Dr. Berg's Foot Facts

Posts for: March, 2018

By Dr Rion Berg
March 28, 2018
Category: Bunions
Tags: bunions  

Like most people, you probably know what a bunion looks like. Maybe you have a bunion and you've been dealing with it for a long time. Perhaps as you've gotten older your bunion has progressed and it's become painful to wear closed-toed shoes.

You may have wondered, why you have bunions. Is it just bad luck or is something else going on.

Are Bunions Genetic?

Bunions are not genetic but the underlying foot mechanics that cause bunions are inherited. Each of us is born with a particular foot type. Although babies are all born with flat feet most will outgrow this flat foot pattern at around age four. Those who do not outgrow them will have flat feet for the rest of their lives.

People with flat feet are at much greater risk for developing bunions.

Why?

Men and women with flat feet you are much more likely to pronate or roll their feet inward when they walk. This walking pattern is what causes bunions to form over time.

What Is Going On With My Bones?

The first thing you notice if you have a bunion is the characteristic bump at the base of your big toe. You might wonder if you're growing extra bone, but you are not. In a foot without a bunion, the toe is relatively straight ahead. 

With a bunion you can see on X-ray that the big toe is moving towards the second toe. In addition, you'll notice the first metatarsal separates from the second metatarsal. Without any bone formation, a bump begins to form on the side of the joint.

In addition, the first segment of the great toe and the metatarsal behind it often become hypermobile. As this happens greater and greater separation occurs between the first and second metatarsal causing the toe to drift over.

Let's compare this to your hand. Unlike the great toe, mobility is necessary or you wouldn't be able to touch your thumb to your little finger. If you make a fist with your right hand you'll notice a bump where your thumb knuckle protrudes out. Unless you plan to write with your feet, you don't need that hypermobility.

The hypermobility comes from the tendency of the foot to pronate as mentioned earlier. It's this hypermobility that causes the great toe to drift over toward the smaller toes.

What Causes the Pain?

The pain is not a result having a hypermobile big toe with a bump. It results from your bunion rubbing against your shoes every time you walk. If you lived in a place where the weather is always warm bunions would not be much of an issue since you could accommodate them with a pair of sandals. In a place like Seattle this is a much bigger problem as we need shoes almost all year long. Most shoes are not designed to accommodate bunions.

How Is It Treated?

The earlier you get the underlying cause of the bunion treated, the better chance you have of preventing bunions from forming. For example, children who have not outgrown their flat feet from babyhood can receive treatment to prevent bunions. At the Foot and Ankle Center of Lake City we treat young children with pediatric flatfoot with a special pre-fabricated orthotic designed just for kids called Little Steps. To learn how to identify children foot problems early review Kid's Feet First.

For adolescents whose feet are still growing I'll recommend a splint for nighttime wear to keep the toes aligned properly. For adults as well as adolescents custom orthotics are recommended. Orthotics keep the foot properly aligned when walking to prevent pronation and the first toe from becoming more hypermobile.

Wearing shoes that can properly accommodate your bunion can help prevent bunion pain. A local shoe store I recommend is Sole Perfection. In addition, Kirsten Borrink's website, www.barkingdogshoes.com is a great resource. She is always finding new shoes that work for a variety of foot problems including bunions.

What About Surgery?

After all conservative treatment approaches are tried; surgery may be the most reasonable option. Most people who have surgery have had bunions for many years, but young people can also have an advanced case and prefer a surgical solution. Either way it's important to ask yourself the following questions before talking to a Seattle podiatrist like me about surgery.

Are my bunions more painful?
As bunions progress they often become more painful. If this is a problem for you and you've tried other solutions.

Has it become extremely difficult to wear shoes?
At some point the difficulty of finding any shoes to wear (even bunion-friendly shoes) may have become problematic.

Has my bunion discomfort forced me to limit the activities I wish to pursue?
For many people, giving up athletics or fitness activities is not acceptable. If this is true for you then surgery may be the best option

If you or a loved one are suffering from bunions, call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

Your free foot book "No More Foot Pain" is waiting to be sent to your home.

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

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March Madness is upon us! If your children are dreaming about playing college basketball and they're either on a middle school or high school team you should know that competitive basketball is very hard on the feet and ankles. Although you can't prevent all their foot and ankle problems, here are five tips to give them a fighting chance of leaving the court injury-free.

  • Suggest they play on an indoor court whenever possible. Wood floors provide the most shock absorption while concrete provides the least.

  • Purchase new basketball specific shoes before the bottom of the shoe becomes smooth. For kids who play on a team (5 days a week of practice), replace their basketball shoes every two to three months.

  • If your child has flat feet or another biomechanical foot problem, custom orthotics will help prevent heel pain, plantar fasciitis, and Achilles tendonitis.

  • Proper warm-ups are essential for injury prevention. Both stretching exercises and gradual warm-ups such as dynamic warm-ups are recommended. In addition, doing calf stretches are important to prevent the foot problems mentioned above.

  • Purchase socks made of materials that do not absorb sweat. Avoid cotton and purchase synthetic materials that wick away moisture to prevent blisters.

