So, when you rupture your Achilles tendon, and it\u2019s done more in Europe than in this country, but not everybody has to have a complete rupture like you did.\u00a0 There are ways to rehab somebody not operatively.\u00a0 In this country, most people who are relatively healthy usually get it fixed.\u00a0 I usually talk to people about both sides, but I think your recovery is more predictable if you fix it.\u00a0 So, some people like you, if you\u2019ve rupture it, you do okay or you don\u2019t notice it that much.\u00a0 It\u2019s hard to tell when you see somebody.\u00a0 You come in, and you ruptured your foot last week.\u00a0 It\u2019s hard to tell if that person is going to be like you, or if that person\u2019s going to walk all the time with a limp?\u00a0 It\u2019s a little bit of a judgment call, and you talk to people about what they\u2019re activity levels are. \u00a0Talk to them about the risks of the surgery are, and then a lot of times, they just let the patients choose.<\/p>\n
[1:01:33]<\/p>\n
Sometimes you can have those nodules in your plantar fascia.\u00a0 The plantar fascia is when you pull your toes up, you feel that structure tighten up in your arch.\u00a0 That\u2019s your plantar fascia.\u00a0 Sometimes, you can have nodules in there called plantar fibromatosis.\u00a0 Usually, you don\u2019t need to do anything about it unless it causes pain.<\/p>\n
[1:02:15]<\/p>\n
No, that\u2019s a whole other talk, but diabetes is very common.\u00a0 The main I would tell you is from my standpoint in orthopedics, the biggest thing that causes a lot of problems is that with diabetes you often lose the sensation in your feet.\u00a0 As you lose your protective sensation, these are the people that start getting ulcers.\u00a0 So, if you do all the things to maintain your circulation, there\u2019s ways that your circulation could be improved.\u00a0 We don\u2019t really have a good way to prevent you to prevent you from getting the neuropathy or the loss of sensation.\u00a0 The best advice is to first see your primary care doctor and get an early diagnosis.\u00a0 The second thing is to keep your blood sugar under as tight a control for as long as possible.\u00a0 That\u2019s probably the best thing you can do to prevent the neuropathy, but if you\u2019re diabetic, you need to be looking at your feet every day.\u00a0 Diabetics don\u2019t heal wounds the same way nondiabetics do.\u00a0 They have more problems healing wounds.\u00a0 So, a small blister or a small wound, even if it\u2019s pretty minor, you have to take it seriously in treating it very aggressively to get it heal.<\/p>\n
[1:03:45]<\/p>\n
It depends on how deep the ulcers are and where the location is.\u00a0 In people with trouble with sensation, the biggest thing is you have to stop walking on your foot.\u00a0 If you have an ulcer on the bottom of your foot, it\u2019s a pressure ulcer just like people lying in bed are getting pressure ulcers.\u00a0 It\u2019s on the bottom of your foot, and the only way to get it to heal is to take the pressure off.\u00a0 So, we have wound clinics where we work in which has ways to get pressure off.\u00a0 You can do it with a cast or some of these different braces or things like that.\u00a0 You have to get the pressure off to get it to heal.<\/p>\n
[1:04:30]<\/p>\n
No.\u00a0 You can live with it.\u00a0 When you say reverse it, the problem is that a lot of times, you have symptoms related to it.\u00a0 There\u2019s numbness and funny feelings in your feet.\u00a0 There are medicines that can dampen that.\u00a0 As far as taking some medicine that restores the sensation in your feet, there isn\u2019t anything that does that.\u00a0 So, you have to figure out how to live with it and prevent the things that it can cause.\u00a0 So, usually once you have neuropathy, you have to be pretty careful with the shoes that you pick.\u00a0 Once you have any deformity, it\u2019s always good to use molded inserts like a soft molded insert that goes inside your shoes.<\/p>\n
Yes, ma\u2019am?\u00a0 Back there in the red.<\/p>\n
[1:05:34]<\/p>\n
That\u2019s a bunion.\u00a0 Very common.\u00a0 Again the easiest thing to do is get shoes that fit your foot better.\u00a0 It\u2019s not symptomatic.\u00a0 You try and modify the shoes first.\u00a0 If that doesn\u2019t work, there\u2019s a lot of nonsurgical treatments.\u00a0 You can\u2019t really put something on the toe and hold and straight.\u00a0 That may help the symptoms a little bit, but once you take it off, the toe is going to back.\u00a0 So, there are certain ways to correct that.<\/p>\n
