How to Reduce Your Risk of a Heart Attack

Heart attacks are the number one killer of both men and women each year in the United States. A heart attack (myocardial infarction) occurs when a blood clot develops in one the blood vessels (coronary arteries) that lead to the heart. This blockage can damage or destroy part of the heart muscle. A heart attack is not the same thing as cardiac arrest, which is when the heart suddenly stops. Symptoms of a heart attack vary and may include: pressure, pain, or tightness in the heart, feeling of indigestion, heartburn, or abdominal pain, shortness of breath, fatigue, lightheadedness, sweating, feelings of anxiety, and trouble sleeping.

Heart attacks can be caused by numerous factors. The most common cause is a build-up of plaque in the arteries, called atherosclerosis. Plaque is a sticky substance that originates from cholesterol and other substances. When this build- up causes the coronary artery to narrow, it leads to a condition called coronary artery disease. The plaque that is built up in the arteries can rupture and spill into the bloodstream causing a clot, which can block the flow of blood to the heart. Other causes of heart attacks include spasms in the coronary artery, commonly caused by drugs like cocaine, tears in the artery, and small blood clots and tumors.

There are many risk factors for a heart attack that can be decreased or eliminated through dietary modification and exercise. Common risk factors include smoking, high blood pressure, high cholesterol, high triglycerides, diabetes, family history of heart attack, lack of physical activity, obesity, stress, illegal drug use, and a history of preeclampsia. Males over the age of 45 are also at higher risk.

Adopting a heart healthy diet is the most important thing you can do to prevent a heart attack. This includes eating a wide variety of fruits, vegetables, whole grains, legumes, and lean meats. The diet should be low in saturated fat, trans fat, cholesterol, sodium, and added sugars, and high in protein antioxidants, fiber, vitamins and minerals. Avoid processed foods and eat fish two times per week to get omega-3 fatty acids. Take an omega-3 fatty acid supplement if you cannot consume enough fish.

Exercise is another important factor to minimize your risk of having a heart attack. The heart is a muscle and gets stronger through exercise. Find something you enjoy, develop a routine, and do it regularly. Adequate sleep, which is about 8 hours per night, has also been shown to positively effect your blood pressure and your heart.

To further decrease your risk of a heart attack, it is important to decrease your LDL cholesterol. This can be lowered through exercise, cessation of smoking, and a healthy diet low in fat and high in fiber. It is also important to lower your blood pressure through a low salt-low fat diet, decreased alcohol intake, exercising, and smoking cessation. When dietary interventions are not enough, prescription medications such as statins and diuretics can be used to lower cholesterol and blood pressure respectively.

The key to heart health is diet and exercise. February is heart health month, the perfect time to start your heart-healthy diet and exercise program.

Benefits of Exercise

You Think I’m Doing This for My Health???  Actually, Yes!!!

It is common knowledge that exercising has many health benefits, yet according to the Center of Disease Prevention, over half the US population does not exercise; only 48% of adults meet the 2008 Physical Activity Guidelines.  This is mind-boggling, considering how physical activity positively effects health and improves quality of life.

Physical activity affects both the mind and body.  From a physical standpoint, it helps prevent many diseases and health conditions.  For example, exercise reduces the risk of cardiovascular disease, diabetes, hypertension, high cholesterol levels, and stroke.  Additionally, studies show that physical activity is associated with lower incidences of colon, breast, and lung cancer.  Weight-bearing exercises strengthen bones and help prevent osteoporosis.

With proper diet, exercise can also help combat obesity.  When you exercise, you burn calories.  One pound is 3500 calories; so in order to lose one pound a week, one must have a calorie deficit of 500 calories per day.  Burning calories through exercise and physical activity helps reach this goal.

Besides weight loss, exercise through strength training can change body composition and tone muscles.  Also, certain physical activity can help alleviate arthritis pain by improving functional ability and joint mobility.

Exercise also has positive mental benefits.  Research shows that cardiovascular exercise aids in stress reduction.  Additionally, exercise can improve mood by decreasing stress, tension, fatigue, and anger. It also helps decrease depression and anxiety and has a positive influence on self-esteem.  When you look and feel better, you are happier and your confidence tends to increase.

Working out can help improve memory, both in adults and children.  This is because of an increased production of cells in the hippocampus section of the brain, which is responsible for learning and memory.  Furthermore, exercise appears to enhance creativity up to 2 hours after a workout.

