Baseball has historically been called “America’s Pastime” or “America’s Favorite Sport, although football and basketball are competing for this title. Not only popular in the US, baseball is also very popular in Asia, Central and South America, and the Caribbean.

Many bat and ball sports were historically played in Europe for centuries, especially in Great Britain. The most famous of these was a game called “Rounders”. However, Abner Doubleday was credited as the “inventor” of baseball in Cooperstown, New York, in 1839. The game quickly became popular across the nation. Major league baseball formed in 1871. The first World Series game was played in 1903, between the Pittsburgh Pirates and the Boston Red Sox (Pittsburgh won!).

Because of baseball’s relatively lower injury rates compared to other sports, it can safely be played by people of all ages and athletic abilities. This is why the sport is so beloved in the nation. As the baseball great Willie Mays said, “Playing baseball makes every child feel like an adult and every adult feel like a child.”

Because of the quick starts and stops in baseball (and its cousin, softball), it is no surprise that the lower extremity is the area most commonly injured.

Since injuries can involve tendons, ligaments, and bones, professional evaluation is recommended for all injuries, even those that seem minor.

The most common injuries of the foot and ankle in baseball are muscle strains and ligament sprains. Ankle sprains usually occur from pivoting or from running the bases. These should be professionally evaluated. Most are easily treated conservatively.

The Achilles tendon is often strained in baseball. It can also rupture, especially in middle-aged athletes. As the strain (tendinitis)  and rupture are treated differently, professional evaluation is essential.

Pain in the bottom of the heel is often due to an irritation of the plantar fascia tendon, resulting in what is called “plantar fasciitis”. This is more common in catchers, due to their squatting stance. Altering stance position to vary weight distribution can help to prevent this.

Inevitably, a ball will strike a player’s foot or ankle, resulting in a bruise or “contusion”. This should be treated immediately with ice and elevation. Professional evaluation is required, and x-rays should be taken to determine if a fracture of a bone has occurred.

Fractures or broken bones are not common in baseball, but when they do occur, it is usually from sliding into a base. Proper technique in sliding will help to prevent these injuries.

Cleats or metal  spikes are worn on baseball shoes for traction. It is recommended that children use cleats instead of metal spikes. Both of these devices can lead to ankle injuries, as the shoe tightly grips the ground while the body’s force keeps moving. Make sure that cleats are not worn down. Also, provide a break-in period for the athlete to get used to wearing the cleats.

The doctors at Melbourne podiatry Associates have considerable expertise and experience in the treatment of baseball injuries. All for your appointment.

Basketball is a uniquely American game with an interesting history. A physical education teacher, Lames Naismith, worked at a YMCA in Springfield, Massachusetts. He wanted to create an indoor game that children could play in the winter. He nailed a peach basket to the wall and created a game where a soccer ball would be thrown into it. Basketball was born!  A set of rules was created, and the first basketball game was played on March 11, 1892. The game quickly became popular among all age groups, especially in colleges. Professional basketball began with the National Basketball Association (NBA) in 1946.

Basketball has the highest injury rate of any non-contact sport (although some would consider it to be a contact sport). It involves jumping, cutting, running, and quick starts and stops, and it comes as no surprise that the lower extremity is the most commonly injured body part. The most common injuries are ankle injuries; overuse injuries (plantar fasciitis, Achilles tendinitis, sesamoiditis, turf toe, and stress fracture); and fractures, especially of the 5^th metatarsal.

Ankle injuries are the most common lower extremity injuries in basketball. These account for 22% of injuries but result in 50% of missed playing time. The most common ankle injury is the lateral ankle sprain (inversion sprain), or an overstretching or tearing of the ligaments of the outside of the ankle. This results from landing on the foot with the ankle turned, and occurs most often in rebounding.

Ligaments of the ankle are not the only potentially injured structures. The peroneal tendons course around the lateral ankle, and these can also be injured. Likewise, the ankle bone itself (lateral malleolus) can be fractured.

Ankle injuries always require professional evaluation. This is because treatment will be based on which structures are damaged. X-rays are important for determining this, and often additional imaging techniques such as diagnostic ultrasound, CT and MRI may be needed. Treatment usually involves rest, anti-inflammatory medication, immobilization, and possibly physical therapy. Surgery is not usually necessary, unless the tendon, ligament, or bone require repair.

