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Posts for: June, 2015

Indoors and outdoors, youth athletes stay active year-round in competitive sports, and for many of them heel pain has become “just another part of the game.” Foot and ankle surgeon, Steven A. Gordon, DPM, FACFAS, advises that when a child complains of heel pain, it should be diagnosed promptly because it may be a warning sign of a serious foot problem.  

Dr. Gordon, a member of the American College of Foot and Ankle Surgeons, says heel pain occurs frequently in children ages 6 to 14 as their feet grow and the heel bone develops. “As children become more active in sports they increase their risk for growth-plate injuries and subsequent heel pain,” says Dr. Gordon. This is especially true at back-to-school time when surgeons see an increase in middle and high school athletes experiencing heel pain with football and soccer seasons simultaneously underway.  

“New bone forms in an area behind the heel, known as the growth plate, and cartilage is vulnerable to severe inflammation from strain or stress. With repeated stresses and strains from over activity, the heel becomes very painful,” Dr. Gordon explains.

Even though growth-plate trauma is the leading cause of heel pain in young people, Dr. Gordon says the condition can be difficult to diagnose. He cautions that parents should be concerned if a child has pain in the back or bottom of the heel, limps, walks on the toes, or seems to have difficulty participating in normal recreational activities. The condition is diagnosed by a thorough examination of the child’s feet and legs and possibly medical imaging tests to rule out other serious causes of heel pain, such as bursitis, tendonitis and fractures.

In most cases, mild or moderate heel pain can be treated successfully with shoe inserts to soften the impact on the heel, anti-inflammatory medications, stretching and physical therapy. In severe cases, the foot and ankle will be immobilized in a cast and, in some instances, surgery may be necessary.

Heel pain in young people often returns after treatment because the growth plate is still forming until the age of 14 or 15. However, the risk for recurrence can be lowered by choosing well-constructed shoes with good support and restricting use of spiked athletic shoes, especially on hard fields. It also is advised that young athletes avoid competition that exceeds their physical abilities.

If your child is experiencing heel or foot pain, call Dr. Gordon’s office at (703) 437-6333 for an assessment.   

For more information on heel pain in children visit the American College of Foot and Ankle Surgeons’ Web site, FootHealthFacts.org.

 

 

 


Foot injuries common after storms, hurricanes, or tornados

(Reston, Manassas, and Leesburg, VA – 6/19/15) – With storm season officially underway, a Northern Virginia foot and ankle surgeon reminds residents about the risk of serious foot injuries during disaster clean-up.

“In the aftermath of a storm, people just want to clean up the debris as fast as they can and get on with their lives,” says Steven Gordon, DPM, FACFAS, a foot and ankle surgeon with offices in Reston, Manassas, and Leesburg. “By taking some simple precautions to protect their feet from injury, they can make the cleanup go more quickly and more safely.”

Many hurricane or tornado survivors suffer puncture wounds on their feet. After Hurricanes Katrina and Rita, foot and ankle surgeons along the Gulf Coast reported treating patients who injured themselves wearing flip-flops and sandals during debris clean-up. Some patients developed bone infections from improperly treated puncture wounds caused by nails and other sharp objects.

According to the American College of Foot and Ankle Surgeons’ (ACFAS) FootHealthFacts.org Web site, puncture wounds require medical treatment within 24 hours to avoid infection and other complications from embedded foreign objects. Pieces of skin, sock and the shoe itself can be forced into the wound during a puncture, as well as dirt and debris from the object itself. If medical care is inaccessible, every hurricane survival kit should include first aid supplies.

“If you can’t get to a doctor, you can still irrigate the wound, apply a topical antibiotic, and a clean bandage,” says Gordon. “Then see a doctor for follow- up care, including a tetanus shot if necessary.”

After initial treatment, the ACFAS recommends puncture wound victims see a foot and ankle surgeon for a thorough cleaning and careful follow-up to monitor the wound for infection and to prescribe antibiotics if necessary.

Other storm foot safety tips include:

Watch where you walk. Debris and murky floodwaters can conceal sharp objects. Be careful standing on unstable surfaces and piles of debris that can throw you off balance, causing ankle sprains or fractures.

Wear appropriate shoe gear, work boots if possible. Don’t go barefoot. Avoid open-toed footwear like sandals.

