Lateral ankle sprains are the most common type of ankle sprains. These sprains happen after an inversion injury or inward rolling of your foot on your ankle and affect the ligaments on the outside of your ankle. They most commonly occur in sports, especially seen in basketball and football, but also can occur in everyday activity. The lateral ankle is composed of three major ligaments, the anterior talofibular ligament (ATFL), the calcaneal fibular ligament (CFL), and the posterior talofibular ligament (PTFL). There are varying degrees of severity of ankle sprains, but the most commonly injured ligament is the ATFL.
Certain people are more prone to ankle sprains than others, especially those with a higher arch foot or those who have had a severe or multiple sprains in the past. It is normal after suffering from a sprain to have varying levels of swelling and bruising. The most important thing following a sprain is over the first 24-72 hours to practice the pneumonic RICE. RICE stands for rest, ice, compression, and elevation. Studies also show that initiation of early range of motion is key in the recovery process. Once the swelling goes down, then strengthening of the muscles around the ankle joint should be initiated to help prevent chronic ankle instability. Taping, bracing, and balancing exercises also can help in preventing re-injury. Most people start to feel better after a sprain over a couple of days, but in the case of severe sprains this could take several weeks to recover. If you develop a sprain that is not improving over a couple days, especially if you have followed the pneumonic RICE, then make sure you schedule an appointment with your doctor.
-Dr. Colleen Law
If you begin to develop a nagging pain without significant change in your mileage or training, you must consider your shoe gear. Running shoes typically are good for about 300-500 miles depending on running surfaces, experience, and size of the runner. These first few signs of a nagging pain is usually a way of your body telling you that you need a new pair of sneakers.
Another important way to prevent injuries when it comes to running shoes is to find a type of shoe that is most compatible with your foot structure. Everyone’s feet are different so a type of shoe that works well for your friend, may not work as well for you. People who have a flatter arch and overpronate need more of a motion controlled stability type shoe, whereas those who have a high arch and underpronate do better with more cushioned and neutral type shoe. Especially if you are new runner, I would recommend going to your local running store to help you find a pair of sneakers. These stores typically have experienced runners who will evaluate your foot type as well as running goals to help find you a shoe that would work the best for you. Once getting your new sneakers, make sure you take a couple of days walking around in them prior to running in order to help break them in. Also, another good tip is to buy two pairs at once and alternate running in them every other day in order to slow down the wear of an individual pair.
-Dr. Colleen Law
I am very excited to be joining Dr. Murray, Dr. Chang, Dr. Baglio, and Dr. Schustek and the rest of the team at Blue Ridge Foot and Ankle Clinic in July! I graduated from Temple University School of Podiatric Medicine in Philadelphia, Pennsylvania and completed my residency at St. Luke’s University Health Network in Allentown, Pennsylvania. While at St. Luke’s, I had experience training in both the inpatient and outpatient setting, as well surgical training in elective and non-elective foot and ankle surgery, and experience with wound care and diabetic limb salvage.
I am interested in treating a variety of different pathologies in the foot and ankle, but one area that I am particularly interested in is sports medicine. In college, I competed on the cross country and track teams at Lehigh University. After suffering from a foot injury, which required surgery during my freshman year, I was introduced to the field of podiatry. I really like that I can relate my love for running with my job as a podiatrist and understand what it is like recovering from an injury and returning to activity.
In my free time I like to spend time with my husband Matt and viszla, Zoey. We enjoy running and other outdoor activities and look forward to getting involved with the Charlottesville community.
I am really excited about the move to the Charlottesville area and am eager to start meeting and working with patients in July!
-Dr. Colleen Law
What is Sesamoiditis?
Sesamoids are sometimes referred to as the ball bearings of the foot. They are a set of accessory bones found beneath the large first metatarsal bone. Incredible forces are exerted on the sesamoid bones during aerobics, and inflammation and fractures can occur. Proper shoe selection and custom orthotic devices can be useful in treating sesamoiditis.
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Heel spurs are a common injury that many runners experience along with plantar fasciitis. Below is a brief description of heel spurs, and how you may be available to avoid this uncomfortable injury.
