St. Kilda Defender Fisher To Have Surgery

St. Kilda defender Sam Fisher will have surgery on his foot and will not play again this season.
Fisher sustained the injury before the premiership season began and was a late withdrawal before last Saturday evening's 35 point win over Melbourne at the MGG.
Coach Scott Watters congratulated Fisher on being able to make it through the season, saying, "(Fisher) managed that throughout the course of the year and at times has been unbelievably courageous in actually just getting to a game."
Ruckman Ben McEvoy will play for Fisher against Richmond on Sunday.
Fisher is a two-time Trevor Barker medalist and will have surgery on the degenerative toe injury next week.
"I'm disappointed that my season has come to an end but I intend to spend the rest of the year working with the club's younger players and getting myself ready for a full pre-season," Fisher said.
The 30 year old backman has played just nine games this season, bringing his career total to 191 games. Fisher is expected to be recovered in time for the 2014 preseason training.
Reference: Herald Sun
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Virgina's Harris To Miss World University Games

Virginia senior guard Joe Harris will miss next week's training camp for United States' World University

Games men's basketball team due to a stress reaction in his left foot.
Harris was set to compete for one of twelve spots on the University Games Team, but he will be out three to six weeks. Cavaliers coach Tony Bennett announced the injury last Friday.
"Obviously, we are disappointed for Joe because he was really looking forward to this opportunity with USA Basketball," Bennett said in a statement. "Joe has worked really hard and he was excited about competing and measuring his game against some great players. His senior season and future professional career are the main priorities moving forward. We'll ensure he gets the proper rest and rehabilitation, so he'll be ready for the 2013-14 season."
Harris was seen wearing a walking boot last Friday in Charlottesville. Training camp for the U.S. team began this Monday, with the Games starting July 7th in Kazan, Russia.
Harris was an All ACC First Team Selection and led the Cavaliers with 16.3 points per game last season.
Reference: Sporting News and NBC 29.
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Young Athletes Should Play More Than One Sport

Young athletes who play just one sport and train intensively have an increased risk of stress fractures and other severe overuse injuries, says a new clinical study, the largest of its kind.

Young athletes who spend more hours per week than their age playing one sport are 70 percent more likely to experience overuse injuries than other athletes. Take for example a 12 year old gymnast who spends 15 hours a week training. They would be a prime example of someone with an increased risk for stress fractures.
Loyola University Medical Center sports medicine physician Dr. Neeru Jayanthi presented the findings on April 19th at the American Medical Society for Sports Medicine (AMSSM) meeting in San Diego. The study is called "Risks of Specialized Training and Growth in Young Athletes: A Prospective Clinical Cohort Study."
Jayanthi said at the meeting, "We should be cautious about intense specialization in one sport before and during adolescence. Among the recommendations we can make, based on our findings, is that young athletes should not spend more hours per week in organized sports than their ages."
Jayanthi and colleagues at Loyola and Lurie Children's Hospital of Chicago enrolled 1,206 athletes ages 8 to 18 between 2010 and 2013 who came in for sports physicals and treatment for injuries. The research follows each athlete for the three years of the study.
Overall, there were 859 total injuries, with 564 of them overuse injuries. Of the 564 overuse injuries, 139 were serious injuries, such as stress fractures in the back or limbs, elbow ligament injuries, and injuries to cartilage and underlying bone. Injuries like these can sideline an athlete for up for six months, depending on the severity.
The study confirmed the preliminary findings, which stated that playing one sport increases the risk for overall injury. Other findings from the study include:

• Young athletes who spent twice as much playing organized sports as they did in unorganized free play were more likely to be injured. 
• Those who had serious injuries spent more than 21 hours per week in physical activity, including 13 hours of organized sports. Athletes who were not injured spent 17.6 hours per week in total physical activity, including just 9.4 hours of organized play. 

Jayanthi and colleagues have the following recommendations for young athletes:

• Do not spend more hours a week in your sport than your age. If you are 11, do not spend more than 11 hours per week in that sport. 
• Do not spend more than twice the hours playing organized sports as you do in the gym and in unorganized play.
• Do not specialize in one sport until you are in later adolescence. 
• Do not play sports competitively year round. Take a break of at least one to three months per year from sports. 
• Have one day a week when you do not play your sport. 

