Foot News Blog

NEXT ALBUM:  Jacked Up Toe!!

A recent photo of rock star and American Idol judge, Steven Tyler, walking on the beach reveals a rather unflattering deformity of his 2nd toe.  The 2nd toe is crossed over, lying on top of his great toe.

 

So what causes this sort of problem and how did it happen?  Tyler had bunions of both feet, at least one of which was surgically corrected in the Spring of 2008.  What developed, either before or after the surgery, is an instability and severe contracture of the 2nd toe.  Frequently the second metatarsal bone is longer than the 1st metatarsal, causing the ball of the 2nd toe to bear more weight than the others when walking.  Inflammation of this joint can frequent develop, causing pain in the ball of the toe.  Over time, if this inflammation continues, the joint tissue on the bottom of the foot can stretch, eventually causing a hammer toe.  When a bunion is present, there is even more pressure under the ball of the 2nd toe, making the development of the toe deformity occur much faster.  Over time, the joint becomes unstable due to tearing or stretching of the capsule on the bottom of the ball of the toe, and the toe begins to drift over on top of the great toe. 

If this deformity is identified and addressed at the same time as a bunion, the progression of the deformity can be minimized; and as we can see in Mr. Tyler's condition, if left untreated, it can get worse even after bunion surgery.  When the deformity gets to this stage, surgery is necessary to repair the tissue on the bottom of the joint and stabilize and straighten the toe.  Overall the success rate is very good, although the one common problem following surgery is the inability of the toe to "rest perfectly on the ground" when standing.  This may make gripping a flip flop or sandal difficult.  If you have toe deformities or a bunion, they are easier to address when they are not as severe, with the outcome much more predictable.  Call us with any questions about your foot pains or deformities, so YOU don't have to "WALK THIS WAY."

Joba Chamberlain Out For Year

Yesterday, New York Yankee pitcher, Joba Chamberlain, sustained a compound ankle fracture/dislocation while jumping on a trampoline at home.  Known for being the fast ball hurler of the team, Chamberlain was recouperating from Tommy John elbow surgery, and was scheduled to return to action this summer.  The nature of his ankle injury involves not only a fracture of the ankle bones, but also a fracture involving bone exposure through the skin, and the ankle joint completely pushed out of its normal position.

The severity of this injury can not be overstated.  An open fracture, involving exposed bone, bears significant risks of infection, and a complete ankle dislocation bears the risk of lost blood supply to the bone in the center of the ankle.  If this occurs, potential long term arthritis can develop, resulting in potential debilitating pain.

It has already been determined that Chamberlain will miss the entire 2012 baseball season, with hopes of returning to baseball activities late in the year.

A BEAR, Tiger of a Problem

Well known golfer, Tiger Woods, recently sustained a set back in his recovery from left foot and leg problems by reaggravating his achilles tendonitis.  During an awkward stance at a golf event, he came up limping, having to withdraw from the tournament.  After seeing his doctors, it was revealed no damage had occurred, and that he had sustained a strain of the achilles tendon, with the potential of returning to golf events the following week.

What should be pointed out is the length of time required for adequate healing of ANY achilles tendon problem.  Some types of injuries continue to heal while still remaining active.  Muscle strains, ankle sprains, toe problems, all can improve while still being used.  The achilles tendon is a different animal.  The amount of strain and tension pulling on the achilles tendon is the absolute number one factor in the development of achilles tendonitis and bone spur formation around the achilles tendon attachment to the heel bone.  The achilles tendon possesses little blood flow in every one.  As a result, it takes a considerable amount of time for any injury or inflammation of the achilles to heal. 

While I have not seen nor evaluated his achilles tendon, it is for this reason that I have significant doubts as to Tiger's ability to finish the PGA Tour season in 2012.  If he wants to be sure to be able to play in the four Major tournaments this year, rest until there is absolutely NO pain would be my recommendation.

The age of patients with foot problems varies widely; I've removed ingrown toenails on a 6mo old, and have performed surgery on a 92 year old.  Through the years, I've seen women come in with foot pain of varying types and severities, the majority of which could be effectively treated with a good quality arch support and a sturdy walking shoe.  The resistance in following this recommendation, however, seems to grow with each decade of life.  Why?  It seems apparent that with each decade of life, the shoes women find both comfortable yet appealing must be lighter and lighter in weight.  Tell a 45yo woman that she needs to purchase a pair of good quality supports and wear a walking shoe regularly and there is little resistance nor problem.  Tell an 85yo woman the same thing, and you will be scorned!  "You can't be serious?  Those clunky things?"  It is not understood why, but the shoes I find most women prefer to wear from 70 years of age and older are usually slip on, have a flimsy sole with little support, and do not possess enough room for insertion of any type of arch support.  Vanity has its price!!  If one would simply start to wear a good walking shoe regularly, they would become more tolerable, and in turn, more comfortable.  As the adage goes, "It hurts when I do this."   --then stop doing that!

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