Whether you are running in the St. Patrick’s Day 5K at Flannagan’s this Saturday in Columbus or simply running to the pub, taking care of your feet can make or break your celebration of this lucky holiday.  Properly fitting shoes are imperative for good foot health, and also can help in avoiding knee, hip and back problems that develop from the problems originating in your feet! 

When you travel to a shoe store, most have what is called a “Brannock device” that is used to measure feet and estimate shoe size.  This device measures not only the length of your foot from heel to toe, but also measures width, and the distance from heel to the ball of your foot.  The heel to ball distance is most critical in determining whether a shoe fits correctly.  Located at the “ball” of your foot on the middle or inner aspect is the joint called the 1^stmetatarsophalangeal joint or 1^stMTP.  This is where a bunion develops, but the normal movement permitted by the joint is also critical to the overall function of the foot.  The base of the joint is the first metatarsal which slides downward in order for the big toe to flex upwards and help propel the foot when walking or running.   When this motion sequence occurs in a normal foot, the foot pushes off the ground and swings into the next step.   

Correctly fitting shoes allow the 1^stMTP to function as it should, while shoes that are too small can cause major problems.  Shoes are designed to allow the normal bend at the 1^stMTP joint and to inhibit abnormal bending of most other joints in the foot.  However if the shoe is too small, the 1^stMTP joint will not be allowed to bend normally and big toe will be forced to flex upwards when it should not be.  This leads to the condition called hallux limitus, where, as the name implies, the movement of the hallux, or big toe, is limited.  Overtime, hallux limitus can progress to hallux rigidus where the joint big toe joint is practically immovable.  This is a painful form of arthritis that has resulted from the abnormal wear and tear of the joint.  Not only is this painful, but the combination of hallux limitus or rigidus in an already too small shoe can lead to calluses, corns and even ulcers developing on the big toe. 

It is important to recognize that biomechanical problems, including excessive pronation, can also contribute to the development of hallux limitus so custom orthotics can often help with this condition.  Wearing one size larger shoe is only a difference of one third of an inch in the actual length of the shoe.  So this St. Patrick’s day even if you think that a smaller size shoe may look better, by getting the correct size for your foot you will definitely have the luck of the Irish and keep your feet looking great!!

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

By Dr. Animesh (Andy) Bhatia

Many diabetic patients may have heard warnings to look out for “charcot foot” but they may not know exactly what this means.  Different from diabetic charcot foot is an inherited disease with another characteristic foot type called Charcot-Marie-Tooth disease.  As a part of September’s Charcot-Marie-Tooth (CMT) disease awareness month, it is critical for patients to understand the differences between these two neurological disorders. 

CMT

Charcot-Marie-Tooth disease is caused by a gene defect that is often inherited.  If CMT is seen in other family members, parents should be on the lookout for the development of slowly progressing muscle weakness in the lower extremities before age 20.  Individuals with CMT have nerves that lose their myelin covering, which normally allows signals to be sent to and from skin and muscles at a normal speed allowing sensation and muscle contraction.  Patients will not usually complain of any numbness because their sensation was likely never completely normal.  As a result of the weakness and loss of sensation, first in the legs then typically seen in the upper extremities, kids with CMT may seem clumsy and have difficulty walking without tripping or rolling their ankles. The feet will often have a high arch appearance and may be prone to ulcers from damage caused by lack of ability to sense pain. 

Diabetic Charcot Foot

Patients with diabetes need to be concerned about charcot arthropathy when they develop areas of the foot where they can no longer feel anything.  The combination of lack of sensation allowing damage to the foot that patient cannot feel and an increased blood flow supplying mediators of the inflammatory process allows a “charcot joint” to develop.  In the charcot joint, the repeated small injuries occurring cause bones to gradually fracture and dislocate.   This causes deformity (often an extreme flat foot) which typically places the diabetic patient’s foot at a greatly increased risk of developing ulcers and subsequent infection with severe consequences.  The most common signs of the development of charcot arthropathy are swelling and increased temperature of the affected area of the foot, redness, pain and the feeling of a “loose bag of bones” when the joint is moved. 

In both diabetes with loss of sensation, and Charcot-Marie-Tooth, foot self-exams are immeasurably important in preventing ulceration and further complications.  Protective shoe gear and custom made orthotics can provide additional protective measures for the foot.  As shown by these two disease processes, loss of sensation in the foot is a major problem that should always be evaluated by your 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 Worthington. 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

This past Wednesday, June 1, National Running Day was celebrating by runners of all levels across the country.  Only a few minutes from the office here at Columbus Podiatry and Surgery, there were meetings in both Worthington and Dublin, Ohio to have an extra celebratory run and train for upcoming races. 

All runners out there know that foot and leg soreness and sometimes pain can go along with running, but when pain becomes an aggravation to the runner, they need to contact their podiatrist to prevent more serious issues from developing.  One of the most common athletic injuries seen in both the foot bones and shin bone, or tibia is a stress fracture.  Stress fractures are a small crack in the surface of the bone caused by overuse.  Running is a common trigger for this type of injury because the repetitive motion of each stride on the foot can allow too much pressure to be absorbed by an area of bone.  This results in a fracture that can often be difficult to conclusively diagnose without taking an x-ray or bone scan.  By obtaining an image of the bone through one of these methods, a stress fracture in the shin can often be differentiated from an even more common, but less serious running injury called a shin splint.   In a shin splint, the bone itself is not damaged, but the area of muscle attachments on the bone has become irritated and painful. 

Runners should take measures, not only on National Running Day, but everyday to try to prevent stress fractures.  Properly fitting, supportive running shoes are a key to prevention.  Gradually building up your training and adding on miles slowly also can help in avoiding both stress fractures and shin splints.  If even with these measures you begin to feel a persistent, localized pain in your foot or leg, a stress fracture could be the culprit.   Taking recovery time from sports and icing the area can often help to lessen or alleviate more minor causes of pains.  If pain continues, it is important to remember that the earlier a stress fracture is diagnosed; the quicker the recovery will be and the better the chances are that it can be treated without surgery.  By taking proper care of feet and visiting a podiatrist at the first signs of injury, runners can limit what they often despise more than anything else: having to take time off from running!!

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, Ohio.

By Dr. Animesh (Andy) Bhatia