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Impingement Syndromes in Dancers
P
BY DR. JOHN GOODNER
ain in the front or back of the ankle can occur from a dancer standing “en point” or “demi point.” Pain behind the ankle is due to a bone prominence that pinches the soft tissue or due to a fractured bone or cartilage in the back of the ankle (Os Trigonum). A deep pain in the back of the ankle is felt and is made worse if the foot points down.
Treatment includes rest, physical therapy and anti-inflammatory medication. If the pain does not improve, a Cortisone injection is given to decrease inflammation and scar tissue. Unresolved pain may be treated surgically, thus allowing a full return to dance. The back of the ankle is cleaned out and a small piece of bone may be removed with arthroscopic surgery to allow the dancer to return to full activity. Rarely an open procedure is needed. Pain in the front of the ankle is usually caused by thickening of the ankle joint lining and can cause pain while moving the leg forward on the foot. This impingement syndrome is usually associated with an ankle ligament injury and can become very painful, especially the first thing in the morning when getting out of bed to walk or after sitting for a short period of time and getting up to walk. The inflammation and soreness usually lessen with activity but return later on in the day. Physical therapy and a short course of anti-inflammatory medication may be necessary to reduce the inflammation in the ankle joint. If that does not improve, a Fluoroscopic Guided Cortisone injection may be necessary to reduce the thickening of the soft tissue. If conservative measures fail, a Platelet Rich Plasma (PRP) injection can be given into the joint to improve healing
potential. In some cases, the impingement in the front part of the ankle does not improve and arthroscopic surgery may be necessary to completely regain the ankle mobility without discomfort. In some cases, a small spur is present on the front part of the lower leg bone. This can cause chronic pain and stiffness in the ankle. If present, arthroscopic removal of the bone spur is also performed to allow the dancer to resume activity. Prognosis is excellent with full return to dancing with proper treatment. n Dr. John Goodner is a Board Qualified Reconstructive Foot and Ankle Surgeon with the Foot, Ankle and Leg Specialists of South Florida and specializes in sports medicine foot and ankle injuries, foot and ankle arthroscopy, lower extremity trauma, and lower extremity deformities in infants, children, teens and adults. The South Florida Institute of Sports Medicine in Plantation is located at 220 S.W. 84th Avenue, Suite 102, 954-7201530. The practice website is www.SOUTHFLORIDASPORTSMEDICINE. com.Instagram @SouthFloridaSportsMedicine. Twitter @SFLSportsMed.
ACCEPTING: MEDICARE •BLUE CROSS BLUE SHIELD • UHC • CIGNA • AETNA • AV MED • AMBETTER • TRICARE WORKERS COMP • ACCIDENTS/LOPS • SIMPLY • STAYWELL • SUNSHINE • BETTER HEALTH • OSCAR • MEMORIAL PHO
South Florida Institute of Sports Medicine
FOOT, ANKLE, & LEG SPECIALISTS OF SOUTH FLORIDA
OPEN DAILY FOR SAME DAY APPOINTMENTS & TELEMEDICINE DURING THE COVID19 CRISIS
PEDIATRICS
• Flat feet • High Arches • Fractures • Growing Pains • Warts
• Toe Walkers • In Toe • Out Toe • Limping • Ingrown Nail
FRACTURES Why go to an Emergency Room? All Foot, Ankle, and Leg Fractures in Children and Adults! FOOT AND ANKLE ARTHRITIS Total Joint Replacement, Ankle Replacement, Arthroscopy, Fusions, Joint Realignment
CARTILAGE INJURIES Microfractures, Cartilage Transplants, Osteochondral Grafting RECONSTRUCTIVE FOOT, ANKLE AND LEG SURGERY Flat Foot, Bunions, Hammertoes, Ligament Repair, Achilles Tendon Tears, Arthritis Surgery SPORTS MEDICINE Tendon and Ligament injuries, Heel Pain, Shockwave Therapy, PRP & Stem Cell Injections, Arthroscopy and Tendoscopy, Shin Splints, Compartment Syndrome
SERVING OUR PATIENTS FOR OVER 30 YEARS Dr. Warren Windram, D.P.M.
Board Qualified FOOT, ANKLE, & LEG SPECIALIST
Dr. John Goodner, D.P.M.
Board Qualified FOOT, ANKLE, & LEG SPECIALIST
Dr. Robert Sheinberg, D.P.M. - In Loving Memory -
Dr. Carlo Messina, D.P.M.
Board Certified FOOT, ANKLE, & LEG SPECIALIST
WESTON
PEMBROKE PINES
954-389-5900
954-430-9901
1600 Town Center Blvd.
17842 NW 2nd St.
Dr. Michael Cohen, D.P.M.
Board Certified FOOT, ANKLE, & LEG SPECIALIST
PLANTATION
220 S.W. 84th Ave., #102
954-720-1530 SATURDAY HOURS
Make Your Appointment Online at www.SouthFloridaSportsMedicine.com
FOOT, ANKLE & LEG QUESTIONS? EMAIL THE DOCTOR! DrJohnGoodner@gmail.com (Don’t Send Protected Health Information)
IMEs • Personal Injury • Worker’s Compensation Most HMOs/PPOs • All Foot Ankle & Leg Emergencies Same Day Appointments • Saturday Appointments Early Morning & Evening Appointments
SELF PAY RATES (Procedure cost is in addition to office visit.) New Patient . . . . . . . . . . . . . . $200 Surgery Consult . . . . . . . . . . . $200 Injections . . . . . . . . . .$75 per shot Casts . . . . . . . . . . . . . . . . . . . . .$175 Follow Up Visit . . . . . . . . $50-$100 Orthotics . . . . . . . . . . . . . . . . . $350 Ingrown Nail . . . . . . . . . . . . . .$125 X-Rays . . . . . . . . . . . . $50 per area PRP . . . . . . . . . . . . . . . . . . . . .$600 Shockwave (3 sessions) . . . . $500 Laceration Repair . . . . . . . . . $250 Wound Care . . . . . . . . . . .$75-$125 (FOR CHRONIC HEEL PAIN & TENDONITIS)
SPORTS MEDICINE ASSOCIATES (Self Pay Rates Do Not Apply To This Practice Below)
Dr. Al DeSimone, M.D. Board Certified SHOULDER & KNEE SPECIALIST
Dr. Fernando Moya, M.D. Board Certified SHOULDER & KNEE SPECIALIST
26 / Our City Pembroke Pines / February 2021 / OurCityMedia.com
Dr. David Shenassa, M.D. Board Qualified HAND & WRIST SURGEON
Dr. Alexander Bertot, M.D. Board Certified SPORTS MEDICINE SPECIALIST
Dr. Franz Jones, D.O. Board Certified SPINE SPECIALIST
