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Doctors Recognized for Sports Medicine Care

Congratulations to 9 of our doctors, who were declared the “Best of Washington” in the June 2018 issue of Washingtonian Magazine! Each year, the magazine sends out a survey to doctors in the Maryland, Virginia, and DC region to vote for their peers, which results in their Top Docs list. The doctors featured in the June “Best of Washington” issue were compiled from their annual Top Docs list and emphasized which doctors to turn to if you’re facing a sports-related injury. The following doctors have been named to the list of the DC area’s Top Docs for Sports Medicine Care:

Sports Medicine Care

Ian Beiser, DPM

Man Cho, DPM

Lee Firestone, DPM

Eric Masternick, DPM

Gene Mirkin, DPM

Howard Osterman, DPM

Seth Rubenstein, DPM

Erika Schwartz, DPM

Adam Spector, DPM

  Thank you to our patients who entrust us with your care, and to our professional colleagues for their continued and generous vote of confidence.

Fall Risk in Older Adults

Fall Prevention

Fall prevention is not a sexy topic but as we get older (> 60 years of age) physical changes, health conditions and medications can make falls more likely. Stepping on a crack and breaking your mother’s back, is an old childhood game that we didn’t take too seriously.  Something we should take seriously: the 1 year mortality rate for seniors over the age of 60 after a hip fracture is between 14 - 58%. Therefore fall risk prevention is of utmost importance.  

Footwear Style and Risk of Falls in Older Adults

The results of a study reported in the Journal of the American Geriatrics Society 16 August 2004 showed that athletic and canvas shoes (sneakers) were the styles of footwear associated with lowest risk of a fall. Going barefoot or in stocking feet was associated with sharply increased risk. Relative to athletic/canvas shoes, other footwear was associated with a greater likelihood of falling, varying somewhat by style. What this means: Contrary to findings from gait‐laboratory studies, athletic shoes were associated with relatively low risk of a fall in older adults during everyday activities. Fall risk was markedly increased when participants were not wearing shoes.

Fall‐Risk Assessment and Management in Clinical Practice: Views from Healthcare Providers

Another study reported in the same edition of the Journal of the American Geriatric Society from the August 16, 2004 revealed the following: healthcare providers were most likely to report directly intervening with or referring older patients for gait and transfer impairments and balance disturbances and least likely to do so when encountering foot or footwear problems and sensory or perceptive deficits. Patient compliance was the most commonly reported barrier to successful direct intervention across several risk factors, whereas inadequate availability of other healthcare providers and lack of Medicare reimbursement were the most commonly reported barriers to successful patient referrals. What this means: see your podiatrist for foot or footwear problems and any problems with numbness or loss of balance as these are the key areas that are being overlooked by other health providers.  

Begin Fall Prevention now:

  1. Make an appointment with your Podiatrist for Fall Risk Assessment: (bring with you the following information)
    • Medications - that make you tired or affect your thinking
    • Previous falls - have you fallen before, near misses where you caught yourself or someone else caught you
    • Health - dizziness, joint pain, shortness of breath or numbness in feet and/or legs, loss of balance, weakness
  2. Physical activity
    • Develop a walking, water workouts, tai chi program in conjunction with your podiatrist and physical therapist.
  3. Appropriate shoes
    • Wear shoes with firm non-skid, non-friction soles.
    • Avoid wearing loose-fitting slippers that could cause you to trip.
    • Do not walk around barefoot or in your stocking feet. Your podiatrist will help you select or will prescribe appropriate shoes that will not add to your fall risk
  4. Remove hazards to make your home safer
    • Remove loose items from walkways, move furniture like coffee tables
    • Secure loose floor coverings, repair loose flooring, store things you use regularly in an easy to reach place
    • Immediately clean spills
    • Use non-slip mats in bath or shower
    • Do not take chances! Stay away from a freshly washed floor. Never stand on a chair or table to reach something that is too high.
  5. Keep your living space well lit.
  6. If your doctor suggests that you use a cane or a walker to help you walk, please use it! This will give you extra stability when walking and may help you avoid a bad fall. Use assistive devices and get help learning to use them.
  7. Do not use stairs without rails on both sides for support. If you must carry something while you are going up or down, hold it in one hand and use the handrail with the other.
  8. Know your limitations.
  9. See your physician if you have dizzy spells or fainting spells; see your eye doctor at least once a year and have your hearing tested too.
  10. When you get out of bed in the morning or at night to use the bathroom, sit on the side of the bed for a few minutes before standing up. Moving too quickly can make you dizzy, and you might lose your balance and fall. If your feet are numb from neuropathy they don’t know where they are so turn on the lights and look them onto the floor.

What to do if you fall

If you fall at home, remember:

  • Step 1. Stay quiet for a moment — don’t panic
  • Step 2. Decide whether or not to try to get up.

If you decide to try to get up:

  • Step 1. Use strong, stable furniture for support as you try to get up.
  • Step 2. Take some time to recover from your fall after you get up.
  • Step 3. Tell someone that you had a fall.
  • Step 4. Get medical advice if necessary.

