Reston, Manassas, and Leesburg, foot and ankle surgeon says new procedures, techniques speeding patients' recoveries
Reston, Manassas, and Leesburg Virginia 11/10/2017 Many Achilles tendon surgery patients in Reston, Manassas, Leesburg are getting back on their feet faster, thanks to new procedures and techniques.
Steven Gordon, DPM, FACFAS, a foot and ankle surgeon with offices in Reston, Manassas, and Leesburg, says the introduction of tissue graft products, bone anchors, radio frequency treatments and new arthroscopic procedures provide patients with less invasive treatments and speedier recovery times.
"These surgical advances will shorten recovery times for many patients, allowing them to get back to their jobs and active lifestyles in less time," says Gordon.
The Achilles tendon connects the calf muscle to the heel bone in the back of the leg and facilitates walking. The most common Achilles condition is tendonitis, an inflammation of the tendon. Gordon says most tendonitis cases can be successfully treated with non-surgical methods such as rest, ice, anti-inflammatory medications and physical therapy.
But some tendonitis patients develop scar tissue on the tendon, or their tendon fibers weaken and develop microscopic tears, a condition called Achilles tendinosis. Fixing these problems may require surgery and weeks to months of recovery.
Gordon says recently-introduced radio frequency technology can shorten recovery time for some patients by using radio waves to stimulate healing in the tendon. The procedure requires smaller incisions to insert the wand-like radio frequency device. Smaller incisions mean less damage to skin and muscle, less pain, and lower risk of surgical infections. Patients recover faster.
Overuse, especially in athletes, can cause the Achilles tendon to tighten and pull so hard on the heel bone that a bone spur, or bump, develops. Shoes can rub against the spur and cause pain. In addition, a painful fluid-filled sac called a bursa can develop between the heel bone and the tendon. Traditionally, correcting this tightness involved cutting the tendon, removing the bone spur or bursa, and then reattaching the tendon.
According to Gordon, new arthroscopic techniques can provide a minimally invasive option to removing bone spurs and bursas without significant damage to the Achilles tendon. When the tendon does have to be surgically detached, new bone anchor constructs (screws that are drilled into the heel bone to secure the tendon and tissues) can reattach the tendon, minimizing the chance of a potentially painful knot developing on the back of the heel.
Achilles tendon ruptures are the most serious Achilles injuries. Most patients require surgery to decrease the likelihood of a re-rupture. Various techniques are available, and increasingly may include tissue grafts used as a bridge to link the detached tendon lengths. The graft provides a scaffold on which new tissue grows, increases the overall strength of the repair, and is usually absorbed by the body within a year.
Go to the ACFAS consumer Web site, FootHealthFacts.org, for reliable information on Achilles tendon problems.
Foot and ankle surgeons share reassuring insight on managing pain after surgery
Reston, Manassas, and Leesburg, Virginia 11/09/2017 – With any surgery comes reasonable concerns. Depending on the person, your mind could start racing anywhere from the seriousness of your condition, to the procedure itself, to out-of-pocket costs or the required downtime. However, when it comes to foot and ankle surgery, there is the inevitable question: How bad will it hurt afterward?
Even if you have a high tolerance for pain, the unfortunate truth is that pain can accompany the healing process following any surgery. “But, with the proper care, healing after foot and ankle surgery can be more comfortable than people might expect, according to Virginia- based foot and ankle surgeon and American College of Foot and Ankle Surgeon Fellow Member, Steven Gordon, DPM AACFAS.
“With the availability of such a large variety of highly effective pain medications, fear of pain should be the last deterrent keeping patients from having foot or ankle surgery. Patients can take comfort in knowing that as surgeons, we have an equally vested interest in keeping them comfortable so their surgical experience is positive and they have a speedy recovery,” said Dr. Gordon
Dr. Gordon explains that patients can receive a local, long-lasting anesthetic immediately following surgery, which significantly decreases pain. Also, in today’s healthcare climate where efforts to reduce prescription drug addiction are at an all-time high, there are stronger anti-inflammatory medications available, which can eliminate the need for pain relievers containing narcotics.
Of course, not all pain being created equal, there are other options for patients to manage their comfort levels following surgery. Depending on the expected degree of pain, patients can take home a pain pump, which allows them to self-administer pain medication intravenously, allowing for a faster and more potent delivery.
“Ultimately, if a patient needs to undergo surgery, it clearly means something is wrong and requires medical correction or extraction. That in mind, we want to help patients feel good about their surgery and think about how better they will feel afterward, versus the pain during healing,” reasons Dr. Gordon.
