With fall backyard football gatherings and holiday party peep-toed shoes in the near future, people in Columbus and across the country are looking for ways to relieve the pain and embarrassing appearance of fungal toenails. Onychomycosis, or fungal infection of the nail, is reported to affect up to nearly 15% of individuals in North America and can cause a variety of problematic symptoms.

Toenails that are discolored and thickened are the most common signs that a toenail has developed a fungal infection. These nails may also be painful. To be invaded by a fungus, nails first must have an inciting trauma or secondary condition that results in changes to the underlying nail bed. Most commonly, a small repetitive trauma caused by an abnormally functioning or deformed foot will contribute these changes. Other underlying causes can include vascular disease and psoriasis. Tinea pedis, or athlete’s foot is also often present and a contributing factor to the development of a fungal toenail.

Different types of onychomycosis exist and the specific type must be diagnosed to set a successful treatment plan. The classic symptoms described above are seen in the vast majority of cases and are caused when fungus enters under the tip of the nail and proceeds backwards. Another form of fungal nail is known as causes the nail to appear white and sometimes crumbly. While this form is rarer, it is also the form that responds most readily to topical treatment because the fungus is located primarily on the top of the nail.

Treatment of toenail fungus can be difficult. The first step in treatment is to first visit your podiatrist to obtain an accurate diagnosis as soon as changes in the nail are noticed. Early on, when less than half of the nail is infected, a topical nail polish-like solution can be applied daily. Once the fungus has caused damage in more than half of the nail, serious oral medications may be needed. At Columbus Podiatry and Surgery and Surgery, the PinPointe Foot Laser is available as a painless alternative that can be used at any stage of toenail fungus. Laser treatment of fungal nails avoids blood tests and the serious side effects including liver and blood cell disease that can be caused by oral medications. With all treatment plans for a fungal nail, underlying biomechanical issues need to be addressed with orthotics or shoe modifications if present to end the cycle of trauma allowing the fungus to enter the nail. Talk to your podiatrist to have toenails looking and feeling picture perfect for all your upcoming events!

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.

Whether you are trick-or-treating, visiting Hoffman’s Farm Market or other pumpkin patches, October in Columbus can mean a lot of walking. Foot pain should not be one of the scares you face this Halloween season, and the fright of a flatfoot should be made to disappear by a visit to your podiatrist as soon as possible!

While having flat feet can be normal in children, a flat foot that develops in adulthood is not normal and a sign of disease in the tendons in the foot. The condition known as posterior tibial tendon dysfunction, or PTTD, is the number one cause of unilateral acquired adult flatfoot. The posterior tibial tendon runs along the middle side of the foot, affects several joints and maintains the arch foot. In PTTD, the sheath surrounding the tendon becomes inflamed, which leads to the tendon beginning to degenerate and may eventually tear completely. While the exact trigger of this disease process is unknown, it has been associated with diabetes, obesity, hypertension and an underlying abnormality of the tendon. As the tendon degenerates, it will often cause pain along the middle side of the foot and an inability to rise up on the toes of the affected foot. As the muscle weakens, other ligaments and supporting structures in the foot fail and the foot transitions from a flexible flat foot to a rigid flat foot.

The earlier this disease is caught, the better the treatment outcome. Early on, while the deformity is still flexible, a sturdy custom orthotic called a UCBL or a lace up gauntlet style brace called an Arizona brace can be used to offer pain relief and prevent further degradation of the tendon. If the tendon has already torn, or relief is not gained through more conservative means, flatfoot surgery may be necessary. Addressing this problem as soon as possible can prevent years of a painful tendon and foot arch. Trick or treat and check your feet this Halloween!

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.

Although Ohio NFL teams will not be facing the Washington Redskins for a few weeks, they may still gain an advantage if Redskins’ wide receiver Pierre Garcon does not take extra good care of his feet until then! Foot problems have affected a large number of football players as usual this year varying from Hakeem Nicks of the New York Giants foot infection to Cedric Benson of the Green Bay Packers lisfranc injury. Pierre Garcon’s injury has capsulitis of his second toe of his right foot, meaning that the joint capsule at the base of the toe has become irritated and inflamed.

Garcon’s injury may sound minor, but has been severe enough hinder his ability to play to his full capacity. A number of factors can contribute to an irritation to the capsule at the base of a toe. The second toe is most commonly affected due to a number of structural reasons. A long 2nd metatarsal (the bone at the base of the toe), the presence of a bunion, overpronation and tight calf muscles have all been found to be contributing factors to the development of this condition. Patients with capsulitis will often have a thick callus on the ball of the foot at the base of the painful toe. This callus and the bottom of the base of the toe will often be excruciatingly painful with pressure, as is likely the case for Pierre Garcon. This form of metatarsalgia will often feel like there is a lump in the ball of the foot, like the patient is walking on a stone. Capsulitis of the toe is also known as “predislocation syndrome” because, if not properly addressed, the toe can not only progress to develop a severe claw toe or crossover toe but can eventually dislocate.

