The Doctors at Gulfcoast Foot and Ankle can help you!

Roethlisberger Suffers High Ankle Sprain

2011-12-15T15:33:00.000-06:00

Ben Roethlisberger and the high ankle sprain

Last week in the football game between the Pittsburgh Steelers and the Cleveland Browns, Ben Roethlisberger the quarterback for the Steelers was tackled in such a way that he suffered an injury to his ankle. Using slow motion analysis of video online, it can be seen that “Big Ben” was planting his left foot trying to escape tacklers when he was hit from behind and from the left essentially trapping his left foot on the ground with the inside of the foot against the ground. His left knee then hits the ground and creates a rotational base as he was hit from the right by another opponent. The top of the left shoe can be seen clearly as he falls on his left side effectively making the lower part of his foot and leg point 180 degrees from normal (or backwards).

Amazingly he walked off the field and returned and completed the game later. Reports of his injury over the past week include that he has a grade 1 high ankle sprain. He is in a walking cast boot and may compete against the 49ers on Monday night.

Big Ben’s injury differs from the usual ankle sprain because of the mechanism of injury. Normally ankle sprains are on the outside (lateral aspect) of the ankle and involve tearing of the lower ankle ligaments. Big Ben’s injury involves the ligaments that hold the leg bones together. The term ankle sprain can be used to indicate anything from a minor injury or an actual tearing of the ligaments.

From my analysis of the injury from one perspective of video on the internet it appears to me that it is amazing that the ankle was not dislocated at the time of injury and that it is likely that the ligament was ruptured or torn. In normal adults, ligament healing will usually take about three weeks and will need protection during this time. I would anticipate a significant amount of pain would be present if an individual were to try to weight bearing without significant support of the ankle before it is healed.

Big Ben is getting the best of care by getting an immediate X-ray and then an MRI. Many times normal ankle sprains will require both of these studies as well. Support and protection are requirement for normal healing of ankle sprains as well.

So, the take home point is:

1. Don’t attempt to walk off ankle sprains

2. Start Rest Ice Compression and Elevation

3. Get professional help and imaging

For more information see Gulfcoastfootcare.com

Ray Lewis may watch from the sidelines on Turkey Day

2011-11-23T08:29:00.000-06:00

Ray Lewis missed playing against Cincinnati last week due to a toe injury. This is the first game he has watched from the sidelines since 2007. There is a less than 50 percent chance that he will play against the Bengals on Thanksgiving. He may be out up to 4 weeks.

Please visit our website if you would like to learn more about Sports Injuries.

November is Foot Health Awareness Month!!

2011-11-23T08:15:00.002-06:00

November is foot health awareness month as it relates to issues that affect diabetes and foot health by

the US Department of health and human services. This department recognizes the need for diabetics

to be aware that foot health is an integral part of their medical care. Two separate studies have

indicated that amputations may be decreased and healthcare costs may be decreased by regular visits

to podiatrist’s office by diabetics. This is something that I have personally observed over the years.

If patients understand they are diabetic and they need special care for their feet, we can help them

remain ambulatory and decrease their risk for amputations and ulcers. In the past, when Medicare

did not cover the cost of special diabetic shoes for diabetics at risk, I personally witnessed many

unnecessary ulcerations and amputations because of ill-fitting shoes. As a result of the Medicare shoe

program for at risk diabetics, I have seen the number of ulcers drastically reduced over the past 10

years. For the ulcerations and infections that do happen, the new materials and treatments for wound

care have allowed us to heal diabetic ulcerations that were previously untreatable.

The most important point that I have for diabetics is that regular visits to a podiatrist’s office are an

investment in your future which can eliminate and prevent ulcerations and amputations. Even at the

very beginning of the progressive disease of diabetes, even when you feel nothing is wrong with you, a

visit to a podiatrist office can help make you aware of problems that you may not understand presently.

At that first visit, your feet can be examined and evaluated for foot deformities, circulatory problems

and neurological problem. Common problems as hammer toes and bunions can be evaluated and

treated conservatively with a variety of shoes and appliances. The mechanics of your walking will be

evaluated and the structural integrity of your feet can be reviewed. The range of motion of your lower

extremity can be evaluated. Many problems in these areas can be addressed with special supports and

exercises.

For diabetics, circulation, the amount of blood going into and leaving your feet, is a very important to

be evaluated. Using the latest technologically advanced noninvasive testing, the amount of blood flow

to and from the foot can measured and problem areas can be identified. This is important because

decreased blood flow can be associated with changes in healing, ulcerations and limb threatening issues.

Being able to identify and treat problems with circulation in diabetics can help prevent or treat many of

these problems.

Sometimes patients will come to office and say “I feel like I have a sock wadded up on the bottom of

my foot” or “I feel like my feet just don’t belong to me anymore.” These and other symptoms such

as numbness, tingling or other changes in sensation may be the beginning of the disease known as

neuropathy. Often this disease is associated with diabetes and is major cause of difficulties for patients.

Several times a year patients will come to the office with an infection in their feet from foreign bodies

that they didn’t realize they had stepped on because they could not feel it. At our office all patients are

screened for neuropathy with special attention placed on diabetics. It is important for diabetics to have

their neuropathy recognized early and have medical and accommodative treatment performed. This can

help prevent some of the more tragic complications of diabetes.

For more information please see our web site at www.gulfcoastfootcare.com or call out office at 239-

Back to School Sports Injury Prevention Tips

2011-08-31T09:56:00.002-05:00

By Dr. Dalia Krakowsky, Podiatrist, Marshfield Clinic Minocqua and Park Falls Centers

The fall time for our community’s children typically means back to books and homework. For many of them it also means back to fall sports. Many return to strenuous sports such as football, cross-country running, and basketball after a summer of relaxing. This can predispose them to injury. This can further be exacerbated by a child’s level of physical maturity and degree of athletic ability.

Proper training and conditioning can help prevent injury as well as help improve coordination and overall physical performance. There are several methods one can help avoid injury.

One of the most important ways to avoid sport related injuries in all activities is to properly warm up. Warming up helps to loosen muscles and prepare for an athletic activity. This includes proper stretching (but not overstretching), whether it be passive or dynamic as well as a light cardiovascular warm up.

Other ways to help avoid injuries is proper training prior to competition, which is typically sport specific and well managed by team coaches and trainers. Training typically includes cardiovascular fitness, strengthening and conditioning, stretching and improving flexibility, coordination and agility improvements as well as other sport specific modalities.

Despite proper warming up and training, a child still may unfortunately incur an injury during athletics. Injuries are commonly seen as a result of overuse, and are often seen as the sport season progresses. Common injuries include:

1.Ankle sprains: This can involve either a partial tear or stretching of ankle ligaments. Symptoms may include ankle pain, swelling and bruising. Treatment typically involves a period of rest, icing, and either protective weight-bearing with a boot or a period of non-weight-bearing. It may take several weeks and often months for complete healing to occur. Once symptoms improve it is important to restore balance, coordination and strength in order to help prevent recurrence.

1.Shin splints: This can occur due to improper training, increase in acceleration during athletics, or overtraining. It can also be seen in sports where running on an incline or with quick acceleration is performed. Symptoms typically include pain to the front of the leg with activity, alleviated with rest. Treatment predominantly includes rest, possible use of physical therapy modalities and anti-inflammatory measures. Prevention of recurrence typically includes slower progression through the specific sport, conditioning and possible use of orthotics.

1.Heel pain: This can be a result of inflammation of the plantar fascia (the ligament that attaches to the bottom of the heel bone), inflammation of the heel cord as it attaches to the back of the heel bone, or inflammation of the growth plate located at the back of the heel bone. Symptoms typically include pain and possible swelling. Treatment is catered to the level of discomfort, and can include icing, resting, use of heel cushions and orthotics.

1.Stress Fractures/Fractures: Fractures due to overuse are less commonly seen in younger people, as their bones are often more flexible. As a child matures, they are more predisposed to stress fractures due to overuse. Symptoms typically consist of pain and often associated swelling. There can be bruising as well. Often advanced imaging such as an MRI or a bone scan is needed to further evaluate a fracture if it is not easily seen on an X-ray. Treatment depends on level of injury and can involve rest, protective weight-bearing in a boot, non-weight-bearing in a cast or surgery to repair the injury.

If your child complains of pain, or has symptoms of unusual swelling, contact a health care provider to immediate care in order to prevent worsening of the situation. Early detection of a specific injury and early treatment means your child can most likely return to their sport or activity in a timely fashion.

Check out these shoes!!!!

2011-08-16T18:55:00.001-05:00

NBA All Star John Starks and founder of Ektio shoes talk about the new high-top basketball shoe that potentially can prevent ankle sprains.

Giants Prince Amukamara out indefinitely

2011-08-08T09:37:00.000-05:00

Amukamara fractured his fifth metatarsal and will undergo surgery. It is his very first broken bone and surgery he has ever had! To read the whole article click here.

Lawsuit pending against toning shoes

2011-08-08T09:31:00.000-05:00

The new fad of toning shoes might not be the best option for most of the general public. To read the entire article regarding the lawsuit click here.

Lions rookie Nick Fairley has foot surgery

2011-08-08T09:27:00.000-05:00

Lions cant catch a break!!! Nick Fairley was injured in practice last Monday and underwent surgery a few days later. He will have to miss a big portion of training camp and it is unsure if he will be ready by the start of the regular season. To read the entire article click here.

Aretha Franklin Breaks Toe over Jimmy Choos

2011-07-21T14:41:00.000-05:00

The Doctors at Gulfcoast Foot and Ankle can take care of your fractures no matter how they happen!

Click here to read story about Aretha Franklin.

Kobe Bryant has Platelet Surgery on his Knee

2011-07-07T09:22:00.000-05:00

The Doctors at Gulfcoast Foot and Ankle may not be able to do platelet surgery on knees but if you are having problems below the knee then platelet surgery might be right for you and we have the Doctors that can help!

Click here for the rest of the article.

Florida Gators Austin Maddox pitching in orthotics

2011-06-27T21:47:00.000-05:00

Maddox suffered a sprained foot in the NCAA regionals a little over 3 weeks ago. He is pitching tonight in the 1st of 3 games in the College World Series with a taped arch and custom made orthotics.

To learn a little more about his injury click here.

Have Smelly Feet?

2011-06-01T08:35:00.000-05:00

Foot odor can occasionally happen. But for some its always there. Click here to reveal the reasons for smelly feet and ways to get rid of them. You will be amazed that food, alcohol and adrenal stress can all change the smell of your feet. There are many ways to help foot odor in this article......even one that usually treats wrinkles!

Plantar Fasciitis and Sports

2011-06-01T08:29:00.000-05:00

Below is a link to an article all about Plantar Fasciitis. Its affects many people each year and can be very debilitating to athletes. Scott Podsednik, Chris Burgess and Tim Duncan are just a few athletes spoken about in this article that have had this keep them from playing.

Click here to read the full article

With diabetes, save a leg, save a life

2011-05-02T16:46:00.000-05:00

Each year in the U.S. diabetes results in the amputation of about 65,700 legs or feet. About 85% of those began with a diabetic foot ulcer. And for Dr. David Schwegman, the mission to educate people about the issue is personal.
His father, a diabetic, had a foot ulcer that resulted in the amputation of his left leg, which contributed to his death, his son said.

"He became a statistic," Schwegman said. "He was one of the 50% of people that died within five years after having an amputation."

Diabetic foot ulcers, or DFUs, are usually located on the ball of the foot, the bottom of the big toe or sides of the feet. They can be a result of neuropathy, or nerve damage which leads to a loss of feeling.

Although prevention is key, simply not treating an ulcer can lead to infection, particularly in the bone, and eventual loss of a limb.

"If you have a DFU that leads to a major amputation, your risk of death in five years is greater is higher than that of breast cancer and prostate cancer combined," Schwegman said.

"This is a very, very serious health problem that has very serious risks if not dealt with properly and quickly," the doctor said. "In order to do that, we really need to get the word out to both the patients and the physicians."

That's where the Save a Leg, Save a Life Foundation , or SALSAL, comes in. On Saturday, Schwegman, along with the Atlanta chapter of the national group, are offering free foot screenings as part of the American Diabetes Association's Health Expo.

You can find an expo near you by visiting the American Diabetes Association's calendar for 2011. Diabetics can be screened for cuts, blisters, discoloration of feet, and any signs of bacteria or infections, conditions that can lead to foot ulcers.

Right now, 18.8 million adults and children in the U.S. have diabetes. The Centers for Disease Control and Prevention estimates that 7 million people have undiagnosed diabetes and 79 million are prediabetic.

Diabetics need to know that treating the ulcer early is the best way to get it healed.

"If we're not treating them aggressively, the chances that they heal is actually very, very low," Schwegman said.

An important part of the evaluation of a person with a diabetic foot ulcer is a thorough vascular exam, since diabetics have a higher risk of having peripheral arterial disease. The condition results when circulation to the legs and feet is blocked or narrowed by calcifications. The poor blood flow can cause pain and discoloration in the feet- an increase in a red color, a dusky bluish color or sometimes the toes turn black and result in amputation.

Dr. Desmond Bell, a wound care specialist and founder of SALSAL, recommends going straight to a podiatrist or wound care specialist if a cut, sore or wound does not heal in a week or two. Those with a history of diabetic foot ulcers should see a specialist immediately.

Bell said several newer treatments are available to treat these wounds. None are a "silver bullet" for every single wound.

SALSAL hopes to educate both physicians and the general public about them in order to prevent unnecessary amputations. Of the thousands of products available, only these three have evidence that they have increased wound healing rates:

-Advanced skin cell substitutes include Dermagraft and Apligraf. These are similar in that they are derived from neonatal foreskins.

-A growth factor gel, Regranex.

Hyperbaric oxygen therapy can also heal wounds and treat infections.

Most exciting, Bell said, is peripheral revascularization, in which cardiologists and others, go into the groin similar to an angioplasty for the heart. Through this new procedure, doctors can open up blockages in the leg and restore blood flow.

"It requires lots of doctors often times and it requires a motivated patient," Schwegman said. "By saving their leg, it really does save their life."

Bunions more common in women

2011-04-05T10:34:00.002-05:00

New research has found that an increase in the severity of bunions not only increased foot pain and impaired mobility, but also affected people's general health and quality of life.

Bunion deformity was found in 36% of the study sample. It occurred more frequently in women and older individuals. The study also found that pain in other parts of the body beyond the foot was associated with increased bunion severity.

Associate Professor Hylton Menz of La Trobe University in Melbourne, Australia, and colleagues at the Arthritis Research UK Primary Care Centre, Keele University examined the prevalence of and factors associated with hallux valgus – bunions.

The Medical Research Council funded study assessed the severity of deformity on general and foot-specific Health Related Quality of Life (HRQOL) of 2,831 people aged 56 years or older in North Staffordshire.

The research team established five severity grades of hallux valgus, corresponding to the angle of deformity - from 0, 15, 30, 45, and 60 degrees.

Results showed that the impact of increasing hallux valgus severity on HRQOL is independent of age, sex, education, body mass index, and pain in other parts of the body.

They also revealed that impact of bunion extends beyond pain and physical function to affect general health, vitality, social function, and mental health.

"Our findings indicate that hallux valgus is a significant and disabling musculoskeletal condition that affects overall quality of life," concluded Associate Professor Menz.

"Interventions to correct or slow the progression of the deformity offer patients beneficial outcomes beyond merely localised pain relief."

Hallux valgus is a common foot condition that is caused when the big toe bends in towards the smaller toes. It develops over time and is accompanied by a painful soft tissue and bony protrusion, known as a bunion.

As the deformity progresses the lateral displacement of the hallux (big toe) begins to interfere with normal alignment and function of the smaller toes, leading to further deformities such as hammer toe or claw toe, altered weight-bearing patterns, and the development of corns and calluses.

Family history, wearing high-heeled shoes or shoes that are too narrow, and flat footedness have all been suggested to contribute to the development of bunions.

Details of this UK population-based study appear in the March issue of Arthritis Care & Research, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology (ACR).

American Diabetes Association ALERT! DAY

2011-03-21T15:50:00.002-05:00

Americans are urged to “Join the Million Challenge” on American Diabetes Association Alert Day^SM by taking the Diabetes Risk Test and finding out if they are at risk for developing type 2 diabetes

Tuesday, March 22, 2011 is the 23^rd annual American Diabetes Association Alert Day, a one-day, “wake-up” call asking Americans to “Join the Million Challenge” by taking the Diabetes Risk Test and find out if they are at risk for developing type 2 diabetes and if they are at high risk, to speak with their health care provider.

At the end of 2010, the American Diabetes Association surpassed their goal of inspiring one million Americans to join the American Diabetes Association’s movement to Stop Diabetes®. To continue this momentum, the Association is asking the public to “Join the Million Challenge” by rallying one million people to take the Diabetes Risk Test and find out if they are at risk for developing type 2 diabetes, beginning on Diabetes Alert Day on March 22, 2011 and ending April 22, 2011.

Diabetes is a devastating disease that affects nearly 26 million Americans including. A quarter of those affected by diabetes are not aware that they have the disease. If current trends continue, one in three American adults will have diabetes by 2050. In addition, approximately 79 million, or one in three American adults have prediabetes, which means that their blood glucose (sugar) is higher than normal but is not high enough to be classified as diabetes. Without intervention, individuals with prediabetes are at a much higher risk for developing type 2 diabetes. Seeking to change the future of diabetes, the American Diabetes Association is using Diabetes Alert Day to help identify the undiagnosed and those at risk for type 2 diabetes by educating people about diabetes risk factors and warning signs.

