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Podiatric Articles | Orthopaedic Articles | Postop Instructions / Expectations | Upcoming Events | Athletic Training Coverage Schedule | Physiatry Information Podiatric ArticlesINTRODUCTION TO OUR EDUCATIONAL ARTICLES: THE ROLE OF SPORTS MEDICINE IN OUR MODERN WORLD Robert H. Sheinberg, DPM You are watching a sport on TV. You see a player go down with an injury. You see the athletic trainers, possibly the team doctor, running out onto the field, examining the patient and the patient is carried off the field. You listen to the sports news that night or the next day and there is a report divulging the injured athlete’s condition. A prognosis is given on how many weeks the athlete will be away. The next thing you know, time goes by and you see the athlete out on the field performing again. Many of us today still have the perception that medicine, particularly sports medicine, is a reactive process. An athlete goes down with an acute injury. He is diagnosed, treated, rehabilitated by the physician and other allied medical specialists and that athlete is back out onto the field playing his or her sport. However, there is an entire facet of sports medicine that you may or may not be aware of. In today’s faced pace world it is better to be proactive than reactive. A vast majority of patients that are seen in our office are presenting with chronic, overuse type symptoms and conditions. Granted, we do see our fair share of acute injuries such as fractures, dislocations, tendon ruptures, muscle tears but the sheer number of people who are presenting with low-grade pain that began without injury or incident that has been escalating, This is particularly the case for our young athletes in our community here in South Florida. Emphasis on year round sports, increased demands of the sport itself with regards to the number of athletic contests in the given season, length of the season, increased number of practice sessions and/or length of practice sessions are factors contributing to this pattern. The human body is amazing. It can withstand significant amounts of use and abuse but each individual has their own breaking point with regards to withstanding these physical demands. Quite often if we can educate an individual with techniques and measures to help minimize these rigors upon the body, there is a greatly increased potential for these overuse injuries, which at times may be more debilitating and more difficult to recover from as opposed to an acute injury. The articles below will review both acute and chronic injuries and conditions. We do hope you gain knowledge from these articles as well as the orthopaedic articles with hopes that you can forearm yourself with means and methods to hopefully avoid an escalation of a problem that can easily be solved.
GROWTH PLATE INJURIES TARSAL TUNNEL SYNDROME Tarsal Tunnel Syndrome is an entrapment or compression neuropathy of the posterior tibial nerve or its branches. This entrapment may occur on the inside of the ankle or the arch region. The resulting symptoms may occur in the ankle, rear foot midfoot, or forefoot regions. More>> HEEL PAIN IN CHILDREN There are several heel-related conditions which may cause pain to individuals of all age groups. However, the most common type of heel pain which involves children from ages eight to twelve is Sever's osteochondrosis. Sever's osteochondrosis is a temporary injury to the growth plate of the heel bone. More>> PLANTAR FASCIITIS Heel and arch pain is one of the most common injuries to the musculoskeletal system. Plantar Fasciitis is a common problem among people who are active in sports, particularly runners. It is also common among people who walk and/or stand for extended periods of time during the day. More>> DEVELOPMENTAL FLATFOOT Most children's feet are flat, don't hurt and are not deformed; they are, therefore, assumed to be "normal." Nothing could be further from the truth. Developmental flatfoot is one of the most common conditions affecting the musculoskeletal system of children and teenagers. More>> FOOT AND ANKLE FRACTURES AND SPRAINS
IN CHILDREN Why are injuries common in children? · Competitive Sports are becoming a greater part of the lives of young families. There are more kids competing in multiple sports. Many improperly conditioned children are predisposed to injury. More >> ARTHROSCOPY OF THE FOOT AND ANKLE Robert H. Sheinberg, DPM Robert H. Sheinberg, DPM There aren't many exercises other than cycling where you complete 90 repetitions per minute. And if you multiply those repetitions out to a one, two or three hour bike ride, that's a lot of repetitive motion. More >> BASIC STRETCHING Robert H. Sheinberg, DPM How often do you talk to a person who sustained an injury such as an ankle sprain and they tell you "All of my swelling, bruising and pain is gone, but my ankle still feels weak! I'm afraid to walk over uneven surfaces because I'll sprain my ankle again. More >> IT BAND SYNDROME CHRONIC EXERTIONAL COMPARTMENT
