Athletes Foot

I Have Athletes Foot, How Can I Get rid of it?

The dark, enclosed and moist environment that is your shoes are perfect for the fungus that is athletes’ foot. And what is worse is that it can spread around locker rooms, spas, pools and other such areas. To avoid athletes’ foot you should protect your feet while in such areas by wearing flip flops, crocs etc. Keeping your feet dry by wearing socks made of natural fibers or other fibers that wick away sweat, and applying an anti-fungal powder to your feet should help clear the fungal infestation. Also remember to change your socks regularly if you sweat heavily.


How do I Know if I Should Have my Bunions Fixed or Just Leave Them Alone? I am Unsure Whether I Should Have my Bunions Fixed, How Can I Tell if They Need to be Removed?

If the bunions are interfering with the activities you love, or if you are unable to find a pair of shoes that fit without hurting your feet then you should see a podiatrist for X-rays and a discussion of treatment options.

Children's Feet

My Child has Flat Feet. Does it Need to be Treated?

If your family has a history of flat feet that need to be treated with surgery, or other foot related complications then, yes you should seek treatment for your child’s flat feet. But, there are a large number of people who have flat feet who never have a problem with them.

Foot Pain

My Toes are Becoming Crooked and They now Hurt, Why is This?

Crooked toes can be a hereditary trait or it can be a result of the shoes you wear. Over time, they may begin to become painful. Crooked toes are called “hammertoes” and when they begin hurting it is due them becoming arthritic and less flexible. Wearing wider shoes and adding padding can help. If these solutions do not help relieve the pain caused by hammertoes, there is a surgical procedure that can straighten the toes.

I Have a Pain Under the Balls of my Feet, What is the Cause?

Metratarsalgia, or pain under the ball of the foot, can have many causes from a torn ligament responsible for stabilizing the toe to a stress fracture. The only way to find out for sure is to see your podiatrist.


Why do the Foot and Ankle Take so Long to Heal?

The foot is the first structure to hit the ground with weight-bearing. Because the foot has to disperse greater force than any other joint in the body, it takes a long time to be able to efficiently manage this after surgery.

How do I Know Whether I Should See a Podiatrist or an Orthopedic Surgeon for my Foot Problem?

A podiatrist is a specialized medical physician focusing on surgical procedures involving only the feet and ankles, while an orthopedic surgeon’s practice may include knees, hips, shoulders, arms etc. So when it comes to foot and ankle problems it is better to see a physician that specializes in foot and ankle procedures exclusively, as they will be best versed in the latest techniques in treatment.

Heel Pain

What can be Done About the Pain in my Heel?

Heel pain is usually caused by a condition known as plantar fasciitis. The ligament called the plantar fascia on the bottom of the foot become inflamed where it attaches to the heel. To prevent this inflammation, you should avoid walking barefoot. Also, taking an anti-inflammatory such as Advil or Motrin along with wearing a pair of shoes with good arch support should help manage the pain; you may also ice the heel. If the problem persists, see your podiatrist as soon as possible to prevent further damage.


My Heels are Dry and Cracked. What can I do?

If you have a bleeding cracked heel, it is important to see a podiatrist. If they are just dry and cracked, you can start with moisturizing using a cream (lotion is too thin). Unfortunately, cracked heels are usually hereditary and will never just go away, but controlling the problem is within reason. After moisturizing, use a pumice stone after a shower or foot soak (This is when your feet are softest). If this does not work, there are numerous creams that can help.

Ingrown Toenails

How do I Avoid Ingrown Nails?

To avoid ingrown toe nails, trim your nails straight across and slightly round off he edges with a file. If you tear you toenails instead off cutting them, you will eventually develop an ingrown toe nail.


How do I Know if my Aches and Pains are an Injury?

Running hurts…..especially marathon running. An ache or pain is usually an injury if it persists for more than 5-7 days in the same pot. If you have pain > 5-7 out of 10 (10 being I’m dying and 0 being no pain); you should seek immediate attention. If you have a mild ache that is nagging more than a week, get it checked out before it becomes a serious injury.

