Posts for tag: surgical solution
Heel pain has many causes, but the results are always the same – pain. If you’re living with heel pain not brought on by an injury, you need to see a podiatrist for an accurate diagnosis. Pump bump (Haglund’s deformity), bursitis, heel spurs, and tendonitis are all common causes of heel pain and can lead to Insertional Achilles Tendonitis.
A tendon is a strong band of tissue connecting a muscle to a bone. There are over 1,320 tendons in the human body. The Achilles tendon connects the calf muscle to the heel bone (calcaneus) and helps lift the heel off the ground when walking. Achilles tendons are prone to both overuse injuries, such as tendonitis, and sudden injuries, such as a tendon rupture.
READ MORE: Kids and Heel Pain
Insertional Achilles Tendonitis is a condition in which the end of the Achilles attached to the calcaneus begins to deteriorate. Onset is slow, with pain occurring at first during activity and then progressing in severity until you are forced to discontinue activity. Swelling and redness will be present, and it may be difficult to stretch the back of your ankle.
Your podiatrist will begin with a physical examination of your heel and ask you about your activity level and the type of pain you are experiencing. Although deterioration will not show on an X-ray, your doctor may take them to check for fractures and bone spurs. MRIs are the ideal choice for imaging the tendon to see the exact severity and location of the deterioration.
Conservative treatments for Insertional Achilles Tendonitis include RICE (rest, ice, compression, elevation), stretching, use of orthotics, and physical therapy to strengthen the foot and ankle. Laser treatments can assist in pain management and promote faster healing times. Lasers have documented success in reducing bone spurs and preventing further degeneration of tendons.
READ MORE: Heel Pain? Arch Pain? Could be...
For severe pain and deterioration, a surgical solution may be necessary. During the surgical procedure, the tendon is detached from the heel, bone spurs are removed, the tendon is prepped, and the Achilles is reattached using the Arthrex SpeedBridge repair system. We use this innovative 4-anchor bridge because it allows for additional compression and stability which will increase your range of motion and speed healing.
If you are experiencing heel pain without an obvious injury, you need to see a podiatrist. Don’t wait until heel pain takes you out of the game and keeps you from the activities you love. Call the FAAWC today.
One minute you’re running down the field after the ball and in a split second your ankle twists and gives way. You fall, allowing the other team to score the winning point. Does that sound like a familiar scenario? For people dealing with ankle hypermobility, also known as weak ankles, this is a very real possibility.
What is a Sprain and Why is it Bad?
An ankle sprain occurs when the ligaments holding our ankle joint steady are stretched or torn, usually from a sudden twist such as a quick direction change or bad misstep. This can happen to anyone, but those with chronic instability will suffer repeated sprains, leaving ligaments looser each time. Cartilage and tendons are also affected by this trauma and arthritis can develop in the ankle joint. You can’t live an active lifestyle if your ankles can’t keep up.
READ MORE: Sprain or Strain?
Who Should Consider Surgery?
Minor sprains can be treated with RICE. Your podiatrist may also recommend physical therapy to strengthen muscles and tendons. Ankle braces should be worn for sports or any vigorous activity. If the ligament has torn completely apart, bracing and ankle exercises have not prevented further injury, or if you suffer two or more ankle sprains a year, you need to consider a surgical solution.
READ MORE: What is RICE?
Lateral ankle stabilization is the best approach to correct chronic ankle instability. Procedures are performed as an outpatient service (meaning you get to go home that same day) under general anesthesia. The surgeon will make an incision on the outside of the ankle over the joint. Separated or torn ligaments will be sewn together while loose but intact ligaments are shortened and tightened. The ligament is then anchored to the fibula bone using special stitches or pins. The surgeon may connect other tissues to the repaired ligament for support. The incision is then closed, and your foot is wrapped in a cast or splint.
Patients will need to remain non weight-bearing with the cast or splint in place for 2 to 6 weeks, after which they will progress to a brace or walking boot. At this time, physical therapy to strengthen the ankle will begin. Patients should wear an ankle brace during sports and activities for a minimum of 6 to 12 months, though many choose to continue using it long after for added safety.