SYNDROME BENEFITS OF CUSTOM-MOLDED IN-SHOE ORTHOTICS FOR ATHLETES Robert H. Sheinberg, DPM Michael Jordan takes off from the top of the key, sailing through the air and jamming in a dunk. Jaromir Jagr skates deftly through a sea of defenders, fakes out the goalie and puts the puck in the back of the net. Eddie George swings out of the backfield, catches a pass, sidesteps a would-be tackler and streaks down the sideline to score a touchdown. Other than being excellent athletes, these individuals share something else common- they all have lower extremity problems, of which part of their treatment plan has been receiving custom-molded in-shoe orthotics. More>>> BENEFITS OF IN-SHOE PRESSURE GAIT ANALYSIS Robert H. Sheinberg, DPM The mechanics of the foot and ankle and their effects on the lower extremity and body as a whole are very intricate. Due to these complexities, it is sometimes difficult not only for the lower extremity specialist to have a precise and accurate measurement of these mechanics, but also a means by which to communicate, explain, or visually demonstrate to a patient what is occurring during the gait cycle. The F-Scan is a highly useful tool that provides a solution to this challenge. More>>> SUCCESSFULLY SELECTING SHOEGEAR FOR YOUR CHILDREN Robert H. Sheinberg, DPM How a shoe fits your child’s foot is quite important for providing proper stability, protecting the foot, and helping to prevent injury. Unfortunately, there are few resources available to educate parents about how to determine not only if a shoe is appropriate for a child, but also if the shoe is fitting properly. Taking the time to examine shoes properly, ensure that the shoe fits, and to be aware of the life span of shoes can help your child’s lower extremity health. More>>> COMPLICATIONS OF ANKLE JOINT SPRAINS Augustine A. Bollo, DPM An ankle sprain is a common sports, and non-sport related injury which can occur in most age groups usually ranging from young adolescence to adulthood. The mechanism of injury usually involves excessive inward twisting of the ankle, which causes a stretching and strain on the outside ankle ligaments and capsular structure. This usually results in pain and swelling on the outside of the ankle. More>>> Robert H. Sheinberg, DPM Gait disturbances are one of the most common concerns of parents. Children may begin walking with their feet turned in or out, leaving parents with many questions. The problem may be coming from anywhere between the foot and hip. Some deformities occur at one level (i.e. foot, leg, knee, or hip), while others are more complex. Some children may "grow out of it", while others will not. More>>> Augustine A. Bollo, DPM Tarsal coalitions in children are not common. However, it is often misdiagnosed as growing pains or shin splints. A tarsal coalition is an abnormal union of two bones in the foot. This condition may involve one or both feet. Symptoms usually occur between the ages of nine and twelve when a child is becoming more active in sports and/or extracurricular related activities. Further, coalitions are congenital and are not caused by an injury, although symptoms may first appear after an acute injury or overuse to the lower extremity. More>>> KNEE PAIN SECONDARY TO ABNORMAL GAIT Augustine A. Bollo, DPM Knee pain can occur in any age group ranging from childhood to adulthood. Abnormal alignment of the feet and legs is a common cause of knee pain, which begins in early childhood and progresses throughout adulthood, especially when not detected or not treated appropriately. This abnormal alignment may progress to other musculoskeletal conditions, especially in active adults, which may lead to hip and lower back pain, musculature tightness, joint fractures, foot and ankle pain and ultimate osteoarthritis of the knees and/or hips. This type of knee pain usually begins during the increase of walking or exercise activity, which can progress and worsen with daily ambulation. More>>> PEDIATRIC FOOT OR ANKLE SPRAINS MAY BE A MORE COMPLEX PROBLEM Robert H. Sheinberg, DPM Injuries to the growth plate in children may cause damage to the structures at the end of the bone that will allow the child to grow to full adult size. These injuries may be misdiagnosed as a simple sprain of the foot or ankle. However, a more complex injury may be present. More>>> Robert H. Sheinberg, DPM At the beginning of independent walking, toddlers may walk on their toes. Within three to six months the heel should be touching the ground during normal walking. Intermittent toe walking may be present in normal children until seven years of age. More>>> Robert H. Sheinberg, DPM Osteoporosis is a gradual loss of bone mineral content, density, and subsequently strength of the bone. Most people who are generally familiar with the term osteoporosis may think of the old, stooped-over woman who falls and fractures the hip. However, there is much more to osteoporosis, both in terms of what contributes to the disease and at what age we need to start focusing on prevention. More>>> UNDERSTANDING SHOCK WAVE THERAPY FOR PLANTAR FASCIITIS Robert H. Sheinberg, DPM The world of technology that we live in today offers many benefits for us. The world of medicine has benefited greatly from improvements in medical technology and techniques in the recent years. Approximately two years ago the Food and Drug Administration (FDA) approved a type of shock wave therapy that can be used to help people with a painful heel condition called plantar fasciitis. This technology, while offering the foot and ankle specialist yet another treatment option for patients suffering from plantar fasciitis, should be understood in both the mechanism in which it works and what exactly it is treating for this condition. More>>> Robert H. Sheinberg, DPM Overuse injuries to the muscle tendon unit are common occurrences in the work place. Tendons connect muscles to bones and are responsible for the movement of bones and joints. Collagen is the main component of tendons. When a tendon and its covering (sheath) becomes inflamed, it is commonly referred to as TENDINITIS. More>>> TRAUMATIC ACHILLES TENDON DISORDERS Robert H. Sheinberg, DPM The Achilles tendon is the strongest and largest tendon in the human body. It is formed by the gastrocnemius and soleus muscles (calf), and inserts in a broad fashion into the back of the heel (calcaneus). The primary function of this muscle-tendon unit is to provide powerful propulsion in waling or running or powerful jumping. The blood supply to the mid-portion of the tendon is poor, making the tendon susceptible to injury. Injuries may be in the form of inflammation to the tendon covering (paratenonitis), disease of the tendon (tendinosis), spurring at the heel (insertional spurs with tendinitis) and partial or complete ruptures of the Achilles tendon. More>>> ANKLE LIGAMENT INJURIES IN ADULTS Robert H. Sheinberg, DPM The ankle is a complex joint providing motion primarily in the up and down direction. It is composed of three bones and eleven ligaments that connect these bones together. Covering these bones is a firm white substance called cartilage. Cartilage allows the bones to move freely on each other. The smooth gliding motion of the foot on the leg occurs when the cartilage is uninjured.Injuries to the ligaments in the ankle occur most commonly while participating in sports. However, walking in a high heeled shoe or tripping off of a step can often cause a twisting to the ankle, causing injury to one or more of the ligaments in the ankle joint. When injuries occur it is important for these ligaments to heal perfectly so chronic pain and instability do not develop. It is especially important in young teenagers and athletes who want to participate in sports without the ankle constantly giving way. More>>> HEALTHY FEET AND LEGS DURING YOUR VACATION Robert H. Sheinberg, DPM A common factor among many vacationers is the increase in the amount of time spent on our feet.While renting an automobile may be a necessity for a majority of vacationers, there are many reasons to walk, whether it is lack of knowledge of an area to feel comfortable driving from place to place or local destinations in the area of the vacation spot are easily accessible on foot, vacation tours of an area, or shopping. Many people attempt to begin a healthier lifestyle and may participate in sport activities such as tennis or jogging, while others may be working on improving their golf game. Also, the selection of shoe gear may take a dramatic change from our usual business wear and/or casual wear to sandals, low cut casual shoes (flats, topsiders) and often bare feet. All of the above factors may lead to people experiencing foot, ankle and/or lower extremity problems related to the foot and ankle. More>>>
Robert H. Sheinberg, D.P.M. Lower extremity muscle cramps are one of the most common on-the-field problems in all sports. Most muscle cramps occur in the calf muscle but they can also be seen in the hamstring and thigh muscle. More>>>
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