Parkinson's Disease Research at NorthShore Strives to Lead to Better Patient Outcomes

Friday, April 11, 2014 1:11 PM comments (0)

parkinsons

As part of National Parkinson’s Disease Awareness Month, Demetrius Maraganore, MD, Chairman of Neurology at NorthShore, shared some of the findings of his ongoing research into the genetic factors that influence Parkinson’s disease progression and outcomes. He also tells us why research like this is so important for Parkinson’s disease patients and their families: 

Why is funding for and research into Parkinson’s disease so important? 
It’s important because the treatments that we have available don’t prevent Parkinson’s disease (PD) or slow or halt its progression.  PD is characterized by progressive motor and cognitive impairment.  PD patients have a seven-fold increased risk of nursing home placement and a two-fold increased risk of death.  The annual cost of PD in the U.S. exceeds $23 billion. Presently 2% of people will develop PD during their lifetime, and the prevalence of PD is expected to double by 2030. The cumulative burden of PD to society is and will be staggering.  Our patients and their families deserve methods to predict, prevent and halt PD and those will only come through research.

How long have you been conducting research into Parkinson’s disease?  
My research in Parkinson’s disease (PD) started in 1989, when I was an honorary clinical and research fellow to the late Professor C. David Marsden at the National Hospital for Neurology and Neurosurgery in London, England.  Dr. Marsden was the founder of the international Movement Disorders Society and its official journal, Movement Disorders.  His associate, Professor Anita Harding, was a pioneer in the field of neurogenetics.  Together, we launched the first genetic studies of Parkinson’s disease.  

That has remained the focus of my research, including for 20 years on the faculty of the Mayo Clinic in Rochester, MN, and in the four years that I have been Chairman of Neurology at NorthShore. While my research at Mayo focused on identifying genetic factors that contribute to the cause of PD, my research at NorthShore has focused on understanding how those genetic factors influence disease progression and outcomes.  Our research aims to develop methods to predict outcomes in PD, and to use that information to improve neurological health.

Why have you focused the bulk of your career on the study and treatment of Parkinson’s?  
As a clinician, it’s very gratifying that there are many treatments that we can employ in the first many years to reduce the burden of the disease on patients and families.  However, I recognize that the benefits of the existing treatments wane with time, and I’m driven by the sense of urgency to identify the factors that contribute to the progression of Parkinson's disease. Our goal is to target those factors so that every individual patient can have the best possible outcome. 

For more information on the NorthShore Neurological Institute and the research being done at NorthShore, click here. 

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Fresh Recipe: Healthy Spring Rolls Three Ways

Monday, April 07, 2014 8:00 AM comments (0)

Spring rollsFresh spring rolls are a quick way to boost your intake of nutrient-dense foods. Simply purchase the pre-made rice papers (spring roll wrappers), fill with your favorite vegetables, roll, and enjoy.  You can add lean protein like shrimp, chicken breast or tofu to make spring rolls a more filling snack or a meal.  Low sodium soy sauce is a perfect accompaniment to these healthy treats. 

Katrina Herrejon, Certified Diabetes Educator at NorthShore, shares her recipe for healthy spring rolls three ways:

Ingredients:
Spicy: Serrano pepper, radish, lettuce and green onion
American: Avocado, carrots, zucchini, red pepper and basil
Shrimp: Shrimp, cucumber, bean sprouts and cilantro 

Reasons to Love Spring Rolls:

 

  1. Portable. Sometimes there is just no time for a knife and fork.  Springs rolls are a great way to take your vegetables on the go. And, they can be eaten with one hand.
  2. Raw. Uncooked vegetables are packed with fiber, vitamins and minerals.  They are also particularly filling, which helps to make these low-calorie wraps satisfying.
  3. Quick. You don’t need to perfectly julienne your vegetables to make a delicious spring roll.  Just finely chop whatever vegetables you have on hand and roll it up!  

