Achilles Tendonitis

The Achilles tendon is a continuation of the calf muscles.  More specifically, it is a continuation of the soleus and gastrocnemius muscles.  The tendon serves as an attachment of the muscles to the heel bone, known as the calcaneus.  The Achilles tendon plays a vital role in walking, by helping to lift the heel off of the ground. 

            Common conditions affecting the Achilles tendon include Achilles tendonitis and tendonosis.  Symptoms of both of these conditions include pain and tenderness in the area directly above the heel.  This pain may be worse in the morning after a long period of rest, or with a prolonged period of activity.  The pain can usually be reproduced by squeezing the tendon. 

            Both Achilles tendonitis and tendonosis are considered to be overuse injuries.  They are commonly seen in patients who have just begun rigorous exercise programs, laborers, and “weekend warriors” – those who participate in physical activity on the weekends and may be less conditioned than more regular athletes.  During these activities, too much stress is put on the tendon too quickly, which can lead to micro-tears and ultimately pain.  Tendonosis refers to these tiny micro-tears, while tendonitis refers to the actual inflammation.  Because the activity is ongoing, the injury to the fibers of the tendon can alter the shape of the tendon, leading to a situation of prolonged pain. 

            Once diagnosed by a doctor, Achilles tendonitis and tendonosis will usually be treated first with immobilization.  This is generally achieved by putting the affected foot in a cast or a removable walking boot.  Icing the inflamed area will help bring down some of the inflammation and relieve some of the pain – anti-inflammatory drugs like ibuprofen may help with this as well.  Once the pain from the tendon subsides, physical therapy may be used to strengthen the muscles, which can help prevent future cases of Achilles tendonitis and tendonosis.  Physical therapy can also be used to help improve running form.  Proper footwear is another important step in preventing the conditions, as well as preventing other conditions that can develop from physical activity. 

            If you are experiencing pain that you think may be Achilles tendonitis/tendonosis, it is important to have your ankle evaluated by a foot and ankle specialist.  Only they will be able to rule out other possible causes, and treat the condition effectively.  Remember that pain is never normal, and should be taken care of promptly and appropriately.  

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Got Sesamoiditis?

Got a pain in the ball of your foot?  One possible explanation is sesamoiditis.  Sesamoiditis is a pain in the ball of the foot underneath the big toe.  This is where the sesamoid bones are located. 

Sesamoid bones are bones that are embedded in tendons, and help reduce friction and act as a pulley across a joint.  This makes the motion of the joint much smoother, and more efficient.  The sesamoids of the great toe help to increase leverage during the toe-off phase of gait.  These bones are about the size of a kernel of corn. 

Sesamoiditis is most common in young, active people.  It is particularly common in runners and dancers, as there is a lot of pressure put on the ball of the foot during these activities.  Every time that you push off with your big toe, the sesamoid bones are involved in the movement.  This can eventually lead to irritation.  Since the sesamoid bones are buried within a tendon, sesamoiditis can actually be considered a form of tendonitis, as the tendon encapsulating the bones are generally inflamed as well.

Cases of sesamoiditis are usually distinguished from other causes of foot pain by their gradual onset.  The pain will typically begin as a mild ache during activity, that slowly progress to a more intense, but dull, pain.  Most cases do not show any apparent signs of redness or bruising of the skin.  Sesamoiditis generally is caused by an increase in physical activity.  This may be seen in people just beginning to run or dance, or in a runner that has recently increased mileage or intensity of their training.  It is also often seen in baseball catchers, who usually put a lot of weight on the balls of their feet.

Sesamoids, like any other bone in your body, can also fracture.  When your doctor diagnoses sesamoiditis, they will take an X-ray to see if the bones are fractured or not. 

Treatment of sesamoiditis starts with a good amount of rest.  It is important to stop the activity that is causing the inflammation.  Invasive measurements are usually not necessary.  Icing the effected area will help lessen the pain, as well as non-steroidal anti-inflammatory drugs (NSAIDS).  Sesamoiditis can be prevented by wearing a well-padded shoe when performing physical activity.  Some people may simply not have a thick enough fat pad in the ball of their foot.  This may be aided by a soft metatarsal pad inserted into the shoe.  

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Annual Best Walking Cities Competition

The American Podiatric Medical Association, in partnership with Prevention magazine, has just published the results of the annual Best Walking Cities Competition.  Topping the list this year was San Francisco. 

            The Best Walking Cities Competition takes an analytical look at the 100 largest metropolitan areas of the United States, and ranks them according to various categories, such as the amount of trails and public parks in a certain area, and the percentage of people that walk for fitness. 

            In addition to the objective analysis, a panel of nationally-recognized experts on the subject was asked to weigh in on the competition.  These experts were asked to weight the criteria, as well as to rank the cities on walkability. 

