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Category: Regenerative Medicine

Tibialis Anterior Tendonitis: Symptoms and Treatment Options

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Muscles and tendons tibialis anterior tendonitis

The foot has several tendons that originate in the lower leg and extend into the foot. They each have different functions to stabilize the foot and help us to propel our bodies forward when we walk or run. The anterior tibial tendon is one of these tendons. Although tibialis anterior tendonitis may be the least common complaint of those experiencing tendon pain around the ankle joint, it’s important to understand how to recognize and what can be done to eliminate your pain.

Anatomy and function- The anterior tibial tendon is the third largest tendon in the foot and ankle. The largest is the Achilles tendon and the second largest is the posterior tibial tendon. The anterior tibial tendon originates as a muscle in the lower leg adjacent to the shin, tibia, and extends down to the foot. It is on the front of the ankle. It inserts onto the top and inner side of the arch.

Its function is to pull the foot up and support the arch. It also assists in supinating the foot. Supination is a motion often referred to and means that the arch of the foot increases and the foot angles towards the opposite foot. Finally, it decelerates the downward motion of your foot towards the ground. From the time your heel contacts the ground to the point of the ball of the foot bearing weight it prevents your foot from slapping against the ground. So, it’s very important for normal gait to occur. It helps to identify the tendon by pulling your foot up towards you and it will be the tendon that protrudes on the front of the ankle and is running towards the inside of the foot towards the big toe.

Tibialis anterior tendonitis is a condition that causes pain and discomfort along the front of the lower leg and ankle due to inflammation or degeneration of the tibialis anterior tendon. This tendon plays a crucial role in foot movement, particularly in lifting the foot upward while walking or running.

Where Will The Pain Be If I Have Tibialis Tendonitis?

It is most common towards the front of the ankle area. The symptoms of tibialis anterior tendonitis may also create pain above the ankle in the lower leg adjacent to the tibia. This may be referred to as anterior shin splints. Referring to shin splints on the front of the leg. Symptoms may also be closer to or at the point where the tendon attaches to the foot on the inner side of the arch.

What Causes Tibialis Anterior Tendonitis?

Several factors can contribute to tibialis anterior tendonitis, including:

  • Overuse – this may occur from doing too much too soon which can happen in any activity. However, any activity that requires you to extend your foot in front of the knee joint may increase the probability of overuse. Examples of this may be racquet sports, hiking, or running downhill.
  • Biomechanics – If your born with a flat foot the tendon may have to work harder to help support your arch.
  • Improper running technique – Over striding while running can also cause overuse of the tendon. By taking shorter strides you won’t be extending the foot in front of you as much as this will help to reduce the need for the anterior tibial tendon to stop foot slap.
  • Neurological problems – Neurological problems may not cause pain along the tendon, however, may cause damage to the nerves that stimulate the anterior muscle to contract. This is referred to as drop foot. Drop foot can be associated with back issues of a nerve issue around the see. Nerve surgery called decompression surgery can help with this.
  • Trauma – a severe ankle sprain could cause a tear to the tendon. Also, a laceration to the ankle area may also cause a partial or full tear.
  • Shoe gear – High heels may also be a cause and they will put more demand on the tendon to reduce the potential for foot slap because of the elevation of the heel off the ground.
  • Improper Footwear: Wearing unsupportive or worn-out shoes can alter foot mechanics, leading to excessive strain.

Symptoms of Tibialis Anterior Tendonitis

Common signs and symptoms of tibialis anterior tendonitis include:

  • Pain and tenderness along the front of the shin, ankle, or top of the foot.
  • Swelling in the affected area, especially near the tendon insertion.
  • Weakness or difficulty lifting the foot, potentially leading to a “foot slap” while walking.
  • Stiffness and discomfort that worsens with activity, particularly when walking downhill or running.
  • Pain when pressing on the tendon or flexing the foot upward against resistance.

Diagnosis or Evaluation of Tibialis Anterior Tendonitis

A podiatrist will typically diagnose tibialis anterior tendonitis through:

  • Clinical Examination: The physical examination alone will give the doctor a good idea if the tendon is damaged. There will be pain and swelling along the tendon or its muscle higher up the leg. Also, weakness of the tendon may be noted.
  • X-rays – these will not show tendon damage but are useful to rule out other problems.
  • Diagnostic Ultrasound: Assessing the tendon’s structure and detecting any tears or degeneration.
  • MRI Scan: MRI scans or diagnostic ultrasound are useful to confirm the diagnosis and see the extent of the tendon damage. The diagnosis will frequently be tibialis anterior tendinopathy. The tendon may be damaged but not torn.
  • Gait Analysis: Observing walking patterns to detect abnormalities such as foot drop or imbalance.

Treatments for Tibialis Anterior Tendonitis

Most cases of tibialis anterior tendonitis can be managed with non-surgical treatments, including:

  • Rest and Activity Modification: Reducing strain by limiting high-impact activities.
  • Cold Therapy: Applying ice packs to reduce inflammation and pain.
  • Anti-inflammatory Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) may help relieve symptoms.
  • Immobilization: Wearing a CAM walker or brace to reduce movement and promote healing.
  • Orthotic Devices: Custom arch supports to help alleviate stress on the tendon.
  • Physical Therapy: Stretching, strengthening exercises, and modalities like ultrasound therapy can aid recovery.

