Click, Pop, Wobble, Oh My! Curing Chronic Soccer Ankle Injuries with Arthroscopy

Posted by on Thursday, February 28th, 2013

It’s almost impossible to play soccer for more than a day and not get injured. The sport is just too demanding on the feet and ankles. After all, it’s a prerequisite to kick things, including (more often than most players would like to admit) each other and the hard ground. Then there’s the sprinting, quick stops, jumping, twisting, foot planting, and landing. Of course, you’re wearing cleats while you do it all—shoes that are designed to grip the grass for traction. So when you misstep, land funny, twist too quickly, or otherwise need your foot to move, it often doesn’t. This causes twisting that can really wrench your ankle. Ankle sprains are extremely common in this sport. For an athlete who plays for a number of years, sprains may become chronic like Lindsay Lohan’s trouble with the IRS.  Eventually, scar tissue builds up in the joint, which causes a number of problems all on its own.

While it may not sound so bad, if you’ve ever had scar tissue or damaged cartilage in a joint you know that it can be debilitating. Imagine shoving rubber in a door hinge. The next time you try to close that door it’s going to be much more difficult. It probably won’t close all the way. Or, the joint may pinch the rubber, causing tears that pop or stretch. Now imagine that rubber is scar tissue or torn cartilage and that joint is your ankle. The tissue causes a lack of mobility in your joint. The popping and tearing causes pain and inflammation. All told, you’re probably not feeling much like playing soccer.

Ankle arthroscopy is an excellent and effective surgical treatment for removing damaged tissue from a chronically sprained ankle. It’s minimally invasive thanks to the technology of fiberoptics: tiny cameras with magnifying lenses that broadcast an image of the inside of your ankle onto a monitor. So the surgeon only has to make a tiny incision, watching his instruments at work on a screen. While he works, the doctor circulates sterile fluid in the joint to create more space for the arthroscope and instruments. Recovery is typically much quicker than with traditional surgery.

Ankle arthroscopy isn’t just effective for removing scar tissue or damaged cartilage. It is also used to remove bone spurs that may be inhibiting joint movement, and to treat pain in the back of the ankle (as occurs in some types of tendonitis).

Thanks to the wonders of technology, chronic ankle problems don’t always require major surgery (avoiding all of the many potential dangers and complications that go with it). If you’ve got a chronically weak, painful, or immobile ankle and think you might be a candidate for arthroscopy, visit The Center for Podiatric Care and Sports Medicine for an evaluation. Then get back on that field and score one for us.

When to Replace a Running Shoe? Nobody Knows!

Posted by on Wednesday, February 27th, 2013

If you’re a runner you’ve probably got your own answer to this question. People tend to be very particular about their running shoes. In many ways running is a quiet, introverted sport. You spend a whole lot of time communing with your body, thinking about what feels good, what doesn’t, how tired you are, how your tight your muscles are, etc. When I’m running, I’m keenly aware of my feet. I know when my soles feel flat, my heels feel like they’re slipping, and the pep in my new-running-shoe step just isn’t what it used to be. And it’s good that I do because, as it turns out, the experts don’t.

For many years, podiatrists, running experts, sporting goods retailers, running bloggers, European marathoners, African sprinters, and your momma have been coming up with recommendations for when to replace those shoes. It’s usually a mile marker: 200 miles, 300 miles, or even 500 miles, depending on the shoe and on the person making the recommendation. There have been some biomechanical studies of shoe integrity, most showing that a shoe loses some of its bounce after several hundred miles. But when you consider how many variables we’re talking about—runner weight; gait; forefoot, midfoot, or heel strike; brand of shoe; terrain; weather—the recommendations suddenly seem rather arbitrary. I mean, if I’m a very slight woman running lightly with no significant pronation, and you’re a 300 pound man with an uneven gait, shouldn’t my shoes last longer than yours? Yes. Yes they should.

In a recent article in the New York Times, esteemed exercise columnist Gina Kolata explored this very issue. As you might expect, her multiple interviews returned multiple answers. Some runners pride themselves on using a shoe until it falls apart. Others keep careful track of their mileage and get a new pair as soon as they hit the quota, shoe condition be damned. What seemed to make the most logical sense: use your best judgment. If your shoe feels thin, your feet ache after a run, or you notice you’re lacking lateral support, replace your shoes. (Just an aside: why parents with the last name Kolata would name their poor daughter Gina is beyond me.)

