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FOREFOOT RUNNING ALTERNATIVE FOR RUNNERS WITH ACHILLES OR HEEL PAIN

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Achilles or heel pain with running can be very debilitating to the impact athlete. Transitioning to a forefoot or midfoot strike with running can allow for continued running while simultaneously rehabilitating injured tissues. This is mostly due to the eccentric load that is placed on the plantar fascia and the achilles tendon during the deceleration phase of forefoot running. Who wouldn’t want to rehab and exercise at the same time!

Thanks to the OrthoNOW Team and Dr. Alejandro Badia, I was able to present at the OrthoNOW Athletic Trainer’s Symposium at the Marlin’s Stadium in Miami, FL. Having the opportunity to speak and share ideas with trainers who care for our young athletes is on of the many ways we as physicians can reach out and make a positive impact.

Also is the image of my high school mentor and Athletic Trainer Mr. Vinnie Scavo. I was a student in his training room, learning to care for athletes, while I was at Coral Gables Senior High School. Now, I am a board-certified orthopaedic surgeon. I am grateful to my teachers and mentors and am so very happy to have connected again with Mr. Scavo!

Ankle Fractures and Tendons

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Ankle fractures come in all shapes and sizes. Most are mild and can be managed with a walking-boot or a cast. Occasionally, they are more severe and can involve several parts of the ankle, such as the medial and lateral malleoli. Once two of the three main bony supports of the ankle are compromised, surgery is often required. Operating on the medial (or inside) malleolus is often completed percutaneously. Small incisions are beneficial due to less pain, swelling, bleeding and scarring. However, they can make it hard to identify other vital anatomic structures, in this case, the posterior tibial tendon. This patient had persistent pain and swelling about the inside part of the ankle many months after their fracture healed. Upon removal of implants, it is evident that the screw head was rubbing on the posterior tibial tendon, secured here with a red band. Luckily, removing the screw was sufficient to resolve their symptoms. However, it is a good point to remember that smaller incisions are not always better. It’s a little like driving with blinders on. Keeping a broad field of exposure allows the surgeon the best opportunity to fully evaluate the surrounding structures. So, sometimes a bigger incision is better.

Independence AND recovery!!!

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I-Walk-Free keeps patients moving!

This patient suffered a calcaneus, or heel bone fracture. He was unable to bear weight on the foot for 8 weeks. This is significantly limiting as use of crutches or a walker make it nearly impossible to mobilize in a home or office setting. Use of these aides also occupies the hands – so preparing meals or accomplishing tasks becomes arduous. The I-Walk-Walk free crutch offers an alternative. Post-injury and post-operative foot and ankle patients can obtain this crutch, covered by most insurances and within 1 – 2 sessions of physical therapy, can learn to successfully manage their independence. For those contemplating a surgical procedure and are wary of the postoperative restrictions, this device is a significant game-changer.

PRP brings Cobi Morales back to Racing!

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Cobi is a nationally ranked triathlete and co-owner of iRun.  He was also #1 in the world in his age group for triathlon.  A chronic, debilitating achilles tendonitis kept him from training and performing at his true capacity.  This gifted athlete came to my office ready to stop running, ready to have surgery and ready to give up his dream.  Fortunately, a successful platelet-rich-plasma (PRP) injection, and rigorous adherence to a recovery protocol, brought him back to racing, and to winning.  Here are his words…

“After trying virtually everything and spending thousands of dollars, I came across Dr Deben. What I am most impressed of is that not only she got me back to FAST running, she also delivered the steps one by one of the PRP treatment. Something hard to get why? Because is not effective to get the treatment done if the procedure doesn’t deliver the following steps into the ultimate recovery. Dr. Deben did and I will be eternally grateful for that.”

Runner returns to racing!!!

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Meet Ana Cadreche, one of our many athletes!  Ana runs 80+ miles weekly and often places in her age group for marathon.  She is also a part-time triathlete and a full – time special education Teacher.  Ana suffered a stress fracture of her hip, requiring a large metal plate and screw implant to heal the fracture.

We are now over two  years out, and Ana has won again!  She placed second overall in her age group in the A1A Full Marathon with an outstanding time of 3:11:05!  Here are some shots of her running and catching tape.  She was kind enough to share with Dr. Deben her first award on return to racing, 3rd place in the America the Beautiful race.  She dedicated it to the surgeon that got her back running.  Go Ana!!!

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Cadreche Ana cadreche plaque