Small Problems, Big Obstacles After Foot Surgery

Whenever planning for foot or ankle surgery, it is important to consider how extensive the surgery will be, and whether or not you will be able to walk. Many people underestimate the difficulties of not being able to walk while recovering after foot surgery. Although most people tend to worry about the pain that they have after foot or ankle surgery, this is not typically the biggest problem.

One patient explained that after having foot surgery, she can get around to be very difficult. She said that her doctor did explain that she would have to be non-weightbearing that she underestimated the difficulty and discovered that even minor tasks that could seem challenging.

She explained that even the simplest tasks take a LOT longer when you do it on crutches or in a wheelchair. Even though she has a ranch style home, which has no stairs, she still famished needed help.

Like most homes, some doorways are not quite big enough to get through with a wheelchair. This makes it difficult to move from room to room.

Other things that she previously took for granted like getting a bowl from a high cabinet like the one below is virtually impossible without help.

Because she has a stacked washer and dryer, she found the same is true of doing laundry. Getting anything out of the basement is impossible.

Moving from the kitchen to the dining room with a plate of food is a real challenge as well. . Fortunately, she has recruited the help of her husband without any difficulty. For anyone living alone, all of these tasks can prove to be very difficult.

Because of this it is important to make sure that you discuss what your living situation is like, prior to foot surgery. Many people don’t even think about one or two stairs in a split level home as much of an obstacle, until they have foot surgery.

As long issue plan ahead, even more extensive surgeries requiring crutches or a wheelchair can go smoothly. But it’s important to be realistic about your expectations in the amount of help, you will have while recovering.


Dr. Christopher Segler is an author, inventor and award winning foot doctor with a surgical podiatry practice in Chattanooga. He invented the patented surgical instrument that simplifies flatfoot surgery and bunion surgery. He publishes articles and teaches other surgeons about his unique methods to decrease pain after foot surgery. You can order a FREE copy of his informative book about common causes of foot pain at http:www.anklecenter.com.

Mid-Foot Sprains, Pains, and Fractures

The midfoot is a complex area involving 10 different bones coming together to form more than a dozen separate joints. A sprain in this area can result in aching or throbbing midfoot pain, swelling and bruising. Sometimes the pain will start on the top of the foot and go deeper all the way through to the bottom of the arch. This type of injury can interfere with running and has the potential for serious problems if ignored. 

The most common way for an injury of midfoot to occur, is trauma. But it doesn’t have to be the hit-the-foot-with-a-hammer sort of trauma. For a runner, this sort of injury happens when twisting the foot while stepping in a pothole, accidentally stepping off the shoulder, or tripping over a root on a trail run. 

Fortunately, this sort of injury is rare from running. However it is common in other accidents. The classic midfoot injury is sustained in an automobile accident while braking. You have your foot on the brake, smack into the car in front of you and all of the force causes the midfoot joints to be dislocated or fractured.  The area most often injured is actually a collection of joints called Lisfranc’s joint. For trivia buffs, Lisfranc was Napoleon’s surgeon. These injuries are often misdiagnosed as a “midfoot sprain.”

In 2004, I began a research project in order to determine how accurately different doctors are able to diagnose Lisfranc’s injuries. The results of that study were quite frightening. We found that primary care physicians and emergency room physicians were only able to recognize 1.6 % of the identifiable features of these injuries on x-ray. That means that more than 98% of these injuries could be missed if not evaluated by a foot and ankle specialist. 

As a result of this research, I won an award from the American College of Foot and Ankle Surgeons.  Since that time I have seen many patients that came into the office having been misdiagnosed. In most cases they bring their x-rays from the emergency department and the injury is visible. It was just not noticed. In every case, the doctor told the patient that it was just a sprain and would get better.

The difficulty is that we know in fact, these will not get better unless appropriately treated.

Pain and tenderness on the top of the foot is relatively common in runners, but this is more often related to irritation of the tendons on top of the foot. This common problem is not that serious, and is easily treated. 

