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By Dr. Kuvent, October 27, 2009 11:05 pm

If you’ve ever walked barefoot across a gravel parking lot, you’re probably well-aware that human feet are very sensitive structures. That’s a good thing because it allows our feet to move and adjust to potentially damaging objects on the ground-such as a sharp stone or a piece of glass. Normally, we are able to avoid such objects with ease and protect ourselves from cuts, infections, and other risks. However, the greatest threat to our feet is more internal rather than external. It occurs when our nerves become damaged and that vital protective sensation in our feet is lost.

There are unfortunately MANY things which can lead to weakened or damaged nerves in our feet. One of the most common and well-known causes is diabetes. As individuals lose control of their blood sugars, the nerves particularly in the feet tend to become damaged and insensitive. Other metabolic issues such as B-vitamin deficiencies, alcoholism, and various toxins such as heavy metals can also lead to this problem. It’s pretty interesting to consider how certain health issues like Ulcerative colitis or Crohn’s disease can affect vitamin absorption to affect nerve function and indirectly the health of our feet!

Certain inherited and autoimmune disorders can also cause the feet to become insensitive. Things like Charcot-Marie-Tooth disease, Lupus, Guillain-Barre syndrome, allergic conditions, and blood disorders can all have this effect. Mechanical issues like an entrapped nerve or a spinal root problem may also be causing the problem. On top of these and other causes, the medications you are taking can also alter the nerve function in your feet. Various seizure medications, immunosuppressive agents, oral contraceptives, and tuberculosis drugs can all have this side effect.

Perhaps one of the biggest problems with nerve dysfunction to affect our feet simply occurs as we age. Often times, visual changes in combination with insensitive feet make it extraordinarily difficult for individuals to monitor the ground as well as the health of their feet. Believe it or not, it’s not uncommon for some people to have needles and other sharp objects lodged in their feet without them even knowing it! Not only can the individual not feel the object, but they’re also not able to see what may be a large and potentially-infected wound. This can be a huge hazard for those who live alone or do not have their feet checked regularly, as the infection can spread quickly and cause major damage.

Podiatrists have lots of experience dealing with insensitive feet. They’re able not only to closely monitor the various components of nerve degeneration, but they’re also able to check for infections, care for wounds, and determine whether a foreign body is actually lodged within the foot. Sometimes various objects show up within the foot on an X-ray which is not otherwise very obvious. If you suspect you’re having such a problem, contact your podiatrist immediately.

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By Dr. Kuvent, September 22, 2009 12:17 pm

As the Fall sports season gets underway, many fans and athletes are excited for another year of events and competition. Though no one can predict exactly what will happen this year, athletic injuries are always a given. One of the most common injuries associated with football players is referred to as “Turf toe”. While this may sound like a relatively benign issue, it can actually prove devastating to athletes, teams, and even non-athletes who encounter this condition. Even NFL stars such as Deion Sanders, Darren McFadden, and LaDainian Tomlinson have missed significant playing time because of this injury.

Turf toe basically results from hyperextension or an excessive upward bending of the first toe at the ball of the foot. There’s a major joint in this area with many important structures which can each be easily damaged in such an injury. This scenario commonly results when an individual’s foot-with the heel raised and the forefoot about to push off-receives a direct force down and through the ball of the foot. The end result is usually pain, swelling, and stiffness of the joint which, of course, depends on the extent of the injury.

The phrase “turf toe” has actually become somewhat of a junk term to refer to any traumatic injury of the big toe joint. In reality, it is a unique entity which separates it from other similar issues. For example, “sand toe” is a separate injury involving hyper-flexion or a downward over-bending of the big toe which is often seen in volleyball players. Turf toe actually ranks third in frequency behind knee and ankle injuries in football players, and though not as common as ankle injuries, it results in more missed playing time. The issue has become more prevalent over the years for several reasons. First, many sporting events now take place on synthetic surfaces like AstroTurf which have more friction and don’t allow the toes to adapt as well to various forces. Secondly, whereas older athletic cleats had a metal plate in the forefoot to limit excessive bending, newer models are generally more flexible (for speed) and less shock-absorbing.

Podiatrists typically address turf toe cases by first assessing the symptoms and possibly ordering and x-ray or an MRI to determine the extent of the damage. Based on these findings, they can classify the injury, give an accurate prognosis, and implement proper treatment. Mild cases may involve simple taping and plate splinting of the toe with return to activity in a few days. More serious cases may require the use of crutches or casting and may necessitate up to six weeks of missed playing time. Very severe cases might warrant a surgical approach to repair soft tissue structures, remove bony fragments, or provide other corrective measures. It all depends on the particular case.

Whether in sports or everyday life, traumatic injuries are certainly not fun. Thanks, however, to proper treatment and our bodies’ healing abilities, they can often be managed effectively.