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Friday, 29 September 2017 00:00

What is Sesamoiditis?

After you take some time to get used to saying the word, you may wonder what that is! Doesn’t really sound harmless, does it? Well, your intuition is correct! It is a condition of inflammation or injury of the tendons around the sesamoids (two small bones near a joint). In this case, they are the sesamoids right under the big toe joint).

As with other forms of tendonitis (like Achilles tendonitis), it is a condition that commonly affects athletes that injure the tendons via overuse from repetitive motions or from traumatic injury. Dancers, basketball players, and runners are prone to this condition, causing them pain and inflammation after putting excessive pressure or force on the big toe joint area. They may experience swelling, bruising, pain, and stiffness. Bearing weight on the balls of the feet or standing at all can become painful.

What can be done to treat sesamoidits?

  • If the inflammation or injury is due to overuse, you should stop the activity. Allow the tendons to rest and recover so that it doesn’t become a worse issue. This also goes for if the problem is caused by a blunt trauma injury, in which case, using the foot would probably cause pain anyway.
  • For mild pain, be sure to use the RICE method at first sign of symptoms: Rest, Ice, Compression, and Elevation will help to ease swelling and pain. You may also need to use NSAIDs (non-steroidal anti-inflammatory drugs) in conjunction with the RICE method for pain relief and reduction of inflammation.
  • If you can bear weight on the sesamoids, tape some cushioning like foam pads under the sesamoids to reduce pressure and minimize pain. Taking steps when you have pain can worsen inflammation, so stay off the feet as much as possible.
  • Additionally, shoes should be cushioned and have no heel so that the weight is distributed more evenly across the foot. Any height in the heel can move the pressure forward toward the balls of the feet, increasing pressure on the sesamoids.

If you have pain around the big toe joint, it’s best to consult with our podiatrist at Texas Foot WorksDr. Jonathan M. Kletz. He will assess your foot for a proper diagnosis for your foot pain, and together with his team will provide quality care to treat your sesamoid issue and get you back on your feet. Make an appointment today at our offices in Abrams (Dallas)Athens, and Gun Barrell City, TX!

Published in Blog
Thursday, 21 September 2017 00:00

Analyze This: Your Gait

Some of our actions are second nature. Walking, yawning, and even brushing your teeth – there are some things that we just don’t think about while we are doing it. But maybe it’s time for us to pause for a moment and think about the way we walk.

If you’ve never thought about it before, it may seem strange to analyze the way you walk, also called your gait. Where do you even start? What do you look for? And why should you do it? Read further and we’ll help you figure it out!

Where to start:

  • Stand up straight. Do whatever you think that means. Now analyze how you stand. Your posture should include: a neutral neck, shoulders back, chest a bit forward and slight curve in your spine. Think of it as lifting the upper part of your body to straighten and lengthen the spine.
  • Now see assess how you hold your weight. After a little while, are you shifting your weight to one leg or the other? Did you hunch your shoulders and lose the curve in your spine? Are your feet flat on the ground? Or do you have an arch? (If you have flat feet and have foot or ankle pain, consult with our podiatrist) When you have bad form while standing, it may also affect the way that you walk.
  • Next, walk (barefoot) normally across the room. You will have to do this a few times to really understand your foot and ankle positioning while you walk.

What to look for:

  • First feel for how your feet touch the ground. Your foot strike should go in the order of: heel, midfoot, ball of the foot, toes. Some people may walk on the tips of their toes or stomp the entire foot down with each step. Toe walkers may have a habit since childhood, perhaps along with an issue in the soft-tissue along the bottom of the feet. Stepping with the entire foot can cause higher impact on the joints.
  • While you are checking for stomping, plug your ears with your fingers and walk across the room again. Does it sound loud? Try again, while walking a bit softer to reduce impact. 
  • Next, check the weight distribution on your feet. Do you tend to put more pressure on the insides or outsides of the feet? The way you pronate can affect or be affected by the ligaments and tendons in the ankles. If you have pain, check your pronation.
  • Then, check for the direction of your toes. They should be facing forward. Are they facing inward (in-toeing) or outward (out-toeing)? This could say something about the structure of your legs.

Why you should analyze your gait:

  • Gait issues can cause problems down the road. The wear and tear on your soft-tissues can mean pain. Joint issues can be worse with arthritis. Muscles and bones can become deformed.
  • Your shoes may wear down faster if you have gait issues. Check your shoe’s outer soles to see if it’s wearing down unevenly, looking on the inside vs. outside part of the feet, or front vs. back. 
  • You can also see where you might be getting foot pain from by analyzing your gait. For example, if you are pronating, it may help to get arch supports.