Take precautions when cutting down tree limbs. One hurricane victim broke several bones when sawing down a heavy tree limb that landed on her foot.

For treatment of puncture wounds or other foot or ankle trauma, contact Dr. Gordon in the Reston office at 703-437-6333, Manassas office at 703-368-7166, or Leesburg office at 703-777-2101.


Reston, VA Both long-distance runners and casual joggers can improve their performance by keeping their feet in top condition and taking steps to control foot problems common in runners, according to a Reston foot and ankle surgeon.

"The human foot is a biological masterpiece that amazingly endures the stresses of daily activity," says Steven Gordon, DPM, FACFAS, a member of the American College of Foot and Ankle Surgeons (ACFAS). "For runners, the feet are more vulnerable to injury than any other part of the body, and these athletes should be on the alert for signs of foot problems that can slow them down if not treated promptly."

Dr. Gordon says the most common complaint from runners is heel pain. This condition, also called plantar fasciitis, is frequently caused by inflammation of the ligament that holds up the arch.

"In athletes, heel pain can result from faulty mechanics and over pronation in which pressure is unequally applied to the inside of the foot. It also can be caused by wearing running shoes that are worn out or too soft," he explains.

At the first sign of heel pain, Dr. Gordon recommends runners do stretching exercises, wear sturdier shoes and use arch supports. In some cases, icing and anti-inflammatory drugs, such as ibuprofen, are helpful. Should heel pain continue, custom orthotics, injections and physical therapy might be required. Surgery normally isn’t considered unless heel pain persists for more than a year and conservative treatment has failed to bring relief.

Neuromas and tendonitis are other common foot problems that affect runners. A neuroma is a pinched nerve between the toes that can cause pain, numbness and a burning sensation in the ball of the foot. Overly flexible shoes often are the cause and padding, orthotics or injections usually are effective. Sometimes surgery is the answer if pain between the toes continues for more than six months.

Serious runners can be sidelined with tendonitis if they ignore the warning signs of this overuse-related condition.

"There are several forms of tendonitis that affect the Achilles and other areas, and all are treated with rest, icing, stretching and anti-inflammatory medications, and sometimes with orthotics and physical therapy." Dr. Gordon says. "Over-zealous training usually causes tendonitis, especially among beginners who try to do too much too soon."

A common myth among athletes, according to Dr. Gordon, is that it’s not possible to walk or run if a bone in the foot is fractured.

"I often hear surprised patients say ‘It can’t be broken, I can walk on it,’" he says. "That’s dead wrong, especially with stress fractures when pain and swelling might not occur for a few days."

If a fracture or sprain is suspected, DR. Gordon advises runners to remember the word RICE as an abbreviation for Rest-Ice-Compression-Elevation.

"If pain and swelling continues after following the RICE procedure for three or four days, you should see a foot and ankle surgeon for an x-ray and proper diagnosis."

Other common foot ailments runners should watch for are:

Athlete’s Foot: This fungal skin disorder causes dry, cracking skin between the toes, itching, inflammation and blisters. It can be prevented and controlled by washing the feet regularly and carefully drying between the toes; switching running shoes every other day to allow them to dry; wearing socks made with synthetic material instead of cotton; and applying over-the-counter ointments.

Toenail Problems: Ingrown nails can cause inflammation and possible infection and usually are treated by cutting the corner of the nail with sterile clippers. Black toenails happen when a blood blister forms under the nail from trauma, and it’s best to let the nail fall off by itself. Fungal toenails are yellow, brown or black and sometimes are irregularly shaped and thick. They are best treated with oral anti-fungal medications.

Foot Odor: There are more than 250,000 sweat glands in the foot and daily hygiene plus regular changing of shoes and socks are best for controlling sweat and odor. Runners should avoid wearing cotton socks and running without socks. Foot powders, aerosols antiperspirants and vinegar soaks also are helpful.

Blisters, corns and calluses: Never pop blisters unless they are larger than a quarter or are painful or swollen. Use a sterile instrument to lance the corner, leave the top as a biological dressing, wash, apply antibiotic ointment, and cover with a Band-Aid. Corns and calluses are caused by repeated friction, and should be treated by aseptically trimming the dead skin and eliminating the underlying cause.

Contact Dr. Gordon's office at (703) 437-6333 for more information on these conditions, or visit the ACFAS consumer Web site, FootHealthFacts.org.

