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  • Best Shoes for Plantar Fasciitis

    Best Shoes for Plantar Fasciitis

    The plantar fascia is a wide, flat ligament made of collagen that runs from the heel to the ball of the foot. It supports the arch of the foot and disperses weight across the foot when walking or running. Plantar fasciitis is the term used to describe an inflamed and painful plantar fascia, a condition often resulting from overuse, lack of a proper warm up, sudden increase in training mileage, change of running surface, wearing inadequately supportive shoes, or just a biomechanical flaw.

    Walking with plantar fasciitis can be extremely painful, as every step will be stretching an already overstretched plantar fascia. However, it is important to keep the ligament reasonably stretched in order to avoid it tightening up and causing even more pain when moving. For this reason it can be helpful to wear a specialized splint, sock or sleeve during the night.

    The correct shoe to look for depends on the cause of your plantar fasciitis. If it is a result of overpronation (the collapse of the arch when weight is put on it) you will need shoes that control the tendency to overpronate. The degree of support will depend on the level of overpronation you experience. Some examples of shoe brands to consider are Asics, New Balance, and Brooks.

    In order to minimize pain while walking, the best shoes will be those with a good, supportive arch. Keeping the arch supported will prevent the plantar fascia overstretching at each step. Along with good arch support, look for shoes with a solid outsole and a slightly elevated heel. The back of the shoe that surrounds your heel should fit firmly and snugly, with no sliding up and down of the heel when you walk. It should be strong, but not overly stiff; you should not be able to squash it.

    The sole should be firm, but it needs to have a good rocker and a slight heel. When you hold the shoe and flex it, it should bend in the toe box (front part of the shoe) i.e., where the ball of your foot would be, not in the middle or back. Cushioning will help absorb the impact of your heel striking the ground.

    When trying on a new pair of shoes, do it in the afternoon, or after a walk, when your feet will be warm and slightly swollen. Whichever shoes you choose, they should be immediately comfortable and not need any Ďbreaking-in.í

    Choose activity-specific shoes, i.e., tennis shoes for tennis, running shoes for running, and so on.

    And donít rule out flip flops for the summer. ABEO, Orthaheel, and Okabashi all make flip flops that provide arch support and are reported to be extremely comfortable to wear, even with plantar fasciitis.

    Heel cups, insoles, and arch supports can be purchased to customize your regular shoes. If purchasing an over-the-counter arch support, make sure that you canít squash it down with your hands. If you can, it isnít strong enough.

    Whatever you do, donít try to walk barefoot until your symptoms have gone.

  • Can I Use Compression Socks for Shin Splints?

    Can I Use Compression Socks for Shin Splints?

    The term shin splints is used to describe pain felt in the front of the lower leg, usually as a result of exercise. Although pain in that area can be caused by other conditions such as compartment syndrome or a stress fracture (which is why you should always get medically assessed) the milder condition of medial tibial stress syndrome is often the reason for the painful symptoms. Medial tibial stress syndrome is the second most common running injury. Runners who suddenly increase the length or intensity of their runs, or start running on a harder surface, along with basketball players, tennis players, and other athletes are susceptible.

    Too much pressure on the shins inflames the layer of connective tissue that covers the surface of the shinbone (periosteum). Medical advice is to avoid running until all symptoms have subsided (at least two weeks), and then to gradually resume. Icing the sore area, or foam rolling the shins can help, and strengthening the muscles in the legs to help support the lower leg structure is recommended.

    In order to minimize the chances of developing shin splints, itís important to wear high-quality running shoes with insoles that absorb shock. Flat feet can cause medial tibial stress syndrome, so if you suffer from that condition, use arch supports in your shoes.

    Compression socks can help with the symptoms of shin splints. The elasticated fabric provides gentle support for the lower leg, while adjustable straps over the tendons and muscles reduce pressure on the shin. The compression supplied by the socks holds the bones, muscles, and tendons tightly together so the vibration of the leg on striking the ground is lessened.

