Toe Trauma

Summer tends to be a time when more often than not you see runners out and about. Whether training for marathons in the fall or just enjoying the chance to exercise in good weather, runners tend to become commonplace this time of year. Perhaps you might know a runner or perhaps you might be a runner yourself. If so, you might be familiar with a condition called black and blue toenail which can be secondary to running-induced trauma. The usual setting under which a toenail can turn black and blue would be if a heavy object happened to fall onto it which might indicate a possible fracture. However, it's also possible for this condition to surface during times of repetitive trauma, such as running, where the nail tends to hit the front of the shoe repeatedly. If this condition has ever happened to you or a friend, seeing a podiatrist for a complete evaluation would be the first step (you want to be sure it's not a break from some other incident!). If you are an avid runner, prevention is also key. Some of the things you can do to avoid this type of trauma would be making sure you are wearing the appropriate running shoes (size, type, etc.), trimming your nails properly, and again, consider visiting your local podiatrist for further evaluation and advice. With proper prevention and/or treatment, you can go for miles and miles!

Stressing about fractures: when is it time to operate?

Perhaps you have seen the recent news regarding Yao Ming, the stress fracture in his foot, and his decision to undergo extensive surgery to repair it. Ming, after many weeks of consulting with specialists and considering the amount of time off the court he must dedicate to rehabilitation, has decided to undergo two extensive procedures. One will repair the actual fracture in his left foot, and the other will prevent the injury from occurring again. This recent news in sports brings up a important question: when suffering from a stress fracture, is it time to head off to the operating room or not?

Stress fractures, like it or not, can be a fact of life. With the number of people today running in marathons, participating in intramural sports teams, and racing from here to there, people may expect to face an occasional injury from time to time. Sprains and strains can generally be treated with time, rest, and isolated care, but what about those pesky stress fractures?

Stress fractures often develop from overuse during high impact sports such as running, or in Ming's case, basketball. This constant overuse causes the muscles to fatigue, meaning they can no longer absorb repeated shock impacts. During this process, when the muscles get excessively tired, they transfer this stress to the bones which can create the infamous stress fracture. Some bones in the foot are more susceptible to breaks. These include the metatarsals, the heel (calcaneus), and the navicular (the bone which Ming happened to fracture). Once a break occurs, the question at hand revolves around the treatment. For the normal individual, stress fractures may heal with reduced activity and restricted mobility with casts or certain shoe gear. Fractures can take as short a time as two weeks to heal or up to eight weeks. With Ming, the navicular bone usually takes a long time to heal. In his case, being that he is a professional athlete, depends greatly on his feet for his career, and may be susceptible to further injury in this area, surgery was a better option. But in the case of the normal intramural athlete, conservative care, such as casts, may be the best choice. So if you suddenly find yourself in a situation similar to Ming's, understand that surgery is more than likely better left to the pros.