Research shows that exercise increases productivity.  Those who exercise regularly seem to have more energy and are able to get more done.

Research shows that some physical activity is better than none and the benefits of exercising exceed the possible complications involved.  The Guidelines suggest 60 minutes of physical activity per day for both adults and children.  Additionally, the higher intensity, more frequent and longer duration the exercise, the more benefit that is derived.  Benefits usually occur with 2 hours and 30 minutes of moderate intensity physical activity per week and two days a week of muscle-strengthening activities that involve all major muscle groups.

Weighted Vests

Gyms and fitness center are loaded with machines and equipment; there are balls, bars, free weights, balance discs, and all sorts of gadgets for the exerciser to choose from.  Sometimes it is hard to know the benefits of using one piece of equipment over another.  Weighted vests are tools that have become popular for a variety of fitness activities.  However, many people are not sure how or why to use weighted vests.

Weighted vests are heavy vests worn over the torso, which have varying amounts of resistance.  The most common weights are 20 pounds and 50 pounds.  The purpose of a weighted vest is to increase the intensity of a workout.  Since more weight is added to the body, the body is forced to work harder, which causes increased muscle mass and fat burning.  Vests are versatile; they are used for resistance training, weight loss, cardio benefits, and variation.

First, vests supplement resistance training and increase performance. Resistance exercise, or strength training, increases the strength and mass of muscles. This was demonstrated by a research study at Texas Tech University, where a group of athletes wearing vests were compared to those not wearing vests. They found that the group wearing vests had substantially better results with their resistance training .

Next, weighted vests intensify aerobic workouts, thereby increasing the number of calories burned and promoting weight loss.  A study in The European Journal of Applied Physiology showed this increased cardio effect by looking at a group of distance runners wearing a 50 lb weighted versus those without added weight.  Those wearing the vest had improvements in their VO2 max and lactate thresholds, both of which affect endurance exercise.

Further, using a vest can change up an exercise routine.  Our bodies adapt to the same patterns of movement, and it becomes harder to see a change when we repeatedly do the same exercises in the same routine.  By wearing a vest, we provide variation to our normal routine.  This will challenge our bodies so that we can continue to see results.

Another benefit from exercising with a vest is improved bone density.  Several small studies show that the extra load from a weighted vest can help build bones.  One four-year study on postmenopausal women showed increased bone density when a weighted vest was used during stair climbing.

Weighted vests have many benefits, but it is important to remember they should be used in moderation.    When first wearing a vest, a low amount of weight should be used and it should never exceed more than 20% of an individual’s body weight.  Too much weight may negatively affect the joints, muscles, and bones.  It should also be worn tightly secured to the body to avoid any additional strain.  An individual may experience back pain if it isn’t strapped on properly or if the weight is not distributed evenly.  When wearing a weighted vest, the force upon landing is greater, increasing the risk of impact-related joint injury.  Also, flexibility is limited because the vest constricts some types of movements.  Lastly, there is a potential for overheating since the vest covers a large area of the body.

While there are many reasons to try using a weighted vest during a workout, it is important to remember that weighted vests are not for everyone.  A doctor or personal trainer should be consulted before it is added to any exercise routine.

Strength Training for Children

Strength training offers many benefits to all types of children and adolescents. Strength training is a type of exercise and conditioning that focuses on the use of resistance to build strength, endurance, and size of the skeletal muscles1.  When done properly, strength training can improve sports performance, protect against sports-related injuries, increase muscular strength and endurance, strengthen bones, promote healthy cholesterol and blood pressure, improve self-esteem, and help children maintain a healthy weight2.

There seems to be controversy surround the proper age a child can begin strength training and whether or not lifting weights is appropriate.  The American Academy of Pediatrics (AAP), the American College of Sports Medicine  (ACSM) and the National Strength and Condition Association (NSCA) all support strength training for kids.  In fact, AAP stated that “appropriate strength-training programs have no apparent adverse effect on linear growth, growth plates, or the cardiovascular system2.”

