Items filtered by date: September 2011

This past Friday, the Columbus Dispatch published a story in support of “Falls Prevention Awareness Day” in Ohio. The article discussed ways for the senior citizen population of Columbus to prevent falls and the serious injuries and hospitalizations that can accompany them. One crucial aspect of fall prevention not directly stated in the article is the importance of foot health in the elderly in maintaining good balance and stability.

Feet provide the base of support for the body and in an older individual changes have often occurred that weaken that base. Arthritis of the foot joints, foot deformities, muscle weakness and improper footwear can all play a role in changing the way that the foot keeps the body balanced. Bunions, calluses, hammertoes, and ingrown toenails can all cause pain in the foot. The body’s natural response is to avoid causing pain by changing the weight distribution on the foot so less pressure is placed on the deformity. This change can alter the gait to be more unsteady and increase the chance that a fall may occur. With a visit to your podiatrist there are many options to relieve these types of pain, and thus increase stability. Calluses and ingrown toenails can often be removed at an office visit, while hammertoes and bunions can be treated with surgery or their pain can be lessened using nonsurgical methods. Arthritis or other problems that may not allow the normal range of joint motion also can be treated with surgical methods, or with nonsurgical methods such as custom orthotics that can allow for better functioning of the entire foot while decreasing the pain of the afflicted joint. Simple foot exercises can be used to maintain muscle strength against the loss of muscle mass that accompanies normal aging. In the article in the Columbus Dispatch, this concept was being put to practice by the woman “tracing alphabet letters” with her toes. One last tip is to ensure that shoes fit properly and that the shoe bottom is not slippery. Shoes that do not fit properly can cause pain if they are too small or can cause tripping from the abnormally increased foot motion in the shoe if they are too large.

By taking small measures to “fall-proof” your feet with the help of your podiatrist you can avoid the big health problems and expenses that come with a serious fall!

Please visit 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.

Tuesday, 20 September 2011 19:00

Understanding what Charcot Means for Your Feet!

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.


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 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.

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 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.

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 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.

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