Archive for March, 2013

Achilles Tendonitis

March 27th, 2013 by Dr.Chang

achilles     If you are experiencing achilles tendonitis, you are not alone. In the United States, there are an estimated 250,000 sports-related achilles tendonitis cases per year. Many of these cases arise from nagging, and often neglected, pain in the back of the ankle. This blog will provide more information about achilles tendonitis: what it is, why can it cause recurring pain, and how can you work to prevent and heal your achilles tendonitis.
     The achilles tendon is a band of tissue that connects your calf muscles to your heel bone. When your calf muscles contract, the achilles tendon enables your heel to rise. Likewise, it helps decelerate your foot as it hits the ground during walking, running, or jumping, incurring a lot of impact while doing so. In fact, the achilles tendon can take on a load up to 4 times your body’s weight during a running or jumping activity! The achilles tendon is an active an crucial component of any standing movement or activity.
     There are different types of achilles tendon disorders and injuries. Achilles tendonitis is caused by the breakdown of the achilles tendon, which leads to inflammation and micro-tears in the tendon itself. When your tendon tears at a rate faster than the body can heal it, achilles tendonosis occurs, which is a chronic and irreversible tearing and inflammation of the tendon. Other achilles injuries include tenosynovitis, an inflammation of the tissue sheath that surrounds the achilles tendon, which can occur with, or lead to, chronic problems and irreparable tears in your achilles tendon. Retrocalcaneal bursitis is another commonly occurring achilles disorder, an inflammation of the fluid-filled cushion, called a bursa, under the achilles tendon. And, finally, an achilles rupture is a partial, or often complete, tear of the tendon.
     Most frequently, achilles tendonitis is a progressive injury, with a gradual onset due to overuse rather than being caused by a specific traumatic injury. It can be caused by weakness or lack of flexibility in the calf, or weakening due to age, and, most likely, by repetitive stress on the tendon and calf muscle. Achilles tendonitis is common among weekend warrior athletes, runners who have suddenly increased their mileage or increased it too quickly, or other athletes, such as tennis players, who put a lot of repetitive stress on their calves. Achilles tendonitis is also seen among those who have experienced rapid weight gain, those whose feet are flat or pronate excessively, and even those who wear poorly fitted shoes.achilles pain
     Symptoms of achilles tendonitis often begin with stiffness and creaking when getting out of bed in the morning, a mild ache in the back of the leg or above the heel after running or sporting activities. Light pinching of the sides of the achilles tendon will cause pain or soreness. Episodes of more severe pain may occur after prolonged running, stair climbing, or sprinting. Because achilles tendonitis symptoms are bound to worsen without treatment, it is paramount that you treat it early with a combination of working with your doctor, and learning self-maintenance strategies.
If you are experiencing persistent pain around the achilles tendon, contact your podiatrist. Dr. Chang and Dr. Murray at Blue Ridge Foot and Ankle Clinic are experienced and highly successful at treating achilles tendonitis.
     When you make an appointment with Blue Ridge Foot and Ankle to discuss your achilles tendon pain, be sure to think through what information will be crucial for your doctor to properly diagnose your achilles pain. Did your pain begin suddenly or gradually? When are your symptoms worst? What types of shoes do you wear regularly during the day, and what types of shoes do you wear for exercise? Have there been any dramatic changes in your lifestyle recently? Where exactly is the pain, and does any activity or movement trigger it? Does the pain lessen with rest? Have you tried any home remedies (such as Advil or Ibuprofen, ice, compression, or rest), and how has your achilles tendon felt in response? You doctor will consider this info, as well as conducting a physical exam of the area to identify pain, tenderness and swelling, as well as testing the raninflammed achillesge of motion, alignment and reflexes of your foot and ankle. If a tear is likely or suspected, your doctor will order an MRI to produce images of your achilles tendon.
     There are various measures your doctor and you can take to make your ankle repair and stop hurting, so you can get back to the activities that you love. Most cases of achilles tendonitis respond well to self-care: over-the-counter pain medications such as ibuprofen, rest, ice, compression, elevation, home exercises, even better fitting (more appropriately supportive) shoes. Your doctor may prescribe heel lifts, orthotic devices, physical therapy, and, if it does not heal over several months, possibly even surgery to repair tears in your tendon.
     To prevent injuries such as achilles tendonitis, remember to increase your activity level gradually. Cross-train and be sure to do exercises that specifically strengthen your legs and calves without putting undue stress on them. Stretch daily, after exercise. Keep your body hydrated and consume nutrient rich foods, which increase circulation and the rate of healing. Avoid smoking, which weakens tendons by reducing the rate of healing at a cellular level. Wear well-fitted shoes (with adequate cushioning for your heel and a firm arch support), which you can find in Charlottesville at Ragged Mountain Running or Richey and Co. Shoes . And, most importantly, rest (slow down or stop) when you start feeling the pain come back.
Dr. Chang and Dr. Murray to have decades of experience successfully treating achilles tendon injures. So contact us at Blue Ridge Foot and Ankle to help you solve your achilles pain.
 
Comment on this post to share your thoughts or contact Blue Ridge Foot and Ankle Clinic. We’d love to hear from you!
 