For Garcon, hopefully he has had custom orthotics made to correct biomechanical deformities that have led to his capsulitis and to offload the painful area on the ball of his foot. While cortisone injections can be used to temporarily relieve pain in some conditions, they can actually accelerate the degeneration of the bottom of the joint in predislocation syndrome and should be avoided in most cases. After his season, Garcon’s best option for pain relief in the future may be metatarsal surgery to decompress and alleviate stress on the joint and plantar surface of the foot. Predislocation syndrome can frequently be confused with stress fracture, neuroma, or various other conditions and your podiatrist should be contacted to correctly diagnose and treat the true problem.

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.

On rainy falls days around Columbus, many exercise enthusiasts can be found barefoot enjoying a break from the elements at their favorite yoga studio. Yoga has been reported to have many benefits for the body, and the feet are not an area of exception for these benefits. However, as with any exercise program, you need to make sure that your feet and body are physically up to the challenge of yoga before beginning.

Much like barefoot running shoes are said to stretch and strengthen the muscles of the foot and relieve tension placed on parts of the foot by shoes, yoga has similar benefits without the repetitive pressures placed on the foot in barefoot running. There are many poses in yoga that stretch the toes, feet, ankles and legs in a way that is often suggested to relieve painful conditions such as plantar fasciitis. The popular downward-facing dog position, in which the person is in an upside down “V”, reaches the heels towards the ground and offers a great stretch for the commonly tight calf muscles. When calf muscles are tight, a condition known as equinus can result. Equinus is a decrease in the normal range of motion available at the ankle joint and can contribute to many problems and deformities in the foot including overpronation, bunions, hallux limitus, and hammer toes to name a few.

There are also some conditions you should let your yoga teacher know about before beginning your yoga practice that may cause pain in certain positions. A dorsal exostosis, or bony bump on the top of the foot can cause pain in positions such as child’s pose where the tops of your feet are pressed against the ground. If this bony bump is becoming irritated in shoes on a day to day basis, custom shoe modifications can be made to can alleviate pain or foot surgery can be performed to remove the excess bone. Certain transitional movements may also be painful in yoga if you have pain in the ball of your foot, or metatarsalgia. In the sun salutation practiced in certain types of yoga, participants jump from one pose to the next and land on the ball of their foot. In addition to avoiding this painful movement, those with metatarsalgia should contact their podiatrist. Fractures, neuromas and predislocation of the joints in the ball of the foot are all possible underlying causes of this condition. Yoga encourages its participants to listen to their body and its connection to the Earth, which especially means listening to your feet and calling your podiatrist at the first sign of pain!

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.

While many falls sports are reaching the midpoint of their season, spring and winter athletes who are currently in their offseason in Ohio should take advantage of the time off to address any ailments. One of the fastest female sprinters in the world, Sanya Richards-Ross had surgery on her big toe last week to address an ailment that had bothered her for years. Although it is not advisable to continue running through athletic foot pain, Richards pushed through her pain to win her first individual Olympic gold medal in the 400 meters this summer. Now she is taking advantage of her time off from competitions to correct the source of her pain!

There are many ailments that can cause pain in the big toe, or hallux that can worsen over time. One common disease that many athletes suffer from in their big toe is known as hallux limitus. This condition is a form of arthritis characterized by limited motion of the big toe, which is especially important for sprinters like Richards-Ross who require more propulsion from their toes than other longer distance runners. Other athletes that are commonly affected by this condition are football players, in which the limited motion results from trauma to the toe, or “turf toe”. A bony bump may develop on the top of the toe and motion may become extremely painful over time.

Hallux limitus can also occur slowly over time in non-athletes. Biomechanical problems where the foot does not function properly cause the base of the toe to jam on the 1stmetatarsal. This jamming instead of the normal gliding motion of the joint leads to inflammation, pain and eventual formation of the bony bump on the top of the top known as an osteophyte. Over time the joint motion may become limited. Overpronation is one of the most common causes of this unnatural jamming motion. Overpronation can also contribute to the development of a bump on the side of the big toe, or bunion, and a similar bump on the side of the smallest toe, called a tailor’s bunion.

Custom foot orthotics can be used to limit the pronation of the foot and thus limit the development and progression of these deformities. Special modifications including what is called a “Morton’s extension” can be added to orthotics to reduce the painful motion occurring at the joint in patients with hallux limitus. In severe cases, surgery may be necessary for hallux limitus pain relief. So start your next sport season like Sanya by addressing any lingering issues with your podiatrist during your off time to ensure you will be able to run pain free when competition begins again!!

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.