 

Nutrition Information Spicy: 

Calories 48
Total Fat 1g
Total Carbohydrate 9g
Fiber 1g
Protein 1g

Nutrition Information American:
Calories 62
Total Fat 3g
Total Carbohydrate 10g
Fiber 2g
Protein 1g

Nutrition Information Shrimp:
Calories 59
Total Fat 1.5 g
Total Carbohydrate 9g
Fiber 1g
Protein 3.5g

*Nutrition information may vary based on brand of spring roll wrapper used. 

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Survive the Season: How to Combat Seasonal Allergies in Your Home [Infographic]

Wednesday, April 02, 2014 6:35 AM comments (0)

April showers bring May flowers, and May flowers just might bring seasonal allergies. Don’t suffer the sniffles, sneezes, and itchy, watery eyes of seasonal allergies without fighting back. Our springtime infographic highlights some allergy basics and provides tips to help you combat seasonal allergy symptoms in your home. 

Click on our infographic for more information and useful tips.

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Reduce the Pain, Choose the Right Medication

Tuesday, April 01, 2014 8:00 AM comments (0)

aspirinIt can be challenging to choose the right over-the-counter pain medication. While the choices are many, it’s very important to make a decision based on your symptoms and other medical issues. Not all pain relievers are created equal, and knowing the difference between various types can be very helpful.

Before taking any medication, you should consult with your physician and/or pharmacist. Additionally, you should carefully read labels for warnings and other information. This is especially true for combination products used for treating pain and other conditions, such as colds, allergies, arthritis and muscle aches.

Acetaminophen and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are the most commonly used over-the-counter pain medications. The main difference between the two is that NSAIDs help reduce pain, fever and inflammation. Acetaminophen only reduces pain and fever.

George Carro, Pharmacist at NorthShore Evanston Hospital, helps clarify the differences between these common over-the-counter pain relievers to help you make a better, more-informed decision:

Acetaminophen (Tylenol®) tends to be milder on the stomach. Keep in mind that acetaminophen will not help with inflammation. Acetaminophen is an active ingredient in many other medications, including cold and flu preparations. Be sure to read all labels carefully so you do not exceed the recommended maximum daily dose of acetaminophen.
Safe for Children? Acetaminophen is generally considered safe for use in children. Always be sure to confirm proper usage and dosing information with your pediatrician.
Side Effects? Liver toxicity, including liver damage and failure, can be associated with improper use of this drug.  Alcohol consumption in combination with acetaminophen use may increase this risk.

NSAIDs—Aspirin (Bayer®), Ibuprofen (Advil ®or Motrin®), Naproxen (Aleve®) and others—can help relieve pain and reduce inflammation.
Safe for Children? As with any drug for children, it is recommended to discuss proper usage and dosing information with your pediatrician. Please consider the following for use in children:

  • Aspirin should not be used in children under the age of 16 years. It has been associated with Reyes’s syndrome, a potentially fatal disease in children.
  • Ibuprofen is not recommended for use in children under the age of 6 months.
  • Naproxen is not recommended for use in children under the age of 12 years.

Side Effects? The most common side effects include stomach and kidney problems. It is recommended to take all NSAIDs with food to help minimize stomach irritation. If you have heart conditions, stomach ulcers or blood disorders, please consult with your physician before taking these medications.

No drug—prescription or over-the-counter—is without risks. Always consult with your physician if you have any questions or concerns about your medications. Our NorthShore pharmacists can also answer questions and help you make informed, over-the-counter pain reliever selections.

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Honor Your Doctor on Doctors’ Day

Sunday, March 30, 2014 9:00 AM comments (0)

Dr. TalamontiNational Doctors’ Day was established to honor physicians and the profound impact their work has on patients and the larger community. There are too many doctors at NorthShore worthy of recognition to honor each individually, so we extend our thanks and congratulations to each and every one for their individual achievements and the excellent care they always strive to provide.

We regularly hear from grateful patients, like Paul Upchurch, who want to find a way to honor their doctors. Paul developed a pancreatic tumor that required a highly complex surgery. After meeting with several doctors, he eventually found his way to Mark Talamonti, MD, Surgical Oncologist at NorthShore.

