Running local races? Keep your feet healthy

Runners keep a steady pace while running down McHenry Street during the 2023 Illinois Marathon. From buying new shoes regularly to stretching ankles and toes, foot self-care is key to improving competitive performance.

Photo: Sentinel/Clark Brooks

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StatePoint Media - Whether you’re a novice jogger embarking on a couch-to-5K program or a marathoner serious about racking up finishers’ medals, it’s critical you take great care of your feet.

“Running is an amazing form of cardiovascular exercise, but because it’s a high-impact sport that involves repeated trauma to the feet, everyone from long-distance runners to casual joggers is at risk for developing painful and debilitating foot conditions,” says Bryce A. Paschold, DPM, FACFAS, a board-certified foot and ankle surgeon and a Fellow Member of the American College of Foot and Ankle Surgeons (ACFAS).

To help you identify signs of some of the more common foot issues associated with running so you can get proper treatment before the condition keeps you from the activity you love, the foot and ankle surgeon members of ACFAS are offering the following insights:

• Plantar Fasciitis: Plantar fasciitis is perhaps the most common complaint from runners. Presenting as heel pain, it’s caused by inflammation of the ligament that holds up the arch. At the first sign of heel pain, Dr. Paschold advises runners to stretch the calf, wear sturdier shoes and use arch supports. In some cases, icing and anti-inflammatory medications, such as ibuprofen, are helpful. Should pain continue, visit a foot and ankle surgeon, who might recommend custom orthotics, injections and physical therapy.

• Neuromas: A neuroma is a pinched nerve between the toes that can cause pain, numbness and a burning sensation in the ball of the foot. Overly flexible shoes are often the cause, and padding, orthotics or injections are usually effective treatments.

• Tendonitis: Runners can be sidelined with tendonitis if they ignore the warning signs of this overuse condition. There are several forms of tendonitis that affect the Achilles and other areas, and all are treated with rest, icing, strengthening, stretching and anti-inflammatory medications, and sometimes with orthotics and physical therapy. Because overzealous training is usually the cause, especially among beginners, it’s important to ramp up mileage and speed gradually. A running coach can tailor your training plan to your current fitness level.

• Broken bones: Don’t assume that because you’re able to run, your foot is not fractured. Signs of a stress fracture can include pain, swelling, redness and possibly bruising. If a fracture is suspected, remember to practice RICE (Rest, Ice, Compression and Elevation). You should also see a foot and ankle surgeon for an X-ray and proper diagnosis. Remember that like with other overuse injuries, stress fractures are often brought on by trying to do too much too soon. A general rule of thumb is to increase mileage by no more than 10 percent week to week.

• Lisfranc injuries: One misstep can lead to a sprain, fracture or dislocation of the Lisfranc joint. Consider wearing a headlamp in low lighting for surer footing. It is also a good idea to incorporate exercises into your regimen that will keep ankles and feet mobile and strong.

“While completing a marathon or even longer distance race may seem like the ultimate goal, it’s wise for new runners to start with shorter races first. This conservative approach will keep your feet in good shape so you’re able to run pain-free for years to come,” says Dr. Paschold. “And of course, it’s vital to listen to your body and seek care from a foot and ankle surgeon whenever a foot problem is suspected.”

For more information on foot care or to find a foot and ankle surgeon near you, visit FootHealthFacts.org, the patient education website of the American College of Foot and Ankle Surgeons.

4 steps to take after getting a tooth knocked out

Photo provided

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StatePoint Media - A survey from the American Association of Endodontists (AAE) shows that nearly a third of adults say they fear getting a tooth knocked out more than breaking a bone or tearing a muscle, and more than a third say they avoided sports for fear of getting their teeth knocked out.

“While knocking out a tooth can have devastating effects on your smile and oral health, proper actions can help save the tooth so that it can be replanted successfully and last for years to come,” says Dr. Craig S. Hirschberg, president, AAE.

Not everyone knows what to do in the event of a knocked-out tooth. That’s why the American Association of Endodontists and the International Association of Dental Traumatology (IADT) are encouraging everybody to review and remember these steps to take that may help increase the chances of saving the tooth.

1. Locate the tooth immediately; don’t leave it at the site of the accident. Pick it up by the crown (the chewing surface), not the root, and handle it carefully. To minimize injury to the root, touch only the crown. If the tooth is dirty, gently rinse it with water only.

2. Insert the tooth back into its socket immediately, if possible. The sooner the tooth is back in its socket, the greater the likelihood it will survive. To insert the tooth, gently push the tooth into the socket with your fingers. Hold the tooth in place with your fingers or have the injured person gently bite down on it. A gauze can be used to bite on as well.

3. Keep the tooth moist at all times. The tooth must not be left outside the mouth to dry. If it cannot be placed back in the socket, place the tooth in an emergency tooth preservation kit or milk. If none of these options are practical, use water.

