A bunion, otherwise known as hallux abducto valgus, involves misalignment of the bones at the big toe joint and sometimes the joint within the big toe. This abnormal anatomy causes the boney prominence on the inside of the big toe. Conservative treatments vary, but surgery is the best treatment and extremely common. Some people avoid the surgery because they have heard stories and misconceptions. The surgery does typically require realignment of the bones through bone cuts and screws. The podiatrists at Coastal Podiatry Associates are well trained, having executed hundreds of bunion surgeries. The following statements are myths, especially when using Coastal Podiatry Associates.
Myth 1: Bunion Surgery is Extremely Painful
Bunion surgery is not different from other surgeries. In general, foot surgery can lead to increased pain due to swelling as the foot is below the level of the heart and blood can easily rush to the area. In addition, the foot has less soft tissue surrounding the bones, so moderate swelling can aggravate the nerves leading to pain. Swelling can be reduced through elevation and icing the affected foot.
Myth 2: Bunion Surgery Means a Cast and Crutches
Modern surgical techniques allow patients to mobilize quicker. Most bunion surgeries involve walking in a surgical shoe for six weeks. Mild surgeries can lead to an early return to shoes, while more complex surgeries may require casting and crutches.
Myth 3: You Have to be Off Work
As a general statement, this is not true. The amount of time away from work depends on the demands of the job and type of surgery. A patient can return to a sedentary desk job within two weeks of the surgery. However, jobs requiring excessive walking, standing, and physical activity may require a medical leave of absence.
Myth 4: Healing after Bunion Surgery Results in Unsightly Scars
Surgical healing is part of the process with any surgery. Newer techniques allow for smaller incisions and alternative surgical approaches may be used to hide surgical scars. Bunion incisions are either on the top of the foot or along the side, based on the surgeon’s technique. A surgeon may use a plastic surgery-type closure to minimize scaring.
Myth 5: Bunions Come Back After Surgery
Recurrence can happen after any surgery. The return of a bunion is no different, and it may be something that can happen over time. Patients that have excessive motion in the foot or do not reduce their risk for developing a bunion may experience a recurrence.
Septic arthritis is an extremely painful infection of a joint where germs infiltrate a joint and cause damage that leads to severe pain, warmth, and swelling. Bacteria and other microorganisms are the cause of septic arthritis and commonly target the knee, hip, or ankle. In the United States, 20,000 cases are reported each year in mostly young children and older adults. Septic arthritis is considered a medical emergency, as the microorganisms can destroy the joint in a few short days or can spread to other areas of the body.
There are four main causes of septic arthritis. The first is called contiguous spread. This occurs when a preexisting bone infection travels down the bone and reaches a joint. Direct implantation of bacteria can occur when a puncture or stab wound occurs in the joint. Heamtogenous source of septic arthritis develops when an infection enters the bloodstream from another area of the body and reaches a joint. The last cause takes place after joint surgery and is due to contamination.
Septic arthritis typically causes extreme discomfort and difficulty using the affected joint. Signs and symptoms can include fever, severe pain especially when moving the joint, swelling, joint warmness, and redness. Medications for other types of arthritis may mask the pain and fever. It is important to seek a doctor if these signs develop. It is especially important if signs and symptoms of infection such as fever and chills occur, as this may indicate a severe infection. To diagnosis septic arthritis, a doctor will consider the clinical presentation, vital signs, x-rays, and blood labs. Generally, septic arthritis is treated with joint aspiration, removal of infected tissue, and antibiotics.
Platelet-rich plasma therapy otherwise known as PRP, is an emerging trend in treatment for professional athletes. This treatment is extremely straightforward and preliminary studies display great benefits for treating plantar fasciitis. Plantar fasciitis is inflammation of the ligamentious tissue found on the bottom of the foot. It connects the heel bone to the toes and creates the arch of the foot.
