Category Archives: Injury Prevention

Don’t Stress the Gate River Run

The excitement of the Gate River Run is building here on the First Coast as the largest 15K race in the US will once again serve as the race where America’s top Olympic athletes will compete for $85,000 in prize money.  Many athletes can experience foot pain when they do not properly train for races or when they compete in too many and the repetitiveness of running causes an “overuse injury”.  The one overuse injury seen in many runners is the stress fracture.

Stress fractures are small, painful cracks in bones that are most commonly caused by forces that are repetitively applied to the bone overtime. It is very common for runners and track and field athletes to have stress fractures because they are running long distances every day and are therefore having these stresses occurring more at the bones in their feet.  Stress fractures are also seen in people who start a new work out program and do too much too quickly.  Another common reason in which stress fractures occur are because of osteoporotic bone, most commonly seen in the elderly and females.  Osteoporosis is a weakening of the bone, therefore making bones more susceptible to breaking.  Osteoporosis can be detected by a simple bone scan that can be done in the office.

At first, stress fractures may not be too bothersome, but they tend to get worse overtime.  Some ways to tell that you have a stress fracture include: increase in pain and swelling with activity, decreased pain and swelling with decreased activity, pain in a specific area, and pain that gets worse overtime.  After having a stress fracture for a long period of time, the pain may be chronic and/or get worse, so it is important to try and detect it early.  Many times the later you catch it the more difficult it is to treat, as well as taking longer to heal.  After a podiatric examination of the foot, the way to confirm that you have a stress fracture is to get an x-ray or MRI.  The mainstay of treatment for stress fractures is by immobilizing the foot, which is most commonly done by having the patient wear a removable CAM boot in which most cases they are still able to walk.

Here at First Coast Foot Clinic we treat stress fractures on a daily basis. Whether you’re a runner, have started a new workout program, or just have foot pain in general, make an appointment today to make sure you do not have a stress fracture.  Remember that they start out minimally painful, or sometimes even without symptoms so it is good to catch it early for the most effective treatment.

Common Exercising Injuries

images[5]It’s a couple weeks into 2013 and many people are still very dedicated to their new year’s resolution of weight loss or a healthier lifestyle.  Some of these new exercisers are filling the gyms or enjoying the jogging paths in their new, hopefully perfectly fitted, athletic shoes, while still others are starting to develop pains and injuries.  There are many common injuries associated with running and new exercise routines, many treatable at home, while others require a visit to your podiatrist.

Many new exercisers start out in a very high intensity routine, almost guaranteeing themselves an injury from overuse.  The constant repetition of contraction and release of muscles that many exercises require can lead to muscle tears or ruptures.  Injuries can occur in all body parts including the knee, shin, ankle, and foot.

Pains that occur in the knee are commonly called runners knee and are caused by the foot rolling inward too much, called excessive pronation.  This can be treated and prevented by custom orthotics which can be prescribed by a podiatrist.  Orthotics can also be an effective treatment for another common injury that presents with a painful ache on the front and medial side of the leg caused by inflamed muscles, called shin splints.

heel pain

The left image shows a foot with a healthy arch: the plantar fascia is relaxed. The right image shows a flattened arch: the plantar fascia is stretched tight with inflammation at it’s heel attachment.

The foot can experience many different injuries from overuse.  A pain in the heel of the foot, called plantar fasciitis, is often caused by stress on the bottom of the foot.  This can be caused by excessive pronation, poor fitting shoes, and overtraining.  Heel pain can also be caused from pain and tightness in the large muscles of the leg from repetitive rising up on the toes that leads to achilles tendon inflammation and pain at the back of the heel.

Another common overtraining injury is a stress fracture.  This happens because of repetitive forces from the ground and body being applied to the bones in the foot.  This temporarily weakens the bone and without proper time to recover, commonly seen with overuse, the bone will eventually fracture. This could stop your activity altogether for 4-8 weeks wiping out the work you’ve done previously.

 Make an appointment with First Coast Foot and Ankle Clinic and let us help keep your new exercise routine going strong, and your feel feeling great.