If you are unsure about checking your gait on your own, we can help you. Come in for a gait analysis by contacting our podiatrist at Texas Foot WorksDr. Jonathan M. Kletz is ready to help. Make an appointment today at any of our Abrams (Dallas)Athens, and Gun Barrell City, TX offices!

Published in Blog
Thursday, 14 September 2017 00:00

Treating a Bunion Deformity

Bunions are a bone deformity that can really affect quality of life, depending on how far the issue has progressed. The bony growth on the side of the big toe joint not only causes pain and irritation, but it can also make it difficult to fit into footwear made for the masses. 

Non-invasive treatment of this uncomfortable deformity includes addressing symptoms of bunions, such as: bony growth, swelling or redness, corns or calluses, pain, stiffness, or inflammation of the joint. Treatments may include:

  • Changing your shoes to ones that have a wider toe box so that your toes and joints do not experience tightness from shoes.
  • Using bunion pads and cushions to reduce external pressure from shoes. 
  • Orthotic inserts and custom orthotic shoes to help reduce pain.
  • Bunion relief exercises, in-shoe splints, and overnight splints to help slow the progression of bunions.

When these remedies do not work, you may need surgical intervention. Depending on the severity of the bunion, there are different surgical options (bunionectomy):

  • Tendon and Ligament Repair – If the problem of the bunion or joint deformity is due to tight or loose soft tissues, surgery to loosen or tighten them can fix the problem.
  • Exostectomy – This is considered “shaving the bump”, but usually is not the ideal choice since it only includes removing the bony bump. Truly fixing the bunion issue, however, requires realignment of the joint.
  • Osteotomy – In this type of surgery, the bones are broken and realigned. Pins or screws may be needed to hold it in the right place. Tendon or ligament repair may also be required in conjunction with this surgery.
  • Arthrodesis – This is a surgery in which arthritic joint surfaces are removed, and then screws or pins are used to hold the bones together until they heal properly.

If you have developed a bunion issue or have one that is getting worse, contact your friendly podiatrist at Texas Foot WorksDr. Jonathan M. Kletz is ready to help you find the best treatment for your bunion problem. If surgery is necessary, we will help you prepare and ensure proper maintenance after the procedure. Make an appointment today at any of our offices in Abrams (Dallas)Athens, and Gun Barrell City, Texas!

Published in Blog
Friday, 08 September 2017 00:00

Common Sports Injuries for Children

These days, there are so many technological devices that seem to grab and keep our children’s attention. Many children can spend several hours at a time, engrossed in the screens. This has led to a more sedentary lifestyle for children, making it more important than ever for parents to encourage physical activity. One such way is to have children participate in sports, whether it be in a children’s group setting, after school programs, private lessons, or community leagues.


Participating in group activities can benefit children in many ways, including teaching sportsmanship, promoting teamwork skills, and improving social skills. The increased activity also helps to keep a healthy lifestyle. However, with sports comes the added risk of injuries. Some common injuries include:

  • Chronic repetitive stress at the elbow, wrist, knee, ankles, or feet. Repetitive motions can cause strain in the muscles and tissues. Additionally, any repetitive impacts, such as with jumping or kickingequipment can cause stress fractures. If there are symptoms of pain, make sure your child is correcting technique and modifies time spent doing repetitive movements.
  • Broken Bones. Falls, collisions, or impact with equipment can cause painful injuries that lead to broken bones. The bones will need to be set (probably through surgery) and cast. To reduce risk of breaking bones, children should follow sports guidelines, as well as wear protective gear and shoes that are appropriate for the sport.
  • Sprains. When a ligament(s) is stretched beyond their natural flexibility limits, children can experience a sprain. The most common is an ankle sprain from landing on the ankle in a strange position. Proper footwear can help prevent this injury.


For growing children, one of the most important injuries to pay attention to is an injury to a growth plate. The growth plate is the area that is still growing on long bones such as in the legs or in the feet. It may require specialized care from an orthopedic surgeon. After an injury, assess your children’s feet. If pain and symptoms are mild, you may be able to treat with the RICE method (rest, ice, compression, elevation). If pain and swelling are moderate or severe, it’s important to see our podiatrist, who can determine how to best proceed. 


If your child has sustained an injury, contact your local podiatrist at Texas Foot WorksDr. Jonathan M. Kletz is ready to help you find the best treatment for your growing little one. Make an appointment today at any of our Abrams (Dallas)Athens, and Gun Barrell City, TX offices!

Published in Blog
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