No More Foot Pain

Simple as Tying Your Shoes

2012-01-03T13:01:00.000-05:00

Did you know that simply the way you tie your shoes can prevent foot pain and problems?

For example, to relieve shoe pressure from your big toenail there is a simple technique to pull the shoe off the big toenail. Begin by lacing the shoelace through the eyelet closest to the big toe and then the eyelet farthest from the big toe on the opposite side (closest to the ankle). Then take the other end of the shoelace, lace the shoelace in a repetitive pattern diagonally and then directly across from the eyelet. When you tighten the shoelace it should remove pressure from the big toe.(see figure on right below).

If the shoe rubs on the top of the foot causing burning, tingling, or pain onto the top of the foot, simply skip the eyelets where the irritation occurs. Without the tight laces over the top of the foot, these symptoms should resolve. Just a tip, don't skip more than 2 eyelets in a row to prevent a poor fit of the shoes.

Do you develop blisters on the back of your heel from the shoes slipping? Try tying your shoes in lace lock around the ankle to secure the heel. A lace lock is performed by threading the lace directly above the last eyelet closest to the ankle, then the other end of the lace is threaded through the opposite lace loop. Once this is done you can tighten the laces at the ankle without tightening the whole shoe.

Some miscellaneous shoe lacing tips include: making sure to tie and untie your shoelaces every time you take your shoes on and off.

By just slipping your shoes on and off without using the laces, you reduce how much support your shoes can offer and wear out the counter and heel of the shoe.

If you have difficulty bending down and tying your shoes, consider elastic shoelaces (available now in our office). Also, for patients suffering with neuropathy be sure to check your feet regularly to prevent pressure form the shoelaces.

http://www.podiatrycarespecialists.com/

Diabetes Day Chester County

2011-11-12T20:59:00.001-05:00

Chester County Diabetes Day

Drs Bradford Jacobs and Chad Friedman from Podiatry Care Specialists, were at Chester County Hospital Diabetes Day on November 12th 2011. Diabetes Day is an annual event sponsored by The Chester County Hospital on information to help manage Diabetes. We were excited to have a lot of visitors at our booth and to help educate the Diabetics and non diabetics, on how important it is to take care of your feet.

http://www.podiatrycarespecialists.com/

Main Line Health Fair

2011-09-26T08:38:00.001-04:00

Podiatry Care Specialists, P.C. of Newtown Square, PAand West Chester, PA, participated in Main Line Health’s ,Paoli Hospital ‘sevent “Healthy Living Expo which was held on Wednesday September 21, 2011 atChadwick’s in Audubon, PA.

Drs. Ted Mushlin, Brad Jacobs, Chad Friedman , AlexandraGrulke, and Practice Administrator Fay Mushlin were there to answer questionsand provide information to all who attended. To further promote awareness about foot health,Podiatry Care Specialists had a representative from Aetrex ,scan the feet ofthe participants showing pressure points and the doctors were then able to discuss theresults.

Also inattendance was a representative from Bako Dermatologic Pathology lab with information on skin cancer of the feet.

Podiatry Care Specialists, P.C. will be opening theirthird office in Main Line Health’s new location in Audubon, Montgomery County,PA scheduled to open December 2011.

http://www.podiatrycarespecialists.com/

Halle Berry Foot

2011-09-23T19:51:00.000-04:00

Halle Berry was filming a video in Spain and broke her foot. Word has it that she broke it while a day off from filming. Were not sure what bone in her foot was broke but there is a picture here of her being wheeled out from the hospital in a splint. A splint is used to help immobilize the foot and help with swelling. Stay tuned for more updates

http://www.podiatrycarespecialists.com/

FALL PREVENTION TIP SHEET

2011-09-22T17:01:00.002-04:00

FALL PREVENTION TIP SHEET

With our population living longer, staying healthier, and increasing their physical activity; a new situation has arrived. Older adults are falling more often. One in every three adults age 65 or older will fall every year. Falls are the leading cause of injury death. Falls can cause more severe injuries such as hip and ankle fractures as well as head trauma. This has become a public health problem as there is an increase in emergency department visits and overall health care costs. Many older adults, even if they don’t get injured, develop a fear of falling. This may lead to less physical activity, which can lead to a reduction in mobility, and a decrease in overall physical fitness.

The first week of fall every year is recognized as Fall Prevention Awareness Week. As a result, we at Podiatry Care Specialists have written this tip sheet as a guideline that we hope can prevent a potential fall to you or a loved one.

1-Wear supportive shoes

Shoes should have a cushioned sole, a wide area on the bottom to stabilize the foot on the ground, and be lace-up or Velcro rather than slip-ons. Visiting a podiatrist will enable you to be fit properly for shoes and if any other devices or braces need to be added for additional balance, their experience in the lower extremity will be of great benefit to you.

2-Schedule regular doctor visits

Routine checkups can help prevent falls. Any condition involving the ears and eyes can cause balance problems. Certain medications have side effects that can cause drowsiness. Inform your physician if you have joint pain or shortness of breath when walking.

3-Stay active

Keeping fit and exercising on a regular basis maintains good health and can reduce the risk of falling. Walking, pool aerobics, and working out regularly will improve balance, flexibility, and muscle strength.

4-Prevent potential falling areas

Watch out for loose rugs, stray electric cords, and wet floors. Have easy access to light switches and maintain wide enough walkways. Have shoes at bedside to put on immediately and never walk in the dark.

5-Assistive devices may be necessary

Walkers and canes may be needed at times for balance. Use handrails on steps. Bathrooms should be equipped with grab bars for the shower, tub, or adjacent to the toilet seat.

Please visit our website for more information
http://www.podiatrycarespecialists.com/

Alex Trebek Achilles Tendon

2011-07-28T11:13:00.000-04:00

Mr Jeopardy himself tore his Achilles tendon yesterday while chasing after a burglar. He tripped and fell and also hurt his other leg in the process. This is terrible news for him. He is going to have surgery done Friday July 29th. With Achilles tendon ruptures, it could take up to a year to make a full recovery from this type of injury.

Sometimes we will see Achilles Tendon Ruptures with weekend warriors. This occurs when one just goes out playing a sport and running without doing any warm up or exercise. Typically with Achilles Ruptures one will feel as if someone had kicked them in the back of their leg. Not everyone needs surgery for this. Should you have any Achilles injuries, please consult your Podiatrist for treatment.

http://www.podiatrycarespecialists.com/

Are Snooki's Flip Flops a Flop?

