Archive | Bunions RSS feed for this section

Introducing “Walk Away” Bunion Surgery

23 Mar

A zero downtime bunion procedure is now a reality.

PA Foot and Ankle Associates is the first podiatric practice in the Lehigh Valley (and one of only two on the U.S. east coast) to offer a revolutionary new bunion correction procedure called the FastForward System. FastForward offers minimal discomfort, minimal scarring and no downtime for the patient.

fast-forward-bunion-procedure

Dr. Adam Teichman, Senior Partner at PA Foot and Ankle Associates comments, “We continue to offer innovative approaches to podiatric medicine with the FastForward System. This bunion procedure allows a patient to resume their lifestyle much sooner, and helps to dispel the myth that bunion surgery is painful and requires a patient to be off their feet feet for long time.”

Why is FastForward revolutionary?

A bunion, known medically as a Hallux valgus deformity, is a prevalent and debilitating foot condition that affects 23% of people age 18-65 each year. Prior to the invention of FastForward, a bunion was treated surgically by means of a bunionectomy. This foot surgery used a series of bone cuts and bone screws to realign the first metatarsal – the longest bone in the foot – with the big toe. As cuts to realign bone are by their nature traumatic, bunionectomies require the patient to stay off of their feet for a period of days, followed by a recovery period of 1-2 months. The larger the bunion deformity, the more aggressive the procedure, leading to longer recovery time and downtime for the patient. With the FastForward procedure, a patient can walk immediately after surgery (in a protective shoe) and can be back in a sneaker in 2-3 weeks.

FastForward also eliminates certain painful complications which occur in some bunionectomy patients – namely, intolerance to bone screws or bones which don’t heal correctly. These complications often required a 2nd surgery to correct.

FastForward bunion procedure uses 3D printing technology

The key to this new bunion procedure is the FDA-approved FastForward Bone Tether Plate. The unique design of this medical device, achieved through 3D printing technology, allows an as-close-as-possible match to the anatomy of the second metatarsal (3D printing allows for the fabrication of devices with complex geometries). Working through a tiny incision, the podiatric surgeon anchors the FastForward Bone Tether Plate to the 2nd metatarsal, wraps the 1st and 2nd metatarsals with suture tape, and then safely pulls the bones and big toe into proper alignment. Less drilling and bone cutting means a quicker recovery and less pain for the patient.

Previous bunion correction procedures which pulled the metatarsals into alignment, required drilling into the 2nd metatarsal, subjecting it to significant stress. For some patients, this resulted in fractures of the 2nd metatarsal. The FastForward Bone Tether Plate eliminates that complication, as it conforms to the shape of the bone and requires no drilling of the 2nd metatarsal.

More info on FastForward Bunion Correction

Advertisements

Which physician is best to treat foot and ankle pain?

25 Jun

We sure take our feet and ankles for granted, don’t we?

best doctor for foot pain ankle pain toe pain

That is, until the Millenium Falcon breaks our ankle, or a foul ball clips our right foot. Ouch.

When your feet are painful, you’re miserable. Your lifestyle is instantly affected – pain forces you to dial back or give up walking, running, dancing, standing, or your favorite sports. Prolonged pain might even cause you to go from star athlete to couch potato.

It’s appropriate to visit the ER if you have an unusual amount of pain in your feet or ankles, especially if the pain is sudden and intense, is accompanied by bleeding or swelling, or if your foot and ankle have been involved in a trauma like a fall down the stairs. Or if you tried to break a cement block in half with absolutely no martial arts training.

For less painful events, like a suspected fracture, or wounds that won’t heal, many people choose to see their primary physician, which may or may not be a good choice, depending on that  physician’s field of expertise.

And for even less worrisome injuries, like a minor sprain, or minor heel pain, some seek no medical attention at all – which is never a good idea, as both injuries can develop into more complicated conditions, especially for athletes.

Which doctor is expert in treating foot and ankle problems?

When you have trouble with your ears, you should see an ENT. Trouble with your knees, an orthopedist. When you have pain or discomfort in your feet, toes, or ankles, you should see a podiatrist.

Podiatrists and podiatric surgeons are trained exclusively in the treatment of foot and ankle disorders – they do nothing but study the foot and ankle, it’s diseases and deformities. After all, 1/4 of all of the bones in your body are in your feet, and there are many conditions unique to this area of the body. That’s a lot of ground to cover in med school. If they choose to be a podiatric surgeon, they complete further schooling to study surgical techniques to correct these problems.

