Summer is over, but for those avid runners among us, it’s still running season:  time to hit the road with your properly fitted shoes, and moisture-wicking sportswear.  Follow each run with these 7 stretches and you will assure that you’re able to enjoy your jogs, injury free.

Standing Calf Stretch

The calf muscle runs along the back of your lower leg. In runners, this muscle is prone to a calf pull or strain.

• Stand about an arm's-length from the wall.
• Lean forward and place both hands on the wall about shoulder width apart.
• Extend one foot (the side to be stretched) behind you with one heel on the ground and one foot closer to the wall.
• Lean into the wall with your hips until you feel a stretch in the calf of the extended leg.
• Hold this stretch for about 30 seconds and change sides.
• For a deeper stretch, move your foot farther back.

Standing IT Band Stretch

The IT band is a tough group of fibers that run along the outside of the thigh. IT band syndrome is a common running injury that is generally due to inflammation and irritation of this band. Here is a simple stretch you can do while standing.

• Stand with your left leg crossed in front of your right leg.
• With your right arm extending overhead, reach to the left.
• Put your left hand on your hip.
• Push slightly on your left hip until you feel a slight stretch along the right side of your torso, hip, upper thigh and knee.
• Hold 20 to 30 seconds and change sides.
• For a deeper stretch, keep your feet farther apart, bend the knee of your forward foot and keep the back knee straight.

Standing Quad Stretch

The quadriceps (quads), are a group of muscles along the front of the thigh. There are many different ways to stretch your quadriceps, but here is a simple one you can do while standing.

• Stand on one leg (grab onto something solid if you need support).
• Bend your knee and bring your heel toward your buttock.
• Reach for your ankle with your hand.
• Stand up straight and feel a slight pull along the front of your thigh and hip.
• Hold the stretch for 20-30 seconds, release and repeat on the other leg.
• Be careful not to strain your knee - the goal is not to touch your heel to the buttock, but rather to stretch the thigh.

Seated Hamstring Stretch

Because tightness in the low back and hamstrings is often related to muscle pain and stiffness in runners, this stretch can help maintain good running form and reduce the risk of stiffness, pain and injury.

• Sit on the floor with your legs stretched out in front of you with knees straight.
• In a slow, steady movement, lean forward at the hips, keep your knees straight and slide your hands up your legs to your feet.
• Extend as far as you can, and flex your feet slightly to increase the stretch.
• Hold the stretch for 20-30 seconds, release and repeat two to three times.

Hip Flexor Stretch

The hip flexors are a group of muscles that bring the legs up toward the trunk. Runners rely on these muscles, particularly when running uphill.

• Begin in a forward lunge position and drop your back knee to the floor.
• Raise your arms and hands up over your head and look up.
• Press your hips forward and down toward the floor and feel a stretch through your torso, hip, groin and thigh.
• Hold the stretch for about 20-30 seconds, release and repeat on the other leg.

Shoulder Stretch

This is a basic shoulder stretch you can do anytime and anywhere.

• Begin standing up straight with shoulders relaxed and back.
• Reach your right arm up over your head, bend your elbow and reach your hand behind your neck.
• With your elbow pointing up to the sky, slide your right palm down to your back.
• With your left hand, grip your right elbow and gentle pull it toward your ear.
• Continue sliding your right palm down your back without straining.
• Hold for 10-20 seconds and release.
• Repeat with the opposite arm.
• Be sure to keep your head up and resist the urge to bend your neck forward.

Plantar Fasciitis Stretch

This stretch is used to relieve the pain of plantar fasciitis by stretching the plantar fascia, a band of tough connective tissue that runs along the bottom of the foot to the heel.

• Stand barefoot.
• Lift one heel off the ground but keep the ball of the foot and toes flat.
• You will feel a stretch on the underside of the ball of the foot.
• Hold for a count of ten. Release.
• Repeat ten times.

Americans love competition, which makes it no wonder why it is so pervasive in sports. This competition is usually accompanied by a strong desire for maintaining good fitness habits. However, many sports aficionados experience one of the costs of the endeavor to pristine health, sports injuries.

No one likes getting hurt, in the near term it causes us to sit out the game, hold back on our exercise routine for recovery time, and may increase our medical costs. In the long term it may exacerbate arthritic conditions with aging or weaken a body part making it more prone to injury in the future. In the very extreme, it may cause catastrophic injury or death.

