What is a Stress Reaction

Previously reported on this blog, I am both a foot doctor in Sarasota, Florida and a New York Giants football fan. The latest out of New York is that Eli Manning has more to worry about than his long suffering plantar fasciitis. Now it has been reported that Eli has a "stress reaction" in a bone called the cuboid bone of his foot.
Well, what is a "stress reaction?" In order to explain that I want you to think of a dimmer switch on a light. You see, a bone can be either broken or not, just like a light can either be on or off. That said, there are also the dimmer options. Using an MRI (a special medical device that takes images of the bones and soft tissues and feeds the results into a computer) a radiologist can add more options to the mix. Thinking of a spectrum, where one end is normal bone and the other is a broken bone, now we can add stress reaction and stress fracture.
Eli has a stress reaction. The treatment for this is rest, stiffer shoes and time. If he continues to play on this foot he can end up with a stress fracture (the next phase on the dimmer switch) or ultimately a fracture of his cuboid bone. If he does fracture the bone he is looking at 6 weeks of healing time, which basically means the season is over for him.
With Eli hurt and the Giants on a 5-game-out-of-6 losing streak the stress is affecting all Giants fans.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
Sarasotafootcarecenter.com

One Giant Painful Foot

My worlds collided last week as a New York Giants football fan and as a podiatrist living in Sarasota, Florida. I was watching the game when quarterback, Eli Manning pulled up lame after planting his right heel on a play action pass. My first thought was, "I really hope that was not his Achilles tendon." Luckily for me, and Eli and Giants nation, it was not the Achilles tendon but the plantar fascia that was injured. The plantar fascia is a tight band of connective tissue, basically a blending of many tendons, that goes along the bottom of the foot. Many people, as many as 1 in 4 Americans, will suffer from sharp, shooting pains in the bottom of the heel. Often this pain is worse when you get out of bed in the morning or when you stand up after sitting for a period of time.
The most common cause for this is called plantar fasciitis or inflammation of the plantar fascia. In my office in Sarasota I treat this condition every day. None of my patients are professional quarterbacks who have to plant their feet in order to throw footballs, but it is not a fun condition for a lawyer, waitress or hairdresser either. Typically this condition is treated with anti-inflammatory drugs like Advil, rest, ice, stretching and sometimes a cortisone injection. Taping of the foot or a small foot brace is also used to limit the pain. Long term treatment consists of stretching exercises and use of orthotics, a molded shoe insert that controls foot motion.
Not only do I treat this condition every day, I also suffered from it in my early twenties. I am pain free now due to orthotics and stretching.
I expect to see Eli out on the field on Sunday. First of all because it is amazing what you can do with cortisone, second because the guy just does not quit. Eli has made 82 consecutive starts including the one following a serious shoulder injury. He will start but hopefully the Raiders will allow the Giants to build up a big lead and allow Eli to take a break. I am sure his foot will feel much better if he does.


Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com