Every February, New York Fashion Week in New York City brings strange new trends for the people of Columbus and the world to be entertained by.  One strange fashion presented at a previous fashion week took the term “pigeon toed” literally by having real stuffed birds positioned as if they were sitting on top of the foot.  As a shoe trend, “pigeon toed” may be stylish, but when seen as a walking pattern in children, parents should contact their podiatrist for a checkup as soon as possible. 

Kid feet are not simply smaller versions of adult feet.  The bones in the legs and feet of a small child are still developing and can sometimes take on an appearance that would be abnormal for an adult, but is normal for a kid.  For example, infants can have flat arches that would be abnormal for an adult, but are normal for a for certain periods of childhood development.  Walking with the toes turned in toward the midline of the body is the walking pattern commonly referred to as being “pigeon toed” or “in-toeing” and can appear and spontaneously resolve in some children, while in others can be a major cause for concern. 

Being pigeon-toed can represent bone deformity in the feet, tibia (or shin bone), or hip.   When the foot bones are involved, the condition is typically called “metatarsus adductus”.  The metatarsal bones at the base of each toe develop angled toward the midline of the body, commonly as a result of the child’s position while developing in the mother.  Treatment can be highly successful if the condition is caught before the infant is two years of age using a series of casts to properly re-align the bones.  Custom shoes and orthotics may also be used.  When the tibia or hip is rotated towards the midline of the body causing the feet to also appear “pigeon toed” casting or surgery may also be needed as treatment.  For all of these conditions, the earlier a parent notices the problem and contacts their podiatrist, the more treatment options will be available.  Take care of your little ones’ feet beginning before they begin walking and they can avoid being pigeon toed for a life that will hopefully also be free of wearing pigeon high-heels!

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

By Dr. Animesh (Andy) Bhatia

The Patriot’s tight end Rob Gronkowski’s performance at the Super Bowl should serve as a reminder to all athletes and non-athletes of the impact a few ligaments in your foot can have on your daily activities.  Earlier in the season, Rob had suffered one of the most common sports injuries, a severe ankle sprain and like many professional athletes, was willing to sacrifice the health of his feet and body to try to help his team at their biggest game of the year.  Luckily, Rob did not suffer any additional injuries while playing football on his already weakened ankle and underwent surgery this past Friday to treat his partially torn ligaments. 

Most ankle sprains occur when an individual has their foot in an inverted and plantar flexed position, meaning that the inner arch is lifted off the ground and their toes are flexed towards the ground.  Gronkowski’s injury occurred in the opposite of this motion with his foot everted, or with the side of the foot closer to the smaller toes lifted off the ground.  When injuries do occur with the foot in this position, damage tends to be more severe with a longer time needed for healing.  Although he did not break any bones, Gronkowski is said to have torn two ligaments.  While many would people think this should mean faster healing, it is important to remember that while a fracture can take around 6-8 weeks to heal, a damaged ligament also requires six to eight weeks to heal back to good strength. 

Ankle arthroscopy was used to surgically stabilize Gronkowski’s torn ligaments.  Arthroscopy is a minimally invasive surgery where a small incision is made that allows a tiny camera and surgical instruments to enter inside the affected joint.  This type of surgery was used because the damaged ligaments are intricately connected to not only to the opposing bones of the joint, but also to the capsule surrounding the joint.  This type of minimally invasive procedure means a smaller scar, and less wound for bacteria to try to enter.  Following this surgery, Gronkowski will be in a cast for about eight weeks to minimize excessive movement of the ligaments and promote healing.   This is very similar to bone healing, in which motion also needs to be minimized to prevent a nonunion, or the bone fragments not coming back together. 

In the meantime, Gronkowski’s doctor has hopefully gotten him into a physical therapy program to maintain his range of motion and reduce joint stiffness in the future.  To lessen the workload of the healed ligaments, orthotics, a brace, or specialized athletic shoes can also be used to increase the stability of the ankle joint after the eight weeks in the boot are completed. 

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

Although they do not have a date set in Columbus, fans traveling to see the Red Hot Chili Peppers tour for their 2011 album may be wondering what has led them to reschedule many of their appearances.   The cause of these major changes in concert dates is due to lead singer Anthony Kiedis’s painful foot injury of the two small bones at the base of the big toe called sesamoids. 

While many people believe there are 26 bones in the foot, there are technically 28 due to the 2 small constant sesamoids that Kiedis appears to have injured.  Normally the term sesamoid refers to a bone that is not found as part of the normal bones of the body and only appears in a small percentage of the population.  Sesamoids form in tendons and joint capsules to reduce the friction or alter the pull of the tendon.  The 2 constant sesamoids at the base of the big toe are found in a tendon; however they are present in the majority of the population unlike a typical sesamoid and thus are termed “constant”.  Sesamoids can also form elsewhere in the foot not as part of the normal anatomy and thus can occasionally cause discomfort.  Anthony Kiedis unfortunately discovered that the constant sesamoids can become irritated or fractured.  Because these bones are placed under tremendous pressure with each step we take as the foot propels off the ground, any damage to them can cause immense pain and trouble ambulating. 

