Ryan Howard Fractured Toe

Ryan Howard can not catch a break!!! Literally. The latest injury he has suffered was a broken big toe. And how did he do it?? Dropping a lead pipe on it. He suffered a chip (or avulsion) fracture off the big toe. Hopefully it just missed the joint. If it didn't, there is a chance he may develop arthritis in the joint. The good news is that they said he does not need to wear a camwalker like he did when he ruptured his Achilles tendon last year. He also has a wedding coming up in December and they said should be fine by then.

Chip or avulsion fractures can occur at any bone. It usually involoves ligaments or tendons that can cause a sudden contraction that "avulses" or "chips" off a potion of the bone. The X-rays show an example of this.
 So how does one treat this? It depends on how big the fracture is, if it is located in the joint, and if there is displacement. Some may require a screw or a pin to help fixate the fracture.


One should always seek their Podiatrist for treatment for any toe fracture. If a toe is broken, there is something that can be done with them besides just splinting it.

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

What are those Nike green shoes that I see on the Olympic athletes?

If you have been watching this years Olympics, you might have seen those bright green sneakers that the Olympic runners have been wearing. What are those you might ask? Those are the Nike Flyknit shoes. These shoes are trying to be as close as the minimalist shoes that are our their now. They have a special stitching that will knit the sneakers upper part with individual threads that will make them very lightweight.

These sneakers were unveiled back in February and sparked a lot of interest in the running community. Now with millions of people watching the Olympics it is starting to spark the trend all over again. The release date was July 27, 2012. It appears the only place at the current time to get these are online at Nike.com

When looking for athletic shoes it is important to look for quality characteristics that makes the shoe comfortable and well constructed. Running shoes must be lightweight, yet well supported. For most recreational runners, walkers, and athletes; a good cross trainer is sufficient.

Foot type is also important as athletic shoes are now manufactured more specific for a flat foot, a high instep, and you have a propensity to pronate (arch flattens) or supinate (foot rolls to the outside).

For more information please visit our webpage
http://www.podiatrycarespecialists.com/

Are There Healthy Flip Flops ?

The summer is coming and the weather is definitely getting warmer. We have traded our sweaters and pants for shorts and tanks. We also have kicked off our sensible cold winter shoes and now need to

look for sensible summer sandals. But are there summer sandals that are good for you feet? YES.

In general,  the concern with flip flops is the lack of support. The flimsy rubber flip flops offer no arch support and result in overworking  of the muscles in the legs and feet. As a result the toes curl, the arch ligaments can be strained, or you can develop tendinitis around the ankle. In addition, the plantar fascia can be put under strain which can result in heel pain. Also, flip flops tend to be a flat rubber mat which can cause ankle sprains. The lack of a heel cup in a flip flop also allows the heel to move excessively and can allow the ankle to roll and  be more susceptible to a sprain. 

Newer sandals have been engineered to have built in arch support or custom orthotics, such as Sandalistas by Aetrex or Dr. Comfort flip flops. In general cork soles are better than most rubber soles. Look for solid straps or Velcro straps to hold your foot securely in the sandal.

For more information regarding healthy flip flops please watch this informative video from APMA.

Dr. "Sandie" Grulke
http://www.podiatrycarespecialists.com/

Hakeem Nicks Foot Fracture

Giants WR Hakeem Nicks fractured his foot during OTAs today. He’ll undergo surgery on Friday to have a screw inserted into the broken bone. The team expects Nicks to be out 12 weeks. That timetable would have him back by mid-August. He’ll miss virtually all of training camp, but barring a setback, he should be able to get in some action in the preseason and be ready to roll for Week 1. There are 5 different types of 5th metatarsal fractures. The first type is called a Jones Fracture. Athletes will usually get these fixed because of the poor blood supply to the bone as it heals. 

These still can take a long time to heal and requires one to be in a cast  and non weight bearing.

http://www.podiatrycarespecialists.com/

Podiatrists can help lower back pain

Recently on the show "The Doctors" TM  a patient suffering from lower back pain was followed. She had attempted massages, strength training but her back pain persisted. She was examined on the show by a chiropractor who determined that in part her lower back pain was caused by her feet. He used a scanner showing areas of high pressure and weight distribution across both feet. Often, the feet are overlooked at the cause of ankle, knee, hip and lower back. However, your feet are your foundation of your body.

 In our office, we use a scanner similar to what is shown in the chiropractor's office. It allows us to visulaize both feet while standing naturally. You can determine with the scan where there are areas of high pressure, where the center of gravity is, the arch height, and size of your feet. We use the scanner with on a large number of patients from patients with sport injuries to diabetic patients. With the results from the scanner you can prescribe insoles or orthotics that will try to restore the arch, regain a normal center of gravity or redistrubute pressure through the foot.

In scans with a decreased arch height often means a flatfoot. With the foot collapsing the ankle rolls inward with the knee and hip follow the ankle. This results in more pressure being in the inside portion of the knee and hip and can result in knee, hip and lower back pain. High arched feet are associated with high insteps. In extreme cases these feet are rigid, limit shock absorption from having reduced ground contact area and can result in foot pain. On a scan that shows an area of high pressure can be as a result of corns, calluses, hammertoes, bunions, etc. The concern especially in the diabetic population is these high pressure areas can result in ulcerations.

The scanner has become an effective tool in our efforts to treat lower extremity pain. Often the feet are overlooked as a cause of back, hip and knee pain. Your feet are the foundation for the rest of your body. If there is some problem with the foundation other problems can result. If you are suffering from lower back pain, knee and hip pain consider that your feet may be the problem.

Dr. "Sandie" Grulke
http://www.podiatrycarespecialists.com/

Michael Martinez fractures his 4th metatarsal

The last thing the Phillies needed was another injury but unfortunately on Tuesday in the game against the Orioles, Michael Martinez suffered a foot fracture after being hit by a pitch. Like Chase Utley, Martinez will start the season on the disabled list.

Martinez suffered a 4th metatarsal fracture after a pitch hit him directly in the foot. The metatarsal is a long bone that is located behind the digits. With a direct hit it seems that bone fractured but has remained in good position. If the bone had fractured into several pieces or moved away from each other surgery would be necessary. Instead, he will be forced to immobilize the area until healing occurs. The fracture fragments will knit together in 4-6 weeks. This process can be sped up with the use of a bone stimulator. A bone stimulator uses ultrasound or electric current (which does not hurt) to increase bone healing.

Hopefully he will heal uneventfully and be back on the playing field soon, the Phillies could use a break.

Dr. "Sandie"Grulke
http://www.podiatrycarespecialists.com/

Ingrown Toenail West Chester and Newtown Square Update

A few weeks ago we talked about ingrown toenails. An ingrown toenail can occur on any of the toes (as well as fingernails). They can occur from improper trimming of the nails, trauma to the nail, family history of ingrown toenails, style of shoe/sneakers, and toe deformities (such as a bunion or hammertoe). Treatment options vary depending on how severe the toenail is. The pain can actually come from a callous that has formed in the corner of the nail. As the toenail grows into the skin, a callous may form in the corner of the nail. This also may cause some pain more so than the ingrown nail. Both usually will get removed when they are present.

One may also develop referred pain of the ingrown nail where it will happen at the base of the nail or even around the joint of the nail. Its always important to get these checked out if you are dealing with pain to prevent them from getting infected. Most of the over the counter products do NOT work and can make it worse.

If you keep getting ingrown nails, there is a minor in-office procedure that can be done to help prevent the ingrown nail from coming back.

Please visit our website for more information and a video on ingrown toenails!

Chad Friedman, DPM

http://www.podiatrycarespecialists.com/videos.html