The Washington Nationals anxiously awaited their catcher’s Major League Baseball debut. Catcher Sandy Leon walked onto the field with excitement and nerves filling his stomach. Unfortunately, Leon’s MLB debut was cut short. Leon had to leave the field in the 4th inning due to a high ankle sprain. On a play at the plate, the opponent took a slide into Leon. While proper sliding technique diminishes the potential for a collision, circumstantial factors tend to get in the way.

On this particular play, the Padres’ Headley took a slide into Leon in an attempt to score. After the game, Headley said, “coming in, you intend to slide until there’s nowhere to go. He really left me nowhere to go. You hope that he’s going to be OK. It’s a bummer to have that happen in your debut.”

A bummer is right. Leon had to leave the field with the help of an assistant athletic trainer due to his high ankle sprain. The Nationals are expected to have Leon on the disabled list for 15 days, a huge disappointment following his expected inception into the league.

High ankle sprains are incredibly common in professional athletes. Also known as a syndesmotic ankle sprain, these injuries got the name “high ankle sprain” due to the location of the injury in the lower leg above the ankle. These injuries are caused when the lower leg and foot twist out. Typically, the most common professional sports that see this injury include soccer, hockey, football, and basketball.

If you have endured a high ankle sprain, contact Dr. Schilero and get on the road to recovery!

Fortunately, “turf toe” is likely a phrase you have never heard before. Unfortunately, if you are familiar with this term, you or someone you know may have suffered from this, for lack of a better term, annoying injury. Turf toe plagues many athletes, dancers, and other active professionals. An injury to the soft tissue around the big toe joint, turf toe is commonly found in football players, hence the namesake. However, turf toe can affect anyone who is extending his or her big toe past the normal range of motion. Let’s take a look at what causes turf toe and how to prevent this injury from occurring.

Causes of Turf Toe

• Normal walking causes one to “push off” on one foot to step down with the other

• If this “push off” toe remains flat to the ground, you run a risk of potentially injuring the surrounding joint area on the big toe

• As such, when tackled in football, turf toe may occur if the toe stays down while the body is propelled forward

• Generally, turf toe occurs in a sudden instant. However, sprains can also arise over time

Turf Toe Symptoms

• Pain in the base of the big toe is the biggest indicator of turf toe, this usually is felt immediately after an injury

• At times, a “pop” is felt in the big toe following an injury

• Swelling around the big toe may arise

• Limited to no range of motion in the big toe depending on the severity

If you believe you may have acquired turf toe, call Dr. Schilero to get on your path to recovery today!

Foot and ankle injuries are an all too common occurrence amongst teens. You may not think this is any more significant than foot pain at any other age, but the teen years are when growth spurts result in major foot growth. Gait, lateral movement, and running form are constantly developing until full growth is reached. Foot injury and malformation during this critical time can result in permanent affectation of gait and foot health. For athletes who rely on movement, speed, and agility, this can be devastating if not prevented or treated in the early stages.

75% of high school students play sports either recreationally or for school. The number of active teens is much higher than in adults. While physical activity is essential to good health, it sometimes results in painful stress on the body. 30% of all teens suffer from sports related foot pain. Often the pain is compounded by ill-fitting footwear. Separately, 20% of teens complain of pain from shoes and footwear. Oft times, girls high heels are the culprits. The foot is built to have the toes splayed while walking, creating greater balance and keeping the pressure on the balls of the feet. Many shoes sold today squeeze the toes together, alter the arch of the foot and cause painful blisters and sores.

Every foot is built differently and requires unique support and protection. Basketball shoes should have a thick, stiff sole that gives support when jumping and running on the hardwood. With running shoes, it is important to have maximum shock absorption and an arch that matches your foot type. So, make sure you know your foot type and whether you have a high, medium, or low arch.

It is important to remember that absolutely any foot pain experienced as a teenager is not normal and should be treated immediately. If, after switching to appropriate footwear, your foot pain persists, call Dr. Schilero to get advice on possible orthotics, braces, or inserts that compliment your natural foot shape.

“Claw toe”, “hammer toe”, and “mallet toe” may all sound like superpowers or martial arts moves, but they are, in fact, very painful medical conditions. Each of these deformities is named due to the unnatural appearance of the toe when it permanently curls upwards. A claw toe refers to bending at the first joint (closest to foot), a hammer toe refers to the middle joint, and a mallet toe, the third joint. All three conditions are associated with bunions and calluses as they cause the toes to dig into the soles of shoes.