Advanced and Surgical Treatments

For severe cases where conservative measures are ineffective, the following treatments may be recommended:

  • Laser Therapy: Multiwave laser (MLS laser) MLS treatments have shown success in reducing pain and inflammation.
  • Human Cellular Tissue Products: Also known as stem cell therapy, these injections can promote tendon healing. This treatment has significantly reduced the chance of surgery when partial tears are noted. It is important to note that in many cases the tendon may not be inflamed as much as it is breaking down. This is sometimes referred to as tendinosis rather than tendonitis. For this reason, regenerative medicine is very appropriate as it helps to repair the tendon.
  • Corticosteroid Injections (With Caution): While cortisone injections may provide short-term relief, excessive use can weaken the tendon and increase the risk of rupture.
  • Surgical Repair: If a partial or full tear is noted surgery to repair the damage may be recommended. With a full tear weeks of non-weight bearing may be needed. In cases of complete tendon rupture or severe degeneration, surgical intervention may be necessary to restore function. Post-surgery, a period of non-weight-bearing followed by rehabilitation is typically required.

How to Avoid Tibialis Anterior Tendonitis?

It’s important when taking up a new activity to not do too much too soon. Also, if you suffer from flat feet, make sure you have supportive shoes or consider over-the-counter arch supports or custom-made orthotics.

Hopefully this blog will help you to better understand if you have tibialis anterior tendonitis and how some of the newer treatments available including regenerative medicine and laser treatments can help manage the condition. Our foot and ankle clinics cater to patients from Colorado, Wyoming and Nebraska. We also see patients from all over the United States and even our neighbors from Canada who have searched for a ‘expert podiatrist near me‘. Watch our patient testimonials on YouTube as we now have over +11000 followers.

For expert evaluation and treatment, schedule an appointment with Anderson Podiatry Center today.

Call us today at our Fort Collins location (970) 484-4620, Broomfield location (720) 259-5053 or use our online scheduling system to book your appointment.

Hallux Rigidus Surgery: Is a Big Toe Cheilectomy Right for You?

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cheilectomy surgery

Cheilectomy is a surgical procedure performed on the great toe to remove spurring from the top of the joint. However, to truly understand cheilectomy surgery we must start at the beginning by explaining a foot problem referred to as hallux rigidus. The surgery is performed to help with pain in the great toe joint and also on top of the great toe joint.

What is hallux rigidus?

Hallux refers to the big toe and rigidus means that the great toe joint is stiff. The great toe is referred to as the first metatarsophalangeal (MTP) joint. Normally it should be able to move 60 to 70 degrees off the ground. With hallux rigidus range of motion of the great toe is reduced. Sometimes it may be 30 degrees and other times motion may be reduced a great deal more, maybe only 10 degrees. Generally, with more restriction of motion there is more pain associated with the problem. In laymen terms what is really occurring is that the great toe joint is becoming arthritic, commonly referred to as osteoarthritis.

Another name that was used to describe hallux rigidus is hallux limitus. It is used to describe the same thing, however the name in recent years has been changed and many doctors agree that hallux rigidus is more severe than hallux limitus. With hallux rigidus you will get bone spurs on the top of your big toe. You may find that your shoes rub this area, and it becomes painful to wear certain shoes. You may also get pain in other areas of the foot, leg, knee or back from favoring the great toe joint. Understand the great toe joint is one of the most important joints of the foot to allow you to walk or run normally.

How does hallux rigidus affect your gait or walk?

When you have lack of motion in the great toe you’ll roll to the outside of your foot as you push off the ball of your foot. You have to do this because the joint motion is limited so you have to get motion elsewhere and you achieve this by rolling onto the ball of the foot by the smaller toes. The modification in your gait may cause all kinds of other aches and pains. Frequently the first think to happen is you start to notice pain in the great toe, but you may adapt the pain by favoring the great toe thereby reducing the pain in the toe joint and increasing pain in other areas up into your ankle knee or hip joint. But it all started in your dysfunctional great toe.

What causes hallux rigidus?

  • Trauma – you may have had a severe sprain or jamming of the great toe joint. You may also have had a fracture in the joint. Both can damage the cartilage in the joint and therefore start the arthritic process.
  • Other arthritic conditions – If you have chronic gout your gout attacks frequently occur in the great toe joint. Because a gout attack causes severe inflammation in the great toe joint this will cause damage to the cartilage. The same idea holds true with autoimmune conditions such as rheumatoid arthritis.
  • Improper biomechanics – This is by far the most common cause. For the big toe to move up to 60-70 degrees of the ground two motions need to occur. First the great toe, hallux will move up 20 degrees. However, the first metatarsal bone forms the portion of the great toe joint that you bear weight on needs to push down against the ground. When the first metatarsal head pushes down against the ground the great can now glide up higher another 40 degrees to get up to 60-70 degrees of motion. It’s as if there are two axis of motion. One axis of motion allows the toe to move up 20 degrees then when the first metatarsal bone moves downward the great toe can move upwards even more. If the first metatarsal cannot move down then the great toe will jam as it tries to move upward. This jamming on the top of the joint is what causes spur formation and also wearing down of the cartilage on the upper portion of the joint. So now you may have pain from the spurring on the top of the joint rubbing shoe gear, and pain on motion of the joint as it jams as it moves upwards.