There\u2019s a fairly high recurrence rate in bunions, and the reason that is is that people undercorrect them to begin with.\u00a0 So, you say why do people undercorrect them.\u00a0 The reason is\u00a0 because people with the deformities are younger people, and they\u2019re trying to get back to work. So, they do a surgery that\u2019s a smaller surgery so they have a quick recovery.\u00a0 Sometimes that will help for about 5 years or so, but as you get older, the toe starts going back over again.\u00a0 So, if you undercorrect the deformity, there\u2019s a high chance it\u2019s going to come back, but if you correct it all the way, it does very well.<\/p>\n
Yes?<\/p>\n
[1:07:15]<\/p>\n
Pain in the ball of your foot, like under your big toe?\u00a0 The second toe?\u00a0 Yeah.\u00a0 Usually, that\u2019s related to the joint, your metatarsal-phalangeal joint, or MTP joint, where the toe meets the foot.\u00a0 As that gets tender, usually people with longer metatarsals have more pain because that\u2019s the area where most of the pressure concentrates when you go up on your toes.\u00a0 It\u2019s the first stage of hammertoe.\u00a0 That joint gets irritated.\u00a0 The treatment for the most part if you get a good arch support, you can probably relieve a lot of the symptoms.\u00a0 If you have a deformity of the toe, there\u2019s some little things you can put in your shoe.\u00a0 If your toes are getting cocked up like that, there are little things you can put on your shoe that let your toe lay down, then that redistributes the weight off the pad into the arch of your foot. So, if you don\u2019t have a big deformity and you\u2019re not having a problem with your shoe, usually you can treat that within inserts or some type of arch support.<\/p>\n
Yes?<\/p>\n
[1:08:34]<\/p>\n
We\u2019re trying to answer both those questions with a research study.\u00a0 Most of the people who get better get better within a month or six weeks.\u00a0 They\u2019re seeing the difference.\u00a0 We don\u2019t really restrict them a lot.\u00a0 Obviously, it does hurt to get a needle jabbed into your Achilles tendon, again we do it on Friday afternoon.\u00a0 I tell them to put ice on it and take it easy for about a week, but I don\u2019t really restrict them more than that.\u00a0 There\u2019s no boot or brace you have to put them in.<\/p>\n
The way our study\u2019s working is we have to fill out these pain scores before they do it.\u00a0 Then, we get the pain scores at two weeks, four weeks, six weeks, three months, and a year, and the success rate of all the people we\u2019ve put in our study is we haven\u2019t had to do surgery on any of them.\u00a0 There aren\u2019t people there giving me a hug in two weeks saying this is the greatest thing they ever had, but on the flipside most of them are saying they feel better.\u00a0 Fifty, 60% of them say they feel better to the point where they\u2019re not going to physical therapy.\u00a0 They\u2019re not doing a shoe modification, and they\u2019re not wanting to do surgery.<\/p>\n
So, what we\u2019re to try and follow them for a while and find out whether it\u2019s a lasting effect, but for the cost of one injection and no hospitalization and no surgery, there\u2019re really no loss time from work.\u00a0 I think it\u2019s really a reasonable option.<\/p>\n
Yes, ma\u2019am?<\/p>\n
[1:10:28]<\/p>\n
No, like in the back of your lower leg?\u00a0 Like along your Achilles tendon?\u00a0 Stretching is good.\u00a0 For Achilles tendon problems, one of the things that we promote is a thing called negative stretching.\u00a0 It\u2019s basically, if it\u2019s my left foot that\u2019s affected, you stand on a step.\u00a0 You go up on your toes on both feet.\u00a0 Then, you shift your weight all the way to your left foot.\u00a0 Then, you go all the way on your left foot and you slowly go down.\u00a0 It gives you an eccentric muscle, and the theory is that it\u2019s supposed to be better for the tendon.<\/p>\n
Yes, sir?<\/p>\n
[1:11:28]<\/p>\n
It\u2019s on the top of this foot?\u00a0 No change in alignment of this foot?\u00a0 Yeah.\u00a0 Both feet. This is like a collegiate competitive runner?\u00a0 Does it ever prevent him from running?\u00a0 I\u2019d probably just cross train him as much as I can.\u00a0 I don\u2019t know, probably an overuse issue.\u00a0 Just cross train him as much as you can, especially if it\u2019s both feet.\u00a0 That goes against an injury.\u00a0 Get him a bike.\u00a0 I think you stumped me on that one.<\/p>\n
Yes, ma\u2019am?<\/p>\n
[1:13:17]<\/p>\n
