Getting older by the foot: Common ailments as you age
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You tend to take them for granted until a foot ailment crops up. Then you find yourself limping around and your exercise routine curtailed.
Dr. Armen Kelikian, a foot and ankle orthopedic surgeon with NorthShore University HealthSystem, talks with the Daily Herald about common foot issues; new advances in foot procedures; and how to keep your feet healthy.
Q: Why are foot ailments more common as people age?
A: The small structures of our feet take four times our body weight -- more than any other joint in our bodies. Years of walking, moving and bearing the brunt of the weight takes a toll on joints and cartilage -- the smooth connective tissue on the end of bones that cushions joints and helps them move easily.
Plus, people are much more active today in sports as they age, so we see a lot of ankle and foot injuries related to that.
Q: What are the most common foot issues people face as they age?
A: One of the most common problems is tendon ruptures, particularly the posterior tibial tendon on the inside of the ankle and the Achilles tendon.
Degenerative problems, such as arthritis, are common because people are more active in sports.
Bunions, too, are common, but if they're not painful, we don't remove them.
It's the same with cars, so to speak. If the tires on your car are fine and functioning, leave them alone.
Q: What steps can people take to improve foot health?
A: Proper shoes and fit are very important, and make sure you wear proper shoes the majority of the time.
This means shoes that don't affect your gait and have plenty of room for your feet to spread naturally while moving in them.
Also, take foot pain seriously. Don't ignore it; have it checked out.
Foot care is especially important for diabetics, who need annual exams to check for diabetic neuropathy, which is damage to the nerves usually caused by chronic high blood sugar levels.
Q: Some patients may hesitate to have foot surgery because of the recovery time and having to be off their feet. What issues should a patient weigh when deciding what plan of care is best for their situation?
A: Once again, think of a car. How would your car function without a tire?
Foot surgery means no weight bearing for two months, or in a cast for that long. You have to consider being unable to drive and whether you can get around with crutches or knee walkers.
Elevation is very important after foot surgery, so think about whether you can adhere to your doctor's orders about keeping your foot elevated.
Swelling can last up to 4½ months after foot surgery, and this is what slows recovery the most.
Q: What are some recent medical advances to help those with foot issues?
A: The Cartiva Synthetic Cartilage implant for big toe arthritis is a hot one right now.
People are coming out of the woodwork to ask about it because it is an alternative to fusion surgery, which results in a total loss of joint movement.
The design of artificial ankles has been significantly improved, and arthroscopic surgery in the ankles, similar to what we do in the knee, has advanced for debriding or cartilage transplants.
Q: What exactly is Cartiva and how does it help alleviate pain from arthritis in the foot and toe?
A: The Cartiva implant is a pea-sized pad that is implanted in the big toe joint to act as a shock absorber.
Think of a rubber bumper on your car that protects your fender. This implant acts as an interface to cushion the two surfaces of raw bones.
It is a viable alternative to fusion surgery, which has traditionally been the treatment. With this implant, the foot's natural movement is protected.
• Dr. Armen Kelikian, MD, is a foot and ankle orthopedic surgeon with NorthShore University HealthSystem.