What is Plantar Fasciitis?

Written by admin on January 16, 2013 – 7:02 am -

Plantar fasciitis is the progressive degeneration of the plantar fascia of the foot and is a common Orthopaedic complaint. . Plantar fascia is the medical term for the fibrous connective tissue that comprises and creates the arch of the foot by connecting the calcaneus (heel bone) to each of the phalanges (toes). The plantar fascia is located along the bottom side (plantar surface) of the foot, and is amongst the densest fascia in the body. Originally presumed to be an inflammatory disorder of this tissue, we now know that inflammation is only rarely the culprit. Numerous men, women, and even world-class athletes suffer from plantar fasciitis. Marcus Camby of the New York Knicks and Derrick Favors of the Utah Jazz are two NBA players currently battling the condition.

Plantar fasciitis is most prevalent in men between the ages of forty and seventy but is also frequently seen in women. The most common complaint of plantar fasciitis is a sharp pain in the heel or arch of the foot. Others include a ‘pulling’ sensation, a sharp or dull ache, or a burning sensation. Someone suffering from plantar fasciitis may complain of pain during or after intense exercise, or after standing for long periods of time; however, the classic report is pain in the morning when getting out of bed but subsiding throughout the day, or a gradual onset of dull pain which then turns into sharp pain as the day progresses. Individuals with pes planus (flat feet/no arch) or pes cavus (very high arch) are more prone to plantar fasciitis (albeit for different reasons) than individuals with normal arches. Other causes or risk factors for plantar fasciitis are sudden weight gain or obesity, long distance running, and poor arch support in shoes.

Initial treatment begins with rest, ice massage (freezing a water bottle and rolling the bottle back and forth under the foot), OTC anti-inflammatories, and stretching the foot and heel throughout the day–especially before getting out of bed– by rolling over a tennis ball, wearing shoes with the appropriate amount of support, shoe inserts, and wearing night splints while sleeping to keep the foot and fascia stretched throughout the night, preventing contraction (tightening) of the fascia tissue. If conservative treatment fails, PRP or steroid injections and/or surgery may be considered. We have had excellent results with the emerging technique of Platelet Rich Plasma (PRP) injections.

Plantar fasciitis symptoms may take anywhere from days to years to subside. Prevention of plantar fasciitis is best ensured by optimizing the flexibility of the ankle joint, Achilles tendon, and calf muscles (gastrocnemius and soleus)

References

A.D.A.M. Medical Encyclopedia. (2012, March 1). Plantar fasciitis. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004438/

Dr. Mark Galland is a Board Certified Orthopaedic Surgeon specializing in sports medicine, practicing in Wake Forest and North Raleigh. He serves as team physician and Orthopaedic consultant to the Carolina Mudcats, High-A Affiliate of the Cleveland Indians of Major League Baseball, as well as several area high schools and colleges. Dr. Galland can be reached at (919) 562-9410 or by visiting www.orthonc.com or www.drmarkgalland.com.

Caitlin Davis, LAT, ATC is a post graduate fellow at GOSM. For more information, visit us at www.atcfellowship.com


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Posted in Foot & Ankle, Injury Prevention, Platelet-Rich Plasma Therapy (PRP), Sports Medicine | No Comments »

“The Right Shoes Can Ease Knee Pain”

Written by admin on January 3, 2013 – 8:45 am -

“Boots, sandals, pumps, sneakers, loafers … When it comes to shoes, the options are dizzying. What you wear on your feet can affect your knees, so it pays to know which footwear may lessen pain and protect your knee joints. These tips can help you choose the right shoes.”

To read the entire article, please click here.

Medical Reviewer: Williams, Robert, MD
Copyright: © Copyright 2011 Health Grades, Inc


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The Relationship Between ACL Injuries and Physical Fitness…

Written by admin on December 31, 2012 – 8:15 am -

While “several physiological and physical variables, such as muscle strength, aerobic and anaerobic power, coordination, flexibility and the ability to sustain stress, are required (for physical activities/ exercise). Carter and Micheli stated in their review that poor physical fitness in youth athletes is a risk factor for sports-related injuries”

“This study contributes to the current knowledge of physical fitness as a modifiable ACL injury risk factor by identifying one main risk factor in young ski racers: core strength deficit. Coaches must understand the importance of core training and the strength and neuromuscular aspects of core training. The current findings provide evidence that the ACL injury risk was greater in female…”

For more information or to read the entire British Journal of Sports Medicine article by Christian Raschner, Hans-Peter Platzer, Carson Patterson, Inge Werner, Reinhard Huber, and Carolin Hildebrandt please click below.

skiier article


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Posted in Arthroscopy, Injury Prevention, Knee, Sports Medicine | No Comments »

Deep Vein Thrombosis (DVT)

Written by admin on November 10, 2012 – 9:43 pm -

When hearing of a blood clot, one typically considers a person who recently had major surgery, for example, a knee replacement, or a traveler after a long plane ride. While these assumptions may be accurate, many are surprised to learn that athletes can develop blood clots as well. Serena Williams (Tennis) and Phil Dalhausser (beach volleyball) are two examples.