Jayanthi and colleagues are planning a follow-up study to see if their recommendations reduce the risk of overuse injuries. The study is called TRACK: Training, Risk Assessment and Counseling in Kids.
"We will test our hypothesis that many of these serious injuries are potentially preventable," Jayanthi said.
Reference: Science Daily.
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Nets' Brooks Has Surgery Once Again

Brook Lopez just can't seem to get a break.
Lopez underwent surgery on his right foot recently for the third time since 2011. The need for surgery was discovered after an MRI revealed a bent screw in his right foot. Lopez had been experiencing no pain in his foot before the MRI, and the decision to have surgery was described by GM Billy King as "proactive." The screw was intended to support his fifth metatarsal and had bent over time.
Lopez is now in a walking boot following the minor procedure to replace the screw, which was performed at the Hospital for Special Surgery in Manhattan. The Brooklyn Nets center's bent screw was replaced with a new one. He is expected to return to basketball related activities by August.
Should Nets fans and coaches be worried about Lopez's recurring foot problems? It's tough to say, but this same foot was fractured twice during the 2011-12 season and the screw was implanted to prevent further injuries. Many 7 foot tall basketball players fall victim to foot injuries because their feet can't support the weight of their frame, hence why Lopez's screw bent.
Lopez is the Nets' best player and in the 2012-13 season, he led all NBA centers in scoring with 19.4 points per game. He needs to concentrate on getting stronger in his foot this summer so he doesn't get the dreaded "injury-prone" label.
References: Sports Illustrated and Sports Illustrated.
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Alex Ovechkin's Foot Healing

After playing on a broken left foot for three games last month, Alex Ovechkin says it's finally healing (uh,

duh? Could it be because you're not playing on it?).
The Washington Capitals' captain sustained a hairline fracture in Game 6 of the Eastern Conference quarterfinals against the New York Rangers. Ovechkin chose to play Game 7 the very next night on the fractured foot and at the world championship a couple of days later.
Ovechkin said during a conference call last Sunday, "Right now, I'm walking fine. I'm going to start playing tennis soon so I'm going to be in good shape... It's kind of getting better. I feel pretty good about my foot." Well, your foot isn't going to feel any better unless you stay off it, so give up that tennis for right now, Alex!
Ovechkin, who won his third Hart Trophy as the NHL's MVP, said the puck broke his foot when he blocked a shot and failed to talk with the team's trainer or doctor about getting an MRI.
"I just played the game because it's the playoffs," he said. "It doesn't matter what happens. You have to be there and you have to play the best that you can."
Ovechkin waited until after playing for Russia in Stockholm to have an MRI, even though he knew something was wrong with his foot. This playing through the injury behavior was common for Ovechkin throughout the season and it was likely he was playing through other injuries as well, none as serious as the broken foot.
The 27 year old says he'll be back for training camp, saying, "I'm never going to say I'm not going to play. It's not my style."
Reference: ESPN.
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Popular Kiwi Player Out With Foot Injury

St. Helen's Saints player Sia Soliola will be out ten weeks with a foot injury.
Soliola has missed just one game this year of the Saints' 19 Super League and cup matches and sustained the injury a week ago Friday playing for the Exiles in the 30-10 defeat by England.
St. Helens is on the bottom half of the Super League table after losing half of their first 18 fixtures and is upset about losing the New Zealander after failing to capture the imagination of rugby fans.
"It's disappointing to lose Sia, who has to have an operation, Saints coach Nathan Brown said. "The upside is that it gives another player the chance to step up and stake a claim for a place."
"Our squad as a whole has gained vital experience throughout the course of the year and I have no doubt we will adapt and continue to develop," Brown added.
The 26 year old popular Kiwi joined the Saints from the Sydney Roosters and has been a regular in Brown's side this season.
Joe Greenwood played for the squad on Friday at Salford as Soliola's replacement and prop Anthony Laffranchi returned from injury.
Reference: St. Helens Reporter
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Giants' Sandoval Dogged By Foot Injury

