What is a Calcaneal Fracture?

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Article featured on Cedars Cinai

Overview

The calcaneus is the large bone at the heel of the foot. It is usually fractured after a fall from a great height or in a motor vehicle accident.

Symptoms

Some calcaneal fractures are obvious, resulting in an inability to put weight on the heel, swelling of the heel and bruising of the heel and ankle. Pain is usually severe enough to require an emergency room visit. If the fracture is caused by a stress fracture, over time, then symptoms may be far more vague. There may be some pain, increasing throughout the day, often described as being dull and achy. Bruising may or may not be present.

Causes and Risk Factors

Calcaneal fractures are most commonly suffered by roofers and climbers after a fall, although automobile accidents can also cause such fractures to the heel bone. Males between 30 and 50 years old fracture their calcaneal most often of any age group or sex.

Diagnosis

A physical examination followed by X-rays and/or CT scans are generally used to diagnosis calcaeneal fractures. Such diagnostic studies also help determine the extent of the fractures. An MRI can be used to distinguish a calcaneal fracture from plantar fascitis.

Treatment

Calcaneal fractures can be difficult to treat. The heel bone is like an egg with a strong shell and a soft interior. Therefore, the heel bone often shatters when it is traumatized by a fall or accident. Therefore, treatment requires the repair of multiple fractures in the heel bone, as well as restoring the subtalar joint. The subtalar joint connects the calcaneus and the talus, which is the small bone connecting the heel and the leg. Given the joints location, it carries most of the load of the body.

If the fracture has not displaced the bone, rest and partial to complete immobilization can heal the bone. Usually a cast of some sort is used to immobilize the heel. The time required to heal depends on age, degree of fracture and general health of the patient. Some such fractures take more than 6 months to heal.

Some calcaneal fractures can be treated by manipulating the foot while a patient is under anesthesia, but not involving surgery. This procedure is called closed reduction. If such a procedure does not treat the fracture or if the fracture is more extensive, then surgery may be required (called an open reduction). Surgery may be recommended immediately after a fracture or a few weeks later to allow inflammation to decrease. After both closed or open reduction, a patient must avoid putting weight on the foot, usually through the use of a cast or splint.

In severe cases, further surgery may be required to fuse the subtalar joint. If the subtalar joint is severely damaged, fusion is the only option.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

3 Common Causes of Heel Pain & How it is Treated

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Article featured on NY Orthopedics

Heel pain is one of the most common complaints of patients with foot and ankle disorders — but what causes heel pain, exactly? The pain often occurs at the back surface of the heel and can limit any standing, walking, or running activities. Explore our guide to the common causes of heel pain to learn how a foot and ankle specialist can get you back on your feet in no time.

Why Does My Heel Hurt?

Heel pain is not typically caused by a single injury, like a twist or fall, but from repetitive stress and pounding of the heel. Common heel pain causes include:

  • Plantar fasciitis. Too much running or jumping can inflame the fascia (tissue band) that connects the heel bone to the base of the toes. The pain, centered under your heel, may be mild at first but flares up when you take your first steps in the morning. Muscle cramps in the calf may also occur if the Achilles tendon tightens as well. If plantar fasciitis is left untreated, it may lead to heel spurs.
  • Stress fracture. This is often linked to repetitive stress to the bone over a short period of time, especially in young athletes who alter their training regimen suddenly. This may include more sprints, increased mileage while running, or increased training intensity. Stress fractures can also be caused by osteoporosis.
  • Achilles tendonitis. Achilles tendonitis occurs when the tendon that attaches to the calf muscles to the heel becomes inflamed or painful due to overuse. Any activity that requires pushing off — like basketball or running — can result in tendonitis.

How Can Heel Pain Be Treated?

Treatment for heel pain varies depending on the severity of the injury and your health goals. Your foot and ankle specialist may first suggest some home remedies — like rest, applying ice to the heel, and over-the-counter pain medications — to ease your symptoms. If your heel pain doesn’t get better within a few weeks, you should make an appointment with your doctor so that they can provide you with the appropriate treatment.

Your doctor may prescribe physical therapy in most cases. This can help strengthen the tendons and muscles in your foot, helping to prevent further injury. If your pain is severe, your foot and ankle specialist may provide you with anti-inflammatory medications that can be injected into the foot or taken orally. They may also recommend that you support your foot as much as possible — either by using orthotics or taping the foot.