2011-06-22T22:08:00.000-04:00

Snooki Polizzo, from the Jersey Shore", has started her own line of Flip Flops. Part of the collection will include sandals and wedges that are suited for the beach. They will range in price from anywhere between $15-$50 for them.

With seeing some of her styles, these do not appear to be foot friendly. On the APMA's website, there is a list of good quality sandals and what to look for in a sandal. Typically we look for a sandal with good heel and arch support in them. One should also avoid prolong wearing of sandals as this can increase foot pain. Snooki's sandals appear to be very flat with no cushion, no heel or arch support. Wearing this type of sandal can cause foot pain. Typically we will see this in the arch area as well as the heel and the ankle.

The following list of sandals and flip flops have the APMA seal of acceptance.
http://www.apma.org/MainMenu/RecommendedProducts/SealofAcceptance/Seal-Flip-Flops.aspx

http://www.podiatrycarespecialists.com/

Buster Posey Breaks Ankle

2011-05-26T13:48:00.000-04:00

Many of you in the Philadelphia area remember Buster Posey, the Giants Catcher, who played a big role in unfortunately helping the Giants beat the Phillies in last years NLCS. Yesterday, while trying to block someone from running home, he broke his ankle. There are many different types of Ankle fractures as well as ways to treat them. Bone typically takes 6-8 weeks to heal. Some ankle fractures may need to be operated on to fix while others may need to be casted. If you have any type of ankle injury it is very important to be seen by your Podiatrist for an evaluation. If you continue to walk on a sprained or an injured ankle, you have a high chance of re-spraining the ankle. Initial treatment options consist of rest, ice, anti-inflammatory medicine, and compression. For more information please see our webpage.

http://www.podiatrycarespecialists.com/

Eric Chavez Breaks bone in foot

2011-05-07T19:53:00.000-04:00

Eric Chavez of the New York Yankees has broke his 5th metatarsal bone. The metatarsal is the bone behind the toe. This type of injury can occur from turning in your foot. There are many different treatment options to treat these types of fractures. Some are treated conservatively and some must be through surgical intervention. Bone typically takes 6 to 8 weeks to heal. Sometimes you may need to be either casted or placed in a fracture boot. You may or may not need to be weight-bearing. This all depends on the extent of the fracture. A Jones fracture is a type of fifth metatarsal fracture which has a decrease in blood supply to the metatarsal bone. These typically may need surgical intervention to allow for adequate healing to occur. It is always important to see your podiatrist with any type of injury that you have. This also includes ankle sprains. With ankle sprains we will check your foot because you can also fracture your fifth metatarsal bone. For more information please visit our website. Thank you

http://www.podiatrycarespecialists.com/

Kobe Bryant - Is it his foot or ankle ?

2011-04-26T13:48:00.003-04:00

Kobe Bryant, the heart and soul of the Los Angeles Lakers, injured his foot when he stubbed his toe Sunday night. He has refused an MRI which has led to speculation that the injury is mild or that receiving the results might reveal a more serious problem that would cause the medical staff to shut him down. With the pivotal game 5 against the New Orleans Hornets set for tonight, the series is deadlocked at 2 apiece and Kobe's presence on the court is a must. Due to the lack of medical information out of the Lakers camp, we can only speculate what type of injury he has.

Possibilities include:
1-Tendinitis of the tendons on the top of the foot (extensor tendons).
2-Jamming of the big toe joint, a version of turf toe.
3-An strain of Lis-Franc's ligament- located in the middle of the foot.
4-A small fracture at the top portion of the heel bone that connects to the bones in the ankle.
5-A strain or partial tear of the smaller muscles in the foot known as the intrinsics.
6-A good old fashioned sprain of the lateral (outside of foot) ligaments.

Foot injuries are not to be treated lightly and hope that Kobe does not further injure himself by playing on it. We'll keep watching for updates or more information.

Bradford J. Jacobs, DPM
http://www.podiatrycarespecialists.com/

Phil Taylor

2011-04-17T17:44:00.000-04:00

Phil Taylor, whose position is Tackler from Baylor, has a foot condition that is causing him to move down in the projected drafts for the NFL. He recently had an MRI which shows that the bones in his feet are growing close together. A source has mentioned that it is not correctable through surgery. I dont have anymore information on this and will continue to monitor it. Some of the NFL teams may be scared if his feet start to give him problems. He may also start to begin to distribute the weight in other areas of his body putting more strain for example on his knees.

http://www.podiatrycarespecialists.com/

One Day with out shoes

2011-04-04T12:42:00.000-04:00

Tomorrow is "One Day Without Shoes" global event. This is being held to show to create an awareness what underprivelaged children have been going through without shoes. MSN is donating thousands of pairs of shoes to help the cause. Without shoes, the children are more at risk for developing foot infections, foot ailments, cuts, and bruises.

If you are going to participate, please be very careful with this. Make sure to check your feet regularly to make sure that you did not step on anything. Make sure to clean your feet afterwords as well. If you are expericing any problems please see a Podiatrist.

Please see the original story at:
http://entertainment.msn.com/one-day-without-shoes/?gt1=34148

http://www.podiatrycarespecialists.com/

BMI, Body Mass Index

2011-03-06T09:24:00.001-05:00

There has been a new way to measure ones Body Mass Index (BMI). The BMI, has been used to measure how much ones body fat there is. This can determine if one is at risk for certain health conditions.
BMI under 25 is noted to be healthy where over 30, the person may be obese. However this doesn't take into account if someone is muscular or not.
The BAI which stands for the Body Adiposity Index may be a better way to measure the amount of body fat one has. Researcher Richard N. Bergman, Keck Professor of Medicine at the University of California's Keck School of Medicine, tells WebMD: With the new BAI, ''you get a number which is the percent fat." The new method, he says, is more accurate.

Stay tuned as we may someday may need to make a change on how we can determine certain health risk conditions.
http://www.podiatrycarespecialists.com/

Jennifer Grey Neuroma surgery

2011-02-24T13:22:00.000-05:00

Jennifer Grey, famous actress from Dirty Dancing and recently on Dancing With the Stars Winner, had undergone neuroma surgery this past week. She was tweeting that she was even having pain and discomfort during the show.

