The Key to Better Health Could Be Right Under Your Toes

Custom Orthotics - Putting Your Body In Balance

What is the function of the foot?

The foot contains 26 bones, 33 joints, and over 100 tendons, muscles, and ligaments. This may sound like overkill for a flat structure that supports your weight, but you may not realize how much work your foot does! Let's start with an easy one. Your feet function as a primary "shock absorber" for your body. When your foot hits the ground, it adapts to the surface and lessens the actual impact of that contact. Your foot also acts as a "rigid lever", allowing you to effectively push off from the ground when walking or running.

What do my feet have to do with pain in my ankles, legs, knees, and/or lower back?

Your feet have a direct impact on the rest of your body. Like the foundation of a house, your feet support the weight of everything above them. When a small bio-mechanical problem developing in your foot/feet leads to a subtle change in the way you walk, a chain reaction will occur in your overall posture. These changes can put stress on joints higher up in your body that can lead to these secondary problems. At Foot, Ankle & Leg Specialists of South Florida, we look to correct the underlying issue in your foot with custom orthotics.

What are orthotics? 

Custom orthotics are insoles constructed from a plaster impression of your foot. They are designed specifically to address any abnormality or mechanical problem that your foot is experiencing. A plaster impression is made of your feet. The casts are then sent to a lab and prescription custom insoles are made from them. Small additions called "posts" are added if necessary to allow the foot to function at its best.

How do I know if I have a problem that could be treated by custom orthotics?

The symptoms of poor foot biomechanics may include one or more of the following:

Pain in the bottom of your foot could be fixed by a
custom orthotic!

• Localized foot pain
• Bunions
• Hammer toes
• Arch pain
• Heel pain
• Knee pain
• Hip / Lower back pain
• Tendonitis
• Plantar Fasciitis
• Shin splints
• Stress fractures
• Recurrent injuries
• Fatigue with standing or walking

Why would I or my child need orthotics?

Sometimes the foot is ineffective in absorbing shock or very weak when trying to push off during walking or running. Orthotics will help in both cases. 

Poor shock absorption in feet can lead to:

• Stress fractures
• Heel spurs
• Ankle instability
• Knee pain
• Neuromas

Don't let lower leg pain stop you from doing
what you love!

Poor ability to push off can lead to:

• Flat feet
• Shin splints
• Bunions
• Hammer toes
• Neuromas
• Plantar Fasciitis
• Back pain
• Osteoarthritis
• Achilles tendinitis
• Metatarsal joint abnormalities
• Foot instability
• Turf toe
• Shin splints
• Ankle instability
• Arch pain
• Growing pain
• Premature fatigue with activity
• General avoidance of activity
• Poor cardiovascular fitness

How do the orthotics help correct these problems?

The foot and lower extremities function best in what doctors call "Neutral Position”. This position allows the foot

to function optimally in both absorbing shock and improving stability. Any position in which the arch is too high (cavus foot) or too low (flat foot (links to pre- and post-operation photos)) doesn’t allow this optimal function, and problems can develop in the foot, ankle, knee or back.

Custom orthotics can mostly, if not completely, eliminate fatigue in the feet and legs during or after activity by providing proper support. They can eliminate “growing pains” in children and allow pain-free activity while also lessening the stressful impact of heel strike on the ground.

Orthotics can also lessen signs and symptoms of foot and ankle instability by adding small “posts” to the

device to help even out weight distribution during walking and running. This helps to decrease ankle sprains.

Our patients will typically be able to run faster and a longer distance without pain once they begin using their orthotic devices. Extensive walking (such as through Disney World, hooray vacation!) becomes much easier. Standing in general becomes more pain-free. All of this leads to a better quality of life.

So, why choose our practice to make your orthotics?

Here's what you can expect from the Foot, Ankle & Leg Specialists when it comes to fitting you for a custom orthotic:

• We will perform a comprehensive lower-extremity evaluation to determine your needs.
• This includes evaluation of joint mobility, muscle strength, ligament stability, and your specific gait imbalance.
• Once we have this information, we will make a plaster impression of your foot, placing it in the optimal position to design and produce the best orthotic to treat your imbalance.
• We will make any necessary modifications to the impression in order to make sure your orthotic is optimally shaped to provide you the best short- and long-term quality of life!

What types of shoes are orthotics good for?

