Why Does My Big Toe Joint Hurt: Part 2

Well its been a little over a week wearing my orthotics.  I must say that the biggest challenge about wearing these is getting used to tennis shoes and socks....not the orthotics.  Living in Florida has put me in the bad habit of wearing thin, crappy flip-flops.  I took my first long walk with them in on Tuesday.  My toe was a little bit stiff at first but once I started walking it felt pretty darn good.  The bad part of my walk was the squeaking.  It was so loud it made me self conscious.  The good part of my walk is that my destination was the grocery store where I could pick up some baby powder.  As soon as I took my orthotics out and sprinkled baby powder in the bottom of my shoes the menacing noise disappeared.

Wednesday I had a softball game and I wanted to wear them but Im not to that point yet.  Not because they are not comfortable but because Im too superstitious!  I know that it is extremely silly but hopefully Dr. Gordon will understand. My toe really doesn't hurt as much as it used to so I am pretty excited that the orthotics are making a difference.  Tomorrow will be the big test....I am going to take a run in them.  Wish me luck!

Why Does My Big Toe Joint Hurt

As  I walked into Gulfcoast Foot and Ankle I was greeted by the familiar faces behind the desk.  I was not walking in as an employee that day, but for the first time as a patient.  For about 5 months now my big toe joint has hurt me pretty badly.  Why would I wait so long to see a podiatrist….especially when I work for one!?  Well I guess the main reason is sheer stupidity.  But in all honesty I just figured the pain would go away.  Well it did not so there I sat in the waiting room to see Dr. Gordon.  He was extremely surprised to see me thinking I stopped by to discuss marketing strategies or to go over the Student Scholar Athlete Awards we need to present….no Dr. G Im here as a patient.  I was placed in a chair and asked a few questions and he decided the best thing to do was some simple x-rays to see what was going on in that toe joint.  A lovely lady appeared in the room and whisked me away to the x-ray machine.  After a few minutes I was back in the chair studying my bones with Dr. Gordon.  Hallux Limitus, Dr. Gordon told me with no look of question or doubt in his face.  

Hallux Rigidus/Limitus involves the 1^st metatarso-phalangeal joint.  This joint is located at the base of the big toe.  Hallux Rigidus/Limitus causes pain and stiffness in the big toe, and with time it becomes increasingly harder to bend the toe.  This is a progressive condition during which the toe's motion decreases as time goes on.  In the early stages, motion of the big toe is only limited, and at this point, the disorder is called Hallux Limitus.  As the problem advances, the big toe's motion gradually decreases until it becomes rigid or frozen.  At this point, the disorder is referred to as Hallux Rigidus.  As motion becomes progressively limited, pain increases, especially when the big toe is extended, or pushed up. 

            

Great…what now… was the only thing I could think.  Im trying to start running and this really was putting a damper on things!!  Dr. Gordon decided to cast me for orthotics.  My feet are flat I had this Hallux Limitus thing going on so it seemed like the best thing to do.  He had me lay on my back and lay on my stomach and took measurements of my feet.  Then he proceeded to put strips of wet plaster on my foot to make a mold.  He made quick work of the plaster and before I knew it he was taking these white molds off my feet that sort of resembled a thin version of a wooden shoe from Holland that looked just like my foot!  So off to the lab went my feet molds.

            

This morning a received the call that my orthotics were in!  I was so excited to see what they would feel like.  I packed up my sneakers and socks and headed to the office.  This was a special trip because I was going to the office today as both an employee AND a patient.  Dr. Gordon put the orthotics in my shoes and told me to give them a try.  My feet felt AMAZING!!!  Even after 1 minute of walking in them my feet felt so good.  The pain in my toe isn’t gone yet but Im sure it will take more than 2 minutes.  I was almost sad that I was only allowed to wear them for a couple of hours today.  But…Doctors orders!  I will let you know next week the progress that I am having since I will be wearing them a lot more then.

Jennifer Grey of DWTS has Foot Neuroma Removed

Jennifer Grey has undergone surgery to have a neuroma removed from her foot.

The 50-year-old Dirty Dancing actress and Dancing With The Stars champion, said that the growth got worse after her stint on the show, leaving her with no option but to have the surgery.