Eating a balanced diet is important for all aspects of good health. Certain foods have been shown to alleviate or aggravate specific conditions. Gout especially has been linked to specific types of food triggering the condition, but recently, cherries have been shown to have a positive effect in avoiding a gouty attack.

Gout is known as a metabolic arthritis. Like rheumatoid arthritis or osteoarthritis, this disease affects the joint space located between two or more bones that, in a healthy joint, is filled with synovial fluid. However, gout is different from these other types of arthritis because it is caused by an imbalance in the amount of uric acid in the body. When proteins are degraded, uric acid is the breakdown product that is normally excreted in the urine. If the body makes too much uric acid or does not excrete enough through the kidneys, uric acid molecules become so abundant that they “clump together” to form crystals. These crystals then accumulate in tissues that do not have a large blood supply, including cartilage and the membrane that line the joint space. Some medications may also trigger these crystals to accumulate and a gout attack to occur.

For many individuals who have high levels of uric acid in their body, a gout attack never occurs and treatment for the elevated levels is not necessary. Once a gouty attack does occur though, the affected individual will want to contact their podiatrist immediately. A gouty attack typically causes extreme pain with redness, swelling and warmth of the affected joint. The joint at the base of the big toe (where bunions also develop) is the most common location for gout, however other joints in the foot and the rest of the body may be affected. If you are diagnosed with gout, studies have found that the earlier treatment is begun, the less pain that is experienced and the shorter the attack will last. Your podiatrist will also want to rule out the presence of an infection, allergic reaction or other diseases of the foot, which also may present with some similar symptoms. To prevent future attacks, along with following their medical treatment plan, patients should try to limit their consumption of meats, seafood, and alcohol intake and consider adding cherries or cherry products to their diet. Good nutrition not only helps avoid gout pain, it is also imperative in healing many other conditions of the feet. In extreme cases of recurring gout, surgical options may even be utilized to minimize the joint space, and thus the space for crystals to deposit.

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.

As cooler weather returns to Columbus, with the official first day of fall this past Saturday, many people will be transitioning from their open to closed-toed shoes. While toenails may be out of sight in closed-toed shoes, they also may be more prone to developing painful ingrown toenails.

Onychocryptosis is the term that describes toenails that puncture the skin surrounding the nail. The feet and toes come in contact with a multitude of bacteria, and these areas of skin punctured by curved nails have a propensity to become infected. Nails that are naturally curved are at a higher risk for irritating or piercing the skin. Onychocryptosis is most commonly caused when an individual attempts to trim nails in a way that rounds the corners of the nail. When rounding the toenail, a barb or small angular piece may remain and cause irritation to the skin. If allowed to progress, the irritation may become infected. Signs of an infected ingrown toenail include swelling, redness, pain, warmth and drainage from the affected nail border. These infections in the skin surrounding the nail are referred to as paronychia. Because the bone comprising the tip of the toe lies directly underneath the nail bed, paronychia can spread down to bone causing osteomyelitis, or bone infection.

With such serious consequences, infected ingrown toenails should be avoided if possible and treated by your podiatrist when if they do occur. Preventative measures against ingrown toenails include: trimming toenails straight across, keeping feet clean and choosing shoes with an appropriately wide toebox. When an ingrown toenail does occur, warm soaks of the toe may offer some temporary relief, but the problem will not be resolved until the nail piece causing the irritation is removed. There are several options when it comes to the treatment of ingrown toenails. A partial nail avulsion may be performed in which the offending strip of nail is removed. Another more permanent option is known as a partial chemical matrixectomy. The procedure removes the offending portion of the nail and your podiatrist then applies a chemical that will kill the area that the nail grows from. This prevents the regrowth of a section of the nail and thus future occurrences of ingrown toenails. In some cases, the skin surrounding the nail may be enlarged from repeatedly being irritated by the nail. When this occurs, the skin can be reduced along with a partial removal of the nail growth center, or matrix – a technique known as a Winograd surgery. Whichever treatment course you and your podiatrist decide upon, this fall can end the cycle of repeated painful ingrown toenails!

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.

As kids reunite with their friends for the new school year in Columbus, there is bound to be some extra zealous recess playtime. While many parents may worry about injuries in their growing kids, parents will be relieved to know that foot fractures account for only around five to eight percent of pediatric fractures. By properly preparing children for physical activity at school and knowing what injuries can occur, parents can keep their kids healthy and enjoying the playground!

Growth plates are unique to children’s bones. All bones in the lower extremity begin as a cartilage structure that is, over time, ossified or transformed completely to bone. A growth plate is a small section of cartilage that remains ossifying between two sections of bone. In the foot and leg, most bones begin to ossify while the child is still in the womb and growth plates do not close until the child is done growing. For most bones, growth plates close around 18 to 20 years of age. Injuries in children’s feet must always be carefully evaluated to avoid or minimize damage to a growth plate. If a growth plate suffers an injury, whether it be a bruise, crush or separation from the ossified bone, the bone may not develop to its full length which can result in deformity and loss of function for the child.

