Items filtered by date: January 2012

As the Williams sisters joined the international team tennis competition called the Fed Cup this past week, it is astonishing to look at the health and foot and ankle problems they have had to overcome to continue to be a force in the world of tennis. In 2011, not only did Serena survive a pulmonary embolism following several foot surgeries, but in August Venus finally received a diagnosis for a variety of symptoms that had plagued her for the past 4 years. After visiting many doctors, Venus Williams eventual diagnosis was the autoimmune connective tissue disease that can affect the feet called Sjogren syndrome.

While most people have heard of rheumatoid arthritis, which is also an autoimmune condition where the body attacks the joints, few have heard of Sjogren syndrome even though it is the second most common autoimmune joint disease. Rheumatoid arthritis or a variety of other autoimmune disorders often occurs with Sjogren syndrome, adding even more damage to the joints of the body. Chronic fatigue and difficulty breathing were some of the initial symptoms that brought Venus to seek a diagnosis for her condition. Women are most commonly affected by Sjogren syndrome, with dry mouth and dry eyes being some of the cardinal signs of the disease as white blood cells multiply past their normal amount.

Venus also noted that she developed misshaped joints and swelling. These are the rheumatological aspects of Sjogren that can affect the feet and could have contributed to foot pain while playing tennis. If rheumatoid arthritis is occurring with Sjogren syndrome, the toes and area of the foot closest to the bases of the toes can be the first site where the autoimmune joint destruction can be seen on an x-ray. As the joint is destroyed, the space between the adjacent bones becomes smaller and motion becomes limited and painful. When this occurs in the foot, your podiatrist can prescribe custom orthotics to limit painful motion during walking or in severe cases perform surgery to fuse the joint and stop all motion, and thus pain from occurring. Another common symptom in the foot and ankle in Sjogren syndrome is neuropathy, or loss of sensation. Like the neuropathy that occurs in diabetes, special attention is required to prevent ulcers and subsequent infection in these areas where the individual can no longer feel.

Venus’s Sjogren syndrome symptomsseem to be relatively mild at this stage and she has begun medication to limit the pain and damage caused by her body’s overactive immune system. As Venus makes her return to professional tennis competition this week, her story should serve as a message in perseverance to those suffering from medical problems. A patient knows when something is painful or wrong with their own body and should seek medical attention until the problem can be identified. Had Venus not persisted in finding out her diagnosis, she would not have been able to improve her tennis and quality of life.

Please visit for more information or call 614-885 FEET (3338) to schedule an appointment with a podiatrist in Columbus, OhioColumbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

After Chef Paula Deen finally announced her diagnosis of type 2 diabetes mellitus that she had been hiding for two years this past week, there has been an outcry from people across Columbus and the country. Deen promoted to everyone who watched her cooking shows the exact lifestyle that leads to the development of type 2 diabetes. Now, if Deen and fans of her cooking who also have type 2 Diabetes don’t change their ways, many severe complications of diabetes, including foot amputation are likely to be the next course.

Type 2 diabetes typically develops later in life and as a result of an underlying genetic defect involving the beta cells of the pancreas that causes them to produce insufficient amounts of insulin, along with a resistance of other tissues to the minimal insulin that is secreted. Three major risk factors for diabetes development that Paula Deen possessed are being over age 50, obesity and a family history of diabetes. While age and family history are uncontrollable, obesity and overeating are easily modifiable with a little effort. Lifestyle modifications to reduce obesity and thus the risk for diabetes type 2 can include exercising, dieting, and reducing fat intake. These simple lifestyle modifications have been shown to prevent or delay type 2 in about 60% of people at risk. In severely obese patients, gastric bypass surgery has even been shown to reverse the diagnosis of diabetes.

Foot problems represent a major complication in diabetic patients, with 25% of hospital stays for diabetic patients being foot related. The neuropathy, or nerve disease that occurs in diabetes affects the longest nerves first; which is why loss of sensation commonly begins in the feet. Aside from losing sensation completely, patients may experience painful tingling or burning in their feet and legs especially when sitting or resting. With loss of innervation can also come motor weakness and wasting away of the muscles in the feet. The combination of motor and sensory loss can lead to ulcers, infections of those ulcers, and Charcot foot. All three of these conditions are debilitating and need to be examined and treated by your podiatrist. Preventing ulcers and their subsequent infection can mean saving not only the leg from amputation, but also the patient’s life.

For Paula Deen and others with type 2, it is important to remember that they can greatly improve their condition and possibly even reverse it by cutting back on the butter and sweet cream, developing a regular exercise plan, and regularly self-examining their feet as they go.

Please visit for more information or call 614-885 FEET (3338) to schedule an appointment with a podiatrist in Columbus, OhioColumbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

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 for more information or call 614-885 FEET (3338) to schedule an appointment with a podiatrist in Columbus, OhioColumbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

With the unusual warm weather we have been seeing in Columbus, Ohio it is great to see so many people outside walking and exercising their feet lately. Any extra exposure to sunlight is always appreciated during the short and often dreary months this time of year. While excess sun exposure can be dangerous for skin, sunlight does provide the beneficial vitamin D, or calciferol that is crucial to bone health.

Osteoporosis is the most common skeletal disorder. It is characterized by an absolute reduction in bone density and mass. Bones become weak and are at increased risk of breaking. Because 28 of the bones in the body are located in the foot and they are under the pressure of the entire body weight, fractures commonly manifest here. Sunlight does not directly provide vitamin D; it stimulates the body to make vitamin D from a precursor found in the skin. The active form of vitamin D promotes the uptake of calcium from the intestines so it can be used to calcify bone as well as stimulating the parathyroid hormone to reabsorb calcium before it is filtered out by the kidneys as waste. Without enough vitamin D, not only are individuals at risk for osteoporosis, but they can also develop a similar condition called osteomalacia. In osteomalacia, bone cannot be mineralized and symptoms include muscle weakness, bone pain and bone deformities. The childhood form of osteomalacia that is more commonly known is called rickets. In rickets, children affected will typically be six to 12 months of age and will have symptoms of muscle tetany or extreme muscle contraction, delayed development, smaller overall stature and soft tissue swelling, or edema around the growth plates located at the ends of bones. Bowing of the tibia bone inward in the legs is a common consequence of vitamin D deficiency in rickets.

The one upside of these diseases is that there are some preventative measures that can be taken to avoid their occurrence. To keep your foot bones and the rest of the bones in your body healthy, be sure you have enough vitamin D as a part of your healthy diet. Bone mass peaks at age 35, so it is especially important to maintain an adequate amount of vitamin D and calcium in your diet and through exposure to sunlight later in life. Females are prone to developing osteoporosis following menopause and therefore should also take extra care to keep their bones strong. By contacting your podiatrist at the first signs of foot injury or bony pain in your feet and ankles, both any fractures that have occurred as well as loss of bone density can often be identified in one set of x-rays. The sooner that loss of bone density is identified, the sooner steps can be taken to supplement vitamins and minerals necessary to keep you healthy and on your feet.

Please visit for more information or call 614-885 FEET (3338) to schedule an appointment with a podiatrist in Columbus, OhioColumbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

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