Any orthopedists or docs or anyone know much about joints and such? | FerrariChat

Any orthopedists or docs or anyone know much about joints and such?

Discussion in 'Other Off Topic Forum' started by SRT Mike, Aug 12, 2008.

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  1. SRT Mike

    SRT Mike Two Time F1 World Champ

    Oct 31, 2003
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    Here's something I can't figure out and docs can't seem to either - but it seems simple enough.

    The other day I get out of bed, I put my right foot on the ground, step onto it and I feel a "click" in my foot. It felt like the tendon was out of place and snapped into position (like cracking a knuckle but it was a tendon or ligament snapping into place, not a bone). Hurt a little, not too bad though. Throughout the day, it's kind of hurting more - like it's tensing up. Go to bed last night and it's more sore, but I can still walk with a slight limp. Wake up this morning and OH BOY... I can barely walk. I can put weight on it fine - if I step forward with my right foot, it's OK... but as soon as my right foot goes behind my center of gravity (so that I would be bending the toes and preparing to push off on it), it hurt like no pain I've ever felt before. It's not that it's tender to the touch, but if I move it in some certain way, the pain is unbearable.

    Now this seems to happen to me once every year or so. Last time I went to the podiatist... he grabbed my foot, pushed in on the flat part halfway down my foot (across from the arch) and I almost hit the roof. He was susprised and said "wow! it hurts that much?". He was sure it was broken... took x-rays and nothing. I asked if he had seen something like this before and he hadn't.

    This time, if I push that part of my foot, it's fine.. I could pound on it with a fist and not feel it. But... this time if I grab the front of my foot just behind my toes and try to bend it down/forward... wow doggie does it ever hurt. So whatever happened, it happened in a different place than it did last time. This is probably the 3rd or 4th time this has happened in the last 2 years. In 2-3 days, the pain will be gone, I will be walking like nothing ever happened. But today - I could barely put a shoe on, because the contortion you do to get your foot into the shoe must move whatever tendon is hurting and it's too intense to grin and bear it. And every time, the docs can't see anything wrong, they prescribe some vicodin and send me home. I've had it at least twice now in my right foot and once or twice in my left foot. Always in the foot - never the ankle or heel - always in the central area of the foot, it seems (but sometimes its the bottom that hurts, sometimes the top, sometimes it feels like it's right inside in the middle).

    Anyone had anything like this? If you guys have had back pain, you know how sometimes it seems like a muscle is just out of place, andyou turn a certain way and tweak it... and it hurts a little then, but the next morning it tightens up and really hurts? This sort of feels like that, but the intensity of the pain is about 10x worse.

    Is it possible that tendons or ligaments or something can get out of place, and by me putting my foot down and stepping up first thing in the morning, I am tweaking something in my foot causing this?

    Is there anything I can do to prevent it?

    I had a motorcycle accident about 8 years ago - my foot got dislocated and the socket joint cracked and had to be screwed together. I originally attributed the phenomenon to that, but since then it's happened sometimes in my left foot, sometimes in my right.

    F-chat diagnoses, FTW! ;)
     
  2. PT 328

    PT 328 F1 Rookie
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    Where, specifically, is the discomfort? Is it in the top of the foot, bottom of the foot? Since you stated it happened when you got out of bed I am more inclined to think it is the plantar fascia. The plantar fascia runs from the calcaneal tuberosity ( bottom of the heel ) to the metatarsal heads ( base of the toes ). This tissue as does our other musculature shortens slightly over night. That is one of the reasons we stretch upon awakening. It is very common for people to strain the plantar fascia during the first few steps after getting out of bed.

    The popping people hear is usually one of 2 things. It is a tendon rolling over a bone or air being released from the synovial capsule ( cracking your knuckles ).

    If the pain is predominantly on the lateral ( outside ) of your foot near the lateral malleolus ( the bone that sticks out on the outside of your ankle ) I would think it is an ankle sprain. 99% of ankle sprains are inversion sprains where the ankle rolls inward. This sprains the anterior talo-fibular ligament. Did you have any bruising?

    My last thought is the possibility of a stress fracture. Sometimes difficult to diagnosis as they sometimes will not show up on x-ray in the acute phase of the injury.

    I would make another appt. with the podiatrist for further manual examination and testing just to make sure. Once you have a diagnosis let me know and I can provide suggestions of care and prevention.
     
  3. SRT Mike

    SRT Mike Two Time F1 World Champ

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    Hi Dan!

