Find Relief from Common Foot Problems

April is National Foot Health Awareness Month!

Johnkby Dr. Hannah Johnk, Podiatrist at Myrtue Medical Center

What exactly are bunions and hammertoes?

Contrary to popular belief, it is not just a growth of extra bone. It is actually a dislocation of the joint behind the big toe. The bone behind the big toe, called the 1st metatarsal, moves and pushes the big toe toward the 2nd toe. This causes the 1st metatarsal to become prominent at the inside of the foot, creating the bump. This can make finding comfortable shoes very difficult because shoe pressure in this area causes pain. The joint dislocation can lead to arthritis, which can be painful even when walking barefoot. You can also have pain in the 1st and 2nd toes due to rubbing.

The lesser toes are all those except the big toes. If you’ve noticed that your lesser toes aren’t sitting straight, you likely have hammertoes. There are many joints, ligaments, muscles, and tendons associated with toes that make them function properly. A hammertoe results from an imbalance of these structures. There are two joints in each of the lesser toes, and one or both of them can be contracted. The entire toe can also be contracted at the joint behind the toe. These contractures cause the toe to curl, sit up higher than the other toes, and overlap neighboring toes. This can result in painful corns and calluses, as well as joint pain. Hammertoes can affect just one of your toes or all of the toes. They often go hand in hand with bunions, but not always.

What causes bunions and hammertoes?

The main cause of bunions and hammertoes is simply genetics; you were born with a predisposition to develop them. Injury and ill-fitting shoes are far less likely causes. Both issues tend to worsen slowly over time. If your bunions and/or hammertoes don’t bother you, then no specific treatment is necessary. I would recommend you exercise caution when choosing shoes as ill-fitting shoes can cause issues to develop. If your bunions and/or hammertoes do bother you, rest assured there are many treatment options to relieve pain.

What treatment options are available?

The initial treatment involves wearing properly fitting shoes. The toe box of your shoes needs to be wide and deep enough to accommodate the toes. Narrow and shallow shoes will put pressure on the toes and cause pain. Also consider the material of your shoes; leather is less forgiving than mesh or cloth and can put more pressure on the toes. Even with properly fitted shoes, you may still notice your toes rub together. There are various types of padding that can help with this, decreasing friction between toes and pressure from shoes. The pads can be foam, cotton, or silicone. You can purchase these at many pharmacies or online. I also dispense many from my clinic. You may also benefit from orthotics, which can cushion and offload the front of the foot, and if appropriate, I can dispense these from my clinic.

If these conservative measures are not successful at relieving pain, then surgery may be necessary. There are many horror stories surrounding bunion and hammertoe surgery; however, these surgeries have advanced significantly within the last decade. The procedures I perform to correct bunions and hammertoes produce consistently successful results. Sometimes crutches are necessary for about 5 weeks after surgery, but many times you can walk the day of surgery. While there is some pain during the first few weeks, it is manageable with medication.

You don’t have to live with foot pain. If you’ve had enough, make an appointment with me at Myrtue Medical Clinic. I will perform a complete evaluation and determine the best treatment course with you.

Call 833.662.2273 or 712.755.4516 to schedule an appointment today!

Governor Kim Reynolds Learns More about School-based Therapy

School-based therapy got the attention of Governor Kim Reynolds and Lieutenant Governor Adam Gregg when they visited Harlan Community School earlier this year. Governor Reynolds was interested in the success of Myrtue Medical Center’s unique permanency model within the school verses mobility of care that others tend to offer across the state.

The Governor reached out to learn more about the collaboration between Myrtue’s partnership with Harlan Community Schools and the innovative approach of removing barriers for kids while integrating services.

This aligns with the Governor’s recent bill covering recommendations for establishing an Iowa children’s mental health system. The Governor signed an executive order to create an Iowa Children’s Mental Health Board. The state board will take a comprehensive look at current resources and create a strategic plan with specific recommendations to implement a better approach to help children with mental health issues.

“Harlan Community Schools are taking a practical, passionate approach to helping children struggling with mental illness,” said Gov. Reynolds. “When touring the school, I sat down with behavioral health counselors who found a way to utilize private-public partnerships to deliver innovative, integrated mental health services that is beneficial for both students and their families. I see Harlan Community Schools as an effective model to be replicated across the state.”

By providing integrated mental health treatment for children and adolescents, Myrtue Medical Center Behavioral Health is offering year-round school-based therapy within the Harlan Community School preschool, elementary, middle and high school facilities for district families. Due to the success at Harlan Community Schools, the Shelby County Catholic School recently entered into a similar agreement to provide onsite services.

School-based mental health services are outpatient services delivered in schools to overcome behavioral, emotional and social problems that interrupt success at school and at home.

“The vision and initiation of the program came from Justin Wagner and his wholehearted belief in the importance of taking care of the ‘whole’ student,” said Deb Meissner, Director of Myrtue Medical Center’s Behavioral Health Department.  “In order to fully facilitate learning, the social and emotional needs of each student should be addressed.  From that desire to get students what they needed, Myrtue Medical Center was approached to explore what could be done to meet that need.”

Benefits of the program include removing barriers at the school for better accessibility and less disruption to the school day. Additionally, families have the option for greater collaboration between the therapist and other support at the school.

“I am excited about the difference we are making in the lives of children by emphasizing the social and emotional aspects of wellness for our children,” said Katie Sandquist, Myrtue’s School-Based Therapist for 6th through 12th grade students. “Many of these children would not be getting the emotional support they need if we were not providing therapy within their school day.”

With the parent/guardian’s support, the child’s therapist can work with school staff such as school counselors, administrators and teachers to develop a plan for support that will help the student thrive in and outside of school.

“Many times, children have exhausted their own problem-solving tools and express themselves in ways, such as acting out at home, with friends, or at school,” said Liz Smith, Myrtue Medical Center’s School-Based Therapist for Pre-school through 5th grade students. “Some evidence-based methods we use include play and art therapy and TF-CBT (Trauma Focused Cognitive Behavioral Therapy) to help children cope with difficult emotions and achieve positive health and wellness outcomes.”

Smith was hired by Myrtue in October 2018 and is a part of the National Health Service Corps that provides loan repayment for qualified candidates. Myrtue is an approved site under the Health Service Corps student loan forgiveness program.

“Myrtue CEO, Barry Jacobsen, and his Administrative Team have been supportive and fully invested in the development of the school-based therapy program and understanding of the barriers that stand in the way of accessing care,” said Meissner.  “Along with the vision to care for the whole child, the support and collaboration between our schools and Myrtue Medical Center has been the crucial link in making this a successful program.”

If you want to learn more about school-based therapy services, please call Myrtue Medical Center’s Behavioral Health at (712) 755-5056.