Retired Jacksonville Jaguar Fred Taylor Inducted into the Pride of the Jaguars

Despite the Jacksonville Jaguars losing to the Cincinnati Bengals at last Sunday’s game there was a silver lining for First Coast fans.  The official NFL referees are back and Fred Taylor was inducted into the Pride of Jaguars during halftime!  But the last thing any football fan, team, or coach needs at this point in the season is their star football players being injured.  Steve Smith, the veteran wide receiver for the Carolina Panthers missed practice earlier in the season due to an infection in his left foot.  Fortunately Smith was able to play in the season opener against the Tampa Bay Buccaneers.

How the foot infection came about still remains a mystery, but there are numerous ways for a foot to become infected, from bacterial to fungal.  Anytime you have an open lesion or a possible opening to the skin such as a blister, or even a bug bite, the wound can become swarmed with bacteria and cause an infection.  Ingrown toenails can also commonly become infected.  Signs of infection include:

  • Redness
  • Swelling
  • Pain
  • Drainage
  • Warmth
  • Foul odor

This is especially important for diabetic patients due to the fact that diabetes is a systemic disease which predisposes these patients to infection.  It is crucial that the diabetic patient perform daily foot checks to make sure that they do not have a new wound.  Something of equal importance is to make sure the web-spaces between the toes is dry, since wet, web-spaces can also be a portal of entry to infection.

At First Coast Foot and Ankle Clinic, we see many diabetic patients for routine foot checks every three months, as well as treat a multitude of painful ingrown toenails that can potentially lead to infection.  Not only do we prevent the infection, but we can also treat it by prescribing antibiotics to rid your body of those pesky bacteria.

If you or someone you know may be suffering from a possible infection request an appointment today to see what Dr. Vimal Reddy can do for you.

Fiasco-Free Flip-Flops!

070 flip flopsThe warm sunshine of summer is near and feet everywhere are happily stepping out into a variety of sandals and flip-flops. However, in Florida these types of footwear are a wardrobe staple year-round. Though they may seem carefree and harmless, the wrong pair of flip-flops can lead to a variety of issues including, but not limited to: blisters, tendinitissprained ankles, ligament injuries, plantar fasciitis, cuts, scrapes, and stubbed toes.

Despite their fun or trendy appearance, flip-flops are typically not healthy for your feet. Generally speaking, most flip-flops should not be worn exclusively throughout the day. Like most things in life, moderation is key!

The following American Podiatric Medical Association (APMA) flip-flop “do’s” and “don’ts” can help keep you from falling victim to flip-flop related foot problems this summer:

  • Do gently bend a flip-flop at the ends, ensuring it bends at the ball of the foot. Flip-flops of any kind should never fold completely in half.
  • Do look for the APMA’s Seal of Acceptance on flip-flops. Many companies, such as FitFlop, Chaco, and Orthaheel, have certain flip-flops or sandals that have been awarded the APMA’s Seal of Acceptance for demonstrating proper support.
  • Don’t re-wear flip-flops year after year. Inspect older pairs for wear. If severe signs of wear are found, discard them.
  • Don’t wear flip-flops if you have diabetes, as the footwear leaves feet susceptible to cuts and scrapes that may lead to serious injury. Instead, opt for lightweight footwear that covers and protects the toes.

If you have questions regarding making healthy shoe decisions, request an appointmentwith the First Coast Foot & Ankle Clinicin Jacksonville today.

Seven Steps to a Better Winter Run

065 Doggy-Winter-RunningSnow may only very rarely be in the weather forecast during winter in Jacksonville FL, but that doesn’t mean it doesn’t get a bit chilly. Runners, who frequently hit the pavement or trails early in the morning, often experience the coldest part of a day. As such, it’s recommended that runners have two different types of training regimes- one for warmer days (thankfully plentiful in Florida!) and one for cooler days to help keep you going.

Whether you’re a casual recreational jogger or a competitive athlete considering participation in the upcoming “26.2 With Donna – National Marathon to Finish Breast Cancer” consider the following for your “winter running regime”:

1.     Not too much:Do not plan to make any increases in mileage or speed during colder weather. Pushing oneself harder in the cold could lead to injury (and a visit to the First Coast Foot and Ankle Clinic!)

