Sports Injury Information & Tips |
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Sports Injuries and TipsShin SplintsThis is an inflammation of “posterior tibial” muscle that runs on the inside of the calf along/behind the tibia bone. This muscle supports the arch and prevents over pronation or flattening of the arch. This injury is common in a person that has a pronated foot, continues to run on shin pain, and sometimes a tight calf muscle group. If left untreated, this injury may progress into a stress fracture of the tibia. Achilles TendonitisThis is an inflammation of the large tendon behind the ankle. If the problem lingers for more than a couple of weeks, it may become a chronic condition which is much more difficult to treat quickly. If the muscles that make up the Achilles tendon are tight or weak, there is a predisposition to injury. The symptoms may include warmth and swelling, and could be very stiff in the morning, upon arising, or during or immediately after exercising. Very early aggressive and conservative treatment is important as it may take a long time to rehabilitate. Heel/Arch PainThe thick band under the foot in the arch is called the “Plantar Fascia.” It tethers the heel to the ball of the foot. Although not a serious injury, early aggressive treatment is imperative as lingering untreated heel pain may lead to a chronically thickened and scarred band of tissue which may take quite a long time to heal. Runner’s KneeA truly biomechanical related condition of misaligned tracking of the kneecap in the groove of the thigh bone “the femur”. This is usually due to a few things; over pronating of the foot, a weak core/hip muscles, and a tight quadriceps muscle. Correcting the biomechanical issues is imperative to resolution of the problem. Exercising with this injury is not typically a problem, but conservative treatment should occur early on. Metatarsal/Neuroma Pain These are two very common conditions that occur in the forefoot. “Metatarsalgia” is an injury to the soft tissues surrounding the small metatarsal joints. These joints can become red, hot, and swollen, which can make walking difficult. This problem should be treated quickly with aggressive conservative treatments. The presence of a bunion which is the angulation of the big toe joint is very common with Metatarsalgia. Illiotibial Band PainThis large strap like band travels from the outside of the hip down along the leg and attaches into the outside of the knee. This band will get injured if it is very tight, or there is weakness in the hip muscles, which will allow the knee to rotate inward/collapse. Pronation of the foot, will allow the knee to collapse inward as well, which will put increased tension on the band too. Treatment always should include correcting any misalignment of the hips, and feet, as well as strengthening the leg/hip muscles. Piriformis SyndromeThis is an injury that occurs in the central area of the buttocks. The Piriformis muscle is an outward rotator muscle of the leg, and it may place strain on the sciatic nerve that runs below it. If the muscle abnormally presses on the nerve it may produce “sciatica” like nerve pains down the leg. Tightness of the muscle, unleveled hips, and a pronated foot are common denominators for this injury. Simple conservative care will easily improve this problem. Ankle SprainsThis injury is a traumatic twist to the outside ankle ligaments. It is imperative that treatment begins immediately after the injury to help guide the ligaments into proper repair. Physical therapy treatments will reduce swelling and pain and improve strength and balance. X-rays may be necessary to determine if there are any fractures present. Re-injury is common due to improper rehabilitation and immediate care. Leg Length DiscrepanciesUn-leveling of the hips and pelvis is NOT “normal” but very “common.” There are 2 types of Leg length discrepancy; functional and structural. Functional LLD is most common, and occurs due to poor foot and body mechanics, weak hips and core muscles, or a scoliosis in the back. Improper posture may also create this issue. Diligent strength, flexibility, massage, chiropractic and improving foot mechanics with orthotics or lifts will often correct the deformity and prevent long term dysfunction of the lower back and pelvis. Structural LLD is less common, but occurs from a true difference in the lengths of the lower leg bones ( tibia and femur). This may have come from a fracture which caused shortening, or if a joint replacement surgery has changed the lengths of the legs. A lift in or on the shoe of the short side is imperative to reduce any further damage to other body locations. BunionsThe proper medical term is called “Hallux Valgus” which is an angulation of the large toe toward the second toe. A pronated foot that rolls inward