In very rare cases, your foot and ankle specialist may recommend surgery to correct the problem.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What is Achilles Tendinitis

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Article featured on Mount Sinai

Achilles tendinitis occurs when the tendon that connects the back of your leg to your heel becomes swollen and painful near the bottom of the foot. This tendon is called the Achilles tendon. It allows you to push your foot down. You use your Achilles tendon when walking, running, and jumping.

Causes

There are two large muscles in the calf. These create the power needed to push off with the foot or go up on the toes. The large Achilles tendon connects these muscles to the heel.

Heel pain is most often due to overuse of the foot. Rarely, it is caused by an injury.

Tendinitis due to overuse is most common in younger people. It can occur in walkers, runners, or other athletes.

Achilles tendinitis may be more likely to occur if:

  • There is a sudden increase in the amount or intensity of an activity.
  • Your calf muscles are very tight (not stretched out).
  • You run on hard surfaces, such as concrete.
  • You run too often.
  • You jump a lot (such as when playing basketball).
  • You do not wear shoes that give your feet proper support.
  • Your foot suddenly turns in or out.

Tendinitis from arthritis is more common in middle-aged and older adults. A bone spur or growth may form in the back of the heel bone. This may irritate the Achilles tendon and cause pain and swelling. Flat feet will put more tension on the tendon.

Heel pain can be a common problem. Though the cause is rarely serious, the pain can be severe and sometimes disabling.

Heel pain is often the result of overusing your foot. Causes may include, running, especially on hard surfaces like concrete, tightness in your calf, or from Achilles tendonitis (inflammation of that large tendon that connects your calf muscle to your heel), shoes with poor support, sudden inward or outward turning of your heel, or landing hard or awkwardly on your heel after a jump or fall.

Problems related to heel pain include bursitis (inflammation of the bursa at the back of the heel), bone spurs in the heel, and plantar fasciitis (swelling of the thick band of tissue on the bottom of your foot). Heel pain is something you can usually treat at home.

If you can, try resting as much as possible for at least a week. Apply ice to the painful area twice a day or so, for 10 to 15 minutes. If you need to, you can buy a heel cup, felts pads, or shoe inserts to comfort your heel.

You should call your doctor if your heel pain does not get better after two or three weeks of home treatment. But also call your doctor if your pain is getting worse, or your pain is sudden and severe, your feet are red or swollen, or you can’t put weight on your foot.

If you visit the doctor, you may have a foot x-ray. Your treatment will depend on the cause of your heel pain. You may need to see a physical therapist to learn exercises to stretch and strengthen your foot. To prevent future heel pain, we recommend you exercise.

Maintaining flexible, strong muscles in your calves, ankles, and feet can help ward off some types of heel pain. And do yourself a favor, trade those sleek high heels in for a comfortable, properly fitting pair of shoes.

Symptoms

Symptoms include pain in the heel and along the length of the tendon when walking or running. The area may feel painful and stiff in the morning.

The tendon may be painful to touch or move. The area may be swollen and warm. You may have trouble standing up on your toes. You may also have trouble finding shoes that fit comfortably due to pain in the back of your heel.

Exams and Tests

The health care provider will perform a physical exam. They will look for tenderness along the tendon and pain in the area of the tendon when you stand on your toes.

X-rays can help diagnose bone problems.

An MRI scan of the foot may be done if you are considering surgery or there is a chance that you have a tear in the Achilles tendon.

Treatment

The main treatments for Achilles tendinitis do not involve surgery. It is important to remember that it may take at least 2 to 3 months for the pain to go away.

Try putting ice on the Achilles tendon area for 15 to 20 minutes, 2 to 3 times per day. Remove the ice if the area gets numb.

Changes in activity may help manage the symptoms:

  • Decrease or stop any activity that causes pain.
  • Run or walk on smoother and softer surfaces.
  • Switch to biking, swimming, or other activities that put less stress on the Achilles tendon.

Your provider or physical therapist can show you stretching exercises or eccentric loading exercises for the Achilles tendon.

You may also need to make changes in your footwear, such as:

  • Using a brace, boot or cast to keep the heel and tendon still and allow the swelling to go down
  • Placing heel lifts in the shoe under the heel
  • Wearing shoes that are softer in the areas over and under the heel cushion

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, can help ease pain or swelling.

Other treatment include injections, such as platelet rich plasma or steroids, to reduce the inflammation. However, the tendon can become even weaker following injection and should be protected after the injections.

If these treatments do not improve symptoms, you may need surgery to remove inflamed tissue and abnormal areas of the tendon. If there is a bone spur irritating the tendon, surgery can be used to remove the spur.