San Francisco Giants third baseman Pablo Sandoval was placed on the disabled list last week after being

plagued with a foot injury for several weeks.
Sandoval originally injured his foot on May 30th when he attempted to running out a groundball. He sat out the next three games and after starting the next four games, left the next in the third inning.
The exact nature of his injury has been difficult to determine, with team president Larry Baer and general manager Brian Sabean saying Sandoval has a hairline fracture in his foot, and head trainer Dave Groeschner saying he has no fracture. The team has resorted to calling this injury a left foot strain, which could be just about anything.
Sandoval likely reinjured his foot on June 9th after grounding into an inning-ending double play against the Arizona Diamondbacks. Sandoval was placed in a walking boot and began a rehab assignment yesterday in the minors as the designated hitter for Class A San Jose. The All-Star took batting practice and fielder grounders before San Francisco's game against San Diego on Tuesday.
The 26 year old "Kung Fu Panda" is hitting .289/.326/.427 with eight home runs, numbers that are only slightly lower than last year's.
The talk of the season with regards to Sandoval has been his weight. Many have pointed out the link between his injury and his current overweight status. Sandoval is listed at 240 pounds, which is 20 pounds heavier than he was last year. This is a recurring problem between Sandoval and managers: late in the 2010 season Sabean threatened to send Sandoval to the minors. Sandoval consequently lost 40 pounds over the winter, but since then he's gained it back, plus some. He's gained some leeway because of his performances, which have included two All-Star appearances and a World Series MVP award. Sandoval told reporters in April, "I'm at the weight that I feel great to play at... If you feel good, you're going to play good. And I feel great."
We'll see how Sandoval progresses after he is eligible to return from the DL on Monday. Will his "foot strain" continue to bother him? And most importantly will he continue to blow gum bubbles, like pictured above?
Reference: Sports Illustrated
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Winnipeg Jets Kane Has "Open Mouth Insert Foot" Week

Winnipeg Jets forward Evander Kane had a tough week, partly due to big mouth syndrome.

Not only was he blasted after making a homophobic tweet on Twitter, calling NBAer Chris Bosh a "fairy" he underwent surgery on his foot last week. Kane later deleted the post, but not before people lashed out at him. Officials spoke with Kane about the tweet and he will not be fined for the comment.
Kane had surgery last Thursday to relieve pressure from a nerve on his left foot. He told the Jets' website, "Kind of have to let that rest for about three to four weeks. Then hopefully start getting back on the ice pretty soon here, and that way I can stop feeling like I'm a house hockey player and kind of get back to being that player that I know I can be, so I'm looking forward to that."
He tweeted after surgery, "Just got out of surgery. Thanks to the doctors for taking great care of me here in Winnipeg and the @NHLJets training staff."
The left wing player also finished the season with a wrist injury in addition to the nerve damage to his left foot. During the season Kane was sidelined with knee and foot issues. The 22 year old had 17 goals, 16 assists, and 33 points for the Jets this season, playing in all 48 games. This was the first year in a six year contract Kane signed with the Jets just before the lockout last September.
"Fortunately, I'll be able to work out off the ice in terms of some upper body stuff, but I won't be able to do any lower body until about three to four weeks from now," Kane said. "When that happens, get back doing some leg press and some lower body exercises and getting back on the ice first and foremost is going to be fun for me."
"We thought we might need another surgery, but fortunately we didn't, and that was a good thing. Once we got my leg figured out and what was really wrong with it, we were able to go in and get that fixed," Kane said.
"Hopefully by the time training camp rolls around I'll be 100 percent."
Reference: NHL
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Spurs' Patty Mills Done For Season

Imagine that the biggest game of your career is coming up. Everything is on the line; your team's reputation,
the championship, your role on the team. But you can't play because you have a foot problem that needs surgery.
This scenario happened this week to San Antonio Spurs' reserve guard Patty Mills, who had surgery last Friday to remove an abscess from his foot. The abscess originally started out as an infection on his right foot and developed into a bigger problem between his fourth and fifth toes. The abscess was removed during short out-patient surgery.
Basketball fans in Australia, Mills' home country, were disappointed to see their home star miss such an important moment in his career. Mills is a one of a small handful of Australians playing basketball in the United States, including Kyrie Irving and Andrew Bogut.
Mills is best known for his enthusiastic towel waving and cheerleading from the benches, as he gets little playing time on the courts. Mills played just 31 minutes throughout the playoffs, appearing in the garbage time of two NBA Finals games for a total time of 13:26, during which he scored four points.
Mills holds a $1.1 million player option for next season. During the season he averaged 5.1 points and 1.1 assists in 11.3 minutes over 58 regular season games and 1.3 points and 3.4 minutes during nine postseason games.
Reference: Sports Illustrated
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Foot and Ankle Injuries From Lacrosse