Irritation and inflammation of the tendons surrounding the sesamoids is called sesamoiditis.  This is a type of tendonitis that does not typically require surgery as part of its treatment.  Fracture of the sesamoids occurs more commonly to the medial sesamoid, or the sesamoid that is located to the side of the big toe away from the other toes.  This is because the two sesamoids are separated from each other by a bony ridge called a crista on the bone they lie beneath.  The medial sesamoid can often slide under this crista and burst or fracture into many small pieces of bone when placed under pressure.  Surgery may be required to remove pieces of the sesamoid bone that have “died” from loss of blood supply.  Kiedis underwent this surgery to not only clean up the sesamoid fracture but also to correct the placement of the muscle tendon that the sesamoid usually lies within. 

Continuing to walk with a painful injury could have led to additional problems by the body attempting to compensate and avoid placing pressure on the sesamoid.  By undergoing the appropriate treatment soon after identifying his sesamoid injury, Kiedis should enjoy immense pain relief and regaining the ability to give high energy performances at his newly scheduled tour dates!

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 Lewis Center. 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

Holiday parties filled with colorful drinks and rich meals are an integral part of this time of year for many people.  However, all of this drinking and feasting can increase your risk of a painful attack of the arthritic condition that tends to strike in the foot known as gout. 

Gout is a disease of the metabolism or breakdown of purines.  Purines are nucleotides that are essential to the survival of all the cells in our bodies because they are vital building blocks of DNA.  While we naturally make proteins, they are also found in many foods.  When purines are broken down by the body, uric acid is created.  Abnormally high levels of uric acid in the body, or hyperuricemia, precede the development of gout. 

When the excess uric acid causes crystals to form in the joint, the joint will become inflamed and often extremely painful.  Gout more commonly affects men, but its prevalence increases in women after menopause.  The most commonly affected joint is at the base of the big toe, or hallux called the metatarsophalangeal joint (MPJ).  Other than the MPJ of the hallux, gout also occurs in the ankle, wrist and knee.  The affected joint will most often become red, hot and so painful that even the weight of a bed sheet will feel unbearable.  A bump, or mass filled with the urate crystals is also often seen at the joint affected. 

It is important to rule out a paronychia which is an infection of an ingrown toenail, a painful fracture, and other types of arthritis of the foot before being able to offer relief from gout.   With proper diagnosis, gout can be managed and the pain eliminated with various medications.  Lifestyle changes can also be helpful in gout management and prevention.  Excessive alcohol consumption and a diet rich in meat and seafood are associated with a greater risk of gout.  So while it may be difficult to resist this holiday season, you will certainly regret not limiting your intake of these items if you are unfortunate enough to develop painful gout later on! 

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

By Dr. Animesh (Andy) Bhatia

Last Thursday’s Thanksgiving and the rest of the upcoming holiday season are the time of year when families all around Columbus gather together, reuniting nieces, nephews, cousins and great grandparents that may not get to see each other as often as they would like.  As young relatives play together, this can provide a great opportunity for parents and other family members to observe and make sure that kids feet and legs are developing in a normal way, similar to other kids of the same age.

Kid’s feet are not simply smaller versions of adult feet.  What may be common in an adult’s foot can be much more serious if seen in a child’s foot.  As kids are growing, the earlier injuries and abnormalities are detected and brought to a podiatrist’s attention, the more treatment options will be available.  Maladies detected early on also have better chances of being corrected more easily and not continuing to pose problems into adolescence and adulthood. 

What you thought was a normal behavior may be brought to light as not being the norm when you can observe your child interact with a group of peers.  For example, a child that regularly walks only on their toes is never normal and can be an indication of serious neurological disease.  Certain milestones of development should also occur around the same time in all kids.  Six months is approximately around the time when a baby should first be able to sit up on their own and by around one year a child should be starting to walk.  Slight variation in the timing of these events may be normal.  Kids that seem clumsy compared to other kids of the same age and tend to trip a lot can also be a sign of developmental problems that should be watched carefully.  Even though hammer toes and bunions are relatively common in adults, children who develop these deformities early on can have a more rapid progression of the deformity becoming severe.  Clubfoot is another birth defect that twists the heel and turns the toes upward.  The sooner clubfoot is diagnosed the more likely bracing and casting will be able to lessen the deformity.   Hip dislocation and dysplasia also occur in infants and their incidence is frequently increased in kids with clubfoot or other foot and ankle deformities. 

In summary, it is always important to watch the development of your child’s feet and motor skills, and the holidays can provide an additional opportunity to compare your child’s progression with that of other children.  Be sure to contact your podiatrist at the first sign of pain or other abnormal findings – and don’t forget that no matter how cute children’s holiday shoes are, they need to first and foremost fit comfortably!

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. Columbus Podiatry & Surgery is now in Dublin! Call 614-885-FEET (3338) to schedule an appointment with a podiatrist in Dublin, Ohio.

By Dr. Animesh (Andy) Bhatia