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5 Great ways to HURT your Back this Winter

According to the Centers for Disease Control, this winter, more than 50,000 Americans will wind up with a winter-related back injury. Here are 5 activities that could put you at risk:


Back Pain from ShovelingMuch of the country will have at least a few inches of snow in the next few months. If you have sidewalks or driveways around your home, that means shoveling. Here are some quick tips to avoid a back injury when clearing the snow.
-Lift with your legs, not your back.
-Don’t overload your shovel.
-Don’t twist and throw the snow; walk it over.
-Be ambidextrous (if you’re so inclined).
-Take breaks.
-Hire the neighbor kid, get a snowblower, or move to California!


Back Pain from DecoratingTake a look around your neighborhood. Chances are holiday decorations range mightily from restrained to ridiculous. Whatever your capacity for decorating madness, take some precautions to avoid back injury. First, don’t work alone. Having an extra set of hands and an additional pair of eyes is your first line of defense. Second, there is no doubt climbing a ladder will be a part of your efforts--up the tree, into the attic, on the roof. Be efficient and take as few trips up and down as possible. Use a spotter to take or give necessary items so you aren’t forced to overreach or awkwardly twist.


Back Pain while TravelingIf you’re planning on heading out of town this winter, take notice of your luggage. Are you overpacking? Does your luggage have wheels and handles so you can pull it behind you? If your luggage isn’t up to par, take the opportunity to ask Santa for an upgrade.


Back Pain While ShoppingThe same rules go for shopping too. Don’t get caught hauling around too many shopping bags. Make multiple trips out to the car if you have to. It’s worth the extra few minutes to not hurt yourself. As always, lift with your legs! You can even ask retail clerks for a little help, particularly at big box stores. And think about spreading the cheer by throwing your holiday helpers a few bucks as they close your trunk.


Back Pain in SleepWhile the summer sun is a fabulous accompaniment to an outdoor run or a game of beach volleyball, the shorter and colder days of winter beg for a warm fire, a cozy blanket and a good book. The more sedentary your habits, the more prone you are to back injury. Laying or sitting on couches and sofas provides little support for your back and can result in the tightening of certain muscle groups--hip flexors and hamstrings--that can directly lead to back pain. While it is best to get regular aerobic and strength exercise, If you can’t muster up the energy to get to the gym, try these 5 indoor at-home exercises as an alternative.


Remember to stay active, watch your movements and pay a little extra attention to your winter habits. Keep from being laid up with back pain this New Year’s Eve.

Winter Boots and Your Feet

As the cold, snowy weather approaches, it is important to have and wear good snow boots.  Snow boots should have two goals:  protecting the feet from the cold weather and protecting the feet from slippery surfaces.  However, it is also important that snow boots offer support and cushioning to the feet.  Many people report to my office during the winter months because they have new foot pain from boots that are not supportive.

The cold and wet weather can cause injuries such as frostbite, and people with certain conditions, such as peripheral vascular and autoimmune diseases, various arthrities, cancer, diabetes, and other diseases  are more predisposed to these issues.  Homeless patients are also at very high risk for developing frostbite.  Boots should have warm linings to insulate the feet and must be made of waterproof material, so slush, rain, and snow do not soak through.  When looking for boots, it is important to inspect the bottom of the boots to make sure that the soles provide traction.  Many people slip on ice and snow during the winter months, and this can cause fractures, sprains, and other serious injuries.

Finally, from a podiatric perspective, it is essential that the boots provide adequate support to the feet.  Each year
during the cold months of the year, people irritate the feet by wearing boots that are not stable and supportive.  The boots should have some arch support and cushioning on the bottom.  They should not be flexible and bendable at the ankle
or around the heels.  Patients can develop heel pain, plantar fasciitis, tendontitis, stress fractures, and other conditions by wearing boots that are not good for their feet.

Happy Holidays, and remember to keep your feet safe during the winter by wearing boots that are protective and supportive!