    Compression socks tend to be thin and lightweight, although styles and brands can vary, but generally they are comfortable to wear both during exercise and afterwards.

    They donít help all users, but enough athletes claim that compression socks have been extremely effective in reducing the symptoms of shin splints to warrant giving them a try. Long-distance runners find them particularly effective. People report that wearing them not only during exercise, but also after exercise and while sleeping greatly improves recovery time from the exertions of the exercise.

    Compression socks vary in the amount of compression they provide, so you might have to experiment to find the right level for you, but as they are relatively inexpensive this should be possible, and they might be just what you need to avoid the pain of shin splints.

  • Foam Rolling for Injury Recovery

    Foam Rolling for Injury Recovery

    Foam rollers are cylinders of varying lengths and density, and have ridged or textured surfaces.

    F
    oam rolling, or self-myofascial release, are terms for self-massage that uses your own body weight to apply pressure to specific parts of the body. The benefit of using a foam roller is that you can determine for yourself how much pressure to apply. It is recommended that you check with your medical practitioner or physical therapist first, to make sure there are no reasons to stop you using one.

    The fascia is a connective tissue, rich in sensory receptor cells, that surrounds every muscle (as well as every nerve, bone, blood vessel, and organ) like a continuous web. It has a role as a structural support for function and movement. Damage to the fascia can lead to the formation of trigger points, or Ďknotsí that are painful when compressed or stretched and can cause referred pain elsewhere in the body.

    Referred pain is the term to describe what happens when pressure is applied in one spot, and pain is felt radiating to another spot, i.e., when rolling the iliotibial (IT) band, which lies along the outer side of the thigh, pain can be felt going up to the hip or down to the ankle.
    The IT band is not muscle but connective tissue, and cannot be manipulated by foam rolling. Instead, roll the muscles that attach to the IT band: the gluteus maximus (the big muscle in the buttock) and the tensor fasciae latae (the muscle that runs along the outer edge of the hip).

    Another reason not to roll the IT is the danger of rolling over the bursa sac on the bony protuberance on the outside of the hip (greater trochanter). A constantly irritated bursa can lead to many complications.

    Self-myofascial massage, or foam rolling, applies pressure to specific parts of the body to aid the recovery of muscles. It is thought that it works by breaking down adhesions and scar tissue to promote better blood flow, thereby increasing the efficiency of nutrient and waste exchange at the cellular level. This results in better cellular function, which leads to faster healing.

    I
    t can be uncomfortable in the same way a deep tissue massage can be uncomfortable, but it should be bearable. If you are new to this technique, start with a softer roller. Apply moderate pressure to a specific muscle or muscle group by using your body weight on the roller.

    It is important to avoid rolling on a joint, tendon, or bone. Never roll your lower back as the spinal muscles will contract to protect the spine. Instead, roll your upper back where the shoulder blades and shoulder muscles protect the spine. Donít go below the rib cage. And donít roll on a torn muscle because you will only aggravate the injury.

    Itís recommended to start indirectly, rather than directly on a sensitive area. Work a few inches away from that spot. When you hit a tight or sore spot, pause and try to relax. Within five to thirty seconds the pain should ease. Gradually move inwards.

    Roll slowly, no more one inch per second. It isnít necessary to work over an entire muscle if only a few places are sore. Use short, slow rolls over the sore spots, and spend not more than twenty seconds on each sore place. Too much time and too much pressure increase the likelihood of hitting a nerve or causing damage to the tissue.

    Keep doing it to reap the full benefits.

  • Low Impact Exercises

    Low Impact Exercises to Stay in Shape During Recovery

    Aerobic exercise increases the heart rate, which in turn increases the flow of blood around the body, taking healing nutrients to all body structures. It also improves strength and flexibility without jarring the joints or spine. If you are recovering from an injury and want to keep in shape, it is important to first obtain approval from your doctor. Start slowly and carefully. As you build strength and endurance, increase the time and intensity of your exercise, but take care not to aggravate existing conditions.

