Keep Your Feet Feeling Young

We’re well into March Madness 2010 and the West Virginia Mountaineers have reached the Final Four for the first time since 1959. One of the Mountaineers star players, Guard Truck Bryant, broke his fifth metatarsal two weeks ago, but may see some play time as the tournament comes to a close.

The fifth metatarsal is a common bone injured in basketball. A strong tendon, the peroneus brevis, attaches to the base of the bone. When the ankle twists, which happens often in basketball, the tendon can pull on its attachment to the fifth metatarsal and break the bone. This is a serious injury that requires immobilization and sometimes requires surgery to correct.

Mountaineers’ trainer Randy Meador said how a specialist has constructed a custom orthotic device for Bryant. This orthotic is designed to redistribute pressure away from the injured bone to allow him to bear weight, but still allow the fracture to remain stable. This isn’t a cure-all by any stretch, but we’re talking about championship basketball, not a YMCA pick-up game…there’s a lot at stake!

Ideally the fracture would be allowed to heal.   Meador said that it’s not a “big break” which likely means the fracture is not displaced.  I wouldn’t be surprised if Bryant ends up with surgery to repair the injury after WVA’s season is officially over.  If not, he will likely be in a boot to immobilize him for 6-8 weeks.  Until then, Bryant and his team will do what they can to capitalize on the position they’ve worked so hard to get their team to.  Good luck!

Foot pain is common. At some point most people will experience pain or discomfort in their foot. While much of the time this is due to a direct foot issue, it sometimes can be because of instability elsewhere in the lower extremity. If left untreated, this can lead to pain in the ankles, knees, hips, back, or even your rear end. So my title can be taken literally or figuratively.

A literal “pain in the rear” due to unstable mechanics comes in a condition known as Piriformis Syndrome. The Piriformis muscled lies deep to the gluteal muscles and the sciatic nerve passes right beneath or through it. It functions to move the thigh away from the body’s midline and externally rotates it. Piriformis Syndrome is a condition in which the piriformis muscle irritates the sciatic nerve. This causes a pain deep in the buttocks and can even cause symptoms of Sciatica, a referred pain down the leg. The pain is generally made worse by sitting, squatting, or climbing stairs.

The primary cause of Piriformis Syndrome is biomechanical in nature. Overpronation of the foot can ultimately lead to the formation of this syndrome. It is essential that this be addressed with the use of a custom orthotic to prevent recurrence of the issue. Treatment also involves a stretching regimen and physical therapy. In resistant cases anti-inflammatory medication can be used and a cortisone injection may also help.

Speaking more figuratively, any pain in the foot has the ability to become a pain in the butt! From an ingrown toenail, heel pain, and Achilles tendon pain to something like a simple painful corn, foot pain can make everyday activities painful and laborious. I see it daily in my Houston, TX, podiatry practice – people waiting weeks, months, or even years for their foot pain to go away. There is no reason to wait so long!

The quickest avenue to eliminating the pain in your foot is by visiting your podiatrist. A podiatrist can simply diagnose the cause of your pain and offer solutions to quickly resolve it. Many people I treat are stunned how quickly the pain resolves…all regretting that they waited so long! Most find that the difficult part of solving their foot pain taking charge and scheduling the appointment.

Who would have thought that a foot doctor could treat the pain in your foot that’s become a pain in your ass? Both at the same time!

I am an unapologetic fan of the Grateful Dead – a Deadhead. I saw them many times before the passing of Jerry Garcia and have seen their many reincarnations and offshoots over the years. Unfortunately, the band rarely comes close to me in Houston, TX so I have to travel to see them. Most recently I took my family to see Furthur, the latest incarnation, in San Francisco for shows over New Years and took friends and colleagues to Fairfax, VA, where I happened to have a meeting. All agree – there is nothing like the unique experience of a Grateful Dead concert. In fact, it’s an experience I try to adapt to my office.

What is your typical experience at a doctor’s office? I know that I often have to wait long past my appointment time and then feel rushed because the doctor is running late. Since I have been in practice, I’ve never wanted to be that kind of office! We schedule our days in my podiatry office based on who is coming in and for what. Our staff is warm and friendly and we’re always happy you chose to visit us. Believe it or not, we will even schedule extra time with some patients who we know like to stay and schmooze! I want your time in our office to be more than a positive one – I want it to be exceptional!

The Dead are famous for each show being unique with a completely different setlist each night. In fact, in their Spring 2009 tour, they went more than the first ten shows without repeating a single song! During a show, their ability to improvise and blend one song into another is legendary. This is also something I adapt into my day.

No two patients are the same and no two conditions present exactly the same. Although I will follow a protocol for a particular issue, such as heel pain, different people will respond to different treatments and will have different results. many doctors will stick to their standards and become befuddled if it doesn’t produce the expected results. It is vital to recognize when a therapy is not working for someone and redirect the focus for that patient. It is just as important to explain to a patient that just because a treatment worked for their friend, it may not be right for them.

It is easy to reconcile my love for the Grateful Dead with being a better doctor to serve my patients. Attending a show also allows me to clear my head and refocus when I return to the office. My next trip is around the corner – I’m off to San Francisco with my friend and travel buddy Wayne to see Furthur and celebrate bassist Phil Lesh’s 70th birthday. No doubt I’ll return refreshed with some new stories to tell.