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

This past week Logan Steiber of the Ohio State Wrestling team was awarded the Intermat Freshman of the year award.  The exciting wrestling season may have recently come to a close in Ohio high schools and at Ohio State, but for serious wrestlers, offseason training will be starting shortly.  While athletes are supposed to be the epitome of good health, wrestlers can face a variety of foot and other health problems both on and off the mat. 

Wrestlers frequently will often force themselves to extremes to reach their weight class for wrestling.  Those reaching for heavy weight status may, to the detriment of their own health, indulge in unhealthy eating habits.  While the extra weight may provide an advantage in the short term of trying to hold down an opponent, the resulting diabetes later in life may end up knocking the wrestler’s feet out from under them.  These facts were a sad reality this past week for the World Wrestling Entertainment’s retired wrestling legend Kamala when he underwent his third amputation in recent months from complications of diabetes and high blood pressure.  Podiatrists work with their diabetic patients to avoid amputations at all costs, performing them only when it is necessary to save the patient’s life from an infection of the foot travelling further up the leg to the body causing gangrene, or tissue death and septicemia.  By maintaining a low blood sugar, wrestlers with type 2 diabetes or pre-diabetes can avoid many of the complications seen in the foot that Kamala likely suffered from including neuropathy, and slow wound healing. 

At the other extreme, wrestlers trying to remain a lightweight frequently take up running in the offseason.  Wrestlers who enter into an intense running regimen too quickly after months spent just wrestling can experience common running ailments including shin splints, heel pain, and the development of painful corns and calluses.  By starting off slowly with low mileage, purchasing proper shoe gear and stretching these injuries may be avoidable.  Orthotics may also be helpful in avoiding painful conditions if the individual has underlying biomechanical and structural problems with their feet. 

When they are in season, a study in the American Journal of Sports Medicine found that collegiate wrestlers have an injury rate second only to spring football.  The ankle is one of the most commonly and most seriously injured parts of the body in wrestling.  During takedowns and sparring, ankle sprains and muscle strains can occur when the foot is planted on the ground and forced to twist in an unnatural way.  Wrestling is also notorious for the occurrence of athlete’s foot or “ring worm”.  This skin condition is not actually due to having worms in the skin, but is caused by infection with a fungus.  When it occurs in the foot this is also known as tinea pedis and can spread to cause fungal toenails if not treated. 

Wrestlers should make good use of the beginning of their offseason to visit their podiatrist and make a complete recovery from any lingering foot and ankle injuries or skin infections.  With good health, they will be quick on their feet when the time comes for their next big match!

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

Golfers hitting up the greens at the York,  Worthington Hills, Muirfield or Tartan golf courses near the offices here at Columbus Podiatry in Surgery, need to take their feet into consideration when looking for ways to lower their scores.  While many golfers look to the newest technology in their clubs and golf balls to enhance their drive, custom foot orthotics could be the missing link to correcting many parts of your swing!

Even though golf is thought of a relatively low risk sport, there are many painful foot problems that commonly arise in golfers from the intense amount of walking involved.  Heel pain can occur from a variety of causes.  Plantar fasciitis can cause heel pain that radiates down the arch of the foot and is often worst in the morning or upon standing after periods of sitting.  Stress fractures of the calcaneus, which can occur from chronic strain on bone resulting from excessive walking, are another cause of heel pain.  Metatarsalgia which is a term that refers to pain in the ball of the foot also commonly occurs in golfers.  Stress fractures of the metatarsals, most commonly the second metatarsal, can be one underlying cause of this pain.  Plantar plate tears can be another common cause of metatarsalgia.  The plantar plate supports the head of the metatarsal bone and pain results from a tear because the metatarsal head becomes subjected to higher ground pressure with each step. 

Many of these problems are caused not from golf itself, but because excess pressure from walking being placed on an abnormally functioning subtala rjoint, which is most commonly functioning overpronated.  When this joint does not function optimally, problems can start in the foot, but may also progress higher up the body’s “kinetic chain” or chain of movement.  This can result in knee, hip, back and neck pain.  Using a digital gait scanner, as is used at Columbus Podiatry and Surgery, an orthotic can be fit specifically to address an individual’s foot problems and create a custom orthotic to correct any biomechanical problems.  With improved function, a golfer’s body will have the capacity to achieve the perfect swing!!