    Walking is possibly the best exercise you can do. Walk two to three miles, three times a week, to strengthen the muscles in your feet, legs, hips, and torso. Walking also strengthens bones, reduces loss of bone density, and helps to control weight. If youíre just beginning, start on a treadmill, which is lower impact than on natural terrain. Add hills and varied terrain as your strength and endurance increases.

    Swimming is also excellent aerobic exercise that places no impact on your joints and uses almost every muscle in the body. Water counteracts gravity, which allows more mobility. You donít even have to swim; any exercise in water will help keep you in shape as you recover.

    • Try walking forwards and backwards in chest-high water, using hand held weights to increase the workout.

    • Holding on to the side of the pool and standing on one, slightly bent, leg while stretching the other leg out in front of you stretches and strengthens the muscles in the lower back, hip, and leg.

    • Floating on your back and making paddling movements with the arms and legs exercises the four limbs.

    • Floating on your stomach, holding on to the side of the pool with both hands and stretching the legs out behind you stretches the muscles and joints of the back and shoulders.

    Stationary bicycling strengthens the legs, increases endurance, and provides a cardiovascular workout. Arm ergometers give the arms and upper body a workout.

    Elliptical trainers or step machines increase strength and endurance without jarring your joints. You can even use your own stairs; depending on your beginning condition, start with a few steps and gradually increase the number of stairs climbed.

    Rowing or kayaking on water exercises the back, shoulders, and arms. If you have the use of a rowing machine, that works the legs as well.

    Yoga, Pilates, and Tai Chi strengthen, stretch, and improve flexibility.

    Weight training increases endurance and power. Begin with a weight that you can comfortably hold while doing 8Ė15 repetitions. When that starts to feel easy, increase the weight a little. Weight training can help to maintain bone density.

    Circuit training: If you have the use of a gym, circuit training is an excellent, low impact way of staying in shape. Do 10 minutes on a bicycle, 10 minutes walking, and 10 minutes on the rowing machine, alternating these sessions with exercises using weights.

    Whatever type of exercise you choose to do, get medical approval before beginning, start slowly and carefully and gradually build up time and intensity. Taking care not to overdo it at the beginning means you are less likely to reinjure yourself.

  • Shoes to Use for Drop Foot

    Shoes to Use for Drop Foot

    Drop foot occurs when the muscles in the front of the lower leg are not strong enough to lift the ankle and toes upwards (dorsiflexion). As a result, instead of the foot being lifted at each step, it hangs down and can even drag on the ground. Drop foot is a result of another, separate condition that might be a herniated disc, an injury to the nerve behind the knee, a disease of the nervous system, or even caused by surgery on the knee or back.


    Finding a comfortable, supportive shoe that isnít so heavy that it makes the condition worse can be difficult. Heavy shoes will hold the foot firmly, but weigh the foot down. Lighter shoes are easier to walk in, but may not provide enough support. Many foot drop sufferers find that shoes that hold the ankle firmly, such as high top tennis shoes, are a good solution. Some orthopedic surgeons and orthotic/prosthetic practitioners recommend cross-trainers. Other possibilities are Doc martens or Mary-Jane-style shoes. Shoes with Velcro straps or laces that can be adjusted for optimum tightness will give you extra support.

    For a dressier shoe, try a boat shoe or penny loafer. Bear in mind the material that the shoes are made from. Leather is heavier than canvas, which in turn is heavier than mesh.

    If you use an ankle-foot orthosis (AFO) or brace such as the Elevate Foot Drop Brace, your options are greater as you can wear an orthosis with regular shoes. You might have to buy your shoes in a larger size so the AFO can fit inside. Look for styles with extra depth to accommodate the orthosis, or shoes with insoles that can be removed to provide the necessary depth. Foot drop sufferers have recommended Nike, Keen, New Balance, LA Gear Poise, Ecco, Hush Puppies, Avia, and Brooks Adrenaline as being lines and styles to try. Itís a good idea to take your AFO with you when you go shoe shopping.

    If you find a brand or style that works for you, buy more than one pair if you can. It will save you having to start your search over if the brand you like is discontinued.


