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Posts for: December, 2011

By contactus
December 27, 2011
Category: Uncategorized
Tags: Untagged

 

Are you a runner who has been experience lateral (outside) knee pain? Have you recently been increasing how much you run? If so, you may be experiencing what is called Ilio-Tibial Band Syndrome, which is the most common cause of knee pain in runners. The ilio-tibial band (ITB) is a thickening of superficial tissue that runs from your pelvis down the outside of your thigh, passing over the hip and knee before finally inserting on the outside of your leg below the knee.

http://4.bp.blogspot.com/_2rXl4UWSQ9Q/SwrS2XFmnPI/AAAAAAAAAOg/YrpYMR7AIQA/s1600/IT-BandKem42B1.jpg

 

 

 The ITB helps to stabilize the knee during the continuous flexion and extension of the knee during running activities. During these knee motions, the ITB slides back and forth across a normal bump on your thigh bone (femur), called the lateral femoral condyle. This continuous rubbing can lead to ITB syndrome, which is a sharp or stinging pain above and on the outside of your knee due to inflammation of the ITB.  While the area may be tender to touch, you likely will not see redness or swelling usually associated with inflammation.

http://beginnertriathlete.com/cms/articleimages/1214/Iliotibial-band-syndrome.jpg

           

The most common cause of ITB syndrome is overtraining, whether that means adding too much to your normal exercise regimen or perhaps starting out with too much too fast if you are a new to running. Other physical factors also play a role, such as hip abductor weakness, one leg being shorter than the other, or a cavus (very high arched) foot structure. Other factors can be related to the exercise itself, including always running on the same side of uneven or banked surfaces, inadequate warm-up or cool-down, or too much running up or down hills. All of these things put more strain on the ITB, causing it to become tight and inflamed.

 

Treatment for ITB Syndrome starts initially with rest, ice and anti-inflammatory medication, but this is usually not enough. Physical therapy modalities such as ultrasound, electrical stimulation, massage therapy and hip abductor strengthening may also be useful in not only calming down the inflammation, but also in preventing further injury. Once the pain is controlled, it is very important to stretch the ITB (and the hamstrings, calf muscles, and quadriceps to maintain proper balance between muscle groups).

http://www.endurancesports.com/images/ibsstretch.jpg

One way to do this is to use a foam roller on the ground and roll the outside of your hip and thigh across the roller.

http://www.stretchingworld.com/images/IT Band SMR.gif

Custom orthoses and a change in shoe gear may also be warranted to prevent chronic pain from ITB syndrome. Supportive, properly fitting shoes are important for running, and shoes tend to lose their valuable properties (and should be replaced) every 300-500 miles of use. It is usually necessary to make a change in the exercise itself. Once you return to running after getting rid of the pain, start slow and gradually increase your frequency and intensity. Minimize the amount of up and down hill running if possible. If you run on a sloped/banked running surface, make sure you switch which side of your body is dropping down lower (ie – if you run on the right side of the path going one direction, run on the left side coming back).

 

When in doubt about your pain, stop running and come see me today! Pain usually means something is wrong and should be fixed, not suffered through.

 

Everyone have a very safe and happy New Year! Remember to practice moderation in your holiday eating and try to incorporate family exercise into your family traditions.

 

 

 

 

 


By contactus
December 14, 2011
Category: Uncategorized
Tags: Untagged

Now that winter has arrived, every week brings the chance of rain, snow, and ice to accompany the chilly air. This means we all need to take extra precautions whenever we go outdoors. As important as a warm winter coat, hat, and gloves is the protection of your feet during this season. Today, I will discuss a few risk factors for cold injuries that you should all be aware of so you can prevent them from happening, as well as signs of cold injuries of which you should be aware.

Some general things that put people at risk for suffering a cold injury include:

·         Inadequate clothing (socks and shoes in the case of your feet)

·         Harsh weather – low temperatures, high winds, and moisture

·         Damp/wet shoes and socks in cold environments (cold and wet causes injuries faster and more severe at warmer temperatures than dry and wet!!))

·         Age – children and the elderly are at a higher risk

·         Poor nutrition and fatigue

·         Use of vasoconstricting medications (call me if you have questions regarding your medications)

·         Use of alcohol and tobacco products

·         Previous cold injury

Some particular ways to prevent cold injuries begins with adequate shoes and socks. Thicker socks will be warmer by nature, but you must allow enough extra room in your shoes or boots to prevent too much tightness or cutting off of your circulation. Cotton socks (100% cotton) are good at absorbing moisture, but the moisture stays in the sock and may be allowed to freeze in certain conditions, so try to avoid 100% cotton socks. A wool sock, acrylic sock or a blend of fiber-types actually wick away the moisture, which may help decrease the risk of cold injuries. Of course, if your socks get wet from the weather, warm or cold, you should take them off and replace with dry socks as soon as possible, making sure to also keep your shoes or boots as dry as possible. A water-resistant sock and multiple layers (without overcrowding your shoe) are the keys to keeping your feet warm and dry. Along the same lines, a thick, wind-resistant, water-resistant shoe is necessary, especially if you know you will be spending a large amount of time out in the elements. Mesh-topped sneakers and open-toed shoes should not be worn in inclement weather.