Today, Paul is doing well. This year, he honored Dr. Talamonti and the exceptional care he received with a donation to support the groundbreaking research being done at NorthShore. He shared his NorthShore patient story with us:

“Nearly two years ago, I discovered that I had a tumor on my pancreas that required a highly complex surgery and long recovery period. I knew I needed to get better to be able to take care of my family. I met with several doctors, but I knew Dr. Talamonti would be my surgeon during our very first meeting."

“Dr. Talamonti’s approach was to treat me as a whole person, not just a disease. Through his research, he was able to develop an individualized treatment plan based on my health history and the makeup of my tumor. The surgery was every bit as tough as Dr. Talamonti had said it would be. But my story ended happily. Today, I feel better than ever. I’m extremely grateful to Dr. Talamonti for his work and research in individualized medicine. I thank him for saving my life. I look forward to celebrating Dr. Talamonti for many Doctors’ Days to come.”

It’s patients like Paul who make the work of healers such as Dr. Talamonti possible. If you would like to make a gift of your own on Doctors' Day please click here. Your gift can support research or programs in a clinical area of your choice. If you have a NorthShore patient story to tell, email philanthropy@northshore.org.

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Spring into Training with Fewer Injuries

Friday, March 14, 2014 11:44 AM comments (0)

runningSpring is on its way, which means athletes everywhere are emerging from hibernation and throwing on their running shoes. Before you join their ranks, follow along as Adam Bennett, MD, Sports Medicine at NorthShore, answers our sports-injury prevention questions, from what changes you should make to your diet if you’re in training, to what you should do if training starts to hurt:

If you experience pain while in training for an athletic event, what are your options?
The main issue is to determine the cause of the pain. If the cause is muscle soreness, then more rest between runs or training may help. Additionally, some strength training via yoga, Pilates or basic weight lifting may diminish soreness after a workout. If pain persists, seek medical care, which could include X-rays depending on the site and severity of the pain.

What causes shin splints and what is the best way to deal with them and still be able to exercise?
First order of business is to make sure that your shin splints are in fact, shin splints. Other causes of shin pain include muscle strains, stress fractures and tendinitis. "Shin splints" is a painful condition that occurs when the muscle attachments pull on the periosteum (a membrane that covers bones) of the tibia, which leads to inflammation and pain. If you do have shin splints, anti-inflammatory over-the-counter pain relievers, intense stretching, deep tissue massage, gait analysis, modifying the type of shoe you wear and rest days in your training program all may help diminish your symptoms. Formal physical therapy is an effective way to implement all of these strategies.

Are sports and recovery drinks after a workout or training better than simply drinking water? Do they aid recovery?Sports drinks contain glucose and electrolytes, which need to be replenished after sweating during training or exercise. Sports drinks are probably not essential for exercise lasting 20 minutes or less. For exercise lasting longer than 20 minutes, research shows improved performance when utilizing fluids that contain glucose and electrolytes. Research also indicates that ingesting carbohydrates and protein within 10 minutes of an intense workout improves recovery. I don’t have brand recommendations but I believe it’s a good idea to replenish with a drink that uses natural flavors and sweeteners and avoids ingredients like high fructose corn syrup. Certainly anything with caffeine, which might dehydrate the athlete, is a bad idea. Please tell your kids not to drink soda pop after exercise.

Is it better to consume protein drinks or food sources of protein after a workout for muscle recovery?
I would guess they are about equivalent. The advantage of a drink is that you replenish fluids as well.

If you have an injury in your arms or wrists, such as tendonitis, what exercises could you do to increase strength without causing further injury? 
This is a tough scenario but there are things you can do. Specifically putting resistance in your mid-forearm and keeping your hands and wrists relaxed can allow you to work out the major muscles of your upper body without irritating the tendons in your wrists. If you’re having trouble figuring out how to pull this off try working with a personal trainer a couple of times and have him or her show you.

For those training for a marathon, half marathon or triathlon, do you have any diet and training recommendations?
My first recommendation is to consider implementing rest days as part of your training. I often suggest athletes work longer and more intensely one day and then allow for complete rest the next day. If that is too much rest, consider a two-days-on, one-day-off schedule. Rest days allow for replenishment of glycogen stores in the muscle cells and fluid losses to be replaced adequately. As a result, athletes typically feel better on workout days and can push themselves even harder, which ultimately leads to a better performance on race day.