Dr. Bender is a podiatrist at Advanced
Physical Medicine.  She works out of the Oak Park and 63rd Street offices.  Dr.
Bender is also a clinical instructor at William Scholl College of Podiatric
Medicine.  Call 708-763-0580 or 773-776-3166 for your appointment.

5 Great Ways to GAIN Weight over the holidays

Take a cue from Santa, not exactly the pinnacle of physical health, and use these five tips to ensure that you put on those holiday pounds.

1. Taste Test Your Cookies

Cookies for Holiday WeightMaking holiday cookies for family and friends is a long-standing tradition for millions of Americans. Amateur cookie experts around the country have their specialty--that one cookie they’ve been baking for years. What’s your specialty? And are you resting on your laurels? Have you gotten a new oven? Tweaked ingredients? Is that cookie really the same deliciousness you’ve always concocted? This year try at least one or two cookies from each batch...just to be sure.

2. Two Words: Egg Nog

Eggnog for Weight GainSure, one glass of red wine each day is good for the heart, but why stop there? The holidays are a time for indulgence. So instead of that 100 calorie glass of fermented grape juice, reach for that delicious glass of milk, cream, eggs and bourbon--egg nog.

3. Leave the Athletics to the Athletes

holiday weight gainThe professional football season is coming down to the wire; teams (maybe even your team!) are fighting for playoff contention. The college football season is reaching its climax, dozens of bowl games played in the waning days of 2012 and the opening days of 2013. If the gridiron isn’t for you, NBA and NCAA basketball is ubiquitous. With all these games to watch, there is no reason you need to leave the couch. Let the best athletes in the world do the competing. You can just reach for another handful of potato chips and a beer.

4. Forget the Resolutions

Healthy New Years ResolutionWhat kind of masochist makes self-improvement promises only to fail eighty percent of the time? That’s just mean! You’re pretty happy, right? So why try and change anything? This New Year, don’t force yourself to eat better or exercise more. Keep smoking; keep drinking. Those New Year’s resolution promises are just frivolous nonsense.

5. Invite Your Mother-In-Law To Stay For A While

Mother in Law HolidaysThat difficult person on your gift shopping list. The impending credit card bill. The awkward office holiday party. All this stress is inevitable, so why not pile it on and ask your mother-in-law to stay in your house for a week? While we always seem to look forward to the holidays all year ‘round, we conveniently forget the stress that this time of year always seems to bring. Fear not, the holidays also seem to bring a whole lot of food to the table. So, when the stress comes your way, take solace in some delicious sugary treats or a turkey and mayonnaise sandwich. It’ll make you feel better, even if just for a moment.

Good luck with your weight gain goals over the holidays. Remember, it just means more of you to love!

Photo Sources:
1. http://www.branchportlibrary.org/wp-content/uploads/2012/08/cookies.jpg
2. http://www.rachaelray.com/images/recipe/eggnog.jpg
3. http://guardianlv.com/wp-content/uploads/2012/11/Football-on-tv-460x250.jpg
4. http://blog.affinityhealth.org/wp-content/uploads/2012/11/new-years-resolution-apple.jpeg
5. http://cbswycd2.files.wordpress.com/2010/09/mother_in_law_rs.jpg?w=420

3 Healthy Comfort Food Recipes

There’s something about cold weather that makes us want to eat! Whether it’s our animal instinct to fuel up and survive the winter, or because the holidays and food are so inextricably linked, ‘tis the season for feasting. Avoid packing on the pounds this winter with these three healthy twists on classic comfort foods.

Chicken Pot Pie

Chicken Pot PieLike unwrapping a generous gift, there’s nothing quite like sticking your fork into the crust of a luscious chicken pot pie. By cutting back on the cream and going heavy on the veggies, there is no reason a pot pie can’t be a healthy winter treat for you and your loved ones.

