Items filtered by date: April 2013

In the middle of the NBA’s season, Deron Williams of the Brooklyn Nets was recently suffering from an injury that has sometimes been termed “footballer’s ankle”. Unfortunately for Devon, the condition formally known as ankle synovitis can affect athletes in all sports, not just football. Any activity that results in an ankle sprain increases the likelihood of chronic lateral ankle pain developing. Ankle synovitis is one of the causes of such chronic pain.

It has been found that up to 50% of basketball players who have suffered an ankle sprain continue to experience residual symptoms after the initial problems of the sprain resolve. The lateral ankle ligaments that connect the foot bone to the leg bones known as the anterior talofibular and calcaneofibular ligaments may become stretched and inflamed when an individual rolls their ankle. If a serious enough ankle sprain occurs, swelling and bruising may develop. Individuals should contact their podiatrist to rule out ankle fracture or serious soft tissue damage. Early treatment is critical in the treatment of ankle conditions to halt their progression to chronic pain. Following injury of the lateral ankle ligaments, excess abnormal motion occurs at the ankle joint that results in inflammation of the joint capsule, or synovium. The synovium becomes thickened and impinges on the normal joint space of the ankle. Due to this limitation in joint space, pain occurs and a clicking sound may be heard during ankle motion. Over time, bony spurs, or osteophytes may even develop on the ankle and further limit joint motion.

Radiographs, or x-rays and magnetic resonance imaging may be needed to fully evaluate bone and soft tissue damage of the ankle before a treatment plan can be developed with your podiatrist. Injections may be very helpful for temporary pain relief, as Deron has discovered. After receiving several corticosteroid injections he has luckily been able to return to game play this week! Surgery may become necessary if conservative treatments do not relieve ankle pain following an injury in three to six months. Depending on the condition of the ankle joint, the joint may need to be opened and excess inflamed tissue removed to restore normal ankle anatomy. The technique of arthroscopy may also be used in some cases where a very small incision is made to clean out the joint. Ankle arthroscopy has been shown to have a much shorter recovery period in cases where it is appropriate.

Please visit www.ColumbusFoot.com for more information 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 Saturday, the Walk MS event was held at the Columbus Zoo & Aquarium. This walk for Multiple Sclerosis is held across the country each year to raise money towards working towards a cure for multiple sclerosis. While the first noticed symptoms of this disease typically involve vision, problems with the feet and legs frequently develop later on.

Multiple Sclerosis first presents in the age range of 20 – 40 in most cases. It involves the white matter of the brain and spinal cord, which is where myelin is located. Myelin is a substance that covers the portion of a nerve that transmits information. When this myelin is lost, information cannot be sent as effectively to and from processing centers in the brain. Because the pathways of neurologic information going to and from the foot are the longest in the body, the feet are frequently involved when damage occurs to the brain, spinal cord or peripheral nerves. In multiple sclerosis, the white matter is lost in specific areas in the brain, in the spinal cord and around the optic nerve, which controls vision.

The damage in the brain and spinal cord affect both sensation and muscle control in the foot and ankle. When information from the brain controlling motion cannot reach the leg and foot, reflexes are excessively responsive and muscles become both spastic and weak. Information regarding sensation and position of the foot cannot be sent up to the brain and be processed, so sense of position and protective sensation in the foot are diminished or lost.

Early treatment for multiple sclerosis and the problems it causes in the foot and ankle are imperative. Spasticity of muscles over time leads to contracture and foot deformity that can make functional ambulation difficult. Stretching, physical therapy and bracing may be beneficial in early disease where deformity has not yet become rigid. When spasticity has been present for long enough, deformities including claw toes and cavus foot type may be so rigid that foot surgery is required to release contractures of soft tissue holding the abnormal position. Muscle weakness, while typically mild compared to the symptoms of spasticity, can lead to the development of a foot drop. This makes normal ambulation challenging and causes the foot to drag on the ground at the point where it would normally lift up during gait. A variety of treatment options exist for a drop foot gait, most commonly used is the ankle foot orthosis, or AFO. Loss of sensation, similar to diabetic peripheral neuropathy, requires that individuals with this symptom of multiple sclerosis be extra vigilant with daily foot inspections and keeping their feet protected from injury. With the nearly $250,000 raised in Columbus this past weekend, individuals suffering from multiple sclerosis are hopefully one step closer towards a cure and improved treatment of multiple sclerosis and its effects in the foot.

