While Katy Perry was in Columbus at the Schottenstein Arena on September 13, one of her original opening acts, up and coming pop star Jessie J was unable to perform that night and for most of the tour. In June, Jessie had jumped off a stage while dancing during rehearsals and badly hurt her foot. Now, in recent interviews, Jessie has been describing the story of her injury and how she now feels it will cause her painful arthritis for the rest of her life. Jessie and anyone else who has suffered a traumatic ankle injury need to know their treatment options to avoid or cope with possible arthritis in the future.

After her ankle injury, Jessie was initially diagnosed with a ligament injury of the ankle. Unfortunately it was not diagnosed until later that she had also fractured 4 bones in her foot and ankle. While ankle sprains are one of the most common injuries that dancers can encounter, it is also important that the individual be evaluated by x-ray or other radiographic imaging for bony injury if have symptoms of tenderness when they press on bone or are unable to stand on only the injured foot. Chronic lateral ankle pain, or pain on the outside of the ankle, can result from both ligament or bone damage to the ankle, but bone fractures can also lead to arthritis of the ankle. While arthritis in the knee or hip common result from wear and tear over time, the most common cause of arthritis of the ankle is a previous traumatic injury.

The missed diagnosis of broken bones has led to a more severe situation for Jessie’s ankle. Because Jessie’s fractures were not diagnosed until later, the broken bone pieces were allowed to continue moving in an unstable manner in her foot as she continued to bear some weight on them in a brace for the ligament injury. Without proper blood supply or biomechanical stability, bone pieces cannot realign and unite. This is called a non-union and when it occurs as it likely did with Jessie a graft of bone material must be surgically placed in the foot to promote union and healing of the bones. After this “bone transplant” as Jessie has been referring to it, she now complains of chronic pain in her ankle and a possible future of painful arthritis. Because she cannot turn back time and get her foot promptly diagnosed correctly to have possibly avoided the non-healing of her bones, Jessie and all foot and ankle arthritis suffers should talk to their podiatrist about their options to reach a much less painful state. Physical therapy may be an initial step to healing and regaining motion in the joint after surgery. There are also other surgical options to help an arthritic joint function less painfully and thus with better motion, including a fusion of the bones that make up the joint or a total joint replacement. For active individuals such as Jessie, studies have shown that in arthritic patients who received a total ankle replacement were able to greatly increase their sports activity from their previous arthritic state.

Luckily for Jessie J her diagnosis was eventually caught and she will hopefully look into future treatments to alleviate some of the pain of her current condition and possible arthritis!

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.

Congrats Columbus Marathoners! Now, what were those crazy compression socks you saw people wearing & should you get some for your next race?

Fall brings marathon season with Chicago last weekend, New York coming up the first weekend of November and most importantly, the Columbus Marathon this Sunday, October 16^th! Runners are known to do whatever it takes to reach their goals including forcing down that last Gu, waking up at the crack of dawn to get those miles in, or unfortunately, attempting to continue training through foot pain and injury. One item that many marathoners and distance runners have been seen wearing as a part of their race day uniform are tall compression socks in black and a rainbow of other colors. But the real question is: are these socks just successful at intimidating competitors on the line with their cool looks, or do they actually serve a purpose?

Interestingly, while it may seem like compression socks are the ultimate new running necessity aside from proper fitting running shoes, it is not the runner population that tends to know a bit more about the benefits and uses of compression socks. It is diabetic patients with swelling, or edema that podiatrists regularly prescribe compression stockings, or socks to. Patients with venous stasis from causes such as improperly functioning, or insufficient valves and varicose veins also can have their condition improved with the use of compression socks. With normal valves and vessel structure, the calf muscles function to pump blood upwards against gravity to prevent this pooling. In patients with the conditions mentioned, there is a slowed return of blood via the veins to the heart, resulting in some venous blood pooling. This pooling can not only result in dermatitis, or a rash, but it can also lead to the formation of dangerous deep vein thrombosis and venous ulcers. In order to help restore normal venous blood flow, compression stockings are used to gradually increase pressure up the leg, assisting the “calf pump”. While this has been shown to have positive effects in groups of people with the disease states discussed, the effects of compression sock induced decreased venous pooling, assistance of the skeletal muscle pump and increased deep vein blood speed still require more research before they can be conclusively linked to their claims of performance gains in running. Many athletes also utilize compression stockings post-exercise in order to decrease lactic acid build-up, but this use also requires more research.

