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

Halloween can be a rough time of year for children with diabetes as well as for parents trying to keep their kids healthy.  Several Columbus area dentists and doctors have made efforts to give more options to keep Halloween healthy and fun for diabetic kids.  A local dentist’s office has offered to buy candy from kids after Halloween for $1 per pound to then be donated to Operation Gratitude which then gives the candy to troops overseas.  

Type 2 diabetes typically develops later in life than type I diabetes, but is becoming more common in children.  This increase in diabetes in kids has been linked to the increase in childhood obesity.  While type 2 diabetes has a genetic component, individuals who are overweight or do not exercise are at a greatly increased risk of developing the disease.  In this sense, while walking house to house may provide good exercise for kids, the excessive consumption of candy should be avoided. 

People with both types of diabetes often develop nervous system disease with loss of sensation in their foot.   When sensation is lost in the foot, people may develop injuries without being able to feel any pain and continue to cause further damage to their tissues.  This is why it is critical for diabetic patients perform regular self-foot exams and have complete checkups with their podiatrist.  These areas where sensation is lost are typically where ulcers develop and can lead to amputation. 

While diabetic ulcers are not often seen in children’s feet, it is important to take preventative measures to avoid serious diabetic disease changes that increase the risk of ulcers later in life.   One good preventative measure to start with during the Halloween season is to avoid excessive sugar consumption.  The more extremely elevated, or uncontrolled a diabetic individual’s blood sugar is, the higher their “HbA1C” values are.  The HbA1C indicates an excess amount of sugar that gets “stuck” to hemoglobin, the molecule that transports oxygen to tissues.  When the HbA1C is elevated, there is a much higher risk of developing problems with blood vessels, leading to diseases including high blood pressure and problems with the retina of the eye.   By not eating too much sugar and getting a lot of exerciseat Halloween and all year, kids with and without diabetes will be sure to have a scary good time keeping their feet healthy!

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

In July, we posted a blog on international tennis champion Rafael Nadal’s troublesome heel pain he was forced to play through at this year’s Wimbledon games.  In Nadal’s new memoir titled “Rafa” he discussed another foot problem that has worried him throughout his career and in 2005.  The pain caused by the problem was so severe that it almost caused him to give up on the game of tennis entirely and try his luck at professional golf instead! 

While plantar fasciitis, the likely culprit begind Nadal’s previous heel pain, is very common here in Columbus, OH and around the world, his 2005 foot problem was likely due to a much more rare condition called Kohler’s disease.  Nadal refers to his problem as a congenital condition in which the navicular bone of the foot did not harden completely and has caused him problems ever since.  Kohler’s disease is not truly thought of as a congenital disease, but develops in a child’s foot typically around ages 5-10 when a traumatic event has caused loss of blood supply to the bone before it finished ossifying.  While this type of blood loss causes similar diseases in other bones in kids, the navicular plays an important role in the support of the long and transverse arches of the foot and is the last foot bone to ossify.  A child with Kohler’s disease will normally limp on the affected foot; have pain over the middle side of the arch; avoid putting pressure on the middle side of the foot and redness and swelling will often be present.  Foot pain in a child should always be treated carefully to ensure that any problems with the growing and ossifying areas of bone are handled appropriately to ensure proper development.   As kids go back to school, it is important to keep this in mind that not only are the right shoes important to prevent injuries, but so is proper care when an injury or pain does develop!  While Kohler’s disease typically heals normally with no adverse effects later on, it seems that Rafael Nadal unfortunately did not find the best podiatrist for him until later on in his tennis career!

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 near Lewis Center.

Looking for a podiatrist in Dublin, OH? Columbus Podiatry & Surgery's foot doctors are now in Dublin!

By Dr. Animesh (Andy) Bhatia

This past Sunday, the city of Columbus began working with the Diabetes Prevention and Control Alliance’s program to say “NOT ME” to diabetes.  As diabetes has become an epidemic in, programs such as “Not Me” are an important way to increase awareness about diabetes prevention and control.  The program involves a lifestyle coaching program to counsel those who are at risk for diabetes on making healthier choices involving diet and exercise. 

