AF&A Blog

We all know of Colt McCoy.  This Longhorn had a 45-8 college record making him the NCAA’s winningest quarterback.  After being selected in the 3^rd round of the NFL draft, Cleveland Browns president noted that Colt McCoy would be unlikely to see much playing time since the team already had three quarterbacks.  That prediction proved to be completely untrue after ankle injuries to Jake Delhomme and Seneca Wallace.  McCoy made an impressive rookie NFL start in week 7 when he led the Browns to a win against the defending Saints.  After a bye week, McCoy then helped the team to their 3^rd win of the season against the Patriots in week 9.  Weeks 10 and 11 were disappointing, even with over 200 passing yards from McCoy they couldn’t pull out another win.

This former Longhorn had a noticeable limp as the game progressed, but that didn’t stop him from leading a valiant effort late against Jacksonville.  After leaving the stadium with his right foot in a walking boot, it has been reported that he sprained his ankle.  We have talked about ankle injuries, especially in the NFL, several times before.  The collection of ligaments that keep your ankle in place are prone to injury when the leg and foot are strained in different directions.  For the average individual, getting knocked off your feet by a sack isn’t too much of a worry.  Even so, there are a variety of activities that can cause you to strain, or in other cases tear, the ligaments in your ankle.  Colt McCoy was able to continue playing through his injury, we hope without furthering his injury.  We here at AFAS would never recommend this course of action.  The possibility of making your injury worse and keeping you out longer should always keep you from continuing your activity once you are hurt.  Instead implement the RICE principle and seek medical attention.

Until next time, keep those ankles happy and healthy Austin!

We are halfway to the NFL’s Week 8 and there are a number of high profile quarterback’s whose seasons have become questionable. Tony Romo, who may not recover from his shoulder injury until the last few games of the season, and Brett Favre, who severely injured his ankle, are just two of them. While there may not be a lot of us rooting for the Vikings, the career achievements of Brett Favre have made him a much publicized player. Records including most consecutive starts by a player, most consecutive wins, and most career playoff completions just a few of a long list of achievements for him. The latest injury to the aged player caused him to limp off the field after a loss to the Packer’s on Sunday. This injury may cause him to end his streak of consecutive starts as well as his ability to be an effective player.

He may be the first one to admit that he’s ‘no spring chicken anymore.’ As with any older individual, it takes your body a little longer to heal than it may have when you were younger. Brett Favre, at around $1 million per game salary, isn’t your average 41 year old and has expressed a desire to play through the pain. While it has been reported that he can’t do further damage to the broken bone by playing, we here at AFAS have our reservations. This week he has been seen in a walking boot to help off load the ankle allowing it to rest and heal. While rest is important, it may be of no use if he rests all week only to jump into a game on Sunday. This athlete has played through injury before, and his high profile status may bring him to do it again, but at what peril to his health and performance?

This should be a word of warning to any ‘weekend warriors’ out there who are anxious to bounce back from an ankle injury. You must be sure to give your injury ample time to heal. Additionally, you should slowly work up to your activity with the proper exercises and physical therapy. Conditioning your body for your activities is the best way to prevent initial or recurring injuries. Failure to properly rehabilitate an injury can cause re-injury and continued complications…..even for professional athletes.

Until next time, keep those feet (and ankles) happy and healthy Austin!

It was game 3 of the Western Conference semifinals in May 2009 that Yao twisted his ankle. That year was one of his healthiest since a long list of injuries that began in 2005. That year, osteomyelitis infected his big toe; the 06-07 season brought a break to the right leg and 07-08 required foot surgery for a stress related fracture of the left foot. After coming back from all that, Yao was a significant factor in the 08-09 Rockets march to the NBA semifinals. He told reporters after game 3 that he played through a ‘twist’ in his ankle each quarter. Doctors took subsequent CT scans of the injured ankle and noted another fracture. After spending the year recovering from that surgery, Yao has spent the preseason slowly working up to his old self.

So, why are basketball players, especially the tallest ones, so susceptible to injury? There are several factors that play into this. One factor that we have talked about before is the compounding pressure and weight applied to your feet when you run. Many of the tallest players in the NBA are also the heaviest. When one foot takes the impact of a 300+ pound athlete sprinting down the hardwood floor, their bones and ligaments are put under a stress many of us will never experience. Add to that, a second factor. Quick changes in direct, pivots and cuts all subject the foot to ligamentous strain that can easily turn into injury. For these reasons, footwear and orthotic inserts are of the utmost importance to basketball players be they professionals or high school players.

Let’s get back to Yao. Is there hope for our center? Can we expect a productive season out of this international star? Only time will tell. For now, his doctors have limited him to playing only 24 minutes per game. This will provide time for him to work back to performance condition, but will provide challenges for the Rockets team. We can hope that Yao follows in the footsteps of Zydrunas Ilgauskas of the Miami Heat who has fully recovered from a similar surgery. Unfortunately, there is the old adage ‘the bigger they are the harder they fall’ and there are many big players who have never recovered. Here’s hoping some medical expertise, the proper physical therapy, and a little luck make Yao Ming the strong center that has helped the Rockets out in the past.