Blood clots are also referred to as a DVT or Deep Vein Thrombosis. They are most common in the legs, causing extreme calf pain, swelling and tightness, but also can occur in the upper extremity where they cause similar symptoms. DVT results from: diminished flow of blood through the veins, injury to the veins and hypercoagulability (“thickening” of the blood). Typically after surgery, patients are less able to move the lower extremities and joints due to pain and swelling. Since the flow of blood in the veins is dependent upon movement and contraction of muscles, this lack of mobility results in a decrease in blood circulation and increased viscosity (or thickness) of the blood. Both factors predispose to developing a clot. Upper extremity DVT is much less common, comprising only 10% of all cases of DVT. The typical cause of an upper extremity DVT in an athlete is repetitive micro-trauma of the subclavian or axillary veins (as is typical of a high level overhead athlete: tennis, volleyball, or baseball).

Signs and symptoms of an upper extremity DVT are similar to those seen in the lower extremity: pain, swelling and tightness of the affected arm/shoulder region.

DVT is a serious medical condition and can progress into an even more serious complication–pulmonary embolism. PE occurs when the blood clot or portion thereof, dislodges itself and travels into the lungs, causing shortness of breath, chest pain, dizziness and rapid pulse. PE can be fatal, and immediate medical attention must be sought if these symptoms occur.

Months before the London Olympics, Phil Dalhausser experienced significant swelling in his left arm. He was admitted to the hospital, diagnosed with DVT and treated with blood thinners (anti-coagulants and thrombolytic agents) to dissolve the clot. It was determined that the DVT was precipitated by scar tissue in his subclavian vein which resulted from being pinched between his first rib, collar bone and the surrounding muscles each time he struck the ball or reached for a block. Since his DVT, Dalhausser has successfully competed in the London Olympics representing the United States in men’s beach volleyball.

Serena Williams’ case, while much different was more typical. After sustaining a laceration in her foot, she first developed a hematoma in the wound. They are a local collection of blood but not related to DVT, nor can they ever become DVT or lead to PE. Hematomas result from blunt force trauma or within a healing wound. She subsequently developed a DVT in the same leg. Presumably this was the result of the immobilization required to allow the injury to heal. The pulmonary embolism occurred months after she cut her foot, and required immediate hospitalization. She recovered fully and won the 2012 US Open and gold medals in the London Olympics.

Resources:

Associated Press. (2011, March 02). Serena Williams hospitalized after suffering blood clot in lungs. Retrieved from http://www.foxnews.com/sports/2011/03/02/serena-williams-hospitalized-suffering-blood-clot-lungs/

Joffe, H. (2012). Upper-extremity deep vein thrombosis. Retrieved from http://circ.ahajournals.org/content/106/14/1874.full

Vein Specialists of the South. (2012). Olympic beach volleyball star develops blood clot in subclavian vein. Retrieved from http://varicoseveintreatmentga.com/wpi/deep-vein-thromobosis/olympic-beach-volleyball-star-develops-blood-clot-in-subclavian-vein/

Dr. Mark Galland is a Board Certified Orthopaedic Surgeon specializing in sports medicine, practicing in Wake Forest and North Raleigh. He serves as team physician and Orthopaedic consultant to the Carolina Mudcats, High-A Affiliate of the Cleveland Indians of Major League Baseball, as well as several area high schools and colleges. Dr. Galland can be reached at (919) 562-9410 or by visiting www.orthonc.com or www.drmarkgalland.com or you can follow him on twitter: @drmarkgalland.

Kate Anderson, ATC/LAT is a post-graduate fellow at GOSM, Galland Orthopaedic and Sports Medicine. Follow her on twitter @kattethegreatt.


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Injuries and Preventative Measures for Young Soccer Athletes

Written by admin on September 13, 2012 – 5:35 am -

Soccer is the most popular sport in the world with up to 230 million amateur participants. In the U.S. alone 3 million are registered in either high school or youth programs with an estimated growth of 21.8% annually.

As a result, soccer-related orthopedic injuries are more and more common. In 2006 alone, the CPSC (The US Consumer Product Safety Commission) estimated 186,000 soccer-related injuries. Up to 45% of those injuries reported occurred in athletes ages 15 years or younger.

The lower extremity is the most common location of injury. The ankle is the most common area injured, followed closely by the knee. In addition, Sever’s disease is perhaps the most common over-use injury seen in younger soccer athletes.

