Huber Heights Office
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.
What do Albert Pujols, Kobe Bryant, and Eli Manning have in common? Besides all being athletes, they have all suffered from plantar fasciitis. Plantar fasciitis is the most common cause of heel pain in adults, and has affected many professional athletes during their career. Unfortunately, this condition also occurs in many adults who are not athletes, so read on to learn more about what plantar fasciitis is and how it is treated.
What is the plantar fascia anyway?
The plantar fascia is a thick band of tissue that runs from your heel bone to your toes. It helps support the arch of your foot. Plantar fasciitis results from stress to the tissue, and can be very painful.
What are the symptoms?
Most patients with plantar fasciitis complain of pain in their heels. Often, the pain is worst when getting out of bed in the morning, but gets better as you walk throughout the day. As the tissue stretches throughout the day, it becomes less painful to walk. Resting allows the tissue to return to its pre-stretched state, which makes the pain come back.
What treatments are available?
There are several treatments for plantar fasciitis. Conservative treatments include icing and stretching the plantar fascia. Orthotics and physical therapy might be needed for some patients. Others still might need a night splint, which is a device that keeps your foot in a fixed position overnight to help stretch the tissue.
Many patients know that corticosteroid shots in the heel can help with the pain of plantar fasciitis. While this is true, repeated shots to the plantar fascia can do more harm than good, so not all patients need cortisone shots.
Finally, it is important to talk to your doctor if you have heel pain, because several conditions can cause pain in the heel. If your heels hurt, make an appointment with any of our doctors for an examination and discussion on the best treatment options for you.
One of the most common injuries we see in the office is broken bones. Broken bones, also known as fractures, can occur in the bones of the leg and the foot, and often require us to place a patient in a cast in order to promote the best alignment for healing. When I put patient’s in a cast, I get many questions about the process. Here are some answers to the more common questions I hear in my office:
How long will it take for my bone to heal?
How long will it take for my bone to heal?
Broken bones take a while to heal, and healing times can vary due to the type of injury and the bone that is broken. Age, gender, and overall health also can play a role. It is important to keep your cast on for as long as your doctor recommends, to achieve the best outcome when it is finally ready to be taken off.
How will you take the cast off? Will it hurt?
How will you take the cast off? Will it hurt?
Casts are removed with a device called a cast cutter; the cast cutter has a circular head that vibrates very rapidly. Many patients do not like this part, because they fear that the cast cutter can injure them. In truth, while the cast cutter can be quite loud, it cannot hurt you. It is designed so that it can easily cut through a cast, but is not able to break skin.
While in a cast, your muscles don’t need to do as much work as they need to, and they can get weaker. For this reason, we recommend physical therapy after the cast is removed to strengthen the muscles and help you return to your proper level of activity. If you have any questions after reading this, do not hesitate to call our Piqua office.
With the Summer Olympics fast approaching I remember one of the greatest and most memorable Olympic moments in history. For the 1996 US women’s gymnastics team to have a chance at gold, little Kerri Strug would have to nail her vault. The unthinkable happened as Kerri completed her first of two vaults; she fell while landing, ripping ligaments in her ankle. She then ignored her injury and stuck the landing of her second vault. Who can forget her collapsing to the floor in pain after securing the American team its first ever Olympics gymnastics gold?!? Kerri Strug went on to become one of the most recognizable faces of the 1996 games. What a great ending, right? Well, if this really was the end of the story, it would be. But it wasn’t.
In 1997 Sports Illustrated wrote about Strug, “A year after her Olympic vault to fame, Kerri Strug now carries herself stiffly and walks with a trace of a limp. Physical therapy took a backseat to making appearances.” A lot of people are like Kerri Strug and see a sprain as a minor injury that they can struggle through without treatment. They don’t take time out of their busy lives to treat the injury, and they end up paying for it later. This time of year is the height of the ankle injury season at Advanced Foot and Ankle Care, and we have all of the experience, diagnostic and treatment tools to get you back on your feet and enjoying the rest of your summer.
To understand how to adequately treat an ankle sprain first we should start at the beginning and understand the injury itself.
Anatomy of an Ankle Sprain:
The ankle bones are held in position by ligaments. The ligaments protect the ankle against abnormal movements like twisting, turning, and rolling of the foot. Ligaments are elastic within their limits, but when they are forced beyond their normal range, a sprain occurs. Sometimes the ligaments even tear, and you may hear a popping sound. Pain and swelling soon follow. Sprains are given grades 1, 2, and 3, increasing in pain and swelling along with ligament injury from stretching to complete rupture.
Diagnosing the Sprain:
The first step in treating an ankle sprain is properly diagnosing it. At Advanced Foot and Ankle Care we have several techniques to properly diagnose ankle injuries. The most important technique we employ is the history and physical examination. By listening to our patients’ mechanism of injury and examining their injured foot and ankle we usually have a good idea of what we’re dealing with. We also take x-rays to rule out a break in the bones. The diagnostic ultrasound machine is often used to evaluate tendons and ligaments for ruptures and tears. It’s also possible that an MRI might be ordered to confirm our diagnosis if we suspect injury to the joint surface, a small bone chip, or a very severe injury to the ligaments and tendons.
Treating the Sprain:
We treat ankle sprains based on their severity or grade.
Grade 1 sprains should be treated with rest using a special boot called a CAM boot, icing, a compressive wrap, and elevation. After a patient has healed enough that a CAM boot is no longer necessary they may find a non-custom brace helpful as they transition back into normal physical activity.
Grade 2 sprains are again treated with rest using a CAM boot (possibly with the addition of an assistive device such as crutches), icing, compressive wraps, elevation, non-custom bracing, and physical therapy. Physical therapy is an invaluable part of treatment to regain strength and range of motion after ankle injury. Adequately rehabilitating an ankle sprain goes a long way toward preventing reinjury to the ankle.
Grade 3 sprains may be treated the same as Grade 2 sprains but could possibly require surgical repair. Physical therapy is of even more importance in these high grade injuries, and a custom brace may be helpful for walking on uneven surfaces or performing sporting activities that require sharp, sudden turns (cutting activities) like tennis, basketball, or football.
Healing an ankle sprain can take as long as healing a broken ankle bone. Lower grade sprains usually take 4-6 weeks to heal, and higher grade sprains can take months to feel back to normal. It may even be several months before you are able to return to sporting activities. 40% of those with acute ankle sprains will develop chronic symptoms of ankle dysfunction such as pain, swelling, recurrent injury, and weakness. The healing process can be slow, but it’s so important to be patient and seek the proper treatment to avoid these problems.
Hillarie Amburgey, DPM