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Foot and Ankle Surgery

When conservative, noninvasive methods prove ineffective, surgery may be selected as the next course of action for the treatment of your foot or ankle condition.  A wide number of foot and ankle surgical procedures exist, and it is up to your podiatrist to determine which intervention will be most appropriate and helpful for your case.  Some surgical procedures include bunion surgery, fusion, hammertoe surgery, heel spur surgery, metatarsal surgery, nail surgery, neuroma surgery, reconstructive surgery, skin surgery, and tendon surgery.  Typically, surgery is turned to as a definitive way to alleviate excessive pain or discomfort and to return your foot to full mobility.

Regardless of the location on the body, all surgical procedures require preoperative testing and examination to ensure the surgery’s success and preferred outcome.  A review of your medical history and medical conditions will take place, as will an evaluation of any current diseases, illnesses, allergies, and medications.  Tests such as blood studies, urinalyses, EKG, X-rays, and blood flow studies may be ordered.  Because the procedure involves the foot and/or ankle, the structures of your feet while walking may also be observed by your podiatrist.

Care post-surgery will depend on the type of surgical procedure performed.  Typically, all postoperative care involves rest, ice, compression, and elevation.  To improve and ensure a safe recovery, your foot and ankle surgeon may also employ the use of bandages, splints, surgical shoes, casts, crutches, or canes.  He will also determine if and when you can bear weight.  A timely and thorough recovery is a priority for both you and your podiatrist, and carefully following postoperative instructions can help achieve this.  

Foot Pain

Our feet are arguably the most important parts of our bodies because they are responsible for getting us from place to place.  However, we often don’t think about our feet until they begin to hurt. If you have pain in your feet, you need to first determine where on the foot you are experiencing it to get to the root of the problem. The most common areas to feel pain on the foot are the heel and the ankle.

Heel pain is most commonly attributed to a condition called plantar fasciitis. Plantar fasciitis occurs when the plantar fascia, which is the band of tough tissue connecting the heel bone to the toes becomes inflamed. Plantar fasciitis pain is usually worse in the morning, and it tends to go away throughout the day. If you have plantar fasciitis, you should rest your foot and do heel and foot muscles stretches. Wearing shoes with proper arch support and a cushioned sole has also been proven to be beneficial.

Some common symptoms of foot pain are redness, swelling, and stiffness. Foot pain can be dull or sharp depending on its underlying cause. Toe pain can also occur, and it is usually caused by gout, bunions, hammertoes, ingrown toenails, sprains, fractures, and corns.

If you have severe pain in your feet, you should immediately seek assistance from your podiatrist for treatment. Depending on the cause of your pain, your podiatrist may give you a variety of treatment options.

Falls Prevention

Elderly Americans are very susceptible to falls as they get older. Everyone experiences decreases in flexibility, balance, strength, and the senses as they age. This correlates to some eye-opening statistics. 1 in 4 Americans aged 65 and older fall each year. An elderly American is being treated for a fall in an emergency room every 11 seconds. In light of these striking statistics, one can see the importance of taking steps to prevent falls.

Finding an exercise program for the elderly is an excellent way to reduce the likelihood of falls. Look for an exercise program that improves strength and balance. Elderly people who live a more sedentary lifestyle, with little physical activity, are at an increased risk of falling. Wearing well-fitted footwear that provides good foot support and cushion will help prevent falls from poorly fitted shoes. Talking to a podiatrist about your susceptibility to falls and about inspecting your prescriptions will help to avoid any medication that could make falls more likely. Due to a decline in the senses among the elderly, having your eyes and hearing checked is recommended.

Around half of all falls occur in the household. Removing tripping hazards in the home and making it more accommodating to older persons can significantly reduce falls. Some notable household changes include increasing lighting around the house, installing grab bars in the shower and bathroom, and making sure the floor is clear of clutter. Other smart options include installing a shower chair, using rubber-bottomed rugs, and placing railings on both sides of stairwells.  

Finally, discuss with a doctor and your family about your fear of falling. This will help to increase awareness among the population on the need for fall prevention. A lack of awareness on the matter, and a downplaying of importance are what increase the risks of falling. Following these tips can help to reduce the risk for yourself and your loved ones.

Diabetic Foot Conditions

Diabetes is the condition in which the body does not properly process food for use as energy. People with Type 1 diabetes cannot produce insulin, which is required for glucose to feed your body’s cells. It is typically caused by the immune system mistaking healthy cells for foreign invaders and destroying the insulin-producing cells in the pancreas. On the other hand, people with Type 2 diabetes cannot respond to insulin properly, and eventually cannot produce enough.  The Centers for Disease Control and Prevention reports that over 30 million people in the United States have diabetes, with 1 in 4 having no idea they have it. Surprisingly, diabetes is the seventh leading cause of death in the US. The symptoms of diabetes include frequent urination, fatigue, hunger, and even blurry vision.

