Watching my four year granddaughter in ballet brought the question, is one foot type better than another. The great toe can be longer or shorter than the second. The former is an Egyptian foot and the Greek foot presents with a longer second toe. Much of this is in reference to statues of antiquity where Egyptian statues have a longer Great toe, and more realistic Greek statues had the higher arch, and longer second toe. Back to ballet, neither foot type is preferred. After ten, when one goes up "on point", having three toes of equal length is optimal to evenly distribute the pressure. 

How do we prevent ingrown nails? You're told to cut the nail staight accross and not too short. That's because ONE of the causes is cutting the edge of the nail incompletely when trying to "round" the corners. There are other reasons why we get ingown nails, however. So then, we try to stuff cotton under the ingowing nail. Why cause more pressure? I tell kids and adults of the "cotton" school, I'm of the school of "vaseline". OK, swipe a miniscule amount of vaseline along the edge of the nail to "lubricate" and soften the groove, thereby allowing the nail edge to grow out and not dig into the flesh. Before "swiping", soaking the foot and pulling the edge back helps. For more information, please contact our office.

Do you have heel pain upon arising? It might be the common plantar fasciitis. It affects middle aged persons and or athletes of any age after their teens. Sometimes it's confused with the stone bruise you might have had as a child, which you'd expect would go away in a month or two. When it doesn't, pills, ice, walking different, stretching, taping, and cortisone shots may all be tried. A lot of the time, the pain resolves. You can't have multiple cortisone shots or your fat pad may atrophy. Sometimes. "nerve" shots to are used.

An end stage procedure for recalcitrant plantar fasciitis is microfasciotomy. This can be done with a one hole endoscopic portal, to release some of the tight fibers. In my hands this has worked best using a cast after the treatment for 3-4 weeks. A variation of the microfasiotomy is multiple perforations done with or without an incision. The former has a slight risk of adding stress to the lateral side of the foot. The latter is about 80 % successful with the jury still being out on the long term results.

For more information, please contact our office.

When those metatarsals are splayed apart causing bunions, why not just lasso them together?  Instead of cutting the bone to reduce a bunion, a fine strong fiber can be passed through respective metatarsals anchored by small metallic buttons.  The same tightrope apparatus can be used to rebalance overcorrected and imbalanced toes. Frankly, it's easier to cut and move the bone over and the patients generally do well with the traditional surgery. However, it is a new "tool" available to us, and it's especially helpful in correcting wayward toes that went too straight, also know as Hallux varus.  

With Facebook, Twitter and blogging, the latter seems the easiest to create a portal for patient and staff communication. I've been in practice for more than three decades. There was a time when surgically removing a heel spur was the reasonable path of treatment. For heel spur syndrome/"plantar fasciitis", where a patient has pain on the bottom of the heel upon arising out of bed or a chair, conservative therapy is exhausted for three months. Even when surgery is contemplated, the fascia which pulls and precipitates the spur is addressed by a lengthening procedure leaving the spur alone. We use an algorithmic guide for patients with plantar fasciitis/heel spur syndrome. The first visit is usually conservative where taping, stretching, ice, gait training and oral anti-inflammatories are prescribed. Depending if the condition is more acute and inflamed, or chronic, the course of treatment is affected as well. Any comments, questions or feedback are welcome....