Ankle Injuries Aren’t Just for the Sporty

Ankle injuries can happen to any of us, anywhere, anytime. All it takes is a twist or a turn at an inopportune moment at an inopportune place. There is pain and debilitation from the resulting sprain (damage to ligaments that have been stretched beyond their normal capacity and range of motion), strain (damage to tendons that have been stretched or pulled too far), or fracture (a break in a bone).

There are a number of causes of an ankle injury. They include the following:
• falling or tripping
• walking or running on an uneven surface that forces the ankle into an unnatural position
• twisting or turning the ankle
• rolling the ankle
• a sudden impact
• walking or running in high heels or other unstable shoes

So what’s a body to do? Here are some ounces of prevention that are worth pounds of cure…
• Keep your bones and muscles strong, increase flexibility, improve circulation, and reduce fatigue by walking regularly.
• Improve balance by doing balancing exercises.
• Maintain a reasonable weight or lose weight to get to a reasonable weight.
• Shoes are good friends when they are supportive and comfortable. Worn out padding, tread, or heels are signs that new shoes are in order. Be low-down and skip the stilettos. As much as the ladies do not want to admit it, the higher the heel, the more likely they are to experience an ankle twist or turn.
• Be alert about where you are walking or running.
• Stretch before and after you exercise.
• If you have already experienced an ankle injury, your ankle is weaker than it once was, so wear a supportive brace/splint or wrap your ankle to prevent a recurrence.
• Avoid rapid increases in any type of sport or exercise.
• Listen to your body! Pain is its way of telling you something is wrong.

If you believe that you have suffered an ankle injury, please schedule an appointment for a consultation at Jacksonville Orthopaedic Institute Beaches. One of our highly-skilled physicians will be happy to discuss your symptoms, make a diagnosis, and develop a treatment plan for you. Contact us today at 904-241-1204.

Happy Healthy New You Year!

Resolutions are typically made at the beginning of the new calendar year. And, typically, they are broken shortly thereafter. The resolution to have a safe and healthy life by being active and by exercising should be practiced every day of every year. Activity and exercise contribute to improvements in

• overall health;
• stamina and energy levels;
• fitness;
• quality of sleep;
• posture and balance;
• mood and mental health;
• muscle and bone strength;
• conditions that affect the joints;
• self-esteem;
• weight loss and weight control;
• stress levels; and
• the ability to perform everyday activities of an independent life.

It’s really a no-brainer. You have the ability and the power to make lifestyle choices that can result in life-long benefits. When you make the choice to follow an exercise regimen or simply to be more active,

• choose activities and exercises that you enjoy;
• join forces with a partner;
• set short-term, reasonable, and reachable goals that have measureable benchmarks along the way;
• post your goals to keep them top-of-mind;
• compete only with yourself;
• compare your performance with no one else’s;
• add variety to your plan;
• practice patience;
• talk to an expert or do some research about what you want to achieve and why; and
• always remember the reason you made this resolution in the first place.

The benefits of being active and fit are many. A major benefit is a reduced risk of injury. Aerobic (“with oxygen”) exercises strengthen and tone muscles, reduce chances of osteoporosis by stimulating bone growth, increase endurance, and reduce the risk of falling. Aerobic exercises are performed over a long period of time with moderate intensity. Anaerobic (“without oxygen”) exercises strengthen bones, protect and strengthen joints, yield growth in muscle mass, and improve the ability to move with quick bursts of speed. Anaerobic exercises are performed over short periods of time with high intensity and/or speed. Agility training improves the ability to maintain balance and control while changing direction as well as the ability to increase and decrease speed. Stretching exercises improve flexibility, posture, coordination, and balance.

Congratulations on resolving to achieve positive health outcomes through activity and exercise! If you have questions about what you can do become a healthier new you, contact us at 904-241-1204.

Be “Hip” About Hip Strains

A hip strain involves an injury to the muscles and tendons of the hip area.

Usually, the cause of a hip strain is an accident or traumatic impact to the hip that results in small tears in the muscle fiber or tendons. Previous injuries in the area, repetitive overuse, and insufficient warm up can bring about a hip strain.

