FAQ Category: Foot


Can you help me sort out a problem I am having? I know I have a hole in the cartilage of my ankle bone from a hockey injury last year. We’ve been keeping an eye on it and hoping it might heal on its own. The fact that I’m young (20 years old) seems to be in my favor. But the latest MRI that was done showed a cyst was forming under the damaged cartilage. Is that good or bad?

Sprains, strains, fractures, and other trauma to the ankle can result in a condition known as osteochondral lesions of the talus or OLT. The talus is the bone located below the tibia (lower leg bone) and above the calcaneus (heel). The lesion or defect can affect just the cartilage lining […]


It’s amazing the kind of information you can get now about your health problems. I had an MRI done of my ankle after an injury and they sent me home with a CD of the images and a written report. It says I have an osteochondral lesion of the right talus. Can you please interpret what this means for me?

Sprains, strains, fractures, and other trauma to the ankle can result in a condition known as osteochondral lesions of the talus or OLT. The talus is the bone located below the tibia (lower leg bone) and above the calcaneus (heel). The lesion or defect can affect just the cartilage lining […]


I am a semi-professional dancer with a few years left in me but my big toe on the left side is going. I’ve been told I have a degenerative joint called hallux rigidus. The only treatment is to cut out the damaged part and/or fuse the joint. I’m definitely NOT ready for that. Do you have any other suggestions?

There is a new study out from the Hospital for Special Surgery in New York City that may be of interest to you. They see many athletes and dancers with a wide range of orthopedic problems who want to remain active. Treatment for painful, limiting hallux valgus is usually surgical. […]


I have a foot condition known as hallux rigidus. I just call it a “tight toe”. Over time, I’ve noticed it’s actually getting worse. I’ve been told if I wait too long, I may end up with a joint fusion when I could have had a repair job. How do they decide when a joint like this is too far gone?

Degenerative arthritis of the big (great) toe called hallux rigidus affects the metatarsophalangeal joint (where the main bone in the foot meets the first bone of the big toe). The condition is characterized by degeneration of the articular cartilage (lining the joint), bone spurs called osteophytes, and significant narrowing of […]


I’ve heard there is some use of stem cells to repair cartilage. I have a deep hole in my ankle bone that has not responded to any other treatment (I’ve had three surgeries so far). I’m looking for anything that might work. What do you know about this and where do these stem cells come from?

Ankle sprains and other significant trauma (e.g., bone fractures) can cause a condition known as osteochondral lesions. These are defects or “holes” in the cartilage lining a joint. Sometimes the damage is enough to create a hole all the way down into the bone.It sounds like this might be what […]


I failed physical therapy for an Achilles tendon rupture. The injury happened too long ago. And I think I’m too old and too heavy for the tissue to repair itself. Are there any other treatment options? I’m not terribly active (okay, I’m a total couch potato) but maybe I could get out more if the foot didn’t hurt so much all of the time. What do you recommend?

Older adults who rupture the Achilles (heel) tendon may end up with a case of Achilles tendinosis that does not respond to conservative (nonoperative) care. Tendinosis refers to replacement of normal collagen fibers in the tendon with scar tissue or fibrous material. The substandard replacement tissue is weak resulting in […]


I’m lined up for surgery to help me with a long-standing problem with my Achilles tendon. The surgeon calls it a tendinopathy from an old Achilles tendon injury that was never treated. The surgery is in two parts. First, clean out the old, diseased tissue. Then use my big toe flexor muscle to replace the bad Achilles tendon. My question today is: what should I expect for recovery after this type of surgery?

There are small studies with results published for this type of procedure. We found three studies with 20 to 26 patients and another larger study with 48 patients. Results were similar for all three studies. We’ll fill you in on the larger one. The study of 48 patients included adults […]


After a very severe ankle injury, I found out I have a hole in the ankle bone that goes clear down to through the cartilage to the bone. The surgeon is recommending something called an OAT procedure. At age 55 (and being a post-menopausal woman), will this work for me? I don’t heal as well as I used to.

Holes referred to as “defects” in cartilage that go clear down to the bone can be treated with the technique you mentioned: osteochondral autograft transfer or OAT. Osteochondral autograft transfer (OAT) involves removing a plug of cartilage and bone from a healthy area (usually from a non-weight bearing area of […]


I had an ankle injury that left a hole in my talus bone. After filling the hole in with cartilage and bone from my knee, the surgeon wants to do another arthroscopic exam to see how it looks. I’m not really wanting another surgery. Couldn’t they just do an X-ray to see what they want to see?

Holes referred to as “defects” in cartilage and bone such as you had can be treated with the technique you described: osteochondral autograft transfer or OAT. Osteochondral lesions refer to damage or defects to the joint cartilage (chondral) that go all the way down to the first layers of bone […]


I took my neighbor in to the emergency department over the weekend. She’s a known diabetic and was complaining she couldn’t feel her toes. I know they tell you not to use the emergency department for minor problems but I didn’t know what else to do. Is this something that could have waited until Monday? It was the first time she had ever have this happen and she was so panicked.

