If you need a more accessible version of this website, click this button on the right.Switch to Accessible Site

(212) 391-1279


Larry Cohen, DPM

November 2019

Monday, 25 November 2019 00:00

How to Prevent Running Injuries

Overtraining and overusing the feet are the main causes of common running injuries. A number of these common injuries are caused by overrunning. Runner’s knee is a condition that is characterized by the back of the kneecap beginning to wear away and cause pain in the knee. This frequently occurs due to either a decrease in strength in the quadriceps muscles or ill-fitting shoes that are lacking in proper support for the inside of the forefoot. Strengthening exercises focusing on the quad muscle and sports orthotics are the usual treatments for those suffering from runner’s knee. Prevention of the condition lies in a focus on hip strengthening and quad-strengthening to keep the kneecap aligned. To help learn the best exercise to heal runner’s knee, one can also undergo physical therapy.

One common injury, called iliotibial band syndrome, is often caused by overtraining. This condition occurs when the iliotibial band gets irritated, creating pain and discomfort in the outside knee area. Plantar fasciitis, another common running injury, also occurs as a result of inflammation and irritation. Plantar fasciitis is an inflammation and irritation of the bone in the foot. A large amount of pain is often experienced due to plantar fasciitis. The condition can be caused by a high arch, improper footwear, tight muscles, or flat feet. It can best be avoided by stretching and wearing appropriate footwear that supports the foot.

Another common injury for runners is stress fractures. These injuries occur due to running style, overtraining, or a lack of calcium. Stress fractures most often occur in several locations in runners, including the inner bone of the leg, the thighbone, the bone at the base of the spine and the bones of the toes. Stress fractures are best prevented by wearing proper footwear and by running on flat and hard surfaces; this will absorb some of the shock created during running.

Aside from overtraining, other causes of common running injuries include ill-fitting footwear, a lack of flexibility and strength, and irregular biomechanics. The best way to avoid running injuries is to prevent them from even occurring. Both iliotibial band syndrome and stress fractures are preventable. The first step that should be taken to prevent running injuries is to only wear footwear that fits properly and that is appropriate for whatever activity you are doing. Running shoes are the only protective gear available to runners that can safeguard them from sustaining injuries. Choosing the right pair of shoes is therefore extremely important. While running shoes are an important factor, it is also important to consider other facets of your running routine such as training schedules, flexibility, and strengthening. These elements should be considered and altered according to your running needs to best maximize your run and minimize the possibility of injury. Careful stretching before and after a run should also be considered to help prevent running injuries. Stretching muscles enables greater flexibility and a lesser chance of sustaining injury.

Published in Featured
Monday, 18 November 2019 00:00

Ingrown Toenails

An ingrown toenail is a nail that has curved downward and grown into the skin.  This typically occurs at either the nail borders or the sides of the nail.  As a result, pain, redness, swelling, and warmth may occur in the toe.  If a break in the skin forms due to the ingrown nail, bacteria may enter and cause an infection in the area; this is typically characterized by a foul odor and drainage.

Ingrown toenails have multiple reasons for developing.  In many instances, the condition is a result of genetics and is inherited.  The most common cause, however, is improper trimming; cutting the toenails too short forces the skin beside the nail to fold over.  An ingrown toenail can also develop due to trauma, such as stubbing the toe, having an object fall on the toe, or participating in activities that involve repeated kicking or running.  Wearing shoes that are too tight or too short can also cause ingrown toenails.

Treatment for an ingrown toenail varies between patients and the severity of the condition.  In most cases, it is best to see your podiatrist for thorough and proper treatment.  After examining your toe, your podiatrist may prescribe oral antibiotics to clear the infection if one is present.  Surgical removal of either a portion of the nail or the entire nail may also be considered.  In some cases, complete removal or destruction of the nail root may be required.  Most patients who undergo nail surgery experience minimal pain afterward and can return to normal activity the following day.

Ingrown toenails can be prevented with proper nail trimming and by avoiding improper-fitting shoes.  When cutting the toenails, be sure that you are cutting in a straight line and avoid cutting them too short.  Shoes should not be too short or tight in the toe box.

Published in Featured
Monday, 11 November 2019 00:00

Foot and Ankle Trauma

Broken Feet

A broken foot can either refer to a fracture or a straight break. The location of any break can tell you how the break happened. Toes, for instance, break typically as a result of something being kicked hard and with great force. Heel breaks almost always are a result of an improper landing from a tall height. Twists or sprains are the other two frequent occurrences. As with all usual breaks, they result from unexpected accident or sudden injury. As with stress fractures, breaks form as a process over time from repeated stress on already present cracks. Runners, dancers, and gymnasts are the usual athletes who receive this type of break. Stress fractures result from incredible pressure on the feet. It is no surprise these athletes bear the majority of reported fractures.