Hammer, claw, and mallet toe usually occur after wearing poorly fitting shoes that force the toes into unnatural positions. High heels are often culprits, as well as shoes that are too narrow or too short. When the toes are held in an unnatural position for too long, the muscles of the toes shrink to facilitate this new position. When the foot is freed from the confines of the shoe, it is sometimes too late. The toes become malformed; sometimes permanently. However, there are available treatments, therapies and surgeries that can ease the pain and possibly even correct the deformity.

Hammer toe treatments, claw toe treatments, and mallet toe treatments are all very similar in nature. The following remedies are often applied for treatment. However, it is imperative that you consult a podiatrist such as Dr. Schilero to determine the best course of action for you.

• Get rid of the footwear that caused the issue and wear shoes with wider and longer toe boxes.
• Wear inserts or insoles to relieve pressure on the affected toe.
• Use pads or gel shields inside the shoe in order to protect any joints that are rubbing.
• Use toe splints or toe crests (after consulting a physician)
• Twice daily, stretch your toes down into normal position, holding them in place, one at a time.
• Place a towel or cloth under your foot and use your toes to pick them up. Repeat.
• If these treatments do not help the problem, surgery may be required.

If you believe you may have hammer, claw, or mallet toe, consult Dr. John Schilero immediately and curb the problem before your condition has deteriorated past the point of no return.

Let’s face it, it’s a topic no one likes to discuss, but that ugly, aching, embarrassing fungus on your toes is a real issue. Toenail fungus effects so many of us, yet the general population fears discussion of such a sensitive topic. As the problem persists, many choose to hide their toenails, rather than facing the embarrassment of finding a West Palm Beach foot doctor to treat the infection. Onychomycosis is fungus infection of the toenail is one of the most common dermatologic disorders affecting the foot.

While proper hygiene and regular inspection of toes and feet is critical to preventing an infection, there a variety of factors that make people more susceptible to incurring a toenail fungus:

• Excessive Sweating

• Nail Bed Injury

• Athlete’s Foot

• Circulation Issues

• Footwear Distress

• Diabetes

• Immune-deficiency Illnesses

One of the fastest growing methods of curtailing toenail fungus is most certainly laser treatment. Using a laser, patients will see vast improvements with no pain. In the first year, 88% of the treated patients grew out a normal looking nail after one treatment. If you are dealing with embarrassing toenail fungus, call Dr. Schilero today to learn more about laser treatment.

It’s one of the most bothersome injuries to endure; yet for some reason, most of us tend to ignore our ankle sprains. “It’s not that bad”, “I’ll keep running, and it will heal eventually”, or the most common, “oh don’t worry, it’s just an ankle sprain”, are phrases we hear all too often, especially in the sports world. The truth of the matter, however, is that ankle sprains cannot be taken too lightly. Not only will improper care impede healing, it may prolong or even worsen the injury.

An ankle sprain occurs when one or more ligaments are stretched or torn from excessive force such as a sudden twisting during sports, stepping on an uneven surface, or a blow to the ankle. Ligaments are fibrous bands of tissue that provide stability to the joint. Without that stability, walking becomes much more difficult or even impossible depending upon the degree of severity. The bottom line is that ankle sprains are injuries that must be given proper attention.

Athletes have a tendency to ignore ankle sprains, chalking them up to some sort of minor injury that will just “go away” eventually. Unfortunately, the body does not operate in that manner. Without proper rest, ice, compression, and elevation (RICE), rehabilitation becomes much more difficult. In fact, Derrick Rose of the Chicago Bulls is a perfect example of how serious ankle sprains can be.

Rose has sat for 23 games so far this season, leaving his Bulls to win games without their star MVP. Rose’s ankle sprain has kept him off of the court for quite some time, pointing to the critical nature of this injury and how far-reaching the effects can be. If you have had a recent ankle sprain, contact Dr. Schilero and get a path to quicker healing.

