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Category: Surgery

Tibialis Anterior Tendonitis: Symptoms and Treatment Options

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Muscles and tendons tibialis anterior tendonitis

The foot has several tendons that originate in the lower leg and extend into the foot. They each have different functions to stabilize the foot and help us to propel our bodies forward when we walk or run. The anterior tibial tendon is one of these tendons. Although tibialis anterior tendonitis may be the least common complaint of those experiencing tendon pain around the ankle joint, it’s important to understand how to recognize and what can be done to eliminate your pain.

Anatomy and function- The anterior tibial tendon is the third largest tendon in the foot and ankle. The largest is the Achilles tendon and the second largest is the posterior tibial tendon. The anterior tibial tendon originates as a muscle in the lower leg adjacent to the shin, tibia, and extends down to the foot. It is on the front of the ankle. It inserts onto the top and inner side of the arch.

Its function is to pull the foot up and support the arch. It also assists in supinating the foot. Supination is a motion often referred to and means that the arch of the foot increases and the foot angles towards the opposite foot. Finally, it decelerates the downward motion of your foot towards the ground. From the time your heel contacts the ground to the point of the ball of the foot bearing weight it prevents your foot from slapping against the ground. So, it’s very important for normal gait to occur. It helps to identify the tendon by pulling your foot up towards you and it will be the tendon that protrudes on the front of the ankle and is running towards the inside of the foot towards the big toe.

Tibialis anterior tendonitis is a condition that causes pain and discomfort along the front of the lower leg and ankle due to inflammation or degeneration of the tibialis anterior tendon. This tendon plays a crucial role in foot movement, particularly in lifting the foot upward while walking or running.

Where Will The Pain Be If I Have Tibialis Tendonitis?

It is most common towards the front of the ankle area. The symptoms of tibialis anterior tendonitis may also create pain above the ankle in the lower leg adjacent to the tibia. This may be referred to as anterior shin splints. Referring to shin splints on the front of the leg. Symptoms may also be closer to or at the point where the tendon attaches to the foot on the inner side of the arch.

What Causes Tibialis Anterior Tendonitis?

Several factors can contribute to tibialis anterior tendonitis, including:

  • Overuse – this may occur from doing too much too soon which can happen in any activity. However, any activity that requires you to extend your foot in front of the knee joint may increase the probability of overuse. Examples of this may be racquet sports, hiking, or running downhill.
  • Biomechanics – If your born with a flat foot the tendon may have to work harder to help support your arch.
  • Improper running technique – Over striding while running can also cause overuse of the tendon. By taking shorter strides you won’t be extending the foot in front of you as much as this will help to reduce the need for the anterior tibial tendon to stop foot slap.
  • Neurological problems – Neurological problems may not cause pain along the tendon, however, may cause damage to the nerves that stimulate the anterior muscle to contract. This is referred to as drop foot. Drop foot can be associated with back issues of a nerve issue around the see. Nerve surgery called decompression surgery can help with this.
  • Trauma – a severe ankle sprain could cause a tear to the tendon. Also, a laceration to the ankle area may also cause a partial or full tear.
  • Shoe gear – High heels may also be a cause and they will put more demand on the tendon to reduce the potential for foot slap because of the elevation of the heel off the ground.
  • Improper Footwear: Wearing unsupportive or worn-out shoes can alter foot mechanics, leading to excessive strain.

Symptoms of Tibialis Anterior Tendonitis

Common signs and symptoms of tibialis anterior tendonitis include:

  • Pain and tenderness along the front of the shin, ankle, or top of the foot.
  • Swelling in the affected area, especially near the tendon insertion.
  • Weakness or difficulty lifting the foot, potentially leading to a “foot slap” while walking.
  • Stiffness and discomfort that worsens with activity, particularly when walking downhill or running.
  • Pain when pressing on the tendon or flexing the foot upward against resistance.

Diagnosis or Evaluation of Tibialis Anterior Tendonitis

A podiatrist will typically diagnose tibialis anterior tendonitis through:

  • Clinical Examination: The physical examination alone will give the doctor a good idea if the tendon is damaged. There will be pain and swelling along the tendon or its muscle higher up the leg. Also, weakness of the tendon may be noted.
  • X-rays – these will not show tendon damage but are useful to rule out other problems.
  • Diagnostic Ultrasound: Assessing the tendon’s structure and detecting any tears or degeneration.
  • MRI Scan: MRI scans or diagnostic ultrasound are useful to confirm the diagnosis and see the extent of the tendon damage. The diagnosis will frequently be tibialis anterior tendinopathy. The tendon may be damaged but not torn.
  • Gait Analysis: Observing walking patterns to detect abnormalities such as foot drop or imbalance.

Treatments for Tibialis Anterior Tendonitis

Most cases of tibialis anterior tendonitis can be managed with non-surgical treatments, including:

  • Rest and Activity Modification: Reducing strain by limiting high-impact activities.
  • Cold Therapy: Applying ice packs to reduce inflammation and pain.
  • Anti-inflammatory Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) may help relieve symptoms.
  • Immobilization: Wearing a CAM walker or brace to reduce movement and promote healing.
  • Orthotic Devices: Custom arch supports to help alleviate stress on the tendon.
  • Physical Therapy: Stretching, strengthening exercises, and modalities like ultrasound therapy can aid recovery.