Unfortunately, people with type 2 diabetes can live for years without realizing that they have this serious disease. While some people with diabetes exhibit noticeable symptoms (such as frequent urination, blurred vision and excessive thirst), most people diagnosed with type 2 diabetes do not experience these overt warning signs at the time that they develop the disease. Often, type 2 diabetes only becomes evident when people develop one or more of its serious complications, such as heart disease, stroke, kidney disease, eye damage or nerve damage, which can lead to amputation.

2011 Diabetes Alert Day

“Studies have shown that type 2 diabetes can be prevented or delayed by losing just 7% of body weight (15 pounds if you weigh 200) through regular physical activity (30 minutes a day, five days a week) and healthy eating,” said Gina Perales Hethcock, Director of Communications and Hispanic Initiatives for the North Texas office. “The American Diabetes Association hopes that this American Diabetes Association Alert Day will encourage people to ‘Join the Million Challenge.’ By understanding your risk, you can take the necessary steps to help prevent the onset of type 2 diabetes.”

To help people determine their risk for type 2 diabetes, the American Diabetes Association provides the Diabetes Risk Test, which entails answering simple questions about weight, age, family history and other potential risk factors for diabetes. People at high risk are encouraged to speak with their health care providers. You can “Join the Million Challenge” by getting your free Diabetes Risk Test (English or Spanish) at www.stopdiabetes.com, 1-800-DIABETES (1-800-342-2383) or text JOIN to 69866 (Standard data and message rates apply). Although Diabetes Alert Day is a one-day event, the Diabetes Risk Test is available year round.

The Association is also encouraging the public to help spread the word about Diabetes Alert Day by sending out messages on Facebook and Twitter. You can download a Diabetes Alert Day application to post on your Facebook page or you can tweet about the importance of understanding one’s risk for type 2 diabetes and provide a link to the Diabetes Risk Test at stopdiabetes.com.

The primary risk factors for type 2 diabetes are being overweight, sedentary, over the age of 45 and having a family history of diabetes. African Americans, Hispanics/Latinos, Native Americans, Asian Americans and Pacific Islanders are at increased risk, as are women who have had babies weighing more than nine pounds at birth.

Laser is new tool in targeting toenail fungus

2011-03-21T09:37:00.000-05:00

http://www.mlive.com/health/index.ssf/2011/03/laser_is_new_tool_in_targeting.html

'Diabetes belt' emerges in Southeast U.S.

2011-03-21T09:31:00.002-05:00

Individuals who live in one of several Southern states are significantly more likely to receive a positive HbA1c test for diabetes, as a new study from the Centers for Disease Control and Prevention has identified what officials are calling the "diabetes belt" of the U.S.

The belt stretches from Pennsylvania in the Northeast to Texas in the Southwest and includes all the states in between. The rate of diabetes in these states is 11 percent, compared to a national rate of 8 percent.

The researchers said that obesity and sedentary lifestyles were most likely the causes of this discrepancy. Nearly 33 percent of people from these states are obese, while the national average is 26 percent. More than 30 percent are largely sedentary, compared to a national rate of 24.8.

Identifying areas where prevalence of the disease is highest could allow public health officials to direct their resources more efficiently and hopefully contain diabetes, the researchers said.

"Identifying a diabetes belt by counties allows community leaders to identify regions most in need of efforts to prevent type 2 diabetes and to manage existing cases of the disease," said Lawrence E. Barker, who led the study. "Although many risk factors for type 2 diabetes can't be changed, others can."

Why Does My Big Toe Joint Hurt Part 3

2011-03-09T12:36:00.000-06:00

Well folks, its official....I had my first pain free run in months! I was about a mile into my run yesterday and I thought to myself, "Wow my toe doesnt hurt a bit!" I ran 3 10 minute miles and my toe is not sore at all today. Other parts of my body...well that is a different story. Dr. Gordon is truly special and has helped me a lot. I am a firm believer of orthotics now. Also I have noticed that when I walk up stairs the cracking and popping in my knees has decreased dramatically! Im only 30 so that is a GREAT thing.

Today I developed blisters on my heels from my stupid dress shoes. I put my orthotics in them but I didnt take the shoe inserts out. I think that may be the trick. My shoes were rubbing too high on my heels. But...my toe still doesnt hurt so that is a big plus. Its all trial and error. Who knows maybe I will get my husband to dish out some cash for better dress shoes that my orthotics fit nicely in. Its a medical necessity right????!!!!

Paramedic took severed foot from car crash victim... to use it to train her dog

2011-03-09T09:05:00.002-06:00

By Daily Mail Reporter

Last updated at 11:19 PM on 8th March 2011

A former paramedic who admitted to taking a man's severed foot from the scene of a crash is now being sued for going 'beyond the bounds of decency'.

Cynthia Economou, a former fire-fighter-paramedic from Florida, admitted to taking Karl Lambert's foot in September 2008 to use as a training aid for her body recovery dog.

But now Mr Lambert is seeking unspecified damages in a lawsuit issued last week.

Enlarge Sued: Cynthia Economu is now being sued for taking a foot she found in a car wreck in 2008. She said the foot was used to train her cadaver dog

The lawsuit lists the taking of the foot as: 'Outrageous and went beyond the bounds of decency...was odious and utterly intolerable in a civilized society.'

Economou was originally sentenced to six months probation in 2009 for second-degree petty theft.

At the time, she told a court the foot was unusable when she found it at the crash scene an hour after Mr Lambert was airlifted to hospital.

She said: 'It was an unrecognisable mass of flesh.

'It wasn't a clean cut. You couldn't even recognise it as a foot....If I had thought it was somehow re attachable and usable, I would have gone to my commander.'

The lawsuit, however, contends that Economou: 'Removed the leg rather than delivering it to the hospital where it could have been reattached.'

At the time of her 2009 arrest, police records show the foot was valued at less than $100.

At the time it was alleged that Economu brought the amputated foot to a fire station before a family member brought it home to use for training her cadaver dog.

Body recovery or 'cadaver' rescue dogs help search teams find dead bodies in murder or disaster recovery situations.

They are trained to sniff out decaying of putrefied human remains in a range of climates, including freezing water.

Crash: This is the car crash where the foot was found by Miss Economu in 2008

Speaking to website TCpalm at the time she said: 'This is just so unbelievable, it’s like a dream I’m in.

'I can’t believe it’s happening.'Economou left her paramedic job after the incident came to light.

Mr Lambert had to have his leg amputated roughly five inches below the knee after the accident.

She was sentenced to six months probation, but was not formally convicted of the crime.

In 2007 Economou was named St Lucie County fire fighter of the year.

Yanks C Cervelli out indefinitely with broken foot

2011-03-07T14:50:00.002-06:00

– Fri Mar 4, 4:16 pm ET

TAMPA, Fla. – New York Yankees backup catcher Francisco Cervelli will be in a protective boot for at least four weeks because of a broken left foot, and it's uncertain when he'll be able to play again.

Cervelli was hurt when he fouled a ball off his foot Wednesday against Houston, and the break is above the toes. Yankees manager Joe Girardi announced the extent of the injury before Friday night's game against Boston.

Test results will be reviewed by a foot specialist. It's not known how long it will take for Cervelli to complete a rehab program once the boot is removed.

"How long it would take after, if it was healed, you don't know," Girardi said.

Girardi said there are no current plans to use Jorge Posada, who is moving from catcher to designated hitter this season, behind the plate in spring training games.

"I can't tell you 100 percent, exactly, what's going to happen over the next four weeks," Girardi said. "I can't. Just like I wouldn't have predicted this, but right now I don't plan on having him really catch in a game. We'll see what the other guys can do."

Jesus Montero, Austin Romine and Gustavo Molina are the top contenders to back up starter Russell Martin, who had offseason surgery to repair a minor tear in his right knee.

"We still have plenty of guys here that could earn that spot," Girardi said. "Basically what it does, it eliminates a catcher from the opening day competition."

Cervelli does not have much luck in spring training. Last season he was sidelined with a concussion and in 2008 he broke his wrist in a collision at the plate.

"He's had a rough go at spring training," Girardi said. "I feel for him. You could see the disappointment when we walked over to tell him."

Montero played at Triple-A last season and Romine was in Double-A. Molina has 23 games of major league experience, including four with the Red Sox last season.

"When you look at Montero and Romine, the one thing they're lacking was the big league experience," Girardi said. "But, they're not lacking in talent. We're not sure, if it's one of the kids, how they're going to handle it, but we might find out."

NOTES: RHP Rafael Soriano, the former Tampa Bay closer who be the primary eighth-inning setup man for closer Mariano Rivera, threw 20 pitches during his first batting practice session. Bradley Suttle and Daniel Brewer put the ball in play in just three of 11 swings. "Probably as many swings and misses in a batting practice session as I've ever seen," Girardi said. Soriano could be ready for his first game action after one more BP outing.

Why Does My Big Toe Joint Hurt: Part 2

2011-02-25T10:04:00.000-06:00

Well its been a little over a week wearing my orthotics. I must say that the biggest challenge about wearing these is getting used to tennis shoes and socks....not the orthotics. Living in Florida has put me in the bad habit of wearing thin, crappy flip-flops. I took my first long walk with them in on Tuesday. My toe was a little bit stiff at first but once I started walking it felt pretty darn good. The bad part of my walk was the squeaking. It was so loud it made me self conscious. The good part of my walk is that my destination was the grocery store where I could pick up some baby powder. As soon as I took my orthotics out and sprinkled baby powder in the bottom of my shoes the menacing noise disappeared.

Wednesday I had a softball game and I wanted to wear them but Im not to that point yet. Not because they are not comfortable but because Im too superstitious! I know that it is extremely silly but hopefully Dr. Gordon will understand. My toe really doesn't hurt as much as it used to so I am pretty excited that the orthotics are making a difference. Tomorrow will be the big test....I am going to take a run in them. Wish me luck!

Why Does My Big Toe Joint Hurt

2011-02-16T14:18:00.000-06:00

As I walked into Gulfcoast Foot and Ankle I was greeted by the familiar faces behind the desk. I was not walking in as an employee that day, but for the first time as a patient. For about 5 months now my big toe joint has hurt me pretty badly. Why would I wait so long to see a podiatrist….especially when I work for one!? Well I guess the main reason is sheer stupidity. But in all honesty I just figured the pain would go away. Well it did not so there I sat in the waiting room to see Dr. Gordon. He was extremely surprised to see me thinking I stopped by to discuss marketing strategies or to go over the Student Scholar Athlete Awards we need to present….no Dr. G Im here as a patient. I was placed in a chair and asked a few questions and he decided the best thing to do was some simple x-rays to see what was going on in that toe joint. A lovely lady appeared in the room and whisked me away to the x-ray machine. After a few minutes I was back in the chair studying my bones with Dr. Gordon. Hallux Limitus, Dr. Gordon told me with no look of question or doubt in his face.

Hallux Rigidus/Limitus involves the 1^st metatarso-phalangeal joint. This joint is located at the base of the big toe. Hallux Rigidus/Limitus causes pain and stiffness in the big toe, and with time it becomes increasingly harder to bend the toe. This is a progressive condition during which the toe's motion decreases as time goes on. In the early stages, motion of the big toe is only limited, and at this point, the disorder is called Hallux Limitus. As the problem advances, the big toe's motion gradually decreases until it becomes rigid or frozen. At this point, the disorder is referred to as Hallux Rigidus. As motion becomes progressively limited, pain increases, especially when the big toe is extended, or pushed up.

Great…what now… was the only thing I could think. Im trying to start running and this really was putting a damper on things!! Dr. Gordon decided to cast me for orthotics. My feet are flat I had this Hallux Limitus thing going on so it seemed like the best thing to do. He had me lay on my back and lay on my stomach and took measurements of my feet. Then he proceeded to put strips of wet plaster on my foot to make a mold. He made quick work of the plaster and before I knew it he was taking these white molds off my feet that sort of resembled a thin version of a wooden shoe from Holland that looked just like my foot! So off to the lab went my feet molds.

This morning a received the call that my orthotics were in! I was so excited to see what they would feel like. I packed up my sneakers and socks and headed to the office. This was a special trip because I was going to the office today as both an employee AND a patient. Dr. Gordon put the orthotics in my shoes and told me to give them a try. My feet felt AMAZING!!! Even after 1 minute of walking in them my feet felt so good. The pain in my toe isn’t gone yet but Im sure it will take more than 2 minutes. I was almost sad that I was only allowed to wear them for a couple of hours today. But…Doctors orders! I will let you know next week the progress that I am having since I will be wearing them a lot more then.

Jennifer Grey of DWTS has Foot Neuroma Removed

2011-02-15T10:23:00.000-06:00

Jennifer Grey has undergone surgery to have a neuroma removed from her foot.

The 50-year-old Dirty Dancing actress and Dancing With The Stars champion, said that the growth got worse after her stint on the show, leaving her with no option but to have the surgery.

Writing on Twitter, she said, 'Hard to believe, but I just had my foot operated on so hopefully I can walk again. Gotta dance. Miss you all. I guess that's the price of doing business when you kick ass like that at my age... haha.

'I had a neuroma the size of a small city removed. I think I went down a shoe size on one foot. After Dancing With The Stars it just got worse and worse, so do whatcha gotta do.'

She added, 'Ain't no thang. Pain is just a feeling. Then it's gone.'

Study finds increase in running-related injuries among children

2011-02-08T12:03:00.002-06:00

The annual number of running-related injuries has increased 34% during a 14-year period, according to a study published in the Feb. 2011 issue of Clinical Pediatrics.

Investigators examined running-related injuries — primarily sprains and strains to the lower extremities — among children and adolescents aged 6 to 18 years, finding an estimated 225,344 cases treated in emergency departments throughout the United States from 1994 to 2007. The data was collected from the National Electronic Injury Surveillance System.

One-third of the injuries involved a fall, the investigators noted, and more than 50% of running-related injuries occurred at school. The injuries varied by age, however, with children aged 6 to 14 years being more likely to suffer injury as the result of a fall or while running at school. Adolescents 15 to 18 years of age were more likely to sustain injuries while running in the street or at a sports and recreation facility.

“Encouraging children and adolescents to run for exercise is a great way to ensure that they remain physically active,” investigator Lara McKenzie, PhD, stated in a press release. “However, the findings from our study show that formal, evidence-based and age-specific guidelines are needed for pediatric runners so that parents, coaches and physical education teachers can teach children the proper way to run in order to reduce the risk of injury.”

The authors noted that this is the first study to examine a nationally representative sample of running-related injuries treated in U.S. emergency departments, but added that further research is necessary to thoroughly understand pediatric running-related injuries and the role injury prevention can play in reducing them.

References:
Mehl AJ, et al. Running-related injuries in school-age children and adolescents treated in emergency departments from 1994 through 2007. Clin Pediatr. 50(2);126-132. doi: 10.1177/0009922810384719.
www.nationwidechildrens.org

Flat Feet Are Associated With Knee Pain and Cartilage Damage in Older Adults

2011-02-02T12:20:00.001-06:00

Researchers assessed the cross-sectional relation of planus foot morphology to ipsilateral knee pain and compartment-specific knee cartilage damage in older adults. The study, of 1,900 adults in their 50s or older, found that those with the flattest feet were 31 percent more likely than other study participants to say they had knee pain on most days. And they were 43 percent more likely to show damage to the cartilage at the inside of the knee.

Dr. Gordon has always believed that bad knees can be caused or exacerbated by flat feet. In 1994 he was talking about a research project with the Chairperson of the Department of Orthopedics at the University of Washington to see if a well made orthotic device would prevent knee surgeries specifically joint replacement surgery. Regrettably he left Seattle before the project could get off the ground.

Abstract

Objective.

To assess the cross-sectional relation of planus foot morphology to ipsilateral knee pain and compartment-specific knee cartilage damage in older adults.

Methods.

In the Framingham Studies, we adapted the Staheli Arch Index (SAI) to quantify standing foot morphology from pedobarographic recordings. We inquired about knee pain and read 1.5 Tesla MRIs using whole-organ magnetic resonance imaging scoring. Logistic regression compared the odds of knee pain among the most planus feet to the odds among all other feet, and estimated odds within categories of increasing SAI. Similar methods estimated the odds of cartilage damage in each knee compartment. Generalized estimating equations adjusted for age, sex, BMI, and non-independent observations.

Results.

Among 1903 participants (mean age 65± 9 years; 56% female), 22% of knees were painful most days. Cartilage damage was identified in 45% of medial TF, 27% of lateral TF, 58% of medial PF, and 42% of lateral PF compartments. Compared with other feet, the most planus feet had 1.3 (95% CI: 1.1, 1.6) times the odds of knee pain (p=0.009), and 1.4 (95% CI: 1.1, 1.8) times the odds of medial TF cartilage damage (p=0.002). Odds of pain (p_trend=0.05) and medial TF cartilage damage (p_trend=0.001) increased linearly across categories of increasing SAI. There was no association between foot morphology and cartilage damage in other knee compartments.

Conclusion.

Planus foot morphology is associated with frequent knee pain and medial TF cartilage damage in older adults.

A Guide To Conservative Care For Adult Flatfoot

2011-01-25T08:41:00.000-06:00

Author(s): Patrick DeHeer, DPM, FACFAS, and Jessica Taulman, DPM

In recent years, the management of adult flatfoot has shifted from early surgical treatment to more conservative options for this commonly seen condition. Accordingly, these authors discuss the evaluation of adult flatfoot and enumerate various conservative methods to consider as initial treatment.

Adult flatfoot is a common problem we, as podiatrists, see every day. Without early identification of the problem, the flatfoot deformity can progress.

There has been a shift in protocol over the years from surgical treatment early on in the diagnosis of adult flatfoot to a more valiant attempt at conservative treatment. In 1997, Sferra and Rosenberg stated that “conservative management is a critical part of initial treatment of posterior tibial tendon insufficiency, especially in patients with advanced age, sedentary lifestyle and medical comorbidities that preclude surgical intervention.”

