Jenrry Meija had to leave a spring training game after five innings in March because of pain from... a bunion.
So will Meija's bunion bother him the rest of the season? It likely will if the bunion continues to progress.
At the end of March, Terry Collins said that how long he could last in a game would determine his status as a starter. If the bunion continues to bother him, it would prevent his ability to start.
The Mets were attempting to decide between Mejia and Daisuke Matsuzaka as their fifth and final starter.
Pitching coach Dan Warthen had said, "They're both still fighting for a position on the team. They have both thrown extremely well so it's made it very difficult on all of us. Which is a nice thing to have."
Meija had said that his foot felt "good" and that he did not expect his bunion to be an issue. Something was going to be applied to relieve the pressure from the bunion.
"We've always liked Meija's stuff," Warthen said. "We'd just like to see him get deeper into the game without the high pitch counts and see how everything feels afterwards because he really has 'plus' stuff and if he commands the zone and gets hitters out then he deserves the position as well. A young, good arm."
Meija was obviously able to push through the pain from his bunion, since he made his second start of the season last night. In his first outing against the Reds Meija gave up just one run and struck out eight in six innings.
A bunion is a bone deformity caused by an enlargement of the joint at the base and side of the big toe. Bunions form when the toe moves out of place. The enlargement can cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward other toes, sometimes overlapping a third toe. The growing enlargement then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists. Bunions can also lead to other toe deformities, like hammertoes.
Meija will have to monitor the progress of his bunion, wear padding, and an orthotic as well. He may need shoes that are wider in the toe box to compensate for his bunion. We'll monitor him throughout the season, as the pain from the bunion may prove too much for this pitcher.
References: NJ.com and SB Nation
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Friday, April 11, 2014
Friday, March 14, 2014
How the Internet Has Changed Clubfoot Treatment
Clubfoot is a common birth defect, affecting 1 in every 1,000 newborns, and is characterized by feet that turn inward, forming a twisted U-shape.
Mary Synder was devastated to learn at her 19 week ultrasound that her unborn baby had clubfoot.
"It was terrifying," said Synder. "It was very emotional. We did a lot of testing and everything to make sure she was going to be OK, but you never really know until you see them when they're born."
Until a decade ago, 90 percent of babies born with clubfoot were treated with surgery that had to be done several times. This would lead to a buildup of scar tissue that could bring a lifetime of pain, arthritis, stiffness, and medical bills. A noninvasive solution along with an Internet campaign by parents changed treatment courses and outcomes.
Alice is now 6 and is seen every year by Dr. John Herzenberg, an orthopedic surgeon at Sinai Hospital in Baltimore. Alice follows all of his instructions: walk back and forth, stand on her tippy toes, and walk with her feet turned out like a duck.
For those who aren't familiar with clubfoot, Alice's feet look perfectly normal. They can turn out just like anyone who wasn't born with clubfoot.
Dr. Herzenberg used the Ponseti Method, which involves a series of full-leg casts that slowly turn out the patient's feet. Casts are changed every three to eight weeks. When it is time for the final cast, which stays on three weeks, a small incision is made above the Achilles tendon. The child will then wear at night special boots that are connected by a bar to ensure the feet stay in the right position.
This method was developed by Dr. Ignacio Ponseti at the University of Iowa in the 1950's when the Spanish physician discovered that an infant's feet could be trained to turn the correct way.
"In the past, before I learned Ponseti, guaranteed I would literally have had to do a surgical operation to take apart and pull together the entire foot," said Dr. Herzenberg.
The Ponseti method is almost painless and patients who have this treatment have a complete recovery with no long-term discomfort. It also costs less than surgery. Ponseti would spend 50 years trying to get other physicians to adopt this method, but would be largely unsuccessful.
"People were falling over themselves to do fancy invasive surgery, and this one strange old guy who speaks softly with a Spanish accent in Iowa was getting sort of ignored by the drumbeat of people who were in favor of surgery," said Dr. Herzenberg, who is one of the top physicians to see for this procedure.
Traditionally, surgeons are trained to operate, and that's how they can make more money. For orthopedists, the Ponseti method brings in less money. So for 50 years the Ponseti method stayed in Iowa.
But the internet changed that. Jennifer Trevillian's daughter was born with clubfoot in 2000 and doctors said surgery was the only course of action. "He started talking about her pending surgery before he physically examined her foot," Trevillian recalls.
Trevillian wasn't going to have any surgery for her daughter. On her new dial-up connection, she began to research the condition. Initially, she didn't find much, but she stumbled upon a support group on iVillage called NoSurgery4ClubFoot. Several days later she and her daughter traveled from Chatham, Michigan to Iowa to see Dr. Ponseti.
"In the amount of time that we would have just been waiting for her to be big enough to tolerate the anesthesia for the reconstructive surgery she was supposed to have, Dr. Ponseti completely corrected her foot," Trevillian said.
Trevillian became a proponent of the Ponseti method, setting up websites with her daughter's story, staying active on support groups, and spreading the message. Parents began to listen, and would travel long distances to find doctors who would perform the treatment.
"The way that the clubfoot treatment pendulum has swung is really a classic example of supply and demand- because once parents found out about it, they demanded it for their kids, and it really forced the medical industry to rethink the Ponseti method," said Trevillian.
Herzenberg agrees with Trevillian's statement. "Clubfoot is a real prototype for how the Internet has changed medicine and how parents have been the driving force in many ways," he says.
Now the Ponseti method is the treatment option of choice by physicians for clubfoot and is recommended by the American Academy of Orthopedic Surgeons. When done properly, 97 percent of children will never need surgery.
Reference: NPR
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Mary Synder was devastated to learn at her 19 week ultrasound that her unborn baby had clubfoot.
"It was terrifying," said Synder. "It was very emotional. We did a lot of testing and everything to make sure she was going to be OK, but you never really know until you see them when they're born."
Until a decade ago, 90 percent of babies born with clubfoot were treated with surgery that had to be done several times. This would lead to a buildup of scar tissue that could bring a lifetime of pain, arthritis, stiffness, and medical bills. A noninvasive solution along with an Internet campaign by parents changed treatment courses and outcomes.
Alice is now 6 and is seen every year by Dr. John Herzenberg, an orthopedic surgeon at Sinai Hospital in Baltimore. Alice follows all of his instructions: walk back and forth, stand on her tippy toes, and walk with her feet turned out like a duck.
For those who aren't familiar with clubfoot, Alice's feet look perfectly normal. They can turn out just like anyone who wasn't born with clubfoot.
Dr. Herzenberg used the Ponseti Method, which involves a series of full-leg casts that slowly turn out the patient's feet. Casts are changed every three to eight weeks. When it is time for the final cast, which stays on three weeks, a small incision is made above the Achilles tendon. The child will then wear at night special boots that are connected by a bar to ensure the feet stay in the right position.
This method was developed by Dr. Ignacio Ponseti at the University of Iowa in the 1950's when the Spanish physician discovered that an infant's feet could be trained to turn the correct way.
"In the past, before I learned Ponseti, guaranteed I would literally have had to do a surgical operation to take apart and pull together the entire foot," said Dr. Herzenberg.
