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Posts for tag: sports medicine

Arthroscopy of the ankle is a less invasive surgical technique performed through small incisions that give full access to a joint that can be used to treat joint adhesions, small joint fractures, bone spurring, and soft tissue build-up, which, as a result of repetitive injury, can clog the joint.

Typically, patients are non-weightbearing for 2 weeks to permit the small incisions to fully heal, slowly increasing activities as tolerated for the next 4-6 weeks, until a return to full activities can be accomplished.

The person who may benefit most from undergoing an Ankle Arthroscopy procedure is that individual who has suffered a twisting ankle injury and felt that their ankle has never been 'quite right' since. Prolonged repetitive activity when playing demanding sports like soccer or basketball can cause a gradual build-up of tissue without obvious injury.

Below are intraoperative images of an ankle arthroscopy revealing significant scar tissue and an osteochondral lesion of the talus, both of which were treated during the procedure.

If you have ankle pain and would like to discuss if arthroscopy is right for you, please give us a call for an appointment today! (425) 339-8888, ext 0

 

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.