How To Care For Your Feet In The Summer

Whether you’re walking on the beach, wandering your local park or enjoying your own backyard, going barefoot is one of the simple pleasures of summertime.

But bare feet need to beware. Cuts, puncture wounds and other barefoot injuries are waiting to happen.

To keep yourself and your feet safe this summer, keep reading!

 

A puncture wound can embed unsterile foreign objects deep inside your foot and trap bacteria.

A puncture wound must be cleaned properly and monitored throughout the healing process. This will help to avoid complications, such as tissue and bone infections or damage to tendons and muscles in the foot. You should see your podiatrist, or if it is after-hours, go the emergency room. Do not delay in getting care.

Apply Sunscreen to the tops and bottoms of your feet. Many people are surprised to learn that skin cancer, including the most serious form, melanoma, does occur on the feet. In fact, melanoma of the foot is very dangerous because people rarely think to look for it on their feet which may result in a later-stage diagnosis. If you see any odd marks or unusual blemishes on your feet, be sure to see your podiatrist.

In Phoenix where our temperatures are well over 105 all summer, burns injuries to the soles of the feet may occur.  Protect your feet from hot surfaces especially concrete, pavement, stones, and pool decking.  If you develop a burn noted by redness, blistering, or worse breaks in the skin see your podiatrist without hesitation.  For weekend or after hour injuries go the emergency room.

 

Wear flip-flops or sandals around swimming pools, locker rooms and beaches. It’s best to keep your feet protected to avoid cuts and abrasions from rough surfaces and sharp objects hidden beneath sandy beaches and to prevent contact with bacteria, fungus or viruses that can cause athlete’s foot, plantar warts or other problems.

Inspect your feet and your children’s feet for skin problems. Going barefoot can increase your risk for athlete’s foot, warts, calluses and other skin problems. Inspect your feet (and your kids) regularly for any changes or signs of problems. The earlier a skin condition is detected, the easier it is to treat.

Sadly, every year, people lose toes while mowing the lawn barefoot. Others suffer serious burns from accidentally stepping on stray campfire coals.. Murky rivers, lakes and ponds can conceal sharp objects underwater.

People with diabetes should never go barefoot, even indoors, because their nervous system may not “feel” an injury and their circulatory system will struggle to heal breaks in the skin.

Remember, any type of foot or ankle pain is never normal. A podiatrist can examine your feet and give you the best course of action.

Quick Recovery From Bunion Surgery

How are you going to take care of yourself after bunion surgery?  There are a lot of factors involved in planning for your surgery, not only by me, but more importantly by you.  If you have not already done so, download a copy of my ebook, “Top 3 Things To Know Before Surgery”.

Here are some things you need to plan for after your bunion surgery to make the recovery as easy as possible.

  1. Which foot is having surgery?  If it is your right foot, you will not be allowed to drive until the bone is healed.  This is a huge factor for everyone.  How dependent are you on your car?  Your recovery may involve physical therapy besides doctors visits, work, getting kids or grandkids to their various activities.  Plan for carpooling before your surgery to save you the headache and temptation to drive, which will slow your healing if you don’t follow instructions.  Your left foot is much easier unless you drive a standard transmission (stick shift).
  2. Weight bearing:  Bunion surgery involves creating a surgical break in your bone.  The area where your bone is broken will determine if you are allowed to walk after your surgery or if you will need a period of time without putting weight on your foot.  At Desert Foot Surgeons we discuss all of the options before your surgery and make training has been satisfactory before you have your surgery.  The various ways to stay off your foot are crutches, wheelchair, or knee walker.  A cane or walker are not adequate assistive devices for keeping weight off of your foot.
  3. The kitchen is the most dangerous room to be in after you have foot surgery!  Why such a harsh statement condemning the room everyone gathers to on a daily basis?  Cabinets!!  The area under your cabinet is just big enough to get a foot under, but when you have a surgical shoe, boot, or cast on your foot, not so much.  Appropriately named the toe kick, more often than not a patient will get their foot stuck beneath the kitchen cabinet and damage their surgery trying to get the foot out.  I find it easier just to avoid the cabinet area of your kitchen all together.  Prepare a weeks worth of meals before you have surgery.
  4. Three days of doing nothing.  If you can give me 3 days of laying in bed or on the couch with your foot above your heart, ice behind your knee, and barely take any steps; I can assure you that swelling, pain, and ultimately recovery time will all be much less.  The better behaved you are following the directions the first 3 days, the better your bunion surgery experience will be.

 

I want your surgical experience to go as smooth as possible.  The way to make sure this happens is to be prepared before you have surgery.

Myths About Bunion Surgery

A bunion is a structural deformity where your big toe drifts toward the 2nd toe and a lump gradually develops on the inside of your foot near the base of the big toe.  This leaves you with two potential areas of irritation: 1. the bump can rub against shoes causing pain; and 2. the joint falling out of position causes wear and tear on the cartilage, which is painful deep inside the joint.  Surgery is often recommended when altering shoes, inserts, and anti-inflammatory medications have failed to alleviate your pain.  Many patients come with pre-conceived notions regarding bunion surgery based on rumors they have heard.  Let’s discuss some of the more common rumors and get to the truth.

