For those searching/google'ing in based on cycling foot-related issues (tarsal coalitions, forefoot varus, Cotton osteotomy, orthotics, etc.), some information here might prove helpful. I've become quite familiar with foot problems so feel free to email me (via the Email Webmaster link above).
I'm looking to upgrade to either a Ultegra or Dura-Ace double setup. I have a line on the crankset/chainrings and cassette. So, I still need the shifters/cables, front (31.8 mm-1 1/4" clamp-on) and rear derailleurs, and bottom bracket. 847-381-5817 or email me via the webmaster link at the top of this page.
Monsters of Midway Crit cancelled - rescheduled for June.
Rode for the first time on over a year with no pain. Right hamstring pain: gone. Right soleus pain: gone. Ankle tendons feel perfect. I finally felt like I was a part of the landscape while riding this past Wednesday rather than simply being on a bike rolling over a road. We must take more time to enjoy the scenery rather than focusing solely on the effort to ride. There were times last year out past Bull Valley and Woodstock that were very scenic but I was too focused on the road ahead to notice.
Strength on the bike, however, is another matter entirely. The atrophy "looks" gone, but I feel somewhat feeble. But, that's the least of my worries. Time will fix this, too.
I'm up to a 42/17 gear in the rehab. I still have some ankle muscle/tendons that are still a little tender from the atrophy that occurred. Aerobically, I think I'm in far better shape now than at the same point last year.
How's everyone's base training going? I'm playing catchup in the basement on my new CycleOps Fluid2 trainer (should have bought one of these 2 years ago when I started cycling). At least this year will be the first year that I can work on both aerobic conditioning and leg strength. My good doctor hasn't had to sustain a beating from me as the foot pain does get better each week. Hopefully by June it will be 100% gone. Speaking of June, anyone watch her on Leave it To Beaver on TVland?
Rode a bike with both cycling shoes on for the first time since November 9, 2003. Right foot is almost back to normal other than a really tight heel cord that will limber up with a more normal walking stride. Anyone wanting to do any weekday riding between 9 AM and 5 PM let me know. However, it will have to be your zone 1 ride as I'm not allowed out of a 42/25-23 for now.
Atrophy SUCKS!!!!!!!!!!!! I got lab tested at VisionQuest Coaching (Robbie Ventura) and found out an amazing statistic about my cycling. It has provided tremendous motivation. Can you guess what it was? with your guess.
Pics of my left foot surgery from 11/11/2003 (and you thought your offseason was going to be difficult). I even get two titanium screws in each foot (permanent). Right foot was done on 12/30/2003. Riding to commence late February (hopefully). Here is a link to Dr. Thomas Roukis' website. He's the incredibly talented podiatrist/DPM who has solved my foot problem. I had gone to one orthopedic surgeon and two podiatrists who had no clue how to solve my problem. They didn't even hit the barn. Conversely, Dr. Roukis had the problem identified within 5 minutes of my first office appointment with him.
| Before - note forefoot inverted - up off ground | After - note big toe brought down towards ground (and an arch created) |
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End of year party
When: Sunday, November 2nd, 2-6 PM
Where: Stuart Ellington's House - 230 S. Elmwood Ave., Palatine, IL
RSVP: 847-202-1297
Food/soda/beer will be provided. However, you are encouraged to bring a dish or dessert to share your culinary talents with other Flyers.
There will be entertainment too! If you have a jersey design that you would like to share, please bring it to the party. We will share ideas for a new jersey and hopefully pick a winning design. Also, there will be an award ceremony where we will distribute Flyer awards to members who have demonstrated exemplary bike skills.
I have decided that it's 90% likely that I will have surgery on both feet over winter. I'm sick and tired of all the pain involved in cycling (2 ankle/foot tendons in each foot). If anyone wants to help wean me back to some type of conditioning after surgery (I'll certainly have physical therapy) via indoor trainer setup please with suggestions. It will be one foot at a time involving a softcast for 3 weeks and then 3 careful weeks before any type of PT.
I was lucky enough to find on the internet, an orthopedic seminar in which my particular surgical procedure is to be discussed in-depth (later this year). It also turns out, that one of the 11 patients from said medical paper has a very similar flatfoot deformity. Basically, the surgery takes bone from somewhere else (no snickers, please) and creates a keystone/arch in the bone between the archbone and big toe (cuneiform). Below you can see the one patient who had a tarsal coalition. In my case, my heel and archbones never unfused during childhood. Luckily though, my coalition is fibrous/cartiligenous rather than bony/osseus. That means the coalition itself can remain untouched because I have the minimum heel eversion and inversion needed. Thus, I'll be able to dorsiflex my big toe twice as much as I can now and all my foot biomechanics will be "normal". I'm waiting to see if the good Dr. Johnson will put me in touch with the tarsal coalition patient to see what they say about how they feel aftersurgery. The bad news is the $600 I wasted on custom cycling orthotics and custom regular-shoe orthotics. Oh, and I've got only catastrophic insurance (self-employed) so I get to pay for all of this by myself.
The surgery/paper is entitled:
The Use of a Plantarflexion Opening Wedge Medial Cuneiform Osteotomy for Correction of Fixed Forefoot Varus Associated with Flatfoot Deformity
Christopher B. Hirose, M.D.; Jeffrey E. Johnson, M.D. (St. Louis, MO)
Hypotheses/Purpose: Flatfoot presents as a wide spectrum of foot deformities exhibited by varying degrees of hindfoot valgus, forefoot abduction, and forefoot varus. Numerous combinations of soft tissue and osseous procedures have been described to correct the different types of flatfoot deformities and to address the varying amounts of rigidity in the hindfoot joints. Medial displacement calcaneal osteotomy and lateral column lengthening will both provide correction of heel valgus, but may not adequately correct fixed forefoot varus. Additional procedures may be required to correct residual forefoot varus and to restore the balanced "tripod" of a plantigrade foot. Arthrodesis for stabilization of the first tarsometatarsal joint has been used as an adjunct to the reconstruction of a flatfoot deformity but may not provide adequate correction and, in addition, the apex of the dorsiflexion "sag" is often located more proximal than the first tarsometatarsal joint. The purpose of this study is to reacquaint surgeons with a novel adjunct to the operative treatment of flatfoot deformity using an opening wedge, plantar flexion medial cuneiform osteotomy which was first described by Cotton in 1925. A search of the literature discovered that no peer reviewed report of this procedure has been published since Cotton' s original description.
Conclusions/Significance: Opening wedge medial cuneiform osteotomy is an important adjunctive procedure to correct the forefoot varus component of a flatfoot deformity. Advantages of this technique in comparison to first tarsometatarsal arthrodesis include more predictable union, preservation of first ray mobility and potential to correct greater degrees of deformity. We have had excellent results without significant complications using this technique.
Summary of Methods/Results: Eleven (11) patients had an opening wedge plantarflexion
medial cuneiform osteotomy to correct forefoot varus associated with flatfoot
deformities from several etiologies including chronic posterior tibial tendon
insufficiency (n=4, average age 35), overcorrected clubfoot deformity (n=2, average
age 19), skewfoot deformity (n=1 average age 17), tarsal coalition (n=1 average
age 18), congenital flatfoot n=2 average age 39, and rheumatoid arthritis (n=1,
average age 59). All patients have had an average of 15.5 months followup. All
patients at followup described mild to no pain with ambulation. There were no
nonunions or malunions. Screw removal has not been required in any of the cases.
Radiographic measurements and clinical results will be described.