Hammertoe: No Walk in the Park!

Hammertoe is a painful deformity of the second, third, or fourth toe, frequently caused by improper mechanics—the way a person walks or the shoes they wear that do not allow room for the deformity. Similar to mallet toe and claw toe, hammertoe involves different joints of the toe and foot. Shoes that are too narrow or short for the foot, or have excessively high heels, can cause of hammertoe. Improperly sized shoes force the toes into a bent position for long periods, causing the muscles to shorten and bend the toes into the hammertoe deformity.

Other causes of hammertoe may be complications from RA (rheumatoid arthritis), osteoarthritis, trauma to the foot, heredity, or CVA (cerebral vascular accident). Symptoms of hammertoe include, but may not be limited to, pain and difficult mobility of the toes, deformity, and calluses or corns from toes abrading one another.

A patient experiencing symptoms of hammertoe should seek examination by a physician, specifically a podiatrist. Podiatrists diagnose and treat disorders of the foot. If the doctor finds the involved toes have retained some flexibility, treatment may involve simple exercise, physical therapy, and a better fit to shoes worn by the patient. Treatment often targets controlling the mechanics, such as walking, that cause hammertoe by using custom orthotics.

In more advanced cases, where the toes have become rigid and inflexible, the doctor may suggest surgery. The operation would consist of incising the toe to relieve pressure on the tendons. The doctor may re-align tendons and remove small pieces of bone in order to straighten the toe. The insertion of pins may be necessary to fix bones in the proper position while the toe heals. Usually the patient is able to return home on the day of surgery.

If surgery is necessary, it is important to follow the postoperative directions of your physician. Theses may include various stretches, attempting to crumple a towel placed flat against your feet, or picking up marbles with your toes. Striving to wear shoes with low heels and ample toe space will ensure healthy feet and toes. Avoid closed shoes and high heels. Laced shoes tend to be roomier and more comfortable. Shoes with a minimum of one half inch space between the tip of your longest toe and the inside of the shoe will provide adequate space, relieve pressure on your toes, and prevent hammertoe from re-occurring.

Some tips on feet may include purchasing shoes at mid-day as your feet are smaller in the morning and swell as the day progresses. Ensure that she shoes you buy are both the same size and have the store stretch shoes at painful points to provide for optimum comfort.



Elderly and their Feet

While proper foot care is important for everybody, senior citizens have the tendency to be more susceptible to certain conditions and should therefore be well informed about problems that may arise and what they can do to properly avoid or treat them.    

Some of the most common problems are foot ulcers, ingrown toenails, fallen arches, and fungal infection. A foot ulcer is an open sore on the foot and  can be a result of decreased sensation in the feet. An ingrown toenail is defined as when the nail grows into the side of the toe. Fallen arches are indicated by the instep of the foot collapsing. A fungal infection is a condition that results in deformed and discolored toenails.         

In order to avoid these conditions it is recommended that the feet be inspected by the patient on a regular basis. If these inspections are carried out routinely, there is a good likelihood that problems can be identified before they become severe, or can even be avoided altogether. If any abnormality is discovered, it is important that the individual consult a doctor for diagnosis and information on treatment options.

Proper foot hygiene is also important. Making sure that you always have clean, dry socks on can be a major deterrent to many different problems including bacterial infections, foot odor, and certain types of fungus. Wet feet are a major cause of many of these problems.  If your socks get wet, it is important to change them. Walking around in wet socks may not only lead to various infections, but can irritate the skin and result in a number of various complications. Clean, dry feet are less likely to be affected by fungal and other infections.

As people age, the fat present on your feet begins to deteriorate. The protective nature of this fat keeps the feet healthy by providing a barrier and between your bones and the ground as well as giving the skin on the foot a certain amount of elasticity. This is one factor that causes elderly people to develop some serious foot issues. Foot moisturizers can be helpful to avoid certain problems associated with this. However, water-based moisturizers do not work as well for elderly people as they do for the young. Instead, it is more effective to use an emollient instead. An emollient is effective because it binds the water in the foot, keeping it from becoming absorbed too readily which will result in dry skin. They also have a special property called occlusion, which provides a layer of oil on the skin. This layer prevents the foot from drying up and can be very effective in treating dry skin disorders.  If you can keep the skin on your feet healthy, this will substantially reduce the number of foot problems you will encounter in old age.

Proper footwear is another way to keep feet healthy. Shoes that fit well and provide proper support help prevent ingrown toenails and fallen arches.        

Certain medical conditions such as diabetes or poor blood circulation increase the risk for foot issues. For individuals with any of these conditions it is extremely important to conduct regular foot inspections to make sure that there are no sores or infections present.



Diabetic Foot Care

Diabetes affects millions of people each year. Diabetes damages blood vessels in all parts of the body, including the feet. The legs and feet may have slow blood flow which causes neuropathy (nerve damage). Once a diabetic patient develops neuropathy, it is imperative that the feet are well taken care of to avoid amputation of the feet or legs.

It is important when caring for the feet of diabetics to always wash and thoroughly dry the feet, especially between the toes. Next, examine your feet and toes for any redness or sores that may be there, even if you do not feel any pain. You may also use a mirror to examine your feet from the bottom side. Avoid wearing colored socks to prevent infections that may occur from the dye used in them. Well-fitting socks are also highly recommended.

Anyone with diabetes should have their physicians to monitor Hemoglobin A1C levels as this test lets the physician know how well the blood sugar levels have been controlled during the past 3 months. It is very important to keep the blood sugar levels in the normal range (70-110mg/dl). There are medications that a physician may prescribe to help with neuropathy of the diabetic patient. It is also advisable to visit a podiatrist if the diabetic patient is experiencing any conditions involving the feet. Toe nails may need to be taken care of by a podiatrist as some patients may cut to deep or not deep enough around the cuticles and risk having an infection that could occur.

While at home a person can take care of their feet if they follow instructions given by their physician or nurse. An effective treatment is using creams and applying them to the heels due to the possibility of extreme dryness. Be careful when using tools to remove the calluses as severe diabetics may not be able to feel pain, and this can cause a severe wound to develop.

Diabetic feet absolutely need to be inspected on a daily basis. Always notify your health care professional with any concerns that you may have about the care of your feet. Waiting to see if a wound will get better is not a good idea as it can turn into a life threatening condition. Gangrene is a serious problem for diabetics and can lead to sepsis and amputation. Early treatment and daily inspection of the diabetic feet are keys to staying healthy.


Getting Back into Sports after Foot and Ankle Injuries

One of the most common injuries that athletes suffer from is a sprained ankle, a very painful and frustrating problem. A sprained ankle usually causes one to avoid participating in sports, and once someone has sprained their ankle, they are very likely to sprain it again.

To get back into sports after a sprained ankle, one should follow the RICE method, which is consistently recommended by physical therapists and sports medicine doctors. The RICE method involves rest, ice, compression, and elevation. If one follows the RICE method soon after experiencing a sprained ankle, he or she will likely get back to the playing fields in no time. In addition to using the RICE method, an athlete should wear an ankle brace after experiencing a sprained ankle to help alleviate the pain and keep the ankle safe until it heels. A brace will also help to stabilize the ankle, and prevent serious injuries in the future. Many times, people suffer from sprained ankles due to weak ligaments near the ankle; because an ankle brace keeps the ligaments in the foot from moving too much, it will help someone avoid this injury.

Fractures in the foot and ankle are another common type of injury athletes suffer. Stress fractures typically occur in the bones of the forefoot. An athlete will usually experience stress fractures if he or she partakes in a sudden increase in athletic training. A stress fracture can be either stable or displaced. A stable stress fracture involves no shift in bone alignment, while a displaced stress fracture involves bone ends that no longer line up.

After an athlete has a stress fracture in the foot, he or she will immediately need to see a doctor. Rest is usually the key to treat this problem. One will have to refrain from any strenuous activities or the sports that caused the injury. A doctor or specialist may be able to pinpoint the specific part of an athlete's training that caused the stress fracture. If this is possible, then an athlete will not have to worry about refraining from his or her sport in the future; he or she will simply have to stop training in such a way that an ankle or foot injury results.

The key for any athlete is to care about the treatment process for an ankle or foot injury. Athletes need to rest and take time before hitting the fields. The more an athlete invests in the treatment and recovery process, the more likely he or she will be able to return back to normal athletic performance.

Proper Shoe Fitting

Proper shoe fitting is one of the most common concerns people have when it comes to the health of their feet. To some this may not seem like a major issue, but the reality is that improperly fitted shoes account for a tremendous amount of injuries to the foot. Because our feet, our posture, and our gait directly affect the bio-mechanics and the overall structure of our entire body, pains and discomforts felt elsewhere within the body can frequently be attributed to improperly fitted footwear. Here are a few factors to consider, which will help you select the proper footwear when shopping.

Do not purchase shoes with the expectation that they will stretch to accommodate the size of your feet. You are looking for shoes that fit correctly right away. If the shoes you purchase are too large and are slipping in the area of the heel while you walk, do not purchase them. Do not look favorably upon shoes that slip with the intention of wearing thicker socks to compensate for the slippage. Make certain that in the widest portion of the shoes, the ball of your foot, fits comfortably in the shoe.

It may be difficult to focus on these things with all the distractions of shopping, or tempting to ignore them because you badly want an uncomfortable shoe. However, if you cannot wear shoes because they hurt too much to use, your money and time will be wasted. When you get your new shoes home, put them on and walk around on a carpeted surface to see ensure your shoe's fit comfortably with normal activity.

With 33 joints, 26 bones, and over 100 ligaments, the potential for damage to the sensitive components within the foot are greater than many people realize. Finding a properly fitting shoe is the single most important factor you can do to help prevent injury and maintain optimal foot health. Adults tend to forget the fact that our feet continue to change as we grow older. So, even though they may no longer experience growth spurts associated with youth, their feet still change shape as they mature.

If you already have problems with your feet, wearing improperly fitted shoes can potentially exacerbate those problems. Fortunately, it does not require a tremendous amount of effort to find shoes that fit correctly. When shopping for shoes, keep in mind that improperly fitted shoes can not only cause a whole host of disorders and problems to occur within the feet themselves—they can affect the entire bio-mechanical structure of the body. Your posture and your stride are based on your feet, so your footwear can have a tremendous impact on the legs, back, and rest of your body. Finding the proper shoe fitting is essential to keep your feet and body healthly.



How Obesity Affects Your Feet

Maybe you have gained a few extra pounds over the past couple of years. It comes on slowly and you are not always aware of it until your feet start hurting at the end of the day. After all, they carry the weight of your whole body. Experiencing foot pain and swelling is one of the biggest side effects of being overweight.

Many problems that occur in the feet are directly related to carrying even a small amount of extra weight. If you are overweight, the body may try to compensate by changing the way it moves. You may lean forward a bit and put extra weight on the wrong part of the foot. Your feet were designed to carry a normal amount of body weight and any extra will put undue stress on them.

Many people who are overweight as adults develop type 2 diabetes and it is often the cause of leg and foot pain. This is very serious and often older people who do not control their condition may lose all feeling in their legs and feet. It is also possible to develop small sores on the feet, and when you have diabetes, these do not always heal properly which can lead to serious infection.

The extra pressure and stress placed on muscles, joints, and tendons in the feet by extra body weight can also trigger plantar fasciitis. Plantar fasciitis is an inflammation of the tissue along the bottom of the foot, and causes pain and stiffness when walking and climbing stairs. Pain caused by plantar fasciitis can be relieved by foot stretches and orthotics inserted into the shoe.

Foot problems triggered by excess body weight may be treated by special attention to footwear. Shoes that properly support the foot – especially the arch and ankle – and allow for good circulation are very important. A podiatrist can help you decide what kind of shoe is best for your feet. Orthotics – special inserts that can be inserted into shoes – can absorb shock, support the arches, and keep the feet properly aligned. These can be found in shoe stores or may be fitted by a podiatrist.

It may also be time to consider taking off a few pounds to prevent diabetes and other life threatening diseases. Your feet will certainly thank you for it and you will feel better in a short amount of time. A water aerobics class at a local gym is a way to get needed exercise without putting any stress on the feet or ankles. Yoga is also an activity that is beneficial both to your feet and your entire body. Don't risk losing your freedom by ignoring foot pain. If you take care of your feet, you can keep your feet and your entire body feeling great.

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