The bone in our bodies is a specialized form of connective tissue comprised of 60% mineral (mainly calcium hydroxyapatite), 35% organic material (mostly collagen), and 5% water. Like any other tissue in the body, bone responds to stress caused by weight-bearing activity. Bone remodels in response to mechanical stress, depending on the load, cycle frequency, and the amount of strain. When collagen molecules are compressed, the strain causes microscopic cracks known as stress fractures, which can be a precursor to full fractures. The muscles are a helpful ally in protecting the bone, as they absorb some of the shock that would otherwise be taken up by the bone. Therefore, a muscle-strengthening program is often part of successful stress fracture prevention and a recovery routine.
The development of a stress fracture is complex. We must take into consideration intrinsic factors like sex, race, age, bone geometry, leg length, and foot structure, as well as extrinsic factors like shoe type, training surfaces, regimen, muscle strength, medications, and smoking. We cannot overlook the importance of a healthy diet in protecting against stress fractures or in expediting bone healing.
Of the 206 bones in the average human body, more than half are located in the hands and feet. That being said, the feet, in particular, withstand a tremendous amount of force. When running, a 150-pound person can withstand 1,000 pounds of pressure. Repetitive motions, poor footwear support, diminishing bone density due to age, and weaknesses in other areas of the body all make foot fractures more likely to occur. As such, our NYC foot surgeons treat fractures frequently, and some of these fractures require the use of orthopedic hardware implants. But you may be wondering, “What exactly does that mean?” So today, we’d like to shed some light on these types of implants and whether you should consider orthopedic hardware removal.
Actress Gwyneth Paltrow was spotted in Los Angeles at the end of May, wearing a soft cast on her right foot. The Daily Mailspeculated that the cause could have been Paltrow’s assertion that “earthing”—walking without shoes to “absorb electrons from the earth and neutralize free radicals”—is the way to improve mood, inflammation, and insomnia. They also pointed to ex-husband Chris Martin’s admission that Paltrow suffers from osteopenia, a decrease in bone density and a precursor to osteoporosis. She appeared on Jimmy Kimmel a few days ago to set the record straight.
Casts are common immobilization devices used in White Plains podiatry. Unfortunately, a cast can form a very unappealing odor in a matter of days. The unpleasant odor occurs when the cast becomes wet or moist for any reason. Moisture, particularly sweat, feeds the bacteria on your skin’s surface, resulting in that awful odor. While you may be doing an excellent job keeping your cast out of water, sweating can still cause you to feel self-conscious. Our NY foot surgeons have a few tips for getting through this challenging time in your recovery.
Maintaining a positive disposition during recovery is one of the biggest challenges for our Manhattan foot fracture patients. The feet are central to everything we do — whether it’s getting out of bed in the morning, fixing a snack, ambling to the bathroom, or working. Two months is an awfully long time to “lay low,” especially for the busy professionals, athletes, and celebrities that populate New York. Perhaps we can all take a page from Kelly Osbourne, who put on a brave face for the judging of “Australia’s Got Talent” despite being in excruciating pain.
“Stress fracture” is a dreaded phrase in NYC runner circles, but it’s a fact of life for 5-K runners, marathon trainers, triathletes, and recreational weekend warriors alike. Within the foot bones, there are thousands of toothpick-like structures called spicules that support your weight. Repetitive motion through over-training, running form errors, or nutritional deficiencies can cause these “toothpicks” to snap. They’ll eventually be replaced by new ones that make the bone stronger, but you can expect a good six-week break from running activities.
Noncompliance is a big issue for medical practitioners who want to see their patients make the best recovery possible. With podiatry, it’s a particularly big challenge to stay off one’s feet for months on end. There are all sorts of products like casts, boots, wheelchairs, crutches, and orthopedic shoes to help, but patients often feel silly or find them difficult to use. Many times, the body feels better even though it has not, in fact, healed fully. Professional baller Joel Embiid of the Philadelphia 76ers learned this the hard way. After stress fracture surgery on his right foot in March 2014, he took an entire season off, spent some time in a boot, and wound up back in the operating room this past June.