The most common type of cold injury people experience in their feet is frostbite. This can be caused by exposure to below-freezing temperatures (or above-freezing cold temperatures if moisture is involved) which decreases blood flow to tissues in your feet. Cells become damaged and can start to die if frostbite is not recognized and treated quickly enough. At the beginning of frostbite, you may notice your skin turn a white or blue color and become numb.

Once you re-warm the area and stop exposure to cold, you may notice redness, itching, and some swelling in the area for up to 10 days. The key is to remove yourself from the cold and re-warm as soon as possible. As frostbite gets worse from continued cold exposure, blisters can form, which will eventually cause the skin to turn a dark color and peel off as new skin grows underneath..

Ulcers could develop and eventually that body party may turn black and have no feeling. As your body part re-warms, you may feel tingling and burning sensations as well as possibly severe pain, but it is absolutely necessary to warm the body part. If you notice severe discolorations from cold exposure, you should come to our office immediately so we can re-warm the part for you in the proper manner. At all costs, avoid re-freezing after you have thawed out the injured body part, as this freeze-thaw-refreeze cycle can cause even more damage.

Another common cold injury seen in the feet (or any cold-exposed part of your body) is called asteatoic eczema, which is really dry, scaly, rough, cracking skin.

 This is common in the elderly since they tend to have less natural skin moisturizing properties, and it is often seen on the front of your shins. The dry, itchy skin often leads to scratching, which may allow the skin to crack even more, begin to bleed, and increases the chances of infection. Besides removing exposure to cold, the most important treatment is moisturizing the skin. A great effective, and cheap, way to do this is apply petroleum jelly in a thin layer over your skin after taking a shower, which will help trap the moisture in the skin.

Remember to always keep your feet, socks, and shoes as warm and dry as possible during these winter months. If you have any concerns or would like to find out more about how to prevent or treat cold injuries, please call my office immediately and I will be happy to answer your questions or make an appointment to sit down with you in person. Stay warm and stay dry this winter!


By contactus
December 07, 2011
Category: Uncategorized
Tags: Untagged

 

Do you have a nagging pain in your big toe around the sides of the toe nail that seems to be getting red and tender? This could be a very common problem called an “ingrown toe nail”, and it is caused by the one or both sides (left or right as you look at the big toe nail from above) of the toe nail growing in an abnormal direction into the skin that is located to the sides of the nail. As the nail continues to grow into the skin, the area can become red, swollen, painful, and possibly even infected. As this occurs, the area becomes very tender, and even a minor bump or light touch can cause extreme pain. For some people, this can be a genetic problem, which means it will keep recurring over and over unless that part of the toe nail is permanently removed me during on office visit. For others, these ingrown toe nails can be caused by trauma from wearing shoes that are too tight or poor technique in cutting the nail causing edges to start growing into the nearby skin. Today I will discuss some prevention and treatment options for these painful toe nail problems.

http://www.allhealthsite.com/wp-content/uploads/2010/07/ingrown-toenail-2-.jpg  https://encrypted-tbn0.google.com/images?q=tbn:ANd9GcQS26SmS34d24kihq_lwG7Vcj_4BwQSi_wdqM4gHp5Lrm9YdtVL

                If this is one of the first few times you have experienced this problem, I will discuss all of your options, but could likely decide to just cut out the bad edge of the toe nail. This is a temporary procedure called an “incision and drainage”, in which a local anesthetic is applied to the toe to cause numbness, and then the bad edge of the nail is cut out all the way down to its root. The area is cleaned and drained, with an antibiotic cream and a bandage applied. If these ingrown toe nails continue to happen again and again, I may recommend a more permanent procedure. This procedure is the exact same as the procedure above, except after the nail edge is removed, I will apply a liquid chemical called “phenol” to the area where the nail was removed (there are a couple other chemical options besides phenol as well). This chemical actually kills the nail root and cells in the area, preventing new nail from growing in that area again. After both of these procedures, I will instruct you on how to keep the area clean for a few days and how to change the bandage to treat and/or prevent any infection in the area. This may include the application of antibacterial cream or soaking your foot in Epsom salt and warm water for 20 minutes once or twice per day.

                There are some ways to prevent these painful toe nails from occurring. You should make an appointment with me to discuss how to ensure proper shoe size and shoe fit, because a shoe that is too small can cause your toes to crunch together and lead to these nail problems, along with a multitude of other possible problems. Another preventative measure is proper nail cutting. You should avoid cutting the nail too short and avoid cutting the corner edges at an angle. The toe nails should be cut straight across in order to promote normal outward growth of the toe nail and prevent crooked corner edges that could grow into the skin. Most important in treatment or prevention is to take action as soon as you notice a problem. Ingrown toe nail removal is a very common procedure done our office, and the earlier ingrown toe nail problems are addressed, the quicker they can heal and the less likely they will become infected.  Call our office today for ingrown toe nail pain or any other question or concern regarding the health and condition of your feet, and remember—you don’t have to live with the pain!