A hip strain can result in pain felt directly over the injured muscle or tendon. Because the bones in the hip anchor muscles that are in the leg, across the abdomen, and in the buttocks, pain can also appear in other areas. Pain increases with activity. There may also be swelling, stiffness, tenderness, muscle spasm, bruising, or a partial/full loss or muscle strength or joint flexibility. Walking may be difficult in some cases.

When your injury does not improve with home treatments, or it is obvious that the injury is severe, it’s time to see one of the physicians at Jacksonville Orthopaedic Institute Beaches. A diagnosis will be made after a thorough exam that may include placing pressure on the injury area, x-rays, and performance of movements to determine limitations, stability, strength, and amount of pain. Magnetic Resonance Imaging (MRI) may or may not be needed.

Mild and moderate hip strains are treated with RICE: Rest, Ice, Compression, and Elevation. Avoiding activities that aggravate the condition is also recommended. Your JOI Beaches physician may prescribe the use of anti-inflammatory medication and crutches. Moderate hip strains may require additional measures including physical therapy, massage, and/or heat therapy. Severe strains usually require surgery and, afterward, rehabilitation. No matter how severe, hip strains need to be allowed to heal completely before normal activities are resumed.

If you believe that you have suffered an injury resulting in a hip strain, please schedule an appointment for a consultation at Jacksonville Orthopaedic Institute Beaches. One of our highly-skilled physicians will be happy to discuss your symptoms, make a diagnosis, and develop a treatment plan for you. Contact us today at 904-241-1204 or online at






Sports Injuries in the Knee

The knee is a complex joint.  Because of the complexity of its parts, the ordinary person is susceptible to having a knee injury.  Normal use of the knees plus participation in sports increases the possibilities for injury.  Acute knee injuries happen suddenly and are extremely painful.  Chronic knee injuries are those that have developed and continued over time.  An acute injury might become chronic if not treated.  A chronic injury might be considered acute during a flare up or period of extreme pain.

Knee injuries in athletes may be caused by acute, traumatic injuries like a sudden fall.  Or they may be caused by chronic, repetitive overuse injuries.  Sometimes both factors play a role in the injury.  Chronic injuries may become acute because of a traumatic occurrence.

Some common knee injuries that may occur during participation in sports include:

  • ACL (Anterior Cruciate Ligament) injuriesThe twisting or pivoting motion that accompanies landing from a jump, slowing down when running, and rapidly changing directions may cause an injury to the anterior cruciate ligament, or ACL.  Football players and other athletes who wear cleats as well as basketball players and skiers are candidates for ACL injuries.  An ACL injury increases the chances of repeat injuries.  Surgery is a very likely treatment.
  • MCL (Medial Collateral Ligament)  injuriesA direct blow to the outside of the knee may cause an injury to the medial collateral ligament, or MCL.  Contact sports such as soccer and football are where athletes may see such injuries.  An MCL sprain often occurs when an athlete’s knee is forced inward by a hit on the outside of the knee.  In most cases, surgery is not necessary.
  • PCL (posterior cruciate ligament)  injuriesSimple missteps on a playing field or a blow to the front of the knee may cause an injury to the posterior cruciate ligament.  A PCL injury happens when the knee is impacted or twisted in such a way that it is bent the wrong way.
  • Cartilage Meniscus injuriesForceful injuries when direct contact occurs while cutting, pivoting, decelerating, or being tackled may cause a cartilage meniscus injury.  Meniscal tears sometimes occur when there is a ligament tear.  Surgery is usually necessary for a torn meniscus.
  • Kneecap/Patella painRunners knee, or patella pain syndrome or Iliotibial band syndrome, and jumpers knee, or patella tendonitis, are common kneecap conditions.  Runners knee occurs behind the kneecap where the kneecap tracks wrongly against the bone underneath causing kneecap pain or on the outside of the knee as the long tendon rubs over the bone on the outside of the knee.  Jumpers knee occurs below the kneecap.  Young female athletes may develop chondramelacia patella, a cause of pain under the kneecap.   Runners are candidates for these overuse injuries.  They develop over time and could be due to over training, improper running shoes, or poor foot biomechanics (how the structures of the foot work together to perform assorted functions).Young athletes are susceptible to experiencing dislocations or partial dislocations of the kneecap.  The athlete may feel something popping out of and then back in the joint.  Occasionally, the kneecap can be seen toward the outside of the knee.  In any case, the kneecap needs to be correctly repositioned as soon as possible.
  • Back of knee painOccasionally, a knee injury will cause the knee to produce too much fluid.  A Bakers Cyst develops and causes swelling behind the knee.  Relief for the uncomfortable nature of the cyst comes with successful treatment of the original knee injury.