Advanced and Surgical Treatments

For severe cases where conservative measures are ineffective, the following treatments may be recommended:

  • Laser Therapy: Multiwave laser (MLS laser) MLS treatments have shown success in reducing pain and inflammation.
  • Human Cellular Tissue Products: Also known as stem cell therapy, these injections can promote tendon healing. This treatment has significantly reduced the chance of surgery when partial tears are noted. It is important to note that in many cases the tendon may not be inflamed as much as it is breaking down. This is sometimes referred to as tendinosis rather than tendonitis. For this reason, regenerative medicine is very appropriate as it helps to repair the tendon.
  • Corticosteroid Injections (With Caution): While cortisone injections may provide short-term relief, excessive use can weaken the tendon and increase the risk of rupture.
  • Surgical Repair: If a partial or full tear is noted surgery to repair the damage may be recommended. With a full tear weeks of non-weight bearing may be needed. In cases of complete tendon rupture or severe degeneration, surgical intervention may be necessary to restore function. Post-surgery, a period of non-weight-bearing followed by rehabilitation is typically required.

How to Avoid Tibialis Anterior Tendonitis?

It’s important when taking up a new activity to not do too much too soon. Also, if you suffer from flat feet, make sure you have supportive shoes or consider over-the-counter arch supports or custom-made orthotics.

Hopefully this blog will help you to better understand if you have tibialis anterior tendonitis and how some of the newer treatments available including regenerative medicine and laser treatments can help manage the condition. Our foot and ankle clinics cater to patients from Colorado, Wyoming and Nebraska. We also see patients from all over the United States and even our neighbors from Canada who have searched for a ‘expert podiatrist near me‘. Watch our patient testimonials on YouTube as we now have over +11000 followers.

For expert evaluation and treatment, schedule an appointment with Anderson Podiatry Center today.

Call us today at our Fort Collins location (970) 484-4620, Broomfield location (720) 259-5053 or use our online scheduling system to book your appointment.

Hallux Rigidus Surgery: Is a Big Toe Cheilectomy Right for You?

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cheilectomy surgery

Cheilectomy is a surgical procedure performed on the great toe to remove spurring from the top of the joint. However, to truly understand cheilectomy surgery we must start at the beginning by explaining a foot problem referred to as hallux rigidus. The surgery is performed to help with pain in the great toe joint and also on top of the great toe joint.

What is hallux rigidus?

Hallux refers to the big toe and rigidus means that the great toe joint is stiff. The great toe is referred to as the first metatarsophalangeal (MTP) joint. Normally it should be able to move 60 to 70 degrees off the ground. With hallux rigidus range of motion of the great toe is reduced. Sometimes it may be 30 degrees and other times motion may be reduced a great deal more, maybe only 10 degrees. Generally, with more restriction of motion there is more pain associated with the problem. In laymen terms what is really occurring is that the great toe joint is becoming arthritic, commonly referred to as osteoarthritis.

Another name that was used to describe hallux rigidus is hallux limitus. It is used to describe the same thing, however the name in recent years has been changed and many doctors agree that hallux rigidus is more severe than hallux limitus. With hallux rigidus you will get bone spurs on the top of your big toe. You may find that your shoes rub this area, and it becomes painful to wear certain shoes. You may also get pain in other areas of the foot, leg, knee or back from favoring the great toe joint. Understand the great toe joint is one of the most important joints of the foot to allow you to walk or run normally.

How does hallux rigidus affect your gait or walk?

When you have lack of motion in the great toe you’ll roll to the outside of your foot as you push off the ball of your foot. You have to do this because the joint motion is limited so you have to get motion elsewhere and you achieve this by rolling onto the ball of the foot by the smaller toes. The modification in your gait may cause all kinds of other aches and pains. Frequently the first think to happen is you start to notice pain in the great toe, but you may adapt the pain by favoring the great toe thereby reducing the pain in the toe joint and increasing pain in other areas up into your ankle knee or hip joint. But it all started in your dysfunctional great toe.

What causes hallux rigidus?

  • Trauma – you may have had a severe sprain or jamming of the great toe joint. You may also have had a fracture in the joint. Both can damage the cartilage in the joint and therefore start the arthritic process.
  • Other arthritic conditions – If you have chronic gout your gout attacks frequently occur in the great toe joint. Because a gout attack causes severe inflammation in the great toe joint this will cause damage to the cartilage. The same idea holds true with autoimmune conditions such as rheumatoid arthritis.
  • Improper biomechanics – This is by far the most common cause. For the big toe to move up to 60-70 degrees of the ground two motions need to occur. First the great toe, hallux will move up 20 degrees. However, the first metatarsal bone forms the portion of the great toe joint that you bear weight on needs to push down against the ground. When the first metatarsal head pushes down against the ground the great can now glide up higher another 40 degrees to get up to 60-70 degrees of motion. It’s as if there are two axis of motion. One axis of motion allows the toe to move up 20 degrees then when the first metatarsal bone moves downward the great toe can move upwards even more. If the first metatarsal cannot move down then the great toe will jam as it tries to move upward. This jamming on the top of the joint is what causes spur formation and also wearing down of the cartilage on the upper portion of the joint. So now you may have pain from the spurring on the top of the joint rubbing shoe gear, and pain on motion of the joint as it jams as it moves upwards.