So while they may look cool, and can be extremely beneficial if you have venous insufficiency in your legs and feet, compression stockings have a ways to go before they can definitely prove themselves as doing more for your race time than just making you LOOK fast. At this point, if athletic compression socks make you feel better when running, then do what is best for you – just make sure you test them out before your big race and always call your podiatrist if you develop any foot or ankle pain!

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.

Halle Berry may not only have been afraid for her foot after she fractured it while shooting the movie “Cloud Atlas”, but she also may have feared for her job in revealing what she was doing when the fracture occurred! Initially Berry reported that she was taking a casual stroll on her day off around the property she was staying at. However, more recently she admitted that she was actually chasing goats with her young daughter leading up the injury! Although the idea of chasing goats does not seem to make much sense, it at least makes a lot more sense for how a foot fracture developed!

To better understand fractures and how they occur, it is important to know that fractures can generally be divided into two groups: stress fractures and general bone fractures. Stress fractures typically occur in people doing a low-intensity repetitive motion, such as running, marching or walking long distances. The bone is not able to remodel and heal itself fast enough to keep up with the repetitive stress being place on it. Muscles that are fatigued may also play a role in the development of a stress fracture because they will not be able to contract and redistribute force over a larger area.

In this acute instance however, it is more likely that Halle suffered from a general bone fracture than a stress fracture. This means that the cortex or hard outer shell of the bone was damaged all the way through in the area of the injury. It was reported that Halle heard a “crack” & felt pain immediately shooting up her foot. Because she was running on uneven terrain, it possible that Halle also sprained her ankle by rolling her foot. While it has not been reported which metatarsal Halle broke, the fifth (or little toe metatarsal) is the most commonly fractured of the metatarsals in people above the age of 5. In the instance of a 5^thmetatarsal fracture, it would be imperative to know exactly what position Halle’s foot was in and to have x-rays and other images taken to determine the location and characteristics of the fracture. If she did in fact roll her ankle, she may not only have ligament and tendon damage, but the forceful stretch of tendon’s connecting to the bone may have pulled off, or avulsed a piece of the metatarsal causing the fracture. Another scenario would be if she were propelling herself off the side of her foot, to run after a goat, she may have incurred a “Jones fracture”. A Jones fracture not only disrupts the cortex of the bone, but also disrupts the blood supply to the bone that is crucial to its proper healing. This type of fracture can require more serious treatment including surgery and longer periods of being non-weight bearing on the foot.

The most important step in adequate healing of a fracture foot is getting the correct diagnosis in a timely manner. Each of the different types of fractures described may have a slightly different course of treatment and identifying that course is critical to prevent delayed or improper healing or a longer course of foot pain for the patient. Any actress, athlete or other individual who believes they may have a fracture or other foot injury should contact their podiatrist as soon as possible to ensure that they will be able to get back to chasing goats and all other fun activities as quickly as 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.

In July, we posted a blog on international tennis champion Rafael Nadal’s troublesome heel pain he was forced to play through at this year’s Wimbledon games. In Nadal’s new memoir titled “Rafa” he discussed another foot problem that has worried him throughout his career and in 2005. The pain caused by the problem was so severe that it almost caused him to give up on the game of tennis entirely and try his luck at professional golf instead!

While plantar fasciitis, the likely culprit begind Nadal’s previous heel pain, is very common here in Columbus, OH and around the world, his 2005 foot problem was likely due to a much more rare condition called Kohler’s disease. Nadal refers to his problem as a congenital condition in which the navicular bone of the foot did not harden completely and has caused him problems ever since. Kohler’s disease is not truly thought of as a congenital disease, but develops in a child’s foot typically around ages 5-10 when a traumatic event has caused loss of blood supply to the bone before it finished ossifying. While this type of blood loss causes similar diseases in other bones in kids, the navicular plays an important role in the support of the long and transverse arches of the foot and is the last foot bone to ossify. A child with Kohler’s disease will normally limp on the affected foot; have pain over the middle side of the arch; avoid putting pressure on the middle side of the foot and redness and swelling will often be present. Foot pain in a child should always be treated carefully to ensure that any problems with the growing and ossifying areas of bone are handled appropriately to ensure proper development. As kids go back to school, it is important to keep this in mind that not only are the right shoes important to prevent injuries, but so is proper care when an injury or pain does develop! While Kohler’s disease typically heals normally with no adverse effects later on, it seems that Rafael Nadal unfortunately did not find the best podiatrist for him until later on in his tennis career!

