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• I think I may have a hammertoe. Can you explain what a hammertoe is?
  
  

  I think I may have a hammertoe. Can you explain what a hammertoe is? - Louise, Worcester, MA

  A hammertoe is caused by a shortening of the tendons that control toe movements. The toe knuckle is usually enlarged, drawing the toe back. Over time, the joint enlarges and stiffens as it rubs against shoes. Your balance may be affected. Wearing shoes and stockings with plenty of toe room is a treatment for hammertoe. In very serious cases, surgery may be needed. You should talk to your health care provider if you think you may have a hammertoe. Thank you for your question! Kenneth Leavitt, DPM, Podiatry

  
  
  
• Are there any exercises that can ward off or help bunions?
  
  

  All of the women in my family have horrible bunions. Are there any exercises that can ward off or help bunions? -Janet / Pennsylvania

  A bunion is an irregular bony prominence (a bump) on the joint where your big toe meets the main bones of your foot. The bunion causes the end of the big toe to bend toward the other toes and crowd them, while the bone at the base of the toe where it meets the foot moves outward beyond the normal limits of where the bone should be. Pain is caused by inflammation and the bone pressing against the shoe. Bunions are more common in women and are caused by a number of reasons, including shoes that are too tight, years of abnormal motion (like dancers on point), poor foot mechanics, bone deformities, flat feet, and arthritis. Treatment usually includes shoes with a roomy toe box (you should be able to wiggle your toes; the toe box should be wide enough to accommodate the bony prominence), padding, over-the-counter arch supports, orthotics, and taping by a physical therapist or doctor. Surgery is an option when conservative treatment fails and you have chronic pain. As for exercises, keeping your feet strong and building up the arch might help (particularly if you have flat feet). Although there isn't a lot of evidence for strengthening feet as an effective treatment for bunions, it's certainly worth a try. Here are some exercises to strengthen your feet. Do 10-15 repetitions of each, two to three sets, every other day. 1. Towel pull. Sit in a chair barefoot with your toes on the edge of a towel. Start flexing (curling) your toes and pulling the towel to draw it up under your toes. 2. Big toe pulls (barefoot). Wrap a thick rubber band around both big toes and pull them away from each other. You can keep heels together if you like but it's not necessary. Hold each repetition for two to three seconds. 3. Marble or pencil grab (barefoot). While sitting or standing, try to pick up marbles or pencils with your toes. I recommend that you consult with your doctor or a podiatrist if you have not already done so. Thank you for your question! Kenneth Leavitt, DPM, Podiatry

  
  
  
• My foot hurts and people say it might be plantar fasciitis. What is it and what can I do about it?
  
  

  My foot hurts and people say it might be plantar fasciitis. What is it and what can I do about it? - Helene, Winchester, MA

  Plantar fasciitis is that pain in the bottom of your foot that especially hurts first thing in the morning when you try to get out of bed and stand on it, or after sitting for awhile. It is caused by wounding the tough fascia connective tissue on the bottom of your foot. This band runs from your heel to the ball of your foot. It supports your arch and it transmits your weight across the bottom of the foot with each step you take. If the plantar fascia gets bruised or over-stretched, the inflammation causes the heel and foot pain. It can also get partially detached from the heel and a calcium deposit can form - a heel spur. You should see your health care provider if your pain persists. Thank you for your question! Kenneth Leavitt, DPM, Podiatry

  
  
  
• My trainer thinks I may have Achilles tendinitis. Can you tell me what it is?
  
  

  My trainer thinks I may have Achilles tendinitis. Can you tell me what it is? - Christine, Scituate, MA

  Achilles tendinitis is a painful and often debilitating inflammation of the Achilles tendon, also called the heel cord. This large tendon is an extension of the two calf muscles; it runs down the back of the lower leg and attaches to the heel bone (calcaneus). Achilles tendinitis is often an ailment of athletes but women who wear high-heeled shoes and switch to sneakers for exercise also can develop Achilles tendinitis. The inflammation that characterizes tendinitis reflects tearing of the tendon tissues caused by excessive stress. The problem may be caused by a single incident of over-stressing the Achilles (such as failing to stretch or "warm up" sufficiently before exercising) or it may result from an accumulation of smaller stresses that produce numerous small tears over time. The injury may occur at the point where the tendon attaches to the heel or at any point along the length of the tendon. This condition is common in the "weekend warrior" who exercises infrequently, and those who are just starting to exercise. In these people, the muscles and tendon have little flexibility because of inactivity. Overdoing exercise in the beginning can cause tendinitis because the muscles are not flexible enough to withstand the new forces being placed upon them. It is especially important for people who are just starting to exercise to stretch properly, start slowly, and increase gradually. If pain develops even with proper stretching and training techniques, you should contact your health care provider. Thank you for your question! Mark Slovenkai, MD, Othopedic Surgeon