Neuromas are not a tumor. It is a thickening of a nerve as it courses between the metatarsals of your foot. The metatarsals are the bones behind the toe. Certain factors such as tight shoes, trauma, abnormal biomechanics of the foot can cause these neuromas to form. The neuroma is basically a pinched nerve. As it gets pinched the nerve tends to scar and fibrose within itself which can cause a lot of pain and discomfort. People may say that their toes may feel numb or they are walking on a pebble or stone. The most common location for the pinched nerve is between the 3rd and 4th toes most commonly called a Morton's Neuroma. They can occur in any of the toe web spaces.

Treatment options vary for this condition. Ranging from wider toe box shoes, cortisone injections, sclerosing injections, and orthotics with special padding to help offload the neuroma area.

If you are experiencing any discomfort or pain please see a Podiatrist right away for this.

Please visit our site for more educational information of neuromas. We have videos on this as well
http://www.podiatrycarespecialists.com/

Neuroma Surgery Jennifer Grey

2011-02-15T11:26:00.001-05:00

Neuromas are not a tumor. It is a thickening of a nerve as it courses between the metatarsals of your foot. The metatarsals are the bones behind the toe. Certain factors such as tight shoes, trauma, abnormal biomechanics of the foot can cause these neuromas to form. The neuroma is basically a pinched nerve. As it gets pinched the nerve tends to scar and fibrose within itself which can cause a lot of pain and discomfort. People may say that their toes may feel numb or they are walking on a pebble or stone. The most common location for the pinched nerve is between the 3rd and 4th toes most commonly called a Morton's Neuroma. They can occur in any of the toe web spaces.

Treatment options vary for this condition. Ranging from wider toe box shoes, cortisone injections, sclerosing injections, and orthotics with special padding to help offload the neuroma area.

If you are experiencing any discomfort or pain please see a Podiatrist right away for this.

Please visit our site for more educational information of neuromas. We have videos on this as well

http://www.podiatrycarespecialists.com/

Lis Franc Surgery

2011-01-25T12:30:00.001-05:00

Chris Ivory, running back for the New Orleans Saints had just undergone Lis Franc's surgery of his foot. The Lis Francs ligament is an important structure of the mid foot. With this type of surgery, there is a long recovery time. This could take up to 8-12 months to fully heal. This type of injury can be misdiagnosed. One common mechanism of injury is a direct trauma or stepping your foot in a hole. Its always a good idea to have your feet checked if it is not getting better. A simple sprain may turn out to be something more important.

http://www.podiatrycarespecialists.com/

Top Doctors in Mainline Today

2010-12-05T16:14:00.000-05:00

We wanted to congratulate Dr Chad J Friedman for being listed in the December 2010 issue of Mainline Today as one of the areas Top Doctors in Podiatry.

http://www.podiatrycarespecialists.com/

Copper Socks for Chilean Miners

2010-10-14T18:59:00.000-04:00

What great news to hear that all the Chilean miners are safe and well after their historic rescue! One of the amazing components of their rescue was the supplies sent down to them to enable a safe and healthy return to civilization. One of the items that caught our attention was the importance of the 33 miners getting to wear socks with copper soles. The advantage to this is the active ingredient, Cupron, will remove moisture from the feet which will inhibit bacteria, fungi, and yeasts from attacking the foot. At Podiatry Care Specialists, we have long been supporters of copper sole socks and have had them in stock at our offices for a number of years. If more information is desired, please stop by our offices in West Chester, PA or Newtown Square, PA to see them what makes them so special or visit our web site.

http://www.podiatrycarespecialists.com/

For more information please click on the article about the miners and the copper socks.
http://www.infobae.com/salud/534290-0-0-Chile-mineros-usaran-ropa-cobre-su-calidad-bactericida

http://www.podiatrycarespecialists.com/

For more information please click on the article about the miners and the copper socks.

http://www.infobae.com/salud/534290-0-0-Chile-mineros-usaran-ropa-cobre-su-calidad-bactericida

Hershey's Mill Health Fair

2010-09-30T10:55:00.000-04:00

Podiatry Care Specialists in West Chester, PA and Newtown Square PA, were happy to join the 1st Annual Health Fair at Hershey's Mill. The Senior Helpers of Chester County ran this spectacular event. Dr Theodore Mushlin, Dr Alexandra Grulke, and Fay Mushlin, Practice Administrator, attended the event to help spread the word about Podiatric foot care. In addition, Mark Fallecker from Aetrex Shoes, brought in the iStep Scanner (Please see previous blog on this) to scan the feet of the residents at Hershey's Mill. Some other attendees at this event were Genuardi's, (located on Boot Road in West Chester, PA), offering flu shots and giving out food, and Bayada nurses checking blood pressure and talking to the residents. It was a wonderful opportunity for the residents and very well attended.

http://www.podiatrycarespecialists.com/

iStep Foot Scanner

2010-09-14T11:49:00.000-04:00

We are very excited at Podiatry Care Specialists to announce a new technological product in our office, the iStep Scanner by Aetrex. Have you ever wanted to know the accurate size of your foot? Or where the pressure points are in your feet? How about what type of orthotic or arch support best fits you? With the iStep Scanner, all this is possible.

The iStep is the considered one of the leading digital foot analysis tools on the market today. We are able to print out a copy of your foot type along with pressure distribution. We can also get a scanned reading of your foot length and width. We are also able to help you choose from various shoes or sneakers based on your foot type as well as help fit orthotics or arch supports that will correspond to them. We can even show you where the pressure points are and compare that scan with one that has a biomechanical device placed in your shoe gear.

Please visit our website for more information and feel free to make an appointment to have your feet examined and scanned.

http://www.podiatrycarespecialists.com/

Toning Shoes...Fad or Bad?

2010-09-09T10:14:00.000-04:00

There has been an increase lately in the number of shoe companies that are producing these toning shoes. Some of the common ones that are out are the Skechers Shapeups, Reebok EasyTone, New Balance and the MBT's. There are also making these in sandals now. These shoes are claiming to help solve knee and back problems, tone your legs, relieve tension in the neck and ease joint pain. What are all the thoughts on this? Since some of these products are fairly new, we dont have long term studies on them. Once more long term data is out on these we will get a better idea on how these products work over the long term.

