April Articles 2013

PRP Injections In Your Feet
Platelet rich plasma, or PRP, is blood taken from a patient and spun in a centrifuge, concentrating the amount of platelets and growth factors. This plasma, containing a very high concentration of platelets, is re-injected into the site of injury or damage, inducing the body to repair damage to muscle, tendons, ligaments, and soft tissue. Although the body does this naturally when an injury occurs, the PRP helps speed the healing process.

Many injuries to the foot, especially those affecting tendons, do not heal well because poor blood supply to the area prevents healing platelets and growth factors carried by the blood from getting to the injury site. PRP injections can help fix this problem and speed recovery.

This is the first regenerative treatment ever for damaged muscles, tendons, and ligaments. It avoids the need for surgery, and as it requires only the insertion of a needle, is minimally invasive. The injection of PRP is done with the use of ultrasound to ensure the proper placement of the platelets.

Once the first injection is received, the patient will return to the doctor's approximately 2 to 3 weeks later to be checked on how well the treatment is moving along. As with most treatments, each patient's response is different. Based on a patient's condition, the doctor will make the decision about how many more injections will be needed. Acute and chronic injuries will require more injections than mild ones.

Common injuries of the feet such as ankle sprains, Achilles tendonitis, and plantar fasciitis, as well as acute and chronic tendon and joint diseases such as arthritis, can all be treated with PRP injections. For many, this therapy has lead to greatly reduced pain and increased function of the foot. Combining exercise or physical therapy with the PRP injections will help increase the success of the treatment.

This treatment, being minimally invasive, means that surgery can be avoided, in many cases, and recovery time cut down. Other benefits of PRP injections are a decrease in scar tissue and fibrosis to the damaged area, as well as increased range of motion, flexibility, and strength. The risks from using PRP injections as a treatment is very low as the patient is injected with his own blood, so that there is no risk of rejection or of getting a disease from using another person's blood. As with any injection into the body, there is a risk of infection, but this is very rare. Research is showing that PRP may have an anti-bacterial property that would further decrease the risk of infection.


Dealing with Stress Fractures of the Foot and Ankle
Stress fractures in the foot and ankle happen when muscles become weak due to too much or too little use. Stress fractures cause the muscles to stop cushioning the foot and ankles from the impact of hitting the ground. Since there is nothing to protect the bones of the foot, they absorb the full impact of each step you take. This additional stress causes little cracks, or stress fractures, to form in the bones that are being pressured.

Stress fractures are common in highly active people, especially athletes. Basketball, tennis or and gymnastics are activities where stress fractures occur more frequently. However, anyone can receive a stress fracture. Normally sedentary individuals who suddenly begin an intensive high impact work out may incur a stress fracture. This is because their muscles are not resistant enough to handle and cushion the intensity of the activity. Osteoporosis patients may also suffer stress fractures because the disease weakens the victim’s bones, making it easier for them to wear and tear.

Pain from stress fractures occurs in the site area of the fracture. It may be either constant or intermittent, causing sharp or dull pain accompanied by swelling and/or tenderness. Engagement in any kind of high impact activity will only exacerbate the pain. In fact, it can even cause a full fracture, especially when the area is not fully healed. Full fractures are much more serious, and can prevent you from using your foot at all.

Treatment varies depending on the patient and the degree of his or her injury. The most important treatment is to rest the injured foot. Some fractures may heal quicker with brief rest, while others need a longer rest period and utilizing crutches. In some cases surgery is required to install support pins around the fracture to aid healing.

To prevent stress fractures, be sure to get plenty of Calcium and Vitamin-D in your diet. This helps keep your bones strong and fortifies their resistance. If you begin a new regimen that involves high impact activity, set incremental goals on a weekly basis so you can build up the proper muscular strength. For example, if you wish to walk every day, you could ride a bike on some of those days to take stress off your feet. Also, make sure to wear supportive shoes that provide adequate protection.

If you experience any symptoms of stress fractures, you should stop exercising and rest. If these symptoms do not go relieve themselves, consult with an orthopedic specialist. Taking these measures can help prevent stress fractures to your foot and ankle, and allow you to continue the activities  you enjoy.


Biomechanics in Podiatry
Podiatric biomechanics is a particular sector of specialty podiatry with licensed practitioners who are trained to diagnose and treat conditions affecting the foot, ankle and lower leg. Biomechanics deals with the forces that act against the body causing an interference with the biological structure and focuses on the movement of the ankle, the foot and the forces that interact with them.

At some time in our lives we will all experience foot problems, regardless of our lifestyle or age, and we all take our mobility for granted until we are in pain. Twists or turns can cause problems and apply stress to the feet, and that pain will spread from the foot structure to the surrounding tissues. The pain will concentrate in the foot and ankle, but may eventually spread up into the knees, hips and back.

The history of biomechanics dates back to the BC era in Egypt where evidence of professional foot care has been recorded. Afterwards, during the first century AD, corns on feet were recorded as specifically growing on feet and toes. In 1974 biomechanics gained a higher profile from the studies of Merton Root, who claimed that by changing or controlling the forces between the ankle and the foot, corrections of conditions could be implemented to gain strength and coordination to the area. His basic principles of thermoplastic foot orthotics are still in use throughout the industry today.

