FOOT & ANKLE
Ankle Sprains
Bunions
Morton's Neuroma

Foot and ankle pain is a common disorder. Almost 80% of the population will experience foot pain in their lives. At OrthoWest's Foot and Ankle Center, we believe that no one should have to live with lower extremity pain. We are trained and equipped to diagnose and treat problems involving the foot and ankle. We treat common problems such as calluses and bunions, as well as serious injuries and disorders. Many foot and ankle problems can be remedied with conservative care, including correctional orthotic devices. For patients with conditions that fail to respond to conservative care, surgical intervention may be necessary.

Foot and ankle surgery includes the treatment of fractures, repair of tendon injuries, correction of deformities, management of ankle instability and bone/cartilage from sports-related injuries, and comprehensive management of heel pain.

The OrthoWest Foot and Ankle Center is dedicated to keeping our patients' feet in the healthiest condition. We tend to people of all ages, treating any problem concerning the foot and ankle. Our physicians are supported by a dedicated staff that will provide you with complete care throughout your treatment. In addition, our physicians hold regular clinics three times a week for all your nonsurgical foot and ankle needs.

Bunions

A bunion is generally considered as an enlargement of the joint (a lump of bone) at the base and side of the big toe. Bunions form when the toe moves out of place. As the big toe bends toward the others, this lump becomes larger and the bunion can become painful – arthritis and stiffness can eventually develop. Hallux valgus or hallux abducto valgus (HAV) is the name used for the deviated position of the big toe and a bunion refers to the enlargement of the joint – most of the time the two go together and can be referred to as "bunions."

Wearing footwear that is too tight or causing the toes to be squeezed together are the most commonly blamed factors for the cause of bunions and hallus valgus. This probably is the reason for the higher prevalence of bunions among women.

Bunions are most widely considered to be due to an imbalance in the forces that is exerted across the joint during walking. The result is abnormal motion and pressure over the joint, over many years (combined with poor fitting footwear) leads to instability in the joint causing hallux valgus and bunions. Bunions are really only a symptom of faulty foot mechanics and are usually caused by a combination of the way we walk, genetics and inappropriate footwear use.

There are many treatments for bunions, and they will vary with the type and severity of each bunion and will also depend on what is causing the symptoms. Bunions are almost always progressive and tend to get larger and more painful with time – how fast this happens may be a function of the fit of the footwear.

The initial goal of the treatment options is to relieve pressure on the bunion and any symptoms that may be present and to halt or slow the progression of the joint deformity. There is no effective way to "get rid of" a bunion without surgery. However, there are a number of things that individuals and doctors can do to help the symptoms and slow (if not halt) progression. These include padding, physical therapy, treatment or removal of calluses and corns, proper footwear and regular exercise. All have been proven to be beneficial to varying degrees.

Hammer Toe

A hammer toe is a toe that is contracted at the PIP joint (middle joint in the toe), potentially leading to severe pressure and pain. Ligaments and tendons that have tightened cause the toe's joints to curve downwards. Hammer toes may occur in any toe except the big toe. Hammer toes result from a muscle imbalance which causes the ligaments and tendons to become unnaturally tight. Arthritis can also lead to many forefoot deformities, including hammer toe.

Changing the type of footwear worn is a very important step in the treatment of hammer toe.

Arthritis of the Foot

The pain and stiffness you feel in your foot or ankle as you grow older could be arthritis. If left untreated, this nagging pain can grow worse, eventually becoming so excruciating that you can no longer walk even short distances. Severe arthritis can restrict your mobility and limit your quality of life, but with proper treatment, you can slow the development of arthritis and lead a more productive life.

Proper treatment of foot and ankle arthritis addresses both pain and joint deformity. Pain develops when the joint is injured. Injury to the joint may result from swelling caused by inflammatory arthritis or from loss of joint surface (cartilage), often caused by trauma. If left untreated, the foot and ankle may eventually become deformed.

Once your doctor confirms you have arthritis, he/she will recommend a treatment regimen, which may include medication by mouth (anti-inflammatories), injections (steroids), physical therapy, occupational therapy, or orthotics such as pads in your shoes, shoe inserts, additions to the insoles or heels of your shoes, or custom-made braces. Surgery may be necessary. This may mean cleaning the arthritic joint, eliminating the painful motion of the joint, replacing the joint with an artificial joint or a combination of all three.

Tendinitis of the Foot

Because we use our feet continuously, tendinitis of the foot is a common problem. As we age, our tendons can degenerate, or wear down or weaken over time. Degeneration in a tendon usually shows up as a loss of the normal arrangement of the fibers of the tendon. Tendons are made up of strands of material called collagen. Some of the individual strands of the tendon become jumbled because of degeneration, other fibers break, and the tendon loses strength. As the tendon heals itself from wear and tear, scar tissue forms, thickening the tendon. This process can continue to the extent that a nodule, or knot, forms within the tendon. This condition is called tendinosis. The area of tendinosis in the tendon is weaker than a normal tendon. The weakened tendon sets the stage for the possibility of rupture of the tendon. Tendinosis becomes tendinitis when the weakened tendon becomes inflamed. The symptoms of tendinitis of the posterior tibial tendon includes pain in the instep area of the foot and swelling along the course of the tendon.

Treatment begins with the use of a firm arch support inserted into your shoe. The arch support is useful because it supports the arch and takes some of the stress off the tendon. Additionally, the doctor may prescribe anti-inflammatory medication, such as ibuprofen or aspirin. Sometimes a physician may suggest a cortisone treatment called ionophoresis, which uses electric current to increase the absorption of a cortisone cream through the skin and down around the tendon where the inflammation is occurring.

If all else fails, surgery may be required, wherein the thickened tissue around the tendon is removed. This procedure is usually done through a small incision in the instep of the foot just over the posterior tibial tendon. The surgeon simply identifies the tendon and removes the thickened tissue.

If the tendon has ruptured, surgery may be required to either repair the ruptured tendon or to replace it with a tendon graft.

Finally, in cases which have been neglected and a fixed flatfoot deformity is present, a fusion of the foot may be required.

Frequently Treated Problems

• Bunions
• Achilles Problems
• Claw Toes
• Ankle Pain
• Shoeing Problems
• Athletic Injuries
• Ulcers Due to Insensate and Diabetic Foot Problems
• Pediatric Foot Problems
• Fractures and Pains
• Calluses
• Painful Flatfeet