Sever’s disease, or calcaneal apophysitis, typically occurs in physically active youth between the ages of 8 to 15. The name sounds bad, but it is really not serious. Not really a “disease,” it is an inflammatory response at the growth plate of the heel bone where the Achilles tendon attaches. For soccer athletes, it usually results from excessive running on hard surfaces (not every pitch is covered in soft cushiony grass, too often the field is hard-packed earth) in cleats lacking proper fit, heel or arch support. Common symptoms include pain at the back of the heel and a limp that are aggravated during running. In severe cases, the pain may also be present with walking. As with many overuse injuries, the best treatment is to dramatically decrease activity. Severe cases may warrant complete non-weight-bearing for a period of time. Additional measures include rest of the injured area, providing a heel lift or heel cup for support, and stretching the calf and hamstring muscles 2-3 times per day. Prevention of Sever’s disease requires maintenance of flexibility of the calf and hamstring muscles, wearing well-fitted shoes that allow proper support throughout the entire foot, and adoption of a reasonable training regime that will not allow extensive amounts of vigorous activity for young developing athletes (particularly during growth spurts).

While Sever’s disease is among the most common soccer-related injuries, there are a number of other conditions to which soccer players are prone. Ankle and knee injuries account for over half of all injuries in soccer athletes regardless of the age. The major concern for all parents and athletes is the complete rupture of the anterior cruciate ligament (ACL) in the knee. Fear not, mom and dad! Help is on the way. A recent study published in the American Journal of Sports Medicine reported that the implementation of an injury prevention program resulted in 21% fewer injuries. Proper warm-up and cool-down, taping unstable joints, and exercises designed to improve the core stability, coordination, reaction time, and endurance were all incorporated into the training regime. The researchers also included a process of educating the coaches on proper training and the promotion of fair play.

While athletic participation will always carry the inherent risk of injury, Taking the proper steps towards injury care and prevention can be the difference between staying healthy and missing a number of games or even an entire season.

Orthopaedic Specialists of North Carolina partner with a number of youth athletic organizations in the greater Raleigh area. Dr. Mark Galland and his colleagues at OSNC are specialists in orthopedic surgery and sports medicine and are eager to assist any and all young athletes injured on the playing field. For immediate needs, our Wakefield and Knightdale locations have an urgent care clinic open 7 days a week from 9:00am to 9:00pm, no appointment needed.
www.orthonc.com

Article by Dr. Mark Galland with Matt Rongstad, ATC/LAT


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Dr. Mark Galland Discusses Concussion Treatment and Prevention On NBC 17’s My Carolina Today

Written by admin on February 8, 2012 – 7:39 am -

RALEIGH, N.C. – Dr. Mark Galland, a physician at Orthopaedic Specialists of North Carolina (OSNC) (http://www.orthonc.com/galland.html), appeared Wednesday, Jan. 18 on NBC 17’s My Carolina Today to discuss issues surrounding concussions, including how to prevent their occurrence and recognize symptoms. While on the show, Galland explained what happens during a concussion, how to recognize when one occurs, which preventative measures can help avoid the injury and how to properly fit a helmet for physical sports such as baseball, football and hockey that might pose the risk of head injury.

Much national sports media coverage has been devoted to concussions as of late following notable cases throughout the National Football League and the National Hockey League, including local Carolina Hurricanes superstar Jeff Skinner and Sidney Crosby of the Pittsburgh Penguins. Orthopaedic Specialists of North Carolina offers an annual concussion clinic servicing more than 2,000 local athletes, led by Galland and Dr. Chad Greer.

The My Carolina Today segment can be found on the show’s website at http://bit.ly/wITuja.

QUOTES:

“It is my hope that the parents and athletes watching My Carolina Today will benefit from learning more about concussions,” said Galland. “As we continue to become acutely aware of the implications of these traumatic injuries, athletes today are becoming adept at recognizing symptoms and taking precaution to avoid sustaining a concussion themselves.”

NEW MEDIA CONTENT:

Dr. Mark Galland Blog

http://drmarkgalland.com

Dr. Mark Galland YouTube Channel

http://www.youtube.com/user/DrMarkGalland

ABOUT DR. MARK GALLAND:

Dr. Mark Galland is an orthopaedic surgeon, sports medicine specialist and physician at Orthopaedic Specialists of North Carolina. Galland received his medical degree from Tulane University’s School of Medicine and completed his residency in the university’s Department of Orthopaedic Surgery. He began his career in orthopaedic surgery and sports medicine while serving in the United States Navy at a naval hospital at Camp Lejeune, N.C. There, he served as chief of orthopaedic surgery and was the recipient of numerous awards for both leadership and excellence in treating injuries common to sailors and marines. Since beginning with Orthopaedic Specialists of North Carolina, Galland has continued to treat injured athletes. He currently serves as a team physician and orthopaedic consultant to the Carolina Mudcats, the High-A affiliate of the Cleveland Indians Major League Baseball team, and as medical director and orthopaedic consultant to the Louisburg College athletic program. He also serves as the team physician and orthopaedic consultant to several local high schools, as well as on the board of directors for the Trentini Foundation, a nonprofit scholarship organization. For more information, visit http://www.orthonc.com or http://drmarkgalland.com.


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Preventing Concussions with My Carolina Today

Written by admin on January 18, 2012 – 1:16 pm -

I appeared on NBC 17’s My Carolina Today to discuss concussions in youth athletes. The segment can be found below, or by clicking over to the My Carolina Today website.


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