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Posts Tagged ‘sports injury’

Don’t Play Games When It Comes to Your Achilles’ Tendon…

Monday, August 29th, 2011

On June 7, 2011 Tiger Woods announced he would not be attending The United States Open at Congressional Country Club because of a mild sprain to his medial collateral ligament (M.C.L.) and a mild strain of his Achilles’ tendon. This raised more questions than it answered about the extent of the damage to his left leg. Woods, 35, has been unable to work on his game since withdrawing from the Players Championship last month after shooting 42 for nine holes. Since injuring the leg while hitting a shot at the Masters eight weeks ago, Woods has been rehabilitating the M.C.L. (medial collateral ligament) and the Achilles. The announcement on his Web site said the injuries had not fully improved.

Achilles ruptures can be a career ending injury. It occurs when there is a sudden sharp movement and flexion of the Achilles causing the weakest area to break. The person will say that they felt like were hit in the back of the leg and are looking behind them to see who hit them. It depends on the activity level of the person and the degree of rupture whether it is treated by casting or by surgery. Stretching and strengthening the tendon can help prevent the injury. Ruptures can happen to the professional athlete but often is the weekend warrior that does not warm up properly and stretch well before an activity like, tennis, basketball, soccer and football.

Treatment normally includes a bandage specifically designed to restrict motion of the tendon. Taking non-steroidal anti-inflammatory medication for a period of time. Note: Please consult your physician before taking any medication.

Orthotics, which are corrective shoe inserts designed to help support the muscle and relieve stress on the tendon. Both nonprescription orthoses (such as a heel pads or over-the-counter shoe inserts) and prescribed custom orthotics may be recommended depending on the length and severity of the problem. Rest and switching to exercises that do not stress the tendon (such as swimming) are recommended as well as stretching and exercises to strengthen the weak muscle group in front of the leg, calf, and the upward foot flexors, as well as massage and ultrasound.

If you think you may have problems with your Achilles’ tendon, please come in to see a podiatrist at Affiliated Foot & Ankle Center, LLP, with locations in Howell, Edison, and Monroe, New Jersey. Your health is important to us, so please let us help you as soon as possible to get you back to your normal quality of life.

By Valerie Gregory, MSPT, CKTP

Tags: Achilles Tenon, Affiliated Foot and Ankle Center, foot pain, howell, sports injuries, sports injury, Tendon Rupture, Tenon Tear, Tiger Woods, valerie gregory
Posted in Achilles Tendon, Sports Injury | No Comments »

Happy Feet; Preparing Before You Start Dancing

Thursday, May 19th, 2011

A quick browse through the channels and you will see a variety of TV shows that suggests that America is obsessed with dancing. Some of the popular shows include Dancing with the Stars, America’s Best Dance Crew and So You Think You Can Dance? It’s true, whether you are dancing competitively or just for fun, dancing is pretty hot right now!

Dancing can be a great way to stay fit. For those who are currently watching Dancing with the Stars, it is hard not to notice how much the actress and fan favorite Kristie Alley has slimmed down. If running or going to the gym doesn’t hold your interest, dancing may be an activity that is worth looking into. It’s obvious that feet are very important to dancers. However, before you hit the dance floor or consider taking lessons, you should seriously take a good look at the health of your feet.

Since they spend a lot of time on their feet, dancers tend to have a variety of foot problems. Common problems include pain from overuse, foot fractures, and bunions and corns associated with poor fitting shoes. A newcomer to dancing may also experience tendonitis. Tendons are structures in your body that connect muscles to bone and there are many tendons in your feet. Tendonitis occurs when these structures get inflamed or damaged. The most common cause of tendonitis is overuse. Sometimes being new to exercise in general, let alone dancing, is enough to irritate tendons in your feet. Tendonitis is common in the 40-60 year old range because as we age our tendons lose flexibility. Common signs of tendonitis are pain when moving muscles and tendons, tenderness when the tendon is felt, and swelling of the tendon.