READ MORE: Chronic Ankle Instability
You should never have to sit out of the game due to chronic ankle instability or hypermobility. Ankle sprains do major damage to your joints and preventing this is the number one step in living a healthy and active lifestyle. All of the FAAWC podiatrists are board certified for Lateral Ankle Stabilization and other corrective surgeries. Talk to your podiatrist today if you are tired of persistent ankle sprains.
Your toes are permanent roommates and if you’ve ever had a roommate, you know that people who live in close proximity need their space. Your toes are no different! When you crowd your toes by wearing pointed-toe shoes, high heels that put pressure on the front of the toes, or any shoe with a narrow toe box, it can lead to a hammertoe. What is a hammertoe? I’m glad you asked…
A hammertoe is an abnormal bend in the middle joint of a toe. It most often occurs in the second, third, and fourth toes. When your toes are curled under for extended periods of time, they begin to hold that shape. It may become painful to stretch or manipulate the toe and secondary issues such as blisters, corns, and calluses can arise. Improperly fitting shoes are a huge factor in the development of hammertoes. They are also more likely to develop in toes that have experienced a trauma, such as a bad break, jam, or stub. There are some genetic risk factors too, so let your podiatrist know if you have a family history of hammertoes (even if you haven’t developed one yourself). Arthritis and muscle imbalances are also causes of hammertoes.
READ MORE: Hammertoes
Women are more susceptible than men and the chances of developing this condition increase as you age. If your second toe is longer than your big toe, you will need to pay particular attention to the way your shoes fit and give extra space. Your shoes may also become uncomfortable due to corns or calluses that form on the bump of the toe. Use a pumice stone to reduce calluses and put a silicone or moleskin pad on the toe to avoid further rubbing.
Time is of the essence with a hammertoe. If treatment begins as soon as the toe begins to bend (when it’s still moveable), the condition can often be halted with simple methods such as toe exercises, roomier shoes, toe splints, or orthotics. If you allow your hammertoe to go untreated until it is fixed into position, which is what about 50% of our patients do, a surgical solution may be your only option. Your podiatrist might release or reposition the tendons and ligaments holding the toe curled or use pins and bone fusions to correct the bend.
The best thing you can do for your feet is to wear the proper shoes and make an appointment with the FAAWC immediately when you notice a hammertoe developing. We’re here to help.
READ MORE: Quick Tips for the Shoe Store
Last week we focused on ligaments and the ways we can sprain, tear, and stretch them. Today, we focus on our tendons, specifically the Achilles tendon. Achilles was a great hero of ancient Greece and the battle for Troy. Legend has it that he couldn’t be defeated in battle, but a single arrow to the back of the heel was enough to bring him down. If you’ve ever torn or ruptured your Achilles tendon, you know exactly why.
READ MORE: High Heels and Your Achilles Heel
A tendon is a strong cord that connects muscles to bones. The Achilles tendon connects your calf muscle to your heel bone and is the biggest tendon in your body. During recreational sports or heavy activity, the tendon may overstretch (causing pain) or tear/rupture (causing lots of pain). If your tendon ruptures, you might hear an audible “snap” or “pop” followed by severe pain and an inability to walk on the affected limb. While minor injuries can recover with rest and time, an Achilles tendon rupture may need to be surgically repaired to ensure proper healing.
Diagnosing an Achilles Tendon rupture is relatively straightforward. Your podiatrist may ask you to try pointing your toes, or they may feel around the calf for the tendon itself. In cases of a complete rupture, they may be able to feel a gap between the two ends. If there is any question about the severity of your injury, they may request additional tests such as an MRI or ultrasound to get a better look. Strains and ruptures can be treated with surgical or non-surgical options. Which you choose depends on a lot of factors so be sure to discuss your options thoroughly with your podiatrist.
