Call to schedule an appointment today!

(907) 344-2155
  • Google+
  • facebook

Foot & Ankle Education in Anchorage, AK

 

The health of your feet is very important when it comes to maintaining an active and comfortable lifestyle. There is no reason why you should have to deal with unnecessary pain and physical limitations because of problems with your feet.

Take control of your life now by learning how to manage—and even overcome—difficult foot and ankle conditions by reviewing the information below that you need to stay active in Anchorage, AK. And if you don’t find an answer here, contact us right away, and we will answer your questions quickly.

Each of the links provided here will take you to the Information you need to understand the most common foot and ankle conditions in Anchorage, AK that you may be facing:

Bunion Deformity
Hammertoe Deformity
Hallux Limitus
Hallux Rigidus
Plantar Fasciitis (a.k.a. Heel Spur Syndrome)
Endoscopic Gastrocnemius Recession
Morton’s Neuroma
Posterior Heel Spur

Bunion Deformity
A bunion is a foot deformity caused by abnormal shifting of the first metatarsal bone (the bone behind the toe bones) away from the lesser metatarsal bones. It generally appears as a bump at the base of the great toe that gets bigger over time. Sometimes the skin over this bump may become red and irritated and a callous may form over the bump as well. The bump itself is actually the end of the bone called the “head”. As the metatarsal bone continues to shift, the head will become more prominent. This occurs for a multitude of reasons including:
Narrow/pointed toe shoes; abnormal foot mechanics; excessive mobility of the joints in the foot; and there is also a genetic predisposition to develop bunions.

Bunions are a structural and progressive deformity which can worsen over time and can become very painful, limiting the ability to walk comfortably and to wear shoes comfortably. There are ways in which a bunion deformity can be managed and made more comfortable in shoes. These include:

Additionally, custom orthotics may be helpful to control movements of the foot that may contribute to worsening of the deformity over time. However, they will not correct the deformity that is already present.

If conservative care fails to alleviate the pain, then surgery to realign the metatarsal bone back behind the great toe may be pursued. This is an outpatient surgical procedure which takes an hour or less to complete. Ask your podiatrist about your surgical options as well as the necessary recovery.

If you would like to watch a video on bunion surgery, please follow this link:

“Austin Bunionectomy with Screw Fixation” Thalia Oster

(This video includes live operative footage and may be disturbing to some audiences.)

In cases of very severe bunion deformity, or when there is excessive motion in the joint at the base of the first metatarsal bone, a more proiximal (closer to the leg) procedure may be necessary. This may include fusing the joint between the first metatarsal bone and the bone behind it, called a cuneiform bone. This is also an outpatient procedure which takes between 1 ½ and 2 hours. Following this procedure, patients must remain non-weight bearing with crutches for approximately 6-8 weeks. For more information about this procedure, consult your podiatrist.

If you would like to watch a video on this type of surgery, please follow this link:

“Lapidus Arthrodesis (ENG)” Normed Germany

(This video includes live operative footage and may be disturbing to some audiences.)

Hammertoe Deformity
A hammertoe develops when a joint in a toe contracts, causing a bend in the toe that does not straighten back out. This is a result of abnormal alignment and/or pulling of tendons that control the motion of the toe.

Depending upon the level of joint contracture, the contracted digit may be referred to as a mallet toe, claw toe, or traditional hammertoe. Your podiatrist can discuss your specific toe deformity with you.

A hammertoe is a structural deformity and can progress and worsen over time. The skin over the joint that is contracted may become red and inflamed due to rubbing inside of shoes. Callus lesions may develop over prominent joints and, in extreme cases, the skin may actually break down causing a hole to develop, which is known as an ulcer.

There are ways in which a hammertoe can be managed and made more comfortable in shoes. These include:

Additionally, custom orthotics may be helpful to control movements of the foot that may contribute to worsening of the deformity over time. However, they will not correct the deformity that is already present.

If conservative care fails to alleviate the pain, then surgery to straighten the toe may be pursued. This is an outpatient surgical procedure which takes 30 minutes or less to complete. Ask your podiatrist about your surgical options as well as the necessary recovery.

If you would like to watch a video on hammertoe surgery, please follow this link:

“Hammertoe surgery explained, Podiatry claw toe, mallet toe…” DrGlass DPM

(Please note that this video depicts placement of a pin in the toe. This is not always necessary, and depends on the severity of the deformity.)

If you would like to watch a video on hammertoe surgery with fusion of the toe joint with an implant, please follow this link:

“2nd PIPJ Arthrodesis with Smart Toe Implant from MMI” Patrick DeHeer

(This video includes live operative footage and may be disturbing to some audiences.)