This article will hopefully shed some light onto details that can aid in understanding what sports are the most dangerous. What qualifies as the most dangerous sport is a matter of opinion, as it can be measured in a variety of ways.  The approach taken in this case was to generally look at sports most people play and compare them against each other in terms of number of injuries, body parts injuries, ages of those injured, and what types of injuries occurred using the Consumer Product and Safety Commission’s NEISS database .

Overall research paints only one perspective of what qualifies as the most dangerous sport. There are so many other qualitative factors that each individual should consider before determining what sport may be safest for them.  In particular, it is hard to consider the severity of injuries incurred in the research since everyone has different pain tolerances. For example, one could argue that basketball is dangerous since they had the most ankle injuries, however since most injuries would not qualify as a catastrophic injury, it may be an injury risk the sports enthusiast considers worth taking.

Comparing sports is by nature comparing apples to oranges since some sports by design have increased personal contact and can be affected by the level of protection required by the sport. The choice of the player to wear certain optional protection will affect incidence or severity of injury. For example ice hockey is a high contact sport and players wear considerable padding, but the amount of padding depends on the player. Hockey players can choose a face mask to prevent facial injuries, but it is not universally used, rather at the option of the player. That said there are 5 interesting takeaways:

Protect your head! - The most common injuries to occur for all sports in the sample were to the head (8554), mouth (1544), and face/cheek (5927), so protect your noodle. The national estimates translate into a large number of injuries that might be preventable. The national table (Table 1) is presented below:

Table 1

Head protection is becoming more common even in sports such as soccer (due to head on head or head to ground collision) because health officials and players alike recognize the value of injury prevention. Whether on a bike, the ice, or the gridiron, where your head and face protection, and where it properly. Let others worry about the fashion statement a helmet may make while you worry about the scoreboard.

Get a ‘Leg’ up on competitors by taking care of yours – Sample injuries to the Ankle (8052), knee (5470), foot (2076), lower leg (2750), and upper leg (764) comprise many sport participants’ injuries. While often these injuries may not be catastrophic as head injuries, they often lead to health problems as the individual ages. Lack of proper stretching and warm up are often contributors to many over extension injuries. If your team is relying on your legs to make that jump shot or punt kick, rely on proper stretching to help keep you at your best.

Playing by the numbers…- If one defines the ‘most dangerous’ sport by the sport most likely for a participant to become injured, the top 3 would be Basketball, Bicycling, and Football (Table 2). It makes sense since these activities are some of the more popular sports. This definition does not suit everyone since a sport that is more popular is more likely to have more aggregate injuries. If one defines ‘most dangerous’ as the sport with the greatest number of injuries per number of participants then football, skateboarding, and basketball could be considered the most dangerous  (Table 3).

Table 2:

Table 3

What to play if you don’t want to get hurt- Mountain biking, tennis, and golf where those that scored lowest in terms of injuries per participant. Keep in mind though, that the survey was of hospital visits, so it probably doesn’t include tennis players who go to their medical doctor for tennis elbow.

Injuries favor the young – The vast majority of injuries occur within the 10 to 15 age group, with the 15 to 20 age group a somewhat distant second. The peak injury age, that is the age at which the greatest number of injuries is recorded below for each sport (Table 4). While the peak age differs between sports, all are a relatively young age. If you’re a parent concerned about your youngster’s health in sports, this is especially important. Children are not only learning how to play these new sports, but are also learning to play in their growing bodies. Instilling proper warm up and stretching technique is even more imperative. If contact sports concern you, see if there are intramural sports are available, which can teach sports and healthy activity while avoiding some overly competitive nature that may lead to increased injury incidence. It’s always a good idea to consult your doctor as well as sports injury professionals on prevention methods and devices such as sports goggles, knee or elbow supports.

Table 4

In short, what qualifies as the most dangerous sport is anyone’s guess because it depends on the person who’s guessing. Every individual must first ask themselves what their definition of what qualifies as ‘most dangerous’ and what risk they wish to take in pursuing healthy sports activities.  The important take away is that since every sport has different tendencies for injuries. If you know what sport you want to play, then the best way to protect yourself is to understand the most common injuries of your sport and use preventative injury techniques accordingly.  Lastly, have fun! (As safely as possible).

