Foot & Ankle Allografts; The NBA Combine; Spectator Sports & Long Flight Stretches

Episode 17.06 with Hosts Steve Kashul and Dr. Brian Cole. Broadcasting on ESPN Chicago 1000 WMVP-AM Radio, Saturdays from 8:30 to 9:00 AM/c.

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Segment One (02:36): Dr. Brett Sachs for AlloSource discusses the most common uses of allograft transplants in treating foot and ankle defects; the evolution and new innovations in treatments; ongoing stem cell research at AlloSource.

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Dr. Sachs is a board-certified foot and ankle surgeon and part owner of Rocky Mountain Foot & Ankle Center. Dr. Sachs studied biology at the University of Maryland and completed his Doctor of Podiatric Medicine degree at Temple University School of Podiatric Medicine. He completed a 3-year podiatric surgical residency at Presbyterian/St. Luke’s Medical Center in Denver, Colorado, followed by an orthopedic trauma residency at Kaiser Permanente.

For More Information Please Visit AlloSource.org


Segment Two (11:21): Dr. Cole talks with Steve about wrapping up the end of season with the Chicago Bulls, overview of injuries, off-season activities and the 2017 NBA Combine.


 Segment Three (19:44): Anne Bierman PT, DPT, SCS from Athletico talks about the importance of stretching and posture while at spectator sports and during long flights. The combination of cramped flights and sitting for hours on end during games often leads to back pain and muscle soreness for fans. What are the signs of injury and muscle strain from sedentary activity that you should be aware of. 

Anne Marie Bierman (“Anny”) received her Bachelor of Science in Exercise Science, MPT, and DPT all through Saint Louis University.  At SLU, she was an All-Conference and All-Region soccer player, and Female Athlete of the Year in 2004.  She is a board-certified clinical specialist in sports physical therapy and certified in Astym.  Anny represents the Eastern Central District of the IPTA on both Nominating Committee and as a State Assembly Representative.

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Achilles Tendon Tear Repair

The achilles tendon is often injured during sports resulting in an inflammatory condition called tendonitis which is characterized by swelling and pain. The tendon ruptures because of weakened tendons due to advanced age or from sudden bursts of activity during sports. The classic symptom of an Achilles Tendon rupture is the inability to rise up on your toes.

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Featured Body Part: Foot

By ATIPT

Our foot and ankle complex needs to be both dynamic and stable to allow for us to walkFeatured Body Part: Foot without stressing other areas in the body. The ankle may seem like a simple joint, but there are actually four bones that combine to provide the stability and motion necessary – tibia, fibular, talus, and calcaneus. The rest of the foot consists of multiple smaller bones that each must be able to withstand the movement and stress placed on it by the weight of our body. Your ankle is also an integral part of your daily function, as it is responsible for your ability to drive a car, climb stairs, and squat. If you suffer an injury to your foot/ankle it will likely become increasingly difficult to perform your normal activities without pain. The more knowledge we have regarding prevention and common causes of injuries, the better our chances are to avoid future injury.

Common Causes
Unfortunately, with the complexity of the foot/ankle joints it is often difficult to isolate a singular cause of injury. As with other body parts, increasing age leads to increased risk of injury from general wear and tear. After the ankle is injured there is a high likelihood that you can suffer another injury due to remaining deficits and/or poor healing.

  • Overuse (Chronic) Injuries – With age and use cartilage can wear down and the ligaments, muscles, and tendons can become damaged.
  • Sudden (Acute) Injuries  – During a fall or other injury, the bones of the foot/ankle can be fractured.  You can also have ligament tears and ruptures of the tendons.

Common Conditions
Foot/ankle pain can be caused by any one of these common conditions:

  • Adult Acquired Flat Feet (Fallen Arches) – Fallen arch, or flatfoot, is known medically as pes planus. This is characterized as a loss in arch height in the foot. There are many causes of this disorder, but among the most common is decreased muscular strength. The muscles in the foot and ankle are required to help support the arch and if the weaken the arch can collapse
  • Bone Fracture – There are multiple bones in the foot/ankle that can break and each needs to be managed differently. Most will require a period of not putting weight through the foot to allow for healing.
  • Metatarsalgia – Athletes who run and jump a lot may be susceptible to metatarsalgia, a type of foot injury that results in pain and inflammation in the ball of the foot.
  • Plantar Fasciitis – Affecting nearly 2 million Americans each year, Plantar Fasciitis is when there is an inflammation of the thick band of ligament that extends from the bottom of the heel to the toes (primarily the big toe).
  • Calcaneal Bursitis – In the heel, bursitis may cause bruise-like pain mostly on the bottom of the heel, but also at the back of the heel. This pain is most often felt at the end of the day, especially for people who spend much of their time on their feet.