Non-surgical treatments to avoid cheilectomy surgery

  • Anti-inflammatory – To reduce pain and swelling Anti-inflammatory drugs may be used in the early stages as a pain reliever. However, long term use may be detrimental to the health of the joint.
  • Orthotics – depending on the type of custom-made inserts called orthotics are very helpful in the early stages of Hallux rigidus as the help to combat the biomechanics the promote the condition and may offer some pain relief. If the type of orthotic you’re using is store bought or not created from a non-weight bearing impression of your foot it may not be effective.
  • Regenerative medicine – The use of human cellular tissue products may be used to successfully eliminate pain in the joint and delay or possibly eliminate the need for surgery in some cases. Many of you are aware that stem cell treatments are commonly done for arthritis knees however very few realize this is an option for the great toe joint. See below to understand why the great toe has more opportunity to repair itself. And please watch this video.

What is involved in cheilectomy surgery?

Cheilectomy surgery is a procedure involving removal of the excess bone on the top of the joint and revising the joint of the big toe. If there is significant damage to the cartilage in the joint, then microfracture technique may be part of what the surgeon does during surgery. By making small drill holes(microfracture) in areas of the joint where cartilage is worn down to bone this will allow blood into the joint after surgery and in doing so allows repair of the damaged cartilage. The cheilectomy surgery technique works very well on the great toe joint. It is believed that cartilage has a difficult time repairing when there is vertical load on the cartilage. This would be the situation for a knee or hip joint. However, there is very little vertical load on the great toe joint the microfracture technique will have more potential benefit.

Post operative recovery – most patients are able to walk immediately after surgery in a surgical shoe or Cam walker. Sutures are usually removed between 2-3 weeks after surgery so the foot will have a dressing on during that time and the foot will need to be kept dry. Most patients are going back to shoes in 3 weeks and returning to some activities by 4 weeks and more full activities by 6-8 weeks. The risk of this surgery are not as significant as other foot surgery but you should be aware of them as problems such as blood clotting referred to as deep vein thrombosis may occur.

How to reduce the chances of joint fusion or joint replacement?

It needs to be stressed that this procedure may not be the end of your great toe pain. It’s possible for the cheilectomy procedure to work for years but the arthritic condition continues. Pain returns as the joint becomes more damaged and needs to be replaced or fused.

Regenerative medicine – The big toe joint has an unfair advantage for stem cell treatments to work. This is because the vertical load on a joint inhibits repair on joint cartilage and the great toe joint has very little vertical load. The procedure is simple to do. It’s done in a clinic setting and you’re able to walk immediately returning to regular shoes in 48 hours with no pain pills needed. Also, it important to consider before you symptoms become severe

Surgical treatment – If surgery is considered earlier, it is better to do a cheilectomy. First you need to have pain to consider a surgical approach. However, removal of the bone spurs and revising the joint with the microfracture technique may have a greater benefit long term if its done before the damage to the joint has become severe.

In summary

Cheilectomy surgery may not be the only surgery option, but if you wait too long it could result in hallux rigidus.

Regenerative medicine has an important role in reducing or delaying the need for surgery including fusion and joint replacement. And should be done early.

Schedule your appointment online or call our Fort Collins and Broomfield, Colorado locations to connect with a trusted foot doctor near you at our renowned foot and ankle clinic.

Frequently asked questions

1) What is a big toe cheilectomy, and how does it help with hallux rigidus?

A big toe cheilectomy is a surgical procedure that removes bone spurs and part of the arthritic joint to improve movement and reduce pain in patients with hallux rigidus—a condition that causes stiffness and pain in the big toe. It is most effective in the early to mid-stages of the condition, helping to preserve joint function and delay the need for more extensive surgery.

2) Who is a good candidate for a big toe cheilectomy?

This procedure is ideal for patients with mild to moderate hallux rigidus who experience pain and restricted motion due to bone spurs but still have some cartilage remaining in the joint. If arthritis is severe or joint damage is extensive, alternative procedures like joint fusion (arthrodesis) or joint replacement may be more suitable.

3) What is the recovery time after a cheilectomy?

Recovery typically takes 6 to 8 weeks. Most patients can walk with a stiff-soled shoe within a few days but should avoid strenuous activities for several weeks. Swelling and stiffness may persist for a few months, and physical therapy may be recommended to restore mobility and strength.

4) What are the risks and potential complications of this surgery?

As with any surgery, risks include infection, nerve damage, prolonged swelling, or incomplete pain relief. In some cases, arthritis may continue to progress, requiring future procedures. However, most patients experience significant pain relief and improved mobility after surgery.

5) Will I be able to return to sports and physical activities after a cheilectomy?

Many patients can resume low-impact activities such as walking and swimming within a few weeks. However, high-impact sports like running and jumping may take longer and could be limited if arthritis worsens. Your surgeon will guide you based on your healing progress and activity goals.

Call us today at our Fort Collins location (970) 484-4620, Broomfield location (720) 259-5053 or use our online scheduling system to book your appointment.

Conquer Chronic Ankle Instability: Your Guide to Stronger Steps!

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chronic ankle instability

Ankle sprains are a common foot and ankle injury. When ankle sprains recur frequently or if not treated properly this can lead to chronic ankle instability. Proper treatment and evaluation are important as ankle sprains tend to be undertreated and not always thoroughly evaluated.

Basic anatomy of your ankle

The outside of the ankle is supported by three ligaments that connect the smaller leg bone, the fibula, to the bones of the foot.

