Pediatric Sport Foot Injury Prevention

Great diagram illustrating pediatric sports injuries and prevention.

http://www.acfas.org/uploadedFiles/_ACFAS_Home/Practice_Management_and_Marketing/Marketing_Your_Practice/Marketing_Toolbox_Landing_Page/ACFAS%20Infographic%20-%20Pediatric%20Foot%20Injuries.pdf

Chi Running for Chronic Foot Pain

Are you training for an upcoming race or can't run as long as you want? Is your foot and ankle hurting you after just a few miles? If this is the case then you may consider taking a look at your running style and posture.

Over the past four years I have personally used this running technique rooted in Tai Chi which has helped me avoid foot pain and allowed me to run longer distances. 

ChiRunning focuses on posture, leg swing, the position of the pelvis and a forward lean. Here are the basics:

Run Tall.  When you're standing straight, your joints are in alignment and your skeleton is supporting your weight. When you run, you want to keep this alignment so your skeleton continues to be involved.
It's common, however, for runners to slump the shoulders or bend at the waist, which then requires the leg muscles to support most of the body weight, instead of the stronger skeleton. By maintaining good posture, you lessen the amount of work your legs have to do and move more efficiently.

Lean Forward.  By adding a slight forward lean when you run, your body falls forward and you use gravity for your propulsion instead of your legs. This lean also helps keep your body in alignment, with your foot landing under you.
To do this, lean from your ankles, not your waist, and keep your spine straight. The lean is subtle; don't lean so far forward you are out of control or actually falling.

Land on the Mid-Foot. To keep your posture in alignment--which helps reduce injuries--while you're leaning forward, land with a mid-foot strike when you run. You want your foot to land underneath or slightly behind you, in line with your hips and shoulders.

Run from Your Core. To reduce injuries, it's vital to keep your pelvis level. You do this by engaging your core muscles while you run.To level your pelvis, try this simple exercise: Stand against the wall and try to press your lower back into the wall. Watch what happens to your pelvis. You have to engage your lower abdominal muscles in a vertical crunch movement. Remember that feeling in your body and try to maintain it as you run.

Relax, Relax, Relax. It's common for runners to tighten up their shoulders or other muscles as they get tired. But all that stiffness and tension wastes energy and makes you less efficient. When you feel your technique slipping, ask yourself: Where am I tense, and what can I do about it?
Sense and respond with the correct adjustments, which might be as simple as straightening your arms and shaking them out or reminding yourself to lower your shoulders. In my book, I recommend a series of pre-run body looseners--such as shaking out your arms and legs, ankle rolls and hip and pelvis circles--to help your muscles learn to stay relaxed when you are running and throughout the day.


Danny Dreyer has developed this running technique and if you have time purchase his book callled,
" ChiRunning: A Revolutionary Approach to Effortless, Injury-Free Running.

Cross Training- Friend or Foe?

Whether you're recovering from the Charleston Marathon/Half, preparing for the Cooper River Bridge Run or just simply a routine runner you should ALWAYS make sure you are Cross Training (yes, even if you aren't preparing for an event).

"Cross Training builds strength and flexibility in muscles that running doesn't utilize. It prevents injury by correcting muscular imbalances. Runners have their obvious strengths: power, endurance, tenacity. But within those strengths lies the potential for weakness: quads that overpower our hamstrings, neglected upper bodies, and poor flexibility—qualities that could lead to problems and/or injuries." ~ Runners World

Cross-Training could be swimming, biking, yoga, pilates, weight lifting, walking or other forms of aerobic training. Cross-training days should be considered easy days that allow you to recover from the running you do the rest of the week.

If you are suffering from shin splints, heel pain, achey ankles or feet it may be due to a lack of cross training. By seeing us we can evaluate your problem and have you back on your feet in no time!


Charleston Office~Dr. Adam Brown
615 Wesley Dr. Ste 340 Charleston, SC 29407 (843)-225-5575

Mt. Pleasant Office~Dr. Andrew Saffer
501 Bramson Ct. Ste 301 Mt Pleasant, SC 29464 (843)-654-8250

2015 Has Started On the Right Foot

2015 has gotten off to a great start for Carolina Foot Specialists! Since the first of the year we have launched a new & improved website, added three digital scanners for our custom orthotics AND have added an online appointment booking system through our website and Facebook page.

