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
facebook-logo-150x150

No Comments »

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

 

No Comments »

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.


 

No Comments »

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.

lot org

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.

vest org

©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.

No Comments »

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!

One comment »

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!

 

3 Comments »

11 Jul

Treatment for Plantar Fasciitis

Posted in Uncategorized

This blog is a sequel to last week’s blog that discussed the epidemiology of plantar fasciitis. We will touch briefly on treatments/prevention used by podiatrists and discuss treatment pearls podiatrists tend to follow when athletes and dancers present to their office with plantar fasciitis.

Alternative Physical Activity is one of the first steps to treatment. It is important to change the cardiovascular fitness routine to one that avoids high impact on the plantar fascia. This means limiting running and jumping and pursuing swimming and upper body weights as an alternative method of cardiovascular fitness. This is often called a period of “Relative Rest”

Changing footwear is another critical treatment step. Barefoot and sandals should not be worn while trying to treat this condition, instead shoes with a slightly elevated heel and a strong mid-shaft insole, should be worn inside and outside the house. We favor the use of plantar arch strapping (taping) which proves to be very successful, especially in athletes and active people who want to maintain their busy lifestyle.

Home Therapy consists of stretching the heel cord to encourage healing, and massaging the foot to increase blood flow. Night splints are also indicated for plantar fasciitis as it maintains the foot in a passive stretch position to encourage healing. This prevents unwanted re-tightening of the fascial band during the night and reset of stretch receptors that trigger pain activation.

Customized orthotics is an important long term strategy in the management of patients with this condition. Additional adjuncts to expedite recovery include: physical therapy which proves to be useful in alleviating pain associated with plantar fasciitis, and anti-inflammatory drugs which are given to control pain when appropriate for the patient.

These conservative methods typically suffice when treating plantar fasciitis in up to 90% of people with this condition, however when not successful, corticosteroid injections are considered for the more severe cases. Along with these treatments, rest and the maintenance of a healthy weight can also limit predisposal to plantar fasciitis so it is highly encouraged. If pain persists and all conservative treatments are unsuccessful, surgery may be required to release tension on the plantar fascia ligament. We are also using the Topaz radio frequency coblation technique with great success on our patients. If you suffer from plantar fasciitis or know someone who does, Drs Murray and Chang, can offer complete evaluation and tailor an appropriate treatment plan designed around the persons needs.

One comment »

07 Jul

What Is Heel Pain?

Posted in Uncategorized

A very common complaint presented by patients to their podiatrist is that of heel pain. It is caused by a variety of conditions but this blog will discuss heel pain due to plantar fasciitis. Plantar fasciitis is the most common condition associated with heel pain, especially in athletes, dancers and individuals within the ages of 40-60. It causes a mild discomfort to an aggressive form of pain in the plantar aspect of the foot- in the area of the heel.

The plantar fascia ligament, illustrated in the picture below, runs between the calcaneus (heel bone) and the base of the toes and is defined as a strong connective tissue that helps in forming the arch of the foot. A person’s biomechanics, such as being flatfoot or having high arches can create a pressure on this tissue. Incorrect shoes or even physical activity as well as diabetes or arthritis can also impact this fascia. A surplus of exercise and physical activity, including excessive running and jumping can result in loss of elasticity and compliance overtime second to micro injuries. At the same time, individuals with inflammatory types of arthritis can unfortunately develop inflammation within the tendons consequently resulting in the same condition. While being overweight is a significant contraindication, walking or exercising in improper shoes can cause impairment in weight distribution considerably increasing the pressure on the plantar fascia. When overload occurs, microtears in the tissue present themselves, and the plantar fascia becomes inflamed, typically in its central band, resulting in what is known as heel pain.
Symptoms include:
  • Pain in the heel
  • Stabbing, burning, aching pain
  • Pain worse in the morning when stepping out of bed
  • Diminishing pain as the tissue “warms up”
  • Intensity of pain increases over a period of months
Stay tuned for next week’s blog when we discuss ways to prevent, manage and treat plantar fasciitis.

15 Comments »