Yo, Ho, Ho, I Have Ship Foot

Back when sailing, fishing, whaling, maritime, and war ships were a larger part of our culture and livelihoods,

sailors would often drop heavy objects on their feet. Ouch! 
The term ship foot is believed to have originated with sailors on gun ships. After a cannon recoiled it would often strike the sailor's toe. The toe and toenail would then bruise and if the impact was strong enough, the toenail would die and fall off the toe. 
Today, this term can be used in any situation, not just ships, and can often accompany toe fractures. Symptoms may include discoloration of the toenail, usually bruising in blue, purple, black, or red. You may notice trapped blood under the toenail as well, along with blisters and cracked skin. 
Podiatrists will often recommend the R.I.C.E. course of treatment for a ship foot- rest, ice, compression, and elevation. Even if a toe fracture accompanies ship foot, your podiatrist will still recommend R.I.C.E. The discoloration of the toenail will eventually grow out. If the toenail is cracked or blood is coming from under your toenail it may be necessary to remove the toenail. 
While recuperating from this injury, you may experience pain in your foot, legs, or back as you alter your gait to take pressure off your injured toe while you walk. It is crucial to follow the R.I.C.E. procedure to avoid affecting other parts of your body. 
Reference: Wise Geek. 
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Nathan Lane Injures Foot

Last Wednesday 2013 Tony nominee Nathan Lane injured his foot during a performance of The Nance and had to be replaced by his understudy Stephen DeRosa. Despite the injury, Lane was back on the stage at the Lyceum Theatre last Thursday. 
According to a phone interview with the New York Times Arts Beat, the Birdcage actor injured his foot and leg during the play's first act when Lane stepped off the production's turntable, which spins around to allow the sets to transform from a burlesque house to the apartment of Lane's character, Chauncey Miles.
"The turntable was moving very quickly and I misjudged it, and had one foot on the stage while the other was still on the turntable, and it pulled my leg," Lane said. "It twisted badly. I'm seeing a physical therapist today, and we'll see. I hope to be back in the show tonight."
The Nance tells the story of a 1930's era homosexual burlesque performer named Chauncey Miles. A "nance" was a show business term for a stereotypically camp homosexual man, who struggles with his own identity and society's hypocrisy towards homosexuality. In The Nance Playwright Douglas Carter Beane tells the story of a homosexual man living and working in the secretive and dangerous gay world of the 1930's New York City. The play runs through Sunday August 11th. 
References: Broadway World 
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What Is Freiberg's Disease?

Freiberg's Disease is a painful condition that affects the second metatarsal head. This is the bony knuckle in the ball of the foot behind the second toe. It can also affect the third and fourth metatarsal bones, but they are less commonly affected.
More than 80% of cases are females, and most of those are women up to the age of 20 years. Children who are athletes are often most commonly affected, especially those who are on their toes a lot in sprinting or jumping. The primary complaint is often vague forefoot pain, worsened by activity and weight-bearing and relieved with rest.

Freiberg's Disease occurs in children when there is a disruption of blood flow to the tip of the bone because of excessive pressure. It happens at the site of the growth plate, which closes in adolescence and therefore does not affect adults. In some cases a mechanical cause is thought to be the reason for the condition. A traumatic event, such as a heavy blow, or several small incidents can also cause Freiberg's Disease.
Freiberg's Infarction is the term applied when it occurs to children. Infarct means tissue death because of lack of blood. It is likely the excessive pressure causes a small fracture to occur within the cartilage growth plate that is between the long shaft of the metatarsal bone and the head, cutting off the blood flow. On an x-ray the area will be transparent as calcium leaves the bone, which will collapse on itself. The process takes about a year and when it is complete, the bone will be denser and whiter. An x-ray will also show the flattening of the rounded tip of the metatarsal bone and thickening of the shaft.
Freigberg's Infraction is applied to adults where the x-rays are similar. Most people have two or three arteries supplying blood to the area, but some have only one artery, making possible bone death. In others, the first metatarsal does not function properly and shuns its share of the body weight over the second, third, and fourth bones.
Treatment includes examination of the foot, which should show the area to be swollen, stiff, and painful. To find the tender spot, the podiatrist will flex the toe back as far as possible to expose the end of the metatarsal as well as the bottom surface. Treatment will focus on reducing the pressure on the second metatarsal head, by deflecting the pressure away from the area, causing the first metatarsal to take its share of the weight.

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Anatomy of the Foot

The foot is made up of 26 bones, 33 joints, 107 ligaments, 19 muscles, and numerous tendons. Complex biomechanics keep all these parts in the right position and moving together. Given these intricacies, it is not surprising that most people will experience some problem with their feet at some time in their lives.
Within each foot, the essential structure can be summed up as follows:

• Seven short metatarsal bones make up the heel and back of the instep.
• Five metatarsal bones spread from the back of the foot toward front and make up the structure for the ball of the foot. Each metatarsal is associated with one of the toes.
• Fourteen phalanges, small bones, form the toe structure.
• Tarsal and metatarsal bones provide the structure for the arch of the foot.
• Bands of ligaments connect and hold all the bones in place. 
• A thick layer of fatty tissue under the sole helps absorb the pressure and shock that comes from walking and everyday movements.