We are very excited about the things to come in 2015 and are looking forward to another year of giving BEST treatment options to our patients throughout Charleston and beyond.

Visit our new website and tell us what you think~
http://www.carolinafootspecialists.net/

Check out the new options on Facebook such as Appointments & Locations ~
https://www.facebook.com/pages/Carolina-Foot-Specialists/

Our goal is to make seeing us a simple part of your day, from scheduling straight through your visit, we want all our patients to know we put them first. Whatever your aches, pains, injuries or concerns visit Carolina Foot Specialists for all your foot & ankle problems.

Charleston Office~Dr. Adam Brown, 
615 Wesley Dr. Ste 340 Charleston, SC 29407 (843)-225-5575

Mt. Pleasant Office~Dr. Andrew Saffer
501 Bramson Ct. Ste 301 Mt Pleasant, SC 29464 (843)-654-8250

Fixing Heel Fissures

Dry, cracked heels (known as heel fissures) can not only be unsightly, but can often be source of pain and embarrassment. Did you know a podiatrist can remove the dead skin from your feet leaving them soft, smooth and pain free?

While most cracking and splitting is ultimately caused by dry skin, there can be more to the problem than meets the eye. Most dry skin left untreated on the heels leads to thickening of the skin, also known as calluses, which crack and break under pressure. A podiatrist can safely remove the thickened skin, without risking infection, provide you with information on what sort of creams are best for your skin type as well as rule out more serious health conditions. While patients suffering from heel fissures are more comfortable in open backed shoes or flip flops this footwear actually tends to leave the feet exposed to dry air making the problem worse.

Genetics, skin conditions such as psoriasis, obesity, pregnancy, walking gait, ill fitted shoes, climate, diseases and hormone imbalances can all play a role in heel fissures. Some people also have a large fatty pad on the sole of their feet, which requires more elasticity in the skin to expand without cracking making their feet more susceptible to heel fissures.

At home treatments and DIY suggestions can be helpful, but once heel fissures become severe and include deep painful cracking and bleeding infection becomes a big risk. Heel fissures flare up with winter and cause many people pain. Erase your aches by seeing us.

Call for an appointment today! 
West Ashley: 843-225-5575
Mount pleasant: 843-654-8250

Avoid New Year's 'Shoe-icide'

New Year's Eve planning is in full force. It's a great night to dress up, add some extra sparkle and take on the town, but before you buy those sky high heels to go with your perfect dress there are some things you should know.

- 42% of women admitted they'd wear a shoe they liked even if it gave them discomfort.
- 73% admitted already having a shoe-related foot issue.
- High heels don't cause bunions, but they can aggravate them.
- Feet change with age. Over the years a loss of fat in the bottom of the foot makes higher heels less comfortable than they were in your youth.
- The ultra narrow heels of stilettos are particularly risky, pinpointing weight on one area and creating a less stable stance.
- The average woman gets foot pain after a mere hour in pumps.
- Research shows four-inch stilettos can up the amount of pressure on the front of the foot by 30% or more.
- Any heels 3 inches or higher can shorten the Achilles tendon just by wearing them once or twice a week.

Fear The Yoga Mat

Being barefoot when practicing yoga is not only good etiquette to the practice, but also better for your body. Much like with running being barefoot during yoga allows your body to engage in it’s natural stance. However there are precautions...

As with other types of exercise done indoors in groups, yoga has the potential to create a germ-filled environment.  Yoga mats can contract and contain infections from toenail fungus to the common cold. To be safe we suggest you always use your own yoga mat, and clean it properly after each use (whether you felt sweaty or not). Don't go barefoot if you have open sores on your feet, and wash your feet after class to avoid any contamination.

If you are prone to picking up fungus, viruses or bacteria we also suggest looking into Yoga socks. They come in a variety of types and colors and actually enhance performance with no-slip grips.

Countdown is On- Cooper River Bridge Run 2015

The countdown is on...108 days to go until the 2015 Cooper River Bridge Run.

