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NEWSLETTER FOOTNOTES
When golfers follow through, they can overextend the big toe joint on their back foot. Those who have played the game for several years eventually can wear out the cartilage or jam the big toe joint. The likely outcome, if left untreated, is painful arthritis in the big toe, which would make it very difficult to continue playing. If you have pain and swelling around the big toe joint or have less mobility in this area than other parts of the foot, schedule an appointment for an examination. A history of trauma to the big toe area and bone structure also can precipitate the condition. Individuals with a long first metatarsal bone (big toe), for example, are more susceptible to joint compression and hallux limitus. In most situations, orthotics can be prescribed to provide relief, but advanced cases may require surgery.
Check Those Golf Shoes, Too
Another foot problem that is common in golfers is a neuroma or pinched nerve at the bottom of the foot. The weight transfer to the front foot that occurs in the follow through applies pressure that, over time, can cause a pinched nerve. Wearing shoes that have a spike located directly beneath the ball of the foot can worsen the problem. Also, pressure from that single spike, magnified by the several thousand steps taken during an average round, can cause intense pain and swelling in the ball of the foot. Your golf shoes can be made more foot-friendly, without sacrificing traction, simply by removing poorly located spikes.
Based on results of clinical studies of adults with flat feet, we now believe that reconstructive surgery in the early stages of the condition can prevent complications later on. Left untreated, the arch eventually will collapse, causing debilitating arthritis in the foot and ankle. At this end stage, surgical fusions are often required to stabilize the foot. Surgical intervention for adult-acquired flatfoot is appropriate when there is pain and swelling, and the patient notices that one foot looks different than the other because the arch is collapsing. As many as three in four adults with flat feet eventually need surgery, and it's better to have the joint preservation procedure done before your arch totally collapses. In most cases, early and appropriate surgical treatment is successful in stabilizing the condition. As many as three in four adults with flat feet eventually need surgery... Collapsed arches occur in 5 percent of adults 40 years and older, especially those who are overweight or maintain sedentary lifestyles. At the onset of the condition, adult-acquired flat foot can be controlled with anti-inflammatory medications, physical therapy, taping and bracing and orthotics. While most cases of adult-onset flatfoot require surgery, congenital flatfoot is an entirely different condition that is best treated with orthotics in children. Ninety percent of children born with flat feet will be fine with conservative treatment.
Sandal Season is Here; Time to Fix Your Feet!If unsightly foot problems, such as bunions and hammertoes, prevent you from exposing your feet on the beach or in stylish sandals this summer, there are remedies available that will have your feet looking and feeling better before the warm weather comes. In our practice, we find that many women with common structural feet problems are embarrassed about exposing their feet. As a result, they are deprived of a comfortable pleasure of summer.
Bunions are the most common deformity for which women seek surgical treatment, both for improved mobility and comfort while wearing shoes and for a better appearance when barefoot or wearing sandals. Bunions can be repaired with a short post-operative recovery period, depending on the extent of the deformity. Women are more frequently affected with bunions from wearing tight and pointed shoes that aggravate the deformity. Seniors also are vulnerable to bunions because of their higher incidence of arthritis affecting the big toe joint. Unsightly hammertoes also can be a source of embarrassment, but they too can be corrected in time for summer. Hammertoes are flexible or rigid, and may occur on any of the lesser toes. Ligaments and tendons that have tightened cause joints to buckle and, depending on the number of toes involved, recovery can be expected within several weeks.
Many adult, adolescent and child athletes are competing or working out with seemingly normal but persistent foot pain that could be a sign of a more serious injury. Play with pain often is viewed as a badge of honor among athletes, but they should be aware that persistent pain that seems to be normal exercise-related stress could be something far more serious. In our practice, we believe that athletes of all ages should visit when due to overuse injuries from repetitive loading of the foot and ankle during running and aerobics. When athletes overdo their workouts some discomfort is normal. Athletes who ignore persistent foot pain and inflammation and continue to train are at risk for potential complications that could sideline them for months. Among possible injuries associated with persistent foot and ankle pain are stress fractures, muscle strains, tendonitis and subtle fractures after inversion ankle sprains. An examination and diagnosis by a qualified podiatric foot and ankle surgeon will determine if the pain is from overuse or subtle trauma, requiring only a few days of rest, or something that may need surgical intervention.
Tips for Athletes
Need Foot Surgery? Schedule Before SpringThose who might need surgery to correct deformities, such as hammertoes and bunions, can take advantage of the winter months to have the surgery done and be fully recovered in time for spring. In most cases, bunions and hammertoes are correctable with routine day surgery. The decision to employ a procedure is based on the severity of the deformity, the patient's age and general health, and the condition of the bones and connective tissue. Following surgery to correct a mild or moderate bunion, the foot is bandaged and a postoperative shoe is usually worn for three to four weeks. The amount of activity allowed will vary, and the podiatric surgeion may suggest that flexible footwear be worn for several weeks either directly after surgery or after wearing a postoperative shoe. If you need foot surgery and want to be active in time for the warm weather, now is a great time to see us for an examination to determine the right treatment and to schedule a procedure, if surgery is needed.
In children, heel pain often is caused by injuries to the growth plate and secondary growth centers in which tendons pull at the top and bottom of the growth plate of the heel. Boys and girls ages 8 to 14 often experience this problem, and its major symptom is pain on either side of the heel. Growth-plate trauma is common in soccer and other sports that involve a lot of running, and we advise parents to make sure their children stretch before playing and apply ice to the back of the heel after the game or practice. In some cases, we recommend anti-inflammatory drugs and shoe inserts or lifts to relieve heel pain, but the potential for recurrent injury exists until the growth plate closes. Podiatric foot and ankle surgeons provide many forms of treatment to keep children pain-free and participating in sports activities.
We urge all our diabetic patients to make sure their primary-care physicians check their feet during every office visit for signs of ulcerations that, left untreated, can lead to infection and ultimately result in lower limb amputations. It's a simple exam that takes two minutes to determine if you are at risk for developing a foot ulcer. Perhaps the easiest way to remember to get your feet checked is to remove your shoes and socks in the examining room. Most diabetic patients are vulnerable to foot ulcerations caused by poor blood circulation in the lower extremeties and neuropathy that inhibits nerve sensation. Ulcers are the leading cause of foot amputations among people with diabetes, but they are preventable in most cases if doctors routinely check their patients' feet. In a routine foot exam we check for nerve sensation, skin irregularities (corns, calluses, punctures and areas of redness), swelling, drainage, and foot deformities that cause unnatural pressure points that are prone to ulceration. Patients with diabetes who have their feet checked regularly can prevent foot ulcers or have them treated at early stages by a podiatric foot and ankle surgeon.
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Advanced Podiatry Services
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