Injury Prevention
Kurt Gengenbacher, PT, DPT, OCS, SCS, CSCS a Regional Director of Clinical Excellence, gives us some tips to help prevent and rehabilitate foot/ankle injuries:

  • Stay Flexible – Make sure to stretch your calves daily. Hold those stretches for at least 30 seconds and repeat 2-3 times.
  • Keep Your Foot Strong – Focus on functionally strengthening your foot.  The foot must be able to assist in stabilizing the body while standing, so the best exercises are often in a standing position.  Try to perform appropriate balancing tasks, standing toe crunches, heel raises, and toe raises.
  • Avoid Overtraining – Make sure you vary your exercises and don’t always do the same thing. If you have pain after exercising, stop the activity, rest, ice and elevate your leg.

Rehabilitation
If you have pain in your foot/ankle that isn’t going away, rehabilitation is a great step to take to improve your functionality. During rehabilitation:

  • A Strong Foot Is A Healthy Foot – Working on strength in the small muscles of the foot (intrinsics) can help your ability to walk barefoot and on uneven surfaces.
  • Be Balanced – Work on dynamic balance exercises to improve your proprioception and ability to stay upright.
  • Don’t Let Tightness Be Your Achilles Heel – Stretching your ankles can help to improve your ability to go down stairs and squat.
  • Stay On Your Toes – Strengthening of your calf muscles can help to improve your ability to walk, run, and climb stairs.
  • Wear Proper Footwear – It is important to provide appropriate support to your foot.

When weighing your treatment options for foot pain and injuries, consider physicalATI 300x250 therapy. Physical therapy offers a wide variety of treatment options including strengthening, stretching, and sustainable home exercise programs. Stop in or call any ATI location for a complimentary injury screen or to learn more about how physical therapy can help you overcome your foot pain.

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Tips for Keeping Your Feet Dancing Through the Holidays

By  Kelli Barton for Athletico

The Nutcracker is the most iconic holiday ballet performed by ballet schools and professional companies around the world.

Between December 10th and December 30th, the Joffrey Ballet Chicago will perform The Nutcracker 27 times. That’s an average of 1.2 shows per day! For optimal performance, it is crucial that dancers are proactive in preventing injuries from occurring and correctly manage injuries when they do occur. Foot and ankle injuries represent 34-62 percent of all injuries reported by dancers. Female ballet dancers are especially vulnerable to these injuries because of the increased demand put on the foot and ankle when dancing en pointe.

To help prevent dancing injuries from happening, consider the following tips:

Overuse Injuries
Overuse injuries are aches and pains that occur due to the repetitive nature of danceballet-dancing movements and lack of adequate rest. Examples of overuse injuries are stress fractures and tendinitis. Fortunately, the risk for these injuries can be decreased through appropriate rest, adequate warm up and nutrition.

 

Getting Appropriate Rest

Fatigue has been cited as a common reason for injuries in dancers as overall injury rates vary from 0.8 to 2.9 injuries per 1,000 hours of dance training. When fatigued, decreased trunk control and faulty lower extremity alignment results in increased demand on joints and ligaments to provide stability. While you may not be able to alter the amount of time you spend dancing, you can control what you do during time outside the studio. For example, active rest is preferred over complete rest, including gentle movements, stretching, as well as strengthening and stabilizing muscle groups. This helps avoid excessive stiffness throughout the body.

It is also important to note that fatigue-related injuries have been reported to increase when psychological stressors such as work or school conflicts are present. Since performances may induce additional stress, it is important to find strategies to appropriately rest your brain in addition to your body to stay healthy during this time.

Warming Up

An appropriate warm-up primes the body for optimal performance. Morrin et al found that a combination of static and dynamic stretching provided a significant change in hamstring flexibility as well as superior balance and vertical jump values in comparison to a static-only or dynamic-only warm up.