 
Blue Ridge Foot and Ankle Clinic
Charlottesville Podiatrist Location: 887 A Rio E Ct., Charlottesville VA, 22911 (434) 979-8116
Waynesboro Podiatrist Location: 417 S. Magnolia Waynesboro,VA 22980 540-949-5150
 
Blue Ridge Foot and Ankle Clinic has been a part of the Waynesboro and Charlottesville communities for over 20 years. Podiatrists Dr. Kevin Murray and Dr. Stewart Chang offer services in sports podiatry, foot and ankle problems and diabetic foot care. Our friendly, accommodating team of Certified Podiatric Medical Assistants look forward to welcoming you to our practice.
 
 
 
 
 
 
 

Youth and Adolescent Ingrown Toenails

March 13th, 2013 by Dr.Chang

     A large number of young patients visit us for help with their ingrownpainful ingrown toenails. Typically, these children and adolescents are in a considerable amount of pain and discomfort, and have already sought treatment from their pediatrician multiple times. Pediatricians can prescribe oral antibiotics and other temporary fixes, but, ultimately, the most effective and long-lasting treatment comes from an experienced podiatric specialist. Podiatrists are trained in minimally-invasive procedures to treat the vast majority of ingrown toenails, and are able to do so with the best results and the least amount of pain involved.
     An ingrown toenail is a curved nail that grows into skin around toenail borders. Basically, the nail doesn’t fit its border, and the sharp edges of the nail gradually grow into the skin around the nail, irritating the skin. Ingrown toenails start out as tenderness when pressure is applied to the outside of the nails. They lead to redness, swelling, warmth and pain in the skin around the nail. If an ingrown nail breaks the skin, bacteria can easily enter and cause an even more painful infection in the area.
     Ingrown toenails have various causes. Contrary to popular belief, they are more often hereditary than caused by incorrect nail maintenance or clipping, especially among younger populations. Second to heredity, pediatric ingrown toenails commonly result from improperly sized footwear, such as wearing socks or shoes that are too tight, or from repetitive activities, such as kicking and running, that involve repeated pressure on the toes. Causes also include trauma, such as stubbing the toe, having an object falling on it. In more rare cases, ingrowns result from improper trimming such as cutting the nails too short, encouraging the skin next to the nail to fold over the nail. Other nail conditions such as fungal infections or losing a nail due to trauma, certain medications, and a deepening of the nail groove due to obesity, can also cause ingrown toenails.
     A number of highly effective treatment options are available to patients with ingrown toenails. While copious material is available on the Web for home-treatment, such as soaking feet in Epsom® salt, using antibiotic ointment, using ingrown nail medications such as Outgrow®, or cutting the nail in certain ways, these treatments almost always provide only temporary relief from pain: these products do not prevent or heal ingrown toenails. Ultimately, the nail continues to cause problems until a specialist can remove the part of the nail that is causing the problem.
     At Blue Ridge Foot and Ankle, we perform a minimally invasive procedure, removing 15% of the offending nail border. Cosmetically, nails end up looking normal, and healthier, and, more often than not, patients never again have ingrown toenail problems. The key to successful treatment is early intervention and this kind of specialized treatment from your podiatrist.
     Be sure to communicate with your children what Cleaning of a foot.they should expect in the podiatrist’s office, and from ingrown toenail treatment. Ingrown toenail surgeries take place in the podiatrist’s office. Local anesthetics are used to anesthetize the entire toe, which will last for approximately eight hours. Once the toe is anesthetized, there is no pain involved with performing the actual procedure, and the procedure takes only minutes. The nail border, and sometimes the root of the nail, is removed with the treatment best suited for each person’s individual case. The foot is then lightly bandaged.
     Most patients experience minimal pain after ingrown toenail procedures, and are able to resume normal activities after one day, and most do not even need a follow-up appointment. If an infection is present, an antibiotic may be prescribed. In fact, most patients are so surprised by how easy the procedure is that they wish they had come in much earlier to get their ingrown nail problem fixed!
     After the surgery, and in everyday life, proper nail maintenance routines are important to prevent further incidence of ingrown toenails. Be sure not to cut notches into the nail, since they are proven ineffective: notches do not to reduce the tendency for the nail to curve downward. Do not repeatedly trim nail borders, because this will not change the way the nail grows. Do not place cotton under the nail, because it will not relieve pain and can increase the incidence of infection by providing a place for harmful bacteria to grow. Also, remember that foot maintenance is paramount for patients with diabetes or other secondary nerve or circulatory problems. If you or your children have such problems, be sure to consistently seek help from a trained medical specialist for routine podiatric care.
     Ingrown toenail procedures are easy and highly effective; so don’t postpone making an appointment with Dr. Murray and Dr. Chang at Blue Ridge Foot and Ankle. As in the case with most medical conditions, remember that the earlier the symptoms are treated, the more successful the outcome. So visit us at Blue Ridge Foot and Ankle to help you solve your ingrown toenail problems.
 
     Comment on this post to share your story or contact Blue Ridge Foot and Ankle. We’d love to hear from you!
 
 
Blue Ridge Foot and Ankle Clinic
Charlottesville Podiatrist Location: 887 A Rio E Ct., Charlottesville VA, 22911 (434) 979-8116
Waynesboro Podiatrist Location: 417 S. Magnolia Waynesboro,VA 22980 540-949-5150
 
Blue Ridge Foot and Ankle Clinic has been a part of the Waynesboro and Charlottesville communities for over 20 years. Podiatrists Dr. Kevin Murray and Dr. Stewart Chang offer services in sports podiatry, foot and ankle problems and diabetic foot care. Our friendly, accommodating team of Certified Podiatric Medical Assistants look forward to welcoming you to our practice.

 

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