In terms of a daily diet, avoiding fried foods, caffeine and alcohol is likely to bring benefit. If you sweat a lot, you may need to add salty foods to your diet. This is especially important if you cramp easily.

For those not in training but who still want a great workout, what would you recommend?
High-intensity interval training is likely the most effective way to improve overall fitness. For my patients who are frustrated with their ability to lose weight, I often suggest they incorporate high-intensity interval training into their workout routine. Crossfit is a popular example, which works for some, but there are many ways to do this type of training. 

If you are concerned about the risk of injury during strength training as an older athlete, what should you do? Are lighter weights with more reps better? Or, should you increase weight and reduce reps?
Most people don't realize the importance of resistance training to overall health. My only concern about injury is if you had arthritis in any of your upper extremity joints (shoulder, elbow, wrists). If you do have arthritis in these joints, then lighter weights would be preferred. If you continue to lift to the point your muscles become sore the next day, it is unlikely you will lose significant muscle mass. My only suggestion is to vary the weight, repetition or motion of your regimen so your body won’t adapt as easily. This will ensure maximum benefit from every session. 

For more information on keeping your young athletes healthy, join us on Thursday, March 20th from 7:00-8:30 p.m. for a Sports Medicine Symposium at Highland Park High School. We invite you to join us for a discussion on how to keep young athletes in optimum health and prevent injuries. For more information, call Matt Castle at 224-765-2090. 

 

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It’s Nap Time

Friday, March 07, 2014 11:22 AM comments (0)

nappingA lack of sleep can leave you feeling groggy and foggy all day, impairing your ability to focus on work and even retain information. That’s not all; lack of sleep also decreases libido, ages skin and can inhibit your ability to lose weight. Chronic sleep deprivation—regularly forgoing the recommended 7 to 8 hours or due to other sleep disorders—can have serious consequences on your health, including increased risk for heart disease, heart attack, stroke, high blood pressure, diabetes and depression. In other words, maintaining good sleep habits is an essential part of a healthy lifestyle. And, unfortunately, most of us aren't doing that. 

If done correctly, there is great power in a well-timed nap. While you should not rely on naps to repair the damage done by inadequate sleep or chronic sleep deprivation, naps can recharge your energy levels and improve your mood. The key is to time them just right. Short naps are preferable. Longer naps may be taken on occasion to make up for an occasional lapse in sleep schedule.

Thomas Freedom, MD, Neurologist and Program Director of Sleep Medicine at NorthShore, breaks down nap time to help you achieve maximum benefits from a little daytime shuteye:

10 to 20 minutes. Often called the “power nap,” this short rest period is a great way to recharge your personal energy battery, boosting alertness and increasing your midday focus. Keep your power naps to 10 to 20 minutes because you’ll stay in lighter stages of non-rapid eye movement (NREM), which means you won’t wake up feeling groggy and can get right back to work feeling refreshed. Also try to take the nap early in the afternoon.

30 minutes or more. Word of warning: Naps longer than 20 minutes could leave you with sleep inertia, or grogginess that can last up to 30 minutes after waking. If you need to be back on your feet right away, keep your nap to less than 20 minutes. Otherwise, after the fog wears off, you’ll enjoy the same restorative benefits of the power nap.

60 minutes. If you find yourself forgetting information halfway through your day, 60 minutes of shuteye might be able to help. A nap between 30 and 60 minutes will get you to slow-wave sleep, which can help improve your decision-making skills and recollection of information. You’ll need to give yourself a little recovery time after an hour nap, as the effects of sleep inertia could be more pronounced. There is a possibility that a nap of this length could also disrupt your sleep at night.

90 minutes. A 90-minute nap gives you a full sleep cycle—from the lighter stages of sleep all the way to REM (rapid eye movement). A nap of 60 to 90 minutes can improve decision-making skills and even enhance creativity. At this length, make sure to nap with care. You don’t want to disrupt your regular sleep schedule or keep yourself up at night by napping too long during the day. Sleep inertia may also be more of an issue.