In 99% of cases, a podiatrist can resolve your ankle, toe, or foot problem much faster than a general physician. Podiatrists are also expert at spotting the early signs of diseases you can easily overlook, like diabetic foot disorders, rheumatoid arthritis and cardiovascular disease.

Without your feet in good working order, your life can be…. well, challenging. Don’t take them for granted.

If there was a report card for foot care, you’d get an F

11 Jun

Unfortunately, when it comes to foot care, most of you are failing miserably. Well maybe not YOU, because you’re reading this, but everyone else is failing…

foot pain foot health

The American Podiatric Medical Association has released a very illuminating survey on American’s attitudes and experiences concerning their foot health. The results are very surprising to us in some ways, and completely predictable in others, based on the patients we see. Unfortunately, your feet continue to rank low on the list of body parts you consider important to your well-being, and you’re paying less attention to them than you should.

The survey, released in March, shows that 8 out of 10 of you have experienced foot pain at some time in your life. Those of you who’ve experienced foot pain on a regular basis, also report regular issues with other health complications, primarily back pain, eyesight issues (probably diabetes-related), arthritis or other joint pain, weight issues, knee pain, and heart and circulatory disorders.

Half of you said that foot pain has restricted your activities in some way: walking, standing for long periods, exercising, sleeping, going to work, or playing with your children or grandchildren.

You said that you understand how important foot health is, and that consistent or chronic foot pain can indicate other health problems.  You also said that you understand what a complex mechanism the foot is and that a podiatrist is best qualified to treat your foot pain.

However….

You also reported that you have little knowledge of or experience with podiatrists. When a foot problem arises, you’re more likely to visit your primary care physician for help, or try and treat it on your own. But those of you who have visited a podiatrist give them high marks for care and are more satisfied with the outcome than those of you who were treated by your primary care physician.

This last fact highlights a common misperception about the healthcare system – that your primary care physician is some kind of wizard who knows how to treat every conceivable ailment. While we respect our fellow physicians, every MD’s training is different. Primary care physicians are a sort of first line of defense and are trained to identify and treat the most common illnesses and complaints in the population. They’re also trained to flag unusual symptoms and to refer out injuries and disorders which are best treated by a specialist. Yet 60% of you say that you would talk to your PCP about a foot condition before seeking advice from a podiatrist (we understand however, that some insurance plans require this). Hello? Podiatrists know more about foot and ankle injuries and disorders than any other physician. When given the choice, always opt for a specialist.

Shame on you: Only 32% of you report doing foot, ankle, or leg exercises to keep them strong, and only 43% wear proper, supportive footwear (that explains all of the comments/questions on our blog post about why your feet hurt). Speaking of footwear, 71% of women who wear high heels experience foot pain which they directly attribute to wearing high heels. Yet they own NINE PAIR (!).

Unfortunatley, nearly 50% of you experiencing foot pain wait until it’s severe to see a podiatrist. Most of you don’t even consider a visit to a podiatrist for conditions like persistently sweaty or odorous feet, blisters, pain from high heels, hammertoes, problems with your toenails, or even diabetic wound care. Yet each of these conditions can indicate a more serious potential problem or set of problems. Treated early and properly by a podiatrist, your pain and discomfort can be relieved without further complications. In fact, 34% of you said that a podiatrist helped you identify other health issues such as diabetes, circulatory issues, or nerve damage.

But what is up with the fact that only 74% of you report keeping your toenails trimmed?  OMG! What are the other 26% of you doing? Do you have man servants to trim your toenails for you? Or extra long shoes to accommodate your lavishly long toenails?

Click here to read the entire APMA survey.

What Your Feet Tell You About Your Health

28 May

foot health

Seems to us that every general physician should ask you to take your socks off. Even if you’ve gone to see your doctor complaining of a chest cold, an inspection of your feet might inform them of the early symptoms of many conditions.

Our feet are farthest from our hearts and spine, so in many cases they’re the first area to indicate problems with the nerves or circulatory disorders. The brain and internal organs receive blood before our toes and feet do, so our appendages are the first to suffer.