Non-surgical treatments to avoid cheilectomy surgery

  • Anti-inflammatory – To reduce pain and swelling Anti-inflammatory drugs may be used in the early stages as a pain reliever. However, long term use may be detrimental to the health of the joint.
  • Orthotics – depending on the type of custom-made inserts called orthotics are very helpful in the early stages of Hallux rigidus as the help to combat the biomechanics the promote the condition and may offer some pain relief. If the type of orthotic you’re using is store bought or not created from a non-weight bearing impression of your foot it may not be effective.
  • Regenerative medicine – The use of human cellular tissue products may be used to successfully eliminate pain in the joint and delay or possibly eliminate the need for surgery in some cases. Many of you are aware that stem cell treatments are commonly done for arthritis knees however very few realize this is an option for the great toe joint. See below to understand why the great toe has more opportunity to repair itself. And please watch this video.

What is involved in cheilectomy surgery?

Cheilectomy surgery is a procedure involving removal of the excess bone on the top of the joint and revising the joint of the big toe. If there is significant damage to the cartilage in the joint, then microfracture technique may be part of what the surgeon does during surgery. By making small drill holes(microfracture) in areas of the joint where cartilage is worn down to bone this will allow blood into the joint after surgery and in doing so allows repair of the damaged cartilage. The cheilectomy surgery technique works very well on the great toe joint. It is believed that cartilage has a difficult time repairing when there is vertical load on the cartilage. This would be the situation for a knee or hip joint. However, there is very little vertical load on the great toe joint the microfracture technique will have more potential benefit.

Post operative recovery – most patients are able to walk immediately after surgery in a surgical shoe or Cam walker. Sutures are usually removed between 2-3 weeks after surgery so the foot will have a dressing on during that time and the foot will need to be kept dry. Most patients are going back to shoes in 3 weeks and returning to some activities by 4 weeks and more full activities by 6-8 weeks. The risk of this surgery are not as significant as other foot surgery but you should be aware of them as problems such as blood clotting referred to as deep vein thrombosis may occur.

How to reduce the chances of joint fusion or joint replacement?

It needs to be stressed that this procedure may not be the end of your great toe pain. It’s possible for the cheilectomy procedure to work for years but the arthritic condition continues. Pain returns as the joint becomes more damaged and needs to be replaced or fused.

Regenerative medicine – The big toe joint has an unfair advantage for stem cell treatments to work. This is because the vertical load on a joint inhibits repair on joint cartilage and the great toe joint has very little vertical load. The procedure is simple to do. It’s done in a clinic setting and you’re able to walk immediately returning to regular shoes in 48 hours with no pain pills needed. Also, it important to consider before you symptoms become severe

Surgical treatment – If surgery is considered earlier, it is better to do a cheilectomy. First you need to have pain to consider a surgical approach. However, removal of the bone spurs and revising the joint with the microfracture technique may have a greater benefit long term if its done before the damage to the joint has become severe.

In summary

Cheilectomy surgery may not be the only surgery option, but if you wait too long it could result in hallux rigidus.

Regenerative medicine has an important role in reducing or delaying the need for surgery including fusion and joint replacement. And should be done early.

Schedule your appointment online or call our Fort Collins and Broomfield, Colorado locations to connect with a trusted foot doctor near you at our renowned foot and ankle clinic.

Frequently asked questions

1) What is a big toe cheilectomy, and how does it help with hallux rigidus?

A big toe cheilectomy is a surgical procedure that removes bone spurs and part of the arthritic joint to improve movement and reduce pain in patients with hallux rigidus—a condition that causes stiffness and pain in the big toe. It is most effective in the early to mid-stages of the condition, helping to preserve joint function and delay the need for more extensive surgery.

2) Who is a good candidate for a big toe cheilectomy?

This procedure is ideal for patients with mild to moderate hallux rigidus who experience pain and restricted motion due to bone spurs but still have some cartilage remaining in the joint. If arthritis is severe or joint damage is extensive, alternative procedures like joint fusion (arthrodesis) or joint replacement may be more suitable.

3) What is the recovery time after a cheilectomy?

Recovery typically takes 6 to 8 weeks. Most patients can walk with a stiff-soled shoe within a few days but should avoid strenuous activities for several weeks. Swelling and stiffness may persist for a few months, and physical therapy may be recommended to restore mobility and strength.

4) What are the risks and potential complications of this surgery?

As with any surgery, risks include infection, nerve damage, prolonged swelling, or incomplete pain relief. In some cases, arthritis may continue to progress, requiring future procedures. However, most patients experience significant pain relief and improved mobility after surgery.

5) Will I be able to return to sports and physical activities after a cheilectomy?

Many patients can resume low-impact activities such as walking and swimming within a few weeks. However, high-impact sports like running and jumping may take longer and could be limited if arthritis worsens. Your surgeon will guide you based on your healing progress and activity goals.

Call us today at our Fort Collins location (970) 484-4620, Broomfield location (720) 259-5053 or use our online scheduling system to book your appointment.

Conquer Chronic Ankle Instability: Your Guide to Stronger Steps!

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chronic ankle instability

Ankle sprains are a common foot and ankle injury. When ankle sprains recur frequently or if not treated properly this can lead to chronic ankle instability. Proper treatment and evaluation are important as ankle sprains tend to be undertreated and not always thoroughly evaluated.