Please visit www.ColumbusFoot.com for more information 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.

Stilettos are practically the first thing that comes to mind when people think of Sarah Jessica Parker’s character Carrie Bradshaw on Sex and the City. Now, several years after the show and movies have wrapped, Parker is suffering so badly from foot pain and deformity that she has given up her heel sporting ways as often as possible. In a recent interview, Sarah Jessica Parker discussed how she has irreparably damaged her feet from her years of wearing high heeled shoes.

At Parker’s visit to her foot doctor, she noted that he told her she had grown “extra bone” in her foot from her shoe choices. It was most likely that he was referring to a “pump bump” deformity. A pump bump is also known as a retrocalcanealexostosis, which means a growth of excess bone on the back of the heel bone, or calcaneus. The term Haglund’s deformity is also often used interchangeably with the term pump bump, although there may be a slight difference in location on the heel of the two bumps. In general, individuals suffering from a pump bump have a dull aching soreness over the upper back portion of their heel bone. High heeled shoes, and cowboy boots have been associated with aggravation of the condition, as well as living in a cold environment due to the increased use of closed back shoes. Achilles tendonitis should be considered as another possible cause of this posterior heel pain. However, in patients with Achilles tendonitis, pain occurs with ankle movement both in and out of shoes; whereas pain with a pump bump occurs mainly while wearing shoes.

Initial conservative treatment of pump bump may include heel lifts, custom orthotics to address underlying biomechanical problems such as abnormal tilt of the heel or forefoot, and changes in shoe gear to prevent further irritation. Surgery may be required to resect the excess bone for heel pain that is not resolved or has recurred with conservative treatment.

Please visit www.ColumbusFoot.com for more information 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.

Following his horrendous leg injury last week, Kevin Ware has to be in better spirits as his Louisville teammates beat Wichita State Saturday night to advance to the title game of the NCAA finals. Ware has already undergone surgery for what is being described as one of the most gruesome sports injuries of all time. Basketball players and athletes may be wondering how this injury, in which both leg bones, the fibula and tibia broke and protruded out of Ware’s skin after landing a jump, could have happened and how they can prevent such injuries in the future.

There are several underlying factors that could have contributed to the development of Ware’s fractures. Most likely, is that he developed stress fractures in his tibia, the larger bone of the leg. Bones of the foot and leg are subject to excessive stress during sports due to the repetitive nature of motions involved. Stress fractures most commonly occur in the foot in the metatarsals, followed by the calcaneus and then the tibia. In basketball, both running and repeated jumping and landing add stress. Because bone is constantly remodeling, when excess stress occurs it disrupts the normal balance of bone breakdown and building. A stress fracture may not initially appear on a plain x-ray and bone scan or MRI may be needed to obtain a diagnosis. When a stress fracture occurs in the tibia, symptoms may feel similar to shin splints including pain and mild swelling of the shin. It is for this reason, that consulting your doctor about any pain in your feet and legs is imperative to continuing to play your sport, and your overall health. If Ware had been previously diagnosed with stress fractures, it would have been recommended that he remain non-weight bearing on his affected leg. By avoiding weight-bearing, the excess stress is removed, and bone remodeling may occur and strengthen the site of the fracture. If weight-bearing continues, bone continues to weaken and is at higher risk for the extreme type of fracture that Ware experienced.

Unusual fractures may also be attributed to other causes of abnormal bone. These include osteoporosis, which is more common in older females, and bone tumors, which commonly affect the lower extremity. Ware’s age group of 20-30 is a time in which a variety of types of bone tumor may develop. While there are malignant bone tumors that can occur in the foot and leg, most are benign other than causing weakening of the bone and in some cases, pain. Bone cysts and enchondromas are two bone tumors that are benign, common in the lower extremity and often painless unless they contribute to the development of a fracture.

Ware luckily underwent successful surgery utilizing a rod to repair his broken bones on the evening of his injury and has been able to continue providing motivation and support to his team as they advance in the NCAA finals.