Most frequently damaged ligaments

The anterior Talofibular ligament ATFL – The connects the fibula to the ankle bone called the talus. It runs forward from the ankle parallel to the ground. It’s function is to keep your foot from moving forward out of the ankle joint

Second most frequently injured

The calcaneal fibular ligament CFI- This connects the fibula to the heel bone and travels vertical to the walking surface. This ligament keeps your foot from rolling out of the ankle joint. It supports the subtalar joint which is the joint beneath the ankle. Its function is like a universal joint on a car. It allows your foot to move in different body planes. When you make big circles with you foot most of that motion is coming from the subtalar joint.

The posterior talofibular ligament – This ankle ligament connects the fibula to the talus the ankle bone and runs towards the Achilles tendon. This ligament is the least frequently injured.

Why do ankle sprains occur?

  • Activities – certain risk activities are more likely to put you at risk of an ankle sprain. Any sports that require side to side motion such as racquet sports, tennis and pickleball. Sports that are ballistic and involve contact such as basketball, football and soccer. Activities that involve hiking over irregular terrain can also be riskier.
  • Shoe gear – shoes that are broken down and not as supportive may also lead to a sprain.
  • Foot types – Certain foot biomechanics are more likely to lead to chronic ankle sprains.
  • Ligamentous laxity – some are born with ligaments that are very flexible such as Erlos Danlos syndrome.
  • Neurological issues – you may have a mild case of drop foot from nerve damage. This could be from common peroneal nerve entrapment. The muscles that pull your foot upwards and sideways are weaker because of this condition.

Evaluation for chronic ankle instability

  • Proper evaluation starts with a good history – The mechanism of your injury will likely help the doctor to determine what structures may be injured.
  • Physical examination – There will usually be pain and swelling over the ligaments that are frequently injured.
  • X-rays – these may be taken to insure there are no fractures.
  • MRI – If a severe sprain takes place then imaging studies will be useful to determine the severity of the ligamentous damage.

Chronic ankle instability Treatments

This may require an extended period of time to rest the injury.

  • Immobilization– depending on  the severity of the injury the doctor may recommend the use of a Cam walker to allow the damaged ligament that were torn to repair properly.
  • Physical therapy– to help promote healing and strengthen the muscles around the ankle. This can also strengthen the peroneal tendons that support the outside of the ankle.
  • Ankle bracing– this may be used during healing and even for a longer period of time to protect the area from another sprain as you return to full activity
  • Anti-inflammatories– these may help with pain and swelling during the early stage of the ankle sprain.
  • Orthotics– custom made arch supports can help provide a stable base for the foot to stand on in the shoegear and reduce the frequency of recurrent ankle sprains.
  • Surgery-Surgery may be performed to repair the ligaments that have become damaged and weakened and no longer provide support to the ankle. The ligaments may be repaired along with using tendons around the ankle to increase support to this area. This can prevent repeated ankle sprains.
  • Nerve surgery– if it is from weakness because of neurological issues decompression of the common peroneal nerve may be performed.  The common peroneal nerve tunnel can become tight, or the nerve tunnel could be damaged. Reference for my research paper.

What will happen if left untreated?

With repeated ankle sprains the possibility of getting arthritis in the ankle or subtalar joint beneath the ankle joint increases. Treatment for the ankle arthritis may include ankle scope surgery to clean out the damage in the ankle, Stem cell treatment with human cellular tissue products, see video below.

Two suggestions to help prevent the chance of having chronic ankle instability.

Proper evaluation and treatment

The first and most severe sprain you have is the most important to properly treat. A common mistake I see is patients may not get an ankle sprain looked at by a doctor. Or if they do they may go to the emergency room or urgent care. X-rays shoe there is not fracture. They may leave with an ace wrap or ankle brace and are told to ice it. In other words ankle sprains are under treated and under evaluated.

Ideally if it a severe sprain with a good history taken by the doctor and a complete exam and in some cases and MRI a better treatment plan could be determined. If it’s a third degree sprain meaning one or more ligaments of the ankle are fully ruptured than immobilization of the ankle may allow the ligaments to fully repair and retain there strength. So when in doubt see a foot and ankle specialist.

Consider trail running or hiking

Yes, I know this may sound contradictory and I’m speaking from my own experience. I’ve run all my life from college, through medical school and all the way through my sixties. However, starting in my sixties, I gave up running on concrete and asphalt. I started train running as it really reduced the wear and tear on my body from running on hard surfaces. I was amazed. However I was very afraid at first as I was prone to ankle sprains. I have found that I’ve dramatically reduced the number of sprains I have, and I believe its for three reasons.

  1. I’m extremely efficient and looking where I step every time! I got very lazy doing this on smooth surfaces.
  2. Muscle strength in my lower legs has increased. This is simply because the muscles that have to support my foot from moving side to side are being used more and I believe it protects me from having sprains and I can make a faster correction when I sense I’m about to sprain my ankle.
  3. I have found that trail running shoes are important to use. They are treads that have more grip and have lower profile which I believe lowers the center of gravity of my foot in the shoe. It also allows me to feel irregularities in the terrain and make adjustments better.

So remember to get a professional certified local foot doctor’s opinion when in doubt and consider the suggestions for ankle sprain treatment and prevention in this blog. If you live in Colorado or nearby states consider making at appointment at our Broomfield or Fort Collins foot clinic. Our staff is compassionate and caring towards all our patients. We also have several testimonials and have now surpassed 5000 subscribers on our Anderson Podiatry Youtube channel.

