Pop Goes the Tendon

Lateral view of the human ankle, including the talus (Photo credit: Wikipedia)

The Achilles tendon is a tough fibrous cord which attaches the calf muscles of the lower leg to the heel bone. When overstretched, the tendon can become inflamed and sore. This is called Achilles tendonitis. In many instances home treatment is successful when done under a doctor’s supervision. If further damage occurs to the tendon, small tears may begin. These tears are also called ruptures, and may be partial or complete. A rupture results in sharp pain and the inability to walk normally. Sometimes there is an audible “pop” when the tendon first ruptures. Other symptoms include:

• Pain and swelling in the heel area, and pain may be severe.
• Unable to bend foot downward.
• Inability to raise up on toes.
• Popping noise when injury first occurs.

Rupture of the tendon usually occurs near the point where the tendon attaches to the heel bone. Ruptures are most frequently caused by increase in physical activity, traumatic injury like falling high up or stepping into a hole.

Men between the ages of 30 and 40 present the greatest risk for Achilles tendon rupture. Also, the likelihood is increased if you participate in recreational sports that involve running, jumping and quick starts and stops. There are also certain types of medicines that can increase the risk of tendon rupture.

Because an Achilles tendon rupture affects your ability to walk, you should seek immediate treatment. Dr. Blaakman has certain tests he can perform to determine if it is your Achilles tendon and the degree of rupture. He may order additional tests like an MRI so he can view the extent of the damage. This is a painless test that creates a computerized image of the tissues in your body.

Both non-surgical and surgical treatment methods are common. Younger more active people may choose surgical repair to try to get back to their routine quicker, while older individuals may choose non-surgical methods.  Non-surgical methods may work equally well, but probably take a bit longer to heal and run a greater risk of the injury recurring. You would be required to wear a boot or cast for a period of time while the tendon mended itself.

Surgical correction is done through an incision, whereby the tendon is sewn back together. As with any surgery, infection is a possible risk. Regardless of the treatment method, a rehabilitative time of 4-6 months is necessary during which time you will undergo muscle strengthening exercises and physical therapy.

Exercises that strengthen the calf muscles can help prevent a rupture. Also alternating activities to avoid overuse is important as well as gradual increase of duration and intensity of exercise. If you have tendonitis or an Achilles rupture, contact Dr. Blaakman at (877) 941-3338. Don’t wait for things to get worse. A little help from Dr. Blaakman and you’ll be right back up and running in no time.

References:

http://www.mayoclinic.com/health/achilles-tendon-rupture/DS00160/DSECTION=prevention

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The Road to Shin Splints

(Photo credit: Wikipedia)

Shin splints is an injury that results from cumulative stress brought on by physical activity without benefit of proper conditioning or warm up. It is characterized by pain usually felt in the outer front of the lower leg. Because of the pain location next to the tibia, shin splints are also referred to as medial tibial stress syndrome. Shin splints are a common complaint of athletes whose rigorous physical activity includes a lot of sudden starts, stops and running like football, basketball or soccer. The pain may tend to cease when you stop exercising and ease up with rest, but eventually it will probably return if not treated. Thankfully, shin splints respond well to:

• Rest
• Ice
• Over-the-counter pain medication

If you have tried conservative treatment methods and your pain has intensified and does not improve with rest, you should see Dr. Blaakman. By questioning you, Dr. Blaakman may find that your shin splints can be traced back to:

• Running downhill or on a slanted or uneven surface
• Running in footwear that lacks the proper cushioning, or is worn beyond usefulness
• Rigorous sports activity
• Running too hard, fast and long to avoid stress overload

Sometimes shin splints can be caused by biomechanical weakness or abnormalities. In these instances, after a complete evaluation, Dr. Blaakman may be able to prescribe custom orthotics that would correct faulty movement, bring your body back into correct alignment and allow you to move pain free. Other treatment options include taping, bracing, stretching and medication.

Shin splints can be avoided or prevented from returning by paying close attention to the surfaces you walk or run on, the condition of your shoes and adequate warm up activity. If running is the cause of your shin splints, there is no need to completely give up the activity. Limit the time spent and intensity of running. Change to a more mild form of aerobic exercise such as swimming or bicycling until you are healed enough to resume regular activity. Return to normal routine slowly and with proper conditioning and take a couple of days off running and do some strength training, including a workout for your toes. Slowly rise up on your toes, and slowly lower to the floor. Repeating this ten times can gradually build up strength.

Call Dr. Blaakman at (877) 941-3338 if your pain persists. He has great treatment options just right for getting you off the round-a-bout of pain and on the road to recovery.

References:

http://www.upstatefootcare.com/new-patients/video-library/
http://www.mayoclinic.com/health/shin-splints/DS00271

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Wrestling with Restless Leg Syndrome

(Photo credit: Wikipedia)

Do you ever experience a sensation in your legs that occurs usually in the evenings or during the night that makes it difficult to sleep? You may be experiencing some symptoms of Restless Leg Syndrome (RLS).