How do I Treat a Sprained Ankle?

Rest, Ice, Compression, and Elevation. Stay off of the injured ankle, do not attempt to “walk it off,” as this could further injure the ankle. While resting, apply an ice pack with cloth barrier to the injury – keeping it on for twenty minutes and the off for twenty minutes. An elastic wrap can be applied fimly, but not too tight as to cause a sensation of throbbing in the effected area. And lastly, elevating the foot to heart level (usually with a pillow) will help drain the fluid build up.


My Orthotics Feel too Hard, but Softer Ones Wear out too Quickly. What can I do?

Sports orthotics should be firm to brace your foot into the correct bio-mechanical position during the stress of running. If you feel your orthotics are too hard they may not fit correctly. If they fit well, a topcover that distributes stress can be added. If you are concerned that your orthotics aren’t working properly, contact the office.

I Have Orthotics. How Often do I Need to Have These Replaced?

Orthotics lose their function, that is their ability to properly control abnormal foot function, somewhere between 1-3 years. This will be on the lower end if you are heavy or very active. When you reach this point (or sooner if you find your feet becoming more tired or your foot pain is returning) it is time to have them replaced.

Will my Insurance pay for Orthotics?

We recommend that you contact your insurance company to find out what your plan will pay for or call Columbus Podiatry & Surgery to verify.

How Long do Orthotics Last?

This depends on the type of activity. The more running one does, the quicker the orthotic will wear out. Over-the-counter orthotics typically last about one year. Custom orthotics usually last three to five years – sometimes longer. With children, we usually replace orthotics every one to two shoe sizes, depending on comfort.

Do I Need a Custom Orthotic?

Although over-the-counter orthotics work, custom orthotics work better and are more comfortable; therefore, we use them when over-the-counter orthotics fail to relieve symptoms. Custom orthotics are made out of higher-grade materials that last longer and are more expensive. When a custom orthotic is necessary, it is crucial that a podiatrist is involved, as the wrong type of orthotic can actually make people feel worse or even cause a different problem.

How do Orthotics Work?

Hundreds of scientific studies have been performed to determine how orthotics work. Orthotics perform three major functions:

  • First, orthotics help disperse forces across your foot so one specific area of the foot is not getting overloaded.
  • Second, orthotics help slow down pathologic motion, such as over-pronation or over-supination.
  • Third, orthotics improve what is called proprioception, which is your foot’s awareness of its position in relation to the ground. This is a subconscious, neurological pathway, which probably contributes to why orthotics usually feel good when you put them in your shoes.

What is an Orthotic?

An orthotic is an insert, either soft or firm, which replaces the insole of your regular shoe. It is classified as either custom or over-the-counter. Custom orthotics should only be made by a podiatrist or physical therapist who has experience treating foot and ankle disorders. The best over-the-counter orthotics are available at running stores or specialty shoe stores. Orthotics can be expensive; therefore, we recommend not spending much more than $60 on an over-the-counter orthotic.

How Often to I Need to Replace my Orthotics?

Orthotics are designed to control abnormal foot function, and they do lose their function eventually. This is usually right around a year to a year and a half depending on activity level and weight. When you have reached this point, or you are experiencing reoccurring foot discomfort it is time to replace your orthotics.


How Often Should I Replace my Running Shoes?

Rule of thumb is every 6 months or 500 miles, whichever comes first. Heavier runners should replace their shoes close to the 350 mile mark while lighter runners can stretch shoe mileage closer to the 550 mile range. If you run around 25 miles per week, you should replace you shoes every three to four months. Remember that the midsole wears out way before the outsole and runners who wear out their shoes faster than this should be evaluated for bio-mechanical stress problems.

How Often Should I Replace my Running Shoes if I Run Regularly as Exercise?

It is a good idea to replace your shoes every three to four months, if you run an average of about 25 miles a week. This number fluctuates based on your height and weight, but the range is between 350-550 miles with heavier runners needing to replace shoes closer to 350.


What Else can I Take?