Lacrosse has a long history in the United States. Originally played by Native Americans, lacrosse is our country's oldest and fastest growing team sport. Played by both girls and boys, it's a fast paced, free moving game. However, the game's combination of quick movements, speed, stick, and ball make feet a prime target for injuries.
At the scholastic level, 21 percent of all reported injuries for girls and 16 percent for boys are ankle sprains due to cutting and dodging while playing. Many of these sprains are inversion ankle sprains, which can damage the ankle ligaments. Also related are peroneal tendon injuries and fractures.
Shin splints and blisters are common because of continuous running and changing field surfaces.
Overuse injuries include heel pain, Achilles tendonitis, sesamoiditis, stress fractures, posterior tibial tendonitis, and calcaneal apophysitis in children and adolescents.
Here are some tips in preventing foot and ankle injuries in lacrosse:

• Know the rules. Boy's play allows for a lot of contact, but is still a game that values finesse and skill. Unprotected hits should be calls for foul. Girl's play has limited contact but promotes free play. 
• Maintain open communication. Talk with your coach, organization, trainer, other parents, or health provider to ensure that the right environment is being fostered for safe play and fun.
• Be proactive in your conditioning. Stay in shape year round. Before the lacrosse season starts, begin a graduated program of plyometrics, neuromuscular training, conditioning, and strength training that will get you ready for the season. Always be sure to warm up properly and increase the intensity of your workouts appropriately. Drink plenty of water and rest.
• Wear the right equipment. Wear protective equipment that is sized for you. Mouth pieces and gloves should not be tampered with.
• Take a break. To stay fresh you should have at least one to two days off a week and one to two months off a year to prevent burnout and overuse injuries. 
• Report all injuries. You're not doing yourself any favor by keeping quiet about injuries, whether they are large or small. Small injuries can turn into larger injuries when untreated immediately. 
• Have a plan. Your lacrosse organization should have an emergency medical plan and injury prevention/educational programs for you to read or attend.

Shoes are an important part of playing lacrosse. Played in the spring and summer time, the fields can be muddy, wet, and slippery, and therefore excellent ground for injuries. When your child decides they want to play lacrosse, you should head to a specialty sports store, as the department store in your area will likely not have the shoes they need. Lacrosse cleats have an upper leather and rubber outsole, which give the player the traction they need. Check with your lacrosse organization, but most will not allow cleats that are metal. The cleat should be lightweight, plastic, comfortable, and be able to fit custom orthotics, if need be.
Reference: Stop Sports Injuries
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Barefoot Running Can Cause Injuries

