While people around Columbus may feel as though they have difficulties finding comfortable shoes, one man from Rochester, Minnesota has truly not had a pair of properly fitting shoes in six long years.  Igor Vovkovinskiy is the tallestman in America at 7 feet 8 inches tall.  His feet are so large that no shoe template existed for the estimated size 26 extra wide shoe he would need.  Because of this, the $16,000 price of the shoes posed a major barrier to Igor’s foot health, until he reached out via the internet to ask for donations.  He has now surpassed the $16,0000 goal and has various shoe companies offering to produce the shoes. 

Like Igor, people suffering from a variety of diseases or congenital deficits may also require a custom or modified shoe in order to maintain good foot health.  Nerve disease is one condition that can result in the need for custom shoes.  When loss of sensation occurs in the feet, bony changes can occur that result in arthritis.  This arthritis resulting from nerve disease is called neuropathic arthritis.  Individuals with diabetes represent a major portion of the population who develop neuropathic arthritis in the form of Charcot foot.  In Charcot foot, damage is inflicted on the foot bones as the individual continues to walk on damaged tissue because they are unable to feel pain from the damage.    The bone fragments into pieces, and then coalesces and reforms into an extremely misshapen foot.  A Charcot foot is typically very wide with complete collapse of the arch by the time bone remodeling is complete.  The combination of foot deformity with inability to feel is a potent combination leading to the development of dangerous ulcers for a diabetic patient. 

Luckily, custom shoes can be found with much less work than Igor had to put in to obtain his, simply by visiting your podiatrist.   Charcot and other complications of diabetes can frequently be avoided through regular podiatric care.  It is believed that the biomechanical condition called “equinus” where the foot is unable to lift off the ground, which can result from overpronation, contributes to the development of Charcot foot and ulcers in patients with diabetes.  Your podiatrist at Columbus Podiatry and Surgery can create individualized custom orthotics using a digital gait scanner to correct these biomechanical abnormalities.   Unlike Igor’s $16,000 extremely large shoes, many insurance companies recognize the need and offer coverage of custom shoes and orthotics for diabetic patients meeting specific criteria.

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 a podiatrist in Dublin, Ohio near Tuttle Crossing, call 614-859-FEET (3338) for an appointment.

By Dr. Animesh (Andy) Bhatia

Fans of both American Idol and Aerosmith may have noticed that Steven Tyler has recently been getting media attention not for his singing, dancing or judging skills – but for the wild appearance of his toes!  Stephen claims that the years of dancing and wearing ill-fitting, unsupportive shoes have taken their toll on his feet, which now bear a variety of deformities. 

The most noticeable problem in Stephen’s feet is his overlapping and underlapping toes.  The second toe of his right foot completely overlaps the big toe, or hallux, and toes three, four and five of both feet underlap the adjacent toe.  Not only are underlapping and overlapping toes thought of as cosmetically unappealing, but they also can cause painful corns and calluses on the tops of the toes and make finding properly fitting shoes  a challenge.  Many times underlapping of the toes are a congenital deformity that is present from birth.  Most commonly the fifth toe will be rotated and underlap the fourth toe, a condition specifically called digiti quinti varus.  There are a variety of underlying causes of digiti quinti varus but one of the most common is a coalition, or fusion of the two bones that normally make up the fifth toe.  Another common cause of underlapping and overlapping toes that develop early in life is muscle and ligament imbalances, which can often be treated by taping and bracing.  When the condition develops later in life, as in Steven Tyler’s case, a tear of the plantar plate may have occurred.  The plantar plate is a thickening in the capsule of the joint at the base of each two and serves as an attachment for ligaments that connect the metatarsals.  When the plantar plate tears, these connections are disrupted and the involved toe may deviate over another and metatarsalgia, or pain in the forefoot, and swelling may develop. 

Tyler has also complained of a history of Morton’s neuroma contributing to the painful state of his feet over the years.  A neuroma is an enlargement of a nerve that typically results from irritation to that nerve.  A Morton’s neuroma is found between the third and fourth toes that is the most common location of a neuroma in the foot.  Metatarsalgia, tingling and burning pain are common complaints of those suffering from a neuroma.  Neuromas may be treated by your podiatrist with injection of corticosteroids to decrease pain and swelling, or surgery to excise the painful neuroma.  To avoid Steven’s neuromas and toe deformities, be sure to keep your feet in rock and roll shape with supportive shoes and regular checkups with your podiatrist at the first signs of problems!