Nine health problems which first show up in your feet

1.Always cold feet could be a sign of hypothyroidism, a condition in which your thyroid gland is underperforming. Most common as we approach middle age, hypothyroidism can also cause hair loss, fatigue, weight gain, and depression. A simple blood test ordered by your doctor can confirm this condition, and daily oral medication can get your thyroid gland functioning properly.

2. Suddenly hairless toes and feet could be a sign of a circulatory disorder, as your feet may not be receiving enough blood flow to sustain hair growth. Your doctor should check for a pulse in your feet, and if she has any doubts, should order a thorough cardiovascular screen.

3. Foot cramps that won’t quit may indicate a nutritional deficiency or dehydration. Sure, everybody’s feet cramp up now and then, but what matters is how often and how severe. If you exercise a lot, make sure you drink plenty of water to hydrate your muscles. You also should eat a balanced diet with plenty of potassium, magnesium, and calcium, as a lack of these nutrients can also cause cramping (good sources are nuts, leafy greens, and dairy). To relieve cramps in your feet, stretch your toes up, not down. If the cramping in your feet just won’t let up, see your podiatrist so that he or she can test for circulation issues or nerve damage.

4. Yellowing toenails is a sign of aging, but may also indicate a fungal infection. Yellowing can also occur when you wear nail polish for months without a break. If your toenails are flaky or brittle, you probably have a fungal infection and should see a podiatrist for treatment.

5. Flaky, itchy, or peeling skin between your toes is a sure sign of athlete’s foot. Even if you’re not an athlete, it’s easy to pick up a case of athlete’s foot if your feet are crammed in shoes all day or you walk barefoot in common areas like a sauna or swimming pool. Use an over the counter creme to relieve the symptoms, but if your flaking, itching, or peeling continues, you may have psoriasis or eczema. Your podiatrist can determine which is which and suggest a course of treatment.

6. Your big toe suddenly becomes swollen and painful. This is an almost sure sign that you have gout, a condition that inflames the joint. But it might also indicate inflammatory arthritis or infection. If it’s due to trauma, like someone landing on your foot after a jump shot, well, you’ll probably figure that one out.

7. A sore on your foot that won’t heal is a common side effect of diabetes, skin cancer, or circulatory disorders. In the case of diabetes, blood glucose levels that have raged out of control for long periods lead to nerve damage and small blood vessel damage, which in many cases appears first in your feet.  If the sore gets infected, it can lead to an amputation. But a sore on your foot – even between your toes – can also indicate certain kinds of skin cancer, so be sure to have it checked out by your podiatrist as soon as you discover it.

8. A slowly enlarging “growth” aside your big toe is probably a bunion. Faulty, inherited foot structure leads to this common foot deformity, which can be exacerbated by poor choices in footwear like high heels and flip flops. Unfortunately, bunions rarely stop growing, so that small, slightly sore bump today may be quite large and painful years from now. The only sure way to correct a bunion is with surgery. Splints, toe separators, and the like are temporary measures which will relieve symptoms, but won’t stop the deformity from becoming worse.

9. Pain in your heel may indicate plantar fasciitis, an inflammation of the tissue which connects your heel to your arch. If you have a sharp pain in your heel when you get out of bed in the morning, which slowly subsides as you move around, you probably have PF. There are many causes of plantar fasciitis, but primarily poor footwear, obesity, or working out too aggressively are to blame. To relieve minor symptoms of plantar fasciitis, ease up on your exercise program, lose weight, or wear shoes which support your feet properly. If symptoms persist, see your podiatrist for treatment.

Bunion Surgery Without Bone Screws

22 May

A bunionectomy (the repair of a bunion deformity) is one of the most common outpatient procedures performed by podiatric surgeons like those at PA Foot and Ankle Associates.

There are a number of different kinds of surgeries to repair bunions, depending on the patient’s condition. In most cases, an incision is made on the top or side of the big toe, and parts of the bone and soft tissue are either removed or realigned. The bones are held in place with surgical bone screws, a process called fixation. The surgery restores normal function and movement to the big toe, joint, metatarsal, tendons, and soft tissue, relieving pain and discomfort.

Bone fixation is necessary so the patient can get back on their feet as soon as possible and spend less time in a surgical boot. Without fixation of any kind, a patient would have to stay off of their feet for weeks after bunion surgery until the bones in their feet were capable of bearing their full body weight.