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), such as aspirin, ibuprofen and naprosyn are safe and effective, but only work on certain portions of the inflamed area. They do not have any effect on scar tissue. Tylenol is not an anti-inflammatory.

Is There a Limit to the Number of Injections I can Have?

Although it is known too much cortisone is harmful, an absolute maximum number of injections has never been established. As long as the injections are providing a therapeutic benefit, a series of up to six injections is well-tolerated (most people only need one to two injections).

Steroid Injection or Pill?

The benefit of a steroid injection is that it is a potent anti-inflammatory administered directly into the painful area. Absorption is very slow, so side effects are rare. However, the injections are fairly painful. The oral form of steroids are not painful, but they have more side effects and do not work directly on the painful area. Steroid injections are much safer, more effective, but more painful.

Are Steroids Safe?

Corticosteroids are very safe and effective in low doses. Side effects usually involve facial flushing, insomnia, increased irritability and increased pain, and occur in less than 1 percent of patients.

How Do Steroids Decrease Inflammation?

When cells are injured, they release products called phospholipids. There are enzymes called phospholipases which convert phospholipids to arachidonic acid. Arachidonic acid (AA) is the chemical mediator of inflammation in the body. AA goes through several different chemical reactions (called oxygenation) to produce several chemical mediators of inflammation (leukotrienes, prostaglandins, and thromboxane). These chemicals have many effects which include blood platelet aggregation, increased cell permeability (swelling), further recruitment of inflammatory chemicals (histamine, serotonin, bradykinin), and recruitment of cells called macrophages (these cells remove damaged tissue but their byproduct is scar tissue).

Corticosteroids are phospholipase inhibitors therefore phospholipids cannot be converted to AA, thus stopping inflammation at the beginning of the process. Corticosteroids have what is called a catabolic effect, meaning a breakdown effect, which is how they decrease scar tissue. The mechanism of this effect is unknown.

What do Steroids do?

Corticosteroids have many metabolic functions, the most potent and primary function being their anti-inflammatory properties.

What are Steroids?

Steroids are hormones produced by the body that have many metabolic functions. The steroids VM podiatrists use for controlling inflammation are called corticosteroids. They are produced by the cortex of your adrenal glands — the glands above your kidneys. Therapeutic steroids are synthetic analogs of the body’s naturally occurring corticosteroids, cortisone and hydrocortisone, and come in injectable and oral forms.


Who do I Call After Surgery if I Have Questions?

Your surgeon will be available to answer any questions you have after surgery and will give you information on how to contact him or her for questions. Some surgeons work with residents or fellows during surgery, and if they are involved with your case, you will be able to contact them after surgery.

Will my Insurance pay for Surgery?

Most foot and ankle surgery is considered elective but because we are doing it to reduce pain and dysfunction, most insurance plans have good coverage for elective foot and ankle surgery. We do not know the intricacies of each individual insurance plan; therefore, it is up to you to determine whether your insurance will pay for your surgery. We can give you procedure codes to give to your insurance and you can contact our billing department to find out how much Virginia Mason will charge your insurance for certain procedures. In addition to surgeon’s fees, there are anesthesia fees and facility fees that come with using the operating room.

Will I be Admitted to the Hospital?

Unless your surgery is done on an emergent basis, or there is a significant complication, you will not be admitted to the hospital. Most surgeries are done on an outpatient basis and you can go home the same day as your surgery.

What is a Tourniquet?

A tourniquet is a cuff that is placed around your ankle or thigh during surgery to stop the blood flow to your leg. This allows us to be more efficient. A tourniquet is safe for up to two hours and can be deflated and reinflated for longer cases.

What Kind of Anesthesia is Involved During Foot and Ankle Surgery?

Anesthesia is based on the length of procedure, type of tourniquet used and your anesthesia wishes. There are many options for anesthesia, which include local anesthesia, regional blocks (popliteal/spinal) or general anesthesia. All local and regional anesthesia is accompanied by conscious sedation so that you are unaware of the procedure. Our primary goal is to provide you the safest, pain-free anesthesia.