The Ponseti method is almost painless and patients who have this treatment have a complete recovery with no long-term discomfort. It also costs less than surgery. Ponseti would spend 50 years trying to get other physicians to adopt this method, but would be largely unsuccessful.
"People were falling over themselves to do fancy invasive surgery, and this one strange old guy who speaks softly with a Spanish accent in Iowa was getting sort of ignored by the drumbeat of people who were in favor of surgery," said Dr. Herzenberg, who is one of the top physicians to see for this procedure.
Traditionally, surgeons are trained to operate, and that's how they can make more money. For orthopedists, the Ponseti method brings in less money. So for 50 years the Ponseti method stayed in Iowa.
But the internet changed that. Jennifer Trevillian's daughter was born with clubfoot in 2000 and doctors said surgery was the only course of action. "He started talking about her pending surgery before he physically examined her foot," Trevillian recalls.
Trevillian wasn't going to have any surgery for her daughter. On her new dial-up connection, she began to research the condition. Initially, she didn't find much, but she stumbled upon a support group on iVillage called NoSurgery4ClubFoot. Several days later she and her daughter traveled from Chatham, Michigan to Iowa to see Dr. Ponseti.
"In the amount of time that we would have just been waiting for her to be big enough to tolerate the anesthesia for the reconstructive surgery she was supposed to have, Dr. Ponseti completely corrected her foot," Trevillian said.
Trevillian became a proponent of the Ponseti method, setting up websites with her daughter's story, staying active on support groups, and spreading the message. Parents began to listen, and would travel long distances to find doctors who would perform the treatment.
"The way that the clubfoot treatment pendulum has swung is really a classic example of supply and demand- because once parents found out about it, they demanded it for their kids, and it really forced the medical industry to rethink the Ponseti method," said Trevillian.
Herzenberg agrees with Trevillian's statement. "Clubfoot is a real prototype for how the Internet has changed medicine and how parents have been the driving force in many ways," he says.
Now the Ponseti method is the treatment option of choice by physicians for clubfoot and is recommended by the American Academy of Orthopedic Surgeons. When done properly, 97 percent of children will never need surgery.
Reference: NPR
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Friday, February 14, 2014
Myotonic Dystrophy and Foot Deformities
Myotonic dystrophy is one of the most common myopathies and is inherited through an autosomal dominant gene. Often, many members of the same family have this condition.
The manifestation of this disease does not appear until late adolescence or early adulthood. Early symptoms include muscle stiffness, cramping pains, or difficulty relaxing the grasp. Diagnosis is usually made through an electromyogram.
Characteristics of fully developed myotonic include long, thin, facial expressions with temporal and masseter weakness and frontal balding. The neck will look like a long swan's neck due to the weakness of the musculature. The voice has a nasal quality and speech can become dysarthric, meaning trouble pronouncing words. Swallowing may also be impaired. Cataracts and endocrine abnormalities, like disturbances of the adrenal, pancreatic, and gonadal function are also affected. In men, testicular atrophy is seen, and in females infertility.
Myotonic dystrophy should not be confused with myotonia congenita, also known as Thomsen's disease. In Thomsen's disease there is stiffness of the muscle with difficult in initial movements. No atrophy or mental retardation is found, with no physical limitation. After activity, the muscles loosen, and the patient's movements are almost normal.
Foot and ankle weakness presents early and is associated with stiffness and cramping pains. In general, foot deformities are not severe enough to need surgical correction. Treatment is directed towards the modification of the shoe. Shoe lifts, pads, and wedges are used to help prevent painful feet and aid with gait. If the patient is able to keep up strength in their legs, footdrop can be alleviated by orthotics.
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
The manifestation of this disease does not appear until late adolescence or early adulthood. Early symptoms include muscle stiffness, cramping pains, or difficulty relaxing the grasp. Diagnosis is usually made through an electromyogram.
Characteristics of fully developed myotonic include long, thin, facial expressions with temporal and masseter weakness and frontal balding. The neck will look like a long swan's neck due to the weakness of the musculature. The voice has a nasal quality and speech can become dysarthric, meaning trouble pronouncing words. Swallowing may also be impaired. Cataracts and endocrine abnormalities, like disturbances of the adrenal, pancreatic, and gonadal function are also affected. In men, testicular atrophy is seen, and in females infertility.
Myotonic dystrophy should not be confused with myotonia congenita, also known as Thomsen's disease. In Thomsen's disease there is stiffness of the muscle with difficult in initial movements. No atrophy or mental retardation is found, with no physical limitation. After activity, the muscles loosen, and the patient's movements are almost normal.
Foot and ankle weakness presents early and is associated with stiffness and cramping pains. In general, foot deformities are not severe enough to need surgical correction. Treatment is directed towards the modification of the shoe. Shoe lifts, pads, and wedges are used to help prevent painful feet and aid with gait. If the patient is able to keep up strength in their legs, footdrop can be alleviated by orthotics.
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Friday, January 24, 2014
Guillain-Barre Syndrome And Foot Deformities
Guillain-Barre syndrome is a polyneuropathy that has associated muscle weakness in the upper and lower extremities, respiratory muscle weakness, and respiratory paralysis.
Recovering from the syndrome is possible and patients with mild cases may feel better at the end of a month. Patients who have severe cases see a longer recovery time, typically years, with residual effects from the illness.
Diagnosis of the syndrome is made with the association of a preceding or accompanying illness that is along the same strains with polyradiculoneuropathy, muscle weakness, and cerebral fluid analysis.
Foot deformities associated with Guillain-Barre syndrome can be put into two categories: those that develop early, and those that develop later as the disease progresses.
Early foot problems include muscle weakness, with pain in the muscles of the thighs, legs, and toes. This pain can be unbearable at times. Treatment should be directed towards easing the pain with analgesics and physical therapy. The position of the lower thigh is important and can be supported by night splints at first and then orthotics. Until muscle strength has been achieved, these devices will be necessary.
Full recovery of the muscles can take up to 24 months. After this time, the likelihood of gaining any more strength and function should not be expected. In patients where muscle weakness is still experienced, the most common problems are foot drop and deformities secondary to the muscle imbalance.
Foot drop can be treated with orthotics and appropriate tendon transfers. Triple arthrodesis has been used to correct some foot deformities, which may include bunions due to muscle weakness.
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Recovering from the syndrome is possible and patients with mild cases may feel better at the end of a month. Patients who have severe cases see a longer recovery time, typically years, with residual effects from the illness.
Diagnosis of the syndrome is made with the association of a preceding or accompanying illness that is along the same strains with polyradiculoneuropathy, muscle weakness, and cerebral fluid analysis.
Foot deformities associated with Guillain-Barre syndrome can be put into two categories: those that develop early, and those that develop later as the disease progresses.
Early foot problems include muscle weakness, with pain in the muscles of the thighs, legs, and toes. This pain can be unbearable at times. Treatment should be directed towards easing the pain with analgesics and physical therapy. The position of the lower thigh is important and can be supported by night splints at first and then orthotics. Until muscle strength has been achieved, these devices will be necessary.
Full recovery of the muscles can take up to 24 months. After this time, the likelihood of gaining any more strength and function should not be expected. In patients where muscle weakness is still experienced, the most common problems are foot drop and deformities secondary to the muscle imbalance.
