My Blog

Posts for: March, 2019

Turf toe taping is a good taping technique for anyone who has a sprain of the big toe joint, called a Turf Toe injury.

What you'll need: 1 and 2 inch athletic tape. Spray adhesive for skin can help athletic tape stick better and longer. 

Watch our video below to see Dr. Bowlby demonstrate one version of the turf toe taping technique. 

 


Tight calves can play a role in many foot and ankle conditions, especially Achilles tendinitis, plantar fasciitis, flat feet and ball of the foot pain.  Below Dr. Bowlby is demonstrating  our recommended calf stretch that will stretch both muscles in your calf, the gastrocnemius and the soleus muscle. 

To stretch the right calf (as Dr. Bowlby is demonstrating):

Gastrocnemius stretch: Push against the wall, with your right leg the furthest back and knee straight. Hold this pose for one minute. 

Soleus stretch: Push against the wall, with your right leg the furthest back and knee bent. Be sure to keep your heel down the whole time. Hold this pose for one minute. 

To stretch the left calf:

Gastrocnemius stretch: Push against the wall, with your left leg the furthest back and knee straight. Hold this pose for one minute. 

Soleus stretch: Push against the wall, with your left leg the furthest back and knee bent. Be sure to keep your heel down the whole time. Hold this pose for one minute. 

Repeat 2 more times, twice a day.


 

The Achilles tendon is prone to injury because the center of the tendon has poor circulation. For patients who are young and active in sports, or have demanding occupations that require a strong Achilles tendon, surgery is the treatment of choice. The surgery involves suturing the ruptured ends of the tendon back together and applying a splint for several weeks while the tendon heals. We use a published functional, rehabilitation Achilles Rupture Protocol.

To learn more about Achilles tendon ruptures, visit our website, Seattle Achilles Rupture & Injury Doctor | Ankle and Foot Specialist.

Below is an MRI revealing an Achilles tendon rupture with 16.9 mm gap. The Achilles tendon was repaired and the patient is doing very well after surgery.

 


Ready to start running again? Beginning gradually is the key to prevent injury. Below is a guide designed to help you begin running again safely. 

Return to Running Program

First, start with a running test:

  • 2 minute warm up at 5 mph (12 min mile)

 

  • Then record distance when running at 6mph/hr (10 min mile) and pain level reaches 2 out of 10.
  • Based on this distance, you will be in one of the following phases of the graduated running program:
  • Phase 1: 0-1/4 mile
  • Phase 2: >1/4-1/2 mile
  • Phase 3: >1/2-3/4 mile
  • Phase 4: >3/4-1 mile
  • Phase 5: >1 mile or more

For example, if you begin to experience pain (2 out of 10)  at a little over 1/2 a mile, you would be in phase 2. This means you would begin running for 2 minutes (at 7.5mph), followed by walking for 2 minutes (at 3.5mph) and so on for a total of 16 minutes on a treadmill every other day.  

Graduated Running Program:

Running Phase

Surface

Minutes

Total

Speed Intensity

1

Treadmill

22222222

16

2=run 6 mph; 2=walk 3.5 mph

2

Treadmill

22222222

16

2=run 7.5 mph; 2=walk 3.5 mph

3

Over Ground

32323232

20

3=run at intensity 1-2;

2=walk at 3.5 mph

4

Over Ground

32323232

20

3=run at intensity 2-3; 2=walk at 3.5 mph

5

Over Ground

Continuous

16

Intensity 1-2

6

Over Ground

Continuous

18

Intensity 2-3

 

  • Intensity 1- Light jogging
  • Intensity 2-Jogging and talking
  • Intensity 3-Jogging and difficult talking

 

  • Program is performed 3 times a week, every other day.

 

  • May begin next phase when can complete current phase with pain level 4 out of 10 or less.

 

Adapted from:  Moen MH, Holtslag L, Bakker E et al. The Treatment of Medial Tibial Stress Syndrome in Athletes: A Randomized Clinical Trial. Sports Med, Arthrosc, Rehab, Ther and Tech 4;12:2012.


Do you have pain in your big toe joint? Do you have trouble bending your big toe? Maybe you are beginning to notice a bump on the top of the big toe joint? These are all symptoms of big toe joint osteoarthritis, also called Hallux Limitus or hallux rigidus. There are many conservative treatments including stiff soled shoes, orthotics, and steroid injections which can help relieve joint pain. Sometimes a joint clean up procedure, called a cheilectomy can be effective. Fusion of the big toe joint is a very reliable and durable procedure for severe hallux rigidus.

Below is an example of a patient with severe hallux rigidus who underwent a big toe joint fusion. The patient is doing well after surgery and able to walk without pain.

If your big toe joint is giving you trouble, please give us a call today!