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

If you are a follower of football news, this year it almost seems as though turf toe is a contagious disease at both the professional and collegiate level, even though that is not actually the case.  Luckily, this injury has not made the news for sidelining any Ohio State football players recently!

While ankle sprains are the most common foot and ankle sports injury, metatarsophalangeal joint sprains in the big toe, or hallux, have also been very common since the injury was first given the name “turf toe” in 1976.  Football players including Eddie Lacy of the University of Alabama, Kevin Kolb of the St. Louis Cardinals, and Evan Mathis of the Philadelphia Eagles are just a few of the players this year who have gotten medical attention for their turf toe injuries in order to not only to return to practice and games, but also to prevent long term problems with the use of the joint at the base of their big toe, the metatarsophalangeal joint. 

Turf toe gain its name because the hard surfaces of turf, along with more flexible athletic shoes, cause the big toe to hyperflex up towards the top of the foot in a way that stretches ligaments and causes a sprain.  This hyperflexion typically occurs when an athlete is on his toes running quickly and the foot is pushed down, flexing the toe past its normal range of motion.  As with most sprains, this is a painful injury that will also swell and sometimes bruise.  If you see and feel these symptoms in your big toe, it is also important to see your podiatrist to be examined not only for ligament sprain, but also for sesamoiditis, fracture of the bones in your big toe, or a tear of the plantar plate which is a structure crucial for keeping bones in place during motion of the toes.   The metatarsophalangeal joint at the base of the big toe is crucial for normal walking and running, and can be very painful if it is not functioning normally.  Thus, proper diagnosis and treatment is imperative in the short term for athletes who want to miss as little of their season as possible.  In the long term proper podiatric care of a turf toe is essential for everyone as the injured joint’s articular cartilage can wear down causing arthritis and loss of function.  When the motion of the big toe, or hallux is reduced, the disorder is called hallux limitus, and eventually when motion is completely lost it is called hallux rigidus.  Both of these conditions can be very painful during walking and when severe enough may require surgical correction. 

Hopefully Ohio football players will continue to avoid the notorious turf toe and players on other teams currently suffering from this injury will continue to receive proper care and treatment of this condition!

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

Last Friday, on “The Doctors” they featured what they described as an extreme cosmetic procedure where a woman had a toe shortening surgery to wear designer high heeled shoes with less pain.  While this may initially sound like a crazy procedure you would only see in Hollywood, it is actually done across the country and here in Columbus to correct a deformity of the toes that can disrupt the normal function of the foot and cause pain when wearing ANY type of shoe. 

Based on the images of the woman’s feet, it appears that she suffered from Morton’s toe.  This is actually a problem where the first metatarsal is shortened, which is called brachymetatarsia, making the second toe appear longer than normal.  In some cases, where the second toe is only slightly longer than the second this is a normal variation in the foot and will not cause pain.  However, in more extreme Morton’s toe, such as the woman on “The Doctors” had, the second metatarsal begins to bear all of the body weight that the thicker first metatarsal would normally bear.  Calluses and pain can develop in the ball of the foot in the area of increased pressure.  This painful condition is often referred to as metatarsalgia. Morton’s toe can also cause excessive pronation, or rolling in and flattening of the arch of the foot.  This overpronation contributes to the pains of metatarsalgia, as well as possibly affecting the individual’s stride enough to cause hip, back and neck pain by disrupting proper posture.  In the woman on “The Doctors” it is also likely that she would have had black or darkened toenails, causing by bruising under the nail from the long second toe hitting her pointed shoes. 

While “The Doctors” made this toe shortening surgery sound like a radical and extreme way to wear more attractive shoes, the real problem was that the woman was suffering from pain associated with Morton’s toe.  For this woman, surgery was her best choice to eliminate the symptoms and the underlying toe deformity causing her pain.  For others suffering from Morton’s toe, depending on the severity of their foot problems, there are also options such as padding under the second metatarsal to relieve pain or custom orthotics to help correct the problem.   

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

Heel pain is most often caused by plantar fasciitis, an inflammation of the long, dense band of connective tissue (the plantar fascia) that runs from the heel to the ball of the foot.

Repeated strain on the plantar fascia can cause tiny tears in the ligament. As tension and tearing increases, so does inflammation and irritation of the affected area. Risk factors of plantar fasciitis include foot arch problems (flat foot and high arches); excess weight; running; and a tight Achilles tendon.
The most common complaint of plantar fasciitis is pain in the bottom of the heel that develops gradually. The pain is usually worse in the morning and after sitting or standing for a long period of time. For some, the pain subsides after walking or stretching.
To reduce pain associated with plantar fasciitis:

• Rest. Limit and/or avoid activities that make your heel hurt.
• Ice. Reduce pain and swelling by icing the affected area each day.
• Stretch. Stretch your heel throughout the day, especially when you first wake up in the morning.
• Footwear modifications. Wear shoes that provide good arch support and a cushioned sole. Ask your podiatrist about pads and shoe inserts to relieve your heel pain.

When conservative treatments aren't effective or your pain persists for more than a few weeks, schedule an appointment with a podiatrist at Columbus Podiatry & Surgery to discuss your symptoms and treatment options. A podiatrist can recommend an appropriate treatment plan for your individual needs. This may include, stretching exercises, shoe padding, orthotic devices, night splints or therapy. Most patients respond to non-surgical treatments, but for pain that won't go away, surgery may be considered.

With proper rest and treatment, recovering from plantar fasciitis can take just a few months. Visit Columbus Podiatry & Surgery on the North side of Columbus, Ohio in between Worthington, Westerville and Powell when you first experience pain for a proper diagnosis and an appropriate treatment plan for your individual needs.

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 neuroma is a thickening of nerve tissue that can develop in various parts of your body. In the foot, the most common occurring neuroma develops at the base of the third and fourth toes. This condition is referred to as Morton's neuroma.

There are typically no physical signs of Morton's neuroma, such as a lump or a knot. Instead, symptoms may include:

• A sharp, achy or burning pain in the ball of your foot
• Numbness, tingling, or cramping in the toes or forefoot
• Feeling as if you're standing on a pebble in your shoe

While the exact cause of Morton's neuroma is unknown, the growth of the neuroma seems to occur in response to injury, pressure or irritation to one of the nerves that lead to the toes. People with certain foot deformities - bunions, hammertoes and flatfeet- are at higher risk for developing a neuroma. Women are also more likely to develop this condition as wearing high-heels or narrow-toed shoes can increase pressure on the toes. Other potential causes are activities that involve repetitive irritation to the ball of the foot, such as running.

Morton's neuroma can make walking and performing normal activities difficult and painful. Treatment options vary with the severity of each neuroma, and identifying the neuroma in its earliest stage of development is important to avoid more invasive treatments or surgical correction. Left untreated, neuromas tend to worsen, so it's always best to visit our Columbus office at the first sign of pain.

Early treatments aim to relieve or reduce pressure on the area around the affected toes. Depending on the severity of your neuroma, a podiatrist may recommend:

• Modifications to footwear. Wide-toed shoes relieve pressure on the neuroma.
• Shoe inserts or padding to provide support for the arch of the foot, which removes pressure from the nerve.
• Anti-inflammatory medications can help ease any pain and inflammation. Ask your doctor first.
• Icing to reduce inflammation.
• Rest to lessen repetitive pressure on the neuroma.

In the most severe cases, surgery may be recommended for patients who do not respond to conservative treatments. Columbus Podiatry & Surgery can help you determine the best approach for your specific condition.

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