Items filtered by date: March 2012

An article published in “USA Today” this past week discussed the scary reality that many elderly patients will leave a hospital much weaker than when they arrived. Even though the patient’s original condition will be treated, the overall health of the patient may suffer from lack of physical activity. A similar concept can be applied to many treatments of the foot and ankle, in that even though a treatment may remove the original pain or deformity, post-treatment actions must be taken by the patient to ensure that they maintain optimum health and their condition does not return.

One condition that requires continued maintenance even after a pain-relieving treatment is plantar fasciitis. Stretching and orthotics are often suggested as the first line of treatment because they address the root of the problem. However, individuals with severe plantar fasciitis may find even stretching to be too painful and can receive steroid injections for more immediate relief. In plantar fasciitis, the fibrous band of tissue called the plantar fascia that attaches from the heel to the ball of the foot becomes irritated from having too much tension placed on it. Overpronation and equinus, or stiffness of the ankle, can add to the tension placed on the fascia causing its inflammation. Even though a steroid injection removes the heel pain of plantar fasciitis, the underlying causes of tension will remain and eventually allow the pain to return if they are not addressed. For a patient to get optimal results from their treatment, they should discuss a daily stretching regimen with their podiatrist that should be easier to adhere to after their pain has been alleviated by the injection. Simple stretches and custom orthotics will often relieve tension and thus the irritation on the tissue, allowing the patient to avoid recurrences of the condition.

This concept of stretching and physical therapy following treatment is often used following surgeries that actually have removed the underlying problem, including those performed to remove a bunion. While the bunion deformity is gone, physical therapy to get the toe moving after surgery can prevent complications down the road that may result from the prolonged inactivity of the toe following the operation. Bones and tissues that have been cut need time without bearing the weight of the body in order to fuse together properly. Unfortunately this period of rest that is necessary for bone healing may cause joints and ligaments to become overly stiff from the inactivity. Physical therapy can be used to remove or prevent any adhesions of tissues to one another that can lead to painful limitation of motion or even arthritis.

While for some patients, following a post-treatment schedule involving stretching, foot exercises and physical therapy may be difficult, other patients will struggle with the idea of doing as little as possible with their affected foot. Whether you are eager to return to sports practice, or someone who does not look forward to the idea of any sort of exercise, it is crucial to follow the treatment plan your podiatrist or other doctor has provided to you to completion for your best health possible!

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

With the record setting high temperatures the past few weeks in Columbus, kids have been soaking up the sun and playing outside as much as possible. While the exercise is excellent for foot health, some new pains may develop from the sudden increase in activity level. Parents need to pay careful attention to new pains as they can sometimes indicate issues more serious than just normal muscle soreness. One of these conditions often identified during childhood years is called a pedal coalition.

Pedal congenital coalitions are caused when the tissues destined to become two separate bones in the foot during development fail to separate and remain united as one bone. These two bones may be united together by bone, fibrous or cartilage tissue. The type and amount of tissue connecting what should be two separate bones will determine how much motion will be allowed where the joint would normally be.

While some coalitions may never cause any problems and go unnoticed, others can cause severe foot pain, stiffness, muscle spasm and foot deformity. Some of the symptoms of a foot bone coalition can resemble the normal pains of post-playtime soreness with aching, and fatigue. These symptoms are brought about by activity, and thus kids with lower activity levels may remain asymptomatic and undiagnosed. The bones involved in a coalition can be identified by matching up the normal time the bones are ossifying with the onset of symptoms. For example, a child who develops the foot pain and joint stiffness around three to five years of age would have a coalition between the talus and navicular bones as a possible diagnosis.

Luckily, the most common congenital coalition in a child’s foot is typically not painful and is a fusion of the two bones that make up the fifth or “pinky” toe. However, common coalitions that occur in the tarsal bones will cause symptoms in an active child. Fusion of the talus and calcaneus, or heel bone, is the most common of the tarsal coalitions. The subtalar joint, which is located between these two bones, requires mobility in each phase of walking or running and a coalition of the talus and calcaneus will limit that mobility. When movement necessary for normal ambulation becomes limited, the body will try to force through the motion, causing pain, or will make changes to work around the need for that movement, causing deformity. Commonly, with the talus-calcaneus coalition, overpronation will be part of the deformity and the child may appear flat footed.