Basic anatomy of your ankle

The outside of the ankle is supported by three ligaments that connect the smaller leg bone, the fibula, to the bones of the foot.

Most frequently damaged ligaments

The anterior Talofibular ligament ATFL – The connects the fibula to the ankle bone called the talus. It runs forward from the ankle parallel to the ground. It’s function is to keep your foot from moving forward out of the ankle joint

Second most frequently injured

The calcaneal fibular ligament CFI- This connects the fibula to the heel bone and travels vertical to the walking surface. This ligament keeps your foot from rolling out of the ankle joint. It supports the subtalar joint which is the joint beneath the ankle. Its function is like a universal joint on a car. It allows your foot to move in different body planes. When you make big circles with you foot most of that motion is coming from the subtalar joint.

The posterior talofibular ligament – This ankle ligament connects the fibula to the talus the ankle bone and runs towards the Achilles tendon. This ligament is the least frequently injured.

Why do ankle sprains occur?

  • Activities – certain risk activities are more likely to put you at risk of an ankle sprain. Any sports that require side to side motion such as racquet sports, tennis and pickleball. Sports that are ballistic and involve contact such as basketball, football and soccer. Activities that involve hiking over irregular terrain can also be riskier.
  • Shoe gear – shoes that are broken down and not as supportive may also lead to a sprain.
  • Foot types – Certain foot biomechanics are more likely to lead to chronic ankle sprains.
  • Ligamentous laxity – some are born with ligaments that are very flexible such as Erlos Danlos syndrome.
  • Neurological issues – you may have a mild case of drop foot from nerve damage. This could be from common peroneal nerve entrapment. The muscles that pull your foot upwards and sideways are weaker because of this condition.

Evaluation for chronic ankle instability

  • Proper evaluation starts with a good history – The mechanism of your injury will likely help the doctor to determine what structures may be injured.
  • Physical examination – There will usually be pain and swelling over the ligaments that are frequently injured.
  • X-rays – these may be taken to insure there are no fractures.
  • MRI – If a severe sprain takes place then imaging studies will be useful to determine the severity of the ligamentous damage.

Chronic ankle instability Treatments

This may require an extended period of time to rest the injury.

  • Immobilization– depending on  the severity of the injury the doctor may recommend the use of a Cam walker to allow the damaged ligament that were torn to repair properly.
  • Physical therapy– to help promote healing and strengthen the muscles around the ankle. This can also strengthen the peroneal tendons that support the outside of the ankle.
  • Ankle bracing– this may be used during healing and even for a longer period of time to protect the area from another sprain as you return to full activity
  • Anti-inflammatories– these may help with pain and swelling during the early stage of the ankle sprain.
  • Orthotics– custom made arch supports can help provide a stable base for the foot to stand on in the shoegear and reduce the frequency of recurrent ankle sprains.
  • Surgery-Surgery may be performed to repair the ligaments that have become damaged and weakened and no longer provide support to the ankle. The ligaments may be repaired along with using tendons around the ankle to increase support to this area. This can prevent repeated ankle sprains.
  • Nerve surgery– if it is from weakness because of neurological issues decompression of the common peroneal nerve may be performed.  The common peroneal nerve tunnel can become tight, or the nerve tunnel could be damaged. Reference for my research paper.

What will happen if left untreated?

With repeated ankle sprains the possibility of getting arthritis in the ankle or subtalar joint beneath the ankle joint increases. Treatment for the ankle arthritis may include ankle scope surgery to clean out the damage in the ankle, Stem cell treatment with human cellular tissue products, see video below.

Two suggestions to help prevent the chance of having chronic ankle instability.

Proper evaluation and treatment

The first and most severe sprain you have is the most important to properly treat. A common mistake I see is patients may not get an ankle sprain looked at by a doctor. Or if they do they may go to the emergency room or urgent care. X-rays shoe there is not fracture. They may leave with an ace wrap or ankle brace and are told to ice it. In other words ankle sprains are under treated and under evaluated.

Ideally if it a severe sprain with a good history taken by the doctor and a complete exam and in some cases and MRI a better treatment plan could be determined. If it’s a third degree sprain meaning one or more ligaments of the ankle are fully ruptured than immobilization of the ankle may allow the ligaments to fully repair and retain there strength. So when in doubt see a foot and ankle specialist.

Consider trail running or hiking

Yes, I know this may sound contradictory and I’m speaking from my own experience. I’ve run all my life from college, through medical school and all the way through my sixties. However, starting in my sixties, I gave up running on concrete and asphalt. I started train running as it really reduced the wear and tear on my body from running on hard surfaces. I was amazed. However I was very afraid at first as I was prone to ankle sprains. I have found that I’ve dramatically reduced the number of sprains I have, and I believe its for three reasons.

  1. I’m extremely efficient and looking where I step every time! I got very lazy doing this on smooth surfaces.
  2. Muscle strength in my lower legs has increased. This is simply because the muscles that have to support my foot from moving side to side are being used more and I believe it protects me from having sprains and I can make a faster correction when I sense I’m about to sprain my ankle.
  3. I have found that trail running shoes are important to use. They are treads that have more grip and have lower profile which I believe lowers the center of gravity of my foot in the shoe. It also allows me to feel irregularities in the terrain and make adjustments better.

