While it has not become a craze in Columbus yet, a new cosmetic surgery craze in Great Britain has begun making headlines in the US over the past few weeks.  Dermal filler is being injected into women’s feet to provide additional cushioning in areas that are placed under excess pressure by wearing extreme high heels.  The surgery has been nicknamed a “Loub job” in reference to the French shoe designer Christian Louboutin who has been quoted that he does not care if his shoe creations are uncomfortable.  With unpleasant thoughts of wearing painful heels to upcoming graduations and graduation parties for their kids at Westerville South High School, Beechcroft High School or any of the other schools in the Columbus area, women should be pleased to know that less extreme measures can offer great pain relief!

While it would be ideal for optimal foot health to completely eliminate high heels and stilettos from a woman’s shoe choices, it is understandable that there are occasions where dressing up is necessary.  When choosing a dress shoe there are a few things women can do to decrease the pain and potential for injury or deformity caused by the shoe.  Selecting a shoe with a wider toebox versus a pointy toe can limit the development of painful corns and calluses as well as bunions and hammertoes.  If possible, choosing a lower height heel can also decrease the extreme amount of pressure placed on the ball of the foot. 

Certain areas of the foot are affected worse than other when wearing heels.  These areas include the ball of the foot, the bottom and back of the heel and the toe pads, which are some of the areas where dermal filler is being injected in the cosmetic surgery “Loub job”.  High heels are notorious for causing a painful bony bump on the back of the heel in women that is called a “Haglund’s deformity” or “Pump Bump”.  This bump develops from the excess irritation caused by the rigid structure of a pump or high heeled style shoe.  Changing the shoes and adding a heel grip device to the shoe to provide a cushion in the painful aspect are options to decrease the symptoms.  Surgery offers the ability to completely remove the painful bump.  Metatarsalgia, or pain in the ball of the foot, is another issue being targeted by these injections.  There are many custom padding options that your podiatrist can create that will offer the extra cushioning, without having to go through an injection.  It is also important to realize that pain in the ball of the foot may be occurring for reasons that will not be cured by increasing the foot’s cushioning.  For example, neuromas are seen with increased frequency in women who wear heels but often require surgery or injections to remove the irritated nerve in order to alleviate the pain.  For this reason, it is always crucial to have a thorough appointment with your podiatrist to correctly diagnose a problem before self-treating or selecting a treatment from another health professional if they have not identified the underlying cause of the pain. 

Talk to your podiatrist to discuss all the options to enjoy and show off your toes at graduations and spring events without suffering through foot pain!

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 Westerville. 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

Whether you are running in the St. Patrick’s Day 5K at Flannagan’s this Saturday in Columbus or simply running to the pub, taking care of your feet can make or break your celebration of this lucky holiday.  Properly fitting shoes are imperative for good foot health, and also can help in avoiding knee, hip and back problems that develop from the problems originating in your feet! 

When you travel to a shoe store, most have what is called a “Brannock device” that is used to measure feet and estimate shoe size.  This device measures not only the length of your foot from heel to toe, but also measures width, and the distance from heel to the ball of your foot.  The heel to ball distance is most critical in determining whether a shoe fits correctly.  Located at the “ball” of your foot on the middle or inner aspect is the joint called the 1^stmetatarsophalangeal joint or 1^stMTP.  This is where a bunion develops, but the normal movement permitted by the joint is also critical to the overall function of the foot.  The base of the joint is the first metatarsal which slides downward in order for the big toe to flex upwards and help propel the foot when walking or running.   When this motion sequence occurs in a normal foot, the foot pushes off the ground and swings into the next step.   

Correctly fitting shoes allow the 1^stMTP to function as it should, while shoes that are too small can cause major problems.  Shoes are designed to allow the normal bend at the 1^stMTP joint and to inhibit abnormal bending of most other joints in the foot.  However if the shoe is too small, the 1^stMTP joint will not be allowed to bend normally and big toe will be forced to flex upwards when it should not be.  This leads to the condition called hallux limitus, where, as the name implies, the movement of the hallux, or big toe, is limited.  Overtime, hallux limitus can progress to hallux rigidus where the joint big toe joint is practically immovable.  This is a painful form of arthritis that has resulted from the abnormal wear and tear of the joint.  Not only is this painful, but the combination of hallux limitus or rigidus in an already too small shoe can lead to calluses, corns and even ulcers developing on the big toe. 

It is important to recognize that biomechanical problems, including excessive pronation, can also contribute to the development of hallux limitus so custom orthotics can often help with this condition.  Wearing one size larger shoe is only a difference of one third of an inch in the actual length of the shoe.  So this St. Patrick’s day even if you think that a smaller size shoe may look better, by getting the correct size for your foot you will definitely have the luck of the Irish and keep your feet looking great!!

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 Powell. 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

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