The top ten cities are:
1.      San Francisco, CA
2.      Boston, MA
3.      New York, NY
4.      Philadelphia, PA
5.      Chicago, IL
6.      Washington, DC
7.      Seattle, WA
8.      Honolul, HI
9.      Portland, OR
10.  Pittsburgh, PA

Walking is a very healthy activity, and one of the most popular forms of exercise out there.  It is easy to do, and has been shown to decrease the risk of heart disease, stroke, obesity, diabetes, and cancer.

To read more about the Best Walking Cities Competition, check out this link to the APMA website.  You can find out more about the results, including where your city falls on the list!

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Server's Disease and Osgood-Schlatter Disease

If you know a young athlete that’s having some trouble with heel pain, it may be Sever’s disease.  Sever’s disease is a condition common in growing athletes, where the growth plates in the heel are subjected to repetitive microtrauma.  This microtrauma, or tiny cracks in the growth plate, is the most common cause of heel pain in male athletes aged 10-14.

Sever’s disease is a self-recovering ailment.  That is, with rest and minimized impact to the heel (i.e. less running) the pain will subside on its own.  Symptoms include pain in the heels, especially while playing a sport or immediately following, as well as pain in the heels when waking up.  The pain is also felt from squeezing the calcaneus, or heel bone. 

Treatment of Sever’s disease is typically rest, ice, compression, and elevation (The R.I.C.E. method).  Orthotics or heel cups are often beneficial, as these tend to reduce the shock that the heel absorbs while running and playing sports.  Also, the young athlete should wear a proper fitting shoe, with firm support and a heel that is able to absorb some of the shock.  Stretching the calf muscles and hamstrings has also shown to be beneficial.

Osgood-Schlatter disease is a related disease that is inflammation of the growth plates at the top of the tibia, or shin bone.  Similar to Sever’s disease, Osgood-Schlatter’s is often seen in young athletes.  It is different however, in that it primarily presents as knee pain.  This knee pain occurs in both knees about 25% of the time.

Osgood-Schlatter disease can be attributed to overuse, especially sudden overuse, of the quadriceps muscles.  This is the group of muscles that are on the front of the thigh, and act as extensors of the leg, such as the motion in running and jumping.  The tendon that attaches the quadriceps to the patella (knee bone) and to the tibia ends up pulling very hard on the tibia just below the knee, causing microtrauma to the tibial tuberosity, the point where the tendon attaches.  This microtrauma is what causes the inflammation of the growth plates in the tibia, which in turn causes knee pain.

            The treatment of Osgood-Schlatter disease is similar to that of Sever’s disease.  Rest, ice, compression and elevation are the first line of defense.  Usually, there will have to be a period of at least three months without intense physical activity to allow the knee pain to go away.  Following this period, it is essential to begin training slowly, so as not to re-aggravate the tibia. 

            If you know a young athlete that is suffering from heel or knee pain, know that this pain is not normal.  A doctor can evaluate the injury, and can tell if they are suffering from either Sever’s or Osgood-Schlatter disease.  Each of these conditions is treatable, and young people will grow out of these conditions.

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com

Runners’ Nightmares!

If you are an avid runner, chances are you have run into some kind of foot or lower extremity problems. Think about it: the action of running involves the repetitive pounding of the foot on surfaces and sends shock waves up your body.

It is important to understand that running too soon, running too fast, or running too long are the major causes of running injuries. The conditions you may experience are your body’s way of telling you to stop overworking it! 

What are some common running ailments?

Stiff Calves

Novice runners may experience tight and stiff calf muscles and is intimately associated with the Achilles tendon. This tendon comes from your calf muscles and joins the heel to your leg. If your body is not used to exercising the calf muscles and associated structures, you will definitely experience an ache on the back of your leg.

Runner’s Knee

Have you ever walked, climbed stairs, or ran and felt a grinding and grating in your knee joint accompanied by severe pain? If so, Runner’s Knee may be one cause! This ailment is caused by an unstable patella. (The patella is your kneecap).

Shin Splints

Running on hard surfaces such as asphalt or concrete may lead to the development of shin splints. Shin splints is that burning, irritating pain originating from the center of your lower leg. Without rest or treatment, shin splints may progress into stress fractures! 

What is the best way to treat running injuries?

Stiff Calves

Make sure that prior to starting your running routine that your calves experience a full, deep stretch. You can build up the area by rising on to your toes one foot at a time, holding that position for a count of five and then lowering it.

Runner’s Knee

The best way to alleviate this condition is to ease off of the physical activity for a week and work to strengthen the muscles around the knee. To improve muscle strength clench your thigh muscles as often as you can in sets of 5. It’s a simple way to work the muscles that connect to your patella.

Shin Splints

To reduce the occurrence of shin splints, it is advised to run on soft surfaces such as grass while wearing shoes with ample cushioning. You may have to hold off on running for an extended period of time.

Different injuries require different modes of treatment, but the tried-and-true methods always involve prevention and a good stretching regimen. Watch and pace yourself when exercising – do not overdo it! And of course, ALWAYS seek a podiatrist’s consult when evaluating the intensity of the injury and deciding on the best treatment option! 

Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.flfootandankle.com