Loss of sensation is a common problem in people with diabetes. The disease affects circulation and blood supply to the hands and especially the feet. The first time numbness develops, it can be very anxiety producing. As a nonmedical person yourself, it may not have occurred to you to look […]


Sometimes I just don’t get the medical world. I took my mother in to the local clinic at the strip mall downtown. I thought she was having a heart attack. They seemed much more concerned about a sore on her big toe. She ended up with a bill for several thousand dollars for a foot infection. Go figure! And they never even checked her out for a heart problem. What do you make of all that? Am I way off base in my thinking here?

Anytime someone comes to a clinic or hospital, vital signs are taken as a routine first-step in the evaluation and diagnostic process. Questions are asked about history and current signs and symptoms. From this information, the health care professionals make a mental list of possible problems. Further testing proceeds in […]


I need some help with a decision I have to make about my ankle. I have an Achilles tendon rupture but I’m not sure if I need surgery or not. The physician’s assistant at the surgeon’s office talked circles around both options but I couldn’t tell which way to go and she wasn’t helping. What do you advise your patients?

For quite some time, there has been debate and controversy over the optimal way to approach management of the acute Achilles tendon rupture. Should it be treated surgically? Can the complications of surgery be avoided by going with a more conservative treatment plan? What is the best way to measure […]


I am a fashion model at a very high level with a serious problem. I fell during one of our shows and ruptured my left Achilles tendon. The doctor I saw wants to do surgery but I can’t afford to have any scars on my legs. How big is the scar and how much will it show? Is there any way around this problem?

The Achilles tendon is a strong, fibrous band that connects the calf muscle to the heel. The calf is actually formed by two muscles, the underlying soleus and the thick outer gastrocnemius. Together, they form the gastroc-soleus muscle group. When they contract, they pull on the Achilles tendon, causing your […]


I am a physiatrist interested in treating plantar fasciitis with shock wave therapy. What’s the latest thinking about this modality? Does it work? Is there evidence for a best way to apply the energy?

As you already know, treatment is usually with conservative (nonoperative) care. This could include stretching, wearing a splint at night, the use of antiinflammatory medications, and/or a special arch support to help reduce the pressure on the fascia. Shock wave therapy is a newer form of nonsurgical treatment used when […]


My husband is going in for surgery to repair a ruptured Achilles tendon that just happened two days ago. The surgeon briefly mentioned I would have to help watch out for any post-operative complications. The nurse said she would go over all this with me before he is discharged. Now I’m wondering what sorts of problems can develop?

The Achilles tendon is a strong, fibrous band that connects the calf muscle to the heel. The calf is actually formed by two muscles, the underlying soleus and the thick outer gastrocnemius. Together, they form the gastroc-soleus muscle group. When they contract, they pull on the Achilles tendon, causing your […]


I need some quick help. Just took my son to the doctor’s for a calf injury. Looks like he has a torn Achilles tendon. Doc gave us the run down on surgery versus no surgery and what to expect. I need a few more details before deciding which way to go. What can you tell me? What works best? How do we decide?

The best way to manage acute Achilles tendon ruptures has not been discovered. One important outcome of successful treatment is to avoid rerupture or other complications (e.g., infection, bleeding into the muscle, adhesions, altered skin sensation, blood clots). A recent meta-analysis of 14 studies with over 1000 patients performed at […]


I have severe toe arthritis in my big toe on the right side. Got it from a time years ago when a draft horse stepped on that toe. It’s pretty painful and I’m hobbling around. The surgeon suggests an operation called cheilectomy. What can I expect from this procedure?

Degenerative arthritis that affects the large joint at the base of the big toe is referred to as Hallux rigidus. Degenerative arthritis can result from wear and tear on the joint surface over time. The condition may follow an injury to the joint such as you described. The degeneration causes […]


I have a condition the surgeon calls rigid hallux (or maybe it’s the other way around: hallux rigid — I can’t remember). Anyway, it’s some kind of big toe arthritis. I’m looking into the different treatment options. The surgeon is advising I strongly consider a joint replacement. What can you tell me about these — especially how well something like this would hold up with all the walking I do for my job as a mail carrier.

You are probably thinking of a condition called hallux rigidus, a degenerative type of arthritis that affects the large joint at the base of the big toe. The degeneration causes two problems–pain and loss of motion in the metatarsal phalangeal (MTP) joint of the big toe. Without the ability of […]


I am 13-years-old and need some advice. My best friend just got cut from the dance team because she has an extra bone in her foot that is causing terrible pain. She says the doctor told her this is a common problem but usually the person doesn’t know it unless dancing or doing some other athletic activity. How can I tell if I have it too?

Many people are born with oddly shaped bones, extra bones, or fused bones and never know about it. In fact, studies show up to one-third of the general population have what is called an accessory (extra) bone. Sometimes these extra bones are in the joint and sometimes they occur embedded […]