Article written by Dr. Bronwyn Wilke, D.P.M

I recently read an article by a woman's fashion magazine listing shoes that every woman should have.  I was stunned that sneakers did not make the list!  A good solid walking/hiking athletic shoe is number one on my list of must have shoes.  Athletic shoes are the one line of shoegear that is focused on function and has research dedicated to product performance.  I appreciate that the basis of the article was fashion.  What woman doesn't have her glam moments?  But for every moment of glamour and less than practical shoe choices there is a moment of relief when the shoes are taken off.  If you've strutted in pumps you appreciate the NYC exec who runs to appointments in her suit and sneakers with her dress shoes in her purse.  If you have danced in peep toes or platforms you understand Kim William's character wearing sneakers under her wedding gown in "Father of the Bride".  No matter how gorgeous the shoe it cannot be sexy if you have to limp.  As a lover of stilletos, pumps, peep toes, sandals and boots I must draw attention to the unsung hero of every womans closet - the sneaker.  If you are having trouble finding a sneaker that is right for you, your foot health professional will give you guidance on foot deformity and appropriate sneaker choices.  Come see us in York, Lancaster, Shrewsbury, or Hanover.  We are Podiatrists that specialize in you.

By Dr. Bronwyn Wilke D.P.M  F.A.C.F.A.S.

Bunions are not just the nasty bump you saw sticking out of the side of your grandmother’s shoe.  They are a progressive foot deformity that can appear as early as the teen years.  Over time the great toe moves toward the smaller toes, making the great toe joint prominent on the inside of the foot.  Bunions are hereditary and the deformity can be worsened by pointy toed shoes.

In the early stages there is no pain with this deformity.  As a bunion progresses shoes become irritating to the bump.  Patients will usually start to wear wider shoes to accommodate the bump, and stretching out of the shoe over the bunion can be seen.  With the joint out of alignment the cartilage will start to degenerate and become arthritic.  Pain changes from an irritation over the bump from shoes to a deeper ache in the joint as the cartilage is destroyed.  If a bunion is not treated, compensation can be seen throughout the foot.  Hammertoe formation of the second toe is caused by the great toe pushing the second toe out of position.  Callouses can be seen across the forefoot and along the great toe as the mechanics of the foot and the way a step is taken changes because of the deformity.

Treatment early on for bunions includes orthotics.  An orthotic is a shoe insert that controls the mechanics/function of the foot and its joints. Podiatrist recomment  using an orthotic early on to slow down progression of a bunion deformity and ease pain.  This is important in juvenile bunions where surgery runs the risk of disrupting the growth plates. 

The type of surgery necessary to correct a bunion depends on the severity of the deformity.  It is generally an outpatient procedure, where the patient can go home the same day the procedure is performed.  The majority of bunion procedures allow the patient to walk in a special shoe or protective boot immediately after surgery.  No high impact activity (such as jogging or aerobics) is allowed until the bone heals which generally takes 6-8 weeks.  Very severe bunions may require a cast and several weeks on crutches.  Physical therapy after surgery helps restore motion to the joint and ensures the patient walks without a limp.

If a bunion is neglected and allowed to progress, the joint becomes arthritic.  Treatment options include arthritis medicines to control the pain and stiff soled shoes to limit motion at the joint.  Surgical treatments include joint replacement and fusion/arthrodesis.  Joint replacement maintains motion at the great toe joint placing a piece of metal to give a smooth surface for the joint to glide.  Joint replacement patients can start walking inmmediately after surgery.  Joint arthrodesis fuses the great toe to the long bone behind it, eliminating motion and pain.  Joint fusion takes 6-8 weeks for the bone to heel and a cast and crutches are used during this time. 

Ideally, bunions should be treated before the joint becomes arthiritic.  Maintaining alignment of the joint will prevent deterioration of the cartilage and the pain associated with arthritis. 

If you are near the York, PA; Lancaster, PA; Hanover PA;  or Shrewsbury PA area and are having these symptoms, Please call our office for treatment.  1-800-456-0076.