During the 2013 AAOS annual meeting earlier this year, Dr. Silverman was interviewed on Hometown Radio on the topic of ankle instability. We’ve converted that interview into a video (below) for your viewing pleasure! A transcript of the interview is also listed below the video.
Interviewer: What might cause someone to have an unstable ankle?
Dr. Silverman: Most commonly, someone has an ankle sprain sometime previously in their life, whether they were running or just stepped on some rock or piece of uneven ground.
Interviewer: So what’s the effect of that over time?
Dr. Silverman: Well over time, people who have instability will develop a series of troubles. Sometimes they don’t even recognize they have instability. They’ll have ankle pain and they’ll try to avoid the things that bother them. They may have true ‘give way’ episodes, and just think that they’re klutzy or that their ankle is a trick ankle. They can develop ankle arthritis, tendon troubles, even knee and hip problems.
Interviewer: So what can be done to help these people?
Dr. Silverman: Generally I take two different approaches that are very successful. The first one is offering non-surgical treatment, which would include ankle bracing and physical therapy. There are other options that can be done at any time, such as fixing the ankle ligaments through reconstructive procedures. There are some very successful ones that have high rates of success across the country and especially in my patient population.
For more information on ankle instability, check out our ankle instability webpage.
When vacation time rolls around, you will be excited to get away from it all. But, if you have an injury that causes you to hobble around on crutches, your excitement might be pushed to the side a bit. Being on crutches isn’t easy at home, much less away. However, there are a few things you can do to help you enjoy your vacation even when you are injured. Here are some traveling tips for those on crutches.
Tip 1: Plan Your Routes
Traveling on crutches will be tiring, but if you plan things out in advance, you will know the fastest way to get from place to place. Think about the sites that you want to se that might have disabled access points so you can save time. Make sure you work frequent breaks and rest time into any route you plan.
Tip 2: Avoid Lines
Standing around in a line on crutches is about the last thing you want to do when you are on vacation. Many airports and sight seeing destinations will have entries that allow handicapped individuals to skip the line. You might feel bad about going in front of other people, but standing in line is so physically draining you’ll get over your guilt fast.
Tip 3: Call Ahead
Be sure to call your hotel or other accommodations in advance to request a room either on the ground floor, or one that is close to the elevator. When you explain that you are on crutches, most places will be happy to help you in any way they can.
Tip 4: Consider Portable Bags
If you are taking a trip that is long enough to drag luggage along, try to see if you can fit the essentials into a backpack. You can wear it on your back and allow yourself your hands to work your crutches. Normally, suitcases on wheels are nice, but not when you have no hands to drag them.
Tip 5: Pre-Board your Transportation
If you are flying somewhere, taking a train, or riding the bus, request pre-boarding privileges so you can get on before everyone else and get situated. You will have to deal with working your crutches through the small aisles and it won’t be easy if other people are in the way.
Tip 6: Gain Strength
When you will be doing a lot of walking, it is a good idea to get in shape and use your crutches a lot in advance so you are in shape for the occasion. Then, once you are on vacation, you won’t feel as sore from using them so much.
Tip 7: Consider Alternatives
If being on crutches wears you out at home, it will most likely be even harder when you are away. There are alternatives to crutches that might be better options for you. Goodbye Crutches has three such devices: the Hands Free Crutch, the Knee Walker, and the Seated Scooter. The Hands Free Crutch, for example, will allow you the use of your hands at all times. The Knee Walker can help you take the pressure off your hands and armpits be allowing you to scoot from place to place instead. And the Seated Scooter gives you the rest you need because you can sit while you move from place to place. Take a look at the differences between the devices and think about what type of vacation you are planning, then match a mobility device up to your summer needs. Not only will one of those items make your vacation easier and more fun, but it will also help you in your day-to-day life as you recover.
Brooke Williams is an award winning writer for Goodbye Crutches, the largest distributor of modern alternatives to crutches that serves those who can’t bear weight and can’t bear crutches. A former radio announcer turned freelance writer, she contributes to many other websites. She has authored four complete books as well. Brooke has been married for 10 years and has two daughters, Kaelyn, who is nearly 4 and Sadie who is one month old.
