Tag Archives: foot

Read This before having tight Rope procedure for your bunion

A bunion is caused when toe bones shift into the wrong areas of the foot.  When a person has a bunion, the first metatarsal bone will jut outward at the joint of the big toe and causes a bump on the outside of the foot.


This bump can become red and swollen and rub against the side of a shoe, which can cause considerable pain when standing, walking or running. In some cases, the bump can be so large and painful that a person is unable to wear shoes. A bunion doesn’t improve on its own; instead it only worsens over time, and can result in severe arthritis.


There are treatments available that can eradicate the painful deformity, but not all treatments are good ones.  In fact, people should avoid what is called “tightrope bunion surgery.”


Tightrope bunion surgery is when two small holes are drilled into the metatarsal bone through which fiberwire is threaded through to bind the first and second metatarsals together, pulling the first metatarsal into proper alignment. The idea is that tension of the wire will pull and hold the bones correctly.


While it sounds good on paper, what many foot surgeons or even hospitals don’t tell patients is that complications from tightrope bunion surgery can include loss of correction, loosening of the wire and fracture of the 2nd metatarsal during the surgery.  Now, you have a bunion and a broken bone.


Also, there are no long-term studies to validate tightrope bunion surgery, only loud marketing claims of a “miracle cure.” Don’t believe the hype.  The bottom line is that tightrope bunion surgery is a very bad procedure because the “tightrope” can pull on the metatarsals and cause them to fracture.


Does that mean people with bunions simply have to suffer?  Of course not.


An experienced foot and ankle doctor will recommend trying non-surgical remedies before having bunion surgery. Orthotics (in shoe orthopedic devices), changing shoe sizes and changing shoe styles may relieve bunion pain.


Only chronic bunion pain and/or bunions that interfere with daily activities are reasons to consider surgery.


An osteotomy is the most common type of bunion surgery. In this procedure, the foot and ankle surgeon makes an incision near the toe joint and returns the bones to their original position. At the same time, the ligaments surrounding the toe joint may be brought into balance.


Remember, any type of foot, leg or ankle pain is never normal. A foot and ankle doctor can examine your feet, leg or ankle and give you the best course of action.


Please call 626-447-2184 (Arcadia) or 818-408-2800 (San Fernando) to speak to a foot and ankle specialist about your foot, leg or ankle needs.

Achilles Tendon Rupture: A Painful Reminder You Are Not a God

If you’re an athlete of just about any kind and have been one for any length of time — and you’re a man — chances are you or another athlete pal of yours has suffered a ruptured Achilles tendon.

The Achilles tendon is that ropey fibrous tissue that connects your heel to the muscles of your lower leg. It’s named for the Greek god Achilles whose mother, the goddess Thetis, heard a prophecy that her son would die young. So she dipped him into the River Styx to protect him, yet she held him by his heels and his feet/ankles never touched the water, making that part of his body vulnerable. Achilles’ was struck on his “unprotected” heel by an arrow during the Trojan War, killing him. (According to Wikipedia.org, the first use of Achilles tendon to describe this part of the human anatomy took place in 1693 by Flemish/Dutch anatomist Philip Verheyen.)

If you’ve ever experienced an Achilles tendon rupture, you know how excruciatingly painful it can be. Some victims have described the pain as feeling as if they’ve been shot in that area.

A rupture of the Achilles tendon is not uncommon, although most people who experience the rupture are men (the ratio of Achilles tendon rupture sufferers is 20:1, men to women). Most rupture the tendon while playing sports, often when they jump up and land awkwardly. Yet ruptures can occur — rarely — when stepping off curbs or even tripping on high heels, so long as the force of the misstep or landing is powerful enough. Dancers also rupture these tendons relatively frequently (relative to the sports athletes).

An Achilles tendon rupture can be misdiagnosed as an ankle sprain; a podiatrist will examine the injured area and, if he or she feels a gap above the heel, a rupture has occurred.

You’ll more than likely not be able to walk very well or at all on the affected leg. You won’t be able to step off the ground; neither will you be able to stand on your toes.

Your podiatrist may recommend surgery. If so, the surgeon will make an incision on the back of your leg and literally stitch the tendon back to together. If your rupture was serious, the surgeon may take another, smaller muscle and wrap it around your Achilles tendon. This helps keep the tendon strong.

