Category Archives: Deformities

Flat Feet Forever?

Lots has happen this month on the First Coast; The successful 2012 Southern Women’s Show, Zac Brown Band performing at Veterans Memorial, The Jacksonville Beach Sea and Sky Spectacular, Florida vs. Georgia and lets not forget Halloween 2012!  With all the different events that happened in Jacksonville this October, parents had enough to worry about, but there children’s flat feet does not have to be one of them.

Many parents express concern about the appearance of their children’s feet at a young age.  Children under three years old have many bones that are not fully formed.  This lack of support can give the appearance of a flat foot.  Children may also appear pigeon-toed or walk on the inside of their foot; both can be normal in the very young.

Flat feet, also called pes plannus, can be flexible or rigid.

  • Flexible flatfoot: The foot is flat when the child is weight-bearing, but appears normal when child is non-weight-bearing.
  • Rigid flatfoot: The foot will appear flat, regardless of the child’s position, whether weight-bearing or not.


Sometimes flat foot can cause pain in areas other than the feet.  The child may have pain in their ankle, knee, or even hip by changing the way they walk because of their flat feet. Due to the pain and weakness parents may see a decrease in the activity of their child. If you suspect this is happening your child should be evaluated by a podiatrist.  However, with young children, the flexible flatfoot is much more common and generally not something to be too concerned with if it is not bothering them.

If an older child that is closer to skeletal maturity still has a flat foot, then you may want to consider having them wear an orthotic in their shoes.Professionally fitted Orthotics that are placed in the shoe help control the foot’s motion and place it in its proper alignment.  The orthotics also help with common symptoms and deformitiesseen with flat foot including:

  • Pain
  • Weakness
  • Bunions
  • Toe deformities

Getting the foot in correct alignment now can help avoid more serious conditions later on in life. Custom orthotics are the easiest way to prevent problems associated with flat foot and increase walking comfort.

Addressing flat feet today can prevent more serious complications, as the child gets older.  For more information on what’s normal, and what’s not or if you have questions about how First Coast Foot and Ankle Clinic can custom fit you or your child’s feet for orthotics, visit our website or contact us today.

Penguin Podiatry and Charcot Foot

064 Lucky the penguinLucky the Penguin wasn’t so lucky at birth.  He was born with a badly deformed foot, which made it difficult for him to swim and when walking develop sores, which would get infected. The zoo vet determined surgery would be too risky. Luckily for Lucky Teva, a local shoe company stepped forward and was able to engineer footwear to help Lucky function normally.

At the First Coast Foot and Ankle Clinic, Dr. Vimal Reddy sees this issue on a daily basis; but in humans, not penguins, of course. With diabetes a growing problem in Jacksonville FL, severe case can result in foot deformations called Charcot [shar-COH] neuroarthropathy or simply Charcot FootLike Lucky the Penguin, people with Charcot Foot have altered bone structure.  Walking will put stress on the foot in ways that can damage it, resulting in sores that can become infected. Like Lucky the Penguin, people with Charcot Foot are able to benefit enormously from custom shoes designed to distribute pressure across the foot.

For some, surgery could be the option to correct a foot deformity like Charcot but it’s no walk in the park. The procedure takes a great deal of metal fixators (plates, screws, pins, etc.) and the recovery period is long. For the right patient, it’s worth it if it can restore a patient’s ability to function normally.   Although surgery isn’t for everyone, patients like Lucky the Penguin will do just fine with their custom shoes.

If you have any questions or concerns for yourself of someone you love, please don’t hesitate to contact the First Coast Foot and Ankle Clinic to set up an appointment today.

Pigeon Toed?…. Not Forever!

046 pigeontoesHave you noticed your child’s toes point inward?  Is your son or daughter pigeon toed? Dr. Vimal Reddy will be able to identify one of the three reasons your child’s feet are doing this.

As children’s legs develop from infancy into adolescence, the bones undergo various twists and turns. Inward pointing toes, or intoeing, may be due to one or more of the following:

  • Inward twisting of the thigh bone (the femur)
  • Inward twisting of the shin bone (the tibia)
  • Inward pointing of the front bones of the foot (the metatarsals)

Will my child grow out of this? In the majority of cases, yes. The bones of the feet will likely straighten out before age 2, while the bones of the shin and thigh might take a bit longer—age 6. The thigh is especially tricky since it twists in such a way that intoeing may not become obvious until age 5. Your First Coast pediatrician will be a valuable resource in helping you decide if you need to watch and wait, or if you need to seek the help of a podiatrist.