    Thanks for the info - very helpful! The pain feels like it's inside the foot, but towards the top. It sort of feels like it's a line roughly in the center of my foot going from where the "wrist" of the foot is (where the vertical meets the horizonal area) and extending forward towards my toes. I can walk fine on the right side of my right foot (the side opposite the arch). I can put all my weight on the heel of my foot (so I can sort of hobble around) but as soon as I put weight on the ball of my foot... the pain comes like an avalanche.

    Its funny you mentioned the getting out of bed thing... it seems like whenever this happens it's when I am running on low sleep, so when my alarm goes off, I go from deep sleep straight to standing up (and on a hardwood floor in the bedroom no less). Every time this has happened it was during the week when my alarm went off and I almost literally jumped out of bed. On the weekends, I wake up and lie and relax before getting up - never happened on a weekend.

    The pop noise - it's not so much of a noise that I hear, as it is a "click" that I feel inside the foot... it's like when you yawn and you get that click in your jaw.

    I am going to make another appointment with the pod to see what he says. He's a great guy, but he's a friend also, and he always charges me next to nothing when I go, so I feel bad pushing him to "do the full work up and figure this out" when I know he's losing money on me. It sounds silly but he's too polite to tell me that he wants to charge me for the works, and I am too polite to tell him to go ahead and charge me the full amount. I'll just spit it out and get him to take a look.

    on the plus side, this morning I thought I was going to be unable to walk... by the end of the day I can put weight on it again, before bed I can almost walk normally, and I'll bet by tomorrow I'll be right as rain.

    Thanks again for your input Dan, its greatly appreciated!
     
  4. velocetwo

    velocetwo F1 World Champ

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    I had similar symptoms with my joint popping in the morning, later in the day I hopped off a ledge landing on the side of my foot. Felt OK and thought that was close, it could have been bad. Walked into the house and felt a pop! Next day they took x rays and saw a small fracture. The doc also mentioned that the tendon was probably torn 6 weeks later I am good, but I can feel it is not the same.
     
  5. ryalex

    ryalex Two Time F1 World Champ
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    #5 ryalex, Aug 14, 2008
    Last edited: Aug 14, 2008
    On my right hand, 3rd knuckle (ring finger):

    -the knuckle bone is [apparently] underdeveloped on the right side of the joint;
    - when I close my hand, the tendon slides out of the groove in the bone and across the knuckle to the right side of the bone; and
    - No pain at all, but I can feel the tendon move around sideways when I make a fist.

    My question: is this likely to be arthritic or any other degenerative issues from this as I age?

    I'm not really concerned about it, but I have developed a bit of carpal tunnel in my hands from typing on laptops for years and sometimes I worry about that joint/tendon causing problems later.
     
  6. DrStranglove

    DrStranglove FChat Assassin
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  7. PT 328

    PT 328 F1 Rookie
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    Ryalex,

    No this does not mean you are certain to have arthritic conditions as you age. What you are describing and arthritis are two totally different things. Arthritis is when we lose/break down the articular cartilage. It is a misnomer that if we crack our knuckles we will develop arthritis. The noise you hear when you crack your knuckles is gas being forced out of the synovial capsule, it is the same thing you hear when you go to the chiropractor. The joint feels better after cracking it because there is less "stuff" occupying the space so it feels looser/more free. Arthritis is more genetic based and/or overuse.

    In regards to your carpal tunnel. Many people believe or are misdiagnosed with carpal tunnel syndrome. Carpal tunnel is very specific to the middle finger, the medial aspect (inside) of the ring finger and the medial (inside) of the index finger. The reason it is so specific is that the median nerve is the nerve that passes through the carpal tunnel. Using improper ergonomics, sleeping with your hand tucked under you ( wrist flexed ) can lead to swelling of the carpal tunnel. This swelling decreases blood flow to the median nerve which results in loss of strength, numbness, and pain. The best way to diagnosis carpal tunnel is a Tinel's test or better yet a nerve velocity conduction study.

    Carpal Tunnel prevention: Take frequent breaks when working on a computer to stretch your wrists/ fingers into extension while keeping your elbow straight. Hold the stretch for 20-30 seconds. A laptop is horrible for ergonomics unless you have an external keyboard/mouse. The leaning over a keyboard with monitor attached for prolonged periods of time is asking for trouble. You can also ice the wrist to help with the localized swelling, try a carpal tunnel wrist brace and wear it when you sleep to prevent the aforementioned from occurring.


    SRT Mike,

    From your description and my not being able to physically exam you it could be a variety of things. I'll bet you have some underlying plantar fascitis and a "possible" stress fracture. Keep me posted on what the podiatrist finds.

    I think I have developed carpal tunnel typing this.

    Dan
     

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