 

The bunion returns over time:

There are many different approaches to surgically correct a bunion.  Remember, feet are like snowflakes, no two are alike.  If your mother had bunion surgery it does not mean you will have the same procedure to fix your bunion.  A thorough exam of your foot sitting, standing, and  walking is necessary with x-rays to determine the best possible surgical procedure to correct your bunion.  No one wants to see your bunion return.  If the appropriate procedure is selected, it is unlikely that your bunion will return.  Often I hear of patients and physicians making a compromise in the selected procedure to allow you to walk earlier than otherwise would be allowed with the more appropriate procedure.  Don’t fall into this trap!  At Desert Foot Surgeons, we discuss options based upon what is best for correcting your deformity given your lifestyle and goals.  If you are not able to recover from the best possible surgery to correct your bunion, We often recommend that you wait.  It is much more difficult to correct a failed bunion surgery than it is to do it right the first time.

You will have pins sticking out of your foot after bunion surgery:

Deformity correction involves surgically cutting bones to improve their position.  In order for bone to heal it must be held in place with no motion.  Pins were used initially, but technology has improved.  Cutting edge technology used at Desert Foot Surgeons, means you will not have pins sticking out of your foot after bunion surgery.  Options range from screws and plates to absorbable pins and screws.  As always in my practice, you will be part of the discussion regarding what type of fixation is used.  If you have specific requirements or desires, these will be addressed.

Bunion surgery is the most painful surgery ever:

Let’s put this in perspective.  You have a bone that is out of position.  In order to place that bone in corrected position, I need to surgically break the bone and hold it together with plates and screws.  There is not a lot of space available for swelling in the foot so when your foot does swell there is pressure on the nerves and this results in pain.  Less swelling equals less pain.  When you have bunion surgery with Desert Foot Surgeons, you will be given a detailed plan for recovering from your surgery.  Part of this plan is to keep your foot elevated above your heart and ways to use ice to minimize swelling.  Studies have shown that bunion surgery is no more painful than other surgeries, but pain is very individual; what hurts one person is hardly a nuisance to another.  Part of your recovery plan will involve a discussion of what works best for you to alleviate pain.  This will be incorporated into your game plan after surgery.

There are many rumors about bunion surgery.  Here I have addressed just a few of the more common ones.  It never hurts to get an opinion.  At Desert Foot Surgeons, you will never be pressured into surgery.  Often I spend more time talking patients out of surgery when expectations don’t meet reality.  If you can’t talk to your surgeon, should you really allow them to cut on you?  I welcome you to come and have your bunion examined sitting, standing, and walking to see what the best plan would be for you.

Bunion Surgery Without The Pin

When you have foot surgery, you want your foot to look better immediately.  When that first bandage is removed, I want you to say, “Wow! That looks good.”  Do you think you would be able to say that with a pin sticking out of your foot?

Why do some surgeons still use pins that stick out of your foot?  A bunion is a “deformity”, which means bones have shifted out of position leaving you with a bump or lump behind your big toe.  In order to fix this deformity, bone must be shifted back into position to get rid of the prominence.  The way I shift bone back into position involves cutting the bone at some point, basically the same as saying I am breaking your bone to shift it back into the correct spot.  Broken bones heal fastest when held together using screws, staples, pins, etc.  There are a huge number of options, but just casting your foot is not one of them.

Now the question, would you want a pin sticking out of your skin?  Plain and simple…don’t give me a “maybe” or “if”…no “that depends”.  Would you want to see a pin sticking out of your foot when that first bandage is removed?  My answer would be NO!!  Things are not supposed to be sticking out of your foot.  Everything that belongs in your body is supposed to stay under your skin.

When devices to hold bones together, now called fixation, were first discovered there was no option.  A pin had to be used because it was the only form of fixation available.  But now medical science has advanced.  We have a variety of screws made out of space age metals like titanium, staples made out of nitinol or memometal, plates designed by computer to fit the bones precisely, pins and screws that absorb in your body over time.  It’s my job to make your foot look and feel better.  Why would I leave a pin sticking out of your foot when I have all these options?

At Desert Foot Surgeons, your surgery is done using the most up to date technology and techniques.  You won’t have a pin sticking out of your foot.  I want you to look and feel better as soon as you leave the operating room.  Cosmetic foot surgery is not magic, it just takes attention to detail.  There will be no surprises after your surgery since everything is carefully planned and reviewed with you long before you get to the hospital or surgery center.  This is our “personalized approach” to foot care.  Come to Desert Foot Surgeons and see the difference.

 

Cosmetic Bunion Surgery and Hammertoe Surgery

What’s the first thing that came to mind when you saw the word “cosmetic” in the title?  Was it maybe breast implants or a face lift, tummy tuck or liposuction?  These are the traditional uses of the word cosmetic and refer to correcting problems in people, who in their opinion, need to look better in order to feel better.  Over the years it has become popular for people who can afford to undergo these same surgeries to enlarge their breasts, tighten the skin of their face to reduce wrinkles, and even remove fat from areas considered to be unsightly.

