Hands & Feet
Your spirit fingers and your pattering puppies are two of your busiest—and most abused—assets. We’ve checked in with local specialists for the most current ways to ensure you are keeping your hands and feet operating at 100 percent—so you are always in the ready for some clapping and dancing.
Minimally Invasive Foot Surgery
by Borys E. Markewych
You only get one pair of feet to last a lifetime. The average 70-year old walks 70,000 miles in their lifetime. Mechanically, the feet are the most complex part of the body with 26 bones, 30 joints, 19 muscles and 107 ligaments each.
Foot problems are one of our most common medical ailments. Up to 85 percent of the general population will suffer from a foot complaint in their life. Many of these foot problems—such as bunions, twisted and contracted hammertoes, corns, calluses, bumps and spurs—if not successfully treated will require surgery to alleviate the pains.
Traditional surgical techniques performed by physicians requiring large incisions, aggressive techniques requiring soft tissue dissection and in most cases surgical orthopedic hardware: pins, screws or plates to correct the foot pathologies. The current trends in modern orthopedic and podiatric surgery clearly favor the use of minimally invasive or percutaneous techniques that resolve or reduce some of the problems associated with open surgery, decreasing the incidence of complications and improving and shortening postoperative recovery.
What is minimally invasive foot surgery? Minimally invasive foot surgery is a philosophy and set of techniques that allow the surgeon to treat common foot problems using specially designed instruments under radiological imaging which allows us to work through smaller openings in the skin compared to conventional traditional foot surgery. This results in less soft tissue trauma which usually means less pain, less disability and quicker return to normal activities for the patient.
What kind of foot problems can be treated with minimally invasive foot surgery? Minimally invasive surgery can be used to treat bunions, hammertoes, corns and calluses, bumps, bone spurs and flat feet.
What are the advantages of minimally invasive surgery? In addition to less pain, swelling, and disability due to less soft tissue dissection, the procedures can be performed in an accredited surgical office suite or surgical center under local anesthesia. This means the procedures are more cost effective. Also, local anesthesia is considered safer than IV sedation or general anesthesia. Cast and crutches are rarely needed. You can walk out of the facility with an adhesive tape dressing and a special surgical walker. The surgical walker is usually needed significantly less time than traditional surgery healing time. Some patients require narcotic analgesics—which can create side effects—while other patients will only need either aspirin, Tylenol or ibuprofen for discomfort. Because you can walk immediately, you are less likely to have complications such as phlebitis or blood clots.
Surgery, as practiced in this office, does not usually mean lengthy stay in the surgical facility or overnight hospitalization, incapacitation, or discomfort. The objective of ambulatory minimally invasive foot surgery is to aid the sufferer with a minimum of inconvenience, discomfort, surgical complication and expense. An ambulatory patient is a walking patient. We say, “the patient who can walk into our office can walk out after surgery.”
Dr. Borys E. Markewych is a physician with South Hill Foot and Ankle Clinic.
Sports and Ankle Injuries
by Katie Swanstrom
Autumn is wrapping up and both club and school sports are in full swing. Along with cooler weather—and football, softball, soccer, volleyball and basketball games—comes an increase in sports injuries. The most common sports injury that I see, as a foot and ankle surgeon or Podiatrist, is by far ankle sprains. Having played soccer on Spokane Select teams growing up, I have had multiple ankle sprains. The treatment I received was RICE (rest, ice, compression, elevation) and “walk it off.” With this treatment I “healed” for a short time, but without fail, I would sprain an ankle every three months. Without follow up, my ankle instability worsened to the point where I missed more games than I was able to play in a year.
Ankle sprains are most common in contact sports with cutting activities such as football, basketball, volleyball and soccer. For parents, injury can occur trudging across the uneven ground to get to your assigned field, which is inevitably at least a mile from where you parked. Regardless of how the injury occurs, it will take a year to fully heal. Most of my patients are shocked to hear the recovery time and have an expectation that sprains heal within a few weeks. If it didn’t break, then it can’t be that bad, right? A sprain by definition is a ligamentous injury. Ligaments have less blood supply and can take longer to heal than bone.
Many people try to return to sports activity too soon after an ankle sprain. This leads to recurrence of swelling and increased pain, especially if not braced properly. The ligaments need time to heel and appropriate exercises to strengthen and retrain. This is not something that can typically be done on one’s own. Taking time out of a busy schedule to see a foot and ankle specialist and go to physical therapy will allow for faster healing. This gets you back to pre-injury activity level much faster with a stable ankle. Otherwise a moderate sprain can lead to re-injury and more time off the field.
An ankle sprain does need RICE initially, but it also requires long term follow up from a foot and ankle specialist, temporary bracing, and physical therapy. There are different grades of ankle sprains and the treatment regimen varies based on the severity of the sprain. The ligaments can become lax if left untreated, and result in ankle instability and chronic sprains.
Over years of functioning with an unstable ankle, arthritis can occur and may require an ankle fusion or total joint replacement. In children, the growth plates are very close to the injured area and need serial radiographs to monitor closely. Cartilage or tendon damage can also occur with a severe sprain. A foot and ankle specialist is trained to detect these injuries and treat them appropriately.