When to Seek Medical Care

Pain and swelling in the knee may be indications of a mild knee joint injury.  If the pain or swelling persists, however, it is wise to make an appointment with one of our JOI Beaches orthopaedic doctors.  More immediate treatment is likely to be in order if a popping noise occurred or the knee gave out at the time of injury, if there is a visible deformity of the knee, if there is an inability to put weight on the leg, or if the knee cannot be moved.


The surgeons at Jacksonville Orthopaedic Institute Beaches employ various methods to treat the knee injuries of athletes.  For specific knee injuries, surgery may be required.  JOI Beaches surgeons will evaluate your condition and discuss treatment options with you before deciding on a treatment plan.

Fall Sports Are Back In Swing… And So Are Sports Injuries

soccer ballThe air is crisp, the leaves are falling, and the sound of cheering crowds and band music floats in the wind. Traditionally, fall sports are played from late August through early December. Unfortunately, fall sports are some of the most dangerous, causing injuries that can end the season in a matter of seconds. Fall sports injuries are either cumulative due to overuse or acute due to trauma. Cumulative injuries develop over time as a result of stress on muscles, joints, and soft tissues. Acute injuries are the result of impact or sudden force. Getting a pre-season physical exam to get a doctor’s clearance for participation is the first step to preventing injury for all fall sports.

Although most any sport can be play any time of the year because of indoor facilities, there are a few that are always associated with autumn. The most popular fall sports are soccer, football, track and field, and cross country. Let’s look at each one…

Soccer has been one of the fastest growing sports in the United States. An increase in popularity has meant an increase in soccer-related injuries. Some possible soccer injuries include ankle sprains; Achilles tendonitis; blisters; broken bones; concussions; delayed-onset muscle soreness; hamstring pulls, tears, or strains; heat exhaustion; iliotibial band syndrome; ligament injuries to the knee (ACL, PCL, MCL, LCL); muscle cramps; patellofemoral pain syndrome; plantar fasciitis; pulled or strained calf muscles; shin splints; sprains and strains; stress fractures; tendinitis and ruptured tendons; and torn knee cartilage.

The best way to reduce the chance of soccer injuries is to do everything possible to prevent them in the first place. Soccer players should follow the ACL Injury Prevention Program for Soccer Players, warm up properly, wear well-fitting cleats, use properly fitting protective equipment (shin guards), use correctly sized synthetic balls, be aware of field hazards, and use fixed goals whenever possible.

The contact sport of football is well known for the injuries it produces. Amazingly, most of the injuries actually occur during practice rather than during a game. Some possible football injuries include ankle sprains; Achilles tendonitis; blisters; broken bones; concussions; dehydration; delayed-onset muscle soreness; hamstring pulls, tears, or strains; heat exhaustion; iliotibial band syndrome; ligament injuries to the knee (ACL, PCL, MCL, LCL); muscle cramps; patellofemoral pain syndrome; plantar fasciitis; pulled or strained calf muscles; shin splints; shoulder dislocations; spinal cord injuries; sprains and strains; stress fractures; tendinitis and ruptured tendons; and torn knee cartilage.

Prevention is the key when it comes to reducing the chance of football injuries. Football players should warm up properly, use properly fitting protective equipment (mouth guard, helmet, pads, braces), and use proper technique when tackling and blocking. In addition, team coaching staffs and officials should have a medical staff with an automated external defibrillator (AED) at games and practices, give immediate attention to and remove from the practice or game any player who exhibits signs of a concussion, and strictly enforce all rules and regulations.

Track and FieldTrack_and_Field
Track and field injuries tend to be due to repetitive use and lack of treatment. They are usually not severe at the onset but become worse over time. Some possible track and field injuries include blisters; chondromalacia(runner’s knee); compartment syndrome; iliotibial band syndrome; microscopic stress fractures; muscle strains; patellar tendinitis; Osgood-Schlatter disease; plantar fasciitis; scrapes and burns from falling; shin splints; sprains; and tibial stress syndrome.
There are various steps that track and field athletes can take to reduce injuries. Track and field athletes should stretch, warm up and cool down properly, wear shoes appropriate for their event(s), and participate in individual event training and conditioning programs that concentrate on strength, endurance, and flexibility. Special attention should be given to the nutritional needs of the endurance athlete.

Cross Country
The highest rate of injury for all school sports is found in cross country running. Teens are especially affected due to the fact that their bodies are still developing. Muscles and joints in the hips, ankles, knees, and feet are where most running injuries occur. Some possible running injuries include ankle sprains; Achilles tendonitis; blisters; delayed-onset muscle soreness; groin pulls; heel spurs; hamstring pulls, tears, or strains; iliotibial band syndrome; muscle cramps; overtraining syndrome; patellofemoral pain syndrome; piriformis syndrome; plantar fasciitis; calf muscle pulls or strains; shin splints; sprains and strains; stress fractures; and tendinitis and ruptured tendons.

Cross country injuries can be reduced by taking preventative measures. All runners from novice to elite should wear the correct shoes, replace footwear when needed, warm up properly, cross train, avoid overtraining, and increase distance, intensity, weight lifted, and duration of exercise no more than ten percent each week.

There is one more important group involved with fall sports… the Cheerleaders. This group of athletes does not always get credit for athleticism. Cheerleaders have to condition and train just as hard as soccer, football, track and field, and cross country athletes do in order to prevent injuries. Their intricate and highly athletic stunts are spectacular. So are the possible injuries. They include broken bones, cuts, head injuries, spinal injuries, sprains, and strains. Practice and performance should be done on cushioned surfaces while using proper technique and proper spotting.

If you or your student athlete has suffered an injury while participating in a fall sport, please schedule an appointment at Jacksonville Orthopaedic Institute Beaches. One of our highly-skilled physicians will be happy to evaluate the injury and prescribe the best course of action to get you back in the game. Contact us today at 904-241-1204 or online at

Meteorology 101: Your Joints and Seasonal Changes

fall leavesDo your toes tell you when it’s going to rain? Can your knees predict a drop in the temperature? If so, you are not a freak of nature, but rather a normal human being with arthritis or joint pain. And, you are not alone. Many Jacksonville Orthopaedic Institute Beaches patients who suffer from joint pain or arthritis believe that their pain is influenced by the weather. Now that the change of seasons from summer to fall and from fall to winter is upon us, the resulting cooler to cold, wet weather may contribute to pain in your joints.

Research has been conducted, but the jury is still out due to conflicting results. Here are the theories:

• Drops in temperature associated with cooler and colder weather may cause joint pain.
A 2007 study at Tufts University found that each ten-degree drop in temperature brought about an increase in arthritis pain. Researchers found that joint fluid thickness was changed by colder temperatures, thus causing pain. Johns Hopkins Health Alerts reported on another study in Argentina. Patients with fibromyalgia, osteoarthritis, or rheumatoid arthritis felt more pain on days when the temperature was lower. It may be that an increase in pain in colder weather is due to a drop in a person’s pain threshold.

• Changes in barometric pressure may cause joint pain.
The 2007 Tufts University study found that increases in barometric pressure had an effect on knee pain. The Argentina study found that increases in pressure affected patients with rheumatoid arthritis and fibromyalgia. It also found that drops in pressure contributed to hand pain in women. It is possible that drops in air pressure cause body tissues to expand. If this is the case, tissue that is already inflamed would swell even more to cause an increase in joint pain.

• Damp weather may cause joint pain. The Argentina study found that patients with osteoarthritis or rheumatoid arthritis were affected by an increase in pain when the humidity was high. As the weather gets colder and damper, it is less likely that people with arthritis or other joint pain issues will be getting the exercise that is needed to help alleviate arthritis and joint pain.

So what’s a body to do? It’s not as complicated as one would think. Simply taking a proactive approach to maintain joint health is perhaps the most effective course of action.

• Eat healthy. Foods that reduce inflammation, stop cartilage loss, and soothe pain are preferable. Include foods that are rich in omega-3 fatty acids, Vitamin C, Vitamin K, and high-fiber whole grains.

• Move it, move it, move it! Exercise helps lubricate the joints. Low-impact aerobics are easy on the joints. Weight lifting builds muscle that helps support joints. When the weather won’t cooperate, there are plenty of indoor options, including heated pools.

• Check with your JOI Beaches physician about taking supplements. Some of them may interfere or react badly with prescription or over-the-counter drugs.

If your joints are starting to tell you what the weather will be like before the local meteorologist does, please schedule an appointment for a consultation at Jacksonville Orthopaedic Institute Beaches. One of our highly-skilled physicians will be happy to discuss your pain and ways to ensure that the weather doesn’t impact your lifestyle. Contact us today at 904-241-1204 or online at

Running in Humidity

Enjoy your run even in the most humid


Running is a pleasurable and addicting way to get in shape. As the temperature rises, however, it can be harder to keep the pace. Running in humidity can really affect your performance and really slow you down if you are not prepared for it. Here are a few tips to keep you running even on the most humid day:

  • First, you need to learn to dress the part. Clothing on humid days can make a major difference between reaching your goal distance and time and giving up pretty early in your run. What you want to look for is lightweight clothing that lets your skin really get some air so that your body’s natural cooling system, sweat, can do its job. Some shirts and shorts are made from a material that helps wick moisture away. Others may have mesh panels that allow for the most airflow. There are a lot of options on the market today, so be sure to research your options and find the one that will work best for you.
  • Don’t forget accessories. Shoes are the most important item for runners, and if you are dealing with high heat and humidity, you want a pair that will help keep your feet cool and dry. Look for a pair of shoes that offers ventilation, as well as gaps, on the soles to allow the most air to circulate. Don’t forget breathable socks as well if you wear them. Other accessories like sunglasses and hats can help protect your face from the sun’s rays and keep you cool. Sweat proof sunscreen is also a must if you are running on sunny days, but really it applies to any time of the year.
  • There are some ways to work around the humidity that you may want to consider. Before you run, sit in a nice air-conditioned car or home and really cool down. This will help you to last just a bit longer when you start running as it will take a little time for your body to heat up. It is also important to stay hydrated, especially on hot muggy days.
  • One of the biggest keys to being able to run on muggy days is getting yourself slowly acclimated to the weather. If possible, try running early in the day or later in the evening on hot days, and slowly build yourself up for runs closer to the middle of the day where the temperatures are at their highest.

Follow all these tips and you won’t let the humidity get you down! For more information on exercise and health, keep reading our blog!

Running on grass

Remember when you were just a child and running was simple? It was nothing more than a large open space, a tag opponent within a reachable distance, and the green grass under your feet. It’s no wonder this sense of freedom and wonderment has spurred a new type of running called the “minimalist” style. In an article titled “New styles of running require new types of shoes,” Dr. Lancaster explains this new trend and how to enjoy it without hurting your tendons and muscles.

Venture off the track and onto something new. The green grass and open trails allows for runners to feel as no terrain is unapproachable.

Getting back to basics is exactly what this style is reminiscent of. Gone are the heavy tread shoes and hard concrete surfaces.  “This [style] involves running barefoot or with minimalist footwear,” says Dr. Lancaster, a renowned orthopedic surgeon at Jacksonville Orthopedic Institute Beaches. “The five finger-type shoe features individual toes that are separately covered, allowing greater flexibility when running.”

Although this type of running brings on more of a sense of adventure and fun, it does come with its precautions to avoid injury.

“This type of running is similar to running in the sand and will stress the calf muscles more, as well as the small individual muscles of your toes and feet,” says Dr. Lancaster. His advice is to exercise or stretch “the foot and toes through a complete arc of motion repetitively [to] minimize the strain experienced.”

An Interview with Running Coach Paul McCrae

Paul McCrae – Founder and Personal Coach at Personal Running Solutions in Jacksonville, FL

History of your running experience – how long have you been running, any important races that you’ve placed in.

Paul has competed for 15 years as a professional runner both internationally and nationally. He was selected to represent his native home, New Zealand in World Mountain Running Championships in the 1993, 2001, and 2004. He also earned a position on the New Zealand’s Oceana Championships team in 1990. He has earned many local achievements, which included winning the 2005 Jacksonville Track Club Male Athlete of the year. Paul is regularly on the podium for winning many of the local road races in Jacksonville. He has also been as high as second in the Jacksonville Bank Marathon when he set his personal best of 2:27:50.

Paul was part of WSC’s National team, which competed in four consecutive NCAA Division II cross-country championships, a first at any division at the NCAA Championship. WSC finished as high as 7th during the 2003 season. One pivotal achievement at WSC was his third place in the 5000m. Paul shares this NCAA Division II Indoor honor with his WSC teammates who finished first through sixth.


Lifetime Personal Records:

•             Mile – 4:05

•             5K – 13:57

•             10K – 28:53

•             1/2 Marathon – 64:35

•             Marathon – 2:27:50

What is some good advice you provide about staying injury free:

People need to realize it’s not just about the training but also what you put into your body and how you take care of yourself. Running and training is only a small part of the picture. I recommend watching things like sleep, how old your shoes are, how hydrated you stay, the clothes you wear to workout in, the use of sports massage, the food you put into your body.

How do you personally stay injury free:

Sometimes staying injury free is more about knowing when to push through a run or workout and when to stop and rest. More often than not this is the best reason to get a coach. Their job is to make sure they notice when you need to take it easy or push through. Most of us aren’t self aware enough to do this alone.  And that coach can be anyone from a sports medicine doctor or a friend that can monitor your training from the outside.

Any insider tips for beginner runners?

Start with the rule, “less is always better.” Quite often new runners feel good so they push themselves too hard the first few runs and then when they get sore they wonder why they lose motivation and the desire to continue. Sometimes a running coach can help you get started without the guessing and chance of injury.

The other thing I would suggest is finding a good group of people to start out with. It helps to have like-minded individuals around who will and can motivate you and keep you on track. It also keeps the monotony of running a little less when you have other great people to do it with.

Anterior Hip Replacement Can Help Keep You Active and In Control

For active people, arthritis in the hip can seem like an unfair sentence of pain. This prospect is intolerable for many people that value their mobility. Staying active is vital to their lifestyle, or career. Hip pain, because it is right at the core of your body can leave you unable to enjoy the basic pleasures of life.

Thankfully, there is an option for those people that have been plagued with this painful affliction. It is called anterior MIS or Minimally Invasive Surgery. This is not the same as the type of procedure required after a traumatic hip injury, with strict restrictions on movement throughout the rehabilitation process. This is a hip replacement surgery that is done by going through the front (anterior) as opposed to the side or back.

Comparing Anterior Minimally Invasive Surgery and Traditional Hip Replacement

Anterior hip replacement allows for removal of the hip without detaching gluteal muscles from the femur or pelvic bones. By working between the natural separations in the muscle groups, the surgeon can remove your old hip and put in the new one. This process is much less traumatic than other forms of hip replacement surgery, and allows patients to be up and around after a much shorter rehabilitation time. Where lateral and posterior hip replacement procedures require 6 to 8 weeks of immobility to allow re-attached muscles to heal, anterior hip replacement encourages a full range of movement right away.

Who Should Consider Anterior Hip Replacement?

Arthritis sufferers, those who have chronic inflammation, or ongoing joint pain are certainly viable candidates. Gout patients, with joints damaged by purine deposits, even those confined by limited motion should look at anterior hip surgery as a solution. Now, because of the popularity of this type of hip surgery, other types of hip replacement have been relegated to injuries and situations where options are limited. This is representative of the advancements in both methods and the materials used over the last ten years. Often the only exterior scar is as small as 4-5 inches, easily covered by undergarments.

Mobility is often the key to maintaining your health. It is certainly the most important component to exercise, socializing, vacationing and so many of the activities that people associate with having an enjoyable life. If your hip pain is the only thing that is keeping you living to your full potential, give us a call. Our orthopedic surgeons at JOI Beaches can look at your specific situation and see if anterior hip replacement can offer a solution for you.

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