Thinking About Hammertoe Surgery?
Many people develop what are referred to as hammertoes that are unsightly and often painful. They usually develop because of an imbalance with the muscles of the foot that help flex and extend the toes. The deformity and pain can be worsened with constrictive or ill-fitting shoes. The bony prominence at the joints become pronounced and become an area of increased pressure within the shoe. A bursitis (small, inflamed, fluid-filled sac) may develop over the prominence and be an added source of pain. Conservative treatment options/lifestyle changes include, but are not limited to:
-Wearing appropriate width and depth shoes
-Strapping/Padding of the affected toes
-Corticosteroid injection or Anti-Inflammatory medication for bursitis
There are surgeons who will shorten the toes strictly for cosmetic reasons, but this is not a widely accepted practice. However, surgical intervention is indicated if there is pain. There are several different methods for straightening of the toe. Many of these utilize wires, screws, or other types of implants to maintain the correction of the deformity. Sometimes additional procedures are needed on the joints and bones in the foot where the toes “attach”. A much more simple procedure can be performed in the office with only 2-3 bandaids for dressing and splinting. It requires no downtime. When the toe is contracted or hammered, but can be manually corrected during the exam, a simple procedure on the tendon that flexes the toe can be performed. This is done with local anesthesia. No stitches are needed. There is a small amount of loss of muscle strength in the toe, but this is more pronounced in the other types of surgeries mentioned and also typically not that important to the patient that is suffering pain. For the right patient it is an excellent alternative to enduring a long recovery process. It is also a fraction of the cost when comparing it to the charges associated with performing surgery in an OR setting.
For a more comprehensive explanation of what a hammertoe is, please visit www.westfieldfoot.com. This site will provide you with a library of information that will prepare you for your visit with the doctor. An overview ov anatomy, biomechanics, how hammertoes form, and what is involved with treatment are all covered comprehensively.
Dr. Sullivan performs the above mentioned procedure in his office on a regular basis with excellent results. The recovery is almost not an issue because there are no sutures and only involves a couple of bandaids for 1-2 weeks. Risks of infection and other common complications associated with hammertoe surgery that involves cutting of bone are avoided much better.
Mourning Morning Heel Pain?
Stabbing, aching, sharp shooting, feels like a stone bruise…these are some of the descriptions of pain that many people complain of when they have heel pain, especially on their first few steps out of bed in the morning. When people either have mechanical issues with their feet or have added stress to them, they often get symptoms similar to those just mentioned. Plantar fasciitis (planter fash-e-ite-is) is the most common heel pain diagnosis. It is caused by excessive physical stress to the plantar fascia (fasha), which is a strong, wide, fairly thick ligament that stretches from the heel to the ball of the foot. The reason that this pain is often worse on the first few steps out of bed or after any amount of rest is that the fascia tightens when at rest when that rest comes after a physically demanding activity. Then, when weight is placed on the foot it naturally wants to flatten out, but the tight fascia does not want to stretch, so it jerks on the heel bone where it attaches or sometimes along its course through the arch. This causes inflammation and pain. The physically demanding stress can be any or a combination of the following:
-poor foot mechanics
-weight gain
-prolonged stance or walking
-uneven terrain
-poor shoegear/poor support
-new exercise routine
-excessive barefoot walking
If this condition goes undiagnosed or untreated for several months, then the inflamed tissue thickens similar to scar tissue. The vast majority of patients respond very well to conservative treatment with only 3-5% requiring surgical intervention. Treatment begins with determining the actual stress, then it may include: orthotics, cortisone injections, anti-inflammatory medication, education on shoes, splinting, lifestyle changes, and physical therapy. If pain is not adequately controlled with conservative treatment then surgery is usually the next step. Call Westfield Foot and Ankle for an appointment and you will soon be thankful that you did.
Stabbing, aching, sharp shooting, feels like a stone bruise…these are some of the descriptions of pain that many people complain of when they have heel pain, especially on their first few steps out of bed in the morning. When people either have mechanical issues with their feet or have added stress to them, they often get symptoms similar to those just mentioned. Plantar fasciitis (planter fash-e-ite-is) is the most common heel pain diagnosis. It is caused by excessive physical stress to the plantar fascia (fasha), which is a strong, wide, fairly thick ligament that stretches from the heel to the ball of the foot. The reason that this pain is often worse on the first few steps out of bed or after any amount of rest is that the fascia tightens when at rest when that rest comes after a physically demanding activity. Then, when weight is placed on the foot it naturally wants to flatten out, but the tight fascia does not want to stretch, so it jerks on the heel bone where it attaches or sometimes along its course through the arch. This causes inflammation and pain. The physically demanding stress can be any or a combination of the following:
-poor foot mechanics
-weight gain
-prolonged stance or walking
-uneven terrain
-poor shoegear/poor support
-new exercise routine
-excessive barefoot walking
If this condition goes undiagnosed or untreated for several months, then the inflamed tissue thickens similar to scar tissue. The vast majority of patients respond very well to conservative treatment with only 3-5% requiring surgical intervention. Treatment begins with determining the actual stress, then it may include: orthotics, cortisone injections, anti-inflammatory medication, education on shoes, splinting, lifestyle changes, and physical therapy. If pain is not adequately controlled with conservative treatment then surgery is usually the next step. Call Westfield Foot and Ankle for an appointment and you will soon be thankful that you did.