While intoeing will usually not cause pain or arthritis, it may lead to children stumbling as they catch their toes on their heels. In each of these cases, treatment generally consists of casting with or without bars. The purpose of these treatment schemes is to gradually guide the bones into a more functional position. It’s important not to wait, since, by age 7 or 8, the bones a child has will be the bones he or she takes into adulthood. In severe cases, surgery may be necessary. Dr. Reddy at the First Coast Foot and Ankle Clinic will be able to help you decide what treatment is best, if any is needed at all.

Pain in the Bunion: Take Two!

tailorsbunionIn the beginning of March I discussed bunions:  the at times uncomfortable, and sometimes unsightly bumps, on the inner sides of your feet next to your big toe. Today I would like to focus to the other side of the foot and discuss, Tailor’s bunion, or Bunionette.  Tailor’s bunion refers to a similar deformity as a bunion but on the outer side of the foot next to the pinky toe.  Both types of bunions are seen frequently at the First Coast Foot and Ankle Clinic.

The Tailor’s bunion got its name centuries ago when tailors would sit cross-legged on hard floors for hours at a time*. The pressure from the hard floor on the side of their foot caused irritation to the spot next to their little toe.

While there is a genetic component to tailor’s bunion there are other contributing factors, such as:

  • The way you walk: This can stretch the ligaments holding your bones together, causing the bone to jut outwards as a result.
  • Wearing High Heels: Compounding the issue, high-heeled shoes will place additional pressure on the toes, accelerating this process of ligament stretching. This progression can give rise to a condition known as splay foot, where the bones on either side of the foot protrude outwards.

Since Tailor’s bunion is usually a natural result of aging, Dr. Vimal Reddy does not find this condition worrisome unless it becomes painful. As always, the goal is to make sure you are comfortable and can go through life easily without being bothered by bunions. We can achieve this with:

  • Padding may help reduce pain in the affected area
  • Measuring your feet to see if your shoe size has changed
  • Icing to reduce pain and inflammation

Surgery is another option to straighten out the bunions but only in severe cases.  Therefore in closing; if sitting cross-legged for hours is causing pain in your pinky toe region, or perhaps you’ve noticed pain in your little toe area while taking a stroll around the Jacksonville, FL St. Johns Town center, consult with Dr. Reddy for appropriate treatment options for your tailor’s bunion.

*Fun fact: The sartorius muscle is the longest muscle in the body, found in the front thigh.  Sartoriusderives from the Latin word for tailor because it functions to position your legs in a tailor’s cross-legged position!

Pain in the Bunion!

X-20110309150712156Ladies, are you having problems fitting into your favorite heels to strut around Downtown? Gentlemen, do your feet feel suffocated in your shoes by the end of the night out in Jax Beach? Do you have bumps on the insides of your feet next to your big toe? If so, you may have… bunions!

Bunions occur when the bones of your foot have changed shape or orientation. Ultimately, the cause is genetic — either your supportive structures are not strong enough to hold your bones in place, or the way your foot strikes the ground causes the bones to shift and protrude. Bunions are a mild problem, but can lead to pain and blisters. Cosmetically, many people just don’t like the way they look and unfortunately can become more pronounced as we age. This is a very common condition seen at the First Coast Foot and Ankle Clinic.

The primary goal for Dr. Vimal Reddy, or any podiatrist, is to improve functionality. If you can walk with little to no pain then we are happy! However, bunions often become painful and the first effort is conservative treatment:

  • Padding: simple pads will take pressure off of the bunion and alleviate the pain and blistering.
  • Shoe sizing: As we advance in age, our feet change. Have Dr. Reddy measure your shoe size to determine if you need a better fitting shoe.
  • Orthotics: If the way your foot hits the ground is the cause of your problems, an orthotic shoe insert will correct the way you walk and work towards taking pressure off of the bunion, thus alleviating the pain.

If these treatments are not enough, we may need to try a more aggressive approach such as surgery. Nevertheless, Dr. Reddy always makes surgery his last resort. In addition to the usual surgical risks, there is no guarantee the end result of bunion surgery is any more cosmetically pleasing than your natural foot and over time your feet may revert back to the way they were. However, a trained and experienced podiatric surgeon will know how to address these risks.