BIPEDAL

Key diabetes statistics in the United States:  Total Prevalence: Approximately 40.1 million people (diagnosed or undiagnosed) have diabetes, about 12% of the US population. Diagnosed vs. Undiagnosed: Of the 40.1 million, roughly 29.1 million are diagnosed, while 11 million are undiagnosed. Prediabetes: An estimated 115.2 million American adults aged 18 and older have prediabetes. New Cases: Every...

Equinus, or a tight heel cord, is a major contributor to foot pathology. In some cases it is subtle and the body can compensate to the point where it is unnoticeable. However over years the compensatory motion that is "borrowed" from other joints becomes apparent as either pain in areas such as the Achilles insertion or the plantar fascia, or structural changes such as collapse of the arch or buni...

Nerves play a critical role in how we experience pain, balance, and movement. Nerves are two-way messaging electrical conduits that carry signals for motor function from the brain to the periphery, and sensory input, carrying information from the periphery to the brain. When there is a disturbance either mechanically or chemically in the signal pathway, symptoms can emerge.  Systemic conditions su...

In this episode of BIPEDAL , we explore one of the most common deformities of the forefoot—hammertoes. These toe deformities affect millions of people and often develop gradually due to biomechanical imbalance in the foot. A hammertoe occurs when one of the lesser toes—most commonly the second, third, or fourth toe—becomes bent at the middle joint, creating a characteristic hammer-like appearance....

Beginning with early primates more than 50 million years ago, the episode examines how primitive feet functioned primarily as grasping tools for arboreal life, featuring a divergent big toe, long toes, and a flexible midfoot. As environmental changes pushed early hominins toward life on the ground, the foot gradually adapted to support bipedal locomotion. Key fossil discoveries—including Ardipithe...

In this episode of BIPEDAL , we take a comprehensive look at arthritis of the foot and ankle, a common condition that can significantly affect mobility and quality of life.  Foot arthritis is actually quite common, particularly in adults over the age of 50, while ankle arthritis is less frequent but often more debilitating when it occurs. Osteoarthritis is the most common joint disease worldwide,...

Approximately 10% of all fractures in the human body occur in the foot and ankle. It is a load bearing, highly stressed region of the body whereby forces are continuously being applied. Move the foot suddenly in the wrong direction, and these forces can overwhelm the ability of the bones to stay intact. However, all injuries resulting in fractures do not have to be the result of sudden movement or...

The great toe joint is just that - it's great! Until it's not. Stiffness and immobility are very common conditions. Some studies show that over 60% of people will develop arthritis in this joint at some point in their life. Patients will report initially with occasional pain with bending, or when performing certain activities such as jumping or stooping. As the condition progresses, limitation of...

Gout is a term we use to describe the intense inflammatory episode that occurs when elevated uric acid levels in the blood - a condition called hyperuricemia - cause crystal deposition in the joints. Very often this occurs in the foot since this is a cooler area of the body. Patients will remark that even the sheets touching the joint elicits intense pain.  Clinically, we often see the great toe j...

Ankle sprains are very common orthopedic injuries. A sprain is stretching or tearing of ligaments. Since there are multiple ligaments holding the ankle complex together, there is a myriad of injury patterns that can result from "rolling" your ankle.  On the outside of the ankle there is a ligament complex called the lateral collateral ligaments. These are the most commonly injured in a typical ank...

Flat feet are common. And not all of them are painful. Some people are born with a flexible flatfoot and have no issues with common activities, while others were born with a normal arch but develop a flat foot over time. This is more likely related to posterior tibial tendon dysfunction, or PTTD. This condition can happen as a result of poor biomechanics, repetitive stress, age, weight, certain me...

The Achilles tendon is the combination of the gastrocnemius and soleus muscles as they course down the leg and attach to the calcaneus. This large tendon is a powerful plantar flexor of the foot. The tendon is under a resting tension, ready to propel the foot forward when the brain sends it a signal. It is this resting tension that may become problematic. For example, part or a flatfoot condition...

Orthotics are a mainstay of treatment for many foot and ankle conditions. This is because so many conditions are a result of poor biomechanics. Pronation, a normal foot motion required for efficient gait, can be excessive in some individuals, leading to a variety of downstream problems. For example, excessive pronation leads to hypermobility, hypermobility leads to foot deformity such as bunion an...

Many patients present to my clinic complaining of bunion pain. These patients range in age from adolescents all the way to my geriatric population. There is no predilection for age, gender, body weight, race, or any other factor - yet they can be painful and are quite often progressive. The major factor playing a role in development is genetics. When coupled with biomechanics, bunion formation is...

Pronation is a complex triplanar motion: eversion of the heel, abduction of the foot, and dorsiflexion of the ankle. Supination is the reverse motions: inversion of the heel, adduction of the foot, and plantarflexion of the ankle. These motions occur at specific phases of gait, the cycle of taking a step.  Pronation is critical for proper shock absorption and adaptation to uneven terrain. Supinati...

Plantar Fasciitis is one of the most common conditions I see in my clinic. Roughly 1 in 10 people will experience this in their lifetime, making it extraordinarily prevalent. There can be confusion as to how the condition evolves, but I will say it mainly has to do with form and function. By that I mean our feet were not designed for the surfaces we walk on each day. This can be corroborated by th...

Dr. Weinstein discusses the impetus for creation of a podcast that discusses all aspects of medical and surgical treatment of foot and ankle disorders.  Dr. Weinstein has been practicing foot and ankle surgery for over 20 years. In this time new formats for public education have emerged.  No single source exists where a comprehensive discussion of common pathologies and treatment algorithms are ex...