This is one of our favorite events of the year, but we urge participants to be prepared. The bridge run isn't a race to begin blindly- we've compiled some great reads for you as you kick off your training:

Training Schedule
Bridge Run Tips
Bridge Run Preparation Tips
Bridge Run Injury Prevention Tips
Bridge Run Injury Prevention (2)
Barefoot Running Tips
Tips for Running Up Hill

And don't forget to check out the Bridge Run Gear- great holiday gift ideas for the runners on your list!  Shop here.

Make a New Thanksgiving Memory- Join Us For The Turkey Day Run!

Create a new tradition this Thanksgiving by joining Carolina Foot Specialists' Dr. Adam Brown & his family for the 37th Annual Turkey Day Run & Gobble Wobble, downtown Charleston.

One of the best races in the area, the Turkey Day Run, has been held for over 100 years, but wasn't made into a 5k until 1978- marking 2014 as the 37th official year.

Spend your Thanksgiving morning running or walking through historic downtown Charleston and around the beautiful peninsula. The route is primarily flat making it great for all levels, ages and abilities (There is a Children's Fun Run, too!).

We are truly thankful to live in this great city, and what a better reminder than to spend the morning enjoying its beauty. We hope to see you on the course!

Visit http://www.turkeydayrun.com/ for details and registration. 

Barefoot Therapy, Is It For You?

If you are an endurance athlete, active in sports centered on running or walking, and you are suffering from nagging chronic foot pain then barefoot therapy may be for you.

Dr. Brown began self-studies of this therapy back in 2006 after suffering chronic foot pain following his first marathon. While this course of treatment isn’t for everyone many Carolina Foot Specialist patients have had great success with the program.

We do not recommend anyone heading out to their first 5k barefoot, but a lot is to be said for letting your body self-adjust flaws in your gait and stride. Being barefoot helps to strengthen your feet preventing many injuries. Our best suggestion is to visit a professional before beginning a barefoot regimen. The doctors at Carolina Foot Specialists can aid you on your journey to injury recovery, stronger feet and a future of barefoot training with proper guidance and support. 

How can you get started safely? “Dr. Brown suggests going barefooted for 15 minutes a day inside your house for a week. If all goes well, double it every consecutive week.”

Read more about his journey to Barefoot Therapy via the Postand Courier.

Pain Free is an Option

Are you one of the many individuals suffering from chronic heel pain? Any pain that lasts more than a few consecutive days should be treated by a professional. Don’t let the fear of treatment sway you from coming to see us. No matter the extreme or cause Carolina Foot Specialists will make sure you have the knowledge you need to make the best decisions for your route to being pain free.

What are some options?  

Padding and strapping.
Placing pads in the shoe softens the impact of walking. Strapping helps support the foot and reduce strain on the fascia.

Orthotic devices.
Custom orthotic devices that fit into your shoe help correct the underlying structural abnormalities causing the plantar fasciitis

Injection therapy.
In some cases, corticosteroid injections are used to help reduce the inflammation and relieve pain.

Removable walking cast.

A removable walking cast may be used to keep your foot immobile for a few weeks to allow it to rest and heal.

Night splint.
Wearing a night splint allows you to maintain an extended stretch of the plantar fascia while sleeping. This may help reduce the morning pain experienced by some patients.

Physical therapy.
Exercises and other physical therapy measures may be used to help provide relief.

Call to schedule an appointment today

West Ashley: 843-225-5575

Mount pleasant: 843-654-8250

Treating Calcaneal Apophysitis with Dr. Saffer- Say goodbye to Heel Pain

Last week we spent some time with College of Charleston alumni and former basketball star, Jermel President filming a spot for his streamed broadcast, DAE TV. Jermel approached us to discuss some common issues in student athletes (of all ages and abilities), as well as learn more about sports podiatry in general.

One of our case discussions focused on one of Dr. Saffer's former patients, Aaron Thornton, an active teenager, that was suffering from chronic heel pain. Aaron was diagnosed with Calcaneal Apophysitis (inflammation of the growth plate in the heel) a common issue in kids and young teens, especially those active in athletics.

