Flat Feet

Thinking about flat feet might conjure up images of Fred Flintstone loping around Bedrock, but did you know that everyone is born with flat feet? As we grow, the tendons located in the bottom of the foot tighten to produce a natural arch.

Patient with flatfoot deformity.
Patient with flatfoot deformity.

Most of the time flat feet, also known as fallen arches, that become painful started out as normal feet. Over time, however, they can develop into a flat foot deformity. It’s partly a degenerative process that can also have some genetics involved.

Can the Possibility of Flat Feet Be Reduced?

Unfortunately, there’s nothing currently that works to prevent flat feet. However, there are some things patients can do to help the problem in the early stages, such as:

  • Using arch supports
  • Using shoe inserts
  • Selecting correct footwear
  • Doing strengthening, physical therapy-type exercises

Treating Flat Feet

The key to treating a fallen arch or flat foot is early detection. An x-ray may be required to complete the assessment. If you can detect early on the foot problem and deformity

Flatfoot deformity x-ray.
X-ray of a patient’s flat foot deformity.

that’s occurring, you’ll have additional options available for treatment. For instance, the achilles tendon plays a big roll in arch support, so regularly stretching out the achilles tendon is important and beneficial. If all non-operative approaches fail, surgery to correct the ligaments, tendons, bones and/or joints may be required.

Schedule an Appointment

The Center for Advanced Orthopedics (CAO) offers same day appointments and in-office radiologic imaging/testing, such as x-rays and musculoskeletal ultrasounds. Dr. Grebing specializes in the foot and ankle and is board-certified and fellowship-trained.

Call us at 618-288-9460 to schedule an appointment or visit www.c4ao.com for more information.

Bone Spurs: When Your Body’s Good Intentions Go Bad

Osteophytes, more commonly called bone spurs, are small, outward bone growths that typically occur near joints or where muscles, tendons or ligaments attach to the bone. Bone spurs occur as a result of the body attempting to repair itself (good intentions). The body generates more bone at locations that have experienced increased wear and tear, sometimes resulting in painful friction and limited range of motion (gone bad). Those with osteoarthritis are more susceptible to this condition due to the lack of cartilage allowing bone to rub on bone.

Different Types of Bone Spurs

Bone spurs can occur in various parts of the body. They often go undetected until a patient begins to experience pain or reduced motion. Here are some of the locations that bone spurs can form:

Bone spurs can cause heel pain or go completely undetected.
Heel pain can be caused by bone spurs.

• Heel– The American Academy of Orthopaedic Surgeons states that “one out of 10 people has heel spurs, but only 1 out of 20 people (5%) with heel spurs has foot pain.”
• Knee – Knee spurs are typically slow growing but can reduce range of motion in the knee joint.
• Hip– A hip bone spur can cause pain when moving the hip joint, depending on location of the spur.
• Shoulder – Bone spurs located in the shoulder can lead to shoulder tendinitis or a torn rotator cuff due to repeated rubbing.
• Fingers – Bone spurs in the fingers often appear as hard bumps near the finger joints.


Diagnosing and Treating Bone Spurs

To diagnose bones spurs, the orthopedist will discuss your symptoms and perform a physical examination. Confirming the diagnosis will require diagnostic imaging tests, such as an X-ray, ultrasound imaging, MRI or CT scans.
Unless a bone spur is causing pain or limited motion, they do not have to be treated. The pain is a result of the bone growth rubbing on the adjacent nerves or tissue. If a bone spur does become problematic, conservative treatment options such as weight loss (for knee spurs), over-the-counter pain relievers or physical therapy can be utilized.
The physician may recommend cortisone injections to reduce inflammation and provide pain relief. Cortisone injections typically last anywhere from several weeks to several months. If problems persist, surgery may be recommended. Arthroscopic surgery, a minimally invasive procedure, is effective and reduces recovery time, as opposed to traditional surgery.

Schedule an Appointment

The Center for Advanced Orthopedics (CAO) offers same day appointments and in-office radiologic imaging/testing, such as x-rays and musculoskeletal ultrasounds). Our board-certified doctors are highly qualified to assess, diagnose and treat patients experiencing symptoms of bone spurs. Call us at 618-288-9460 to schedule an appointment or visit http://www.c4ao.com for more information.

Don’t Let Bunions Leave You Feeling ‘Defeeted’

Bunions can really be a bummer. However, the deformity doesn’t exclusively plague the older generation. These unsightly and bothersome bumps can also affect younger generations, such as millennials, too. In fact, more than one-third of American women have bunions, according to the American Orthopaedic Foot & Ankle Society.

What is a Bunion?

What appears to be a bump is actually bone. A bunion occurs when the metatarsophalangeal joint (the joint at the base of your big toe) juts outward. The area is often swollen and painful, especially when walking. Bunionettes (don’t let the adorable name fool you) are smaller bunions that typically form on the outer joint of your little toe.

This shift in the joint may cause your big toe to point towards your other toes instead of parallel. As the bunion increases in size, painful swelling, known as bursitis, may occur. Other complications, including calluses, corns, hammertoe, arthritis, and difficulty walking due to severe pain or overlapping toes may also arise.

What Causes Bunions?

While the specific cause of bunions is still up for debate, there are several factors that are thought to contribute to the uncomfortable bunions. Here are some of the suspected causes of foot deformity:

  • Faulty Footwear – Shoes that are too tight, narrow or high. Sky-high heels and narrow shoes constrict the foot and force all the toes together.
  • Genetics – Thanks a lot, Mom! All joking aside, different foot shapes can be more susceptible to various foot problems and injuries, including bunions.
  • Congenital Foot Deformities – A foot deformity present at birth can be the culprit of toe pain related to bunions.
  • Arthritis – Those that have a form of inflammatory arthritis, such as rheumatoid arthritis, are at greater risk for bunions.

