I have been dealing with a painful great toe on my left foot for one year now. It started while I was rock climbing. I fell from a hand hold and stubbed my toe. Immediately, I knew I had an injury. I went to a podiatrist who gave me a shot of cortisone.
That helped and I thought I was cured. I went climbing again and within minutes I felt the same pain. I went back to the podiatrist and he put me on an anti-inflammatory. I decided to get a second opinion. I went to another podiatrist and he said I need orthotics. No relief, so I went to an orthopedic foot and ankle surgeon. He told me to go to physical therapy and get a CAT scan. The physical therapy did not help. The CAT scan showed a bone bruise at the base of the great toe…which was almost 5 months after the accident date. The surgeon then told me to get a carbon fiber foot insert with a Morton's toe extension. I continued to deal with the pain and he gave me another cortisone shot…it did not help.
On January 1, 2010, I went snowboarding and fractured my left ankle. The surgeon said hopefully being in the cast will also help my toe to heal. I just had the cast removed two weeks ago and my toe is actually hurting even more. I just made an appointment for acupuncture to help with the pain management. The surgeon said he thinks only surgery will help me at this point and he is not a 100 percent sure it will help. Any advice would be appreciated.
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Gary:
As per usual, this is confirmation yet again that most of the fixes for this kind of sore toe end up failing many people miserably while costing somebody (often the tax payer) a whole lot of money.
First of all, my impression is that foot problems like these are most common in First World societies, so we need to look for contributing factors in our lifestyles.
Shoes
Too much time spent in shoes. Joints are designed for constant movement. The joint surfaces rely on movement for their nutrition. Without movement, the cartilages deteriorate and soften. The obvious solution is to get about barefoot as much as possible and to choose shoes that are more like moccasins than rigid appendages. If the toe is to be splinted, this should only be for no longer than 3-4 days and then discarded in most cases. Any longer and the splint may make recovery even more difficult.
Vitamin D Deficiency
The last 15 years has seen vitamin D levels in the developed nations plummet due to commercially motivated fear-mongering over skin cancer. Vitamin D helps regulate inflammation and strengthens nones and cartilages.
Excess Calcium relative to other minerals
80% of all those tested by me using the Hair Tissue Mineral Analysis have excessive calcium in their diets. Those with high calcium tend to have the lowest bone density (I know, I know - this totally contradicts what you are told about calcium - That is: Take more and more for strong bones). Excess calcium also makes cartilages hard and dry and cause calcification of joint margins.
Excess Refined Foods
Refined sugar, flours and oils have an inflammatory effect on the body when in excess. In addition, these supply empty calories. Bones and joints need a nutrient rich environment if they are to thrive. Go back to natural foods that are relatively unprocessed. Buy raw and cook at home and avoid eating out.
Inadequate Protein Intake
This does not mean lack of protein; more to do with all the protein being packed into a single meal. Bones and cartilage need a constant, steady supply of amino acids from protein, rather than a single daily big hit. Have a little protein with all meals and snacks.
Medication Side Effects
Many drugs, including statins, may directly affect joint health, or indirectly due to damage to the liver and other organs. The damage from toxins and poor circulation will most likely be first to show in the parts of the body furthest away from the heart - the toes.
Excessive use of anti-inflammatory medicines and injections
Please read my articles about inflammation. These medicines interfere with proper healing and should be avoided.
Turf Toe? Then pull it!
Yes, do all of the above and get your sore toe pulled about once a week. Your toes joint surfaces have been impacted. Pull the joint apart to relieve the pressure and then repeatedly glide, slide and rotate the joint each and every way while keeping the traction on. You will need 3-4 sessions to get significant relief.
That helped and I thought I was cured. I went climbing again and within minutes I felt the same pain. I went back to the podiatrist and he put me on an anti-inflammatory. I decided to get a second opinion. I went to another podiatrist and he said I need orthotics. No relief, so I went to an orthopedic foot and ankle surgeon. He told me to go to physical therapy and get a CAT scan. The physical therapy did not help. The CAT scan showed a bone bruise at the base of the great toe…which was almost 5 months after the accident date. The surgeon then told me to get a carbon fiber foot insert with a Morton's toe extension. I continued to deal with the pain and he gave me another cortisone shot…it did not help.
On January 1, 2010, I went snowboarding and fractured my left ankle. The surgeon said hopefully being in the cast will also help my toe to heal. I just had the cast removed two weeks ago and my toe is actually hurting even more. I just made an appointment for acupuncture to help with the pain management. The surgeon said he thinks only surgery will help me at this point and he is not a 100 percent sure it will help. Any advice would be appreciated.
________________________________________
Gary:
As per usual, this is confirmation yet again that most of the fixes for this kind of sore toe end up failing many people miserably while costing somebody (often the tax payer) a whole lot of money.
First of all, my impression is that foot problems like these are most common in First World societies, so we need to look for contributing factors in our lifestyles.
Too much time spent in shoes. Joints are designed for constant movement. The joint surfaces rely on movement for their nutrition. Without movement, the cartilages deteriorate and soften. The obvious solution is to get about barefoot as much as possible and to choose shoes that are more like moccasins than rigid appendages. If the toe is to be splinted, this should only be for no longer than 3-4 days and then discarded in most cases. Any longer and the splint may make recovery even more difficult.
Vitamin D Deficiency
The last 15 years has seen vitamin D levels in the developed nations plummet due to commercially motivated fear-mongering over skin cancer. Vitamin D helps regulate inflammation and strengthens nones and cartilages.
80% of all those tested by me using the Hair Tissue Mineral Analysis have excessive calcium in their diets. Those with high calcium tend to have the lowest bone density (I know, I know - this totally contradicts what you are told about calcium - That is: Take more and more for strong bones). Excess calcium also makes cartilages hard and dry and cause calcification of joint margins.
Excess Refined Foods
Refined sugar, flours and oils have an inflammatory effect on the body when in excess. In addition, these supply empty calories. Bones and joints need a nutrient rich environment if they are to thrive. Go back to natural foods that are relatively unprocessed. Buy raw and cook at home and avoid eating out.
Inadequate Protein Intake
This does not mean lack of protein; more to do with all the protein being packed into a single meal. Bones and cartilage need a constant, steady supply of amino acids from protein, rather than a single daily big hit. Have a little protein with all meals and snacks.
Medication Side Effects
Many drugs, including statins, may directly affect joint health, or indirectly due to damage to the liver and other organs. The damage from toxins and poor circulation will most likely be first to show in the parts of the body furthest away from the heart - the toes.
Excessive use of anti-inflammatory medicines and injections
Please read my articles about inflammation. These medicines interfere with proper healing and should be avoided.
Turf Toe? Then pull it!
Yes, do all of the above and get your sore toe pulled about once a week. Your toes joint surfaces have been impacted. Pull the joint apart to relieve the pressure and then repeatedly glide, slide and rotate the joint each and every way while keeping the traction on. You will need 3-4 sessions to get significant relief.
_______________________________________
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As a physical therapist I would recommend seeing a PT to help restore normal ROM as stiffness is frequently an issue.
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