Pregnancy and Foot Pain
Pregnant? Feet Hurt?
You don’t have to be barefoot AND pregnant to cause harm to your feet. Either one adds stress to the feet for different reasons. With pregnancy comes weight gain and typically swelling in the feet (most commonly in the 3rd trimester). The stress on the feet from added weight can result in multiple foot ailments including:
1. Plantar Fasciitis
2. Achilles Tendonitis
3. Peroneal or Posterior Tibial Tendonitis
4. Stress Fractures
5. Ingrown Toenails
There is concern when treating musculoskeletal problems during pregnancy because xrays obviously need to be avoided. A good clinician should be able to diagnose most of these problems without x-ray. MRI’s and other forms of advanced imaging are sometimes needed to confirm a diagnose, so often times the suspected diagnosis is treated without a definite diagnosis, so as not to put the fetus at risk. Supportive shoegear and orthotics will typically decrease the stress enough to either eradicate or at least lessen the pain of the first three ailments listed above. Stress fractures may be immobilized. Ingrown toenails are typically treated in the same manner as when not pregnant.
Added stress from weight is not the only cause for discomfort in the feet during pregnancy. Many women suffer from significant swelling in the feet, especially during the third trimester. This causes much frustration when putting on shoes. It is highly advised that pregnant women have there shoe size checked throughout pregnancy. Pay attention to width and the depth of the toe box, not just the length. Swelling can be controlled with compression hose to some degree, but rest and elevation along with routine exercise to keep the fluid pumping efficiently through your system is the best way to control this common problem.
A well trained Podiatrist will know what treatment regimen is best for each patient. The biomechanics of one pregnant patient will not be the same as another. That is why custom foot orthoses provide the most benefit to patients with problems related to the positioning and balance of their feet, ankles, knees, hips, and back. These devices prevent overpronation and therefore decrease the stress during stance and gait on many structures including the plantar fascia, Achilles Tendon, multiple joints at different levels, and many other soft tissue and bony structures of the foot.
Edema control is done through disciplined use of the compression hose. These come as prefabricated and custom. If they are not worn, then they will not work. Gravity will also decrease swelling. Keep the feet elevated above the level of the heart for the quickest reduction in swelling. This will help reduce pain associated with poor fitting shoegear and general irritation.
Remember: You don’t have to live with your foot pain just because you are pregnant. There are many ways to safely treat problems of the feet and ankles without putting you or your baby at risk. Contact me at Westfield Foot and Ankle, LLC. www.westfieldfoot.com OR 317-896-6655
You don’t have to be barefoot AND pregnant to cause harm to your feet. Either one adds stress to the feet for different reasons. With pregnancy comes weight gain and typically swelling in the feet (most commonly in the 3rd trimester). The stress on the feet from added weight can result in multiple foot ailments including:
1. Plantar Fasciitis
2. Achilles Tendonitis
3. Peroneal or Posterior Tibial Tendonitis
4. Stress Fractures
5. Ingrown Toenails
There is concern when treating musculoskeletal problems during pregnancy because xrays obviously need to be avoided. A good clinician should be able to diagnose most of these problems without x-ray. MRI’s and other forms of advanced imaging are sometimes needed to confirm a diagnose, so often times the suspected diagnosis is treated without a definite diagnosis, so as not to put the fetus at risk. Supportive shoegear and orthotics will typically decrease the stress enough to either eradicate or at least lessen the pain of the first three ailments listed above. Stress fractures may be immobilized. Ingrown toenails are typically treated in the same manner as when not pregnant.
Added stress from weight is not the only cause for discomfort in the feet during pregnancy. Many women suffer from significant swelling in the feet, especially during the third trimester. This causes much frustration when putting on shoes. It is highly advised that pregnant women have there shoe size checked throughout pregnancy. Pay attention to width and the depth of the toe box, not just the length. Swelling can be controlled with compression hose to some degree, but rest and elevation along with routine exercise to keep the fluid pumping efficiently through your system is the best way to control this common problem.
A well trained Podiatrist will know what treatment regimen is best for each patient. The biomechanics of one pregnant patient will not be the same as another. That is why custom foot orthoses provide the most benefit to patients with problems related to the positioning and balance of their feet, ankles, knees, hips, and back. These devices prevent overpronation and therefore decrease the stress during stance and gait on many structures including the plantar fascia, Achilles Tendon, multiple joints at different levels, and many other soft tissue and bony structures of the foot.
Edema control is done through disciplined use of the compression hose. These come as prefabricated and custom. If they are not worn, then they will not work. Gravity will also decrease swelling. Keep the feet elevated above the level of the heart for the quickest reduction in swelling. This will help reduce pain associated with poor fitting shoegear and general irritation.
Remember: You don’t have to live with your foot pain just because you are pregnant. There are many ways to safely treat problems of the feet and ankles without putting you or your baby at risk. Contact me at Westfield Foot and Ankle, LLC. www.westfieldfoot.com OR 317-896-6655
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