Buried Alive and STILL on his Feet!

Five hours, 40 minutes, and 51 seconds is how long it takes to run a marathon after training underground. Edison Pena was one of the 33 men who survived trapped underground in a mine for 69 days. He was known as “the runner,” because he filled the days underground by running through the mine tunnels and signing Elvis. Not even a dark hole of abyss stopped him from keeping his running spirit. What have you done lately?

It is all too easy to start making excuses to not hit the pavement, go to the gym, or attend your weekly yoga class. Are any of our excuses any good? The Chilean miner had only work boots, mining clothes, a bummed knee and dark tunnels and he found a way. What’s the secret to keeping up with the running spirit?
2 hours, 8 minutes and 14 seconds is how long it takes to win the New York Marathon. Gebre Gebremariam won the marathon while a former marathon champion Haile Gebrselassie announced retirement leaving the race after only 16 miles with an injury. Running professionals, these men make a living by concurring world records and finishing in times unfathomable by the hobby runner. Does it have to be your source of income to stay dedicated?

The first couple weeks of training are strenuous, mortifying, painful and agonizing, yet so many make it through with one goal in mind: finishing the 26 mile, 385 yard race. Nearly 45,000 runners had that common goal in New York City this year. Whether your goal is a marathon or a mile on the treadmill, it takes self motivation and determination to get to the end of your race. No one will do it for you and only you can get yourself there.

The Chilean miner stated he did this to motivate others. Hopefully he motivated you. The only way we can keep ourselves healthy and decrease the growing rates of obesity and diabetes is to become more heath conscious and active. There is a solid link between obesity and diabetes, heart disease and a number of other illnesses. Going to the gym or hitting the pavement is more than a hobby, it is a life saving activity. Every day I see patients who let go of their running hobbies because they got too busy. Not only did they lose an enjoyable hobby, but they also lost their health and are now trying 10 times harder to reverse the consequences of an inactive lifestyle. Let Pena, Gebremariam and Gebrselassie’s running accomplishments be your motivation to get up, get out, and run!

Common Running Pains & Injuries

Aches and Pains of Running

Even with the best preparation, aches and pains are an inevitable result of a new jogging regimen. If the pain subsides with slow easy exercise, you may continue, but if it gets worse, stop the activity and rest. If it persists, see your podiatrist.

The most common pain associated with jogging is known as runner’s knee, a catch-all for jogging-related knee pain. One of the most common causes of runner’s knee is excessive pronation, or rolling in and down, of the foot. This syndrome is now often called the patello-femoral pain syndrome.

Orthoses (arch supports — shoe inserts) prescribed by your podiatrist are the best way to alleviate the problem. Occasionally, rubber pads in the arch of the shoe will help.

Shin splints, which painfully appear at the front and inside of the leg, are caused by running on hard surfaces, overstriding, muscle imbalance, or overuse. Treatment includes changing running technique or insertion of an orthotic device in the shoe.

Common Running Injuries

Plantar fasciitis (arch pain) — Arch pain is often caused by frequent stress on the plantar aspect, or bottom of the foot. When the plantar fascia, a supportive, fibrous band of tissue running from the heel to the ball of the foot, becomes injured, pain on the bottom of the foot results. Forefoot and rearfoot instability, with excessive pronation, may result in plantar fasciitis. Overtraining may contribute. Shoes with good midfoot stability may help prevent plantar fasciitis. If pain persists visit your sports podiatrist.

Heel spurs — Heel spur syndrome, related to plantar fasciitis, occurs after calcium deposits build up on the underside of the heel bone. Heel spurs form gradually over many months. Both plantar fasciitis and heel spurs can be avoided by a proper warm-up that includes stretching the band of tissue on the bottom of the foot. The soft tissue injury is usually the cause of the pain and not the spur itself.

Sesamoiditis — Sometimes referred to as the ball bearings of the foot, the sesamoids are a set of accessory bones found beneath the large first metatarsal bone. Incredible forces are exerted on the sesamoid bones during aerobics, and inflammation and fractures can occur. Proper shoe selection and custom orthotic devices can be useful in treating sesamoiditis.

Shin splints — Aside from ankle sprains, shin splints are perhaps the most common injury to the lower body, as the muscles attached to the shin bone bring the foot up and down. The pain is usually an inflammation of the shin muscle and tendon due to stress factors. Treat shin pain with cold compresses immediately after the workout to reduce inflammation. Proper stretching before the workout should prevent the onset of shin splints. Strengthening of muscles also helps reduce shin splints.

