Dr. Berg's Foot Facts

Posts for category: sports injuries

athlete with ankle injuryPresident Elect Biden needs to be more careful. Over the Thanksgiving holiday he slipped and twisted his ankle while playing with Major, one of his German shepherds. Initially he thought the injury was just a sprain since an X-ray didn’t reveal a break.  However, a follow-up CT scan found hairline fractures in the lateral and intermediate cuneiform bones in his midfoot. Fortunately, Biden won’t need crutches, but he will need to wear a walking boot for several weeks to ensure his foot heals properly.

What can this incident tell us?

So many of us sprain our ankles and don’t think much of it. We put some ice on it or take a few ibuprofen and hope for the best. This is particularly true of my male patients. For many of them, running to the doctor at the first sign of an injury or symptom seems unmanly. Or they just assume their injury will heal on its own.

While this may be true some of the time, often this type of thinking is a mistake. Not treating a injury can lead to foot and ankle problems down the road that may only be resolved with surgery.

Here are some common foot and ankle injuries that will likely get worse if you don’t treat them in their early stages.

Stress Fractures

Hairline fractures or stress fractures like the type Joe Biden experienced can turn into much larger breaks if not adequately treated. Runners, underweight women, people with osteoporosis, and people with flat feet are all at risk for developing this condition. While this condition is easily treated in the early stages, if it progresses to a break, surgery may be needed to repair it.

Plantar Fasciitis

Plantar fasciitis is not typically caused by an acute injury but develops overtime. Runners and other athletes often develop this condition through overuse and ramping up their training too quickly. Waiting to treat this condition or continuing to engage in sports activities will prolong the recover from this painful condition. If you do develop sudden onset of heel pain during exercise and there are signs of bruising, this indicates a tear has occurred. You should seek immediate attention from a podiatrist. 

Achilles tendonitis

Like plantar fasciitis, Achilles tendonitis also develops overtime. When this condition is inadequately treated it can lead to Achilles tendonosis, a progressive and degenerative condition. The tendon becomes weaker and prone to re-injury and rupture. Treatment will require immobilization of the foot and ankle and treatment with regenerative medicine.

Ankle sprains

Ankle sprains that go untreated or do not adequately heal can turn into a condition called Chronic Ankle Instability. While the first line of treatment is physical therapy, if the instability is not resolved, newer advances in surgery now require much less recovery time.

Preventing Foot and Ankle Injuries

The best thing to do is to prevent foot and ankle injuries from occurring in the first place. Because so many of the conditions described above are more prevalent in athletes, the recommendations I’m giving will focus on those involved in sports. 

Wear Appropriate Footgear

It’s important to wear footgear designed for the sport you engage in. Athletic shoes are designed to help prevent injuries based on the type of moves the athlete makes while engaged in their particular sport. For example, basketball players regularly jump and twist during play. Basketball shoes rise up around the ankle to help prevent ankle sprains which occur when that much twisting force is placed on the body.

Build Up Training Time Gradually

Oftentimes when we start a new sport or engage in a sport after a long period of time, we want to ramp up as quickly as possible.  While keeping up with friends and colleagues seems like a good idea, participating at a new or old sport at the same level is a recipe for injury. Our bodies take time to accommodate changes, including increases in sports activity. Start off slowly and build up by 10% each week.

Stretch and Condition Sufficiently

Stretching is also key to preventing injuries. Many of the conditions named above are in part caused by having tight calf muscles. Stretching your calf muscles enough to prevent these conditions from occurring will often require more than just a static wall stretch. If you know you have tight calf muscles, consider using an Achilles splint to stretch them during the daytime. It’s also important to keep the rest of your body in condition so that less stress transfers to your feet and ankles during play.

If you've injured yourself while running or playing sports, give our office a call at 206-368-7000 or request an appointment online.


 

 

Wikimedia Commons Nicole Kidman is a trouper. While husband Keith Urban was doing a surprise benefit concert in support of frontline workers in Tennessee she showed up all smiles while donning a walking boot. Turns out she was running around her neighborhood and didn't see a pothole.  She rolled her ankle and ended up breaking it. 

You might think foot and ankle injuries occur most often in the young and the restless or athletes. But just as often, hanging out at home can be just as hazardous. One of the most common dangers is slamming your toe into a dresser or other hard object in the middle of the night.

But there are many other hazards in the home and backyard which can lead to a broken ankle an other foot injuries. Now that you're home more, scanning your house and yard for tripping dangers will help prevent a broken ankle or worse.