Extracorporeal shock wave therapy (ESWT) may be an alternative to surgery for people who have not responded to other treatments. This treatment uses low-dose sound waves.

Outlook (Prognosis)

In most cases, lifestyle changes help improve symptoms. Keep in mind that symptoms may return if you do not limit activities that cause pain, or if you do not maintain the strength and flexibility of the tendon.

Possible Complications

Achilles tendinitis may make you more likely to have an Achilles rupture. This condition most often causes a sharp pain that feels as if you have been hit in the back of the heel with a stick. Surgical repair is often necessary. However, the surgery may not be as successful as usual because there is already damage to the tendon.

When to Contact a Medical Professional

Contact your provider if:

  • You have pain in the heel around the Achilles tendon that is worse with activity.
  • You have sharp pain and are unable to walk or push-off without extreme pain or weakness.

Prevention

Exercises to keep your calf muscles strong and flexible will help reduce the risk for tendinitis. Overusing a weak or tight Achilles tendon makes you more likely to develop tendinitis.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Common Dance Injuries and Prevention Tips

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Article featured on Johns Hopkins Medicine

Dance may look effortless, but it requires a lot of strength, flexibility and stamina. It also comes with a high risk of injuries. Whether you are a dancer, the parent of a dancer or a dance teacher, you should be aware of the most common dance injuries and learn how to avoid them.

Johns Hopkins performing arts physical therapists Andrea Lasner and Amanda Greene share valuable information about dance injury treatments and prevention tips. Lasner and Greene, both dancers, have turned their love for the art into a means of helping injured dancers.

What are some common dance injuries?

A few studies that looked into dance injuries found that injuries from using your joints and muscles too much (overuse injuries) are the most common in dancers. The majority of these overuse injuries involve an ankle, leg, foot or lower back. Some common dance injuries are:

  • Hip injuries: snapping hip syndrome, hip impingement, labral tears, hip flexor tendonitis, hip bursitis and sacroiliac joint dysfunction
  • Foot and ankle injuries: Achilles tendonitis, trigger toe and ankle impingement
  • Knee injuries: patellofemoral pain syndrome
  • Stress fractures: metatarsals, tibia, sesamoids and lumbar spine
  • Dancers are also likely to develop arthritis in the knee, hip, ankle and foot

Generally, dancers have a much lower rate of anterior cruciate ligament (ACL) injuries than other athletes. One explanation could be that dance training involves much more intense jumping from an earlier age than other sports, which helps improve muscle control.

How do I know if the pain is from an injury?

In most cases, the pain you experience after dancing is muscle soreness that usually subsides within 24 to 48 hours. Sometimes, it takes a few days for muscles to get sore, which is also normal. However, if you experience the following types of pain, you may have suffered an injury:

  • Pain that wakes you up at night
  • Pain that is present at the start of an activity
  • Pain that increases with an activity
  • Pain that makes you shift your weight or otherwise compensate your movements

If you experience such pain, consult with a medical specialist — preferably a physical therapist or physician with experience in treating dancers. They will be able to determine whether additional testing is needed and will formulate an appropriate treatment plan.

Why do dance injuries happen?

Dance is a physically demanding activity. Dancers perform repetitive movements for several hours a day. Studies have shown that dancing five hours a day or longer leads to an increased risk of stress fractures and other injuries.

On top of the intensive training, many dancers get little time to recover between the sessions and have no “offseason.” Restrictive diets and unhealthy body weights may also contribute to dance injuries. Proper nutrition is important for dancers of all ages.

How do dancers get ankle sprains?

Ankle sprains are the number one traumatic injury in dancers. Traumatic injuries are different from overuse injuries as they happen unexpectedly. When an ankle is sprained, ligaments on the inside or outside of your foot get twisted or overstretched and may experience tears. Ankle sprains often happen due to improper landing from a jump, misaligned ankles (when they roll in or out) or poorly fitted shoes. Torn ligaments never heal to their preinjury condition. Once you’ve sprained your ankle, you are at risk of doing it again. It’s important to build muscle strength to prevent further injuries.

Dance Injury Prevention

How can dance injuries be prevented?

The majority of overuse injuries and even some traumatic dance injuries can be prevented. Follow these guidelines to reduce your risk of injury:

  • Eat well and stay hydrated before, during and after class.
  • Get enough rest and avoid overtraining.
  • Do cross-training exercises to build strength and endurance in all parts of your body.
  • Always wear proper shoes and attire.
  • Always warm-up before training or performances.
  • Lead a healthy lifestyle and get to know your body.