The stretching or inflammation of the posterior tibial tendon causes posterior tibial tendon dysfunction (PTTD), also known as adult acquired flatfoot. This tendon runs along the inner calf, down into the inside of the foot. Left untreated, this condition could worsen until mobility is too painful to bear. As the tendon takes constant pounding and stretching, it lengthens and becomes enflamed. Without the support on the inside of the foot, normal gait is compromised. When walking form is altered, stress is placed on other ligaments and tendons that are not accustomed to the increased load. Therefore, PTTD often results in secondary knee, ankle and foot injuries if not treated.

Here are the indicators:

1. One or both of your ankles are rolling inwards.
2. Your arch is gradually flattening over time.
3. Your arch suddenly disappeared after trauma to the area.
4. There is inflammation around your foot and ankle.
5. Standing on your tiptoes cause you pain.
6. Bearing weight causes pain in your medial (inner) ankle.
7. Side to side movement of your foot causes you pain.
8. Dorsiflexion (moving toes towards shin) is difficult or impossible.
9. You pass the too many toes test.
   1. Place someone directly behind you while you stand straight up and in your natural, comfortable stance. If your toes are protruding to the outside and are visible from behind, then you may have PTTD.
10.  Pain on the outside of the foot and ankle.

Be sure to have this condition treated quickly and effectively. If left alone, PTTD could eventually cause arthritis and leave you immobile. Dr. Schilero recommends orthotic devices for shoes, use of a cast, splint, or brace, physical therapy, and anti-inflammatory medications for mild to moderate cases of PTTD. Thankfully, 90% of orthotics users see improvement in foot and ankle alignment and symptoms. Fully torn posterior tibial tendons sometimes require surgery in order to repair.

*Women are 3 times more likely to be diagnosed with PTTD

*There are three stages of PTTD:

1. PTTD with no tear
2. PTTD with partial tear
3. PTTD with full tear

Unfortunately, ankle sprains are among the most frequent sports injuries, commonly reoccurring time and time again. In fact, on a yearly basis there are over 850,000 ankle sprains. While these injuries vary in degree, ankle sprains have the potentially to drastically affect one’s ability to perform daily activities. Ankle sprains account for 85% of the approximate 1 million ankle injuries each year. With that said, let’s take a look at the three degrees of ankle sprains based upon the severity of the injury.

First Degree Ankle Sprain
In a first degree ankle sprain, one or more of the ligaments in the ankle are stretched. One will feel mild pain, difficulty walking, and quite a bit of tenderness. In addition, bruising and inflammation will be noticeable. Also be aware of potential joint stiffness and slight joint instability. While first degree ankle sprains are the most minor form of ankle spraining, proper care is essential to timely and adequate healing

Second Degree Ankle Sprain
Second degree ankle sprains are the most frequently seen type of injury. In this case, one or more of the ligaments in the ankle is partially torn. As such, the ankle cannot bear much, if any, weight. Pain will be moderate and patients will notice significant disability, bruising, and inflammation. The excess of swelling is often the first sign that a second degree ankle sprain has occurred.

Third Degree Ankle Sprain
In the case of a third degree ankle sprain, one or more the ligaments are completely torn. Loss of function and joint instability ensues, causing severe pain and swelling. In addition, the extreme loss of motion commonly calls for some form of physical therapy to complete the healing process.

Regardless of the degree of your ankle sprain, Dr. Schilero has the technology and tools to get you on the quickest road to recovery. Call us today to learn more!

Foot, ankle, and lower leg pain affect countless individuals across the world. For many, surgery is too costly to pursue. However, many note that they would be willing to pay for a less invasive method of pain relief. Introducing WellWave and the Acoustic Compression Therapy (ACT). This targeted, non-invasive pain relief is one of the leading mechanical stimuli helping to alleviate and, in some cases, even stop the pain completely. The acoustic waves that are produced by the WellWave connect at a point deep within the soft tissue to produce an intense, extremely short direction compression burst. Following the burst, a force is released to the surrounding tissue, much like a deep tissue massage.

The results of using Acoustic Compression Therapy speak for themselves. The targeting option given to healthcare professionals allows them to heal with unmatched precision. Using this tool, Dr. Schilero is able to positively influence cellular form and function. This influence breeds improved circulation and a substantial reduction in pain.

The benefits of using Acoustic Compression Therapy are vast. Taking a look at some of the most prominent advantages to using this treatment for foot, ankle, and lower leg pain relief reveals just how powerful this machinery can be. Chronic pain in the foot, ankle, and lower leg can hinder almost every aspect of daily activity. WellWave’s ACT has the capacity to improve range of motion, circulation, muscle tightness, and overall healing.

