Items filtered by date: June 2013

The San Francisco Giants activated infielder Pablo Sandoval this past Monday after tendon pain in his foot had placed him on the disabled list for 15 days. Pablo is reported to have injured his peroneal tendons, a relatively common foot problem for athletes. Unfortunately for highly active individuals like Pablo, depending on exactly what structures are damaged around his tendons, surgery may eventually be necessary to achieve optimal function.

The two peroneal tendons that are injured are called the peroneus longus and peroneus brevis. These two tendons course directly adjacent to each other along the lateral side of the ankle and foot, where they are held in place by a fibrous band called the superior peroneal retinaculum. There are a variety of possible conditions that can develop with the peroneal tendons. Tendonitis may occur, in which the tendons become irritated and inflamed. This could be a portion of Pablo’s injury, as tendonitis is typically caused by repetitive activity, which is common during practice for high level athletes. Accessory bones and muscles can also develop and interfere with the normal function of the peroneal tendons. An extra bone called an “os peroneum” develops in about 20% of the population within the peroneus longus tendon. Like any other bone in the foot, the os peroneum can become fractured and cause pain. This accessory bone can also contribute to the development of tendonitis by irritating the tendon and disrupting its normal course. Having a supinated foot, which usually appears as a high arch, can also increase stress on the peroneal tendons. Supination causes the heel to be inverted, or “roll” inwards, increasing the work the two tendons must perform to maintain a relatively normal foot position during gait.

Conservative treatment is an excellent initial option, which is likely the treatment Pablo began with during his time on disability. Remaining off of the affected leg and taking non-steroidal anti-inflammatory medications can aid in reducing pain and inflammation around the tendons. Custom orthotics can be extremely helpful in controlling the abnormal foot structure and function that contributed to the development of tendonitis. Physical therapy to maintain proprioception is also a key portion of treatment, especially for athletes. After several months of these less invasive treatments, surgery may become necessary. Damaged tendons may need to be surgically repaired, the peroneal retinaculum may need to be tightened to better maintain the position of the tendons, or a painful accessory bone may need to be removed. Additional diagnostics studies such as an MRI or ultrasound are obtained as needed to aid your podiatrist in developing an appropriate surgical plan.

Please visit www.ColumbusFoot.com for more tips for healthier and happier feet or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.

This past week contestants from around the world gathered in Derbyshire, England to show off their skills in an unusual sporting event: toe wrestling. The world toe wrestling championships began in the 1970s and have continued annually ever since. The competition requires not only toe and foot strength to maintain position in the match, it also requires good motion of the big toe joints.

When motion becomes limited or painful in any joint, arthritis, or inflammation of the lining of the joint has likely developed. In the foot, the joint at the base of the big toe, known as the metatarsophalangeal joint, is commonly affected by this condition specifically called hallux limitus. Trauma is the number one trigger in the development of this arthritis, either a single episode such as dropping a heavy object on the toe or repetitive low grade trauma that may occur in sporting events. Underlying structural deformities in the foot may also contribute to joint damage in the big toe. A long or short 1st metatarsal bone as well as an elevated 1st metatarsal may cause increased wear and tear on the joint.

In the earliest stages of 1st metatarsophalangeal arthritis, there may be mild painless stiffness of the joint. At this point, the average toe wrestler may continue without any problems, however as the disease progresses, pain, reduction in motion and bony growth around the joint will increase. Initially, conservative measures such as padding and custom molded orthotics may provide adequate relief and even slow progression of joint deterioration. More severe stages of arthritis can require steroid injections to decrease inflammation. Eventually toe surgery can become a necessity. It is important to discuss your activity level and goals with your podiatrist when it comes time to select the best surgical procedure. Every foot is different and treatment programs must be individualized – a world class toe wrestler’s demands of their foot are going to be different from an individual who enjoys a more relaxed lifestyle!

Please visit www.ColumbusFoot.com for more tips for healthier and happier feet or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.

Summer is in the air around Columbus, with warm temperatures and sunshine aplenty. However, with summer also comes more risky outdoor activities for kids and teens in the area. One teen from Arizona made national news this week after a risky activity lead to a serious foot injury. After jumping from the height of her house roof, instead of hitting pool water, her heels hit cement and she suffered fractures of both her heel bones.