In 90% of cases, bunion surgery with screw fixation is successful and the patient has no problems. But for some, the head of the screw or the threads can cause irritation and soreness, requiring a 2nd, minor procedure to remove the screws from the bones.

No Surgical Screws

Dr. Thomas Rocchio at PA Foot and Ankle Associates takes a no-screws approach to bunion surgery, yet his patients are back on their feet quickly. His secret is SonicPin, a system which uses a specially designed drill to prepare the bone site, and a liquid polymer to fixate the bones. It offers all of the strength of screw fixation, with none of the potential side effects.

SonicPin is loaded into a hand piece, which is inserted into the bone. Then, the SonicPin is melted via sonic vibrations. Within seconds, the liquid polymer flows into the area to be fixated, and cools almost immediately.  As the bones heal, the polymer is easily absorbed into the patient’s body with no side effects.

Watch the bunionectomy video below to see how Dr. Rocchio uses SonicPin.

 

Do bunion splints and braces actually work?

14 Mar

Most people who first develop a bunion reach for over the counter remedies to control the pain and soreness which accompany the deformity. After all, who wants bunion surgery if they don’t absolutely need it? We understand completely.

bunion splints and braces

If you google “bunion splints” you’ll find a dizzying and overwhelming array of products, some of which make rather spurious claims. You’ll also find it difficult to look at a product description and image and decide that this is the right bunion splint (or whatever) for you.

The problem is, a bunion is the result of certain faults in foot structure and function, which are inherited traits. Because of these subtle differences, each patient’s bunion symptoms and pain tolerance are unique. Some develop huge, painful bunions in their youth, and others live with a small bunion for 20 years until they opt for surgery in their mid-50’s.

Read about how a bunion forms

What are your choices for over the counter bunion products?

This list could be very long, but we’ll limit it to the most common products. In spite of marketing claims, none of these remedies can actually correct your bunion, they can only (possibly) slow down the bunion development and temporarily relieve symptoms. What works for one person may be completely ineffective for another, so you’ll most likely have to try a few products until you find the right one for your condition.

  1. Bunion splints or bunion braces are the most effective products if they address the underlying foot problems. A bunion splint usually holds the big toe in place with a loop, which is connected to a binding around the mid-foot. This exerts a force which moves the toe into proper position, and relieves tension on the tendon and toe muscles. Some are rigid and can only be worn at night. Flexible splints are made of fabric and can be worn inside your shoe.
  2. Protective pads or cushions placed on the bunion protect it from rubbing on the inside of the shoe, but do not straighten the big toe.
  3. Wedge-shaped toe spreaders fit between the big toe and the adjacent toe, and move the big toe back into a straight position. This will provide some relief to the tendons in the upper mid-foot, which become sore form the stretching caused by the bunion.
  4. Toe spreaders that fit all of your toes are somewhat more helpful, as they re-align all of the toes in the foot. They can provide relief for your sore foot in as little as 30 minutes. If you can tolerate sleeping in them, they’ll relax the tendons in your foot and provide some comfort.
  5. Toe straighteners are padded splints that run along the inside of the foot and rest against the heel, to force the big toe back into proper position.

If you opt to not have corrective bunion surgery, we recommend that you consider custom orthotics which provide support for your foot and can be molded to provide relief from your bunion pain.

As new over-the-counter products are continually introduced, we can’t recommend one over another, but you may visit our foot and ankle healthcare products page for a wide selection of products which may offer you some temporary relief.

What Is A Tailor’s Bunion?

9 Oct
tailors bunion

Even though it appears small, a Tailors Bunion below the samll toe can cause significant pain

A bunion is an abnormal growth that appears on the joint at the base of your big toe. It’s caused when your big toe pushes up against your other toes, forcing the big toe joint in the opposite direction, away and to the inside of your foot. Over time, the stress enlarges your big toe joint, pushing the big toe even further against your smaller toes and causing significant pain.

A Tailor’s Bunion is similar to a bunion, but appears on the opposite side of your foot. It’s formed for the same reasons a bunion is – inherited foot structure aggravated by footwear – but it affects the joint at the base of your small toe where it joins your foot.

Specifically, a Tailor’s bunionalso called a bunionette, is a prominence of the fifth metatarsal bone at the base of the little toe. That is, the rounded end of the bone slowly moves away from the foot.