Is Physical Therapy Necessary After Foot and Ankle Surgery?

Physical therapy (PT) is patient- and procedure-specific. Usually, PT is necessary for major reconstructive procedures and in situations where transient complications, such as excessive scar tissue or stiff joints occur.

How Much Time do I Have to Take off Work After Foot and Ankle Surgery?

This depends on your job. If your job can accommodate non-weight-bearing, then you can usually return to work three to five days after surgery, depending on pain. If your job will not accommodate non-weight-bearing, you will have to be off of work during this period and need to have modified duties when you return and until you are out of your protective boot.

Can I Drive After Surgery?

You need someone to bring you to your surgery and take you home. You should avoid driving for the first week after surgery no matter what was done. After that, driving depends on your transmission and which foot was operated on. If you have a manual transmission, you cannot drive during the entire nonweightbearing period. If you have an automatic transmission, you may drive if your left side was operated on. If your right side is operated on, you should not drive during the entire nonweightbearing period, which may be up to six to eight weeks. If you absolutely have to drive after right foot surgery, there are left foot accelerators that you can install so you can drive.

Will I Have a Cast After Foot and Ankle Surgery?

That depends on the procedure. Some procedures only require a protective shoe postoperatively, which we will dispense. Other procedures require a postoperative cast for one to two weeks, followed by a removable walking cast for protection. The removable walking cast (boot) is then worn for protection during the remaining period of non-weight-bearing, and then used as protection to transition from non-weight-bearing to weight bearing.

Can I Shower or Bathe After Surgery?

For most procedures you cannot get your surgical site wet until the stitches are removed, which is usually done 10 to 14 days after surgery. There is a special bag we dispense to keep your leg protected while showering or bathing after surgery. If there is external hardware, you cannot get your foot wet until the hardware is removed, usually about six weeks after the procedure. After the stitches and/or hardware are removed, we require that you avoid soaking your foot in a hot tub, bath tub or swimming pool for an additional two weeks.

How Much Pain am I Going to Have After Foot and Ankle Surgery?

Generally, foot and ankle surgery is not tremendously painful provided you follow postoperative instructions. A numbing medicine is placed around your ankle after surgery and you may not have any pain for four to 24 hours after surgery. Also, the more you have your foot elevated above heart level after surgery, the better you will feel. We give painkilling medications after surgery, but most people do not need to use these medications longer than a week.

Are There Complications of Foot and Ankle Surgery?

No surgical procedure is without complications, but most complications are minor and do not effect final outcome. These include swelling, numbness, excessive scar tissue, superficial infections and acute pain. Complications that can affect the final outcome of surgery include, but are not limited to continued pain, worsened pain, recurrence of the problem or deformity, delayed or nonunion of bone correction and hardware failure.

The three most potentially devastating complications following surgery are Osteomyelitis (bone infection), DVT (blood clot), and CRPS (Complex Regional Pain Syndrome). We do have standard procedures in place to quickly recognize and treat these complications when they arise so long-term complications can be minimized.

How Well Does Surgery Work?

Foot and ankle surgery works very well when the correct procedures are chosen for specific problems. The more we focus on pain relief as our primary reason for surgical intervention, the higher chance of success. Patient satisfaction after foot and ankle surgery is well over 90 percent.

Should I Have Surgery to Fix my Foot or Ankle Problem?

The decision to have foot or ankle surgery is a complex one, as recovering from foot or ankle surgery could require non-weight-bearing on the involved extremity for up to six to eight weeks, followed by a short period of time in a walking cast. This limits your normal lifestyle significantly, and may take many months to recover from. However, surgery does provide acceptable pain relief and return to function, and is especially useful for treating conditions that have not responded to non-surgical methods, especially when there is bone, joint, ligament or tendon damage.


Are Warts Contagious?

Warts are in fact a virus, and as such is contagious. If you have one on your feet, it would be unwise to pick at it as that is how they spread to others. Taking some basic precautions such as wearing flip flops while in moist public environments such as locker rooms can prevent the spread of warts.

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