Ankle

Ankle sprains are very common and, most commonly involve the lateral (outside part of the ankle).

Frequently a person steps in a hole or steps down a stair inappropriately causing the ligaments on the outside part of the foot to stretch.

Ankle sprains are classified in three different categories. A

1st degree is common and can be treated conservatively. It doesn’t have any laxity of the ankle.

In a 2nd degree, there is laxity of the ankle and some bleeding of the tissue, which occurs causing discoloration.

A 3rd degree is the most severe and usually represents a complete rupture of the lateral ligaments of the ankle.

Treatment

Treatment of ankle sprain is generally some form of immobilization and, most importantly, neuromuscular reeducation exercises to help prevent further ankle sprains in the future.

In resistant cases, PRP ( Platelet Rich Plasma) can/may be utilized.

Achilles tendonitis is a common problem, which causes pain where the Achilles tendon inserts into the heel bone or further up the tendon. Most people complain of this while performing activities and do not have pain while at rest.

The pathology of Achilles tendonitis is partial rupturing of the internal fibers of the internal tendon. These fibers are very vascular, have a very poor blood supply, and take a very long time to heal.

In many cases, Achilles tendonitis can progress to a point where the Achilles tendon itself becomes weak and with moderate athletic activities can, in fact, rupture.

Diagnosis of Achilles Tendonitis

Diagnosis of Achilles tendonitis can accurately be performed with an ultrasound. The exact location of the Achilles tendon fibers, which are ruptured, can be found and quantified making accurate treatment possible without surgery.

Treatment

Utilizing ultrasound technology, an ultrasound guided technique (revascularization of the Achilles tendon) can be performed with a multiple trephination technique, and in many instances, platelet rich plasma injections can be performed.

Plantar fasciitis is a common problem, which causes pain in the patient’s heel. The pain is persistent and classically most sore first thing in the morning.

The plantar fascia is a fibrous band of tissue that attaches on the heel bone and fans forward toward the toes.

The problem that occurs is that part of the plantar fascia tears off the heel bone and creates a scar. Scar tissue, in that area of your body takes a long time to heel and frequently doesn’t heel, therefore continues to tear causing the person a great deal of disability.

Diagnosis of chronic plantar fasciitis

The diagnosis is most accurately performed utilizing an ultrasound, which will show the exact location of the plantar fasciitis and the amount of tearing and scar tissue present. This is as specific as an MRI scan, at a much lower cost.

Treatment

Treatment of plantar fasciitis is first stretching, trying to get the calf muscles relaxed and also, trying to stretch out the forefoot. If that does not work, anti-inflammatory medications are worth a try, but if the symptoms persist, other treatment options are available.

In our office, treatment of confirmed plantar fasciitis is an ultrasound guided multiple trephination procedure, utilizing a local anesthetic with specific techniques, revascularizing the scar tissue effects a cure. The procedure generally takes 10 minutes and is effective 85% of the time.

In chronic cases, PRP injections can/may be utilized.

Neuromas occur toward the base of the toes from nerves that are pinched and become enlarged. Pain is noted in the forefoot with weight bearing, and there is usually no pain at rest. Occasionally the toes become numb secondary to the inflammation of the nerves as it goes through the neuroma.

Diagnosis of Neuromas

Diagnosis can be performed accurately with an ultrasound and physical examination.

Treatment of Neuromas

Neuromas can be treated with injections and direct visualization with an ultrasound. A cortisone injection is attempted and if this is unsuccessful, either a surgical removal of the neuroma or an alcohol block can be performed to treat the neuroma.
Ankle sprains are very common and, most commonly involve the lateral (outside part of the ankle).

Frequently a person steps in a hole or steps down a stair inappropriately causing the ligaments on the outside part of the foot to stretch.

Ankle sprains are classified in three different categories. A

1st degree is common and can be treated conservatively. It doesn’t have any laxity of the ankle.

In a 2nd degree, there is laxity of the ankle and some bleeding of the tissue, which occurs causing discoloration.

A 3rd degree is the most severe and usually represents a complete rupture of the lateral ligaments of the ankle.

Treatment

Treatment of ankle sprain is generally some form of immobilization and, most importantly, neuromuscular reeducation exercises to help prevent further ankle sprains in the future.

In resistant cases, PRP ( Platelet Rich Plasma) can/may be utilized.

Achilles tendonitis is a common problem, which causes pain where the Achilles tendon inserts into the heel bone or further up the tendon. Most people complain of this while performing activities and do not have pain while at rest.

The pathology of Achilles tendonitis is partial rupturing of the internal fibers of the internal tendon. These fibers are very vascular, have a very poor blood supply, and take a very long time to heal.

In many cases, Achilles tendonitis can progress to a point where the Achilles tendon itself becomes weak and with moderate athletic activities can, in fact, rupture.

Diagnosis of Achilles Tendonitis

Diagnosis of Achilles tendonitis can accurately be performed with an ultrasound. The exact location of the Achilles tendon fibers, which are ruptured, can be found and quantified making accurate treatment possible without surgery.

Treatment

Utilizing ultrasound technology, an ultrasound guided technique (revascularization of the Achilles tendon) can be performed with a multiple trephination technique, and in many instances, platelet rich plasma injections can be performed.

Plantar fasciitis is a common problem, which causes pain in the patient’s heel. The pain is persistent and classically most sore first thing in the morning.

The plantar fascia is a fibrous band of tissue that attaches on the heel bone and fans forward toward the toes.

The problem that occurs is that part of the plantar fascia tears off the heel bone and creates a scar. Scar tissue, in that area of your body takes a long time to heel and frequently doesn’t heel, therefore continues to tear causing the person a great deal of disability.

Diagnosis of chronic plantar fasciitis

The diagnosis is most accurately performed utilizing an ultrasound, which will show the exact location of the plantar fasciitis and the amount of tearing and scar tissue present. This is as specific as an MRI scan, at a much lower cost.

Treatment

Treatment of plantar fasciitis is first stretching, trying to get the calf muscles relaxed and also, trying to stretch out the forefoot. If that does not work, anti-inflammatory medications are worth a try, but if the symptoms persist, other treatment options are available.

In our office, treatment of confirmed plantar fasciitis is an ultrasound guided multiple trephination procedure, utilizing a local anesthetic with specific techniques, revascularizing the scar tissue effects a cure. The procedure generally takes 10 minutes and is effective 85% of the time.

In chronic cases, PRP injections can/may be utilized.

Neuromas occur toward the base of the toes from nerves that are pinched and become enlarged. Pain is noted in the forefoot with weight bearing, and there is usually no pain at rest. Occasionally the toes become numb secondary to the inflammation of the nerves as it goes through the neuroma.

Diagnosis of Neuromas

Diagnosis can be performed accurately with an ultrasound and physical examination.

Treatment of Neuromas

Neuromas can be treated with injections and direct visualization with an ultrasound. A cortisone injection is attempted and if this is unsuccessful, either a surgical removal of the neuroma or an alcohol block can be performed to treat the neuroma.