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    Exercise is great for you, and it comes in so many forms: biking, walking, swimming, running, weightlifting, etc. For many people who struggle with foot and leg pain, however, exercise can be a terrible trial. One of the most common overuse injuries from exercise is shin splints. This is often used as a catch-all term for lower leg pain, but shin splints specifically refer to the chronic damage done to muscles, tissue, and bone through the stress of overuse.
    The medical term for shin splints is Medial Tibial Stress Syndrome. This happens when a muscle is pulled away from the bone, causing micro-tears in the muscle and surrounding tissue that present as generalized pain. Sometimes pain can occur on the outside of the shin bone, and this is called anterior shin splints. Medial pain will present on the inner side of the leg and is more common.
Repetitive motion injuries such as ligament sprains or stress fractures only occur to ligaments or bones. Shin splints cause damage to multiple parts of the leg, meaning it is extra important for us to avoid them and treat them if they do occur. Shin splints are most common in runners, dancers, and the military, but can present during any sport or heavy activity.

Specific conditions and activities that can contribute to shin splints include:
-Starting with too much exercise, too quickly
-Changing terrain or surface (such as switching from flat routes to hills)
-Always exercising on hard surfaces
-Not allowing for body recovery time between strenuous activities
-Exercising without proper stretching
-Worn out shoes
-Flat feet or high-arches

    If you feel pain or tenderness, or see redness and swelling in your legs, use the RICE method. In case you forgot, RICE stands for Rest, Ice, Compression, and Elevation. Stop all activity and do not resume until the pain has completely dissipated. Ice the front and sides of your shin while laying with your legs elevated above your heart. Compression socks can also help reduce swelling. Over-the-counter pain relievers may be taken in addition to RICE treatment.
    Once you have rested and the pain has subsided, it’s important to make sure shin splints don’t happen again. Change the intensity, frequency, or location of your workout to reduce strenuous surfaces or terrain. Have your running stride evaluated for potential imbalances and work to correct these. Replace your athletic shoes every 300-500 miles. If you have flat feet or high-arches, consider a support or orthotic to support important areas of the foot.
    If you have shin splints that reoccur even after these changes, it’s time to see a podiatrist. Stress fractures and compartment syndrome can both be mistaken for shin splints. Your podiatrist will perform an examination and take x-rays to rule out other causes. Often, small changes to your workout or working in lower-impact activities can help reduce injury and pain. The doctors at the FAAWC are here to help. Make an appointment today and learn how you can exercise free from the pain of shin splints.

February 19, 2018
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This month, we’ve talked about ligaments and we’ve talked about tendons. Now we need to talk about your bones. Your feet have over a quarter of the bones in your entire body (26 in each foot to be exact). We rely on our feet to get us through everyday life, but everyday life might be getting back at us with damage to our bones.

Bones are rigid, unlike tendons, muscles, and ligaments, which bend and stretch. If you break a toe from a sudden event, you usually know by the immediate pain and the amount of cursing that accompanies it. Not every broken toe comes from a sudden trauma though, and the signs of a slow stress fracture aren’t always as obvious as a sudden injury.

A stress fracture is brought on by repetitive motion. This could be from sports or just from everyday activities. Over time, hairline cracks in a small bone can turn to big cracks and eventually full breaks. The early warning signs of a fractured toe are subtle, but if you pay attention to your feet (like I always tell you to!), you should be able to recognize when your feet just don’t feel right. The first sign is pain. I say it time, and again, pain is not normal. Any sudden pain that occurs during a specific motion or activity is bad. Pain that gets worse during activities and then feels immediately better when you rest can be indicative of a stress fracture.

As the fracture deepens, the pain will get worse and stick around longer. It may now be accompanied by swelling, bruising, or tenderness. You may find it difficult to put on a shoe or even walk on the fracture. Seeing a podiatrist before you get to this point is important. Stress fractures are more likely to occur in people who train on hard surfaces (like concrete), repeat certain motions (like jumping and running), or wear improper shoes with little cushioning.

Even though treatment is generally straightforward, these injuries take a lot of time to heal. Your podiatrist may recommend a splint or boot to immobilize the joint and protect the toe. During this time, you may have to sit out of your favorite activities until the fracture heals. If you return to the same activity too soon, you’ll continue to damage to your bones, and more drastic treatment options may need to be taken. During your healing time, try activities like swimming or cycling which take pressure off the feet.