I would not recommend these shoes/sneakers to run in. I am going to post a link to a study that was done on them. A team of exercise scientists from the Exercise and Health Program at the University of Wisconsin had studied the 3 shoes above. They evaluated muscle activation in the toning shoes vs a New Balance Running shoe as well as exercise responses.

For the exercise response the researchers had 12 patients complete 12, 5-minute exercises on a treadmill that with different speeds and gradients(inclines) with the toning shoes and a running sneaker. For the muscle activation response, 12 patients rotated shoes at random while having electrodes tied to different muscles on the body while doing similar exercises on the treadmill.

The results showed that none of the toning shoes showed a statistically significant increase in exercise response or muscle activation on the treadmill.

As of now, I think there needs to be even more research on these toning shoes. I like how this study was performed and how it showed that there was no difference in muscle activation or exercise response on a treadmill.
Here is the link for further reading.
http://www.acefitness.org/getfit/studies/toningshoes072010.pdf

http://www.podiatrycarespecialists.com/

Pregnant Women and Flip Flops

2010-06-21T08:16:00.000-04:00

I recently saw an article published by the NY Daily Times on pregnant women and their shoe gear. I will include the original link at the end of this blog.

The British Society of Chiropodists and Podiatrists performed a study on 1,000 pregnant women and found many women wear fashionable shoes while being pregnant. 7/10 women had swollen ankles, feet, heel, and arch pain during their pregnancy. 66% wore flip-flops regularly, 32% high heels, 30% Uggs, and 53% ballet pumps.

What I didnt see listed in the study is when along their pregnancy they wore the above. When the feet swell it becomes more difficult to find a comfortable pair of sneakers/shoes. Typically the further along pregnancy we may recommend Crocs. It is not a good idea to wear high heels. pumps, and Uggs. These shoes do not have the proper support for the foot as well as the shock absorption. The high heels can also aggravate your back and other joints. Its always a good idea to wear comfortable and supportive shoes to prevent any foot pain especially while being pregnant.

For more information please visit our website.

http://www.podiatrycarespecialists.com/

Here is a link to the original article:

http://www.nydailynews.com/lifestyle/health/2010/06/15/2010-06-15_stilettoclad_momstobe_risk_longterm_foot_problems.html

Exercise With Care

2010-05-31T09:55:00.000-04:00

Recently as I have been going to the gym for a workout, or walking outside, I cant help to notice ones footgear. Whats amazing is what I see people wearing when running on the treadmill or using the elliptical. I see different forms of footwear ranging from what should be used, sneakers to things one doesn't want to wear in loafers, shoes, sandals and flats. Its very important when exercising and going for walks or runs to have your foot supported and have good shock absorption. You will not be able to get this with loafers, shoes, or sandals. You should always be in a good supportive sneaker when you are very active at the gym. You will not be as fatigued and you can prevent less problems with your feet!

http://www.podiatrycarespecialists.com/

Ryan Madson Breaks Big Toe

2010-05-01T15:24:00.000-04:00

Ryan Madson, the pitcher for the Philadelphia Phillies, broke his big toe the other day after blowing a save for the Phillies. He kicked a folding chair in frustration. After this happened the toe started to swell and ache. Treatment for a fracture of a toe depends on the type of fracture. Its more serious in the big toe and sometimes the fracture needs to be fixed either with screws, pins, or wires. It sounds like he will not need surgery for this, but will be in a walker boot for a few weeks. If the fracture occurs in the joint he may develop arthritis in the toe. In the lesser toes if there is a fracture, usually these will be treated with a splint to the other toe. This again depends on the type of fracture that has occurred. Bone typically takes 6-8 weeks to heal. If you have any more questions please visit our webpage.http://www.podiatrycarespecialists.com/

Neomycin Allergen of the year

2010-04-05T09:27:00.003-04:00

Lets talk about skin for brief moment. Some people may develop allergies to certain topical medications as well as certain chemicals in household cleaners or even the material in shoes/sneakers. When the skin has an allergic reaction it is a dermatitis, inflammation of the skin. According to MD Consult the American Contact Dermatitis Society has named "Neomycin" as the allergen of the year. Neomycin is an the product Neosporin. Neosporin is a very common antibiotic cream used for simple cuts and lacerations. If you are noticing any redness, small red areas, pimple like areas, blistering after using Neosporin you should discontinue the product. This also should be with any topical creams or ointments that you apply to your skin. If you are concerned whether or not you may be allerigic to Neomycin or Neosporin you can always have a patch test which will test very common chemicals to see if you are allergic to them.

http://www.podiatrycarespecialists.com/Preview

David Beckham Achilles Torn

2010-03-17T08:07:00.001-04:00

David Beckham, world known soccer player and who is married to former Spice Girl Posh Spice, sustained a devestating injury to his foot. He had ruptured his Achilles Tendon. The inury occurred during one of his recent games. The Achilles tendon connects the calf muscle to the back part of the heel bone. There is a common area in the Achilles tendon that has a decreased amount of blood supply called the watershed area. This usually occurs about 2cm-6cm from the area it originates in the heel bone. The injury can occur from a direct trauma to the area or a quick contraction from the calf muscle. This is most likely what has caused his rupture. It may take up to a year to gain full recovery from this type of injury. Conservative measures include being in a cast or brace for a few months to surgery where the tendon is repaired. Even with surgery, a cast or brace is usually needed. Physical Therapy is paramount after this type of injury to strengthen back the calf musle. There is always a risk of a re-repture of the tendon in any case of conservative or surgial treatment options. Athletes typically will have the surgical route because of a quicker healing time and may be more durable. It is always best to see your doctor to see which treatment is best for you. For more information please visit our website

Chad Friedman, DPM
http://www.podiatrycarespecialists.com/

Ankle Injuries

2010-02-08T10:56:00.001-05:00

Congratulations to the Saints for winning Super Bowl XLIV! Lets talk for a minute about the Colts star defensive player, Dwight Freeney. He suffered from a torn ligament in his Right Ankle. There was debate on whether or not he was going to play in the Super Bowl. He was able to, but he still had significant pain as the game went on and was not able to play the entire game. Lets discuss what the grading system is for Ankle Ligament injuries. These are usually caused by "rolling in " on the ankle.