Non-surgical treatment  will probably see your foot/ankle pointed downwards in an enclosed cast for six to eight weeks.

To help prevent Achilles tendon rupture, be sure to stretch the back of your leg by the ankle each and every time before exercising any type of sport — and watch your step and jumps.

Watch a video about Achilles Tendon Rupture. Some pictures are very graphic .


Moles on the Soles of Your Feet? Keep an Eye on Them

If you’ve discovered moles on the soles of your feet, you may be wondering if you’ve cause for concern.

That depends on a few things. First of all, while not the most “common” place for a mole to show up, moles can and do appear on the soles of feet. In fact, moles can show up on just about any part of your dermis (skin), even between your toes and fingers, on your scalp under your hair, your armpits, and in private parts of your anatomy.

Moles usually appear as small, brown spots, often raised a bit from yours skin. But they can be flesh-colored, reddish-brown, dark or medium brown, even blue. Most are oval or round in shape and can be as small as a pinhead or as large as your entire limb (very rare), although most moles are smaller than ¼ inch.

You probably have between 10-40 moles on your body. They usually show up by age 20, but if you’ve had a mole since you were very young and are now approaching or beyond the age of 50, don’t be surprised if some of you moles disappear — most moles have a “lifespan” of about 50 years.

If you’re female, you may have noticed moles may change a bit with your hormonal fluctuations; many  women, for example, sometimes report an increase in the number of moles and a darkening in their established moles during pregnancy. Adolescent males also may see some changes in their moles.

You also can acquire new moles in midlife, so be vigilant and check your skin regularly because a change in the look, feel and size/shape of a mole can be one of the first sings of skin cancer.

In addition, you should also keep a close eye on large (the size of a closed fist, or larger) moles you’ve had since birth, as these could increase your chances of acquiring malignant melanoma.

If you notice a change in any mole on any part of your body, including the soles of your feet, you should have a medical professional look it over, as the change could be an indication that you may have cause for concern.

Melanoma, the most serious kind of skin cancer, often start as an abnormal mole. Is the mole painful? Does it itch or burn? Has it changed color, shape or its elevation above your skin? If so, you should definitely have it checked out.

If the changed mole is on the sole of your foot, you may wish to visit a podiatrist. You may want to see a podiatrist even if a mole on the sole of your foot hasn’t changed because a mole on that location can become agitated from the friction caused by just your daily living (walking). Changes in a mole, even those caused by an outside force (such as friction), take place at the cellular level. Cancer can occur when your cells change (mutate).

Your podiatrist will help determine if you’re a mole of on your sole should be removed.  A simple Punch Biopsy in the office can determine if this mole is benign or malignant. This usually takes 10-15 minutes but the ramifications of missing

Sprained Ankles and what to do before going to the doctor

If you’ve sprained your ankle, you should see a foot and ankle specialist such as a podiatrist.

But how do you know if you’ve sprained your ankle? And what should you do before you get to the doctor’s?

You can sprain your ankle doing “exciting” activities such as skiing; you also can sprain an ankle in your everyday, “mundane” life: many sprains occur stepping off a step or curb. Sprains, in fact possibly are the most common of foot and ankle injuries.

Sprains occur when you foot suddenly twists or turns sideways. Your ligament — the tissue that connects bones to other bones — gets stretched too far and becomes either totally or partially torn.

your sprain will either be an inversion sprain (when your foot twists inward) or an eversion sprain (when your foot twists outward). Most sprains (about 90 percent) are inversion sprains. You’ll feel the pain on the outside of your ankle; rarely will you feel it on your ankle’s inside with an inversion sprain.

If you’ve given yourself an eversion sprain, you’ll feel it on the inside of your ankle.

Many sprains don’t require a podiatrist’s or physician’s care. However, if you can’t walk at all on the ankle, if you see significant swelling, if these symptoms don’t go away after a few days, or if you have pain in your foot or above the ankle, you should see a health-care professional.

Don’t be too concerned if you have some swelling. That is normal and is to be expected. If you have considerable pain and considerable swelling, you may have fractured (broken) an ankle bone. A visit with your podiatrist or other health care professional definitely is in order if you’re in considerable pain so that he or she can x-ray your ankle to see if you’ve broken a bone.

