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

A new treatment option that may one day be of great help to all those suffering from heel pain in Columbus has been making news for its success in a clinical trial.  The study focuses on an injection that shows potential for being used to treat individuals with plantar fasciitis who have not had significant pain relief with other treatments.

Luckily for the time being, patients suffering from plantar fasciitis can visit their podiatrist for a variety of treatment options that, for the majority of individuals, will provide great pain relief.  The first step in treating your plantar fasciitis is to determine if you in fact have plantar fasciitis.  While plantar fasciitis is one of the more common causes of heel pain, there are many other problems that occur relatively frequently that can also cause heel pain.  Some of the cardinal signs of this condition include the most intense pain of the day occurring when you take your first step out of bed in the morning and pain localized primarily to the bottom of the heel, at the front edge of the heel fat pad, on the side closer to the opposite foot.  A nerve entrapment can also cause similar pain on the bottom surface of the heel.  A nerve entrapment in this area typically involves what is known as “Baxter’s nerve” which supplies sensation and power to a muscle that allows movement to the smallest toe.  When the nerve is compressed, it is similar to a bruise and is called neuropraxia.  This bruise of the nerve then causes pain and decreases its ability to transfer information.  If the entrapped nerve is caught and treated, recovery occurs in around three to four months.  In areas around the heel that could cause heel pain in a location very near to the pain of plantar fasciitis also include fractures, and tendonitis.  

Once your plantar fasciitis has been correctly diagnosed, there are a variety of treatment paths to begin with.  While treatment varies for each individual, most people begin treatment with a conservative approach using the least invasive options available to start.  Some of the conservative treatment options include:  stretching, taping, icing, and wearing orthotics.   All of these treatment options can have great success in many patients if performed correctly.  The next step in treatment for plantar fasciitis that has not responded to the previously mentioned treatments can be an injection of a steroid with numbing agents.  This is done in addition to continuing conservative treatments.  The steroid is injected for its anti-inflammatory properties which serve to “soothe” the aggravated plantar fascia and relieve pain.  While surgery would typically be the last treatment resort as a plantar fascia that is still painful, the aforementioned research study provides a potential new option.  It has suggested that injecting plasma rich protein actually provides greater pain relief and healing potential than injecting steroids.  Hopefully this new research will continue, and the information gained can allow patients to receive the highest quality treatment options from their podiatrist!

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 614-885-3338 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

New York Giants co-owner has discovered an unusual good luck charm for his team with a little help from his two daughters.  In late December, his daughters painted his nails in red and blue, the Giants’ colors, and the team has not lost a game since then.  Steve has left the polish on in the hopes that the good luck charm can work its magic for one last game at the Super Bowl. 

While his nail polish certainly may not be looking “pedicure perfect” after 5 weeks, the health of Steve’s toes and nails are in no danger as long as he still has been taking regular care of his feet.  Pedicures for both men and women can be relaxing and safe for as long as you keep the health of your feet a priority.  If Steve decides to keep his trend going there are a few things he should know about the relationship between toenails and overall health.  First, nail polish is completely safe to use on healthy toenails.  However, if a toenail fungus, or onychomycosis is present, nail polish should not be applied.  The polish “locks in” the fungus and allows it to continue thriving on nail tissue.  Treatment should be sought when nails appear abnormally thickened or discolored, as this can be a sign of an invasion of “dermatophytes”, the organisms most commonly at the root of a nail fungus.  After the nail infection is treated with PinPointe Foot Laser or a variety of other medications and the fungus has resolved, regular nail polish may be applied. 

The length of the nail after it has been trimmed can be another area of podiatric problems for those trimming their own nails or having them trimmed at a nail salon.  In some individuals, toenails are extremely curved along the sides.  When these curved nails are cut too short, the individual’s likelihood of developing an ingrown toenail is greatly increased as the nail regrows.  Ingrown toenails can become infected and extremely painful.  Contact your podiatrist at the first signs of an ingrown nail.  Attempting to remove the ingrown portion of the nail on your own can lead to dangerous infection that is capable of spreading beyond the affected toe. 

Whether you are prepping your nails for the big game or a big date before Valentine’s Day be sure to keep your feet healthy and call your podiatrist if you notice any unusual changes!

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 614-885-3338 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