Dr. Berg's Foot Facts

Posts for tag: Dr. Rion A. Berg

By Rion A. Berg, DPM
June 30, 2011
Category: foot care

On June 21, 2011, the Seattle Mariners suffered an unfortunate 6-5 loss in the bottom of the 9th inning while they were visiting the Washington Nationals. Perhaps more important than losing the game is the injury suffered by Seattle’s shut-down closer, Brandon League, who is currently tied for 4th in Major League Baseball with 21 saves. While pitching in the bottom of the 9th inning, he was struck by the baseball in the back and side of his right leg in the area of the calf muscle (gastrocnemius muscle) after the Washington batter hit a low line drive. Though he was able to run after the ball to try to throw the runner out at first base, Brandon had to leave the game after that play due to the injury. He is currently listed as day-to-day with a calf muscle contusion.

A contusion can be considered a large bruise on a much more severe scale and in sports is usually due to a direct traumatic blow or repeated blows from a blunt object. In Brandon’s case, force or energy was transferred from the baseball into the tissue of his leg, crushing the underlying muscle fibers, blood vessels and connective tissue without breaking the skin. The injured tissue was then likely flooded with a collection of blood and inflammatory products as a result of a) the tissue damage from the blow, and b) the body’s natural inflammatory response to injury. This would be seen by the naked eye as swelling in the area, multiple blue-purple-yellow colors associated with bruises, and increased warmth as part of the inflammatory process.

The reason Brandon had to leave the game is that he was unable to pitch with the same effectiveness because he could not push off of the mound with his right (now injured) leg due to pain in the area, temporary weakness and stiffness of the calf muscle, and perhaps decreased range of motion in his right knee due to swelling and pain. Also, if he tried to continue playing, there is a very good chance he would have caused further damage to the muscle tissue and perhaps made his recovery that much longer.

Any injury caused by a direct blow from a blunt object could lead to a contusion. This could be sports-related, including (but not limited to) being hit by a baseball, being kicked or having your foot stepped on by another player in basketball, or by running in shoes that are too large or too small causing repeated traumatic contact between your foot and the shoe. Foot and ankle contusions can also come from regular daily activities, such as improperly fitting shoe gear, stubbing your toe or foot on a bed frame, someone stepping on your foot, or dropping a heavy object on your foot.

In most cases of a contusion, you would want to see your doctor as soon as possible to rule out extensive damage and be educated on the quickest way to regain normal function. In some cases, this may include an xray, CT scan or MRI depending on the situation and location of the contusion. The team doctor decided Brandon did not need xrays because the ball struck him in the meat of the calf muscle tissue rather than directly on any bone, but anytime you suffer this type of injury, you should see your doctor to rule out any fractures or other damage, especially in the foot where there is more bone than muscle tissue.

The treatment for a contusion (after you see the doctor as necessary) is usually going to be RICE, (rest, ice, compression and elevation.) doctor-recommended NSAIDs (non-steroidal anti-inflammatory drugs) and after a couple of days some light stretching of the muscle to prevent any scar tissue formation within the muscle tissue. Recovery time can vary depending on the severity and location of the contusion, from no limitations on activity to keeping weight off of the area for several days.

Injuries to the foot or ankle may take a week or two to feel "normal" because obviously every step we take puts force and motion throughout the foot. You would definitely want to limit activity until at least all the pain and swelling are gone. With any contusion, whether to bone or muscle or other soft tissue, you should consult your doctor’s advice regarding the next step in treatment and recovery, especially if the swelling and pain has not decreased after 2 days of RICE.

If you or someone in your family - particularly a child - sustains a foot or ankle injury while having some summer fun, please do not hesitate to call our office at 206-368-7000 or request an appointment online. Childhood injuries that do not heal correctly can cause long-term foot problems. The Foot and Ankle Center of Lake City is here to help "kids" of all ages keep their feet happy and healthy!

 

 

By By Rion A. Bertg, DPM
March 29, 2011
Category: foot care

 

Up to 10% of the population suffers from heel pain, plantar fasciitis. Millions of dollars are spent per year in health care to resolve this problem. Many common treatments including cortisone injections, physical therapy, orthotics, and surgery are available, but the advantages of one over the other are not necessarily proven in randomized studies.

I’ve been in practice for thirty years, and I continue to utilize the latest techniques in resolving heel pain. My heel pain patients in Seattle are happily running, walking, skiing and enjoying the active lifestyle the Northwest offers. I continue to hope that some of these techniques will resolve your heel pain faster, with less down time, and provide more lasting relief.

Speaking of lifestyles, with the passing of the infamous, Elizabeth Taylor, passes a time when high heels are required as part of the work "uniform" for women. Save the stillettos for evening. To keep your feet happy and healthy in the long term, wear lower heels with work attire and consider a dress flat to wear with slacks.
 



1.   So what is plantar fasciitis?

  • It is the inflammation of the attachment of a long flat ligament, the plantar fascia, at it’s attachment to the heel or along its course to the base of your toes.
  • It becomes inflamed when it is over pulled from the heel to the toes. If the process continues it pulls on the bone and a spur can develop.

2.  What are the most important factors contributing to heel pain?

Self Assessment

Your Weight             Overweight?  Yes     No
Your Work                Prolonged Standing?  Yes     No
Your Play                  Runner?  Mileage/wk  _____ Court Sports______ Other___________
Your Foot Type        Flatfoot?  Yes    No    Very High Arches   Yes      No
Your Shoes              Slip On?  Yes    No     Stable?    Yes    No   

                                    Stable = Bends at ball, not in the middle
                                                  and doesn't twist easily from side to side

Barefoot/stocking feet/house slippers at home?   Yes     No

3.  Where do you start when it comes to treatment?

Begin by being honest with yourself and deciding how long you have been having your heel pain.  1-4 weeks, 1-3 months, 3-6 months, 1 year or longer

What is your pain level on a scale of 0-10?

Divide this up_______AM pain level

_______During the day

_______Pain only at end of day

_______Pain during athletic activities

_______Pain when you are off your feet

4. First Steps to Self Help
 

Don’t go barefoot/slippers at home

If you have a house rule of no shoes, buy Crocs for in house only

 

For acute pain >6/10, short duration

(1-4weeks) with no Hx of injury

Begin icing ten minutes/day, if tolerant and no GI issues/or other contraindications, oral anti-inflammatory per your physician’s recommendation

 

Check your shoes for stability

Generally an athletic shoe with slight heel is preferred. Remove insole of the shoe and replace with a good OTC support such as Powerstep or Superfeet

 

Before rising

Stretch your calf, flexing your ankle 20 reps, stretching against the wall.

 

Runners

Stop running until symptoms are subsiding.

 

Heel pain can prevent you from enjoying your dailing life as well as leisure time at the parks and urban trails we have right here in Lake City, Shoreline, Ravenna and Kenmore. Take care of your feet and get outside to enjoy the beginning of Spring!

If you have signs of heel pain, call us today for an appointment at 206-368-7000 or request an appointment online.