Tuesday, June 29, 2010

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.

Thursday, June 17, 2010

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.

Wednesday, June 9, 2010

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.