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Pain Management After Foot Surgery
In addition to medication, a tried and true method in controlling pain following foot or ankle surgery is to apply rest, ice, compression and elevation (RICE). “Using the RICE method reduces swelling in the surgical area. By reducing the swelling, inflammation is minimized, which in large part lowers pain," added Dr. Gordon.
The American College of Foot and Ankle Surgeons recommends patients talk to their foot and ankle surgeon before their procedure to determine how much pain they can expect and the plan of action for managing their pain after surgery.
For more information on controlling your pain after foot or ankle surgery, contact Dr. Gordon at (703) 368-7166 (703) 368-5103, or visit the American College of Foot and Surgeons’ patient education website at FootHealthFacts.org.
Don’t let foot injuries keep you from your fitness resolutions
(Reston, Manassas, and Leesburg, VA – 11/3/17) -- In the New Year, don’t forget to keep your feet in tip-top shape while following through with your resolutions to get fit. Northern Virginian foot and ankle surgeon Steven Gordon, DPM, FACFAS, offers tips for foot safety while at the gym.
Start new workouts gradually— Increase your stamina and the length of your workouts gradually to avoid overuse injuries such as stress fractures or tendon strains and sprains. Stretching your muscles before and after workouts also helps prevent these types of injuries. “If you do feel you’ve sprained your ankle, be sure to seek treatment right away,” Dr. Gordon, a member of the American College of Foot and Ankle Surgeons explains. “Untreated or repeated ankle sprains may lead to chronic ankle instability, a condition that causes persistent pain and a ‘giving way’ of the ankle.”
Wear the right shoe and sock—Wear well-fitting athletic shoes designed for the exercise or sport. According to Dr. Gordon, shoes that don’t support the arch of the foot and provide cushion for the heel can cause heel pain (plantar fasciitis). Shoes that are too small can also cause a neuroma or a thickening of the nerve tissue, in the foot and may require injections, medication or physical therapy. Wearing cotton or non-slip socks are also key to help avoid painful blisters, which can become infected and cause more serious issues.
Use good technique— Improper exercise techniques can result in injury to the tendons or ligaments in your feet and ankles. “Incorrect posture or misuse of exercise equipment can cause decreased stabilization in the foot and ankle, leading to joint sprains and muscle strains,” Dr. Steven Gordon says.
Protect yourself from bacteria—Sweaty shoes, public showers, exercise equipment and the pool deck at the gym are breeding grounds for fungus, viruses and bacteria, including drug-resistant strains like MRSA (methicillin-resistant Staphylococcus aureus) which has become increasingly more common. Never go barefoot while in public areas; water shoes can provide a great barrier between your feet and the wet surfaces. “It’s also best to cover cuts and cracks in the skin or ingrown toenails since these minor tears in the skin’s surface can act as entry points for bacteria. If you have a cut or scrape that becomes red or swollen and is not healing in a timely manner, don’t hesitate to see a foot and ankle surgeon for an examination,” Dr. Gordon says.
Keeping Deadly Clots at Bay After Foot Surgery
Medication, movement can prevent DVT, pulmonary embolism
Reston, Manassas, & Leesburg October 26, 2017 Each year in the United States, pulmonary embolisms (PE) kill more people than AIDS, breast cancer and motor vehicle crashes combined. According to (CITY/REGION) foot and ankle surgeon Steven Gordon, DPM, AACFAS, this little known condition occurs when a blood clot in the leg travels to the lungs, blocking one or more arteries.
Most recently, news that tennis star Serena Williams suffered a PE after undergoing surgery is raising awareness about the condition, its risk factors and how to prevent the potentially deadly condition from occurring.
The blood clots that cause PE often originate in the deep veins of the leg, a condition called deep vein thrombosis or DVT.
Dr. Gordon explains that women are at the highest risk for blood clots and pulmonary embolism as well as men and women who are overweight, smokers and those taking oral contraceptives. “Surgery is also one of the leading causes of blood clots in patients, which means those at highest risk need to be diligent in speaking to their surgeon about their elevated risks so preventive measures can be taken,” Dr. Gordon said.
Patients facing surgery should take note, though, that blood clots in the leg are relatively rare after foot and ankle surgery, Dr. Gordon said. In addition, the clots can be prevented with medication and exercise.
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Depending on a patient’s risk factors, the surgeon may decide to prescribe an anti-clotting medication to prevent DVT. The most common medications are low-molecular weight heparins, which patients inject into their arm, leg or stomach for about two to three weeks after surgery.