In order to provide adequate treatment, whether it is surgical or conservative, to a patient with flatfoot, it is important to evaluate the patient clinically and radiographically to determine the cause of his or her flatfoot deformity. During the physical exam, the patient should stand during the observation. The physician should look for asymmetrical swelling, abduction of the forefoot and pes planus.

One should perform the bilateral heel rise test. When the heels appear asymmetrical or there is not a complete heel rise, consider posterior tibial tendon dysfunction (PTTD). Also perform the single limb heel rise. Incomplete inversion of the heel on toe rise or difficulty performing this test should alert the practitioner to a problem with the posterior tibial tendon.

During a seated exam, palpation of the tendon is necessary to evaluate soft tissue swelling and tenderness along the course of the tendon. To test motor strength, the podiatric physician should have the patient invert the foot against resistance with the foot plantarflexed to keep the tibialis anterior from substituting.

Radiographic evaluation reveals lateral subluxation of the talonavicular joint, an increase in the talo-first metatarsal angle and an increase in the divergence of the talus and calcaneus on the AP view. The lateral view will demonstrate plantarflexion of the talus, a decrease in the lateral talocalcaneal angle and collapse of the longitudinal arch. As the deformity progresses, the subtalar and talonavicular joints narrow. Ankle radiographs show arthritis and talar tilt in a longstanding deformity.

After clinically and radiographically evaluating the patient with a flatfoot deformity, it is important to distinguish between a flexible and rigid deformity. One can do this by evaluating the range of motion of the subtalar joint and perform the Hubscher maneuver (“Jack’s test”). If the arch cannot be recreated and the subtalar joint motion is limited, one must suspect a tarsal coalition or rigid flatfoot.

After determining whether the flatfoot deformity is rigid or flexible, the clinician should further evaluate the flexible flatfoot to determine the level of involvement of the posterior tibial tendon (PTT). The PTT is often the culprit of flexible adult flatfoot. The tendon is located posterior to the axis of the tibiotalar joint and medial to the axis of the subtalar joint. It functions to plantarflex and invert the foot.

The PTT also creates a rigid lever during gait.

When it is not functioning properly, the tendon is unable to form the rigid lever needed for gait and the forward propulsion of the gastroc-soleus complex acts at the midfoot, thus causing midfoot collapse. The PTT is injured by a combination of vascular insufficiency and the mechanical pulley of the tendon along the medial malleolus.

A Primer On PTTD Classifications

Johnson and Strom developed a PTTD classification system, which was later modified by Myerson to include stage IV.

Stage I. Peritendinitis and tenosynovitis of the posterior tibial tendon present. The rearfoot remains mobile and the patient has pain medially. A single heel rise test reveals mild weakness to the posterior tibial tendon.

Stage II. The posterior tibial tendon is elongated and attenuated. The rearfoot remains mobile. However, the calcaneus is in valgus on stance. There is still pain medially. The patient is still able to perform the single heel rise test although it is weak. A positive “too many toes” sign is present.

Stage III. Degeneration of the posterior tibial tendon is evident. The rearfoot becomes fixed and less flexible, and the calcaneus remains in valgus on stance. The patient may have pain both medially and laterally due to impingement laterally. A positive “too many toes” sign is visible.

Stage IV. A valgus tilt to the talus in the ankle mortise and early degeneration of the ankle joint are present.

Conti and colleagues developed another common classification system.11 This classification system is based on MRI and evaluates the state of the posterior tibial tendon.

Type I tear. One or two fine longitudinal splits occur in the tendon without degeneration of the tendon.

Type II tears. This involves wider, longitudinal tendon splits and intramural degeneration. The tendon also may show a variable diameter on selected cuts where a bulbous section may be distal to an attenuated portion.

Type III tears. More diffuse swelling and uniform degeneration of the tendon are present. A few tendon strands may remain or the tendon may be replaced entirely with scar tissue.

Current Concepts In Conservative Treatment

Goals for conservative treatment of flexible flatfoot include eliminating clinical symptoms, improvement of rearfoot alignment and prevention of progressive deformity.

Treatment for flexible flatfoot generally begins with immobilization via a removable cast boot or below the knee cast for up to six to eight weeks. This decreases inflammation and prevents overuse for acute tenosynovitis. Steroid injection into the tendon sheath for tenosynovitis continues to be controversial due to the adverse effect of tendon rupture.

One may also utilize UCBL orthotics to stabilize the rearfoot. These are helpful in patients with a stage II deformity because the rearfoot is flexible and passively correctable in this stage. These orthotics limit the range of motion of the subtalar joint and forefoot abduction. Other orthotics may have a medial posting, like the Blake inverted orthotic, to decrease the strain on the posterior tibial tendon medially and push the foot into a more rectus position.

Changes in shoegear and shoegear modifications are often beneficial to patients with a flexible flatfoot deformity. An extra depth shoe is able to provide a long rigid medial counter, a soft leather upper, high toe boxes and soft soles to absorb some ground reactive forces during gait.

One can add a medial stabilizer to the shoe as well as a rocker bottom to assist in toe off. It is also possible to add a medial wedge inside the shoe to support the posterior tibial tendon.

The Baldwin Boot Brace (Bolt Systems) is able to provide edema control, stability of affected joints and soft tissue protection. This low-profile device controls and restricts subtalar joint motion. This boot is able to provide good control of tibial rotational forces and has anterior padding to protect the anterior lower leg. One can use the Baldwin Boot Brace for patients with stage III deformity and patients with a fixed deformity as it holds the deformity and protects soft tissues.

A temporary bracing option for posterior tibial tendon tenosynovitis is a stirrup brace. This brace is not able to control motion in the sagittal plane but it is able to help unload the posterior tibial tendon by transferring plantarflexion to the Achilles tendon and relieves strain from plantarflexion from the posterior tibial tendon.

A short ankle-foot orthotic (AFO) is helpful for stage II PTTD. This is able to control and restrict the subtalar joint more than orthotics alone. Use a tall AFO in stage III cases because the rearfoot can no longer be passively corrected to neutral. This tall AFO is able to prevent pronation during push off. The AFO also stabilizes the mediolateral movement of the ankle and limits excursion of the posterior tibial tendon by preventing plantarflexion and pronation.

There are numerous types of AFOs that are options. One common AFO is the Arizona brace. This brace reduces rearfoot valgus and midfoot collapse. The Richie brace is another effective AFO, which clinicians can use to help address the early stages of posterior tibial tendon dysfunction.

The patellar tendon bearing brace is an option to consider for elderly patients. This redistributes weight to the patellar tendon, medial tibial flare and popliteal area.

Iontophoresis with dexamethasone is a physical therapy modality. While this option is not as commonly employed as bracing options, iontophoresis can provide effective relief of inflammation to the PTT. There are no documented risks of tendon rupture with this modality and one may use this as a substitute for the controversial steroid injections into the tendon sheath.

To further determine which treatment options are helpful for patients with various stages of flatfoot, see “Recommended Treatments For Different Flatfoot Stages” at top right.

Other Considerations In Managing Flatfoot

Stretching of the gastroc-soleus complex is also important to consider. A tight heel cord increases the levering upward on the calcaneus and increases tension on the plantar fascia and ligamtents. When a flatfoot deformity occurs, the Achilles tendon assumes a position lateral to the subtalar joint axis and the gastroc-soleus shortens over time. Thordarson demonstrated that the Achilles tendon has a threefold greater effect on the deformation of the arch than the PTT has on supporting the arch.

Equinus is an essential piece to the puzzle of adult flatfoot that one should treat in order to reduce the pain and deformity. Adding a heel lift to orthotics or bracing will also help eliminate the equinus component to the flatfoot deformity.

The peroneus brevis is another muscle that one should consider when evaluating adult flatfoot.

Mizel and colleagues evaluated 10 patients with loss of both the peroneal tendon and the posterior tibial tendon due to common peroneal nerve palsy.17 This study showed that after five years, there were no patients who developed a flatfoot deformity. The authors concluded that the posterior tibial tendon and the peroneus brevis provided the balance of the foot medially and laterally. Since these tendons were not functioning, neither provided unopposed force. With no unopposed force, a rearfoot valgus did not result. The authors determined from this result that dysfunction of the posterior tibial tendon alone was not enough to cause a flatfoot deformity.

Tarsal coalition can result in a rigid flatfoot that causes a static foot deformity. The talocalcaneal and calcaneonavicular joints are common joints involved in tarsal coalition. Accommodative orthotics are first line treatment for flatfoot caused by tarsal coalition.

Final Thoughts

Conservative treatment is often able to decrease pain and the progression of flatfoot deformity. Early detection and treatment of posterior tibial tendon dysfunction can keep the deformity from progressing to further stages in the adult flatfoot scheme. Therefore, it is important to do a thorough history and physical exam with radiographic studies. Surgical correction is indicated for both complete posterior tibial tendon rupture and progressive deformity of the foot.

Should tenosynovitis persist after an extended period of conservative treatment, one should consider surgical correction as well. It is important to evaluate the patient thoroughly to be certain that one has explored the proper treatment methods.

Dr. DeHeer is a Fellow of the American College of Foot and Ankle Surgeons, and is a Diplomate of the American Board of Podiatric Surgery. He is also a team podiatrist for the Indiana Pacers and the Indiana Fever. Dr. DeHeer is in private practice with various offices in Indianapolis.

Dr. Taulman is a first-year resident at Westview Hospital in Indianapolis.

Zsa Zsa Gabor's Lower Leg To Be Amputated

2011-01-09T16:47:00.000-06:00

UPDATE: Doctors decided Monday to try an aggressive course of antibiotics in order to avoid having to amputate. They say they won't know until Tuesday, when she undergoes the second half of the treatment, if the meds are working.
___________________________

Some more bad news for Zsa Zsa Gabor: After a New Year's celebration filled with champagne and caviar, the veteran diva returned to the hospital on Sunday to have the lower part of her right leg amputated.

The 93-year-old was rushed by ambulance to Ronald Reagan UCLA Medical Center after doctors ordered the surgery.

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"She wanted to stay home and have a holiday. They wanted to do this before the holiday, but now the doctors have forced us," the actress's husband, Prince Frédéric von Anhalt, told People.

What exactly went so wrong?

Gabor, who has been in poor health since suffering complications from hip surgery over the summer, had recently developed a lesion on her swollen leg. The wound, which did not respond to treatment, had quickly grown from just over an inch to nearly a foot in length.

"Doctors had wanted to operate on it for several days," said Gabor's spokesman, John Blanchette, but the actress wanted to first spend New Year's at home with von Anhalt.

"Frédéric and Zsa Zsa asked if they could spend New Year's at home, and [they] shared champagne and caviar. The doctors came to the house [Sunday], and when they unwrapped the bandages, the wound had festered and they were afraid of gangrene developing, which would be life-threatening," Blanchette said.

She was then taken to the hospital and prepped for surgery in the early evening.

"It's a dangerous operation, but the upside is that, if successful, she will remain her same old feisty self for a few more years," Blanchette said.

The Hungarian actress has been confined to a wheelchair since a 2002 car accident. Three years later, in 2005, she suffered a stroke, and has since experienced more health problems.

Before this latest emergency, Gabor had fallen out of bed and broken several bones. She was sent home a month later this past August but two days later was rushed back and even read her last rites by a priest.

What is Turf Toe?

2010-12-21T08:32:00.000-06:00

Turf Toe is a sprain injury to the big toe joint (also known as the 1^st MPJ, hallux or great toe). The incidence of this injury has increased over the years secondary to athletic fields being covered by artificial turf and also by increased flexibility of the toe box in athletic shoes.

The rough nature of many contact sports is a factor involving abnormal extension, flexion and rotational movements that cause injury to joints and soft tissue structures. One such injury is a sprain to the big toe joint, commonly referred to as turf toe. Turf toe is seen most common in football, but it can occur in any activity, such as soccer, tennis, volleyball, wrestling and even dancing.

The big toe joint is composed of 4 bones, 9 ligaments, 3 muscular attachments and the joint capsule (which is considered a ligament). Two of the bones are called sesmoids, which are encapsulated inside a tendon and the other are two are 1^stmetatarsal bone and the proximal phalanx (your toe, which moves up and down). Your big toe joint has a large range of motion in two main directions: dorsiflexion (toe going up) and plantarflexion (toe going down). This is required for normal ambulation, however when this range of motion is exceeded, you get turf toe.

The most common example of turf toe is in a football player. If you can imagine a football player at the start of a play, you will notice that the athlete has their foot planted on the ground, the big toe joint hyperdorsiflexes (bending more than it should) and the heel is raised up off the ground. During an applied downward force (up to 8 times his/her body weight), the big toe is dorsiflexed beyond its biomechanical limits, resulting in tear of the joint capsule.

The initial treatment of turf toe is RICE: rest, ice, compression and elevation. In the initial stages of suspected turf toe, taping is not recommended due to the swelling that occurs and the possibility of neurovascular compromise. Is you suspect that you may have a turf toe injury, call your podiatrist and have them take x-rays to rule out a possible fracture.

By David Hunnicutt

$8m device saving life and limb

2010-12-08T09:19:00.002-06:00

A DEVICE produced by a small company in St Leonards offers hope for people who face losing a limb due to peripheral vascular disease.

After six years and $8 million of research and development, the product has already saved, in a pilor study, seven legs and a hand from being amputated.

Worldwide, 1000 legs are amputated each day - and 40 per cent of those amputees die within a year of surgery. Smoking and diabetes are the primary causes.

But those statistics could change dramatically due to the peripheral access device made by Australian Surgical Design and Manufacture in collaboration with North Shore vascular surgeon Professor Rodney Lane.

The device, implanted into an artery and connected to a high pressure pump, has been shown to stimulate the growth of new blood vessels.

ASDM chief executive Greg Roger said the product, approved by the Therapeutic Goods Administration for an unassociated use - isolated organ chemotherapy - was being trialled on vascular patients as part of a pilot study.

Its success rate had been about 50 per cent on 15 patients who all had serious health issues. “We know it works and once we have done thousands, patterns will appear to produce an even higher success rate,” Dr Roger said on a tour of his plant. The company also makes orthopaedic devices such as artificial knees.

The device is availabe only for those with no other options outside amputation.

Professor Lane, who invented the hypertensive extracorporeal limb perfusion procedure, said he developed it because he was “sick and tired of amputating legs” and that he was pleased with the trial results.

Shoes and knee pain

2010-12-01T07:10:00.000-06:00

Chicago hospital to study shoes and knee pain

Associated Press

2:18 a.m. CST, December 1, 2010

CHICAGO —

A Chicago hospital is recruiting people with knee pain to test a shoe designed to mimic the mechanics of barefoot walking.

Dr. Najia Shakoor of Rush University Medical Center is researching how footwear changes forces on the knee joints. She's designed a shoe that's flat and lightweight with flexible soles.

Study participants will wear the shoes for six hours each day, six days a week, for six months. They must be older than 35 and have knee pain caused by mild or moderate osteoarthritis. They also must be able to walk without assistive devices.

Shakoor's prior research has shown that barefoot walking puts less of a load on the knees than does walking in conventional shoes.

Diabetic foot ulcers in underinsured patients

2010-11-19T08:20:00.002-06:00

According to the CDC, almost 24 million Americans have diabetes, and it is estimated that six million of those individuals are undiagnosed.¹ In 2007, financial costs attributed to diabetes totaled $174 billion.² Additionally, comorbidities linked with diabetes may lead to serious complications and create additional economic and individual burdens. The development of diabetic foot ulcers (DFUs) is one such complication.

DFU treatment utilizes a considerable portion of health-care dollars and may also lead to significant disability and a decrease in quality of life. Patients with diabetes have a 15%-25% lifetime risk for developing a foot ulcer.^3,4When ulceration occurs, the risk for infection is present and may range in severity from a superficial area to one that pervades the bone. About 25% of diabetic foot infections will extend to deeper subcutaneous tissue or bone, and up to 50% of those individuals will have a recurrent ulcer within the next few years.⁵ Infection is the leading risk factor for amputation among those with DFUs.⁶

Considering the prevalence of diabetes, it is conceivable that most primary-care providers (PCPs) will encounter patients with foot ulcers. Practitioners treating patients with diabetes must focus on prevention of ulcerations, prompt diagnosis, treatment initiation, and appropriate referrals to preserve optimal functioning. Given the number of uninsured or underinsured individuals, adhering to this seemingly straightforward strategy can prove difficult. Lack of access to primary care leads many patients to delay care, which prevents detection or delays diagnosis until the advanced stages of disease.

The following case illustrates the challenges faced by many PCPs when caring for an underinsured patient with type 2 diabetes mellitus (DM) and a DFU.

CASE STUDY

Mr. J, aged 45 years, was hospitalized for two weeks with cellulitis and a left plantar foot ulcer. Incision and drainage (I & D) revealed three purulent sinus tracts extending from the superficial to the deep space of the left foot involving the first and second metatarsal heads. An MRI established the presence of osteomyelitis, but fortunately the bone was viable, and amputation was avoided. Culture was positive for group B Streptococcus and methicillin-susceptible Staphylococcus aureus, and the patient was treated with antibiotics for six weeks. Ankle-brachial indexes (ABIs) and toe waveforms were within normal limits. On admission, Mr. J's blood sugar was 312 mg/dL and hemoglobin (Hb) A1c was 12.9%. He was diagnosed with type 2 DM and started on insulin therapy. Mr. J achieved good glycemic control, extensive diabetes education was provided, and he was discharged to follow-up in the primary-care setting.