Another shocker: nobody really knows what happens if you wait too long before replacing those shoes. There is no clear spike in injury, which is a bit of a surprise. Then again, the barefoot runners have been fighting the cushioned-shoe evangelists for a few years now with no clear winner, so perhaps a shoe’s integrity is less important than we all think.

Female Athletes Fear Pregnancy Foot Growth

Posted by on Tuesday, February 26th, 2013

Pregnancy can be a challenging time for the female athlete in many ways. In addition to the million things you now have to think about – cribs, schools, getting that reliable minivan – pregnancy brings many physical restrictions: high-impact sports are not recommended and working out for long periods of time can be dangerous. Even when an activity is allowed, like jogging, it can become awfully uncomfortable. A bouncing baby belly puts pressure on the bladder, pulls on sore round ligaments, and may cause back and leg pain. Weight gain is also a major factor since it can have a dramatic effect on stamina. But the committed athlete will still find ways to exercise, and she should. But she should also watch out for her amazing, expandable feet. Pregnancy can wreak some havoc on those tootsies, causing pain, foot and ankle swelling, increased foot size, and a greater chance of injury.

Regular moderate exercise has been shown to be extremely healthy for mother and baby: improving the baby’s birth weight; increasing the chances a pregnancy will be full-term; helping the mom to have a healthier, easier birth; and helping her to recover faster afterwards. The key: get some new, supportive shoes and be very careful. Your feet aren’t the old trusty pavement pounders they used to be.

During pregnancy a woman’s body secretes a protein called relaxin. It does just what you’d think: relaxes ligaments and cartilage to help the pelvis stretch during labor and delivery. This is a very important protein. Without it the baby’s head would never fit through the pelvis or, if it did, would cause major damage along the way. The downside of relaxin: loosened cartilage and ligaments all over the body, including in the feet.

Pregnant women’s feet typically grow between ½ and a full size during pregnancy – a change that is usually permanent. In addition to requiring a whole new shoe wardrobe, larger feet may feel ungainly, making the pregnant woman a bit wobbly or clumsy. Clumsiness isn’t great news when you’re exercising. Larger feet may also affect gait and any change in gait can be dangerous. Add to that some top heaviness, overall weight gain, and loose ligaments everywhere and you’ve got a dangerous situation on your feet. You may find yourself tripping or stumbling more easily or misjudging curbs.

Of course, any fall is scary when your pregnant, and pregnant women tend to sacrifice their limbs for their stomachs. So, what might have been a minor ankle sprain under normal circumstances becomes a major sprain or even a brake as you twist your body and give in to the pain to protect your baby. So how do you prevent injury at this delicate time while still working up a daily sweat?

  • Try low-impact, safer activities like yoga, swimming, or walking.
  • Wear great, supportive shoes and take it slow.
  • Don’t push yourself too hard, both to avoid injury and to protect your baby from overexertion. If you can talk while you work out, you’re a-ok.
  • If you do suffer injury, get it treated right away. Try The Center for Podiatric Care and Sports Medicine. The longer you’re laid up, the less active you’ll be able to be for you and your baby.

Five Essential Tips for Keeping Feet Healthy

Posted by on Monday, February 25th, 2013

I spend a lot of time writing about specific foot problems and for good reason: when they crop up, you need to know what to do about them. But foot health is more than just recognizing when there’s a problem. Like with diet, exercise, good sleep, and stress avoidance, regular maintenance and everyday attention are infinitely more valuable than any one treatment can ever be. The way you treat your feet morning, noon, and night will have a direct impact on their long-term health. And since foot health is so closely associated with health in general, paying close attention to your feet is a great way to increase your chances of a healthier, longer, more productive, and more enjoyable life.