So remember to get a professional certified local foot doctor’s opinion when in doubt and consider the suggestions for ankle sprain treatment and prevention in this blog. If you live in Colorado or nearby states consider making at appointment at our Broomfield or Fort Collins foot clinic. Our staff is compassionate and caring towards all our patients. We also have several testimonials and have now surpassed 5000 subscribers on our Anderson Podiatry Youtube channel.

Call us today at our Fort Collins location (970) 484-4620, Broomfield location (720) 259-5053 or use our online scheduling system to book your appointment.

The Advantage of Choosing a Podiatry Clinic With It’s Own Surgical Center

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foot surgical center

Teamwork, Savings, And Great service – Why It All Really Matters!

When you’re needing surgery for your foot problems, having a surgical center within the clinic gives you an advantage. When non-surgical options such as physical therapy fail to give relief of your foot or ankle problems, surgery may become part of your treatment plan. Our surgeons are board certified foot and ankle surgeons who specialize specifically in the foot and ankle. We provide surgery for a variety of foot and ankle problems. Oh, and did I mention that all of our podiatric surgeries are day surgeries and require no overnight stay? That is what I mean by “the advantage”.

Not only do we have the top foot and ankle specialists, but our surgery center is also the only foot and ankle surgery center in Colorado. In fact, the only one in the entire rocky mountain region.

The Advantage

The Team Approach: As a patient, you may not be aware of the challenges a surgeon faces when needing to travel to various facilities in order to conduct their procedures. Each and every time they go, they will be faced with having staff who have no familiarity with them, and vice versa. Not to mention the staff may not specialize in the specific surgery that they may be conducting.

At Anderson Podiatry Center, our staff is here for us when it comes to day-to-day patient care, and for surgery. They have been selected and trained by us for our specialized needs during surgery. This team approach helps us to serve our patients better in the operating room. They are knowledgeable on every surgical procedure we do!

surgical-center-savings-anderson-podiatrySavings Cost transparency this is the new “buzzword” in healthcare, but nothing new at Anderson Podiatry Center. We have been offering bundled pricing for many years.

What is bundled pricing?

Simply stated, we include the surgeons’ fees, anesthesia fees, and facility fees all together with one cost. There are no surprises. We have found our patients to be excited about this, as it seems to be the opposite approach when they get their services from big healthcare facilities. Also, in today’s world of high deductibles, patients may save money by not using their insurance in certain situations by instead simply paying out of pocket. Again, a significant cost savings.
We also offer services that are unique! Amongst the most popular include the reversal of restless legs, and neuropathy.

Many people travel here from throughout the United States and Canada without insurance, or because we are not part of their insurance plan. We always offer affordable pricing for many.

How can we offer such affordable pricing?

Let me explain: When you look at healthcare dollars in the past, 70% of those dollars went to the doctors and nurses who delivered the care, and 30% to the administration. Now the percentages have flipped. 70% goes to administration, and 30% to the doctors and nurses. At larger facilities you are paying for that administrative cost. In a smaller facility such as ours, we don’t have that administrative cost. That is how the cost saving can be passed on to you!

Great Service.

As a final thought, I think you’ll find our staff to be exceptional in their expertise and friendliness. We have the best staff around! Please consider our clinic and surgical center as your one-stop clinic for all your foot and ankle care.

What Are Bunions and How To Treat Your Big Toe Pain

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Big toe pain can make you dread putting on your favorite shoes or boots am I right? Matt felt that way too but not anymore!

Matt called our office with fairly advanced big toe pain which had progressed to the point that walking was painful and running and sports were getting harder and harder to participate in enjoyably. His big toe pointed towards his second toe and he had a bump on his big toe joint, both of which are classic signs of a bunion. He like many were looking for a solution to end his pain and get back to the activities he enjoys.

Matt, like many other patients we’ve seen, felt discouraged because his feet ached to the point of distraction and caused downright pain!

Does walking or running hurt? Take look at your bare foot. Does your big toe point in toward your second toe? Does your big toe hurt to the point you’d classify it as big toe pain? Is there a bump on your big toe joint? If so, you might have a bunion.

Just What is a Bunion?

A bunion is a misalignment of the big toe joint. This misalignment causes the big toe to point outwards and rotate towards the smaller toes, and appears as an enlargement at the base of the big toe. Similarly, if you have a sizeable bump at the base of your little toe you may have a bunionette.

What are the Symptoms of a Bunion?

Some symptoms of bunions and bunionettes include:

  • Inflammation and redness in the enlarged joint
  • Irritation or tenderness
  • Inflammation in a small fluid-filled sac adjacent to the joint
  • Swelling
  • Localized arthritis in the joint (typically occurs during later stages of the deformity)
  • Chronic pain in the enlarged joint and toe

One of the worst effects of bunions is a decrease in activity level. Bunions can make you hesitate to be active, especially if you are in pain. With bunions it’s often impossible to run or go on long walks, and if you can walk, you have to slow down or alter how you walk to relieve some of the pain. This can cause additional problems from ‘favoring’ the painful bump.

What Causes a Bunion?

Although the precise cause of bunions is unknown, there are certain factors that contribute to them:

  1. Inherited Genetic Factors: Though shoes can play a role in aggravating this deformity, the majority of bunions are a result of biomechanics, or inherited foot types. We also know that bunions are 10 times more likely to affect women than men.
  2. Abnormal Biomechanics: Instability in the joint and muscle imbalance can create bunions.
  3. Trauma: Though uncommon, some sprains, fractures, and nerve injuries have led to the development of bunions.
  4. Neuromuscular Disorders: Certain disorders, such as polio, though rare, have had a correlation with the occurrence of bunions.
  5. Limb-leg discrepancies: When one leg is longer than the other the longer leg tends to grow the bunion.

