A Stress Fracture from Golf?

Yes, it is true.  The best swimmer in the world injured his foot, not by kicking a pool deck, but from golfing.  I read the article and found that it wasn't actually from golf itself but from walking the golf course.  Apparently, Phelps walked something like 20 miles over the course of the tournament.  This lead to the injury, a stress fracture of his foot.

There is a lesson in this for all of us.  A stress fracture can occur over time.  It does not have to be a single instance.  In fact, in my experience, Phelps is a perfect example of what can lead to a stress fracture.  It is usually when we walk too much or wear a new or ill-fitting pair of shoes and are too active that leads to stress on the bone.

A stress fracture can lead to a swollen foot that is very painful to walk on.  It does not always even show up on x-ray but left unchecked can lead to a complete break in the bone (usually a metatarsal).  This can be much more difficult to treat and may even require surgery to repair.  Therefore, it is important to see your podiatrist right away with any foot pain.

Something to Celebrate

As a podiatrist, I read with interest a recent study that shows a drastic increase in lower extremity diabetic amputations.  The study was published in this month's Foot and Ankle International.  The study pointed out when looking at Medicare claims from 2000-2010, lower extremity amputations decreased 28.8%.  I am wondering if this is related to the 143.3% increase in the treatment of foot ulcers in the same time period.  Also interesting is that amputations at the upper and lower leg level are down 47% while partial toe amputations increased 24%.  (Sometimes a toe amputation is needed to be done by a physician like myself to prevent the infection from getting worse).  To me this means podiatrists are saving feet and legs.

This is a big deal on many levels.  First, it saves money.  Lower extremity amputations cost our health care system a lot of money.  Second, it improves patients quality of life.  Obviously, having a limb amputation is a big deal and can lead to other problems.  Earlier studies have found that a lower extremity amputation has a mortality rate of 50% within 5 years.  So one can argue that saving some one's limb, saves some one's life.

I am proud to have a hand in all of this and excited to continue to help bring down the level of amputations in my community.

Alex Ovechkin's Broken Foot

As I have said before, I am a Penguins fan so I am biased to say Sidney Crosby is the best player in the world.  However, last evening, the Washington Capital's captain beat Sidney Crosby out by winning the Hart Trophy as the NHL's MVP.

As a podiatrist, I was also interested to learn that Ovechkin played a few playoff games and for Team Russia with a broken left foot.  Surprisingly he admitted not telling doctors about it until after the season.  It is thought that he sustained a "hairline fracture" blocking a shot in the Capitals / Rangers playoff series.

This, in my opinion, is unwise as a hairline fracture or "stress fracture" can become a "full fracture" and lead to a break in the bone that can heal in a poor position or not well.  Sometimes surgery, especially in a pro athlere, is then needed.

Usually stress fractures cause swelling in the foot and pain especially after being on the foot for awhile.  I have seen countless stress fractures that are not visible on x-ray but very evident on MRI.  Therefore, just because one recieves a normal x-ray reading does not mean nothing is wrong.  Any foot pain, especially with severe swelling, should not be overlooked.

Blame your parents for your bunions?

As a podiatrist, one of the procedures I perform most is correction of bunion deformities.  This is a deformity in which the great toe turns out and creates a bump on the inside of the foot just below the great toe.  If conservative treatment fails, surgery is an option for many patients.

A study came out last month that suggested this deformity is inherited.  In my opinion, however, it is more complex than this.  I believe your foot type can be inherited (ie, flat or high arch) and this foot type can lead to deformities.  For example, a young lady can have a foot type that she "inherited" from her father but she gets bunions unlike her father because she wears tight high heels that can lead to easy development of a deformity based on her inherited foot type.

I believe, the environment does come into play.  Another example would be a flat flimsy foot.  An individual with this foot type who wears flip flops all the time may develop a much more severe bunion than someone who wears a supportive shoe and insert most of the time.

Just like other medical risks such as heart disease it is likely that most bunions can be prevented with the proper decisions and care.  You should see a podiatrist if there are any concerns you have a bunion or believe you are developing one.

NBA Playoffs: Full of Foot & Ankle Problems

I have admitted before that I am not a huge NBA fan but could not avoid the news recently as several players have made the news with foot and ankle problems.

First off, Tiago Splitter of the Spurs sprained his left ankle earlier this week in game 3 against the Lakers.  Radiographs were reported as negative, but to me that doesn't mean much as a bad ankle sprain can be very painful and needs treated appropriately.

To a Chicago news station this week, Joakim Noah stated that "plantar fasciitis sucks."  This is a very common condition I see, and I am sure many of my patients will relate.  However, with the right treatment we can help most people significantly.

Chicago's first round opponent, the Nets, also apparently has a player suffering from plantar fasciitis as well.  Joe Johnson received a "cortisone injection" for plantar fasciitis earlier this week and Johnson admitted that this was very helpful.  When appropriate I can also give injections as part of my treatment.

As I often say you do not have to be an athlete to suffer from these conditions.  Come see us at Spring Hill Podiatry with any foot or ankle problems.

Exciting Annoucement

I am very excited to announce that effective April 24, 2013 I will be joining a new practice.  I will be the first podiatrist in a multi-specialty practice in Spring Hill, Florida.  I think my 8 years of experience will allow me to incorporate great podiatric care into this new practice.  I am thankful for the opportunity and am thrilled to continue to practice in the State of Florida.  Here is the information on the location with contact information:

ABSOLUTE HEALTHCARE LLC
3378 MARINER BLVD
SPRING HILL, FL 34608
352-678-3033

Kobe Bryant's "Bone Spur"

Thursday night after the Lakers game against the Bucks, the Lakers revealed that Bryant has a "bone spur" in his left foot.  This could mean many things as there are several places that an individual could have a bone spur in the foot.  However, there are really only two places where a bone spur is common.  The most common is at the bottom of the heel bone.  This is also called the "plantar" part of the heel and a band of tissue that attaches there called the plantar fascia can often get inflamed.  Not always, but usually heel spur syndrome and plantar fasciitis are the same thing and treated the same way.

The other common area for spurring is at the back of the heel where the largest tendon, the achilles, attaches.  This can be more difficult to treat and when conservative measures fail surgery to remove the spur and reattach the achilles tendon is often necessary.

It is difficult to say exactly were Bryant's spur is, but Laker fans should hope it is at the bottom of the heel instead of the back.  Either way, however, both conditions can be very painful.  Fortunately, though, both conditions can be treated and in most instances successfully resolved.