November 2023

When conservative, noninvasive treatments prove unsuccessful, podiatrists will often turn to surgery as the last line of treatment for their patients. If patients are suffering from joint pain, issues in mobility, or are seeking to correct a deformity, joint replacement surgery is an effective option. Joint replacement surgery is also successful in treating arthritis, which is the most common cause of improperly working joints.

Patients with symptoms that include joint pain, stiffness, limping, muscle weakness, limited motion, and swelling are typically considered for joint replacement surgery. Range of motion and activity post-surgery will vary between patients and depending on the specific surgery performed, the affected joint, and the damage that will need to be repaired.

Joint replacement surgery replaces the damaged cartilage and bone, the latter if required. The damaged cartilage is typically replaced with a prosthesis that is attached to the bone, allowing the implant to grow into the bone. Following surgery, the patient will typically undergo physical therapy to become familiar with movement using the replaced joint.

Diabetes is the condition in which the body does not properly process food for use as energy. People with Type 1 diabetes cannot produce insulin, which is required for glucose to feed your body’s cells. It is typically caused by the immune system mistaking healthy cells for foreign invaders and destroying the insulin-producing cells in the pancreas. On the other hand, people with Type 2 diabetes cannot respond to insulin properly, and eventually cannot produce enough.  The Centers for Disease Control and Prevention reports that over 30 million people in the United States have diabetes, with 1 in 4 having no idea they have it. Surprisingly, diabetes is the seventh leading cause of death in the US. The symptoms of diabetes include frequent urination, fatigue, hunger, and even blurry vision.

Diabetes can also affect the feet as well. Over time, diabetes can cause nerve damage to your feet, which could then lead to symptoms such as tingling, pain and numbness in the feet. Neuropathy can be very dangerous to a person with diabetes, since it prevents them from feeling injuries such as cuts or blisters in the feet, and if not detected early enough, may lead to infection. Neuropathy can also lead changes in the shape of your feet and toes. The best way for people with diabetes to prevent or delay neuropathy is keeping their blood glucose levels in their target range. This consists of eating right, having the correct amount of exercise, and taking medications.

Diabetes can also create calluses and foot ulcers as well. Calluses build up faster and occur more frequently with those affected by diabetes. If there are too many calluses, therapeutic shoes and inserts may be required. It is important to have calluses trimmed by a health professional, as doing it yourself may lead to infections. If these calluses continue to develop and thicken, they can lead to foot ulcers. Foot ulcers are open sores, that appear on the ball of the foot or on the bottom of the big toe. These ulcers can lead to future infections if not treated and may possibly result in losing a limb. It is important to report any ulcers to your podiatrist right away. Your doctor may take x-rays to examine the foot and clean out any dead and infected tissue.

Lastly, diabetes can also lead to poor circulation and peripheral arterial disease (PAD). The poor circulation in the feet and leg area is a result of diabetes narrowing and hardening, eventually slowing down the blood flow in that area. The best way to prevent this is to keep away from smoking and follow your doctor’s advice for maintaining blood pressure and cholesterol. PAD is similar to this complication. PAD is when blood vessels narrow or are blocked by fatty deposits. PAD also increases your risk of heart attacks and strokes and is a common condition to those affected by diabetes. The combination of both PAD and neuropathy may lead to infections and can result in amputation of certain limbs. PAD can be prevented with wearing the proper foot wear and regularly taking care of your feet.

If you want to take care of your feet, you should wash and dry them carefully and perform daily inspections to check for cuts, blisters, or swelling. Any physical activity you partake in should be approved by your health care provider. You should also be sure to wear special shoes if advised to do so by your doctor.

Debilitating foot pain is a problem for many people. But just as stretching the torso can help alleviate back pain, stretching the feet can also help mend existing foot problems and prevent future ones.

The feet, as the body’s foundation, carry the body’s entire weight and can get easily strained from overexertion. Persistent sharp pain and cramping in the feet are often common concerns. Foot pain and foot problems can be due to any number of causes, and in many cases pain may be eased without medication or doctor visits. It is always a good idea, however, to first rule out any serious medical issues with a physician.

Stretching can help relax the feet and alleviate pain, but is especially important before heavy aerobic exercise. Stretching before such activities can help you avoid experiencing painful cramps or strained foot muscles. Stretches should be performed slowly and deliberately without forceful pulling. The stretch should be held for several seconds before relaxing.

A great way to stretch out and loosen up the foot muscles while sitting is to cross one leg over the other and pull the toes carefully back without overextending. Start by resting the left ankle on the right knee. With the left hand, gently flex the left foot by pulling back on the toes. Do not pull too hard; just hard enough to feel the stretch in the arch of the foot. Then point the toes of the left foot as far as you can. Rotate the motion of pointing with pulling back on the toes. This should relax and stretch the muscles on the bottom and the top of the foot. Doing this stretch ten to twenty times should bring relief. Repeat the whole process for the other foot by resting the right ankle on the left knee.

A stretch that focuses on the often injured Achilles tendon involves standing and facing a wall with your arms out and hands flat against the wall. Step back with one foot, keeping it flat against the floor. Move the other leg forward and lean toward the wall. You should feel a stretch through the back of your leg and your Achilles tendon, but do not push yourself too much. Stop when you feel a stretching sensation, and hold for 30 seconds. Ten repetitions may be done for each foot.

Stretching the feet is important for athletes or those performing aerobic exercise, but it can also help anyone with foot pain caused by poor footwear, plantar fasciitis, or long hours standing and walking. Individuals who tend to their feet by regularly stretching every day should be able to minimize foot pain and prevent new problems from arising.

A congenital foot problem is a problem affecting the feet, toes, and/or ankle that a child is born with. Several issues with a child’s feet can occur congenitally. Such problems include clubfoot, vertical talus, tarsal coalition, polydactyly, macrodactyly, and cleft foot. Some of these problems have a genetic basis, with someone in their family history having a gene causing the condition, and some are simply an anomaly.

The following are specifics about a few of these conditions:

-    Clubfoot, also called congenital talipes equinovarus or talipes equinovarus, is When the tendons of the foot shorten, the bones are of an unusual shape, and the Achilles tendon is tight, causing an inward and downward pointing of the foot. The soles of the feet might also face each other. In most cases of clubfoot, both feet are affected. If not treated, the affected child will walk on the sides of their feet or ankles.

-    Polydactyly is a condition where the child has more than five fingers or toes on either or both feet. Presentation usually consists of a nubbin or small lump of tissue without a bone, a toe that is partially formed but has no joints, or an extra toe.

-    Vertical talus is where the talus bone forms in the wrong position, other bones in the foot do not line up properly, the front of the foot points up, and the bottom of the foot is stiff, has no arch, and usually curves out. This can occur in one or both feet and if left untreated, can lead to serious disability or discomfort as the child grows.

-    Tarsal coalition is when there is an abnormal connection of two or more bones in the foot leading to severe, rigid flatfoot. The tarsal bones, located toward the back of the foot and in the heel, are the ones affected. This condition is often present at birth, but signs of the disorder usually come on in early adolescence.

-    Cleft foot is a rare condition where the foot has missing toes, a V-shaped cleft, and other anatomical differences. Surgery can often help improve the foot’s function since the heel remains normal and is what is most needed for walking. The main issues with this affliction are whether the affected foot can fit into a shoe and the shape and appearance of the foot.

-    Macrodactyly is when the toes are abnormally large due to overgrowth of the underlying bone or soft tissue. Having this condition makes it harder for the child to use the affected foot for certain activities.