November 2012 - Advanced Physical Medicine
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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.

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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.

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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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