Jenrry Meija had to leave a spring training game after five innings in March because of pain from... a bunion.
So will Meija's bunion bother him the rest of the season? It likely will if the bunion continues to progress.
At the end of March, Terry Collins said that how long he could last in a game would determine his status as a starter. If the bunion continues to bother him, it would prevent his ability to start.
The Mets were attempting to decide between Mejia and Daisuke Matsuzaka as their fifth and final starter.
Pitching coach Dan Warthen had said, "They're both still fighting for a position on the team. They have both thrown extremely well so it's made it very difficult on all of us. Which is a nice thing to have."
Meija had said that his foot felt "good" and that he did not expect his bunion to be an issue. Something was going to be applied to relieve the pressure from the bunion.
"We've always liked Meija's stuff," Warthen said. "We'd just like to see him get deeper into the game without the high pitch counts and see how everything feels afterwards because he really has 'plus' stuff and if he commands the zone and gets hitters out then he deserves the position as well. A young, good arm."
Meija was obviously able to push through the pain from his bunion, since he made his second start of the season last night. In his first outing against the Reds Meija gave up just one run and struck out eight in six innings.
A bunion is a bone deformity caused by an enlargement of the joint at the base and side of the big toe. Bunions form when the toe moves out of place. The enlargement can cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward other toes, sometimes overlapping a third toe. The growing enlargement then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists. Bunions can also lead to other toe deformities, like hammertoes.
Meija will have to monitor the progress of his bunion, wear padding, and an orthotic as well. He may need shoes that are wider in the toe box to compensate for his bunion. We'll monitor him throughout the season, as the pain from the bunion may prove too much for this pitcher.
References: NJ.com and SB Nation
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Friday, April 11, 2014
Friday, March 14, 2014
How the Internet Has Changed Clubfoot Treatment
Clubfoot is a common birth defect, affecting 1 in every 1,000 newborns, and is characterized by feet that turn inward, forming a twisted U-shape.
Mary Synder was devastated to learn at her 19 week ultrasound that her unborn baby had clubfoot.
"It was terrifying," said Synder. "It was very emotional. We did a lot of testing and everything to make sure she was going to be OK, but you never really know until you see them when they're born."
Until a decade ago, 90 percent of babies born with clubfoot were treated with surgery that had to be done several times. This would lead to a buildup of scar tissue that could bring a lifetime of pain, arthritis, stiffness, and medical bills. A noninvasive solution along with an Internet campaign by parents changed treatment courses and outcomes.
Alice is now 6 and is seen every year by Dr. John Herzenberg, an orthopedic surgeon at Sinai Hospital in Baltimore. Alice follows all of his instructions: walk back and forth, stand on her tippy toes, and walk with her feet turned out like a duck.
For those who aren't familiar with clubfoot, Alice's feet look perfectly normal. They can turn out just like anyone who wasn't born with clubfoot.
Dr. Herzenberg used the Ponseti Method, which involves a series of full-leg casts that slowly turn out the patient's feet. Casts are changed every three to eight weeks. When it is time for the final cast, which stays on three weeks, a small incision is made above the Achilles tendon. The child will then wear at night special boots that are connected by a bar to ensure the feet stay in the right position.
This method was developed by Dr. Ignacio Ponseti at the University of Iowa in the 1950's when the Spanish physician discovered that an infant's feet could be trained to turn the correct way.
"In the past, before I learned Ponseti, guaranteed I would literally have had to do a surgical operation to take apart and pull together the entire foot," said Dr. Herzenberg.
The Ponseti method is almost painless and patients who have this treatment have a complete recovery with no long-term discomfort. It also costs less than surgery. Ponseti would spend 50 years trying to get other physicians to adopt this method, but would be largely unsuccessful.
"People were falling over themselves to do fancy invasive surgery, and this one strange old guy who speaks softly with a Spanish accent in Iowa was getting sort of ignored by the drumbeat of people who were in favor of surgery," said Dr. Herzenberg, who is one of the top physicians to see for this procedure.
Traditionally, surgeons are trained to operate, and that's how they can make more money. For orthopedists, the Ponseti method brings in less money. So for 50 years the Ponseti method stayed in Iowa.
But the internet changed that. Jennifer Trevillian's daughter was born with clubfoot in 2000 and doctors said surgery was the only course of action. "He started talking about her pending surgery before he physically examined her foot," Trevillian recalls.
Trevillian wasn't going to have any surgery for her daughter. On her new dial-up connection, she began to research the condition. Initially, she didn't find much, but she stumbled upon a support group on iVillage called NoSurgery4ClubFoot. Several days later she and her daughter traveled from Chatham, Michigan to Iowa to see Dr. Ponseti.
"In the amount of time that we would have just been waiting for her to be big enough to tolerate the anesthesia for the reconstructive surgery she was supposed to have, Dr. Ponseti completely corrected her foot," Trevillian said.