Diabetes can also affect the feet as well. Over time, diabetes can cause nerve damage to your feet, which could then lead to symptoms such as tingling, pain and numbness in the feet. Neuropathy can be very dangerous to a person with diabetes, since it prevents them from feeling injuries such as cuts or blisters in the feet, and if not detected early enough, may lead to infection. Neuropathy can also lead changes in the shape of your feet and toes. The best way for people with diabetes to prevent or delay neuropathy is keeping their blood glucose levels in their target range. This consists of eating right, having the correct amount of exercise, and taking medications.

Diabetes can also create calluses and foot ulcers as well. Calluses build up faster and occur more frequently with those affected by diabetes. If there are too many calluses, therapeutic shoes and inserts may be required. It is important to have calluses trimmed by a health professional, as doing it yourself may lead to infections. If these calluses continue to develop and thicken, they can lead to foot ulcers. Foot ulcers are open sores, that appear on the ball of the foot or on the bottom of the big toe. These ulcers can lead to future infections if not treated and may possibly result in losing a limb. It is important to report any ulcers to your podiatrist right away. Your doctor may take x-rays to examine the foot and clean out any dead and infected tissue.

Lastly, diabetes can also lead to poor circulation and peripheral arterial disease (PAD). The poor circulation in the feet and leg area is a result of diabetes narrowing and hardening, eventually slowing down the blood flow in that area. The best way to prevent this is to keep away from smoking and follow your doctor’s advice for maintaining blood pressure and cholesterol. PAD is similar to this complication. PAD is when blood vessels narrow or are blocked by fatty deposits. PAD also increases your risk of heart attacks and strokes and is a common condition to those affected by diabetes. The combination of both PAD and neuropathy may lead to infections and can result in amputation of certain limbs. PAD can be prevented with wearing the proper foot wear and regularly taking care of your feet.

If you want to take care of your feet, you should wash and dry them carefully and perform daily inspections to check for cuts, blisters, or swelling. Any physical activity you partake in should be approved by your health care provider. You should also be sure to wear special shoes if advised to do so by your doctor.

Flat Feet

Flatfoot is a condition that occurs when the arches on the foot are flattened, which allows the soles of the feet to touch the floor. Flatfoot is a common condition and it is usually painless.

Throughout childhood, most people begin to develop arches in their feet, however, some do not. Those who do not develop arches are left with flatfoot. The pain associated with flat feet is usually at its worse when engaging in activity. Another symptom that may occur with those who have this condition is swelling along the inside of the ankle.

It is also possible to have flexible flatfoot. Flexible flatfoot occurs when the arch is visible while sitting or standing on the tiptoes, but it disappears when standing. People who have flexible flatfoot are often children and most outgrow it without any problems.

There are some risk factors that may make you more likely to develop flatfoot. Those who have diabetes and rheumatoid arthritis have an increased risk of flatfoot development. Other factors include aging and obesity.

Diagnosis for flat feet is usually done by a series of tests by your podiatrist. Your podiatrist will typically try an x-ray, CT scan, ultrasound, or MRI on the feet. Treatment is usually not necessary for flat foot unless it causes pain. However, therapy is often used for those who experience pain in their flat feet. Some other suggested treatment options are arch supports, stretching exercises, and supportive shoes. 

Heel Pain

Heel pain can be difficult to deal with, especially if you do not know what the underlying cause is. If you ignore your heel pain, the pain can magnify and potentially develop into a chronic condition. Depending on the location of your heel pain, you have developed a specific condition.  

One condition is plantar fasciitis.  Plantar fasciitis is caused by the inflammation of the plantar fascia, or the band of tissue that connects the heel bone to the base of the toes. The pain from this condition is initially mild but can intensify as more steps are taken when you wake up in the morning. To treat this condition, medication will likely be necessary. Plantar fasciitis is often associated with heel spurs; both require rest and special stretching exercises.

There are various options your podiatrist may suggest for heel pain.  Treatment options for heel pain typically include non-steroidal anti-inflammatory drugs (NSAIDS), which may reduce swelling and pain. Other options are physical therapy, athletic taping, and orthotics. In severe cases of heel pain, surgery may be required.

Preventing heel pain is possible.  If you are looking to prevent heel pain from developing in the future, be sure to wear shoes that fit you properly and do not have worn down heels or soles. Be sure to warm up properly before participating in strenuous activities or sports that place a lot of a stress on the heels. If you are experiencing any form of heel pain, speak with your podiatrist to determine the underlying cause and receive the treatment you need.