Grade 1: Usually caused by stretching of the ankle ligaments on the outside part of the ankle. The ligaments are not torn. There is no instability of the ankle joint. Treated best with Rest, Ice, Compression, Elevation (RICE).

Grade 2: There is more damage than a Grade 1 with partial tearing of the ligaments of the ankle. There is no instability of the ankle joint. Treatment is the same with 1, but patients will require a brace, need to be immobilized in either a cam boot, Unna boot, and crutches or cane.

Grade 3: There is tearing of the ligaments of the ankle joint, there is ankle instability, along with swelling and pain. Treatment is the same as 2 but more aggressive in offloading the ankle and stabilizing it to prevent it from rolling in or out again. Soft tissue injuries can take a minimum of 2-3 weeks to heal.

Treatment options for Freeney probably ranged from physical therapy, tapings to support the ankle, and ankle braces. Continually playing on a damaged ankle without the ligaments having a chance to heal can have long term consequences such as but not limited to; frequent spraining of the ankle, arthritis, instability, and continued pain. It's always important to seek medical treatment if you have sprained your ankle for the right treatment protocol. Please visit our site for more details.

http://www.podiatrycarespecialists.com/

Moisturize Those Winter Feet

2010-01-26T15:20:00.000-05:00

Brrrrrrrrrr. It’s winter time in the Southeastern Pennsylvania area. The harshness of the cold temperatures and gusty winds that occur during December, January, February, and even part of March wreck havoc on the body. The hands and feet are particularly vulnerable as the extremities are the farthest parts of the body from the heart. We protect our body from the cold by wearing warmer and layered clothing. Gloves, hats, and scarves protect the most exposed parts and are important elements for protection, especially as we get older. Something we commonly overlook is moisturizing our hands and feet, especially our fingertips and heels. The back of the heel is especially vulnerable to scaling and cracking. A crack through the skin is called a fissure and can result in a foot infection as there now is a portal of entry for bacteria to enter the body and grow. Diabetics and vascular compromised people are most at risk.

Treatment-Prevention and maintenance of the integrity of the skin surface is done through regular use of skin moisturizing agents. There are many products on the market as many of them do an adequate job. Some leave a greasy film and some are tacky, so choose one that you are comfortable with. I prefer to recommend ones that leave a smooth finish and will penetrate easily without a large amount used. It doesn’t matter which one you choose as long as it is applied at least once and preferably twice per day, especially in the winter. A pumice stone or callus scraper can be utilized prior to moisturizing, but never use any sharp instruments like scissors or razor blades. Free edges of skin should not be pulled. If there are many layers that need to be treated, seek a podiatrist’s help and not a pedicure salon. This is a serious condition and should only be performed by a well-trained professional.

http://www.podiatrycarespecialists.com/
By Bradford J. Jacobs, DPM

Barefoot Running Part 2

2010-01-18T09:10:00.001-05:00

We briefly mentioned last week about the potential hazards and dangers of barefoot running. I thought that I would just add a few more interesting things about it. A study published in The Journal of Sports Medicine and Physical Fitness said that barefoot runners had less impact than runners in shoes. On the flip side to this, there has been no documented studies that show running with sneakers can cause foot problems or lead you to an injury. But if you can think about some of the stuff that I had posted last wee I will not recommmend doing it. This is because it can lead to stepping on something, lacerations, increase in pain, and blisters just to mention a few.

Happy Running/Walking, but of course with sneakers on :)

Chad J. Friedman, DPM

http://www.podiatrycarespecialists.com/

Barefoot Running

2010-01-11T09:41:00.000-05:00

There has been a lot of talk in the literature recently on barefoot running. In fact there was even a book written on the topic (Born to Run). Its going to be something that many people will begin to try or continue to do. For me, I will not be recommending it. Some of the reasons for this is the risk of stepping on something, contusions, sprains, strains, and possible fractures. Depending on your foot type, the foot should be constantly supported through all phases of gait. If not, it can cause other muscles to compensate for other muscles and lead to tendon problems or other stresses in the feet. The feet need good support to support the rest of the body. Think about this as well; could you imagine running on a track, concrete, or gravel barefoot? Imagine this even on a hot sunny day. Your feet would burn and increase your chance of developing blisters. And of course this would never be good in a diabetic or someone who has developed neuropathy of their feet(loss of sensation). We will continue to update you on more information that will come out with the topic, but for the time being it is something that I will not recommend.

Happy Running/Walking, but of course with sneakers on :)
Chad J Friedman, DPM

http://www.podiatrycarespecialists.com/

Happy New Year

2010-01-01T08:18:00.000-05:00

Podiatry Care Specialists, would like to wish everyone a Happy and Healthy New year!

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Happy Holidays

2009-12-23T09:18:00.001-05:00

Happy Holidays from all of us at Podiatry Care Specialists, P.C.

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Holiday Shopping

2009-12-14T14:43:00.000-05:00

This is a busy time for everyone. Holiday shopping, running around, and being on your feet. It is important to remember, not only during the holiday season, but whenever doing long periods of walking and standing on your feet to wear the appropriate shoe gear. We generally tell our patients that anything is better then going barefoot, socks, sandals, and flip-flops. For around the house, Crocs can be very beneficial for your feet. Our office dispenses different styles of Crocs, with the most common we recommend is the Crocs Relief. They are great for heel and arch support. As for during the holiday shopping, it is not a great idea to do this while in heels, Uggs, or narrow pointy shoes. Wear comfortbale shoes or sneakers with a firm heel counter and great arch support. Happy Holidays to all and please feel free to visit our site for more info

Happy Holidays,
Chad J Friedman, DPM

http://www.podiatrycarespecialists.com/

Philadelphia Eagles Wide Receiver Plantar Fasciitis

2009-12-08T17:05:00.002-05:00

It appears that another NFL player is suffering from one of the most common foot conditions that we treat, plantar fasciitis. Jeremy Maclin has not been limited yet in his activity and is still practicing with the team. Expect him to play this weekend in a must win divisional game for the Philadelphia Eagles. He will most likely have a lot of physical therapy, strappings, ice, and anti-inflammatory medicine to calm this down. For more information on Plantar Fasciitis, please visit at webpage listed below.

