Welcome to winter Central Illinois!  Thinking back on the Blizzard of 2011, I was especially concerned for my patients who had to shovel out their driveways and sidewalks with all the ice underneath the snow.  Although winter time falls are common, here are some tips to help brave those cold winter months injury free!

• Make sure that sidewalks and outdoor spaces have been salted or have had a de-icing treatment on them to prevent falls in the first place!
• When you injure something (ankle, foot, wrist, etc) in a fall, it is very important to perform PRICE therapy to the area:
  • P  - protect. For my feet and ankles, I recommend either a walking boot, ace bandage, or BOTH.
  • R– rest. In order for an injury to fully heal, you need to stay off of it and REST for a minimum 24-48 hours….soft tissue injuries sometimes take up to 8-10 weeks to fully heal, so it is very important to rest them right away!
  • I– ice.  Placing an ice pack to an affected area for 10-15 minutes each hour will decrease the swelling to the area and can help speed up healing!
  • C– compress.  You need to wrap the area with an ace bandage or some sort of slight compressive device to minimize swelling.
  • E– elevate.  Elevation is especially important for FEET and ANKLES because it allows all that extra fluid to head back up to the heart and will minimize swelling and inflammation as well.
• Anti-inflammatory medication can be very helpful but you will want to check with your doctor prior to beginning any treatments that may interact with other medications!
• If you suspect a break of ANY kind (can’t move an area easily, doesn’t look/feel like is lined up, cannot bear weight/put pressure to the area), it is very important to see a doctor immediately!  For my foot and ankle injuries, we offer same day appointments and digital xray to quickly check for any broken bones.  We even have diagnostic ultrasound to check for ligament and tendon injuries as well!  No matter what the issue, if you fall and are not able to get up and perform the above PRICE therapy easily at home RIGHT AWAY, head straight to Prompt Care/ER or your physician’s office!!

Several NFL players have been afflicted with ‘turf toe’ recently, most notably Ray Lewis of the Baltimore Ravens and Mark Ingram of the New Orleans Saints.  (Funny how so many players are getting hurt on PLAYOFF teams??)  I wanted to review with everyone exactly ‘what is turf toe’ and what players and trainers need to do to get back on the field quickly and safely.

First, turf toe, which will typically occur to the big toe joint (first metatarsophalangeal joint), occurs when the foot is plantarflexed (toes bent down) in a fixed position and has force placed upon it.  In a nutshell – when defensive players are crouching down at the line of scrimmage, the stance that they take to bounce off of their feet puts them at risk for turf toe.  It is a sprain of several of the TEN ligaments that make up the big toe joint.  Sometimes there can even be a little fracture of the sesamoid bones associated with it.  Depending on which ligaments are sprained and if there is a fracture (MRI and xray can show us that) will factor in on how long a player must be off the field.  Most of the time with aggressive physical therapy to strengthen the ligaments and a stiff soled shoe to not allow ‘bending’ of the toe at the big toe joint for 4-6 weeks will do the trick.  This is always accompanied by icing several times/day, anti-inflammatories, and even steroid shots if needed. 

In many cases, athletes will need functional, custom orthotics in their cleats to help prevent the injury from occurring again.  Rushing back from this type of sprain without the additional support of an orthotic can cause arthritis in the big toe joint – possibly leading to surgery.  Since the Chicago Bears don’t have to play either the Saints OR the Ravens this December, I am hopeful that both Ray Lewis and Mark Ingram recover nicely from their injuries! :)

As any Chicago Bears fan can attest, these past two weeks have been torture.   First, we are 7-3 with an edge over several other wild card playoff teams, THEN tragedy struck!  Jay Cutler, the quarterback we always knew he could be, was OUT with a broken thumb.  I get a lot of questions about what seems to us as fans as ‘little injuries’ for foot related problems (Baltimore Ravens Linebacker, Ray Lewis’ Turf toe will be a post NEXT week!).   But as I am not familiar with Cutler’s injury I decided to investigate…

Here’s the nitty-gritty of what’s going on and how LONG we have to deal with Caleb Hanie!

Jay has a “Bennett fracture” first described in 1882.  The reason it is a problem (especially for professional athletes!) is that it is intra-articular – it passes through the thumb and hand joint space (carpo-metatacarpal).  High incidence of arthritis for ANYONE, so it is important to treat it early and get good reduction of the injury – especially an NFL Quarterback on his throwing hand L

Jay had surgery on November 23^rd and reported that his orthopedic surgeon placed three screws and two pins to reduce and stabilize the fracture.  The pins can come out quickly IF the soft tissues heal around correctly, most importantly the abductor pollicis longus muscle attachment – the muscle that lets us grasp and pinch things like a football! 