Here are my recommendations:

  • Don't go barefoot - as much as you might want to kick off your shoes while cleaning up your yard or gardening, don't do it. Lack of foot support can lead to trip, fall, and twisted ankle.  It's best to wear tennis shoes or a clog like Oofos (which can also be helpful for people with heel pain) when in the garden.    
  • Check your shoes to wear - turn your tennis shoes over. Do you see any uneven wear? If so, it's time to buy a new pair.  Worn out shoes do not provide good support.
  • Always wear closed toed shoes when mowing your lawn.
  • Check your yard for stray hoses, fallen tree limbs, and divots. 
  • Remove clutter from your home - now is a great time to clean up the areas of your home that are potential fall hazards.  In particular, remove any objects on the floor.
  • Check area rugs to ensure edges can't come up and that there's non-slip backing.
  • Coil or tape cords and wires next to the wall. If needed, have an electrician install another outlet.
  • Install a night light so you can see where you're going in the middle of the night.

What To Do If You Think Your Ankle Is Broken

So you've fallen and your ankle is killing you. Should you go see your podiatrist or doctor? The short answer is yes, if you want to make sure it's not broken. It's almost impossible to tell without an X-ray if your ankle is broken or sprained. The truth is that a sprain can take much longer to heal than a fracture or break.

Whatever you decide to do, it's important to take action right away to keep down the inflammation, swelling and pain you'll experience with either situation. We recommend using the RICE protocol to accomplish this. RICE stands for Rest, Ice, Compression, and Elevation.

  • Rest - stop all physical activity and don't put any weight on the affected ankle.
  • Ice - apply an ice pack to the affected area (with a layer of cloth between your skin and the ice), 20 minutes on and 20 minutes off.
  • Compression - use an elastic or Ace bandage to provide compression to the area.
  • Elevate - keep the ankle elevated as much as possible.

If the affected ankle isn't healing after a week or so, please make an appointment with our office. In addition to an X-ray, an MRI may be required to assess damage to the underlying soft tissue.

Call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

We are now offering telemedicine in addition to in person appointments.

For more information about foot and ankle problems, download our eBook, "No More Foot Pain".

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Pinterest.

Photo credit: Wikimedia, Georges Biard

young woman runnerAs a runner, you know already know the benefits of your favorite sport. Better sleep, weight control, more energy, chronic disease prevention--just to name a few.

You've probably had some injuries and want to do everything you can to prevent another one. As a runner with flat feet, keeping your feet in tip top shape can be a bit challenging--but it can be done.

How Flat Feet Affect Runners

Runners with flat feet are over-pronators--meaning their feet roll excessively inward toward the arch when they walk or run. When this happens pain and discomfort can occur in the feet, lower legs, low back, and hips. In the feet this usually means plantar fasciitis (pain in the bottom of the heel or arch) or Achilles tendonitis (pain in the back of the heel).

neutral, flat, and high arched foot printsIf you've experienced problems in any of these areas of your body as a result of running, there's a good chance you have flat feet and are over-pronating. Not sure if you have flat feet? Find out by doing this test. Wet the sole of your foot. Step onto a blank piece of paper or a shopping bag. Step off the paper or shopping bag to examine the shape of your footprint and compare it to the photo on the right.

While over-pronation is a key reason runners with flat feet are more prone to foot pain, another factor--equinus or tight calf muscles--also plays a major role in the development of heel pain and plantar fasciitis.

That's why prevention of the two most common foot problems for runners with flat feet requires both correction of foot mechanics and treatment of tight calf muscles.

Correcting Your Foot Mechanics

While some runners can get away with correcting their flat feet with over-the-counter inserts such as Powersteps or Superfeet, the vast majority will need custom orthotics. Custom orthotics are designed for your feet only and provide the best correction for flat feet.

Stretching Out Tight Calf Muscles

Most runners stretch right before they run. While wall or tree stretches (if you run outside) may seem adequate, stretching for a few minutes will have little impact on very tight calf muscles. Instead, Dr.Rion Berg of the Foot and Ankle Center of Lake City recommends using an splint while reading or watching TV for 20-30 minutes for his patients with tight calf muscles.

Keeping Your Feet in Top Shape

It's also important to keep your plantar fascia or heel cord stretched and your feet strong.

Tennis ball massage
Tennis balls are great for keeping the bottom of your feet stretched out. While seated, use a tennis ball to massage all areas of your feet with special emphasis on your plantar fascia. Massage each foot for 2-3 minutes.

Towel curls
Towel curls can help strengthen your feet. While seated and with your feet on a towel, scrunch up the towel with your foot while your heel stays planted. Repeat 15-20 times with each foot for 2-3 sets.

Maintain A Healthy Weight

Running with a few extra pounds translates to more stress on your feet; seven extra pounds of pressure for every extra pound of weight. So maintaining a healthy weight will reduce the pressure on your feet and reduce your chance for foot pain.

Built Up Your Running Slowly

Just starting a running program with flat feet? Increase your training schedule by no more than 10-20% per week to prevent injury.