4. Seek professional help immediately: Dial 911 if there are other injuries to tend to. You may wish to see an endodontist or the nearest available dentist within 30 minutes or as quickly as possible. Endodontists often are available on short notice, and they are specialists who have completed an additional two or more years of training beyond dental school. Their advanced training makes them ideally suited to save a knocked-out tooth in many cases.

To learn more about the safe and effective treatment for a knocked-out tooth, and to locate AAE member endodontists in your area, who are dedicated to the highest standards of excellence in endodontic care, visit findmyendodontist.com. To locate IADT member dentists, who are experts in the treatment of knocked-out teeth and other dental injuries, visit https://www.iadt-dentaltrauma.org/member-list.html.

In fact, when it comes to learning more about knocked out teeth, did you know there is an app for that? The IADT recommends downloading its ToothSOS app, which provides information for both patients and professionals in the event of traumatic tooth injury. For patients, the app provides easy to understand emergency steps to take in all dental injuries. Find it in the Apple App Store and Google Play.

Additional information in graphic form for free download is available in a “Save-a-Tooth” poster at https://www.iadt-dentaltrauma.org/for-patients.html. The poster, suitable for posting in schools, sports venues and other sites, is available with translation into more than 60 languages.

“Whether it’s due to an accident or a sports injury, knocking out a tooth doesn’t necessarily mean your tooth is lost for good. Taking the right steps at the right time can save your tooth,” says Dr. Liran Levin, president, IADT.

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Commentary |Could tackle football become a thing of the past? Flag football gaining popularity

by Josh Woods
Professor of Sociology, West Virginia University

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One hundred years into the future, what if millions of people gathered every February, not to watch the Super Bowl, but to instead watch the annual world flag football championship?

Once a casual activity played at family reunions, the competitive sport of flag football is “soaring,” “exploding” and “skyrocketing in popularity nationwide,” according to mainstream news outlets.

The number of kids playing flag football has risen dramatically over the past nine years.

Photo: Joshua Choate/Pixabay

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There’s some data behind the breathless headlines: According to the NFL’s official flag football program, since 2015 the number of kids ages 6 to 12 who play flag football has risen by 38%, to more than 1.5 million.

In my recent book, “Emerging Sports as Social Movements,” I explore nontraditional sports like flag football and disc golf. One of my key findings is that splashy headlines about trendy sports rarely capture a sport’s true reach and staying power.

For every sport like pickleball that gains widespread, sustained popularity, there are several – adventure racing, paintball and wakeboarding – that remain firmly ensconced in their niche.

In the case of flag football, there are a handful of recent trends that truly do point to a promising future. But there are also some red flags that could end up hampering its growth.

A fun, fast, safer alternative

Though its rules are similar to tackle football, flag football is currently gaining attention for what makes it different.

It’s considered a no-contact sport. A “tackle” involves snatching one of two flags that hang from the hips of the ball carrier. While players face injury risks, they sustain far fewer head impacts than athletes who play tackle football.

With the public’s concerns about brain injuries on the rise, many parents are opting for flag football instead of tackle for their kids.

Obscurity is a powerful barrier to emerging sports. But getting noticed may not be a problem for flag football.

The International Olympic Committee announced in October 2023 that flag football would be headed to the Summer Games in Los Angeles in 2028. It’s not clear yet if active NFL players can compete, but if they are eligible – and if the U.S. assembles a “Dream Team” like the Olympic men’s basketball team of 1992 that included superstars Michael Jordan, Larry Bird and Magic Johnson – flag football could get on the radar of millions of casual sports fans in 2028.

The Olympic version of flag football is fast-paced

Games are shorter than a typical game of tackle football. Five players compete on 50-yard fields with 10-yard end zones for two 20-minute halves. This format made its first big appearance in the 2022 World Games in Birmingham, Alabama, where the U.S. men won gold and the women took home silver.

The NFL cultivates the grassroots

Although it may come as a surprise, the NFL is embracing flag football and taking its growth seriously.

In 2021, the NFL and Nike committed US$5 million in equipment to support high school flag football teams across the nation. The NFL’s official flag football program operates more than 1,600 local leagues and receives sponsorships from top brands like Visa, Gatorade and Subway.

Most NFL teams are currently supporting the grassroots of flag football with summer camps, clinics and regional tournaments.

During last year’s Super Bowl, an estimated 115 million viewers watched a flag football TV commercial featuring Mexican quarterback Diana Flores bobbing and spinning to evade NFL players and celebrities as they attempted to take her flag.

On Feb. 4, 2024, the Pro Bowl – the NFL’s annual all-star game – sidelined tackle football for the second year in a row. In its place was a 7-on-7 flag football game that aired on ESPN and ABC and streamed on ESPN+.