According to Dr. Avery Faigenbaum, a renowned pediatric exercise scientist, there are many common myths that surround strength training.  The first is that strength training will stunt the growth of children. However, research does not support this myth and does not show decreased stature in children that engage in resistance exercise regularly.  Instead, this type of exercise has a positive effect on bone growth and development.  The second myth is that strength training is unsafe for children.  Actually, the risks of training are no greater than any other activity as long as there is qualified supervision and a safe training environment.  The third myth is that children cannot increase strength because they do not have enough testosterone.  However, testosterone is not needed to achieve strength gains, which is evidenced by strength gains in women and the elderly.  The last myth is that strength training is only for young athletes.  As discussed, strength training has a wide range of benefits and therefore is valuable to all boys and girls, whether involved in sports or not3.

“The American Academy of Pediatrics position on strength training supports the implementation of strength and resistance training programs, even for prepubescent children, that are monitored by well-trained adults and take into account the child’s maturation level.  The only limitation the AAP suggests is to avoid repetitive maximal lifts (lifts that are one repetition maximum lifts or are within 2-3 repetitions of a one repetition maximum lift) until they have reached Tanner Stage 5 of developmental maturity.  Tanner Stage 5 is the level in which visible secondary sex characteristics have been developed.  Usually, in this stage adolescents will also have passed their period of maximal velocity of height growth.  The AAP’s concern that children wait until this stage to perform maximal lifts is that the epiphyses, commonly called “growth plates”, are still very vulnerable to injury before this developmental stage. It is repeated injury to these growth plates that may hinder growth4.”

The NSCA offers these guidelines for strength-training programs:

  • An instructor-to-child ratio of at least 1 to 10 is recommended.
  • The instructor should have experience with kids and strength training.
  • When teaching a new exercise, the trainer should have kids perform the exercise under his or her supervision in a hazard-free, well-lit, and adequately ventilated environment.
  • Calisthenics and stretching exercises should be performed before and after strength training.
  • Kids should begin with one set of 8 to 15 repetitions of six to eight exercises that focus on the major muscle groups of the upper and lower body.
  • Kids should start with no load (resistance). When proper technique is mastered, a relatively light weight can be used with a high number of repetitions. Increase the weight as strength improves. Progression can also be achieved by increasing the number of sets (up to three) or types of exercises.
  • Two to three training sessions per week on nonconsecutive days is sufficient.

It’s important to remember that strength training should be one part of a total fitness program. It can play a vital role in keeping your child healthy and fit, along with aerobic exercise such as biking and running, which keeps the heart and lungs in shape5.

It is important to note that children should have a strong basic exercise foundation and have efficient movement patterns in order to develop strength and flexibility.  An ideal age to start strength training is 7-8 years old because balance and postural control skills have matured to adult levels.  Proper form, technique, and safety are keys to success, and therefore explosive and rapid lifting is not recommended because it is difficult to maintain proper form and perform exercises safely, which may stress body tissues2.

As for as sports specific training, a child athlete must master the basics, such as strength, balance, power, coordination and visual perception in order to improve athleticism. .   You cannot solely train specific skill, like throwing or swinging, for a specific sport.  The key is to improve strength, power, flexibility and speed through efficient movement patterns.  After a child become proficient in the basic skills, more specific skills can be introduced.  It is important to remember that flexibility is the key to preventing injury and stretching should not be neglected6.

In conclusion, strength training is safe for children and adolescents and should be incorporated into their exercise routine to increase both physical and mental performance.

  1. http://en.wikipedia.org/wiki/Strength_training
  2. http://pediatrics.aappublications.org/content/121/4/835.full
  3. http://pediatrics.aappublications.org/content/121/4/835.full
  4. http://www.strongkid.com/uploads/Myths.pdf
  5. http://www.protraineronline.com/exercise/strength-training-for-childrena-review-of-research-literature/
  6. http://kidshealth.org/parent/nutrition_center/staying_fit/strength_training.html#
  7. http://www.todddurkin.com/the-best-exercises-for-youth-athletes/

All Trainers Are Not Created Equal

Most of the people that work with a trainer feel that their trainer is “the best.” I have never met anyone who doesn’t rave about his or her trainer, especially if he/she has been working with them for a substantial period of time. Part of the training experience is the camaraderie and trust formed between the trainer and his client, and the majority of people are very loyal.

However, putting friendship and personality aside, only a handful of personal trainers are truly competent and knowledgeable. As a result, many people get injured, and sometimes the client doesn’t even realize that their trainer is responsible. Many injuries are repetitive injuries, which are injuries that occur gradually over time due to frequent, repeated, unsafe movements.

