Posts for tag: Sports Injury

By Dr. Tracy Warner
February 11, 2013
Category: Sports Injury

By now you have committed to your New Year's Resolution Dr. House had blogged about earlier this year and if you were not exercising regularly and have started a new walking or running routine you may be finding your feet are hurting despite getting a new pair of shoes. Dr. Glynn has already blogged about how to pick those running shoes and you have followed her recommendations so the shoe is not an issue, but despite that the outside of your foot and ankle is painful. You also read Dr. Abdo's blog on high ankle sprains and you have not had any direct trauma so it is not that and you read my earlier blog about plantar fasciitis and you may or may not have associated pain on the bottom of your foot. So what is going on?

There are 3 tendons that are on the side and top of your foot and they are responsible for bringing your foot up to help clear the ground and if you have resumed an exercise program or upped your activity they may not like all the extra stress. These 3 tendons are the Peroneal tendons. So what can be done? First it is good to know for sure that that is the problem and physical exam is important. We may check x-rays to look for a fracture and ultrasound to evaluate the tendon for inflammation or tear. Sometimes MRI is also necessary.

Once it is confirmed that you have PERONEAL TENDONITIS, what can you do about it? For any acute or new pain or trauma RICE is important. R is for Rest and that may be from the activity or with immobilization with an ankle brace or boot. I is for Ice. C is for Compression and E is for Elevate. This can help you get through the short term but you need to look at the biomechanics and getting into a custom molded orthotic to give your foot the biomechanical advantage and is important for long term treatment.

Now you may have done all this and still have pain. We do due surgery to clean up the tendon if there is a split and also stimulate the tendon with either topaz, radio colblation therapy, or with PRP, platelet rick protoplasm to help the body heal itself.

You may have to go to physical therapy before or after surgery.

It is important to continue with your custom molded orthotics from Podiatry Associates of IN to help keep your feet healthy, so you may reach your fitness goals.

By Dr. Tarick Abdo
July 18, 2012
Category: Sports Injury

As school slowly approaches, fall sports have started their early season practices. Specifically, cross country, tennis, and football season will be upon us shortly. Unfortunately one of the most common ailments of the lower part of the leg is shin splints medically known as Medial Tibial Stress Syndome (MTSS). The symptoms of MTSS include shin pain over the inside lower half of the leg. Pain at the start of exercise which often eases as the session continues, but can return the next morning. Mild swelling of the inner aspect of the shin bone, tibia.

The most common cause of shin pain is inflammation of the sheath surrounding the tibia bone known as the periosteum. This results from traction forces on the periosteum from the muscles of the lower leg cause shin pain and inflammation. Shin splints is a form of compartment syndrome where the muscles in either the medial, posterior, or anterior muscle groups in the lower leg swell due to increased activity. As may be seen in cross country, tennis, and football, athletes have not maintained fitness during the offseason and start engaging in high intensity activity. Thus these individuals may need to gradually increase activity and use rest, ice, compression, and elevation to reduce their symptoms.

More typically in my practice, biomechanical factors such as excessive pronation which strains the soleus muscle. This muscle has attachments along the inside of the shin bone. When an athlete excessively or rapidly pronates this places increased stretch on the soleus muscle resulting in pain and even microfractures of the shin bone. Other muscles implicated include the Posterior tibial muscle and the Anterior Tibial muscle. An experience podiatrist can aid in the proper muscle assessment.

In this case treatment is geared toward controlling the abnormal biomechanics, this is done with a custom foot orthosis. A custom foot orthosis requires a gait evaluation to gauge the degree of pronation and any compensation by the leg. In addition, a biomechanic evaluation is done with a custom mold or scan of the foot. Finally, a weightbearing foot x-ray which evaluates the position of the bones of the foot during the stance phase of gait. Furthermore, stretching to increase flexibility of the Achilles tendon helps alleviate symptoms.

Shin splints is a debilitating condition and can become chronic if not managed aggressively and diagnosed early. Thus athletes especially early in the season need to gradually increase their activity, where the proper shoes, and warm-up efficiently to prevent the onset of shin splints. If you unfortunately develop any of the aforementioned symptoms it is imperative that one rest and ice the area; however if symptoms persist, it is imperative that you consult a trained professional. Here at the Foot & Ankle Institute we can help get you back to activity quickly we are trained to evaluate this condition and manufacture a custom foot orthosis quickly so you can return to competition.

Good Luck this season to all the cross country runners, tennis players, and football teams in the Indianapolis Metropolitan area hopefully it will be a successful, injury-free season.



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