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Posts for tag: ankle

March 01, 2015
Category: Laser Treatments
Tags: chattanooga   laser   therapy   ankle  

An ankle sprain is a very common injury seen in people of all ages.  The term "sprain" implies that the ankle was turned (usually with the bottom of the foot turned IN or toward the middle of the body) and is often called an INVERSION ANKLE INJURY.  There are other types of injuries to the ankle, but the vast majority of them are inversion injuries.  The fibula (the long thin bone running on the outside of the leg from the knee to the ankle) can be fractured, and this is easily identified on x-rays.  For purposes of this discussion, however, we are going to assume there is NO fracture, and the injury is a soft tissue only injury.  There are three degrees or GRADES of sprain - I, II, and III.  This refers to the severity of the sprain, and whether the ligaments are stretched (I), partially torn (II) or completely torn or ruptured (III).

Ankle sprains are treated in a number of ways.  Conservative treatment typically consists of R.I.C.E.  This stands for Rest, Ice, Compression, and Elevation.  We should also consider IMMOBILIZATION for the Grade II and Grade III sprains, meaning the foot and ankle are put into something to keep them from moving excessively.  Walking boots, aircasts, splins, and fiberglass or plaster casts are typical forms of immobilization.   A cast is used when complete immobilization is needed, and the foot must be held still and not allowed to move at all.  Other forms of immobilization are more partial forms of immobilization, in that the foot can move a little in the device, but the amount of motion is restricted.  In a Grade III stage, surgery has to be considered in some cases.  This is particularly true in the younger competitive athletic individual, where primary repair of the liagment(s) - basically sewing them back together or repairing them as soon as possible after the injury can prevent scar tissue, weakness, instability, and loss of function.

A newer way to treat these types of injuries, especially in the Grade II or MODERATE injury, is with laser treatment.  We are not talking here of laser surgery, but of laser therapy.  The injured person has anywhere from 3 to 5 treatments in an office setting, space 1-3 days apart, and is given a treatment with a CLASS IV laser.  This is also known as HDLT or High Dosage Laser Therapy.  In my office, we use the Diowave 30 watt laser.   This is done without anesthesia, and the patient feels only a profound sense of warmth during each treatment, which ranges from 10 to 20 minutes in length.  This is a deep pentrating light energy delivered into the body to reach damaged cells and tissues.  This not only makes the patient feel better, but results in healing of damaged tissues at a much faster rate.   Healing of ankle sprains is often 20 to 30% faster than by conventional means of treatment alone (ice, rest, immobilization, etc.).    The patient can still ambulate, although it is still beneficial to restrict movement with a walking boot or pneumatic walker.  The patient also experiences a lot less pain and swelling during the recovery.  If this is an athletic individual, it is often possible for him or her to return to sports acitivites much quicker.  As with any other conservative treatment, the sooner treatment is started, the better the outcome.  Unlike some forms of treatment, however, this type of laser can be used for CHRONIC, as well as ACUTE pain and swelling.

If you, or someone you know, has a foot or ankle sprain and needs a little extra help in healing it, call our office.  We are here to help.


Dr. Richard S. Eby


November 23, 2014
Category: F.Y.I.
Tags: ankle   foot   plantar fasciitis  

Plantar Fasciitis is one of the most common conditions that affects the foot.  Years ago, this was referred to as HEEL SPUR SYNDROME because a bone spur on the bottom of the heel is often seen with the condition we now refer to as plantar fasciitis.  Actually, the presence or absence of a "spur" on the bottom of the heel has little, if anything, to do with the pain one gets with this condition.

 Plantar fasciitis is a mechanical thightening that occurs, usually just in front of the bottom of the heel bone, at the attachment of the plantar fascia.  The plantar fascia is a thick, tough, ligamentous band that runs from the heel, through the arch and ends near the ball of the foot at the toes.  A number of things can cause this to become tight and cause pain, often when first putting pressure on the heel in the morning or after a period of rest.  BUT, the idea of INFLAMMATION in this ligament is simply not the case.

 While oral anti-inflammatory agents (also known as NSAIDs) such as Ibuprofen, Naproxen, and many others)  and steroid injections often reduce, and in some cases eliminate the pain, WHERE IS THE INFLAMMATION?????   Rarely does one see swelling, redness, or heat in the area on the bottom of the heel.  In fact, surgical removal of portions of the fascia, when sent for microscopic examination rarely show signs of inflammation.

 For this reason, there is a movement to change the name of this dreaded condition to PLANTAR FASCIOSIS or even PLANTAR FASCIOPATHY.  This name implies deformity or diseased areas within the plantar fascis rather than actual inflammation.  There are also cases where removing small parts of the plantar fascia that appear abnormal on ultrasound exams of the fascia, and "needling" the remaining fascia, or injecting stem cells and/or platelets that are separated from the patient's own blood can cause the body to "heal itself."

 Shockwave therapy, something we will go into more detail on later, can also cause the fascia to "heal" on its own.  These points seem to suggest that INCREASING the inflammation in and around the ligament is actually a good thing, and can lead to reduced pain, and in some cases, complete resolution of symptoms.  No matter what one calls it, plantar fascitiis is a condition that affects many people, and can be treated in a variety of ways.  

Dr. Richard S. Eby   


October 13, 2014
Category: F.Y.I.
Tags: ankle   foot   podiatry  

    Podiatric medicine, also known as podiatry, is the study of the human foot and its related structures. Podiatrists diagnose an treat deformmities of the human foot and ankle. This treatment can be by medical, mechanical, or surgical means. Because disabilities of the foot affect the well-being, mobility, and independence of the individual, podiatric medicine serves as a vital part in comprehensive health care.

July 15, 2013
Category: Surgery
Tags: ankle   foot   surgery  

We are now offering minimal incision surgery at our office.  Many deformities of the foot and ankle can be treated using minimally invasive surgery, which can result in less pain and swelling, faster healing, and a quicker return to normal activity!  While these procedures have been around for some time, fluoroscopic technology has made these procedures more accurate and predictable.  We recently added the OEC 6600 Mini C-arm to our East Ridge office, which makes it possible for us to offer these procedures IN OUR OFFICE under LOCAL ANESTHESIA.  This makes it much more convenient, cost effective and affordable!  Call our office to set up an appointment to see if you may be a condidate for minimally invasive foot surgery. 

May 09, 2012
Category: F.Y.I.


Welcome to the Blog of Richard Eby, DPM

Whether you are an existing patient or searching for a podiatrist in the Chattanooga area, we're excited you are here. With the podiatry industry advancing, we recognize the importance of keeping our patients and visitors up to date with all of the new and exciting things taking place in our practice.

As we move forward with our blog, we hope to promote podiatric awareness as a vital part of your healthy, active lifestyle.Here you will find a variety of articles and topics including the latest developments in podiatry, podiatric treatments and helpful foot care advice from our team.

We hope you find our blog to be helpful, engaging and informational to ensure the long-term health of your feet.
As always, feel free to contact us with any questions or concerns.