For the Crust:

  • 1 cup all-purpose flour, plus more for dusting
  • 1/4 teaspoon baking powder
  • 1/4 teaspoon fine salt
  • 4 tablespoons cold unsalted butter, cut into small pieces
  • 1 large egg
  • 2 tablespoons 2% milk

For the Filling:

  • 2 small russet potatoes
  • 4 1/2 cups low-sodium chicken broth
  • 5 medium carrots, cut into large chunks
  • 1 to 2 teaspoons chopped fresh thyme
  • 2 tablespoons extra-virgin olive oil
  • 1 large onion, finely diced
  • 3 tablespoons all-purpose flour
  • 1/3 cup 2% milk
  • 3 stalks celery, sliced
  • 3 cups shredded rotisserie chicken, skin removed
  • 1/2 cup fat-free plain Greek yogurt
  • 1 cup frozen peas
  • 1/2 cup minced fresh parsley
  • Kosher salt and freshly ground pepper

Prepare the crust: Pulse the flour, baking powder and salt in a food processor until combined. Add the butter, one piece at a time, pulsing until the mixture looks like coarse meal. Separate the egg; refrigerate the egg white. Beat the egg yolk and milk in a bowl, then add to the food processor, pulsing until the dough comes together. Turn out onto a lightly floured surface and gather into a ball. Flatten into a disk, wrap in plastic wrap and chill at least 1 hour.

Meanwhile, make the filling: Preheat the oven to 425 degrees F. Prick the potatoes with a fork and bake directly on the oven rack until tender, about 45 minutes. Cool slightly, then peel and break into small pieces.

Bring the chicken broth, carrots and thyme to a simmer in a small saucepan over medium heat and cook 2 minutes; cover and keep warm. Meanwhile, heat the olive oil in a large pot over medium heat. Add the onion and cook until soft, about 8 minutes. Sprinkle in the flour and stir until lightly toasted, about 3 minutes. Add the milk, celery, potato pieces and the warm broth mixture and simmer until thickened, about 15 minutes. Remove from the heat and stir in the chicken, yogurt, peas and parsley. Season with salt and pepper.

Transfer the filling to a 2-quart casserole dish. Roll out the dough on a lightly floured surface until about 1/2 inch thick and slightly larger than the dish. Beat the reserved egg white in a bowl; brush over the dough and season with salt and pepper. Press the dough against the sides of the dish. Place on a baking sheet and bake until the crust is golden brown, 20 to 25 minutes.


Tuna Casserole

Tuna CasseroleTuna casserole is an American classic and classically unhealthy. A few changes to mom’s old recipe can up the health quotient without sacrificing comfort or deliciousness.

  • 6 oz “no yolk” noodles
  • 1 tablespoon butter
  • 1 medium onion, minced fine
  • 3 tablespoons flour
  • 1 3/4 cups fat-free chicken broth
  • 1 cup 1% milk
  • 10 oz sliced crimini mushrooms
  • 1 cup frozen petite peas (thawed)
  • 1 cup frozen chopped broccoli (thawed)
  • 2 (5 oz) cans albacore tuna in water, drained
  • 4 oz 50% reduced fat sharp cheddar
  • Butter flavored cooking spray
  • 2 tablespoons parmesan cheese
  • 2 tablespoons whole wheat seasoned breadcrumbs

Cook noodles in salted water until al dente (slightly undercooked). Set aside.

Preheat oven to 375°. Lightly spray 9 x 12 casserole with butter flavored cooking spray.

Melt the butter in a large deep skillet. Add onions and cook on medium heat until soft, about 5 minutes. Add the flour and a pinch of salt and stir well, cooking an additional 2-3 minutes on medium-low heat. Slowly whisk in the chicken broth until well combined, increasing heat to medium and whisking well for 30 seconds, then add the milk and bring to a boil. When boiling, add mushrooms, peas and broccoli, adjust salt and pepper to taste and simmer on medium, mixing occasionally until it thickens (about 6-7 minutes). Add drained tuna, stirring another minute.