Foot drop can be treated with orthotics and appropriate tendon transfers. Triple arthrodesis has been used to correct some foot deformities, which may include bunions due to muscle weakness.
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Friday, November 8, 2013
Bunion Surgery: Don't Listen To Dr. Oz!
We know that a lot of people watch the Dr. Oz show and believe everything that comes out of his mouth to be the truth. Because if Dr. Oz said it, it must be true, right?
We've encountered this scenario with Dr. Oz and the gospel truth several times in the course of his show, including one of his most famous proclamations: Don't wear flip-flops! Podiatrists across the country pounded their heads into their desks, saying "We've been saying that for years!"
Last Wednesday Dr. Oz had on his program The People's Court judge Marilyn Milian to talk about bunion surgery. At first, we were excited to see him put the spotlight on this topic. Bunions are a common foot deformity we see in our practices, and some people, not all, require surgery to correct the bone.
Dr. Oz warned viewers immediately that surgery may not be the answer to your bunion problem. "Today we are talking about a painful and often crippling condition that could affect more than half of you at some point in your life," Oz said. "Many of you will turn to surgery, but will surgery cause more problems than the bunions themselves?"
Milian discussed her surgery, which was the second time she had it done on that foot. This is an important
fact, which is not factored in to the discussion. "The aftermath is very, very, very painful and involves slow recovery," said Judge Milian, who was in the eighth week of her recovery and said that at week four she was still in terrible pain.
We're not going to go into full detail here about the entire segment (you can watch it here), but what we gleaned from it did not make us happy. First of all, when bunion surgery is done for the second time, your podiatrist needs to go in and break the bone in order to correct the deformity. Not only are you dealing with the pain from the surgery, which can be different for everyone, but from the broken bone. Naturally, this will be more painful.
Secondly, those who are in pain from bunion surgery and have problems afterwards are often those who have not followed their podiatrist's post-surgical instructions to the T. They are likely not icing often enough, elevating, staying off their feet, and taking the prescribed medications. In my career of more than 30 years, patients who follow the directions I give them have great success and recovery. Those who do not follow my instructions suffer needlessly.
Third, how Dr. Oz portrayed the podiatric field and what we do was honestly insulting. He poked fun at the instruments we use during surgery, and overall made a mockery of our field. In case you haven't been paying attention, Dr. Oz, podiatry today is not what it was even 20 years ago. Our doctors have four years of medical school, followed by two to three years of a residency, which is standard across many specialties.
It is unfortunate that the report was severely one-sided. The segment had just one patient's account of having difficulties, and he did not even let the podiatrist who was on give a rebuttal. It is true that these procedures require several months to heal, but the overwhelming majority do well and have an improved ability to carry on daily functions more comfortably.
It is advisable to correct bunion deformities when they are moderate because as they progress they tend to be arthritic and the end result is not as positive and healing is more prolonged. We encourage anyone who has a bunion deformity to speak with a podiatrist, and not listen to a surgeon's advice. Please do not be dissuaded by one person's bad experience.
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
We've encountered this scenario with Dr. Oz and the gospel truth several times in the course of his show, including one of his most famous proclamations: Don't wear flip-flops! Podiatrists across the country pounded their heads into their desks, saying "We've been saying that for years!"
Last Wednesday Dr. Oz had on his program The People's Court judge Marilyn Milian to talk about bunion surgery. At first, we were excited to see him put the spotlight on this topic. Bunions are a common foot deformity we see in our practices, and some people, not all, require surgery to correct the bone.
Milian discussed her surgery, which was the second time she had it done on that foot. This is an important
We're not going to go into full detail here about the entire segment (you can watch it here), but what we gleaned from it did not make us happy. First of all, when bunion surgery is done for the second time, your podiatrist needs to go in and break the bone in order to correct the deformity. Not only are you dealing with the pain from the surgery, which can be different for everyone, but from the broken bone. Naturally, this will be more painful.
Secondly, those who are in pain from bunion surgery and have problems afterwards are often those who have not followed their podiatrist's post-surgical instructions to the T. They are likely not icing often enough, elevating, staying off their feet, and taking the prescribed medications. In my career of more than 30 years, patients who follow the directions I give them have great success and recovery. Those who do not follow my instructions suffer needlessly.
Third, how Dr. Oz portrayed the podiatric field and what we do was honestly insulting. He poked fun at the instruments we use during surgery, and overall made a mockery of our field. In case you haven't been paying attention, Dr. Oz, podiatry today is not what it was even 20 years ago. Our doctors have four years of medical school, followed by two to three years of a residency, which is standard across many specialties.
It is unfortunate that the report was severely one-sided. The segment had just one patient's account of having difficulties, and he did not even let the podiatrist who was on give a rebuttal. It is true that these procedures require several months to heal, but the overwhelming majority do well and have an improved ability to carry on daily functions more comfortably.
It is advisable to correct bunion deformities when they are moderate because as they progress they tend to be arthritic and the end result is not as positive and healing is more prolonged. We encourage anyone who has a bunion deformity to speak with a podiatrist, and not listen to a surgeon's advice. Please do not be dissuaded by one person's bad experience.
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Friday, November 1, 2013
Victoria Beckham Considering Bunion Surgery
Victoria Beckham's bunions are so epic, they're part of popular culture.
The former Spice Girls singer and wife to soccer star David is reportedly considering surgery to correct the deformity.
Beckham was warned to have the surgery now or risk "serious problems."
The fashion designer has a notorious love of high heels, even wearing wedge sneakers when she was invited
to throw out the first pitch for a Los Angeles Dodgers game in 2007.
But there is only so long you can wear high heels and stilettos without consequence, and Beckham can expect a huge change in wardrobe if she doesn't have the surgery.
"Vic's been advised that her treatment must be done on both feet ASAP, otherwise, in less than two years, it could cause serious problems," an insider told the British magazine Heat.
"She's been told that if she allows her bunions to get worse, she may never be able to wear heels again."
Besides never being able to wear heels again, which is no tragedy, Beckham's feet will be more likely to get arthritis, face further disability, and have problems with her legs, hips, and spine because of gait issues from the bunions.
The thought of getting rid of her heels and wearing flats for the rest of her life is apparently filling Beckham with horror and she is realizing she needs to do something about her painful bunions.
"She's relenting and saying she would be swayed to do it this winter. At least that time of year, it's easier to keep her feet under wraps and wear flats," the insider said.
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
The former Spice Girls singer and wife to soccer star David is reportedly considering surgery to correct the deformity.
Beckham was warned to have the surgery now or risk "serious problems."
The fashion designer has a notorious love of high heels, even wearing wedge sneakers when she was invited
But there is only so long you can wear high heels and stilettos without consequence, and Beckham can expect a huge change in wardrobe if she doesn't have the surgery.
"Vic's been advised that her treatment must be done on both feet ASAP, otherwise, in less than two years, it could cause serious problems," an insider told the British magazine Heat.
"She's been told that if she allows her bunions to get worse, she may never be able to wear heels again."