We most often see this in patients 8 to 14 years old. The growth plate in the heel is not fully developed until the average age of 14, and most high impact athletic habits begin around the age of 8; but this is not to say it doesn't happen in younger or older cases- every one grows at a different rate.

The heel’s growth plate is sensitive to repeated running and pounding on hard surfaces, resulting in muscle strain and inflamed tissue. If a child is very active in sports before his/her growth plate has fully developed Calcaneal Apophysitis is a risk. While some may be prone to this issue due to their foot structure you can minimize the risk by helping your child or teen maintain a healthy weight, wear only properly fitted, supportive shoes that are appropriate for the chosen activity, limit the use of cleated athletic shoes until age 14 and by ensuring they don't endure activity, training or practice above their ability and age.

We are happy to say that after proper evaluation Aaron's case was treated with custom made sports orthotics and he is now back to being a kid and pain free!

If you know a youth suffering with heel pain, let us help. Call to schedule an appointment today
West Ashley: 843-225-5575
Mount pleasant: 843-654-8250

*Catch Dr. Saffer's full interview streaming on November 9th at 7:20pm via DAE-TV.

Frightening Shoes For Your Feet

We loved this Halloween spirited blog from SHOES-n-FEET- Enjoy & have a great Halloween! 

Top 5 Most Frightening Shoes For Halloween Feet

The jack o’lanterns have been carved and the candy has been set out – Halloween has finally arrived! By now many of you have put together a costume and are planning to dress up for trick or treating with the kids, a parade in your community or a contest at work.

While Halloween costumes may run the gamut from scary to sweet and store bought to homemade (nothing like quality time with the glue gun!), many of them will no doubt include some special footwear. “The shoes make the outfit” rings especially true when it comes to Halloween!
Since you can’t pull off a perfect ballerina costume without a pair of ballet slippers (a better option than painful pointe shoes), we’ve decided to rank the top five Halloween shoes that are a “trick” to wear – and leave your feet in need of a “treat”!

1. Witch Shoes
Witches are known to be cranky and mean and now we know why - their feet must be screaming in agony! The high heel concentrates pressure on the toes, which are shoved together in a pointed narrow toe box. These shoes cause extra stress on the ball and forefront of the foot. If you come across a witch’s feet, expect to find bunions and hammertoes. A witch’s time would certainly be best spent on mixing potions to ease the aches and pains, rather than on wreaking havoc. No wonder older witches are more evil; after hundreds of years in these shoes, you’d be pretty unpleasant, too.

2. Clown Shoes
 Clowns have the opposite problem than witches: their shoes have too much space. The super-wide toe boxes found on clown shoes can cause feet to slide around in the shoe, resulting in painful blisters. The big shoes may be the key to why clowns are so likely to trip and fall all the time – it’s nearly impossible for them to catch their footing in these. Even worse for clowns with problems with their arches? The strange size and shape of clown shoes make it especially hard to fit for orthotics and insoles. Definitely explains why there are so many sad clowns at the circus.

3. Roman-style Sandals
Found on toga fans, goddesses and gladiators alike, these sandals offer little in the way of arch support. The flat sole causes great strain on the Achilles tendon that run up the back of the heel, and the minimal cushioning provides zero-to-no shock absorption when the feet hit the ground. Wearers should be careful with the laces that crisscross their way past the ankle and up to the calf. Tying them too tight may cut off circulation, especially for those warriors battling to the death in the Coliseum.

4. Go Go Boots
Austin Powers loved women in go go boots, but did they love wearing those shoes? We think not. While we are thankful they have a platform heel, as opposed to a stiletto, the high heel of this retro footwear makes us nervous. They might be a bit more stable, but the benefits of this detail go out the window when the disco dancers start shaking their groove thang. These shoes and the way they fit so tightly on the foot and calf; depending on what material the boots are made of, they may not offer a lot of breathability, resulting in some seriously sweaty and smelly feet.

5. Scuba Diver Flippers
There’s really only one thing to say here: unless you are spending your Halloween underwater along with some costumed mermaids, you shouldn’t be in flippers. You don’t see divers strolling down the sidewalk in their swimfins, do you? Wear these on dry land and you’re asking to trip and fall on your face. Not too even mention the stench that will come from the rubber and your sweaty feet.