Hallux Limitus
Hallux Limitus refers to loss of motion in the joint at the base of the great toe, which is also called the hallux. The joint itself is called the first metatarsal phalangeal joint, or 1st MPJ. This occurs when the cartilage over the ends of the first metatarsal and phalanx bones starts to erode, affecting the gliding motion of the joint and the ability of the great toe to move up over the metatarsal bone while walking. Sometimes if the first metatarsal bone is elevated too much this can also affect the ability of the great toe to move over the metatarsal bone while walking. Over time, bone spurs may form around the joint, further limiting the motion of the great toe. Eventually, the joint may become so damaged that motion is completely lost and the great toe cannot move or bend when walking. At this point, the joint is rigid.

There are ways in which hallux limitus can be managed and made more comfortable in shoes. These include:

Additionally, custom orthotics may be helpful to control movements of the foot that may contribute to worsening of the deformity over time. However, they will not correct the deformity that is already present.

If conservative care fails to alleviate the pain, then surgery to improve motion in the 1st MPJ may be pursued. This is an outpatient surgical procedure which takes about an hour to complete. Ask your podiatrist about your surgical options as well as the necessary recovery.

If you would like to watch a video on hallux limitus surgery with joint replacement, please follow each link for this three-part video series:

“Arthrosurface toe DF metatarsal resurfacing technique” – Arthrosurface Part 1

“Arthrosurface toe DF metatarsal resurfacing technique” – Arthrosurface Part 2

“Arthrosurface toe DF metatarsal resurfacing technique” – Arthrosurface Part 3

(This video includes live operative footage and may be disturbing to some audiences.)

If you would like to watch a video on hallux limitus surgery without joint replacement, please follow this link:

“Cheilectomy” vasudevaspai

(This video includes live operative footage and may be disturbing to some audiences.)

Hallux Rigidus
Hallux Rigidus is essentially the end-point of hallux limitus. Unlike hallux limitus where there is still some motion in the joint at the base of the great toe (the first metatarsal phalangeal joint, or 1st MPJ), with Hllux Rigidus there is very little, if any, motion at the joint. This prevents the great toe from being able to bend while walking and the joint itself may be very painful.

There may be very little cartilage remaining on either surface of the joint and sometimes small fragments of bone may be found floating in the joint during surgery. Bone spurs are often seen at either side of the joint.

Hallux Rigidus may occur following an injury to the metatarsal phalangeal joint, such as an old fracture or impaction injury, or may be a result of an abnormally elevated first metatarsal bone which prevents the great toe from moving over the metatarsal bone when walking. It may also be a result of osteoarthritis (sometimes referred to as overuse arthritis).

There are ways in which hallux limitus can be managed and made more comfortable in shoes. These include:

Additionally, custom orthotics may be helpful to control movements of the foot that may contribute to worsening of the deformity over time. However, they will not correct the deformity that is already present.

If conservative care fails to alleviate the pain, then surgery to fuse the joint may be pursued. This is an outpatient surgical procedure which takes about an hour to complete. Ask your podiatrist about your surgical options as well as the necessary recovery.

If you would like to watch a video on 1st MPJ fusion surgery, please follow this link:

“First Metatarsophalangeal Joint Arthrodesis” 1stMTPFusion

(This video includes live operative footage and may be disturbing to some audiences.)

Plantar Fasciitis (a.k.a. Heel Spur Syndrome)
Plantar fasciitis is one of the most common pathologies seen in podiatry. It is inflammation of the plantar fascia, a thick, inelastic band of tissue at the bottom of the foot. This tissue is very strong and helps to support the muscular and soft tissue structures that make up the arch of the foot (much as a truss supports the two ends of an arch).

Inflammation of the plantar fascia can occur for multiple reasons, most common of which are:

Plantar fasciitis presents as severe pain in the bottom of the heel that is often worse in the morning or after periods of rest, improves after a few minutes of walking, but may recur after extended periods of activity. Sometimes this may occur in combination with Achilles tendon or calf pain.

In many cases, x-rays taken of the affected foot will reveal a bone spur coming off of the heel bone and pointing out toward the toes. This spur is a result of the fascia pulling on and tearing at the heel bone and is not the cause of the pain.

Plantar fasciitis is often treated conservatively with a success rate of 90-95% remission with conservative care. Conservative care includes:

Those who fail to improve with conservative care may require surgical intervention. This is an outpatient procedure which takes about 10-15 minutes (if done endoscopically) to complete, and includes releasing the tight fascia from its insertion on the heel bone. Ask your podiatrist about your surgical options as well as the necessary recovery.