Thank you,

Chad Friedman, DPM

http://www.podiatrycarespecialists.com/http://www.podiatrycarespecialists.com/

Turf Toe and Matt Ryan

2009-12-02T10:30:00.001-05:00

Matt Ryan, the Atlanta Falcons QB, is from Exton, PA. He also went to William Penn Charter in Philadelphia, PA. He recently just suffered a condition known as Turf Toe. Turf Toe got its name from players commonly getting this condition while playing on artificial turf. Turf Toe can be better explained as a sprain of the big toe joint. This can happen as shown in the picture. When the foot is in a flexed position, this can sprain the big toe joint. Sometimes it can be severe enough where it actually can tear some of the ligaments of the big toe joint. This can lead to arthritis in the big toe joint and a bunion deformity.
Symptoms start out as swelling and pain in the big toe joint. Also with difficulty propulsing off the big toe joint.
A good clinical history along with X-Rays and a possible MRI can help diagnosis the condition. It is usually treated with RICE; Rest, Ice, Compression, Elevation. Usually a taping to the big toe joint along with a stiff sole shoe to help prevent flexion of the joint allows the injury to heal. It can take up to a month and sometimes even longer for the injury to heal. And atheletes are unable to play during this time. Although it is rare, surgery may be an option if Turf Toe goes undiagnosed or if there is a rupture to the ligament.

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Eli Manning Stress Reaction

2009-12-01T12:13:00.001-05:00

Well it looks like Eli Manning suffered another setback with his Plantar Fasciits. Apparently he must have been compensating too much from the condition and has developed a stress reaction to the cuboid bone in his foot. Now what is a stress reaction? A stress reaction is changes that is occurring within the bone. Could be from overuse or trauma. What is important is that if left untreated, this can lead to a stress fracture in the foot. A stress fracture in the foot, and depending on the bone in the foot, can definitely put an end to a season. And with not that many weeks left in the season, it can end his. Treatment for both is to stay off the foot and offload it. This again can be done via a Camboot, cast, ice, rest, and crutches. He also has shoe gear modification as well. Will keep you posted on his progress.

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UGGS

2009-11-27T09:01:00.003-05:00

Let's face it, as Podiatrists Uggs are not our favorite shoes to recommend. They have a nice cushioned sole, are rounded in the toe box area, but do not have much support in the arch or heel area. This can lead to heel pain,achilles tendinitis, or arch and muscle fatigue. They are an immensely popular shoe, however. We can provide some improvement in the shoe by adding a custom molded orthotic or at the very least a good pre-fabricated arch support device. You have to be flexible in your treatment repertoire as fashion rules.

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Lis Franc Injury

2009-11-23T11:20:00.001-05:00

It looks like there was another devastating injury to a football player just recently. That would be Ronnie Brown, the starting running back for the Miami Dolphins. Lis Francs injuries can be difficult to diagnose and can also be misdiagnosed. So what is a Lis Franc's injury? Lis Franc was a soldier who fell off a horse and damaged this ligament. The ligament is one of the strongest in the foot and is located in the middle of the foot. The mechanism of action can occur with a direct impact or trauma to the midfoot or stepping in a hole and twisting your foot.

It can be diagnosed by X-Rays, MRI, or a CT scan of the foot. Patients will come in with a swollen foot, pain in the middle region, and unable to bear weight on the affected side.

Treatment varies depending on how bad the sprain is, and its worse if there is an associated fracture with that sprain. Non-surgical treatment involves a case or a stiff walking boot for up to 8 weeks and sometimes more. Surgery can involve placement of pins and or screws to realign the midfoot area.

Undiagnosed Lis Franc injuries can lead to arthritis in the foot, chronic pain, and wear and tear of other joints in the foot.

With Ronnie Brown he had surgery to fix his foot and now will be out for the remainder of the season. Only time will tell to see how he does after his healing.

So if you are experienceing any of these symptoms after a recent fall or trauma, get to your foot dr right away

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SAP Health Fair

2009-11-16T08:47:00.000-05:00

A few months ago Dr Chad Friedman was fortunate to give a lecture at the SAP health fair in Newtown Square PA. The health fair was a success as there were many people who stopped by to learn information about Podiatry and what we have to offer in our practice. If you to would like to know more about our services and what we have to offer for your foot health, please visit our website below or call to make an appointment.

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Lecture

2009-11-02T08:52:00.000-05:00

Dr Chad Friedman recently gave a lecture at St Albans Church in Newtown Square. The lecture was presented to St Anastasia's members. The lecture presented was on general foot health and included bunion, hammertoes, neuromas, heel pain, arthritis, fractures, diabetes, and wound care. For more information please visit out site for educational videos

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Surgical Emergencies

2009-10-26T11:05:00.001-04:00

There are many different kinds of surgical emergencies. There are also a few that can occur in the foot and ankle. One such emergency happened to a player yesterday in the New York Jets vs Oakland Raiders game. Leon Washington, the Jets running back, suffered an open fracture of his fibula. Open fractures occur when bone can be visible or breaks through the skin. This actually happened to him right on the field. Some of the players had seen the bone visible through the skin. The fibula is one of the two smaller bones in the lower leg.

With open fractures, the area that has been exposed has an increase chance of an infection. In order to prevent this, the wounds are usually taken care of in the Operating Room or Emergency Room. The broken bones are also fixed at this time. Sometimes if there is a delay in treatment, it may require multiple surgeries.

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Eli Manning Plays Well With Plantar Fasciitis

2009-10-13T11:49:00.001-04:00

Eli Manning had a great game this past weekend against the Oakland Raiders.
"I felt good," the Giants' quarterback said on a conference call with reporters Monday afternoon. "I moved around and didn't have a setback by any means. I feel like it's getting better every day and will and should feel better by the end this week and keep improving.”
He was not limited at all during the game. With plantar fasciitis, getting back to physical activity can be an achievable goal. With daily stretching, taping, orthotics, injections, and physical therapy, can get you back to your normal lifestyle. Its always important to remember, that foot pain is not normal. Plantar Fasciitis can be treated if it is treated early enough. Will keep track of Eli's progress. Please visit our website for more information on heel pain.
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Tom DeLay Dancing With The Stars Foot Injury

2009-10-07T22:15:00.001-04:00

Once again another famous person has had an important injury. Tom DeLay, former Republican majority leader, has stress fractures in both feet. Stress fractures are caused by repetitive injuries. If they are not treated early enough, they can lead to a complete fracture. If this happens, this can take a lot longer to heal. Initial treatment for stress fractures include the principles of RICE- Rest, Ice, Compression, Elevation. Also this includes Immobilization. As we talked about before, CamWalkers are one of the best immobilization options we have for stress fractures. It's unfortunate that Tom DeLay had to withdraw from Dancing With The Stars, but if he did not, then he would be at risk for a complete fracture and longer healing times. This is why it is important to not continue daily activities when you have pain and discomfort. Always visit your Podiatrist if you are having foot pain. Remember, foot pain is NOT normal.