2.    Warm up indoors:at least briefly before running and be especially vigilant if conditions are wet or perhaps even icy.

065 cold weather running tips3.    Wear clothing appropriate for running in colder weather: Running shoes in good condition are a must. Try thick, absorbent, dry socks and make sure you have adequate space in your running shoes to accommodate these thicker socks; consider buying a half-size larger running shoe for your winter regime. Also, wear a warm hat. A significant amount of body heat is lost directly from the head, which affects the whole body’s circulation.

4.    Be mindful of the wind-chill factor! Some runners prefer to run into the wind to start off and then return with the wind at their backs. The return run is easier since you have perspired and your body is warmer.

5.    Protect your skin!Use a moisturizer, protective lip balm, and sun block to prevent blister formation and redness in the face area.

6.    Stay Hydrated:Drink PLENTY of water before and after running to ensure your muscles recover after running in cold weather.

7.    Most Importantly:Be safe, stay warm, and HAVE FUN!

Keeping Feet Safe and Warm on Slippery Slopes

062 Cartoon_Skier_320With the Holiday Season officially under way, ski trips are a great way to make the most of your time off during the wintery weather. While a snowy mountain may not be the first thing that comes to mind when you think of Jacksonville, FL, getting away from the grey skies and misty rain to pristine white ski slopes can be a pleasant change of pace. For those of you who make regular trips, or if you just want to try skiing, Dr. Vimal Reddy offers these tips to make the most of your ski vacation.

1.     Keep your feet warm: Being out with ice cold feet can ruin your day. Make sure not to store boots outdoors overnight, making them frigid the next day.  Also, Invest in thermal socks they are worth the expense. By keeping your feet warm, not only will it be more comfortable, you lessen your risk for cold injuries such as chilblains or  frostbite.

2.     Wear properly fitting boots: Dr. Reddy recommends this for running shoes as well, but it is twice as important in skiing.  Due to the trauma that affects your feet on the bottoms, sides, tips of the toes and ankles, boots should be tight enough to cushion your feet, but not too tight as to bruise your toes or cut off circulation.

3.     Stretch out…Just like any other sport: If you limber up before skiing, you can improve your performance and lessen the chances of developing cramps. This article features some easy stretches to do before hitting the slopes.

4.     Know your skills and know your limits: While a ski vacation is enjoyable and unforgettable, don’t attempt a run that is beyond your level. An inexperienced skier might not be able to react to the twisting forces of the ground against the skis.  This could potentially lead to severe ankle sprains or worse. Enjoy the beauty of a crisp winter day while you relax on a run you can manage… don’t try and overdo it.

If you or anyone you know has more questions about winter and their feet, please contact the First Coast Foot and Ankle Clinic to make an appointment

Reebok Accused of False Advertisement

057 reebok-easytoneBad news for those strutting their stuff around Jacksonville, FL in Reebok EasyTone shoes: Reebok recently agreed to settle a $25 million lawsuit filed by the FTC. The international shoe company claimed their EasyTone shoes strengthen:

  • Buttock muscles (gluteals) by 28 percent
  • Calves and hamstrings by 11 percent.

Although these are very powerful muscles (the gluteals lift the body up stairs and calves propel the body forward) the FTC alleges this to be false advertisement. For a shoe to boast these kinds of strength gains is amazing—and hard to believe.

Supposedly the shoe works because the unstable sole forces the individual to use other muscles in the lower leg to stabilize the body. At best, Dr. Reddy believes the unstable shoe could help to improve balance and strengthen some of the stabilizing muscles of the lower leg—possibly leading to improvement in athletic performance. On the flip side, feet like a flat surface and will bend side to side until they are leveled out. These unstable soles may actually force the foot into bending in ways that are harmful to the wearer. It may even damage the very muscles you are trying to strengthen!

Despite advanced technology and flashy marketing, it’s still best to wear stable and sturdy walking shoes. If you want to tone your calves and glutes you’ll get better results the old fashioned way—diet and exercise… Sorry.

Basketball and Stress Fractures

052 Yao MingAfter nine years with the Houston Rockets Yao Ming announced his retirement. Affecting his decision to retire was a stress fracture in his left foot. While it is not stated which bone he fractured, it is probably his heel bone (calcaneus), or his second metatarsal—one of the bones of the front of the foot where the toes attach.

