Summer is a Good Time to Treat Bunions

SUMMER IS A GOOD TIME TO TREAT BUNIONS, ACCORDING TO FOOT AND ANKLE SPECIALIST, DR. MARK YAKAVONIS.

As sandals return to the wardrobe this summer, the disfiguring prominences known as bunions can present cosmetic and physical problems for those sufSemi circle of colorful flip flops on old weathered blue painted beach decking. Space for copy.fering from the foot condition. Bunions can be extremely painful, making it difficult to find shoes that don’t put pressure on the area or cause more discomfort.

While there’s no explanation why some people develop bunions and others do not, bunions can arise at any time from adolescence through retirement. The condition does affect women more than men though, and studies have shown that wearing high heeled shoes tends to exacerbate the problem.

“Treatment for bunions varies depending on the severity,” said Dr. Mark Yakavonis, an orthopedic surgeon who specializes in foot and ankle surgery and orthopedic trauma at ONS. “Ice, anti-inflammatories and orthotics can help alleviate pain. However, if a bunion is not addressed early, the pain can become disabling and require surgery to realign the bones, ligaments and tendons to bring the big toe back to its correct position.”

In the past, bunion surgery required a lengthy recovery and a cumbersome foot cast. Now, new techniques, materials, and an emphasis on maintaining mobility through the healing process has made bunion surgery much less of an ordeal. Casts are rarely applied, patients normally use crutches for one to three weeks and complete recovery takes two to four months.

“Having bunion surgery in the summer has many advantages over the winter months,” said Dr. Yakavonis. “Navigating ice and snow while recovering can be hazardous, and the recovery shoe, which is essentially an open-toe sandal, is much easier to deal with in the warmer months. After that, almost any open sandal would be more comfortable than putting your healing foot in a shoe.”

Despite the medical advances and reduced recovery time, a bunionectomy is not a procedure to undergo on a whim. Also, cosmetics alone are not a good reason to have the surgery. People with bunions that impact the quality of their daily lives should consult with a specialist to learn which treatment option is most appropriate.

07/10/2019

Are shoes the culprit of foot pain?

ONS orthopedic surgeon Dr. Michael Clain, who specializes in foot and ankle surgery met with News 12 On Health Reporter Gillian Neff to discuss whether the cause of foot pain is related to shoes.

news12_Clain

Dr.Clain says foot issues like bunions and hammer toes are exacerbated by shoes. Bunions may appear to be bumps growing on the foot, but they’re actually bones shifted out of place by frequent wear and tear and it is best to find shoes that can accomodate your feet comfortably. Watch the NEWS12 “What’s Ailing You: Aching Foot Pain” with Gillian Neff.

For more on bunion surgery and the results read: Suffer from Bunion Pain? Dr. Clain Offers Solutions.

What do you do when you are diagnosed with an old (chronic) Achilles tendon rupture?

Mark Yakavonis, MD, MMS, is an orthopedic surgeon who specializes in foot and ankle surgery. Dr. Yakavonis has expertise in treating a variety of foot pain and deformity related conditions including Achilles tendonitis, ankle instability, cartilage injuries, bunions and hammer toes.  His practice will also focus on youth athlete sports injuries and the types of injuries seen in field athletes, gymnasts and ballet dancers.

Achilles tendon ruptures will often not be discovered for months after the injury. In the months between injury and showing up at the doctor’s office, the torn tendon develops scar tissue which decreased the quality and elasticity of the tissue. Because of this, directly repairing the torn tendon, as is done in an acute injury, becomes is less than ideal. In this situation, we will supplement the tendon repair with a tendon transfer. Essentially, we borrow a tendon that bends the big toe (there is another tendon that compensates when it is borrowed), reroute it, and reattach it to the heel bone. This does two very important things:

1. It supplements the strength of the torn Achilles, allowing a quicker and better recovery.

2. It provides improved blood supply to the Achilles repair, providing healing factors to the area of diseased tendon.

In summary, ruptures of the Achilles Foot_AnklePictendon are increasingly common in our aging yet increasingly active population. In cases where an Achilles rupture is missed or the rupture cannot be repaired directly under normal tension, adding the flexor hallicus longus tendon transfer allows for significantly improved results with a shorter recovery.

If you suffer from foot and ankle pain and would like to attend a free seminar, Dr. Yakavonis of ONS is an orthopedic surgeon specializing in foot and ankle surgery, and Greenwich Hospital will present Solutions for Foot & Ankle Pain: Beyond Foot Massage . He will present treatments and surgical techniques for bunions and other foot deformities. Learn more and register online here.

07/10/2019

Suffer from Bunion Pain? Dr. Clain Offers Solutions

Michael Clain, MD
Michael Clain, MD

Bunions are a common deformity encountered in the foot where the big toe is out of alignment. This creates pain in that toe and often in the lesser toes as well. The deformity makes it difficult to find shoes that fit comfortably.  Ill-fitting shoes can contribute to the situation but the underlying deformity is genetic. This is why most patients can recall a parent or grandparent that had the problem.

In consultation, I often tell patients that the options are to accommodate the foot with wider shoes, gentle arch supports and sometimes padding or I encourage them to consider surgery.  The decision to proceed with surgery should be based on the overall level of discomfort and deformity.  This will differ from patient to patient.  It is rare that the patient that must have bunion surgery.  Most people will choose surgery due to the accumulation of annoyances, discomfort, pain and deformity in other toes.

