When a patient with a bunion comes to my office I often hear the same sad tale.  “My mother always made me wear shoes that were too small for me when I was a child.”  This rubs me the wrong way, because I know better.  First of all, I was raised in the South, and I know better than to blame mama.  Secondly, I know that the real cause of a bunion is usually not tight fitting shoes.  The most common cause of a bunion is genetics, and it pains me to say it, but you just might be able to blame Mama for that.

    A bunion is a foot deformity on the outside of your big toe joint.  Bunions develop over time due to improper foot motion and abnormal joint stress.  After awhile this motion and stress forces the bone and soft tissue at the base of the big toe into an abnormal position, creating a bony prominence (a bump, if you will) and instability. 

    Most bunions occur in woman (actually 9 times more than occur in men).  Since women generally wear tighter, higher-heeled shoes than men, it’s no surprise that many women blame their bunions on tight shoes.  The fact is that their XX chromosomes and family are mostly to blame.  Tight, high-heeled shoes may contribute to development of the deformity, can cause bunions to progress quicker, and they certainly make bunions more symptomatic.   Most women with a bunion can attest to the fact that daily wearing of peep toe, pointy toe, or very high-heeled shoes make a bunion very painful.  For those with flat feet ballet flats will usually feel more comfortable, but their lack of support can be a developing bunion’s best friend. 

    When choosing shoes, be reasonable.  I tell my patient’s that there’s nothing wrong with wearing those sexy Christian Louboutin heels to dinner or a nice event.  They just shouldn’t be your everyday shoes.  The APMA has given its Seal of Acceptance to shoes that have room for your piggies (and your bunion), a reasonable heel height, and a supportive arch.  To see the shoes with the Seal visit APMA.org/Seal. 

    So, the question remains, what can be done after you have a bunion?  There are several conservative options that patients can try as well as surgical correction.   I have already touched on better shoe choices, so I won’t belabor the point.  Get shoes that fit your feet- period.  You may also find padding and strapping devices helpful at relieving the pressure on an inflamed bunion.  At Advanced Food and Ankle Care we have several options in this category, and we can help in choosing the one that is right for you.  Often over the counter anti-inflammatories such as Ibuprofen provide pain relief from a bunion.  I often prescribe oral or topical anti-inflammatories for my patients, and I find that these offer satisfactory relief.  Custom orthotics are a great option, especially for an early or developing bunion.  These help correct mal-alignment problems and can keep a bunion from developing further.  They can also relieve some of the pressure on the great toe joint.  Cortisone injections can be very effective at relieving the painful joint inflammation a bunion can cause.  Some patients even find relief from physical therapy and yoga.  All of these conservative treatments can help relieve the pain caused by they bunion, but they will not get rid of the bump that is already there. 

    Surgery is warranted if your bunion is painful and interferes with your quality of life.  Your particular surgical procedure depends on where in your foot the deformity is originating from and how severe your bunion is.  The doctors at Advanced Foot and Ankle Care perform well over 100 bunion surgeries every year, and we would be happy to evaluate your bunion and decide which treatment would be best tailored to you. 

    In April 2013 the American Podiatric Medical Association (APMA) launched its spring campaign, “Beat Bunion Blues” with informative posters, a video, and even a Beat Bunion Blues Pinterest pinboard.  I will leave you with these 5 bunion facts, provided by the APMA:

#1. Bunions are two to nine times more common in women than in men.

#2. 55% of American women have bunions.

#3. Wearing high heels may increase your risk of developing bunions.  The narrow toe box and increased pressure on the front of the foot can put the toe joints out of alignment.

#4. 72% of Americans say that foot pain affects their daily life, but only 22% of Americans with foot pain have consulted a podiatrist.

#5. Up to 95% of patients who undergo bunion surgery are satisfied with the results.

If you would like to find out more about the APMAs “Beat Bunion Blues” campaign go to AMPA.org/Bunion.

Hillarie Amburgey, DPM

What is it?

A “Hammertoe” is an abnormal bending down of a toe so as to resemble a hammer or a claw. It is similar to other deformities such as “claw toe” and “mallet toe,” with the only difference being where on the toe the bending occurs.

What causes it?

Hammertoes can arise from a variety of causes. Genetics are thought to play a role. They can occur due to other deformities, such as from bunions. They can also occur from poor shoe choices, such as high heels and flip flops: the constant clenching of your toes to keep flip flops on your feet can accelerate hammertoe formation, and the extra pressure and that is put on your toes while wearing high heels can also cause your toes to retract.

What are the symptoms?

If a hammertoe is present, shoes can irritate the top of the toe, causing a painful corn. A callus may also develop on the ball of the foot under the affected toe.       

What treatments are available?

For some patients, conservative treatments such as specialized orthotics may relieve some of the pain associated with hammertoes. Shoe modification is important, so pick shoes that offer wider toe boxes and avoid high heels and flip flops.

For select patients, surgery may be necessary if the deformity is advanced. In this case, our doctors here at Advanced Foot and Ankle Care would be happy to discuss all your options with you and make sure that all other reasonable options have been exhausted.

 Dr. Eric Polansky

At the closing ceremony to the 2012 London Olympics, many around the world were shocked to see a reunion performance by the 90s pop group Spice Girls. Victoria Beckham, who was nicknamed “Posh Spice” back when the group was active, is known today for her fashion sense, particularly for her love of high-heeled shoes.

