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When Foot Surgery is necessary

Foot surgery may be necessary for a variety of reasons, but it is normally reserved for cases in which less invasive procedures have failed to help with the problem. Cases in which surgery may be deemed necessary include, but are not limited to, surgically removing deformities of the foot (such as bone spurs and bunions), problems with arthritis that have caused severe bone issues within the foot, and reconstruction to attend to injuries caused by accidents and congenital malformation (such as club foot and flat feet). Foot surgery may be necessary for individuals of all ages and races.

If you find yourself in need of foot surgery, the reason why the surgery has been found to be necessary will dictate exactly what kind of surgery you need. If you have to have a growth, such as a bunion, removed, then you may undergo a bunionectomy. If your bones need to be realigned and fused together, then you may undergo a surgical fusion of the foot. If it is nerve pain and problems that you are enduring, then you may need to undergo surgery in which the tissue that surrounds the painful nerve is surgically removed. Normally other, less serious treatments are first applied when a problem is discovered, but if those treatments are found to be ineffective, surgical techniques are considered and used.

Even though surgery of the foot is usually reserved as a last resort by most physicians, there are some benefits if you and your doctor choose to use surgery to fix the problem. The first is that the pain associated with the issue is normally relieved, which means that you can finally resume the activities your foot problem was preventing you from participating in. The second benefit is that, once you have the surgery completed, the problem is generally eliminated since it has finally been addressed.

History of podiatry has shown that foot surgery techniques continue to advance every year. Endoscopic surgery is just one of the many advancements that have been made in the field of foot surgery. As technology improves, foot surgical techniques will also continue to improve. Many procedures can now be completed using a very small incision and smaller, more refined instruments. Because of these better tools, surgeries are becoming less invasive, and recovery time has become a great deal shorter. Shorter recovery periods mean that you will be back on your feet in no time.


Rheumatoid Arthritis in the Feet

Although rheumatoid arthritis actually attacks multiple bones and joints throughout the entire body, ninety percent of people who actually develop this condition usually do so in the foot or ankle area. Those who develop this kind of arthritis in the feet usually develop symptoms around the toes and forefeet first, before anywhere else. Rheumatoid arthritis appears to have a genetic component. If it runs in the family, then you will be more likely to develop it as well.

Rheumatoid arthritis is an autoimmune disorder in which the body’s own immune system attacks the lining of the membranes surrounding the joints. This causes inflammation of the membrane lining, and the gradual destruction of the joint’s cartilage and even bone.

Some of the most common symptoms that are associated with RA include pain and swelling of the feet. Stiffness in the feet is also another common symptom that people experience. Those who have RA in the feet usually feel the pain in the ball or sole of their feet. This can get to be very painful at times. A person's joints can even shift and become deformed after a period of time.

In order to properly diagnose RA in the feet it is usually necessary for a doctor or podiatrist to evaluate the area. Your doctor will also question you about your medical history, occupation, etc., to determine whether anything in your lifestyle may have triggered the condition. There are a number of tests that may be performed to help diagnose RA such as a rheumatoid factor test, although there is no one single test that will tell you for sure if you have RA. There are different X-rays that can be taken as well to determine if a person has RA in their feet.

There is a range of treatment options for rheumatoid arthritis. Treatment of RA is usually a lifelong process that includes a variety of methods of treatment and therapy. Your doctor can prescribe special shoes that should help with arch support as well as heel support. A physical therapist can help those with this condition learn exercises which will keep their joints flexible. Surgery may be needed to correct some of the issues with the feet, such as bunions, and hammertoes. Fusion is usually the most successful surgical option for rheumatoid arthritis. However, people need to keep in mind that there are some risks associated with these surgeries.


Geriatrics and Podiatry

Bone density loss, dry skin, poor circulation, and rough brittle nails are some of the common problems that can occur as people age. The effect that these problems have on foot health should be of particular concern in comprehensive geriatric care.

Feet that are diseased or injured have a negative effect on overall health and safety. Painful feet limit a person’s willingness and ability to stay active. Poor foot health can also cause gait change, which can lead to falls and accidents. Even though recovery time from health problems naturally slows as we age, many foot problems can be avoided altogether with regular prophylactic care.

Each day feet should be thoroughly washed in warm water. Care must be taken to dry the feet well, making sure to dry between and under the toes. Any left-over moisture can cause problems like foot fungus. After cleaning feet carefully check for problems such as cracked skin, bruises, swelling, cuts, corns, or other irregularities.

Examine toenails for ingrown, jagged, or split nails. Long toenails should be cut straight across. Never cut toenails at an angle or down the side as this may lead to ingrown nails.

Cracked and dry feet should be treated once or twice a day with a non-greasy moisturizer. Rub the moisturizer into the skin and allow it to dry before putting on socks and shoes. Sweaty feet can be dusted with a small amount of talcum powder. Avoid putting talcum directly into shoes as this may make feet slip within the shoe and cause a serious fall.

Wear clean dry socks each day. Not only do clean socks feel better on the feet, but socks worn for longer periods may harbor disease and odor-causing bacteria. Socks should not be so tight around the top as to leave marks on the leg. Socks that are too small can bring about bruising caused by pressure against the toes.

Wear comfortable and well-fitting shoes. If possible, use a professional footwear specialist when purchasing shoes. Do not walk around barefoot as this exposes the feet to possible injury and bacteria.

Good foot health allows a more active lifestyle, which improves blood flow. Good circulation aids in recovery from injury or illness, and is paramount to good overall health.

Serious health problems can manifest themselves as symptoms in the feet. The elderly should seek professional help from a podiatrist if experiencing foot problems like tingling, numbness, pain, infection, or a sore that does not heal. Taking care of these problems right away can avoid worse problems later on.


Exercise for Your Feet

Whether your feet are over-worked or under-worked, chances are they could benefit from some special attention. Even those who exercise regularly probably do not spend any time strengthening their feet. This can be just as rewarding as strengthening the rest of the body, since the health of your feet affects the health of the rest of the body as well, especially the ankles, legs, and spine.

For those who might not have any idea on how a foot-specific exercise might be conducted, there are several workouts that are fairly easy to perform in the comfort of ones’ home. One of the easiest is the toe rise, also known as the tip-toe. This exercise involves standing on the tip-toes for a count of 15 then resting the feet on the ground. This process should be repeated a minimum of three times a day in order to strengthen the feet.

Toe pick-ups strengthen the feet by working them in a very different way. In this exercise, small items are picked up using the toes in order to strengthen the muscles on the upper part of the feet. Once again three sets should be performed, with the item in question being held for 15 seconds then dropped. Items that may be picked up using the feet include marbles and even stationery, which works wonders for the toes and the surrounding muscles.

Yet another simple workout is the ankle pump. This can be done either upwards or downwards, but for the workout to be most effective both can be incorporated into the routine. As the term suggests, this involves lifting the foot off the floor and flexing the toes either towards the shin or towards the ground. This movement puts the feet and ankles through a large range of motion which works muscles.

Last but not least, feet should be stretched so that the muscles can relax and recuperate. This can be done by placing both feet of the floor and bracing oneself against the wall at a 45 degree angle. This ensures that the feet and ankles are adequately stretched once the workout is complete.

In short, giving the feet a good workout every now and then is important in order to avoid problems such as plantar fasciitis, as well as to warm-up or cool-down after running or vigorous walking. Foot exercises may be followed by a good foot massage which encourages circulation in the feet as well as muscle relaxation.


Ankle Sprains

Ankle sprains, while not as severe as a broken ankle, are still a serious injury that needs immediate attention. They can lead to limited mobility and a significant amount of pain, and are often characterized by swelling and sometimes discoloration of the skin. An ankle sprain occurs when the ligaments are stretched beyond their limits, and even though this can happen in other places, such as the wrist, the ankles are the most common place for a sprain.

Ankle sprains can occur in many different ways, even just by simply walking. They happen when the ankle rolls over itself or twists under the foot, causing the ankle and tendon to snap or pop. Athletes who continually push their bodies to the limits are often at risk, as are people who have previously suffered accidents involving the lower extremities.

In most cases, ankle sprains are not severe enough to warrant medical help, such as going to a hospital. There are many self-care remedies you can use to treat your ankle, including applying ice packs to reduce swelling, remaining off your feet to reduce pressure, and elevating your feet above your head to reduce blood flow and inflammation. Often times an ACE bandage and over the counter pain relievers are enough, but it is still important to remember to stay off the ankle for some time to avoid re-aggravating it.

Even though most of these cases are mild, a severe ankle sprain can occur which will require professional, medical care. A sprain that causes a tear in the ligament or damage to the muscles is severe enough to warrant surgery and keep you off your feet for a prolonged period of time. Post-surgery physical therapy is often required in order to completely rehab the ankle back to health, and this will be administered and monitored by your podiatrist.

Even though ankle sprains may seem harmless and only mildly painful, if you are experiencing non-stop pain over a long period of time, if walking is becoming too painful for you, if the swelling is much more severe than initially anticipated, or if numbness and tingling is present, this may be signs that your sprain is a much more severe broken ankle. It is highly recommended to seek treatment right away for these symptoms.

Often times, preventative care is one of the best ways to avoid ankle sprains. Wearing appropriate fitting shoes that provide both ankle and arch support will help, as well as stretching before any kind of physical activity, including sports, weight training, or even simply jogging.


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Dr. Mayer Salama and Dr. Daniel Salama
3408 West Rd (In Grange Plaza)
Trenton, MI 48183 -(734) 676-4664

2200 Monroe
Dearborn, MI 48124 - (313) 274-0990

6770 Dixie Hwy. Suite 101
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