#dynaflange

Foot Notes:

In a world where nothing is all good or all bad, there are certain benefits that can be had from feeling your feet in the grass, but from a functional standpoint I rarely advise patients to be barefoot. In general the foot benefits from being protected from the elements, be that cold, sun or thorns in the landscape. Footwear also protects the foot from both macrotraumas like impact from a falling object, and the repetitive microtrauma of walking, working and physical pressures of life on your feet. With the exception of disfiguring trauma, dancers and soccer players, folks who spend the majority of their time barefoot, historically have the worst feet that I see. As the three-dimensional foot is in constant contact with a hard two dimensional support surface the joints deform under pressure and all the elements for wear and future arthritis are born. There is a lot of thought, biomechanically, that goes in to high-end running shoes, and coupled with the right orthotic, you can make a significant and lasting difference to your structure and improve your quality of life.

Music Notes:

Pressure is certainly something we want to minimize but at one time or another it can't be avoided and must be dealt with. The lyrics of musician and wordsmith Billy Joel come to mind "You've only had to run so far, so good, but you will come to a place where the only thing you feel are loaded guns in your face, and you'll have to deal with pressure"

This 1982 hit comes from the album "The Nylon Curtain" as was easy to single out for this blog because of subject matter but for the younger generation or for those late to the pop music scene, take time to discover the music of Billy Joel.  

Groove Notes:

Foot Notes:  

Recently there's been a lot of discussion about sports related injuries and brain disease secondary to concussions.  Scientists are learning more about the devastating effects of repetitive trauma and inventors are designing things like special football helmets to combat these problems. It's useful to consider each step as a collision between your three-dimensional foot in the hard flat support surface. The repetitive trauma to the foot travels up the body and reeks havoc on our entire muscular skeletal system and just like other Sports gear modifications protection for your feet continues to evolve. Protecting the feet, which is the start point of constant collision can be addressed by using an orthotic. Orthotic is a shoe insert that provides support, cushion and balance to the beleaguered impact area, usually the heel. When collision happens there's energy transfer, deformation and shock. Various forms of cushion inserts have been used to address these issues but none address all the issues of collision dynamics nor are as efficient as the DynaFlange, which makes use of a suspension system like you would see in a car or bicycle, to manage impact and, a divingboard like system, so that energy needed for walking and functioning isn't lost, centering the foot and assisting you forward. Check out the DynaFlange website for more information and a video walk through.

Music Notes:

"Collide" is a wonderfully thoughtful acoustic pop song focused on relationships. This 2003 hit was recorded by Howie Day and written by he and Kevin Griffin. It can be found on the album entitled " Stop All The World Now. As a songwriter I really appreciate the humanity and serendipity of the couplets "Even the best fall down sometime, even the wrong words seem to rhyme, out of the doubt the fills you mind, you finally find, you and I collide"

I have been practicing medicine for nearly three and a half decades and before I was a physician I was a musician. I've been lucky enough to experience some amazing things in my life as both, so passing on my thoughts on Health and turning on a new generation to some old classic music is an honor, privilege and a duty I take very seriously

Foot Notes:

I've heard it said that you have to kiss a lot of frogs before you find your prince, or princess, yet, one of our most intimate and enduring relationships happens too often without a second thought. We are assigned or inherit a doctor or perhaps do some vetting but that is like a first date, with little experience with which to make an informed decision for such a trusted advisor and confidant. A doctor may may be great, but not all good people connect. We just can't be all things to all people.  For instance, you may have a rock start surgeon to address your issue but you were looking for a more holistic approach.  At the end of the day when we choose, we must have an open dialog because your doctor is only as good as the information you share and your willingness to be a compliant patient. If you can't have that type of relationship with your physician, find another one that you can. Your health, quality of life and life itself is at stake, "because the strong give up and move on, while the weak, the weak give up and stay" (Do What You Want, Be What You Are, written and recorded by Hall & Oates, 1976 from the album entitled "Bigger Than Both Of Us" The frustration of "I'm not feeling listened to" is perhaps the most common complaint in healthcare (except insurance) from both patient and doctor, so, remember healthcare is a dialog with lots of listening.  "What if it's lost behind, words we could never find, baby before it's too late, what about now" wise words from Joshua Hartzler, Ben Moody, David Hodges and performed by Chris Daughtry in the song "What About Now"

Music Notes:

Don McLean exploded on the music scene in 1971 with the monster hit, "American Pie", A brilliantly clever impressionistic view of the history of early rock 'n' roll.  Its honed analogies, metaphors and veiled references to music icons challenged listeners to go beyond the literal word and hunt for the meaning of the lyrics. But for me, the piece that demonstrates the true genius of this song writer is "Vincent". This sensitive song is a work of art that shows an artist at the top of his craft, and to the theme of communication, the song "Vincent" offers two evolving thoughts.

"they would not listen they did not know how, perhaps the listen now"

And

"they would not listen they're not listening still perhaps they never will"

Groove Notes:

Foot Notes:

The peripheral circulatory system is like a two lane Highway, delivering oxygenated blood in tubes called arteries, from the heart throughout the body to our limbs, and veins that carry deoxygenated blood and waste back up to the lungs and heart. Though they appear similar, veins and arteries have different internal workings and therefore are assessed by different means during physical exam. As a healthcare professional, I check foot pulses and blood perfusion of the toes to make sure that they are receiving the needed nourishment from the arteries to maintain healthy working feet. The main issue we are concerned with in accessing vascular health is blockage. This is one of the reasons why we check cholesterol levels in the blood as it is known to build up as plaque inside the walls of arteries and jeopardize blood flow. Beware of limbs, feet and toes that are cold or pale as that may indicated a lack of blood flow.   This can be a limb threatening situation so don’t wait, visit your local podiatrist for a diagnosis and treatment plan.  With veins, we also worry about blockage but in a different way. When blood clots form in the veins and then pass, they can head into the lungs and cause life threatening problems. There are two vein systems in the lower limbs, the superficial and the deep. When the deep veins get clogged the superficial system becomes over taxed and we can observer them as being more visible, however veins are also known to come to the surface to cool. A distinguishing characteristic between the two is the clogged vein can often be red and painful and the other is usually not.  