In the foot people can have unsightly problems and what’s worse pain.  A bunion is a lump on the inside of the foot behind the big toe.  The size can vary and the toe can begin to move closer to and even under the 2nd toe.  When the smaller toes are buckled that is a hammertoe.  Here’s the key:  because we wear shoes, bunions and hammertoes hurt much sooner than if we went barefoot all the time.  Let me make this perfectly clear, wearing shoes does not cause the deformity, but wearing shoes does make a deformity hurt sooner than it otherwise would.

Bunion and hammertoe surgery can be cosmetic, which in my opinion means the deformity will look better after corrected so that you feel better since pain will be gone.  That’s a little bit different from other forms of cosmetic surgery.  When I perform bunion surgery or hammertoe surgery I always keep in mind the fact that you will be walking on the end result for years to come.  Because the bunion and hammertoe develop in an unstable foot I have to make sure the problem does not return.  Face lifts, tummy tucks, or breast augmentation have their long term considerations, but honestly you will not be walking, hiking, or running on these parts of your body.

There are people who want to fit into those 4” spiked heels at any cost.  They want their wide foot narrowed and long toe shortened.  I’m not talking about business executives who have to maintain a specific style of dress in order to advance their career and suffer horrible pain in these shoes.  I’m talking about people who would otherwise have no pain, but insist on wearing these heels for social purposes.  I caution those people who do not have pain!  Foot surgery can result in scar within the joint leading to stiffness and arthritis.  There is no true preventive surgery for arthritis.

One final word.  Recently a Beverly Hills Podiatrist coined the term “Cinderella Surgery” for correcting a bunion, long 2nd toe, and bunionette (on the outside of the foot) so that women can wear their high heels.  He did a very nice piece on the television show, The Doctors.  My problem is this:  I always say, feet are like snowflakes no two are alike, well here is a podiatrist telling women he can perform the same procedures on their feet in every case so they can walk immediately after surgery and their feet will fit into their stilettos.  That is just not possible without making some sacrifices.  To read about these sacrifices that might be made check back every few days for my new articles on cosmetic bunion surgery and cosmetic hammertoe surgery.  

Cosmetic Bunion Surgery

That unsightly lump or bump on the inside of your foot behind your big toe is known as a bunion.  This is the hallmark of having an unstable foot.  When your foot won’t work in a stable position the bone behind your big toe (1st metatarsal) drifts toward the inside of your foot.  As the bump on the inside of your foot gets bigger, the big toe gradually slips off of the metatarsal and drifts toward the 2nd toe.  Think of it this way:  a table has a broken leg.  That table is no longer stable in that area.  If you begin to stack objects on the table, eventually the weight over the missing leg will build up and the table will tilt.  The bones along the inside of your arch are very important to maintaining a stable foot when you walk.  Having a bunion makes other areas of the foot unstable leading to hammertoes, arthritis in the back part of your foot, heel pain, inflamed tendons, on and on.

Because your bunion involves an unstable foot, surgery to correct the bunion has to take into consideration this issue of stability.  There are many different surgeries for correcting a bunion ranging from simply removing the lump, correcting the bone in various places, or fusing the joint at the base of the metatarsal.  Planning bunion surgery requires a thorough evaluation of your foot at rest, standing, and walking.  At Desert Foot Surgeons, I perform video gait analysis on all patients with bunions.  I am currently involved in a research project that will show other foot surgeons how to determine exactly where to correct a bunion for the most stable result.

Bunion surgery is very complicated because of the stability issue.  Other surgeons promoting aesthetic bunion surgery state that their surgery will work to, “maintain or enhance the mechanics of the foot”.  Many of these aesthetic foot surgeons also tell patients they can walk immediately after surgery.  That means that they are either just removing the bump or correcting the bone near the lump.  Medical research has shown that this approach to bunion surgery makes the big toe less stable leading to further loss of a stable 2nd toe causing a hammertoe and those other problems we talked about above.

My approach to bunion surgery is to use science and apply to your problem.  You and I will talk about the best surgery to correct your problem.  If you cannot cooperate with the recovery I will work with you to get to the point that you can manage the rehabilitation or suggest alternatives.  It is these alternatives that you  need to understand.  When alternatives are chosen you are making sacrifices.  In the case of a bunion you are usually sacrificing stability.  Think of the table with one broken leg.  If you repair the table leg with duct tape the table is still unstable and will eventually tilt and possibly break completely when objects are placed on the table.

As far as cosmetic bunion surgery, the placement of the scar has to allow the surgeon to clearly see the bone being worked on.  I don’t want you to have an ugly scar, so whenever possible I will hide the scar.  But fair warning, the bigger the bunion the less likely it will be to hide your scar.

When considering cosmetic surgery, remember the goal is to make your lump or bump look better and relieve pain.  If the scar can be hidden it will, but the key to correcting your problem is choosing the correct surgical procedure based on a thorough exam including gait analysis.  Performing an alternative surgery requires sacrifices be made on your part and the part of your surgeon.  When all is said and done, a scar, time off your foot, having to perform physical therapy are reasonable things in order to make pain go away and prevent the problem from returning.