Monday, August 24, 2009

Physical Education Precautions

Physical education classes are needed because of the more sedentary lifestyle of many children, but phys ed teachers and the students need to be aware of the potential for injury in physical education class. In fact, the incidence of injury has been rising - by 150% in 10 years (1997 to 2007). This statistic was gathered by the Center for Injury Research and Policy of The Research Institute at Nationwide Children’s Hospital.

In order to identify the frequency of injuries, researchers examined the types of injuries that occurred most often during PE class and the ages of the children involved. The study’s findings were published in the most recent online issue of the journal Pediatrics.

The injuries overall are:
23% – leg, knee, ankle and foot sprains and strains (lower extremity)
14% – fingers, hands, wrists, arms,
elbows and shoulders sprains and strains (upper extremity)
14% – fractures

While children from 5 to 10 years old had twice the chance of having a
head injury over any other, children from 11 to 14 years were the largest group represented, making up 52% of the injury numbers.

Which activities caused the most injuries?
While any physical activity may cause an injury, the most common ones, making up 70% of the injuries during PE were:


Interestingly, there was no difference between boys and girls in terms of the increase in injuries; both groups were equally affected.

Researchers point out that the goal of such studies is to make administrators and teachers aware of what injuries have the higher risks of causing injury, giving them an opportunity to be more vigilant and take safety precautions.

Article from:

Friday, August 21, 2009

Turf Toe Help!

Turf toe is a condition of pain at the base of the big toe, located at the ball of the foot. The condition is usually caused from either jamming the toe, or pushing off repeatedly when running or jumping. The most common complaint is pain at the base of the toe, but you may also have symptoms of stiffness and swelling.

The name turf toe comes from the fact that this injury is especially common among athletes who play on artificial turf. The hard surface of artificial turf, combined with running and jumping in football and soccer, make turf toe a frequent consequence of artificial turn play. There has also been some blame on athletic footwear. The more flexible shoes, especially used in competition, provides less support to the forefoot joints, possibly contributing to the prevalence of turf toe.

Visit our On-Line Store for the following product to help give comfort to your turf toe:

Dr. Jills "Turf Toe" Insoles 1/2 Steel
Doctor Recommended For The Treatment Of Turf Toe.
The steel acts as a means of partial immobilization of the big toe joint to prevent it from bending during walking and sports, thus hindering the healing process.

These insoles combine the benefits of a special spring steel insert with the cushioning of a padded top. Used to prevent and correct metatarsophalangeal joint pain and injuries.

Ideal for preventing turf toe and other foot problems requiring a rigid or semi-ridged foot bed.
Plates are constructed to limit Dorsiflexion at the MP joints.

Can be used for Hallux Limitus, Hallux Rigidus, Arthritis, Post operatively in everyday shoes to limit MP Dorsiflexion for examples; bunionectomy, fractured rays, and distal implants.

Thursday, August 20, 2009

A New School Year and H1N1

Below is important information from the CDC to assist you in keeping your child healthy during this new school year.

As you may know, flu can be easily spread from person to person, especially when students are close to each other in a school setting.

Here are a few things you can do to help (it's common sense, but it is always good to have a simple review now and then):

Teach your children to wash their hands often with soap and water or an alcohol-based hand rub. You can set a good example by doing this yourself.

Teach your children not to share personal items like drinks, food or unwashed utensils, and to cover their coughs and sneezes with tissues. Covering up their coughs or sneezes using the elbow, arm or sleeve instead of the hand when a tissue is unavailable.

Know the signs and symptoms of the flu. Symptoms of the flu include fever (100 degrees Fahrenheit, 37.8 degrees Celsius or greater), cough, sore throat, a runny or stuffy nose, body aches, headache, and feeling very tired. Some people may also vomit or have diarrhea.
Keep sick children at home for at least 24 hours after they no longer have fever or do not have signs of fever, without using fever-reducing drugs. Keeping children with a fever at home will reduce the number of people who may get infected.

Do not send children to school if they are sick. Any children who are determined to be sick while at school will be sent home.

We certainly hope that your child will maintain a healthy school year, but please take heed to the precautions above to prevent possible infection.

Tuesday, August 18, 2009

Be Aware

Here are a couple more potential foot injuries to know about that may become a possibility with your child's increased activity level. Please take note of this information:

Ankle fractures: Ankle fractures in the skeletally immature usually involve the growth plates of the tibia or fibula (the two shin bones). They usually occur as a result of a twisting injury to the ankle. An adult with the same type of injury would have an ankle sprain (a tear in a ligament). Most of the ankle fractures seen in children do not require operative management, but do if the fracture line extends into the joint. Injury to the growth plate may, on occasion, result in a growth disturbance.