When barefoot running and barefoot running shoes became the latest fad to hit the running market, podiatrists everywhere were skeptical. Running barefoot? No shoes? No support for our feet?
It turns out we were right to be skeptical to some degree. I blogged about a month ago how minimalist shoes can help strengthen toe muscles, which is one good point. But one good point shouldn't overwhelm all the information out there that suggests that barefoot running and minimalist shoes are not right for every person.
Dr. Douglas Brown, a radiologist in Orem, Utah noticed a drastic increase in the number of patients he was seeing with heel and foot problems and he wondered if there was a connection between their injuries and barefoot running. At the time, there were no scientific studies for him to read. So he contacted Sarah Ridge, a professor of exercise science at Brigham Young University in Provo, who studies impact injuries in sports and suggested that she next study this topic.
The resulting study, which was published in February in the Medicine & Science in Sports & Exercise adds fuels to the debate over whether barefoot running is truly better for your bodies, especially our feet. Dr. Ridge studied 36 experienced runners, both men and women, who ran on average between 15 and 30 miles a week while wearing normal running shoes. She sent them to Dr. Brown for baseline MRI scans of their feet and lower legs to make sure they had no injuries or problems. All of her volunteers had normal feet and lower legs.
Half of the runners were randomly assigned to continue running like they had, with the same mileage and shoes. The other half were given a pair of Vibram Five Fingers barefoot-style shoes and told to start incorporating barefoot running techniques into their running, gradually. During the first week they were to wear the minimalist shoes for the first mile, two miles the second, three miles the third, and then as often as they liked.
After 10 weeks the runners had a follow-up MRI. None of the runners had injuries to their lower legs, like to their Achilles. However, more than half of the runners wearing minimalist shoes showed the early signs of bone injuries in their feet.
Most had developed bone marrow edema, which is an accumulation of fluid, like what happens during bruising, in the bones of their feet. The radiologists rated the edema from 0 to 4 with 0 being no edema and 1 being slight bone damage caused by simply moving around on and loading the foot. This level of edema is considered healthy because it's a sign that the body is responding to the changes in training and adapting.
Runners in the control group, who wore their normal shoes, had level 1 edema in their feet. However, a majority of the runners in the minimalist group had at least a level 2 edema "which indicates early bone injury," says Dr. Ridge, and three had level 3 edema, "which constitutes an actual injury." Two runners had full stress fractures in their feet or level 4 edema, one in the heel bone and the other in the metatarsals.
Overall, runners in the minimalist group were running fewer miles at the end of the 10 weeks than they had been at the beginning, "probably because their feet hurt," said Dr. Ridge.
Why some runners developed serious foot problems and others did not is not clear, and Dr. Ridge is currently analyzing information about the runner's mileage, running form, body weight, and other variables.
"What we hope to see is whether there are some runners who, because of their biomechanics or other factors" and why they are predisposed to injuries during the transition from shoe running to minimalist running and if they should even transition.
These results don't mean that every one who switches from shoe running to minimalist or barefoot running will have foot injuries. What is important to note is that you need to take the transition slowly and not over do it. You may not be able to run your average amount of miles to start with. Follow your podiatrist's recommendations and the shoe manufacturer's instructions.
Reference: New York Times
If you are a runner and have a foot problem, call our Newington, Kensington, or Middletown office to make an appointment.
Craig M. Kaufman, DPM
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Should You Eat Before A Workout?

Whether you're going for an hour run, heading to the basketball court to play a pick up game with friends, or

to the gym to lift weights, should you eat before you leave the house? Is it necessary for your body, or is it a waste of calories and time?
We see a lot of marketing of sports drinks, energy bars, and other concoctions, and these food items may give you more energy while you're working out.
"It's a contradiction, but you really do need the calories to perform well," said Barbara Lewin, R.D., L. D., a sports nutritionist who works with professional and Olympic athletes. "The calories are what's enabling you to work out at your best. If you're not well-fueled, you're not going to work out as hard."
If you're planning on endurance training, it is essential that you eat. Andrea Hacker Thompson, M.S., R.D., of the American College of Sports Medicine writes, "A race car never starts a race without new tires and a full tank of gas, so an endurance athlete should not start a workout without fueling. Eating before a workout guarantees that the body starts with a full tank of glycogen."
So what if you're not going to be participating in vigorous endurance training? If your workout plan is longer than 90 minutes, you should still plan on eating a little something beforehand. This is because of the way our bodies use energy during a workout. Any time we exert ourselves, we burn glycogen, glucose that is stored in our muscle and liver cells. After we're done with that store of carbohydrates, we start to feel tired and worn out. Thompson explains that our body can store up to 2,000 calories in gylcogen and if you plan on going over that amount, you will begin to feel lightheaded, or faint.
If you're planning on doing just a 30 minute workout, don't stress over whether you get to eat something beforehand or not. What you should be more concerned about is staying hydrated. Water is perfect for a 30 minute activity, but anything over 30 minutes may require a drink with electrolytes, like a sports drink or fruit.
The Mayo Clinic recommends that you plan on having your snack about an hour before your exercise or a medium meal two hours before an extended exercise session. If you're eating a full meal, give yourself between three and four hours before you head out and do any activity so you can avoid stomach cramps or diarrhea.
But what's most important is seeing how your body responds. Can you do your 30 minute morning run without your yogurt? Then don't eat it.
Reference: Shape Magazine

If you are an athlete and have a foot problem, call our Newington, Kensington, or Middletown office to make an appointment.
Craig M. Kaufman, DPM
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