A Bunionette is not always painful. Just like a bunion, it usually develops slowly over a number of years, in one or both feet, and becomes acute in middle age. If it gets large enough, it can be quite troublesome, especially when shoes are too tight and rub against the bunionette, or if high heels are worn, shifting the body weight and pressure to the front of the foot. Typically, a callus also develops on the bottom outside of the small toe joint, which can also be quite painful and sore.

If you’re developing a Tailor’s Bunion

  • See a podiatrist so that he or she can create a baseline and monitor your condition. Surgery is usually not indicated in the early stages.
  • Wear appropriate shoes – pointy toe boxes and high heels should be removed from your shoe rotation, as these will make the bunion worse and create significant pain. Wear athletic shoes as often as possible and flats for business attire.
  • Use padding or a silicone bunion guard (available over the counter) inside your shoes. This will offer some protection against the shoe rubbing and causing the Tailor’s bunion to become irritated.
  • Ice the bunionette for 10 minutes three times per day.
  • Use ibuprofen (advil) to control the pain and soreness.

When is surgery indicated for a Tailor’s Bunion?

Only your podiatrist can tell you when bunion surgery is necessary. As every person’s condition is unique, there are a number of surgical procedures that may be most effective for your condition.

***

Dr. Adam Teichman of PA Foot and Ankle Associates performs a bunionectomy on a patient with a Tailor’s Bunion. Dr. Teichman narrates.

Why Your Shoes Are Killing Your Feet

25 Jul

If Doctor Evil was a podiatrist, Mini-Me would be a women’s shoe designer.

high heels

Probably not the best choice for the activity

At times, women’s shoes qualify as instruments of torture.  Most certainly for your back, legs, ankles and feet. Wedges, stilettos, pencil heels, high heels, spike heels, all fall into the category that podiatrists refer to as “cruel shoes”.

Any shoe that lifts your heel off the ground shifts your weight onto your midfoot (ball) or forefoot (toe area). The higher the heel, the more forward the shift, and why the girl who dances all night in high heels has her shoes off before she even gets in the car. You may only weigh 100 pounds, but shifting that weight to a place not meant to carry it can cause significant long-term problems. Even if you failed algebra, that math is easy.

Most common injury caused by high heels over 3 inches: fractures and torn ligaments caused by inverting the ankle (twisting inward).

Besides shifting your center of gravity forward, high heels and wedges provide next to no support for your heel. That spike at the back of the shoe is at times only there to remind you how much you paid for them, how good they make you look and how you’re going to get your money’s worth even if it kills you (or your feet). Since your foot is only secured with a tiny strap, one misstep on a slippery dance floor or wet or cracked sidewalk may cause your heel to slide and your ankle to roll. Next stop – one month in a boot to immobilize your foot while your ankle fracture heals.

But let’s not stop with the shifting of the weight, because these styles offer additional torture. Many feature a pointy toe box, which squeezes the front of your foot so tightly that your toes cry for mercy. The result is bunions, arthritis, and any number of toe problems.

Wearing heels causes your foot to slide forward, redistributing your weight, creating unnatural pressure points and throwing your body’s natural alignment out of whack. High heels have been linked to overworked or injured leg muscles, osteoarthritis of the knee and low back pain. You also risk ankle injuries if you lose your balance and fall off your high heels. – Mayo Clinic.

Women account for ninety percent of the surgeries performed for the most common foot ailments, which is a pretty illuminating statistic. While there’s some debate in podiatry circles about whether footwear or genetics are the actually cause of foot problems like bunions, “pump bumps”, hammertoes, and tight heel cords, there’s no doubt that the high heeled shoe at the very least exacerbates the problem.

Most common injury caused by a platform wedge: Ballet Break. That’s when you fall off the wedge onto the side of your foot, causing a stress fracture.

So what’s a modern woman to do? Nikes and New Balances don’t often match business attire, much less elegant affairs. We recommend that you minimize the amount of time you spend in high heels, wedges, and the like, and don’t buy any heels taller than two inches. The right shoe to wear is the one that causes no pain or discomfort and fits and supports your foot like a glove.

But don’t switch out the high heels for ballet flats or flip-flops, because they can make the situation worse. The lack of support in these “shoes” can worsen conditions like plantar fasciitis. Treat your feet well when you’re young and they’ll treat you well when you’re aging.

%d bloggers like this: