Sunday, August 23, 2009

Will I Be Able to Run After Bunion Surgery?

Running After Bunion Surgery?

Great question! I hear this question at least several times a month from my active, athletic patients. Of course, my first response is always, “Are you able to run now?” This is not sarcasm, but a true fact finding mission. If you are unable to run before your surgery, due to the pain in your bunions, then if you can run afterwards - I am a hero! The same goes for the opposite. If you are running pain free before surgery, and really only want your bunions fixed due to the fact you think your feet are ugly, if you can’t run afterwards - you really don’t like me very much!

Let’s talk about this a little more in depth. A bunion is the result of undue stress on the big toe joint, which causes a protuberance of bone or tissue around that joint. Bunions can be very painful, inhibit normal walking, and make it difficult to fit into some shoes. Contrary to popular belief, bunions are aggravated, not caused, by tight shoes. They usually are due to inherited faulty foot mechanics which put abnormal pressure on the front of the foot. Pain is the primary reason patients seek medical attention for bunions. A majority of bunion surgeries are performed on women because they wear tight-fitting, high-heeled shoes that worsen the underlying foot problem and cause abnormal stress to the joint.

There’s good news for anyone considering bunion surgery. A survey in 2003 by the American College of Foot and Ankle Surgeons (ACFAS) had surgery performed by a foot and ankle surgeon to correct bunions within the past 6 to 24 months found more than 90 percent of patients who had the procedure say they experienced significant pain relief, increased their physical activity, and would recommend it to others.

Many runners who can benefit from the surgery avoid it and continue to endure pain because they have heard that surgery doesn’t work and is excessively painful. Their biggest fear is that they may not be able to ever run again! The truth, as evidenced by the survey results, is that advanced surgical techniques have allowed us to effectively correct bunion deformities with excellent outcomes in terms of pain relief and improved quality of life.

Ninety-six percent of the survey respondents identified pain relief as a desired outcome of the surgery, and 86 percent also said they hoped to improve their walking and increase their physical activity following surgery. On a scale of 1 to 10 with 10 representing “much pain,” the survey respondents averaged a score of 7 when assessing their pain before surgery, and the average score dropped to 2 when they assessed their pain six months after the operation. Ninety-two percent said they were able to increase their physical activities -- walking, golf, tennis, exercise -- and 90 percent said they would recommend bunion surgery to others.

That being said, in most cases, we can treat the pain caused by bunions conservatively. In fact, we feel strongly that surgery should be a last resort. We surprise many bunion patients with our ability to help them avoid surgery when they have been told previously they have no choice but surgery. A custom foot orthotic to off weight the bunion in your shoes is often very helpful. Many patients run for years pain free in orthotics before they decide to have surgery. If you have tried all conservative treatment, however, and bunion pain is causing pain or limiting your activity, surgery as you can see, can be a very effective option.

If the pain in your bunions has caused you to decrease or eliminate running from your life, contact our office for alternatives. Do not let the pain in your bunions change your life!

Run Happy!

Monday, August 3, 2009

Huckabee Encourages Health Reform at APMA National Meeting

Huckabee encourages Heath Reform at the APMA National Meeting

Health care reform is on the tip of everyone’s tongue this week. The debates in Congress and the attempt to pass some kind of legislation that most Congress members have not even read, let alone understood, is the news leader. I was lucky enough this week to be present for Mike Huckabee’s keynote speech to the American Podiatric Medical Association in Toronto, Canada. The former governor from Arkansas inspired and encouraged the APMA to discuss more than health care reform but to think of revolutionary health reform in the United States as the answer to our health care woes.

What does he mean by health reform? He encouraged the physicians to stop thinking about fixing the health care system. The system isn’t broken. It is actually considered the best in the world. If you start discussing socialized medicine overseas, you will quickly realize that most wealthy foreigners would rather have surgery or cancer treatment in the US than in their own countries. We don’t need to fix the system; we just need to work on unhealthy American habits. The combination of obesity, lack of exercise and smoking, lead to most of our chronic health problems in the US. The system is overwhelmed by chronic disease! Why not come up with a system that encourages healthy living, therefore decreasing chronic disease and actually increasing productivity in the country?

Mike Huckabee knows a lot about unhealthy living and its consequences. Several years ago he was diagnosed with Type 2 diabetes and was told he was now in the last decade of his life. His physician outlined what death by diabetes looked like and encouraged him to take control of his future. He lost an incredible amount of weight, starting eating better, and even started running for exercise. Multiple marathons later, he is no longer a diabetic and is healthier than he has been in years. Mike Huckabee took control of his health and wants every American to experience this life-changing heath makeover.

Why do most Americans have unhealthy habits? Is it laziness? Is it hereditary? Is it social? Actually it is a combination of all of these things in most people. We need to encourage healthier lifestyles and teach our children the importance of healthy choices. Multiple studies have shown that regular exercise including around three hours of aerobic exercise and an hour of strength training each week leads to decreased depression, diabetes, heart disease and osteoporosis. This has been well documented, but most Americans are not listening.

How can we encourage healthier life styles and off load the currently overwhelmed health care system? How about an overhaul of the health insurance system with incentives for healthy choices? I do not believe in penalizing people for obesity or smoking, but how about incentive discounts for a healthy BMI, non-smoking and regular exercise? Just like when car insurance companies give discounts for safe driving records. We could even put an accumulative healthy point system with sliding scale premiums for regular checkup and prevention programs.

Think of what this type of system would look like. The current reforms of the health care system being discussed will lead to a two tier system where the wealthy will have the best care and the rest will be stuck with the socialist model which has been shown not to work in many, many other countries. If we focus more of health reform instead of care reform, we can decrease the load on the current system, decrease health care expenditures and actually have a healthier, happier, and more productive society. Political parties aside, call or write your representatives and let them know you are unhappy with this rushed consideration of the most important legislation in decades. Let us not quickly put in place a program doomed for disaster that will significantly decrease the standard of care in the American health care system. Let us uplift the health of the American people instead.