Tuesday, May 21, 2013

Your Crooked Toes May Be Hammer Toes


Do you have crooked toes or toes that look like little hammers or claws? You may have hammer toes. A hammer toe or contracted toe is a deformity caused by a tendon imbalance on the second, third or fourth toe causing it to be permanently bent, resembling a hammer. Mallet toe and claw toe are similar to hammer toes.

Hammer toes are most often caused from wearing ill fitted shoes that force the toe into a bent position. Wearing these shoes for long periods of time can cause the muscles in them to shorten, resulting in the hammer toe deformity.

The hammer toe deformity can be flexible, semi-rigid, or rigid in nature. In a flexible hammer toe, the joint has the ability to move. This type of hammer toe can be straightened manually. A rigid or semi-rigid hammer toe does not have that same ability to move. Movement is very limited and can be extremely painful. This sometimes causes foot movement to become restricted leading to extra stress to the ball of the foot, and possibly causing pain and may also cause painful corns and calluses on the top of the digit (at the joint) and at the tip of the toe--due to pressure--or under the ball of the foot from retrograde pressure.

Conservative treatment starts with new shoes with soft, deep toe boxes to avoid rubbing.  Your podiatrist may also recommend padding to decrease pressure on the area.

Surgery would be the final resort. Your podiatrist can do a simple procedure done in office called Percutaneous Tenotomy, which releases the contracted tendon. For more serious hammer toes, your podiatrist can do 1 or 2 surgeries in the operating room. Arthroplasty is a surgery to relieve pain and restore range of motion by reconstructing a joint. Arthrodesis is a surgical procedure which fuses the bones that form a joint, essentially eliminating the joint.

 If you have hammer toes and live in the Dayton/Springfield area, Community Foot Specialists can help! Call today to schedule your appointment. We’re always accepting new patients! 937-426-9500

Tuesday, May 14, 2013

Joakim Noah and Plantar Fasciitis

Joakim Noah
How would you like to run around feeling like you have hundreds of needles underneath your feet? Doesn't sound very pleasant, does it? Well that’s what Chicago Bulls Center Joakim Noah is dealing with right now. This is called plantar fasciitis.

Plantar fasciitis is a painful inflammatory process of the plantar fascia, the connective tissue on the sole (bottom surface) of the foot. Plantar fasciitis is one of the most common causes of heel pain. Plantar fasciitis is caused by straining the ligament that supports your arch. Repeated strain can cause tiny tears in the ligament. This is more likely to happen if your feet roll inward too much when you walk, you walk, stand or run for long periods of time, especially on hard surfaces.

Most people with plantar fasciitis have pain when they take their first steps after they get out of bed or sit for a long time. As the injury advances into later stages, the pain will begin to feel like little needles sticking you in the bottom of your heel with each step.

There is no instant cure for plantar fasciitis but immediate intervention is very important so it does not get worse. Your podiatrist will likely recommend adequate rest to take the strain off the Plantar Fascia and allow the affected tissues time to heal. There are also exercises your podiatrist may recommend, such as:
  • Stretching your foot by flexing it up and down 10 times before standing.
  • Do toe stretches to stretch the plantar fascia.
  • Use a towel to stretch the bottom of your foot.
  • Use a rolling pin or tennis ball. While seated, roll the rolling pin or ball with the arch of your foot. If you are able to, progress to doing this exercise while you are standing up.
Your podiatrist may also recommend custom made JM orthotics to be worn in your shoe to support your arch.

As for Joakim Noah, he’s still playing for the Bulls during the playoffs. The series is currently at 3-1, with Miami in the lead.Noah was quoted a couple of weeks ago telling reporters, "It really sucks. It feels like you have needles underneath your foot while you're playing. You need to run, you need to jump (and) you need to do a lot of things while you're playing basketball. So you don't want needles on your feet, right?”

According to the ChicagoTribune, Noah is receiving treatment for his plantar fasciitis. Aside from resting when he can, he has tried platelet rich plasma injections, sleeping in a splint and three seasons ago- shock wave therapy. He most recently received cortisone shots. Although these treatments might be beneficial, they are far from the typical prescribed treatments. For those of us who are not Joakim Noah or a pro-athlete during their mid-playoff stride, it is recommended that, first and foremost, you go and see a podiatrist. It is also recommended that you rest and stretch as much and often as you can. It is imperative that you do not put unwarranted stress on the heel of your foot. 

Community Foot Specialists - Podiatrists/Foot & Ankle Surgeons Serving Dayton and Springfield, Ohio Call today to schedule your appointment! (937) 426-9500

Monday, May 6, 2013

Important Things to Know About Stress Fractures

With Spring here more folks are outside, including runners. Oftentimes runners complain experiencing pain in the mid foot. The first concern would be to rule out stress fractures. Stress fractures occur with either normal force on abnormal bone (example: elderly) or abnormal force on normal bone, (example: new activity or increased load on the foot).

 Symptoms include pain with walking, running or any increase in activity. Swelling may also be a problem.

A visit to the podiatrist is critical to help rule stress fractures out before they become more of a serious problem. X-rays can be taken in office to look for evidence of stress fractures. It should be noted, however, that early stress fractures may not show up on the x-ray until 2 weeks after the start of symptoms.

The most common bone in the foot to experience a stress fracture is the 2nd metatarsal bone due to it being the longest bone in the row. The 2nd metatarsal will generate greater loads and greater stress, repetitive loads for a period of time can cause a stress fracture.

Sometimes a person may experience the same pain and symptoms of stress fractures due to a phenomenon known as over use or stress syndrome. Medical tibial stress syndrome is an irritation of the tibia (shin bone) at points where the soleus and tibialis posterior muscles attach to it. It is caused by over-use in runners, however, there are a number of factors, such as altered foot, knee and hip posture, that can predispose a person to the syndrome. This is considered as a precursor to stress fracture. An MRI can help detect this and will show increased signal in the affected bone.

The best treatment is rest and protected weight bearing. Sometimes taking up to 6-8 weeks, something athletes never want to hear. Pain may be treated with ice and anti-inflammatory. Once improved, the goal would be to reduce chances or recurrence with slow modifications and likely functional inserts with specific design to the individual.

By: Dr. Adam M. Thomas, DPM

Community Foot Specialists - Podiatrists/Foot & Ankle Surgeons Serving Dayton and Springfield, Ohio Call today to schedule your appointment! (937) 426-9500