Prior to that game, on Feb. 2-3, the league also hosted the International NFL Flag Championships as part of the Pro Bowl Games, featuring young athletes from 12 countries.

By the numbers

Flag football may be having a moment, but the question remains: Is the sport actually experiencing a meaningful surge in participation that could extend into the future?

According to figures collected annually by the National Federation of High Schools, 21,980 students played high school flag football in 2023. To put this number in context, however, tackle football attracted 47 times more students – roughly 1 million players – the same year. Track and field, basketball and soccer have roughly 1 million participants apiece.

Interest in flag football seems to be concentrated in a few regions, with roughly 80% of high school players living in just three states: Florida, Georgia and New York.

Though high school participation in flag football has increased steadily since 2007, almost all the growth comes from the girls’ side.

A nationwide sports participation survey finds that the number of casual players of flag football is up, but core participation is down. The study defines “casual players” as those who play fewer than 50 times per year, whereas “core players” participate 50 or more times each year.

The share of Americans who play casually increased by 41% between 2016 and 2022. But core participation declined by 13% during this period.

For sustainable growth, nontraditional sports need to generate excitement among both core and casual players. Top-down investments and marketing strategies may attract new players, but grassroots organizing keeps them coming back.

Take pickleball. In recent years, the sport has generated plenty of cultural clout, with high-profile athletes like LeBron James investing in the professional circuit, and celebrity pickleball players making headlines. There has also been tremendous growth in pickleball’s social and physical infrastructure. For these reasons, both casual and core participation in pickleball more than doubled between 2016 and 2022.

Red sport, blue sport

In the end, the future of flag football may hinge on the public debate over tackle football’s safety. Over the past decade, several studies have found a link between repeated head impacts and the risk for serious brain injuries, including chronic traumatic encephalopathy, or CTE.

Photo: Ty Swartz/Pixabay

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Yet recent efforts to make tackle football safer for young athletes have been met with fierce resistance from families, fans and organizers. In many regions of the U.S., tackle football is deeply ingrained in the culture, leading to strong opposition to any changes.

New rules to protect NFL players have seeped into mainstream politics. For instance, in 2019, former President Donald Trump dubbed the NFL’s concussion protocol “soft” and said that safety measures were “ruining the game.”

Meanwhile, Democratic state lawmakers in New York, Illinois and California have introduced bills to ban tackle football for kids under 12, often citing flag football as a suitable alternative. None of these bills, however, have passed.

Some research shows that Democrats are more likely to trust concussion science than Republicans. Democrats also pay more attention to news about concussions than Republicans.

As beliefs about the dangers of tackle football become polarized, the perceived benefits of flag football will likely follow suit. As I showed in a recent study of sport popularity in 207 areas of the U.S., flag football is more popular in regions that tend to vote Democratic, with tackle football more popular in Republican areas.

So in addition to going after the resources needed for sustainable growth – investment, organization, visibility, legitimacy – flag football’s advocates will also need to navigate a nation divided by politics.

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Josh Woods, Professor of Sociology, West Virginia University This article is republished from The Conversation under a Creative Commons license. Read the original article.

Ready to play pickleball? Check the lights on the dashboard

Photo: Brendan Sapp/Unsplash

by Tim Ditman
OSF Healthcare

The popularity of Pickleball, the tennis-like sport that made a comeback in 2023, continues to grow, attracting older adults who want to enjoy a low-impact physical activity with family and friends. But as people flock to the courts for a fun workout and social interaction, healthcare experts are taking notice of an unintended consequence.

A recent report from financial services company UBS says pickleball injuries could cost Americans $250-$500 million in medical costs in 2023.

While the news shouldn’t scare older adults away from physical activity, it’s a reminder that people in their golden years need to take greater care during workouts than their younger counterparts, says James Murphy, MD, an OSF HealthCare orthopedic surgeon.

"We’re not all sixteen years old anymore," Dr. Murphy says with a smile.

Pickleball basics

Dr. Murphy says racket sports like pickleball involve a lot of side-to-side movement, bending and arm swings. Injuries like tendonitis, bone fractures in the wrist or hip, muscle tears and strains and even concussions can follow.

Before picking up pickleball or another sport as a hobby, older adults need to check the lights on the dashboard, so to speak.

"You want to see your internal medicine physician. Make sure your heart and everything else are good for strenuous activity," Dr. Murphy says.

People with a bad back or shoulder should also consider skipping the hard workout. If your health care provider advises so, try another, less taxing sport like golf. Or just take a walk around the neighborhood.

On game day, a good warm-up is a must, Dr. Murphy says. Gone are the recommendations for static stretches like touching your toes. Instead, look into dynamic warm-ups. You’ll see high school and college athletes take this approach in the minutes before a game.

"They’ll do a series of movements," Dr. Murphy explains. "Skipping-type exercises. Twisting exercises.