While this program provides useful information on how to take small steps towards a healthier life, it does not directly address how to prevent one of the scariest complications of diabetes:  amputation.  Diabetic individuals need to regularly see a podiatrist in order to receive proper foot care, keep a close watch on any changes in foot health that may indicate underlying pathological conditions, and to learn how to properly care for their feet on a day-to-day basis.  Diabetic patients should select podiatrists who are known for their excellence in diabetic wound care, such as those at the Columbus Podiatry and Surgery wound clinics located in both Dublin, OH and Columbus, OH. 

All diabetic patients should be educated on how to properly perform a self foot exam as one of the most important preventative measures to take to preventing major problems with the foot and ankle.  Overall skin health, adequate blood supply, and appropriately functioning nerves allowing for touch and pain sensation in the foot are three of the most important areas of the self exam.  While it may seem like a good thing to not feel pain in your feet, it is actually a very dangerous consequence of nerve problems from diabetes. Without the ability to feel pain, you would not be able to tell when tissue is being injured or destroyed in the foot.  Catching a small lesion before it develops into a non-healing diabetic ulcer is when self-exams and regular check-ups at the podiatrist can be a real limb-saver.  When lack of sensation is detected in areas of the foot, accommodative orthotics can be helpful in areas that can easily become irritated.  An accommodative orthotic for a diabetic patient is used to take pressure off and protect an area of irritation that could, unbeknownst to the diabetic unable to sense pain, develop into a dangerous wound. 

A custom-made accommodative orthotic is just one aspect of diabetic wound care and healthy preventative measures that a skilled podiatrist may need to utilize to avoid amputation for their patient.  Hopefully, with programs such as “Not Me!” and the work of all of the best podiatrists in the Columbus & Dublin, OH the diabetes epidemic will be slowed as people become more aware of healthy choices for their bodies and their feet to avoid serious complications or even the initial diagnosis of diabetes!

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

Tennis enthusiasts at the Wickertree Tennis Club and Raquet Club of Columbus, as well as fans around the world are currently enjoying one of the biggest tennis tournaments of the year, the Championships at Wimbledon.  It is always interesting to follow the previous year’s champions to see how they will do.  It is even more interesting when last year’s champion is Spain’s Rafael Nadal, who is widely recognized as one of the greatest tennis players of all time. 

This past Monday, June 27 in the 4^thround of Wimbledon, Nadal began having what appeared to be some very intense heel pain.    Nadal had trainers called onto the court twice to check where the pain was located around the back and sides of his heel.  Luckily, he was able to play through his pain to win and continue on to Friday’s match which he also won, beating out Andy Murray.  Although the injury has not yet been definitely diagnosed, Nadal is taking a risk to play out his last few games at Wimbledon before taking an already scheduled vacation. 

Heel pain can be debilitating to any athlete, especially for one playing at as a high level as Nadal.  The most common cause of heel pain on the bottom of the foot in athletes is called plantar fasciitis, or heel spur syndrome.  The plantar fascia is a thick connective tissue deep on the bottom, or plantar surface of the foot, that connects the heel bone, or calcaneus to the ball of the foot.  Plantar fasciitis occurs when the plantar fascia has too much tension put on it and begins to pull at its attachment point on the heel bone, causing pain.  Pain associated with plantar fasciitis is often worse in the morning, when the individual first steps out of bed.  Individuals who overpronate, or have flat feet are at a greater risk for plantar fasciitis because of the extra tension placed on the plantar fascia when the arch is flattened and elongated.  Ultrasound can be helpful in diagnosing plantar fasciitis versus other causes of plantar heel pain such as a loss of the fat pad under the heel or a nerve entrapment.  If the diagnosis is plantar fasciitis, it can often be treated non-surgically.  More conservative methods that may be used include icing, rest, custom orthotics to relieve plantar fascia tension cause by overpronation, night splints and stretching.  If pain persists, many cases have been successfully treated by similarly non-invasive extracorporeal shock wave therapy. 

Although Nadal will have to work through his pain at Wimbledon, at least his injury at this point is not severe enough to force him to drop out altogether.  The promise of long break to rest your feet and get the best treatment and relief from pain in the near future can be a great motivator for anyone to make it through a tough time!

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 Worthington, Ohio.

By Dr. Animesh (Andy) Bhatia