If you would like to watch a video on Endoscopic Plantar Fasciotomy, please follow this link:

“Endoscopic Plantar Fasciotomy” Thalia Oster

(This video includes live operative footage and may be disturbing to some audiences.)

Endoscopic Gastrocnemius Recession
An Endoscopic Gastrocnemius Recession is often performed in conjunction with the endoscopic plantar fasciotomy. This procedure serves to lengthen the gastrocnemius muscle (also referred to as the calf muscle), which in turn releases tension from the associated Achilles tendon. This is important in plantar fasciitis because the Achilles tendon, which inserts into the back of the heel bone, can limit the amount of motion available to the ankle when walking. If the Achilles tendon is tight, abnormal foot mechanics develop which can increase tension and stress on the plantar fascia and contribute to development and worsening of plantar fasciitis.

Stretching exercises targeting the calf muscle and its associated Achilles tendon may provide some benefit. However, in cases where stretching alone is not sufficient, surgical intervention may be pursued. This is an outpatient procedure which takes about 5-10 minutes to complete, and includes releasing the tight calf muscle (gastrocnemius muscle) from the Achilles tendon. Ask your podiatrist about your surgical options as well as the necessary recovery.

If you would like to watch a video on Endoscopic Gastrocnemius Recession, please follow this link:

“Endoscopic Gastrocnemius Recession” Thalia Oster

(This video includes live operative footage and may be disturbing to some audiences.)

Morton’s Neuroma
A Morton’s Neuroma is an inflamed and enlarged nerve in the forefoot that runs between the metatarsal bones and provides sensory (touch) feedback to the adjacent sides of the toes that it serves. It is commonly felt at the bottom of the ball of the foot and may present as numbness in the toes, sharp stabbing pain, or burning pain in the ball of the foot. Oftentimes, patients will complain that it feels like a sock is wadded up under the ball of their foot (even if they are not wearing socks!), or like there is a pebble or a mass under the forefoot. Removing shoes and rubbing the foot provides immediate pain relief, but the pain often returns once activity is resumed and/or shoes are put on. High heeled shoes may increase pain by increasing pressures on the forefoot and the neuroma itself. Additionally, tight calf muscles may affect increased pressure on the forefoot and the associated neuroma.

There are ways in which hallux Morton’s Neuromas can be managed and made more comfortable in shoes. These include:

If conservative care fails to alleviate the pain, then surgery to remove the neuroma may be pursued. This is an outpatient surgical procedure which takes 20-30 minutes to complete. This includes removing the neuroma itself as well as the nerve branches into the adjacent two toes. Ask your podiatrist about your surgical options as well as the necessary recovery.

If you would like to watch a video on removal of Morton’s Neuroma, please follow this link:

“Surgery Morton’s neuroma pain in the foot” DrGlass DPM

Posterior Heel Spur
Heel spurs are overgrowths of bone that are often found in the back and on the bottom of the heel bone. They occur as a result of chronic traction forces exerted by the soft tissues on the bone. This traction force, if strong enough, can result in tearing of the coating over the heel bone, bleeding and subsequent development of bone growth. (This is seen oftentimes on the bottom of the heel as well in cases of plantar fasciitis.)

In cases of posterior (back of the heel) heel spurs, the spur is a result of chronic traction forces and pulling on the heel by the tight Achilles tendon. When this occurs, the spur that develops is actually within the tendon itself. As a result, inflammation and thickening of the Achilles tendon may occur, known as Achilles Tendonitis or Achilles Tendinosis.

As the spur enlarges, it may start to cause rubbing and irritation within shoes. This may cause irritation and redness of the skin and, in extreme cases, may lead to skin breakdown and ulcers.

There are ways in which a Posterior Heel Spur can be managed and made more comfortable in shoes. These include:

If conservative care fails to alleviate the pain, then surgery to remove the heel spur may be pursued. This is an outpatient surgical procedure which takes approximately one hour to complete. This includes partially removing the Achilles tendon from the back of the heel, removing the heel spur, debriding the tendon as needed, and reattaching the tendon to the heel. An endoscopic gastrocnemius recession is often performed in conjunction with this procedure. Ask your podiatrist about your surgical options as well as the necessary recovery.

If you would like to watch a video on heel spur removal and Achilles tendon repair, please follow this link:

“Retrocalcaneal Heel Spur Reduction and Repair of Achilles Tendon” PatrickDeHeer

(This video includes live operative footage and may be disturbing to some audiences.)

For more details about foot and ankle information in Anchorage, AK, contact us directly, and we will be happy to help you gain a better understanding of your foot conditions.