The presence of cartilage and the structure of newly formed bone in children lowers the incidence of fractures compared to adults. Bones are less brittle but may fracture in different ways than adult bones. Children’s bones may receive a buckle fracture or what is known as a “greenstick fracture”. These fractures bring to mind the image of how a toothpick or piece of wood splinters when it is bent. In small children, if fracture is suspected but not visualized on x-ray, an occult or “hidden” fracture may still be present. If a podiatrists suspects an occult fracture based on clinical exam, the foot will be treated as if there is a fracture with a cast for two to five weeks in most cases.

Children are very resilient and while parents should be on the lookout for any bruising, swelling or tales of school yard trauma, foot injuries typically heal with minimal long term damage. Many fractures and even minor growth plate injuries can typically be healed with an immobilizing boot cast. Parents should ensure that their children wear properly fitted athletic sneakers and that they contact their podiatrist if they notice any disturbances in ambulation including tripping or limping.

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 NFL regular season beginning this week and college classes recently beginning, Buckeyes, Browns and Bengals fans will be on their toes at the first sign of any serious football foot injuries. Ankle injuries including ankle sprains and ankle fractures are two of the most common athletic injuries. This year, Cincinnati Bengal center Kyle Cook has already been placed on injured reserve following an injury to his right foot and ankle. While this injury may allow Cook to potentially return to the field this year, coaches and medical staff for the Bengals are certainly on the lookout for an injury to the lower bone of the ankle known as an osteochondral defect.

Osteochondral defect, or osteochondritis dissecans, is an injury to the cartilage and often underlying bone of a joint. While these injuries most commonly occur in the knee, they also occur in the ankle in up to 50% of acute ankle fractures and ankle sprains. In order for the ankle to function at its optimal level, as is definitely required for a professional athlete, the cartilage of the talus, which is the lower bone of the ankle joint, must be smooth and intact. When an injury tears at the smooth cartilage of the talus, pain, locking and clicking sensations and loss of range of motion occur in the ankle. In patients with chronic ankle pain after a previous ankle injury has been treated or ankle pain without previous trauma, these injuries should be evaluated by your podiatrist as a possible diagnosis. Following an ankle sprain or fracture, osteochondral defects may not appear on x-ray. Magnetic resonance imaging, or MRI, or direct visualization of the joint through arthroscopy may be necessary.

Luckily, with the thorough and prompt treatment professional athletes such as Kyle Cook receive, osteochondral defects of the talus can be identified rapidly. Early treatment will lessen the likelihood of lasting problems and loss of function of this important joint that is subject to more load per unit of area than any other joint in the body. Depending on the severity of the cartilage injury, the ankle may need to be immobilized or operated upon. Studies in recent years have shown that following surgery for osteochondral defects of the talus in elite athletes, almost all individuals were able to return to their normal activity level in four to five months and continue participating in the activities they enjoy!

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.

Over half of all amputations in the United States each year are caused by diabetes mellitus and most of these amputations are of the lower extremity. Trauma, infection and severe deformity of the foot and ankle can all be reasons that an amputation may be needed to allow an individual to continue to have a healthy life with the best possible function of their lower extremity. However, in 11 year old Gabriel Muniz’s case of living without either of his feet, they were not amputated. Muniz was born without feet and has been making news recently for the soccer skills he possesses without the aid of a prosthetic limb.

Muniz’s condition is likely the limb deficiency known as “apodia” in which the distal portion of his lower extremities, the feet, simply did not develop. The causes of this lack of development are not well known but can include genetic factors, nutrient deficiencies, deviations from the normal distribution of sensory nerves in bone and external factors, such as viruses.

Apodia is certainly not the only foot deformity that children may be born with. Another condition called “talipes equinovarus” or more commonly “clubfoot” affects one in 1,000 live births in the United States. Newborn feet with clubfoot appear rotated so the bottom of the affected foot faces towards the other foot, instead of towards the ground. Luckily, like to Gabriel Muniz, children born with clubfoot typically can recover to have an active and healthy foot. As with most conditions of children’s feet, the earlier treatment begins of clubfoot, the better the chances are for a complete recovery. The treatment for clubfoot involves casting the baby’s foot repeatedly over the course of weeks to progressively correct the deformity. Foot surgery may still be required for complete correction after casting. However, casting typically reduces the amount of deformity enough so that the surgery is minor compared to what would be needed if casting were not performed early on.

Gabriel Muniz should be an inspiration to any individual born with foot deformity or struggling after a lower extremity amputation that a happy and healthy lifestyle is 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.