Bunions can make you dread putting on your shoes, limit what shoes you can wear, and greatly decrease your activity level. Yes, wearing loose and supportive shoes or taking certain medications like ibuprofen can help alleviate the symptoms, but those are only short term solutions.

How Do You Treat Bunions?

Though your symptoms may stay the same, it is vital to understand that bunions are progressive and will worsen over time! Also the longer you wait to treat them the more difficult or extensive the repair needs to be.

The good news is that there are long term solutions to treating bunions with big toe joint pain treatment:

1. Orthotics

We create custom orthotics here in our office. We take a three-dimensional scan of your actual foot and create the orthotic based on exactly what your foot needs. These correct the bio-mechanical imbalances in your feet and create a ‘neutral ‘ stance that takes the pressure off your big toe joint and relieves big toe pain.

2. Corrective Surgery

Surgery is a very successful procedure for treating bunions, and it is the best way to correct this deformity, relieve pain, and improve foot function. People tend to have a misconception about how much down time they will have after bunion surgery. But the great news is, in just three to four weeks after surgery, you can be back to your regular shoes again!

Don’t let bunions on your foot control any longer.

Call us today at our Fort Collins location (970) 484-4620, Broomfield location (720) 259-5053 or use our online scheduling system to book your appointment.

Elsie’s Story: Heel Pain & Knee Pain

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Walking On My Toes

Elsie didn’t have time for heel pain. She loved being active and going for runs, and suddenly heel pain had stopped her in her tracks.

“I was walking on my toes,” Elsie said. “The pain was so bad, I couldn’t put any pressure on my heels. So I had to stop running and I was looking for a solution.”

Heel Pain, Gone

Elsie came to see Dr. James Anderson, DPM, and tried conservative treatment first.

Dr. Anderson said, “Elsie had plantar fasciitis (heel pain). We tried orthotics first, but nothing was really helping her. Instead of doing surgery, we recommended stem cell treatment. Often, patients can avoid surgery, and experience pain relief with only one stem cell treatment.”

“I had the stem cell treatment,” Elsie said. “After only one week, the pain was totally gone!”

Two years later, she came to see Dr. Anderson for a follow up appointment, and she was back to running and her heel pain had not returned.

Then, Knee Pain

Elsie had started to have knee pain, and mentioned it to Dr. Anderson. “I wore my cartilage down on the top and bottom of my knee, and it was hurting when I ran.” she said.

Dr. Anderson had good news. “We have recently integrated our practice, and are now offering stem cell treatment for knee pain as well as shoulder and hip pain.”

Elsie was thrilled, “I’m a firm believer in stem cell,” she says. “Because I have not had any trouble with my foot since my injection.”

Dr. Anderson treated her with the newest regenerative product that contains umbilical cord stem cells. “Umbilical cord stem cell treatment has the highest concentration of stem cells, growth factors, and proteins, so it’s a highly-effective product and can help patients avoid surgery,” Dr. Anderson says.

The Power of Stem Cell Treatment

“Stem cell treatment is a really powerful tool,” Dr. Anderson explains. “Because it works by stimulating your body’s natural ability to heal.”

“As we age, our bodies begin to degenerate, and we start to have pain. But, stem cells have the ability to become any kind of cell. They can become bone, tissue, tendon, or cartilage. So, it’s an amazing treatment option for a variety of conditions.”

“We’ve treated plantar fasciitis, Achilles tendonitis, and arthritis in the joints with stem cell therapies for years, and now we can treat knee pain, shoulder pain and hip bursitis as well.”

Back On Track

Elsie had the stem cell injection in her knee two weeks ago. “This week I was hurrying to do something, and I didn’t even mean to, but I started to run, and it didn’t hurt at all!”

“My knee just keeps feeling better and better every day,” Elsie says. “In another week or so, I’ll be back out there, running again.”

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Summer Special!

Now offering a FREE new patient exam and consultation! Expires 6/30/18. *X-Rays, testing and treatment not included.  

Call us today! Just mention this blog to receive the offer.

Learn more about regenerative medicine here.

Grace’s Story: Arthritis in Big Toe Joint

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On My Feet All Day

As a kindergarten teacher for many years, Grace was used to being on her feet all day. “I was busy,” Grace says, “And I just didn’t have time to address all my aches and pains.”

Grace had pain in her big toes, but she ignored it and kept up with her active life, and her daily one-mile walks. “I just sucked it up,” Grace says, “I think a lot of people do that when they are busy.”

Then The Pain Kicked In

When Grace retired from teaching, suddenly the pain kicked in. “I was having trouble walking because of the pain. Finally, I got tired of dealing with it and decided to find treatment.”

Grace went online, began researching, and soon found Dr. James Anderson, DPM. “I didn’t realize I had arthritis in my big toe joints,” she said. “You just know you have pain, but you don’t really know what’s going on until you go in and make an appointment.”

Regenerative Medicine + Surgery

Dr. Anderson says, “Because of the arthritis, there was a bone spur on her joint. I recommended surgery to remove it and clean up the bone. Then, we could follow up with a regenerative medicine injection.”