Besides never being able to wear heels again, which is no tragedy, Beckham's feet will be more likely to get arthritis, face further disability, and have problems with her legs, hips, and spine because of gait issues from the bunions.
The thought of getting rid of her heels and wearing flats for the rest of her life is apparently filling Beckham with horror and she is realizing she needs to do something about her painful bunions.
"She's relenting and saying she would be swayed to do it this winter. At least that time of year, it's easier to keep her feet under wraps and wear flats," the insider said.
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Friday, July 19, 2013
Tips To Follow When Recovering From Foot Surgery
It's likely you've been feeling a lot of anticipation as your foot or ankle surgery date approached. It is normal to feel anxious, scared, upset, worried, or frightened about surgery of any kind. Remember however, that foot and ankle surgeries are rarely life-threatening and the outcomes will make you feel happier and healthier!
After your surgery you will be discharged from the hospital 1-4 hours after the procedure has been completed. Overnight stays are rarely prescribed, but when you get to leave the hospital is determined by your podiatrist and case manager. Previous to your surgery we will go over your discharge instructions and make post-operative appointments. These are very important to keep.
Your podiatrist will give you a prescription for medications you can take at home. Make sure to fill them and take them as prescribed. If you had stopped taking any medications before your surgery, you may start taking them again.
You will need someone to drive you home and possibly stay with you for the rest of the day. Some patients, especially the elderly, may require more care at a nursing or rehabilitation center. If you require therapy, your podiatrist and nurse will let you know. Be sure to use all equipment your podiatrist has provided you with for your post-operative care: walking boot, walking cast, bandages, crutches, and special shoes. These will help you recover quickly, efficiently, and healthfully.
When you return home, watch for signs of infection, which may include redness, fever of 101 degrees or more, swelling, and/or drainage at the incision site. You should also watch for signs of decreased circulation to the foot and ankle, which may include increase in pain, toenail beds that turn blue in color, foot or leg turns pale, coldness of your foot or ankle, and/or tingling and numbness.
You will likely experience pain and numbness for as long as 24 hours after surgery because of the mild anesthesia used at the end of surgery. After this wears off it is normal to feel moderate discomfort in your foot or ankle, as well as the sensation of pinching and pulling. When you put your foot down you may also feel throbbing. These are all normal sensations and you should not be alarmed.
After surgery elevate your foot or ankle to help with the pain and swelling. You should take your pain medication for the first week after your surgery. Take it regularly, even if you are not in pain at that moment. Do not let your pain escalate to intolerable heights. Ice your affected area 20 minutes every hour.
You will go home with a surgical dressing on your foot. Do not remove the dressing, even if it has become loose, dirty, or wet. It is normal to see your dressing soak up discharge from your surgical incision. However, if the dressing rapidly becomes bloodied, soiled, or wet, call the office immediately.
Your podiatrist may have prescribed an antibiotic to prevent infection. It is important you take the entire course of medication to prevent infection in the surgical site. If you take birth control pill, you will have to use another form of contraception to prevent pregnancy.
After your dressing has been changed and bandages have been put on, you should try not to get them wet. Avoid taking a shower, as even when you put a shopping bag over your foot, leaks can occur and may potentially cause infections at the surgical site. Consider taking a bath instead as you can dangle your foot out of the bathtub while you are cleaning up.
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
After your surgery you will be discharged from the hospital 1-4 hours after the procedure has been completed. Overnight stays are rarely prescribed, but when you get to leave the hospital is determined by your podiatrist and case manager. Previous to your surgery we will go over your discharge instructions and make post-operative appointments. These are very important to keep.
Your podiatrist will give you a prescription for medications you can take at home. Make sure to fill them and take them as prescribed. If you had stopped taking any medications before your surgery, you may start taking them again.
You will need someone to drive you home and possibly stay with you for the rest of the day. Some patients, especially the elderly, may require more care at a nursing or rehabilitation center. If you require therapy, your podiatrist and nurse will let you know. Be sure to use all equipment your podiatrist has provided you with for your post-operative care: walking boot, walking cast, bandages, crutches, and special shoes. These will help you recover quickly, efficiently, and healthfully.
When you return home, watch for signs of infection, which may include redness, fever of 101 degrees or more, swelling, and/or drainage at the incision site. You should also watch for signs of decreased circulation to the foot and ankle, which may include increase in pain, toenail beds that turn blue in color, foot or leg turns pale, coldness of your foot or ankle, and/or tingling and numbness.
You will likely experience pain and numbness for as long as 24 hours after surgery because of the mild anesthesia used at the end of surgery. After this wears off it is normal to feel moderate discomfort in your foot or ankle, as well as the sensation of pinching and pulling. When you put your foot down you may also feel throbbing. These are all normal sensations and you should not be alarmed.
After surgery elevate your foot or ankle to help with the pain and swelling. You should take your pain medication for the first week after your surgery. Take it regularly, even if you are not in pain at that moment. Do not let your pain escalate to intolerable heights. Ice your affected area 20 minutes every hour.
You will go home with a surgical dressing on your foot. Do not remove the dressing, even if it has become loose, dirty, or wet. It is normal to see your dressing soak up discharge from your surgical incision. However, if the dressing rapidly becomes bloodied, soiled, or wet, call the office immediately.
Your podiatrist may have prescribed an antibiotic to prevent infection. It is important you take the entire course of medication to prevent infection in the surgical site. If you take birth control pill, you will have to use another form of contraception to prevent pregnancy.
After your dressing has been changed and bandages have been put on, you should try not to get them wet. Avoid taking a shower, as even when you put a shopping bag over your foot, leaks can occur and may potentially cause infections at the surgical site. Consider taking a bath instead as you can dangle your foot out of the bathtub while you are cleaning up.
If you need foot or ankle surgery and do not currently see a podiatrist, call our Bristol office to make an appointment.
Richard E. Ehle, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Bristol, CT
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Friday, July 12, 2013
What Is Gordon's Syndrome?
If your baby was born with clubfoot, they may also have a rare genetic disorder called Gordon's Syndrome. The condition is characterized by stiffness and impaired mobility in the ankles because the tendons in the foot are too short, causing the joints to become fixed in a permanent flexed position. Both feet are usually affected with this disorder.
The exact cause of Gordon's Syndrome is unknown, but some reports suggest it may be inherited through an X-linked dominant manner. Most experts agree it is inherited through an autosomal dominant manner. Having just one mutated copy of the gene in each cell is enough to create the signs and symptoms of the disease. When a person with the autosomal dominant condition has children, each child has a 50% chance of inheriting the mutated copy of the gene.
Gordon's Syndrome may also present as a permanent fixation of several fingers in a bent position and cleft palate. In males scoliosis or undescended testicles may be present. The child's intelligence is not affected by the disease. The wrists, elbows, and knees can also be affected and the severity of the condition can range from individual.
Your child may have an abnormal splitting of the soft hanging tissue at the back of the throat, short stature, dislocation of the hip, abnormal backward curvature of the upper spine, drooping of the eyelids, webbing of the fingers and toes, abnormal skin patterns on the feet and hands, and a short webbed neck.
Prompt treatment after birth is crucial in treating this disorder as your child will have difficulties walking and developing. Typically podiatrists will prescribe casting, bracing, or physical therapy to realign the bones before recommending surgery.