 Beckham’s love of high-heeled shoes has caused her problems with her feet, however. She was known to have developed unsightly bunions in both of her feet, and in the past stated that “the ugliest thing” about her were her feet. While I am unsure as to whether Beckham has had surgery to correct her bunions, I thought I would take a moment to dispel a common myth regarding bunion surgery.

 Many patients think that bunion surgery is performed by simply shaving away at the bony bump near the big toe. In reality, the bump that most people see is one of the bones of the foot protruding out due to abnormal positioning of the bones of the foot. Because of the way bunions form, surgery to fix bunions is not as simple as most patients would like. The surgery involves cutting and realigning the bones of the toe, and can make a big difference for patients who suffer from bunions.

 Not everyone with bunions needs to resort to surgery, however. Several other treatment options exist for patients whose bunions can be managed without surgery. If you suffer from bunions, make an appointment with myself or one of our doctors At Advanced Foot and Ankle Care who would be happy to discuss the best treatment option for you.

Jeffery Carlson, DPM

Stress Fractures are actually very common in the sports world. Just before the 2009 NFL draft, where he was drafted as the 10^th pick to the San Francisco 49ers, Michael Crabtree was diagnosed with a stress fracture to the left foot.

The Boston Celtics' Bill Walton has become a sort of guru to stress fracture sufferers. The injury interrupted his career three times, once almost ending it. "One of the hardest things about stress fractures for athletes is the mental uncertainty," says Walton, who suffered his first such injury in his left foot as a member of the Trail Blazers in 1978.

What Is Stress Fracture?

Stress fractures can be called an overuse injury which is most seen in athletes. It is commonly seen in the foot bones of athletes and caused by unusual or repeated stress”. These kinds of injuries are also called ‘fatigue fractures’. Technically wrong and rapid training can cause a stress fracture. Women seem to be high risk of foot stress fractures than men. Eating disorders, poor nutrition, and amenorrhea make women more vulnerable to stress fractures. Most times, stress fractures may appear like ‘hairline fractures’ but if you don’t take treatment at the right time, a re-injury can happen and that may end your sports career forever.

Symptoms of Stress Fractures

• You may feel pain or tenderness in a generalized area.
• There can be pain in the affected area in the night.
• Diffused swelling could be seen at the affected area. 
• A bruise is common but not always seen

Causes of Stress Fractures

• Obesity can be a catalyst in leading to this condition.
• Foot deformity such as hammertoe or bunion.
• Abnormal foot structure.
• Osteoporosis - This is a condition characterized by a decrease in the density of bone, which results fragile bones.
• Increased levels of activity, without proper conditioning can be another reason.
• Carrying out an improper, hard, and rapid training program develops stress fractures.
• Wearing worn or improper shoes can be a cause of this illness.  

Treatment 

• Rest is the best and only way to get stress fracture cured. It takes six to eight weeks to heal properly. This fracture occurs mostly in weight bearing bones. So obviously the healing may be delayed. If you resume the strain full activity before the fracture gets healed completely, bigger and harder to heal fractures may develop.
• Immobilization
• Muscle strength training can help recovery because it disperses the excessive forces transmitted to the bones.

Prevention of the stress fracture

• Don't go for rapid, hard, technically wrong exercises.
• Following a healthy diet which Includes Vitamin D and calcium-rich foods will prevent such fractures.
• Use good quality comfortable shoes for your foot. Buy inexpensive shoes and change them when they get a bit old and uncomfortable.
• When pain or swelling begins, stop the activity as soon as possible and rest for a few days. If pain persists, consult one of our physicians at Advanced Foot and Ankle Care at any of our four locations: Sidney, Piqua, Troy and Huber Heights, OH.

Dr. Jeff Carlson

Steven Tyler, of Aerosmith and American Idolfame, is a famous sufferer of a common foot problem known as a neuroma. A neuroma is a thickening of a nerve as a response to irritation, and can be very painful. Most people with this condition describe pain or tingling between their toes, most commonly between the third and fourth toes. The pain can also affect the ball of the foot, and usually gets worse when bearing weight on this area.

One of the most common causes of a neuroma is shoe choice. Women are more likely than men to develop a neuroma, due to wearing high-heeled shoes. These types of shoes crowd the toes together, and cause the nerves of the feet to become “pinched”. This pinched nerve will thicken due to pressure, and will cause pain. Because of this, switching to more sensible shoes, such as shoes with a low heel and wide toe box, is recommended.

Shoe choice is not the only to blame, as those with flat feet or high arches are more likely to develop neuromas. Neuromas can also be associated with bunions, hammertoes, and other foot deformities. Custom orthotics can help correct some of these problems, and thus decrease the chance of developing a neuroma.

For our patients at Advanced Foot and Ankle Care in Sidney, Ohio, with a neuroma, we recommend orthotics and three steroid injections over three weeks to take pressure off the affected area and get rid of the pain. This course of treatment works for the majority of our patients, but for the rest we prescribe an anti-inflammatory drug and recommend wearing a night splint for an hour a day.

In rare cases where these other treatments don’t fully get rid of the pain, we may recommend surgery to remove a portion of the irritated nerve. In this case, we will use your own stem cells taken from your blood to speed the healing process.

Eric Polansky, DPM