If you cannot get up, or if you decide not to try:

  • Step 1: Slide or crawl to get help if you can. You might be able to reach one of the following:
      • Telephone
      • Door to the outside
      • Personal alarm device
      • Something to make a loud noise
  • Step 2: Tell someone you have fallen and need help.
  • Step 3: After calling for help, lie quietly until help arrives. Keep as warm and comfortable as you can.
  • Step 4: Get medical advice if necessary.
  Foot and Ankle Surgeon Dr. Gregoy SmithDr. Gregory Smith works in two offices for your convenience-- Gettysburg, PA and Hagerstown, MD. The information on this site is provided for your assistance only; this site does not provide podiatric advice. You should never diagnose or treat yourself for a podiatric condition based on the information provided herein, and the information is not provided for that purpose. Likewise, you should never determine that treatment is unnecessary based on this information. The information contained herein is not a substitute for podiatric care provided by a licensed podiatric professional. The information provided herein is not podiatric, medical or professional advice. This site does not create a doctor-patient relationship. Dr. Gregory Smith and Foot & Ankle Specialists of the Mid-Atlantic, LLC expressly disclaims all warranties of any kind, whether express or implied, related to any products offered for sale on this web site. Dr. Gregory Smith and Foot & Ankle Specialists of the Mid-Atlantic, LLC further expressly disclaims any product warranties of effectiveness or fitness for any particular purpose or use. You are solely responsible for your use of, or reliance on, any products offered for sale herein, and any consequences arising out of such use or reliance. In no event will Dr. Gregory Smith and Foot & Ankle Specialists of the Mid-Atlantic, LLC be liable for any damages resulting from use of or reliance on any such products, whether based on warranty, contract, tort or any other legal theory. This website, and the information contained herein, is provided to you as a service for use at your sole risk.

Which Way’s the Beach, Bro?

We made it to June!  Can you smell the summer warmth in the air? With the summer, comes dreams of sitting by the pool, going to the beach, outdoor hikes, and long bike rides. June also happens to be Men’s Health Month! The purpose is to create awareness of preventable health problems and injuries among men and boys and encourage them to seek regular medical advice and early treatment. It is well established that males typically have less flexibility than females. Testosterone, a male sex hormone, plays a pivotal role in muscle size and flexibility. It increases the size and mass of muscles on the skeleton. This means that men are going to naturally be “tighter.” This muscle tightness and limited flexibility can lead to lack of normal range of motion at certain joints, inability of tendons to stretch to their full capacity, and lead to injury. Every year, as winter comes to an end, the weight room fills up with men dreaming of, and working toward, their perfect beach bodies. As your muscles get bulkier and more toned, the tendons attached to those muscles become less flexible.   In the lower extremity, the most common muscle tightness that we see is in the calf muscle. The calf is made up of 2 muscles, the gastrocnemius and the soleus. These muscles combine to form the Achilles tendon. This muscle group spans from above the knee, where the gastrocnemius starts, and ends at the Achilles insertion on the back of the heel bone. This muscle group controls almost all of the range of motion at the ankle and secondarily controls the motion of the foot. During walking, running or jumping, the calf muscle pulls the heel up to allow forward movement. As a foot and ankle specialist whose majority of the day is spent treating sports injuries, I can say that almost all of the injuries and chronic conditions that I treat stem from lack of flexibility in the calf and Achilles tendon.   When the calf and Achilles tendon are tight, motion at the ankle is restricted and it causes our foot to naturally compensate for this by overpronating. This leads to increased flexibility in the other small joints of the foot that shouldn’t normally have that amount of range of motion. If these compensations persist, it can lead to injury. The common injuries I see that stem from a tight calf and Achilles tendon in men and boys are:
  • Calf strain
  • Achilles tendinitis
  • Peroneal tendinitis
  • Plantar fasciitis
  • Calcaneal apophysitis (Sever’s disease)
  • Metatarsalagia
  • Sesamoiditis
  We are all victims of not taking enough time to stretch-- but men especially. Stretching to maintain the flexibility in the joints and tendons is the key to preventing injuries.  Stretching before, but more importantly, AFTER exercise can go a long way.   Shown below are my favorite stretching exercises to get into the habit of doing.         Foot and Ankle Surgeon Dr. Erin Robles-ShermanDr. Erin Robles-Sherman works in two offices for your convenience-- Washington, DC (K Street) and Chevy Chase, MD. The information on this site is provided for your assistance only; this site does not provide podiatric advice. You should never diagnose or treat yourself for a podiatric condition based on the information provided herein, and the information is not provided for that purpose. Likewise, you should never determine that treatment is unnecessary based on this information. The information contained herein is not a substitute for podiatric care provided by a licensed podiatric professional. The information provided herein is not podiatric, medical or professional advice. This site does not create a doctor-patient relationship. Dr. Erin Robles-Sherman and Foot & Ankle Specialists of the Mid-Atlantic, LLC expressly disclaims all warranties of any kind, whether express or implied, related to any products offered for sale on this web site. Dr. Erin Robles-Sherman and Foot & Ankle Specialists of the Mid-Atlantic, LLC further expressly disclaims any product warranties of effectiveness or fitness for any particular purpose or use. You are solely responsible for your use of, or reliance on, any products offered for sale herein, and any consequences arising out of such use or reliance. In no event will Dr. Erin Robles-Sherman and Foot & Ankle Specialists of the Mid-Atlantic, LLC be liable for any damages resulting from use of or reliance on any such products, whether based on warranty, contract, tort or any other legal theory. This website, and the information contained herein, is provided to you as a service for use at your sole risk.