In contrast, pain that is worse when standing and twisting the foot, or when running, is worrisome. Any associated bruising is always a concern and may signal a much more significant injury. Without appropriate treatment, continued pain and rapid development of arthritis, with associated destruction of the joints in the midfoot, can occur. This can result in significant disability. 

Anytime you have had an injury where you were involved in an accident, stepped off a curb of wrong or stepped into a pothole while running, you should be aware of this possibility. Do not run if you have continued pain. If you are a runner and suspect that you may have a midfoot sprain, it is critical to get evaluated by an expert in foot and ankle care. That way you can get back on the road as quickly and safely as possible.

Dr. Christopher Segler is an author, inventor and award winning foot surgeon with a surgical podiatry practice in Chattanooga. He invented and a patented surgical instrument designed to simplify midfoot fracture surgery and reconstructive flatfoot surgery. He also publishes articles teaching other foot doctors about his methods to prevent pain after foot surgery. You can order a FREE copy of his informative book about common causes of foot pain at http://www.AnkleCenter.com.

What are the Best Shoes for Nurses?

In between cases I wandered into the doctor’s lounge adjacent to the O.R. I got something to eat and sat down.  From over my shoulder I heard, “do you mind if I ask you a question?”  It was Amy, the scrub nurse I had been working with all morning.  “You see I have this heel pain…”

I listened to her story, about how her heels first hurt when she gets out of bed. About how they don’t usually bother her while she is standing during surgery, but how she gets this sharp pain after she sits down for a break and then gets up and starts walking again. She seemed somewhat frustrated because it had been going on for about two months. 

I looked at her yellow Crocks, that likely used to be bright, long before being splattered with saline, blood and iodine. I paused and said, “So let me guess. You got your Crocs about six months ago.”  And quick came the reply, “how did you know!” 

Well I am not a psychic, palm reader, sole reader, nor any kind of magician, other than a podiatrist. The fact is, its just math. It seems that Crocs will only withstand about 3-4 months of being compressed between a nurse (working hard on his/her feet all day) and the hospital floor (hard as concrete, quite literally). Four months of use plus two months of abuse, past the life of the shoe, equals plantar fasciitis. This was also about the third or fourth time I had a similar exchange with a nurse complaining of heel pain in the hospital. 

The fact is nurses work hard. Up, down, charting, giving meds, dressing wounds, hanging IV’s, putting Mr. Jones’s nasal cannula back in nose instead of his eyebrow, busy, busy all the time. The shoes that nurses wear must be prepared for a world class beating. And not all shoes are created equal. 

The Croslite material (the only material in Crocs) is quite similar to the cushioning midsole of a running shoe.  As a marathon runner and Ironman triathlete I can say that the stuff does not last forever. I am always advising patients (who are also runners) how to tell if the midsole is worn out.  And when it is...time to donate them to a less fortunate recipient at the Chattanooga Community Kitchen. 

Does that mean Crocs are bad? Nope. It just means they are soft and don’t last real long. I will however, say that if you are on the wards, walking fast all day, they are worse than if you are mostly standing (like in the O.R.). If you have any foot or ankle instability, such as flatfeet, bunions or tendinitis, you are at risk of aggravating those problems. If you have high arches you are safe.

One other potential concern is the little air vents in the toe box.  There have been many incidences with sharps, so watch the toes around needles, scalpels and other falling pointed things.  My understanding is that some facilities have actually instituted policies against Crocs, due to safety concerns.

So, if they take away my beloved Crocs, what will I wear? I would suggest something good for your feet. If you have flat feet, wear athletic shoes with stability or motion control features.  If you have high arches, wear cushioning running shoes or something with a rocker sole that will decrease stress in the big toe joint. If I had to pick one shoe for nurses, I would pick Dansko clogs. To see more choices than you could ever want, click on our recommended running shoe list. Or visit the experts at ZUMFOOT, for something healthy and fashionable.  Remember...you nurses deliver all of the care that actually happens. You need your feet to take of the rest of us. Treat your feet as well as you treat your patients.

