Tag Archives: exercise

5 Exercises to Relieve Hammer Toes

2 Oct

Hammer toes occur when the middle joint of the second, third, or fourth toes bends in an upward position, creating a claw-like or hammer look. Hammer toes are not a serious condition, but they can become quite painful, causing shooting pains and discomfort throughout your toes and feet, and soreness where the toe rubs the inside of the shoe. They can develop at any age, even adolescence.

hammer toes hammertoes
There are a number of treatment options for hammer toes, including surgery, but you can also do these 5 exercises at home to reduce your discomfort (but they won’t cure the hammer toe). The reason that normal toes become hammer toes is due to muscles and tendons tightening and pulling the toe into an upward position. Relieving this tension via stretching exercises which pull the muscles in the opposite direction, can work wonders for alleviating pain.

1. Toe Stretch

Sitting on the floor with your legs straight head of you, wrap a bath towel under your toes, and pull towards you so just the toes move. Hold for 30 seconds. This may also be done with your hands.

2. Toe Taps

Sit on a chair and remove your sock. Extend your big toe down toward the floor while at the same time extending the rest of your toes up in the air. Hold for 10 seconds and then lightly tap the floor with your toes 12 times. Then reverse your toe position so the big toe is pointed up and the remaining toes pointing down. Repeat.

 3. Toe Crunches

Sit on a chair barefoot. Place a bath towel on the floor and place the upper half of your foot on top of the towel. While keeping your heel flat on the ground, crunch the towel up with your toes. Release and repeat 12 times.

4. Toe Squeeze

Sitting in a chair, place your foot over your thigh. Slide your fingers in between your toes and squeeze your toes together, as if to pinch your fingers. Release and repeat 12 times.

5. Toe Rolls

Toe Rolls are not pastries – they’re an exercise similar to when you tap your fingers from side to side on a table. Stand barefoot on a flat surface. Lift all of your toes upwards off the ground together, then roll them down one at a time from the little toe to the big toe. Repeat 12 times, then change directions.

Read more about hammer toes and their treatment.

Sign Up Now For The iRUNpigs 5K 2014

18 Aug

irunpigs 5k, i run pigs 5k, marathons lehigh valley, races allentown

PA Foot and Ankle Associates is proud to once again sponsor the 3rd Annual iRUNpigs 5k and Piglet run September 14th, 2014 at Coca-Cola Park in Allentown. The race is open to runners, walkers and kids under 12 (Piglet run).

Once again this year, PA Foot and Ankle Associates is assembling a team for the race. We’re looking for ten team members, each of whom will receive a complimentary registration, a really cool PA Foot and Ankle Associates tech shirt to wear the day of the race, and all of the swag in the standard registration package from the Lehigh Valley IronPigs: commemorative tech t-shirt, chip timing results via text message, and a free entry in an IronPigs team memorabilia raffle. There will also be prizes for overall male and female winners among age groups.

If you’d like to join our team as a walker or runner, send an email to Heather at PA Foot and Ankle Associates (marketing@pafootdoctors.com)  and let her know that you want to be part of our team. She’ll send you the details. Everybody else can sign up for the iRunPigs 5K here

irunpigs 5k

Our iRunPigs 5k 2013 team (we were known as East Penn Foot and Ankle Associates last year)

The iRUNpigs5k has been redesigned for this year to insure a safer run for everyone. As always, the race will conclude on-field at Coca-Cola Park. Over 1,000 runners and walkers have taken part in the event since its 2012 debut.

Pre-registration and online registration ends on Friday, September 5 at 11:59 p.m. If you miss the deadline, you can sign up at Coca-Cola Park on the day of the event.

100% of the proceeds benefit IronPigs Charities, a non-profit organization striving to provide educational and recreational opportunities for children in the Greater Lehigh Valley area.

If you had a choice, would you request an amputation? This guy did.

18 Jul

Joseph Phleban of Fredericksburg, Virginia is a guy who likes adventure. Soccer, competitive swimming, football, wakeboarding, snowboarding, rugby, he did it all in his 23 years.

ankle amputation

Joe Phleban’s “Please Cut Here” tattoo.

In 2008, the day after he graduated from college, Phleban injured his ankle for the umpteenth time while wakeboarding. He wasn’t too concerned about it, was quite used to it in fact, as he’d been plagued with painful ankle problems for 6 years –  a side effect of being a daredevil.