Ankle sprains: Ankle sprains in children are rare because the ligaments are stronger than the growth plate, and the growth plate fails first under the "load" of injury. When they do occur, some form of immobilization (cast or brace) is indicated in order for the ligaments to heal at their normal length. Ligaments that heal in a "lengthened" position result in long-term disability and the increased likelihood of repeated ankle sprains under even minimally vigorous loads.

Please call the office, 419-423-1888, to schedule an appointment if you feel that your child should have his/her feet checked by Dr. Vail. Dr. Vail welcomes patients of all ages and is eager to assist you with your child's footcare needs.
As always, additional information can be found at our website:

Take Care of Your Feet this New School Year

As you get ready to leave for your first day of school, please be sure to take note of the important information below concerning caring for your feet. If you follow these helpful suggestions, you should be able to avoid complications with your feet!

Wash your feet regularly, especially between your toes. Make sure to dry your feet completely.

Trim toenails straight across but not too short. Be careful not to cut nails in the corners or on the sides of the toes – this can lead to ingrown toenails.

Make sure that your shoes fit properly.

Purchase new shoes later in the day because feet tend to be at their largest during this time due to normal swelling.

Replace worn out shoes as soon as possible.

Select and wear the right shoe for the activity you are engaged in, for example, use running shoes for running.

Alternate shoes – don’t wear the same pair of shoes every day.

Avoid walking barefoot to prevent infection or injury.

When wearing sandals at the beach or pool, put sunscreen on your feet to protect them from sunburn.

Monday, August 17, 2009

New School Year, New Activites, New Injuries

As your child begins a new school year, his/her activity level may be greater now that gym class is back in session and sport teams practice. Please take note of the information below and be on the look out for possible problems your child may develop as they continue vigorous activities:

Achilles tendonitis: Achilles tendonitis is an overuse injury seen rarely in children under age 14 but seen with greater frequency as skeletal maturity approaches. It is characterized by pain with activity, particularly jumping sports in the region of the Achilles tendon. Rest, activity modification, a stretching program, shoe change, icing, and the use of an anti-inflammatory medication will usually promote healing and the ability to return to sports. The Achilles tendon should never be injected with cortisone, as rupture due to weakening can occur.

Sever's disease: Sever's disease is a pre-skeletal maturity condition resulting from inflammation of the calcaneal (heel bone) growth plate near where the Achilles tendon attaches. The treatment is similar to Achilles' tendonitis, with the addition of a heel pad or heel cup. Occasionally this condition will plague a youngster off and on for 2­3 years until the growth plate closes. Casting to completely immobilize the ankle joint may be required.

Plantar fasciitis: Plantar fasciitis is an inflammation of the plantar (sole of foot) fascia (a tough band of ligament-type tissue that runs along the bottom of the foot). Again, treatment is directed at relieving inflammation and gently stretching the involved tissues. Arch supports also help here to support the foot and decrease pain. While injection is occasionally indicated in the adult, it is typically not done in the younger population.

Stress fractures: Stress fractures are sustained as a result of repeated "micro trauma." A sudden change in training intensity is the classic cause of these injuries that typically involve the metatarsals (the bones in the mid-part of the foot). Stopping the activity that is causing the problem and casting are the mainstays of treatment. If the activity continues prior to healing, these micro fractures can become "real fractures".

Please call the office, 419-423-1888, to schedule an appointment if you feel that your child should have his/her feet checked by Dr. Vail. Dr. Vail welcomes patients of all ages and is eager to assist you with your child's footcare needs.

As always, additional information can be found at our website:

Keep Growing Your Foot Knowledge


Blood vessels help to give the foot its shape and provide important nutrients for cell regeneration and muscular nourishment.

Nerves allow you to feel and help control the movements of your foot.

Skin is the protective covering of your feet. Every square inch of skin contains thousands of cells, sweat glands, oil glands, nerve endings and their own system of blood vessels. Skin is made up of three layers – epidermis, dermis, and subcutaneous – and is constantly regenerating itself.

Nails are epidermis cells that collect, flatten and press tightly together. These compacted cells create thin plates that pile into layers. Your nails can grow from ½-4 inches per year.