It’s happened to everyone at some point this spring. You’re stuck at work, staring out at the sunny day that awaits you as soon as the clock hits 5pm. But as quitting time nears, rainclouds roll into town and damper your hopes for burgers on the barbeque or an outdoor workout.
While you might be able to throw the burgers on the stovetop, many people forgo their workouts when the weather turns nasty. Those without gym memberships or home-exercise equipment rely on their ability to get outdoors to stay fit during the summer months, but that can be difficult to do if Mother Nature has other plans. In order to keep you healthy during the rainy season, we compiled a list of five exercises you can do to strengthen your legs and ankles from the comfort of your home.
Wall squats – This easy exercise requires you to find a stable wall in your house. Place your back against the wall and maneuver yourself into a sitting position as if you were seated on an invisible chair. Try to keep your thighs parallel to the ground and perpendicular with your lower legs. Hold this position for 60-90 seconds. This exercise provides a great workout for your quadriceps.
Bridges – This exercise will help build your glute muscles. Start by lying on your back with your knees bent and your feet flat on the floor. Lift your back off the floor and create a straight line between your hips, lower torso and knees, leaving your shoulder blades on the ground. Hold this position for 30 seconds, take a 10-second break, and repeat.
Calf raises – This exercise, also known as a “calf blast”, strengthens the muscles in your lower leg. Calf raises are usually done on a step, but you can do them on any elevated surface that won’t move. Begin by standing on the step with your heels hanging off the back so they are lower than your toes. Lift yourself as high as you can onto your toes so you heels are above the rest of your feet. Hold this position for 10 seconds, and then slowly lower yourself back down. If you want to challenge yourself, try using one leg at a time. Do this exercises 10 times, or five times for each foot.
One-Legged Squats – One-legged squats are similar to wall squats because they target your hamstrings, quads and glutes. Put your left leg forward and position the toes on your right foot on the floor, roughly a stride behind you. Bend your left leg until your knee makes a 90-degree angle. Return to your original position and repeat, then switch legs and do the exercise with your right leg in front.
High Knees – The high knees exercise is a simple exercise that will get your heart pumping, but it will also work your thighs and tone your midsection. To start, position your hands in front of your body above where your thigh would be if your raised it up. Simulate a running motion where you pick you legs up so your thighs elevate and touch your hands. Try to get your thighs parallel to the ground when you pick them up. Do 100 high knees for a good burn.
Do this workout 2-3x for maximum effect. So the next time Mother Nature throws you a curveball and tries to wash out your workout, just put on your exercise attire and head for the nearest wall to begin a great workout.
Related source: HowStuffWorks.com
Last week, we explored the signs and symptoms of common foot fractures. Today, we’ll explain the treatment options associated with a fracture, and we’ll look at the standard rehabilitation procedure.
We briefly touched on the non-surgical treatment options in last week’s post. The most common method for patients who opt to forgo surgery is to practice the RICE method, which stands for:
The most important step in the RICE method is rest. Oftentimes people try to compensate for their injury by limping through their day. This is problematic for many reasons. First, since your foot is already in a weakened state, putting any pressure on the area could lead to damage to the surrounding region. If you don’t give your foot ample time to rest, the bruising or swelling may linger for much longer than anticipated. Also, you could end up suffering an injury to another part of your body because other body parts are compensating for the extra weight you can’t place on your foot. Oftentimes patients who try to work through their foot fracture will experience back or hip pain because of the added stress being placed on these areas.
Another common treatment method in non-surgical fractures is casting or splinting. A cast or walking boot can help stabilize your foot while keeping the rest of your body aligned.
If your fracture is severe enough to require surgery, your doctor will preform a minimally invasive operation to ensure the bones in your foot heal properly. Your doctor will preform a surgical operation known as an “internal fixation procedure”. Generally, there are two types of internal fixation surgeries:
- Internal fixation with pins – When smaller bones in the foot break, a doctor can use pins to ensure that the bones heal in place. The pins are placed around the fractured area so the bone reconnects properly.
- Internal fixation with plates and screws – Plates are screws may be used if pins won’t sufficiently address the fracture. The plate is screwed in place to stabilize the affected region as it heals.
