The running joke in medicine is that to a surgeon, every problem needs surgery. When a patient comes to a surgeon’s office, the discussion tends to be what surgery is needed, not IF it is needed? Some areas of the body surgical discussions are very black and white, like hernias, appendicitis, or blocked arteries. The foot and ankle, however, tend to have many variables as to why someone has pain. Advanced objective testing can get to the root of the problem and determine if surgery is necessary. A well trained surgeon, that has a patient-first mentality, will assess the problem and offer every conservative option before going to surgery.
Lebron James, arguably the best basketball player of all time, had a midseason foot injury this year that his primary surgeons were saying needed surgery. He sought a third opinion that told him he could avoid surgery, for which that route he chose. He was able to finish the season and playoffs without a season ending surgery.
Most foot issues have a chronic gait component that hinders the foot from healing. For example, a high arch foot that coincidentally sprains the ankle can have pain a lot longer because of their foot shape. These lingering problems make patients feel there is something deeper going on, when in fact most of the time foot realignment devices and advanced in office rehab can get them completely better. MRI’s are often overprescribed and not indicated unless surgery is clearly necessary. I will order MRI and CT to help plan a surgery that is inevitable, like a shifted fracture and ruptured tendon. A good physical exam, gait analysis, and in-office ultrasound can help pinpoint a problem without need for expensive tests. Heavily researched in-office therapies such as class IV laser, shockwave therapy, custom molded braces and orthotics, and PRP injections can get people back in the game without need for surgery.
People should choose a foot surgeon that looks at every option that has merit to cure a problem, and feel confident in their surgical abilities to help resolve an issue when all else fails. I tell patients all the time with confidence, if shockwave does not resolve the issue, we can always do surgery. Why risk unnecessary complications when in-office therapy has nearly the same outcome.
Dr Barnett’s goal at Align Foot and Ankle is always to provide the most comprehensive care. That starts with a deep discussion of the root cause. Once a clear diagnosis has been made, the options are laid out clearly and advice given based on lifestyle, severity, and time to recover. Align Foot and Ankle is a one stop shop, from conservative to the most innovative procedures to get people back on their feet.
