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Friday, January 19, 2024

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.

Tuesday, January 16, 2024

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

Tuesday, January 9, 2024

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.

Monday, January 8, 2024

Sunday, January 7, 2024

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

 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