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Eli Manning painful heel hurting Giants hopes for upcoming game

2009-10-06T11:36:00.000-04:00

It seems like another famous athlete has developed the painful condition known as Plantar Fasciitis. He also may have developed a bone bruise along with this. After the injury occurred you can see the trainer was taping up Eli's foot. One of the most common things that we do for plantar fasciitis is to tape, or strap the foot. This helps support the heel and arch area which is important in plantar fasciitis. I am sure he will also have a lot of stretching, icing, and physical therapy this week to calm the area down. It is possible he will also be wearing orthotics (shoe inserts) in his cleats as well. Now Eli, had an MRI to help confirm the diagnosis. He may also have had a bone bruise to his heel as well. If this is the case, this may take a little longer for him to heal. Treatment is similar but he may be in a CamWalker for the bruise. Now for people who are into Fantasy Football and have him on your team (like myself) you are probably wondering if you should start him or not. Studies show that with plantar fasciitis it is usually treated conservatively 90% of the time. Depending on which treatment he gets he should be fine for the game. I don't see him being limited too much as long as he is taped up and has inserts in his cleats. I am hoping he has a good game. We will continue to monitor his progress and will update you on his condition.
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Sweaty Feet

2009-09-28T12:41:00.000-04:00

Sweaty feet is also known as Hyperhidrosis. This commonly occurs on the palms and soles of the feet. Some people may have more sweat glands than others. When your feet sweat, this is a breeding ground for fungus and warts to develop. Remember how we talked about that fungus and warts, love a warm moist environment? Hyperhidrosis can also lead to Bromohidrosis which is foot odor.

There are many different treatments that can help hyperhidrosis. One thing that we will typically recommend is to not wear 100% cotton socks. 100% cotton socks do not wick away moisture. So when your feet sweat in these cotton socks, the moisture will also stay with you all day. Socks with the synthetic material consisting of Lycra can help with this. It is also a good idea to constantly change your socks daily. We also have certain topical roll on anti-perspirants that one can roll onto their feet to help with the dryness. These products can be very effective and they range in different concentrations. There are also certain Talc's and lotions that we may dispense to help this out as well.

Please visit our page if you have more questions or call to make an appointment

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Gout

2009-09-16T08:39:00.001-04:00

We have discussed some previous causes of heel pain such as plantar fasciitis and calcaneal apophysits. One overlooked cause of heel pain is Gout. Commonly we will see gout in the big toe joint. It can also be seen in the heel less commonly. Gout is a build up of uric acid in the body. Some people may tend to overproduce these uric crystals and then there are the people who under produce them and the body is unable to get rid of the uric acid crystals. The uric acid then tends to buildup in joints in the body. This leads to a red, hot, swollen, and inflamed joint. This can be very painful. Typically people may describe the pain so bad that the bedsheets are unable to touch the foot. There are many different causes of gout ranging from genetics, drinking too much alcohol, eating a lot of shrimp, shellfish, and red meat. Certain medications can also cause gout. Most commonly are the water pills such as Lasix and HCTZ. Certain tests can diagnose gout as well. This can be confirmed by a looking at the synovial fluid in the joint and a simple uric acid blood test. However these tests are not always positive. Sometimes in an acute gout attack, the blood test comes back normal. X-Rays sometimes can take years before seeing the erosive changes it can take on a joint.

Untreated, and long term gout can lead to arthritis in the joint. This is why it is important to see your Podiatrist (if affecting the foot) and your Primary Doctor to manage the gout. Early treatment during an acute attack most commonly involves a cortisone injection and anti-inflammatory medicine. This helps dramatically reduce the inflammation within a 12-48 hour window. Long term treatment may consist of being placed on medicine that helps control gout and prevent future flare ups. One thing that must always be done is a diet change. Avoiding alcohol, red meat, shrimp, and shellfish can help prevent future flare ups. Gout was typically called "The Disease of Kings" and "Rich Man's disease" because it was believed back in the day it was caused by an overindulgence of food and drink. But now we know more about what the causes and treatment are of gout and how to avoid it. As always if you are having the above symptoms and are suspicious for gout in your foot please contact your Podiatrist to get some relief
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Back To School Shoes

2009-08-31T09:30:00.000-04:00

Summer is quickly ending and now many students and kids will be returning back to school. At this time, many parents will be buying their children new sneakers/shoes to also start the new year off. There are many different things to look into when buying sneakers and shoes. The American Podiatric Medical Association has listed a "1,2,3 test" to ensure a good quality shoe when purchasing new shoes.
The first thing to do it press on both back parts of the heel. this area should be firm and not compress.
(Images on the left are better quality sneakers than images on the right)
Click on picture for bigger picture.

The next step to check for is toe flexibility. The shoe/sneaker should compress at the ball of the foot and not the entire shoe. The shoe should bend with your child’s toes, but should not be too stiff or bend too much in the toe box area.

The 3rd test should be to grab the shoe/sneaker and twist it from side to side. A good quality shoe/sneaker will not easily twist in the middle.

Other important considerations is to go shoe shopping with your children. This will help promote good quality shoes early and often. Always look for the Podiatry Seal of Acceptance on the shoes. We have blogged about this earlier. Continually examine the wear pattern of the heels. Many kids will tend to wear out the heels even though their shoe size has not changed. Lastly, socks is always important when trying on shoes. Make sure to wear the correct socks when trying on shoes to ensure a proper fit.