Reference: Rare Diseases
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
The exact cause of Gordon's Syndrome is unknown, but some reports suggest it may be inherited through an X-linked dominant manner. Most experts agree it is inherited through an autosomal dominant manner. Having just one mutated copy of the gene in each cell is enough to create the signs and symptoms of the disease. When a person with the autosomal dominant condition has children, each child has a 50% chance of inheriting the mutated copy of the gene.
Gordon's Syndrome may also present as a permanent fixation of several fingers in a bent position and cleft palate. In males scoliosis or undescended testicles may be present. The child's intelligence is not affected by the disease. The wrists, elbows, and knees can also be affected and the severity of the condition can range from individual.
Your child may have an abnormal splitting of the soft hanging tissue at the back of the throat, short stature, dislocation of the hip, abnormal backward curvature of the upper spine, drooping of the eyelids, webbing of the fingers and toes, abnormal skin patterns on the feet and hands, and a short webbed neck.
Prompt treatment after birth is crucial in treating this disorder as your child will have difficulties walking and developing. Typically podiatrists will prescribe casting, bracing, or physical therapy to realign the bones before recommending surgery.
Reference: Rare Diseases
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Wednesday, June 12, 2013
Are Bunions Hereditary?
According to a new study published in the journal Arthritis Care and Research, many common foot deformities, like bunions, hammertoes, and claw toes are inherited, especially in those who are of European descent.
"These new findings highlight the importance of furthering our understanding of what causes greater susceptibility to these foot conditions, as knowing more about the pathway may ultimately lead to early prevention or early treatment," said study researcher Dr. Marian Hannan, of Harvard Medical School and Hebrew SeniorLife, who is the editor in chief of the journal in a statement.
Recent studies show that more than one third of older adults have bunions. In this study, researchers looked at bunions, lesser toe deformities, and plantar soft tissue atrophy in 1,370 study participants, with an average age of 66, who were part of the Framingham Foot Study. Researchers found that 31 percent of the participants had bunions, 30 percent had lesser toe deformities, and 28 percent had plantar soft tissue atrophy.
They found that bunions and toe deformities were heritable, but plantar soft tissue atrophy was not.
A previous study by the Arthritis Care and Research showed that bunions were more common as people aged and that women were more likely than men to have bunions.
Australian researcher Neil J. Cronin recently published a study on how high heels alter the biomechanics of the foot, says that high-heel wears should avoid towering heels when selecting shoes.
Wear heels "once or twice a week," Cronin told the New York Times, "or try to remove the heels whenever possible, such as when you're sitting at your desk."
Reference: Huffington Post and New York Daily News
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
"These new findings highlight the importance of furthering our understanding of what causes greater susceptibility to these foot conditions, as knowing more about the pathway may ultimately lead to early prevention or early treatment," said study researcher Dr. Marian Hannan, of Harvard Medical School and Hebrew SeniorLife, who is the editor in chief of the journal in a statement.
Recent studies show that more than one third of older adults have bunions. In this study, researchers looked at bunions, lesser toe deformities, and plantar soft tissue atrophy in 1,370 study participants, with an average age of 66, who were part of the Framingham Foot Study. Researchers found that 31 percent of the participants had bunions, 30 percent had lesser toe deformities, and 28 percent had plantar soft tissue atrophy.
They found that bunions and toe deformities were heritable, but plantar soft tissue atrophy was not.
A previous study by the Arthritis Care and Research showed that bunions were more common as people aged and that women were more likely than men to have bunions.
Australian researcher Neil J. Cronin recently published a study on how high heels alter the biomechanics of the foot, says that high-heel wears should avoid towering heels when selecting shoes.
Wear heels "once or twice a week," Cronin told the New York Times, "or try to remove the heels whenever possible, such as when you're sitting at your desk."
Reference: Huffington Post and New York Daily News
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Wednesday, June 5, 2013
What Is Ollier's Disease?
Ollier's disease is a rare nonhereditary sporadic disorder that occurs in 1 in 100,000 people. It presents as
intraosseous benign cartilaginous tumors that develop close to growth plate cartilage. It is not clear if the disease is caused by a single gene defect or a combination of mutations, but the irregular distribution of tumors suggests that the disease is a result of mosaicism, or error in cell division that occurs before birth.
The disorder, named after French surgeon surgeon Louis Leopold Ollier, consists of numerous endochondromas which develop during childhood. The growth of these endochondromas usually stops after you have reached your full height, but the affected extremity is often shortened and bowed due to epiphyseal fusions. Those with Ollier's disease are prone to breaking bones, have enlarged toes, a bony mass on the toe, and complain of swollen, aching limbs. Ollier's disease typically affects just one side of the body and can transform into a malignant sarcoma. The hands and feet are most affected by Ollier's disease. Sometimes injury or trauma to the toe will result in the formation of the bony irregularity or prominence.
On an X-ray, streaks of low density will be seen on the long bones due to ectopic cartilage deposits. Over your lifetime, this cartilage will calcify in a snowflake pattern. Ollier's disease is often not diagnosed until the patient fractures a bone in their foot and the endochondromas appear on the X-rays.
Only when the tumors are aggressive and destroy bone tissue will they require further treatment. Pain when at rest is also a clue treatment is needed, as it is a sign of malignancy. Surgery can be done to remove the painful and problematic endocondromas. During surgery bone grafts are used to fill the cavity caused from removing the endochondroma.
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
The disorder, named after French surgeon surgeon Louis Leopold Ollier, consists of numerous endochondromas which develop during childhood. The growth of these endochondromas usually stops after you have reached your full height, but the affected extremity is often shortened and bowed due to epiphyseal fusions. Those with Ollier's disease are prone to breaking bones, have enlarged toes, a bony mass on the toe, and complain of swollen, aching limbs. Ollier's disease typically affects just one side of the body and can transform into a malignant sarcoma. The hands and feet are most affected by Ollier's disease. Sometimes injury or trauma to the toe will result in the formation of the bony irregularity or prominence.
On an X-ray, streaks of low density will be seen on the long bones due to ectopic cartilage deposits. Over your lifetime, this cartilage will calcify in a snowflake pattern. Ollier's disease is often not diagnosed until the patient fractures a bone in their foot and the endochondromas appear on the X-rays.
Only when the tumors are aggressive and destroy bone tissue will they require further treatment. Pain when at rest is also a clue treatment is needed, as it is a sign of malignancy. Surgery can be done to remove the painful and problematic endocondromas. During surgery bone grafts are used to fill the cavity caused from removing the endochondroma.
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Wednesday, May 29, 2013
The Sole of My Foot Is Abnormally Thick!
There are three types of patterns of palmoplantar keratodermas, which include:
*Diffuse
- Diffuse palmoplantar keratoderma is characterized by thick, even, and symmetric hyperkeratosis over the whole of the sole. They are present at birth or during the first few months of life.
- Diffuse epidermolytic palmoplantar keratoderma is one of the most common patterns of this condition. This too is evident at birth and is characterized by demarcated symmetric thickening of the soles, with a "dirty" snakeskin appearance.
