Being born with a congenital deformity can be devastating. As a parent, you may struggle to understand why, how, and what should be done. It is incomprehensible to allow your child to suffer or struggle and you shouldn’t have to sit by and be helpless. When Charles Woodson was born with clubfoot, his parent probably never conceived that their son born with a foot deformity would someday be a successful football player. Clubfoot is a congenital foot deformity that occurs in about 1 in every 1,000 births and is twice as common in young boys as girls.
Clubfoot can be identified at birth and the foot will have an appearance of turning inward. The medical name for the deformity is Talipes Equinovarus. The exact cause of clubfoot is still widely debated and unknown. No genetic component has been discovered but statistics show that children whose parents or siblings have clubfoot are twice as likely to be born with club foot.
The child does not experience any pain, but if left untreated, the ability of the child to ambulate in the future is very limited. Disability would be inevitable. Over the last 25 years the treatment protocols have been debated. The current standard of treatment involves a series of casting starting shortly after birth. This treatment method is referred to as the Ponsseti technique. The cast is changed by a trained physician weekly and a series of manipulations and stretching are performed. Casting can be as few as 4 weeks but the amount of time taken correct the deformity is dependent on the complexity of the deformity. Most children also need their achillies tendon lengthened, a minor procedure done through a minimal incision. Fallowing correction of the deformity, the child will need to be in a series of braces that help maintain the correction. Less than 20 percent of children treated by casting will need surgery in the future to correct any residual deformity.
Though the child is bound to braces and continued foot care up the age of four, the deformity and treatment has little effect on the child’s development. By the time the patients is gearing up to ambulate, the braces are worn minimally, mostly while the child is asleep. Most children go on to have a normal childhood with few, if any, limitation. Often the only residual defect is the clubfoot having a slightly smaller size than the normal foot. If treatment is delayed, children may be subject to more invasive surgery and longer recovery times but surgical procedures for clubfoot have been well studied and discussed in the literature with good success.
From Clubfoot to athlete, there have been many professions who were born with the congenital deformity who grew up to be successful athletes. Charles Woodson is a Super Bowl Champion. Kristi Yamaguchi is a gold medal figure-skater. From MVP baseball players to star soccer players, people born with clubfeet have proven to overcome their congenital deformities.
Monday, October 31, 2011
Saturday, October 8, 2011
As Does Ryan Howard’s Achilles Tendon Goes Pop, so Does the Phillies Season
The favorite Philadelphia Phillies lost their playoff series last night to the St. Louis Cardinals. On the very last play, Ryan Howard, the Phillies first baseman, was running out a ground ball. On the way to first base, Howard crumbled to the ground. “I heard my Achilles Tendon pop,” he said.
That pop that Howard describes is a sign of an Achilles Tendon tear. You might say well, he has all off season to recover, but Achilles Tendon ruptures are not to be taken lightly. Since the Achilles is the largest and the strongest tendon, it is also the hardest tendon to heal after an injury. The tendon attaches the big calf muscle to the back of the heel bone, also known as the calcaneus. When the calf muscle contracts, the tendon allows you to point your foot and stand tiptoe. The tendon is necessary to run, walk and put your foot down.
How does the Achilles Tendon Tear?
Tears are really not that common and usually occur in Men over 40 or in athletes who perform a ballistic movement, like Dan Marino did several years ago, when he pushed off his foot to throw a pass. The athlete pivots, jumps or runs in a very quick fashion.
The injury can also happen in these situations.
1) You make a forceful push-off with your foot while your knee is straightened by the powerful thigh muscles. One example might be starting a foot race or jumping.
2)You suddenly trip or stumble, and your foot is thrust in front to break a fall, forcefully overstretching the tendon.
3)You fall from a significant height.
When the injury occurs, a loud pop sound usually happens. It is sometimes sounds like a gun shot went off. Sometimes the tendon doesn’t fully tear, and you get a partial rupture. Partial tears can lead to a full blown rupture if left untreated. In young athletes, surgery is usually needed to repair the tendon if it was fully ruptured. Partial tears can be treated with initial immobilization and physical therapy.
Rehabilitation after surgery can be from 3-6 months. Most professional athletes, like Ryan Howard, would need about three-four months before being ready to play their sport.
Another way to get a tear of the tendon is to ignore pain in the area. It is very common to develop Achilles Tendinitis, which is a swelling along the tendon. If one ignores this pain and continues to stay very active, the inflamed tendon can tear. So, it is very important to see your podiatrist if this happens.
That pop that Howard describes is a sign of an Achilles Tendon tear. You might say well, he has all off season to recover, but Achilles Tendon ruptures are not to be taken lightly. Since the Achilles is the largest and the strongest tendon, it is also the hardest tendon to heal after an injury. The tendon attaches the big calf muscle to the back of the heel bone, also known as the calcaneus. When the calf muscle contracts, the tendon allows you to point your foot and stand tiptoe. The tendon is necessary to run, walk and put your foot down.
How does the Achilles Tendon Tear?
Tears are really not that common and usually occur in Men over 40 or in athletes who perform a ballistic movement, like Dan Marino did several years ago, when he pushed off his foot to throw a pass. The athlete pivots, jumps or runs in a very quick fashion.
The injury can also happen in these situations.
1) You make a forceful push-off with your foot while your knee is straightened by the powerful thigh muscles. One example might be starting a foot race or jumping.
2)You suddenly trip or stumble, and your foot is thrust in front to break a fall, forcefully overstretching the tendon.
3)You fall from a significant height.
When the injury occurs, a loud pop sound usually happens. It is sometimes sounds like a gun shot went off. Sometimes the tendon doesn’t fully tear, and you get a partial rupture. Partial tears can lead to a full blown rupture if left untreated. In young athletes, surgery is usually needed to repair the tendon if it was fully ruptured. Partial tears can be treated with initial immobilization and physical therapy.
Rehabilitation after surgery can be from 3-6 months. Most professional athletes, like Ryan Howard, would need about three-four months before being ready to play their sport.
Another way to get a tear of the tendon is to ignore pain in the area. It is very common to develop Achilles Tendinitis, which is a swelling along the tendon. If one ignores this pain and continues to stay very active, the inflamed tendon can tear. So, it is very important to see your podiatrist if this happens.