Call us today at our Fort Collins location (970) 484-4620, Broomfield location (720) 259-5053 or use our online scheduling system to book your appointment.

Sports and Exercise Training – Ouch! What do I do if I’m Injured?

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Sports and Exercise Training – Ouch! What do I do if I’m Injured?

By Anderson Podiatry Center, in consult with Dr. Stephen Wilkinson, DPM, Sports Medicine Specialist

Congratulations! You’re training for an event, have begun or are maintaining an exercise routine and are motivated to compete or sustain your regime habit. You are to be applauded for taking your fitness and health seriously and incorporating it into your lifestyle. Your happy body, mind, work and social life will reward you for your efforts in a big way!

At some point in your fitness life, however, you will very likely experience pain or an injury that will frustrate or sideline you. Do you keep going? Do you take time off? As a sports medicine doctor, Dr. Wilkinson hears this a lot and has experienced it himself. How you manage these injuries, minor or not, is critical in determining if you can make your event goal or keep your downtime to a minimum and maintain your active life.

In his practice, at Anderson Podiatry Center for Regenerative Medicine, Dr. Wilkinson counsels many people to recover from injuries as quickly as possible and approaches his patient’s care and training plan with these steps and processes in mind, which helps assure they will be up and at it without skipping much of a beat. In this first of a series, we’ll present the initial steps that need to be taken to obtain a complete analysis that forms the basis of a sound and effective treatment and training plan. Then, later on, we’ll go into some of the customized specific treatment options and interventions – physical, mental and nutritional – that are utilized to get you to the finish line fast!

Step One:

A Complete evaluation begins with understanding the injury. An in-depth history is used to isolate the problem by asking questions about

  • The nature, location, and duration of the injury
  • The onset, course, and aggravating factors
  • Any treatments tried thus far

Patients often receive advice via their peer’s experiences or from the internet without a complete understanding of how that advice affects them specifically. Such treatment or training advice can unwittingly lead to injury. Patients often continue these improper training methods beyond the point of injury and then require professional help before they can continue towards their goals. We’ll alleviate this problem with a careful and complete history of the injury.

Step Two:

Step two involves taking time to understand what the patient is trying to accomplish in detail
(weight loss, cardiovascular fitness, a race completion, a time improvement etc.).  

  • Intervention is different depending upon whether the desired result is subjective or objective.

This breaks down to two basic groups of people:

  1. This group is seeking overall fitness and use a specific goal to provide motivation for training. They want to reach the finish line regardless of how long it takes. This requires significant core and mental fitness.
  2. This group has established overall fitness and is pushing to improve their fitness level via improvement in time or distance; more ‘fine tuning’ and achievement of maximum capacity
    while avoiding injury.

Step Three:

Step three involves understanding the patients starting point and whether or not his or her goal is reasonable to obtain by the time the patient needs to be ready to complete.

  • A 10% improvement per week is our target.

In this step, distance, intensity or speed of training are advanced 10% per week. Patients can often become impatient without clear guidelines and try and accelerate their training
faster than this tried and true path resulting in injury and training setbacks. “Slow and steady wins the race” as they say. Good advice to heed! The steps above give us a great foundation from which to build a plan of action to get you recovered and on your way. In the next blog we’ll discuss the nutritional, physical and mental approaches that provide the answers you need to get past your injury and help prevent future occurrences. See you then!

If you have an important goal to accomplish and are hindered by running or exercise pain, foot problems or injury, ankle injuries, plantar fasciitis or other problems, give me a call at
Anderson Center for Regenerative Medicine. I am not only ready to listen and understand, I am also ready to help.

To make an appointment with Dr. Wilkinson, Click HERE

Dr. Wilkinson is an ultra-runner, having completed many 50 and 100-mile races. As a Podiatrist who has successfully weathered his own sports injuries in the past, Dr. Wilkinson enjoys working with patients who are also athletes pursuing their own fitness goals. He believes in injury prevention through gait analysis, biomechanics, and sound, reasonable training techniques but is also an astute provider of clinical and surgical methodology to help return injured athletes to their playing field. Learn more about sports medicine injury treatment

Sports and Exercise Training – Ouch! What do I do if I’m Injured? Part 2

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Sports and Exercise Training – Ouch! What do I do if I’m Injured? Part Two of Two

By Anderson Podiatry Center, in consult with Dr. Stephen Wilkinson, DPM, Sports Medicine Specialist at Anderson Podiatry Center

Injury Treatment Plan
In our last blog we covered the steps Dr Wilkinson takes to obtain a complete analysis that forms the basis of a sound and effective treatment plan for foot and ankle and lower extremity injuries. Those who become injured during training can benefit from an efficient, effective treatment plan to keep downtime to a minimum and still be able to reach their fitness or event goals.

This time we’ll explore some of the nutritional, physical and mental approaches Dr Wilkinson uses to help you get past your injury, get to your event or goal and help prevent future occurrences.