- Diffuse nonepidermolytic palmoplantar keratoderma is an inherited autosomal dominant condition, present at birth, and is characterized by well-demarcated, symmetric keratoses, and a "waxy" appearance.
- Focal palmoplantar keratoderma is characterized by large, compact masses of keratin which develop at sites with recurrent friction. The pattern of calluses may be discoid or linear.
- Focal palmoplantar keratoderma with oral mucosal hyperkeratosis is an autosomal dominant keratoderma that represents an overlap with pachyonychia congenita type 1 without the typical nail involvement.
- Punctate palmoplantar keratoderma is characterized by tiny "raindrop" keratoses which involve the palmoplantar surface, but may be restricted in their distribution.
- Palmoplantar keratoderma and spastic paraplegia is an autosomal dominant or x-linked dominant condition that begins in early childhood with thick keratoderma over the soles.
- Palmoplantar keratoderma of Sybert is characterized by a glove-and-stocking distribution with severe symmetric involvement of the whole surface and is extremely rare.
- Striate palmoplantar keratoderma involves the soles at birth or during the first few years of life.
Wednesday, May 22, 2013
My Fifth Toe Is Constricted!
In the African Yorub language, ainhum means "to saw or file" and in Brazilian dialects it means "fissure". The exact cause of ainhum is unknown and it not caused by infection, parasites, fungi, bacteria, virus, and is not related to an injury. Doctors speculate that walking barefoot as a child may bring on this deformity, but ainhum also occurs in patients who have never walked barefoot. Since ainhum has been reported to occur within families, race and genetics may be one component. It has been linked to inadequate posterior tibial artery circulation and the absence of a plantar arch.
What is known as a groove will form on the lower and internal side of the base of the fifth toe, usually along the plantar digital fold. Over time, the groove will become deeper and more circular. The rate at which this condition spread varies, and may progress to a full circle within a few months or take many years. In roughly 75 percent of patients both feet are affected, though not necessarily to the same degree. There has been no case where it begins on another toe, but occasionally the third or fourth toes are affected. The distal part of the toe will begin to swell due to lymphatic edema distal and look like a small potato. When the groove deepens, compression of nerves, tendons, and vessels occurs and the bone will be absorbed by pressure. The toe's connection to the foot will become increasingly slender and will spontaneously fall off without bleeding. It usually takes about five years for autoamputation to occur.
About 78 percent of those affected have pain, which increases with gradual pressure
Little can be done for those with ainhum. Incisions across the groove have proven ineffective. Excision of the groove followed by a z-plasty can relieve pain and prevent amputation in Grade 1 and Grade 2 lesions. For Grade 3 lesions disarticulating the metatarsophalangeal joint has helped. Corticosteroid injections are sometimes helpful.
To prevent ainhum, avoid walking barefoot.
Reference: Wikipedia
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Thursday, May 16, 2013
NFL Dreams Put On Hold Because Of A Bunion
Monday night Virginia Union athlete Kentrell Harris said that a bunion has put his NFL dreams on hold.
That's right. A bunion.
Harris is a 6-foot-4, 263 pound defensive end who had 6.5 sacks as a senior last year at Union. He was not selected during the NFL draft last month, but agreed to terms on a contract offer with the Oakland Raiders following the draft. When he arrived at rookie camp last week, his plans hit a snag.
The Raiders noticed Harris's bunion. "They already knew about it," said Harris. "But they looked at it, and they said to go ahead and get the surgery to fix it and they'd bring me back."
Harris played last year with the bunion and thought he would be fine playing in the NFL. "I only missed one game. It didn't get too bad, but sometimes, it gets to a point where I can't put a shoe on," Harris said.
Harris will have surgery on the bunion tomorrow, and was told rehab can take from four to six months. This is not Harris's first time dealing with a bunion- he had surgery to correct a bunion on his right foot during his freshman year, and the recovery time was much quicker than the anticipated time.
"I'm hoping this one won't take as long as they say, so I can get back out there. It is real frustrating. You get a chance to do something you have wanted to do your whole life, and then you have a setback like this," Harris commented.
Harris was just one of two Division II players asked to play in the NFLPA Collegiate Bowl in January in Los Angeles.
Reference: Daytona Beach News-Journal
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Harris is a 6-foot-4, 263 pound defensive end who had 6.5 sacks as a senior last year at Union. He was not selected during the NFL draft last month, but agreed to terms on a contract offer with the Oakland Raiders following the draft. When he arrived at rookie camp last week, his plans hit a snag.
The Raiders noticed Harris's bunion. "They already knew about it," said Harris. "But they looked at it, and they said to go ahead and get the surgery to fix it and they'd bring me back."
Harris played last year with the bunion and thought he would be fine playing in the NFL. "I only missed one game. It didn't get too bad, but sometimes, it gets to a point where I can't put a shoe on," Harris said.
Harris will have surgery on the bunion tomorrow, and was told rehab can take from four to six months. This is not Harris's first time dealing with a bunion- he had surgery to correct a bunion on his right foot during his freshman year, and the recovery time was much quicker than the anticipated time.
"I'm hoping this one won't take as long as they say, so I can get back out there. It is real frustrating. You get a chance to do something you have wanted to do your whole life, and then you have a setback like this," Harris commented.
Harris was just one of two Division II players asked to play in the NFLPA Collegiate Bowl in January in Los Angeles.
Reference: Daytona Beach News-Journal
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Wednesday, May 8, 2013
What Can I Expect With Hammertoe Surgery?
Before your surgery, make sure you have scheduled time off. While you will likely not require the full six weeks off, take as much time as you need until you feel comfortable. Your normal routine will be interrupted and things will take longer to accomplish, or may not get done at all, so expect more time to do tasks.
Hammertoe surgery can be done on an outpatient basis in our office or a surgery center using a local anesthetic, sometimes combined with sedation. The surgery takes about 15 minutes to perform. Up to four small incisions are made and the tendons are rebalanced around the toe so that it no longer curls. Patients can usually walk immediately after the surgery wearing a special surgical shoe. Minimal or no pain medication is needed following the surgery.
Icing and elevation of the foot is recommended during the first week following the procedure to prevent excessive swelling and to promote healing. It is also important that the dressing be kept clean and dry to prevent infection. Two weeks after the surgery, the sutures are removed and a wide athletic shoe can replace the post-operative surgical shoes. Patients can then gradually increase their walking and other physical activities.
Keep your bandages on as long as your podiatrist recommends and try not to get them wet. We sell in our offices a bag that goes over your foot and makes showering and bathing more convenient. Your podiatrist will tell you to lay off the high heels and other shoes for a bit, or even completely, until you are recovered. Hammertoes may come back on their own, based on your foot mechanics and structure, so there's no need in speeding up the process with impractical shoes. And no one wants to have surgery again!
If you're an athlete, take your time getting back into your routine. When you feel pain in the surgical area, stop your activity immediately. You wouldn't want to undo all the good work you've done!
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Wednesday, May 1, 2013
I Have A Hard Lump On Top Of My Foot
It's likely you've heard of ganglion cysts, soft, squishy lumps that appear on your feet. But maybe you've
noticed on the top of your foot a hard, bony bump. That certainly doesn't sound like it's a ganglion cyst, does it?