Nonsurgical treatment of an Achilles tendon rupture involves complete immobilization of the foot and ankle. You may wear a cast or walking boot in combination with crutches to avoid weight-bearing. This path requires a minimum of six weeks for healing and can often take months with many follow up visits to your doctor. Tendons left to repair naturally are not as strong as surgically repaired ones so physical therapy and ankle strengthening will be important parts of your treatment plan. The chances of re-rupture are higher with non-surgical treatment.
The surgical solution for an Achilles tendon rupture is to have your podiatrist stretch and sew the two pieces of your tendon back together. While this sounds gross and invasive, it’s a fairly simple procedure. Surgical repair of tendons makes them stronger, lessening the chances of another rupture, and gives you more range of motion than a non-surgical option. Recovery time is shorter with a surgical fix meaning you’ll be back to the activities you love in no time! All of our doctors are well trained in the repair of Achilles tendons and can answer any questions you may have about your procedure or healing.
READ MORE: Achilles Heel Injuries in Gymnasts
Keeping your Achilles tendon strong and protecting your feet and ankles during activity can help reduce the chances of a strain or rupture. Perform calf-raises to keep muscles in shape and vary your activities, so you aren’t putting the same stresses on your feet all the time. Watch yourself during high-risk activities such as jumping or running. If you think you have strained or ruptured your Achilles tendon, call the FAAWC today. Our urgent care access means getting the care you need, right when you need it. Call 740-363-4373 today!
During winter time we don’t spend a lot of time looking at our feet, as they are usually bundled up in thick socks and warm shoes, but there are certain things we always need to pay attention to. One of those things is our toenails. Ingrown toenails occur when the toenail grows down into the skin, rather than outward as it’s supposed to. This condition is easily diagnosable since you can clearly see the skin growing over the nail. This may be accompanied by pain, redness, swelling, or even pus if infection is present.
Ingrown toenails occur on the big toe in nine out of ten cases, but other toes may be affected or even fingernails. Unfortunately, the majority of ingrown nails occur due to simple genetics. If you have larger-than-average toenails, but average size toes, this can lead to your nails growing down into the skin of your toe. People with particularly thick toenails or naturally curved nails may also be at higher risk of ingrown toenails. Although some ingrown nails may not be bothersome, secondary factors can exacerbate your condition to the point where you need to see a podiatrist.
READ MORE: Say Goodbye to Ingrown Toenails
One of the most common culprits of painful or infected ingrown toenails is improper nail cutting. Don’t cut your toenails too short, as this increases the chance they will grow into the skin. Nails should always be cut into a straight line, not a curve, to avoid edges progressing into the sides of your toe. Acute nail damage, such as stubbing your toe forcefully, can lead to misshapen nails that become ingrown. Ingrown nails may also develop if your toes are constantly squeezed together, either by tight shoes or conditions such as bunions that turn the toes toward each other.
Although cutting your toenail away from the skin might temporarily solve your problem, it will simply grow back the same way unless a surgical correction is made. Surgery is a scary word for most people, but fixing an ingrown toenail is a breeze and the procedure can actually be completed in a single office visit. First, a local anesthetic is applied, numbing the area so you remain blissfully ignorant to any feeling.
Next, the nail borders are removed; a fancy way of saying your nail is cut into a narrower shape and the folded skin is disconnected. In some cases, the entire toenail may be removed. Lastly, the nail matrix is chemically cauterized to eliminate the offending nail from growing back improperly. The matrix of your nail is the tissue it forms on and it is responsible for the length, size, and shape of the nail. The “cauterization” is actually just the application of a strong chemical that prevents the nail from growing back.
Almost all of our ingrown toenail treatments are done right in our office in a single visit (even if it’s your first visit). With a proper dressing and a loose (though protective!) shoe, most patients are able to resume normal activity within 24 hours, though extra care should be taken for several weeks while the toe heals. These procedures boast a 99% success rate with no ingrown toenail reoccurrence. Stop cutting away your painful ingrown nail and come see your podiatrist for a lasting solution. It’s really as simple as that.
READ MORE: Choosing Shoes to Avoid Foot Issues