Please visit www.ColumbusFoot.com for more information 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.

Football is known for its brutal injuries, and recently former Miami Dolphins pass-rusher Jason Taylor put the spotlight on just how severe these injuries can be in the foot and leg. Taylor explained in an interview how he nearly was forced to undergo a below knee amputation after developing what is called compartment syndrome.

Any severe sports injury should be thoroughly inspected by a doctor to determine the need for treatment. Compartment syndrome occurs when pressure increases in an enclosed area of tissue and can cause nerve and vessel injury and death. What Taylor had thought was just a deep bruise, escalated rapidly when doctors informed him that if he didn’t undergo surgery quickly, he could lose his leg.

There are nine compartments in the foot and four in the lower leg that can suffer tissue death if their pressure increases above the normal range. Signs of compartment syndrome include pain out of proportion, tingling or burning sensation, change in temperature, paralysis and lack of a pulse in the foot. Once pain begins to subside, the condition has reached a late stage in which muscle tissue may already have died from lack of blood supply. It is for this reason that it is crucial to contact your podiatrist or emergency doctor as soon as possible after an injury occurs with severe pain.

Not only does compartment syndrome occur acutely after a sudden intense injury, there is also a variant of the condition called chronic compartment syndrome. Chronic compartment syndrome or chronic exertional compartment syndrome occurs repeatedly after a certain duration or intensity of activity in younger athletes. The front compartment of the lower leg is most commonly affected. The individual with this condition typically feels a recurrent cramp, squeeze or gnawing pain in the area of the foot or leg that is affected by transient increases in pressure. If untreated, this condition can progress to the acute form of compartment syndrome over time and cause major tissue damage. For acute compartment syndrome, such as Taylor’s case, foot surgery to release pressure from the compartments is the best treatment. In chronic compartment syndrome, individuals affected should first attempt conservative treatment including icing and stretching before progressing to a surgical cure. Recent studies have even suggested that minimalist forefoot running style can offer a way to reduce pressure in the most commonly affected compartment of the leg in the chronic form of this condition.

Please visit www.ColumbusFoot.com for more information 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.

Hopefully, we are through the snowy, cold winter in Ohio. While the snow storm “Nemo” did not hit Columbus as hard as it did along states bordering the Atlantic Ocean, there is still plenty of snow and cold in the area for people to enjoy some fun winter activities! Skiiers and snowboarders alike have been able to take advantage of the weather at nearby ski resorts such as Mad River Mountain in Zanesfield, OH. As with any sporting activity, there are always risks of foot and ankle injury and ways to prevent such injuries from occurring!

While knee injuries are the most common of all ski injuries, the alignment and function of the foot can play a role in the development of these problems. The kinetic chain is the term used to describe the interrelated motion between the foot, leg, knee, hip and so on continuing up through the head and neck that allows motion to occur. Due to its critical role as the base of the chain, any problems in the foot can translate to mean problems in the knee, hip or back. In downhill skiing, the foot pronates to maintain control by edging skis into the slope. When an individual suffers from overpronation, this exaggerates the motion required for control and can cause a variety of problems. Pronation rotates the leg towards the middle of the body, a position that can increase the chances of a knee injury. Overpronation can also cause the outside or the heel and foot to rub against the inside of ski boots. This rubbing can result in soreness or even painful blisters or callus formation in points of rubbing. Custom orthotics can be used to correct overpronation and other mechanical deformities to allow the foot to function more efficiently for skiing. Much like custom orthotics in shoes, the ski boot must fit properly in order for the orthotic to be effective. Boots that are not long enough or wide enough will continue to cause pain regardless of what orthotic is used.

Boot fit also contributes to another common problem in skiing called “skiier’s toe”. Skiier’s toe appears as a darkening underneath the toenail. Toes often naturally slide forward in a boot while skiing, but a properly fitted boot should not be too tight at the toes or allow too much sliding. When toes hit the front of a boot excessively, bruising and a hematoma develop causing a portion of the toenail to appear black or dark brown. Small hematomas may be drained by your podiatrist if seen within a few days of their development. In some cases, if the blood has pooled under more than half of the nail, the nail may need to be removed to relieve pressure on the area.