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.

This is the time of year when all runners want to be in their best shape possible and stay injury free during this critical training season. With high school and college runners beginning their season and the Columbus, OH marathon coming up in October, runners of all ages need to be functioning at their peak level.

There are a few things runners starting up running for the first time, or those more experienced runners who are upping their intensity should do to stay injury free. Wearing the proper running shoe is absolutely imperative to avoiding injuries. Shoes not only need to fit properly, but they should have the appropriate amount of support, stability and cushioning for your foot. By scheduling a checkup with your podiatrist before you have begun purchasing expensive running sneakers, they can evaluate your type of foot and how it functions so that you can use that information to make an appropriate shoe choice. Black toe nails can develop when shoes are too small from the foot jamming against the front of the toebox and causing bruising under the nail. Shoes that do not fit properly may allow too much slippage or rubbing of the shoe against the skin causing calluses, and blisters. A few good tips to help ensure you get the right fit of running shoe include trying on shoes at the end of the day when feet are slightly swollen and wear the type of socks you will be wearing when you are running. Shoe types vary based on whether you tend to overpronate, and typically have a flatter foot, or supinate, in which case shoes tend to be more worn on their outer edge. If a person has a severe enough problem with pronation, supination, or problems in foot function, a custom orthotic may be needed to allow the foot to function to the peak of its ability and to prevent injury.

Along with proper shoes and orthotics, stretching and warming up are other simple ways to avoid two of the most common running problems: plantar fasciitis and shin splits. Shin splints and plantar fasciitis are both inflammations at the point where the muscle and connective tissue, respectively, attach to bone. Stretching, warming up and slowly increasing activity all help avoid the pain of shin splints by decreasing the chances of placing extra strain on the muscle attachment to the tibia, or shin bone. Stretching the calf muscles can help to prevent plantar fasciitis by allowing for normal range of motion at the ankle joint and thus reducing the strain placed on the deep connective tissue, plantar aponeurosis that becomes inflamed and causes heel pain.

Happy fall training to all the Columbus and Dublin area runners and remember that if you experience foot or ankle pain while running, do not wait to contact your podiatrist until a serious injury has already progressed!

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.

Many diabetic patients may have heard warnings to look out for “charcot foot” but they may not know exactly what this means. Different from diabetic charcot foot is an inherited disease with another characteristic foot type called Charcot-Marie-Tooth disease. As a part of September’s Charcot-Marie-Tooth (CMT) disease awareness month, it is critical for patients to understand the differences between these two neurological disorders.

CMT

Charcot-Marie-Tooth disease is caused by a gene defect that is often inherited. If CMT is seen in other family members, parents should be on the lookout for the development of slowly progressing muscle weakness in the lower extremities before age 20. Individuals with CMT have nerves that lose their myelin covering, which normally allows signals to be sent to and from skin and muscles at a normal speed allowing sensation and muscle contraction. Patients will not usually complain of any numbness because their sensation was likely never completely normal. As a result of the weakness and loss of sensation, first in the legs then typically seen in the upper extremities, kids with CMT may seem clumsy and have difficulty walking without tripping or rolling their ankles. The feet will often have a high arch appearance and may be prone to ulcers from damage caused by lack of ability to sense pain.

Diabetic Charcot Foot

Patients with diabetes need to be concerned about charcot arthropathy when they develop areas of the foot where they can no longer feel anything. The combination of lack of sensation allowing damage to the foot that patient cannot feel and an increased blood flow supplying mediators of the inflammatory process allows a “charcot joint” to develop. In the charcot joint, the repeated small injuries occurring cause bones to gradually fracture and dislocate. This causes deformity (often an extreme flat foot) which typically places the diabetic patient’s foot at a greatly increased risk of developing ulcers and subsequent infection with severe consequences. The most common signs of the development of charcot arthropathy are swelling and increased temperature of the affected area of the foot, redness, pain and the feeling of a “loose bag of bones” when the joint is moved.