He expected the surgery to repair his ankle to be routine, but surgeons discovered that Phleban had developed a rare disease called Pigmented Villonodular Synovitis. PVS usually affects the knee, but in about 2 percent of cases it appears in the ankle, causing inflammation and tumors in the joint lining. Phleban’s PVS was far advanced, with tumors, dangerous inflammation, and extensive bone and tissue damage.

Pigmented Villonodular Synovitis produces malignant non-cancerous tumors which damage cartilage, causing painful, degenerative arthritis.

ankle amputation

Phleban uses mirror therapy to adjust to his amputation

Doctors performed a second operation to remove the tumors in Joe’s ankle, but they reappeared inside of six months. In 2010, Phleban underwent surgery yet again to remove more tumors, followed by radiation therapy. At that point, Joe’s doctors informed him that because his ankle had been so badly damaged, playing sports would be impossible. Phleban was crushed.

In March of this year, doctors ordered an MRI, which revealed that tumors had once again returned. His doctors recommended that they fuse the bones of the ankle, which would have meant periodic lifelong surgery and limited activity. Phleban didn’t care for that prospect, so he asked his doctors to amputate his lower leg. He figured he’d wear a prosthetic device and be able to do some sports afterward, and not be resigned to a life of surgeries, recoveries, walking boots, and canes.

ankle amputation

Phleban goes skydiving, checking one more thing off his bucket list.

In an interview with the U.K.’s Daily Mail Online, Pleban said, “Over six years I had to give up all of the sports I loved. Although taking my ankle away was a big sacrifice, the chance to regain the ability to play those sports again meant it was a no-brainer. It came down to either going through surgeries for a good portion of my life or have one surgery to end them all and be as active as I want on a prosthetic.”

And then he made a bucket list. A one-last-time run at unfulfilled adventures. All of it chronicled, from the point of view of his soon-to-not-be-there appendage, on a Facebook page called The Last Adventures of Joe’s Left Foot. Paintballing, go-karting, watersliding, a Caribbean vacation with his girlfriend, skydiving, and concerts. He even got a tattoo – a dotted line that wrapped around his intended amputation, with the words, Please Cut Here. Which he emailed to his surgeon.

In June, Phleban’s foot was amputated at Georgetown University Hospital in Washington, D.C. “Right before the surgery, I was definitely freaking out a bit,” he said. “It was such a ‘no turning back’ decision. But as soon as I woke up from the surgery and looked down, I knew I had done the right thing.”

exercising after ankle amputation

Phleban exercising with his girlfirend after his amputation

Phleban shared at least one plan for the future. This Halloween, he’s planning to dress up “as a surfer, my girlfriend as a shark.”

How To Run Downhill

1 May
We bet you think running downhill is the easiest, most natural thing in the world, right? Well believe it or not, when it comes to training for long races, there’s actual technique involved in running the downslope. And a significant risk of injury.

woman running downhill

Descending while running feels easy – like you have to actually hold back. But each step downhill can produce muscle-damaging contractions in your quadriceps and lower legs, according to Greg Wells, Ph.D., an exercise physiologist at the University of Toronto. When running on level ground, these same muscles shorten as they fire, but on declines, they elongate and control your speed, creating micro-tears in the muscle fibers. While these tears ultimately lead to growth in the muscle, they also leave you tired and sore. It’s why the cruel planners of the Boston Marathon torture all of the competitors with a 4-mile downhill opening stretch.

If you’re planning on running a marathon or even a 5K with significant downhill territory, you should practice running downhill to prepare your legs and the rest of your body to handle these very specific muscle demands. Your overall performance will vastly improve for any race, because the muscle you build from the downhill terrain will help you run faster uphill or on level ground with less effort.

Practice running downhill

You can build your downhill muscle with either focused repeats or by running a hilly route. But choose your hills wisely and don’t go too steep, too soon, or you risk injuring your ankles, knees, and hips.

Start with a medium length gradual slope, not a steep decline. And look for a soft surface like grass or gravel, not a paved surface. If you’re training for a long distance race, ultimately you want to combine both kinds of surfaces.