You can avoid stress fractures by taking proper precautions such as good shoes for activity, varied training surfaces, and paying attention to early warning signs. If you think you have a fractured toe, stop all activity, use the R.I.C.E. method for symptom treatment, and make an appointment with the FAAWC. Your toes will thank you.

February 08, 2018
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Last week we focused on ligaments and the ways we can sprain, tear, and stretch them. Today, we focus on our tendons, specifically the Achilles tendon. Achilles was a great hero of ancient Greece and the battle for Troy. Legend has it that he couldn’t be defeated in battle, but a single arrow to the back of the heel was enough to bring him down. If you’ve ever torn or ruptured your Achilles tendon, you know exactly why.

A tendon is a strong cord that connects muscles to bones. The Achilles tendon connects your calf muscle to your heel bone and is the biggest tendon in your body. During recreational sports or heavy activity, the tendon may overstretch (causing pain) or tear/rupture (causing lots of pain). If your tendon ruptures, you might hear an audible “snap” or “pop” followed by severe pain and an inability to walk on the affected limb. While minor injuries can recover with rest and time, an Achilles tendon rupture may need to be surgically repaired to ensure proper healing.

 

Diagnosing an Achilles Tendon rupture is relatively straightforward. Your podiatrist may ask you to try pointing your toes, or they may feel around the calf for the tendon itself. In cases of a complete rupture, they may be able to feel a gap between the two ends. If there is any question about the severity of your injury, they may request additional tests such as an MRI or ultrasound to get a better look. Strains and ruptures can be treated with surgical or non-surgical options. Which you choose depends on a lot of factors so be sure to discuss your options thoroughly with your podiatrist.

Non-Surgical

Nonsurgical treatment of an Achilles tendon rupture involves complete immobilization of the foot and ankle. You may wear a cast or walking boot in combination with crutches to avoid weight-bearing. This path requires a minimum of six weeks for healing and can often take months with many follow up visits to your doctor. Tendons left to repair naturally are not as strong as surgically repaired ones so physical therapy and ankle strengthening will be important parts of your treatment plan. The chances of re-rupture are higher with non-surgical treatment.

 

Surgical

The surgical solution for an Achilles tendon rupture is to have your podiatrist stretch and sew the two pieces of your tendon back together. While this sounds gross and invasive, it’s a fairly simple procedure. Surgical repair of tendons makes them stronger, lessening the chances of another rupture, and gives you more range of motion than a non-surgical option. Recovery time is shorter with a surgical fix meaning you’ll be back to the activities you love in no time! All of our doctors are well trained in the repair of Achilles tendons and can answer any questions you may have about your procedure or healing.

 

Keeping your Achilles tendon strong and protecting your feet and ankles during activity can help reduce the chances of a strain or rupture. Perform calf-raises to keep muscles in shape and vary your activities, so you aren’t putting the same stresses on your feet all the time. Watch yourself during high-risk activities such as jumping or running. If you think you have strained or ruptured your Achilles tendon, call the FAAWC today. Our urgent care access means getting the care you need, right when you need it. Call 740-363-4373 today!

February 01, 2018
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    There are many parts of the foot and there are equally as many ways to damage all of them. One area of concern is our ligaments. Ligaments are thin bands of fibrous tissue that connect bones together at the joints. This is not to be confused with a tendon, which connects muscle to bone. Ligaments are tight yet springy so that joints can flex and return to a natural position. When we sprain a ligament, we stretch it further than it wants to go and it gets mad at us by swelling and becoming painful.

    Sprains can come from any activity that twists the foot into an unnatural position. Twisting or rolling your ankle is the number one cause of sprained ligaments. These injuries tend to occur suddenly from a very identifiable cause such as jumping and landing on your foot wrong. The ankle is supported by four separate ligaments: the deltoid ligament, anterior talofibular ligament, posterior talofibular ligament, and the calcaneofibular ligament. (Don’t worry, we won’t quiz you on them). Any of these can be damaged or torn in a sprain.

