Nicholas Campitelli, DPM | Akron Podiatrist | Foot and Ankle Surgeon

The Foot Doc Blog – Leading Blog on foot and ankle pain

Providing information on foot, toes, and ankle pain or deformities. Questions? Please ask them in the comments section below. Check out our Youtube and Instagram sites as well.

img_4727-2-scaled.jpg?fit=1200%2C1600&ssl=1

Chances are, the bump you’re referring to is arthritis of the big toe joint. Many people will call this a bunion, which it is not. A bunion is a bump on the side of your great toe joint that is the result of a dislocation of the joint. The bump that can occur on top of the big toe joint is the result of arthritis from cartilage erosion in the joint. As the cartilage erodes, bone will rub against bone in the joint causing more bone to form in response to the stress. Fragments can also start to occur which can cause grinding to occur.

Wha causes this?

It’s typically a genetic predisposition that you are born with and it worsens over time.

Treatment

Treatment early in is to reduce the motion to the toe which causes the condition to worsen. This is difficult. Sometimes rigid inserts help but most patients see little relief. Cortisone injections can buy time before the inevitable surgical intervention occurs. Surgery can involve cleaning out the joint, replacing the joint, or fusing it.

Questions? Ask them in the comments section below or search my YouTube channel for more information and surgical videos!


IMG_9547.png?fit=1200%2C750&ssl=1

Achilles tendinitis is a painful inflammation of the Achilles’ tendon with pain occurring to the back of the Achilles’ Achilles tendinitis is a painful inflammation of the Achilles’ tendon with pain occurring to the back of the Achilles’ tendon behind the ankle joint. With Achilles tendonitis, the pain will usually occur within the tendon itself as opposed to bursitis which is a similar condition that effects the back of the heel bone. The pain can present with sharp stabbing pain to the tendon that will be worse in the morning and then improve as you walk around and the tendon “warms up”. Pain will then occur later in the day as the tendon begins to become tired from being on your feet all day. You may feel a “creaking” in the tendon when moving your foot up and down if the sheath overlying the tendon becomes swollen. As the condition becomes chronic one will begin to see thickening or enlargement of the tendon itself. This can take months to resolve and will be painful for a long time if left untreated.

Treatment for Achilles tendonitis begins with rest from aggravating activity, taking anti inflammatories, and beginning stretching exercises. If this fails, immobilizing the ankle in a cam walker to reduce the motion to the tendon and take the stress off of it is the next step. Patients will sometimes need to be immobilized for 6 weeks in a cam walker to all the tendon to heal. After resting the tendon and allowing the inflammatory phase to resolve, strengthening with physical therapy is the next step. One can try eccentric strengthening exercises at home, but going to a physical therapist and receiving hands on treatment will provide more predictable results.

When conservative treatment options fail, the next step is surgical intervention. Surgery can involve an minimally invasive technique where a needle like probe is inserted into the Achilles’ tendon and the chronic inflammatory tissue is broken up and removed. This is a great option for patients who present with thickening of the central portion of the Achilles’ tendon that is not responding to conservative therapy. Severe cases of tendonitis that develop tears within the tendon itself that are seen on MRI may eventually require open repair and augmentation with adjacent tendons.

It is important to treat Achilles tendonitis before the condition becomes so severe that the tendon ruptures. Ruptured Achilles’ tendons can take months or even years to recover from, and will often leave patients with life long symptoms. Ruptured Achilles’ tendons are now being repaired with a minimally invasive technique that Dr. Campitelli performs and allows for a faster recovery.

behind the ankle joint. With Achilles tendonitis, the pain will usually occur within the tendon itself as opposed to bursitis which is a similar condition that effects the back of the heel bone. The pain can present with sharp stabbing pain to the tendon that will be worse in the morning and then improve as you walk around and the tendon “warms up”. Pain will then occur later in the day as the tendon begins to become tired from being on your feet all day. You may feel a “creaking” in the tendon when moving your foot up and down if the sheath overlying the tendon becomes swollen. As the condition becomes chronic one will begin to see thickening or enlargement of the tendon itself. This can take months to resolve and will be painful for a long time if left untreated.

