Ice Submersion for Acute Injuries

Great video on Diagnosing Plantar Plate Tears on MRI

https://youtu.be/JQxweI_KJzY

Excellent Article about Rotating Different Types of Shoes: Great Common Sense

https://run.outsideonline.com/gear/the-three-different-shoes-every-runner-needs/

Sesamoid Fracture presenting as a BiPartite Sesamoid

Only the abstract is linked here. It shows the dilemma patients are left with when they have bi- or tri-partite sesamoids. Fractures are missed and a needless year of suffering is documented here. We fracture at weak spots in bone. The junction between two fragments of bone like a bipartite sesamoid is such a weak spot. In so many cases, the injury is called a normal variant, and the possibility that there is a possible fracture is dismissed. If you have pain in your big toe joint, and the x-ray shows a bipartite or tripartite sesamoid, discuss the probability that this can be a fracture with your physician. 

https://www.jfas.org/article/S1067-2516(18)30550-7/fulltext

NSAIDS (like advil and aleve) can Affect Bone Healing

A well known fact is NSAIDs (non steroid anti-inflammatory drugs) can slow down bone healing. And like anything, one person will be greatly affected and another almost not at all. If you need to decrease inflammation, ice and contrast bathing remain the non drug of choice for home treatments. And of course, Physical Therapy is wonderful with their machines to reduce inflammation. There are also homeopathic remedies, acupuncture, etc. 

https://pubmed.ncbi.nlm.nih.gov/30260913/

Sesamoid Fractures: Typical Orthopedic Approach with Comments

     I have just retired. My time now can be more involved in this blog I started almost 14 years ago. One of the injuries I write about, and treated extensively, was sesamoid fractures. I just received emails from two readers about sesamoid injuries. All doctors will treat injuries slightly differently. When I read the article below, I would emphasize the importance of some treatments more. But, overall the article is well written. Exogen bone stimulators are a must to me. 3 months of cast or bike shoe immobilization is very important. Daily contrast bathing. Evaluation of Vit D and overall bone density is crucial. Orthotic devices with off weighting the sesamoid needed. Spica taping to limit big toe bend can get patients back into activity. Avoiding NSAIDS since they can retard bone healing. Ice activity aggravation. Hope this helps. Rich

https://orthoinfo.aaos.org/en/diseases--conditions/sesamoiditis

Stretching Achilles and Plantar Fascia for Plantar Fasciitis: You Have to Stretch Both

https://journals.sagepub.com/doi/10.1177/1071100717732762

Here is a helpful video!!

https://youtu.be/0eAqJ4-oKTM?si=t0NBhcIL1OsY_Oe_

Slowing Pace Down can Improve Knee Pain

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0295645

If Your Child Has Very Flat Feet, here is a Checklist for the Doctor to Evaluate

https://pubmed.ncbi.nlm.nih.gov/10943496/

Plantar Fasciitis: Stretching May Be Your Best Treatment

Stretching of the achilles for plantar fasciitis may be the best treatment overall per this article. I have attached a video on Plantar Fascia Stretching for your information. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6134886/

https://youtu.be/0eAqJ4-oKTM?si=bXkfMjxZBGzE4Qqx

One of the Most Predictable Reasons for an Injury: You had the same one less than 12 months ago

Why is this important? Because healing the injury is one thing, getting at the cause and reversing it is another thing totally!!!

https://link.springer.com/article/10.1007/s40279-014-0194-6

Comparison on 15 and 25 Degree Inverted Orthotic Devices on Lower Extremity

The following paper is a good look at the dynamics of 2 Inverted Orthotic Devices (15 degrees and 25 degrees) and the Shoe alone. There are questions around the loss of ankle plantar flexion motion with the 2 inserts vs shoe only which has possible explanations on the positive and negative side. At foot loading, a loss of ankle plantar flexion probably only implies that the orthosis is supporting the arch and less ankle plantar flexion range is needed. But, does a loss in ankle plantar flexion at toe off imply a more inefficient push off or a more stable foot with less plantar flexion needed for push off? The summary of angles in the paper show these findings are less than 1 degree in amount in any direction, but of the the 31 subjects the variation could have been more or less. 

     If you are looking for a good paper on Inverted Orthoses, this one is very good with 60 plus references to sink your teeth into. Rich Blake

J Multidiscip Healthc. 2023; 16: 2613–2623.

Published online 2023 Sep 5. doi: 10.2147/JMDH.S420003

Effect of Different Foot Orthosis Inverted Angles on Walking Kinematics in Females with Flexible Flatfeet

Nour Alsaafin, 1 , 2 Nabil Saad, 1 Shima A Mohammad Zadeh, 1 , 2 and Fatma A Hegazy 1 , 2