According to Cutler, we may see him back in time for the Week 17 game versus Minnesota.  That would be cutting it close but HOPEFULLY the Bears can pull out 3 more wins (I am predicting that they will kill the Broncos, Seahawks, AND Vikings!!  Even with Forte out, I love my Bears!  And beating Green Bay would be AWESOME!) and get that wild card spot – déjà vu from last year with our beloved Bears will run that table and make it to Indianapolis in February!!!  (I have a great baby Bears cheerleader onsie from my friend Tricia that will be perfect for our Super Bowl Party!!)

The 21-year-old Twilight super star, Kristen Stewart, was seen limping around in her Jimmy Choo shoes at the premiere of The Twilight Saga: Breaking Dawn – Part 1.  The Twilight series is four fantasy romance novels by American author Stephenie Meyer.  It is a love story about Bella Swan, a teenage girl who falls in love with a 104-year-old vampire named Edward Cullen but might also have feelings for a werewolf named Jacob Black.  (I personally have a unicorn collection at home with 200+ figurines, so I am not about to ‘bash’ this story line or those in love with vampires and/or werewolves.) 

Since the release of the first novel, Twilight, in 2005 the books have gained immense popularity worldwide.  The series has won multiple awards including Children’s Book of the Year.  Thus far every book has been made into a motion picture, and this third film may have been the most highly anticipated film to date. 

So, millions watched as the Twilight stars strutted down the BLACK carpet outside the Nokia Theater in L.A. for the premiere of The Twilight Saga: Breaking Dawn - Part 1. Although, Kristen Stewart wasn’t doing as much strutting as she was limping.

She confessed that her feet were in pain due to a stunt injury on the set of the fairytale film Snow White and the Huntsman, where she illustrates Snow White, the only person fairer in the land than the evil queen, Charlize Theron.  (Snow White and the Huntsman is the inside cover in the special double issue of this week’s People Magazine, where Bradley Cooper is featured as the sexiest man alive!)

Stewart confessed to Hollywood Access that her feet were hurting her tremendously. "I just hurt my foot on Snow White of course, because I do that to myself all the time."  She continued: "I was running around on Snow White and I tend to hurt myself when I get really into stuff, and I did it again."

The actress admits that the Jimmy Choo heels intensified her pain.  "I think this is the last interview I'm going to stay in these heels… [the injury is] not that bad, it's just these are crazy killer heels.” Kristen confides, "I'm such a klutz… I hurt myself... (But) I love stunts."

Even if you’re not a Hollywood heart throb or stunt person, if you have a foot or ankle injury, come in to see Dr. Lockwood immediately! Heartland Foot and Ankle Associates is here for all Bloomington, Normal, and central Illinois residents.

Last night I attended a function for a local sorority here in Bloomington/Normal.  I am the Advisory Board Chairman and went to the Chapter House for a meeting. (To learn more fun facts about me or a staff member, click here!)  On the way in, I noticed that my shoe kept making a ‘scratchy’ sound and felt a little weird or off-balance.  I didn’t pay much attention until this morning when a close inspection revealed a potential NIGHTMARE for a diabetic patient….

I wear extra depth shoes and inserts.  Not only are they stylish (my fashionista sister has the same pair and LOVES them!) but they protect my feet and I can ‘practice what I preach’ to my patients.  These shoes have additional toe room, and are sturdier and deeper than regular shoes.  This extra volume accommodates inserts, or orthotics, as well as deformities commonly associated with a diabetic foot.  Extra depth shoes are light weight, have shock-absorbing soles, and come in a wide range of shapes and sizes to accommodate virtually any foot.  Extra depth shoes are IDEAL for diabetic patients because with neuropathy (loss of sensation to the feet) diabetics are at increased risk for problems if something were to penetrate a shoe…

Which brings me back to the campus for my sorority meeting.  As I inspected my shoes this morning, I discovered two 1.5 inch pieces of brown glass (bottle of something?) penetrating the bottom of my shoe!  Luckily, because of the depth of the shoe, I didn’t feel a thing and my foot was untouched.  I just heard that ‘scratchy’ sound.  It took 1 pair of forceps, 2 pairs of hands, and 1 podiatrist, but I got that glass out!  Just imagine if I had on flip flops or ballet shoes!!  I would be numbing up my own foot to get that glass out!! 

A picture is worth 1000 words – so check these out!  And make sure the soles of YOUR shoes can handle whatever they step in!!