Music Notes:

When I think about flow and the ease of nature, the song Blue Sky always comes to mind. A banner Allman Brothers tune written by Forrest Richard "Dickey" Betts, from the classic album Eat A Peach, 1972. This song begins with some southern flavored blues vocals by the recently deceased Gregg Allman, stuffed with some of my favorite guitar fills and solos, and a killer opening couplet.

"Walk along the river, sweet lullaby, it just keeps on flowing, it don't worry 'bout where it's going. Turn it up to enjoy all the blending overtones and rhythms.

As many of us look forward to a long weekend of family, fun and food in celebration of the birth of our nation, I also think of our struggles and the many folks who don't feel free. On that day in 1776, we were in the struggle for our very existence and with our perseverance came success then independence, peace and prosperity. Have faith in your future, the best is yet to be. BTW-this is not me butI certainly can be enthusiastic in a guitar shop!

Foot Notes:

Our feet tend to be invisible in our early lives, carrying us through the rigors of our day and helping to keep us independent. We don't give them much thought until they demand attention, so today, and at least once a week do something nice for them. Massaging your feet regularly with moisturizing lotion will help maintain proper health, keep you in touch with a vital part of the body that is often taken for granted and cut down on callous build up that can be quite problematic if left untreated. Calluses form as a response to friction and pressure. Underneath the feet, they can be painful and destabilizing as the nucleated varieties make it difficult to stand and get around, change the way you move and jeopardize your joints. They feel like your walking on stones or have pebbles in your shoes. All these problems for a condition that is easily preventable with the right shoes, inserts and topical foot preparations. 

One important caution though, please avoid using acid plasters to "eat away the corns and calluses" as acid burn indiscriminately, it doesn't know good tissue from bad tissue. Over the years I have seen a number of serious ulcerations that have been caused by people using these acid plasters. I recommend enzymatic products like Callex to treat callous related issues as homecare but see your local podiatrist to keep them trimmed appropriately.  Shoe inserts, like DynaFlange® can also help reduce the impact and friction.  Help yourself stay foot loose and fancy free so you can get out and enjoy the fireworks.

Music Notes:

As our national bird is the Bald Eagle, I thought it appropriate to feature one of the most influential and successful bands of all time, the Eagles. This Los Angeles band formed in 1971 and hit the charts hard and often throughout the 70s with pop classics such as Take It Easy, Peaceful Easy Feeling, Desperado, Lying Eyes, Best Of My Love, Hotel California and so many more. One of my favorite quotes about freedom, faith, independence and understanding comes from a song penned by Jack Tempchin‎ and Robb Strandlund‎, named Already Gone, from the album On The Boarder, vintage 1974.

“So often times it happens that we live our life in chains and we never even know we have the key.”

I also love this quote about awareness and understanding from the same song.

Foot Notes:

A few weeks ago I posted some footnotes about time heals all except for your feet. The larger point was that early diagnosis and treatment, when appropriate, leads to better outcomes. Time is usually part of that equation but after diagnosis and treatment plan. Let's for instance take the situation where someone has an open wound from trauma. The wound will have to be cleansed, if there are broken bones they may need to be set and antibiotics may be recommended. With that initial support and rest, the body can aid in wound repair. If we move to rehabilitation before healing is complete, that wound will likely experience a delay resolution. It's like picking at a scab before it has finished it's job. We also run the risk of reinjury as the tissues, bone or soft tissue have not completely knitted together and therefore are weaker as a functional unit and more vulnerable to forces. That is why we often see professional athletes reinjured when put back into play too soon.  The body responds naturally to injury, consider what happens in a common cut. The skin is split, blood comes out and cotes both sides. The quality of blood, over a short time, is sticky and that holds the two sides together so they can heal. Healing is really the opposite of rehabilitation. In healing, as demonstrated by the scenario above, we want to approximate tissues and limited motion but with rehabilitation we want move and work tissues. Both are important parts of the medical protocol but rest before rehabilitation

Music Notes:

Grammy Award winning Michael Bolton took the adult contemporary music scene by storm with his sensitive song choices, sense of song presentation and powerful, blue-eyed soulful voice. His remake of the Ray Charles hit Georgia On My Mind is always an inspiration and can be found on the album Soul Provider, 1989, which is a great listen from top to bottom. Time, Love and Tenderness was the follow up album in 1991 featuring a song of the same name which was written by veteran songwriter Diane Warren and offers up this great advice on the value of time. "Nothing heals a broken heart like time, love and tenderness"

Diane Warren has a storied career, writing the hits performed by many "A" listers such as Aerosmith, Carrie Underwood, Eric Clapton, Celine Dion, Chicago, Whitney Houston, Edwin McCain, Beyoncé and so many more. And as to wounds and the power of words and music,

"Love's like a knife it can cut deep inside, Words are like weapons, they wound sometimes"  

This couplet from "If I Could Turn Back Time" was also written by Diane Warren and cut by Cher in 1989.