Many overuse injuries occur in basketball. These include plantar fasciitis (tendinitis of the bottom of the heel and arch); Achilles tendinitis; tendinitis of the posterior tibial tendon (tendon of inside ankle area); sesamoiditis and turf toe (bruising and inflammation of the bottom of the big toe joint);calcaneal apophysitis (heel pain of the sides, bac, or bottom of the heel in children); and stress fractures (incomplete breaks in bones). All of these conditions will require professional diagnosis and treatment. Fortunately, conservative treatment is effective in the majority of cases.

Fractures or breaks of bones are common in basketball, especially the 5^th metatarsal base (bone on side of midfoot), often associated with lateral ankle injuries.  Pain in this area should always be professionally evaluated , to determine if the injury is an avulsion fracture, which requires casting or a boot, or a  Jones fracture, which requires surgery.

Prevention of basketball injuries involves proper shoes (often high-topped); protection of the ankle with taping or ankle bracing; and proper conditioning.

The doctors of Melbourne Podiatry Associates have considerable experience and expertise in the treatment of basketball injuries. Call for your appointment.

Why should you come to our office? Is it because we have excellent credentials and extensive experience? Those are good reasons, but some other doctors have similar credentials and experience.

Is it because we have four doctors in three convenient office locations, with convenient hours, same day appointments available, and plenty of free parking? Because we have well-trained, friendly staff? Because each patient is treated like family?  These and many more are compelling reasons to visit our office. But some other offices have at least some of these reasons. What makes us different from all of the others?

The difference is YOU! When it comes to our office, it’s all about YOU!

Our doctors and staff make your visit a unique experience, because YOU are the only reason that we are here. Every visit begins with a detailed history and physical examination, during which your doctor intently listens to you. This is followed by a thorough explanation of your diagnosis and possible treatment methods. For most conditions, this is nonsurgical treatment. For others, it is surgery. For still others, it is referral to another specialist, while in still other cases , it is simple reassurance. In all cases, YOU, the patient, makes the decisions.

When you leave our office, you will know what your problem is and how to treat it. In some cases, treatment may occur on that very visit.

In summary, there is only one reason to see a doctor, and that is for evaluation and treatment of your specific medical problem. Melbourne Podiatry Associates is the place where this will occur. Remember, it’s all about YOU!

The term ‘martial arts” refers to a variety of sports that practice fighting techniques. There are millions of participants worldwide. Martial arts include styles from around the world, and some of these techniques have been practiced for centuries.

The most popular martial arts in the USA are karate (originating in Japan); taekwondo (from Korea); judo or jiujitsu (from Japan); kung fu (from China); muay Thai (from Thailand); boxing (from ancient Greece?); and mixed martial arts (MMA), an American amalgam of many styles.

Injury types vary in martial arts depending on the style. In styles that involve kicking or striking with a fist or elbow (especially karate, taekwondo, kung fu, and muay Thai), fractures, bruises, and abrasions are common. Some of these styles also teach breaking boards with the hand or foot as a training technique, and doing this improperly can result in fractures, bruises, and sprains.

Styles that involve grappling and throwing an opponent (particularly judo and aikido) have increased rates of sprains and tendon injuries.

Overall, the lower extremity is more frequently injured than any other part of the body, with the knee being the most commonly injured body part. These injuries are usually ligament sprains.

Fractures, dislocations, and sprains of the hands and feet are common from striking, and are more common in males than females.

Prevention of martial arts injuries is important. Because most participants train in a school (dojo) with instructors, proper technique is taught and helps to prevent injuries.

The lower extremity injuries that occur in martial arts are usually easily treated conservatively. The doctors at Melbourne Podiatry Associates have experience and expertise in the treatment of martial arts injuries and stand ready to help you. Call for an appointment!

Although we practice in Florida, we treat many winter sports injuries. This is because many Central Floridians travel to participate in snow sports such as alpine skiing, cross country skiing, or snowboarding. Some are injured, and they seek initial or follow-up treatment when they return home.