POST-HOSPITALIZATION FOLLOW-UP

Over the next six months, Mr. J lost 83 lbs, his HbA1c dropped to 5.5%, and his foot ulcer healed. He kept regular appointments with a podiatrist and maintained routine foot care. A small blister was discovered near the site of the previous left plantar DFU (Figure 1). Antibiotic therapy was ordered along with an OTC antimicrobial ointment to be applied to the wound site. While the culture showed no infection and x-ray did not reveal osteomyelitis, the ulcer continued to extrude a small amount of nonodorous serosanguinous drainage. After caring for Mr. J for two months, the PCP referred him to a hospital outpatient wound-care clinic.

Taking Care of Your Skin

2010-11-15T18:52:00.000-06:00

What Can I Do to Take Care of My Skin?

After you wash with a mild soap, make sure you rinse and dry yourself well. Check places where water can hide, such as under the arms, under the breasts, between the legs, and between the toes.

Keep your skin moist by washing with a mild soap and using lotion or cream after you wash.

Keep your skin moist by using a lotion or cream after you wash. Ask your doctor to suggest one.

Drink lots of fluids, such as water, to keep your skin moist and healthy. Wear all-cotton socks. Cotton allows air to your feet and can help to absorb moisture.

Check your skin after you wash. Make sure you have no dry, red, or sore spots that might lead to an infection. Always check between your toes for trouble spots. Be sure that you dry well after bathing and do not use moisturizers between your toes unless specifically directed to do so by your doctor.

Tell your doctor about any skin problems.

For More Information about diabetes and diabetic foot problems in particular, just ask your doctor or health care provider. Remember, you must be involved in your own diabetic foot care to prevent problems and maintain proper foot health!

If The Shoe Hurts, There May Be A Remedy

2010-10-26T10:13:00.000-05:00

If The Shoe Hurts, There May Be A Remedy

by Patti Neighmond

Many people figure foot pain is just another problematic part of aging, and they'll just have to live with it and get used to the pain. Hannan says nothing could be further from the truth. If you have foot pain, she says, go see someone who specializes in feet. That would be either a podiatrist or a physical therapist with foot expertise. The pain can often be treated successfully and further problems prevented.

Foot pain in Hannan's study most commonly came from bunions, but people also had hammertoes, corns, calluses, flat feet and a very painful condition called plantar fasciitis. All of these conditions get worse with age, Hannan says.

The problem is also exacerbated by the obvious: Shoes — heels, pointy and narrow — that just don't fit. Men tend to buy ill-fitting shoes that are too big, which can present support problems.

But for women, the problems are more varied. Toes squished into pointy shoes. Foot bones crunched into shoes that are too narrow. And feet smooshed into shoes that are just too small. Heels, of course, put added pressure on the ball of the foot, and if the ball of the foot is squished into a pointy toe box, the problem is even worse.

And, unfortunately as we age, our feet can feel the brunt.

"Our feet can actually get wider, and they can change shape," says Emily Cook, the podiatrist. "They can change size. You can lose flexibility within your joints. Certain foot deformities — bunions, hammertoes" — can worsen over time. Weakened ligaments and joints, arthritis and a thinning of the fatty pads on the bottom of our feet can also cause complications.

And men aren't exactly off the hook. The same things happen to the aging male foot. But because of the shoes women tend to wear, foot problems are far more common among women.

The New Shoe Remedy

Cook says there can be remedies. Many problems, she says, can be diminished by simply buying more appropriate shoes. And she offers a number of suggestions: First off, shoes should fit properly. It's best to buy shoes at the end of the day, as feet can swell as the day wears on. Also, get your feet measured routinely. Aging feet can get wider and longer. You may no longer be that size 6 at age 55.

You should be able to wiggle your toes in the shoe. They should not be crunched. The heel should offer support and shouldn't collapse when you squeeze the heel-box portion of the shoe. If shoes don't feel comfortable right away, don't buy them. And don't be fooled by the you-just-have-to-break-them-in argument. There's no such thing as a break-in period.

If you feel you have to wear dressy shoes or heels for work, try wearing different pairs on different days.

"What I tell women in this particular situation is that you need to think of different types of shoes for different types of purposes," Cook says. "For example, when you're traveling, you don't want to wear a dressy type of shoe. You need something like a sneaker, something very supportive that's comfortable so you're not beating up your foot before you even make it to the event."

Cook also encourages patients to minimize the amount of pressure placed on their foot by wearing lower heels.

"If you must wear heels, try to change the heel height and use different-size heels on different days," she says. Cook appreciates women's need to appear stylish on the job, adding that it's frustrating for women in particular because the shoe industry is driven by fashion — not comfort and fit.

The Next Step

For some patients, new, more comfortable shoes may not be adequate enough to relieve and even treat foot pain. They may need orthotics, which are plastic inserts that fit directly into the shoe for cushioning and support. Some over-the-counter products are fine. Cook says patients often try these less expensive options first.

Some foot doctors think custom orthotics are too expensive, especially since they are typically not covered by health insurance. But for particularly complex problems, Cook says custom orthotics may be exactly what's needed.

For 62-year-old Robin Bentz, just putting her foot on the ground and standing up had become excruciating. Early on, she thought the pain would just go away. It didn't. As a retired nurse, Bentz suspected plantar fasciitis. She was right.

"It got so bad that I would get up in the middle of the night and go to the bathroom, and my feet would ache so badly by the time I went to the bathroom and came back to bed," Bentz says. "The pain would just literally keep me awake for the rest of the night."

Bentz tried to adjust how she walked to compensate for the pain. But then, her knees started to hurt. She went to an orthopedic surgeon and had cortisone injections, but the pain continued.

Finally, she went to see Cook. After an examination, Cook suggested custom-made orthotics. Bentz has two pairs of orthotics that she alternates.

"It's been like a miracle," Bentz says. "My feet never touch the ground unless I have my orthotics."

Bentz says she was astounded that something so simple would cure such a huge problem, and she's forever grateful. But things don't always work out this way. Cook says some patients eventually require surgery, particularly for bunions. But often surgery can be put off for years with good shoes — and, possibly, orthotics.

Possible Causes Of Smarting Feet

Stiff Shoes: Shoes should be stable, but flexibility is also key. They should bend in the spot where the toes bend.

Shoes That Don't Fit Properly: Shoes that are too big or too small can pinch or strain feet. As you age, your feet may grow wider and longer, and your shoe size may change, so measure your feet regularly.

High Heels: If you have to wear high heels, try varying the shoe and the heel height during the week.

Same Shoes Every Day: Alternating shoes on different days can help keep feet limber.

—Eliza Barclay

Reggie Bush fractures fibula

2010-10-26T09:52:00.000-05:00

Reggie Bush Injury: Injured Saint Has Broken Fibula
BRETT MARTEL 09/21/10 10:13 PM

NEW ORLEANS — Reggie Bush's broken leg likely will sideline him about six weeks but not the rest of the season, a person familiar with the injury said.

Bush was expected to be examined again Tuesday, according to the person who spoke to The Associated Press on condition of anonymity because the team has not officially updated Bush's condition.

The Saints had the day off after returning early in the morning from their 25-22 Monday night victory at San Francisco. Saints spokesman Greg Bensel said there were no planned updates on Bush's injury.

The bone in Bush's lower right leg was broken when recovered his muffed punt with 6:58 remaining. He had trouble catching the ball at windy Candlestick Park and was injured during the scrum after he dove for the ball and players landed on him.

"Last second it kind of shifted a little bit, just enough for me to drop it," he said. "I tried to recover it and somebody took my leg out. I don't know who it was, what happened or how it happened. I just know my leg got taken out. That's it.

"It hurt like hell," Bush said. "When I got back up and tried to walk on it, it felt terrible."

The injury capped a difficult past few days for Bush, who gave back his Heisman Trophy last week. The NCAA punished USC after concluding that Bush and his family improperly accepted money and gifts from sports agents while Bush played for the Trojans. Bush said he returned the award to end the controversy.

"It's been a pretty tough week," he said. "It's just the way life goes.

"I'm just trying not to think the worst and just try to stay as positive as I can in this situation," Bush said. "That's all you can do, hope for the best."

Brett Favre injures ankle again

2010-10-26T09:47:00.000-05:00

Avulsion Fracture: Brett Favre's Injury Could Snap Snap Viking QB's Streak

By Adam Lazarus (Correspondent) on October 26, 2010 2,967

An avulsion fracture (broken bones in his ankle) caused Favre to limp during the end of the Vikings 28-24 loss Sunday Night against Green Bay.

Favre's ankle was a major issue this offseason--he injured it late last year--and surgery was required. The elbow tendonitis that bothered him and the Jenn Sterger scandal set the ankle issue on the backburner for a while. Now it has returned.

Favre was noticeably limping throughout the second half of the Vikings game against the Packers on Sunday night. Still, he continued to play and nearly led the team to an incredible last-second comeback.

When the game was over, Favre hobbled into the locker room. Team officials confirmed the injury on Monday but have not yet ruled him out. Favre has started 291 consecutive games, dating back to the 1992 season.

Dr. Adarve Performs an Ankle Arthroscopy

2010-10-21T11:36:00.000-05:00

Antonio Gates injures toe

2010-10-19T09:43:00.000-05:00

Injury Spin Cycle: Chargers Optimistic About Antonio Gates' Toe

.10/19/2010 9:00 AM ET By Tom Lorenzo

There was some good news out of San Diego on Monday, as the Chargers said they were optimistic about Antonio Gates suiting up in Week 7 against the Patriots, according to the San Diego Union-Tribune. Gates left Sunday's game against the Rams in the second quarter, having suffered a toe injury on his left foot. It's on the same foot he was forced to have surgery on back in 2007, but the Chargers are saying that the two injuries are not related.

This is promising for fantasy owners relying on the game's top tight end who had 29 catches and seven touchdowns heading into Week 6. There's absolutely no way to replace Gates' production at the tight end position, so keep those fingers crossed and hope that the news only gets better as we get closer to Sunday.

Willis out with broken foot

2010-10-19T09:20:00.000-05:00

WR Willis lost for season

October 18th, 2010 6:05 pm MT.
The Broncos will once again be a man down as wide receiver Matthew Willis will miss the rest of the season with a broken foot, the Denver Post is reporting.

Willis left Sunday’s game with the Jets with a foot injury sustained on a special teams play. His foot will require season-ending surgery and he will be placed on injured reserve by the team.

It is not yet clear how the Broncos will fill his spot, but they do have another wide receiver, Britt Davis, on the practice squad. However, with the strong play of Brandon Lloyd, Jabar Gaffney, Eddie Royal and rookie Demaryius Thomas and with fellow rookie Eric Decker still in the mix, they may choose to fill another need with that spot.

Royal’s status is still unknown after he left Sunday’s game with a groin injury after a big hit from Jets cornerback Darrelle Revis.

Botox for foot problems

2010-10-19T08:59:00.000-05:00

Botox Now Being Used to Treat Foot Problems

LAKE CHARLES, La. -- You've heard of botox to reduce the appearance of fine lines and wrinkles, but how about problems with the feet?

That's just what one local group of doctors is using to get patients on their feet without pain.

At Center for Orthopaedics in Lake Charles, Drs. Craig Morton and Tyson Green are using botox injections to treat a wide range of foot problems.

"If there's damage to the brain or spinal cord," said Dr. Morton, "such as what you'd see in a spinal cord injury, head injury, stroke, multiple sclerosis, cerebral palsy - it can result in an abnormal posturing of the muscles of the hands and feet."

For the feet, Dr. Green said the muscle spasticities can cause the feet to remain contracted in a position which makes it difficult or impossible for the patient to walk comfortably.

"That's when the botox will come into play to relax a contracture," said Dr. Green, "so that we can either brace the foot or provide casting to provide stability and flexibility within that foot."

Botox weakens the targeted muscle, keeping it from contracting. Dr. Morton said by paralyzing one muscle or muscle group, the foot can relax enough to no longer overpower the surrounding muscles.

"It takes about two or three days from the initial injection into the spastic muscle to start to see results," said Dr. Morton, "and about two weeks after the injections, we see a peak effect - that can last about three months before slowly wearing off."

Dr. Green said many of the patients he treats in wound care have painful lesions resulting from the inability to move their feet in bed - reducing circulation. Botox has helped with this.

"When you relax the tension on the foot, you give it a more stable position," said Dr. Green, "that way the wound can heal and it will have adequate offloading, so that you're not having added pressure on the wound."

This pair says young children with cerebral palsy - all the way up to the elderly with muscle spasms can benefit from botox for the feet.

*Most insurance plans will cover botox treatments for foot problems.

Dont ignore your foot problems

2010-10-19T08:54:00.000-05:00

Health Tip: Alert a Podiatrist to Foot Problems

Don't just ignore them
Posted: October 12, 2010

(HealthDay News) -- Problems with your feet shouldn't be ignored. They can get worse over time, and can signal trouble elsewhere.

The American Podiatric Medical Association mentions these issues that should be discussed with a podiatrist:

•An open sore or ulcer on the feet, as they can indicate problems such as high blood pressure, sickle cell disease or a blood vessel condition.

•Swelling of the feet, which can indicate problems with the heart, circulatory system or kidneys.

•A burning sensation in the feet, which may indicate poor circulation.

These underlying medical issues also should be discussed with a podiatrist:

•Cardiovascular disease or high blood pressure, which could lead to insufficient blood flow to the feet.

•Rheumatic heart disease, as medications used to treat it may interfere with some medications used to treat foot problems.

•Diabetes, as it may affect sensation and circulation in the feet.

Greek Health System Opts for Amputation as Money-Saver

2010-10-18T08:51:00.000-05:00

Greek Health System Opts for Amputation as Money-Saver

This Saturday, one of Greece’s most respected newspapers, To Vima, reported that the nation’s largest government health insurance provider would no longer pay for special footwear for diabetes patients. Amputation is cheaper, says the Benefits Division of the state insurance provider.

The new policy was announced in a letter to the Pan-Hellenic Federation of People with Diabetes. The Federation disputes the science behind the decision of the Benefits Division. In a statement, the group argues that the decision is contrary to evidence as presented in the international scientific literature.

Greece’s National Healthcare System was created in the early 1980s, during the tenure of Prime Minister Andreas Papandreou. Papandreou, an academic, won election under the slogan, Αλλαγή, which is the Greek word for Change.

NFL players sporting pink cleats

2010-10-07T09:22:00.000-05:00

NFL Pink For Breast Cancer Awareness: NFL's Pink Shoes & Gloves

Share: by Jon Azpiri
October 1, 2009 at 01:27 pm

Pink is a color not normally associated with the NFL, but Week 4 of the NFL will see a wave of pink to honor Breast Cancer Awareness Month. All 30 NFL teams will be hosting several pregame and in-stadium initiatives to raise awareness about breast cancer. Many NFL players will be getting in on the act as the league has allowed players to wear pink accessories during games.

Several NFL players will wear pink shoes, tapes or other accessories to remind viewers that October is Breast Cancer Awareness Month. Players will wear a pink ribbon sticker on the back of their helmets.

At least 100 players are expected to wear pink shoes during this weekend's games. Perhaps the most prominent players wearing pink is Cincinnati Bengals wide receiver Chad Ochocinco, who will wear pink shoes during Sunday's game against the Cleveland Browns.

Chad Ochocinco has been twittering non-stop about his pink shoes.

While Ochocinco has been the most vocal supporter of the NFL's pink football shoes, the campaign was spearheaded by Carolina Panthers running back DeAngelo Williams. Williams had heard about the idea of NFL players wearing pink accessories and suggested that players wear pink cleats. The issue of breast cancer is a very personal one: his mother is a breast cancer survivor and three of his aunts died from the disease.

Military Boot Technology Improved

2010-10-07T09:11:00.000-05:00

GORE-TEX Footwear Technology Improves Comfort in Military Boots

W. L. Gore & Associates, Inc., has introduced a footwear technology for the U.S. military with optimized breathability in extended climate ranges. Specifically designed for hot climate conditions, GORE-TEX® Extended Comfort Footwear protects feet from exposure to rain and inclement weather, while allowing moisture vapor to escape from the boot, keeping feet dry and more comfortable. Boots made of this construction also pick up less water and dry out faster, in addition to reducing boot weight.

With a single-wall construction, GORE-TEX® Extended Comfort Footwear has been engineered specifically to ensure maximum breathability without compromising durable waterproof performance. Unlike other jungle or hot weather footwear, boots with this new technology have proven to provide waterproof protection and breathable comfort. Lab tests showed that these new boots retained 90 percent less water than comparable boots and that breathability over time was excellent. In field tests, participants perceived that these boots kept feet as cool as both the current desert boot and the temperate weather boot.

This new technology provides the opportunity to have one pair of boots for the widest range of climate conditions. According to Bill Candy, Gore’s North American footwear product specialist, Gore works closely with each manufacturer as each new boot design is developed. Candy explains, “We work with our customers to deliver the best product for their intended application, which in this case was to increase the comfortable climate range, particularly on the warm to hot side, of waterproof boots. We also work with customers to understand their requirements, develop a solution, and test the final designs to ensure that each product meets the unique environmental challenges that the military is faced with today.”

W. L. Gore & Associates

Gore is a leading manufacturer of thousands of advanced technology products for the electronics, fabrics, industrial and medical markets. Perhaps best known for its waterproof and breathable GORE-TEX® fabric, the company’s portfolio features a diverse array of innovations, including everything from guitar strings to life-saving cardiovascular devices. Gore is headquartered in Newark, Del., and employs 9,000 associates in 30 countries worldwide. It is one of a select few companies to appear on all of the U.S. “100 Best Companies to Work For” lists since the rankings were introduced in 1984. Visit www.GoreMilitary.com to learn more.

Padres' Hairston on DL with stress fracture of tibia

2010-09-23T09:32:00.000-05:00

Padres' Hairston back on DL with leg injury
Associated Press 0 Published: September 21, 2010

LOS ANGELES (AP) â€” San Diego Padres infielder Jerry Hairston Jr. is going back on the disabled list, barely a week after he came off it.