The client may not even know that they are being injured! For example, one morning a person can wake up with his knee bothering him and he is unable to walk without pain. He may not remember doing anything the day before to cause the injury; in fact, this injury may have been happening gradually over a period of time. Therefore, a client may be ignorant to what is causing his ailment. Injuries may be caused by improper form, unsafe exercises, or lack of knowledge about anatomy and how the body works. Clients need to be able to evaluation their trainers objectively; you cannot assume that all gyms are hiring qualified, competent trainers.

Currently, in order to become a personal trainer, intensive training or education is NOT required. All that is required is a certification that is accredited that the National Commission of Certifying Agencies (NCAA); for example, the National Academy of Sports Medicine (NASM), NFPT (National Federation of Personal Trainers and the Aerobics and Fitness Association of America (AFAA). Most gyms require that their trainers are certified, but NOT all do! Make sure that your trainer is certified and that he attends seminars and takes continuing education courses to stay current.

The body is a complex machine, and it is important that a trainer understands proper mechanics to avoid injury, especially if the client has pre-existing conditions. A trainer should perform an initial evaluation and obtain a health history so that he may target weak areas and avoid aggravating an injury or condition that is already present. The evaluation should include testing flexibility, balance, core strength, muscle strength and endurance, and proprioception. Your trainer should be able to explain why he is choosing certain exercises and how they benefit you. He should also be knowledgeable in functional training, which is training for daily activities or a specific goal. Additionally, your trainer should be able to use the initial assessment to design a tailor-made workout program for each individual. There is no one-size-fits-all personal training.

There are many benefits to using a personal trainer rather than working out on your own. Choose wisely, because not all trainers are created equal. Do your due diligence and do your research to ensure you get the results that you want.

Circuit Training for a New You

Circuit training is a type of interval training that incorporates a series of strength and/or cardio exercises with little or no rest between sets. It increases your heart rate while simultaneously strengthening your muscles using a combination of resistance training and high-intensity aerobics. This combination of weight training and cardiovascular work makes circuit training a valuable way to exercise.

One “circuit” consists of a set of prescribed exercises performed in order with little rest between each exercise. The circuit is then repeated one to several times. Many different exercise stations can be incorporated into circuit training. Usually, stations alternate between muscle groups so little rest is needed. To increase cardiovascular endurance in circuit training, brief bouts of high intensity aerobic exercise, like jumping rope, can be incorporated. The exerciser gains muscle through the resistance training, while she/he simultaneously increases cardiovascular endurance as a slightly elevated heart rate is maintained throughout the entire program.

There are many advantages to circuit training. First, it is fun and brings change and excitement to routine workouts. There are endless numbers of exercises you can add to each circuit to change it up and make it more interesting. This type of workout also burns more calories than doing cardio alone as you maintain an elevated heart rate throughout the whole exercise routine. Additionally, circuit training is a practical solution for those with time constraints as it allows you to combine cardio and muscular fitness together in one session. Further, you can set up as many stations and exercises as you want, to either shorten or lengthen your workout. Another benefit to circuit training is that it is portable and convenient. It can be done at home, outside, or in the gym with minimal equipment. You can do use bodyweight to perform pushups, planks and lunges for strengthening and use stairs and jump ropes for cardio stations anywhere and at any time.

If you are looking for a new routine to help you lose weight and increase muscle mass, circuit training may help you achieve your goals. Circuit training is fun and is a great way to challenge your body, whether you are just beginning an exercise program or are a seasoned athlete.

December Gym Specials!!

Give The Gift Of Fitness This Holiday Season

December 2015 SpecialFor Them:
Receive 20% Off Any Training Package* Or Annual Membership
You Purchase For A Friend or Loved One

For You:
For Every Gift Certificate You Purchase, Receive 1 Complimentary Training Sessions

*Offer only valid for 10 pack training packages
** Offer valid through December 31, 2015

Why Buy Organic?

Organic food is food that is produced without synthetic chemicals or fertilizers, herbicides, antibiotics, hormones, pesticides, genetic engineering, radiation or sewage sludge. Animal products that are labeled as organic do not use antibiotics, growth hormones or any medications except for vaccines and those used for illnesses. They are also fed only organic non GMO feed. Organic foods are, however, more expensive than conventional foods, and many people wonder if the health benefits justify the extra cost.

