May Articles 2014

Hammertoe: No Walk in the Park!

Hammertoe is a painful deformity of the second, third, or fourth toe, frequently caused by improper mechanics—the way a person walks or the shoes they wear that do not allow room for the deformity. Similar to mallet toe and claw toe, hammertoe involves different joints of the toe and foot. Shoes that are too narrow or short for the foot, or have excessively high heels, can cause of hammertoe. Improperly sized shoes force the toes into a bent position for long periods, causing the muscles to shorten and bend the toes into the hammertoe deformity.

Other causes of hammertoe may be complications from RA (rheumatoid arthritis), osteoarthritis, trauma to the foot, heredity, or CVA (cerebral vascular accident). Symptoms of hammertoe include, but may not be limited to, pain and difficult mobility of the toes, deformity, and calluses or corns from toes abrading one another.

A patient experiencing symptoms of hammertoe should seek examination by a physician, specifically a podiatrist. Podiatrists diagnose and treat disorders of the foot. If the doctor finds the involved toes have retained some flexibility, treatment may involve simple exercise, physical therapy, and a better fit to shoes worn by the patient. Treatment often targets controlling the mechanics, such as walking, that cause hammertoe by using custom orthotics.

In more advanced cases, where the toes have become rigid and inflexible, the doctor may suggest surgery. The operation would consist of incising the toe to relieve pressure on the tendons. The doctor may re-align tendons and remove small pieces of bone in order to straighten the toe. The insertion of pins may be necessary to fix bones in the proper position while the toe heals. Usually the patient is able to return home on the day of surgery.

If surgery is necessary, it is important to follow the postoperative directions of your physician. Theses may include various stretches, attempting to crumple a towel placed flat against your feet, or picking up marbles with your toes. Striving to wear shoes with low heels and ample toe space will ensure healthy feet and toes. Avoid closed shoes and high heels. Laced shoes tend to be roomier and more comfortable. Shoes with a minimum of one half inch space between the tip of your longest toe and the inside of the shoe will provide adequate space, relieve pressure on your toes, and prevent hammertoe from re-occurring.

Some tips on feet may include purchasing shoes at mid-day as your feet are smaller in the morning and swell as the day progresses. Ensure that she shoes you buy are both the same size and have the store stretch shoes at painful points to provide for optimum comfort.

 

Morton's Neuroma

Morton's Neuroma also called Intermetatarsal Neuroma or Plantar Neuroma is a condition that affects the nerves of the feet, usually the area between the third and fourth toe. Neuroma refers to a benign growth that can occur in different parts of the body. Morton's Neuroma strictly affects the feet. This condition causes the tissue around the nerves that lead to the toes to become thick, causing pain in the ball of the foot.

This condition can be caused by injury, pressure or irritation. Normally no lump will be felt, but instead burning pain in the ball of the foot that will often be sensationalized in the toes will be experienced. Numbness and tingling may also occur. With the onset of this condition, a person may feel pain when tight or narrow shoes are worn. As the condition worsens, the pain may persist for days, or even weeks.

Persistent foot pain should always be a concern. The foot should be examined by a podiatrist if pain persists longer than a few days with no relief from changing shoes, or relieving stress from the foot. The earlier the foot is examined and treated, the less chance there will be for needing surgical treatment.

There are some factors that can play a role in the development of Morton's Neuroma. These include wearing ill fitting shoes that cause pressure to the toes, such as high-heels. Also, high impact exercise may contribute to the cause of this condition. Morton’s Neuroma may also develop if the foot sustains an injury. Another cause includes walking abnormally due to bunions or flat feet, which causes excessive pressure and irritates the tissue. At times, people are affected for no apparent reason.

Podiatrists can alleviate the effects of this condition using a treatment plan to help decrease the pain, and heal the foot tissue. Depending upon the severity of the Morton's Neuroma, the treatment plan can vary. For cases that are mild to moderate, treatments may include applying padding to the arch to relieve pressure from the nerve and reduce compression while walking. Ice packs can also help reduce swelling, and the podiatrist may devise a custom orthotic device to support the foot and reduce compression and pressure on the affected nerve. The doctor will probably advise against partaking in activities that cause constant pressure on the affected area, and may provide wider shoes to ease the pressure from the toes. If these treatments do not relieve the symptoms of this condition, the doctor may use injection therapy.

Surgical treatment may be recommended by the podiatrist if all other treatments fail to provide relief. Normally, the podiatric surgeon will decide on either a surgical procedure that involves removal of the affected nerve or will choose surgery to release the nerve. After examination, the surgeon will decide on the best approach to treat the problem.

Recovery varies according to the type of surgical procedure. The patient will also be instructed on the best shoe wear to prevent the return of this condition, along with changes to workout routines, if this was the cause. Preventative measures are important so the condition does not return.



Stretching the Feet

Debilitating foot pain is a problem for many people. But just as stretching the torso can help alleviate back pain, stretching the feet can also mend existing problems and prevent future ones.

The feet carry the entire weight of the human body all day and can get easily strained from overexertion. Persistent sharp pain and cramping in the feet are common problems. Foot pain and problems can be due to any number of causes, and in many cases pain may be eased without medication or doctor visits; however, it is always a good idea to rule out any serious medical issues first with a physician.