So should we all stop dancing? Of course not! Dancing can be a great way to stay in shape, but like any other activity, start slow if you are a beginner and know your limits. Since dancing depends a lot on foot health, another great idea is to go see your podiatrist before you begin taking lessons or if you experience foot pain while you are dancing. If you are in the New Jersey area, Affiliated Foot & Ankle Center, LLP with locations in Howell, Edison, and Monroe, NJ, is an excellent place to talk to podiatrists about foot issues associated with dancing. A podiatrist can give you a better explanation about the health of the foot tendons and, based on your foot type, which dance movements you should avoid to prevent injury. Don’t forget that the right dancing shoe is also very important. Your podiatrist may even suggest an orthotic (a special type of foot insole) that can help making dancing more comfortable.

Lets be honest; not everyone will be able to do the back flips and splits that are popular on the dancing shows. That is completely okay! There is a dance out there for every age group and comfort level! If you are able, go ahead and see if this exciting activity is for you. But remember to keep your feet healthy so that you can dance for as long as possible.

By Dr. Varun (Ben) Gujral

Tags: Affiliated Foot and Ankle Center, athlete, athletes, Bunions, dancing, dancing with the stars, Dr. Gujral, edison, fractures, monroe, proper footwear, sports injury
Posted in dancing, Exercise | No Comments »

Barefoot Running: Is It For You?

Tuesday, April 12th, 2011

Serious runners agree that wearing the right shoe is very important. Wearing the wrong shoe can cause discomfort and even injuries. But what if wearing no shoes while running was an option? Common sense tells us that wearing shoes protect and support our feet. Believe it or not, some runners are now choosing to run without shoes. These runners believe that barefoot running provides several benefits such as reducing foot injuries, strengthening the feet, arches, and knees, and also providing the satisfying natural feeling of your feet on the ground. Do a search on the Internet and you will quickly discover that barefoot runners are very passionate about their decision to leave their shoes at home!

Barefoot running is just now becoming more popular in the United States, but Kenyan runners have competed barefoot in marathons for several years. Although Kenyan runners have had much success with barefoot running, podiatrists are not yet ready to give all patients the OK to run regularly barefoot. Even the most advanced runner in a safe environment can be the victim of an unexpected sharp rock. The benefits of barefoot running may seem tempting, but there is simply not enough research that compares the long term benefits and risks of running with and without shoes.

Barefoot running is not for everyone. For instance, diabetics and patients who experience numbness of the feet should ALWAYS wear proper shoes when running. If you want to know if barefoot running is a safe option for you, set up an appointment at the Affiliated Foot & Ankle Center, LLP. We can examine your feet and provide you with professional advice to help you make a better choice about barefoot running. The Affiliated Foot & Ankle Center, LLP has locations at Howell, Edison, and Monroe, New Jersey.

Remember, like most exercises, barefoot running is something that will require practice, so be patient and ease into the technique. Keep in mind that there are also new types of shoes such as Nike Free and Vibram Five Fingers that can give you that natural feeling without going shoeless. No matter how you feel about the subject now, barefoot running is certainly a trend to watch. With continued interest and more research, barefoot running may prove to be a safer, healthier, and cheaper alternative to running with shoes.

By Dr. Varun (Ben) Gujral

Tags: Affiliated Foot and Ankle Center, athletes, Dr. Varun (Ben) Gujral, edison, Exercise, foot injuries, foot injury, foot pain, monroe, proper footwear, runner, runners, sports injury
Posted in Footwear | No Comments »

What is Turf Toe?

Monday, December 6th, 2010

Turf Toe is a sprain injury to the big toe joint (also known as the 1^st MPJ, hallux or great toe). The incidence of this injury has increased over the years secondary to athletic fields being covered by artificial turf and also by increased flexibility of the toe box in athletic shoes.

The rough nature of many contact sports is a factor involving abnormal extension, flexion and rotational movements that cause injury to joints and soft tissue structures. One such injury is a sprain to the big toe joint, commonly referred to as turf toe. Turf toe is seen most common in football, but it can occur in any activity, such as soccer, tennis, volleyball, wrestling and even dancing.

The big toe joint is composed of 4 bones, 9 ligaments, 3 muscular attachments and the joint capsule (which is considered a ligament). Two of the bones are called sesmoids, which are encapsulated inside a tendon and the other are two are 1^st metatarsal bone and the proximal phalanx (your toe, which moves up and down). Your big toe joint has a large range of motion in two main directions: dorsiflexion (toe going up) and plantarflexion (toe going down). This is required for normal ambulation, however when this range of motion is exceeded, you get turf toe.