Please visit www.ColumbusFoot.com for more information 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.

Following this week’s inauguration, Pope Francis officially became the 266th pope. With all of the traveling necessitated by his new position in the Catholic Church, Pope Francis will be relying on his feet more than ever. At 76 years old, the Pope and other individuals around his age need to take extra care of their elderly feet.

While many foot problems that affect elderly individuals affect all ages, certain problems may be more prevalent or have more serious risks with increased age. Common problems that can cause foot pain including bunions, hammer toes and corns may also increase the chances of a fall occurring. One study in the Journal of American Podiatric Medical Association found that older people with foot pain performed worse in a leaning balance test, stairs, a step up test and a timed six meter walk. This indicates that older people should address their foot pain with a podiatrist to receive treatment and increase their ability to balance and function.

Conditions such as diabetes and osteoporosis are more prevalent in elderly populations. It is reported by the American Diabetes Association that 26.9% of individuals age 65 years and older have diabetes. Diabetes can become complicated with peripheral neuropathy, or lack of sensation in the feet and lower extremities. Lack of sensation can lead to inability to balance, as well as increased risk of developing a foot wound. When fracture occurs in an elderly individual, it can carry higher risk of serious adverse outcomes. Diabetes, older age and osteoporosis have all been found to be associated with increased risk of delayed bone healing. Proper nutrition offers one way to keep feet healthy and minimize the odds of developing diabetes and osteoporosis. The Pope and other active elderly individuals can discuss many of the other options to be pro-active in maintaining their healthy feet for years to come with a visit to their podiatrist!

Please visit www.ColumbusFoot.com for more information 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 Tuesday was declared as Diabetes Alert Day by the American Diabetes Association to bring awareness to the risks and signs of undiagnosed diabetes. This day is to be celebrated the fourth Tuesday of each March as a “wake up call” for everyone to take their health into their own hands (& feet!) and catch diabetes before the many serious complications associated with the disease develop. Foot care is extremely important in diabetic patients and daily self-exams of the feet are needed to keep feet healthy.

Eight percent of the United States population has diabetes. This would mean that approximately 63,554 people in Columbus are affected by this disease. All of these diabetic individuals may not know exactly what to look for or why they need to conduct a self-exam of the feet. The key role of the foot exam is to identify a potential site of a foot ulcer before it starts or when in it is still in its early stages. In the US, the risk for foot ulceration is 2% annually in diabetic patients. Applied to the estimated diabetic population of Columbus, this would be about 1,271 individuals developing a foot ulcer each year.

Self-foot exam should begin with a general inspection with shoes and socks off in a well-lit area and assistance from another person needed. Shoes and socks should be examined for proper fit and to ensure that there are no foreign objects adhered inside. A shoe that is too small or rubs excessively in a prominent area of the foot generates pressure and friction that can cause an ulcer. Diabetic individuals with peripheral neuropathy, or loss of sensation in their feet need to be especially careful to look out for potential irritants because they are unable to feel the normal pain associated with the development of foot injury. Skin changes should also be noted for signs of ulcer development and infection. Calluses and corns are indicative of an area of increased pressure on the foot that is at risk of ulceration. Foot deformities are often affected by these pressure areas, which is why surgical correction of foot deformity plays a key role in ulcer prevention and care. Ingrown toenails are a serious matter in diabetic patients, in whom the nail changes could lead to infection including osteomyelitis, or bone infection, of the toe bone that lies directly under the nail. Redness surrounding any wound, callus or ingrown toenail can be an indication of infection. Temperature differences between the feet should also be noted. Increased temperature in a foot can be a sign of infection, or the serious joint collapse disease known as Charcot neuroarthropathy. Cold feet can indicate problems with blood flow which may also lead to ulcer development. By conducting regular self-exams of the foot and contacting your podiatrist at the first signs of changes, foot complications that occur with diabetes can be identified early and treated can be initiated. In the spirit of Diabetes Alert Day, people can also take the Diabetes Risk Test to identify their risk level for developing diabetes and receive preventative tips.

Please visit www.ColumbusFoot.com for more information 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.