Maggie McKay (Host): When it comes to our feet, do you ever stop to consider what a beating they take day after day after day? Well, today, Dr. Zach Lind, doctor of Podiatric Medicine, will discuss foot health.

 Welcome to Stoughton Health Talk. I'm your host, Maggie McKay. Thank you so much for being here today, Dr. Lind.

Dr. Zach Lind: Hi, Maggie. Thanks for having me on.

Host: I cannot wait to dive into this topic because I've had foot issues here and there, and I never thought I would, and I think I just overuse them. So, let's just start with what are the main causes of bunions and hammer toes?

Dr. Zach Lind: Yeah. Great question. Typically, there's a couple of things that cause hammer toes and bunions. A lot of times it's an improper fitting shoe, something that kind of tapers. So if you think of women's shoes, stylish shoes, they all kind of have that toe taper that's putting extra pressure, pushing your toes over. There can be a genetic disposition to o. People that have family history of bunions are more likely to have bunions. And then, there's things like rheumatoid arthritis, psoriatic arthritis, gout. There's different ligamentous diseases that can cause kind of loose ligaments, loose joints, or destruction of joints, which can also cause bunions.

Hammertoes specifically are caused more by a muscle imbalance or a foot structure imbalance. And then, you just have a different pole of tendon or a compensation of a tendon over a weak tendon. And that's kind of how you develop those hammertoes.

Host: And for people who don't know, what are bunions and what are hammer toes? What do they look like?

Dr. Zach Lind: Bunion is basically an enlargement on the inside of your big toe joint. Your big toe, you'll notice, start to kind of encroach over onto your second toe. You might have pain in the joint. You might get some redness overlying the skin. You might have a burning and kind of a tingling because of a nerve that runs over that space as well.

Hammer toes are sort of, if I could show you, if you think of your toes like your fingers, you have three different sections. So, hammer toes is basically when your toe starts popping up at or two of the joints. There's also different things called a mallet toe, where it's basically just the end that goes. And then, claw toe would be the whole toe kind of curls.

Host: Wow, that's got to be hard to find shoes that fit. Is that why a lot of people wear flip flops? I mean, how do you deal with that?

Dr. Zach Lind: Yeah, absolutely. A lot of people do have pain when walking in regular shoes and that's why they'll sort of adjust. Most people in the winter tend to have problems with different boots because they tend to be stiffer construction out in the toes. So, sometimes we'll recommend something like a mesh toe or open toe just so it doesn't cause as much pressure on the toes.

Host: Wow. You mentioned ill-fitting shoes and how they contribute to these conditions. The first thing that goes to my mind are high heels for women. Are there other kinds of shoes and how does it contribute to the conditions like you mentioned briefly?

Dr. Zach Lind: Yep. High heels are kind of the main contributing ones that we see. Just because they're so pointy, they sort of smash the toes together and it really just puts your foot in an improper position. Most shoes, most running shoes these days tend to have some sort of taper. Dress shoes in general tend to have some sort of taper. And also, with any shoe that has an elevated heel, sort of wedges or heels specifically, but a lot of regular shoes will have some level of heel draw or heel decline. It just puts excess pressure out on the front of your foot as well, which can again lead to hammer toes and bunions.

Host: And what treatment options are available for managing the pain? Because as you mentioned, people with hammer toes are in pain.

Dr. Zach Lind: Yeah. There's a couple of different options. When you look specifically at shoes, like I said, with a mesh top, something that doesn't cause as much constriction, if you do have a pair of nice leather shoes, there are cobblers in the area still that you can sort of heat up that leather and push it out a little bit to give you a little bit more room just to kind of compensate for the fact that you have a wider foot with the bunion. Again, in the summer, sandals are a great option because they don't cause rubbing on the top. If you have something contributory, sort of, you know, a flat foot, that sort of deal, orthotics can get your foot back into a better alignment, which can help alleviate some of the pain and stress that your foot's taking and causing some of those bunions and hammer toes.

Host: Dr. Lind, when should someone consider surgery for bunions or hammer toes?

Dr. Zach Lind: It really comes down to the patient. When it gets to a point where it's limiting their daily activities, there's somebody who likes to walk their dog or walk with their spouse or family and they can't do that anymore and they've tried these different options. They've tried wide toe box shoes. They've adjusted how they're doing things. They may be done some physical therapy to try to strengthen or they've used inserts. There's different splints as well you'll find online that kind of keep the toes separate or keep them down. These are all sort of temporary options, I would say. And if they get by and you don't have pain, then typically we just kind of keep going that route. If it's something where your pain is significant enough that you can't get through the day, then that's usually when we consider surgical options.

Host: What about magnesium at night? Like if you have foot pain.

Dr. Zach Lind: I'm not sure I've seen any significant literature on it as far as that goes. So, I wouldn't comment on it.

Host: I just heard that from friends and I thought I'm going to ask Dr. Lind that one. So, good to know. Anything else you'd like to add in closing that we didn't cover?

Dr. Zach Lind: Yeah, I think really just staying on top of your foot health is important, especially when it comes to bunions and hammer toes. A lot of people have them. They're extremely common. That's one of the most common things that we see in practice. And again, when some of these conservative options fail, that's typically when we suggest coming in and at least having another look at it.

Host: Well, I learned a lot. Thank you so much for sharing your expertise. This has been very educational and helpful.

Dr. Zach Lind: Yeah, not a problem. Happy to be here.

Host: Again, that's Dr. Zach Lind. and if you'd like to learn more, please visit stoughtonhealth.com. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. I'm Maggie McKay. Thanks for listening to Stoughton Health Talk, presented by Stoughton Health.