Today is the first day of fall and the Falls Free Coalition has dubbed today National Falls Prevention Day. Accidental falls are a major health problem among the elderly in the United States. One in three people over age 65 fall each year. Many falls result in hospitalization. Ten percent of elderly people who fall have serious injuries resulting. These include fractures, joint dislocations, and severe head injuries.
As a podiatrist in Houston, TX who treats a fair number of elderly patients, the results of falling is far more than physical alone. There are significant emotional and psychological effects as well. An unwillingness to venture outside, fear of falling again, changes in a person’s gait, and an overall “aging” affect are commonly noticed after a fall. It is important to identify these factors as well. Falls can lead to depression which can have a devastating effect on the elderly person.
What can you do to help prevent falls? Starting an exercise program is a great way of lowering the chances of a fall. Especially helpful are exercises that increase balance and coordination. You should also review all of your medications with your doctor. There are some medications and other combination of medications that can cause drowsiness and can cause a fall. You should also have your eyes checked once a year to be sure you eyesight is as good as it can be.
Making your home safer also is helpful in preventing falls. Remove things that can be tripped over, such as books, area rugs, and shoes. Putting grab bars in areas that can be slippery, such as the bathroom and shower, as well as using non-slip mats are helpful. Also, wearing shoes inside and outside the house can help with stability and minimize the chance of falling.
It is impossible to prevent falls entirely, but taking some steps can certainly help to reduce the chances. If you or your loved one does have a fall, be sure to get checked out, no mater how minor it seems. The quicker you get something taken care of, the less chance it can be a problem later on.
It’s a question I get often in my Houston, TX office…from patients and non-patients alike. Why do I want to work with feet all day? I believe that there is no greater satisfaction than when someone comes into my office with pain and leaves pain free, or confident that they are on the road to recovery.
American Podiatric Medical Association (APMA) produced a great video that really answers this question well. Take a look and let me know what you think.
[youtube]http://www.youtube.com/watch?v=fvDu7oeAzRE[/youtube]
In rehearsals for Dancing With the Stars, Tom DeLay, former congressman from a suburb of Houston, TX, suffered a foot injury. Originally thought to be a stress fracture, it was later announced that it was a “pre-stress fracture.” I was amazed to hear this. After several years of school, residency, and practice, I’ve never encountered such a thing.
So what do you do when you come across something new…you Google it! So I did and guess what? Everything that pops up has to do with Tom DeLay! Well that’s the trend now…Pre-Diabetes, Pre-Hypertension…we’ve become too afraid to label someone with what they’ve got. So you end up with patients telling you: I’m not diabetic…I’m pre-diabetic as they eat a cupcake.
It is probable, however, that Mr. DeLay has a biomechanical situation in his feet that increases the pressure beneath the metatarsal bones. This can set the stage for a stress fracture. He should be managed with a custom orthotic device to allow the pressures to be redistributed. This way, no one area will have undue pressure beneath it. If he does develop a stress fracture, then it is a problem. If he continues to dance, the stress fracture, or a “hairline” fracture, can develop to be a full fracture which can require surgery to repair.
I’m sure Mr. DeLay’s getting the best treatment. He should…he’s got one of those lifetime congressional health plans we’ve heard so much about! Keep on dancing Tom!
It seems like it has always been a problem. Kids just don’t like to tie their shoes. Sure, it only takes a few seconds, but look at all the time is saved by just slipping them on. Even kids who have Velcro closures on their shoes still don’t undo them…they just slip them on!
A shoe is meant to provide stability for your foot. Tying your shoes daily will make them secure and prevent your foot from slipping around. When a shoe is untied for a period of time and just slipped on and off (you should see the size of some of the knots I see!), the laces loosen and the foot slips around in the shoe. This causes the foot to have to work harder to stabilize itself, often leading to overuse injuries.