Sensations that are experienced include:

• Leg pain
• Itching 
• Burning
• Tingling
• Cramps
• Pulling or tugging

Symptoms have been known to start in the evening usually while seated, and persist and get worse during the night often leading to insomnia. This may lead to typically irritable and tired behavior during the day, especially on the part of children. RLS tends to begin slowly then increase in frequency and severity. Sometimes it affects the arms as well as the legs. There is no known specific cause for RLS, which seems most often to affect people middle aged and up. There may be a genetic propensity, although a specific genetic link has not been identified. Some medications may also play a role.

Other conditions have symptoms similar to RLS, which makes it more difficult to diagnose. In order to clearly define some parameters for this condition the National Institutes of Health specifies four criteria that must be present:

• Symptoms start or get worse in the evening or at night
• Strong desire to move the legs
• Relief occurs with walking
• Symptoms start or worsen during periods of inactivity

You are more apt to have RLS if you suffer kidney disease, diabetes or have an iron deficiency. It is not considered a serious or life threatening condition, but it often leads to insomnia and the inability to stay alert during daytime hours. Often the unpleasant sensations that are experienced can be overcome by getting up and moving, but this can lead to wakefulness and decreased sleep quality.
It is difficult to treat a condition that is so difficult to diagnose because of such ambiguous symptoms that mimic other conditions or diseases, but the following may be helpful at reducing unpleasant sensations:

• Gentle stretching exercises
• Massage
• Warm relaxing baths

If you have annoying symptoms of RLS, call Dr. Blaakman and Upstate Footcare's staff at (877) 941-3338. He is sure to have some recommendations for you to help relieve the effects of RLS.

References:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001810/
http://www.webmd.com/sleep-disorders/guide/restless-legs-syndrome-rls
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001810/

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Football and Soccer Cleats - Prepare Now for Autumn Sports

F50.9 TUNIT (Photo credit: Wikipedia)

It may seem like school just let out, but time is fleeting and the beginning of the school year is closer than you think. If you have a young student that participates in football or soccer, take a little time out and begin to prepare. Chances are you will need to consider new cleats, specific to their sport. Seldom can a growing youngster or teen get two seasons out of a pair of shoes. They grow too fast!

Any concerned and involved parent is going to be concerned with the safety of their child. Shoes are a major consideration. They go a long way to protect the foot and ankle regardless of the sport. For football, shoes that allow for running, the proper amount of side to side motion as well as flexion are important. Prior to investing money, make sure you are in synch with the regulatory agencies that govern safety for the age group or divisions your child plays in. You may wish to consult a coach or school official for information, but consider the following:

• Purchase new shoes. You may think hand me downs or used will save you money. They may look good on the outside, but be completely worn on the inside. If the cushioning and inner structure is lacking support, it is a wiser decision to go with new shoes.

• Make sure that the cleats or cleat patterns are in compliance and are appropriate for the surfaces your youngster will be playing on.

Purchasing the best quality cleats available is not going to make anyone a star. It’s not about the money. Shoes that fit snug, but not tight are important. A sport store that specializes in what you are outfitting for has knowledgeable staff familiar with fitting shoes. If shoes do not fit appropriately or if they hurt the feet, it can prevent the athlete from playing up to their potential. Leather shoes are usually preferable, but in wet conditions they become weighty and burdensome. Cleat lengths vary, so you need to carefully consider the surface. Consult a local professional for recommendations.

If your child experiences an injury, consult with Dr. Blaakman at (877) 941-FEET. His knowledge and experience can guide you and help to maintain foot health and safety.
 
References:

http://www.livestrong.com/article/14240-choose-soccer-cleats/

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Overcoming Bunions

X-ray (Photo credit: Wikipedia)

A bunion is a deformity of the big toe and can occur on one foot or both. It occurs when the big toe deviates from a normal growth process toward the other toes. This then forms a bony growth at the base of the big toe. If the deformity is allowed to continue untreated it begins crowding the other toes and can become quite painful. Bunions can cause other complications, like hammertoes.

Bunions may respond to conservative treatment if they are diagnosed early. A change of shoes would normally be required to accommodate the bunion and keep pressure off the area. You could wear a  pair of sandals that is non-restrictive. However, other options may include:

• Customized or pre-fabricated orthotics
• A bunion sleeve
• Anti-inflammatory medications
• Injections of steroidal medications

Treatment options for bunions depend on your individual case. If you lead an active life-style and the pain has become unbearable, Dr. Blaakman may suggest surgery. There are various surgical options available and Dr. Blaakman would again take into consideration your exact circumstances. Dr. Blaakman would discuss these options with you.

Surgical removal of a bunion is referred to as a bunionectomy and is usually only performed if your bunions hamper your day to day activities. A bunionectomy involves removal of the bone and swollen tissue around the big toe joint. The toe then undergoes straightening and realignment before the incision is closed. The more mild the case of bunions, the lesser the tissue damage at the time of surgery. This may hasten the recovery period somewhat. The decision made to have bunion surgery should not be taken lightly. There is a six to eight week recovery period during which time a special shoe, boot or cast may have to be worn. You may also have to probably miss several weeks of work while the foot heals.