The most popular winter sports are alpine skiing, cross country skiing, and snowboarding. Each of these sports has specific types of  injuries.

Alpine skiing, also called downhill skiing, is the most popular winter sport, with some 18 million participants in the USA and over 200 million worldwide. It involves descending a hill or mountain on skis in a type of “controlled sliding”. In alpine skiing, the ski is attached to a boot with bindings. Prior to the 1970’s, many lower extremity injuries were due to faulty binding design. Since the binding designs have improved, such injuries have decreased by over 50%. Now, most alpine ski injuries are sprains of knee or shoulder from falls. Tibial fractures also occur from falls. The head or neck are injured in 18% of injuries, but the use of helmets has decreased the severity of such injuries. Foot injuries include nail injuries such as ingrown nails, and bleeding under the nail, both usually from a tight ski boot. This tightness can also cause pain in the forefoot joints.

Cross-country, or Nordic, skiing is a completely different sport, with 5 million participants in the USA. It is usually done on flatter surfaces and is a very strenuous cardiovascular exercise. Cross country skis are considerably longer than alpine skis. They are attached to the boot only in the forefoot area. The heel lifts off   of the ski and when it comes back down, propels the ski forward. Also, in contrast to alpine skiing in which the poles are used for balance and turning, the poles in cross country skiing are used to forcefully propel the body forward.

The most common cross country skiing  injuries are sprains of the knee and thumb (from pole use). More overuse and cold injuries (hypothermia and frostbite) are seen in cross country skiing than in alpine skiing.

Snowboarding is yet another popular winter sport, with 9 million participants in the USA. This sport differs from both types of skiing in that no poles are used. The boarder balances on the snowboard and glides down the mountain, somewhat like surfing or skateboarding on snow. Snowboarding has less knee injuries than skiing, but more ankle and wrist injuries. Wrist injuries usually occur when the boarder falls backward and lands on the wrists. Shoulder and clavicle injuries are also common from falling. Interestingly, 8% of snowboarding injuries occur from loading or unloading on the ski lift.

Most winter sports injuries are treated conservatively. The exceptions to this would be certain types of fractures.

The doctors at Melbourne Podiatry Associates are themselves winter sports enthusiasts and have considerable experience and expertise in the treatment of winter sports injuries. Call us for your appointment.

Go Gators!

Go Dawgs!

Go ‘Noles!

Let’s Go Pitt!

Football season has arrived, and with it the hearty cheers for our favorite teams! Be it collegiate, professional, high school, or youth league, football is a popular sport, loved by millions.

This uniquely American sport evolved from rugby and its other British variations during the 1800’s. Sports historians consider the game between Rutgers and Princeton in 1869 to be the first modern “football” game. Many modifications of the sport have occurred since then.

As a dangerous contact sport, football does have the potential for serious injuries, particularly of the head, neck, and spinal cord. However, these injuries are not common. A recent study from the National Library of Medicine found the most common injury types to be muscle strains (40% of total injuries); contusions (bruises) (25%); dislocations (15%); fractures(10%); and concussions (5%).

Of specific injuries, the 10 most common were :

1. Concussion
2. Jumper’s knee (Pain around kneecap)
3. Foot fractures
4. Shin splints (Muscle strain along shin)
5. Achilles tendinitis
6. Ankle sprain
7. Rotator cuff injuries (shoulder)
8. Knee ACL (Anterior cruciate ligament ) injuries
9. Hamstring injury (Muscle at back of thigh)
10. Quadricep injury (Muscle on front of thigh)

Interestingly, of these 10 injuries, 8 involve the lower extremity. In our offices, we frequently treat many of these , especially ankle sprain, foot fractures, Achilles tendinitis, and even Achilles tendon rupture.

Injury prevention strategies continue to reduce overall incidence of injuries. These include adequate pre- and post- game stretching, proper hydration, proper gear, and proper training technique.

The doctors of Melbourne Podiatry Associates are experts in the treatment of football injuries. If you or a loved one suffer a sports injury, please call our office for and appointment.