is common which is typically inherited. This condition will worsen over time, and symptoms may become painful due to tight or poor shoe fit. Conservative Treatment to halt the progression, should be proper shoes, padding and orthotics to correct the foot pronation, but true correction and straightening is only accomplished through surgery. Hammer ToesWhen any or all of the small toes start to curl under and the toe joint becomes prominent and possibly rubs on the toebox of the shoe causing a corn. This condition occurs from an imbalance of tendons within the foot which create this cocking up of the toes. Because they are related to faulty foot mechanics, they will progress and get worse, but tight shoes or stockings can contribute to the development. Treatment will include toe padding, shoe size changes will help, but if they are rigid, the only true treatment is surgery. Stress FractureThese fractures are hairline cracks within a bone typically from overuse from repetitive trauma, ie; running. The fracture may be seen on x-ray only after some healing has occurred and bone callus has developed (typically at about 3 weeks). Bone typically takes 10-12 weeks to repair, so this injury takes time to fully heal. Evaluating shoe gear, foot mechanics, training programs and occasionally evaluating bone density for female patients is important. Bone typically heals perfectly and just as strong as prior to the injury. Corns, Calluses and BlistersFriction against skin will cause rubbing resulting in blisters (quick, high frequency friction) or corns/calluses ( slow, low grade friction) onto prominent bony spots. Tight/improperly fitting shoes can cause the friction and increased perspiration can increase the friction as well causing these rub spots. Typically blister products found at the pharmacy, will protect and help with pain. Certain “anti-sweat” socks and/or skin lubrication will help to prevent this problem. SciaticaThis condition may occur from the irritation of the lower back lumbar or sacral nerves that exit out of the spine. Arthritic spurs, a disc protrusion a functional or structural leg length discrepancy may create this problem. Symptoms may include sharp shooting pain into or down the leg numbness, tingling, burning, spasms or deep achy muscles in the leg or buttocks. Physical therapy, Chiropractic and massage therapy works very well. MRI can rule out these and other conditions. Running Shoe Fit Tips
Running Shoe InformationCushionDesigned for a neutral runner or a supinator. This shoe has softer light weight (EVA) material within the midsole, it wears out faster, so rotating shoes or changing more frequently is important. StabilityDesigned for the mild to moderate pronator who needs some extra support. There is a very wide range of stability shoes in all the specific brand of shoes from very soft and flexible to very firm. Motion ControlDesigned for the moderate to severe over pronator. This is the heaviest shoe of all three types, with heavier material in the midsole. This shoe may work well for the heaver runners. What are Orthotics?These are custom made prescription insoles that are designed to correct the alignment of the bones and joints within the foot and the lower extremity and back. When the foot architecture is corrected, the internal foot and external leg muscles will function at their peak performance. Each foot is casted with a plaster mold and a proper biomechanical exam is performed as well to make sure the alignment of the orthotic is correct. The plaster molds and the measurements are sent to the lab for the devices to be fabricated. Adjustments and follow-ups are usually necessary to make sure the fit is correct. Orthotics may be made for many types of shoes including sandals, high heels, cycling, and skate boots for men and women. Orthotics may last upwards of 15 years, especially when regular refurbishing (recovering/repair) is done. We evaluate each persons need for biomechanical correction, and can make suggestions on the perfect orthotic for your needs. Types of Physical RehabilitationModalitiesThese are therapy treatments ( ultrasound, electric stimulation) that can reduce swelling, decrease inflammation, increase blood flow, and improve soft tissue elasticity and function. Different modalities can be used in the acute or chronic phases of injury or post surgery. Strength/flexibility workRegular strength training 2-3 times per week will greatly improve overall muscle function, balance, and posture. When injury results from imbalances of the strength of the lower extremity, it is imperative to improve it. We design a strength program to target the areas that need improvement. Continual strength work will reduce lower extremity injuries. Flexibility varies from person to person. Even slight improvement will help to decrease the rate