Hairston, a key contributor for the Padres in their bid to win the NL West title, has a stress fracture of his right tibia and he will be out four-to-six weeks.

Hairston came off the 15-day DL on Sept. 12 after having a strained right elbow.

He said if the Padres advance to the NL championship series he might try to play.

Hairston is hitting .249 with a career high-tying 10 home runs and a career-best 50 RBIs. He filled in while shortstop Everth Cabrera and then second baseman David Eckstein served stints on the DL.

Taylor Hashman released from hospital

2010-09-21T07:37:00.000-05:00

Naples baseball standout Taylor Hashman released from hospital

By ADAM FISHER
Published Tuesday, August 31, 2010

NAPLES — A former Naples High baseball standout has been released from the hospital after being severely injured in an altercation a month ago. Meanwhile, Taylor Hashman’s assailant has yet to be charged.

Hashman, a 2006 graduate and former baseball player at the University of Mississippi, was discharged from the Regional Medical Center in Memphis on Saturday. Hashman, 22, had been in the hospital since July 31 when he was struck in the face following an argument and injured his head when he fell to the ground.

The incident happened in front of Hashman’s apartment in Oxford, Miss., where the he had recently completed his senior season playing for the Ole Miss baseball team.

Hashman had surgery to remove part of his skull to reduce pressure on his brain. He was listed in critical condition by the hospital for more than a week. Hashman’s father, Don Hashman, told WMC-TV 5 in Memphis that his son was in a medically-induced coma for almost two weeks.

Attempts to reach the Hashman family Tuesday were unsuccessful.

While Hashman recovered, investigators in Oxford were waiting to press charges against the baseball player’s attacker. Oxford police chief Mike Martin said the department knows who hit Hashman and could charge him with a misdemeanor right now.

Police are waiting to see the extent of Hashman’s injuries, Martin said, to see if they should pursue felony charges.

Martin said a police investigator and an assistant district attorney went to Memphis to interview the Hashmans last week. The police chief said he expects the district attorney to present the case to a grand jury to see if felony charges can be made against Hashman’s assailant.

“I think they will go ahead and present the grand jury with the whole case to see what the grand jury says,” Martin said. “That should be upcoming within the next month.”

Naples High Grad called up to the Big Leagues

2010-09-21T07:35:00.000-05:00

MLB: Naples High grad Jeff Smith called up to big leagues for Twins' playoff push

By WOODY WOMMACK
Updated Wednesday, September 15, 2010

During his days as a minor leaguer in the Minnesota Twins organization, former Naples High baseball star Jeff Smith never got a shot at playing in the major leagues.

Despite reaching Triple-A in parts of six different seasons with the Twins and Texas Rangers, the call never came, and after an injury ended his career in 2004, Smith put his major league dreams on hold.

Earlier this week, Smith finally got his shot to put on a major league uniform, but not as a player — as a coach. That small fact didn’t diminish the accomplishment for Smith, the manager of the Twins’ Double-A affiliate who was invited to join the Minnesota coaching staff for a 10-game stretch this month.

“The last three days have probably been three of the best baseball days of my career either as a coach or player,” said Smith, who joined the Twins in Cleveland for their recent three-game series with the Indians, on Tuesday. “Just getting to be around a playoff atmosphere where our major league team is making a playoff push, and getting to spend time with the players and coaches is incredible.”

Each year, the Twins pick one staff member from the minor leagues to join the team’s coaching staff following the conclusion of the minor league season. Smith, who managed the Twins’ Single-A affiliate Fort Myers Miracle during the 2008 and 2009 seasons, recently finished his first year as the manager of New Britain Rock Cats.

Smith started with the organization as a hitting instructor for the Gulf Coast League Twins in 2005, and has continued to impress as he’s been promoted from level to level.

“Jeff has a high ceiling, and this gives him an opportunity to see how things are done at the major league level,” Twins minor league director Jim Rantz said. “It’s a chance to see what it’s like, and it’s a good experience for him.”

While Smith is making his first appearance in the Twins’ major league clubhouse, he’s not exactly a stranger to many of the players on Minnesota’s roster.

“It’s kind of a unique situation because it’s a combination of players that I coached at the minor league level and guys that I played with during my minor league days,” Smith said. “That’s a unique combination and a pretty special thing for me.”

Smith will stay with the team for a total of 10 games, including a key three-game series against the Chicago White Sox, which started Tuesday night. His family, which still resides in Naples, will fly to Minnesota on Friday to watch the Twins play a three-game series with the Oakland Athletics.

“You never know when you’re going to get this opportunity, so I’m going to fly them up for the weekend series before I have to head back,” Smith said.

During his time with the team, Smith will perform the duties of a regular staff member, including throwing batting practice, and working one-on-one with players.

After his 10-game stint as a major league coach is over, Smith won’t get much of a break as he prepares to coach in the instructional league, which starts up today

Scholarships offered to Collier County high school students

2010-09-21T07:27:00.000-05:00

Three local businesses offer scholarships for Collier County high school athletes

By Naples Daily News staff report
Published Monday, March 8, 2010

Gulfcoast Foot & Ankle Center, Bank of Florida-Southwest and Physicians Regional Medical Center are recognizing Collier County student athletes through a new scholarship program. Each season, two male and two female graduating seniors from each of Collier County’s public high schools are being recognized. The students are awarded certificates and sports medals and become eligible for one of three $2,500 scholarships awarded in late spring.

Students recognized for the winter season include, from Barron Collier High School: Carter Mack, soccer, cross country and swimming; Gabriella Paisan, cross country, track, soccer and swimming; Jenna Tinney, swimming; and Jon Coulter, swimming; from Gulf Coast High School: Kristine Ma, soccer and track; Riki Carach, basketball, track and softball; and Mackenson Timothee, track and field and cross country; from Immokalee High School: Samantha Molina, volleyball, soccer and softball; and Stephen Herrera, wrestling and cross country; from Lely High School: Cody Mendel, golf, basketball and tennis; Da-Anna Paul, basketball and track and field: Kayla Douglas, swimming and soccer; and Paul Tateo, cross country, basketball and golf; from Naples High School: Jordan Leach, basketball; Kimberly Loewel, basketball and softball: Kyle Zech, football and baseball; and Ryan Iamurri, golf, soccer and softball; and from Palmetto Ridge High School: Dylan Gamret, wrestling and football.

The student-athletes recognized for the fall season were, from Gulf Coast High School: John Shelton, golf; and Rachel Elliott, track and swimming; and from Immokalee High School: Argeo Cruz, cross country and track.

Dr. Mickey E. Gordon, a Naples podiatrist with Gulfcoast Foot & Ankle Center, created the program after hearing of the difficult times his patients’ children and grandchildren were having with increased expenses of a college education. During his 31-year career as a podiatric physician and surgeon, Gordon has treated many athletic and sports injuries and has become well aware that lower extremity injuries are all too common in high school sports.

Gordon recruited his bank, Bank of Florida-Southwest and hospital Physicians Regional Medical Center to jointly pledge three $2,500 scholarships for student athletes.

“It is a pleasure to recognize these student-athletes for their hard work and accomplishments both in the classroom and on the field, court, pool or track,” Gordon said.

FGCU cross country team has a record setting day

2010-09-21T07:25:00.000-05:00

Record-setting day in Gainesville for FGCU cross country teams; Immokalee's Pierre breaks record

By Naples Daily News staff report
Updated Sunday, September 19, 2010

Florida Gulf Coast University freshman and Immokalee High graduate Argeo Cruz set an FGCU record Saturday as the Eagles men’s cross country team finished in sixth place of 19 Florida schools at the Mountain Dew Invitational in Gainesville.

And another Immokalee High graduate, Jacksonville's Joane Pierre, was the overall women's winner. In doing so, she broke a 17-year-old school record by finishing in 17 minutes, 33.50 seconds.

University of Florida runners grabbed eight of the top 11 spots to claim the men's team title. Former Estero High standout and UF freshman Erick Montoya finished the 8K course in 83rd in 28:02.

As for FGCU, Cruz crossed the finish line in 20th in 26:09, which set a school freshman record for an 8K, and was only 42 seconds shy of the overall school mark.

Eagles sophomore Jonathan Lanning finished 36th, and his time of 26:40 set the school’s sophomore record.

Representing Ave Maria University, which finished 18th as a team, St. John Neumann graduate Taylor Peliska finished 103th in 28:26.

In the women’s race, FGCU finished seventh out of 22 teams, with two runners breaking the school 5K mark.

Eagles sophomore Barrie Cohen (25th, 18:42) and Kelly Perzanowski (28th, 18:49) broke the record set by teammate Megan Thies at last year’s Atlantic Sun Conference meet. Thies finished 50th in 19:30.

The area’s top finisher was Ave Maria freshman Marya Haegler, who was 13th in 18:14.

Giants Aaron Ross waiting for plantar fasciitis to heal

2010-09-13T09:06:00.000-05:00

Giants CB Aaron Ross waiting on foot injury
Associated Press
Posted September 10, 2010 at 11:59 a.m., updated September 10, 2010 at 12:43 p.m.

EAST RUTHERFORD, N.J. (AP) — New York Giants cornerback Aaron Ross is starting another season waiting for an injury to heal.

A year ago, a hamstring injury late in training camp caused Ross to miss the first nine games of the season and limited him to four for the season. His right foot is the issue this year, and it has left the former first-round pick doubtful for Sunday's opener against the Carolina Panthers.

Ross has plantar fasciitis, sustained in a preseason game against the Pittsburgh Steelers on Aug. 21. He only returned to practice this week.

While coach Tom Coughlin says the four-year veteran is making progress, he refused to say on Friday whether he would be in the lineup in the first regular-season game in the new $1.6 billion New Meadowlands Stadium.
Ross, who is married to Olympic track gold medalist Sanya Richards, hopes to play.

"In the beginning it was really difficult," Ross said. "I couldn't put my heel down, couldn't plant. But this week, I have been doing a lot, 50 percent the first day, 75 percent the next and the whole thing today, and I felt really good. It is getting better and better. I still have two more days, so don't count me out."

The Panthers are predominantly a run-orientated offense, so it might be better for the Giants to give Ross another week to rest. That would get him back in the lineup for Week 2 against Peyton Manning and the pass-heavy Colts in Indianapolis.

If Ross can't play this week, second-year cornerback Bruce Johnson will get more time in nickel and dime formations.

"It feels good," said Ross, who had to wear a cast on his foot for about a week after the injury was diagnosed. "I practiced a lot today, jumping, sprinting, everything, and I felt pretty good."

The injuries the past two seasons have been a concern for the Giants' first-round draft pick in 2007. The length of the injury last season cost him his starting job, and the one this year also took away the punt returner's role that he had picked up after Domenik Hixon was hurt in June.

"The first couple of days I was down," Ross said of the most recent injury. "But talking to the guys, coaches, my family, they picked my spirits up. It is nothing compared to the hamstring. The hamstring, I was sitting here pouting the whole time. With this, I can get out there and practice a little bit."

Ross said the injury happened in the second quarter against the Steelers. The only indication that he had was the tape on his foot suddenly felt too tight.

"I cut off the tape and that's when I realized that my heel was a little painful," Ross said.

Ross wasn't sure what caused the injury, but he speculated it might have happened when he planted his foot.

An examination revealed a partial tear of the plantar fascia, the flat band of tissue along the bottom of a foot that connects the heel bone to the toes. Besides the cast, Ross now wears orthotics, gets a different tape job and has a cushion placed under his heel.

"As a football player, we play in pain all the time," Ross said. "If it's just pain, I will be ready for Week 1. But if it's still injured and I hurt the team, once again, I can't make that decision."

Ross really doesn't want to wait.

"I have never been a cautious guy," he said. "I missed all of last year so I am anxious to play. I love the game so if I have to play with a little pain I am willing to do that, as long as I don't hurt the team."

Broncos lose LenDale White to an achilles tendon tear

2010-09-13T08:57:00.000-05:00

Report: Broncos RB White out for year with torn Achilles tendon
ProFootballWeekly.com

The Broncos lost RB insurance behind starter Knowshon Moreno(notes) on Friday as LenDale White(notes) will miss the entire 2010 season with a torn Achilles tendon.

ESPN's Adam Schefter reported that White, who left Thursday's preseason finale after a nine-yard run with an injured ankle, tore his Achilles tendon. The Broncos signed White this summer after he was released by the Seahawks. Moreno just returned to practice at what he called "80 percent."
White had to sit out the first four games of 2010 as it was for violating the league's substance-abuse policy. Now, the five-year veteran out of USC will miss the entire season. White's best year came in 2007 when he started all 16 games with the Titans and rushed for 1,110 yards with seven touchdowns.
White, a native of Denver, only ran for 222 yards and zero touchdowns last season with the Titans. Injuries to Moreno and RB Correll Buckhalter(notes) have hurt the Broncos' depth at that position; Buckhalter made his preseason debut Thursday night.

Dr. Adarve performs a PRP

2010-08-30T15:53:00.000-05:00

Patients blood ready to be spun in the centrifuge

The blood will be spun for 5 minutes

Clear separation of plasma and red blood cells

PRP ready for ultrasound guided injection

Dr. Adarve ready to inject PRP

Appropriate ultrasound visualization

PRP ulttrasound guided injection to heel

Continuing to inject PRP

Close-up of PRP injection

NY Jets Calvin Pace is having foot surgery today!

2010-08-30T12:26:00.000-05:00

Sources: Calvin Pace out 4-6 weeks
Rich Cimini covers the Jets for ESPNNewYork.com.

NEW YORK -- Outside linebacker Calvin Pace is headed to a North Carolina surgeon to have his broken right foot repaired.
Pace's injury, coupled with the absence of star cornerback Darrelle Revis, has created major questions for the New York Jets vaunted defense -- a brash unit that describes itself as "swagger-licious."
"I'm not nearly as concerned as maybe other people are," Jets coach Rex Ryan said Sunday with a hint of defiance.
Amid league sources telling ESPN NFL Insider Adam Schefter that Pace was expected to miss four to six weeks, Ryan said he reached out to free-agent linebacker Adalius Thomas, confirming an ESPNNewYork.com report from earlier Sunday.
Jets blog
Looking for more information on thegreen and white? ESPNNewYork.com has you covered. Blog
Thomas, 33, released April 26 by the New England Patriots, spent seven seasons under Ryan with the Baltimore Ravens. The Jets envision Thomas as the third outside linebacker, behind Bryan Thomas and Jason Taylor, and were working Sunday night to hammer out a deal.
"I would say it would be a possibility," Ryan said. "I'm not going to rule that out."
Curiously, the Jets refused to give a timetable on Pace's injury. Pace, speaking on a conference call with reporters, conceded only that he won't play against the Ravens in the season opener.
"Hopefully, it will be somewhat of a speedy recovery," said Pace, who was injured Friday night when Washington Redskins tackle Stephon Heyer banged his helmet into the linebacker's foot on a cut block. "I'll probably definitely miss the first game. I think that's safe to say. Beyond that, I don't have any idea."
Ryan echoed that sentiment, saying there are "differences of opinion" on how long Pace will be sidelined. The Jets say they will have a better idea once the surgery is complete. It will be performed Monday by foot specialist Robert Anderson, as first reported by ESPN's Schefter.
Because his position requires him to push off with his feet, Pace may need even more time than the month-and-a-half before he's 100 percent, according to an NFL personnel executive. Evidently, the Jets are approaching it as a long-term injury. Othewise, they likely wouldn't have called Thomas, who apparently hasn't drawn serious interest from other teams.
Taylor, who turns 36 on Tuesday, will replace Pace in the starting lineup. The Jets envisioned Taylor as a situational pass rusher when they signed him as a free agent, but he will be an every-down player until Pace returns.
Thomas was a Pro Bowl player in his heyday, but his production declined steadily in three seasons with the Patriots. In 14 games last season, he recorded only 34 tackles and three sacks. He also fell out of favor with coach Bill Belichick.
Ryan said the best-case scenario would be to sign Thomas immediately and let him play in the final preseason game, and "see if he's the same guy you remember."
Bu that's a lot to live up to.
"A lot of the defenses we came up with, that are looked upon as maybe unique in the league, were due to his physical abilities and his mental abilities," Ryan said.
The Jets also can use Vernon Gholston at outside linebacker, his old position. Even though he has switched to defensive end, where he's starting to show signs of life, Gholston still is getting reps at linebacker. He saw fourth-quarter action against the Redskins, and he will play both positions in the preseason finale.
But with Pace out and Revis' contract holdout reaching 29 days, the Jets' defense is clearly back on its heels.
"It's going to be tremendously difficult to stay at the same level," linebacker Bart Scott said, "but we have to adjust the way we attack."
The Jets went 3-1 last season when Pace served a four-game suspension for violating the league's policy of performance-enhancing drugs. Of course, they had Revis for that stretch. Pace wound up leading the team with eight sacks.
"I'm still upbeat, I really am," Pace said of his situation. "Stuff happens in football. I'll say this: It's better to get injured playing rather than having to sit out four games because of a silly mistake as far as supplements."

Giants center O'Hara could miss rest of preseason

2010-08-30T12:09:00.000-05:00

Giants center O’Hara may miss remainder of preseason
NFL Aug 26, 2010

New York, NY (Sports Network) – New York Giants center Shaun O’Hara is likely to miss the remainder of the preseason with a nagging ankle injury.
The New York Post reported Thursday that O’Hara, who was suffering from a sprain, tendinitis and a sore Achilles on his left ankle, was put in a cast to aid in healing the area.
The hope is once O’Hara is rested and kept out of the final two preseason games — against the Ravens this Saturday and with New England on September 2 — that he’ll be ready for the Giants’ season-opener September 12 against Carolina. O’Hara was quoted as saying he’d only wear the boot for five days.
Guard Rich Seubert will take the first 25 snaps in the Baltimore contest, with backup center Adam Koets taking the rest, according to the paper.