Actual X-ray of patient of Dr. Clain before bunion surgery
X-ray of patient of Dr. Clain before bunion surgery
Same Patient. Post-Bunionechotmy
Same Patient. Post-Bunionechotmy

It is very important, from my point of view, to communicate realistic expectations for the procedure and the ultimate result. I try hard to be very specific about the time involved in recovery and give every patient a written “expected surgical recovery.” It is obviously difficult to remember everything when you as the patient are given a great deal of information so it’s helpful to have a summary to refer to.

Not all bunions are the same. Routinely, I perform about six different surgical procedures.  The goal is to do the most appropriate operation for your particular foot and circumstance.  With careful communication and a well thought-out plan it is highly likely that we should be able to get a great result for almost any foot.”

For more information about Dr. Clain, click here.

If you suffer from bunions and would like to attend a free seminar on foot pain Dr. Yakavonis of ONS and Greenwich Hospital will present Solutions for Foot & Ankle Pain: Beyond Foot Massage is an orthopedic surgeon specializing in foot and ankle surgery. He will present treatments and surgical techniques for bunions and other foot deformities. Learn more and register online here.

07/10/2019

ONS Physical Therapist, Alicia Hirscht Discusses How to Help Avoid Neck and Back Pain in the Workplace

ONS Senior Clinical Specialist Alicia Hirsch
ONS Senior Clinical Specialist Alicia Hirsch

Let’s face it, if you don’t have a smartphone or a tablet, LTE or Wi-Fi, if you are not tweeting and networking 24/7….well, with the way we all depend on technology today, you might as well be living in a cave and drawing hieroglyphics!

We’ve come a long way from the years of the caveman, the question is, at what expense have we make this progress? From manufacturing and robotics, trading and purchasing, to filing and storage of records and data, almost everyone in the workplace uses computer technology. While computers and the internet enable workers to be more efficient and productive, our global workforce is quickly becoming more sedentary, and more painful.

Data collected from office workers reveals that 20% suffer from chronic neck pain, and 60-70% report having suffered from neck pain at some point in their career. Neck pain is highly correlated to workers who sit with a forward head for more than 5 hours per day, and is twice as likely to affect women and workers older than 40. Luckily, though, research also shows that workers who exercised regularly, reported good sleep habits and engaged in productive stress management reported a lower incidence of neck pain.

While 8 hours of sleep, regular meditation and a gym membership (that you actually use) might not fit into your busy, computer driven life, do not worry, hope is not lost. There are small steps you can take to keep yourself as pain free in the office as possible… and less irritable.

Step 1: Get up and move! We are not built to sit, we are built to MOVE. Set a timer on your computer that reminds you to change position every 20 minutes. Even if you stand for 1 minute 2 times an hour, your risk of developing neck pain reduces dramatically. While standing, engage is some basic exercises that can be done easily at your desk (see below).

Extensions: Place your hands on your waist and lean your shoulders back. Move slowly, repeat 15 times.
Extensions: Place your hands on your waist and lean your shoulders back. Move slowly, repeat 15 times.
Chin tuck: Pull your chin back towards your spine, keeping your eyes focused straight ahead. Hold for 3 seconds, relax, repeat 15 times.
Chin tuck: Pull your chin back towards your spine, keeping your eyes focused straight ahead. Hold for 3 seconds, relax, repeat 15 times.
Stand with your shoulders back and your chin tucked. Take a large step back with your right foot, allowing your left leg to bend. Sit your hips down into the stretch, hold for 20 seconds, repeat on each leg.
Stand with your shoulders back and your chin tucked. Take a large step back with your right foot, allowing your left leg to bend. Sit your hips down into the stretch, hold for 20 seconds, repeat on each leg.
Chest stretch: Reach up and back with one arm while reaching down and back with the other, open up your chest and squeeze your shoulder blades together. Keep your chin tucked, hold for 15 seconds.
Chest stretch: Reach up and back with one arm while reaching down and back with the other, open up your chest and squeeze your shoulder blades together. Keep your chin tucked, hold for 15 seconds.

Step 2: Make sure your work area is set up properly. Your desktop monitor should be even with your line of sight. Not in a corner away from you, right in front of you. If you work with a lap top or tablet, prop them up on risers so that you do not have to look down. Consider wireless/external keyboards to keep your hands in front of you and your elbows bent at 90 degree angles. Use a lumbar support to keep your spine in a neutral position, and adjust your seat height so that your hips, knees and ankles can rest at 90 degree angles. (See the picture below) Download or view our Workstation Ergonomics flyer to use as a guideline for improving your work space to help improve sitting posture and help to minimize neck and back pain.

NeckPain_Office
Desktop even with your eye sight, lumbar support to keep spine in a neutral position, knees and ankles resting at 90 degree angles.

If you are experiencing neck and back pain it may be time to talk to the experts at the ONS Spine Center. ONS Spine Center physicians specialize in non-operative and operative treatments for neck and back pain. Visit the Back and Neck Pain page on our website to learn more and see our physicians. To learn about our physical therapy services visit ONS Physical Therapy.

Orthopaedic and Neurosurgery Specialists, PC (ONS) physicians provide expertise in the full spectrum of musculoskeletal conditions and injuries, sports medicine, minimally invasive orthopedic, spine and brain surgery, joint replacement and trauma. The main office is located at 6 Greenwich Office Park on Valley Road, Greenwich, CT. For more information, visit www.onsmd.com or call 203.869.1145.