Dance, or the movement of the body to music, has been done in every country since before recorded history. Dance has been used for many purposes, and the variety of types of dance is endless. Interestingly, dance appears to be a rather uniquely human activity. Although many animals can be taught dance movements, studies show that only the elephant and parrot can spontaneously move to music!

Dance today in western countries is primarily done for recreation and sport. Lower extremity injuries are common in dancers because of the physical demands of dynamic overload, extreme positions and motions, and overuse. Additionally, many types of dance are done without shoes or in thin shoes without support, such as the ballet slipper.

Of all types of dance, ballet has the highest injury rates . The most common dance injuries that are seen in all dance forms are most common in ballet. These include sesamoiditis, flexor hallucis tendinitis, os trigonum syndrome, anterior ankle impingement, and stress fractures.
Continue reading→

Sometimes you might notice some thick areas of skin on your foot, possibly even causing some pain. It could be a corn or callus, but what is the difference between the two?

A corn gets its name from its resemblance to a corn kernel. It is a small, circular, thickened area of the skin of the foot , usually involving the toes. Its medical name is clavus. Corns are hard in the middle and usually form after repeated pressure on the skin, such as rubbing by a shoe.

A Callus is a localized thickening of the skin, usually found on the bottom of the foot. It results from friction and pressure. A callus can vary in size, and does not have the hard center that a corn has, so may not be as painful. Sometimes, however, a deep nucleated callus may form directly beneath a metatarsal bone and can be very painful. These growths are called intractable plantar keratoses.
Continue reading→

There is a nationwide shortage of primary care providers (PCP’s), which include family practitioners, internists, pediatricians, among others.  A recent US Department of Health study documented shortage of 17,000 PCP’s.  In many areas, it is often difficult to get an appointment with a PCP.  Many are not accepting new patients, and established patients may experience long waits.

The good news is that, at least when it comes to the lower extremity (foot, leg, and ankle), the specialty of podiatry stands ready to help!  Podiatrists are surgeons, but they are first and foremost PCP’s of the lower extremity.

Podiatrists treat hundreds of lower extremity conditions.  In the lower extremity, podiatrists  are the experts in rheumatology, dermatology, neurology, pediatrics, geriatrics, orthopedics, vascular disease, medicine, wound care, and sports medicine.

Podiatrists are experts in dermatology of the lower extremity. Skin rashes of all types, skin tumors, and toenail conditions are commonly treated. The ingrown toenail is ,in fact, the most common condition that we treat.

Rheumatology, or  arthritic conditions of the lower extremity, is another common  area of podiatric expertise.  Any of the multiple joints of the foot as well as the ankle joint are prone to  arthritic conditions.

Neurology, or nerve  problems, is another common area of podiatric involvement.  Nerve injuries, nerve entrapments, and nerve disease (neuropathy) are common in the lower extremity and are often difficult to diagnose and treat.

Podiatrists also specialize in lower extremity pediatrics, or children’s foot problems.  These include gait abnormalities, flatfoot, and sports injuries. Podiatrists also specialize in geriatrics, or treatment of conditions of the elderly.

Circulation problems, both arterial and venous, commonly affect the lower extremity.  Podiatrists are often the first to diagnose these.  Evaluation of poor arterial circulation and prompt referral for vascular intervention, especially in diabetic patients, can be limb saving or life saving. Vein problems, ranging from venous leg ulcers to unsightly spider veins are all conditions treated in the office by podiatrists.

When it comes to orthopedics (bone problems), of the lower extremity, podiatrists are the experts. We treat all types of fractures, sprains, bone, muscle and tendon conditions. We are especially adept at treating athletic injuries.

Finally, it should be noted that many systemic conditions have manifestations in the lower extremity, and sometimes these are the earliest symptoms. These include diabetes mellitus, kidney disease, congestive heart failure, nutritional deficiencies, among many others. Podiatrists recognize these and make the appropriate referrals.

Most PCP’s understand the value of podiatry and refer conditions of the lower extremity to them. Podiatrists work closely with PCP’s, other specialists, and health care providers as a part of the medical team to provide the best care for every patient.

Most health insurance plans, including Medicare, do not require a referral from a PCP to see a podiatrist. You can make an appointment directly with us without a referral.

Call our offices for any condition of the lower extremity. We will be glad to help you!