Query: Achilles Tendon Injuries from Pickle Ball
As pickle ball becomes extremely popular, I am seeing more patients with injuries relating to the sport. Besides the typical ankle sprains, I have recently seen three patients with Achilles tendon injuries. MRIs revealed partial longitudinal tears in the tendon on all three patients. While waiting to get their MRIs, I have been dispensing 1/2" heel lifts bilaterally for them to use until I get the diagnostic results. If I have a patient with an Achilles tear, I refer them out to other podiatrists or orthopedic surgeons for continued care. Being semi-retired, I cannot do the proper follow-up needed for treatment of this condition.
Normal conservative treatment would be a CAM walker with heel lifts that are gradually reduced in a timely manner. I would appreciate some advice with a treatment plan that my colleagues are using to treat their patients with this type of injury. Please include treatment plans, time intervals especially with follow-up MRIs, and criteria followed if surgical intervention is needed.
Jack Ressler, DPM, Delray Beach, FL
Query: Soccer Cleates for Young Children
I would like to hear my colleagues' opinions on the appropriateness of soccer cleats for younger kids (<6 years old). Do you feel these are necessary and more importantly, safe? I never played organized soccer and can't speak from experience, but at their light weight and limited strength and speed, I can't imagine traction is a huge problem for this age group, and being anchored to the ground could increase torsional strain on lower extremity joints.
Brad Shollenberger, DPM, Reading, PA
Query: Cross-Country Runner Using Spikes
What are the advantages and/or disadvantages of a 16 year-old male running cross-country on grass using spikes?
Martin E. Karns, DPM, Miami Beach, FL
Query: Source For Football Cleat
Are any readers aware of a football cleat that comes with a straight last and a rounded toe box?
Howard J. Bonenberger, DPM, Nashua, NH
Query: Do Runners Need Orthotics?
Dr. Nick Campitelli, a member of the medical advisory board for the Vibram Fivefinger shoes suggests that, instead of podiatrists using foot orthoses to treat running injuries, they should instead be instructing runners on proper running form, including using forefoot-striking running technique: Campitelli said, "In my practice, when runners bring up the question of what type of shoe they should be wearing, I explain that they first need to 'learn how to run.' Then footgear and orthotics become irrelevant."
I am interested in this rather unusual way to treat running injuries. How many podiatrists think that shoe selection and the presence or absence of proper foot orthoses are "irrelevant" in running injuries as does Dr. Campitelli? Certainly the scientific literature is very clear that foot orthoses not only change the kinetics and kinematics of running gait, but are also quite effective at treating many running injuries, a fact that Dr. Campitelli has conveniently omitted from his blog. How many podiatrists tell runners to change their gait from a heel-striking gait to a forefoot striking pattern when treating running injuries and think running shoe selection and foot orthoses are "irrelevant," as does Dr. Campitelli?
Kevin A. Kirby, DPM, Sacramento, CA