  • What is Pulsed Electromagnetic Field Therapy?

    What is Pulsed Electromagnetic Field Therapy?

    The use of magnets to aid a patientís recovery was used by the Chinese as far back as 2000 B.C., and noted by the Greek physician Galen around 200 B.C. Over the years its popularity has waxed and waned, and was for a time only used by vets, usually treating broken bones in racehorses. Horses showed a remarkable increase in strength and endurance following electromagnetic therapy, and scientists began to investigate its use for humans. In 1971, the successful healing of a nonunion fracture was achieved through the use of 10 microamps of direct current delivered via electrodes.

    Pulsed electromagnetic field therapy (PEMFT), also known as pulsed magnetic therapy, pulse magnetotherapy or PEMF, is a non-invasive treatment used in many applications, particularly orthopedics, pain relief, and swelling. It has the benefits of being drug-free and without side effects, and does not interact with prescribed medicines.

    Each magnetic pulse produces a tiny electrical charge, which, it is claimed, affects the cell membrane, allowing channels to open so that nutrients may enter and waste leave with greater efficiency. PEMFT is believed to shut down the inflammatory response in the body. According to many, it also increases ATP production. ATP is a chemical used by the body for energy, hence the demonstrated increased power of the racehorses. However, increased production of ATP depends upon the magnetic current staying below 500 microamps. Any higher than that, and ATP production drops.

    Cells of the same type join to form tissue, and similar tissues form organs. Restoring or improving cell function increases overall function of the body, so optimizing cell function increases the possibility of healing.

    Bones, in common with other body tissues, contain electrical properties. A pulsing magnetic field applied to a bone causes very small movements that result in tiny electrical charges within the bone cells, which is believed to stimulate the cells into regenerating. PEMFT is being used as a supplemental therapy in cases where broken bones have failed to fuse, or are taking longer than normal to mend.

    As well as orthopedic applications, PEMFT is being used to treat injured or swollen tissues such as backs or shoulders, joints, scars, and even cancer, where it has effectively reduced pain and, in some cases, reduced tumor size. Used for post-operative pain relief in cosmetic surgery, patients have reported half as much pain as other patients who did not use the technology.

    Successful treatment can depend on the intensity (measured in Tesla) and frequency (pulses per second, measured in Hertz) of the magnetic pulses. The most beneficial range for people is between 1 and 50 Hertz. Efficiency rapidly decreases when Hertz levels reach 100-200. Although studies are not complete on the optimum intensity and frequency for particular applications, it is known that the pulse will not be able to penetrate to deeper areas of the body if the magnetic field is too weak.

    There are several patches, mats, and other devices available for the home use of pulsed electromagnetic field therapy, which may be an effective adjunct to the treatment of your painful joints and muscles.

  • What's the Best Night Splint for an Achilles Tendon?

    What's the Best Night Splint for an Achilles Tendon?

    People who suffer from a painful Achilles tendon often complain of stiffness in the tendon after a night's sleep.

    Tendinopathy is the term used by many doctors to describe a tendon injury. Such injuries are usually as a result of overuse, and are common in athletes, particularly older athletes. The term covers both tendonitis (inflammation of the tendon) and tendonosis (tiny tears to the tendon fibers.) Usually tendonosis is the cause of pain. Sometimes the tears can be more severe, or even ruptured. Such injuries can take a long time to heal, and require weeks or months of rest.

    During the day a walking boot or cast can be worn, but these are bulky and unsuitable to wear at night.

    There are two main options to prevent the Achilles tendon stiffening up overnight and causing increased pain when trying to walk. One is the Strassburg Sock: This covers the foot and lower leg. An adjustable strap runs from the toe end of the sock and fastens at the calf, keeping the foot flexed upwards and slightly stretching the tendon during the night.
    Strassburg Sock with adjustable strap

    The other option is a brace, or night splint. These have a rigid shell with a padded interior. The shell can be behind the calf and under the foot, or over the top of the foot, ankle, and lower shin. They have adjustable straps with hook and loop fastenings. Night splints hold the foot in a neutral position, rather than slightly stretched, which many users claim is more comfortable than the Strassburg Sock. They can also be more effective as the sock is designed primarily to dorsiflex the toes in order to ease symptoms of plantar fasciitis rather than Achilles tendon pain.

