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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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DVT

 

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 

Hikers and hunters: Long, vigorous hikes take toll on feet, ankles

(Reston, Manassas, and Leesburg, VA – 10/06/2017) –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,” said Dr. Shaun Hafner, a member of the American College of Foot and Ankle Surgeons (ACFAS) located in Northern 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 Hafner. “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.”

Dr. Hafner 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. Hafner 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/SHE) added.

What happens if your feet or ankles hurt during a hike or hunt? Dr. Hafner 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,” Dr. Shaun Hafner said.

Hikers and hunters seeking further information about ankle sprains, Achilles tendon injuries and other foot and ankle problems may contact Dr. Hafner at the Reston Office at 703-437-6333, Manassas Office at 703-368-7166, or Leesburg Office at 703-777-2101.

Reston, Manassas, and Leesburg, September 29, 2017-- Soccer season is in full swing and a local foot and ankle surgeon strongly urges parents and coaches to think twice before coaxing young, injury-prone soccer players to “play through” foot and ankle pain.

“Skeletally immature kids, starting and stopping and moving side to side on cleats that are little more than moccasins with spikes – that’s a recipe for foot and ankle sprains and worse,” cautions Steven Gordon, a member of the American College of Foot and Ankle Surgeons.

“Kids will play with lingering, nagging heel pain that, upon testing, turns out to be a stress fracture that neither they, their parents nor their coaches were aware of,” He said. “By playing with pain, they can’t give their team 100 percent and make their injuries worse, which prolongs their time out of soccer.”

Gordon said he has actually had to show parents x-rays of fractures before they’ll take their kids out of the game. “And stress fractures can be subtle – they don’t always show up on initial x-rays.”

Symptoms of stress fractures include pain during normal activity and when touching the area, and swelling without bruising. Treatment usually involves rest and sometimes casting. Some stress fractures heal poorly and often require surgery, such as a break in the elongated bone near the little toe, known as a Jones fracture.

“Soccer is a very popular sport in our community, but the constant running associated with it places excessive stress on a developing foot,” Gordon said. He added that pain from overuse usually stems from inflammation, such as around the growth plate of the heel bone, more so than a stress fracture. “Their growth plates are still open and bones are still growing and maturing – until they’re about 13 to 16. Rest and, in some cases, immobilization of the foot should relieve that inflammation,” Gordon said.

Other types of overuse injuries are Achilles tendonitis and plantar fasciitis (heel pain caused by inflammation of the tissue extending from the heel to the toes).

Quick, out-of-nowhere ankle sprains are also common to soccer. “Ankle sprains should be evaluated by a physician to assess the extent of the injury,” said Gordon. “If the ankle stays swollen for days and is painful to walk or even stand on, it could be a fracture."

Collisions between soccer players take their toll on toes. “When two feet are coming at the ball simultaneously, that ball turns into cement block and goes nowhere. The weakest point in that transaction is usually a foot, with broken toes the outcome,” he/she explained. “The toes swell up so much the player can’t get a shoe on, which is a good sign for young athletes and their parents: If they are having trouble just getting a shoe on, they shouldn’t play.”

For further information about various foot conditions, contact Dr. Gordon at 703-368-7166 or visit FootHealthFacts.org, sponsored by the American College of Foot and Ankle Surgeons.

After wearing flip-flops all summer, students head back to school with painful feet

Manassas, Virginia 8/30/2017 The sounds of back to school season include the ringing of school bells and cash registers, the slamming of locker doors, the noisy ruckus of school hallways and cafeterias, and the moans and groans of students over tests, homework, relationships, and increasingly, their aching feet.

Flip-flops are the summer footwear of choice for many students. But while these sandals are inexpensive and stylish, they don’t cushion or support the foot, leading to problems. After wearing flip-flops all summer, some students will head back to school this fall with foot pain and even injuries. Steven Gordon DPM, FACFAS, a foot and ankle surgeon with offices in Reston, Manassas, and Leesburg Foot and Ankle Centers, reminds parents and students that foot pain isn’t normal and can be reduced or eliminated.

“People may not realize that even into your mid-teens, there’s new bone growing in your heel,” says Gordon, “Flip-flops don’t cushion the heel, so repetitive stress from walking can inflame that heel bone growth area and cause pain and tenderness.”

Heel pain and arch pain rank among the most common complaints among students who wear flip-flops. Other flip-flop feet problems students can take back to school include inflammation of the Achilles tendon, painful pinched nerves, sprained ankles, broken or sprained toes, cuts and scrapes, plantar warts, Athlete’s foot, and callus build-up on the heels and toes.

Foot and ankle surgeons can usually reduce or eliminate students’ foot pain with simple treatment methods including stretching exercises, ice massage, anti-inflammatory medications, and custom or over-the-counter shoe inserts.

Back to school season will always be painful for some students, but it doesn’t need to involve foot pain. Contact Dr. Gordon’s office in Manassas 703-368-7166 or Reston 703-437-6333 to have your student’s painful foot evaluated, and visit FootHealthFacts.org for more information on foot and ankle conditions.