Stress fractures are a consequence of repeated weight on a bone without enough periods of rest. It is especially common in sports such as basketball, tennis, dance, and gymnastics, because an athlete will need to literally stay on their toes during play and training.

Whether you are the star center of the Houston Rockets, or a weekend warrior in a local league around Jacksonville, FL The First Coast Foot and Ankle Clinic has these recommendations to help prevent stress fractures:

  • Avoid doing too much too soon: Instead, build your way up, setting incremental goals, so your body can become accustomed to your level of activity.
  • Diet: include foods rich in calcium and vitamin D to strengthen your bones.
  • Rest your feet! This will give your bones a chance to recover from the stress you put them through.
  • If it hurts, stop! Stress fractures are tiny, but painful. In fact, they are often not detectable on X-ray. The good news is that fractures are small enough to recover quickly, and, with adequate preventative measures, you’ll be back in the game!

Putting your Achilles in Jeopardy

“Jeopardy” host Ale051 Alek Trebekx Trebek recently made headlines after injuring his Achilles tendon.  When his hotel room was broken into, Trebek chased the burglar down his hallway until he heard a loud pop from his heel.  This is the attachment point for the Achilles tendon, a thick, rope-like structure that connects the powerful calf muscles to the heal bone. A ruptured Achilles tendon is one of the most severe injuries that can occur in the leg, and it must be repaired surgically. Fortunately for the game show host, it looks like he will have a speedy recovery.

While this took place on the West Coast, Dr. Vimal Reddy has some lessons for us here in Jacksonville, FL about what we can do to prevent this devastating injury from happening.

  • Stay in shape. At age 72, Mr. Trebek probably leads a less active lifestyle.  For those of us who are able however, staying in reasonably good shape is the best way to prevent injuries in general.
  • Warm up before exercising.  Of course, if you need to chase a burglar down a hallway, you may not have a chance to warm up. However, if you do some brisk walking to get your calf muscles warmed up, you lessen the chance of injuring your Achilles.
  • Strengthen your calf muscles. A good way to do this is to stand up on your toes and then slowly lower yourself down. Lowering oneself down in a slow, controlled manner will really build up strength.
  • Wear the proper shoe gear. Dr. Reddy may sound like a broken record saying this, but wearing the right shoes goes a long way to preventing injury!

051 Ruptured-Achilles-TendonAs a podiatric surgeon and sports medicine specialist at the First Coast Foot & Ankle Clinic, Dr. Reddy is qualified to perform Achilles tendon repair surgery. Consult with Dr. Reddy for a detailed assessment of your foot structure and recommendations for exercising your legs to prevent such injuries.

Keep the Blood Flowing!

050 val5When is the last time you showed off or took a good look at your legs?  Celebrities like Heidi Klum have made a career out of showing off her legs.  Even going as far as having them insured!

One of the body’s amazing adaptations is the network of vessels carrying blood from the heart to the feet and back again. Arteries transport blood away from the heart to the feet, and our veins are equipped with valves and muscular pumps to move the blood against gravity back to the heart.

As we age some will find that the veins of the lower leg have a harder time carrying the blood back up, causing blood can to pool in the lower leg. This will result in swelling (edema)and veins that pop out—varicosities.  Unfortunately, there is not much we can do to prevent varicose veins. The most important factor is genetics, so look to your parents to see what may be in store for your legs. Also, women are particularly at risk.

If you have swollen legs, ankles and varicose veins, Dr. Vimal Reddy recommends:

  •  Elevating your legs above the level of your chest: This way, your veins can work with gravity instead of against it! So sit back, kick your feet and chill.
  • Compression stockings: available at the First Coast Foot & Ankle Clinic, over the counter or as a prescription. These will compress the feet and legs, preventing blood from pooling in them. To get the most out of your compression stockings, make sure you put them on the moment you get out of bed in the morning and wear them all day.  This may mean you will need to start showering at night.
  • In severe cases, more advanced treatment may be necessary. Consult with Dr. Reddy to determine the best strategy for dealing with your varicose veins.