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Friday, May 31, 2013

Protein for Tendon & Bone Healing

Protein for Tendon and Bone Healing

The foot is a common site for bone and tendon injuries. Tendons are tough fibers that connect muscle to bone. A tendon injury can happen as a result of many small tears to the tendons that have come about over time. Most of the tendon injuries occur near the joints such as the ankle. Anyone can have a tendon injury but those who make the same motions over and over in their daily activities, jobs, or sports are more likely to have tendon damage.

In the case of bones, any break of any size is called a fracture. If more pressure is placed on a bone than it can stand, it will break or split. A hairline crack can also develop due to repeated forces against the bone, which is called a stress fracture.

With the most modern and current treatment methods, most tendon and bone injuries heal without any problems. But for complete healing to happen, there should be adequate blood supply and stability. The blood brings oxygen, healing cells, and various chemicals to the injured site. These are necessary for healing. Poor healing is more likely to happen if the area has a limited blood supply. To hold the bone together, the doctor may use various ways to stabilize the injured area. In the process of healing, there are many phases of recovery. Healing restores the tissues to its original physical and mechanical properties.

Tendon and bone injuries also need adequate nutrition to heal. These include vitamin C, vitamin D, calcium, and protein. Without proper nutrition, the process of tendon and bone healing cannot be at its best.

Adequate protein is important for bone health and is especially essential to help heal and repair bone and tendon injuries. Proteins help synthesize a new matrix structure for the bone. Protein also provides the body with amino acids. The amino acids are necessary for tissue regeneration. Proteins also increase muscle strength, bone integrity, and improves the immune response.

Researchers have sped up bone healing in mice by 33% after using proteins to naturally regrow new tissues. Proteins are known to stimulate bone formation and tissue regeneration. Protein helps repair the damaged tissues.

Protein has a number of key roles in the body. Proteins are the main component of enzymes, which control many of the chemical reactions in the body. Proteins also play a role in having a healthy immune system. In the wound healing process, proteins are involved in the inflammatory response. They are also needed for the formation of collagen and elastin which provide the basis for new tissue formation. Because of the various roles of protein in the body, it can be said that it is indeed a vital nutrient in tendon and bone healing.


Thursday, May 30, 2013

What is Board Certification in Podiatric / Foot and Ankle Surgery

I get asked this by my patients all the time for the information out there is very confusing even to other doctors who are not in our field.    A Podiatrist, Doctor of Podiatric Medicine (DPM) goes to college for 4 years, then attend Podiatric Medical School for another 4 hours.   The first 2 years are spent in the health basic sciences to help students hone up the science skills to become doctors, mostly a repeat of courses learned in college with a slant towards patient care.  These two years are usually spent with other student physicians such as D.O. , M.D. for the basics.   The next two years are spent doing clinical rotations with emphasis on foot and ankle medicine / surgery as well as other allopathic / osteopathic services that a Podiatrist will often interact with or share common privileges with.  These fields are Vascular, Plastic, General Surgery as well as Family/Internal Medicine, and Emergency , Trauma, Orthopedics, Anesthesia services.     Podiatric students skip psychiatry, OB, Optho, etc.  

After graduating with a D.P.M. degree the allopathic foot and ankle doctor then goes onto a residency training of at least 3 years now.     The first year is an internship usually and the last 2 years doing mainly surgery in the field of foot and ankle medicine / surgery via different services in hospitals.  There is an option to do a year or two or even more of a fellowship after residency for Podiatric Physician.   This is not mandatory and offers extra practice outside of residency.   Doctors at this stage typically learn how to practice in a real world setting.   With all this said, what really counts in choosing a foot / ankle physician?
Is a fellowship trained podiatric physician / surgeon better trained?   NO

Two words: Board Certification.   Fellowships are wonderful in that it allows the doctor to have additional apprenticeship under a Board Certified Physician and to practice the craft without having to worry about running a practice  or working independently yet.  

To be board certified by the American Board of Podiatric Surgery, the candidate needs to be in practice (not fellowship) for at least 4 years and compile over 1000 cases with a variety of situations, these cases are then scrutinized by a panel of Board Certified, nationally well respected surgeons in the field for quality and outcome.  Once that has been established then the candidate goes on to an oral examination whereby the candidates are given clinical scenarios, usually of complex cases which tests their clinical knowledge and judgement.   The American Board of Podiatric Surgery (ABPS) has two separate tracts.
1) Foot Surgery
2) Reconstructive RearFoot and Ankle Surgery

For those candidates who have both certifications, they would have pass two separate case review paths and then two separate oral examinations.    