MRI confirms 76ers Andres Nocioni's ankle injury

2010-08-26T11:09:00.002-05:00

Sixers G/F Nocioni slowed by ankle injury

Philadelphia, PA (Sports Network) - Philadelphia 76ers newly acquired swingman Andres Nocioni is suffering from a left ankle sprain and no timetable was given for his return, the club announced on Tuesday.
The injury was confirmed following an MRI and examination by Dr. Dave Rubenstein.
The 30-year-old came to Philadelphia along with center Spencer Hawes in a trade with Sacramento on June 17, which shipped center Samuel Dalembert to the Kings.
Over 449 career games, 185 of those starts, Nocioni is averaging 11.3 points, 4.7 boards and 1.3 assists while shooting 37.5 percent from three-point range.
The Sports Network

Giants Aaron Ross suffers from plantar fasciitis

2010-08-26T11:09:00.001-05:00

Giants' Aaron Ross would have been better off if he completely tore his plantar fascia
Published: 07:54 p.m., Wednesday, August 25, 2010
By Vinny DiTrani
The Record (Hackensack N.J.)
(MCT)

EAST RUTHERFORD, N.J. — Tom Coughlin became a little sensitive Wednesday during his post-practice news conference when question after question centered on injured Giants.
"Do the guys who practice ever get a question?" he said as he gazed to the roof of the Timex Center's indoor practice facility.
Unfortunately, this time of year, with the regular season looming, training camp injuries take on greater importance. The timetables for a return become more meaningful as the opener nears.
Take cornerback Aaron Ross, suffering from plantar fasciitis. Coughlin said Wednesday that Ross probably will have his right foot in a cast for about 10 days. That would leave him about a week to get ready for Carolina on Sept. 12, if everything goes right.
The injury was not discovered until after the team played Pittsburgh last weekend. It's still uncertain how it occurred, although Coughlin said Ross complained about his tape job during the game.
Ross missed almost all of last season because of a lingering hamstring problem. He worked hard during the off-season to make sure there would be no recurrence, and wore a big smile throughout camp as practice after practice went by with no hint of its return.
This new problem has hit him hard. He was so bummed out Wednesday he didn't want to talk to reporters about the injury. He knows his availability for the Panthers will be a question, and after what he went through in 2009, this is not the way he wants to begin the 2010 season.
Ross went to Charlotte, N.C., on Tuesday to get a second opinion from foot specialist Dr. Robert Anderson. The second opinion mirrored the first: Ross has the same injury that bothered quarterback Eli Manning for a while last season.
But Ross plays a position where there's more starting and stopping, cutting and backpedaling, all things that could irritate the injury. Safety Antrel Rolle knows all about it: He suffered a complete tear of the planter fascia while playing for Arizona last season against the Giants at Giants Stadium.
"I was backpedaling and it felt like a rock hit the bottom of my shoe," he recalled. "I thought maybe I stepped on something or someone threw something. I felt like a pop at the bottom of my shoe. It didn't hurt at first, but once I started running, it grabbed my toes and everything started pulling together."
Rolle, like Manning, did not miss any playing time because of the injury. Ross will not be that lucky.
"Actually, his is a little bit different than mine," said Rolle. "He has plantar fasciitis, which is a partial tear. I tore my plantar fascia completely.
"To tear it completely is actually better than to tear it partially. Once you tear it completely, it pretty much takes care of itself. It's a matter of much pain you can play on."
Plantar fasciitis is a swelling of the band of muscles at the bottom of the foot. And Coughlin was adamant Wednesday that in Ross' case, "There's no tear."
Rolle has counseled Ross on how the injury might affect a defensive back.
"I wouldn't say it was a lot of trouble; it's a matter of how much pain you can take while playing," he said. "For the first three games, I felt like it was pretty tough. After that, it was pretty much downhill and I got used to it.
"Just pretty much treatment, that's all you can do for it. It's not anything you can surgically repair or speed up the process with. They just do treatment, ice and (stimulation), and things of that nature."
Rolle said he still has some flashbacks to the injury.
"Trust me, it was painful," he said. "Even to this day, when I wake up, it's still, very, very stiff and very sore on the bottom (of the foot). It's going to be something that you have to deal with for a long time.
"Once it warms up, it's fine. When I wake in the morning, it's still sore and it still gets tight. Once you've walked on it and it's loosened up, it's fine."

Dustin Pedroia returning to disabled list

2010-08-23T11:01:00.000-05:00

Dustin Pedroia's Injury Requires Two More Weeks in a Boot, Jason Varitek Still on Crutches
by Tony Lee on Jul 16, 2010 8:49:08 PM

Since he is sidelined with a broken left foot, Dustin Pedroia has to find competition any way he can. For now, it is beating the doctors' timetable of six weeks to return to action.
After a CT scan taken Friday afternoon showed some good healing in the foot, he still has a chance. However, Pedroia, who is off crutches and can put weight on the foot, will wear a boot on the foot for up to two more weeks.
"They said my bone is healing good," Pedroia said. "There already is some of it forming back together. But I'll have to be in the boot for a couple of weeks, which stinks, and they kinda of told me I can't play until I don't feel anything because I guess that bone can break off."
Therein lies the issue. If Pedroia pushes anything too hard he runs the risk of causing the bone to break again, which would end his season. That threat will cause him to pull back the reins once in awhile, despite his desire to get going.
"That's the thing that I'm gonna have a problem with is lying to [the doctors]," he added. "I'll be honest about it. I don't want to come back too soon and play three games and then be out for the rest of the year. That would be stupid and it wouldn't really help us in the long run."
Pedroia went on the 15-day disabled list on June 26. Six weeks off would put him back in the lineup during a series in New York the first weekend of August.
He will be fitted with a protective shoe and has a shin guard he will wear when he does return.
Until then, team officials just hope Pedroia curbs his competitive spirit just a bit.
"What I'm worried about is he'll try to do too much," manager Terry Francona said. "Listening to the doctors, they're relying on him a little bit, which scares everybody.
"If he's sore he'll back off, and getting an honest answer out of him is tough. All the qualities that we love in him, we don't want him to hurt himself."
Catcher Jason Varitek also had his broken left foot scanned Friday. He is "probably a couple of weeks behind" Pedroia, Francona said. Varitek remains on crutches and has yet to see any significant healing in the foot.

Truckee climber benefits from platelet rich plasma treatments

2010-08-23T10:59:00.000-05:00

This climber had prp treatments done to his wrist but the Doctors at Gulfcoast Foot and Ankle can perform the same procedure on your ankles.

Truckee climber benefits from platelet rich plasma treatments

TRUCKEE — After two years of wrist pain and a forced hyatis from his favorite outdoor pursuit, 29-year-old Truckee rock climber Max Rodatz was getting cranky.In a search of relief, Rodatz made the medical rounds, visiting more than a dozen doctors ranging from orthopedic specialists to a hand surgeon. "The pain was keeping me up at night," Rodatz recalled, noting that doctors originally thought it was a result of a scaphoid bone injury, which is common with skateboarders.However, after "a million X-rays" Rodatz's doctors concluded that the bone was not injured. Later an MRI scan revealed the source of the pain: an injured ligament. A hand specialist suggested surgery, but the youthful Rotatz opted out. When Rodatz was at wits end, fellow climbing buddy Dr. Dennis Chez, of Gateway Urgent Care, suggested an alternative: Platelet Rich Plasma treatment, a procedure that consists of drawing a patient's blood, concentrating the growth factors and platelets and then injecting into the injury site."The MRI scan showed exactly where the injured ligament was, and in turn I was able to inject the medicine in the precise location," explained Chez, adding the hand/wrist joint is more complex than other joints, such as the knee.Rodatz said Chez told him that he could offer a "no-risk chance to change things." The entire procedure took approximately 40 minutes."After the injections I felt discomfort for a week," Rodatz recalled. "Four weeks after the procedure my hand felt close to 100 percent and the healing continues."After two years of pain, Rodatz, a manager at the Sports Exchange in Truckee, has returned to climbing."I'm taking it really easy," Rodatz said. "But still, I'm doing stuff that I haven't been doing in years and I love that fact that there was not surgery, no scars, no cuts."Platelet Rich Plasma (PRP) treatment has been used in musculoskeletal medicine as early as the 1990s, and since the 1980s in surgical and dental procedures. The treatment helps regenerate tendon and ligament fibers and because it is comprised of one's own blood there is no chance of rejection from the body. Basically, it accelerates the body's natural healing process. Not surprisingly, PRP is popular with professional athletes who desire a speedy healing process.According to Chez the treatment is virtually painless and risk-free. "There's absolutely no downside because you are never allergic to your own blood," he noted.To obtain more information about PRP or to schedule an appointment, call Dr. Chez at 582-2070.Dr. Chez has practiced emergency medicine in the North Lake Tahoe area for over thirty years. He is the founder and Medical Director of Gateway Urgent Care in Truckee, which he opened in 1995. Gateway Urgent Care is located at 11105 Donner Pass Road in Truckee.— Submitted via aedgett@sierrasun.com

UCLA center Kai Maiava out for season with fractured ankle

2010-08-23T10:26:00.000-05:00

Center Kai Maiava fractures ankle, is out for season
LOS ANGELES TIMES BY CHRIS FOSTER Sun, Aug 22, 12:12 AM

LOS ANGELES -- UCLA offensive line coach Bob Palcic shook his head, with hands almost trembling, and said, "I am sick to my stomach," after having seen center Kai Maiava go down with a fractured left ankle on the third play of the Bruins' scrimmage Saturday night.
Maiava, who started 12 regular-season games last season, will undergo surgery once the swelling goes down and could have a screw put on the bone to help it heal. He will be lost for the season.
The injury overshadowed some bright spots for the offense, as players and coaches were concerned about losing the rock on which the offensive line is built.
"He's a leader, and one of our best front guys," Coach Rick Neuheisel said. "That's a blow. That's always the fear with a scrimmage, and it was the third play. It's not like we went too long."
Redshirt freshman Greg Capella played center with the first team after Maiava was injured. But Palcic said that left guard Ryan Taylor will move to the center, with Darius Savage likely filling the left guard spot.
"The reason I didn't move Taylor to center tonight is because he hasn't played the position in training camp," Palcic said. "I told Rick that I have two weeks to get Ryan ready."
But the domino effect will be felt. The Bruins, at the moment, are without the five players on the offensive line that started the 2009 season.
That will change when guard Eddie Williams returns from a concussion. Williams is expected to be back Monday, but only for non-contact drills, Neuheisel said.
The offensive line has lost Xavier Su'a-Filo, who is on a two-year Mormon mission; Jeff Baca, who is out because of a stress fracture in his right leg, and Mike Harris, who is suspended for the season opener.
"You get guys beat up and hurt, and you've just have to find guys who can play," offensive coordinator Norm Chow said. "I think the difference between a real good program and the program that we want to become is depth, the depth of a team, because you're going to get injuries."
This, though, seemed to go beyond a numbers game. Maiava was a key leader, not only on the line, but on the offense.
Last season, when quarterback Kevin Prince was leveled by what the Bruins felt was a cheap shot by Washington's Donald Butler, it was Maiava who walked halfway to the Huskies huddle hurling obscenities.
"It's a tremendous loss," tackle Micah Kia said. "Kai is a tremendous leader, tremendous offensive lineman, and the spirit he brings to the game is irreplaceable."

Seahawks Russell Okung suffers high right ankle sprain

2010-08-23T10:24:00.000-05:00

Seahawks lose LT Okung to ankle injury
By GREGG BELL / AP Sports Writer
Published: August 21st, 2010 10:22 PM
Last Modified: August 21st, 2010 10:47 PM

SEATTLE - The Seahawks could be without sixth-overall draft choice Russell Okung for a while after he left Seattle's second preseason game with an ankle injury.
Coach Pete Carroll said after Green Bay beat Seattle 27-24 on Saturday night that the left tackle to whom Seattle just guaranteed $29 million to replace retired All-Pro Walter Jones could have a high right ankle sprain, pending an MRI exam Sunday. Those sometimes take two months or more to heal.
"It's pretty significant," Carroll said of the loss of the foundation to his changing offensive line. "Obviously we made it as big a priority as we could make it to get him."
Carroll said he didn't know how Okung got injured, only that it stings the entire team that is banking on improved offensive line play to lead a comeback season from 9-23 the last two years.
He sprained the same ankle in Oklahoma State's opener against Georgia last season but missed only a few plays. The 6-foot-5, 310-pound stalwart started all 13 games for those college Cowboys last season, though the ankle continued to bother him late into the year.
Mansfield Wrotto, normally a guard, replaced him. Seattle is already without backup tackle Ray Willis for an indefinite time because he is facing knee surgery.
After Okung missed the first eight days of training camp because of a contract impasse, the Seahawks gave him a six-year deal earlier this month that has a maximum value of $58 million.
"That's a big loss if he can't come back. We put a lot of time and effort to get this guy right and he's done everything we've asked of him," Carroll said. "We'll see what it is. I don't know how long it's going to take."
Asked if it could be more than a couple of weeks that a more conventional, lower ankle sprain sometimes needs to heal, Carroll said: "It could be. We don't know that yet. We'll figure him out. We don't know him as a healer, either."
For a point of reference at the same position, Seattle was without fill-in left tackle Sean Locklear for six games last season because of a high ankle sprain. Locklear is now starting on the right side but could be headed back to left tackle with Okung's injury.
Okung was not in the Seahawks' locker room following the game.

Read more: http://www.adn.com/2010/08/21/1419467/seahawks-lose-lt-okung-to-ankle.html#ixzz0xq4sCYDL

Boston Bruins Trent Whitfield ruptures his achilles tendon

2010-08-23T09:49:00.000-05:00

Whitfield Injured, Door Open
August 22, 2010

It looks as if the injury bug that hung around Boston last year hasn't moved on yet. It has been reported that veteran centerman Trent Whitfield has ruptured his achilles' tendon while training for the upcoming season. Whitfield played a majority of last year with the P-Bruins but was called up at times to Boston when there were injuries to both Savard and Bergeron. Whitfield would have been counted on to provide leadership and guidance to the younger players in Providence this year. He has a lot of NHL and AHL miles, and from everything I have heard, is a great influence and professional when it comes to hockey. It is going to be hard to replace that influence in Providence. So now that you have heard the bad news, what does this mean for the roster in the upcoming season? Most likely, Whitfield was going to be the 5th center in the organization once again this year. His injury may give Joe Colbourne the oppourtunity to either become the top line center in Providence or even battle for the last spot on the Boston Roster. The injury also leaves Reich as one of the only vets in Providece, so that signing is looking to be more important than originally thought. I think you will see Boston go out and sign an AHL veteran or journeyman that can fill the void left if Whitfield is going to miss the season.

Brian Urlacher injures calf in Saturdays game against the Oakland Raiders

2010-08-23T09:47:00.000-05:00

Bears’ Brian Urlacher injures leg in exhibition
SportingNews Aug 22, 11:08 am EDT

Brian Urlacher's woes continued Saturday when the middle linebacker was removed from the Chicago Bears' exhibition against the Oakland Raiders. Reports indicate Urlacher injured his left calf.Urlacher missed all but one game last season with a broken wrist.Saturday's injury occurred on the fourth play from scrimmage. He came off the field and was seen on the bench with an ice pack on his left, the Associated Press reports.The extent of Urlacher's injury was not immediately known, but it was not believed serious. Team officials decided to play it safe and kept him out the remainder of the game.

Dolphins Nate Garner has foot surgery

2010-08-23T09:46:00.000-05:00

Breaking News: Nate Garner out 4-6 weeks
Found 10 days ago on Phin Phanatic:

Injuries continue to mount for the Miami Dolphins in the pre-season. Omar Kelley tweeted that in Tony Sparano’s presser today that he announced Nate Garner had surgery on his foot five days ago and will be out 4-6 weeks. This is purely speculation but chances are Garner could be placed on the PUP list to start the season and not available until week 7. Last year Garner became extremely valuable to the Dolphins for his ability to play multiple positions along the line. This year is going to be no different and Garner is the swing man that will be the back up at 4 or the 5 positions along the line. His loss just adds to the injuries that have been mounting throughout camp. According to Kelly, Sparano also expressed concern about John Jerry’s knee and the continued soreness that has held him out of practice.