When injuries happen, address them immediately and get advice from a doctor or physical therapist.

What are good cross-training exercises for dancers?

Core and hip strengthening exercises like Pilates and stability-based yoga are great for dancers. And so are aerobic and cardiovascular activities, such as running, swimming or biking. They get your heart rate up and help build stamina for long performances.

Many dancers don’t do enough cardio during their regular training. Just 30 minutes three to four times a week is usually enough to improve your endurance. As always, do this in moderation and in short intervals to avoid stressing your joints. Being screened by a physical therapist with experience treating dancers will help you identify individual areas of weakness to address with specific exercises.

How much rest should a dancer get?

While many experts stress the importance of proper rest, there are no specific guidelines on the frequency and amount of rest. However, we know that dancing five hours a day or longer is linked to an increased risk of injury. It is also known that intense activity leads to microdamage, which peaks in recovery 12 to 14 hours after a workout. So it would make sense to take the next day off after a high-intensity activity. Dancers should work at their highest intensity a couple of times per week and then take at least two days off, preferably in a row. Also, a three- to four-week period of rest after the season is ideal for recovery.

Dance Injury Treatment

Should I ice or heat after a dance injury?

If it’s a sudden injury, it’s best to apply ice first to reduce swelling and inflammation. RICE treatment is a common approach that involves rest, ice, compression and elevation. After a few days, you can switch to heat to increase blood flow to the area and promote healing. However, every person is different. If you feel that ice helps you better than heat, then there is nothing wrong with continuing to ice. But be careful not to ice before dancing or stretching, because you want those muscles to be warmed up to prevent re-injury.

What are my treatment options for a dance injury?

It depends on the type of injury, your level as a dancer and many other factors. For example, for traumatic injuries like ankle sprains, your doctor may recommend RICE, joint protection and physical therapy. For stress fractures you may need to limit weight on your foot by using crutches, wearing a leg brace or walking boots. Surgery is typically used as the last resort. It is best to discuss your treatment options with a doctor who specializes in dance injuries. And if you are working with a physical therapist, make sure he or she is experienced in treating dancers. A big part of physical therapy is correcting the training technique that led to the injury. Otherwise, you risk hurting yourself again by making the same mistake.

What should be in the first aid kit for dance injuries?

Your regular first aid kit might already have many of the essentials for handling a medical emergency. However, when it comes to common dance injuries, you may want to include a few additional items, such as:

  • Instant cold pack
  • Pre-wrap and athletic tape (if qualified providers are available to apply)
  • Elastic bandages (to be used only for compression, not support while dancing)
  • Crutches
  • Topical pain reliever

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Causes of Arch Pain

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Article featured on News-Medical 

Arch pain, also known by the medical term plantar pain, refers to pain in the arch at the bottom of the foot. This pain can present as a result of various causes, usually following activities that involve significant stress to the arch of the foot.

The arches of the feet are a principle structure of the foot, which play an important role to absorb and return the force between the body and the ground, supporting bodily movement when people are on their feet. However, when the arches are put under excessive stress due to intense movements or extended periods of time standing on their feet, injury and pain to the area can present.

Plantar Fasciitis

The most common cause of arch pain is a condition known as plantar fasciitis, which involves inflammation of the plantar fascia connective tissue along the arch of the foot. This usually follows excessive stress to the area from activities such as extended periods of time spent on feet at work or after sporting activities.

Injury to the arch of the foot can occur due to direct force trauma can result in pain and inflammation. This may include:

  • Ligament sprains
  • Muscle strains
  • Biomechanical misalignment
  • Fractures due to mechanical stress
  • Muscle overuse
  • Inflammatory arthritis

Activities that are most likely to cause damage to the foot arch include those that involve a significant amount or extended period of stress to the feet. This includes intense sport activities, long distance running and simply standing on the feet all day in a workplace environment.

Foot Deformity

Some deformities of the foot, such as hammertoe or clubfoot, may also cause arch pain. Additionally, people with abnormal arches of the feet are more likely to be affected by arch pain, including both people with flat feet and those with high arches.

Sudden Weight Changes

Drastic changes in weight that occur over a short period of time can be responsible for causing stress to the arch of the foot and result in arch pain.

In particular, people who are obese, have Type 2 diabetes mellitus, or are pregnant are more likely to be affected by excess stress on their feet and report symptoms of arch pain.