 


Runners: Fit feet finish faster

(Reston, Manassas, and Leesburg, VA – 6/5/15) Both long-distance runners and casual joggers can improve their performance by keeping their feet in top condition and taking steps to control foot problems common in runners, according to a Northern Virginia foot and ankle surgeon.

The human foot is a biological masterpiece that amazingly endures the stresses of daily activity," says Steven Gordon, DPM, FACFAS, a member of the American College of Foot and Ankle Surgeons (ACFAS). "For runners, the feet are more vulnerable to injury than any other part of the body, and these athletes should be on the alert for signs of foot problems that can slow them down if not treated promptly."

Gordon says the most common complaint from runners is heel pain. This condition, also called plantar fasciitis, is frequently caused by inflammation of the ligament that holds up the arch.

"In athletes, heel pain can result from faulty mechanics and over pronation in which pressure is unequally applied to the inside of the foot. It also can be caused by wearing running shoes that are worn out or too soft," he explains.

At the first sign of heel pain, Dr. Gordon recommends runners do stretching exercises, wear sturdier shoes and use arch supports. In some cases, icing and anti-inflammatory drugs, such as ibuprofen, are helpful. Should heel pain continue, custom orthotics, injections and physical therapy might be required. Surgery normally isn’t considered unless heel pain persists for more than a year and conservative treatment has failed to bring relief.

Neuromas and tendonitis are other common foot problems that affect runners. A neuroma is a pinched nerve between the toes that can cause pain, numbness and a burning sensation in the ball of the foot. Overly flexible shoes often are the cause and padding, orthotics or injections usually are effective. Sometimes surgery is the answer if pain between the toes continues for more than six months.

Serious runners can be sidelined with tendonitis if they ignore the warning signs of this overuse-related condition.

"There are several forms of tendonitis that affect the Achilles and other areas, and all are treated with rest, icing, stretching and anti-inflammatory medications, and sometimes with orthotics and physical therapy." Dr. Steven Gordon says. "Over-zealous training usually causes tendonitis, especially among beginners who try to do too much too soon."

A common myth among athletes, according to Gordon, is that it’s not possible to walk or run if a bone in the foot is fractured.

"I often hear surprised patients say ‘It can’t be broken, I can walk on it,’" he says. "That’s dead wrong, especially with stress fractures when pain and swelling might not occur for a few days."

If a fracture or sprain is suspected, Dr. Gordon advises runners to remember the word RICE as an abbreviation for Rest-Ice-Compression-Elevation.

"If pain and swelling continues after following the RICE procedure for three or four days, you should see a foot and ankle surgeon for an x-ray and proper diagnosis."

Other common foot ailments runners should watch for are:

Athlete’s Foot: This fungal skin disorder causes dry, cracking skin between the toes, itching, inflammation and blisters. It can be prevented and controlled by washing the feet regularly and carefully drying between the toes; switching running shoes every other day to allow them to dry; wearing socks made with synthetic material instead of cotton; and applying over-the-counter ointments.

Toenail Problems: Ingrown nails can cause inflammation and possible infection and usually are treated by cutting the corner of the nail with sterile clippers. Black toenails happen when a blood blister forms under the nail from trauma, and it’s best to let the nail fall off by itself. Fungal toenails are yellow, brown or black and sometimes are irregularly shaped and thick. They are best treated with oral anti-fungal medications.

Foot Odor: There are more than 250,000 sweat glands in the foot and daily hygiene plus regular changing of shoes and socks are best for controlling sweat and odor. Runners should avoid wearing cotton socks and running without socks. Foot powders, aerosols antiperspirants and vinegar soaks also are helpful.

Blisters, corns and calluses: Never pop blisters unless they are larger than a quarter or are painful or swollen. Use a sterile instrument to lance the corner, leave the top as a biological dressing, wash, apply antibiotic ointment, and cover with a Band-Aid. Corns and calluses are caused by repeated friction, and should be treated by aseptically trimming the dead skin and eliminating the underlying cause.

Contact Dr. Steven Gordon's office at in Reston at 703-437-6333, in Manassas at 703-368-7166, and in Leesburg at 703-777-2101 for more information on these conditions, or visit the ACFAS consumer Web site, FootHealthFacts.org.