A's Rosales on DL due to ankle injury

2010-08-20T07:37:00.000-05:00

Ankle injury forces A's Rosales to DLOakland calls up Tolleson to replace ailing infielder
08/13/10 7:39 PM ET

MINNEAPOLIS -- Adam Rosales isn't one to ever really slow down, but Oakland's ultra utility man will have to do just that for the next month after learning he has a stress fracture in his right ankle.
A's assistant general manager David Forst confirmed the diagnosis Friday, when the club placed Rosales on the 15-day disabled list and recalled infielder Steve Tolleson from Triple-A Sacramento.
According to Forst, Rosales initially had an MRI last week that showed his old stress fracture, first suffered during his time with the Reds nearly a year ago.
"All indications were that it was an old fracture," Forst said, "so it was hard to tell if the pain in his ankle was really stemming from that. The pain he was feeling was in a different spot."
Thus, Rosales was simply given a couple days to rest before being inserted into the starting shortstop spot Wednesday in Seattle, where he played just one inning before the ankle forced him to exit the game. The 26-year-old Rosales was subsequently sent to Oakland to see a specialist, who finally determined the pain he was enduring was, in fact, the result of his old stress fracture.
"The only way to treat that is really to rest," Forst said. "Our best guess, at least from what the doctor said, is that we should assume he'll need four weeks or less."
The move represented the 22nd time the A's have used the disabled list this season, which is tied for second most in Oakland history only to the mark of 25 set in 2008. The club currently has a season-high-tying 11 players on the DL.
"It's frustrating," Forst said. "Obviously, there are some injuries that are more frustrating than others. With Rosales, this is just an overuse injury. There's no way to prevent something like this. So this is something he'll be able to deal with and then move on."
In the meantime, Tolleson will likely be given a longer look than was given during his first stint with the A's this year, which saw him appear in just three games. He collected one hit -- his first one as a Major Leaguer -- in four at-bats during that time.
The 26-year-old utility player was batting .332 with nine home runs and 43 RBIs in 80 games with Sacramento. Furthermore, he left the River Cats having hit safely in each of his last nine games, going 17-for-39 (.436) over that stretch.
"He's swung the bat great, and he's been a big part of the offense down there," Forst said. "We're hopeful he comes in and can give some guys a day off here and there, because we know he can play all the infield positions. That's something we'll need as we get down to the grind of the last couple months of the season."
"He's done a fine job with Triple-A," manager Bob Geren added. "We'll get him some action."

A promising treatment for athletes, in blood PRP

2010-08-20T07:17:00.000-05:00

A Promising Treatment for Athletes, in Blood
By ALAN SCHWARZ
Published: February 16, 2009

Two of the Pittsburgh Steelers’ biggest stars, Hines Ward and Troy Polamalu, used their own blood in an innovative injury treatment before winning the Super Bowl. At least one major league pitcher, about 20 professional soccer players and perhaps hundreds of recreational athletes have also undergone the procedure, commonly called platelet-rich plasma therapy.
Experts in sports medicine say that if the technique’s early promise is fulfilled, it could eventually improve the treatment of stubborn injuries like tennis elbow and knee tendinitis for athletes of all types.
The method, which is strikingly straightforward and easy to perform, centers on injecting portions of a patient’s blood directly into the injured area, which catalyzes the body’s instincts to repair muscle, bone and other tissue. Most enticing, many doctors said, is that the technique appears to help regenerate ligament and tendon fibers, which could shorten rehabilitation time and possibly obviate surgery.
Research into the effects of platelet-rich plasma therapy has accelerated in recent months, with most doctors cautioning that more rigorous studies are necessary before the therapy can emerge as scientifically proven. But many researchers suspect that the procedure could become an increasingly attractive course of treatment for reasons medical and financial.
“It’s a better option for problems that don’t have a great solution — it’s nonsurgical and uses the body’s own cells to help it heal,” said Dr. Allan Mishra, an assistant professor of orthopedics at Stanford University Medical Center and one of the primary researchers in the field. “I think it’s fair to say that platelet-rich plasma has the potential to revolutionize not just sports medicine but all of orthopedics. It needs a lot more study, but we are obligated to pursue this.”
Dr. Neal ElAttrache, the Los Angeles Dodgers’ team physician, used platelet-rich plasma therapy in July on a partially torn ulnar collateral ligament in the throwing elbow of pitcher Takashi Saito. Surgery would have ended Mr. Saito’s season and shelved him for about 10 to 14 months; he instead returned to pitch in the September pennant race without pain.
Dr. ElAttrache said he could not be certain that the procedure caused the pitcher’s recovery — about 25 percent of such cases heal on their own, he said — but it was another encouraging sign for the nascent technique, which doctors in the field said could help not just injuries to professional athletes but the tendinitis and similar ailments found in the general population.
“For the last several decades, we’ve been working on the mechanical effects of healing — the strongest suture constructs, can we put strong anchors in?” Dr. ElAttrache said. “But we’ve never been able to modulate the biology of healing. This is addressing that issue. It deserves a lot more study before we can say that it works with proper definitiveness. The word I would use is promising.”
Platelet-rich plasma is derived by placing a small amount of the patient’s blood in a filtration system or centrifuge that rotates at high speed, separating red blood cells from the platelets that release proteins and other particles involved in the body’s self-healing process, doctors said. A teaspoon or two of the remaining substance is then injected into the damaged area. The high concentration of platelets — from 3 to 10 times that of normal blood — often catalyzes the growth of new soft-tissue or bone cells. Because the substance is injected where blood would rarely go otherwise, it can deliver the healing instincts of platelets without triggering the clotting response for which platelets are typically known.
“This could be a method to stimulate wound healing in areas that are not well-vascularized, like ligaments and tendons,” said Dr. Gerjo van Osch, a researcher in the department of orthopedics at Erasmus University Medical Center in the Netherlands. “I call it a growth-factor cocktail — that’s how I explain it.”
Dr. van Osch and several other experts said they had used the procedure as a first option before surgery for reasons beyond its early results. There is little chance for rejection or allergic reaction because the substance is autologous, meaning it comes from the patient’s own body; the injection carries far less chance for infection than an incision and leaves no scar, and it takes only about 20 minutes, with a considerably shorter recovery time than after surgery.
Because of those apparent benefits, the consensus among doctors is that the procedure is worth pursuing. However, several doctors emphasized that platelet-rich plasma therapy as it stands now appeared ineffective in about 20 to 40 percent of cases, depending on the injury. But they added that because the procedure costs about $2,000 — compared with $10,000 to $15,000 for surgery — they expected that with more refinement, insurance companies would eventually not only authorize the use of PRP therapy but even require it as a first course of treatment.

Bills rookie WR, David Nelson, out indefinitely with lower leg injury

2010-08-18T08:31:00.000-05:00

Bills rookie WR Nelson injures right leg, carted off field
Associated Press
Published: Aug. 17, 2010 at 07:10 p.m.
Updated: Aug. 17, 2010 at 09:52 p.m.

By Associated Press

PITTSFORD, N.Y. -- Buffalo Bills rookie wide receiver David Nelson is out indefinitely after being carted off the field with a right leg injury during Tuesday's practice.
"It doesn't look good," said Bills coach Chan Gailey, who didn't provide specifics on Nelson's injury.
Based on the initial prognosis, Gailey said it was uncertain that Nelson will recover in time for the Bills' Sept. 12 season opener against the Miami Dolphins.
Nelson was hurt about an hour into practice Tuesday while participating in a team red-zone drill. He caught a Levi Brown pass over the middle, turned toward the end zone and was on his way down when he was nudged sideways by a defender, who was attempting to avoid a collision.
It appeared that Nelson's right foot was caught in the turf as he fell.
Nelson immediately clutched at his lower leg. Trainers spent about five minutes treating the player and keeping his foot elevated. Nelson was then loaded into a cart and unable to put any weight on his foot.
An undrafted rookie free agent out of Florida, Nelson is part of a raw and inexperienced receiving corps competing for a backup spot on the team. He had a solid NFL debut, making a team-high five catches for 47 yards and one touchdown during a 42-17 loss Friday at Washington in the Bills' preseason opener.
Buffalo already is down two receivers entering its preseason game Thursday against the Indianapolis Colts in Toronto. Rookie Marcus Easley is set to have surgery on his left knee, and James Hardy has missed a week with an undisclosed injury.

And that doesn't include Felton Huggins, who was waived/injured last week after he hurt his left shoulder
Starting free safety Jairus Byrd missed practice Tuesday because of what Gailey called a "physical complication." Gailey provided no other details except to say he believes it will be resolved very quickly and that the player was having the complication checked out.
Copyright 2010 by The Associated Press

Three Researchers Awarded 2010 Toshiba America Medical Systems/RSNA Grants

2010-08-18T08:27:00.000-05:00

One of these Grants was awarded to Kenneth Lee. He is looking to find a more effective treatment for moderate to severe plantar fasciitis. He will also be evaluating platelet rich plasma injections.

Three Researchers Awarded 2010 Toshiba America Medical Systems/RSNA Grants
08.18.10, 06:00 AM EDT

BusinessWire - The Radiological Society of North America (RSNA) Research & Education (R&E) Foundation awarded 2010 Toshiba America Medical Systems/RSNA grants to Kenneth S. Lee, M.D., Nitin Ohri, M.D., and Ben Paxton, M.D. The grants are made possible by Toshiba's support of the RSNA R&E Foundation.
The Toshiba America Medical Systems/RSNA Research Seed Grant enables investigators to test hypotheses and conduct feasibility studies en route to major trials. These pilot phases of projects are critical to the development of applications for funding from major corporate and federal sources. The grant award is up to $40,000 for a one-year study.
Kenneth S. Lee, M.D., University of Wisconsin, was awarded the Seed Grant and will look to find a more effective treatment option for moderate to severe chronic plantar fasciitis. His study will evaluate acoustoelastography as a way to measure the healing changes and outcomes of platelet-rich plasma injections in order to improve patient care.
The Toshiba America Medical Systems/RSNA Research Resident Grant is designed to give residents an opportunity to gain insight into a research career by providing dedicated time for research projects. The grant award is $30,000 for a one-year study. Dr. Ohri and Dr. Paxton received the Research Resident Grant.
Nitin Ohri, M.D., Thomas Jefferson University Hospital, will use his grant to characterize the FDG-PET response patterns of non--small cell lung cancer tumors after chemoradiotherapy. Ben Paxton, M.D., Duke University Medical Center, will further develop a minimally invasive, image-guided intervention for treatment of morbid obesity by utilizing an innovative and novel percutaneous endovascular procedure.
The RSNA R&E Foundation is awarding a total of 71 grants in 2010, valued at $2.25 million. "The R&E Foundation is proud to take a leadership role in funding grant awards to young investigators. We recognize the critical link between today's research and tomorrow's practice," said Jack E. Price, chair of the R&E Foundation Board of Trustees. "In addition, our commitment to education ensures the development of tomorrow's workforce."

Titans rookie RB, Stafon Johnson, has surgery on ankle

2010-08-18T08:22:00.000-05:00

Titans rookie RB Johnson has surgery on dislocated ankle
NFL.com Wire Reports
Published: Aug. 14, 2010 at 02:40 a.m.
Updated: Aug. 15, 2010 at 08:05 p.m.
By NFL.com Wire Reports

Rookie running back , who overcame a potentially life-altering throat injury last September, vowed to persevere again after he dislocated his right ankle during the Tennessee Titans' 20-18 preseason-opening loss to the Seattle Seahawks.
Johnson had surgery on the ankle Sunday, writing on Twitter shortly afterward: "Feeling kool thank u guys 4 all the love specially my titan bro's."
Johnson was hit high and spun around by Seahawks defensive back following a short reception on the final play of the third quarter in Saturday night's game in Seattle. Johnson then landed hard on his right leg.
As the Titans prayed on one knee nearby and coach Jeff Fisher held Johnson's head, the running back was driven off the field while seated on the back of a cart. An air cast was placed on his lower right leg. He briefly held his hands over his face, then pointed toward the heavens.
Johnson's injury opens the door
Stafon Johnson faces another long recovery from injury, and his misfortune could give undrafted rookie RB LeGarrette Blount a better opportunity to make the team. More ...
"Bouncing back from trials and tribulations, this is just a bump in the road," Johnson told The Tennessean on Saturday. "God has brought me back this far, and it felt good to be where I'd gotten to. This is minimum compared to what I have been through, really.
"I'm going to continue to try and prove myself," add, whose final season at USC ended when a falling weight bar crushed his neck and larynx. "I'm just going to rehab it and try and get back as soon as possible."
Johnson's teammates talked about the injury in somber tones after the game.
"All that stuff he has been through, we just have to be motivating for him and keep him in our prayers," quarterback said.
Johnson, an undrafted free agent, had been battling to win a backup job to 2,000-yard rusher Chris Johnson.
"It's very, very tough for Stafon," said Fisher, who spoke only in generalities about the injury.
"With what he's been able to overcome, he's a special young man," Fisher said.
About the only time that new Seahawks coach Pete Carroll wasn't giddy in his Seattle debut came when he zipped across the field in front of the Titans' bench to express concern for Johnson, whom he tutored at USC.
"I told him I loved him, and no one can get tougher or stronger than he is," Carroll said. "I was so sorry to see that. This guy, what he's undergone to get here, so much pressure physically and emotionally, and to have a serious injury. ... If anybody can get back, he can. He's an absolute warrior."
Johnson was thankful for his teammates and ex-coach's words.
"I appreciate the love and support," he said. "I am just a regular guy trying to make it like everybody else. I'm just going to try and get back as soon as I can."
The Associated Press contributed to this report.

Texans running back, Ben Tate, suffers severe ankle injury

2010-08-18T08:15:00.000-05:00

Kubiak: RB Tate will need surgery for ankle injury
Aug-15-10 6:50pm
From:

Houston Texans rookie running back Ben Tate will need surgery after suffering a severe ankle injury in Saturday's preseason opener in Arizona.
The 5-foot-11, 211-pound Tate was hurt in the third quarter of the Texans' 19-16 loss to the Cardinals. Tate, the Texans' second-round draft pick out of Auburn, had only two carries for 7 yards before he was carted off the field.
Coach Gary Kubiak said Sunday that the injury is "pretty severe," and that Tate will likely have surgery on Tuesday or Wednesday.
"It doesn't look good," Kubiak said. "That's the best I can describe it for now."
Houston plays its second preseason game in New Orleans on Saturday.
Tate's injury drops him out of a crowded competition at running back. Arian Foster started Saturday's game, and had four rushes for 31 yards.
Steve Slaton is Foster's main challenger after his 2009 season was cut short by a neck injury. He ran 10 times for 22 yards in Arizona, but fumbled on the goal line. Slaton had seven fumbles last season.
"It's tough, because that's what held us back and him back last year," Kubiak said. "To have it happen in the first preseason game, it's obviously disappointing. If it's going to happen, I'm sure glad it happened there, and not three weeks from now. But it's something that's got to get corrected for us to be successful."
Chris Henry, also in the mix for the running back job, had two carries for 6 yards and caught a pass for a 14-yard gain. Kubiak said Henry will move up the depth chart with Tate injured. Henry is also playing special teams.
"We're trying to get him a little more settled, but he's very aggressive," Kubiak said. "He showed up for (special teams coach) Joe (Marciano) and he will get more time at the back position, as we move forward with Tate being out. So we'll see, he did some good things."
Kubiak closely watched backup quarterback Dan Orlovsky, who completed 12 of 21 passes for 129 yards in two quarters.
The Texans signed Orlovsky as a free agent in March 2009. He was inactive for all 16 games last season, but has moved into the backup role behind Matt Schaub.
Kubiak liked what he saw from Orlovsky in Arizona.
"He was steady," Kubiak said. "Since he's been here with me, I thought it was his best outing in the preseason. He protected the ball, he moved his group, he had two big, long drives.
"He could still play better, and I think he will," Kubiak said. "It's important that Dan continues to show this team that he's taking steps forward and he took one last night."
The Texans advanced inside the Cardinals 20-yard line four times in the game, and came away with only three field goals. Their lone touchdown came on Schaub's 44-yard pass to Andre Johnson in the first quarter.
"We've got to do something better down there, we were 0 for 4," Kubiak said. "We just didn't finish down there. We didn't finish plays. We've talked about trying to run the ball better. It's a point of emphasis, and we'll go back to work on that."
The Texans' starting offense and defense looked impressive in the first quarter, building a 10-0 lead.
Schaub completed 5 of 6 passes for 78 yards and Johnson caught three passes.
Defensive end Mario Williams, slowed by a hip injury early in training camp, had two sacks, linebacker Brian Cushing forced a fumble and safety Bernard Pollard delivered a crunching hit on Arizona running back Tim Hightower before Kubiak called on his backups.
The Cardinals rallied from a 16-0 deficit to win in the fourth quarter, but Kubiak was encouraged by how well his first unit played.
"We've got to keep it in perspective," Kubiak said. "Our first group felt really good about themselves when they walked off the field. That's important, and that's all they got to play. That's not their fault they didn't play four quarters, that's on me."
Kubiak said receiver Andre Davis (bruised tailbone) and fullback Jack Corcoran (shoulder) had the only other significant injuries in the game.

The hazards of sky high heels

2010-07-28T14:56:00.000-05:00

Below is an interesting article about the different ailments that can result from wearing high heels.