Who Should You See? Choosing the Best Care for Your Needs.

A common question we get is whether or not one should see a podiatrist or an orthopaedist. While the two practices may seem quite similar the difference is a matter of scope.

An orthopaedic doctor (or surgeon) specializes in bone, joint and nerve problems within the entire body.  In general chronic pain, rheumatic diseases, musculoskeletal injuries and arthritis all are part of the field of orthopaedics. Since this scope of practice is so large most orthopaedic professionals will specialize in a certain disease or part of the anatomy (such as hand surgeons, spinal specialists, pain management centers or arthritis).

In one sense a podiatrist is a form of specialized orthopaedic doctor, focusing on the foot, ankle, and related structures of the leg. However, along with managing all the aspects of the feet, ankles and lower extremities a podiatrist also manages the dermatology and biomechanics of the foot and ankle. Podiatrists can specialize in many fields as well, including surgery, sports medicine, wound care, pediatrics, diabetic care for the feet, ankles and legs.

While a 'foot and ankle orthopaedist' can treat and manage foot and ankle issue pertaining to the bones, soft tissues and joints, your general orthopaedist is likely more adept at managing hips, knees and shoulders; therefore it is often more beneficial for patients to see a Podiatrist who has expert knowledge targeted at your area of concern.

No matter what professional you decide to see make sure they are familiar with the area you are being seen for and you are comfortable in their care. There is never any harm in having a second opinion.  All medical professionals should always put your well being first.

Dr. Saffer and Dr. Brown have offices located in both Charleston and Mount Pleasant and pride themselves on making sure patients are well informed, having the knowledge to make good choices about their foot and ankle care, heel pain, or whatever problem they may face. Their goal is to educate each patient first, then begin a relevant treatment program with the highest quality of care available. Whatever your foot and ankle trouble, Dr. Brown and Dr. Saffer work together to find the answers that will comfort you and bring you relief. Call for an appointment today 843-654-8250 or visit us online at www.carolinafootspecialists.net.

Football, Feet and More

Football season is in full swing, and whether it’s pro ball or pee-wee injuries are likely to occur. Even on the best day, with the most well trained athlete, accidents can happen, but we are here to help!

The most common injuries we see from team sports, like football, are plantar fasciitis, achilles tendonitis, neuromas, stress fractures and capsulitis. One of the most important things for athletes of all levels to remember is not to over-do it. The majority of injuries in athletes are what we call ‘overuse injuries’. 

More often than not injuries start off as small problems, which are easy to self-heal, however these injuries become exaggerated when the proper time-off/rest time isn’t observed.  With team sports it is sometimes hard to sit on the sidelines, but it can be a vast difference in the severity of your injury and your recovery time. 

At the first sign of pain, impact, swelling or chronic soreness it is important to not only seek medical treatment, but to adhere to your recovery plan for the best outcome. This is especially vital in younger athletes in order to avoid chronic or long-term foot and ankle damage. 

Dr. Saffer and Dr. Brown are experts in the fields of sports podiatry, and love working with youth to establish healthy and successful plans for an active future. Come see us today! 

Arches Making You Ache?

Many of those suffering from chronic pain on the balls or heels of their foot are victims of a high arch (aka Cavus Foot). A high arch can be a symptom of your genes, a neurologic disorder or from other medical conditions. The cause of your high arches will determine the course of treatment recommended by our expert staff.

Even the most subtle factors can be signs of a high arch issue: calluses on the ball, heel or side of the foot, pain when standing, chronic ankle sprains or hammer toes are just a few. When you make an appointment to visit us we will view your gait (foot form when walking), muscle strength and general coordination. It is also good to bring in your most commonly worn shoes so we can check for habitual wear and tear giving us a better idea of how you walk on a regular basis.

After determining the root cause of the high arch(es) treatment may entail custom orthotics, recommended shoes, bracing or surgery.

If you are tired of suffering from daily pain or nuisances and think high arches may be your problem- visit us at Carolina Foot Specialists for the best in your foot care.

You can also take our online assessment to pinpoint warning sings of foot and ankle problems.

Underpronating Can Lead to More Ankle Pain

Wondering why you keep spraining your ankle? It could be your shoes!

If you underpronate, your foot tends to roll to the outside when walking or running, you naturally have greater risk of ankle sprains. Not wearing shoes with the correct support for can lead to ankle sprains and stress fractures, torn ligaments and worse. When being fitted for athletic or active shoes make sure your gate is checked when walking and running for the best evaluation of your needs.

A correct assessment for shoes should contain the following:
- Asking questions about you! What will the shoes before, what’s your activity level, past injuries and so forth should all be addressed between you and your fit professional.

- Measurement. You should always have your feet measured for length and width. Feet can change sizes and one foot is always bigger than the other, a new purchase should not be based on your last shoe’s size.

- Gait Analysis. Your fit professional should observe you running and walking, either on a treadmill or designated area. A trained professional will determine your personal movement "map" from this process.  That "map" reveals the programming of everything happening within your body including your levels of mobility, stability, flexibility and functional strength. The analysis of all these different elements taken together is what creates a complete picture of a person's gait, and allows them to better understand the type of footwear you need. (*This is where it is decided on whether you under or over pronate.)

- Arch Analysis. Either by viewing your feet (without shoes) from various angles or by having you step on a arch pad your fit professional should measure your arch to determine the best shoe for you and your chosen activity, as well as the need for inserts and what type.

- Fitting. Try on the shoes with the socks you will most likely use. Run around the parking lot, bend, stretch, stand on your tip toes- move in the shoes and see how they feel. Tell your fit professional about any tight areas, slipping, rubbing or any other complaints- you need to find the shoe right for your foot, but that you also feel good in.

Dr. Brown and Dr. Saffer are both skilled in athletic shoes and fitting and are happy to sit down with you to discuss inserts, if your shoe is right for you and foot tips for your active life!

Find a professional fit equipped store near you with the Runners World Store Finder.

Say No to Sprains

Are you prone to sprains in your ankles? A sprained ankle occurs when your ankle ligaments are overstretched. Ankle sprains vary in their severity, from mild "twisted ankle" or "rolled ankle" sprain through to severe complete ligament ruptures, avulsion fractures or broken bones.

Sprains are a common injury in everyone, from your everyday Joe to professional athletes, however constant reoccurring sprains can be a sign of improper shoes, tight calves, a weak tibialis anterior muscle or overuse.

Almost half of all people who sprain their ankle once will experience additional ankle sprains and/or chronic pain. Having a rolled or sprained ankle in the past increases your future injury chance 40-70%. Many people don’t take a sprain as a serious injury, and in result do not allow for full healing and recovery time making ligaments loose and more prone to re-injury. Correct healing time and stretching/strengthening techniques are the key to lessen your chances of multiple injuries.

Visit us, at Carolina Foot Specialists, if you are suffering from any ankle or foot pain. Treatment and correct healing will ensure you a pain free future. Dr. Brown and Dr. Saffer are both experts on sports injuries and helping you get back to your regular routine quickly and safely.

Technology for your Toes

Most people don’t relate technology to the practice of podiatry.  However many tools greatly aid in the advancement of our treatments. At Carolina Foot Specialists we are proud to be able to offer the latest in treatment procedures, technological tools and continuing education for our staff.

Being able to provide our patients with in house digital x-rays and diagnostic ultrasounds have led to a much higher recovery rates and more accurate treatment plans. Diagnostic ultrasounds of the foot and ankle advance the prevention and treatment of wounds, detecting tendon and ligament pathology, and detecting soft tissue lesions and foreign bodies.

Digital x-rays provide instantaneous images for the doctors to review. The data is transferred to a computer where technicians can adjust the image for better quality, magnify the area that needs to be studied, or even decide if the image needs to be retaken.

For those who are concerned about the risks of radiation exposure, these digital
pictures are actually better than traditional X-rays.

Also, having the ability to custom make custom orthotics for individual issues and feet have greatly improved the health and well being of many of our patients.

While a lot of our work stems from knowledge and clinical diagnosis technology has not left podiatry behind. Come by and see us for happier feet and ankles today.