on level surfaces, and may result in strain and sprain injuries! In addition, wearing flip-flops will cause back, hip, and knee pain and overuse injuries at the level of the ankle! It is almost unbelievable that the wearing of flip-flops wreaks such havoc on your body and is responsible for so many abnormalities! 

            But, there’s more! Unlike other shoes, flip-flops do not hold onto the foot and so it becomes necessary to use your muscles and tendons to clutch them in place.  If you have a high-arched or flat foot type, wearing flip-flops is particularly bad because you are likely to develop problems related joint stability and tendons. Depending on the length and duration of wear, you may develop chronic tendinitis!

1.             Most flip-flops are constructed with a springy, elastic sole. As your foot hits the ground when wearing normal shoes, it rolls inwards or everts. Flip-flops actually allow the foot to roll inward even more than usual! This eversion of your foot is called pronation and too much pronation will lead to many foot problems! Your arch is supposed to lock in place in order to absorb shock every time your foot hits the ground. Pronation of the foot opens your arch and loosens its locking mechanism. If this happens, you will encounter problems in various foot areas: toes, forefoot, arch, and heel!  

The open style of flip-flops also predisposes your feet to environmental factors such as friction, heat and moisture which can lead to the formation of blisters, warts and athlete’s foot!

So before you rush to your closet and chuck out all your flip-flops, keep this important idea in mind: moderation! Do not wear flip-flops for long periods of time for walking and do not wear them while driving (since flip-flops are not anchored to your feet, they may get lodged under your brakes or gas pedal). This summer, just wear them to lounge by the pool or play in the sand while on the beach!
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Skip the Flip! Part 2

In addition to soaring stilettos and towering high-heels, the down-to-earth flip-flops are now considered to be notorious footwear! Why exactly is this the case?

The number one reason that flip-flops cause the problems that they do is due to misconception! Many people believe that flip-flops are footwear designed to relieve the stress on your feet! However, nothing could be further from the truth!

To understand how dynamic feet are, think about all their functions:

1)     They are essential for our mobility

2)     They help with preserving our balance

3)     They bear our full body weight

 As a result of trying to maintain their many roles, our feet are subjected to many stresses.

            As mentioned before, wearing flip-flops will overwork your feet and lower extremity because flip-flop laden feet lead to change in gait patterns. So now along with a change in your walking, your feet have to readjust themselves to make sure they still maintain your mobility, keep your balance, and support your full body weight!

Another reason that flip-flops are no good in terms of foot health is because they provide zero support. Athletic shoes, for example, have excellent cushioning which assists the heel in shock absorption. Since flip-flops do not have shock-absorbing capabilities, the foot will take on the stress which over time can lead to pathologies like tendinitis.

Furthermore, the foot is well-confined in an athletic shoe and consequently does not deviate in different directions. A flip-flop has open sides and as a result, the foot has the ability to maneuver itself in any direction it sees fit. Excessive and improper movement of the foot diminishes its shocking-absorbing capability since the foot is now not in the proper position to take on the stress.

Additionally, many flip-flops provide poor traction on smooth surfaces. For that reason, people are more prone to falling and slipping. When you walk on a wet surface in flip-flops, your foot may slip off of the actual shoe and twist, causing a painful strain or sprain. If you step off of a sidewalk incorrectly while wearing flip-flops, there are no sides to a flip-flop available to support the foot or ankle. Now pair that with the fact that the foot has the ability to move in any direction it wants while you are in such footwear. You are setting yourself up for a potentially serious injury since flip-flops make it easy to take that wrong!
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Pregnancy and Your Feet Part 3

Pregnancy is a wonderful phenomenon that brings about so many changes in a woman. Every major body system undergoes alterations in anticipation of the baby’s development and arrival into the world!

            Pregnancy brings about certain foot changes such as edema, overpronation and increased foot size. Hormones cause almost all the changes that occur in a woman’s body due to pregnancy. Hormones are involved in almost every biological process including growth, immunity, metabolism, and reproduction. A hormone molecule acts like a little key that is secreted by a gland in the body into the blood. This key travels in the blood to link up with its matching lock elsewhere in the body to open up chemical processes like the manufacture of a certain protein, the multiplication of cell number or the stimulation of a chemical change.

Increased Foot Size

One of the key players in pregnancy is the hormone relaxin. The purpose of relaxin is to relax the tissues that bind the bones of pelvis together. By loosening up the pelvic connective tissue, the body will allow for the passage of the baby through the birth canal. However, relaxin does not just affect the pelvis.

Relaxin increases foot size because it loosens the hold of the ligaments in the foot. (Ligaments are tissues that connect bone to bone.) As a result, the arch of the foot starts to decrease in height and cause the foot to spread. Another reason that the foot grows in size is due to the increased pressure on it as a result of weight gain. The extra weight stems from the body hormones that amplify breast size and uterus size as well as the growing baby. The pressure also decreases the arch and flattens out the foot. Scores of women have reported that their foot grows by a half-size or more during pregnancy!

An array of foot problems can occur if you do not accommodate your increasing foot size! If you keep wearing tight footwear you can exhaust the muscles at the ball of your foot which play a role in keeping your toes straight! Also the jamming of your foot into tight shoes causes the development of corns, ingrown toenails, and bunions. 

The effects of additional weight and slack ligaments on your foot require well-fitting shoes with good support. Start with over-the-counter arch supports to maintain the arch and minimize problems. Furthermore, make an appointment with your podiatrist to keep your foot health in check! They may prescribe custom orthoses and advise you on other courses of treatment!

www.FLFootandAnkle.com

Pregnancy and Your Feet Part 2

The wonder of pregnancy does not just stem from the fact that there is another human growing within you, but the considerable and diverse internal and external changes occurring throughout the body! Unfortunately, not all of these changes are favorable as they may cause discomfort or pain. Pregnancy may cause a variety of uncomfortable foot conditions stemming from edema, overpronation, and increased foot size like varicose veins, foot pain and leg cramping. To ensure that your foot health remains optimal during pregnancy, it is important to educate yourself and talk to your podiatrist

 Overpronation

            When the arch of an individual’s foot flattens out when weight is put on it, it is referred to as overpronation. Overpronation is seen in obese individuals, flat-footed people and in pregnant women. A person with this foot condition will find that their feet roll inwards while walking – which leads to all sorts of biomechanical effects such as ankle, knee and hip pain. All the joints in your leg work together to function in gait and balance and improper movement at the ankle will lead to the inappropriate delivery of forces up the leg and cause all sorts of problems.

            Pregnant women experience overpronation and its associated symptoms because of the weight gain and the resulting added pressure on the foot. Overpronation causes your walking experience to be unpleasant and strains the muscles in the foot, leg, and back. In addition, the plantar fascia (a fibrous connective tissue connecting your heel to your forefoot) will become inflamed causing painful plantar fasciitis. Other problems that can occur if overpronation is not corrected are bunions, tibialis posterior tendonitis, metatarsalgia and heel spurs!

            The good news about overpronation is that surgery is not required to correct it, however, if overpronation is not treated – it may lead to foot pathologies that will require surgery! Ready-made orthoses are available to treat overpronation. These will specifically be made to have arch support as well as rearfoot posting for the innermost surface of your foot. You can also make wise choices by selecting comfortable shoe gear that provides sufficient shock absorption and added support.

            If you find that your symptoms worsen, make an appointment with your podiatrist! They will fully evaluate your foot health and make appropriate recommendations! 

www.FLFootandAnkle.com