Patients with confirmed DVT, which is diagnosed with an ultrasound, may be put on warfarin (Coumadin) for six months to a year to prevent new clots from forming.
Patients also would be advised to get up and move around after surgery — even if they are wearing a cast or using crutches.
“The biggest recommendation you see in the airline magazines when you’re flying is to move your legs to prevent DVT, because people who sit on a long flight have a high incidence of DVT,” Dr. Gordon explained. “Similarly, if you’re sitting after surgery and the blood is not moving in the calf and you’re not exercising, you could end up with a clot in your calf. Surgeons have learned over the years that getting people moving after surgery will reduce the risk of a clot causing a pulmonary embolism.”
Symptoms of pulmonary embolisms vary and can mimic those of other conditions such as a heart attack. The most common signs include sudden, unexplained shortness of breath, chest pain and a cough that produces blood-tinged mucus. “Other symptoms may include wheezing, leg swelling, excessive sweating, rapid heartbeat and fainting,” adds Dr. Gordon. “Pulmonary embolisms can occur quickly, and prompt medical attention is vital for recovery, so patients need to seek care if they are suffering from any of the symptoms associated with the condition.”
If you are suffering from foot or lower leg pain or have concerns about your foot health, call Dr. Gordon’s office at (703) 368-7166 or (703) 437-6333 for an evaluation.
Reston, Manassas, and Leesburg Virginia–As brightly colored leaves dazzle the fall landscape, hikers and hunters nationwide will migrate to mountains, woods and fields, but many, unfortunately, are ill prepared for the beating their feet will take, warns a local foot and ankle surgeon.
“Hikers, hunters and others who love the outdoors often don’t realize how strenuous it can be to withstand constant, vigorous walking on uneven terrain,” Steven Gordon, a member of the American College of Foot and Ankle Surgeons (ACFAS) located in Reston, Manassas, and Leesburg, Virginia "Lax physical conditioning and inappropriate footwear bring scores of outdoor enthusiasts into our office each fall for treatment of foot and ankle problems such as chronic heel pain, ankle sprains, Achilles tendonitis, fungal infections and severe blisters."
“Walking up and down steep hillsides and tramping through wet, slippery fields and wooded areas puts stress on the muscles and tendons in the feet and ankles, especially if you haven’t conditioned properly before hitting the trail,” said Gordon. “Also, many don’t realize that cross-training athletic shoes aren’t the best choice for extended hiking and hunting. Had some of my patients worn sturdy, well-constructed hiking boots, they wouldn’t have suffered sprained ankles or strained Achilles tendons.”
Gordon advises hikers and hunters to make the investment in top-quality hiking boots. He said strong, well-insulated and moisture-proof boots with steel or graphite shanks offer excellent ankle and foot support that helps lessen stress and muscle fatigue to reduce injury risk. “The supportive shank decreases strain on the arch by allowing the boot to distribute impact as the foot moves forward. So if a boot bends in the middle, don’t buy it.”
In wet and cold weather, wearing the right socks can help prevent blisters, fungal infections and frostbite. Gordon recommends synthetic socks as the first layer to keep the feet dry and reduce blister-causing friction. For the second layer, wool socks add warmth, absorb moisture away from the skin, and help make the hiking boot more comfortable. “Wool lets moisture evaporate more readily than cotton, so fewer blisters develop,” He added.
What happens if your feet or ankles hurt during a hike or hunt? Gordon said pain usually occurs from overuse, even from just walking. “If you’re not accustomed to walking on sloped or uneven ground, your legs and feet will get tired and cause muscles and tendons to ache,” He explained. “To avoid a serious injury, such as a severe ankle sprain or an Achilles tendon rupture, rest for a while if you start hurting.”
According to the ACFAS consumer website, FootHealthFacts.org, pain is a warning sign that something is wrong. “Serious injury risk escalates significantly if you continue hiking in pain.” He likened hiking to skiing, in that beginners should take on less difficult trails until they become better conditioned and more confident.
Evaluation by a foot and ankle surgeon is recommended if there is persistent pain following a hiking or hunting outing. “I’m most concerned about ankle instability and strained Achilles tendons. Inattention to these problems at their early stages may lead to a serious injury that will keep you off the trails for a long time,” Gordon said.
Hikers and hunters seeking further information about ankle sprains, Achilles tendon injuries and other foot and ankle problems may contact Dr. Gordon at 703-368-7166 or 703-437-6333
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