Best Training Terrain

Stick to training on flat ground. Running hills can increase your over-pronation putting more stress on your feet and plantar fascia. In addition, hill running and stair climbing put a lot of strain on the Achilles leading to Achilles tendonitis. Finally, softer surfaces are better than hard ones. A running track is a good option.

Buy Running Shoes for Flat Feet

Your shoes are your best defense against foot pain. Old, worn-out shoes will not adequately support your feet. Likewise running shoes that aren't designed for your foot type and the kind of running you do won't either. Be sure to go to a shoe store that specializes in running like Super Jock N Jill, Brooks, or REI in the Seattle area. Their employees are trained to help you find the shoe that will best meet your needs. In addition, check out my blog, "How to Buy the Best Running Shoes".

Call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

For more information about heel pain in runners download our eBook, "The Complete Guide to Stopping Heel Pain in Runners".

For chronic heel pain, download our eBook, "Stop Living With Stubborn Heel Pain".

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Pinterest.

 

 

By Dr. Rion Berg
March 10, 2020
Category: sports injuries
Tags: Untagged

different types of ahtletic shoesProfessional and amateur athletes spend hundreds and sometimes thousands of dollars each year on shoes. Often shoe purchases are made based on promises from shoe companies that athletes will be able to run faster, jump higher, and have less foot pain because of extra cushioning, more revolutionary materials, or special qualities.

While some of these claims may be accurate they can't possibly be right for all of us. We each have a different foot type, different needs when it comes to our level and type of exercise, and different foot problems that require a range of solutions.

With injuries of the foot and ankle rampant among athletes it's important to buy a shoe that's ideal for the foot, level, and type of activity.

Here are some of the most common signs that the athletic shoes you're wearing are wrong for you:

Toenail loss or bruising
While toenail bruising and loss are common among athletes, wearing shoes that are too short will certainly accelerate the process. If you've lost a toenail or notice that your toenails have become black or purple it's time to get your feet measured.

Blisters
Blisters form when a shoe rubs continuously over a part of the foot. This occurs when shoes are either too tight or too loose. It's important to check the length and the width of the shoe to be sure it's the right size for you.

Plantar fasciitis
Because athletes often apply tremendous force to their feet during sports activities, they are at greater risk of developing plantar fasciitis and Achilles tendonitis, a related condition. Many factors combine to cause these foot problems, including unsupportive or inappropriate shoes. Athletic shoes are created to support the foot for specific sports. It's important to wear shoes designed for that activity only.

Stress fractures
Stress fractures are tiny, hairline cracks in the bone caused by repetitive force. These can occur in the foot and are common in athletes. If left untreated stress fractures can result in a complete break. Runners and athletes who play basketball, tennis, or are involved in gymnastics are most at risk, but any sport where your feet take a pounding can cause this condition.

Athletes who have flat feet and other faulty foot mechanics should wear shoes appropriate to their sport and should talk to their podiatrist about getting custom orthotics.

Low weight women athletes including those with an eating disorder and male and female athletes with osteoporosis are at particularly high risk for stress fractures.

Shoes That Are Worn Out/Have Uneven Wear
Athletic shoes should be purchased every 500 miles or when shoes wear unevenly on the bottom. Worn out shoes can't provide the proper support required for athletic endeavors resulting in greater likelihood of an injury. Uneven wear on shoes can result in trips, falls and turned ankles.

Am I Wearing the Right Athletic Shoe?
Many factors go into ensuring if an athletic shoe is right for you. In addition to replacing your shoes at the right time, follow these guidelines to help you make that determination.

  • Only wear shoes made for your particular athletic pursuit.

  • Neutral, flat, and high arched foot typesKnow your foot type. For some sports such as running, certain shoe types will work better than others to prevent foot problems. To determine your foot type, wet the sole of your foot. Step onto a blank piece of paper or a shopping bag. Step off the paper or shopping bag to examine the shape of your footprint and compare it to the photo on the right.

  • Know your motion mechanics. (e.g. over pronation, flat feet)

  • Your level of running experience including number of miles/week can also affect the best type of shoe for you.

  • Test your shoes before purchasing them. Although new athletic shoes should be supportive, it's always a good idea to test the shoes yourself as demonstrated in this video.

If you're experiencing foot or ankle pain or an injury, call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

For more information about heel pain in runners download our eBook, "The Complete Guide to Stopping Heel Pain in Runners".

For chronic heel pain, download our eBook, "Stop Living With Stubborn Heel Pain".

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Pinterest.

 

 

youth athletesAs a parent of kids who play sports, you want to do everything possible to make sure your child has the best equipment and plays safely. While there's been a lot of news coverage about the problems kids can suffer as a result of concussions, there's scant information about the impact of foot and ankle injuries on youth athletes.