Static stretching involves holding a specific position for a period of time whereas dynamic stretching has an aerobic approach in which the body part is repetitively moved through its available range of motion. Examples of dynamic stretching include leg swings, alternating kick-to-buttocks and scissor jumps.

Good Nutrition

Low energy availability occurs when a dancer is not consuming enough food for the amount of energy expended during physical activity. Therefore, a dancer will need to eat more as the volume of dance participation increases.

Signs of low energy availability include fatigue, difficulty concentrating and loss of menstrual cycle. Consistently low energy availability can cause sub-optimal bone mineral density and place the dancer at increased risk for stress fractures. High caffeine intake, noted as greater than two cups of coffee per day, can also contribute to low bone mass density. For specific nutrition recommendations, please seek attention from a nutritionist in order to develop a plan based on your individual needs.

Acute Injuries

Acute injuries occur when a bone, ligament, tendon or muscle is extended past its capability or excessive force is placed onto a region of the body. Examples of acute injuries are ligament sprain and muscle strain.

When an acute injury occurs, the body releases chemicals to create an inflammatory response around the damaged structure. The inflammation assists with promoting new cell growth, defending the body against harmful substances, and disposing of damaged tissue. However, this process results in swelling, redness, warmth, pain and loss of function at the area of injury. The following steps should be taken after an acute injury:

“PRICED”

P: Protection

Relocate to a safe space away from additional danger such as fellow dancers continuing to perform and provide support to the region of injury.

R: Rest

Avoid painful movements with involved body part as continual stress may increase injury and delay healing.

I: Ice

Apply ice to the injured area for 20 minutes every 2 hours for the initial 2-3 days. Ice will decrease blood flow to the area, slow conduction of painful nerve impulses, decrease abnormal accumulation of fluid, and lower temperature.

C: Compression

Utilize an elastic compression bandage to wrap the area. If you experience sensation of pins/needles, numbness or change in skin color, the bandage is too tight. Start away from the heart using a figure 8 pattern with a gradual decrease in tightness as you pass the site of injury. Avoid gaps in bandage that expose skin as swelling will accumulate here.

E: Elevation

Raise the injury area above the heart to increase return of blood and therefore remove waste products away from the area.

D: Diagnosis

All acute injuries should be evaluated by a health-care professional for advice regarding appropriate next steps, especially if not resolved with “PRICE” or unable to bear weight. Choosing a health-care professional who has a specialty working with performing artists will be helpful to allow for a gradual, safe return to dance.

Basic First Aid for the Foot

Although blisters, cramping, split skin and bruising will not likely take you out of a performance, they can be a source of discomfort when participating in a higher volume of dancing.

Blister Blisters are caused by a combination of friction and moisture at bony prominences of the feet. It may be a sign that shoes should be re-sized as the structure of the foot can change over time. Petroleum jelly or tape placed on more vulnerable spots can decrease friction. In addition, using less absorbent material for tights or pointe shoe padding can decrease moisture. Blisters will heal independently and should avoid being popped due to risk for infection. If a blister does pop, it is important to cover with an antibiotic ointment and bandage that will stay secured in shoes.

Cramps A muscle cramp is a strong, painful tightening of a muscle that occurs involuntarily.  Another name that is commonly used to describe a cramp is a “Charley horse.” To avoid cramping, stay hydrated and perform an adequate warm up as well as cool down. Stretching the cramped muscle can assist with relieving symptoms faster.

Split Skin Split skin often occurs in the area of a callous, particularly on the ball of the foot. Prevent skin from splitting by using a fat-based balm such as coconut oil over areas of tough, dry skin. If a skin split does occur, be sure to keep the area clean to decrease risk for infection. There are some over-the-counter products that help to seal the split skin together to promote healing.athletico300x250

Bruising The best prevention for bruising is to wear padding and control descents to the floor during choreography. Avoid heating pads or warming topical creams, as this will bring more blood to the bruised region and delay healing.

By following the above recommendations, you are now ready to tackle the Nutcracker season injury free! If you experience an injury, please contact your physician or set up a screen with a performing arts physical therapist at a conveni ent Athletico Physical Therapy location.

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