In both diabetes with loss of sensation, and Charcot-Marie-Tooth, foot self-exams are immeasurably important in preventing ulceration and further complications. Protective shoe gear and custom made orthotics can provide additional protective measures for the foot. As shown by these two disease processes, loss of sensation in the foot is a major problem that should always be evaluated by your podiatrist.

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.

This past Friday, the Columbus Dispatch published a story in support of “Falls Prevention Awareness Day” in Ohio. The article discussed ways for the senior citizen population of Columbus to prevent falls and the serious injuries and hospitalizations that can accompany them. One crucial aspect of fall prevention not directly stated in the article is the importance of foot health in the elderly in maintaining good balance and stability.

Feet provide the base of support for the body and in an older individual changes have often occurred that weaken that base. Arthritis of the foot joints, foot deformities, muscle weakness and improper footwear can all play a role in changing the way that the foot keeps the body balanced. Bunions, calluses, hammertoes, and ingrown toenails can all cause pain in the foot. The body’s natural response is to avoid causing pain by changing the weight distribution on the foot so less pressure is placed on the deformity. This change can alter the gait to be more unsteady and increase the chance that a fall may occur. With a visit to your podiatrist there are many options to relieve these types of pain, and thus increase stability. Calluses and ingrown toenails can often be removed at an office visit, while hammertoes and bunions can be treated with surgery or their pain can be lessened using nonsurgical methods. Arthritis or other problems that may not allow the normal range of joint motion also can be treated with surgical methods, or with nonsurgical methods such as custom orthotics that can allow for better functioning of the entire foot while decreasing the pain of the afflicted joint. Simple foot exercises can be used to maintain muscle strength against the loss of muscle mass that accompanies normal aging. In the article in the Columbus Dispatch, this concept was being put to practice by the woman “tracing alphabet letters” with her toes. One last tip is to ensure that shoes fit properly and that the shoe bottom is not slippery. Shoes that do not fit properly can cause pain if they are too small or can cause tripping from the abnormally increased foot motion in the shoe if they are too large.

By taking small measures to “fall-proof” your feet with the help of your podiatrist you can avoid the big health problems and expenses that come with a serious fall!

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.

While parents of kids in the Olentangy and Dublin City school districts around our offices at Columbus Podiatry & Surgery prepare for back to school, there is one item that is sure to make every child’s wish list for starting the fall looking their best: new shoes. While getting the best price and shoes that look “cool” for your kids are certainly factors when making a purchase, the health of your child’s feet need to be priority number one.

One of the most important parts for a child’s shoe is to make sure that the shoe fits correctly. Because feet grow so quickly, it is very important to have both feet measured every time new shoes are purchased as a child is still developing. Most stores selling children’s shoes have what is called a Brannock device that not only measures the length of the foot from heel to toe, but also the width of the foot and the length of the foot from the heel to the ball, which is actually the most important determinant in foot size. Once the foot size is measured, this provides a general guide to what shoe size to try. Foot size and shoe size may not always be the same because different shoe companies’ sizes may vary. Check to make sure the toes are not hitting the front of the toe box and that the ball, or widest part of the foot, lines up with the widest part of the shoe. These simple measures can prevent painful foot problems for your child such as black toenails and calluses. A properly fitting shoe also allows bones that are still growing and ossifying to develop in the correct position and prevent foot and ankle deformities. More problematic feet may require orthotics or braces and a shoe with laces versus a slip-on should then be selected to accommodate these devices.

Hand me downs and online purchasing for back to school shoes may seem like an enticing idea to any bargain hunter; however these practices should also be generally avoided. Hand me downs can be problematic not only because of the possibility of foot fungus spreading, but also because the cushioned insole portion of the shoe tends to mold to the shape of the foot of the initial wearer. When a younger sibling or other hand me down shoe “receiver” then wears the shoes, they will not mold to their foot shape and may lack support and cushioning in areas where it is needed. Online shoe shopping does not provide the opportunity to make sure that shoes fit appropriately on a foot that may have grown a size or two since the last shoe purchase; so make sure the retailer has a good return policy just in case!