Remove from heat and add 1 cup reduced fat sharp cheddar and mix well until it melts. Add the noodles to the sauce and mix well until evenly coated. Pour into casserole and top with parmesan cheese and breadcrumbs. Spray a little more cooking spray and top and bake for about 20 - 25 minutes. Place under the broiler a few minutes to get the crumbs crisp (careful not to burn).

Turkey Meatloaf

Turkey Meatloaf for winterLike meatballs in Italy or cassoulet in the south of France, almost every American household has their own “best-ever” meatloaf recipe. Try this turkey meatloaf for a leaner version of the childhood favorite. Add a steamed vegetable for a comforting and healthy winter feast. And, this meatloaf makes great sandwiches for the next day’s lunch!

  • 1 tablespoon olive oil
  • 1 large onion, chopped (1 1/2 cups)
  • 2 garlic cloves, minced
  • 3/4 teaspoon salt, divided
  • 1/2 teaspoon pepper, divided
  • 1 1/2 tablespoons Worcestershire sauce
  • 1/3 cup fat-free, less-sodium chicken broth
  • 3 tablespoons ketchup, divided
  • 1 3/4 pounds ground turkey, 97% lean
  • 3/4 cup dry breadcrumbs
  • 1 large egg, lightly beaten
  • 1 large egg white, lightly beaten

Preheat oven to 375°. Heat oil in medium skillet over medium heat. Add onion and cook, stirring frequently, until soft, about 5 minutes. Add garlic, 1/4 teaspoon salt, and 1/4 teaspoon pepper; cook, stirring, 1 minute. Stir in Worcestershire sauce, broth, and 1 tablespoon ketchup; transfer mixture to a large bowl, and cool.

Add turkey, bread crumbs, egg, egg white, and remaining 1/2 teaspoon salt and 1/4 teaspoon pepper to mixture in bowl, and mix well. Mixture will be very moist.

Cover a baking sheet with aluminum foil, and coat lightly with cooking spray. Form the turkey mixture into a loaf, and place on the pan. Brush meatloaf evenly with remaining 2 tablespoons ketchup. Bake 1 hour or until thermometer inserted into center registers 170°. Let meatloaf stand 5 minutes before serving.
Source: http://www.myrecipes.com/recipe/turkey-meatloaf-10000001559148/

Remember, a few healthy tweaks to any recipe can go a long way. All that winter noshing doesn’t have to lead to an embarrassing spring swimsuit season.

5 Indoor Exercises for the Winter Months

As if finding the time and energy to stay in shape isn’t hard enough, winter arrives, and Mother Nature makes it even tougher. Well, cold weather is no excuse to skip your regular workout. Try these five indoor home exercises. There is no equipment required, and you can do it all in a few square feet.

1. Plank

Indoor Exercise for WinterDon’t worry--no pirate ships involved. Here’s the drill: lie face down with your forearms on the floor. Keep your elbows directly beneath your shoulders, and place your feet together with your legs straight out behind you. Tighten your core (the muscle system that stabilizes the spine and pelvis) by keeping your legs, back and head in straight alignment. Hold for 30 to 60 seconds...or more. The longer the better!



Jump Squats for Indoor Exercise

2. Jumping squats

Stand up tall with your feet shoulder-width apart. Put your hands behind your head keeping your shoulders back and head up. Sit back on your heels, and bend your knees slowly to a sitting position. Pop back up to a standing position with a vigor, jumping off the ground just a few inches at the end. Try 3 sets of 10 repetitions with a 1 minute break between sets.



3. Pushups

Pushups for Indoor Exercise

The old classic. Lying face down on the floor, place your hands slightly more than shoulder-width apart. With your legs parallel behind you and your toes on the floor, tighten the core and lift your body up. It’s important to keep your back and head aligned. Use your arms for support and descend to just above an inch from the floor, and then push yourself back up. Pushup ability will range widely. Do your first set until exhaustion (“I just can’t do anymore!”). Give yourself a one minute break, then do one more set; aim for about the same number of repetitions as the first set. You can modify the exercise by spreading your hands further apart (to focus on chest muscles) or closer together (to focus on arm muscles).