Pain, swelling, bruising, and redness are all indicative of the typical symptoms from a broken foot. Severe pain—to the point of not being able to walk—usually depends on the location of the break in the foot. Toes are on the lower scale of pain threshold, but heels are high, as are a few other particular bones. As the severity of the broken foot increases, symptoms like blueness, numbness, misshaping of the foot, cuts, or deformities will become apparent. These symptoms indicate the need to see a medical professional with access to an x-ray facility.

Prior to seeing a specialist, precautions should be taken to reduce pain and swelling. Elevate and stabilize the foot, and refrain from moving it. Immobilization of the foot is the next priority, so creating a homemade splint is acceptable. Keep in mind that while creating a splint, any increase of pain or cutting off blood circulation means that the splint should be removed immediately. Use ice to decrease swelling and relieve pain symptoms.

When dealing with a medical center, the patient should note that the treatment can vary. The treatment will depend on the severity of the fracture and the cause of the break. Crutches, splits, or casts are common treatments while surgery has been known to be used in more severe cases in order to repair the break in the bones. 

Broken Ankles

Broken ankles are a serious injury that can lead to an inability to walk, function, and also cause a significant amount of pain. A broken ankle is a break in one of the three bones in your body that connect at the ankle joint, the tibia, the fibula, and the talus. The tibia and fibula are your two primary leg bones that connect at the knee, which sits directly upon the talus bone. This is protected by a fibrous membrane that allows for movement in our ankle joint. A broken ankle is usually caused by the foot rolling under or twisting too far, causing one of these three bones to snap.

A broken ankle is different from an ankle sprain, which occurs when the ligaments are ripped or torn but no bones have been broken. A sprain can still be very severe, causing bruising in the foot and an inability to hold your own weight, much like a broken ankle would. If you’re unable to stand, and suspect that you have a broken ankle, the first thing to do would be to get an immediate x-ray to determine the severity of the break.

A common cause of broken ankles is when the ankle is rolled over with enough pressure to break the bones. This usually happens during exercise, sports, or other physical activities. Another common cause is a fall or jump from a tall height.

One immediate treatment for pain relief is elevating the feet above your head to reduce blood flow to the injured area. You can also apply ice packs to your ankles to help reduce swelling, redness, inflammation, and pain. After these initial steps, getting a cast and staying off your feet as much as possible will aid in the recovery of the broken ankle. The less movement and stress the ankle has to endure, the more complete it will heal. A doctor can determine if surgery is needed in order to heal correctly. In these cases, an operation may be the only option to ensure the ability to walk properly again, followed by physical therapy and rehabilitation.

It is highly important to determine if surgery is needed early on, because a broken ankle can become much more severe than you realize. If not professionally treated, the broken ankle will inhibit your walking, daily functioning, and produce a large amount of pain. Treating your broken ankle early on will help prevent further damage to it.

Published in Featured

The human foot has 26 different bones, and the foot is divided into three parts: the hindfoot, the midfoot, and the forefoot. Each section of the foot is composed of a different amount of bones. For instance, the forefoot is made up of 19 bones. The midfoot is composed of five smaller bones called the navicular, cuboid, and three cuneiform bones. Lastly, the hindfoot is made up of only the talus and the calcaneus. The feet tend to be vulnerable to slipping and twisting; consequently, fractured bones within the foot are common. When a bone gets crushed, bent, twisted, or stretched it may become broken.

Many foot fractures occur through an accident or trauma. More specifically, common causes for broken feet are car accidents, falls, missteps, or overuse. If you have a broken ankle or foot, you may have one or more of the following symptoms: throbbing pain, swelling, bruising, tenderness, deformities, and difficulty walking.

There are some factors that may put you at a higher risk of developing a broken foot. People who participate in high-impact sports are more likely to develop foot fractures because of the stresses, direct blows, and twisting injuries involved in gameplay. Additionally, those who suddenly increase their activity level are more likely to suffer a stress fracture.

Unfortunately, there are different complications that may arise because of a foot fracture. For instance, arthritis may be caused by fractures that extend into the joints. Bone infections are also possible in open fractures due to the bone being exposed to bacteria. However, there are ways you can help prevent yourself from breaking your foot. One way to avoid fractures is to wear proper footwear. If you plan on going on a run, you should wear running shoes. You should also replace your shoes if you notice that they are becoming worn out. For runners, it is best to replace shoes every 300 to 400 miles.

Treatment for foot fractures usually consists of rest, ice, elevation, and compression (RICE). If you plan on wrapping your foot, try not to wrap it too tightly because doing so may cut off blood supply in the foot. You should also avoid walking on the fractured foot.

If you suspect you have a broken foot, you should see your podiatrist right away. It is important that you have someone bring you to your doctor, since driving with a broken foot can be dangerous. You should especially seek urgent care if you are experiencing numbness, pain, or deformities in your foot.

Published in Featured
Connect with us