Recovering from a fractured foot
Because your foot is comprised of so many small bones, the recovery time can differ depending on which bone you break. While the timeline may be slightly different, the process is essentially the same. Your bones heal in a three-step process:
Step 1: Inflammation
The healing process begins immediately after you fracture your foot. Blood cells will clot in the fractured area so that extra oxygen, minerals and calcium can reach the affected area. These will help expedite the healing process. Inflammation is the body’s natural response to injury. The inflammation step usually lasts 7-10 days.
Step 2: Soft Tissue Healing
In step 2 of the recovery process, your body begins to stabilize the fracture by replacing the clotted blood with fibrous tissue and cartilage. The tissue is very weak and susceptible to breakage, so it’s important to minimize the amount of pressure you place on your foot. It usually takes 3-6 weeks for soft tissue to develop around the fracture area.
Step 3: Bone Healing
The final stage in the healing process involves the formation of a hard callus that unifies the broken bone back in its original place. The soft tissue around the fractured area begins to harden, and the progress can be tracked by X-ray imaging. A person can usually return to full sporting activities once the hard callus has formed, which typically occurs 6-12 weeks after the initial injury.
Related source: AAOS, Buzzle.com
People are always looking for new ways to push their workout to the next level. Everybody wants to go faster, jump higher or run farther, but some techniques are better than others when it comes to improving your performance. While ankle weights can be beneficial during some workouts, they can do more harm than good if you wear them during long runs. Below, we’ll discuss some of the risks associated with wearing ankle weights during a run.
Improper muscle development – Proponents of ankle weights argue that they encourage muscle development in your legs and feet. While this may be true, overdeveloping some muscles while neglecting others can put you at risk for an injury. Because ankle weights make you to exert more force lifting your foot, you’ll be strengthening your quad muscles, but your hamstrings in the back of your leg will not be getting such an intense workout. Over time, your quad can become disproportionately stronger than your hamstrings, leaving you susceptible to injury.
Imbalance – Similar to when you step off a moving sidewalk in an airport, once you are subjected to a change in your walking pattern you can become imbalanced. If you wear ankle weight during a run, your body will begin to compensate for the extra weight. Once you remove the weights, there will be a natural adjustment period that can put you in danger. If you’re walking up or down stairs, you might step farther than intended because your brain is still compensating for the weight you just removed. You could hurt yourself with just one misstep.
Lower-body injuries – As we noted above, ankle weights force an individual to exert more effort in order to move their legs. The extra weight puts additional stress on your knees, joints and ligaments, which can lead to tears or tendonitis, especially if you have an improper running form. If you ignore a small problem caused by ankle weights, it could lead to an even bigger problem down the road.
Other areas affected – You might think ankle weights only target the muscles in your legs, but they also force you to use your back muscles. With each step you take, your body acts as a natural “stress absorber”. By wearing ankle weights, you force your back muscles to absorb more stress. This can lead to chronic pain in your lower back region.
What you should do instead
There are several ways improve your performance without harming your body. One way to challenge your muscle groups is by running on hilly terrain. We’ve cautioned against running on uneven ground, but it you can find a paved trail that takes you up and down some hills, you’ll soon notice a positive change in your muscle development and endurance.
If you’re dead set on using ankle weights, use them during other activities instead of on a run. Ankle weights are best used in resistance training, and you can consult with a personal trainer or a foot specialist on which exercises you can safely use the weights. Another popular spot to use ankle weights is in your local pool. The natural resistance of the water will help offset some of the strain put on your joints and back.
Related source: Fitness Republic
Keeping Your Ticker Happy
A study by researchers at the University of Texas Southwestern Medical Center found that individuals that increased their fitness levels over an 8-year period, as well as those who continued to stay fit, reported lower rates of hospitalization for heart failure than those who had low levels of fitness.
“The risk of heart failure in your 60s and 70s is modifiable through sustained exercise beginning in midlife,” Dr. Ambarish Pandey said in an interview with MedPage Today. ”We have known for a few decades that a change in fitness is associated with a reduced risk of mortality. But no one had looked at the impact of improved fitness over time on the risk of heart failure.”
For their study, researchers ranked the fitness levels of over 9,000 participants. Each individual was assigned a fitness level, 1 being the lowest level and 5 being the highest level of fitness. The average age of a participant was 48 years old.