The most common example of turf toe is in a football player. If you can imagine a football player at the start of a play, you will notice that the athlete has their foot planted on the ground, the big toe joint hyperdorsiflexes (bending more than it should) and the heel is raised up off the ground. During an applied downward force (up to 8 times his/her body weight), the big toe is dorsiflexed beyond its biomechanical limits, resulting in tear of the joint capsule.

The initial treatment of turf toe is RICE: rest, ice, compression and elevation. In the initial stages of suspected turf toe, taping is not recommended due to the swelling that occurs and the possibility of neurovascular compromise. Is you suspect that you may have a turf toe injury, call your podiatrist and have them take x-rays to rule out a possible fracture. If you happen to live close to Howell, New Jersey, call “Affiliated Foot and Ankle Center” to make an appointment at (732) 905-1110. Our friendly podiatrists will get you back on your feet!!!

By David Hunnicutt

Tags: feet pain, foot, foot injuries, foot injury, foot pain, howell, sports, sports injuries, sports injury, toe pain
Posted in General | 2 Comments »

Have or Need Crutches? Here are some helpful tips…

Sunday, October 3rd, 2010

It does take some coordination to use crutches and being an athlete I have mastered the use of crutches in 2 weeks. It is ironic that I am a Physical Therapist for Affiliated Foot and Ankle Center in Howell, NJ and I am a currently one of their patient’s. I have instructed patients for over 5 years on the proper technique of ambulating with the use of crutches. I am now filling the shoes of my patient’s.

I have suffered from an injury that has me using crutches for quite some time now. I fractured my heel while I was hiking. Immediately when I fractured my heel I was unable to weight bear because of the excruciating pain. I have been using crutches for 2 weeks and I have great sympathy for the individuals that I treat and others who have had the privilege to use crutches. Crutches will put a damper on your activities and tasks. Now that I have had the experience with crutches I have created some helpful tips for my patients or any individual who may need to ambulate with crutches in the future.

#1.) Ask yourself ….Do you have the coordination to use crutches? If not, get a knee walker. (See below)

#2.) Make sure your crutches are properly fitted for you. (See below)

#3.) Go SLOW. Think before you step. You cannot rush with crutches.

#4.) Wear a tool belt or fanny pack. This will come in handy when you need to carry things. My favorite one is a fitness fanny pack with an attached water bottle.

#5.) Prepare your clothes the day before. This will save time and energy when you are getting ready in the morning.

#6.) Set up everything you need on one level so you are not trekking up and down the stairs more than once a day.

#7.) The safest and easiest way to ascend and descend steps is on your butt!

#8.) Take rest breaks. Crutches are not made for long distances. But if you must, make sure there are chairs or benches where you intend to walk.

#9.) Crutches are not meant for leaning on them. Your underarms will thank you.

#10.) Do not use your crutches in a crowded area. A slight push or shove can easily knock you off balance.

I am planning on traveling and using crutches are tiring and not the best for sight seeing. I have researched other forms of medical equipment. I have found that a knee walker is the fastest form of transportation when you are planning to walk long distances. Insurance does not cover this device and most local surgical supply shops do carry knee walkers. You can rent them for approximately $30 a week. I had a difficult time finding a knee walker because all the knee walkers were on hold for other lucky individuals, so I purchased one online for $290.00. If I were to rent one for 8 weeks I would pay $240 so I justified $50 more to have my very own knee walker. This device is great! It is faster than being on two feet and you can travel distances in no time. I have taken my walker to the mall and shopping. The basket on the walker comes in handy when I need to shop. The walker folds up conveniently to place in your car. This is my recommendation when you need to go the distance, and you do not have access to a wheelchair.

Sizing your crutches:

Even if you have already been fitted for crutches, make sure your crutch pads and handgrips are set at the proper distance, as follows:

Crutch pad distance from armpits: The crutch pads should be 2 finger widths distance from your armpits. Make sure you are standing up straight and shoulders are relaxed.