In general, if all you\u2019re doing is the first toe, my standard answer is it takes about 2.5, 3 months to get you back full time in a shoe.\u00a0 So, usually you\u2019re protected weight bearing with crutches for a full month.\u00a0 You start putting more and more weight on it.\u00a0 By three months, you should be on a shoe.\u00a0 Again, the success rate is related to the initial correction that you get.\u00a0 I think the struggle making your decision on a surgery is depending on the deformity, you have to choose a surgery that will fully correct the surgery.\u00a0 You have to be realistic.\u00a0 I\u2019m not one of those guys that tells you to do this surgery and you\u2019ll be back to work and running in a month.\u00a0 It\u2019s not really worth it to go through surgery if you don\u2019t fully correct it.\u00a0 I mean, because you\u2019re going to be doing it again in 10 years.<\/p>\n
Okay. Oh, yes?<\/p>\n
[1:14:29]<\/p>\n
I think the ibuprofen is mainly for pain.\u00a0 I think the anti-inflammatory effects have been overly promoted.\u00a0 It\u2019s not going to help you with swelling.\u00a0 The main reason you take it is for pain.\u00a0 The main risk is stomach problems.\u00a0 So, you have to be careful if you\u2019re prone to get ulcers in your stomach or if you have stomach upset or reflux or things like that.\u00a0 You have to be careful with the anti-inflammatories, but it\u2019s one of the most common medicines prescribed.\u00a0 It\u2019s pretty safe.\u00a0 You\u2019ve got your Tylenol\u00ae and Aleve\u00ae and Motrin\u00ae.\u00a0 You can\u2019t take Aleve\u00ae and Motrin\u00ae together.\u00a0 They do the same thing.\u00a0 Tylenol\u00ae is a different kind of medicine.\u00a0 So, you can mix Tylenol\u00ae with Motrin\u00ae.\u00a0 You can mix it with Alve\u00ae.\u00a0 Don\u2019t mix Aleve\u00ae and Motrin\u00ae.<\/p>\n
Okay.\u00a0 Yes?<\/p>\n
[1:15:39]<\/p>\n
You mean the wound doesn\u2019t heal? Was it like surgery for a broken ankle?\u00a0 There\u2019s a lot of reasons why bones don\u2019t heal. A lot of it has to do with the severity of the injury.\u00a0 It has to do with how it\u2019s fixed.\u00a0 Sometimes, the alignment of the foot can affect whether it heals or not.\u00a0 Most ankle fractures heal.\u00a0 Perhaps the biggest problem we have with ankle fracture is it\u2019s a little bit stiff afterwards or it\u2019s a little more prone to arthritis.\u00a0 If it doesn\u2019t heal, I think the first thing you have to look at if you had surgery is how you fixed it.\u00a0 Sometimes, either you didn\u2019t put enough screws in, or you didn\u2019t fix it stable enough for the bones to heal.\u00a0 Diabetics in general have more difficulty in healing bones.\u00a0 So, there\u2019s some medical reasons why fractures don\u2019t heal.<\/p>\n
[1:16:58]<\/p>\n
I would think that would be unusual.\u00a0 So, there would be some reason that you want to look for that\u2019s fixable so they can walk on it.<\/p>\n
Yes?<\/p>\n
[1:17:22]<\/p>\n
Microscopic in the sense that you use a microscope to do it? Now, the main areas are used a lot in spine surgery.\u00a0 It\u2019s also used a lot in hand surgery or where you\u2019re reattaching vessels or things like that.\u00a0 I\u2019m not sure if you meant arthroscopic which is a way of looking inside joints.\u00a0 So, mostly in the ankle, you do arthroscopic surgery, but not necessarily microscopic.<\/p>\n
Alright.\u00a0 Well, thank you for coming out.\u00a0 It\u2019s been a pleasure talking to you.\u00a0 Usually, when I have these things, there\u2019s always leftover food.\u00a0 So, feel free to grab a bottle of water and a cookie for the ride home, and that way, we don\u2019t have to take them out.<\/p>\n
Thank you for coming, and if you have any questions, I\u2019ll be happy to talk to you later.<\/p>\n","protected":false},"excerpt":{"rendered":"
So, when you rupture your Achilles tendon, and it\u2019s done more in Europe than in this country, but not everybody has to have a complete rupture like you did.\u00a0 There are ways to rehab somebody not operatively.\u00a0 In this country, most people who are relatively healthy usually get it fixed.\u00a0 I usually talk to people […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/footdetox.org\/pads\/wp-json\/wp\/v2\/posts\/108"}],"collection":[{"href":"https:\/\/footdetox.org\/pads\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/footdetox.org\/pads\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/footdetox.org\/pads\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/footdetox.org\/pads\/wp-json\/wp\/v2\/comments?post=108"}],"version-history":[{"count":2,"href":"https:\/\/footdetox.org\/pads\/wp-json\/wp\/v2\/posts\/108\/revisions"}],"predecessor-version":[{"id":110,"href":"https:\/\/footdetox.org\/pads\/wp-json\/wp\/v2\/posts\/108\/revisions\/110"}],"wp:attachment":[{"href":"https:\/\/footdetox.org\/pads\/wp-json\/wp\/v2\/media?parent=108"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/footdetox.org\/pads\/wp-json\/wp\/v2\/categories?post=108"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/footdetox.org\/pads\/wp-json\/wp\/v2\/tags?post=108"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}