Until next time, keep those feet happy and healthy Austin!

The President mentioned the costs associated with it long before the healthcare bill was passed. For anyone living with diabetes or struggling with ulcerations that won’t heal, it is a scary thought. Amputation is the last resort option to save an individual’s life, but at a cost that can only be understood by someone who has experienced it. According to the National Institutes of Health (NIH) diabetic complications are the main cause for amputations of the leg not due to trauma.

Earlier this summer members of the American Podiatric Medical Association gathered for their yearly seminar to teach, learn, and share knowledge with one another. One of the studies that were presented at that meeting dealt with the issue of amputation. The researchers examined 32,000 patients with diabetes and compared their risk factors to their ultimate outcomes. Their findings were that diabetic patients who visited a podiatrist had a significantly lower number of amputations than those who did not. If you are already a patient at AFAS, you should receive a yearly letter to remind you to schedule your annual diabetic foot exam.

We try to take our weekly blog space to educate you on keeping in good health and preventing problems with your feet. Inspecting your feet for changes and maintaining your blood glucose within the recommended ranges are your daily priority if you have diabetes. Living with diabetes can mean changing habits you may have had your whole life, but anything you can do to live healthier can add years to your life. Regular visits with Dr. Thomajan can detect problems early. By assessing where an ulcer might occur, proper off loading and changes to your shoes can stop the issue before it even happens. Don’t become an NIH statistic and make sure a podiatrist is involved in your healthcare.

Until next time, keep those feet happy and healthy Austin!

Tonight’s game aside, the second week of NFL football is complete and along with it some players season. Only two weeks into the season the injury list for the NFL is quite long. With the hard hits on the run, it is no surprise that most of these injuries occur in the knees, ankle and feet.

There is so much media attention paid to the ‘barefoot running trend’ that it seems necessary we visit this topic once more as the summer comes to an end. Lack of footwear obviously opens your foot up to injury from random objects. The development of shoes like the Nike Free and Vibram Five Fingers may help to keep you out of Dr. Thomajan’s office for removal of glass shards or other objects stuck in your foot. These new types of footwear offer some protection but still lack the support of ‘traditional’ footwear. If you haven’t taken the time to slowly allow your body to adapt to this footwear or have not been devoted to the proper training regime, you may need to schedule an appointment for a completely different reason.

While you may be able to avoid getting objects stuck in your feet, the position of your foot may prove to be more problematic. Each one of us has a different variation in foot structure. Some feet will function fine without the support of footwear. Unfortunately, it is much more likely that your foot structure requires some type of support from shoes. The body will attempt to compensate for any lack of support but often the results can be painful or with changes in the way you walk or run. A visit with Dr. Thomajan can help you decide if barefoot running is for you. Part a visit to AFAS may include GAITSCAN computerized assessment in addition to physical examination of your feet.

Our goal here at Austin Foot and Ankle Specialists is to educate you about keeping your feet healthy. There are two books that Dr. Thomajan has written to help do that. Both deal with special issues concerning foot health. ‘Keep Running!’ is most relevant to our discussion of barefoot running. Request your free copy today and learn the best things you can do to avoid injury while running. Until next time, keep those feet happy and healthy Austin!

You don’t have to go very far these days to run into an advertisement for toning shoes. On a recent visit to the store, I noticed almost a fifth of the shoe section was devoted to these types of shoes! It’s high time we take a closer look at their design and claims so that you can make an informed decision next time you go shopping.

The first question everyone asks is “Do they work?” A fair question for any device you are shelling out your hard earned money for. Well, let’s say they accomplish what they are designed for. These shoes create an unstable surface to walk on and your muscles have to help you maintain balance in addition to walking forward. Over long periods of time these added tasks can increase fatigue and lead to injury. Many of these shoes claim to shape your legs, tighten your abs, and help you become more fit. While these shoes may help to some extent, there is no getting around good old physical activity.

Each brand of shoe accomplishes their toning regime a little differently. A shoe made by Reebok claims to offer the benefit of a balance ball workout in their shoe. This is a prime example of the instability we discussed previously. Other shoes marketed by Sketcher and Fila have pretty strange shape. While it may appear to be a new design, this sole is actually a type of shoe modification used by orthopedists and podiatrists for decades. We have a very technical name for this type of modification, a heel to toe rocker sole. The times when these modifications are required are no laughing matter. Rarely prescribed for health individuals, these shoes are most often used in people who have lost motion at the ankle and middle of the foot. This type of sole is thickest in the middle causing a decrease in the forces of the heel striking the ground and increasing propulsion as the toes leave the ground. Pain, such as it associated with arthritis, is another place to allow the shoe to perform the motion that the ankle and foot should do. Eliminating or limiting the natural motion of the foot and ankle in a healthy individual can emphasize some muscle groups but cause problems in others.