If you feel you need to see a podiatrist or other health professional, here are some things you should do. This is known as RICE:

Rest: Curtail your activities for 28-48 hours after your sprain. Put weight back on the ankle gradually.

Ice: Put an ice pack on the ankle and elevate your foot for at least 20 minutes every three to four hours. Don’t ice your ankle for more than 20 minutes at a time; you could cause tissue damage.

Compression: Take an Ace bandage and wrap your foot from your toes, around your ankle and up to the top of your calf muscle. Overlap the wrap by half of the wrap’s width. The bandage should be snug, but not so tight that you’re cutting blood circulation off from your leg ankle. If you foot becomes blue, falls “asleep” or becomes cold, rewrap it.

Elevate: Keep your foot above your heart as much as possible. Get a footstool, wrap some books in a towel or blanket for cushioning, place the bundle on the footstool and place your lower leg on the bundle. Do the same at night. Either place thick pillows below your feet or — better yet — elevate the mattress with books or in some other way so that the mattress remains elevated.

If you have a torn ligament you will most likely be in a boot or cast for few weeks.  If you broke a bone and don’t require surgery then you will be in a cast for 2-4 weeks and then a boot for another 2-4 weeks.

The best way to prevent ankle sprain is to watch were you step. Avoid high heels (more than 2 inch).  Also do some ankle strengthening exercise on regular bases.  One of the easiest and most practical ankle exercises is to do the alphabets with your foot while watching TV.

Orthotics Can Alleviate or Cure Knee and Hip Pain

If you’ve pain in your knees or hips, you know how debilitating the pain can be.

But did you also know that tiny device you wear in your shoe can alleviate that pain, possibly even eliminate it?

The device is called an orthotic. It’s usually an arch support or insole custom made to fit your feet and your needs that you wear in your shoe.

An orthotic created just for you can change the distribution of force through your leg (from ankle, to foot, up to your hip), which can change how the force that’s applied to your hip and knee with every step you take is distributed.

Orthotics also can work as a cushion to reduce the force that’s applied to your joints as you walk. In addition, orthotic can change your foot’s alignment, which will result in a change in the alignment of your knee and/or hip.

Have you noticed that your shoes tend to wear out on the inside of the heals as time goes by? That means your foot pronates (turns inward) as you walk. Or, do you see that your shoes’ heels tend to wear down on the outside? You supinate; your foot turns outward as you walk, which by the way is normal.

Most of people pronate or supinate as they walk, with the majority of us who do so walking a bit on the inside of our feet (pronation). These aren’t readily obvious to the untrained eye.

one way you can tell if you pronate or supinate is to check the soles of your shoes. Another test would be to stand normal and have someone try to put a finger underneath your arch.  If you can’t put a finger under the arch you are flatfooted and you mostly likely pronate. If you can put two fingers under the arch you have an high arched foot and you are most likely a supinator.

Excessive pronation will cause your knee and hip to bend inward thus putting abnormal pressure to the inside of your knee and outside of your hip.  Excessive supination will do the opposite.

A well-made orthotic can help correct pronation and supination. Pronation and supination can cause hip and knee pain because they make your lower leg and knee rotate, causing pressure on the joints, which over time can cause pain. Orthotics help your feet hit the ground squarely, thus alleviating the rotation, the resultant pressure and the subsequent pain.

Your podiatrist more than likely will fashion an orthotic after examining your walking pattern, which we call it biomechanical examination and determining if an orthotic will be of help. Limb length discrepancy, pronation/supination, foot flexibility are amongst the most important measurements in this examination.

Your orthotics may be “soft,” “semi-rigid,” or “rigid.” Soft orthotics are best if your podiatrist determines that your knees and hips need some cushioning. Semi-rigid orthotics will give you more stability while still giving you support and some cushioning. Rigid orthotics will give you the most stability while with support.

It is also important what type of shoe you will be using the orthotics in.  This will tell your doctor what type of orthotics you need.

Your orthotics, naturally, will feel a bit foreign in your shoes for a few days. If you find your orthotics are still uncomfortable after two or three weeks, check in with your podiatrist; your orthotics may need some adjusting.  I recommend wearing your orthotics one hour the first day and increase by an hour each day.