Footwear

Inappropriate footwear that is ill-fitting or does not provide adequate support to the food and may lead to pain and inflammation in the arch of the foot. The sole of the shoe is of particular importance and those with poor arch support or soft soles are most likely to cause problems.

Diagnosis

The structure of the foot is very complex and, for this reason, an individual that is experiencing arch pain should be referred to a podiatrist who will make the relevant investigations as to the cause of the condition.

This usually begins with a physical examination of the foot and a consultation about the medical history and events recent that may have caused the pain. There is often evidence of a lump or bruise in the arch of the foot that is evidence of damage to the connective tissue.

Other tests that may be used to determine the cause of the arch pain include X-ray imaging, magnetic resonance imaging (MRI) or computed tomography (CT) scans.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What is Turf Toe?

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Article featured on Mercy Health

What is turf toe?

Turf toe is a sprain in the ligaments around the big toe joint. Turf toe often happens suddenly when the toe becomes hyperextended.

Athletes, such as football players, are the most likely group of people to develop turf toe.

Causes of turf toe

Turf toe can be caused by the following:

  • The toe is hyperextended and forcibly bent backward, when the toe stays flat on the ground instead of lifting off in an athletic move the joint can be injured.
  • A toe stays flat instead of lifting off when a football player or other athlete is tackled.

Risk factors for turf toe

Athletes who play sports involving their feet including football, soccer, basketball, gymnastics, and dance are at a higher risk for developing turf toe.

Also, people who wear shoes that are not supportive in the toe box are also at higher risk for turf toe. These soft-soled shoes do not provide protection in the case of sudden force.

Symptoms of turf toe

Turf toe can be categorized in 3 grades:

  • Grade 1 — mild turf toe that is tender to the touch and slightly swollen.
  • Grade 2 — moderate turf toe where mobility is impacted, swelling is deeper and it is more painful to the touch.
  • Grade 3 — severe turf toe where ligaments have been torn and it is extremely painful, swollen and mobility is more severely impaired.

Diagnosis of turf toe

Turf toe is diagnosed under the care of your primary care doctor, podiatrist or sports medicine physician.

The physician will perform a full medical exam as well as work with you to understand your medical history. The physician may order an x-ray to determine if there has been a bone fracture or an MRI to confirm turf toe (MRIs provide images of structures that are not bones).

Treatments for turf toe

Early medical intervention for turf toe is important to avoid long term repercussions from the injury. Athletes especially need quick treatment in order to get back to play as quickly as possible.

For mild cases of turf toe (grade 1), the first line therapy is rest, ice, elevation, and compression in conjunction with anti-inflammatory medication and immobilization.

For moderate cases of turf toe (grade 2), patients should take a minimum of 3 days away from sporting activity in conjunction with all the treatments from grade 1.

For severe turf toe cases patients will need to develop a customized treatment plan with their physician that may include:

  • Splint or brace
  • Rehabilitation and physical therapy

Recovery from turf toe

Recovering from turf toe can be quick for grade 1 cases or can take many months for a grade 3 case.

It is imperative to follow your physician’s instructions in order to get back to normal activity as quickly as possible.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Could Your Foot Pain Be Caused by a Problem in Your Spine?

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Article featured on Spine-Health

This blog provides a list of common causes of foot pain and helpful pointers to help you understand the origin of your foot pain.

Foot pain caused by a spinal problem

Nerve root irritation or compression in the lumbar or sacral spine (lower back) may cause sciatica pain to radiate down your leg and into the foot. Specifically, compression of the S1 nerve root, also called classic sciatica, can cause pain along the outer side of your foot.

Nerve roots may be compressed or irritated due to a number of causes. Common examples include:

  • Lumbar herniated disc: Leaking of the inner contents of an intervertebral disc
  • Lumbar degenerative disc disease: Age-related changes causing narrowing and shrinkage of the disc
  • Spondylolisthesis: Slipping of a vertebra over the one below it
  • Lumbar spinal stenosis: Narrowing of the bony openings for spinal nerves and/or the spinal cord

The inability to lift the front part of your foot or frequent tripping while walking may be due to a condition called foot drop. This condition is typically caused due to compression of the L5 nerve root. Rarely, compression of the L4 and/or S1 nerve roots may also cause foot drop.