Achilles tendon and calf pain — The frequent rising on the toes of an aerobics routine often creates pain and tightness in the large muscles in the back of the legs, which can create pain and tightness in the calf and inflammation of the achilles tendon. Again, stretching the calf muscles gently and gradually before and after the workout will ordinarily help alleviate the pain and stiffness.

Stress fractures — Stress fractures often occur from overtraining. Make sure you gradually increase your running distance and intensity and have an adequate dietary intake of calcium.

Before beginning an exercise regimen, proper stretching is essential. If muscles are properly warmed up, the strain on muscles, tendons, and joints is reduced.

The foot is an engineering marvel consisting of 26 bones, 33 joints, 112 ligaments, and a network of tendons, nerves, and blood vessels all working together to establish the graceful synergy involved in running. Running requires balance, support and propulsion which all depend on the foot. Therefore, it is important to make sure your feet and shoes are in good working order before undertaking a serious running regimen.

A good start for someone just starting a training regimen is to examine your feet for anything that may seem irregular to you, such as lumps and bumps, skin irritations or discoloration. A podiatrist can perform a thorough evaluation and recommend any treatment if necessary along with shoe buying recommendations. Of course if you have any underlying medical conditions or have not been seen by a doctor in less than a year, a thorough check up is recommended before starting any training program.

TightRope Procedure

Stop bunion pain today! New advancements in bunion surgery...
Dr. Vargas Performs New Tightrope Procedure for Bunions!!
Revolutionary procedure for bunions using a device called a tightrope. There is no doubt that this procedure represents a huge advancement in bunion surgery.

Traditionally, the bunion procedures I perform involve a bone cut to reposition the bone which is held together with a pin or a screw. Following the surgery, patients walk around in a cast boot for 4-6 weeks to allow for bone healing. With the new tightrope procedure patients experience a faster recovery, less pain and fewer complications. Patients are out of the cast boot and into regular shoes as soon as 3 weeks postoperatively.

While the tightrope procedure is not indicated in every type of bunion deformity, it can be performed in the vast majority. It represents a revolutionary change in bunion surgery and will allow more people to undergo bunion correction due to a faster recovery, less pain and fewer complications. This means fewer days missed at work or less down time with the kids – 2 of the main reasons many people avoid bunion correction.

Nail Fungus 101

Nail Fungus 101:

How to Successfully Treat Onychomycosis

If you have ugly, thick, yellow, brittle nails, chances are you have nail fungus or Onychomycosis. You have probably tried several different products both medical and home made to get rid of this problem with little or no success. If so, you are not alone. Approximately 35 million Americans suffer from nail fungus, or Onychomycosis, and there are almost as many remedies to cure it. The problem is, there are only a handful of treatment options that have been proven successful in the treatment of this stubborn condition.

First, a little background on nail fungus or Onychomycosis. It is caused by fungal organisms that occur naturally in the environment much like the bacteria that cause colds. When it enters the body, it circulates in the blood and infects the nail matrix, which is where the nail originates. It then settles on the nail bed where it thrives and makes it way up into the nail causing the unsightly appearance that everyone associates with nail fungus. It grows mainly on the nails of the feet since it thrives in dark, damp, warm environments like the one found inside of shoes. Nail fungus can appear as a white, flaky plaque on the surface of the nail or it can make the nail thick, brittle and yellow. Occasionally the deformation of the nail can cause infection and pain, making nail fungus a serious medical condition, not just cosmetic. There are only 3 treatments that are used by podiatrists regularly that have been proven reasonably effective: topical and oral medications and laser treatment.

Topical medications, usually recommended for mild to moderate cases, come in the form of creams or polishes. They usually combine a traditional anti fungal with some type of nail softener to allow for penetration of the nail down to the nail bed, which is where the fungus lives. In addition, some products combine this with proven “natural” ingredients, such as tea tree oil and grape seed extract among others.

Oral antifungals are also used but are somewhat controversial because of the misconception that they cause liver damage. While rare, there have been instances where liver enzymes have become elevated in patients taking oral antifungals. However, this condition is easily reversed by stopping the medication. Therefore, it is necessary to do blood work before, during and after treatment to make sure liver function is not adversely affected and that it is prescribed to patients with normal liver function. Usual treatment course is one pill daily for 12 weeks and it is indicated in moderate to severe cases.

Finally, laser treatment is relatively new, and in my opinion, the best way to go. One 30 minute treatment is usually enough to kill the fungus no matter the degree of infection. Treatments are done in the office without anesthesia and rarely need to be repeated. For good measure, I also recommend applying a good topical antifungal polish 3-4 times per week as added insurance and to prevent recurrence.

As with any medical condition, if you suspect you have nail fungus, it is best to treat it as early as possible to have the best chance for a complete cure.

