September 2022

When conservative, noninvasive methods prove ineffective, surgery may be selected as the next course of action for the treatment of your foot or ankle condition.  A wide number of foot and ankle surgical procedures exist, and it is up to your podiatrist to determine which intervention will be most appropriate and helpful for your case.  Some surgical procedures include bunion surgery, fusion, hammertoe surgery, heel spur surgery, metatarsal surgery, nail surgery, neuroma surgery, reconstructive surgery, skin surgery, and tendon surgery.  Typically, surgery is turned to as a definitive way to alleviate excessive pain or discomfort and to return your foot to full mobility.

Regardless of the location on the body, all surgical procedures require preoperative testing and examination to ensure the surgery’s success and preferred outcome.  A review of your medical history and medical conditions will take place, as will an evaluation of any current diseases, illnesses, allergies, and medications.  Tests such as blood studies, urinalyses, EKG, X-rays, and blood flow studies may be ordered.  Because the procedure involves the foot and/or ankle, the structures of your feet while walking may also be observed by your podiatrist.

Care post-surgery will depend on the type of surgical procedure performed.  Typically, all postoperative care involves rest, ice, compression, and elevation.  To improve and ensure a safe recovery, your foot and ankle surgeon may also employ the use of bandages, splints, surgical shoes, casts, crutches, or canes.  He will also determine if and when you can bear weight.  A timely and thorough recovery is a priority for both you and your podiatrist, and carefully following postoperative instructions can help achieve this.  

Morton's Neuroma, also called Intermetatarsal Neuroma or Plantar Neuroma, is a condition that affects the nerves of the feet, usually the area between the third and fourth toe. Neuroma refers to a benign growth that can occur in different parts of the body. Morton's Neuroma strictly affects the feet. This condition causes the tissue around the nerves that lead to the toes becoming thick, causing pain in the ball of the foot.

This condition can be caused by injury, pressure or irritation. Normally no lump will be felt, but instead burning pain in the ball of the foot will be experienced. Numbness and tingling may also occur. With the onset of this condition, a person may feel pain when tight or narrow shoes are worn. As the condition worsens, the pain may persist for days, or even weeks.

Persistent foot pain should always be a concern. The foot should be examined by a podiatrist if pain persists longer than a few days with no relief from changing shoes. The earlier the foot is examined and treated, the less chance there will be for surgical treatment.

There are some factors that can play a role in the development of Morton's Neuroma. These include wearing ill-fitting shoes that cause pressure to the toes, such as high heels. Also, high impact exercise may contribute to the cause of this condition. Morton’s Neuroma may also develop if the foot sustains an injury. Another cause includes walking abnormally due to bunions or flat feet. This causes excessive pressure and irritates the tissue. At times, people are affected for no determinable reason.

Podiatrists can alleviate the effects of this condition using a treatment plan to help decrease the pain and heal the foot tissue. Depending upon the severity of the Morton's Neuroma, the treatment plan can vary. For cases that are mild to moderate, treatments may include applying padding to the arch to relieve pressure from the nerve and reduce compression while walking. Ice packs can also help reduce swelling. The podiatrist may also create a custom orthotic device to support the foot and reduce compression and pressure on the affected nerve. The doctor will probably advise against partaking in activities that cause constant pressure on the affected area. They may provide wider shoes to ease the pressure from the toes. If these treatments do not relieve the symptoms of this condition, the doctor may use injection therapy.

Surgical treatment may be recommended by the podiatrist if all other treatments fail to provide relief. Normally, the podiatric surgeon will decide on either a surgical procedure that involves removal of the affected nerve or will choose surgery to release the nerve. After examination, the surgeon will decide on the best approach to treat the problem.

Recovery varies according to the type of surgical procedure. The patient will also be instructed on the best shoe wear to prevent the return of this condition, along with changes to workout routines, if this was a cause. Preventative measures are important in ensuring the condition does not return.

Foot Therapy for Sports Injuries

Athletes are used to engaging in high-intensity workouts. Consequently, athletes are at an increased risk for enduring foot or ankle injuries. The most common way to treat these types of injuries is the RICE method (Rest, Ice, Compression, and Elevation). However, braces and casts may be required in some cases. If you are suffering from any of these injuries, it is best that you seek help from your podiatrist right away.