Diabetic Limb Salvage

Limb salvage is a procedure that involves saving a lower extremity from amputation. In podiatry, limb amputation often occurs as a result of diabetes. The fundamental goal of limb salvage is to restore and maintain stability and movement of the affected lower extremity.

The procedure typically involves removing the diseased tissue and a small portion of the surrounding healthy tissue, as well as the removal of any affected bone if necessary. If bone is removed it is then replaced with prostheses, or synthetic metal rods or plates, or grafts from either the patient’s body or a donor. Limb salvage is typically the preferred choice of procedure over amputation, as the procedure preserves both the patient’s appearance and allows for the greatest possible degree of function in the affected limb.

Upon diagnosis and determining that limb salvage is the appropriate treatment, the podiatrist may enlist the help of a physical and/or occupational therapist to prepare the patient for surgery by introducing various muscle-strengthening, walking, and range of motion exercises. Such exercises may be continued as rehabilitation post-procedure.

Getting the Right Shoe Size: To Keep Your Feet Happy

People are constantly wearing improperly-fitting shoes. Though it isn’t hard, picking the right shoes does require keeping a few things in mind.

Shoe stores have rulers so you can get an exact measurement of your feet. Be sure to always measure your feet with your shoes on. Measuring just your foot will give you a shoe size that is 1-2 inches too small for picking the right size shoe.

To ensure that your toes won’t be cramped, make sure there is wiggle room. Approximately one inch should be between your toes and the tip of your shoe. It is easy to tell if your shoes are too tight, because you will start to experience pain, blisters, and swelling.

Additionally, do not always assume your shoe size will be the same at every store. Manufacturers sometimes run differently, and your size will vary from brand to brand. Make sure the stores you purchase from have return policies, in case there is a problem.

Rather than shoe shopping in the morning, it is advised to shop for shoes later in the day. Your feet will swell as the day passes. If shoes are purchased in the morning, they may not be as snug as they should be. Furthermore, not all two feet are the same size. Therefore, accommodations may be necessary.

An overall concern in buying shoes is making sure they are comfortable and supportive. There is no such thing as a shoe being ‘broken in’. If they are uncomfortable at the store, they likely will always be uncomfortable.

Since we do a lot of walking, it is important that we pick the right shoes. Our feet will benefit from this, and we will be happier and healthier because of it.

Ankle Pain

The ankle joint is the point at which the bones of the leg and foot join. This joint is crucial because it is responsible for the foot’s mobility. Ankle pain is typically the result of inflammation from an injury to bones, joint space, cartilage, ligaments, tendons, or muscles in the area. Commonly associated symptoms with ankle pain are bruising, redness, numbness, stiffness, weakness, and tingling.

The most common causes of ankle pain are sprains and injuries. Ankle sprains are one of the most common musculoskeletal injuries. Sprains occur when the ligaments of the ankle become partially or completely torn due to sudden stretching. Sprains can occur on either the inner or outer sides of the ankle joint. Usually, these injuries occur when the ankle is twisted in an activity by stepping off an uneven surface. More specific causes include rheumatoid arthritis, gout, osteoarthritis, and Achilles tendonitis.

If you are experiencing ankle pain, you should consult with your podiatrist to choose the best method of care. Your doctor will conduct an examination of your ankle to determine the underlying cause of the pain.

Foot Pain

The feet, being the foundation of the body, carry all of the body’s weight and are therefore prone to experiencing pain and discomfort. If you are experiencing foot pain, it is important to determine where in the foot you are experiencing this pain to help discover the cause of it. While pain can be experienced virtually anywhere in the foot, the most common sites of foot pain are in the heel and ankle.   

Heel pain can be due to a multitude of conditions including plantar fasciitis, Achilles tendinitis, and heel spurs. Pain experienced in the ankle can be a sign of an ankle sprain, arthritis, gout, ankle instability, ankle fracture, or nerve compression. In more serious cases, pain in the foot can be a sign of improper alignment or an infection.

Foot pain can be accompanied by symptoms including redness, swelling, stiffness and warmth in the affected area. Whether the pain can be described as sharp or dull depends on the foot condition behind it. It is important to visit your local podiatrist if your foot pain and its accompanying symptoms persist and do not improve over time.

Depending on the location and condition of your foot pain, your podiatrist may prescribe certain treatments. These treatments can include but are not limited to prescription or over-the-counter drugs and medications, certain therapies, cortisone injections, or surgery.

If you are experiencing persistent foot pain, it is important to consult with your foot and ankle doctor to determine the cause and location. He or she will then prescribe the best treatment for you. While milder cases of foot pain may respond well to rest and at-home treatments, more serious cases may take some time to fully recover.

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