Dr. Grant Gonzalez of the Foot & Ankle Center of Illinois recently met with senior residents and staff at the Eastland Retirement Community facility, an independent living center nestled on farmland owned by Jane Moose, near Auburn. Meeting with the residents in an informal setting was a perfect opportunity to explain some of the most common foot ailments seniors experience and to offer simple solutions.
According to Dr. Gonzalez, “The senior population is expanding and I feel it is part of our role, as podiatrists, to help them get the most out of their future years. A lot of foot problems and related injuries can be prevented through patient education and awareness forums like this one. Both Dr. Sigle and I firmly believe that seniors have the power to reduce their risk of injury by taking preventive measures to live a healthier and independent life.”
The American Podiatric Association estimates the average person walks around 75,000 miles by age of 50. Proper foot care becomes even more vital for seniors if they want to extend the health and capacity of their feet. According to Dr. Gonzalez, “an important element in maintaining proper foot care is to understand what preventive measures to take and what treatment options to pursue when problems occur.”
Here is a basic overview of the common foot ailments and simple solutions.
BUNIONS: Bunions are one of the most common foot problems that affect many people’s lives every day. It is caused by a splaying of the metatarsal bones that sit behind your toe bones. They generally present with a bump at the big toe joint that correlates to a prominent metatarsal head. This deformity can become painful with activity and continues to ache throughout the day. The big toe can also abut the second toe, and cause painful corns or calluses. The simplest solution for relieving bunion pain is to wear a wider shoe and avoid any shoe with a narrow toe box. This compresses the toes together and makes the bunion more prominent. Toe spacers can also prevent the interdigital corns and calluses caused by toes bumping into each other. Over the counter and custom orthotics can also be used to help improve foot function and slow down progression of the deformity. If conservative measures do not offer significant relief, the problem can be fixed surgically.
HAMMERTOES: A hammertoe is a contracture of the toes that often are painful during gait and when wearing shoes. Since there are several joints that can contract, hammertoes can cause pain in several different locations. These can include on the top of the toe at a contracted joint, on the tip of the toe which often presents as a callus or corn, and on the ball of the foot. The simplest fix for hammertoe pain is padding and strapping which is especially helpful to prevent rubbing in shoe gear. Should the pain continue, a number of procedures can be considered to rid a person of the nagging caused by a contracted digit. The simplest procedure is called a tenotomy. The long flexor and/or extensor tendon can be released allowing the toe to sit straight, leaving the short tendon intact which maintains the function of the digit. This can be performed in an office setting and requires no special shoe gear or restrictions afterward.
MORTON'S NEUROMA: A Morton’s neuroma results when a nerve that supplies the third and fourth digits is compressed between the associated metatarsal bones and a ligament that runs between them. This compression causes the nerve to swell, resulting in an odd sensation that can cause the toes to go numb or give the feeling of walking on a wadded-up sock. This is exacerbated by tight shoes that squeeze the metatarsal bones together resulting in further pressure on the already sensitive nerve. A simple fix is a wider pair of running shoes, as well as adding an orthotic that more evenly distributes the pressure of weight bearing. If these are not successful, the nerve can be gradually ablated with a dilute injection of alcohol. Finally surgical removal is an option if deemed necessary.
PLANTAR FASCIITIS: Plantar fasciitis is an extremely common cause of a very painful heel. The plantar fascia is a thick ligamentous band that attaches from the heel out to the toes. When the foot over-pronates, this overstresses the fascia which creates micro-tears from its insertion into the heel bone. During inactivity, the body attempts to heal these tears. These are then reinjured during initiation of weight-bearing which causes an excruciating period of pain that is improved somewhat after the fascia is stretched out during walking. The underlying problem is a tight plantar fascia ligament and Achilles tendon that prevent normal gait pattern and place undue stress on the heel bone. A dedicated stretching routine of the fascia and Achilles are the benchmark of a very successful treatment plan that can also include orthotics to support the fascia and anti-inflammatories to treat the inflammation and pain. Plantar fasciitis is a problem very often solved conservatively, although surgical options are available should the need arise.
There are many common foot and ankle problems that can treated successfully with simple conservative measures. By taking an active role in the health of your feet, you can help maximize your outcome. If your problem is unresponsive to these common remedies, then you can consult with a foot and ankle surgeon who can work with you to eliminate your pain and make every step more comfortable.
If you are experiencing some of these problems, contact Drs. John Sigle, or Grant Gonzalez at the Foot & Ankle Center of Illinois at (217) 787-2700; or visit myfootandanklecenter.com for more information. The Foot & Ankle Center of Illinois is located at 2921 Montvale Drive, Springfield; St. Mary’s Hospital, 1900 East Lake Shore Drive, Decatur; and Carlinville Area Hospital, Carlinville.