Do you take day-time naps to boost your energy levels?

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Cyberbullying: Identifying the Signs and Protecting Your Kids

Wednesday, March 05, 2014 11:01 AM comments (0)

cyberbullyingToday, bullying doesn’t necessarily stop once your child walks through the front door. Cyberbullying, an extension of traditional bullying, uses electronic technology and communication mediums—from emails and texts, to messages on social media sites like Facebook and Twitter—to send threatening and insulting messages anytime and anywhere. How do you protect your child when the threats are happening online? What is the role and responsibility of the school when bullying is happening both on and off school grounds? How do you know when it’s happening to your child?

Benjamin Shain, MD, PhD, Child-Adolescent Psychiatry, answers questions on cyberbullying and bullying to help parents and teachers find the best and most effective ways to protect kids:

How is bullying defined?
Bullying has been defined as having three elements: aggressive or deliberately harmful behavior 1) between peers that is 2) repeated and spans a length of time and 3) involves an imbalance of power, (e.g., related to physical strength or popularity), making it difficult for the victim to defend himself or herself. Bullying behavior falls into four categories: 1) direct-physical (e.g., assault, theft), 2) direct-verbal (e.g., threats, insults, name-calling), 3) indirect-relational (e.g., social exclusion, spreading rumors), and 4) cyber. The 2011 Youth Risk Behavior Survey of students in grades 9 through 12 in the United States indicated that during the 12 months before the survey, 22.0% of girls and 18.2% of boys were bullied on school property, 22.1% of girls and 10.8% of boys were electronically bullied, and 6.0% of girls and 5.8% of boys did not go to school one day in the past 30 because they felt unsafe at school or on the way to or from school.

How can you tell the difference between a joke and cyberbullying? When should you be concerned? When should you get the other parents involved?
Note the definition of bullying in the above question. Look for repeated aggressive or harmful behaviors involving an imbalance of power. That said, there is little you can do to monitor without being highly intrusive. Some teens need this but most do not.

What is the best way for schools to handle cyberbullying when they find out about it? Is it different from the way they would or should handle regular bullying?
There is little difference in consequence between cyberbullying and the face-to-face variety. Schools are in a unique position to intervene. Parents are limited in what they can do and most bullying does not meet the threshold for legal involvement. My belief is that schools should handle all bullying as bullying.

How does a parent’s use of computers impact children? How can we set healthy examples that could contribute to less negative, and potentially bullying, situations?
Children learn more by example than what we tell them. I don't think we can have rules that apply to all (e.g., limit screens to X hours per day) as there is wide variation in needs and abilities of both parents and children. However, parents should consider rules when usage becomes excessive (e.g., seems to limit other activities) and redirection is not effective. How to handle bullying (as both victim and bully) can be modeled by example, as well, with parents talking about how they handle electronic situations as they arise.

How closely should you watch the way your kids use Facebook and their phone? Is it going too far to ask to see messages they send and receive?
Think of how you supervise kids in face-to-face interaction. Most kids navigate going to and from school and participating in class with some, but very limited, parental supervision. Some kids need much more supervision. Electronic situations are something that parents can supervise much more closely, as they are often with the child, or at least in the same house, when the communication occurs. Nonetheless, even if monitoring could be done (children will find ways to circumvent even the strictest supervision), children view supervision as highly intrusive. In addition, studies have shown that electronic communication is used heavily by children for support, which means close monitoring interferes with the support they are receiving from friends and peers. So, yes, for most children, it’s not recommended to ask to view all electronic communication.

Is it safer for kids not to have access to cell phones or social media? 
For most kids, electronic communication is not only the way they stay "in the loop" with their friends, but it is also the main way that they obtain social support. Taking this away protects them (and sometimes that is necessary) but it also denies them avenues for normal social and emotional development.

If your child is on the receiving end of a cyberbully’s attentions, how should they respond? When should they seek an authority figure's help?
First thing is to encourage them to bring in a parent for advice. I can’t emphasize enough, though, that I mean advice and not control. As soon parents clamp down on communication or take unwanted action, the child will stop communicating with them. An authority figure is useful when the actions are repeated and damaging.