Because it's not! So what is this hard bump then? It's called a saddle bone deformity, or a metatarsal cuneiform exostosis. You're probably thinking to yourself, "But I've never ridden a horse before or come anywhere near a saddle! So how did I get this deformity?"
This deformity gets its name from where it appears on the foot. That fancy medical name tells us that it's on the metatarsals, the long bones that connect to our toes; cuneiforms are joints at the base of the metatarsal at midfoot; exostosis is a bony growth. So, we get the saddle name because this bony growth "saddles" the peak of the arch.
So how did you get it? Do you have high arches? Those with high arches are prone to this deformity, as well
as those with poor foot mechanics. If you've had an injury to this area before, you foot may develop the deformity. Finally, if the cuneiform joint moves around a lot, the bone may have formed to stop the joint from moving.
The bone buildup of the saddle bone deformity is typically not painful. However, it is the complications caused by the condition that make it uncomfortable. You'll find it difficult to put on shoes. During the summer, when you're likely to have open-toed shoes on, you'll feel it less, but with cooler weather and closed-toe shoes, your foot will hurt. This is because the shoe not only presses down on the bony bump, but also the peroneal tendon below. You may experience arch pain in your first and second toes.
To tell if you have a saddle bone deformity, try the Tinel's sign. Take your index and middle fingers and lightly tap the bump. If you have the deformity, you'll feel a tingling sensation around the top of your foot or in your toes. This is because of the pressure on the peroneal nerve.
If you're not experiencing a lot of pain, I would recommend changing your shoes to ones that do not rub or irritate your feet. However, if you are experiencing a lot of pain, your podiatrist will recommend removing the bony growth. It's a procedure that lasts less than one hour and you'll be able to put pressure on your foot immediately, which is unlike most foot surgeries. It will take up to six weeks to heal, but you'll feel better than new afterward!
Reference: eHow and Healing Feet.
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Because it's not! So what is this hard bump then? It's called a saddle bone deformity, or a metatarsal cuneiform exostosis. You're probably thinking to yourself, "But I've never ridden a horse before or come anywhere near a saddle! So how did I get this deformity?"
This deformity gets its name from where it appears on the foot. That fancy medical name tells us that it's on the metatarsals, the long bones that connect to our toes; cuneiforms are joints at the base of the metatarsal at midfoot; exostosis is a bony growth. So, we get the saddle name because this bony growth "saddles" the peak of the arch.
So how did you get it? Do you have high arches? Those with high arches are prone to this deformity, as well
The bone buildup of the saddle bone deformity is typically not painful. However, it is the complications caused by the condition that make it uncomfortable. You'll find it difficult to put on shoes. During the summer, when you're likely to have open-toed shoes on, you'll feel it less, but with cooler weather and closed-toe shoes, your foot will hurt. This is because the shoe not only presses down on the bony bump, but also the peroneal tendon below. You may experience arch pain in your first and second toes.
To tell if you have a saddle bone deformity, try the Tinel's sign. Take your index and middle fingers and lightly tap the bump. If you have the deformity, you'll feel a tingling sensation around the top of your foot or in your toes. This is because of the pressure on the peroneal nerve.
If you're not experiencing a lot of pain, I would recommend changing your shoes to ones that do not rub or irritate your feet. However, if you are experiencing a lot of pain, your podiatrist will recommend removing the bony growth. It's a procedure that lasts less than one hour and you'll be able to put pressure on your foot immediately, which is unlike most foot surgeries. It will take up to six weeks to heal, but you'll feel better than new afterward!
Reference: eHow and Healing Feet.
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Wednesday, April 24, 2013
The Doma, A Two-Toed Tribe
The Doma, also known as Vadoma, or Wadoma, are a tribe living in north Zimbabwe, in the Urungwe and Sipolilo areas on the Zambezi river.
A small minority of this tribe have something in common: they have a foot deformity condition called ectrodactyl. Ectrodactyl is a condition when the three middle toes are not present on the foot; only the outer two toes are present and turned in. This has resulted in the tribe being called "two-toed" or "ostrich footed".Ectrodactyl is an autosomal dominant condition derived from a single mutation on chromosome number seven. Those who have this deformity are not handicapped and integrate well into the tribe. The condition continues because of the small genetic pool among the Vadoma and tribal law that forbids marrying outside the tribe. It is believed this deformity may be a help in climbing trees.
Ectrodactyl is also known as a split foot malformation and it can be described as "claw-like". Those with ectrodactyl can also have hearing loss. It does occur throughout the world, in 1 in 90:000 births while limb defects occur in 1 in 1000 births. Ectrodactyl occurs in animals as well, affecting cats, dogs, mice, salamanders, cows, chickens, and others.
The Vadoma are an example of the genetic effects of a small population size and genetic defects with their deep inbreeding. They are also an isolated tribe, and have developed and maintained ectrodactyl better than other groups.
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Wednesday, April 17, 2013
What Shoes Are Good For My Bunion?
High heels. Stilettos. Pointy-toed shoes. Too-tight shoes. Too-small shoes. Yes, these are all shoes that will aggravate a bunion, yet my patients with bunions don't seem to realize the damage they are doing.
While bunions are not caused by the shoes you put on your foot, if you already have a bunion, you will be helping the deformity to progress much quicker. Here's why your favorite shoes are causing your bunion to get bigger:
- Tight shoes. Peep-toe and pointed-toe shoes are bunion's best friends! The tight and small toe box compresses toes together and leads to a slight or severe realignment of the big toe, which is a bunion. Try this: take your hand, and with your other hand, squish your fingers together. Now hold it there for 8 hours. How do your fingers, especially your thumb, feel after that? Probably not so good.
- High heels. Yes, we know, high heels make you feel sexy and feminine. How does that bunion make you feel? Still sexy? It's certainly very sexy to look at, isn't it??? Any time you put your feet in shoes higher than two inches, you are shifting your entire body weight forward, creating this massive pressure, up to seven times, and weight on your toes and balls of your feet. Ever wake up in the night and your arm has fallen asleep because you were lying on it funny? That's how your feet feel at the end of the day, after being in high heels.
- Flat feet. Flat feet are often something you cannot help- flat feet can be genetic. People with flat feet often wear ballet flats, which are just as bad as high heels and pointy-toe shoes as aggravating bunions! Ballet flats have no arch support and this makes a primo environment for a bunion to worsen.
Reference: APMA
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Wednesday, April 10, 2013
Will Yoga Help My Bunion?
When you have a bunion, you're sometimes so desperate to avoid pain, you'll try anything. Over-the-counter
remedies, medications, and herbal remedies, anything that will make that bunion stop hurting. Sometimes these remedies will help relieve the symptoms and pain, but they will not stop the progression of the bunion.
Some patients will ask if exercise will help their bunion, and while there are several types that will, most exercise will aggravate your bunion. For all yogies out there, good news! Yoga is one type of exercise that will help alleviate the symptoms of bunion pain.
Yoga instructor Jennifer LaRue Huget was asked by a client if yoga would reverse the progression of her bunion. The client had heard that by putting the affected foot up against a slanted wall or board and stretching out the other leg, you could stop bunions from forming.