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

With the record setting high temperatures the past few weeks in Columbus, kids have been soaking up the sun and playing outside as much as possible.  While the exercise is excellent for foot health, some new pains may develop from the sudden increase in activity level.  Parents need to pay careful attention to new pains as they can sometimes indicate issues more serious than just normal muscle soreness.  One of these conditions often identified during childhood years is called a pedal coalition. 

Pedal congenital coalitions are caused when the tissues destined to become two separate bones in the foot during development fail to separate and remain united as one bone.  These two bones may be united together by bone, fibrous or cartilage tissue.  The type and amount of tissue connecting what should be two separate bones will determine how much motion will be allowed where the joint would normally be.

While some coalitions may never cause any problems and go unnoticed, others can cause severe foot pain, stiffness, muscle spasm and foot deformity.  Some of the symptoms of a foot bone coalition can resemble the normal pains of post-playtime soreness with aching, and fatigue.  These symptoms are brought about by activity, and thus kids with lower activity levels may remain asymptomatic and undiagnosed.   The bones involved in a coalition can be identified by matching up the normal time the bones are ossifying with the onset of symptoms.  For example, a child who develops the foot pain and joint stiffness around three to five years of age would have a coalition between the talus and navicular bones as a possible diagnosis. 

Luckily, the most common congenital coalition in a child’s foot is typically not painful and is a fusion of the two bones that make up the fifth or “pinky” toe.  However, common coalitions that occur in the tarsal bones will cause symptoms in an active child.  Fusion of the talus and calcaneus, or heel bone, is the most common of the tarsal coalitions.  The subtalar joint, which is located between these two bones, requires mobility in each phase of walking or running and a coalition of the talus and calcaneus will limit that mobility.  When movement necessary for normal ambulation becomes limited, the body will try to force through the motion, causing pain, or will make changes to work around the need for that movement, causing deformity.  Commonly, with the talus-calcaneus coalition, overpronation will be part of the deformity and the child may appear flat footed. 

Early identification of these symptoms can result in earlier treatment and improved quality of life for the affected child.  Whether the coalition is congenital or has been acquired later in life as a result of osteoarthritis wear and tear or a fracture within the joint, a visit to your podiatrist can help relieve pain and work towards allowing your feet to function in the best way possible!

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 article published in “USA Today” this past week discussed the scary reality that many elderly patients will leave a hospital much weaker than when they arrived.  Even though the patient’s original condition will be treated, the overall health of the patient may suffer from lack of physical activity.  A similar concept can be applied to many treatments of the foot and ankle, in that even though a treatment may remove the original pain or deformity, post-treatment actions must be taken by the patient to ensure that they maintain optimum health and their condition does not return. 

One condition that requires continued maintenance even after a pain-relieving treatment is plantar fasciitis.  Stretching and orthotics are often suggested as the first line of treatment because they address the root of the problem.  However, individuals with severe plantar fasciitis may find even stretching to be too painful and can receive steroid injections for more immediate relief.  In plantar fasciitis, the fibrous band of tissue called the plantar fascia that attaches from the heel to the ball of the foot becomes irritated from having too much tension placed on it.  Overpronation and equinus, or stiffness of the ankle, can add to the tension placed on the fascia causing its inflammation.  Even though a steroid injection removes the heel pain of plantar fasciitis, the underlying causes of tension will remain and eventually allow the pain to return if they are not addressed.  For a patient to get optimal results from their treatment, they should discuss a daily stretching regimen with their podiatrist that should be easier to adhere to after their pain has been alleviated by the injection.  Simple stretches and custom orthotics will often relieve tension and thus the irritation on the tissue, allowing the patient to avoid recurrences of the condition. 

This concept of stretching and physical therapy following treatment is often used following surgeries that actually have removed the underlying problem, including those performed to remove a bunion.  While the bunion deformity is gone, physical therapy to get the toe moving after surgery can prevent complications down the road that may result from the prolonged inactivity of the toe following the operation.  Bones and tissues that have been cut need time without bearing the weight of the body in order to fuse together properly.  Unfortunately this period of rest that is necessary for bone healing may cause joints and ligaments to become overly stiff from the inactivity.  Physical therapy can be used to remove or prevent any adhesions of tissues to one another that can lead to painful limitation of motion or even arthritis. 

While for some patients, following a post-treatment schedule involving stretching, foot exercises and physical therapy may be difficult, other patients will struggle with the idea of doing as little as possible with their affected foot.  Whether you are eager to return to sports practice, or someone who does not look forward to the idea of any sort of exercise, it is crucial to follow the treatment plan your podiatrist or other doctor has provided to you to completion for your best health possible!

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