How you hold your head during the downhill training is crucial. Don’t look at your feet – maintain an upright posture and focus your gaze 15 meters in front of you, eyes straight ahead. You may feel a natural tendency to lean backward and slow down, but resist this. Instead, engage your core muscles, lean slightly forward from your ankles, and align your upper body over your lower body. As you descend, take shorter steps, but quicken your cadence. This way, you’ll take lighter steps and land on your midfoot instead of braking with your heel. Also keep your landing leg slightly bent to avoid letting your knees take all the impact.

Training for the race

If you’re planning to run a race filled with downhills, make sure they’re in your training schedule from the get-go. Start small with one downhill training session every other week. When you find that you easily recover from that workout, increase your schedule to one downhill each week and eventually increase that to 2 downhills per week. But only run that second one when you’re sure you’ve completely recovered from your first – no soreness in the legs, knees, ankles, or hips, and no fatigue at all. As race day draws near, dial back these workouts to avoid over exertion and the risk of injury.

Best New Running Shoes for 2014

11 Apr

For all of you runners, spring means that it’s time to shop for new running shoes.

(a note from our docs: please don’t wear last years’ shoes, as they’re probably too worn down to support your feet correctly.) Here are the best shoes for the money for 2014, courtesy of Runner’s World magazine:

Top 3 new running shoes for Men:

adidassuperglide6mar600x600_0Adidas Supernova Glide 6, $130
Top-of-the-line cushioning designed for the long run.

brookspureflow3mar600x600Brooks Pureflow 3, $100
Excellent cushioning, smooth landing.

uaapollomar600x600Under Armour Speedform Apollo, $100
Exciting new shoe worth a look on race day.


Top 3 new running shoes for Women:

womens adidassupernovaglide6fem600x600Adidas Supernova Glide 6, $130
Sturdy trainer with a smooth heel-first landing and springy underfoot.

womens brookspureflow3fem600x600Brooks Pureflow 3, $100
Bargain priced trainer that handles a lot of miles.

uaspeedformapollofem600x600Under Armour Speedform Apollo, $100
Puts your foot close to the ground, but heel cushioning is soft.

That’s right, same shoes for men and women this year.

Remember these tips when choosing a new running shoe

Make sure it fits
The shoe should never slide on your foot – up, down, or sideways. Conversely, it should also not be too tight. It should be “just right” when you put it on.

Are your feet the same as last year?
In other words, do you have any new pain, aches, soreness or fatigue where you weren’t experiencing it before? If so, see your podiatrist for an exam. If you’re developing any problems, they can create a custom orthotic insole for you so that you can keep running.

Remember, it’s best to take simple steps to prevent sports injuries, rather than injuring yourself and sitting out the season.

Here are more tips on choosing the right running shoe.

A stress fracture in your foot can derail your season – how to prevent it

27 Mar
Baseball, football, basketball, Lacrosse, gymnastics, running, tennis – no matter what sport you play, you may experience a stress fracture in your foot or lower leg at some point. And you may not even be aware of it.
rudy owens foot stress fracture

Astros Pitcher Rudy Owens

Even Houston Astros pitcher Rudy Owens didn’t notice the stress fracture in his foot.  “When I first started feeling it, it never hurt when I pitched — only when I’d run,” Owens said. His pain worsened, and eventually he needed surgery to correct the fracture.

But stress fractures can also occur simply by switching playing surfaces from soft to hard, or when a basketball player has a big increase in playing time. Whenever an athlete is engaged in a sport where the foot strikes the ground repeatedly and repetitively, the risk of a stress fracture increases, especially when that athlete doesn’t get proper rest between games or workouts.

Stress fractures occur when muscles in the foot become fatigued. When the fatigued muscle can longer absorb additional shock, it transfers the overload of stress to the bone, which causes a tiny crack. This is the very reason that stress fractures can go undetected and untreated for long periods. You’re not aware of any physical injury – you didn’t drop an anvil on your foot – so you walk it off and keep playing.

Yet the pain worsens, because as you continue to stress the cracked bone, the crack becomes larger, often resulting in a full blown fracture. Then you’re on the sidelines for the season.