Does this really make a difference? Absolutely! I’ve seen kids with infected ingrown toenails because they are hitting the ends of their shoes. Others who developed shin splints because of wearing shoes that are too loose. Still others with Achilles tendon pain or Sever’s disease because they don’t tie their shoes. The more active a kid is, the more important it is for them to tie their shoes well.
The same goes for adults. In fact, I am constantly on the case of my trainer (who tortures me twice a week) for not having his shoes tied. Not such a big deal when he’s working, but I’ve seen him the same way when he’s working out! Think about how much stability your body needs when you’re lifting weights! I’m finally getting through to him after he started feeling some foot pain. Now, I’m a really nice guy so I certainly didn’t tell him “I told you so!” Well….of course I did!
It is important to tie your shoes and to make sure your kids’ shoes are tied every day. If you’re running late, resist the urge to tell them to just slip it on…If you give them permission once, they’ll do it always.
The terrain that an athlete runs on is critical to not only their performance but also to the health and maintenance of their bodies. You might be surprised at what running on a different terrain can do to your body. When it comes to the type of surface that you run on, the most important factor is the amount of shock absorption that the terrain provides. Now just because something is super shock absorbent does not mean it is the most ideal running surface. For example, many people like to run on beaches because it is a very soft surface, but it also takes much more energy to run on sandy surfaces because you sink into the sand as you run. Therefore, there is a cost-benefit ratio to running on very shock absorbent surfaces, on one hand they provide a softer surface for your feet to land on but on the other hand they require more energy to run causing you to get tired more quickly during your run.
More traditional running surface materials are concrete sidewalks and asphalt streets. If you have the choice, the asphalt streets are actually a better option because they are softer on impact compared to concrete sidewalks. You may not be able to feel a difference when running on the two but over long distances, your body will certainly be able to feel the difference.
Besides the material that a running surface is made of, another factor that makes a difference while running is if the terrain you run on is slanted or banked. Running on a banked surface in one direction or another is common because many roads and pathways in Houston are designed this way to help them drain properly. The problem with running on a banked surface is that you get an uneven distribution of force and work that is put onto each leg. The leg that is lower bears more weight and does more work than the leg that is more uphill. If you know you are running on a slant then one thing to consider is make sure you are running on an out and back run route and not a circular path. If you are running in a circle then the same leg is always bearing more weight and doing more work than the other leg. If you run out and back then one leg does more work on the way out and the other leg does more work on the way back. By the end of your run your legs have taken on the same workout which will minimize the chance of injury.
The composition and contour of the surface you are running on is very important to the health and performance of a runner. Making a conscious effort to run on a flat surface that has the optimal shock absorption is important to consider on every run.
I like to see heart…I really do. But, when your job is not on the line, and you have a history of injury…is a risky scramble the right thing to do in a PRESEASON game?
Well, that’s exactly what happened last night in Reliant Stadium when the Texans played Brett Favre and the Minnesota Vikings. I’ll admit, I don’t usually go to preseason games, but since both starting teams and quarterbacks were going to play at least the first half, the fact that it was Monday Night Football, and I’ve been pretty starved for football, I’d give it a chance.
Fortunately, it seems that Schaub’s ankle sprain is not serious. After scrambling to the sideline (nice play, although I don’t agree with it) he limped slightly going back to the huddle. After throwing a touchdown pass later in the drive, he really was limping as he was leaving the field. Halftime came and went and Schaub did not return to the game.
Any twisted ankle can damage the three ligaments on the outside. They are there to support the ankle. The ligaments can either be stretched or torn when this happens. Studies have shown that immobilization provides the best environment for the ankle sprain to heal. For mild sprains, however, good quality elastic ankle support usually suffices.
As with any acute injury, a great way to manage the swelling and pain is through the RICE principle: Rest, Ice, Compression, and Elevation. This especially holds true for ankle sprains, since they can swell pretty quickly. Don’t write off a sprained ankle as something that is minor…it is usually the annoying “minor” issues that linger.
I hope Schaub shows the same heart when he plays in the regular season…but he better stay healthy!!