At Anderson Podiatry Center and our Center for Regenerative Medicine, Dr Wilkinson uses a mind and body restorative process and training redirection to help you meet your goals. This includes addressing nutrition, sleep, mental attitude, injury mechanism, training or exercise schedule as well as equipment and the potential of your current injury. He thereby devises a rehabilitation program specific to your needs. Advanced modalities are used when needed to accelerate healing. The following explains his approach to these individual parts of the rehabilitation process:

Moving Past your Injury – Focus On:

1. Nutrition

  • Although a basic nutrient allocation of 20-30% fat, 10-30% protein, and 45-65% carbs is optimal for those with an active lifestyle, requirements of activity, work and family make this easier said than done. Dietary balance should also be adjusted based upon the unique situation of each athlete. I.e. heavier athletes may include weight loss as a goal, and injured athletes may benefit from an adjustment in the recommended nutritional ratios and/or additional supplements.
  • It is not uncommon to see deficits in calcium, magnesium, vitamin D and iron. Test values are used to indicate replacement or supplements in the correct combination.

2. Sleep

  • The demands of modern life have contributed to a Healthy People.gov report that approximately 25% of average Americans have insufficient sleep half of the time. This, unfortunately, includes athletes, who have increased sleep demands during training, injury or illness. Sleep evaluation and intervention often involves a sincere allotment of time per daily and required activities, in addition to assessment with regards to activity required for sports goal success. Lower priority activities may need to be curtailed: a potentially tough decision but something’s gotta give to provide the long-term sleep requirements for progress in training and/or injury healing.
  • When sleep requirements for training exceeds the amount of daily sleep time available, additional time may be needed to safely reach goals despite many athletes’ desires to charge forward. Here, the vision and experience of a sports medicine consultant can be essential.

3. Mental Attitude

  • Possibly the most beneficial development that occurs when we strive to achieve more involved fitness or event goals is the process through which athletes improve their mental attitude. Improvement in self-confidence and improved self-image can often elevate an athlete’s success capacity beyond what was formerly believed. Important in this process is the conscious control of physical and emotional stress which must include appropriate and attainable goals and small interval reward breaks to allow for physical healing and mental reward for a job well done.
  • Visualization and self-talk, either alone or with a motivation/visualization coach is important preparation for success. Mental preparation and mental toughness require the acceptance of a fluid process with ups and downs in reaching a goal. The ultimate success of this process involves arriving at the final event both physically and mentally prepared.

4. Injury Mechanism

In foot, ankle and lower extremity sports injuries, understanding the injury mechanism is critical to successful intervention. In sports injuries, even in the most complex cases, there is typically a single event or pattern of recurring events that is at fault.

  • Single act injuries are often improved and resolved by isolation, rest, and regeneration.
  • Injuries from chronic repetitive mechanisms can often be overcome through improved balance and redirection of forces to other targeted areas.

The sports medicine consultant can be essential in determining the offending mechanism and developing a recovery program for effective intervention.

5. Training or exercise guidance: schedule and equipment

Once the site and mechanism of injury are identified, a training schedule and specific rehabilitative equipment can be utilized to isolate injury areas, protect healing tissue, and strengthen supportive structures to allow for recovery. Often previously ignored core strengthening exercises, including those for posture and balance, can be performed on readily available equipment such as treadmills and ellipticals. We target larger protective muscle groups and pay specific attention to joint alignment and position, which can have a significant impact on energy utilization and other muscle function. Core strengthening and joint mechanics are often ignored by athletes due to time constraints or lack of specific training with regards to their importance. Attention to these areas in training not only promotes injury healing but also may elevate the athletes post-injury performance above pre-injury levels.

6. The potential of your current injury

The importance of understanding the athletes’ degree of injury and potential recovery cannot be overstated. Most injuries can be overcome with simple interventions. Occasionally, the extent of injury and the recovery potential requires an adjustment in goals and/or time to reach those goals. Additionally, some injuries may require advanced modalities such as prescription orthotics, regenerative medicine modalities, or corrective surgical interventions. As stated previously, appropriate evaluation and management with a clear understanding of time table and athlete goals is essential to success. Sports medicine consultants with proven event success can be essential to this process.

7. Advanced Modalities

These can include custom orthotics and regenerative medicine products:

  • Orthotics: custom-made shoe inserts that are designed to correct abnormal or irregular foot or leg biomechanics. While over-the-counter foot orthotics are available and may help people with mild symptoms, they normally cannot correct the wide range of symptoms that prescription foot orthotics can. Prescription orthotics are custom made to fit an individual’s unique foot structure. If you exercise and train often, you most likely can benefit from an orthotic that best addresses your particular activity, shoe gear, and foot type.
  • Regenerative medicine: an exciting new option for fast healing with little downtime, these products stimulate your body at the cellular level, giving it the power to regenerate injured joints and tissues. At Anderson Center for Regenerative Medicine, we use three types of regenerative medicine products.

If you have an important goal to accomplish and are hindered by running or exercise pain, foot problems or injury, ankle injuries, plantar fasciitis or other problems, give Dr Wilkinson a call at Anderson Podiatry Center and Anderson Center for Regenerative Medicine. He is ready to listen and understand, and to help.

To make an appointment with Dr. Wilkinson, Click HERE

Dr. Wilkinson is an ultra-runner, having completed many 50 and 100-mile races. As a Podiatrist who has successfully weathered his own sports injuries in the past, Dr. Wilkinson enjoys working with patients who are also athletes pursuing their own fitness goals. He believes in injury prevention through gait analysis, biomechanics, and sound, reasonable training techniques but is also an astute provider of clinical and surgical methodology to help return injured athletes to their playing field. Learn more about sports medicine injury treatment

Sports and Exercise Training and Injury: The Good, The Bad, and The Answer

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sports exercise and injury

The Goal (aka: The Good):

Just imagine that you have trained for a running event, such as a full marathon or half marathon, for anywhere from three to six months and have spent thousands of direct and indirect dollars in preparation. Or you have spent time and money revitalizing your exercise routine in a determined effort to meet your fitness goals. You are organized and motivated and, if you are training for an event, have chosen a specific race date. Perhaps you have scheduled vacation time off, and prepaid all expenses. You also try to balance the rest of your life as well: eating, sleeping, working, and being an engaged and active member in your important relationships.