    A sprain comes in three grades of severity. Grade I is mild, usually with only minor swelling and pain. You should still be able to put weight on the foot as the joint is relatively stable. Grade II is, of course, a little bit worse; usually involving an incomplete tear in one or more ligaments. The ankle may not hold weight so crutches or a splint can help with mobility and support. Grade III is reserved for the most severe ligament damage. These ligaments have torn completely apart. You will not be able to move or put weight on the joint for some time.

    If you suspect you have an ankle sprain, the best place to start is R.I.C.E. (rest, ice, compression, elevation). Over-the-counter pain relievers may also be used. Swelling for a Grade I injury will begin to lessen within 24 to 48 hours. If your symptoms get worse after home remedy, go see your podiatrist. Any Grade II or III injury will need medical attention for proper treatment and healing. A 2 to 4 week recovery time can be expected for minor to moderate sprains. Sprains that need casts or splinting could take up to two months for healing. When your doctor gives you the go-ahead, you’ll want to gradually increase your activity. Partially healed sprains will not be strong enough to hold the joint stable and your chances of re injury are high.

    Spraining ligaments isn’t hard to do, but its easy to avoid with some logical steps. Wear supportive shoes for every activity, especially sports. Strengthen your ligaments with simple exercises like ankle rolls or calf raises. While you’re sitting at your desk at work, cross your legs and use the raised foot to write the alphabet. Even if you don’t exercise your feet specifically, make sure to warm up muscles and ligaments with a good stretch before activity.

    If you think you have sprained a ligament in your foot or ankle, make an appointment today. We provide urgent access to our doctors if you call 740-363-4373. Seeing your podiatrist can ensure a proper healing plan and save you money over other urgent cares or emergency rooms. Don’t delay!

If the temperatures outside are keeping you indoors this time of year, you’re not alone. I hate the cold. For the brave souls who like to venture out into the snowy weather, a few words of caution. Your toes need to be protected! Proper footwear is always a must because frostbite and chilblains are common foot injuries brought on by the cold. As usual, they are easy to avoid if we understand how they happen and what to do about it.

 

Frostnip

Many people will know frostbite, but there is a milder form of cold injury called frostnip. Just because it’s milder, doesn’t mean it still isn't uncomfortable and bad for your feet. It generally begins in the toes. The skin will turn white or flush red and feel extremely cold to the touch. In a short time, this can lead to numbness or a feeling of pins and needles. Without rewarming, frostnip will lead to frostbite. Think of it as an early warning sign and get yourself indoors where your feet can get care. Soak your feet in water, but bring the temperature up very gradually. Don’t start with hot water; you probably can’t feel if it’s too hot and scalding your feet.

 

Frostbite

In the cold, the blood vessels nearest the skin narrow, diverting blood to the core of the body to protect the vital organs. Unfortunately, this leaves fingers, toes, and nose tips left out in the cold. Literally. Since your body is no longer trying to warm those areas, they have no defense against cold injuries. If you leave them exposed, frostbite will slowly freeze the skin and tissue underneath. In severe cases, tissue will die and need to be surgically removed. If you think you are developing frostbite, seek medical treatment immediately.

 

Chilblains

Most people know what frostnip and frostbite are and how to avoid them, but there is another type of cold injury that can occur even when it's not below freezing. Chilblains is a condition in which the feet react to cold with inflammation. This causes red patches, itching, swelling, and can be accompanied by painful blisters, called pernio. Just like nail fungus likes to grow in warm and moist socks, chilblains like to form in cold and damp socks. Frostbite can onset quickly due to freezing temperatures, but chilblains occur from long exposure to mild cold and humidity. You may not even feel it happening, but long term damage is being done to your blood vessels. Symptoms can stick around for a while without proper treatment, so get yourself to a podiatrist asap.

 

To prevent any cold injury there are some basic steps to follow. Keep your feet warm at all times. When going outside, wear warm socks that pull moisture away from the skin (wool is a good choice). If you don’t have a lot of body fat to keep you warm, add an extra layer of socks. Same thing if you have excessively sweaty feet. Avoid rapid temperature changes if your feet do get too cold. Never warm up your feet if there is a chance of them refreezing before reaching proper medical care. To read more about frostbite and how to prevent it, click HERE 

 





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