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Related articles

• I Have A Long Second Toe!
• I Think I Broke My Toe- What Can A Podiatrist Do?
• My Fourth Toe Is Very Short!
• I Stubbed My Piggy Toe!

Shoe of the Month: Flip-Flops

Ok, ok, we're not being hypocrites, we promise! Certain, select flip-flops can be worn, but you need to be a choosy consumer when it comes to flip-flops.
Even the most intuitive shopper and shoe addict may have trouble decided between the countless flip-flop color and style choices. Select a pair that has some support and is unable to bend in half to minimize foot pain often caused by poor-fitting straps, so choose a style made of natural materials, such as soft leather, and make sure the foot doesn't hang off the edge. Heel pain sufferers should stay away from flip-flops.

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• If Dr. Oz Says It... Flip-Flops Cause Plantar Fasciitis

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Kristen Stewart's First Hunt Injury

Kristen Stewart is not a fan of high heels to begin with and even wears ballet flats on the red carpet, but her casual look on the Tonight Show with Jay Leno on May 4th was due to a foot injury!

While reshooting scenes for Breaking Dawn Part 2, which hits theaters in November, Stewart got a puncture wound while filming. The wound happened while Stewart was working on her "first hunt" scenes, right after she is turned into a vampire. 

Puncture wounds are not the same as cuts. A puncture wound has a small entry hole caused by a pointed object, such as a nail that you've stepped on. In contrast, a cut is an open wound that produces a long tear in the skin. Puncture wounds require different treatment from cuts because these small holes in the skin can disguise serious injury.

Puncture wounds are common in the foot, especially in warm weather (or on a hunt) when people go barefoot. But even though they occur frequently, puncture wounds of the foot are often inadequately treated. If not properly treated, infection or other complications can develop. 

Proper treatment within the first 24 hours is especially important with puncture wounds because they carry the danger of embedding the piercing object (foreign body) under the skin. Research shows that complications can be prevented if the patient seeks professional treatment right away. 

A variety of foreign bodies can become embedded in a puncture wound. Nails, glass, toothpicks, sewing needles, insulin needles, and seashells are some common ones. In addition, pieces of your own skin, sock, and shoe can be forced into the wound during a puncture, along with dirt and debris from the object. All puncture wounds are dirty wounds because they involve penetration of an object that isn't sterile. Anything that remains in the wound increases your chance of developing other problems, either in the near future or later.

There are different ways of determining the severity of a puncture wound. Depth of the wound is one way to evaluate it. The deeper the puncture, the more likely it is that complications such as infection will develop. Many patients cannot judge how far their puncture extends into the foot. Therefore, if you've stepped on something and the skin was penetrated, seek treatment as soon as possible.

The type and the "cleanliness" of the penetrating object also determine the severity of the wound. Larger or longer objects can penetrate deeper into the tissues, possibly causing more damage. The dirtier an object, such as a rusty nail, the more dirt and debris are dragged into the wound, increasing the chance of infection.

Another thing that can determine wound severity is if you were wearing socks and shoes, particles of which can get trapped in the wound.

A puncture wound must be cleaned properly and monitored throughout the healing process to avoid complications. 

Even if you have gone to an emergency room for immediate treatment of your puncture wound, see a foot and ankle surgeon for a thorough cleaning and careful follow-up. The sooner you do this, the better: within 24 hours after injury, if possible.

The surgeon will make sure the wound is properly cleaned and no foreign body remains. He or she may numb the area, thoroughly clean inside and outside the wound, and monitor your progress. In some cases, x-rays may be ordered to determine whether something remains in the wound or if bone damage has occurred. Antibiotics may be prescribed if necessary.

Follow the foot and ankle surgeon's instructions for care of the wound to prevent complications.

Infection is a common complication of puncture wounds that can lead to serious consequences. Sometimes a minor skin infection evolves into a bone or joint injection, so you should be aware of signs to look for. A minor skin infection may develop in two to five days after injury. The signs of a minor infection that show up around the wound include soreness, redness, and possibly drainage, swelling, and warmth. You may also develop a fever. If these signs have not improved, or if they reappear in 10 to 14 days, a serious infection in the joint or bone may have developed.

Other complications that may arise from inadequate treatment of puncture wounds include painful scarring in the area of the wound or a hard cyst where the foreign body has remained in the wound.

Although the complications of puncture wounds can be quite serious, early and proper treatment can play a crucial role in preventing them. 

What You Should Do:

• Seek treatment right away.
• Get a tetanus shot if needed (usually every ten years).
• See a foot and ankle surgeon within 24 hours.
• Follow your doctor's instructions:

1. Keep your dressing dry.
2. Keep weight off the injured foot.
3. Finish all your antibiotics (if prescribed).
4. Take your temperature regularly.
5. Watch for signs of infection (pain, redness, swelling, fever). Call your doctor if these signs appear. 

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