Different types of orthotics are made for different types of shoes. They can be made specific to shoes necessary for your daily activities, including:

• Sneakers
• Cleats
• Work Boots
• Dress Shoes
• Cycling Cleats
• High Heels
• Flats & Wedges
• Boots
• Running Shoes

How do I get them?

It's simple. Make your appointment with us today and let us fit you for your custom orthotic! Once we get the plaster impressions, we send them to a lab to create your orthotics. Within 2-3 weeks, we'll give you a call that your orthotics are ready.

Whether immediately or within a few weeks of use, you'll feel full relief from your symptoms. 

Use our online scheduler to book your appointment. If you have a busy schedule during the week, we are open Saturdays by appointment only in our recently redone Plantation office. 

Click here to book your appointment and get yourself back to your best!

5 Common Foot & Ankle Injuries in Youth Athletes

Different Effects, Same Goals - Healthy Kids!

Parents should encourage their children to participate in sports. Not only will they gain cardiovascular benefits, but sports also helps to develop attributes like self discipline, teamwork and an appreciation of the importance of good health habits that they will carry throughout their lifetime. In children younger than 10, we believe in multi-sport participation with a training emphasis on proper technique and coordination.

     

We advise that sport specialization be delayed until late teenage years. Research shows that children who specialize too early are more likely to experience foot and ankle injuries. In addition to proper-fitting and supporting footwear, a dynamic warm-up specific to the sport being played is recommended for all ages in order to prevent injury. 

Differing from adults, children are more susceptible to growth plate injuries rather than injuries to tendons and ligaments. These growth plates typically do not finish closing until 15-18 in boys and 13-16 in girls. Many children also suffer from torsional imbalances such as in-toe or out-toe; however, the majority them outgrow these conditions without medical treatment. Still, see a foot and ankle specialist if your child is consistently tripping during activity. It could be related to these imbalances.

Tibial torsion examples in children and youth athletes.

We've put together a list of five common foot & ankle injuries that we see in children that come through our offices, along with different treatments. As always, each case is unique, and we recommend seeing one of our experts if your child is suffering from one of these injuries.

Ankle Sprains

Ankle sprains are typically seen more often in older youth athletes. For younger athletes with the same injury, there tends to be associated growth plate injuries. Immediate treatment is critical to healing and prevention of long term ankle instability. Physical therapy to restore balance and strength is often necessary after offloading the injured ankle.

Pre- and post-operation photos of two types of ankle fractures.

Fractures

If a child is unable to put weight on the injured foot after injury, we recommend an x-ray to rule out a fracture. If the fracture itself is not severe, rest and immobilization with a cast may be enough to let it heal. More complicated injuries may require surgical correction for better long term prognosis. We often see stress fractures in children who participate in over 16 hours of sports practice and activity each week. A good rule of thumb to prevent stress fractures is to keep organized sport participation to fewer hours per week than your child's age in years. 

Heel Pain

Also referred to as calcaneal apophysitis, heel pain is likely caused by an inflammation of the growth plate in the heel from excessive usage, a tight achilles tendon, flat feet, poor fitting cleats or shoes, or blunt trauma. Commonly seen in sprinting sports, like soccer and baseball because of cleat patterns and in basketball from the repeated force when coming down after a rebound. Usual treatment includes rest, immobilization, ice, heel lifts, orthotics, stretching and physical therapy.

Shin Splints

Shin splints are a very common overuse injury. The presence of a tight achilles tendon can cause overuse and inflammation of the weaker dorsiflexion muscles in the front of the leg. In children with flat feet and a tight achilles, overuse of a muscle in the back inside of the leg can become inflamed as well. Treatment includes rest, ice, compression, physical therapy, stretching, strengthening exercises, and orthotics.

Our office is fully equipped and accepts Same Day Appointments for all Urgent/Emergent Foot and Ankle Injuries. If your child is suffering from a foot or ankle injury, save time and money from an expensive trip to Urgent Care or the Emergency Room, and please call the nearest office immediately.

Or, use our online scheduler to book your appointment. If you have a busy schedule during the week, we are open Saturdays by appointment only in our recently redone Plantation office. Click here to book your appointment and get your child back to their best!

Are Stem Cells the Answer to your Foot, Ankle and Leg pain?

Are Stem Cells the Answer to your Foot, Ankle and Leg pain?