Heel spur syndrome, related to plantar fasciitis, occurs after calcium deposits build up on the underside of the heel bone. Heel spurs form gradually over many months. Both plantar fasciitis and heel spurs can be avoided by proper warm-up that includes stretching the band of tissue on the bottom of the foot. The soft tissue injury is usually the cause of the pain, and not the spur itself. If you are having pain in this area of the foot, please give Blue Ridge Foot & Ankle a call!
Here is the latest copy of the APMA Newsletter “Footprints”. Focus on Foot Injury: Identification, management and protection tips from future injury.
There are a few things that come into play when deciding if it is time to replace your athletic shoes. Three ways to determine if they need to be replaced are amount of usage, signs of wear, and the age of the shoe. The components of an athletic shoe that can break down and wear out are the outer sole, midsole, and heel.
The outer sole is typically made of carbon rubber, which is very abrasion resistant and also consists of 2 components. Most athletic shoes will have a harder and more resilient rubber in the heel of the shoe since this is where most of the wear will occur.
The mid-sole is normally composed of a foam material, such as ethylene vinyl or polyurethane, sometimes even a blend of these materials. This area of the shoe is intended to be shock absorbing and in some shoes, controls excessive foot motion. The midsole will begin to compress over time, because of the repetitive load that is placed on that area. The shoe will no longer absorb shock, or control the foot as well as it did when new. Sometimes the midsole can compress and deform unevenly which can create alignment changes in the foot. This can ultimately lead to injuries associated with over-use, such as achilles tendinitis, stress fractures, plantar fasciitis, and metatarsalgia.
Midsoles should be considered worn out if any of the following occur:
- After 300-500 miles of running or walking.
- Shows signs of unevenness when placed on a flat surface.
- Display noticeable creasing
The heel counter of the shoe helps hold the heel on top of the midsole and prevents excessive heel motion. This area is considered broken down when it feels flexible, when compressed side to side, or appears to lean to one side or the other when viewing from the rear of the shoe.
It is typically best to replace athletic shoes that are over a year old, whether they are worn out or not. Replacing athletic shoes when necessary may be costly in the short term, but can help prevent injuries and keep you active in “the long run”.
Shortly after my last blog, I returned the Bondi 3s. They were the most comfortable shoes I’ve ever run in, but the soles were over half worn at only 50ish miles. That makes the Bondi 3s, in my opinion, a very expensive pair of slippers.
I brought the a pair of Hoka Stinson Lites home and so far I am very pleased. Although the cushion seems less than in the Bondi 3s, the rubber compound seems much more durable. Going into the warmer months, I also like the very vented upper. This model comes with two inserts. The thicker one adds just a little more support and cushion, which feels very good in these shoes.
The warmer the days get, the less I run and the more I bike. However, my knees are still pain free and my pace continues to drop. I am very happy with the Hoka brand and the customer service I experienced at Ragged Mountain Running Shop.
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New office in Fishersville will open early 2015 @
66 Parkway Lane Suite #102
Fishersville, VA 22939Blue 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.
HOKA ONE ONE Bondi 3 Shoes
I want to give you my take on the Hoka Bondie 3 shoes I purchased from Ragged Mountain Running shop a couple weeks ago. I have a very broad background in running. In high school, I made the All American Track and Field team, competed at the Kinney Cross Country National meet (known now as Foot Locker Nationals), and attended college on a full scholarship. However, after injuries and many years away from any kind of training, my return to running has proven to be difficult and painful. My runs now are not much more than a jog.
I’ve been trying to implement running as a supplement to my cycling training for months now. Knee pain, however, has crushed my motivation to do so. This winter’s cold and snowy weather has been brutal on my cycling training. Riding a bike in 20+ degree weather against the cold wind, well, just ruins the fun of biking for me. The answer, put my running shoes on and suffer through the pain.
I’ve read and heard great things about the HOKA shoes. I also learned they are not cheap, $130.00+. I really wanted to try a pair, but thought it would be a waste of money. How could a shoe make that much of a difference? Maybe people are writing positive reviews to help justify to themselves the amount of money they spent. After a couple months, I had to try something.