Trevillian became a proponent of the Ponseti method, setting up websites with her daughter's story, staying active on support groups, and spreading the message. Parents began to listen, and would travel long distances to find doctors who would perform the treatment.
"The way that the clubfoot treatment pendulum has swung is really a classic example of supply and demand- because once parents found out about it, they demanded it for their kids, and it really forced the medical industry to rethink the Ponseti method," said Trevillian.
Herzenberg agrees with Trevillian's statement. "Clubfoot is a real prototype for how the Internet has changed medicine and how parents have been the driving force in many ways," he says.
Now the Ponseti method is the treatment option of choice by physicians for clubfoot and is recommended by the American Academy of Orthopedic Surgeons. When done properly, 97 percent of children will never need surgery.
Reference: NPR
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Mary Synder was devastated to learn at her 19 week ultrasound that her unborn baby had clubfoot.
"It was terrifying," said Synder. "It was very emotional. We did a lot of testing and everything to make sure she was going to be OK, but you never really know until you see them when they're born."
Until a decade ago, 90 percent of babies born with clubfoot were treated with surgery that had to be done several times. This would lead to a buildup of scar tissue that could bring a lifetime of pain, arthritis, stiffness, and medical bills. A noninvasive solution along with an Internet campaign by parents changed treatment courses and outcomes.
Alice is now 6 and is seen every year by Dr. John Herzenberg, an orthopedic surgeon at Sinai Hospital in Baltimore. Alice follows all of his instructions: walk back and forth, stand on her tippy toes, and walk with her feet turned out like a duck.
For those who aren't familiar with clubfoot, Alice's feet look perfectly normal. They can turn out just like anyone who wasn't born with clubfoot.
Dr. Herzenberg used the Ponseti Method, which involves a series of full-leg casts that slowly turn out the patient's feet. Casts are changed every three to eight weeks. When it is time for the final cast, which stays on three weeks, a small incision is made above the Achilles tendon. The child will then wear at night special boots that are connected by a bar to ensure the feet stay in the right position.
This method was developed by Dr. Ignacio Ponseti at the University of Iowa in the 1950's when the Spanish physician discovered that an infant's feet could be trained to turn the correct way.
"In the past, before I learned Ponseti, guaranteed I would literally have had to do a surgical operation to take apart and pull together the entire foot," said Dr. Herzenberg.
The Ponseti method is almost painless and patients who have this treatment have a complete recovery with no long-term discomfort. It also costs less than surgery. Ponseti would spend 50 years trying to get other physicians to adopt this method, but would be largely unsuccessful.
"People were falling over themselves to do fancy invasive surgery, and this one strange old guy who speaks softly with a Spanish accent in Iowa was getting sort of ignored by the drumbeat of people who were in favor of surgery," said Dr. Herzenberg, who is one of the top physicians to see for this procedure.
Traditionally, surgeons are trained to operate, and that's how they can make more money. For orthopedists, the Ponseti method brings in less money. So for 50 years the Ponseti method stayed in Iowa.
But the internet changed that. Jennifer Trevillian's daughter was born with clubfoot in 2000 and doctors said surgery was the only course of action. "He started talking about her pending surgery before he physically examined her foot," Trevillian recalls.
Trevillian wasn't going to have any surgery for her daughter. On her new dial-up connection, she began to research the condition. Initially, she didn't find much, but she stumbled upon a support group on iVillage called NoSurgery4ClubFoot. Several days later she and her daughter traveled from Chatham, Michigan to Iowa to see Dr. Ponseti.
"In the amount of time that we would have just been waiting for her to be big enough to tolerate the anesthesia for the reconstructive surgery she was supposed to have, Dr. Ponseti completely corrected her foot," Trevillian said.
Trevillian became a proponent of the Ponseti method, setting up websites with her daughter's story, staying active on support groups, and spreading the message. Parents began to listen, and would travel long distances to find doctors who would perform the treatment.
"The way that the clubfoot treatment pendulum has swung is really a classic example of supply and demand- because once parents found out about it, they demanded it for their kids, and it really forced the medical industry to rethink the Ponseti method," said Trevillian.
Herzenberg agrees with Trevillian's statement. "Clubfoot is a real prototype for how the Internet has changed medicine and how parents have been the driving force in many ways," he says.
Now the Ponseti method is the treatment option of choice by physicians for clubfoot and is recommended by the American Academy of Orthopedic Surgeons. When done properly, 97 percent of children will never need surgery.
Reference: NPR
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Friday, February 14, 2014
Myotonic Dystrophy and Foot Deformities
Myotonic dystrophy is one of the most common myopathies and is inherited through an autosomal dominant gene. Often, many members of the same family have this condition.
The manifestation of this disease does not appear until late adolescence or early adulthood. Early symptoms include muscle stiffness, cramping pains, or difficulty relaxing the grasp. Diagnosis is usually made through an electromyogram.
