Cramming Foot Into Shoe Crooks Toe
Q. I have what my doctor calls a “hammertoe.” I’ve developed a painful corn and have tried a cushion pad without much luck. Is foot surgery my only option? - D.H., Spokane
A. What you’re describing is a clawlike buckling of a toe, especially the second toe. The most common cause for it is the daily ritual of squeezing five toes in a shoe that’s way too tight.
Look at the shape of your foot and toes. Now look at the shape of a ladies’ dress shoe. It’s like trying to jam a square peg into a round hole. Then you contort your poor little toes even more, with a heel that shifts even more weight and stress onto the toe region. It’s no wonder that corns and twisted toes result.
After hours of forcing your toe to remain curled up in a cramped shoe, the tendons that allow you to flex your toes can shorten and contract. In the early stage, there’s just stiffness; later on, the flexing tendons may permanently contract and leave you with a toe that can’t be straightened out.
While inheritance plays a small part in whether a person will get a hammertoe, footwear plays the biggest role.
In the early stages, changing to a flat heel, wide-toe shoe that won’t squish your foot can help prevent further damage. Sometimes, exercises to stretch out those flexor tendons can improve things. Sometimes, a podiatrist or orthopedist will recommend a toe splint.
Corn pads may help cushion your foot, but a better approach is to deal with the reason why you’ve got a corn in the first place. If those treatments don’t work and foot pain continues, foot surgery may be your best bet.
Surgery consists of rebalancing the tendons that are responsible for bending and straightening your toe. Sometimes to do this, a small piece of the bone that’s sticking up and giving you a corn needs to be removed. Then the toe can have a normal shape, alignment and nearly normal function.
This can all be done under a local anesthetic nerve block, and you can go home in a post-op shoe without the side effects of general anesthesia. Healing takes about six weeks.
Here are a few fun foot facts for folks: Each foot has 26 bones, 33 joints, 107 ligaments, and 19 muscles and tendons. The 52 bones in your feet make up about 25 percent of all the bones in your body. There are approximately 250,000 sweat glands in your feet, and they sweat as much as 8 ounces of moisture per day. According to the American Podiatric Association, the average person takes 8,000-10,000 steps a day. The average person may walk up to 115,000 miles in a lifetime. That’s like walking around the world more than four times!
Shopping for shoes is best done in the afternoon, since feet tend to swell a bit during the day.
Q. How do gallstones cause pancreatitis? - H.M., Bradenton, Fla.
A. The short answer is that gallstones plug up the duct that normally allows digestive enzymes produced by the pancreas to empty into the small intestine.
Normally, these enzymes are secreted in an inactive form so the pancreas doesn’t digest itself. However, if a gallstone plugs the pancreatic duct, these enzymes somehow become activated.
That’s not a good thing, since these activated enzymes begin digesting the pancreatic tissue. This “auto-digestion” process causes a terrific amount of pain, pancreas swelling, bleeding and tissue injury/death. Eventually, this attack will subside. But depending upon the extent and duration of blockage, acute pancreatitis can be very serious.
If gallstones are causing pancreatitis, the best solution to the problem, once the pancreas has cooled down, is to have the gallbladder surgically removed. The immediate treatment for acute pancreatitis is supportive care - lots of IV fluids; nothing to eat or drink (that’s to keep the pancreas from having to produce more digestive enzymes); pain medication; and watching for bleeding and infection. Usually, acute pancreatitis runs its course in five to seven days. For some, there’s a low-grade chronic inflammation that continues until the pancreas burns itself out.