What signs of bullying should a parent look for if a child is unwilling to communicate about what is going on inside or outside of school?
First, be patient. You may need to wait but typically waiting patiently and being there for support works faster than putting pressure on a child to communicate when they clearly do not want to. Second, look for signs of depression: overt sadness, angering more easily, isolating more, declining grades, less interest in seeing friends and other activities that had been considered fun. Some of this, such as self-imposed isolation, you may see as a consequence of normal development. However, when it is sudden, or combined with other problems, consider a mental health evaluation.

Why do the bullied often become bullies?
Kids are commonly both bullies and victims. Unfortunately, being a victim may teach children that imposing one’s power on another is important, which predisposes them to becoming a bully. As a parent, if you encounter this, talk to your child about his/her behavior and consider a mental health evaluation if the behavior persists.

If you do discover your child is being bullied, online or off, should you talk to your children and the parents of the other children involved before getting the school involved? Should the schools be told right away?
For a bullying victim, being a victim is highly embarrassing in and of itself. First, consider interventions that are less of a "deal," as long as they are effective at stopping the bullying. On the other hand, bullying involving threats or encouraging a child to commit suicide should be brought to the attention of the authorities immediately.

Does your child communicate with his or her friends online? How closely do you monitor activity?

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BRCA 1 and BRCA 2: Knowing Your Risk and Screening Options

Thursday, February 27, 2014 2:50 PM comments (0)

geneticsPeter Hulick, MD, MMsc, Medical Geneticist at NorthShore, discusses the increased risk for breast and ovarian cancer in women who carry the BRCA1 and BRCA2 gene mutation. He responds to the recent study from the Journal of Clinical Oncology on the impacts these mutations have on women as well as identifies ways women can minimize their risk.

What are your general impressions of the new study? 
The study, particularly given its size, helps further parse out the details of risk differences between BRCA1 and BRCA2.  There have been retrospective studies that have suggested this, but here we have a prospective study that adds further evidence.  In addition, it looks at overall reduction in mortality which shows the gains go beyond the ovarian cancer risk reduction.

Who is most at risk for having the BRCA1 and BRCA2 mutation?  
There are many potential ways someone can be at risk, but certain characteristics stand out:

  1. Anyone of Ashkenazi Jewish descent who has personal history of breast cancer or a personal history of ovarian cancer
  2. Anyone diagnosed with breast cancer at age 45 or younger
  3. Anyone diagnosed with ovarian cancer at any age

Ultimately, if you have been diagnosed with breast and or ovarian cancer, or multiple family members have, you should discuss the family history with a cancer risk specialist.

What is the difference between the two genes?  
Both genes are involved in how the body repairs DNA damage that accumulates and maintaining the “checks and balances” that control cell growth.  As this study reinforces, there are differences in cancer risks associated with each.  While the risk for ovarian and breast cancer might be somewhat lower for BRCA2 than BRCA1 (though still considered high compared to average risk), BRCA2 mutation carriers tend to have higher risk for other BRCA-related cancers (e.g. pancreatic, prostate).

What preventative measures can women engage in to minimize their risk of breast and ovarian cancer?  
The first step is to get an accurate assessment of one’s risk.  Women may still be at elevated risk even if BRCA testing is negative.  Other genes and non-genetic factors contribute to ovarian and breast cancer risk.  Depending on the risk level, certain options exist for increased screening, preventative medications or preventative risk-reducing surgery.  This is a complex and very personal decision and accurate information about risk is key.

What screening options are available for women to learn more about their risk? 
The first thing women can do is to get an accurate family history from BOTH sides of the family, then discuss with one’s physician.

What next steps would you recommend for women with the BRCA1 / BRCA2 mutation? 
I would recommend women talk to their doctors about speaking to someone familiar with cancer genetics such as a geneticist, a genetics counselor, or a gynecologist/oncologist/breast surgeon knowledgeable about the management of BRCA carriers.  There are online resources from Be Bright Pink and FORCE that can be helpful in understanding the implications of having BRCA mutation and putting in a plan to reduce risk.  As this study and others have shown, we have the ability to greatly reduce one’s risk if we know one faces these risks.