Characteristics of fully developed myotonic include long, thin, facial expressions with temporal and masseter weakness and frontal balding. The neck will look like a long swan's neck due to the weakness of the musculature. The voice has a nasal quality and speech can become dysarthric, meaning trouble pronouncing words. Swallowing may also be impaired. Cataracts and endocrine abnormalities, like disturbances of the adrenal, pancreatic, and gonadal function are also affected. In men, testicular atrophy is seen, and in females infertility.
Myotonic dystrophy should not be confused with myotonia congenita, also known as Thomsen's disease. In Thomsen's disease there is stiffness of the muscle with difficult in initial movements. No atrophy or mental retardation is found, with no physical limitation. After activity, the muscles loosen, and the patient's movements are almost normal.
Foot and ankle weakness presents early and is associated with stiffness and cramping pains. In general, foot deformities are not severe enough to need surgical correction. Treatment is directed towards the modification of the shoe. Shoe lifts, pads, and wedges are used to help prevent painful feet and aid with gait. If the patient is able to keep up strength in their legs, footdrop can be alleviated by orthotics.
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
The manifestation of this disease does not appear until late adolescence or early adulthood. Early symptoms include muscle stiffness, cramping pains, or difficulty relaxing the grasp. Diagnosis is usually made through an electromyogram.
Characteristics of fully developed myotonic include long, thin, facial expressions with temporal and masseter weakness and frontal balding. The neck will look like a long swan's neck due to the weakness of the musculature. The voice has a nasal quality and speech can become dysarthric, meaning trouble pronouncing words. Swallowing may also be impaired. Cataracts and endocrine abnormalities, like disturbances of the adrenal, pancreatic, and gonadal function are also affected. In men, testicular atrophy is seen, and in females infertility.
Myotonic dystrophy should not be confused with myotonia congenita, also known as Thomsen's disease. In Thomsen's disease there is stiffness of the muscle with difficult in initial movements. No atrophy or mental retardation is found, with no physical limitation. After activity, the muscles loosen, and the patient's movements are almost normal.
Foot and ankle weakness presents early and is associated with stiffness and cramping pains. In general, foot deformities are not severe enough to need surgical correction. Treatment is directed towards the modification of the shoe. Shoe lifts, pads, and wedges are used to help prevent painful feet and aid with gait. If the patient is able to keep up strength in their legs, footdrop can be alleviated by orthotics.
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Friday, January 24, 2014
Guillain-Barre Syndrome And Foot Deformities
Guillain-Barre syndrome is a polyneuropathy that has associated muscle weakness in the upper and lower extremities, respiratory muscle weakness, and respiratory paralysis.
Recovering from the syndrome is possible and patients with mild cases may feel better at the end of a month. Patients who have severe cases see a longer recovery time, typically years, with residual effects from the illness.
Diagnosis of the syndrome is made with the association of a preceding or accompanying illness that is along the same strains with polyradiculoneuropathy, muscle weakness, and cerebral fluid analysis.
Foot deformities associated with Guillain-Barre syndrome can be put into two categories: those that develop early, and those that develop later as the disease progresses.
Early foot problems include muscle weakness, with pain in the muscles of the thighs, legs, and toes. This pain can be unbearable at times. Treatment should be directed towards easing the pain with analgesics and physical therapy. The position of the lower thigh is important and can be supported by night splints at first and then orthotics. Until muscle strength has been achieved, these devices will be necessary.
Full recovery of the muscles can take up to 24 months. After this time, the likelihood of gaining any more strength and function should not be expected. In patients where muscle weakness is still experienced, the most common problems are foot drop and deformities secondary to the muscle imbalance.
Foot drop can be treated with orthotics and appropriate tendon transfers. Triple arthrodesis has been used to correct some foot deformities, which may include bunions due to muscle weakness.
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Recovering from the syndrome is possible and patients with mild cases may feel better at the end of a month. Patients who have severe cases see a longer recovery time, typically years, with residual effects from the illness.
Diagnosis of the syndrome is made with the association of a preceding or accompanying illness that is along the same strains with polyradiculoneuropathy, muscle weakness, and cerebral fluid analysis.
Foot deformities associated with Guillain-Barre syndrome can be put into two categories: those that develop early, and those that develop later as the disease progresses.
Early foot problems include muscle weakness, with pain in the muscles of the thighs, legs, and toes. This pain can be unbearable at times. Treatment should be directed towards easing the pain with analgesics and physical therapy. The position of the lower thigh is important and can be supported by night splints at first and then orthotics. Until muscle strength has been achieved, these devices will be necessary.
Full recovery of the muscles can take up to 24 months. After this time, the likelihood of gaining any more strength and function should not be expected. In patients where muscle weakness is still experienced, the most common problems are foot drop and deformities secondary to the muscle imbalance.
Foot drop can be treated with orthotics and appropriate tendon transfers. Triple arthrodesis has been used to correct some foot deformities, which may include bunions due to muscle weakness.
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Subscribe to:
Posts (Atom)