Does Your Calf Hurt When You Walk Or Run?

Do you have an unusual amount of pain or discomfort in your calf or heel with any type of movement? Are you a runner or did you just start a new activity or job requiring a lot of time on your feet? If so, you may complain of a pulling pain when you walk or run and even while going UP stairs or a steep incline. The pain may also radiate up towards your knee and thighs. Some people may experience leg cramps with daily activities but also in the middle of the night.

These are the symptoms and activities consistent of someone who has a condition fcalled Achilles tendonitis. The “itis” means inflammation. So this in an inflammation of the Achilles tendon, which is the strongest tendon in your body. A tendon is a strong substance of fibers connecting your muscles to the bone and crosses a joint to allow for range of motion. Those with flatfeet develop a condition called equinus or an inability to fully flex your toes towards your nose. This equinus in flatfeet is due to the malalignment of the foot and the Achilles compensates for this by contracting or tightening up.

There are two main types of Achilles tendonitis – insertional and non-insertional. The Achilles tendon connects the two calf muscles (Gastrocnemius and Soleus muscles) to the heel bone (calcaneus). You have insertional tendonitis if the pain is directly on the bone in the back of the heel but if the area of non-insertional Achilles tendonitis.

This can also be associated with “heel spurs”. The body responds to the pulling of the tendon on the bone by creating new bone called a spur in the back of the heel. You may develop a bump in the back of your heel and shoes rubbing against it may aggravate this condition. This is why a lot of people with insertional Achilles tendonitis wear open-backed shoes or clogs so it doesn’t rub the bump. Podiatrists call the bump a “pump bump” or Haglund’s deformity. Those with non-insertional Achilles tendonitis may have a painful lump or large swollen mass in the tendon itself not involving the bone.

If left untreated, those with Achilles tendonitis can develop scarring, thickening and degeneration of the tendon called “tendonosis.” This is the chronic condition of tendonitis. This leaves one suffering from tendonosis prone to partial tears of the tendon and even acute ruptures of the tendon both requiring surgical repair for optimal treatment success.

So, if you have any of these symptoms do not treat it yourself. Simple stretching exercises will not alleviate your condition. In order to alleviate your condition, see your local foot and ankle specialist, whom is also a podiatric surgeon, to prevent this tendonitis from becoming a bigger problem requiring invasive treatment and months of recovery from the surgery. In addition to rest, ice, elevation, and compression, your doctor may prescribe an anti-inflammatory medication. Temporary heel lifts are also usually prescribed to offload the tendon to avoid the pull of the Achilles. Physical therapy is another treatment that is a necessity as it provides a formal program of rehabilitation and soft tissue mobilization. Once out of the heel lifts, custom orthotics are needed to maintain the new, lengthened, stretched out position of the tendon. Custom orthotics, not the over-the-counter kind, are a pair of devices always for both feet that you put in your shoes for functional restoration of normal foot and ankle mechanics and to stop excessive motion in your foot mostly from pronation or supination for those with high arches. The orthotics will correct the underlying cause of the tendon tightness. This can also help alleviate pain in other joints such as the knees, hips and even the back.

If you are feeling better but you still have persistent pain with all of the above conservative treatments, your doctor may order an MRI to further evaluate the integrity of the tendon to make sure there are no tears of the tendon. If your pain persists and no tear or rupture is present, then there are other non-invasive and minimally invasive procedures that can be done such as extra-corporeal shock wave therapy, laser treatment, radiofrequency ablation and cryotherapy.

So there are plenty of options available for pain-relief. They KEY is to catch this early and seek professional treatment as the longer you wait and the more active you are despite your pain, the more treatment it will take to get you better.

Top 5 Running Injuries

Dr. Peter Wishnie of Family Foot & Ankle Specialists in Piscataway and Hillsborough, NJ discusses the top 5 running injuries amongst runners at the annual Hillsborough Hop 5K. Unfortunately, plantar fasciitis (heel pain) made the list.

National Running Day

Today, June 1st, is National Running Day. Here in New Jersey, it is a beautiful day to run. I ran my six miles. Why do I run? I run for me. Running clears my head and makes me feel good. After a good run I am more motivated and creative and definitely in a better mood.

Besides the mental benefits, running keeps my heart strong, gets rid of excess fat and can make you a lean, mean, fighting machine. Today is a wonderful day to get a group of people together to run. Running with others will make the run easier and is also an excellent way to increase the bond of friendship with the people you like.

If you are not a runner and would like to start, remember to go slow initially. Maybe start with a fast pace walk and then run a little. Always warm up your muscles and stretch and make sure you stretch afterward your run. There are excellent books on running. I recommend a book titled, “If Your Running Feet Could Talk,” by Dr. Marybeth Crane. Go to: http://www.faant.com/reports/.cfm and get a copy.
Now, how about you? Why do you run? Let me know. Happy running.

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.