Grace decided to have the surgery, and then followed up with the regenerative injection, and laser therapy to help reduce inflammation and prevent scar tissue from forming.

“Regenerative medicine works by stimulating the body’s natural ability to heal, and the stem cell components help to regenerate the damaged cartilage,” says Dr. Anderson. “If we see the patient early enough, we can often use regenerative therapies to avoid surgery completely.”

“For Grace, this treatment approach helped us to save her joint and improve function! Many times, patients will have to have a joint fusion or replacement, and we were able to prevent that.”

Hitting the Trails Again

It wasn’t long before Grace was living the retired life she had hoped for. “I’m back to doing anything that I want,” Grace says.

“I can go hiking, and I can travel! I walk two miles every day, and I can wear any shoes I want to!”

Her advice for others is this. “Don’t wait any longer to address your pain. The longer you put it off, the more damage can occur. And then, that’s more time and money you will have to spend to resolve it.”

“Take the time to take care of yourself. It’s important.”

Call today to make an appointment, and we can discuss treatment options with you.

To learn more about regenerative medicine, click here. 

CJ’s Story: Chronic Tendon Pain (The Power of Regenerative Medicine)

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CJs testimonials chronic tendon pain

The new year is here, and for many of us that means it’s time to focus on our health, and address some of those lingering issues we’ve been putting off.

Today, I will share a success story of a patient who was dealing with chronic joint and tendon pain for several years. My goal is to help instill hope in many of you who have been experiencing similar pain, and have perhaps given up on finding a solution. So, here we go.

52, Healthy and Active

This patient is a 52 year-old female, who was healthy and active. We will call her CJ. She came into my office with a variety of foot complaints. The primary issue was chronic joint and tendon pain in her right foot and ankle, and this had been going on for several years.

Seven years prior, a horse stepped on her foot and she was diagnosed with a “hairline fracture” and wore a cast for three months. Once she was out of the cast, she could get back to activity with little pain. However, over the next five to six years, she started having more and more pain in the area that began to significantly limit her activity. This gradually led to weight gain, which only made the problem worse.

Plantar Fasciitis, Arthritis and Tendon Pain

When I first saw CJ, she was planning on having gastric bypass surgery, but was concerned that she would not be able to exercise properly after the surgery because of her foot and ankle pain. She had previously been treated for plantar fasciitis by another doctor.  She had steroid injections and wore a night splint, but neither treatment seemed to give her any relief.

During her initial exam, her X-rays showed that the old injury had been more than just a hairline fracture. She had evidence of post-fracture arthritis in two joints in the middle of her foot. The fracture had healed, but left joint damage behind. Her other main issue of ankle pain was diagnosed as a partial tendon tear. This had likely been aggravated by compensating for the joint pain.

Regenerative Medicine + Surgery

Many times, when patients present with arthritis, tendon pain, or plantar fasciitis, we use regenerative medicine therapy to help stimulate healing and avoid surgery altogether. But, in CJ’s case, we needed to use several different treatments to help address all the issues that had been accumulating for all these years.

We performed surgery to repair the tendon tear and used regenerative injections to help heal the joint damage. To better support the damaged joints, we fitted her for custom orthotics. She then began physical therapy to improve her strength, balance, and flexibility.

Ten Weeks Later

CJ was on crutches for four weeks after the tendon repair. But, once we cleared her to start walking, she progressed quickly. She was highly motivated and committed to her therapy and post-operative rehab. Ten weeks after surgery and regenerative therapy, she was already back to walking and elliptical workouts daily. She still has the occasional sore muscles, but no longer has anywhere near the pain she did before. CJ is still considering gastric bypass surgery. But, she now feels she will be able to lose the weight without it since she can exercise without pain.

So, if you or someone you love is struggling with daily foot or ankle pain, please don’t wait any longer to address it. Call today to make an appointment, and we can discuss treatment options with you.

2018 can be your last year to deal with chronic pain. It’s time to get on the path to healing, together.

Winning the Jules Tinel Award: My Journey

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The Patient Who Started It All

14 years ago, I made a bold decision to do something conventional medicine wasn’t doing. Little did I know it would change my professional life forever. Back then, I never thought that one day I would work to reverse the symptoms of neuropathy (the burning, tingling, numbness and pain many diabetic and non-diabetics suffer with).

That all changed one day when I met this patient. He was diabetic, and hadn’t felt the bottom of his feet in 20 years. I was training under a John Hopkins plastic surgeon, Dr. Lee Dellon, and he had performed surgery on the patient four days earlier. Now here he was for his follow-up appointment. The surgeon stroked the bottom of the patient’s foot, and this man who came in so stoic began to laugh like a child and then the tears started flowing down his face. That moment started my journey. I knew right then and there that I wanted to prove to the medical world that the symptoms of neuropathy could be reversed, and that patients didn’t have to suffer and live on medication.

How the Research Started

It was a slow process to adopt Dr. Dellon’s ideas into my practice. Soon after my training, I helped form an organization with other colleagues called the Association of Extremity Surgeons. In this process, my passion grew for what I was doing and how it was transforming people’s lives. The drive to do research came to me out of frustration. I was frustrated because I wanted patients and doctors to know neuropathy can be reversible, and I had to prove it.

