Category Archives: Musculoskeletal

The Dilemma Faced by Athletes

One of my favorite reads from a few years ago (2017) was ‘The Athletes Dilemma’ by John Weston and I have just now re-read sections of it. Anyone who is working with athletes needs to read this book or at least be familiar with the issues that are addressed in the book. While the book is heavily weighted to the USA sporting context, the issues are applicable to any sport in any country and those issues are faced by all those working in sports medicine on a very regular basis.

The book does a deep dive into the length that professional athletes go to compete with little or no regard to the long term health consequences to themselves. Weston does an excellent analysis as to why they are so willing to do that. The institutions that facilitate this are also critiqued.

The risk of seeing the elite professional athletes do this is the example that they are setting for children for their sporting careers and the lengths that they may feel empowered to go to in order to succeed.

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What is the best-selling product on Amazon.com for ‘Sever’s Disease’?

I was doing some digging around Amazon.com to see what sorts of products people are buying for the self-care of their foot problems and this one for Sever’s disease stuck out like a sore thumb. I can’t say I am surprised by this. What I was surprised by was I had never seen or heard of the product before and just how well it is selling.

It was this ‘half sock’ with a gel under the heel:

severs
severs

They are proving to be very popular on Amazon.com and just go to further illustrate what my not-so-scientific study on calcaneal apophysitis found in the most cases they seem to be self-managed and do just fine.

Link to the product on amazon.com.

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My Not So Scientific Study on Calcaneal Apophysitis (Sever’s Disease)

I have previously written on all my clinical work, research and teaching experiences with calcaneal apophysitis and just how much I realised I did not know and just how much I learnt when my own child got it. As my daughters have just come out of the age bracket where the condition is common, I used that opportunity over the last few years to chat to as many of their friends and their friend’s parents that I could about their experiences with ‘Severs Disease’ whenever I could (an unrepresentative purposively selected sample with recall bias and no ethics approval, but, hey no worries).

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Bunion corrector gullibility

Some people must think some people are really stupid. I recently screen shot some pictures posted on a website that I stumbled across and has now been taken down. They must think that people really are that stupid. It was from a website promoting and selling a “bunion corrector”.

Here is the first image. This was the bunion allegedly before the use of the bunion corrector:

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Cannabis Oil for Plantar Fasciitis

There seems to be increasing advocacy for the use of cannabis oil (medical marijuana) for plantar fasciitis recently, mostly from what I can see, from those who sell it. If you hang out in some of the online communities for those with plantar fasciitis, you see a lot of very bad advice being given, mostly based on anecdotes. In the last year or so, the most popular advice was to use magnesium supplements to cure plantar fasciitis. This was all the rage for a while with an extraordinary number of people advocating its use based on it working for them (when we have no idea if it actually worked or not or if it was just a placebo or just part of the natural history or any other explanation). There is no mechanism that I could find by which it could affect plantar fasciitis. More recently, the volume of advice for the magnesium supplements has started to drop off but is being replaced with an increasing amount of advice for the use of cannabis oil to treat plantar fasciitis. Some of the testimonials are quite compelling … if they are true.

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Platelet Rich Plasma for Plantar Fasciitis – writing about something I know nothing about…

Platelet Rich Plasma for Plantar Fasciitis

I have to be honest and admit that the use of platelet rich plasma (PRP) for plantar fasciitis is something that I have had no more than a superficial interest in. I pretty much scanned the abstracts of the studies and systematic reviews as they are published of it in this thread and the one comparing it to other interventions on Podiatry Arena. I also note comments in social media on it from those whose views I respect. From my superficial understanding, it works, it does not work, it works, it does not work … a lot of the studies that compare it to other treatments do not do the “other” treatment very well (ie wrong dosing), which can easily bias the study to PRP being better. Some of the comments in social media from people who I consider real experts, especially in the context of tendinopathy are that it does not work, yet a lot of people claim it does. Yes, I know that the “plantar fasica” is not a “tendon” and it may or may not be appropriate to translate “tendinopathy” research to “plantar fasciitis” (not that this stops people doing so or not doing so if the research on it matches their pre-conceived biases!).

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