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From Sewing to Surgery: A Brief History on Tailor’s Bunions

Dr. Kuvent — Mon, 16 Aug 2010 18:46:28 +0000

If you have a bunion on the outside of your foot, where the 5th toe meets the 5th metatarsal bone of the foot, you don’t just have a bunion, you have a Tailor’s Bunion. And if you have a Tailor’s Bunion, you can blame those who lived during the Renaissance period for your pain. You read that correctly, people who lived in the 14th century were responsible, at least in part, for the profession that eventually led to the naming of the Tailor’s Bunion. First, a brief history lesson, then more about your condition.

During the Middle Ages, clothing was merely a means of concealing the body. Then came the Renaissance period, where people sought to accentuate the human form not only in the arts but in the fabric they wore on their backs. Gone were the days of wearing a loose robe that had been so easily created from a single piece of cloth. People began shortening, tightening, cutting, piecing, and sewing swatches of fabric together in an eventually successful attempt to bring into prominence the contours of the human body. This, ladies and gentlemen, marked the emergence of tailoring and, as a matter of fact, the birth of fashion itself. It is not too difficult to imagine that with a growing demand for shaped clothing, came also a growing need for someone who could shape the clothes. First came the “cutter”, whose job was to make the patterns. Then came the “tailor”, who did the sewing.

Now, fast-forward a few hundred years, and you could find tailors in every town or city, sitting crossed legged in their shops, sewing away at their newest conceived design. Consequently the outside of their feet, especially the heads of the 5th metatarsals, would be rubbed on the floor with such vigor that it began to hurt. They would go on to develop prominences, or “bunions” on the outsides of their feet, which was simply the body’s way of protecting itself. This is exactly how the Tailor’s Bunion got its name.

Your next question, logically enough, may be how is it that you can have a Tailor’s Bunion if you are in fact not a tailor, and perhaps you don’t even sit crossed legged. The answer is again related to fashion: inappropriate shoe wear. Just like it’s cousin, the bunion on the big toe, a Tailor’s Bunion can form as a result of wearing shoes with a tight toe box. Increased pressure of the foot against the inside of your shoes can, over time, result in the metatarsal bone moving and ultimately the formation of a bunion. In patients with wide feet, a Tailor’s Bunion tends to be one of the more common complaints because even though these patients have wide feet, they still tend to wear standard sized shoes, which leads to increased pressure on the sides of the feet, particularly the toe joints.

Whether you have wide feet, you’re a tailor who still sits on the floor crossed-legged, or you have a Tailor’s Bunion for some other reason, the good news is that this problem is most often completely curable. If you have pain associated with your bunion, you can use over the counter anti-inflammatory drugs and pain killers to help alleviate your pain. If your pain has persisted for a long time or if the drugs don’t help your pain, then your doctor may decide it’s time to recommend surgery. Wearing appropriate shoes is

another important aspect of treating a Tailor’s Bunion. These special shoes, or any shoe geared towards people with wide feet, can be very effective in avoiding the development of a bunion or reducing the pain associated with bunions. These shoes are best used in conjunction with bunion pads, and in many cases can make your everyday activities much easier on your feet.

If you have a Tailor’s Bunion, you should consult your local Podiatrist today to see what course of action is best for you to return to your regular activities, whether that be a physically demanding job, daily exercise or becoming the next big Design Star!

Infraction Distraction

Dr. Kuvent — Wed, 17 Mar 2010 16:36:35 +0000

For most of us, when we think of bone we tend to think of hard, solid structures which are more or less ‘dead’. Like rocks or a piece of metal, bones serve as rigid struts to support our bodies and that’s about it, right? In reality, bone is an extremely dynamic and living type of tissue which requires it’s own blood supply from various arteries- just like any other organ in the body. Occasionally this blood supply may become disrupted, and the underlying bone can become damaged before the body is able to re-establish blood flow to the area. A common example of this occurs in the ball region of the foot and is known as a Freiberg’s Infraction.

A Freiberg’s Infraction is essentially a temporary insult to the blood supply which flows to a growth plate at the far end of one of the long bones in the forefoot. This condition was first described in 1914, and although it was initially thought to be caused by trauma, it may also be due to increased pressure within the bone, blood disorders, irregular bone structure, surgery, or various other causes. It is most common in the 2^nd-5^th long bones, and most often affects girls in their teenage years.

Patients who suffer from a Freiberg’s Infraction often report acute pain and swelling in the ball of the foot which becomes worse with weight-bearing activities. The toe or toes may also become more stiff and difficult to move up or down. The problem is not so much that the bone is not getting adequate blood flow; usually circulation is re-established shortly after the incident. The problem arises because a small portion of the bone does die and change shape. As blood flow is returned, new bone is formed on top of the older dead bone which combines to create an irregular structure in that area. The area in question is an especially important joint between the forefoot and the toes. Consequently, in serious cases the cartilage in that area may become damaged and even the underlying structure of the toe may begin to change shape.

There are many different levels of progression of a Freiberg’s injury as well as multiple different treatment modalities. X-rays are typically utilized to assess the level of damage although in many cases they won’t reveal changes until later stages of the disease process. Regardless, if you are having similar symptoms for any reason it’s certainly not a bad idea to visit your local podiatrist in Chandler. A clear understanding of your condition, prognosis, and potential treatment options is invaluable.

Turf Toe Trauma

Dr. Kuvent — Tue, 22 Sep 2009 19:17:39 +0000

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.