Handgrip: Place it so your elbow is flexed 20 degrees, so you can fully extend your elbow when you take a step. Remember, your weight will be shifted into your wrists and palms (not your armpits) when you take a step. There is no need to wrap your crutch pads with towels because you do not lean on your crutch pads with your armpits.

Crutch length: The total crutch length should equal the distance from your armpit to 10 inches in front of a shoe.

By Valerie Gregory, CPT, CKTP

Tags: ankle, ankle pain, ankle sprain, Ankle Sprains, foot injuries, foot injury, fractures, howell, sports injuries, sports injury, valerie gregory
Posted in General | 4 Comments »

NY Giants Aaron Ross Now Plagued with Heel Pain

Thursday, September 23rd, 2010

Watching the Giants play the Colts this past weekend was painful for many Giants fans alike. Living and working in central New Jersey, we have many Giants fans in the area. Last year we watch Eli Manning be plagued with plantar fasciitis. This year, Aaron Ross, who is the Corner Back for the Giants that suffered several hamstring injuries last year, has now suffered a partial plantar fascia tear. Plantar fasciitis, also known as heel pain, is a common condition that affects many people on a regular basis. Plantar fasciitis can give you sharp stabbing pain to the bottom of your foot, which is worse when getting up from rest or with the first steps in the morning.

Plantar fasciitis, or heel pain, occurs when there is increase strain to the thick tissue on the bottom of the foot that attaches from the heel bone to the skin in the toes. When walking, the heel strikes the ground and the toes roll forward. The Achilles pulls on the back of the heel making the fascia tighten like a sail and propels the body forward. If the foot pronates, or flattens when standing, then the fascia pulls harder then its suppose to. In addition, if the Achilles is tight, the fascia will pull earlier making it pull longer and harder making it become inflamed. The inflammation creates pain when walking or standing. When it gets rested, it is often in the shortest position and then when getting up in the morning or from sitting at the end of the day, it will create a sharp stabbing pain in the bottom of the heel. If not treated then the pain can radiate to the outside part of the foot from walking differently. The longer the fascia goes untreated the more difficult it becomes to treat. As the condition progress it no longer becomes a fasciitis but becomes a fasciosis. There is no longer the acute inflammatory condition but a chronic injury to the area. When it progresses to this it is less likely to respond to traditional treatment. Most patients with plantar fasciitis (heel pain) will respond to conservative treatment which most importantly includes stretching and orthotics. Stretching the Achilles and fascia reduces the pull of the Achilles on the back of the heel. Orthotics prevent the foot from pronating and pulling the fascia. Cortisone injections maybe used to reduce the inflammation to the area. If the condition progresses to fasciosis, then EPAT, or Extracorpeal Pulse Activation Treatment, may be used to break up the fibrotic tissue and increase the growth factors to the area. This is something we use in our offices in Howell, Edison, Carteret and Monroe with much success. If all else fails then surgery may be warranted.

By Dr. Alison DeWaters

Tags: achilles, arch support, athlete, athletes, Dr. Dewaters, feet pain, foot, foot injuries, foot injury, foot pain, heel pain, howell, plantar fasciitis, sports injuries, sports injury
Posted in General | No Comments »

How Would You Like to “Patch Up the Pain”?

Tuesday, September 14th, 2010

In a recent article, in the New York Times, dated September 7, 2010, the author reveals that there are a number of topical non-steroidal anti-inflammatories (NSAIDS) that being used in multiple specialties for pain. Some of the medications come in gels, liquids, and even patches. The active ingredient is Diclofenec Sodium, also known as Voltaren. Voltaren, in oral form, is an excellent NSAID; however, it has been linked to liver problems and GI upset.

There are a few commonly prescribed topical NSAID and they are Flector Patches, Voltaren and Solaraze Gel (which is used off the label). These medications are excellent for arthritic pain and very few side effects; however, as stated in the New York Times article, there are no known or very little randomized controlled studies available. My experiences with these drugs have been good and hopeful for patients that have trouble tolerating Voltaren. I have been employing topical anti-inflammatories for the past 6 years as a podiatrist in Howell, NJ.