Sixty percent of studies show that certain nutrients are higher in organic foods than in conventional foods. This is likely due to the stronger natural defenses of organic plants. Organic plants develop stronger defensive compounds since fewer pesticides are used to combat insects.  Additionally, the nitrogen in conventional fertilizer dilutes nutrients in the plants because the plants are bigger but the nutrients are less concentrated. This causes decreased nutritional value in conventional foods.

Organic foods are also lower in toxic pesticides. Over 600 chemical pesticides are used on conventional foods in America, and according to the National Academy of Sciences, 90% of those chemicals have not been tested for long-term health benefits. Pesticides are hazardous to your health. They impact the body neurologically and affect development. Children are especially at risk since they are more sensitive to adverse effects and because they are exposed to more pesticides.  Chemicals have been shown to cause cancer, hormone disruption, and skin, eye, and lung irritation.

It is important to note that organic foods are not always 100% pesticide free because they can pick up traces of chemicals from air or water from conventional farms nearby. In the US, the EPA does have certain standards for pesticide use. However, the US does not control how produce is grown in other countries, so it is probably a good idea to avoid conventional fruits and vegetables grown outside the US.—- not sure this is necessary? Eating organic allows you to lessen your exposure to pesticides. To further lower pesticide intake, make sure to wash all fruits and vegetables and peel their skins.

Certain fruits and vegetables contain more pesticides than others. The “dirty dozen” are apples, celery, sweet bell pepper, peaches, strawberries, imported nectarines, grapes, spinach, lettuce, cucumbers, domestic blueberries, and potatoes. The “clean 15” consist of onions, sweet corn, pineapples, avocado, cabbage, sweet peas, asparagus, mangoes, eggplant, kiwi, domestic cantaloupe, sweet potatoes, grapefruit, watermelon, and mushrooms.  It is especially important to buy organic produce from the “dirty dozen” list.

Organic farming helps maintain our ecosystem by preserving the soil so that wildlife and insects can play their natural role. It also helps protect the water and soil and reduce overall pollution since it doesn’t permit the use of toxic chemicals, resulting in healthy soil and biodiversity. Organic farms tend to grow an assortment of food instead of focusing on one or two varieties of crops. This diversity is critical to keeping the soil and environment healthy.

The bottom line is that the value of eating organically does seem to be worth the extra cost. It will keep your

 

 

 

Breathe Easily

Breathing is the most basic movement pattern and very often done incorrectly, having tremendous consequences in terms of our musculoskeletal health. If we think about how often we breathe (every moment of our lives), it is easy to see how incorrect patterns can lead to problems. Faulty breathing patterns and the impact they have are often overlooked because it is such a subtle and involuntary movement that we typically do not consciously think about.

Breathing is life. It is common to think of breathing only in terms of respiration, which is obviously essential to sustaining life. But the effects go beyond the basic respiratory function. There has been much research demonstrating a link between breathing pattern disorders and low back pain, neck pain, shoulder imbalances, TMJ pain, poor motor control and posture.

Posture and breathing are directly related. One cannot be addressed without the other. Breathing pattern disorders usually develop as we begin to develop poor postural patterns very early in life. Watching an infant is a great way to see proper breathing, as they have not yet learned to do it the wrong way.

The diaphragm, the main muscle responsible for breathing, can be seen as an essential component of the core function. If we think of the trunk as a cylinder or column, with muscles and fascia wrapping around as a belt, the diaphragm acts a lid, while the pelvic floor muscles make up the floor. Often when working the core, we often focus on the abdominal muscles and do not consider the importance of the diaphragm. If breathing is not correct, one cannot have full core stability.

An easy way to assess your breathing is to stand in front of a mirror placing one hand on the upper part of the chest and one hand over the abdomen. Take a deep breath and notice the movement of the hands. If the hand on the chest elevates, this indicates incorrect breathing, or thoracic breathing.

The correct pattern is when inhaling, the abdomen expands, pushing the hand over the abdomen forward, or outward. The hand on the chest should not move much. This is known as diaphragmatic breathing, and properly engages the diaphragm.

Thoracic breathing engages muscles of the chest, upper back and neck as the primary breathing muscles. Over time, these muscles will develop tension from overloading and doing more work than they are designed to do. While these muscles are overworking, the diaphragm is under-working, contributing to core weakness and the long list of consequences that result.