As always, for more extensive footcare information, check:

Friday, August 14, 2009

A Whole Lot of Brawn

We continue our lesson on the anatomy of the feet. Below is a list of the muscles that are associated with keeping your feet strong and in motion:

Anterior Tibial – enables the foot to move upward
Posterior Tibial – supports the arch of the foot
Proneal Tibial – controls the movement on the outside of the ankle
Extensors – help the ankle raise the toes
Flexors – help stabilize the toes

In order to allow the muscles to work, tendons and ligaments are needed. Tendons and ligaments help keep the muscles in place. Below is a list:

Tendons connect muscles to the bones and joints.
The Achilles tendon connects the calf to the heel.
Ligaments hold tendons in place and stabilize the joints of the foot.
The Plantar Fascia forms the arch and connects to midfoot bones to the hindfoot bones.
This ligament stretches and contracts, curves and flattens, and helps to provide balance when you walk.

As always, for more extensive footcare information, check:

Thursday, August 13, 2009

Developmental Phases

What are they?
Developmental phases are stages that one's lower extremities undergo until a final growth period has been achieved. There are certain terms that are used which refer to these developmental phases. They are genu valgum or "knocked knee" and genu varum or "bowlegged ness". Genu varum or bowlegs are common/normal for toddlers until about 18 months of age. Genu valgum or knocked knees are normal in children between 2-4 years of age. A majority of these developmental conditions correct themselves and the child usually grows out of it. As your child grows you may notice the different configurations that their legs undergo but in most cases, these are normal and require no specific care. If there is any concern that these earlier growth phases are becoming permanent, a physical examination should be performed by your foot specialist.

What causes it?
In general, these developmental phases are considered normal. However, in certain cases, abnormal growth patterns can produce obvious orthopedic problems. The main etiology or cause of such a problem is growth in the uterus. Often times, the uterus becomes a very "tight" environment as the child grows. When this occurs, the child rests his/her feet and legs against the uterine wall, which can cause certain foot and leg deformities. Hereditary factors are another possible etiology to this condition. If one of your family members suffers from a growth condition, your tendency to develop a similar growth deformity significantly increases.

How is it treated?
The treatment of developmental growth phase abnormalities, is usually determined by the presence or absence of symptomatology. Many times if a child has a severe case of bowlegs or knocked knees he or she will complain of painful feet which are frequently flat in appearance. If this occurs, certain orthotics or "cookies" can be made to support the feet and can be worn in the shoes. Stretching exercises can also be performed to stretch muscles in the legs or feet that seem to be tensed. Occasionally, foot and leg braces are used and in rare and severe cases, surgery is utilized. These developmental phases are quite difficult to manage. Therefore, a proper and timely exam needs to be performed by a well-trained specialist. The treatment of prolonged developmental growth phases in the lower extremities largely depends upon whether or not there are symptoms. In the absence of clinical symptoms or patient complaints, these growth stages are rarely treated.

Please call the office, 419-423-1888, to schedule an appointment if you feel that your child should have his/her feet checked by Dr. Vail. Dr. Vail welcomes patients of all ages and is eager to assist you with your child's footcare needs.

As always, additional information can be found at our website:

Do You Know The Bones of Your Feet?

Below is a list of the 26 bones in your feet!
Become a foot expert!

Hallux – the big toe bone

Phalanx – the smaller toe bones

Metatarsal – the long connecting bones

Tarsal – the midfoot bones, 5 irregular shape bones

Talus – the ankle bone

Calcaneus – the heel bone

Tibia and Fibula – the long lower leg bones

The big toe has 2 larger bones, 2 tiny bones and 1 joint.

The other toes have 3 bones and 2 joints.

As always, for more extensive footcare information, check:

Tuesday, August 11, 2009

Some Cool Foot Facts!

Kids! As you prepare to go back to school, you can impress your teachers - especially your health teacher - with these cool foot facts.

Don't be off your foot knowledge!

There are 26 bones in your foot – 25% of the bones in your body are in your feet.

There are 33 joints in each foot.

There are more than 100 muscles, tendons, and ligaments in your feet.

Your feet have a large network of blood vessels and nerves.

There are over 250,000 sweat glands in your feet.

Your feet are protected on the outside by skin and nails.

The FOREFOOT includes the five toes and bears ½ your body weight.

The MIDFOOT is the middle or arch of the foot and acts as a shock absorber.

The HINDFOOT contains the heel and ankle which are the largest bones in the foot. The heel is protected by a layer of fat.

You can also check out Dr. Vail's has so much more information about your feet...become a FOOT EXPERT!

Happy Feet...

Happy Feet...

= Happy Kids...

= Happy Kids...

= Happy Family!

= Happy Family!