How to protect your feet from stress fractures
  • Most stress fractures appear in the weight-bearing bones of the lower legs and feet. Those most susceptible are athletes who subject their feet to repetitive actions on hard surfaces, like basketball players, tennis players, and gymnasts.
  • Proper conditioning is the best defense against stress fractures. If the muscles in your feet and ankles remain strong and flexible, they’re better able to absorb stress. Stretching the muscles in your legs, feet, and ankles pre and post-game or workout is key.
  • Set incremental goals – don’t try to do too much too soon – build up to your goal.
  • Cross training is very effective at working different muscle groups. For instance, if you’re a basketball player, when you’re not on the court, biking or strength training should be your workout, so your feet have time to recover.
  • WEAR PROPER SHOES. We can’t stress this one enough. Many athletic foot injuries can be avoided simply by wearing shoes that offer proper protection and support for your particular activity.
Symptoms of stress fractures

Constant or periodic pain or soreness with activity, which will subside when you rest. There may also be some tenderness or swelling.

Treatment of stress fractures

Rest is essential for healing. If you continue to do the same activity which caused the stress fracture, it will definitely worsen. A stress fracture will take 6-8 weeks to fully heal, which may seem like a long time in-season. However, if you injure the foot further, your healing time will increase, and chronic problems may result.

See a podiatrist as soon as you experience pain in your foot. A stress fracture treated early can have you back in the game quickly.

When resting, elevate and ice the sore foot, and use over the counter anti inflammatory medicine like aleve or advil to manage the pain.

Custom orthotics from a podiatrist’s office, which are worn in your shoes, may be very helpful in shifting weight off of the area of the fracture. This may allow you to resume playing somewhat earlier.

Diabetes May Shrink Your Brain

20 Mar
As if having Type 2 diabetes wasn’t bad enough, there’s now evidence that diabetes contributes to a reduction in the size of your brain.

According to new research, the onset of Type 2 diabetes in middle age, especially when combined with high blood pressure, may actually reduce the size of your brain, when compared to those who do not have diabetes. Those who developed diabetes after 65 showed no significant brain impact from the disease, suggesting that the damage is caused over decades.

What’s the impact of diabetes over decades? Diminished memory and early onset of dementia.

According to researcher Rosebud O. Roberts, M.B, CH.B, of the Mayo Clinic, Rochester, “Our study shows that the earlier you have these conditions, the worse your brain pathology is late in life.”

Cognitive decline goes hand-in-hand with aging. When diabetes is added to the mix, this decline accelerates. Diabetes is thought to hamper blood circulation and weaken tiny blood vessels in the brain, which causes tissue damage and necrosis (tissue death). This new research suggests that the altered glucose metabolism in the brains of diabetics may also lead to the decay of neurons, the cells which transmit signals between nerves. In either case, the progressive brain damage leads to diminished mental functions required for day-to-day tasks – like taking your diabetes medicine. Forgetfulness then creates a vicious cycle of poor blood sugar management, which in turn worsens the decline in cognitive abilities. The end resut may be dementia, Alzheimer’s, or stroke.

How big is the difference between diabetic and non-diabetic brains? On average, those who developed diabetes in middle age had brains that were nearly 3 percent smaller, and their hippocampi were 4 percent smaller than those of non-diabetics. The hippocampus is the area of the brain which controls emotion, memory, and the autonomic nervous system, responsible for functions like digestion, breathing, and heartbeat.

“When your hippocampus begins to shrink, you begin to lose your long-term memory and your ability to remember recent events,” said Roberts, who also is a member of the American Academy of Neurology. “If you have type 2 diabetes, you have an increased risk of brain damage, but if you control your diabetes well, it should reduce the damage that is being caused in your brain.” And people with high blood pressure in midlife were twice as likely to have damage caused by micro-strokes to the hippocampus.

The bottom line? If you develop hypertension or Type 2 diabetes around middle age or younger, you can limit its impact on your brain – and all of your other organs for that matter – by controlling your blood sugar with exercise, diet, and medication.

Basketball: How to avoid the most common foot and ankle injuries

5 Mar

It’s safe to say that no sport demands more from an athlete’s feet and ankles than Basketball. Every movement on the court starts with the player’s feet – every shot, every rebound, and every pass.

The sudden turns, side-to-side cutting, running, stopping, sudden acceleration, changes in direction, jumping, and landing, combined with the immense size of pro basketball players, creates an almost perfect storm of injury possibilities for the lower extremities. Professional athletes train constantly on and off-court, in-season and out of season, yet their bones still fracture and their tendons and ligaments tear.