In our office, I will prescribe NSAID patches for heel pain. The compliance, or in other words, patients using these drugs as prescribed, has been 90-95%. There are some patients who skeptical because they cannot understand how medication is delivered through the skin. These patients will start using the medications and they will “test the waters” by stopping use of the patch or gel and the pain returns to the foot. Patients are truly fascinated that pain relief can be delivered through the skin.

Now, these topical medications are not for everyone. Patients who have bleeding disorders, GI upset, Kidney disease, Liver disease, and also, patients who are taking blood thinners should consult with their doctor. Even though a direct and relatively minimal amount is delivered to the area of pain through the skin, there are not many studies to show the health effects of these medications.

If you are suffering with pain, consult with your doctor for an alternative to taking an oral form of NSAIDS. Even though these oral medications are relatively new in the United States, these old medications, topical NSAIDS, are going to be the future for pain management.

If you have any questions, please feel free to contact our Affiliated Foot and Ankle Center, LLP office.

By Dr. Jasen Langley

Tags: athlete, Dr. Jasen Langley, feet pain, foot, foot injuries, foot injury, foot pain, heel pain, howell, runner, runners, sports, sports injuries, sports injury
Posted in General | No Comments »

The Weakness of the Weekend Warrior

Thursday, June 17th, 2010

Many sports fanatics will engage in highly competitive weekend activities. These activities may include football, volleyball, softball and even paintball. I love paintball and I broke my ankle and ruptured multiple ligaments last year while playing this exciting sport. However, one condition that plagues athletes is the dreaded Achilles tendon rupture.

This condition usually occurs while running and jumping; also, it can happen while making sharp movements. Some patients relate to someone hitting the back of their ankle or even describe as a “pop” like a gunshot. Many will fall to the ground with extreme pain. Once patients gather their wits, they try to flex there ankle and realize there no muscle power or total loss of function while trying to flex that Achilles tendon.

The weakest part of the Achilles tendon is the cord of the muscle. This cord is similar to a braided telephone cord and it compasses three muscles: medial and lateral head of the gastroc and the soleus muscle. The thin plantaris tendon runs along the side of this tendon. This tendon flexes your foot and ankle. Also, it aids in inverting and supinating your foot and ankle which is turning your foot and ankle in an inward fashion. There is very little blood flow supplied to this cord. This is known as the water shed area. Most Achilles tendon ruptures will tear approximately 2.0-2.5 cm above the insertion which is above the heel bone or calcaneus.

Their appearance is pretty frightening!!!! The back of the ankle will start changing from a normal skin color to black and blue. Patients will fear the worst like lose of circulation. The color change is related to the bleeding that is occurring at the rupture. Swelling will ensue. The most profound clinical finding is the deficit. When I examine these patients in the office or ER, you can press right in the deficit and the finger just falls in the “hole.” Other clinical test are performed, like a Thompson test, where the patient is placed on their stomach and the gastroc or the calf muscle is squeezed and this is to determine if there is any flexion. Usually there is none. An MRI is sometimes performed but it is usually not necessary if the patient is treated early.

Treatment for the rupture should be surgical repair. The patient can be immobilized with cast or CAM walker; however, with this type of non-surgical treatment, the chances of re-rupture are high. Age, medical history and social history are considered when considering surgical treatment.

Once the rupture is healed, physical therapy should be implemented and this is important. During the healing process, the patient may develop atrophy or weakness in the muscle group and regaining strength is important so the patient can return to activity.

So, you weekend warriors have fun!!!! If you do have an injury which is an Achilles tendon rupture, treat and repair the tendon early so you can return to activity. It is important muscle which help you flex your foot and ankle which you need to walk, drive and play sports.

Any injuries or trauma to the foot and ankle, please feel free to consult or call any of our office locations, which are Howell, Edison, Carteret and Monroe. We will be happy to see you in the office of emergency and tend to all your foot and ankle needs.

By Dr. Jasen Langley

Tags: achilles, achilles tendon, achilles tendon tear, athletes, feet pain, foot, foot injuries, foot injury, foot pain, sports, sports injuries, sports injury, torn ligaments
Posted in General | 2 Comments »

Which Running Shoes Are Best For My Feet?