Foot pain caused by compression of nerves in the hip, knee, or leg

Foot pain can also occur when nerves are compressed or damaged along their path in the hip, knee, or leg. For example:

  • Peroneal neuropathy, a condition where the peroneal nerve is compressed or injured near the knee may cause foot pain and foot drop when you try to move your foot.
  • Sciatic neuropathy or damage to the sciatic nerve in the pelvic region (hip) may cause foot pain along the top of your foot with some degree of weakness.
  • Tarsal tunnel syndrome or dysfunction of the tibial nerve within the tarsal tunnel of the inner ankle may cause a sharp, shooting pain in your ankle area and along the sole of your foot.
  • Sural nerve entrapment can occur in the leg or near the ankle and typically causes shooting pain along the outer side of your ankle and/or foot.

Additionally, a corn may develop on the skin around your toes. Corns grow over time as a result of excessive friction, and they can compress nearby nerves, causing pain and other symptoms. Another possible cause of nerve pain in your foot is Morton’s neuroma, which is a thickening of the tissue around a nerve in the foot.

How to identify the source of your foot pain

With all the possible causes of nerve pain in the foot, it may be difficult to pinpoint the exact underlying cause. Here are a few useful signs to help you identify the source of your foot pain:

  • Foot pain that follows recent trauma to the lower back, hip, knee, or ankle may help indicate the site of nerve damage
  • Foot pain due to nerve root compression or sciatica may also be associated with other symptoms, such as pain, numbness, and/or weakness in the buttock, thigh, and leg; and typically affects one leg at a time
  • Foot pain that develops after wearing tight boots or shoes may indicate peroneal or sural nerve compression near the knee or ankle
  • Foot pain that develops after a hip injection or hip surgery may indicate sciatic neuropathy.

Nerve pain in the foot may also occur due to nerve damage from systemic conditions, such as diabetes or multiple sclerosis.

Twisting, bending, or a direct hit on your ankle and/or foot may injure the foot bones, ankle joint, blood vessels, muscles, and/or tendons, causing foot pain.

Schedule a visit with your doctor

It is important to schedule an appointment with your doctor to accurately diagnose the cause of your foot pain. Treatments for foot pain can differ widely and must be directed at resolving the underlying cause; not just masking the symptoms. For example, a lumbar herniated disc may require heat therapy and exercise, while a corn on your toe can often be treated with special shoes and warm water.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

2 Simple Exercises to Keep Your Feet Healthy

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Article featured on Cone Health

According to Marcus Duda, MD, a Greensboro orthopedist and member of the Cone Health Medical and Dental Staff, proper foot care is important to your health.

“During the pandemic, people became less active as gyms closed and activities stopped,” says Dr. Duda, a foot and ankle surgeon who has patented a graduated compression sock. “I started seeing a lot more foot and ankle issues.”

Many patients complained of a stone bruise or burning pain on the bottom of the foot and ankle stiffness. Achilles contracture or tendon stiffness was the culprit.

“After prolonged sitting, the Achilles tendon tightens and puts more pressure on the plantar fascia on the bottom of the foot,” shares Dr. Duda. “Stretching out this tendon takes pressure off and relieves the pain.”

Dr. Duda suggests simple exercises. While leaning against the kitchen counter with your hands, place one foot back with the heel flat on the floor and lean forward with knees straight. As you stretch the back of your calf, you should feel the stretch from your heel up through the back of the knee. Stretch for 60 seconds five times a day.

“As you age, connective tissue called fascia weakens,” he adds. “This can lead to pain and weakness in your joints and muscles along with balance problems.”

To build fascial strength, Dr. Duda recommends doing short 30-second exercises several times a day. Hold onto the counter, and face forward. With bare feet, raise up on your toes like you are trying to grab a marble while lifting your heels. Once you have enough strength, try hopping on the ball of your foot.

If your foot or ankle pain is severe or does not go away, consult with your doctor or orthopedist.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What are the Best Foot Exercises for Healthy Feet?

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Article featured on Medical News Today

What are the best foot exercises for healthy feet?

Many people experience foot or ankle pain at some point. Keeping the feet strong can help alleviate this soreness and improve overall health and flexibility.

Regularly exercising and stretching the feet and ankles can help ensure that the muscles are providing the best support. These exercises may also increase range of motion in the feet, helping keep a person active for as long as possible.

Most foot exercises are simple and require no complicated equipment to perform. People can do them at home or in the gym as part of a regular exercise routine. The following exercises can improve flexibility and mobility in the feet.

1. Toe raise, point, and curl

This exercise has three stages and will help strengthen all parts of the feet and toes.