Awareness of breathing pattern disorders through the simple test above is an important step. To begin working on correcting the pattern, try the following. Lay supine (on your back) and prop your legs up on a cushion, or support, so that the hips and knees are both at 90 degree angles. If you cannot do that, simply laying on the back with knees bent will also work. Place one hand on the abdomen and the other on the chest and breathe normally trying pull the breath into the abdomen. With each inhalation, the goal is expand the abdomen lifting the hand. The ribcage will also expand a bit laterally, but should not elevate. Try to stay as relaxed as possible while doing this and don’t worry about taking deep breaths. Breathe easily and normally. Do this for a few minutes three to four times a day.

This will start to groove the movement pattern and reprogram the system. Gradually you will begin notice when breathing incorrectly and will more easily be able switch to diaphragmatic breathing. It is more difficult to do this while upright, which is why the supine position is the best way to start the training process. It is very important to work on posture simultaneously in order to achieve the best, long lasting results. It is very difficult to breathe correctly with poor posture.

Also keep in mind that this is a process. It will not change overnight. It takes a lot of work and consistency to retrain a system that has been in place for so long. Remember how often you breathe, and for how long it has been done incorrectly! Do not get frustrated if you feel like you are getting nowhere. Keep working on it. If you feel you need more help, consider seeking the help of a professional who has experience with this. Many chiropractors, acupuncturists, trainers, physical therapists, massage therapists and other types of body workers can be very helpful.

There are many other health benefits to proper breathing in addition to musculoskeletal health. One can write volumes on breathing in terms of musculoskeletal, biochemical, respiratory, mental/emotional, endocrine, neurological and spiritual health. Many types of meditation and relaxation exercise focus on the breath. It is synonymous with life. So contribute a few easy minutes a day to your breathing, and ultimately your health. It is a worthy cause.

Ankle Pain

As summer gives way to fall, we may find ourselves hitting the hiking trails. Many times, these uneven surfaces can lead to foot and ankle issues. Many people have sprained their ankle in the past, and are aware what this feels like. A lateral ankle sprain is an acute twisting of the ankle (often an inversion injury or an inward twisting of the foot and heel as compared to the leg). However, there is another condition which can cause pain on the lateral (outside) part of the foot, which many people will incorrectly refer to as “ankle pain”. I am referring to a pathology know as sinus tarsi syndrome.

The ankle joint consists of three bones, the Tibia, the Fibula, and a bone called the Talus. There are several ligaments working to help support the ankle which are very commonly sprained or ruptured with inversion sprains. However, sometimes there is only a small trauma, or repetitive micro-trauma from uneven surfaces that can affect another joint. The Sinus Tarsi (sometimes referred to as the “eye of the foot due to its appearance on an x-ray) is a very specific part of a joint called the subtalar joint.

Ankle Pain

This is the joint between a bone called the talus and the heel bone (known as the calcaneus). This portion of the joint contains many ligamentous attachments between the talus and calcaneus themselves, and between these two bones and the other bones of the mid-foot. When this joint is injured, there is often nagging pain along the lateral foot or across the ankle joint. Patients will often complain of pain in the morning or after periods of rest. They may find themselves hurting at the beginning or a run or hike, with the pain actually subsiding after getting warmed up. Certain motions like stepping off a curb, or walking up and down steps may cause sharp sudden pain.

Two tendons know as the peroneal tendons border the outside foot and ankle and help invert and evert the foot. When the sinus tarsi of the subtalar joint is painful, these tendons often over act, leading to a tendinitis which can even extend all the way to the lateral calf. Patients may complain of a pulling or stretching pain which extends to the outside calf. Often, when people complain of an “ankle pain” but have a difficult time expressing just how they hurt, direct palpation of the sinus tarsi will recreate the symptoms.

Treatments often include the standard RICE therapy (rest, ice compression, elevation), range of motion exercises (often pretending the big toe is the tip of a pen and tracing the letters of the alphabet in broad motions), oral anti-inflammatory medications, or steroid injections into the sinus tarsi itself. Also, many times supporting the foot with an orthotic is extremely beneficial and/or wearing supportive shoe gear with increased shock absorption.

So the next time you have a lingering “ankle pain” that just doesn’t seem to be getting better, ask your foot care professional about a possible sinus tarsi syndrome.