The Injury and aftermath (aka: The Bad):

Then the unthinkable happens. You start to feel foot or leg pain and become injured during your training or workout routine, placing your preparation and any event goals in jeopardy. To make matters worse, you take more time to visit a well-intended sports medicine specialist, local podiatrist or other care provider who does not understand who you really are or your motivation. You receive his or her best recommendations that include generic and un-customized directions that often include abandoning your running or activity goals, not taking into account that you are physically and mentally invested. You may even decide to continue with your current training or exercise routine and soon find that you are getting worse instead of better.

The Answer:

What do you do? At Anderson Center for Regenerative Medicine I recommend that you consider our total athlete evaluation and rehabilitation program before you are forced to submit to regret and disappointment.

Here is where I come in:

  • I examine all aspects of who you are in total.
  • I begin by understanding your goals as completely and specifically as possible.
  • I learn the past and recent history of your fitness and its evolution.
  • I trace your health and training or exercise progression in all aspects from the origin of your idea to your current status.
  • I use over thirty years of office experience and road and ultra-running experience to understand what you are going to need to reach your goal and maintain optimal foot, ankle, and lower extremity health.
  • I access the physical and mental assets you possess to reach the finish line.
  • This includes nutrition, sleep, mental attitude, injury mechanism, training or exercise schedule and equipment, and potential of your current injury.
  • As a Podiatrist specially trained in sports medicine, I am able to present and use advanced modalities to stop your foot or ankle pain or injury progression and move you back to the starting line. These can include nutrition and training guidance as well as custom orthotics and regenerative medicine products. Surgery is a last resort.

In essence, I use a success centered mind and body restorative process and training redirection to help you meet your goals to include healing your current injury, preventing future injury, and completing your event or attaining your fitness goals.

If you have an important goal to accomplish and are hindered by running or exercise pain, foot problems or injury, ankle injuries, plantar fasciitis or other problems, give me a call at Anderson Center for Regenerative Medicine. I am not only ready to listen and understand, I am also ready to help.

To make an appointment with Dr. Wilkinson, Click HERE

Dr. Wilkinson is an ultra-runner, having completed many 50 and 100-mile races. As a Podiatrist who has successfully weathered his own sports injuries in the past, Dr. Wilkinson enjoys working with patients who are also athletes pursuing their own fitness goals. He believes in injury prevention through gait analysis, biomechanics and sound, reasonable training techniques but is also an astute provider of clinical and surgical methodology to help return injured athletes to their playing field. Learn more about sports medicine injury treatment. By Stephen Wilkinson, DPM

Elsie’s Story: Heel Pain & Knee Pain

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Walking On My Toes

Elsie didn’t have time for heel pain. She loved being active and going for runs, and suddenly heel pain had stopped her in her tracks.

“I was walking on my toes,” Elsie said. “The pain was so bad, I couldn’t put any pressure on my heels. So I had to stop running and I was looking for a solution.”

Heel Pain, Gone

Elsie came to see Dr. James Anderson, DPM, and tried conservative treatment first.

Dr. Anderson said, “Elsie had plantar fasciitis (heel pain). We tried orthotics first, but nothing was really helping her. Instead of doing surgery, we recommended stem cell treatment. Often, patients can avoid surgery, and experience pain relief with only one stem cell treatment.”

“I had the stem cell treatment,” Elsie said. “After only one week, the pain was totally gone!”

Two years later, she came to see Dr. Anderson for a follow up appointment, and she was back to running and her heel pain had not returned.

Then, Knee Pain

Elsie had started to have knee pain, and mentioned it to Dr. Anderson. “I wore my cartilage down on the top and bottom of my knee, and it was hurting when I ran.” she said.

Dr. Anderson had good news. “We have recently integrated our practice, and are now offering stem cell treatment for knee pain as well as shoulder and hip pain.”

Elsie was thrilled, “I’m a firm believer in stem cell,” she says. “Because I have not had any trouble with my foot since my injection.”

Dr. Anderson treated her with the newest regenerative product that contains umbilical cord stem cells. “Umbilical cord stem cell treatment has the highest concentration of stem cells, growth factors, and proteins, so it’s a highly-effective product and can help patients avoid surgery,” Dr. Anderson says.

The Power of Stem Cell Treatment

“Stem cell treatment is a really powerful tool,” Dr. Anderson explains. “Because it works by stimulating your body’s natural ability to heal.”

“As we age, our bodies begin to degenerate, and we start to have pain. But, stem cells have the ability to become any kind of cell. They can become bone, tissue, tendon, or cartilage. So, it’s an amazing treatment option for a variety of conditions.”

“We’ve treated plantar fasciitis, Achilles tendonitis, and arthritis in the joints with stem cell therapies for years, and now we can treat knee pain, shoulder pain and hip bursitis as well.”

Back On Track

Elsie had the stem cell injection in her knee two weeks ago. “This week I was hurrying to do something, and I didn’t even mean to, but I started to run, and it didn’t hurt at all!”