Formula 3 is now offered by Dr. Bender at Advanced Physical Medicine
 
Last week's blog focused on fungal toenails or onychomycosis.  This week, we will discuss a new topical treatment option that is only available from podiatrists, Formula 3.  This medication employs a very old drug, tolnaftate, but the company that created the product was able to make tolnaftate oil soluble, so that it penetrates the nail better.  The oil used to make this possible is jojoba oil.  Formula 3 is active against a variety of orgnaisms (including the most common fungi that infect toenails):  T. rubrum, T. mentagrophytes, Candida Albicans, and others.
 
This product is applied daily to the infected toenails.   There are NO side effects to the drug.  Fungal toenails require at least 9 months of application of the medication to clear out the fungus.  Topical solutions have been reported to be 50 percent effective for fungal nails.
 
Formula 3 is available from Dr. Bender at Advanced Physical Medicine for $30 (U30 USD). 

Additionally, the company that makes Formula 3 offers a no questions asked money back guaranttee if you are not satisfied with the product. 
 
If you are interested in this product, please make your appointment today!

Mary Ann Bender, DPM
Foot and Ankle Specialist

Believe it or not, what you eat before and after your workout has an impact on your overall performance and energy level. In order to perform and feel your best while exercising, it is important to incorporate a variety of healthy foods into your diet.

Planning your meals before and after you exercise can help you get in a good workout without feeling drained. Here are some tips on what to eat to maximize your workout.

Balance your meals

Two to three hours before your workout, eat a meal that contains a mix of carbohydrates, fat and protein. This mix of macronutrients will give you energy and keep you from feeling hungry shortly after eating. Try a turkey burger with Swiss cheese on a whole grain bun or chicken pasta salad with grated Parmesan cheese.

Go for energy packed snacks

Snacks that will keep you fueled during your workout consist mostly of carbohydrates with a little protein. These snacks should be consumed no less than an hour before your workout and are also ideal to eat post-workout. Yogurt with granola or crackers with peanut butter are two good choices.

If you’re hungry immediately before

Easily digestible snacks like crackers or applesauce are what you should eat if you’re hungry immediately before your workout. Sugary snacks such as candy or fruit juice are a good option if you’re planning on doing a cardio session such as kickboxing, running or swimming.

So practice these tips and eat well for a better workout.

Why are my toenails thick, discolored, and crumbling?

What is it?

A fungal toenail often appears thick, discolored (brown, black, yellow, white), crumbly, loose, and/or distorted in shape. It can involve one nail or multiple nails on the feet.

Causes

Fungi normally inhabit all of our shoes and socks because the warm, moist environment allows the fungi to thrive. The most common causes are the following: trauma or injury to the toe, athlete’s foot infection of the surrounding skin, pedicures, certain diseases which affect the body’s immune system, and genetics. In some cases, it is not known why a toenail develops a fungal infection. Pedicures and injuries of the nails or toes can both cause tears in the cuticle (a protective barrier for the nail plate), and this readily allows the fungus to enter. Athlete’s foot is an invasion of the skin by fungus, causing blistering, scaling, and itching. The same fungus enters the nail plate. Certain diseases that affect the immune system, such as diabetes, cancer, and others, can also weaken the body’s ability to fight of a fungal infection. Finally, some research shows that genetics can play a role in fungal toenail development.

Treatment

There are two ways to treat fungal toenails: topical or paint on treatments and oral treatments. The topical treatments typically work fifty percent of the time and require 9-12 months of daily applications. The oral option is a three month course and has a success rate between 75 and 85 percent. This treatment requires analysis of the patient’s blood work prior to treatment, as the drug is broken down by the liver. There are benefits and weaknesses of both treatment options, so it is important to schedule an appointment to see which is best for you. Also, it is important to know that there is not a treatment available for fungal nails that is 100 percent successful.

Dr. Bender is a podiatrist at Advanced Physical Medicine, with Oak Park and Chicago locations. She is also an instructor for William Scholl College of Podiatric Medicine.

Feeling a little toxic lately? You don’t need to go a on a crazy diet to feel fresh again. Here are five fun and simple ways you can detox your body in no time.