    It can take some time to get used to wearing a splint overnight, but if you start by untucking all the bedclothes and allow your foot to hang over the end of bed you might find it easier. You can also remove the splint during the night if you find it too much. You will eventually get used to it and be able to sleep comfortably. Ideally you should wear it for a minimum of three hours.

    Dorsal splints are regarded as the most comfortable, although they don't have the ability to adjust the amount of ankle flexion. Air form night splints are considered extremely comfortable and lightweight.

    The Ossur Exoform Dorsal Night Splint is very popular. It holds the foot at an optimum 85-90 degree angle. Straps ensure that the brace doesn't slip out of position. Overmolding eliminates any pressure points and the non-slip plantar pad stops the foot sliding forward.

    The Ossur Airform night splint is smaller and lighter. It is designed to be positioned on the front of ankle, unlike the dorsal style. It has padded molding and an air-filled pad lines the splint. The fact that it is open at the heel and doesn't weigh much makes it more comfortable and cooler to wear.

    Other splints that wearers recommend are the Pro-Tec Night Splint, and the Swede-O Deluxe.

    Although it may take a long time for your Achilles tendon to heal, wearing a night splint will speed and ease the process.

  • Who Should Use Compression Braces/Sleeves/Socks

    Who Should Use Compression Braces/Sleeves/Socks

    Compression socks, sleeves, and braces provide gentle but firm support for muscles and joints, and relief for many conditions.

    Compression socks are available in varying degrees of pressure, varying lengths (from knee-high, to the top of the thigh), and various colors. Often they provide firmer compression at the foot and ankle that graduates to lighter pressure higher on the leg. This helps prevent swelling by encouraging blood flow out of the lower extremities.

    Compression sleeves support muscles and ligaments, reduce or prevent mild, localized swelling, and encourage natural blood flow. They are available for the calves, knees, or thighs. Knee sleeves are available with or without a patellar hole. The sleeves with the hole over the kneecap are designed to keep the patella in correct alignment when the knee is bending. This is useful for people whose kneecaps don't track properly. These sleeves are also beneficial post surgery, and for sufferers from chondromalacia.

    Post-operative patients often benefit from wearing compression socks or sleeves for a time, to combat swelling and reduce the risk of deep vein thrombosis. Other conditions such as varicose veins, venous insufficiency causing chronic ankle and leg swelling, shin splints or phlebitis can be relieved by their use.

    People who have to stand for long periods of time will suffer from less leg fatigue and swelling of the ankles if they wear compression socks throughout their periods of standing.

    People suffering from joint and muscle pain, sprains and strains of the ankle or knee, bruised knee, runner's knee, Achilles tendonitis or mild arthritis will also appreciate the comfort and support provided by compression socks or sleeves.

    Athletes find that the increased blood flow from wearing compression socks results in more energy, greater endurance, reduced injury, and faster recovery. However, in order to avoid the danger of deep vein thrombosis, the socks should not extend above the knee. Athletes often wear compression sleeves on their knees or quads for the same reasons, as well as to provide support for weak or recovering muscles, ligaments, and joints.

Athletic Rehabilitation & Injuries

Exercise injuries and pain are especially frustrating because they get in the way of the movements athletes must perform every day. Experiencing any of these common sports injuries can slow at athlete down and force them to disrupt their regular workout schedule, sometimes leading to a major decline in performance. The best way to ensure that you wonít have to deal with a debilitating injury is to learn proper prevention techniques and treatments for early-onset symptoms.

MMAR Medical is proud to offer a comprehensive resource library to teach athletes and sports medicine professionals how to prevent sports injuries and how to treat existing problems. We recommend specific treatments for various types of ailments, including physical therapy and orthopedic bracing options. Identify your ailment and learn how best to deal with it using our professionally written resources above.

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