We hope to have given you enough information for you to make an informed choice your next visit to the shoe store. You should always remember to ‘ease’ your way into any new footwear or orthoses. Start with limited wear, increasing slowly as time progresses. Until next time keep those feet healthy and happy Austin!

With ‘deep sadness’, tennis pro Serena Williams has decided to listen to her doctor and not play in the US Open. This is obviously a difficult decision for her as friends have noted this is one of her favorite tournaments to play in.

This is also a big headline as she is the number one ranked player in the world. Her absence also prevents her sister Venus and her from defending their doubles title. Though not a happy decision, we here at AFAS feel she is making the best decision. Returning to any activity before allowing proper time for healing will only increase the risk or re-injuring, cause more extensive damage, or leave one with permanent deficits.

The injury that will prevent Serena from competing occurred in early July. While dining at a restaurant, her foot was injured by a broken glass. This type of injury involves a sharp, foreign body. Any foreign body carries inherent risk of infection and your Podiatric physician will clean the wound clean promptly. Depending on factors such as the type of object and the depth of the wound, you may be prescribed antibiotics. A sharp object, like broken glass, can cut tendons, blood vessels, or nerves. The recoveries for injuries such as these are varied. Tendon injuries typically require 6 weeks to heal, with additional time to be toned back to their original strength. It is important to follow your doctor’s instruction when you are recovering from any type of surgery. If Serena Williams can sit out the US Open, you can surely keep yourself off you feet long enough to heal properly. Until next time, keep those feet happy and healthy Austin!

Hopefully everyone had a great holiday weekend and took time to appreciate Independence Day! The end of the holiday weekend also brought around the final matches of soccer’s World Cup. If you’ve been keeping tabs on the games, then you know that Spain and Netherlands will be facing off in the final match on Sunday. After an hour of running and fancy foot work, Spain’s first world cup final came about, with sixteen minutes left, by Carles Puyol utilizing his head to score the winning goal. You don’t have to be a diehard soccer fan to appreciate the athleticism displayed in these matches and the huge demands these players ask of their feet.

These demands are met only by utilizing the proper foot wear and extensive practice. For the ‘weekend warrior’ who likes to play soccer, neither of these requirements may be adequately addressed. Soccer is one of very few sports that require minimal equipment. Anyone who plays needs to make sure that good shoes, in addition to the ball, are part of that equipment. Soccer cleats may not always be designed with the best internal support and this is the part most important for your feet. Utilizing the proper insert or a custom designed orthotic can make any off the shelf pair of cleats into the best gear you can use to prevent injuries.

For the any early teenagers or younger, there are added challenges to avoiding injury during soccer. Many bones in a teenager are not fully hardened yet. In the case of the “heel bone”, there in an area of cartilage that can become problematic for young children; especially when the shoes offer inadequate padding. Remember, pain is never normal…..not even ‘growing pains’. Implement the RICE principle and make a visit to see Dr. Thomajan if pain ever becomes a problem. Until next time, stay happy and healthy Austin!

It has been over a week since David Beckham left the field in significant pain from a tear injury to the left Achilles tendon. By Wednesday, the surgical repair was complete and Mr. Beckham is currently on his long road to recovery. This injury will require a period of immobility, followed by range of motion exercises, and lastly physical therapy slowly introducing weight bearing exercise. The road to recovery will take approximately 6 months. Unlike the ancient Greek hero Achilles, there is a high chance that Beckham will play again; unfortunately, this injury effectively ended any chance of playing in this year’s World Cup.

The Achilles tendon is the largest tendon in the human body and required for vital activities, especially for a footballer, such as walking, running, and jumping. Your ‘calf muscles’, on the backside of your leg, are actually a number of different muscles that unite as this tendon before inserting on the top your ‘heel bone’. This injury most commonly afflicts middle aged men. Due to the vital functions it performs and the increased weight placed on it during movements, it is easy to see how it is a target for injury.

After a thorough physical examination and imaging studies (ultrasound, MRI), your podiatric physician can assess if there is a tear of the tendon or a total rupture. Both cases typically require surgical intervention in which the injured portion of the tendon is removed and the healthy portions united by suturing. This video outlines a typical procedure:

Mr. Beckham did the best thing he could once suspecting the injury, stopping the activity. If you feel any type of severe pain, especially at the back portion of your heel, it is important you stop whatever activity you were doing to halt any further damage. The RICE principle should be utilized until you can seek out medical treatment. If you suspect an Achilles tear, or any other injury to your foot and ankle, schedule an appointment with Dr. Thomajan at Austin Foot & Ankle Specialists!