If your knee or hip pain is worse after two or three weeks, you definitely need to check back with your podiatrist.

Some Tips on Preventing Ski and Snowboarding Injuries This Winter.

As winter approaches and you prepare for ski and snowboarding season, get your knees and legs in shape to prevent injury. You’ll enjoy the season all the more if you remain injury free.

You may want to start or continue a fitness program that strengthens your knees. Knee injuries are common among skiers and snowboarders because your knees and ankles are pretty much “locked” in place in your skis and board and, as your body twists and turns on the way down the hill – or if you should fall and your board/skis don‘t release your feet — the pressure on your knees can be intense, resulting in injury.

What kind of injury? A “minor” injury is known as  “menisucus tear,” where the cartilage in your knee is torn. Your knee will swell and the ultimate result could be a “locked knee,” where you are unable to fully extend the knee.

But you also could receive an “ACL tear,” where the anterior cruciate ligament (the largest in your knee) or even a complete dislocation of your knee. Either one is exceptionally painful.

A skiing fitness regimen for knees should include leg presses (for your upper quadriceps), leg extensions (for your lower quadriceps), leg curls (for your hamstrings), calf presses and, if possible exercises (or a machine) that works the inside and outside of your thigh muscles.

Be sure to also get your bindings checked so that they will release quickly should you fall.

As you ski, keep your knees flexed. If you find yourself falling, don’t straighten them — a straight leg hitting the ground puts more force on your knee than a bent leg.

Try not to stop your fall; flow with it. Fall forward; try to keep your arms up and facing forward. Falling backwards actually places an abnormal force across your ACL.

As your skiing, don’t jump unless you’ve been trained and have practiced at much slower speeds. You must be certain you will know exactly where you will land. You’ll also need to be sure you are going to land on both skis (if you’re skiing) at the same time.

Finally, always, always, always, keep your knees flexed.

You may want to consider wearing a knee/or ankle brace to help keep you knee and ankle stable. Visit your local podiatrist; he or she will help you determine if a knee or ankle brace is advisable. Your podiatrist also can help fashion a knee/Ankle/leg strengthening exercise regimen for you.

Foot Cramps During the Night and Day: What’s Going On?

If you’ve ever been awakened in the middle of the night by a cramp in your foot you know that the pain can be nothing less than, well, it woke you up didn’t it?

And if you have foot cramps during the day, you know that it can sometimes take several minutes for the cramp to dissipate.

What is going on, you’re probably asking? Why the cramp?

Although the real reason cramps occur is not completely known, but researchers have noticed feet tend to cramp after a person has done athletic activity — particulary if it’s new activity — and/or when the individual is dehydrated. Older rather than younger people tend to cramp more and many drugs (diuretics, for example) also can cause cramping (check with your doctor if the cramping is frequent or particularly painful to see if some of your medications may be causing the foot cramps). Pregnant women in the later stages of pregnancy sometimes experience foot cramps, as do those with an untreated under-active thyroid gland.

To treat your foot cramp, do just as your mother told you: stretch your foot in the opposite direction of your cramp until the pain subsides. Massaging your foot for five minutes or more also is a good idea.

You can leave it at that, or, if the pain was intense, take some aspiring or ibuprofen to relieve any remaining muscle pain. Elevate your foot, soak it in warm water, if you desire, wrap it in an elastic bandage if necessary and, if chronic, visit a health professional, preferably a podiatrist.

Night time foot cramps, like their daytime counterpart, may be caused by dehydration or lack of electrolytes. If you’re a high consumer of caffeine and you experience foot cramps regularly, you may want to cut down on the amount of coffee and other caffeine-filled beverages you consume. Caffeine acts as a diuretic and you could be becoming dehydrated without knowing it. Some health care practitioners believe a person should consume 16-31 ounces of water for every cup of coffee consumed to counter effect the caffeine’s diuretic properties.

Are you working out a lot and for long periods each session? Excessive sweating also can dehydrate you. Exercisers also lose salt when sweating and excessive salt loss can also cause muscle cramps.

You should drink plenty of water and, as added measure, try this stretching exercise: Stand barefoot before a wall. Wedge your toes up against the wall and feel the stretch.