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Oh My Aching Feet: Common Foot and Ankle Injuries

Friday, February 21, 2014 9:38 AM comments (0)

foot imageFoot and ankle pain might be common in active, athletic individuals but that doesn’t mean it can or should be ignored. If left unexamined, mild foot and ankle discomfort could lead to pain that disrupts day-to-day activities, or even lead to a more severe injury. Pain and noticeable discomfort are signs that there could be something wrong. Identifying the site and source of the pain could be the first step to getting back on your feet, pain-free. 

Lan Chen, MD, Orthopaedic Surgery at NorthShore, discusses foot and ankle injuries common in the sporty set: 

Plantar fasciitis. A common cause of heel pain, plantar fasciitis occurs when the plantar fascia, a band of tissue that connects the heel bone to the toes, becomes swollen or irritated. The pain is most severe after long periods of rest—first thing in the morning or when climbing stairs—and it typically subsides the more active you are throughout the day. In older individuals, plantar fasciitis is caused by the natural wear and tear of aging. Plantar fasciitis is also a common injury in young athletes and those who spend long periods of time on their feet. 
Treatment: There is no cure-all for plantar fasciitis. Giving your feet a break, cutting back on exercise or simply changing your shoes could relieve some or all of the pain. Stretching of the ankle and plantar fascia are also very important. If you think you might be suffering from plantar fasciitis, discuss your treatment options with your physician. 

Achilles tendonitis. Often an overuse injury, Achilles tendonitis is a swelling of the Achilles tendon, which extends from the heel to the calf muscle. Not stretching before and after physical activity, wearing high heels, or simply having flat feet or fallen arches are all common causes of Achilles tendonitis. Tendonitis pain may be mild to moderate but the pain following an Achilles tendon tear will be sudden and severe.  
Treatment: If you give it the time and rest it needs, Achilles tendonitis will heal on its own, but make sure to see your physician to determine the extent of the injury. Your doctor will then help you determine the best way to proceed, which could include rest or the use of crutches to keep your weight off the injury.

Stress fracture. Stress fractures are small cracks that develop in the bones of the feet, ankle and legs. For active individuals, they are most often caused by overuse in high-impact sports like distance running (e.g. feet repeatedly hitting the ground). Worn out, unsupportive shoes as well as a sudden increase in physical activity might also be to blame. The most common locations of stress fractures are the second and third metatarsals in the foot, and the bone at the top of the foot called the navicular. Pain from stress fractures will most likely develop gradually, increasing the more you are on your feet and decreasing when at rest. Also look for swelling and bruising at the site of the pain.
Treatment: Rest is essential! Ignoring the pain could cause more serious injury, including a complete break of the stress-fractured bone. See your doctor to determine the exact location of the stress fracture; treatment varies depending on the severity and location of a stress fracture. 

Turf toe. Common in football players, turf toe is a sprain of the ligaments surrounding the big toe. It’s caused by a hyperextension of the toe, or bending back of the toe beyond the point of normal movement. Injury can occur from a sudden, forceful movement or repeated hyperextensions over a period of time. Pain, swelling and limited movement of the big toe are all indicators of turf toe.
Treatment: As with many overuse injuries, rest is best. Depending on the severity of the injury, your doctor might recommend immobilization, either by taping the injured toe to another to relieve the stress on the joint or the use of a cast or boot. 

Ankle sprain. With the ice and snow on the ground, ankle sprains are most common in the winter months.  Mechanical twisting of the lower leg and ankle can cause simple ankle sprains, which will heal on their own, or high ankle sprains, which can be more serious and require additional stabilization in a cast or boot.  Other injuries such as ligament tears, tendon strain and cartilage injuries can all occur in an ankle sprain. 
Treatment: Most ankle sprains will heal on their own. Resting a short period to allow the initial pain and swelling to subside is common and you may need a brace or boot initially. Chronic pain after an ankle sprain is a clue that there is something else going on.  And that’s when it is important to see your doctor right away. Additional imaging and exam might be needed to clarify the situation and physical therapy might come into play.

Have you injured yourself while playing your favorite sport? 

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