New Tightrope Procedure for Bunions

Dr. Vargas Performs New Tightrope Procedure for Bunions!!

This past week I, Dr. Marco A Vargas of Foot & Ankle Associates, performed a revolutionary procedure for bunions using a device called a tightrope. While the procedure has been around for several months now, I felt that there were enough positive outcomes reported in the podiatry literature to feel comfortable enough to perform the procedure on my own patients. What makes the procedure revolutionary is that patients’ recovery time is half of what it is with traditional bunion surgery and there is significantly less postoperative pain due to no bone cut and less swelling. There is also a significantly reduced risk of postoperative complications due to the fact that there is no bone cut. There is no doubt that this procedure represents a huge advancement in bunion surgery.

Traditionally, the bunion procedures I perform involve a bone cut to reposition the bone which is held together with a pin or a screw. Following the surgery, patients walk around in a cast boot for 4-6 weeks to allow for bone healing. At this time they are able to return to regular shoes; however, postoperative swelling due to the bone cut, fixation and immobilization may limit their shoe gear choices for several weeks more. Although pain is mild to moderate for the first few days, it is usually well controlled with pain medication and physical therapy.
With the new tightrope procedure patients experience a faster recovery, less pain and fewer complications. Patients are out of the cast boot and into regular shoes as soon as 3 weeks postoperative. Because there is no bone cut made to reposition the bone, there is less swelling which means less pain and more choices of shoe gear sooner. Finally, should there be any complications due to the tightrope procedure, it is easy to remove making the procedure completely reversible so that there is no permanent alteration or deformity of the foot structure.
While the tightrope procedure is not indicated in every type of bunion deformity, it can be performed in the vast majority. It represents a revolutionary change in bunion surgery and will allow more people to undergo bunion correction due to a faster recovery, less pain and fewer complications. This means fewer days missed at work or less down time with the kids – 2 of the main reasons many people avoid bunion correction.

Forget The Pain, Running Injuries Can Be Depressing!!

Earlier this year I treated a patient who ran the Houston Marathon and jumped right into training for the upcoming triathlon season the following week, against my advice, while nursing a painful case of posterior tibial tendon tendonitits. Unfortunately this approach eventually sidelined him and forced him to scrap the entire triathlon season in order to undergo surgery and recover from his injury. This eventually led to a major case of depression which far outlasted his recovery from injury and almost kept him out indefinitely.

By nature, athletes have an extremely high tolerance for pain and at times tend to view their injuries as a normal part of their training regimen often to the point of ignoring serious symptoms. Posterior tibial tendonitis is a common injury in runners usually resulting from chronic overpronation and overuse caused by the repetitive force and trauma asociated with overtraining. Symptoms usually begin as soreness along the inside of the ankle and/or arch when pushing off and can eventually lead to weakness and severe pain. Left untreated, it can progress to a tear which usually requires lengthy immobilization or surgical intervention causing a major delay in any training regimen. However, if the injury is caught early and treated aggressively, it can be done without any interruption or possibly a slight, brief alteration in the training schedule while avoiding a lengthy delay which can spoil any runner's plans.

In this particular case, my patient underwent approximately 8 weeks of physical therapy, anti inflammatories and forced rest. During this time he became discouraged, angry and unmotivated, even though I recommended cross training to maintain at least some level of fitness so that his return to running would not be so traumatic. He resisted the entire time and even admitted to feeling "worthless" at one point. Once he was pain free, he was still afraid to resume running for fear he would reinjure his foot and it would sideine him again.

About 3 months after stopping running completely to rehabilitate from his injury, he began cycling, swimming and using the elliptical machine gradually. More recently, he resumed running starting at a much reduced distance than where he left off, and he is starting to regain confidence and a sense of self worth.

He now realizes what caused his depression and I have no doubt that he will return stronger than ever. More importantly, I think the lesson he learned and one that all athletes should learn, particularly runners, is not to ignore any injury. No matter how small or insignificant you may think the injury is, it can become significant if it is not addressed early and aggressively. The resulting depression from the mental trauma of having something so meaningful and enjoyable taken away can lead to an even more prolonged layoff from which you may never fully recover, long after the injury has healed.

Running is my Prozac!

I read a quote today that really outlines how I feel about running's goal in my life so I figured I would share:

"The secret shared by women runners: running is not just physical exercise but a spiritual, mental, and emotional journey. " Taken from Runner's Gazette

Running has always been my stress relief, my Prozac, and my outlet. A time that is all mine with an audience of God and nature.....and a few peeps from time to time. I hate the treadmill because I don't get my daily dose of nature, critters, and fresh air. Thank God it's spring!

Run Happy!