Bunions can be caused by high heels and improper footwear. See a foot doctor for treatment or a bunionectomy.

How to Treat and Correct Bunions

The first (and easiest) corrective measures for bunions is to reconsider your footwear and use shoe inserts. Shoes that offer support and have a wider foot bed will provide more space for your toes and relieve pressure. Also, avoid wearing high heels. Shoe inserts, whether custom or generic, are also beneficial for preventing or soothing bunions. Bunion pads or taping the foot to correct the position of the toes can help, too. Over-the-counter pain medication, such as ibuprofen or acetaminophen, will work to ease discomfort.

If pain persists, your foot doctor may recommend cortisone injections. If all else fails to make your feet feel better, surgery may be required.  The surgical removal of the bunion is called a bunionectomy. A bunionectomy involves realigning and/or removing a portion of the bone to straighten the toe.

The Center for Advanced Orthopedics (CAO) always utilizes conservative treatment options, considering surgery a last resort. Dr. Brett Grebing, a board-certified and fellowship-trained orthopedic surgeon, specializes in the foot and ankle with a focus on foot deformities including bunions.

If you’re experiencing foot or toe pain and need a foot doctor, we’d be happy to help you schedule an appointment! Call us at 618-288-9460. You can also visit www.c4ao.com for more information.

Podiatrist vs. Orthopedist: What’s the Difference?

What is the difference between a podiatrist and an orthopedist that specializes in the foot and ankle? It’s an age-old question . . . Okay, maybe not an age-old, but it’s certainly one that we get asked a lot. When experiencing foot and/or ankle pain or problems, it’s important to know the difference between an orthopedic surgeon that specializes in the foot and ankle versus a podiatrist. Below we cover some of the key differences.

Orthopedist vs. Podiatrist: Who to see when you're having foot problems.
Treating your feet: Orthopedist or Podiatrist?
  • Training – An orthopedic surgeon with a specialty focus must complete medical school, an internship, residency, and fellowship training. A fellowship is the additional year of training a medical doctor undergoes to specialize in a particular field, such as the foot and ankle. Podiatrists attend podiatry school followed by a, typically, shorter fellowship-training program.
  • Board Certification – Orthopedic surgeons are board-certified by one of the subspecialties under the American Board of Medical Specialties. Dr. Grebing, for instance, was certified by the American Board of Orthopedic Surgery.

    Podiatrists can be certified by the American Board of Podiatric Medicine and the American Board of Podiatric Surgery. They are eligible for certification after additional training.

  • Assessment – Simply put, orthopedic surgeons are medical doctors; podiatrists are not. An orthopedist will take the entire body into consideration when assessing and diagnosing a problem. They will review the complete musculoskeletal system, including the bones, muscles, ligaments, tendons, joints, cartilage and connective tissue to rule out any other underlying circumstances that could be affecting the foot and ankle.
  • Treatment – Podiatrists typically treat more common foot and ankle problems, such as ingrown toenails, calluses, fallen arches, and heel spurs. Orthopedists can also treat these foot and ankle issues. However, they are also trained to treat more complex problems, as well, that involve the musculoskeletal system, and perform more complicated surgeries.

If you’re experiencing foot or ankle pain—don’t drag your feet to schedule an appointment! We’d be happy to assist and answer any questions you might have. Please call us at 618-288-9460. You can also visit www.c4ao.com for more information.

Happy & Healthy: New Year’s Resolutions

We know diet and exercise are completely cliché when it comes to New Year’s resolutions. However, they are a great way to commit to maintaining your bone, and of course, overall health. So now that the ball has dropped and the confetti has been swept away, make good on your resolution for a healthier you. paper-3042645_1280

Here’s some suggestions for resolutions that will make a positive impact on the year ahead:

Nosh nutritiously – You are what you eat. Processed food and sugar can sabotage your health and actually weaken your bones. Foods high in vitamin D are essential for providing your body the ability to absorb calcium. Fatty fish, egg yolks, cheese and vitamin D-fortified foods like cereal, dairy products and orange juice are all great sources.   Boost your calcium intake by adding leafy greens, fish, such as sardines and rainbow trout, and foods fortified with calcium. Salmon is a great option for both vitamin D and calcium. Start eating foods that will bolster your bones and keep osteoporosis at bay.

Get physical – Physical activity helps build strong bones when we are younger. As we age, we run the risk of osteoporisis, a disease that weakens the bones and makes them more susceptible to breaking. That’s why it’s important to continue exercising to maintain healthy bones. Strengthen your bones with weight-bearing exercises like walking, jumping rope, tennis and dancing. Increasing the weight placed on bones while exercising makes them work harder and increases bone density. Jazzercise, Prancercize or just plain aerobicize your way to better health and stronger bones.

Lose the extra lbs – Extra weight places more stress on your joints. In fact, obesity is a key contributor to osteoarthritis, a joint disease that results in painful wear and tear typically affecting the hips and knees. Maintaining a healthy body weight is important because each pound puts about five pounds of pressure on your knee joints.

Don’t worry be happy – Stress can wreak havoc on your health . . . and bones. According to a study by the Journal of Clinical Endocrinology and Metabolism, higher levels of the hormone cortisol, commonly known as the stress hormone, decreases bone mineral density. To combat stress, get plenty of rest, take time for yourself, learn to say “no,” identify unrealistic expectations and laugh more. So put down that never ending to-do list and turn on “I Love Lucy” reruns because sometimes laughter really is the best medicine.

Resolutions can be hard to stick with so take it slow and start with small changes. Practicing healthy habits daily can ultimately lead to a long-term healthy lifestyle. Have questions? We’d be happy to schedule a consultation! Call us at 618-288-9460. You can also visit www.c4ao.com for more information.