4. Front lunge

Front lunges for Winter Exercise

This is a killer exercise for a killer derriere. Stand with your feet slightly apart keeping your shoulders back and spine straight. Then, step forward with your right foot about two feet; your knee should not quite go over your toe. Bend both knees to a 90-degree angle, then push off the heel of your right foot to go back to the starting position. Repeat the same motion with your left foot. Try 2 sets of 10 reps on each leg with a 1 minute break between sets. If you have lightweight dumbbells, you can intensify this exercise by holding the weights in each hand while you lunge.



5. Inch Worm

Winter ExercisesInch worms aren’t much of a power animal, but their eponymous exercise is powerful. Stand tall with your legs straight, and bend over and touch the floor. Then start inch worming! Keep your legs straight, and walk your hands forward--inch by inch. Remember to keep your core tight. Then, take tiny steps to walk your feet back to your hands. And don't let your hips sag. Stand up straight to your starting position, and that's one repetition. Try doing ten repetitions in a row.


This whole routine shouldn’t take more than about half an hour. Stay fit, healthy and happy this winter!

Photo Sources:
5. http://fitbie.msn.com/exercise/inchworm-men#nogo

4 Sports that put your child at risk for Concussions

While the National Football League (NFL) is the most popular and richest professional sports league in the U.S., it is no secret that the sport is VERY dangerous. With the professional football season in full swing, it is common to hear talk of concussions. Most parents understand that football is a risky sport. But, let’s look at four other sports that put your child at risk for concussions:

1. Soccer

Soccer ConcussionsSoccer is an increasing popular youth sport, and a deceivingly dangerous one at that. Sure, it is a sport focused on using the feet and legs to control the ball, but one play, the header, puts soccer towards the top of the list for youth concussion risk. When players leap in the air (sometimes two or three at a time), trying to direct the ball with their heads, flailing elbows and shoulders are bound to connect with a player’s head.

2. Hockey

Hockey Concussions

The old joke: “I went to a boxing match and a hockey game broke out!” makes light of the completely unnecessary fighting inthe National Hockey League (NHL). In fact, fighting is banned at nearly every other level of hockey worldwide. So, while your child may not be trading blows on skates, hockey remains a very physical sport. Falls suffered by inexperienced ice skaters, high-flying pucks and unwieldy hockey sticks can all cause accidental injury in the hockey rink.

3. Baseball/Softball

Baseball ConcussionsAmerica’s long-revered pastime sports are leisurely, untimed affairs, but not without concussion risk. While helmets are required on every level of baseball and softball, too often they come flying off, leaving children unprotected. Head first slides are particularly risky. When a child’s head goes barreling into an opposing players shin or foot, the head is always going to lose, with potentially disastrous consequences.

4. Cheerleading

Cheerleading Concussions

Cheerleading is a challenging, demanding and highly competitive team sport--impressive and daring, but dangerous.  Cheerleaders climb, jump and fly through the air with no equipment to prevent injury. In fact, 20% of all cheerleading injuries are concussions (source). Most injuries come from a hard fall or a kick to the head from a teammate.

Treating concussions is no joke. Look out for the following symptoms if your child hits her or his head, no matter how minor:

  • Dizziness
  • Fogginess
  • Fatigue
  • Trouble remembering
  • Nausea (such as car sickness)
  • Trouble reading (difficulty adjusting from looking far away to focusing on text in front of them)
  • Trouble falling and staying asleep

And, head to the ER right away if any of these symptoms occur:

  • Worsening headache
  • Prolonged loss of consciousness
  • Persistent confusion (that doesn’t go away after a few minutes)
  • Vomiting

Regardless, make sure your child stays off the playing field until completely healed. Second Impact Syndrome (SIS) occurs when a second head injury happens on top of an unhealed first concussion. SIS can be deadly, particularly in children.