Bunion surgery is not without possible risks of pain, infection or nerve damage, and since bunions have some genetic link, they can possibly reoccur.

If you show signs near the base of the big toe joint you may be developing a bunion.  Symptoms  include:

• Redness
• Swelling
• Development of corns and callouses
• Pain

Please contact Dr. Blaakman at (877) 941-FEET (3338) for an evaluation and to discuss treatment options. As with most foot conditions, early diagnosis is a key element in treatment success.

References:

http://www.surgeryencyclopedia.com/A-Ce/Bunionectomy.html

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The Doctor and the Physical Therapist

(Photo credit: Wikipedia)

The primary concern of the podiatrist should be treating the injury, and seeing to the comfort and care of the patient. If rehabilitative services are needed, this would be done by a physical therapist. There is no way to predict the number or frequency of visits that it may require for a patient to recover full use after sustaining an injury, but the primary goal of the physical therapist is to see that function is restored. Some foot and ankle specialists operating state of the art facilities may have affiliation with a physical therapist at their location. This is usually provided for patient convenience so that patients can receive all required services at one location.

Athletes usually appreciate referrals to physical therapists. They know that treatment by a therapist will expedite their recovery and restore their function to pre-injury condition more quickly. The back yard sports enthusiast, or adolescent playing high school sports, may not have that luxury. Insurance benefits may be limited to what coverage is provided, so they may need to spend their available dollars more wisely.

From the perspective of a person on the outside, looking in, the relationship between a podiatrist and physical therapist may be somewhat simplistic in its appearance. The doctor might be the equivalent of a head coach, calling the plays from the sidelines, and the physical therapist is the quarterback, provided with the knowledge, necessary to execute the play.

If you have sustained a foot or ankle injury, make no mistake about it, the doctor is calling the shots. It is his knowledge and diagnostic expertise that is getting to the root of the problem. He may then need to refer his patient to a physical therapist who will carry out his prescription and instructions pertaining to physical therapy that provides the quickest path to recovery for the patient. Call Dr. Blaakman at (877) 941-3338 (feet) if you are having a foot or ankle problem that requires treatment. His knowledgeable staff is there to answer any questions you may have to get you on the fastest road to recovery.

Visit Dr. Blaakman’s website, http://www.upstatefootcare.com/ for more information about the services he provides.

References:

http://www.physicaltherapyschdy.com/ASP_Pages/podiatry.asp
http://www.aapsm.org/plantar_fasciitis.html
http://www.podiatrytoday.com/article/6946?page=1

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Vascular Testing - A Roadmap of Blood Flow

Blood pressure measurement. (Photo credit: Wikipedia)

If you are one of the millions of Americans who suffer from circulatory problems, chances are you have already had some form or vascular testing. A vascular test is a non-invasive procedure used to detect blockages or diseases in the arteries.  It provides the doctor with road map type guidance of the overall health of your circulatory system.

There are several different procedures used that can assist your doctor in determining the location of blockage, and the degree or severity of the blockage. This is a helpful tool for the doctor when a patient must undergo surgery. Different forms of testing include: doppler, photoplethysmograph (PPG), ankle-arm index/ankle-brachial index, toe pressures and angiography.

• Doppler - this test is conducted by placing a probe over the blood vessel being tested and uses sound waves to read the blood flow. How quickly the sound waves bounce back to the probe indicates the level of blockage. The probe is directed at red blood cells. The greater the blockage, the slower the cells are moving through the blood vessel. This is then printed to a machine and used for comparison with normal vessels. This test is painless, and the patient who can benefit from it includes smokers, diabetics, elderly and anyone suffering from circulatory concerns.

• Photoplethysmograph - is a test that works similar to the doppler. However, instead of major blood vessels, it measures the health of tiny blood vessels by directing the probe at the tips of the toes. This is another non-invasive and painless test.

• Ankle-Arm/Ankle-Brachial Index - is a test that measures blood flow toward the foot. This test is done on major vessels, and uses blood pressures taken on each arm and ankle for ratio comparison. Differences indicate impeded blood flow.

• Toe Pressures - are similar to blood pressure tests for the toes. If a large discrepancy exists, it indicates presence of disease or blockage.

• Angiography - is a test that uses injectable dye that is then read by a special machine. When less dye is visible, blockage is indicated. This test is useful in determining the amount and location of blockage.

Any of these tests can be used by Dr. Blaakman to assist him in his evaluation. These tests are especially important if you suffer from diabetes or some other circulatory concerns that involve your feet. If you are facing the possibility of surgery and have questions about the tests, call Dr. Blaakman at (877) 941-3338. He can explain details of these procedures. More information on vascular testing will soon be available on his website.

References:

http://www.footdoc.ca/www.FootDoc.ca/Website%20Vascular%20Testing.htm

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