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August 05, 2014
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Use PRP to Increase Your Healing Potential!


What is PRP?

PRP, or Platelet-Rich Plasma, is blood plasma that has been centrifuged to concentrate the platelets.  This concentration contains several different growth factors and cytokines (small molecules used in tissue regeneration) that stimulate healing of bone and soft tissue.

PRP therapy is based on local delivery of a highly concentrated volume of platelets at the site of some musculoskeletal injury.  When activated, (typically with collagen or thrombin), these platelets release various critical growth factors involved in healing.

When is PRP Used?

PRP has historically been used in maxillofacial surgery, plastic surgery, and in open heart surgery.  There has been a recent surge in the orthopedic specialties to improve bone healing and accelerate soft tissue healing as well.

This concentrate can be injected into tissues to promote healing.  Platelet-Rich Plasma has been investigated and used as clinical tool for several types of injuries in the foot and ankle, including: nerve injury, tendinitisosteoarthritis, and bone repair and regeneration.  PRP has also received attention in the popular media as a result of its use in treating sports injuries in professional athletes.

How is PRP Injected?

This procedure is typically done in the Operating Room Suite under local or regional anesthesia.  Blood is taken from your arm and the platelets are removed.  Your body’s own platelets are then injected back into the plantar fascia, Achilles’ tendon, or surgical site.  This provides greater healing potential for chronic injuries or aids in surgical recovery.

The known actions of platelet-derived factors suggest that PRP may have significant potential in the treatment of pathological conditions of cartilage, tendon, ligament, and muscle.  The growth factors in PRP are activated and begin working within 10 minutes of the injection.

If you are suffering from an acute or chronic soft tissue injury, like the ones mentioned above, contact one of the doctors at Academy Foot and Ankle Specialists to see if PRP injections may be right for you. 

June 30, 2014
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Medical Myths:  The Truth Uncovered  #1

There’s Nothing You Can Do About A Broken Toe:  True or False?

There is often a delay in treatment for toe fractures because most people think there isn’t a treatment for them anyway.  This is FALSE!  Toe fractures are treated like any other fracture in the body.  If it’s not displaced (separation between fracture pieces), then immobilization is the typically treatment.  If there is separation of fracture pieces, sometimes a surgical procedure is necessary.  If not immobilized properly (i.e. wearing one of those stylish black Velcro boots), there can be a delay in healing or the fracture may not heal at all.  This can lead to long lasting pain and even deformity.  Kids who fracture their toes through the growth plates can have long lasting deformity as well if not treated appropriately.  The picture shown is of a female patient that broke her toe through the growth center and did not seek treatment.  The growth plate closed prematurely resulting in a shortened digit.  Moral of the story?  If you injure a toe and think it might be broken, seek treatment!  There IS something you can do about it!!  The doctors at Academy Foot and Ankle Specialists treat all conditions of the foot and ankle.  If you are experiencing foot, ankle or toe pain, contact us today for an appointment.  817-424-3668. 

June 23, 2014
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What is the Os Trigonum? 
The os trigonum is an extra (accessory) bone that sometimes develops behind the ankle bone (talus). It is connected to the talus by a fibrous band. The presence of an os trigonum in one or both feet is congenital (present at birth). It becomes evident during adolescence when one area of the talus does not fuse with the rest of the bone, creating a small extra bone. Only a small number of people have this extra bone.
What is Os Trigonum Syndrome?
Often, people don’t know they have an os trigonum if it hasn’t caused any problems. However, some people with this extra bone develop a painful condition known as os trigonum syndrome. 

Os trigonum syndrome is usually triggered by an injury, such as an ankle sprain. The syndrome is also frequently caused by repeated downward pointing of the toes, which is common among ballet dancers, soccer players and other athletes.

For the person who has an os trigonum, pointing the toes downward can result in a “nutcracker injury.” Like an almond in a nutcracker, the os trigonum is crunched between the ankle and heel bones. As the os trigonum pulls loose, the tissue connecting it to the talus is stretched or torn and the area becomes inflamed.