To do this exercise:

  1. Sit up straight in a chair, with the feet flat on the floor.
  2. Keeping the toes on the floor, raise the heels. Stop when only the balls of the feet remain on the ground.
  3. Hold this position for 5 seconds before lowering the heels.
  4. For the second stage, raise the heels and point the toes so that only the tips of the big and second toes are touching the floor.
  5. Hold for 5 seconds before lowering.
  6. For the third stage, raise the heels and curl the toes inward so that only the tips of the toes are touching the floor. Hold this position for 5 seconds.
  7. Build flexibility and mobility by repeating each stage 10 times.

2. Big toe stretch

Keeping a wide range of motion in the big toe is important. The following exercise also has three stages and is designed to stretch and relieve pain in the toes from wearing tight shoes.

To do this exercise:

  1. Sit up straight in a chair, with the feet flat on the floor.
  2. Bring the left foot to rest on the right thigh.
  3. Using the fingers, gently stretch the big toe up, down, and to the side.
  4. Keep the big toe in each position for 5 seconds.
  5. Repeat this 10 times before switching to the other foot.

Exercises for strength

The following exercises can help enhance the strength of the feet.

3. Toe splay

Doing the toe splay exercise can improve control over the toe muscles. People can do it on both feet at once or on alternate feet, depending on which they find more comfortable.

To do this exercise:

  1. Sit in a straight backed chair, with the feet gently resting on the floor.
  2. Spread the toes apart as far as possible without straining. Hold this position for 5 seconds.
  3. Repeat this motion 10 times.
  4. Once a person has built up their strength, they can try looping a rubber band around the toes. This will provide resistance and make the exercise more challenging.

4. Toe curls

Doing toe curls builds up the flexor muscles of the toes and feet, improving overall strength.

To do this exercise:

  1. Sit up straight in a chair, with the feet flat on the floor.
  2. Lay a small towel on the floor in front of the body, with the short side facing the feet.
  3. Place the toes of one foot on the short side of the towel. Try to grasp the towel between the toes and pull it toward oneself. Repeat this exercise five times before switching to the other foot.
  4. To make this exercise more challenging, try weighing down the opposite end of the towel with an object.

5. Marble pickup

Doing the marble pickup can increase strength in the muscles on the undersides of the feet and toes.

To do this exercise:

  1. Sit up straight in a chair, with the feet flat on the floor.
  2. Place an empty bowl and a bowl of 20 marbles on the floor in front of the feet.
  3. Using only the toes of one foot, pick up each marble and place it in the empty bowl.
  4. Repeat this exercise using the other foot.

6. Sand walking

Walking barefoot on sand is a great way to stretch and strengthen the feet and calves. This is a good exercise in general because sand’s soft texture makes walking more physically demanding.

To do this exercise:

  1. Head to a beach, a desert, a volleyball court, or any other location with sand.
  2. Remove the shoes and socks.
  3. Walk for as long as possible. Try increasing the distance slowly over time to avoid overexerting the muscles in the feet and calves.
  4. The following exercises can be helpful for pain relief.

7. Toe extension

The toe extension is useful in preventing or treating plantar fasciitis, which is a condition that causes pain in the heel when walking and difficulty raising the toes.

To do this exercise:

  1. Sit up straight in a chair, with the feet flat on the floor.
  2. Place the left foot on the right thigh.
  3. Pull the toes up toward the ankle. There should be a stretching feeling along the bottom of the foot and heel cord.
  4. Hold for 10 seconds. Massaging the arch of the foot while stretching will help ease tension and pain.
  5. Repeat this exercise 10 times on each foot.

8. Golf ball roll

Rolling a golf ball under the foot can help relieve discomfort in the arch and ease pain associated with plantar fasciitis.

To do this exercise:

  1. Sit up straight in a chair, with the feet flat on the floor.
  2. Place a golf ball — or another small, hard ball — on the floor next to the feet.
  3. Lay one foot on the ball and move it around, pressing down as hard as is comfortable. The ball should be massaging the bottom of the foot.
  4. Continue for 2 minutes, then repeat using the other foot.
  5. A frozen bottle of water can be a soothing alternative if no suitable balls are available.

9. Achilles stretch

The Achilles tendon is a cord connecting the heel to the calf muscles. It can strain easily, but keeping it strong may help with foot, ankle, or leg pain.

To do this exercise:

  1. Face a wall and raise the arms so that the palms of the hands are resting flat against the wall.
  2. Move one foot back, keeping the knee straight. Then, bend the knee of the opposite leg.
  3. Keep both the heels flat on the floor.
  4. Push the hips forward until there is a stretching feeling in the Achilles tendon and calf muscles.
  5. Hold for 30 seconds before switching sides. Repeat three times on each side.
  6. For a slightly different stretch, bend the back knee and push the hips forward.

