July-September, 2003

Seniors' Health

Seniors: repair foot problems to stay active

Anything that keeps you from being physically active has the potential for harming your overall health, says St. John’s podiatrist Dan Mostrom, M.D., who sees patients with foot problems that greatly limit mobility. Some of these problems, he says, can be repaired with minor outpatient procedures.
Crossover toe is one foot problem that outpatient surgery can repair. Individuals with hammertoes, bunions or a second toe that extends beyond the big toe are must susceptible to developing crossover toe as they age, Mostrom says.

“It’s a common problem among older people in which the second toe gradually moves across the big toe. It can be painful and, therefore, difficult to walk comfortably or pursue an active lifestyle.”

Mostrom, who is a Fellow of the American College of Foot and Ankle Surgeons, explains the first symptom is pain in the ball of the foot. The pain is caused by a tear in the underlying joint capsule and can foster instability that allows the second toe to fall out of alignment and eventually drift. Doctors normally check the ball of the foot for a possible plantar-plate tear when an older patient complains of pain in the area. Pre-existing forefoot problems combined with normal wear and tear or possible trauma can cause the plate to tear over time.

“Pain in the ball of the foot is the first warning sign indicating the second toe might cross over and eventually limit your activity,” Mostrom says. “If the pain persists and the toe starts to drift, surgery is recommended to suture the plantar plate or replace it through a tendon transfer.”

Surgery to correct crossover toe is an outpatient procedure performed with a local anesthesia. Patients with bunions or hammertoes are advised to have those corrected during the surgery. Recovery time is about six weeks.

“Given the downstream cardiovascular health risks associated with physical inactivity in older patients, we strongly advise those with persistent pain in the ball of the foot and anyone who has developed crossover toe, to seek treatment and not let the problem restrict their ability to stay active,” Mostrom advises.