Visit the government’s CDC website for more information. Sports can have a life-long positive impact on your children, just make sure it is a safe impact.

Photo Sources:
2. http://www.icehousenj.com/images/youthchamps.jpg?9d7bd4
3. http://tipsforphotographers.com/images/photograph_youth.jpg
4. http://collegesports1.com/wp-content/uploads/2010/07/2cheerleader-picture.jpg

Thanksgiving Favorite Foods that can cause GOUT in your FEET

As the holiday season approaches, many of us enjoy big, festive meals with our families and friends.  Certain foods enjoyed during Thanksgiving can cause gout.  Gout is an arthritic condition that causes red, hot, painful, and swollen joints.  Any joint can develop gout, but the foot is the most common location, especially the big toe joint.  Gout is caused when uric acid is elevated in the bloodstream.

 Thanksgiving favorites that can cause gout include the following:  turkey, leafy green vegetables, shrimp, cheese, organ meat, goose, and pheasant.  Beer and wine may also bring on an attack of gout.  Chicken is a safer choice for Thanksgiving dinner, and vegetables like peas, green beans, and carrots are great healthy options.

 Happy Thanksgiving!

 Dr. Bender is a podiatrist at Advanced Physical Medicine.  She practices at the Oak Park and Chicago/63rd St. locations.  708-763-0580 and 773-776-3166.

Diabetes, Your Feet and Your Skin

Our skin is the largest organ in our bodies. It protects our bodies. Diabetes can cause changes to our skin, and newly diagnosed diabetics often report that the skin on their feet and other parts of their bodies is much drier after becoming diabetic. Dry skin can be itchy or crack open, leading to the risk of infection or sores that do not heal or heal slowly. It is important to check you feet daily for any cuts, sores, or color changes. If you see anything abnormal, contact a podiatrist immediately. If the areas are red, hot, swollen, or have pus present, immediate medical attention is necessary. The area between the toes must stay dry, so after you take a shower or bath, dry carefully between the toes. Powder can be used in this area to keep the spaces dry. The tops and bottoms of the feet need to stay hydrated with vasoline or a thick cream twice per day. Again, it is essential that the vasoline or cream not be placed between the toes, as this can set up an infection or cause break down of the skin, leading to sores or ulcers. If the skin is itchy, red, or has small blisters, you may have developed athlete's foot or another skin disease or infection. Feet are prone to these conditions because they are enclosed in our shoes and socks all day, leading to a warm, moist environment that is perfect for fungus and athlete's foot. Additionally, warts, which are caused by a virus can be more common in diabetics. These may appear as circular callouses, raised areas, or dark little spots on the feet. You will need to see a podiatrist to determine if you have a wart and identify the best treatment. Novemeber is Diabetes Awareness Month. It is essential to check your feet everyday, keep your blood sugar controlled, and see your foot doctor regularly to keep your feet healthy! Dr. Bender is a foot and ankle specialist at Advanced Physical Medicine. She practices out of the Oak Park and Chicago/63rd Street locations. Dr. Bender is also a clinical instructor for William Scholl College of Podiatric Medicine. You can make appointments with her at 708-763-0580 or 773-776-3166.

8 Ways to avoid the Flu without the shot

Annually, around this time of year, millions of Americans get vaccinated for the flu. But the influenza virus is a fickle bug and continues to rapidly evolve, making vaccinations irrelevant year after year. This winter, try these 8 timeless tips to avoid the flu without the shot.


1. Cover your face.

Easy flu prevention

We’re all in it together; flu season happens to everyone. So help keep germs from spreading and cover your mouth and nose with a tissue every time you sneeze. For coughs? Master the art of the elbow cough. Cover your face with the entire inside of your elbow every time you cough. This keeps germs from spreading and your hands clean.