Researchers conducted an initial cardiorespiratory fitness test at the beginning of the study, and they ran a similar test about 8 years later. After analyzing the results, researcher found:
- Participants who had a high level of fitness and maintained that level had a heart hospitalization rate of about 0.30%
- Participants who had low fitness but increased their fitness to a high level experienced a heart hospitalization rate of about 0.65%
- Those who went from high to low fitness had a rate of about 0.75%
- Those who had a low level and stayed at that level had a heart hospitalization rate of 0.83%
Pandey said the results confirmed the importance of exercise as we age.
“It’s important to realize that the benefit of reduced heart failure hospitalization comes from sustained exercise over time.”
Fitness Lowers Cancer Risk
Researchers at the Cooper Clinic in Dallas found that physical fitness in middle-aged men can reduce the risk of lung and colorectal cancer, and exercise can decrease the mortality rates for men who develop these cancers.
For their study, researchers examined 17,049 men to determine their fitness level and lung capacity. The average age of a participant was 50 years old. The study then looked at clinical data 20 years later to determine how many patients had developed prostate, colorectal or lung cancer, the most common cancers among U.S. men.
Researchers found that 2,332 individuals were diagnosed with prostate cancer, 276 with colorectal cancer, and 277 with lung cancer. Over the time period, cancer was the cause of death in 347 patients.
After comparing the data to the previous fitness tests, researchers found that men in the highest quintile of fitness were significantly less likely to develop lung or colorectal cancer, although their was no difference in prostate cancer rates.
Dr. Susan Lakoswi, a researcher in the study, said the findings might impact how doctors prescribe exercise routines for patients.
“Physical activity and fitness are very different,” said Lakoski.
She also cautioned that simply because a person is not obese, doesn’t mean they are physically fit.
“Even if men are not obese, they still have an increased risk of cancer if they aren’t fit,” she said.
Dr. Silverman comments
These studies really highlight the importance of exercise and physical fitness as we age. Workout out is really healthy for you, as it reduces your risk of heart disease and cancer development.
Now that winter is gone, I urge people to get outside and stay active. Summer is here, which gives you less of an excuse to skip your workout.
It’s time we as a nation put down the remote and went outside.
Related source: MedPage Today
There are thousands of ways a person can fracture their foot, and most of them stem from a prolonged or direct impact to the foot region. Below, we’ll examine the signs, symptoms and diagnosis of foot fractures.
Did I just fracture my foot?
Whether you got tackled in football, fell off a ladder, or simply dropped something heavy on your foot, you know how painful a foot fracture can be. Some common ways people fracture their foot includes:
- Direct impact during sports, like fouling a ball off your foot in baseball
- Dropping a weight or heavy object on their foot
- Incorrect running form over a long period of time. Many novice and moderate runners can experience stress fractures due to poor form
- Falls from great heights. Many people suffer foot fractures as a result of falling down stairs.
Symptoms of Foot Fractures
Because your foot is made of many tiny bones, some people will experience different symptoms based on what bone is broken. With that said, some common symptoms of foot fractures include:
- Pain or numbness in the first 24-48 hours after the injury
- Bruising or discoloration
- Discomfort or inability to bear weight
If you’re diagnosed with a foot fracture
If you’re diagnosed with a foot fracture, you may be able to avoid surgery if you take steps to help the bones heal. Treatment of foot fractures is similar to the treatment protocol for heel bruises. Oftentimes foot fractures will heal if you practice the RICE method, which stands for Rest, Ice, Compression and Elevation. The problem for most people is that they are unable to adequately rest their foot, and sometimes compensating for the injury can lead to complications or related issues. Try to stay off the foot as best as possible, especially in the immediate hours after the injury.
Once you’re off your feet, make sure you ice the area for at least 10 minutes. You’ll want to ice at least 3-5 times a day, so consider bringing an ice pack along with you if you have to leave your house.
Compress the foot with a bandage or towel, but do not cut off circulation. Once your foot is wrapped, try to keep your leg elevated. Keeping your leg elevated will help decrease swelling in your foot, which can help expedite the healing process.
In a companion post in the future, we’ll explore the surgical treatment options and recovery protocols associated with foot fractures.