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

This past week Logan Steiber of the Ohio State Wrestling team was awarded the Intermat Freshman of the year award.  The exciting wrestling season may have recently come to a close in Ohio high schools and at Ohio State, but for serious wrestlers, offseason training will be starting shortly.  While athletes are supposed to be the epitome of good health, wrestlers can face a variety of foot and other health problems both on and off the mat. 

Wrestlers frequently will often force themselves to extremes to reach their weight class for wrestling.  Those reaching for heavy weight status may, to the detriment of their own health, indulge in unhealthy eating habits.  While the extra weight may provide an advantage in the short term of trying to hold down an opponent, the resulting diabetes later in life may end up knocking the wrestler’s feet out from under them.  These facts were a sad reality this past week for the World Wrestling Entertainment’s retired wrestling legend Kamala when he underwent his third amputation in recent months from complications of diabetes and high blood pressure.  Podiatrists work with their diabetic patients to avoid amputations at all costs, performing them only when it is necessary to save the patient’s life from an infection of the foot travelling further up the leg to the body causing gangrene, or tissue death and septicemia.  By maintaining a low blood sugar, wrestlers with type 2 diabetes or pre-diabetes can avoid many of the complications seen in the foot that Kamala likely suffered from including neuropathy, and slow wound healing. 

At the other extreme, wrestlers trying to remain a lightweight frequently take up running in the offseason.  Wrestlers who enter into an intense running regimen too quickly after months spent just wrestling can experience common running ailments including shin splints, heel pain, and the development of painful corns and calluses.  By starting off slowly with low mileage, purchasing proper shoe gear and stretching these injuries may be avoidable.  Orthotics may also be helpful in avoiding painful conditions if the individual has underlying biomechanical and structural problems with their feet. 

When they are in season, a study in the American Journal of Sports Medicine found that collegiate wrestlers have an injury rate second only to spring football.  The ankle is one of the most commonly and most seriously injured parts of the body in wrestling.  During takedowns and sparring, ankle sprains and muscle strains can occur when the foot is planted on the ground and forced to twist in an unnatural way.  Wrestling is also notorious for the occurrence of athlete’s foot or “ring worm”.  This skin condition is not actually due to having worms in the skin, but is caused by infection with a fungus.  When it occurs in the foot this is also known as tinea pedis and can spread to cause fungal toenails if not treated. 

Wrestlers should make good use of the beginning of their offseason to visit their podiatrist and make a complete recovery from any lingering foot and ankle injuries or skin infections.  With good health, they will be quick on their feet when the time comes for their next big match!

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 a podiatrist in Dublin, Ohio near Tuttle Crossing, call 614-885-3338 for an appointment.

By Dr. Animesh (Andy) Bhatia

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

Recently, a man named Mike Stevens travelled from Mississippi to California to undergo a surgery that would transfer his big toe to his hand where it will replace the thumb he lost in an accident.  This may be a surprising idea to many people because the thumb and toes are not thought of as being as functional as the fingers.   However, the musculature and bone structure of the hands and feet are remarkable similar. 

 While it is very exciting that Mike will hopefully regain a large portion of the function of his thumb and be able to use his hands better in his career as a mechanic, he will have to take extra care to prevent additional deformities from occurring in his foot.  While Mike’s case is extreme, smaller changes in the action and structure of the muscle and ligaments of the foot are what can lead to various deformities and a decrease in the functionality of the foot.  One common example of this happening is the development of hammer toes.  Commonly, a muscle known as the tibialis posterior becomes weakened and muscles that attach to the bottom of the toes and act to flex them or pull them towards the ground are forced to “fire” earlier, longer and with more force to compensate.  This constant force leads to hammer toes which can cause painful corns on the tops of the second, third or fourth toes.  An excessive pull from one of the flexor muscles that causes hammer toes can also cause mallet toes.  The difference between a hammer toe and a mallet toe is that in mallet toe only the very tip of the toe is bent down towards the floor, while hammer toes have the base of the toe bent up away from the floor and the other 2/3 of the toe bent towards the ground.  Mallet toes can also cause corns or even black toenails from the nail abnormally hitting against the shoe forming a bruise. 

A variety of surgical procedures exist to successfully eliminate these deformities, but there are also many less invasive options for pain relief.  Corns should never be removed at home, especially in an individual with diabetes, as it can lead to serious infection if done improperly.  Your podiatrist can safely remove any corns or calluses and fit padding over the affected toe to lessen the development of painful corns in the future.  Custom orthotics can also be used to help correct the underlying muscle imbalance and any other abnormal changes in foot structure.  So whether you just had your big toe removed or you are tired of corns and your feet feeling tired and aching, contact your podiatrist to address these problems and allow your feet to function to the best of their ability!

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