Katie Swanstrom, DPM, FACFAS, is the owner and physician at Spokane Foot Clinic. spokanefoot.com
Healthy Feet, Healthy Life
by Mariah Neeson
Our feet are comprised of 35 joints and 7,000 nerve endings. Together they send information to the brain about where we are going, the terrain we are walking on and how our body needs to move, balance and counter balance to achieve maximum efficiency. Our feet are designed to carry our bodies where they need to go at any given time.
When our feet are healthy and unrestricted it translates into a healthy body. The more flexibility we can create in our feet, the greater our quality of life will be as we age.
What we do with our feet translates up through the body and affects everything from our knees and hips all the way up to our necks. Try walking around while keeping your feet rigid and tight for a few minutes to feel how quickly all of that tension travels up through the rest of the body.
As an Ashiatsu barefoot massage therapist, I massage people from head to toe with my feet. This practice has opened my feet up to their full range of motion as they have had to adapt to sliding over the uneven surfaces of the body and face new challenges and terrain every session.
Not everyone has the chance to use their feet in this manner. However, you can benefit from using your feet in new and unusual ways to open the joints, adding greater range of motion in your feet and body.
Moving your feet in new ways matters to your overall health, but you don’t have to become an Ashiatsu massage therapist to enjoy the benefits. Here are a few simple things you can do to begin mobilizing your feet:
Shake hands with your feet. Lace your fingers though each toe as if you are shaking hands with your foot; as your fingers spread the toes, feel the space you are creating between your bones.
Walk on uneven ground. Next time you go for a walk do your best to walk on the rocks, on the side of the path, hike on a bumpy trail, or simply walk in the grass. Find ways to change the path your feet are walking on.
Walk further. Take your daily walk goal and double it once a week.
Go barefoot. As often as you can, kick off the shoes and let your feet touch the ground you’re walking on.
This can take some work, so go slow and don’t push yourself too far.
Mariah Neeson can be found on her feet at THE SPACE most days, practicing Ashiatsu Barefoot Massage, teaching massage therapists how to do Ashiatsu, or teaching couples how to massage one another. SpokaneSpace.com
Chiropractic Care for Pain in the Elbows, Hands, Feet, Knees, or Wrists
by Michael R. Valente
Most people associate chiropractic care with neck and back pain. We also treat sciatic pain, headaches, shoulder pain and many other symptoms very successfully. Few people realize that chiropractic care of the hands and feet can work miracles.
Think about how many different ways you use your hands on a daily basis. The majority of our activities include gripping, pulling, pushing, and twisting with our hands. These repetitive, strenuous movements can lead to serious pain in the hands, wrists, and elbows, interrupting our normal daily functioning. If you work a “nine-to-five” job you most likely sit seven hours per day in front of your computer then go home and spend another few hours on your smart phone or tablet. Pretty soon you may feel a searing pain in your elbow. You call it “tennis elbow,” only you haven’t played tennis in years. What you have is a repetitive injury called “mouse elbow” and it develops from gripping and squeezing your computer mouse.
Chiropractors treat “mouse elbow” by breaking up the scar tissue and adhesions in the soft tissue around the elbow, restoring proper alignment of the joint, muscles, and tendons of the forearm. This reduces inflammation and swelling around the joints of the elbow. Individuals with “mouse elbow” often report a dramatic decrease in elbow pain after a few treatments. If you have had wrist or elbow pain, do not ignore the warning signs. Do not make the mistake of taking ibuprofen believing you are curing your condition. A chiropractor can find the source of the problem and create a tailored treatment plan to help eliminate your pain as quickly as possible.
Additionally, foot pain is an ailment that most do not associate with chiropractic care. One of the most common causes of pain to the heel and foot is plantar fasciitis (PF). Plantar fasciitis is a serious and painful condition concerning the long, flat ligament connecting the toes and the heel on the bottom of the foot. It is accompanied by tears, adhesions, and inflammation. When an individual walks or runs, they land on the heel and force transfers through the plantar fascia to the toes. All the body weight is then held up by the plantar fascia. Repetitive force can pull and tear the connective tissue of the plantar fascia. This condition can worsen with standing or exercise for prolonged periods of time. People often report worse pain in the mornings when getting out of bed, but improvement as the day progresses as the fascia “warms up” and loosens slightly, reducing the tension on the ligament and lessening the pain.
Chiropractors use gentle, low-force manipulative techniques to correct the slight misalignments in the foot and toes that cause PF. Chiropractors also implement soft tissue modalities such as pin and stretch, myofascial stripping, voodoo floss, and cold laser therapy. In our office, we have found this approach also decreases the likelihood of PF occurring again in the future. The lack of success of traditional medical treatments has caused people to seek out alternative methods. Chiropractic care has been growing into a leading option for those suffering with PF.
So if you find you are experiencing any of these symptoms to the elbows, hands, feet, knees, or wrists, give chiropractic a try. They don’t call us the “doctors of the last resort” for nothing.
Dr. Michael R. Valente owns Valente Chiropractic. spokanechiropractic.com
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