Stretching may help relax the feet and alleviate pain at any time, but it is especially important before    heavy aerobic exercise to avoid painful cramps or straining muscles in the feet. Stretches should be performed slowly and deliberately without forceful pulling. The stretch should be held for several seconds, and then relaxed.

A great way to stretch out and loosen up the foot muscles while sitting is to cross one leg over the other and pull the toes carefully back without overextending. Start by resting the left ankle on the right knee. With the left hand, gently flex the left foot by pulling back on the toes. Do not pull too hard, just hard enough to feel the stretch in the arch of the foot. Then point the toes of the left foot as far as you can. Rotate the motion of pointing with pulling back on the toes. This should relax and stretch the muscles on the bottom and the top of the foot. Doing this stretch ten to twenty times should bring relief. Repeat the whole process for the other foot by resting the right ankle on the left knee.

A stretch that focuses on the often injured Achilles tendon involves standing, facing a wall, with your arms out and hands flat against the wall. Step back with one foot, keeping it flat against the floor. Move the other leg forward and lean toward the wall. You should feel a stretch through the back of your leg and your Achilles tendon, but do not push yourself too much. Stop when you feel the stretching sensation and hold for 30 seconds. Ten repetitions may be done for each foot.

Stretching the feet is important for athletes or those performing aerobic exercise, but it can also help anyone with foot pain caused by poor footwear, plantar fasciitis, or long hours standing and walking. Individuals who tend to their feet by regular stretching every day should be able to minimize foot pain and prevent new problems from arising.

Ingrown Toenail Care

An ingrown toenail is caused when a toenail grows sideways into the bed of the nail, causing pain and swelling. Sometimes this can become infected causing drainage and may become serious.

There are many risk factors that can predispose a person to this common condition. Cutting your nails too short, participating in sports, diabetes, being overweight, or having a fungal infection of the toe can all cause ingrown toe nails. Many people are genetically prone to ingrown nails and it can often be related to genetics. Often the problem can come from wearing ill-fitting shoes, or even from shoes that keep the feet slightly damp.

There are some things that you can do to prevent and treat these painful problems. Letting your toe nails grow a little longer will help prevent this condition. If you do develop an ingrown nail, soaking the toe in hot water will help prevent infection and lessen pain. You may want to add antibiotic soap or Epsom salts to the water. This will help to prevent infection.

Some experts also recommend placing small pieces of cotton under the affected part. This will help the toenail to grow up instead into in your nail bed. Resting with your feet up can reduce swelling and redness.

If your pain is so severe that it keeps you from everyday activities, it is time to see your podiatrist. Also, if you see a red streak running up your leg, or if your infection is spreading, see a podiatrist immediately. There are many quick treatments that can lessen your pain and have you walking with comfort.

One method of treating an ingrown toenail involves using a Band-Aid. Wrapping the affected toe with a Band-Aid will prevent infection and also keep the nail from growing out at painful angles.

If your podiatrist feels it is necessary, he or she may make a small incision and remove part of your toe nail. Medication will be placed in the nail bed to prevent re-growth of the problem nail parts. This will be done under local anesthesia and should lessen your discomfort in no time. You will be advised to stay off your foot for a day or so, but can then carry on normal activities.

Take care of your feet; you have many steps to take in your life. Walking in comfort should be a priority for a lifetime of healthy living.



What to Know About a Broken Toe

Although most people try to avoid foot trauma such as banging, stubbing, or dropping heavy objects on their feet, the unfortunate fact is that it is a common occurrence. Given the fact that toes are positioned in front of the feet, they typically sustain the brunt of such trauma. When trauma occurs to a toe, the result can be a painful break (fracture). Another type of trauma that can break a toe is repeated activity that places stress on the toe for prolonged periods of time.

Broken toes can be categorized as either minor or severe fractures. Symptoms of minor toe fractures include throbbing pain, swelling, bruising on the skin and toenail, and the inability to move the toe with ease. Severe toe fractures require medical attention and are indicated when the broken toe appears crooked or disfigured, when there is tingling or numbness in the toe, when the injured person experiences fever or chills throughout their body, and when there is an open, bleeding wound present on the toe.

Generally, a minor toe break will heal without long-term complications, but it is important to discontinue activities that put pressure on the toe. It is best to stay off of the injured toe with the affected foot elevated on pillows. Swelling can be alleviated by placing an ice pack on the broken toe for 15 minutes every two hours during the first two days after the fracture. The broken toe should be immobilized by placing a small cotton ball between the injured toe and the toe beside it, then taping the two toes together with medical tape. 

Severe toe fractures may be treated with a splint, cast, and in some cases, minor surgery; especially when the big toe has been broken. Due to its position and the pressure it endures with daily activity, future complications can occur if the big toe is not properly treated. Pain associated with minor toe fractures can be managed with over-the-counter pain medications, and prescription pain killers may be necessary for severe toe fractures.

The healing time for a broken toe is approximately four to six weeks. In severe cases where the toe becomes infected or requires surgery, healing time can take up to eight weeks or more. While complications associated with a broken toe are immediately apparent, it is important to note that there are rare cases when additional complications, such as osteoarthritis, can develop over time. 


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