of injury. It is important to do strengthening and flexibility exercises regularly and together. Massage TherapyTherapeutic massage can be very helpful to promote tissue healing, reduce muscle stresses, improve blood flow, improve tissue pliability and energy flow. There are many various forms that can be used for specific issues and in conjunction with other therapy or holistic treatments. Both our offices have licensed massage therapists. Holistic and Alternative TherapiesOur office offers a variety of holistic treatment regimens. In addition to traditional and physical rehabilitation treatments, our office offers many types of alternative and new treatments. Lower extremity acupuncture, magnetic therapies, as well as Homeopathic medicines are used for many conditions. New therapies are being used such as Kinesiotape for injuries, needling injured tendons and ligaments to promote collagen production, as well as PRP (Platelet Rich Plasma) therapies to treat chronic injuries and ulcers by promoting collagen production by utilizing a special technique using a patients own blood. Using a combination of holistic, traditional, and new emerging treatments will help our patients to recover quickly and conservatively. Nutritional testingAlthough very subtle at times, the nutritional integrity of each patient may predispose a patient to acute injury, or preventing a patient to recovering from a chronic injury. When patients have recurring injury patterns, or slowed recovery times, nutritional evaluation is important. Our office offers a complete intracellular nutritional test, using the patients whole blood cells rather than the serum which is very transient in nature. Evaluating the complete nutritional profile and suggesting proper supplementation, can help the patient attain long term nutritional recovery. We can examine the intracellular testing to determine a variety of deficiencies. Pediatric Gait and PostureEvaluating and screening children’s feet is very important for prevention of adult foot pathology (i.e. Bunions. Hammertoes.) Most children will not complain of foot problems, as the soft tissue adaptations have not yet begun, but they may wake at night, or complain if increased walking occurs. Many mechanical foot deformities can impact posture, and create overuse injury in the child from the foot upwards into the rest of the lower extremity. Our office performs proper biomechanical evaluation of the lower extremity and feet for our pediatric patients, and can evaluate proper fit for athletic and street shoes. For children, proactive and prevention is the key. Diabetes MellitusDiabetes results when your body fails to produce or properly use insulin. The body's failure to produce any insulin is Type I diabetes, while the failure to properly use insulin is Type II diabetes. Diabetics are at risk for sensation loss, vascular disease, and weakened immune systems. Because of this, foot ulceration with infection is a leading cause of hospitalization for diabetics. Successful ulcer prevention begins at home. It is important to check your feet and feel inside your shoes daily. And of course, maintain a healthy diet, keep your glucose under control, and always follow up with your scheduled physician and podiatrist. Peripheral Vascular Disease (PVD)Peripheral vascular disease (PVD) can affect the arteries and veins. The most common type is peripheral arterial disease, or PAD. It is caused by a build-up of fatty material within the vessels, called atherosclerosis. Known to affect the arteries of the heart, brain, and peripheral arteries, it may cause heart attack, stroke, ischemic pain, cold feet, bluish skin discolorations, or gangrene. A simple pulse check to the extremities by a professional can help diagnose this and may warrant further diagnostic work up. By age 65, about 12 to 20 percent of the population will have this with your chances increasing if you smoke, have diabetes, hypertension, or high cholesterol. Peripheral NeuropathyPeripheral neuropathy is a disorder of the peripheral nerves that connect the spinal cord to muscles, skin and internal organs. There are many causes of neuropathy that include autoimmune diseases, tumors, vitamin deficiencies, infections, trauma, toxins, heredity and almost 30% are caused by an unknown factor. Usually affecting the hands and feet, peripheral neuropathy can cause weakness, numbness, tingling sensations or pain. It can come and go, slowly progress, or can become severe and debilitating. If diagnosed early, peripheral neuropathy can often be controlled, some types may even be cured. Therapy is directed to treat the underlying cause and to improve the symptoms.
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Dr. Lisa M. Schoene DPM, ATC, FACFAS
Dr. Andrea L. Peach DPM
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