Statistics by the American Board of Podiatric Surgery to date shows those with both Certifications in the United States is noted at 851 with 844 being active and practicing.     Those with Foot Certification @ 4,402.

What is the American Board of Podiatric Medicine and Orthopedics mean?    That is a board for none surgical podiatrist who are great at dealing with general medical issues and none surgical management of foot / ankle disorders.  Some specialize in orthotic therapy, dermatology, casting methods for foot/ ankle deformities and general medical management with prescriptions or minor procedures.  Most hospitals will require the podiatrist be board certified / qualified by the American Board of Podiatric Surgery as a gold standard to grant surgical privileges and procedures.

In conclusion, fellowships are great experiences for the Podiatric Physician / Surgeon, but the great equalizer is board certification, just as SAT equalizes the students across all schools.


Double Board Certified Podiatric Surgeon

  • American Board Of Podiatric Surgery
    • Foot Surgery
    • Reconstructive RearFoot & Ankle Surgery
  • American Board of Lower Extremity Surgeons
    • Foot Surgery
    • Reconstructive RearFoot & Ankle Surgery





Tuesday, May 28, 2013

Mark Hunt Broke His Toe In First Round Against JDS & Lost His Movement

Is this true asks www.BJPenn.com.   The big toe is a responsible for propulsion and yes, during a standup fight the push off for a kick, knee or just to move forward will be hindered.    The big toe is the propeller that pushes you forward.  
Mr. Hunt may not be off the mark with his complaint of loss of movement.

Hope he has a good podiatrist.

Monday, May 20, 2013

Antioxidants in Wound Healing.


Antioxidants and Wound Healing
Antioxidants are vitamins, minerals, and other nutrients that protect the cells from damage caused by free radicals. Free radicals are termed “free” because they are missing a molecule, which makes them go wild to pair with another molecule. These free radicals will attack cells to acquire their missing molecule. In the process, the free radicals often cause cell injury and DNA damage, leading to various conditions including cancers, liver disease, heart disease, as well as wound healing problems.
Free radicals trigger a damaging chain reaction. They do not just damage one molecule but can set off a whole chain reaction. This can overwhelm the body’s natural defense system and the damage can lead to a number of problems.
Antioxidants work to prevent or stop the damaging effects that free radicals have started. Various antioxidants work differently. Therefore, it is best to have a mix of vitamins and minerals to neutralize the free radical damage more efficiently.
There are numerous substances that can act as antioxidants. The most widely known are vitamin E, vitamin C, vitamin A, beta-carotene, manganese, selenium, glutathione, flavinoids, and phenols. Dietary souces include red beans, blueberries, cranberries, blackberries, raspberries, strawberries, artichokes, prunes, plums, apples, cherries, pecans, green tea, and many more.
It has been found out that antioxidants also help in wound healing. Wound healing requires a balance between oxidative stress and antioxidants. According to a study, the normal physiology of wound healing depends on low levels of reactive oxygen species and oxidative stress. An overexposure to oxidative stress leads to problems in wound healing. Antioxidants can help control wound oxidative stress and thereby speed up wound healing.
In wound healing, the body repairs itself after injury. Healing is a complex process of replacing devitalized cellular components and tissue layers. The process involves inflammation, proliferation, and maturation. In the inflammatory phase, blood flow is increased in the wound. In the proliferative phase, new blood vessels bring nutrients to the wound and dead tissue is removed. During maturation phase, the new skin seals the wound and may form a scar. Any agent that accelerates the process is a promoter of wound healing.
In the inflammatory response, neutrophils and cytokines produce oxidants, which act as free radicals. Antioxidants can therefore be used to reduce the oxidative stress and help in wound healing acceleration by donating electrons to the free radicals, thereby avoiding the damaging effects of oxidation.
Antioxidants have been found to improve wound healing. They have a role in the formation and maintenance of collagen during the healing of wounds. Other antioxidants can detoxify hydrogen peroxide which can cause damage to regenerating cells. Antioxidants also show promise in skin repair and regeneration. Thus, combinations of antioxidants have been used to enhance the healing of wounds.