Of course if your child does sustain an injury, first aid should include rest, ice, compression, and elevation of the injured foot or ankle. Bring them in to see your podiatrist as soon as possible so they can be properly evaluated and treated.

Call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

For more information about heel pain in runners download our eBook, "The Complete Guide to Stopping Heel Pain in Runners".

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Google+


By Dr. Rion Berg
March 13, 2018
Category: sports injuries
Tags: lisfranc injury  

Over the past weekend my marketing director texted me and told me she injured her left foot on her last day in Cabo. It sounded like it could be a sprain or fracture so I told her to ice it and I would examine and X-ray it when she returned to work the next day.

When I examined her foot there was significant swelling. Her pain was localized at her 3rd and 4th metatarsal bones at the point where it joins the midfoot. We call these the Lisfranc joints.

Although frequently found in athletes, a Lisfranc injury can also occur with a simple twist and fall as was the case with my marketing director. She fell off of a step as she was leaving to return home to Seattle.

The biggest concern in a case like this is tearing of the tissues or ligaments that join the bones which can produce instability. The X-ray would reveal whether she had partial to total dislocation of one or more joints and/or a fracture.

Upon X-ray there was normal alignment at the midfoot with no dislocation or fracture. To determine the level of damage to the tissues or ligaments we would need to do an MRI. In her case since the swelling was already going down, the tissues will likely heal with proper treatment. A worse case would likely require surgery.

The treatment is the same as if it had shown a small fracture without displacement. My recommendation in this situation is to:

  • immobilize the foot in order to let it heal

  • use a mid-calf boot

  • add crutches if the pain isn't reduced

  • re-examine after 2-3- weeks

  • refer for physical therapy if needed, or return to normal shoes if not

If you think you've sprained or broken your foot it could be a Lisfranc injury. Call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

For more information about heel pain in runners download our eBook, "The Complete Guide to Stopping Heel Pain in Runners".

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Google+


When I opened my laptop this morning I was greeted by an article about a surgeon that shortens people toes so they can fit into their favorite shoes. Yikes! Apparently Hollywood stars are taking the plunge. I can't say I'm that surprised.

Then I scrolled to the bottom of the page and caught the reaction of one podiatrist whose handle is Marty Pod and I loved what he said. "Make the shoe fit the foot not the other way around." I couldn't agree more.

Just like so called Cinderella surgery, I would never do this kind of surgery to my patients. And yes it would be doing it to them, not for them. Everything I do is for the health of my patients, not some special look they're trying to achieve. Of course I'll do surgery to get a hammertoe back to its proper position and bunion surgery if it's necessary, but I never take any surgery lightly.

Before talking to my patients about surgery I'll exhaust every other option. For hammertoes and bunions that could be fitting them with a pair of orthotics to correct their foot mechanics and relieve their pain.

Educating people about the types of shoes to wear with these conditions is also top on my list. Shoes with a wide and deeper toe box can be of tremendous help since symptoms are caused by the foot protrusions rubbing against the shoes. I often recommend patients go to Sole Perfection or online to Barking Dog Shoes for a solid recommendation for their bunions or hammertoes.

If you're experiencing pain from a bunion, hammertoe, or any other foot pain, call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

Your free foot book "No More Foot Pain" is waiting to be sent to your home.

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Google+


It seems like no matter what life throws her way, Victoria Beckham keeps on going. Instead of problems with her bunions, this time she sustained a stress fracture during a winter ski vacation in Whistler, Canada.

Not longer after, she had a shoe design meeting and took a selfie standing with one foot in a stiletto and her other foot poised precariously in the air with a walking boot. Victoria never seems to avoid risk, especially when it comes to looking her best.

Victoria has suffered for years with bunions most likely made worse by wearing sky high stilettos. To this day I don't know whether she's had surgery for her bunions, but I hope she has for her sake. I don't know whether her pose for a shoe designer was just a one off or whether she truly has given up heels for flats as she proclaimed in 2016.

If you're like Victoria and take risks with your feet and ankles, stress fractures and other foot problems are bound to come your way. If you have flat feet and your wear heels, certainly bunions are much more likely to be a reality in your life.

To decrease your risk for stress fractures here are 5 easy ways to prevent them. If you have bunions, wearing shoes that are one inch or lower in height and have plenty of room in the toe box can help prevent them from getting worse.

No matter what your foot problem, call us today at 206-368-7000 for an appointment. Often same day for emergencies and less than 2 weeks for chronic foot pain. You can also request an appointment online.

For more information about heel pain in runners download our eBook, "The Complete Guide to Stopping Heel Pain in Runners".

In addition, our newsletter "Foot Sense" comes out monthly.  You can also check out our past issues. Every issue contains a mouth-watering recipe and can be printed out for easier reading!

Seattle foot and ankle specialist, Dr. Rion Berg offers foot care for patients with bunions, heel pain, diabetes, fungal toenails, ingrown nails, and surgical solutions when needed to residents of Seattle, Bellevue, Kirkland, Shoreline, Lake Forest Park, Mountlake Terrace, Lynnwood and other surrounding suburbs.

Follow Dr. Berg on Facebook, Twitter, and Google+