Modern technology improvements are based on past theories and therapeutic processes providing a better understanding of podiatry concepts for biomechanics. Computers provide accurate determinations about the forces, movements and patterns of the foot and lower legs with the most important information captured. Today’s knowledge of detailed measurement of external and internal forces in the foot is critical to the individual’s treatment. Like most health industries, precise determinations assist the practitioner in diagnosing and prescribing the best treatment for health improving results.

Advances in materials and more awareness of biomechanics have developed enhanced corrective methods, offering further options for foot-related injuries. Shoe orthotics options have expanded to treat walking inability, helping to realign the posture deviations caused by hip or back health occurrences. Attention to posture and foot mechanics uses individual insoles to position the foot, aligning the ankle and leg. The corrected positioning comforts the pressure and helps to ease the pain. Understanding foot biomechanics can help improve and eliminate pain, stopping further stress to the foot. However, these results can only happen if one seeks a podiatrist who specializes in biomechanics.


Ankle Sprains
Ankle sprains, while not as severe as a broken ankle, are still a serious injury that needs immediate attention. They can lead to limited mobility and a significant amount of pain, and are often characterized by swelling and sometimes discoloration of the skin. An ankle sprain occurs when the ligaments are stretched beyond their limits, and even though this can happen in other places, such as the wrist, the ankles are the most common place for a sprain.

Ankle sprains can occur in many different ways, even just by simply walking. They happen when the ankle rolls over itself or twists under the foot, causing the ankle and tendon to snap or pop. Athletes who continually push their bodies to the limits are often at risk, as are people who have previously suffered accidents involving the lower extremities.

In most cases, ankle sprains are not severe enough to warrant medical help, such as going to a hospital. There are many self-care remedies you can use to treat your ankle, including applying ice packs to reduce swelling, remaining off your feet to reduce pressure, and elevating your feet above your head to reduce blood flow and inflammation. Often times an ACE bandage and over the counter pain relievers are enough, but it is still important to remember to stay off the ankle for some time to avoid re-aggravating it.

Even though most of these cases are mild, a severe ankle sprain can occur which will require professional, medical care. A sprain that causes a tear in the ligament or damage to the muscles is severe enough to warrant surgery and keep you off your feet for a prolonged period of time. Post-surgery physical therapy is often required in order to completely rehab the ankle back to health, and this will be administered and monitored by your podiatrist.

Even though ankle sprains may seem harmless and only mildly painful, if you are experiencing non-stop pain over a long period of time, if walking is becoming too painful for you, if the swelling is much more severe than initially anticipated, or if numbness and tingling is present, this may be signs that your sprain is a much more severe broken ankle. It is highly recommended to seek treatment right away for these symptoms.

Often times, preventative care is one of the best ways to avoid ankle sprains. Wearing appropriate fitting shoes that provide both ankle and arch support will help, as well as stretching before any kind of physical activity, including sports, weight training, or even simply jogging.


Arthritic Foot Care
The average person walks about 75,000 miles during their lifetime, which puts a lot of pressure and stress on your feet. As you age, you lose flexibility and elasticity in the 26 bones and 30 different joints located in your feet, as well as weakening your shock absorbers. Adding arthritis to this mix makes things worse, with inflammation and distorted joints, which is why arthritic foot care is a crucial part of your daily routine at this stage of your life.

The last thing you need if you suffer from arthritis in your feet is for additional, painful conditions to arise, such as bunions, neuroma, or hammertoe. Buying well-fitting shoes, shoes with a lower heel and more room, and shoes that have better arch support are good places to start. Because arthritis will cause you to lose the arch in your foot, it is highly recommended to buy shoes that can support your arch.

On top of getting enough arch support, you need to have a comfortable fit as well. Leaving a finger width between the back of the shoe and your foot is an easy way to measure and gauge the proper size, and having a square or rounded toe box in the front will help even more. It is also recommended to use shoes that have a rubber sole, as this provides a cushion and acts as a shock absorber. It also provides flexibility for the ball of your foot when you push off your heel to walk.

Shoes are not the only way to get proper arthritic foot care though. Exercise helps a lot and will not only strengthen your muscles and joints, but help prevent further injury and pain. For example, stretching the Achilles tendon in the back of your heel will give your foot added mobility, reducing pain because a lack of mobility causes stress in this area. Another good example is massaging the ball of your foot and your toes from top to bottom.

As previously mentioned, one of the best exercises to do is stretching your Achilles tendon. To do this, simply lean against a wall with your palms flat, place one foot forward and one foot back, making sure both feet are flat on the floor, then lean forward, bending your forward knee towards the wall but keeping your back knee straight and unbent. You will feel your Achilles tendon and calf muscles stretch. Another great exercise is the big toe stretch that alleviates stiffness. Place a rubber band around your big toes, keep your feet together, and pull your toes away from each other. You can also place a rubber band around all the toes of one foot and then try to separate them, stretching them out.

Aside from stretching and exercise, pain can be alleviated with non-steroid, anti-inflammatory drugs, heat, and ultrasounds. Topical medicines with capsaicin can also help. So far, there is no completely pain free remedy for arthritic feet, but following some of this advice can go a long way in helping you stay as pain free as possible.


2013
March - April