Tuesday, December 21, 2010

What is Turf Toe?

Turf Toe is a sprain injury to the big toe joint (also known as the 1st 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 1stmetatarsal 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

Wednesday, December 8, 2010

$8m device saving life and limb

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.

Wednesday, December 1, 2010

Shoes and knee pain

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.