"The idea is you’re firing all your muscle groups. Getting the blood flowing to those muscles so they’re not more prone to injury when you start to compete."

Wear proper clothing, too. A knee or ankle brace may be part of the attire, as advised by a provider.

And then remember - it’s a game. You’re there to have fun.

"Going for every point like it’s the final at Wimbledon isn’t a good idea," Dr. Murphy jokes.

"It’s meant to be for exercise and enjoyment. There’s nothing less enjoyable than a torn Achilles tendon or a low back strain," he adds.

After-care

After a pickleball game, Dr. Murphy advises not to jump right in the car. Take a short walk as a cool-down.

If you are injured, go to an urgent care for minor things like abrasions, strains and sprains. A call to 9-1-1 is needed for more serious concerns: chest pain, shortness of breath, a head or eye injury, a broken bone, a dislocated joint, a major wound or sudden dizziness, weakness or loss or balance. Choose an ambulance over driving yourself to the hospital. Seconds matter, and the ambulance can begin treating you at the scene.

"Don’t ignore things," Dr. Murphy advises.

"If you tweak your shoulder playing pickleball, get it checked out. There’s no reason not to. Get a quick X-ray and physical exam. Doctors can tell you, ‘you just strained a muscle group’ or it might be more serious. But you want to know before you do more damage by continuing to participate."

Your provider will come up with a treatment and recovery plan. Dr. Murphy says you may be back on the court in a week or several months depending on the ailment. But don’t push yourself to return and risk re-injury.

About that injury report

Dr. Murphy is quick to point out an omission in the UBS report on pickleball medical costs. It’s one that drives home a key message like a shot to the opposite court.

"People who are active are saving millions of dollars in medical costs by not having diabetes, heart attacks or high blood pressure," Dr. Murphy says.

In other words: be mindful of injury risks, but stay active as you age.

Ankle sprains are not the same as strains, here's how they are different

Photo: PhotoNews Media

StatePoint Media -- As fall sports heat up for kids, so do 5Ks, marathons and golf tournaments for adults, leading to ankle sprains for athletes of all ages.

"Both serious athletes and weekend warriors often underestimate how serious a sprain can be, and they rush back into action without taking time to rehabilitate the injury properly," says Michael J. Cornelison, DPM, FACFAS, foot and ankle surgeon and president of the American College of Foot and Ankle Surgeons (ACFAS). "While no one enjoys being sidelined from the physical activities they love, quickly diagnosing and treating an ankle injury expedites the healing process. It also reduces the chances of long-term, chronic ankle pain."

To help people manage this painful injury properly, the American College of Foot and Ankle Surgeons is sharing some important insights and facts:

What is an ankle sprain? An ankle sprain is an injury to one or more ligaments, usually on the outside of the ankle. The severity depends on whether the ligament is stretched, partially torn or completely torn, as well as on the number of ligaments involved. Ankle sprains are not the same as strains, which affect muscles rather than ligaments.

What are the causes of ankle sprains? Sprained ankles often result from a fall, a sudden twist or a blow that forces the ankle joint out of its normal position. Sometimes ankle sprains occur because of congenital conditions or previous injuries.

"I always recommend that those who’ve suffered sprains and injuries in the past get their ankles checked for chronic instability as they start new fitness routines," says Dr. Cornelison.

Do ankle sprains require a doctor’s visit? Those with ankle injuries should see a foot and ankle surgeon any time there is bruising or the inability to bear weight on that foot. Receiving a correct diagnosis is essential as different injuries require different treatment. An examination can determine if there is a fracture — which involves a crack or break in the bones that form the ankle joint. It can also differentiate between a high ankle sprain and a lateral ankle sprain.

Can an athlete play through the pain? Whether training for a 5K or quarterbacking for a high school team, getting back in the game is often a patient’s top concern, and athletes may experience pressure from teammates and coaches to play through pain. But rehabilitation of a sprained ankle needs to begin right away. If rehabilitation is delayed, the injury may be less likely to heal properly, and may lead to chronic ankle instability, which is not only painful, but can increase the risk of additional ankle sprains down the line.

How are ankle sprains treated? Most ankle injuries require no surgical intervention, according to Dr. Cornelison, who stresses that foot and ankle surgeons will always choose the most conservative treatment for the best long-term outcomes. In addition to rest, ice, compression and elevation, (also known as RICE) doctors may also recommend physical therapy to promote healing and range of motion, as well as NSAIDs to reduce pain and inflammation. In more severe cases, or in cases where the injury was initially neglected, surgery may be required to repair the damaged ligaments. The foot and ankle surgeon will select the procedure best suited to the type and severity of the injury.

For more ankle sprain information and to find a foot and ankle surgeon near you, visit FootHealthFacts.org, the patient education website for the American College of Foot and Ankle Surgeons.