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Monday, July 27, 2015

Congratulations to all the San Francisco Full and Half Marathons 7-26-15

Saturday, July 25, 2015

Inverted Orthotic Technique Patent Request for the Kinetic Blake!!

After designing an orthotic device in 1981, it is fun now seeing it being used in various designs, etc. Here is a patent design for a product called the "Kinetic Blake"!!!

Insect Bite: Email Quite

I took my 2 year old to the park and she came back with what looked like a mosquito bite on her foot. I disinfected it with alcohol.She complained about it but I thought it would heal on its own.However a few days ago there was a bump where the mosquito had bitten her. This morning she woke up with what appears like a bruise.Her foot is swollen around the bite and has a blue and purple color spread all around her foot. She seems to be experiencing some discomfort. What should I do?

Dr Blake's comment: In this situation, with a spread of possible infection, I would definitely go to the ER. They will access things, and probably place her on antibiotics. Warm Water soaks for upwards of an hour can be helpful and drawing out an infection. You can repeat this every few hours. You can also use a damp warm face cloth against the skin, and then wrap this with saran wrap around the entire area. This is called a Koch Mason dressing. Check her temperature now and every few hours. If her pediatrician is available, let him or her know. Do not mask the pain with any medications for now. See what the ER docs have to say. I hope this helps her. Rich

Friday, July 24, 2015

Bunion and General Foot Strengthening Exercise

This exercise I teach for bunions, but it can be a next level exercise after conquering 30 reps of  the more simple metatarsal doming for foot strengthening. Remember to do these in the evening, and never through pain. 

Pronation Analysis through Running Warehouse

Excessive Pronation while you walk or run can be a cause of many injuries. This is a nice video on the evaluation of your amount of pronation. Because high arch, normal arch, and flat feet can all overly pronation, the wet foot test is interesting but can be misleading. To a lesser degree, the forefoot wear test can be influenced by the terrain you run, and your strike pattern (heel strike, midfoot strike, or forefoot strike). So, I believe the video tape method is the most reliable. Running Warehouse offers a free evaluation if you send them a clip from you phone or tablet. Hopefully, there is not too many strings attached. Happy Running!!!

Friday, July 17, 2015

7 Tips from Harvard for a Great Strengthening Program

Demonstration of Hip Abductor Strengthening

Strengthening your body is a life long goal. Here are 7 tips from  Harvard Medical that can prevent you for doing too much or not enough. Hope it helps. Rich

Thursday, July 16, 2015

Achilles Spurs: What should we do?

The image above shows clearly a painful achilles spur. Surgeons like to remove them, but it can be a long recovery. It is not a common surgery, so if it is being recommended, be a little cautious. Try wearing Achilles Gel Pads from Silpsos to see if it is more shoe irritation. Try to do the Plantar Fascial Wall Stretch 3 times daily to breakup scar tissue. Go to physical therapy to strengthen, stretch, and de-inflame. And, if necessary, wear a Removable Boot (cam walker) for 3 months to rest the area. 

FDA warns against any use of NSAIDS (July 2015)

From Google Images

The FDA just came out with more severe warnings against NSAIDS, like ibuprofen, aleve, and diclofenac. Since these drugs are common place in sports medicine practices, it will take some time to filter down to the athletes, coachs, and health care providers. Increase use of icing, contrast bathing, rest, topical sauves, etc, will be encouraged. 

Please see all of the tips at the end of the following blog post on reducing inflammation, even if an area does not appear swollen. 

More from Dr Blake: 

Over the years I have gradually shifted away from drugs and shots for anti-inflammatory measures after an acute injury. So you start with 4 days of straight icing after injury, then begin to add some heat. Yet, most of my patients are in the subacute or chronic states of their injuries at any given time. It is a time of gradual restrengthening and gradual return to full activity. How is the inflammation handled in this arena? Typically, I love (2) 10-15 minute ice packs daily and contrast baths at 4 minute hot to 1 minute cold ratio 3-5 times per week. The patient of course needs to try to control their activities so as not to keep the tissue inflamed and aggravated. NSAIDS (like advil and aleve) can be used  prn (as needed).  Never take the drug within 6 hours before exercise to mask pain. When the inflammation seems deep set and hard to more out (like a squatter!), consider topical anti-inflammatories like flector patches, voltaren gel, traumeel, arnica, compounding formulations, zyflamend, or biofreeze/mineral ice. You can also get an Rx for PT (consider 5 sessions of iontophoresis with dexamethasone or cupping) or acupuncture. 

Sunday, July 12, 2015

Having Fun after Sesamoid Surgery!!!

This is a young lady whom I helped online in an attempt to avoid surgery. It is crucial of course now that there is only one sesamoid left to wear some form of dancer's padding while she is participating in impact sports forever. So simple, but often forgotten. 

Hey!!  Yes sir, the surgery is finished (I had it on 
April 16th) and I am already back to everything.  I ran 4 miles this past Friday and I'm playing tennis later today... and I was able to wear some high heels for my birthday dinner yesterday :)  I am a very, very happy camper.  

The podiatrist said that the sesamoid wasn't necessarily fractured when he took it out, but he said that the cartilage all around it was worn down, and that everything was very inflamed.  It was the right call to do the surgery.  

I'm so thankful to have a new lease on life :)  It's the best feeling ever!  God bless you and your help throughout this long process.  It is people like you who make the world a better place, and you give people hope.  Thank you for being you.  

My best, 

Thursday, July 9, 2015

Ideal Running Form

Ideal Running Form: Slight Forward Lean of Trunk, Powerful Swing of the Arms, Foot not too far in front of body, and very little bounce up and down of the head
If you never have walked a Labyrinth you should. It is a mirror of our spiritual journeys. At times, we are so close to our Center, only to feel miles away minutes later. The correlaries to our own paths are worth reflecting on.

Wednesday, July 8, 2015

Another Video on Calmare Pain Therapy: CRPS and other forms of severe pain can benefit

Bisecting the Negative Cast for Orthotic Manufacturing

I apologize for most of my readers that this means little, but this bisection line on the back of a negative cast to me is crucial in designing orthotic devices. To complicate matters worse, the bisection line must be "tangent to the curve on the lateral side of the heel", whatever that means. I know what it means of course. But, when you are learning this stuff, it can be difficult, and sometimes impossible to learn. The lateral side of the heel is the opposite side from the level, and looks fairly straight. When you use Root Biomechanics, 1 degree changes are important, so a heel bisection 2 or 3 degrees off, can be disasterous. With the Inverted Orthotic Technique, with a rough estimate of 5 degrees of cast inversion to 1 degree foot correction, the exact bisection is not as crucial. 

Inverted Orthotic Technique for Severe Pronation: A Study Attempting to Document what it Actually Does

In 1981 I designed the Inverted Orthotic Technique, also called the Blake Inverted Orthosis. It is well accepted in the world for helping patients, as this study states, but what does it actually do to the running mechanics is hard. I wish I was around the design of these studies to individualize the amount of correction and the modifications necessary based on Strike patterns. But, I am happy it helps patients every day around the world.

Tuesday, July 7, 2015

Running Downhill: Go Gentle

 "Combined with previous biomechanics studies, our normal impact force data suggest that downhill running substantially increases the probability of overuse running injury." This is one of the summary statements from the article below. Having practiced Podiatry in San Francisco, with it's 46 official hills, I know the damage running downhill. Runners just have to be smart about them. Charge up the hills and slow down the down hills!! The force of running at impact is between 2-5 times body weight. Running fast and hard down hills can increase them force. Be kind to your body and you will run longer!!

Charge up the hills, and go gently down them

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