     Many patients are avoiding painful and costly surgery by choosing Stem Cell Therapy. We have seen great results for:

Plantar Fasciitis - Heel Pain
Achilles Tendonosis
Tendinitis around the foot and ankle joints
Ankle and Foot Ligament Damage

      If you have had your pain for months, even years, why not try Stem Cells to reduce inflammation and the associated pain to your foot and ankle. Improve your pain and lessen your disability with the latest technology in regenerative medicine. Give yourself a chance to restore your foot and ankle range of motion and decrease the scar tissue formation from your chronic pain or old foot and ankle injury.

     Traditional treatments of repeated cortisone injections and Platelet rich plasma, can present with potential complications and sometimes unclear results. Stem Cell therapy can deliver safer and more reliable outcomes for patient's foot and ankle conditions.

      Go to our website, at SouthFloridaSportsMedicine.com and use the online scheduler to make your appointment at any of our three convenient locations in Broward. Our job is to get you back to your best. See you soon!

http://www.southfloridasportsmedicine.com/joint-lubrication.html

Please Doc, Treat My Bunion

Bunions - Causes, Symptoms & Treatments

To help you understand how the Foot, Ankle & Leg Specialists at South Florida Institute of Sports Medicine diagnose and treat them, we are going to start by going over the causes and symptoms of these uncomfortable foot deformities.

What is a Bunion?

Photo of a Bunion

A bunion is a "bone deformity caused by an enlargement of the joint at the base and side of the big toe."¹

The medical term for a bunion is Hallux Valgus. "Hallux" refers to your big toe, and "Valgus" is defined as a deformity involving a displacement away from the midline. Put together, your big toe is out of place.

Over time, this displacement will cause the big toe to angle in toward the other toes. Sometimes it will overlap them. Other times, it will rotate or twist. Every time, it's uncomfortable.

What Causes Bunions?

Illustration of bone deformity that causes a bunion.

If your parents or grandparents had bunions, you are likely to get them. Bunions themselves are not hereditary, but they are most commonly caused by a faulty foot structure that may be passed down from your parents or grandparents. 

Wearing tight shoes, foot injuries, neuromuscular problems, or structural foot issues like flat feet and pronated feet can also increase the likelihood of bunions - especially in those people who are predisposed to developing them. 

What are Usual Symptoms of Bunions?

If you have a bunion, you know right away that the main symptom is the discomfort and pain that comes from your bunion rubbing against your shoes. If one of your grandparents told you they wore those ugly shoes because of a bunion, now you know why.

As a bunion gets bigger, it gets more and more painful to walk. Over time, bursitis may occur or arthritis may develop in the area as cartilage wears down.

What Treatments are Available?

Unfortunately, bunions will not correct themselves. If you wait to see a specialist, you are just making it more unlikely that some less drastic treatment methods will fix the bunion.

The goal of any treatment is first, to relieve the pressure and pain caused by the irritation, and second to stop any further growth of the enlargement. Early treatments include protective padding (to eliminate friction), removal of corns or calluses on the foot, changing to those shoes your grandparents wore to accommodate your bunion, orthotic devices to help stabilize the joint, splints, and mobility exercises. 

When these options don't work, you are looking at a surgical correction. Here is what that might look like:

Surgical correction will then require rest for around 3-4 days. You will wear a special shoe or boot for 4-6 weeks, then usually return to athletic shoes by 6 weeks, and dress shoes usually by 12 weeks.

Thankfully, dramatic improvements in bunion surgery techniques means you should experience no long lasting effects from your surgery. You will be able to resume athletic activities, wear your favorite shoes (high heels included), and should not see a recurrence of your bunion. The doctors at Foot, Ankle & Leg Specialists of South Florida have performed thousands of successful bunion surgeries and are up to date on the most recent advances, including hidden minimal incision bunion surgeries (as seen below).

Example before and after of a hidden minimal incision bunion surgery patient.

What Now?

If you are tired of the pain caused by a bunion, you are only making it worse by not having it seen by an experienced professional. It is time to get it checked out by the Foot, Ankle & Leg Specialists of South Florida. 

Go to our website, at SouthFloridaSportsMedicine.com and use the online scheduler to make your appointment at any of our three convenient locations in Broward. Our job is to get you back to your best. See you soon!

Check out more pre and post operative images of our patients at: http://www.southfloridasportsmedicine.com/bunion-pre-and-post-pictures.html

Footnotes:
1. http://www.southfloridasportsmedicine.com/bunions.html