Walking around the shop in several different models of the Hoka brand, I felt what many people had written about in their reviews. Walking on a cloud is the best way to put it. I thought, this is neat, but I’m not sold and it seems gimmicky. Do I really want to spend money on these?
I should also mention, my first answer to my knee pain was to not run on the pavement. Throughout my running career, I ran on grass and gravel to stay away from injuries. However, these days I find myself lazy and only finding the motivation to run straight from my house where the only option is pavement. I need lots of cushion and the Bondi 3s seems like a good gamble.
My first run in the Hoka far exceeded my expectations. I only had time for a couple miles, but that’s all it took for me to fall in love with these shoes. I had no knee pain the first day, nor the following several days. I’ve been running almost every day now for two weeks and my legs, although tired, are still pain free. This experience couldn’t have come at a better time. The several inches of snow recently have kept me off the bike, but not out of my Hokas.
I will follow up with this post over the next few months to let you know how the Bodi 3s perform. The only possible issue I see so far is that the mid foot area of the bottom sole seems to have a very soft compound rubber and therefore, may not be very durable.
Custom Functional Orthotics
Custom orthotics are the best decision people can make to improve their foot health and function. Custom orthotics are unique and specially made to your feet. Orthotics treat and correct individual foot ailments. Proper shoes fitted with custom foot orthotics are the best insurance that we can give ourselves to protect our feet.
Your orthotics are manufactured by a state-of-the-art fabrication facility utilizing the latest advancements in machinery and technology available today. The fabrication starts with an analysis of your feet and a laser casting. The image produced from this scan is sent to our lab where your device is “born”. The technicians analyze these scans and make subtle adjustments to ensure a precise fit and form. Exact models of your feet are created on an automated CAD/CAM milling machine. These models are used to form your orthotics with a high temperature pressure fit system. Then they are assembled by hand and laminated. The result is a set of orthotics made to your feet with Dr. Murray’s or Dr. Chang’s specific instructions and modifications to optimize your foot function. This process typically takes 2 weeks and you will be called when they are ready.
Please bring the shoes you plan on using the orthotics with so one of our assistants can check for a proper fit. You will be given instructions to use with the orthotics during the “breaking-in” period. A follow up appointment will be made to discuss with the doctor how the orthotics are working for you. Some patients may need more time to get used to their orthotics and some orthotics may require adjustments. Although most patients are happy with their devices immediately, we want you to appreciate the uniqueness of the human body and understand this process can sometimes take time to make the proper adjustments. Our goal is to help treat and correct your ailment so you can live a healthy and active lifestyle. Therefore, we include free adjustments for 90 days.
One set of orthotics may suffice for many of our patients, but different activities require different accommodations. Therefore, some of our more active patients order multiple pairs of orthotics. Here are a few of the reasons why:
“I need a second set of orthotics for when my other pair gets wet.” – Local runner
“I need orthotics for standing on a concrete floor all day and another pair for hiking with my family.” – Factory worker
“My orthotics really help in my athletic shoes. I wish they worked in my dress shoes.” – Local business woman (we offer the Cobra, which is an orthotic designed to work with many casual and dress shoes)
Most of our orthotics are designed to last 5 to 10 years. Depending on your particular ailment, activity, and amount of use, your orthotics may need to be refurbished (re-covered) during this time period.
First set – $395.00
Additional set – $300.00
These are the prices for non-covered orthotics; when covered by insurance, the prices are predetermined by the terms of the insurance plan.
Insurance coverage: Please verify with your insurance company that custom orthotics are a covered benefit and how your deductible and coinsurance apply.
Welcome to the Blue Ridge Foot and Clinic team. We look forward to helping you stay healthy and active.Blue Ridge Foot and Ankle Clinic LIKE US ON 887 A Rio East Court Charlottesville, VA 22901 434-979-8116 417 South Magnolia AveWaynesboro, VA 22980 540-949-5150 New office in Fishersville will open early 2015 @ 66 Parkway Lane Suite #102 Fishersville, VA 22939 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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