Healthy Living: Foot Ailments
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“There’s something interesting going on here that doesn’t go on in other areas,” says F. Scott Gray, an orthopedic surgeon who specializes in foot and ankle surgery in Ridgefield and Danbury. “We have a peculiar adult athletic community—quite a few adult soccer leagues, a rugby league, tons of adult hockey and baseball players, even an adult football league, and of course runners well into their 70s—and with that, we’re seeing acute and repetitive injuries in adults that 15 to 20 years ago we saw only in younger people. These include osteochondral fractures, foot and severe ankle sprains and post-traumatic arthritis.”
Injuries among weekend warriors run the gamut from minor sprains (usually treated with icing and anti-inflammatory medications) to stress fractures that can put someone out of commission for eight weeks or more—and even require surgery. Gray says that “turf toe” is one of the most painful injuries sustained while playing vigorous plant-and-pivot sports like soccer. It occurs inside the cleat, when the combination of sudden deceleration and hyperextension causes the ligament under the big toe to rupture. “It’s nasty,” says Gray, “and it can be disabling for months.”
Running barefoot is a craze that’s keeping foot specialists on their toes. “They say it’s a more natural way to run,” says Gray, “but the jury’s out as to whether it is better—or just different. We do know this: We’re seeing more stress fractures because there’s no shock absorption, and more puncture wounds, because shoes provide protection. Interestingly, we’re seeing less Achilles tendinitis in barefoot running, though we’re not quite sure why that is.”
Plantar fasciitis is one of the most common conditions for which adults, whether athletes or not, seek treatment. “We see it all the time,” says Daniel Davis, a podiatrist with the Family Podiatry Center in Bridgeport. “It’s a very characteristic pain that patients feel initially in the first five minutes of waking up. It can make you feel as if you’re 95,” he says.
The most common cause of heel pain, plantar fasciitis is caused by straining the ligament that supports the arch. In severe cases, the strain can cause tiny tears leading to debilitating pain and swelling. While far more common in middle age, it also occurs in younger people who are on their feet a lot.
Duanne Simon works as a photographer in the Ethan Allen studio in New Milford, a job that requires her to be on her feet most of the day. Simon, who’s in her mid-50s, says she first noticed mild discomfort five years ago, “after edging the flower beds with the same foot all day.”
She implemented a homegrown remedy. “Rolling my foot on a frozen drink bottle for 15 to 20 minutes three times a day made it ‘go away’ in a couple of months,” she says.
Although the first episode wasn’t directly related to her job, she says that “concrete floors can’t be good for anyone’s feet.” She had a recurrence a year-and-a-half ago. “My foot would bother me for a bit when I got up in the morning, but would get worse throughout the day. I would begin to hobble after sitting and my walking gait was being affected from favoring the heel of the afflicted foot,” says Simon.
Finally, a podiatrist recommended she do stretches and exercises, and wear a night brace that keeps her foot in a flexed position while she sleeps. While this helped a lot, she still had to have a cortisone injection in her heel after a few months. She reports that the combined treatment “totally worked.”
Simon’s experience is fairly common. While Gray sees as many as 800 cases of plantar fasciitis every year, he says that only perhaps 5 percent of them ever require surgery. “It’s something that can usually be managed with a combination of stretching, physical therapy, nighttime splints and/or cortisone injections,” he says. However, in stubborn cases a “small incision and slight nick across the fascia” will bring relief.
Osteoarthritis is what Gray calls an example of “ungraceful aging.”
Also known as degenerative joint disease, it’s the most common type of arthritis, which is an inflammation to the joint that causes a breakdown of cartilage tissues, resulting in pain and swelling.
Given the number of bones and joints in a foot, it’s no wonder that arthritis affects so many. In mild cases, Gray recommends wearing stiff-soled shoes and taking arthritis (anti-inflammatory) medication. Cortisone injections may be in order if less aggressive treatments fail to work. “In severe cases, the gold standard is surgery to fuse the joint,” he says.
Treatment for arthritis of the ankles may also include total joint replacement surgery, and while the procedure has been effective for some, it may not be the best course of action for many.