Writing on Twitter, she said, 'Hard to believe, but I just had my foot operated on so hopefully I can walk again. Gotta dance. Miss you all. I guess that's the price of doing business when you kick ass like that at my age... haha.

'I had a neuroma the size of a small city removed. I think I went down a shoe size on one foot. After Dancing With The Stars it just got worse and worse, so do whatcha gotta do.'

She added, 'Ain't no thang. Pain is just a feeling. Then it's gone.'

Study finds increase in running-related injuries among children

The annual number of running-related injuries has increased 34% during a 14-year period, according to a study published in the Feb. 2011 issue of Clinical Pediatrics.

Investigators examined running-related injuries — primarily sprains and strains to the lower extremities — among children and adolescents aged 6 to 18 years, finding an estimated 225,344 cases treated in emergency departments throughout the United States from 1994 to 2007. The data was collected from the National Electronic Injury Surveillance System.

One-third of the injuries involved a fall, the investigators noted, and more than 50% of running-related injuries occurred at school. The injuries varied by age, however, with children aged 6 to 14 years being more likely to suffer injury as the result of a fall or while running at school. Adolescents 15 to 18 years of age were more likely to sustain injuries while running in the street or at a sports and recreation facility.

“Encouraging children and adolescents to run for exercise is a great way to ensure that they remain physically active,” investigator Lara McKenzie, PhD, stated in a press release. “However, the findings from our study show that formal, evidence-based and age-specific guidelines are needed for pediatric runners so that parents, coaches and physical education teachers can teach children the proper way to run in order to reduce the risk of injury.”

The authors noted that this is the first study to examine a nationally representative sample of running-related injuries treated in U.S. emergency departments, but added that further research is necessary to thoroughly understand pediatric running-related injuries and the role injury prevention can play in reducing them.

References:

• Mehl AJ, et al. Running-related injuries in school-age children and adolescents treated in emergency departments from 1994 through 2007. Clin Pediatr. 50(2);126-132. doi: 10.1177/0009922810384719.
• www.nationwidechildrens.org

Flat Feet Are Associated With Knee Pain and Cartilage Damage in Older Adults

Researchers assessed the cross-sectional relation of planus foot morphology to ipsilateral knee pain and compartment-specific knee cartilage damage in older adults. The study, of 1,900 adults in their 50s or older, found that those with the flattest feet were 31 percent more likely than other study participants to say they had knee pain on most days. And they were 43 percent more likely to show damage to the cartilage at the inside of the knee.


Dr. Gordon has always believed that bad knees can be caused or exacerbated by flat feet. In 1994 he was talking about a research project with the Chairperson of the Department of Orthopedics at the University of Washington to see if a well made orthotic device would prevent knee surgeries specifically joint replacement surgery. Regrettably he left Seattle before the project could get off the ground.

Abstract

Objective.

To assess the cross-sectional relation of planus foot morphology to ipsilateral knee pain and compartment-specific knee cartilage damage in older adults.

Methods.

In the Framingham Studies, we adapted the Staheli Arch Index (SAI) to quantify standing foot morphology from pedobarographic recordings. We inquired about knee pain and read 1.5 Tesla MRIs using whole-organ magnetic resonance imaging scoring. Logistic regression compared the odds of knee pain among the most planus feet to the odds among all other feet, and estimated odds within categories of increasing SAI. Similar methods estimated the odds of cartilage damage in each knee compartment. Generalized estimating equations adjusted for age, sex, BMI, and non-independent observations.

Results.

Among 1903 participants (mean age 65± 9 years; 56% female), 22% of knees were painful most days. Cartilage damage was identified in 45% of medial TF, 27% of lateral TF, 58% of medial PF, and 42% of lateral PF compartments. Compared with other feet, the most planus feet had 1.3 (95% CI: 1.1, 1.6) times the odds of knee pain (p=0.009), and 1.4 (95% CI: 1.1, 1.8) times the odds of medial TF cartilage damage (p=0.002). Odds of pain (p_trend=0.05) and medial TF cartilage damage (p_trend=0.001) increased linearly across categories of increasing SAI. There was no association between foot morphology and cartilage damage in other knee compartments.

Conclusion.

Planus foot morphology is associated with frequent knee pain and medial TF cartilage damage in older adults.