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

An Ohio woman has recently developed a new invention that may of benefit to podiatry patients whose toenails have gone missing!  “Nail Creations” is an artificial toe nail that can be stuck on to the skin for all those who may have lost a nail due to toenail fungus, injury or other disease process. 

While this addresses a cosmetic non-medical complaint after the toenail is already lost, it is important to consult your podiatrist at the first signs of nail changes to ensure adequate medical treatment against serious infection and disease and perhaps prevent the loss of the nail entirely!!

Nail fungus or onychomycosis is one of the most common disease processes that affect the toe nails.  The process of a nail fungal infection begins with some form of trauma.  This trauma can be something noticeable such as dropping a heavy item on your toenail or something occurring on a continuous basis going unnoticed.  Foot deformities such as hallux limitus, in which the movement in the joint of the big toe is restricted, can cause the toe to regularly undergo small trauma by slamming against the inside of your shoe with each step.  If an obvious trauma has happened a bruise under the nail may be seen as a black toenail.  Athlete’s foot or a tinea pedis also typically precedes the infection of the nail.  This fungal infection of the skin then moves into the toenails where the organisms causing the infection, commonly dermatophytes, thrive by eating the keratin that makes up the nail. 

All fungal infections should be treated to prevent spread and worsening of what can be a painful condition. Treatment of a fungal infection once it has reached the nails is more difficult than when only the skin is affected.  Oral medications are often needed that often have a variety of adverse side effects throughout the body.  At Columbus Podiatry and Surgery, we offer the PinPointe Foot Laser to treat nail fungus in our office in about 30-40 minutes without the harmful side effects.  Along with this treatment, it is also a good idea to be examined and treated by your podiatrist for any deformities that may be exposing your nails to unnecessary trauma and making them more susceptible for future infections.  With such treatment options not only are you keeping your feet healthy and preventing future fungal infections, but you also may prevent the loss of your toenail in the first place!  So while the “artificial toe nail” is a great option for those who have already lost their toe nail, preventing toenail loss is even better!

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

This is the time of year when all runners want to be in their best shape possible and stay injury free during this critical training season.  With high school and college runners beginning their season and the Columbus, OH marathon coming up in October, runners of all ages need to be functioning at their peak level. 

There are a few things runners starting up running for the first time, or those more experienced runners who are upping their intensity should do to stay injury free.  Wearing the proper running shoe is absolutely imperative to avoiding injuries.  Shoes not only need to fit properly, but they should have the appropriate amount of support, stability and cushioning for your foot.  By scheduling a checkup with your podiatrist before you have begun purchasing expensive running sneakers, they can evaluate your type of foot and how it functions so that you can use that information to make an appropriate shoe choice.  Black toe nails can develop when shoes are too small from the foot jamming against the front of the toebox and causing bruising under the nail.  Shoes that do not fit properly may allow too much slippage or rubbing of the shoe against the skin causing calluses, and blisters.  A few good tips to help ensure you get the right fit of running shoe include trying on shoes at the end of the day when feet are slightly swollen and wear the type of socks you will be wearing when you are running.  Shoe types vary based on whether you tend to overpronate, and typically have a flatter foot, or supinate, in which case shoes tend to be more worn on their outer edge.  If a person has a severe enough problem with pronation, supination, or problems in foot function, a custom orthotic may be needed to allow the foot to function to the peak of its ability and to prevent injury. 

Along with proper shoes and orthotics, stretching and warming up are other simple ways to avoid two of the most common running problems: plantar fasciitis and shin splits.  Shin splints and plantar fasciitis are both inflammations at the point where the muscle and connective tissue, respectively, attach to bone.  Stretching, warming up and slowly increasing activity all help avoid the pain of shin splints by decreasing the chances of placing extra strain on the muscle attachment to the tibia, or shin bone.    Stretching the calf muscles can help to prevent plantar fasciitis by allowing for normal range of motion at the ankle joint and thus reducing the strain placed on the deep connective tissue, plantar aponeurosis that becomes inflamed and causes heel pain. 

Happy fall training to all the Columbus and Dublin area runners and remember that if you experience foot or ankle pain while running, do not wait to contact your podiatrist until a serious injury has already progressed!

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. To schedule an appointment with a podiatrist in Dublin, Ohio, near Tuttle Crossing Mall, please call 614-885-FEET (3338).

By Dr. Animesh (Andy) Bhatia

As an athlete, how you care for your injuries is critical to continued and future athletic successes, regardless of whether you are one of my favorite local OSU Buckeye teams, a "weekend warrior" athlete, or a high-paid professional athlete. Tennis star Serena Williams unfortunately seems to be learning this lesson the hard way. Not only has Serena's tennis career suffered this year, but this past week she had a much bigger problem when she developed a pulmonary embolism.

Back in July 2010, Serena was wearing sandals and stepped on glass at a restaurant in Munich. She did some pretty major damage and ended up having stitches in both feet. After returning to the U.S., an MRI was used to diagnose that the tendon of the extensor hallucis longus muscle in her right toe was torn. This muscle is important in lifting up the big toe and actually extends outside of the foot up the leg. Serena opted for surgery to repair the lacerated tendon.

After surgery, Serena was seen wearing a walking cast. This was an important stage in Serena's healing process. Before starting back into playing, Serena should have been sure to obtain a proper fitting tennis shoe to support the foot and avoid "tennis toe". This is where the toe jams against the front of shoe that is too small during the motions of tennis. While this can cause bleeding under the nail in a healthy foot, it could have been especially aggravating to the recently healed area of the big toe. Physical therapy and slowly easing back into tennis would have been the best route to Serena returning to tennis. However, three months later, Serena re-tore her tendon and had to have a second surgery. Being too eager to jump back into your sport can often result in the injury redeveloping or a new injury popping up from compensating for the not fully healed one.

Her two recent surgeries, and sitting on a plane for long periods of time as part of the celebrity athlete life were both factors leading up to a venous stasis and a deep vein thrombosis, or DVT. This is a clot in the deep veins of the leg or foot after loss of proper function of veins, often by an "injury" to the veins, possibly Serena's initial injury. After surgery, such as the ones in Serena's foot, tissue debris could have become irritated and formed a clot if proper precautions were not taken. Swelling in the legs and feet, and tenderness in the calf can both be warning signs that a DVT has formed. This is a life-threatening situation because the clot can get free and travel to form a pulmonary embolism.

A pulmonary embolism is a blood clot that blocks the flow of blood from the heart to the lungs. When this artery is blocked, not only can the blocked lung become deoxygenated and die, but the entire body will receive much less of the oxygenated blood it needs to survive. Luckily, Serena's pulmonary embolism was caught early by her doctor and her life was saved.

Following your podiatric physician's directions after any surgery is critical for a healthy and speedy recovery, especially for an athlete who wants to get back to their sport! It is also imperative to go in for regular post-operative check-up appointments and to schedule an extra appointment if you notice something is not healing right.

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