Achilles Tendinitis

Achilles tendinitis is a type of overuse injury of the Achilles tendon, which is the tendon connecting the calf muscles to the heel. This type of injury commonly occurs in runners who increase the intensity of their workouts. Symptoms for this condition start off as a mild ache in the back leg or above the heel. Some people experience tenderness around the area in the morning, however this feeling tends to improve over time.  If you suspect you have Achilles tendinitis, you doctor may order an x-ray to show whether your Achilles tendon has calcified. Common treatment options for this condition include rest, ice, exercise, and non-steroidal anti-inflammatory medication.

Plantar Fasciitis

Plantar Fasciitis is a condition that is commonly found in women. It is a painful condition that occurs when the bands of tissue that connect the heel to the toes become inflamed. Symptoms for plantar fasciitis are heel pain that worsens in the morning and improves throughout the day with activity. Your podiatrist will diagnose plantar fasciitis by checking for tender areas on your foot. In rare cases, an x-ray may be required for a more thorough examination. There are various treatment options that may be used to help someone with this ailment. Depending on the specific case, some of these options include: physical therapy, shockwave therapy, and in rare cases, surgery.

Stress Fractures

Stress fractures are tiny cracks in the bone that occur due to repetitive force. These fractures are typically the result of overuse injuries such as repeatedly running and jumping. Symptoms of a stress fracture include pain when exercising, tenderness, and mild swelling. To diagnose a stress fracture, your doctor will likely ask you a series of questions about your overall health and the activities you are involved in. Next, an x-ray will likely be performed to check for the fracture. In some cases, fractures don’t appear on x-rays until weeks afterward. In these cases, an MRI or a bone scan may be required. Typical stress fractures may be treated by resting the area and taking a break from highly intense activities.  

Ankle Sprain

Ankle sprains occur when the ligaments that support the ankle are stretched far beyond their limits. These injuries occur when you roll, twist, or turn your ankle in an awkward way. Ligaments are essential in helping us move around because they are responsible for stabilizing the joints. Usually, sprained ankles occur due to ligaments on the outer part of the ankle becoming stretched. Symptoms of ankle sprains are swelling, bruising, instability of the ankle, and restricted range of motion. Normally, when people sprain their ankle, they will hear a popping sound during the injury. Depending on the severity, ankle sprains are graded based on how much damage has occurred to the ligaments. Grade 1 is mild, grade 2 is moderate, and grade 3 is severe.

When it comes to maintaining foot health, wearing properly-fitting shoes is important. While wearing the appropriate pair of shoes may seem like a trivial concern, the reality is that improperly fitted shoes cause an astounding amount of injuries to the feet. The overall structure and the biomechanics of our bodies are directly affected by our posture, gait, and feet. Because of this, pain and discomfort felt throughout the body are often related to a problem in the feet. And, most foot problems usually stem from improper footwear.

Shoes should not be purchased with the expectation that they will easily stretch and contort to the size and shape of your feet. When shopping for footwear, look for shoes that fit correctly and comfortably as soon as you put them on. Do not purchase shoes that are too large or that slip in the heel area when you walk. Do not choose shoes that are loose with the intention of wearing thicker socks to compensate for the space. The widest portion of the shoe, the ball of the foot, must be made sure to fit comfortably in the shoe. 

Keeping all of these suggestions in mind may be difficult when shopping and when trying to select from a wide array of different shoes. Nonetheless, your time and money will be wasted if you purchase a pair of shoes that are too uncomfortable for you to actually wear them. After finally selecting and purchasing a pair of shoes, try them on at home. To truly ensure whether or not your shoes fit comfortably with normal activity, walk around on a carpeted surface to determine how they feel on your feet.

The possibility of damaging your feet’s 33 joints, 26 bones, and 100+ ligaments is much higher than many people suspect. Finding an appropriate and properly-fitted pair of shoes is perhaps the single most important action you can take to maintain excellent foot health and help prevent injury. The fact that our feet continue to change with age is one that many people often forget. Even if our feet no longer change in size when we mature, our feet will still change in shape.

If you already have pre-existing foot problems, there is a greater possibility that wearing improperly-fitted shoes will worsen those problems. The good news, however, is that appropriate footwear is not difficult to find. While shopping for shoes, remember that improper footwear can detrimentally affect the feet, the entire body and its biomechanical structure as well. The shoes you wear can greatly impact your legs, back, and entire body, as your posture and gait are related to your feet. Finding and selecting the best properly-fitted shoes is necessary in achieving optimal health.