1. Eat clean

It is no secret that most fruits and vegetables contain harmful pesticides. The U.S. Environmental Protection Agency warns against the harmful effects of pesticides on the skin, eyes and nervous and endocrine systems. Some of the most pesticide-laden foods include apples, celery, strawberries, spinach and peppers. Choosing the organic option for these foods is essential for your detox.

2. Get moving

Exercise is another great way to cleanse and protect your body. In fact, recent studies suggest that exercise may reduce the ongoing damage done to cells, tissues and organs. The more your body undergoes these detrimental changes, the more likely you are to develop conditions such as heart disease, diabetes and stroke. Exercise is also responsible for increasing your immune system, which will help you ward off viruses and bacteria, as well as some forms of cancer. So put on your gym shoes and get moving.

3. Hydrate

Drinking water is one of the easiest ways to flush your body of toxins and improve its ability to transport nutrients. If drinking water is difficult for you, try incorporating more water-based foods and drinks into your diet such as lettuce, broccoli, watermelon, milk and orange juice.

4. No smoking

Smoking tobacco introduces many chemicals and toxins into your body. Over 4,000 chemicals are found in tobacco, including 19 that are proven to be cancer causing. Still hesitant to quit? The benefits of quitting begin almost immediately after you stop smoking. Within 20 minutes of your last cigarette, your body returns to normal temperature and pulse rate. If you make it five years without smoking, your risk of dying from lung cancer is 50 percent less than moderate to heavy smokers.

5. Lay off the booze

Though consuming small amounts of alcohol may be beneficial to your health, it is still important to remember that alcohol is a toxin and can pose serious health risks. Alcohol dehydrates your body and makes it difficult for your stomach to absorb essential nutrients, making your body more likely to become malnourished.

So go ahead, give it a try and reboot your body to optimal health.

My toenail is hurting me!

An ingrown toenail occurs when the toenail curves into the surrounding skin. On some occasions, it just punctures or pushes on the skin, causing pain. However, if it progresses, it can break the skin (often from a sharp piece on the nail), and this can cause the skin to get infected. Infected skin can become red, hot, swollen, and have pus coming from it.

Why did I get this?

Ingrown toenails can be caused by several things: trauma, cutting the nails incorrectly, fungal infections in the nail, bunion deformities, shoes that do not fit properly, or genetic (or inherited) causes.

What do I do?

It is important that you see a podiatrist to handle this condition. Trying to treat it by yourself can make it worse because it is hard to see, you do not have the correct or sterile instruments, and because you are not able to get out the problematic piece of nail.

What will your podiatrist do?

Occasionally, the nail can be cut out without anesthetic. However, in most cases, the ingrown nail can only be removed by numbing up the toe with anesthetic. If the toe is numb, the whole edge of ingrown nail can be more easily removed by your foot doctor. It is important that all of the offending nail is removed because the condition will not improve if there is still sharp nail cutting into the skin.

What will I have to do to take care of it when I go home?

Your podiatrist will give you soaking and bandaging instructions to perform each day for the next week. Usually, over the counter pain medication and resting (and elevating) are enough to handle any pain you will have. On occasion, there may be a severe infection that requires antibiotic pills or stronger pain medication. However, this is not required in most cases.

Will it come back?

Ingrown toenails can return. It takes 9-12 months for the whole nail edge to regrow. If the condition comes back, your doctor can talk to you about permanent procedures, so that this does not occur again.

If you have this condition, please call for an appointment with Dr. Bender, an Oak Park and Chicago podiatrist. 708-763-0580 Oak Park office

Dr. Bender is in private practice at APM and teaches at Dr. Scholl's School of Podiatry in Chicago.

Mary Ann Bender, DPM
Foot and Ankle Specialist
Advanced Physical Medicine

Back pain is one of the most prevalent types of chronic pain. When experiencing this type of pain, it is easy to get discouraged about exercising or even stop altogether. Though you may never feel 100 percent, there are several important factors to keep in mind about exercising with back pain. Here are four exercise tips that will keep you feeling fit without furthering your pain.

1.  Know what to avoid

Certain exercises can worsen your back pain. Some of the worst exercises for your back are toe touches, leg lifts and sit-ups. Remember, for any exercise, there is a variation. For instance, instead of sit-ups, try partial crunches. A personal trainer or fitness instructor can help tailor your exercise routine to include exercises that will help ease your back pain.