Monday, May 3rd, 2010

This weekend was the New Jersey Marathon at Pier Village in Long Branch. I saw a lot of athletes all shapes and sizes were running to compete their best. Running is a sport for many ages and anyone can run. Plus it is cheap; you don’t need equipment or a gym, all you need is a good pair of running shoes. Because of the weather being warmer and days longer, I have seen more and more people running outside. Being a Physical Therapist at Affiliated Foot and Ankle Center in Howell, NJ many patients ask me, “Which running shoes are best for my feet?”

First you have to figure out the type of feet you have: flat feet, high arched feet, or neutral or normal feet. If you’re looking at your foot in a standing position, you’ll know you have flat feet if you don’t see any arch. The bottom of your foot, from your toes to your heel, is completely flat. If you do the footprint test, you won’t see an inward curve from your big toe to your heel. If you’re flat-footed, you’re most likely an overpronator, which means that your feet roll inward when you run. You will probably need a running shoe that maintains your stability. Look for the words “motion control” and “stability” on the box of running shoes you are considering. In addition to motion-control shoes, some flat-footed runners also need to wear orthotics. Orthotics or custom-made shoe inserts that correct foot issues can be made at our offices in Howell, NJ, Edison, NJ, Carteret, NJ or Monroe, NJ. We will make a custom mold of your feet and design an orthotic that best suits your needs.

If you have high arches, you’ll notice a high arch on your foot. If you do the footprint test, your print will curve inward, making the middle part of your foot look very thin. If you have high arches, you probably supinate or underpronate, which means your feet roll outwards as you run. You need to look for flexible shoes with a soft midsole that absorbs shock. When buying running shoes, look for options with the words “flexible” or “cushioned” included in their descriptions.

If you’ve examined your feet or your footprint and it doesn’t look flat-footed or high-arched, you most likely have a neutral or normal foot. Your footprint will have a noticeable curve inward, but not by more than 3/4 of an inch. This is the most common type of foot, and it’s also the least susceptible to injury provided it’s equipped with proper shoe gear. If you have normal feet, you can choose from a wide variety of running shoes, including ones made for neutral runners.

After you have examined your foot and you still cannot determine the type of feet you have, it will benefit you to be evaluated by a foot and ankle specialist. We can help you determine what type of feet you have and suggest shoes that are best suited for your needs.

By Valerie Gregory, MSPT, CKTP

http://www.footdoctorsnj.com/physical.html

Tags: ankle, ankle pain, arch support, Exercise, Exercising, feet pain, foot, foot injuries, foot injury, foot pain, heel pain, howell, nj, orthotics, plantar fasciitis, runner, runners, running, shin splints, shoes, sports, sports injuries, sports injury
Posted in General | No Comments »

Ankle Sprains; The End to a Sports Career?

Saturday, March 27th, 2010

During the spring, many professional sports teams are at the highest levels of competition. The NBA playoffs, the NHL playoffs and the inauguration of the baseball season are all happening at the same time. This is not only a very exciting time for me, but also for many fans all around the country.

While competing at these high level sporting activities, an injury can be devastating not only to the player, but also to the team involved. The ankle sprain can be one such event that can debilitate a player, anywhere from a minimum of 4 weeks, to a maximum of 6 months to a year depending on the severity of injury. In the worse case, it is even possible that the player might not be able to return to the sport.

It is essential to promptly evaluate an ankle sprain for effective management. The initial studies should include a comprehensive physical exam to assess a fracture, dislocation, and ligament or tendon damage. Many professional sports team will immediately go to an MRI to aid in diagnostic evaluation. Alas, in real life it is not practical to get an MRI every time someone sprains an ankle. At our office, we use other diagnostic tools such as digital x-ray’s and diagnostic ultrasound to evaluate for ligament or tendon damage.

The treatment rendered will depend on the severity of the ankle sprain. The American College of Foot & Ankle Surgeons grades ankle sprains on a Grade I-IV. At our office, I see ankle sprains quite often, ranging at different grades. Amazingly, greater than 90% of our patients are treated conservatively without surgical intervention. Again, I feel the key to proper management is early diagnosis and treatment. The longer the treatment is delayed the more chances for long term instability.