2. Wash your hands.

Prevent the Flu Easily

We all know this rule, but a reminder can’t hurt. Germs live on every surface you touch. The more you wash your hands, the more you wash these germs down the drain. And no matter how often you wash your hands, still keep them off your face. Rubbing your nose, mouth and eyes are a quick route to flu-land.


3. Eat your vegetables.

Physical Medicine Tips

While this is sage advice all year round, it is extra important to eat right during flu season. Anti-oxidant rich vegetables keep our body’s immune system going strong. The three major anti-oxidant vitamins are beta carotene (asparagus, carrots, sweet potatoes), vitamin C (brussel sprouts, cauliflower, sweet peppers) and vitamin E (broccoli, chard, pumpkin). And have fun with it. Try a new recipe and invite some friends over for dinner…as long as they’re not sick.


4. Exercise regularly.

Chicago Flu Prevention

Every time you exercise, you build up your immune system. At least 30 minutes a day should do the trick, but more certainly can’t hurt! Don’t forget that exercise also helps reduce stress. Stress is another immune system killer.


5. Get plenty of sleep.

Healthy Habits

Your body needs time to recover, especially when you’re fighting off germs. Make sure you get at least 8 hours of sleep a night and even more if you’re feeling under the weather.


6. Don’t smoke and drink less.

Healthy Tips for Winter

Even though the Rat Pack never seemed to get sick, science shows that their nasty habits of smoking and drinking all day really wears down your immune system. So, put out that cigarette butt once and for all and say no to that second glass of wine.


7. Drink Water.

Drink lots of water

Staying well hydrated keeps the tissues of the respiratory system moist and helps the immune system work properly, keeping the flu away. And if you do get sick, water flushes out your system, re-hydrates you and washes out the toxins. An adult should drink eight 8-ounce glasses of fluids each day. If the thought of so much water sounds exhausting, squeeze in some fresh citrus juice to liven up that glass.


8. Disinfect common surfaces.


Viruses that cause colds and flu can survive on common surfaces for up to 72 hours. Use disinfecting wipes or spray on phone receivers, doorknobs, light switches, and remote controls. This isn’t just for home. Help your co-workers stay healthy this flu season and bring some wipes to the office.


Stay healthy and happy this winter so you can enjoy the holiday season (not the flu season) with your loved ones.

Image Sources:

Plantar Plate Injuries in the NFL

Several NFL players have sustained plantar plate injuries recently which will end their 2012 seasons:  Pierre Garcon, Sean Lee, and Carl Nicks.  What is this injury and why is it so serious?  The plantar plate is a flexible but strong structure under the metatarsal phalangeal joints.  These joints connect the proximal phalanx with the metatarsal bone.  An example of a metatarsal phalangeal joint  is your big toe joint.   It is a structure that prevents upward movement or dorsiflexion of the toes and connects from the base of the toe to the plantar fascia (a thick band that runs along the bottom of the foot).  It is connected to the collateral ligaments on the sides, and the thick fibrous and cartilaginous structure keeps toes straight.  

 Mild tears to the plantar plate can be treated with conservative therapies:  ice, rest, immobilization, strapping downward, anti-inflammatory medications, and orthotics.  However, more severe cases or those that fail conservative treatment need surgical intervention.  Elite athletes that play sports such as football can encounter such extreme forces that the plantar plate  will endure a severe tear and must be surgically repaired.  Conventional x-rays may be helpful, but the plantar plate is a soft tissue structure that needs MRI or Ultrasound to be adequately visualized.  These imaging modalities are essential for proper diagnosis and surgical planning.  
Dr. Bender is a podiatrist at Advanced Physical Medicine and practice at the Oak Park and 63rd Street (Chicago) locations.  She is an instructor at William Scholl College of Podiatric Medicine.  Appointment can be made by calling:  708-763-0580 (OP) and 773-776-3166 (63rd).

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