Upstate Footcare: 2012

Monday, August 13, 2012

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

Monday, August 6, 2012

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

Monday, July 30, 2012

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/

Monday, July 23, 2012

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/

Monday, July 16, 2012

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

Monday, July 9, 2012

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

Monday, July 2, 2012

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

Monday, June 25, 2012

Diabetic Neuropathy - Danger Lurks Behind Every Sensation You Are Not Feeling

(Photo credit: Wikipedia)

It can’t be stressed enough - good foot care is vital to your health and overall well-being. Just ask someone who has impeded mobility due to a foot or ankle injury or the athlete who is sidelined. The verdict is in - foot and ankle pain or injury is darn inconvenient to say the least. Those in reasonably good health can usually take precautions and preventive measures and a lot of time just knowing what to do and when to do it can save costly trips to the doctor because it can be treated at home. People who suffer from diabetes, though, are not so lucky. When you have diabetic neuropathy every little condition, and injury becomes a potential hazard to your health.

Diabetic neuropathy is damage to nerves due to blood sugar levels being too high, which is caused by diabetes. Nerve damage will affect about half of all people with diabetes, although symptoms may be slow to appear. Symptoms vary and may affect different parts of the body. One location commonly affected is arms and legs and sensation from tingling to deep pain may be experienced. As damage to the nerves continues, sensation decreases due to poor circulation. This is where the danger really begins. Because of the loss of feeling, you may not feel objects you step on, know you have an open wound or realize you have no concept of heat, and actually burn yourself. An untreated wound may result in an infection and with poor circulation the body’s ability to heal itself is greatly diminished. Neuropathy may also mask other things going on in the body such as the pain that functions as early warning of heart attack.

Every person who has diabetes needs to be seen at least annually, more often if warranted. A thorough foot examination should be done each time you visit your doctor. Dr. Blaakman can help diffuse problems with early detection and he can teach you to be more aware of your own feet. Conduct a daily foot exam and make it routine.

Call Dr. Blaakman at (877) 941-3338 for a comprehensive foot examination. Make sure you are writing down all your questions about diabetic neuropathy. Arm yourself for survival with good information and work at controlling your blood sugar.

References:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001713/
http://www.mayoclinic.com/health/diabetic-neuropathy/DS01045/DSECTION=symptoms

Monday, June 18, 2012

Here Come the Summertime Warriors

Marahon shoes (Photo credit: Wikipedia)

With the first 90 plus degrees of the summer, it’s great to be out there to reacquaint yourselves with the outdoors and get back into shape. Constant beach weather is just around the corner, so you’ll want to get rid of that mid-line flab and show off those six packs. It doesn’t matter what your favorite outdoor pursuit is - just do it!

However, it’s important to start slow and gradually condition yourself. You don’t have to run a race this week, and while you might have quite a ways to go, you have don't have to rush your conditioning. It is impossible to emphasize enough the importance of a slow and reasonable pace when it comes to starting any exercise program. You can’t just start out making outrageous demands on the body without risking a serious injury. Regardless of the exercise you choose, there are certain to be pre-requisites for consideration.

Do you have the appropriate footwear to take you where you want to go?

Whether you are cycling, kayaking, running or swimming, there are shoes designed to meet your specific needs. Even within the sport you choose, there may be options for shoes. You need to make sure you are purchasing footwear at a dealer who specializes in that sport. They have the product knowledge and expertise to guide and fit you.

Making sure you have appropriate footwear is almost half the battle. It can save a lot of pain and problems for your feet. But remember that conditioning and warm up are just as important. You need to plan 10 minutes of stretching and warm up exercises prior to your chosen activity. This is your opportunity to talk to your body and advise it on what you are going to ask it to do. Warm and gently stretched muscles are far less likely to become injured than cold tight muscles. So take the time and get loose. You also should modify your program if the heat index reaches 90. Take frequent water breaks or save exercise for the early morning, or evening, when the temperature is a bit more agreeable.

If you find that you have somehow caused an overuse injury, call Dr. Blaakman at (877) 941-3338. If you are in pain, rather than give up the exercise program, let Dr. Blaakman put his experienced hands to work. Remember to ask him all of your questions about conditioning for your favorite sport. He can help you avoid the strains, sprains and fractures commonly associated with ramped up physical fitness programs.

Also, you can like us on Facebook for more updates on foot and ankle news! Check out our Duncan office and Gaffney office Facebook pages!

Monday, June 11, 2012

It Used To Be Wet Shoes Were Ruined Shoes

Canoe-kayak-marathon (Photo credit: Wikipedia)

Years ago it used to be a kid had one pair of shoes. Two pair perhaps if they were from an affluent family, one pair for the work week and one for Sunday worship. No wonder it was so often heard, “Don’t get your shoes wet.” Wet shoes meant cracked leather and that shortened the usefulness of a pair of shoes.

Time marches on and things change. Now a person probably has five or six pair available to them or perhaps more. Shoes are becoming highly specialized. It’s almost like there is a pair for every function and keeping shoes dry is a thing of the past because there are shoes designed specifically to get wet - water shoes. Even water shoes are becoming specialized to the point where they may have multiple pair. Water shoes are designed with specialized mesh linings for quick drying and channeling systems that allow water to flow out of the shoes. Under what circumstances would you choose water shoes? Well, to wear around the deck of a pool. This may be done for different reasons such as foot protection from injuries, traction to prevent slip and fall injuries or hygienic purposes. There are even shoes designed with specific water sports in mind, such as kayaking.

When kayaking, you should consider the weather and performance demands of the shoes. A water sandal is good if the weather is warm because they allow for drainage and quick dry, while providing some protection for the foot. They have a snug fit and not a lot of straps to get tangled. Water booties are a better choice if the water is cold. They help keep the feet warm, have zippered or hook and loop closures to adjust for a snug fit. Serious kayakers may choose water boots that offer protection from water and cold all the way up to your knees.

If you need a shoe to take you close to the pools edge, you may wish to try something like Crocs. It gives you a little something to prevent slip, falls and keep your feet off the pool deck so your feet are away from fungus. However, if you are in the pool for an aqua class and are going to be moving a lot, try a sneaker type shoe that offers a bit of support, stability and protection from impact. Then, hit the water’s edge. There isn’t anything more refreshing than a quick dip, when the mercury rises.

Water shoes offer protection at times when other shoes aren’t appropriate, but if an accident or injury occurs, contact Dr. Blaakman at (877) 941-3338. He provides caring and compassionate full service podiatric care to help keep you active.

References:

http://www.galttech.com/research/sports/best-water-shoes.php
http://www.livestrong.com/article/427103-good-water-shoes-for-kayaking/

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