As podiatrists, our patients are plagued with varied pedal complaints from fractures to sprains to varied skin conditions. Some pathologies are more common to a specific patient population; adults, geriatric, athletes. One pathology that does not discriminate and can present in both our youngest and oldest patients are painful ingrown toenails. Simply, the nail has curved into the skin and pain and swelling develops. For anyone who has suffered themselves this simple complaint can be quite debilitating, make walking in shoe gear difficult and can even develop into a much more severe infection if left untreated.
Strappy shoes are cute, but thick skin on top of your toes might be preventing you from wearing this style. The thick skin, otherwise known as corns, is caused from hammertoes. A hammertoe is a bony deformity of the second, third, fourth, or fifth toes where the middle joint has become fixed into a clenched position.
Hammertoes may be hereditary. So if your parent or grandparents have crooked toes, you may be more prone to them as well. People with higher arches or longer toes are more likely to have hammertoes because a lot of weight is being put on the forefoot and the toes are pulling back. This buckling effect can also cause thick calluses on ball of your feet.
Unfortunately, a hammertoe won't go away on its own. Orthotics may be able to help with pain you are getting on the bottom of your feet, however they won't do much for corns on the tops of your toes. The best option for that would be surgery, especially if you don't want to change your lifestyle because of the chronic pain. So don't put away your strappy Manolos just yet - contact your podiatrist to discuss what is best for you.
Scrolling through some sports articles over the weekend was mostly the same old news, but an injury report brought one that caught my attention and warrants discussion. The NBA playoffs are coming up, and with the push towards the end of the season, star players are getting more court time. Such was the case for Milwaukee Bucks guard Malcolm Brogdon who suffered a minor plantar fascial tear in his right foot which will require a minimum of 6-8 weeks to fully recuperate from. But wait for Dr. D, you say. You just said it was a minor tear, why so long to heal? I'm glad you asked that loyal reader.
The plantar fascia is a ligament on the bottom of the foot which starts from the heel bone, runs underneath the arch, and travels to the base of each of the toes. This ligament helps support the structure of the foot. Basketball players and other court-sport athletes are the most susceptible to plantar fascial strains. The high demand of performing on a hard surface, lateral cutting movements, jumping and landing and repetitive periods of high activity and then rest can predispose to issues with the plantar fascia.
Symptoms can be very mild, ranging from discomfort when walking to extremely severe, where patients cannot put any pressure on their heels and will limp. This injury is very common, something podiatrists see daily, and occurs in all ages and activity levels. The treatments employed depend on the severity of the injury, but generally, most patients do not require a long period of recuperation. Unfortunately, the plantar fascia does not heal quickly, so even an elite athlete sometimes needs a period where no stress is subjected to the plantar fascia. Since the plantar fascia is one of the main structures that support the foot, sometimes that means no walking and running. We try to keep patients on their feet if possible, but each patient is different. Usually, some stretching exercises, rest, physical therapy and custom orthotics are all that are needed to get people back on their feet, raining down threes, smashing winners and pounding the pavement.
You may recognize this famous foot; and if you don't, it might be better that way! This foot serves as a great teaching model. Some of the obvious issues noted to this foot are:1. Discolored, thickened toenails- most people think any discolored, thickened toenail is from a fungus. While that might be true it is important to know that trauma, bacterial/yeast infestation can also cause such an appearance. Often times, a nail biopsy is taken in the office and sent off for analysis to confirm fungal growth. If fungus is present, various treatments ranging from topical treatments, oral medications to laser treatments are available. At Advanced Podiatry, we work with our patients to choose which options are best for each individual.2. Bunion- A bump on the inside of the foot may not only be cosmetic in nature but also painful to walk and put shoes on. Bunions may arise due to biomechanical deformities that were never treated such as flat feet or from long years of high heels. The medical term for a bunion is known as hallux abductovalgus in which the joint deviates and causes the great toe to start turning towards the second toe. With severe bunions, the second toe starts to buckle due to the big toe shifting over. The podiatrists at Advanced Podiatry are trained in both conservative and surgical management of bunions.3. Bunionette/Tailors bunion- A bunionette deformity is analogous to a bunion except the bump is on the outside of the foot. Many times, a callus will form near the bump from friction/rubbing from shoes. This deformity can also cause the fifth toe to drift inwards and develop a corn, Wider and supportive shoe gear are always helpful in preventing this deformity from getting worse. If conservative measures are unhelpful, surgery can be performed to decrease pain and the ability to wear normal shoe gear again.4. Hammertoes- Buckled toes may arise from biomechanical deformities such as flat feet, high arched feet or some neurological conditions. Unsupportive, narrow shoe gear can also cause hammering of the lesser toes. Some of the conservative treatment options for hammertoes include orthotics to address biomechanical deformities or toe caps to prevent friction. Surgical approaches are available for hammertoes as well depending on the flexibility of the joint. Sometimes, a simple bone removal is sufficient to decompress the joint; other times a fusion of the joint with some kind of internal fixation may be necessary.
If you feel like you may have any of the above-mentioned problems, come in today for an evaluation and discuss the various treatment options available!
We do all we can to avoid toxins from entering our bodies. We detox, wear natural makeup and we avoid products with harmful additives. So why are we compliant about possible heavy metal poisoning after elective foot surgery? The hardware placed in your bodies after some foot surgeries can lead to metallosis, which is a medical condition involving deposition and build-up of metal debris in the soft tissues of the body. Abrasion of the metal components of screws placed in your foot during a bunion repair may cause immune reactions within your body. Some of the symptoms of metallosis generally include pain around the site of the implant, rash or pseudotumors.
The SafetyFix System is the first FDA cleared device designed to allow for bunion fixation to occur and all metal hardware to be easily removed. The unique shape of the screw allows the realignment of the bunion correction while keeping the head of the screw just below the surface of the skin. When the bones heal, a small incision is made to remove the screw without having to cut through deep layers of previously healed soft tissue and bone. By removing the screw, the risk of short and long term complications and health problems from metal toxicity is greatly reduced because there is no metal or unnatural foreign material left inside your body.
Feel free to contact your local podiatry office to discuss having your bunion repairs with removable screws.
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