Tuesday, November 22, 2016

The Pillars Of The Body

Dr Rajesh Simon, the newly-appointed secretary of the Indian Foot and Ankle Society, talks about problems, as well as solutions for the feet 

Photo of Dr Rajesh Simon by Albin Mathew; a cross-section of the foot

By Shevlin Sebastian

For one year, home-maker Valsa Kumari, 54, endured a pain in her toes. She went to several doctors but, despite many investigations and medicines, the pain persisted. The normally gregarious Valsa began to feel low. Soon, she began taking antidepressant and sleeping pills. 

It was in this situation that she came to Dr Rajesh Simon, Sr. Consultant – Orthopaedics (Foot and Ankle and Trauma) of VPS Lakeshore Hospital, Kochi. After a careful examination, a surgical repair was done to a small ligament at the base of her second toe. “Today, Valsa is back to her laughing self,” says Dr. Simon. “I don't blame the other doctors, but you need specialised knowledge to solve this problem.”

Dr. Simon is, probably, the only Foot and Ankle expert in Kochi. Recently, he was selected as the National Secretary of the Indian Foot and Ankle Society. “For a long time, foot and ankle had been a part of orthopaedics,” says Dr. Simon. “But a sub-speciality has developed in the West during the past 15 years. This is happening very slowly in India. As for me, I got special training from the University of Birmingham, USA, as well as in Munich, Germany.”

Asked about the commonest problems faced by people, Dr. Simon says, “Heel pain or plantar fasciitis. This happens more to women, because they wear heels. It leads to a bony projection in the heel called a spur, which is painful. When you wear footwear, with a narrow base, the toes, bones and ligaments are tightly pressed against each other. There is a likelihood of them being damaged. This results in bunions [a swelling on the first joint of the big toe].”

The other problems include Achilles tendinosis, flat feet and corns (thickening of skin near the toe).

As for ankle sprains, it usually happens to sportsmen, like basketball and football players, when their ligaments get torn. But the good news is that it can be healed through rehabilitation. “Only 20 per cent of the cases require surgery,” he says.

Meanwhile, two years ago, Dr Simon held a foot and ankle symposium at Kochi. Two foot and ankle doctors came from the US. So, on a free evening, they went to a mall. And, as they roamed around, they also looked at the feet of the people. One of them said, “My God, Rajesh, you have so many patients.” Says Dr. Simon: “Too many people have deformed feet.”

Dr. Simon says that, to avoid problems in the foot, it is important to wear the right footwear. “The footwear should have a broad toe-box,” he says. “The toes should be allowed to spread out. Sandals are relatively fine if you have a back strap. However, stiletto heels does damage in the long run.”

Chappals, for long walks, are a no-no. “You grip the chappal between the first and second toes, like a claw,” says Dr. Simon. “The problems start as you grow older, when you have muscular imbalance, arthritis, and diabetics.”

Diabetic patients have insensate feet. So, a chappal can slip off and the wearer will not know about it. You can then hit a small stone or a thorn, and will only realise it when a passer-by sees blood. “So, the best solution is to use jogging or covered shoes,” says Dr. Simon.

Meanwhile, treatment is divided into four methods: physical rehabilitation, footwear modifications, medicines, and surgery. “Many problems can be solved through simple stretching exercises,” he says. “For me, surgery is always the last option.” 

(The New Indian Express, Kochi and Thiruvananthapuram) 

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