Huget looked up in her favorite health book, Yoga as Medicine by Timothy McCall, but couldn't find the answer she was looking for. So she called McCall, editor of Yoga Journal, and asked him. He had never heard of the pose her client was talking about, but had heard of a pose that may help spread out the toes and metatarsals (Stand with feet side by side, a few inches apart and step the affected foot forward. Sickle your foot inward and rotate the heel inward and lower it down.).
McCall had heard of a woman whose bunion stopped progressing after she practiced a certain yoga move, but he couldn't remember which move it was. But, he acknowledged that bunions are a bone problem, and likely wouldn't be healed by yoga.
Yes, bunions are a bone problem with little that can be done to stop its progression. Patients who wear high heels or tight shoes can slow progression by switching to other shoes, and orthotics are often found to be helpful, but bunions are a mechanical problem with the bone.
"Once bones become altered, that wouldn't be very easy to change," says McCall, even with yoga and strength building exercises. "Spreading the toes and metatarsals, creating space, perhaps could undo some of the damage" done by wearing too tight shoes.
McCall feels that "People want to apply yoga in a quick-fix way. But to help with most chronic conditions, you need to establish a pattern of regular practice over the long term. If you have a bunion and you do yoga almost every day for the next several years, you will certainly feel better. But I don't think your bunion will be fixed."
Dr. Rock Positano, a nonsurgical foot specialist at the Hospital for Special Surgery in NYC, agrees. "When you develop a bunion, the big toe is not functioning as well as it should. So other parts of the foot, like muscles, tendons, and ligaments, have to take up that slack. Yoga gives more strength and flexibility to the area around the bunion and takes some of the stress off the big toe, making the foot work more efficiently. Anything that gives the foot more stability and more flexibility is good for a bunion deformity because it allows the other parts of the foot to pick up the slack for what the big toe is not doing."
I would have to agree as well. When starting a yoga regimen, I would not go in expecting that your bunion is going to be cured- the progression will reverse and it will disappear. The only way a bunion can be "reversed" is through surgery. Your pain, discomfort, and symptoms however, may be alleviated and you may be able to go longer before having surgery.
Reference: Washington Post and Allure.
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Some patients will ask if exercise will help their bunion, and while there are several types that will, most exercise will aggravate your bunion. For all yogies out there, good news! Yoga is one type of exercise that will help alleviate the symptoms of bunion pain.
Yoga instructor Jennifer LaRue Huget was asked by a client if yoga would reverse the progression of her bunion. The client had heard that by putting the affected foot up against a slanted wall or board and stretching out the other leg, you could stop bunions from forming.
Huget looked up in her favorite health book, Yoga as Medicine by Timothy McCall, but couldn't find the answer she was looking for. So she called McCall, editor of Yoga Journal, and asked him. He had never heard of the pose her client was talking about, but had heard of a pose that may help spread out the toes and metatarsals (Stand with feet side by side, a few inches apart and step the affected foot forward. Sickle your foot inward and rotate the heel inward and lower it down.).
McCall had heard of a woman whose bunion stopped progressing after she practiced a certain yoga move, but he couldn't remember which move it was. But, he acknowledged that bunions are a bone problem, and likely wouldn't be healed by yoga.
Yes, bunions are a bone problem with little that can be done to stop its progression. Patients who wear high heels or tight shoes can slow progression by switching to other shoes, and orthotics are often found to be helpful, but bunions are a mechanical problem with the bone.
"Once bones become altered, that wouldn't be very easy to change," says McCall, even with yoga and strength building exercises. "Spreading the toes and metatarsals, creating space, perhaps could undo some of the damage" done by wearing too tight shoes.
McCall feels that "People want to apply yoga in a quick-fix way. But to help with most chronic conditions, you need to establish a pattern of regular practice over the long term. If you have a bunion and you do yoga almost every day for the next several years, you will certainly feel better. But I don't think your bunion will be fixed."
Dr. Rock Positano, a nonsurgical foot specialist at the Hospital for Special Surgery in NYC, agrees. "When you develop a bunion, the big toe is not functioning as well as it should. So other parts of the foot, like muscles, tendons, and ligaments, have to take up that slack. Yoga gives more strength and flexibility to the area around the bunion and takes some of the stress off the big toe, making the foot work more efficiently. Anything that gives the foot more stability and more flexibility is good for a bunion deformity because it allows the other parts of the foot to pick up the slack for what the big toe is not doing."
I would have to agree as well. When starting a yoga regimen, I would not go in expecting that your bunion is going to be cured- the progression will reverse and it will disappear. The only way a bunion can be "reversed" is through surgery. Your pain, discomfort, and symptoms however, may be alleviated and you may be able to go longer before having surgery.
Reference: Washington Post and Allure.
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
Wednesday, April 3, 2013
What Is Podoconiosis?
The history of the condition goes back to the 19th century, when parasitic filariae were discovered to be the cause of elephantiasis, also known as tropical lymphedema. It was believed, at the time, that filaria was the sole cause of the disease, but it became apparent that the distribution of the two conditions did not overlap and scientists recognized that some forms of elephantiasis were not associated with filariae. Ernest W. Price, a British surgeon living in Ethiopia in the 1970's and 1980's studied the lymph nodes and vessels of those afflicted with the disease. Using a light microscope, he discovered macrophage cells weighed down with micro-particles in the lymph nodes of the affected extremity. Then, using an electron microscope, he found the presence of silicon, aluminum, and other soil metals. Price demonstrated that the lymphatic vessels of these patients experienced edema, and eventually collagenization that leads to complete blockage.
The primary symptom of podoconiosis is swelling and deformity of the feet and ankles. The swelling can be either soft and fluid, or hard and fibrotic. Multiple firm nodules will develop over time, as well as hyperkeratotic papillomata that resembles moss. Because of this, podoconiosis is also known as Mossy Foot. Before lymphatic failure, the patient may exhibit itching, burning, hyperkeratosis, plantar edema, and rigid digits. Like with elephantiasis, fusion of the toes, ulceration, and bacterial infection may occur. The disease has an acute component where some patients have moments of foot and ankle warmth, firmness, and pain.
Podoconiosis is most commonly seen in highland areas of Africa, India, and Central America. The highest rates of occurrence are in Uganda, Tanzania, Kenya, Rwanda, Burundi, Sudan, and Ethopia, where the prevalence is as high as 9%. Nearly four million people worldwide suffer from this disease. The incidence of podoconiosis increases with age, due to the cumulative exposure to irritant soil. It is rare to see podoconiosis in children 0-5 years old, and the incidence rapidly rises in the 6-20 age group, with the highest percentage in the 45 plus age group.
Prevention and treatment are characterized by avoidance of the irritant soil . Wearing shoes is the most crucial thing in preventing this disease and further deformity. In Rwanda, where the incidence of the disease is high, the government has banned walking barefoot in public to curtain soil-born disease like podoconiosis.
Even once the disease has begun, vigorous daily washing with soap and water, application of an emollient, and the nightly elevation of the affected extremity has been shown to reduce swelling and disability. Compression wrapping has been shown to be effective in other forms of lymphedema, but this therapy has not been proven in podoconiosis.
If you have a foot deformity, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.
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