Jenn F. on
Wednesday, November 18th, 2015
We get a lot of questions at The Center for Podiatric Care and Sports Medicine from active patients who want to stick with their current plans — be it a vacation or mountain climb — even though they’ve recently injured their foot or ankle. They want to know how soon is “too soon” to push it, what they can realistically accomplish given their state of injury, and whether or not we think it’d be prudent for them to go ahead and follow their hearts’ desires. These are all good questions. The recent story of a woman who climbed a mountain with a broken foot illustrates what CAN be possible, though it’s not what we’d recommend for everyone.
Last Christmas Eve, I stepped on my German Shepherd’s Nylabone while walking down the stairs with a load of laundry. It had been sneakily placed right up against the step and caused my foot to roll outward as I stumbled. It didn’t take me long after hearing the tell-tale crunch, observing the bruise, and feeling the warm rush to know that I had cracked my fifth metatarsal.
What’s a person to do in that situation? An x-ray and expert diagnosis is always a good step. From there, it’s basically up to the individual to run through the regular course of rest, ice, compression, and elevation. The first two weeks of off-loading, getting around the house with a walker, and caring for a baby with a bum foot was worse than the pain itself. About three months later, I shed my compression garment and was able to resume brief stroller walks again. If I did too much, my body let me know and I backed off a bit.
It’s been almost a year since my injury, but every once in a while, that deep ache returns and I worry that something is amiss. So I asked the good doctors at The Center for Podiatric Care and Sports Medicine, “What gives? What might cause a person’s fracture to experience residual pain after healing has supposedly taken place?”
Jenn F. on
Wednesday, October 21st, 2015
The Dallas Cowboys may have won in their match-up against the NY Giants on September 13th, but it’s come at a steep cost. All-Pro wide receiver Dez Bryant fractured the fifth metatarsal–the bone leading to the pinky toe–on his right foot, which necessitates surgical repair.
Averaging 91 receptions, 1,311 yards, and 13 touchdowns a season, the team will undoubtedly miss his presence on the field. The 26-year-old just signed a five-year deal worth more than $70 million, according to Forbes, which he “more than deserved” as “one of the best receivers in the NFL, if not the best.”1http://www.forbes.com/sites/joshbenjamin/2015/09/14/dez-bryants-foot-injury-comes-at-worst-possible-time/
Initial reports speculate that Dez Bryant will return in “4-6 weeks,” but this prognosis is a bit optimistic, say our board-certified podiatrists in NYC.2http://www.al.com/sports/index.ssf/2015/09/dallas_cowboys_wr_dez_bryant_b.html
“I am so grateful for having had Dr. Geldwert perform bunion surgery on both of my feet. I have complete confidence in him and continue to see him for other sports related injuries. I was cautious about having surgery for the first time, but his knowledge, patience, and skill made me completely comfortable in trusting him. And I couldn’t be any happier with the results!! When anything else feels wrong with my feet, I love that I now know to go immediately to him. He is my top choice for anyone searching for the best foot fixer/surgeon/sports doctor in NYC! Thank you, Dr. Geldwert!!!”
– J. M., Manhattan, NY
Manhattan Office 111 East 88th Street New York, NY 10128 (212) 996-1900 See map here
Westchester Office 10 Mitchell Place Suite 105 White Plains, NY 10601 (914) 328-3400 See map here
Manhattan Orthopedic and Sports Medicine 57 West 57th Street New York, NY 10019 (212) 996-1900 See map here
Dr. Josef J. Geldwert DPM, Dr. Katherine Lai DPM, Dr. Ryan Minara, DPM, and Dr. Mariola Rivera DPM serving Westchester County, White Plains, Ardsley, Bronxville, Harrison NY, Larchmont, Mamaroneck, New Rochelle, Rye, Scarsdale, Rye Brook, Chappaqua, and the surrounding area.
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