Further, using ACT, Dr. Schilero is able to get his patients back to their normal daily activities quicker than ever before. Patients have a significant role in the healing process, as they are referenced to pinpoint the source of the pained areas.

Dr. Schilero is on the cutting-edge of the latest trends and technology in foot, ankle, and lower leg healing. Call today for a free consultation!

Dr. Schilero was featured in the Palm Beach Post article below. Thank you to the author, Greg Stoda.

There’s uncertainty, more than ever.

Nothing that Tiger Woods tweeted Monday night changes an increasingly undeniable element of his career.

It’s fine to take Woods at his word when he says he “got good news from doc” that he has only a “mild strain” of the left Achilles tendon. Anyone who enjoys golf – and, please, spare me any referendum on Woods himself – should hope for the best for him in terms of health, because the sport matters more when he plays.

But the questions presenting themselves with more and more regularity are these: How much time does the still-iconic Woods, who has had multiple knee surgeries and previous Achilles problems, have remaining as a meaningful competitor? Does the 36-year-old superstar see a smaller window of opportunity for himself than he’d ever admit?

Woods was in enough distress from the Achilles pain Sunday afternoon to withdraw from the final round of the WGC-Cadillac Championship and drive away from Doral in a Mercedes-Benz as black as his mood.

He had ripped a 321-yard drive off the 12th tee, waited for playing partner Webb Simpson to take his turn and then quit. Simpson’s caddie, Paul Tesori, later said Woods had been “hobbling” since the fourth hole. He added that Woods’ caddie, Joe LaCava, had said the Achilles was “puffed up and swollen.”

These are known as warning signs for someone who has had recent injury issues, as Woods has had.

But he’s hoping to play in the Arnold Palmer Invitational in eight days with the goal of including another tournament of prep work before The Masters next month.

Woods now faces the nasty potential trap of either damaging himself physically by playing too much or damaging his chances of victory by not playing often enough.

Dr. John Schilero, a foot and ankle surgeon with the Palm Beach Orthopaedic Institute, understands Woods’ dilemma.

“It’s the overuse syndrome,” Schilero said. “I deal with it on a regular basis with many of my patients. If it is just a strain, rest is best. A week is good; a month is better. But with any pain of this kind – plantar fasciitis or tennis elbow, for example – what usually occurs is the athlete will begin to feel better, or not feel as injured, and return to the activity before he should.

“In Tiger’s case, he at least benefits from the injury not being on the propulsive leg – the one that supplies most of the power on his golf swing. He’d be more likely to abbreviate the finish than do anything else in an effort to reduce the pain he knows he’s going to feel.”

Tesori, in fact, said Woods appeared to have “flinched” when hitting what turned out to be his final drive Sunday.

Schilero said he thought Woods was prudent to be “cautious” in withdrawing from the tournament. He wasn’t inclined to give advice as to what he thinks Woods should do next other than to rest as much as possible.

“I’m sure he’s getting around-the-clock treatment and the best therapies available,” Schilero said. “But the temptation is the same, maybe greater, for him – he wants to get back to playing. And it’s the repetitive strain that causes the overuse syndrome.

“He’s the one who has to decide what (pain) he can tolerate, if it comes to that.”

As part of Woods’ tweet from Monday, he said: “Can resume hitting balls late in week and hopeful for next week.”

There’s no telling how much the choices Woods makes regarding Bay Hill and/or The Masters might be influenced by some sense of urgency. He already has missed large and precious chunks of time from the prime of his career because of injury.

Once considered a lock to break Jack Nicklaus’ record of 18 victories in major championships, Woods has been stuck at 14 for almost three years. It’s why words from Woods’ former swing coach, Hank Haney, in a soon-to-be-released book The Big Miss – seem to carry more than a little weight.

An excerpt includes a passage indicating that Haney’s work with Woods became less enjoyable in 2007 when ” Tiger was more irritable and impatient he began to be much more concerned about results he never mentioned Nicklaus’ record, but it started to weigh more heavily at every major. And Tiger’s actions indicated he believed he had less time to do it than everyone else thought.”

Uncertainty reigns.