Take care of your feet

If your feet hurt, pay attention to them. Neglecting them may lead to chronic problems later.
How can a tiny toe ligament about as wide as a coffee stirrer sideline a big, healthy athlete like Chipper Jones?

Easily, said doctors who treat the feet, ankles and toes. And painfully, said Jones, who is almost six feet four inches tall and weighs 220 pounds.

"If you don't have chronic foot problems, as I have, you really don't understand," Jones said Friday as he sat in the Braves locker room autographing baseballs instead of getting ready to play the Oakland Athletics.

Lowly foot can cause significant misery

Jones has a torn ligament in his second left toe, and he's wearing an air cast for several weeks to allow it to heal. He saw a noted foot specialist in Charlotte last week who suggested that Jones delay a surgical solution for the time being. Jones said Friday that he believes longtime bunions are to blame. In the meantime, Jones wears the cast and plunges his left foot into a bucket of ice water twice a day, neither of which is much fun, Jones said.

"It seems pretty small, but your feet take the brunt of everything you do. When I even step on it, it's excruciating. It feels like a golf ball in my foot."

Even though the foot and its digits often do not get routine care -- much less respect -- the lowly foot causes significant misery, lost playing time and work, and disruption of everyday activities. Ankle sprains, stress fractures, Achilles tendinitis and bunions are just some of the ways the foot and ankle get hurt -- and get our attention, with sometimes excruciating pain.

"Even a moderate amount of change, and you're going to feel it," said Dr. Robert Duggan, a foot and ankle surgeon in Orlando and director of sports medicine for Walt Disney World's Wide World of Sports. "And for an athlete at that level, they use their bodies every day like an instrument. They can feel it when the sides of their shoes wear down."

While Jones' injury is a particularly bad loss to a badly hurting Braves team, Jones is far from alone in the world of elite athletes who have been laid low by a toe.

An arthritic big toe caused basketball legend Shaquille O'Neal to have surgery two years ago. Deion Sanders, who signed a contract Wednesday with the Baltimore Ravens, had surgery in the offseason on a toe on his left foot.

The foot typically does not get a lot of respect until something goes wrong with it, doctors and foot patients agree. Yet it is an elaborate machine with more than 100 ligaments, tendons and muscles working with 26 bones. Taken together, the bones in the feet account for 25 percent of all the bones in the human body. Under optimal conditions, these moving parts dance a delicate ballet to mobilize the body. If one part goes wrong, the dance falls apart.

The kinetic chain

"It's a very fine-tuned mechanism," said Dr. Rami Calis, a foot surgeon and assistant professor at Emory University School of Medicine. "You can have a little tear on one side, and the other side begins to overpower the other."

A person not only loses at least some mobility with a foot injury, but other body parts are affected in what doctors call the "kinetic chain." Bit by bit, the body begins to compensate for the loss of stability. Knees, hips, abdomen, back, elbows, shoulders and even the neck and head can be affected, doctors said, as the body adjusts to a foot injury.

Athletes must have use of their toes to "push off," or begin their acceleration, jump or run, explained Dr. Andrew Gregory, a professor of orthopedics and pediatrics at Vanderbilt University Medical School.

"It [his injury] affects every facet of my game -- hitting the bag, at the plate, midstride, everything," said Jones, 33, of Alpharetta.

Foot problems catch up with you

Foot problems are not new for Jones. He's had bunions, or protrusions of the big toe caused by a shift in the bones within the foot, for years, he said.

"You know, when you're young, you just rub a little dirt on it, think it'll go away and just keep playing," Jones said. Now, like many others whose feet are not as well-known, Jones is learning that foot problems will catch up with you.

Shannon McLaughlin, 21, of Atlanta has a torn ligament in her toe from an injury she sustained as a child. For years, it didn't bother her, she said. Now, after a few years of wearing high heels, she is starting to be bothered by the old injury.

"I'll step on it the wrong way, and it hurts so much I can feel it in my arm," McLaughlin said.

It's not just toes that keep patients in pain and foot doctors in business. "People will say, oh, it's just a sprain, it'll get better," said Duggan. "But sprains often take longer to heal than a fracture. And people will go back to playing on them sooner than they should."

Robin Muretisch, 40, of Roswell was sidelined for two months because of an arch problem. The pain was terrible, and she experienced another surprise consequence of her foot failing her.

"It's an emotional drain, because you lose your mobility, and you jump to extremes, thinking 'am I ever going to be able to do anything again?' " Muretisch said. "And then you have to hop and limp, and even when you're sleeping, it hurts. I would have never thought I could be so miserable."

Jones is not enjoying his convalescence, either. He can't play with his children, and the cast, while removable, is "a pain," he said. Yet he feels relieved that surgery is not needed, at least for now.

And, sounding somewhat like the Lt. Dan character in the movie "Forrest Gump," Jones had these words of advice: "You gotta take care of your feet. And make sure you get shoes that fit. And when they hurt, pay attention to them."

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