July 2020

A bunion is an enlargement of the base joint of the toe that connects to the foot, often formed from a bony growth or a patch of swollen tissues. It is caused by the inward shifting of the bones in the big toe, toward the other toes of the foot. This shift can cause a serious amount of pain and discomfort. The area around the big toe can become inflamed, red, and painful.

Bunions are most commonly formed in people who are already genetically predisposed to them or other kinds of bone displacements. Existing bunions can be worsened by wearing improperly fitting shoes. Trying to cram your feet into high heels or running or walking in a way that causes too much stress on the feet can exacerbate bunion development. High heels not only push the big toe inward, but shift one's body weight and center of gravity towards the edge of the feet and toes, expediting bone displacement.

A podiatrist knowledgeable in foot structure and biomechanics will be able to quickly diagnose bunions. Bunions must be distinguished from gout or arthritic conditions, so blood tests may be necessary. The podiatrist may order a radiological exam to provide an image of the bone structure. If the x-ray demonstrates an enlargement of the joint near the base of the toe and a shifting toward the smaller toes, this is indicative of a bunion.

Wearing wider shoes can reduce pressure on the bunion and minimize pain, and high heeled shoes should be eliminated for a period of time. This may be enough to eliminate the pain associated with bunions; however, if pain persists, anti-inflammatory drugs may be prescribed. Severe pain may require an injection of steroids near the bunion. Orthotics for shoes may be prescribed which, by altering the pressure on the foot, can be helpful in reducing pain. These do not correct the problem; but by eliminating the pain, they can provide relief.

For cases that do not respond to these methods of treatment, surgery can be done to reposition the toe. A surgeon may do this by taking out a section of bone or by rearranging the ligaments and tendons in the toe to help keep it properly aligned. It may be necessary even after surgery to wear more comfortable shoes that avoid placing pressure on the toe, as the big toe may move back to its former orientation toward the smaller toes.

Ankle foot orthotics are shoe inserts that offer support to control the placement and movement of the ankle, correct deformities, and compensate for weakness. These inserts are used to stabilize the foot and ankle and provide toe clearance during the swing phase of gate.

Athletes often suffer foot problems because their feet are not being supported within the shoe. Ankle and foot orthotics are custom made inserts that alleviate stress on the foot. However custom orthotics should be prescribed by a podiatrist who specializes in customized footwear and orthotics design. These inserts are used by athletes for different reasons. Runners use orthotics to absorb shock at heel contact and to set up the forefoot for push-off. Basketball players wear them to control their forefeet while jumping and running.

The two main types of orthotics are over-the-counter orthotics and custom-made orthotics. To be eligible for custom orthotics, an examination of the foot and ankle will need to be completed. Afterward, both the foot and ankle will need to be casted and fitted for the proper orthotic. When the fitting process is complete, adjustments can be made to make sure everything fits perfectly.

Over the counter orthotics tend to be more popular than custom fit ones. Athletes who have less severe aches and pains in the foot, ankle or lower back area can use the over-the-counter version of orthotics. Unfortunately, over-the-counter orthotics tend to not work in treating severe injuries or ailments. Whenever you suspect you may need an ankle foot orthotic, you should consult with your podiatrist to determine which type of orthotic is right for you.

Flatfoot is a foot disorder that is not as straightforward as many people believe.  Various types of flatfoot exist, each with their own varying deformities and symptoms.  The partial or total collapse of the arch, however, is a characteristic common to all types of flatfoot.  Other signs of flatfoot include:

• “Toe drift,” or the pointing outward of the toes and the front part of the foot
• The tilting outward of the heel and the tilting inward of the ankle
• The lifting of the heel off the ground earlier when walking due to a tight Achilles tendon
• Hammertoes
• Bunions

One of the most common types of flatfoot is flexible flatfoot.  This variation usually starts in childhood and progresses as one ages into adulthood.  Flexible flatfoot presents as a foot that is flat when standing, or weight-bearing.  When not standing, the arch returns.  Symptoms of flexible flatfoot include:

• Pain located in the heel, arch, ankle, or along the outside of the foot
• Overpronation, or an ankle that rolls in
• Shin splint, or pain along the shin bone
• General foot aches or fatigue
• Pain located in the lower back, hip, or knee

Your podiatrist will most likely diagnose flatfoot by examining your feet when you stand and sit.  X-rays may be taken to define the severity and help determine the treatment option best for your condition.  Nonsurgical treatments can include activity modification, weight loss, orthotics, immobilization, medications, physical therapy, shoe modifications, and ankle foot orthoses (AFO) devices.  If nonsurgical methods prove ineffective, surgery may be considered.  Multiple surgical procedures can correct flatfoot; and depending on your specific condition, one may be selected alone or combined with other techniques to ensure optimal results.

It is never normal for a child to experience pain in his or her feet. Foot pain that lasts more than a few days and limits a child’s ability to walk should be examined by a podiatrist. Many adult foot ailments originate in childhood and may be present at birth. Common foot issues that are experienced by children are pediatric flat foot, Sever’s disease, ingrown toenails, and plantar warts.

A child’s foot grows rapidly during the first year, allowing it to reach almost half of their adult foot size. Consequently, foot specialists consider the first year to be the most crucial point in the foot development process. There are ways you can help ensure that your child’s foot develops properly. One way is to carefully look at your baby’s feet. If you notice any deformities, you should immediately seek professional care. You should also loosely cover your child’s foot, since tight coverings may prevent movement and inhibit normal development. Another tip is to change the baby’s positioning throughout the day. If your baby lies down in one spot for too long, it may put an excess amount of strain on the feet and legs.

It is best that you try not to force a child to start walking. Children will begin to walk when they are both physically and emotionally capable to do so. You should also avoid comparing your child’s walking progress with other children because the age range for independent walking may range. When your child’s feet begin to develop, you may need to change both their shoe and sock size every few months to allow room for their feet to grow.

Kids are sometimes prone to splinters, cuts, and severe injuries because they tend to walk around barefoot. This also makes them more susceptible to developing plantar warts which is a condition caused by a virus that invades the sole of the foot through breaks in the skin. These ailments can be avoided by making sure your child wears shoes in unsanitary environments. You should also wash any minor cuts or scrapes on your child’s feet. It is a myth that exposure to fresh air will heal injuries; fresh air will only expose your child’s cuts to germs.

As a parent, you should ensure that your child’s feet are developing properly and are being properly maintained. Consequently, it is important that you perform routine inspections on his or her feet to detect any injuries or deformities in their early stages. Early detection and treatment will help to ensure that your child does not develop any serious foot conditions.