Treating Early

Bob Marley loved playing soccer. He had a recurring sore nail on his right foot that kept falling off that was thought to related to playing soccer at first. The nail bed was slow to heal. He was diagnosed with acral melanoma in 1977 and was advised to A. Have the toe amputated or B. have the foot amputated. The cancer was stage 3/4, the most deadly. Bob decided to let it be and then many months later have the lesion cut out and a skin graft placed on it. By the time the cancer had affected him physically it had already metastasized all over his body and it was too late to treat him. He died in 1981. If he had had at least the toe amputated on detection he would have extended his life probably for at least several years. A dark spot under the nail particularly in a darker pigmented person and particulary if it extends back to the cuticle is not something to be taken lightly.

Nike Free not Always Mantle Worthy

The latest casualty on the shoe circuit is the Nike Free. A patient this month had pain on the outside of their foot at the end of his marathon. It turned out he had a tear on his peroneous brevis muscle that was visualized on ultrasound. I advised him to take 2 weeks off and reevaluate. He had trained without consequence in the shoe but reached a break point at race pace after mile 20. Stay tuned for how to detect injuries in real time with diagnostic ultrasound and you can see the injury.