Dr. Christopher Segler is a nationally recognized award winning foot and ankle surgeon practicing in Chattanooga Tennessee. He is the inventor of a patented surgical instrument designed to simplify bunion surgery. He has published articles teaching other surgeons about his techniques about how to decrease pain after bunion surgery. You can request a FREE copy of his new book about common causes of foot pain at http:www.anklecenter.com.

Secrets to Finding a Qualified Bunion Surgeon

Anyone who is considering surgery, whether bunion surgery or brain surgery, has a potentially stressful and serious decision to make. It is important that you, as a patient considering surgery, make the right decision. By asking the right questions, and with a little footwork (no pun intended) you should be able to find a well qualified bunion surgeon who can help you, correct the bunion, relieve your pain, and get you back to all the activities that help you enjoy life on your feet.

   
Before I begin, I’ll start  with a qualification that I myself am a bunion surgeon. I have been awarded a United States Patent for an instrument and technique which I invented to to simplify complicated bunion surgery and I have also published original research in medical journals teaching other foot surgeons how to reduce or eliminate pain after bunion surgery.  I’ve also been invited to lecture and present my research on the new advances that I developed at multiple medical conferences in the United States, Canada, and New Zealand.

  
Having said that, there are many doctors like me in virtually every area of the United States who are well qualified to perform your bunion surgery.  The goal is to help you discern the real qualifications from deceptive ones.  This way, you will be able to determine for yourself, whether or not your surgeon is likely to provide you the outcome you want...no bunions and enjoyment of life.

 
Board Qualification 

This is actually the area where most of the deception lies. The foot surgeons held to the highest standard with the most hours of training and most extensive board qualification testing are affiliated with the American Board of Podiatric Surgery. There are other “board certifications” such as the American Board of Foot Surgery and the American Board of Multiple Specialties in Podiatry.  While the other boards “sound official,” they are rarely accepted as proof of competence by hospital committees.

Training 

Your surgeon should have three years of foot and ankle surgical training in residency after medical school. The more training, the more experience with a wide range of surgical techniques. There is a reason they say doctors are “in practice,” and the more practice the better.

 
Research 

Making certain your surgeon has experience with medical research, (particular in the areas of your particular problem) will ensure that he/she is interested in finding ways to perform better.  A history “in practice” alone is not enough to indicate your surgeon has the skill you are looking for. Research is what separates leaders from followers.  The leaders are always out in front and aware of the latest advances in technique. 

Awards 

Less than 1% of all surgeons will have won awards for advancing the field of surgery.  If you find one, you likely have a winner for sure. Check their website or search the internet for evidence that they are at the top of their field. 

 
Creativity 

Surgery is a science and an art. Creatively looking at new ways to solve problems is always a useful trait in a surgeon. If you can, find a surgeon who has demonstrated innovative thinking such as patenting a surgical instrument or has patented techniques that improve surgical outcomes. 

 
Authority 

It is no coincidence that the word “authority” starts with “author.”  Those that write books, publish articles in medical journals and use their writing skills to educate other surgeons always stay on top of their game.  All you need to do is search the surgeon’s name on Google.  If they are a winner, you will have many hits.  
Surgery should be a great experience because it will be the start of your recovery, and the start of a new more active, more enjoyable life. The time you spend researching your surgeon will be time well spent. 

Dr. Christopher Segler is a nationally recognized award winning foot and ankle surgeon practicing in Chattanooga Tennessee. He is the inventor of a patented surgical instrument designed to simplify bunion surgery. He has published articles teaching other surgeons about his techniques about how to decrease pain after bunion surgery. You can request a FREE copy of his new book about common causes of foot pain at http:www.anklecenter.com.