Foot health and safety tips

To help keep the feet strong and healthy:

  1. Complete a thorough warmup routine before exercising.
  2. Wear supportive footwear for day-to-day activities and sports.
  3. Replace worn-down shoes as often as possible.
  4. Build up strength and flexibility slowly to condition the feet and ankles.
  5. Avoid uneven surfaces, especially when running. Try not to run uphill too often.
  6. Listen to the body. Do not overdo activities.
  7. Prevent any recurrence of injury by resting and seeking appropriate treatment.

Summary

Keeping the feet and ankles healthy is a good idea. Performing the exercises above can help ease existing pain, prevent discomfort, and reduce the risk of injury.

People with a diagnosed foot condition such as plantar fasciitis or strain to the Achilles tendon may wish to try exercises to help.

Always check with a healthcare professional, if possible, before starting a new exercise and stretching routine.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday

8 Common Foot Injuries

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Article featured on Healthgrades

What to Know About Foot (and Ankle) Injuries

Inside your foot lies machinery that would impress any engineer. A total of 26 bones, 33 joints, and more than 100 tendons, muscles and ligaments work in tandem to support your weight and propel you through your daily routine. Just as the highest-tech machine can malfunction, flaws in the inner workings of your feet—or overwhelming demands from the outside—can cause injuries. Here are eight problems that can strike your feet, along with solutions.

1. Neuromas

Too-tight or high-heeled shoes, among other causes, can compress the nerves between your toes. Most often, this occurs between your third and fourth toes, a condition called Morton’s neuroma. The pain, tingling, and numbness of a neuroma can often be relieved with padding, icing, orthotics, and wearing shoes with a wide toe box and low heels.

2. Stress Fracture

Among the more severe sports injuries, stress fractures often occur when you overdo a high-impact activity like running, dance or basketball. Fatigued muscles transfer stress to the bone. A small, hairline crack forms, causing potentially severe pain. Though stress fractures can occur in any part of your foot, they most often form in the second and third metatarsals, or long toe bones. Rest allows your bones to heal, usually in 6 to 8 weeks.

3. Plantar Fasciitis

Does the first step out of bed in the morning have you howling in pain? You likely have plantar fasciitis, an inflammation of the band of tissue—facscia—connecting your toes to your heel on the bottom of your foot. High-impact sports, extra weight, and jobs that require walking or standing on hard surfaces increase your risk. Stretch your foot and calf frequently, and consider wearing a night splint that lengthens your plantar fascia while you sleep.

4. Heel Spurs

Heel spurs occur when calcium deposits build up on the bottom of your heel bone. Often, they don’t cause pain themselves—but they can irritate the plantar fascia, triggering pain along the arch and heel. Calf and foot stretches work well to relieve it; rarely is surgery to remove the spur necessary.

5. Bunions

This bump of bone and tissue at the base of your big toe forms when the joint connecting it to your foot shifts out of place. Narrow-toed and high-heeled shoes cause most cases, though heredity plays a small role. Left untreated, bunions can cause pain so severe it limits your ability to walk. Fortunately, treatments like ice, over-the-counter foot pads, and wearing shoes with wider toe boxes often bring relief.

6. Sesamoiditis

Your sesamoids—two pea-shaped bones lodged in the tendon beneath the ball of your foot—help the big toe move normally. Activities that place strain on the ball of the foot, including running and golf, can injure the bones, tendons, or surrounding tissue. Padding, strapping, or taping the foot can relieve pressure on the sesamoids, while anti-inflammatory drugs reduce pain and swelling.

7. Achilles Tendinitis

The lengthy Achilles tendon can grow thick, inflamed, swollen or painful when asked to do too much, too soon (for example, after beginning an ambitious exercise program). Tight calf muscles may also play a role. Often, pain decreases after switching from a high-impact exercise to a cross-training program, such as biking, elliptical or swimming, paired with moves to stretch and strengthen the calves.

8. Ankle Sprains

About 25,000 people fall, step or twist their way into an ankle sprain each day. This common injury occurs when the ligaments on the outer side of your ankle stretch or tear, causing pain, swelling, and sometimes an inability to bear weight. Talk with a doctor if that’s the case, or if you have severe swelling or deformity. For mild sprains, rest, ice, compression and elevation—the RICE protocol—usually does the trick.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm