07 Oct

FALL IS HERE!

Posted in Heel Pain, Plantar Fasciitis

Enjoy daylight after work for a few more weeks.

Daylight savings time ends November 2. You don’t have to get on that trainer or treadmill yet.  Here are some tips for exercising outdoors in the fall.
 
1. Wear reflective gear on moving body parts (shoes, socks, hands)
2. Wear a headlight with a rear flashing red light.
3. Avoid the roads and enjoy local trails and parks. 
4. Increase the intensity of your exercise and shorten the time. Many people see more desirable results when they add interval type workouts to their routine. (http://www.runnersworld.com/workouts/quick-workouts-in-just-20-minutes?cid=socTP_20141002_32652116)
5. Don’t be afraid of the dark. Exercising at night can provide a different perspective on your workout and refresh your interest.
Remember we are here for you if you have any foot or ankle pain. 

Local Walk/Jog/Run Events this fall

Crozet - Crozet Trails Crew Trail 5K / October 11th
Waynesboro - Fall Foliage Race 5k & 10k / October 11th
Roseland (Devil’s Backbone Brewery) - The Blue Ridge Burn / October 11th
Charlottesville - Color Me Cured 5k / October 18th
Stuarts Draft - Jack-O-Lantern Jog / October 24th
Waynesboro - Howl-o-Weenie 5k  / October 25th
Charlottesville  -  DANGER! ZOMBIES! RUN! 5K / October 26th
Staunton (Frontier Cultural Museum) - 5k MAD Zombie Run/Walk / October 18th
Staunton - Illuminate 5K Run/Walk / October 18th

Need help with your shoe selection?  Click here for some help.

 

Blue Ridge Foot and Ankle Clinic has been a part of the Waynesboro and Charlottesville communities for over 20 years. Podiatrists Dr. Kevin Murray and Dr. Stewart Chang offer services in sports podiatry, foot and ankle problems and diabetic foot care. Our friendly, accommodating team of Certified Podiatric Medical Assistants look forward to welcoming you to our practice.

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You can also visit us @ www.brfootandankle.com

887 A Rio East Court  Charlottesville, VA 22901
434-979-8116
66 Parkway Lane Suite #102
Fishersville, VA 22939
540-949-5150

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29 Jul

Plantar Fasciitis Information & Treatment

Posted in Heel Pain, Plantar Fasciitis

PF.INTERNALPlantar Fasciitis

A common, yet no less painful, injury, plantar fasciitis refers to the inflammation of the plantar fascia, the connective tissue that runs along the bottom of the foot and creates the arch of the foot. The plantar fascia helps to support the arch of the foot, taking pressure off the arch when the foot bears weight. Experts suggest that the plantar fascia supports up to 14% of the pressure exerted on the foot. During activity, the plantar fascia acts like a spring, propelling us forward as we take steps.

Inflammation of the plantar fascia is called plantar fasciitis, and occurs when the plantar fascia is over stretched or over used. Causes include foot arch problems, obesity or sudden weight gain, long-distance running, especially running downhill or on uneven surfaces, a tight Achilles tendon, and shoes with poor arch support or soft soles. Plantar fasciitis is one of the most common injuries treated among the running population.

Plantar fasciitis is frequently diagnosed in men between ages 40 and 70 years, however, it is such a common podiatric injury that it is seen across the board with various age groups and genders. The symptoms of plantar fasciitis include pain and stiffness in the bottom of the heel, which can be either dull or sharp, ache or burn. Patients commonly complain that the worst pain is felt in the morning, but also after standing or sitting for long durations, while climbing stairs or after intense activity.

Here is the unfortunate catch to plantar fasciitis: while it does not hurt during activity, activity is exactly what causes the pain. Plantar fasciitis will hurt during recovery from a workout, or after waking up in the morning. Despite not hurting during running or activity, be aware that running only causes further damage to the plantar fascia. The cold, hard truth of the matter is that you cannot run through plantar fasciitis – running will only make your injury worse.

Diagnosis and treatment for plantar fasciitis vary. You can expect your podiatrist to perform a physical exam to provide clues from your foot’s physiology – flat feet or high arches, for example. Tenderness in the bottom of the foot, mid-foot swelling, redness, and stiffness are indicators of plantar fasciitis. Your podiatrist may also take X-rays to rule out other problems. Treatment regimens include taking non-steroidal anti-inflammatory meds (NSAIDs), such as Ibuprofen, Advil, Motrin, or Aleve, that work by blocking enzymes that stimulate swelling to reduce pain caused by inflammation, heel stretch exercises, mid-foot massage, plenty of rest, and ensuring that you are wearing supportive and cushioned shoes. Applying ice at least twice a day for 15 minutes at a time will help reduce inflammation and pain, and padding such as heel cups, foot pads, shoe inserts and custom made orthotics will help everyday activity. Night splits will enable your plantar fascia to stretch and heal, and let you get up in the morning pain free. In more severe cases, boot castes may be prescribed, and even steroid shots or injections may be given. If pain continues, in very extreme cases, your podiatric surgeon may suggest surgical methods.

In general, to prevent plantar fasciitis, make sure your ankle, Achilles tendon and calf muscles are flexible. Please continue to read the rest of our site, Heel Pain Center of Virginia, for more information on Plantar Fasciitis and other injuries to the heel.

You can also visit us @ www.brfootandankle.com

 

887 A Rio East Court  Charlottesville, VA 22901
434-979-8116
 
66 Parkway Lane Suite #102
Fishersville, VA 22939
540-949-5150

 

 

 

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24 Jul

We Would Like to Welcome Two New Assistants To Our Practice

Posted in Uncategorized

Rick, who is a Crozet native and UVA grad, recently started working in our Charlottesville location. Our patients and staff really enjoy his sense of humor and dedication to our practice.

Courtney, our newest employee, graduated from Blue Ridge Community College and works in our Fishersville office. She brings a smile to work every day and is fitting in wonderfully.
 
We are very excited to have Courtney and Rick working for us and look forward to their contributions to the team. Thanks and welcome to Blue Ridge Foot and Ankle Clinic.
 
 
        

WE ARE ACCEPTING NEW PATIENTS AND REFERRALS

Blue Ridge Foot and Ankle Clinic
887 A Rio East Court  Charlottesville, VA 22901
66 Parkway Lane Suite #102  Fishersville, VA 22939
 
Visit us on Facebook
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24 Jul

Ground Breaking

Posted in Uncategorized

Work has started on our NEW Fishersville podiatry clinic. Stay tuned for more exciting news and progress pictures.

GB3GB2GB1BRFAA Fishersville Map2WWW.BRFOOTANDANKLE.COM

 

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24 Jul

Achilles Tendonitis and Achilles Tendonosis

Posted in Uncategorized

Achilles Tendonitis and Achilles Tendonosis

The Achilles tendon connects the calf muscle to the heel bone and is the thickest and strongest tendon in the body in humans. While helping raise the foot off the ground with each step, the Achilles tendon can receive a load stress 3.9 times body weight during walking and 7.7 times body weight when running. Despite its ample strength, the Achilles tendon is prone to injury. The most common Achilles injuries are Achilles tendonitis and tendonosis, the former being inflammation of theachil Achilles tendon and the latter being degeneration of Achilles tendonitis. The inflammation from Achilles Tendonitis is usually short-lived. Over time, if tendonitis is not treated, it can degenerate into a worse condition called tendonosis, marked by tears in the tendon. In rare cases, chronic degeneration with or without pain may result in rupture of the tendon.

Repeat after me: I will not run through my Achilles injury. The Achilles will not heal if you keep running on it. When you hurt your Achilles, it is time to start cross training and being gentle with it. The most common risks to the Achilles are sudden increases of repetitive activity without giving it enough time to repair itself. Intense activity causes micro-injuries in the tendon fibers, which require time to heal. Additionally, athletes and runners with inconsistent workout schedules, such as weekend warriors and those who increase their workout intensity and volume too quickly, are prone to Achilles injuries. Achilles injuries may also be due to physiological reasons such as excessive pronation and flat feet, which put extra pressure on the tendon while walking or running.

Achilles tendonitis and tendonosis will result in pain, aching and tenderness along the tendon’s path, increasing when the sides of the tendon are squeezed, but with less pain in the back of the tendon. To diagnose Achilles injuries, your podiatrist will examine the foot, its range of motion, and conduct further assessment with imagining techniques such as X-rays. Initial treatment will include rest. Using heal lift inserts on both feet, or wearing high-heeled shoes with an open back, can help relax the tendon and give it the rest it needs.

Treatment plans will focus on reducing force on the Achilles tendon by means of a cast or walking boot, reducing swelling with ice and oral medications, long term preventative strategies such as custom-made orthotics and night splints, and gradually building a physical therapy regimen that includes stretching and strengthening exercises, soft-tissue massage and mobilization, and ultra-sound therapy. Eccentric stretching and strengthening of the Achilles – that is, elongating the Achilles while doing exercises – are key to long-term rehab. Examples include, first, doing calf stretches in a small lunge with your hands pressing against a wall, second, sitting with one leg straight in front of you while flexing and pointing your toe, or, finally, doing toe raises at the edge of a step or stair. You may even want to consult your podiatrist and physical therapist about working on your gait and stride while running, as gait abnormalities can lead to Achilles tendon and other injuries.

To prevent Achilles tendon injuries, be sure that you strengthen and stretch your calf muscles daily, maintain proper footwear, and use custom-made orthotics if you have flat feet or pronate.


 

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24 Jul

Blue Ridge Foot and Ankle Clinic Will Open New Office Early 2015 in Fishersville, VA

Posted in Uncategorized

front org 1

After 10 long years on South Magnolia Ave in Waynesboro, we are moving into our new office in Fishersville, VA. Construction starts this month near Augusta Health Hospital between the Hampton Inn and the intersection of Tinkling Spring Rd and Goose Creek Rd. Our new facility will offer more space, easier access, and more parking. Dr. Murray and Dr. Chang are excited about our new facility and the conveniences it offers our patients.

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Parking and handicap accessibility is a constant issue with our current office. The new location will have it’s own parking lot with handicap accessible sidewalksparkinglot org and entrance way.  Inside, our hallways and doors will be wide enough to comfortably accommodate wheelchairs.

 

With the new office comes new equipment, the most notable, a digital x-ray machine. This machine makes the whole experience of getting an x-ray quicker and easier. Digital images have a higher resolution and can be burned to a CD for your convenience. Also, there is less radiation exposure because images are more consistently reliable.

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©2014 BRWARCHITECTS, ALL RIGHTS RESERVED.

For more information about our new office visit us on Facebook.

If you or a loved one are experiencing foot & ankle pain, we hope you will consider our practice.  Please contact us to make an appointment.

We are accepting new patients and referrals.

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14 Mar

**NEW** MICROLIGHT ML830 COLD LASER

Posted in Heel Pain, Plantar Fasciitis

 

pic_ml830MICROLIGHT ML830 COLD LASER

Cold laser therapy is a relatively new technology (30 years old) when compared to acupuncture which has been used since 8000-3500 B.C. Just like the abacus evolved into the computer, slowly needles are evolving into light. Recent innovations in low-level lasers now make it possible for the average physician or consumer to own cold laser equipment. Cold lasers are sometimes called Low Level Lasers (LLL) or soft lasers.

In general, cold lasers can be used in 2 distinct ways:

  • Targeting acupuncture trigger points (similar to acupuncture but without the needles)
  • Broad coverage of deep tissue with laser photons to stimulate changes in the tissue

Cold Laser therapy offers a non-intrusive option to acupuncture and surgery. It also provides a non-addicting treatment that eliminates the complications of long-term drug treatment programs. Cold laser are widely use for treatment of:

  • Acute and chronic pain
  • Ligament sprains
  • Muscle strain
  • Soft tissue injuries
  • Tendonitis
  • Arthritis
  • Tennis elbow
  • Back pain
  • Bursitis
  • Carpal Tunnel Syndrome
  • Fibromyalgia

Healing With Cold Lasers

The cold laser produces an impulse of light at a wavelength (approximate 900nm) that maximized the energy (in photons) at a desire depth, usually 10-13cm (4-5 inches) deep. This may be combined with other laser diode with a shorter wavelength (875nm) to add photons to the shallower levels of tissue. In addition, red light diode with a wavelength of 660nm may be used to add energy to even shallower levels of tissues.

The goal of laser therapy is to deliver light energy units from infrared laser radiation, called photons, to damaged cells. It is the consensus of experts is that photons absorbed by the cells through laser therapy stimulate the mitochondria to accelerate production of ATP. This biochemical increase in cell energy is used to transform live cells from a state of illness to a stable, healthy state.

Over 4000 studies have been conducted in recent years to validate the effectiveness of cold laser therapy. Cold lasers treatment systems may be cleared by the FDA.

Benefit of Cold Lasers

  • Easy to apply
  • Extremely safe
  • Non-Toxic
  • Non-Invasive
  • No side effects or pain
  • Cost effective for both the practitioner and patient
  • Highly effective in treating ailments (more than 90% efficacy)
  • Superior alternative to analgesics, NSAID’s and other medications
  • Reduces the need for surgery

General Therapeutic Laser Biological Effects

  • Increased Cell Growth: Laser photons accelerates cellular reproduction and growth.
  • Increased Metabolic Activity: Photons initiate a higher outputs of specific enzymes, greater oxygen and food particle loads for blood cells and thus greater production of the basic food source for cells, Adenosine Tri-Phosphate (ATP).
  • Faster Wound Healing: Cold laser photons stimulates fibroblast development and accelerates collagen synthesis in damaged tissue
  • Anti-Inflammatory Action: Laser photons reduce swelling caused by bruising or inflammation of joints resulting in enhanced joint mobility.
  • Increased Vascular Activity: Laser photons induce temporary vasodilation that increases blood flow to effected areas.
  • Reduced Fibrous Tissue Formation:Laser photons reduce the formation of scar tissue following tissue damage from: cuts, scratches, burns or post surgery.
  • Stimulated Nerve Function: Laser photon exposure speeds the process of nerve cell reconnection to bring the numb areas back to life.

Types of Cold Lasers

Class I – III continuous and modulated lasers

The fixed level of power is too low to deliver photons beyond the surface of the skin, making them ineffective in delivering photons to deep tissues. This includes laser pointers and other low cost laser diodes.

Class IV Continuous Lasers

The increase in the power of class IV continuous wave lasers increases the photon delivery to deep tissues. Unfortunately, it also increases the amount of the heat generated. This heat increases the potential risk of destructive thermal effects. Class IV laser may result in damage to the retina requiring clinicians to exercise additional FDA implemented controls to ensure patient and practitioner safety. This can include a safely lock on the device to prevent accidental exposure.

Modulated Lasers (Class II to IV) Modulating or super-pulsing the laser output power (turning it on and off in less than 1 billionth of a second) provides a unique combination of benefits. It allows the use of very high power levels (up to 50 watts) while insuring that there is no heat or damage. The ratio between the on and off times is call the duty cycle. In general a super pulsed laser class II laser can provide more power to the treatment area than a class IV continuous lasers without a risk of damage. Modulated lasers provide a good combination of safety and power.

Summary

Today, lasers are used extensively in the medical industry for everything from cosmetic surgery, eye surgery and heart surgery. The ability to put just the right amount of energy into a critical area of the human body has been a huge advancement in the medical field. Cold lasers are an important addition to these other established medical laser treatments and the recent development of low-cost professional cold lasers means that cold laser therapy will be a rapidly growing medical treatment option.

Source: ColdLasers.org

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06 Jun

We Now Offer Shockwave Therapy!

Posted in Uncategorized

Are you sick and tired of chronic pain and injuries that won’t go away? Don’t lose hope! The Heel Pain Center of Central Virginia is now offering Extracorpeal Pulse Activation Treatment (EPAT), a cutting edge technology proven to increase the rate of healing for soft tissue injuries.

EPAT, also called Shockwave Therapy, was developed in Europe by the company CuraMedix, but is now being used by doctors world wide. EPAT is an FDA approved emerging technology that delivers non-invasive low frequency (8-11 Hz) acoustic sound waves into a localized area. The sound waves act as pressure, and penetrate deep through your soft tissue. The energy emitted causes the cells in your soft tissue to release certain biochemicals that intensify the body’s natural healing process. These biochemicals allow for the building of an array of new microscopic blood vessels in your soft tissue. Overall, EPAT increases the nutrient flow to the chronically injured tissue, stimulating your cell metabolic rate, and giving hope for those who are considering surgery as their only option.

EPAT studies promise that, with EPAT treatments, you will have your cake and eat it too: first off, you can continue the activities that you love through treatment. Secondly you will not need surgery. Finally, you will still reap positive results – many times, more positive results than any other available treatment. In fact, the results of other treatments such cortisteroidal injections, orthoses, e-stim, and even surgery, seem to be significantly less effective in research studies than EPAT.  Moreover, more than 80% of patients who have failed to respond to anything other treatment are relieved of their pain after being treated with EPAT. Furthermore, While studies on ultrasound methods have been conflicting (Alexander, L.D. et al 2009), EPAT therapy studies, even when conducted by skeptics of EPAT, have seen resounding success in EPAT effectiveness to cure soft tissue maladies (Saxena 2011; Gerdesmeyer, L. 2008; Ibrahim, I. M. in press; Rompe, J.D. 2009; Rompe, J. D. 2008; Rompe, J. D. 2007; Rompe, J. D. 2009; Rompe, J. D.  2009; Furia, J. P. 2009).   These studies, with high standards of wellness and success rates, show between 75% – 95% success with EPAT.

After trying other types of treatment (cortisone injections, stretching, anti-inflammatories, night splints, physical therapy, and orthotic devices), you might be disheartened to start considering surgery for your injury. However, consult Dr. Murray and Dr. Chang about EPAT, since it might be a viable option instead of invasive surgery. EPAT is a small machine with a trigger end that looks like an ultrasound. It is administered once a week for a series of three weeks (up to five weeks), each taking approximately fifteen minutes (depending on the area of injury). Dr. Murray and Dr. Chang will apply coupling gel and use the EPAT on the area, in essence, breaking the soft tissue down and providing an opportunity for your cell responses to quickly get rid of dead cells and regenerate new ones. In essence, this is the most rapid stimulation of cell generation, known to have the most rapid healing rate of any technology out there.

EPAT can be used for acute and chronic musculo-skeletal pain – even knots, dysfunction, plantar fasciitis, Achilles Tendonitis and tendonosis, chronic heel pain, tendonal insertional pain, acute and chronic muscle pain, myofascial trigger points, and the list goes on. There have been very few side effects reported – in few cases, skin bruising may occur, and patients may feel sore afterward, as though they have worked out. Patients who choose EPAT treatment should not take NSAIDs (including ibuprofen, Motrin, Advil, Naproxen, Aleve, and Aspirin) for two weeks prior to and one month after the administration of EPAT, as they interfere with the hormones that regenerate your cells.

EPAT is available for a wide range of patients. Research suggests to postpone EPAT treatment for pregnant women, for deep venous thrombosis or malignancy cases, or if you are taking blood thinners. These studies suggest that women should wait until four months after pregnancy to receive EPAT treatment, waiting for regular swelling in the feet to go down, and for the hormones that act as muscle relaxants during pregnancy to level out.

While the initial fees for EPAT are expensive, you can rest assured that they are cost-effective in the long run. EPAT is not covered by insurance. You can expect to pay $500 for a series of three treatments, not including the fee of a co-pay for your initial office visit and evaluation charge, (after which there will be no co-pay). Inquire with your qualified health savings account or your employer’s flexible payment medical savings account, as these can usually be used to pay for the treatment. If a 4th and 5th treatment is necessary, you can expect to pay $150 per treatment. Despite these initial costs, remember that surgery is much pricier, and that EPAT is proven to be much more effective than other treatments. Additionally, patients treated with EPAT are immediately fully weight bearing, have no incision, no risk of infection or scar tissue, experience very few (if any) side effects, and do not need to be put under anesthesia. Overall, EPAT is sure to save money and time, and to accelerate your road back to having healthy feet!

So inquire with Dr. Murray and Dr. Chang to see if EPAT is the right treatment for you. The Heel Pain Center of Central Virginia is excited to bring such an effective and preeminent technology to the office, in order to serve you with top quality and cutting edge medical care!

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23 Feb

APMA Footprints: Heel Pain

Posted in Heel Pain, Plantar Fasciitis

The Spring 2012 edition of APMA Footprints is now available and it focuses on Heel Pain! CLICK HERE to download a PDF copy.

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01 Aug

Heel Pain In Children

Posted in Uncategorized

If your child is experiencing heel pain, he/she may have a condition known as Calcaneal Apophysitis (aka Sever’s disease). It is typically present in children of ages 8-12 years who are physically active; usually gymnasts and soccer players. However and overweight child may also be at risk as the excess weight may cause extra stress and pressure on the calcaneal apophysis. This condition is basically an injury of the growth plate in the calcaneus (heel bone). The calcaneus forms a separate apophysis on the posterior inferior aspect which appears at 8 years and fuses around 14-16 years of age therefore this is rarely seen in older children/teenagers. During the time of growth, which is early puberty, the muscles and tendons in this area tend to be less flexible and any running and jumping activity may predispose your child to this condition. Your podiatrist may perform a squeeze test where you child will experience pain when the back of the heel is squeezed on both sides. They may also find that your child’s tendons have become tight. Your child may also walk with a limp or experience greater pain when on their tip toes. This pain may be present in one or both heels.
In an effort to prevent this, be sure that your child wears well-fitting, firm and supportive shoes to help maintain flexibility while your child is growing. A shock absorbent sole may also be helpful. Proper diet control may be necessary in the overweight child.
Treatment
-Reduce activity
-Well fitting, supportive shoes
-A soft cushioning heel raise to reduce the pull from the calf muscles on the growth plate
-Stretching before activity and Icing 20 mins after activity
If condition is more severe:
Be sure to consult your podiatrist
Custom orthotics may be recommended
Strapping/taping during activity to limit ankle joint range of motion
Medication to reduce inflammation may be prescribed
A cast may also be given for 2-6 weeks to give the calcaneal apophysis a good chance to heal.
This condition is self limiting and will go away once the bone has fully fused at about 16 years. However it can be really painful so treatment is necessary to relieve symptoms of it during the time of growth.  To Consult Dr. Murray and Dr. Chang about your child’s heel pain, book an appointment online today!

 

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