“My knee just keeps feeling better and better every day,” Elsie says. “In another week or so, I’ll be back out there, running again.”

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Summer Special!

Now offering a FREE new patient exam and consultation! Expires 6/30/18. *X-Rays, testing and treatment not included.  

Call us today! Just mention this blog to receive the offer.

Learn more about regenerative medicine here.

Grace’s Story: Arthritis in Big Toe Joint

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On My Feet All Day

As a kindergarten teacher for many years, Grace was used to being on her feet all day. “I was busy,” Grace says, “And I just didn’t have time to address all my aches and pains.”

Grace had pain in her big toes, but she ignored it and kept up with her active life, and her daily one-mile walks. “I just sucked it up,” Grace says, “I think a lot of people do that when they are busy.”

Then The Pain Kicked In

When Grace retired from teaching, suddenly the pain kicked in. “I was having trouble walking because of the pain. Finally, I got tired of dealing with it and decided to find treatment.”

Grace went online, began researching, and soon found Dr. James Anderson, DPM. “I didn’t realize I had arthritis in my big toe joints,” she said. “You just know you have pain, but you don’t really know what’s going on until you go in and make an appointment.”

Regenerative Medicine + Surgery

Dr. Anderson says, “Because of the arthritis, there was a bone spur on her joint. I recommended surgery to remove it and clean up the bone. Then, we could follow up with a regenerative medicine injection.”

Grace decided to have the surgery, and then followed up with the regenerative injection, and laser therapy to help reduce inflammation and prevent scar tissue from forming.

“Regenerative medicine works by stimulating the body’s natural ability to heal, and the stem cell components help to regenerate the damaged cartilage,” says Dr. Anderson. “If we see the patient early enough, we can often use regenerative therapies to avoid surgery completely.”

“For Grace, this treatment approach helped us to save her joint and improve function! Many times, patients will have to have a joint fusion or replacement, and we were able to prevent that.”

Hitting the Trails Again

It wasn’t long before Grace was living the retired life she had hoped for. “I’m back to doing anything that I want,” Grace says.

“I can go hiking, and I can travel! I walk two miles every day, and I can wear any shoes I want to!”

Her advice for others is this. “Don’t wait any longer to address your pain. The longer you put it off, the more damage can occur. And then, that’s more time and money you will have to spend to resolve it.”

“Take the time to take care of yourself. It’s important.”

Call today to make an appointment, and we can discuss treatment options with you.

To learn more about regenerative medicine, click here. 

CJ’s Story: Chronic Tendon Pain (The Power of Regenerative Medicine)

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CJs testimonials chronic tendon pain

The new year is here, and for many of us that means it’s time to focus on our health, and address some of those lingering issues we’ve been putting off.

Today, I will share a success story of a patient who was dealing with chronic joint and tendon pain for several years. My goal is to help instill hope in many of you who have been experiencing similar pain, and have perhaps given up on finding a solution. So, here we go.

52, Healthy and Active

This patient is a 52 year-old female, who was healthy and active. We will call her CJ. She came into my office with a variety of foot complaints. The primary issue was chronic joint and tendon pain in her right foot and ankle, and this had been going on for several years.

Seven years prior, a horse stepped on her foot and she was diagnosed with a “hairline fracture” and wore a cast for three months. Once she was out of the cast, she could get back to activity with little pain. However, over the next five to six years, she started having more and more pain in the area that began to significantly limit her activity. This gradually led to weight gain, which only made the problem worse.

Plantar Fasciitis, Arthritis and Tendon Pain

When I first saw CJ, she was planning on having gastric bypass surgery, but was concerned that she would not be able to exercise properly after the surgery because of her foot and ankle pain. She had previously been treated for plantar fasciitis by another doctor.  She had steroid injections and wore a night splint, but neither treatment seemed to give her any relief.

During her initial exam, her X-rays showed that the old injury had been more than just a hairline fracture. She had evidence of post-fracture arthritis in two joints in the middle of her foot. The fracture had healed, but left joint damage behind. Her other main issue of ankle pain was diagnosed as a partial tendon tear. This had likely been aggravated by compensating for the joint pain.

Regenerative Medicine + Surgery

Many times, when patients present with arthritis, tendon pain, or plantar fasciitis, we use regenerative medicine therapy to help stimulate healing and avoid surgery altogether. But, in CJ’s case, we needed to use several different treatments to help address all the issues that had been accumulating for all these years.

We performed surgery to repair the tendon tear and used regenerative injections to help heal the joint damage. To better support the damaged joints, we fitted her for custom orthotics. She then began physical therapy to improve her strength, balance, and flexibility.

Ten Weeks Later

CJ was on crutches for four weeks after the tendon repair. But, once we cleared her to start walking, she progressed quickly. She was highly motivated and committed to her therapy and post-operative rehab. Ten weeks after surgery and regenerative therapy, she was already back to walking and elliptical workouts daily. She still has the occasional sore muscles, but no longer has anywhere near the pain she did before. CJ is still considering gastric bypass surgery. But, she now feels she will be able to lose the weight without it since she can exercise without pain.

So, if you or someone you love is struggling with daily foot or ankle pain, please don’t wait any longer to address it. Call today to make an appointment, and we can discuss treatment options with you.

2018 can be your last year to deal with chronic pain. It’s time to get on the path to healing, together.