PRP is blood that has been concentrated with platelets, growth factors, and other blood products. It is used to stimulate the healing of bone and soft tissue. The interesting fact about PRP, is that every part of the process involves a patient’s own blood. Blood is first withdrawn from the patient. It is then spun in a centrifuge to separate the blood into a platelet- rich component, platelet-poor plasma, and red blood cells. The concentrated platelet- rich component is then removed from the rest and injected back into a patient’s problematic areas. This process is nonsurgical and since it involves the patient’s own body, the chance for infection, rejection, or allergic reaction is greatly reduced.
The platelets found in the PRP injection contain proteins and other particles involved in the body’s self-healing process. A teaspoon or two of this injection contains 3 to 10 times the concentration of platelets from that of normal blood. Many times the injection is placed in locations where blood rarely reaches. This allows PRP to deliver the healing instincts of platelets without triggering the clotting response that platelets typically cause.
Since PRP is relatively new and only early studies have been completed, insurance coverage is not universal. If you are interested in this technique to treat plantar fasciitis or other foot pain, it is important to consult a trusted podiatrist. They can help determine the correct treatment path and help you return to pain free activity.
Feet are just like anything else, as they are used and time passes, change is inevitable. The average person takes approximately 10,000 steps per day, which can add up to more than 3 million steps a year. Each of these steps can place a force on your feet equal to two or three times your body weight. It is easy to see that with time, this extensive repetitive use can lead to several changes related to growing older.
Normal aging is associated with gradual stretching of the ligaments that support your foot’s anatomical shape. It is normal to notice your feet becoming wider and longer. This is generally combined with a mild settling of the foot’s arch more often noticed as a flattening of the foot. Another normal change is thinning of the skin on the bottom of the heel. This is from a reduction of a fat pad as the body loses its ability to retain water. Again, normal aging is the corporate. An increase in the stiffness of joints and a loss of joint range of motion may occur. Think back to the facts of taking 10,000 steps where 2-3 times your body weight is placed on your feet, this workload on your joints will cause a natural amount of arthritis that can lead to stiffness.
Some common foot changes are abnormal or pathological. These conditions tend to occur in association with prolonged use of ill-fitting shoes and extreme stress placed on the foot. They are most commonly noticed when people are in their 30s, 40s, and 50s. These problems do not occur naturally and can be slowed or prevented with the use of proper shoes and inserts. A bunion is the most common problem and is a large bump on the inside of the big toe. Another condition is a hammer digit, which occurs when the toe becomes curled or constantly bent. Bunionette is a term used to describe a large bump found on the outside of the smallest toe in addition to the toe pointing toward the rest of the foot. Calluses or corns can occur on the toes or foot in areas of high pressure points. If you notice these changes, it is important to get your feet checked by a doctor. Podiatrists are specially trained to treat these conditions and reduce the associated discomfort or pain.
While running can be great for a person’s overall health, it is harder on the feet than any other physical activity. Foot pain is common in both recreational and competitive runners. This is because the average person hits the ground with two to three times their normal body weight when they run. This pounding places considerable stress on the foot and ankle. According to the American Podiatric Medical Association, a 150-pound jogger will expose their feet to a total impact of 150 tons over the course of a three-mile run. To put this into perspective, a small compact car weighs about 1 ton.
To help the feet cope with this impact, proper footwear is crucial for preventing pain. Foot pain due to running can range from minor aches to serious injuries. Heel pain is due to a condition called plantar fasciitis. The plantar fascia is a band of tissue that connects the bottom of the heel to the base of the toes. This tissue becomes swollen and painful do to overstretching. Tendinitis is an irritation and swelling of tendons and can often affect the arch of the foot. It can be caused by excessive running or running too far too fast. Toe pain is common when running shoes are too small as the toes slam against the front of the shoe. Small shoes can cause toenails to turn black or fall off. Improper fitting shoes can also result in blisters, which form from friction between the skin and shoes.
Wearing running shoes specifically designed for the sport can help prevent many foot problems. Running shoes have extra padding to cushion the impact and are constructed to provide support and stability for the foot’s arch. Other methods to prevent pain include stretching, proper training increases, running on dirt terrain, and stopping once pain is noticed.
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