2.  Keep up with your aerobics

Researchers at UCLA found that 30 minutes of aerobic exercise per day is better for relieving back pain than regular back exercises. The reason why aerobic exercise works better is because people have a tendency to perform exercises incorrectly, which can worsen their back pain. Aerobic exercise is not only a safer option, but it also keeps your heart pumping and increases your cardiovascular fitness. Good aerobic activities include swimming and walking.

3.  Strengthen your abdominals

Just as people with bad knees should strengthen their thigh and leg muscles, people with bad backs should work out their abdominal muscles. Abdominals comprise the body’s core. A weak or imbalanced core can translate into back pain, especially in the lower region. A great way to get a good core workout is Pilates. Taking a class is your best bet because the instructor will explain variations for specific weaknesses including back pain. This way you can strengthen your core without further injuring your back.

4.  Don’t underestimate stretching

Stretching your back muscles helps soften the tissues and mobilize the spine. Keeping up with a stretching routine will ease the pain and allow greater range of motion in your back. Remember to get proper instruction when stretching so you are sure to avoid further injury. Taking a yoga class is an excellent stretching option because the instructor will help you with your form. The benefits of yoga go above and beyond simple stretching.

So get out there and get moving. There is no reason why a bad back should prevent you from feeling your best.

Why are my feet itching and scaling?

The most frequent cause of itching, scaling, and sometimes blistered feet is called Athlete’s Foot or Tinea Pedis. This is a fungal infection of the skin of the feet and can be very annoying if not treated appropriately.

Fungi thrive in warm, moist environments, like our shoes and socks. Additionally, they love gyms, pools, and locker rooms because they are, again, typically hot and humid.

How is this treated?

The best way of treating this condition is to get a prescription from your foot doctor for a cream or ointment that kills the fungus. Over the counter agents that can be purchased at local drug stores only stop the fungus from multiplying, so this might not work in clearing up your condition.

How is it prevented?

1. Keep your feet dry by changing your shoes and socks regularly, especially if you tend to have sweaty feet.

2. Use over the counter antifungal sprays or powders each day.

3. Spray your shoes out with Lysol to kill germs.

4. Wear shower shoes in locker rooms or around pools.

5. Do not go barefoot.

Why do I need to treat it?

1. Fist, it is annoying, and treatment can make you more comfortable

2. The condition can progress if untreated, requiring oral antifungal medication (pills) or antibiotics (pills) if a secondary bacterial infection occurs from the open sores or blisters on the skin.

3. It can lead to fungal infection of the toenails. This causes the nails to become thick, discolored, and crumbly.

If you feel that you have this condition, contact Dr. Bender, a podiatrist in Oak Park and Chicago, for an appointment to see what treatment is best for you. 708-763-0580 Oak Park office.

Contrary to popular belief, snacking is not bad for you. It’s actually very good for maintaining a healthy metabolism and helps prevent overeating during meals. You just have to know how to snack the healthy way.  Here are three simple tips for smart snacking.

1.  Make it healthy and nutritious

The best snacks incorporate protein and carbohydrates to satisfy your hunger and provide you the energy you need. Unhealthy snacks tend to give you an initial burst of energy, but leave you feeling dull and ready for a nap within 20 minutes. Stick to simple, unprocessed snacks with few ingredients and incorporate different food groups. Some of the best choices for snacks include an apple with peanut or almond butter, veggies and hummus, yogurt and granola and cheese and whole grain crackers.

2.  Practice mindful eating

When you are glued to the TV or computer, you are less likely to realize how much you are consuming. The best way to remain mindful when eating is to eliminate any distraction around you. Focus on the smell, texture and taste of your food. This will help you pay closer attention to your hunger cues and will lessen the likelihood that you will overeat.

3.  Don’t eat your feelings

Staying mindful will also help you determine whether you are eating out of hunger or emotion. Take note of your mood before you grab that snack. Are you stressed? Upset? Sad? These can all be reasons for you to comfort yourself by indulging in a treat. Emotional eating usually consists of unhealthy choices, which is another reason to be aware of why you are eating in the first place. So if you figure out that you are actually not hungry, find something else to do instead. Take a walk or treat yourself with something other than food, such as a movie or shopping.

So don’t think twice about grabbing a midday treat. Just take our advice and snack right.