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.

Although it seems far away, the November 2012 presidential election has candidates beginning to campaign near Columbus and across the country. One interesting story related to feet about a candidate over the past few weeks were reports that Michelle Bachman supposedly noticed a link between wearing high heeled shoes and having migraines.

While this may seem like a farfetched idea to those who are unfamiliar with severe headaches, it is actually very likely that not taking proper care of your feet can literally be a pain in the neck. Migraines can be severely debilitating and caused by a variety of triggers. Stress is one of the common triggers and it has been postulated that perhaps the reason Bachman linked her heels to her headaches was that she wore high heeled shoes to stressful events.

While the link to migraines is indirect, the most common type of headache called a tension headache can be directly linked to inappropriate shoe gear. A tension headache is associated with a dull, aching head pain, a feeling of tightness across your skull, and tender scalp, neck and shoulder muscles. These headaches can be so intense that they may resemble a migraine. Poor posture is a trigger of a tension headache and can be caused by wearing shoes that create or amplify an unnatural curvature of the spine. Along with high heels, other foot and ankle issues including limb length discrepancy, and lack of appropriate joint range of motion due to arthritis or limited flexibility can also cause back and neck pain.

One relatively simple fix for many of these issues that can lead to a range of upper body problems are custom made orthotics. Foot pain from arthritis can be lessened with an orthosis that limits the amount of painful motion and holds the foot in a more stable position. Most people have a small difference in length between their two legs and may unknowingly compensate by pronating, or causing the longer limb to be flat-footed to equal out the length difference. An orthotic can relieve this problematic compensation and prevent the limb length from causing pain further up the body. Intense headaches should always be discussed with your doctor. You just may end up finding that although the pain is at the top, relief can be found at the bottom – with proper foot care!

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.

Although 2011 was not the year for an Ohio student to take home the win at the National Geographic World Championships, the event was certainly very exciting for all students participating from around the globe. The championships were made even more interesting this year when host Alex Trebek of Jeopardy hosting fame limped in to the set with a torn Achilles and a wild story of how he sustained the injury.

At 2:30 a.m. the previous night, a woman broke into Trebek’s hotel room and supposedly attempted to steal $650 and a bracelet of Trebek’s that his mother had given him. What happened next would deter anyone from messing with the game show host’s belongings again! Trebek awoke to his door being open and immediately began to chase the burglar! Although the thief was eventually caught and charged with burglary, Trebek unfortunately ruptured or ripped his Achilles tendon in the heat of the chase.

The Achilles tendon is the largest and also the most commonly ruptured tendon in the body. The Achilles connects your calf muscles to the back of your heel and is crucial for normal walking and almost every other athletic activity. Overuse of the calf muscles, a sudden increase in physical activity especially after a period of rest or inappropriate shoe gear can lead to Achilles tendonitis or a ruptured Achilles. Serious Achilles tendonitis can occur for an extended period of time leaving the tendon irritated and making a rupture more likely. With tendinitis, the heel pain comes and goes or may be chronically located in the same spot, pain is often noted during or a few hours after athletic activities, and ankle stiffness will decrease as the tendon warms up during use. These symptoms and onset are different from the ruptured Achilles that Trebek suffered which is a more acute injury, resulting in the tendon quickly being severed. The onset of severe heel pain is more immediate with a substantial amount of swelling often being present. Trebek’s rupture likely occurred due to his sudden change from inactivity of the leg muscles while sleeping to a full out sprint trying to catch the thief.

Because the Achilles is such an important tendon in the body, it is important to talk to your podiatrist about how to keep it healthy. Many people have stiff calf muscles that lack flexibility and can increase the likelihood of Achilles injury. When the calves are too tight, the foot is unable to lift off enough to clear the ground during normal walking and the feet are forced to use other means to compensate. One of the ways of compensating is by overpronating, which can lead to a group of other foot problems including the development of flat feet. Regular stretching is one way to increase flexibility and care for your Achilles.

Trebek has now undergone Achilles surgery to repair his tear and hopefully will not have to chase down any criminals any time soon while he recovers!

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.