After motor vehicle accidents, falls from a height cause some of the most devastating foot and ankle injuries. Severe fractures of the calcaneus, or heel bone and the bones comprising the ankle joint, the talus and tibia are difficult to treat and can be causes of pain years past the initial injury. The calcaneus is the most commonly fractured of the tarsal bones, which make up the midfoot and rearfoot. These fractures are very commonly intra-articular, meaning that they extend into the subtalar joint. Similarly, pilon fractures, or a fracture tibia that makes up the top of the ankle joint, are also intrarticular. Not all fractures require surgery, however if the fracture is comprised of many small pieces of bone or the pieces of bone are severely out of place, surgery will become necessary. In intra-articular fractures, bone surfaces that oppose each other in a joint must be restored as close to their original position as possible to minimize the development of painful arthritis later on. Bone healing may also be delayed, or may heal in an incorrect position if not properly treated. Such problems can result in difficulty walking or bearing any weight on the leg.

Problems also occur with the soft tissue surrounding bones in such severe injuries. After a fall from a roof, top of a skateboard ramp or other high structure, the foot will become very swollen, or edematous. Blisters may also develop from the tearing of skin layers. Any signs of swelling, redness, pain or tenderness in the foot should be a cause for concern after a trauma and reason to contact your podiatrist. Swelling can be a cause of continued pain and a reason to delay surgery until it has resolved. Special casts designed to decrease such edema are often applied after a trauma or surgery. So think twice before taking a leap this summer to prevent foot injuries that will disrupt future fun for months to come!

Please visit www.ColumbusFoot.com for more tips for healthier and happier feet or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.

A recent study from the National Human Genome Research Institute confirmed that there are more types of fungus growing on the feet than many other locations in the body. Feet were found to have more fungus that even the nostril, elbow pit and crease between the thigh and groin. This research could explain why the feet and toenails seem to become infected by fungus much more frequently than anywhere else in the body.

Foot fungus infection or tinea pedis can have several different clinical manifestations. The most common form is known as interdigital tinea pedis, meaning that it occurs between the toes. Skin between the toes will often appear red, or white with moist skin that sloughs off, and with open cracks in the skin. Odor and itching may also be noted. A fungus species called Tricophyton rubrum most commonly causes interdigital, and most other types of tinea pedis, however other fungus or even bacteria may be contributing to the infection. Another very prevalent type of tinea pedis is the more commonly recognized form of chronic tinea pedis, or “Athlete’s foot”. This type of foot fungus infection may cause the feet to become itchy. The skin on the bottom of the foot will often appear red with overlying white scales. These two forms of tinea pedis are both commonly associated with the development of toenail fungus. Once fungus has invaded skin on the feet, it may penetrate the seal of the nail bed and migrate beneath the toenail. Lifting of the end of toenails, extreme thickening, debris under the nails, and color changes are all seen with toenail fungus, or onychomycosis.

When fungus occurs in thin skin, as in interdigital tinea pedis, topical anti-fungal creams or powders can penetrate into cells and kill the fungus. However antifungal medications cannot penetrate into nail or hair that has been infected. This fact combined with the new knowledge of the study showing that feet host from 80 to 100 different species of fungus can make treating a fungal infection, especially of the nails, very difficult. While some antifungal medications stall or slow fungus growth, others kill some species contributing to the infection. With around 100 species on the foot it can be difficult to be sure that the medication will treat the specific fungus causing the condition. It is for this reason that a nail or skin sample may need to be sent for testing to determine whether or not there is fungus present, and in some cases which species of fungus is present. Treatment for both toenail fungus and tinea pedis is very similar. Oral antifungal medications have had success in treating both toenail and skin fungal infection, however this treatment route has a number of drawbacks. Because oral medications are absorbed throughout the entire body, they will have more unwanted side effects in major organs compared to using only a topical treatment. Another option for toenail fungus is the PinPointe Foot Laser which is a non-systemic way of treating your toenails. This treatment method is quick, painless and has no systemic side effects. Once foot fungus has occurred it can often be difficult to completely eradicate, so it is important to take preventative measures to avoid developing a fungal infection. These measures include wearing sandals in public showers or around pools and good foot hygiene, which includes keeping feet clean and dry and not applying any lotions between the toes.

Please visit www.ColumbusFoot.com for more tips for healthier and happier feet or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Columbus Podiatry & Surgery has opened a new location in Gahanna, near Easton. Please call 614-476-3338 (FEET) for an appointment with a podiatrist in Gahanna, OH today.