Lawsuits and Injury: The Pseudoscience of Toning Sneakers

Posted by on Friday, February 22nd, 2013

You’ve probably heard of them: sneakers with curved soles purported to tone and strengthen your legs as you walk. They seemed too good to be true: a passive path to fitness, a way to control your your weight, and by extension your life, without sacrificing time or energy. Two years ago you could find them everywhere. They were prominently displayed in shoe store windows, advertised in magazines, and fashionably shown-off on television. Today, the public tells a different story, one of broken ankles, stress fractures, torn ligaments, and surgeries. But between then and now a whole fascinating saga has unfolded. It turns out the shoes aren’t just potentially damaging: they don’t do a darn thing for your figure.


The Dreaded Jones Fracture: March Madness is Injury Season

Posted by on Thursday, February 21st, 2013

The only good thing about the month of February is that it’s just a few short weeks before the month of March. Pretty soon, it’ll be that time of year again, folks: time for NCAA parties from the tip of Maine to California’s sunny coast. March Madness is an American favorite and for good reason: college basketball embodies so much of what American sports fans hold dear. These are players we’ve been following. We know about their dramatic family lives, their brushes with the law, their outstanding jump shots. These are young, promising players, many of whom are headed to distinguished careers in the NBA. And March Madness is when we get to see them all play each other in a jam-packed, no holds barred basketball off. It’s glorious. Not so glorious: the many foot and ankle injuries these poor players have suffered on the country’s college courts. Today I’m going to talk about one injury in particular: a difficult, painful fracture that, for a b-ball player, can mean the sidelines. I’m talking to you, Jones.


High Schooler Mary Cain Breaks National Track Record: Tips for Injury-Free Running

Posted by on Wednesday, February 20th, 2013

This week a young track and field star achieved an incredible goal. Mary Cain, all of 16 years old, shattered a national high school record by running a mile in 4:28:25. Considering the fact that 4 minutes was once seen as the fastest possible mile for a human being, Cain is well on her way to an illustrious track and field career. Thought by many to be the country’s most talented young female runner since Mary Decker in the 1970’s, Cain has continued to consistently shave seconds off her time. I have no doubt that we’ll be seeing her in the Olympics pretty soon, and hopefully in college competition where she’ll undoubtedly avoid the student loan circuit. But for now, Cain’s main focus should be on preventing injury. Track and field injuries are very common, especially for serious competitors who spend many hours training every day. It’s a demanding sport that requires careful conditioning and preventative care.


Fixing it FAST: Revolutionary New Achilles Tendonitis and Plantar Fasciitis Treatment

Posted by on Tuesday, February 19th, 2013

Any serious athlete knows that practice makes perfect. You’re focused, you’re determined, and you know you can make yourself better if only you work hard enough. So you train, and train, and train. You run, jump, stretch, lift weights, and practice for hours at a time. You visualize the game when you’re going to bed at night, and wake up ready to play the next morning. You’re a machine. You’re unstoppable. You’re seeing amazing results. Then you get tendonitis.

Botox for Plantar Fasciitis? New Treatment With Promising Results

Posted by on Monday, February 18th, 2013

Botox isn’t just for your forehead wrinkles anymore! Actually, the botulinum toxin has been used for years to treat a variety of disorders (including treating foot pad loss and sweaty feet, believe it or not) but it’s only recently that it’s been used to treat plantar fasciitis, a particularly troublesome, common, and difficult to manage foot disorder. The problem accounts for one million doctor visits every year, accounting for 9% of all running injuries. So, any new treatment has the potential to help a lot of suffering people. In some cases the condition is temporary and it responds well to rest, ice, compression, and elevation (RICE). But, in other cases it becomes chronic, debilitating the sufferer for months or years.


It’s Toe Clever: The New Topo Running Hoof Shoe

Posted by on Friday, February 15th, 2013

Several years ago the running world was rocked by the Vibram FiveFinger shoe: footwear designed to emulate barefoot running. The barefoot controversy notwithstanding, the five-finger shoes saw huge sales. Tony Post, Vibram’s creater and a former professional runner, firmly extolled Vibram’s good qualities, like any good father would. To illustrate the strange appeal of the weird looking FiveFingers: my sister got a pair and she’s not even a runner. She thought the design looked cool paired with a miniskirt. Kids! Well, now Tony Post is up to his old tricks, this time with the Topo, a strange hoofed hybrid that separates the big toe, like a traditional Japanese tabi. Is this just a marketing scheme? Are their any podiatric benefits to Post’s Topos? Is it too soon to tell?