My Aching Feet
I’ve been wearing the same pair of walking shoes for so long there’s barely any tread left, the material around the toes is chafed to a gauzy thinness, and whatever insole support there once was has been squashed flatter than a postage stamp. But, I love them! It’s getting ridiculous though, as I’ve suffered over the years from shin splints, bunions, heel spurs, nail problems, swelling, inflammation and soreness, as well as knee and back pain while walking. The average person walks more than 115,000 miles in a lifetime. Every walking step you take exerts pressure up to three times your body weight on your feet.
Running exerts up to ten times your body weight. We cram our feet into ill-fitting shoes, subject them to the unnatural angles of high heels, pound them on pavement and asphalt, smother them in airless socks and shoes, or simply stand on them for hours on end. It's no wonder that the skin, 26 bones, 33 joints and more than 100 ligaments in each of our feet sometimes can't stand up to the pressure.
Women are especially at risk. Of the 356 women involved in a survey by the American Orthopaedic Foot and Ankle Association, 80% had some kind of foot pain -- no surprise when you consider that 88% of them were wearing shoes that were smaller than their feet. “Ankle and foot pain can typically be caused by acute injury, repetitive stress as in running or sports, or by other parts of the body referring pain to that area,” says Dr. Kessler. “It can even be caused by improper footwear or by the way you walk. Finding the cause and getting the appropriate treatment is essential in helping you move around the city with ease and without pain.” So, while I love them dearly, I’m afraid it’s time to retire those golden oldies to the back of the closet where they can bask in the glory of the many miles we’ve traveled together. Labels: Foot and Joint problems, Foot Pain, pain management, spine and sports medicine, Sport Injury, Surgery
Posted by Spine and Sports Medicine on 6:33 AM
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Chronic Back Pain
My brother-in law has suffered from chronic back pain for a decade or so. He’s tried all kinds of things to ease the pain and recently had a spinal cord stimulation system implanted in his back. “That’s where a tiny programmable generator and electrical leads are implanted beneath the skin,” says our own Dr. Kessler of Spine and Sports Medicine. “Low-level electrical signals are then transmitted through the lead to the spinal cord or to specific nerves to block pain signals from reaching the brain.” Using a magnetic remote control, my brother-in-law can turn the current on and off, or adjust the intensity. So now, instead of pain he feels a mild tingling sensation. Approved by the Food and Drug Administration in 1989, spinal cord stimulation has become a standard treatment for patients with chronic pain in their back and/or limbs who haven’t found relief from other treatments. Joking around, I told my brother-in-law he could now be categorized as a cyborg, but he didn’t really care. He was just happy that the pain in his back was manageable again. Labels: back pain, Low back pain, Spinal cord simulation system, Sport Injury, Surgery
Posted by Spine and Sports Medicine on 9:55 AM
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Who Is Tommy John and What Does He Have to Do with Elbow Pain?
In life there aren’t too many sure bets, but for thousands of New York Yankees fans, just having Mariano Rivera on the pitcher’s mound at the end of a game is about as reliable an indicator of victory as anyone could want. Often considered the greatest closer of all time, Mariano has won four World Series titles with the Yankees and is Major League Baseball’s all-time postseason leader in saves. Able to throw with pinpoint accuracy at speeds up to 97 miles per hour, Mariano seems a lock to be elected into Baseball’s Hall of Fame.
But in 1992, if it wasn’t for Tommy John surgery, Mariano Rivera might never have even made it to the major leagues.
In 1974, Tommy John was a successful left-handed pitcher for the Los Angeles Dodgers. But in mid-season of that year he permanently damaged the ulnar collateral ligament in his pitching arm. While it seemed unlikely he would ever pitch again, a revolutionary surgical operation performed by Dr. Frank Jobe, replaced the ligament in the elbow of his pitching arm with a tendon from his right forearm. He spent the entire 1975 season in recovery and returned to the Dodgers in 1976, winning 164 games after his surgery—one fewer game than all-time Dodger great Sandy Koufax won in his entire career.
This operation, now known as Tommy John surgery, in which a ligament in the medial elbow is replaced with a tendon from elsewhere in the body (often from the forearm, hamstring, knee, or foot of the patient), has salvaged or extended the careers of hundreds of baseball players – including the Yankees’ Mariano Rivera.
The strain of pitching can cause serious elbow problems. “The ulnar collateral ligament can become stretched, frayed, or torn through the stress of the pitching motion,” says Dr. Brian Kessler of our pain management facility. “Overuse or repeated pressure on the elbow joint can cause small tears to form in the soft tissue, particularly where the tendons anchor to bone. If a number of these tears occur over a period of time, they can cause discomfort and reduced movement of the elbow joint.”
Today, elbow injuries are on the rise as one of the most frequent sports injuries for youngsters, and elbow surgery is rising rapidly among teen pitchers. Kids are throwing harder and harder at younger ages and are working earlier to master complicated pitches like sliders, curveballs and other breaking balls – advanced pitches that put unnatural strain on young, undeveloped arms.
To combat this trend, coaches, parents and even Little League Baseball, Inc., a sanctioning body for many youth baseball leagues, recommend limiting the number of pitches thrown by young pitchers, staying away from curveballs and other breaking pitches, and instructing players on the best techniques to prevent arm injuries.
“Repetition and torque,” says Dr. Kessler. “Those are the critical elements leading to elbow problems, especially for athletes.”
For Mariano Rivera, like Tommy John, surgery was the answer for turning elbow pain into peak athletic performance. Without it, Yankee fans might never have had the opportunity to watch a sure thing -- the greatest closer of all-time.
Labels: Elbow Problems, Sport Injury, Surgery
Posted by Spine and Sports Medicine on 7:20 AM
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