Gradually, research became a part of the practice. I was warned that research is very hard, and I soon discovered that it was. I had to form a team to support the vision. The process to do this started several years ago and the research continued to grow.

Research On Diabetic Neuropathy

Too many people are suffering from the symptoms of neuropathy, and too many diabetics have amputations and are at risk of dying because of the loss of their limbs. Because of this belief, we completed a study on intraoperative nerve monitoring in diabetics with severe neuropathy. No one had ever recorded and published a paper to prove that nerve function can rapidly be improved when tight nerve tunnels in diabetics are opened (decompressed).

The study objectively proves what I watched the patient I mentioned earlier experience. Our testing shows that the nerve function improves up to 300 percent within minutes during surgery. And this defies the conventional medicine approach. This study was ground breaking, and my hope is that along with other studies that have been and will be published, the thoughts of the medical world and the public will begin to shift.

Winning The Jules Tinel Award

Recently, I attended the annual meeting for the Association of Extremity Nerve Surgeons. This organization includes: podiatrists, plastic surgeons, neurosurgeons and orthopedic surgeons who all share a common goal of reversing nerve pain in the extremities. At the meeting, I was honored to receive the Jules Tinel award for the scientific advancement of knowledge regarding the human peripheral nervous system. Other doctors to have received this award are: Dr. Lee Dellon from John Hopkins who introduced the concept of nerve decompression for neuropathy, Dr. Maria Seminow from the Cleveland Clinic, the first American doctor to do a face transplant, and Dr. Ivan Ducic of Georgetown Medical School, the first doctor to surgically reverse severe headaches.

We all appreciate recognition, but it’s very special when it’s coming from your peers. I’m grateful to have received this award, and grateful for all the support given to me by my colleagues and the team that helps me, and my wife who has always understood and supported me.

And I’m especially grateful to all the patients who have trusted in me and taught me to be grateful for the ability to offer hope where there once was none.

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To learn more about neuropathy, and how we treat it, click here.

To make an appointment, click here.

Peripheral Neuropathy: Don’t Just “Live With It”

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Peripheral neuropathy is a very common issue that affects patient’s legs and feet. Yet for something so common, we have a long way to go to help manage this painful and potentially debilitating problem. For most people, the symptoms start slowly and gradually worsen over time.

This slow onset can delay the onset of diagnosis and treatment for months, or even years. The symptoms are often different from person to person making it difficult for a doctor to easily recognize the problem early. Furthermore, there are multiple potential causes for the chronic nerve damage and multiple potential treatments depending on the cause. Long story short…peripheral neuropathy can be a tough row to hoe. But, there is good news.

Only Two Choices?

Too often in my experience, patients with peripheral neuropathy hear that they have only two choices:

1) Take pain medications to mask the symptoms

2) Live with it until the nerves die off and no longer cause pain

For years, doctors have searched for other options that would relieve or cure the symptoms regardless of the cause or severity of the nerve damage. They have tried many treatments, medications, and therapies that have only lead to disappointment. But, there is good news.

The Good News: ESTIM Treatment

Now, here’s the good part. Recently, one treatment (often referred to as ESTIM therapy) has shown quite a lot of promise in relieving, and even eliminating the pain from peripheral neuropathy. A company called NEUROGENX developed this therapy.

ESTIM combines a commonly used local anesthetic with a new type of electrical signals generated by a computer. Together, they can gradually heal nerve tissue by addressing the primary underlying cause of most nerve damage, lack of blood flow and oxygen to the nerves. Over the last four years, we have been using the NEUROGENX ESTIM treatment at our clinics to help patients suffering with different types of neuropathy. And we have seen dramatic results, especially when compared to other available treatments.

How ESTIM Works

For patients with peripheral neuropathy, limited blood flow and oxygen delivery can cause slow nerve healing. Whatever is causing damage to the nerve also can damage the small blood vessels that feed the nerve.

The ESTIM treatment combines both electrical and chemical treatment to stimulate increased blood flow and increased nerve healing. The injections use a local anesthetic called “marcaine” which opens and dilates the blood vessels feeding the nerves. Once the blood vessels are open, the electrical impulse goes through the nerve to “jump start” it and stimulate healing. The computer generates an electric signal that changes constantly. This means that the nerve does not “get used to” the signal, which would reduce the effectiveness.

So with each ESTIM treatment, the nerve receives both the nutrients it needs and the electrical signals telling it what to do. With this, the nerve is able to repair and heal the damage. With each subsequent treatment, more and more damaged nerve tissue repairs itself.

The Patient Experience

The most important thing to us is that we see patients have a dramatic improvement in their quality of life. When they come back to see us and report 85, 95, and sometimes even 100% improvement, that is the most rewarding part of what we do as doctors. I would like to end this blog with a quote from a patient named Zelda.

“Now after treatment, I can walk again. I’m back to my normal activities, and I don’t have any pain. I’m sleeping through the night, and the jittery feeling in my legs is gone. Just make an appointment because there is no one else out there doing this. Even if it only helps 75%, it’s worth it. To be able to live your daily life again, it makes all the difference in the world.”

If you would like to learn more about ESTIM treatment, please call us and make an appointment. We would be happy to answer your questions or schedule an evaluation to see if this therapy is right for you.

Come see us, we can help. To learn more about how we treat neuropathy, click here.

To make an appointment, click here.