Early identification of these symptoms can result in earlier treatment and improved quality of life for the affected child. Whether the coalition is congenital or has been acquired later in life as a result of osteoarthritis wear and tear or a fracture within the joint, a visit to your podiatrist can help relieve pain and work towards allowing your feet to function in the best way possible!

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

Whether you are running in the St. Patrick’s Day 5K at Flannagan’s this Saturday in Columbus or simply running to the pub, taking care of your feet can make or break your celebration of this lucky holiday. Properly fitting shoes are imperative for good foot health, and also can help in avoiding knee, hip and back problems that develop from the problems originating in your feet!

When you travel to a shoe store, most have what is called a “Brannock device” that is used to measure feet and estimate shoe size. This device measures not only the length of your foot from heel to toe, but also measures width, and the distance from heel to the ball of your foot. The heel to ball distance is most critical in determining whether a shoe fits correctly. Located at the “ball” of your foot on the middle or inner aspect is the joint called the 1stmetatarsophalangeal joint or 1stMTP. This is where a bunion develops, but the normal movement permitted by the joint is also critical to the overall function of the foot. The base of the joint is the first metatarsal which slides downward in order for the big toe to flex upwards and help propel the foot when walking or running. When this motion sequence occurs in a normal foot, the foot pushes off the ground and swings into the next step.

Correctly fitting shoes allow the 1stMTP to function as it should, while shoes that are too small can cause major problems. Shoes are designed to allow the normal bend at the 1stMTP joint and to inhibit abnormal bending of most other joints in the foot. However if the shoe is too small, the 1stMTP joint will not be allowed to bend normally and big toe will be forced to flex upwards when it should not be. This leads to the condition called hallux limitus, where, as the name implies, the movement of the hallux, or big toe, is limited. Overtime, hallux limitus can progress to hallux rigidus where the joint big toe joint is practically immovable. This is a painful form of arthritis that has resulted from the abnormal wear and tear of the joint. Not only is this painful, but the combination of hallux limitus or rigidus in an already too small shoe can lead to calluses, corns and even ulcers developing on the big toe.

It is important to recognize that biomechanical problems, including excessive pronation, can also contribute to the development of hallux limitus so custom orthotics can often help with this condition. Wearing one size larger shoe is only a difference of one third of an inch in the actual length of the shoe. So this St. Patrick’s day even if you think that a smaller size shoe may look better, by getting the correct size for your foot you will definitely have the luck of the Irish and keep your feet looking great!!

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

Recently, a man named Mike Stevens travelled from Mississippi to California to undergo a surgery that would transfer his big toe to his hand where it will replace the thumb he lost in an accident. This may be a surprising idea to many people because the thumb and toes are not thought of as being as functional as the fingers. However, the musculature and bone structure of the hands and feet are remarkable similar.

While it is very exciting that Mike will hopefully regain a large portion of the function of his thumb and be able to use his hands better in his career as a mechanic, he will have to take extra care to prevent additional deformities from occurring in his foot. While Mike’s case is extreme, smaller changes in the action and structure of the muscle and ligaments of the foot are what can lead to various deformities and a decrease in the functionality of the foot. One common example of this happening is the development of hammer toes. Commonly, a muscle known as the tibialis posterior becomes weakened and muscles that attach to the bottom of the toes and act to flex them or pull them towards the ground are forced to “fire” earlier, longer and with more force to compensate. This constant force leads to hammer toes which can cause painful corns on the tops of the second, third or fourth toes. An excessive pull from one of the flexor muscles that causes hammer toes can also cause mallet toes. The difference between a hammer toe and a mallet toe is that in mallet toe only the very tip of the toe is bent down towards the floor, while hammer toes have the base of the toe bent up away from the floor and the other 2/3 of the toe bent towards the ground. Mallet toes can also cause corns or even black toenails from the nail abnormally hitting against the shoe forming a bruise.

A variety of surgical procedures exist to successfully eliminate these deformities, but there are also many less invasive options for pain relief. Corns should never be removed at home, especially in an individual with diabetes, as it can lead to serious infection if done improperly. Your podiatrist can safely remove any corns or calluses and fit padding over the affected toe to lessen the development of painful corns in the future. Custom orthotics can also be used to help correct the underlying muscle imbalance and any other abnormal changes in foot structure. So whether you just had your big toe removed or you are tired of corns and your feet feeling tired and aching, contact your podiatrist to address these problems and allow your feet to function to the best of their ability!

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