In-toe and Out-toe Walking in Children

If you’re a parent who has noticed that your young child seems to walk with their toes pointing inward, you may be concerned that this “in-toe” walking will affect them as they grow.

You may rest assured that most in-toe walking (and even “out-toe” walking) corrects itself in time.

Also known as walking “pigeon toed,” in-toe walking often is caused by what is known as a femoral ante version, in which the top of the child’s thigh bone (femur) has an inwards twist.

For some children, in-toe walking is caused by an inwards twist to their shin bone (tibia), called internal tibial torsion.

Finally, a very few children with in-toe walking do so because the shape of their feet curve and hook inwards. This is called metatarsus adductus.

You may notice that your in-toe walking child may trip a bit more than children who do not walk in-toe. Again, most children outgrow in-toe walking by the time their around ages 7-8.

If, by chance your child’s in-toe walking is caused by the top of the femur twisting inward (femoral anteversion) and the condition doesn’t correct itself as the child ages, you needn’t worry that your child will not be able to play in sports or be physically active. Some children have a severe twist to their femur (this is very rare) that can cause pain at their knees and hips when they become teenagers. You may think of an operation to correct it.

Most in-toe walking decreases as the child ages and special shoes, braces or splints generally are not necessary to correct the condition.

Naturally, if you have any concerns at all, a health care provider, particularly a podiatrist, will be happy to take a look at your child.

“Out-toe” walking is even less common in children. As with in-toe walking, out-toe walking may be caused by the upper thigh or shin twisting outward. If your child doesn’t walk out-toe and then starts doing so, you’ll need to have him or her see a health professional for x-rays of the “lateral hip view” so that the a “slip” of the hip can be ruled out.

The best treatment for out-toe, as well as in-toe? As with the child who walks in-toe, braces, special shoes, etc. are unnecessary. Simple walking is best and, as time passes, most all in-toe and out-toe walking self-corrects as the child grows.

Foot and Ankle Problems Can Develop During Pregnancy

It’s not your imagination — feet can and do grow at least half a size or more during pregnancy.

As you know, your body goes through some significant changes over the months as you carry your child to term and even though most people don’t think their feet are affected by pregnancy, they are!

Have you noticed swelling of your feet? If so, you’re not alone. This swelling – also known as edema — is common during pregnancy, causing your feet to fill and retain fluid. You shoes may not fit and you also may be in some pain.

The edema is caused by your body’s need to increase the volume of blood flowing so that your growing baby receives enough nutrients to grow. More blood flow means possibly putting a strain on your veins and lymph glands, which means possible fluid retention.

Are the veins in your leg turning varicose (larger, blue and somewhat painful)? This also can be a result of increased blood flow to your fetus, as well as the growing baby’s position in your womb — sometimes putting a crimp on your abdominal veins ability to return blood from your leg to circulate back to your heart.

A skilled podiatrist can help you with the edema. He or she may suggest that you avoid standing for long periods of time. In addition, when seated or lying down, elevate your feet above your ankles with a pillow or comfortable stool. Be sure to exercise — walking is a great way to reduce the amount of fluid that builds up in your legs and ankles. Your pumping leg muscles literally “pump” the fluid away.

And, yes, as much as you love those beautiful shoes in your closet in your “regular” size, you may want to consider purchasing larger shoes. Wearing too-tight shoes not only is uncomfortable, but it also restricts blood flow.

Do you feel your feet have “flattened?” Hormones that ready your body’s ligaments for labor by relaxing them can cause this in the later stages of your pregnancy. Your pelvic bones become more flexible as your body prepares for your baby to exit the birth canal. The ligaments — the fibrous tissue that connects muscle to bone — on your legs and even your feet also loosen, so the feet arches may become a bit flatter.

As your weight increases as pregnancy continues, some women can be at risk for plantar fasciitis. There’s a strip of tissue on your arch known as the plantar fascia which can become strained as your feet flatten. Chronic inflammation can result. You will need to visit a medical provider — preferably a podiatrist — for treatment.

Most often Custom made Orthotics is the best treatment for this condition. Your podiatrist will be the best source to have this discussion with.

The good news is that most foot and ankle problems that occur during pregnancy go away once the baby is born or soon after. Your pre-pregnancy shoe size may never return, but most women report it’s a minor price to pay for the wonder of bearing and giving birth to their children.