July 23rd, 2010
Sky High Heels Hazardous to Your Health
By Melissa Conte

Shoe trends seem to be moving in one direction this season—up. On a recent trip to Bloomingdales, I got vertigo just looking at some of this season’s hottest selling platform shoes. (Some of the styles also look like they were designed by the Marquis de Sade. But that’s another story). As designers unveil their latest creations, women will need to work on their balance skills to stay onboard these mile high heels.
And now medical experts tell us that those high heels may produce serious medical problems. If you wear two-inch heels (or higher) five or more days a week you may create problems for your legs and feet. Elevating the foot not only shrinks a your calf muscle fibers by an average of 13 percent, it also thickens your Achilles tendon, the tendon that attaches the calf muscle to the heel by 22 percent. The findings are from a study published in the Journal of Experimental Biology.
Celebrities seem not to have received the memo. Lady Gaga prances around in 12-inch Alexander McQueen creations. And the quartet from Sex and the City 2 have not yet given up their Manolos. During the 2009 spring fashion shows, several models—those professionals who are supposed to make walking in high heels look easy—tumbled on the runway. So if even a skilled catwalk model has trouble keeping her balance, why are designers foisting these killer-heels on normal women? Will this new study cause them to rethink that fashion strategy?
Are sky-high heels the new escapism from the sinking economy? It’s theorized that women buy and wear higher heels when the economy is not good. As the recession seems to worsen, the heel heights grow comparatively higher. According to the stiletto index, the last time sky-high heels were in vogue was during the Great Depression. As this season’s heels climb to an astonishing eight-inch height and beyond, one can’t help but wonder if we’ve seen the worst of the recession yet.
Christian Dior shoe specialist Jonah Bernaki says his clientele prefers the higher styled shoes. “Heels make a woman instantly feel taller, sexier, and more glamorous. It’s an instant emotional pick me up.” Platforms this season have a lift in the front, making them more stable and easier to navigate city streets. According to Bernaki: “They are more manageable and comfortable than a traditional stiletto heel.”
Teetering on top of these stilts may be great for self-esteem, but they can have crippling effects on the long-term health of your feet and spine. Wearing heels takes your spine out of its natural alignment. Hips jut forward, excessive pressure is placed on your forefoot, and your hips move unnaturally. All of this adjustment causes wear and tear on the vertebral discs of your back and postural muscles. Staying in this position for too long will lead to chronic problems with pain and discomfort.
Moving down the kinetic chain of the body, excessive pressure is placed on the knee joint, encouraging the onset of early osteoarthritis. Calf muscles and the Achilles tendon are forced into a short tight position, leading to inflammation of the plantar fascia and other ligaments of the foot. Ankle injuries such as sprains and fractures are not uncommon because you are walking on an unstable surface. Bunions, bony growths on the outside of the foot requiring surgical repair, develop as a result of your foot trying to fit into a narrow and tight toe box. (Think of the Asian practice of binding the feet, and you get the idea).
To go the distance, feet need sturdy and stable shoes. Remember the days when women used to wear running shoes to walk to work and then changed into heels once in the office? Perhaps it’s time to bring that practice back.
Although many of this sesons’s shoe styles are visually attractive, buyer beware. It’s okay to wear high heels occasionally, but long-term wear will result in hammertoes and other unattractive physical maladies. The excessive heel heights this season should come with the label “wear at your own risk.”

Big Brother housemate to have ankle operation

2010-07-27T09:03:00.000-05:00

This article will make you think twice about getting dressed like a spider and crawling out of a giant bath!!! The things people will do for national television! We all hope her surgery goes well and she recovers quickly.

Big Brother 2010: Housemate Keeley needs operation on broken ankle and may have to quit show
By Georgina LittlejohnLast updated at 12:26 PM on 22nd July 2010

Friday's eviction cancelled after her accident
Host Davina McCall is stranded in France
Big Brother contestant Keeley has broken her ankle and may have to quit, show bosses have announced.
The housemate is being treated in hospital and will need an operation to mend the fracture caused as she tackled a task in the Channel 4 show.
Bosses decided earlier today to axe this week's eviction after the programme suffered the double blow of Keeley's injury and Caoimhe quitting the show on Tuesday.

Distressed: Keeley grimaces and cries in pain as she waits for medical treatment for her broken ankle. She is now in hospital and needs an operation
The travel agent from Manchester had to leave the house on Tuesday for treatment following a nasty fall during the weekly 'save and replace' task in which nominated housemates take part.
Keeley had been dressed as a spider and was trying to climb out of a giant bath for her task when she suffered her injury.
After damaging her ankle, she was carried to the diary room by fellow contestants Dave and John James.

Painful: An ice pack is applied to Keeley's foot to try and get the swelling down. The travel agent may be forced to quit the programme, show bosses said
At first she was treated on the spot but her injuries were more severe than first thought and she was later taken to hospital, where she spent the night.
She will spend at least two more days in hospital and it is not clear whether she will be able to return to the show.
A statement from Channel 4 said: 'Keeley has fractured her ankle and is in hospital receiving treatment.
'She will remain in hospital for a couple of days as she needs an operation to mend the fracture.
'Together, Keeley and Big Brother producers will discuss whether she will return to the show once she is feeling better. We all wish her a speedy recovery.'

Lindsay Lohan's ankle monitor

2010-07-27T08:53:00.000-05:00

Ankles aren't just for spraining and ankles aren't just for breaking. Just ask Lindsay Lohan and check out her new ankle bracelet!! Now that really is ankle pain!

Best of Lindsay Lohan Fashion: Ankle Monitor Style
July 14th, 2010 12:32 AM by Free Britney Tags: Celebrity Fashion, Lindsay Lohan

Being shackled with a court-ordered SCRAM alcohol monitor device around one's ankle would crimp the style of many stars, but Lindsay Lohan rolls with it.
Girl is nothing if not flexible. She's also used to it by now.
Whether she's hitting the clubs or the courtroom, the troubled star has turned a fashion challenge into an opportunity. Let's just say she has a lot of boots!
As for why she goes clubbing while unable to drink, and while staring at a jail sentence for violating her probation, we have no clue. That's Lindsay for you.
The good news: The ankle monitor finally gets taken off July 20. The bad news: She'll be wearing an orange jumpsuit for awhile after that. Kind of a drag.
We're behind you all the way, girl. You look great, at least. Call it ankle monitor chic:

Serena Williams foot surgery will cause her to miss 3 tournaments leading up to the U.S. Open

2010-07-20T09:20:00.000-05:00

It pays to wear shoes! Especially at a restaurant! Below is an article about Serena Williams run in with a broken glass at Carmelo Anthony's restaurant. This is just one example of the silly things that can happen to your feet. The Doctors at Gulfcoast Foot and Ankle are here to help no matter what the situation.

Serena Williams Needs Surgery for Cut Foot, Will Miss Three Tournaments

7/17/2010 5:25 PM ET By FanHouse Newswire
FanHouse Newswire

(AP) -- Serena Williams needs surgery on her right foot after cutting it on a broken glass at a restaurant.The top-ranked women's player was injured last week and will miss three tournaments leading to the U.S. Open, the WTA Tour said Saturday.Williams has withdrawn from tournaments in Istanbul, Cincinnati and Montreal. The tour website offered no details about what happened at the restaurant."I'm so upset I won't be able to play in the upcoming events because of this foot surgery," Williams said on the website. "Thank you for all of your support. I can't wait to get back on the courts." A message left with her agent was not immediately returned.On Monday, World TeamTennis said Williams would miss the entire season. Her Washington Kastles team said she cut the bottom of her foot and needed stitches.
On July 10, Williams attended the wedding of Denver Nuggets star Carmelo Anthony in New York. In a photo, it appeared she had two bandages on the top of her right foot.Williams won her fourth Wimbledon crown and 13th major title in July. The Rogers Cup in Montreal begins Aug. 16, and the U.S. Open starts Aug. 30.After winning the Australian Open at the end of January, Williams was sidelined through April because of an injured left knee. She lost in the French Open quarterfinals in June before capturing Wimbledon.

Important information about your Metanx prescription

2010-07-15T10:18:00.000-05:00

Eric M. Wingerter is the President and CEO of Pamlab Pharmaceuticals. Mr. Wingerter wrote two letters to his customers to update and inform them about products that are being substituted for Metanx and other Pamlab products. One of the main products of my concern is Neurpath-B. This is the product that could potentially be substituted for Metanx by your pharmacy. I am going to summarize these two letters for you. If you would like to read the actual letters and browse the Metanx website please visit http://www.metanx.com and click on "Attention Metanx Patients: Important information about your Metanx prescription" located at the top of the page.

Acella Pharmaceuticals products, including Neurpath-B, contain an active ingredient called XOLAFIN-B (described as L-methylfolate calcium). This ingredient comes from a manufacturer in China that is not cGMP (current good manufacturing practice) certified in China or the United States. Pamlabs Metanx also contains a formula of L-methylfolate calcium called Metafolin. All active ingredients in Pamlabs Metafolin (Pamlabs L-methylfolate calcium formula) containing products, including Metanx, are US cGMP compliant.

All ingredients in medical foods must be GRAS (Generally Regarded As Safe) or FDA (Food and Drug Administration) approved. Since XOLAFIN-B is manufactured in a Chinese facility that is not cGMP certified by either China or the United States it cannot be considered GRAS. Pamlabs active ingredients that compete with Acella products have verified GRAS status which took several years to achieve.

Acella labels its Neurpath-B product with a 24 month expiratioin date. Acella nor its contract manufacturer has actually performed any stability testing to support this claim. Stability testing, in the pharmaceutical field, tests how well a product retains its quality over the life span of the product. On June 23, 2010 a third party testing laboratory, BioScreen Testing Services, evaluated Neurpath-B with an expiration date of April 2012. The assay results showed that the active ingredient XOLAFIN-B to be out of specification within 2 months of being manufactured.

The Doctors at Gulfcoast Foot and Ankle want you to know the facts about this alleged substitute for Metanx. Please feel free to contact us at Gulfcoast Foot and Ankle with questions or concerns you may have. We will try our best to get you the answers you need in a timely fashion.

Miami's Chalmers in cast for ankle sprain

2010-07-15T08:23:00.000-05:00

The Doctors at Gulfcoast Foot and Ankle can help you with your pains and sprains!

Chalmers has high ankle sprain, in cast 2-4 weeks
The Associated Press
Posted: 5:22 p.m. Wednesday, July 14, 2010

http://www.palmbeachpost.com/news/state/chalmers-has-high-ankle-sprain-in-cast-2-802984.html?showComments=true

MIAMI — Heat guard Mario Chalmers has a high left ankle sprain and will be in a cast for 2-4 weeks.

The injury took place July 12, the Heat said. Chalmers will be re-evaluated once the cast is removed, at which time a plan for further rehabilitation will be made.

Chalmers, who hopes to be Miami's starting point guard this season, has averaged 8.6 points and 4.2 assists in his first two years with the Heat.

Utah Jazzs' Mehmet Okur playing golf 3 months after Achilles Tendon repair

2010-07-14T08:34:00.000-05:00

Even after a ruptured Achilles Tendon the Doctors at Gulfcoast Foot and Ankle can get you back into your golf game if you take the appropriate measures! Below is an article about Utah Jazzs' Mehmet Okur and his ruptured Achilles Tendon surgery.

Utah Jazz notebook: Mehmet Okur says 'so far so good' on rehab

By Jody Genessy
Deseret News
Published: Saturday, July 10, 2010 8:22 p.m. MDT

LEHI — Mehmet Okur can't do much about his basketball game right now.

The Utah Jazz center, however, was excited to work on his golf game Saturday afternoon at Deron Williams' charity tournament.

That might come as a surprise to some, considering he had surgery to repair his ruptured left Achilles tendon in April.

"Actually," Okur said when asked about golfing in his condition, "it's good for me."

Though he's been cleared to golf — and reap the benefits of walking the fairways — the injured center said he's "hoping" to be ready to join the Utah Jazz on the court in the preseason.

Okur even believes it's possible to play by the beginning of the NBA's regular season, which would be about six months after he ruptured the tendon in Denver. That would fit in the recovery time frame his doctor told him after his playoff-ending procedure.

"Like, so far so good," Okur said of his rehab. "Hopefully I'm going to be able to be back early and maybe catch up (in) the preseason games a little bit and go from there."

Okur still walks with a slight limp on his left side — something that the walking and golfing should help, he claims.

But the good news, he added with a smile, is that he no longer has to wear a walking boot on his right foot, something that was required for a while after he underwent surgery to repair the Achilles that ruptured during Game 1 of the Jazz's first-round playoff series against Denver. The tendon doesn't hurt anymore, either.

"Doing good," he said. "I'm a lot better."

Normally one to leave for his homeland of Turkey in the offseason, the surgery forced Okur to stay in Utah this summer. Along with golfing — a sport he played multiple times just last week — Okur has five rehab sessions a week. He said doing pool exercises and lifting weights has helped him get "a lot stronger."

Okur anticipates being able to start jogging, shooting and doing other things on the court in a month.

But he really has his eye on being fully healed for the season-opener.

"I'm hoping," Okur added. "I don't know what to say about my injury because I've never had such a long-time injury like that in my career."

Farve tests his surgically repaired ankle

2010-07-14T08:10:00.000-05:00

You too can have lower leg surgery and still be able to get back into the game. Let the Doctors at Gulfcoast Foot and Ankle help you play at your fullest potential. Below is an article showing Brett Farve working out with high schoolers after having arthroscopic ankle surgery.

http://www.twincities.com/ci_15497815?source=most_viewed&nclick_check=1

Vikings quarterback Brett Favre tests his ankle, working out with high school players in Mississippi
Associated Press

Updated: 07/13/2010 12:08:18 AM CDT

Vikings quarterback Brett Favre looks like he's getting along just fine on that surgically repaired ankle.

Favre worked out with some high school football players at Oak Grove High School in Hattiesburg, Miss., on Monday, then eluded reporters looking to ask him about his future by running to his truck and driving away.

The 40-year-old quarterback has yet to tell the Vikings if he will return for a 20th NFL season. He had arthroscopic surgery on his left ankle in May and has been throwing to receivers at the high school for a few weeks.

Favre worked out for about an hour, then grinned and waved at reporters as he drove off.

Steelers' Willie Colon out for season

2010-07-09T11:53:00.000-05:00

Achilles tendon surgery can happen suddenly and unexpectedly but rest assured that the Doctors at Gulfcoast Foot and Ankle can take on surgeries such as this. Willie Colon had Achilles tendon surgery and will be out for the season as you will read in the article below.

http://www.pittsburghlive.com/x/pittsburghtrib/news/breaking/s_688139.html

It's official: Colon to miss Steelers' entire season

By John Harris
PITTSBURGH TRIBUNE-REVIEW
Tuesday, June 29, 2010

Steelers right tackle Willie Colon will miss the entire 2010 season following surgery tomorrow on his torn Achilles tendon, agent Joe Linta said today.

Colon, who has started 54 consecutive games (including playoffs), is expected to miss nine to 12 months, which will effectively keep him off the playing field this year.

"It's a classic deal where the Steelers are very positive Willie will be back 100 percent in the nine-to-12 month range," said Linta, who spoke at length with team physician Dr. James Bradley, who will perform the surgery. "He (Bradley) made it very clear that Willie will be fine."

Colon suffered the injury Monday while working out at the Steelers' practice facility.

"He was making a change in direction," Linta said. "He went one way, his Achilles went the other."

Pittsburgh Pirates Steven Pearce to have Platelet Rich Plasma injection

2010-07-09T11:23:00.001-05:00

Although at Gulfcoast Foot and Ankle we only work from the below the knee to the ends of your toes our Doctors perform these Platelet Rich Plasma injections to tendons in the ankles and feet.

Below you will find the article that talks about Steven Pearce and his PRP injection

Pirates' Pearce out until August

July 06--HOUSTON -- First baseman Steve Pearce will be out of action until August, as the Pirates' medical staff will perform an injection in his left knee tomorrow and prescribe at least a week of rest after that.

Pearce was examined this afternoon in Pittsburgh by Dr. Patrick DeMeo, the team physician, and it was decided that his patella tendinitis was not severe enough for surgery. A platelet-rich plasma injection will be administered aimed at accelerating the healing. From there, Pearce will have no activity for 7-10 days, then resume treatment and exercises.

General manager Neal Huntington said that surgery remains an option if the current course does not work, but he expressed optimism that it will based on the doctors' findings.

Alex Wong eliminated from "So You Think You Can Dance" due to lacerated Achilles tendon

2010-07-09T11:12:00.000-05:00

Below is an article from http://hot-celebrity-news-photo.blogspot.com/2010/07/alltv-so-you-think-you-can-dances-alex.html to read about Alex Wong and his Achilles tendon injury.

What happened to Alex Wong is awful and painful. This type of injury is just one of many that the Doctors at Gulfcoast Foot and Ankle can treat! No matter how small or how extreme your problem is we will do our best to find a solution.

So You Think You Can Dance front-runner Alex Wong was eliminated Thursday after learning he required surgery for an injury sustained during the competition.

"The results of Alex's MRI came in late last night," executive producer and judge Nigel Lythgoe said at the end of the show. "Alex has suffered a lacerated Achilles tendon."

Wong was injured Tuesday during rehearsals of his Bollywood number with Adechike Torbert, and was unable to perform on Wednesday night's show. The 23-year-old ballet dancer is set to undergo surgery on Tuesday in Los Angeles to reattach the tendon, though it will take at least three months to heal.

"It is just another thing you've got to get through in your life," Lythgoe said. "It will strengthen you."

With this type of injury, Lythgoe said there is a 20 percent chance that Wong's career in the dance world will be sidelined, but Wong insisted backstage that he is "a pretty positive person, so that's not going to happen."

There were few dry eyes in the house, especially from Wong, who thanked everyone for his time on the show, saying he is "very, very grateful.

"My heart's more in pain," said Wong after the show. "[It's] not so much physical. It was a freak accident and it's unfortunate that it snapped completely in half."

Billy Bell and Ashley Galvan, who joined Wong in the bottom three, were spared elimination this week.

Like Bell, who returned straight to the semi-finals in Las Vegas after having to leave the competition early last season, Wong has a ticket to Vegas and is eligible to be in next season's top 10 despite already competing this season.

"I feel like I haven't finished my journey and I feel like I have so much more to learn," Wong said. "So I would love to come back."

Toning Shoes Article

2010-06-30T08:33:00.000-05:00

Its amazing what companies will make and what consumers will buy. On the front page of todays USA Today's website was the article "A revolutionary sneaker, or overhyped gimick?" This article consists of claims these toning shoe companies are making to their consumers and the opinions of actual wearers and doctors. Dr. Gordon and his staff hope that you find this article informational especially if you are considering buying a pair of these shoes. Below is a checklist of things to consider before buying these shoes.

The doctors at Gulfcoast Foot & Ankle Centers recommend that people only try these shoes after:

1. Checking with a podiatrist if they are having foot, ankle, leg or knee problems

2. If they buy them and are having a problem with legs, stop wearing them and see a podiatrist.

3. If they buy them and have no problems then they can continue wearing them.

But most important remember that this shoe will not correct a structural or biomechanical abnormality.

http://www.usatoday.com/sports/2010-06-30-toning-shoes_N.htm