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Flip Flops and Bacteria

2009-08-24T09:31:00.001-04:00

There was an interesting article posted by NBC about Flip flops and bacteria that I would like to discuss. The University of Miami emergency mobile flip-flop lab found more than 18,000 bacteria on one flip flop. Now remember that's just ONE flip flop. What was even more interesting was that some of the bacteria that was found on the flip flops, were bacteria from fecal matter, respiratory germs, diaper rash, and yeast infection. Oh the places we go....the study tested different parts of NYC. The subway, parts of Coney island, Coney island public restroom at the train station, West Village, and Brooklyn's Prospect Park. Wow I couldn't even imagine wearing a pair of sandals, or flip flops in a subway. Let a lone a busy one like NYC. That one in the public restroom had about 13,900 bacteria!! Another interesting finding by Dr. Philip M. Tierno Jr., director of clinical microbiology and immunology at New York University’s Langone Medical Center, said "if such shoes were worn for three months over the course of an entire summer, 93 percent of them would have fecal bacteria on them and 20 percent of them would have E. coli."
Just think about what you are potentially walking in with those flip flops in bathroom floors, especially in a subway station. And I just don't mean human waste either. You also have small animal droppings as well.
The most important thing that one should consider is not having any open cuts, blisters, or sores. You shouldn't be wearing flip flops to begin with, with any of the above foot ailments. But with all those bacteria, this can lead to severe infections in the foot.
It is always important to take good care of your feet and to recommend checking your feet daily. For further information, please check out our website.

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What is My Foot Type?

2009-08-17T13:08:00.000-04:00

We typically will get many questions regarding "What is my foot type?" and "What type of sneaker should I be looking for? Motion control? Stability?" Well it can be very easy to determine what your foot 'type' is. This can range from a flat foot, high arch foot, or a normal foot. It is very important to know this, so that when it comes to buying a pair of sneakers you can determine which kind to buy.

The images that you see from left to right are pictures of a High arch foot, flat foot, and a normal foot. To find out what type of foot you are you can perform the "Wet Test"

This simple test can be done at home. Basically, pour some water in a pan. Step in the pan so that the bottom of your foot is wet. Then step onto brown paper bag, shopping bag, or heavy paper. Then take a look to see which image your foot type is similar to.

Lets start off with the High Arch foot. If you don't see much of the instep, and a thin line of the outside part of your foot then you have this type of foot. You will basically be looking for a Cushioned or Flexible shoe type

Next would be the flat foot. If you see the majority of your foot than this is your foot type. You will typically be looking for a Motion Control or Stability shoe.

Lastly would be the normal foot type. You would most likely see half of your arch area. If so than you have a normal or neutral foot type. When buying shoes you want to typically look for a Stability type shoe.

This can help out tremendously when deciding between the differences out there between cushioned, flexible, motion control, and stability

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New Running Sneaker Style

2009-08-03T17:28:00.001-04:00

I recently saw an interesting article from Wired magazine. Research is being done that is suggesting barefoot is the way to run. I do not agree with this at all, but we will see what kind of literature will be published in the future. Certain companies are developing models like Nike Free, the Newton All-Weather Trainer and the glove-like Vibram FiveFingers.

Could these things be the new Crocs? Only time will tell. I dont see it as a good idea due to the lack of support and cushion. By running barefoot, you increase your chances of sprain, strains, fractures, and developing cuts and bruises. The new sneakers do not seem at all supportive for the heel and arch. I will keep you posted on the new running style to see if any literature is out there. Until then, its best NOT to run barefoot, and to be in good supportive sneakers and shoes at all times.
The original article can be found at : http://www.wired.com/wiredscience/2009/07/barefoot/

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Exercising and Foot Gear

2009-07-20T07:56:00.000-04:00

Over the past few weeks and months with the warmer weather out, I have been trying to get more and more exercising in. Usually that will be with bike riding, the elliptical machine, and running. One of the good habits that I have developed as a Podiatrist is constantly looking at ones feet or shoe gear. Its more apparent in the Summer months when people wear sandals and flip-flops.

As I talk about different shoes in this blog I would like to mention that I have no affiliations with these company's and I do not get paid for recommending their shoe gear. Its all from personal experience.

I have been amazed that when I went to the gym a few weeks ago what people are working out in. Or even cycling on trails. I have noticed a lot of sandals. They may feel fine while working out in them but it will catch up with them later. They will eventually develop foot problems. Sandals and flip flops offer no support at all. When exercising, your heel and the arches of the foot need to be constantly supported. There also needs to be some shock absorption as well. If not the knees then take a lot of that shock absorption. People will develop plantar fasciitis, arch pain, callouses, and knee pain as well.

Now i know there are a ton of different shoes and sneaker company's out there but not all have the APMA seal of acceptance. I will also post a link for them as well. As for shoes and sneakers I will recommend they are as follows:
Sneakers: New Balance, Asics, Saucony, Brooks, Mizuno, Aetrex
Shoes: Aetrex, Rockport, Ecco, Clark's, and Merrell's

And for a list of the APMA seal of acceptance for shoes and sneakers please see the following link:
http://www.apma.org/MainMenu/RecommendedProducts/SealofAcceptance/ProductsbyCategory.aspx#FOOTWEAR

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Fractures

2009-07-12T15:20:00.001-04:00

The foot has 28 bones. Fractures can occur in any of these types of bones. There are different types of fractures that people can sustain. Recently in the sports world, Yao Ming the basketball player for the Houston Rockets, had suffered a fracture of his navicular bone. He also has a history of different foot ailments. The Dr that is treating him had mentioned that the injury he has recently sustained "could end his career'. Very scary. So what is the navicular bone and why is this a problem for him.

The navicular bone has many different ligamentous attachments to it. It also has a main insertion attachment for the Posterior Tibial Tendon (PTT). One of the main functions of the PT tendon is to hold up the arch of the foot. The bone is the main corner stone of the arch of the foot. The navicular bone, also has a very poor blood supply to this area. When bones have a poor blood supply, it takes longer for them to heal. A CT scan was able to pick this tiny crack that he had in the navicular. Now, Yao's options include either conservative or surgical intervention. Conservative treatment would include casting, bone stimulator use, physical therapy, and most certianly orthotics to control his foot. Surgical intervention would consist of fixing the fracture.

So only time will tell to see how Yao's Dr's figure out a treatment plan for him. Yao's injury continued to get worse. That is why it is always important to consult your Podiatrist should you notice any foot pain.

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