Treatment for Achilles tendonitis begins with rest from aggravating activity, taking anti inflammatories, and beginning stretching exercises. If this fails, immobilizing the ankle in a cam walker to reduce the motion to the tendon and take the stress off of it is the next step. Patients will sometimes need to be immobilized for 6 weeks in a cam walker to all the tendon to heal. After resting the tendon and allowing the inflammatory phase to resolve, strengthening with physical therapy is the next step. One can try eccentric strengthening exercises at home, but going to a physical therapist and receiving hands on treatment will provide more predictable results.

When conservative treatment options fail, the next step is surgical intervention. Surgery can involve an minimally invasive technique where a needle like probe is inserted into the Achilles’ tendon and the chronic inflammatory tissue is broken up and removed. This is a great option for patients who present with thickening of the central portion of the Achilles’ tendon that is not responding to conservative therapy. Severe cases of tendonitis that develop tears within the tendon itself that are seen on MRI may eventually require open repair and augmentation with adjacent tendons.

It is important to treat Achilles tendonitis before the condition becomes so severe that the tendon ruptures. Ruptured Achilles’ tendons can take months or even years to recover from, and will often leave patients with life long symptoms. Ruptured Achilles’ tendons are now being repaired with a minimally invasive technique that Dr. Campitelli performs and allows for a faster recovery.

 

 


IMG_1754-2.jpg?fit=593%2C376&ssl=1

Depending on the procedure performed to correct the deformity, recovery from bunion surgery can take anywhere from 3-6 weeks to 6-8 weeks to recover from. The recovery period is really dependent upon what the patients expectations are or their activity level after surgery.  It is important to remember the surgery involves cutting bone to realign a deformed joint and it takes bone 6-8 weeks to repair itself.  Your foot will be swollen for several months after surgery but again this is dependent on the activity level as well as the procedure that is needed to fix the deformity. Click here to see before and after images of bunion surgery. 


foot-pain.png?fit=1200%2C900&ssl=1

One of the most common complaints for foot pain is the result of tendonitis which occurs when a patient compensates from another foot problem. There are two tendons known as the peroneous longus and peroneous brevis which prevent the foot from inverting or turning in when walking. Essentially they are stabilizers and prevent you from spraining your ankle. If anything occurs to your foot that causes you to "limp", these tendons work harder as you compensate.


img_4553.jpg?fit=1077%2C657&ssl=1

Here’s and interesting look at some old remedies as well some real life medical treatments we once used! 


shutterstock_139326905.jpg?fit=1200%2C860&ssl=1

Suffering from an infected ingrown toenail?

There are two possible solutions for you to fix your ingrown toenail. If this is the first time you are experiencing an ingrown toenail, then a nail avulsion would be indicated. This is a surgical procedure performed in the office where the ingrown border of the nail plate is surgically excised. Antibiotics are typically not needed and the condition resolves by simply removing the ingrown nail border. The recovery period is usually 7-10 days and heavy activity such as running can be performed within 24-48 hours.

CAUTION:  THE FOLLOWING VIDEO CONTAINS REAL SURGICAL FOOTAGE

For recurrent cases of ingrown toenails, a permanent procedure is typically chosen. This involves the same technique as a nail avulsion, but a chemical is introduced into the nail groove and the nail matrix (cells that form the nail) is ablated to prevent the border of the nail from growing back.  The recovery period is slightly extended for this procedure as drainage usually occurs for 14 days. Regular activity, as well as exercise,  can again take place in 24-48 hours.

Questions?  Post in the comments section below!

 


9318 ST RT 43, Streetsboro, OH

2660 West Market Street, Fairlawn, OH

See Dr. Campitelli’s profile on Healthgrades.


Copyright by NAC Health Network 2022. All rights reserved | Akron Podiatrist | Fairlawn Podiatrist | Medina Podiatrist