That's why I wrote this guide. I see far too many kids in my office with foot and ankle conditions and injuries that could have been avoided.

Heel Pain in Youth Athletes

While kids can develop the same type of heel pain as adults, namely plantar fasciitis, a condition called Sever's disease is much more common, particularly among youth athletes. This condition affects kids ages 8-14 who have an open growth plate on their heel bone. When this plate is still open it's susceptible to bruising and inflammation during activities like soccer.

To address the problem, I advise young athletes and their parents to ease up on their activity level, reduce their inflammation and pain through use of anti-inflammatory medications and ice, use of heel lifts to help absorb impact, use of over-the-counter inserts or custom orthotics, and go for physical therapy.

To prevent Sever's disease in your youth athlete, start by purchasing supportive shoes that are designed for their particular sport (see below for more information), stretching the Achilles tendon to reduce stress on the heel if they are prone to this condition, and avoiding play beyond your child's abilities.

Stress Fractures in Youth Athlete

Another overuse injury common in young athletes are stress fractures. When muscles are too tired to take on the additional stress of play it's absorbed by the bones. Stress fractures can occur in the lower legs, ankles, and feet.

Youth athletes most at risk are those who play sports that involve running, jumping, and repetitive movement such as gymnastics, basketball, and track and field. Ramping up sports activity too quickly, without rest in between to adequately condition the body, can also increase the chance of a stress fracture.

To prevent stress fractures in youth athletes make sure they do the following:

  • slow and proper conditioning for their sport

  • eating balanced, nutritious meals rich in calcium and Vitamin D

  • drink plenty of water throughout play

  • adequate warm-up and cool-down

  • stop playing when in pain and visit to podiatrist

  • alternating types of physical activities

  • go for a sports physical before the season starts

  • replace athletic shoes every 500 miles

Ankle Sprains in Youth Athletes

Ankle sprains are common in youth soccer, basketball, and other sports. In fact, researchers have estimated that ankle injuries account for 10 to 30% of all sports related injuries in young athletes. It's almost impossible to tell if your youth athlete has broken a bone or sprained an ankle without imaging--these include X-rays for identifying broken bones and ultrasound to find out the degree of soft tissue damage. Sometimes an MRI will be necessary.

While minor injuries can be treated with rest, protection of the site, and time away from the field, more severe ankle sprains will require immobilization and also rehabilitation through physical therapy. Sometimes surgery will be required.

Ingrown Toenails in Youth Athletes

Another common problem in kids who play sports are ingrown toenails. Tight shoes or cleats in soccer and other sports combined with repetitive actions such as kicking are the major culprits.

Ingrown toenails need to be treated by a podiatrist. To help ease your child's pain in the meantime, soak their foot in room-temperature water with Epsom's salt and gently massage the side of the nail fold to help reduce inflammation.

Nail surgery for treatment of an ingrown nail can be done in the office. Prevention of ingrown toenails includes wearing shoes that fit properly, avoiding tight socks, purchasing (soccer) cleats that aren't too tight, and proper toenail trimming (trim straight across, no rounded corners).

Shopping for Athletic Shoes

Buying proper athletic shoes for your sports minded child is one of the most important things you can do to prevent them from getting foot and ankle injuries on the field.

  • Buy new shoes-it’s important to start out the season with a brand new pair of shoes. Old shoes will not provide the support your child needs to avoid injury and be his or her best on the field.

  • Get your young athlete’s feet measured- these days many parents purchase kids shoes off the shelf or online. Although this is an easy solution it circumvents the need to get your kids feet measured properly. Getting a good fit is always a good idea but its imperative when your kid plays sports. In addition to getting their feet measured, be sure that the shoe is at least one thumb’s length between the top of the big toe and the end of the shoe. Always choose the larger size if one foot is larger than the other.

  • Buy the shoe designed for their sport-choosing the right shoe for their sport is essential. Athletic shoes are designed specifically for the sport they are intended, providing just the right stability and flexibility.

  • Check shoe stability-don’t just go by the name brand of shoe when you purchase it. Even great name brands provide a range of support and may not meet the requirements your child needs. Test the shoe by holding it by the heel and toe. Attempt to bend it in half. It should only bend at the ball of the foot, not in the middle. Then try and twist the shoe. It should not easily twist from side to side.

Checking the field

Many sports-related foot and ankle injuries can be avoided by checking the field before play. The field should be checked for dips, holes, stray objects, and too much water.  Alert coaching officials to any irregularities.

If your youth athlete is experiencing foot or ankle pain, call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

For more information about heel pain in runners download our eBook, "The Complete Guide to Stopping Heel Pain in Runners".

For chronic heel pain, download our eBook, "Stop Living With Stubborn Heel Pain".

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Pinterest.