Signs and Symptoms of Os Trigonum Syndrome 
The signs and symptoms of os trigonum syndrome may include:

  • Deep, aching pain in the back of the ankle, occurring mostly when pushing off on the big toe (as in walking) or when pointing the toes downward
  • Tenderness in the area when touched
  • Swelling in the back of the ankle

Os trigonum syndrome can mimic other conditions such as an Achilles tendon injury, ankle sprain, or talus fracture. Diagnosis of os trigonum syndrome begins with questions from the doctor about the development of the symptoms. After the foot and ankle are examined, x-rays or other imaging tests are often ordered to assist in making the diagnosis.

Treatment: Non-surgical Approaches
Relief of the symptoms is often achieved through treatments that can include a combination of the following:

  • Rest. It is important to stay off the injured foot to let the inflammation subside.
  • Immobilization. Often a walking boot is used to restrict ankle motion and allow the injured tissue to heal.
  • Ice. Swelling is decreased by applying a bag of ice covered with a thin towel to the affected area. Do not put ice directly against the skin.
  • Oral medication. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing the pain and inflammation.
  • Injections. Sometimes cortisone is injected into the area to reduce the inflammation and pain.

When is Surgery Needed?
Most patients’ symptoms improve with non-surgical treatment. However, in some patients, surgery may be required to relieve the symptoms. Surgery typically involves removal of the os trigonum, as this extra bone is not necessary for normal foot function. 

Contact one of the doctors at Academy Foot and Ankle Specialists if you are experiencing foot or ankle pain for a full exam today!

June 01, 2014
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When you take a step, your foot typically hits the ground heel first and rolls toward your toes, flattening the arch slightly. As you push off the ball of your foot, your arch springs back and does not touch the ground. That's how normal feet are supposed to work. Unfortunately, many feet aren't normal.

  Overpronation occurs if your foot rolls too much toward the inside. This can cause arch strain and pain on the inside of the knee. Underpronation occurs if your foot rolls too much to the outside. Underpronation can lead to ankle sprains and stress fractures. You can relieve foot pain by compensating for these tendencies, but first you need to determine which way your feet roll.

One method for determining which kind of pronation you have is the watermark test: Put your feet into a bucket of water, then make footprints on a piece of dark paper.

If your footprint looks like an oblong pancake with toes, you pronate excessively or may have flat feet. Try molded-leather arch supports, which can be purchased in many drug stores. And when shopping for athletic shoes, ask a sales clerk for styles with "control" features—soles designed to halt the rolling-in motion. If arch supports or sports shoes don't help, please contact our office for a custom-molded orthotics.

If there's little or no connection in your footprint between the front part of the foot and the heel, you under-pronate or have a high arch. This means a lot of your weight is landing on the outside edge of your foot. Ask for "stability" athletic shoes, which are built with extra cushioning to remedy this problem. If you are prone to ankle sprains, wear high-top athletic shoes that cover the foot and ankle snugly to minimize damage from twists.

May 29, 2014
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What is Turf Toe?

Turf toe is a sprain of the big toe joint resulting from injury during sports activities. The injury usually results from excessive upward bending of the big toe joint. The condition can be caused from either jamming the toe, or repetitive injury when pushing off repeatedly when running or jumping. Although this injury is most commonly reported in football players, participants in soccer, basketball, wrestling, gymnastics and dance also are at risk.


The name “turf toe” comes from the fact that this injury is especially common among athletes who play on artificial turf. When playing sports on artificial turf the foot can stick to the hard surface, resulting in jamming of the big toe joint. There has also been some indication that less-supportive flexible shoes worn on artificial turf are also to blame.


The signs and symptoms of turf toe can include pain, swelling, and limited joint movement.

If turf toe is caused by repetitive actions that cause injury, the signs and symptoms will usually begin slowly and can gradually worsen. Turf toe can also be caused by a direct injury leading to damage of the bone beneath the cartilage. If direct injury is the cause, the signs and symptoms may begin suddenly and get worse over a 24-hour period.


To arrive at a diagnosis, the foot and ankle surgeonwill obtain your medical history and examine your foot. X-raysare typically ordered to rule out any broken bone. Other advanced imaging studies may also be helpful for proper diagnosis.


Initial treatments include rest, ice, compression, and elevation. (RICE), as well as a change to less-flexible footwear. Operative treatment is reserved for individuals with severe cases and prolonged pain.  


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