Here are the most common basketball injuries to the foot and ankle:
deron williams ankle sprain

Deron Williams of the Nets suffered an ankle sprain in 2013

Ankle Sprains

An ankle sprain occurs when the foot rolls inward or outward and stretches or tears the ligaments in the ankle. In basketball, this usually occurs when the player lands improperly after a layup, or steps or lands on another player’s foot. Swelling and bruising occur, and the foot can’t bear weight. Mild ankle sprains heal relatively quickly, but a severe sprain can disable a player for 8 weeks or more.

Watch a video of Dr. Teichman from PA Foot and Ankle Associates explaining how an ankle sprain occurs.


Fractures of the metatarsals (the long bones in your feet), the tibia (shinbone), and the navicular bone (on the top of your foot near the ankle), are what podiatrists refer to as overuse injuries. As an athlete trains, bones actually develop tiny fractures which heal quickly and strengthen the bone. However, their adjustment is slow, and when outside stress exceeds the bone’s capability to withstand it, the bone fractures. The repeated pounding of running, jumping, and landing is especially difficult on the 5th metatrasal bone on the outside of the foot, and is the bone most often fractured by basketball players.

Read more about foot fractures

Plantar fasciitis

Another overuse injury, plantar fasciitis is an inflammation of the plantar fascia, the band of tissue which connects the arch of the foot to the heel. Repeated pounding on hard surfaces – the basketball court – subjects the plantar fascia to stress, and it reacts with inflammation and pain. Treatment and rest are essential at the first sign of pain from plantar fasciitis, because if an athlete continues to play on the sore foot, the condition will only worsen.

Read more about plantar fasciitis

Achilles Tendonitis

Your achilles tendon is responsible for every step you take, and you couldn’t make that jump shot if you didn’t have one. You’re asking a lot of this tendon during the game and sometimes it can’t keep up, and becomes strained and irritated (itis).

The achilles tendon attaches your calf muscle to your heel, and when you damage it, you’ll usually feel a knife-like pain in your leg, just below the calf muscle. It maybe accompanied by swelling. If you really do a job on it and cause it to rupture, you may be able to walk, but it will be impossible to jump until it’s healed. An evaluation from a podiatrist is absolutely essential to speed its healing.

Read more about achilles tendonitis ​

For any of these injuries, the sooner that RICE begins, the less secondary damage you’ll incur. (Rest, Ice, Compression, Elevation). Do not continue to play or the injury may become much worse. Have your injury examined by a podiatrist as soon as possible.

How to avoid basketball injuries

Proper athletic conditioning

Strong and flexible ankles reduce the occurrence of injuries, improve performance on court, and decrease the time lost to an injury. Weekend athletes in pick-up basketball games are most frequently injured due to their lack of conditioning and weight training. That Michael Jordan-style layup looks beautiful, but hurts like mad coming down, especially if you land on another player’s foot.

Cold muscles are more prone to injury, so stretch and warm up before games with a light run, walking, biking, or calisthenics like jumping jacks and basic stretches. Stretch your muscles after the game also. If you’re out of shape, ease into it and don’t try to play like you did when you weighed 25 pounds less.

Wear new basketball shoes

They’re called basketball shoes for a good reason – they’re designed to support and accommodate the foot for the unique stresses of the game. If you play every weekend, your shoes should be updated every two months, as the padding and support wears out quickly. If you’re in high school or college, and working out almost every day, you should replace your shoes every month during the season.

The padding and stability a good pair of basketball shoes offer is your best defense against injury. Once your foot begins to rock or slide, even a little inside your shoes, your chance of injury goes up exponentially. As you accumulate playing hours on the shoe, the synthetic uppers slowly begin to fatigue and stretch in response to your starting and stopping motion. Slowly, the foot gains more and more rotational movement within the shoe, which in turn offers less and less protection to the foot.

Wear custom orthotics if you had a previous injury

Hands down, the best way to avoid re-injuring your foot or to provide additional arch support is to have custom orthotics made by a podiatrist. Proper balance, support, and foot/leg alignment are not only necessary for you to consistently play at your best level, but for your protection as well. In fact, the use of custom orthotics in the NBA has increased from about 40% in 1990 to more than 80% today.

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