An article published in “USA Today” this past week discussed the scary reality that many elderly patients will leave a hospital much weaker than when they arrived.  Even though the patient’s original condition will be treated, the overall health of the patient may suffer from lack of physical activity.  A similar concept can be applied to many treatments of the foot and ankle, in that even though a treatment may remove the original pain or deformity, post-treatment actions must be taken by the patient to ensure that they maintain optimum health and their condition does not return. 

One condition that requires continued maintenance even after a pain-relieving treatment is plantar fasciitis.  Stretching and orthotics are often suggested as the first line of treatment because they address the root of the problem.  However, individuals with severe plantar fasciitis may find even stretching to be too painful and can receive steroid injections for more immediate relief.  In plantar fasciitis, the fibrous band of tissue called the plantar fascia that attaches from the heel to the ball of the foot becomes irritated from having too much tension placed on it.  Overpronation and equinus, or stiffness of the ankle, can add to the tension placed on the fascia causing its inflammation.  Even though a steroid injection removes the heel pain of plantar fasciitis, the underlying causes of tension will remain and eventually allow the pain to return if they are not addressed.  For a patient to get optimal results from their treatment, they should discuss a daily stretching regimen with their podiatrist that should be easier to adhere to after their pain has been alleviated by the injection.  Simple stretches and custom orthotics will often relieve tension and thus the irritation on the tissue, allowing the patient to avoid recurrences of the condition. 

This concept of stretching and physical therapy following treatment is often used following surgeries that actually have removed the underlying problem, including those performed to remove a bunion.  While the bunion deformity is gone, physical therapy to get the toe moving after surgery can prevent complications down the road that may result from the prolonged inactivity of the toe following the operation.  Bones and tissues that have been cut need time without bearing the weight of the body in order to fuse together properly.  Unfortunately this period of rest that is necessary for bone healing may cause joints and ligaments to become overly stiff from the inactivity.  Physical therapy can be used to remove or prevent any adhesions of tissues to one another that can lead to painful limitation of motion or even arthritis. 

While for some patients, following a post-treatment schedule involving stretching, foot exercises and physical therapy may be difficult, other patients will struggle with the idea of doing as little as possible with their affected foot.  Whether you are eager to return to sports practice, or someone who does not look forward to the idea of any sort of exercise, it is crucial to follow the treatment plan your podiatrist or other doctor has provided to you to completion for your best health 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. If you would like to see apodiatrist in Dublin, Ohio near Tuttle Crossing, call 614-885-3338 for an appointment.

By Dr. Animesh (Andy) Bhatia

Ballroom dancing classes have experienced a jump in popularity in Columbus dance studios with the rise of “Dancing with the Stars” and other dancing programs on television.  Talk show host Wendy Williams, who was a competitor on the current season, tweeted a picture of her seriously beat up looking feet before she was eliminated on that night’s show!  The caption on the picture, which stated “Feet don’t fail me now!” indicates just how important foot health is in any athletic competition, especially one known for its glitzy high-heeled shoes!

Unfortunately for Wendy, her feet were apparently so painful from her bunions that she struggled with her ability to dance on the night she was eliminated.  Bunions on the middle side of each foot were located in the joint at the base of her big toe, which is a typical bunion location.  A bunion of the big toe, or hallux, is caused by “Hallux abducto valgus” which is basically when the tip of the big toe is angled in towards, and often overlaps the second toe, instead of lying straight as it should.  This inappropriate angling of the tip of the toe causes the base of the toe to protrude out from the foot more than normal.

The protuberances caused by bunions have resulted in immense pain for Wendy because of increased pressure and friction against where the shoe would normally just firmly contact the middle side of the foot.  This excessive pressure can cause the body to thicken the outer layer of skin cells as a way to protect the deeper layers of the foot.  These thickenings of the skin are called corns and calluses can cause pain.  Hammer toes, where the first joint in any of the small toes is bent abnormally, are also commonly seen as a consequence of bunions.  Hammer toes can result in increased pressure on the top of the toe and lead to more painful corns. 

There are a variety of bunion treatments as well as a variety of ways to be proactive in preventing a bunion.  Wendy Williams seems to have had a bunion removal surgery, or bunionectomy, several years ago, but has failed to take appropriate preventative measures to keep the bunion from reoccurring.  While bunionectomies can be extremely helpful for relieving the pain and other conditions caused by a bunion, it is important to take additional measures to get the best results from your surgery.  After a surgery, physical therapy and orthotics are often suggested to keep the big toe in its proper position.  For bunion prevention, before a bunion ever occurs or after bunion removal surgery, comfortable well-fitted shoes are key. 

Wendy’s tendency to wear ill-fitting, pointy high heels on a regular basis and even more so with her appearance on Dancing with the Stars may have lead to an exacerbation of her bunion pain and slight re-occurrence of her bunion.  Wendy should have contacted her podiatrist to take care of her bunions before it cost her her shot at the disco ball dancing trophy!

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 in between Westerville, Worthington and Powell.

By Dr. Animesh (Andy) Bhatia

A bunion is an abnormal, bony prominence that develops on the joint at the base of your big toe. As the big toe joint becomes enlarged, it forces the toe to crowd against your other toes, and the pressure exerted on your big toe joint results in inflammation and pain. Early treatment is necessary to decrease the risk of developing joint deformities.

Bunions develop due to prolonged abnormal pressure or motion on your big toe joint, most often caused by inherited structural defects, poor-fitting shoes, foot injuries, or congenital deformities. Women are generally more prone to bunions because of the shoe types typically worn, such as high-heels and narrow-toed shoes.

Bunion pain can range from mild to severe, often making it difficult to wear shoes and perform normal activities. You should contact our Columbus office if you notice the following symptoms:

• An enlarged, visible bulge on your big toe joint
• Restricted movement of your big toe or foot that prevents you from performing normal activities
• Irritation, corns or calluses caused by the overlap of the first and second toes
• Frequent pain, swelling or redness around your big toe joint

Treatment for a bunion will vary depending on its severity. Identifying the condition in its early stages is important to avoid surgery, with the main objective of early treatment being to relieve pressure and stop the progression of the deformity. Many times conservative treatments, such as padding, modified footwear or orthotic devices can be highly effective for preventing further growth and reducing the pressure and pain.

Columbus Podiatry & Surgery recommends the following for reducing pressure and pain caused by bunions:

• Wear comfortable shoes that don't cramp or irritate your toes and avoid high-heeled shoes
• Apply ice to reduce inflammation and pain
• Our podiatrists can show you how to apply padding to your foot to place it in its normal position and reduce stress on the bunion

When early treatments fail or the persistent pain associated with your bunion is interfering with your daily activities, a surgical procedure may be recommended as a last resort to realign the toe joint and alleviate the pressure. Columbus Podiatry & Surgery can advise you on the best treatment options available to relieve pressure on the bunion and slow the progression of the joint deformity.

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 in between Westerville, Worthington and Powell.

By Dr. Animesh (Andy) Bhatia