Posts

Dr. Ng Success Story

Success Story: How endurance athlete Ryan Law got back on the race course after surgery with Dr. Ng

Ryan Law loves to run. So much, that in the past seven years, he’s run 11 marathons and seven ultra-marathons/endurance events (3X50 milers, 4X55k+, and Half Ironman – this guy knows how to #BeActive – we are talking serious distance here people!). But for years, he had been fighting through a chronic injury that was painful and performance-depleting.

After extensive online research to better understand the risks and potential upside of having surgery, in October, 2017 Ryan chose Dr. Alan Ng to perform surgery on his inflamed peroneal tendon. Due to an osteochondroma – a growth that forms on the surface of a bone near the growth plate – the tendon was inflamed and causing chronic pain.

Dr. Ng removed the osteochondroma and some damaged tendon tissue, carved out the channel along the ankle bone, and reattached the peroneal tendon. Shortly after surgery, Ryan began the road to recovery, working toward running and then up to more mileage over time.

“I started running again in March – about five months post-surgery – and I was able to return to my previously established 35 to 50 mile-a-week average by late May,” Ryan recalls. “My performance was not hindered by the surgery and if anything, it improved.”

Just this summer, in July, Ryan competed in the Copper Mountain Under Armor Mountain Running Series, less than a year after his surgery. And he’s still improving. This coming October will be a full year since the surgery and all signs point toward significant overall improvement. Ryan has every reason to be optimistic: “I suspect full recovery has not happened yet,” he said. “As I have yet to hit a full year and all my symptoms have improved since the surgery which is very reassuring.”

Dr. Alan Ng specializes in foot and ankle reconstructive surgery and trauma, and loves to help his patients getting back to the activities they love. And when he’s not helping patients he loves being active too – playing golf, skiing and mastering the martial arts of karate and Muay Thai kickboxing. Learn more https://advancedortho.org/alan-ng-dpm/

Bunion Foot Pain

Painful bump on the side of your big toe? Why you shouldn’t ignore a bunion.

That painful bony bump on the side of your big toe? It’s probably a bunion. Nearly a quarter of people age 18-65 have bunions, making them one of the most common foot issues among adults. They also run in families and are more prevalent among women (thanks, cute heels), and among those over 65. In fact, more than a third of people over age 65 (36 percent) have bunions.

Whether it runs in your family or you’ve been choosing fashion over function, there are five key things you should know to deal with your bunion and move past the pain.

What causes bunion pain?

We know what predisposes people to getting bunions, but what’s happening with our feet to cause so much pain?  It starts when your big toe begins to turn in toward your second toe. As that happens, the joint at base of the big toe bone pushes out to the side, where it meets your footbone (called the first metatarsal) and that pressure causes pain. This area carries a great deal of weight when you are standing or walking, and that pressure causes pain. The area may become red and callused over time. The pain can become so severe that it’s difficult to wear shoes.

Bunions range from mild to severe and should be treated differently

Depending on how prominent and painful your bunion is, your orthopedic or podiatric surgeonmay recommend a variety of treatments that can slow the progression of your bunion, or minimize the pain, but surgery is the only way to truly correct the situation. Beware of ‘treatments’ claiming non-surgical bunion removal.

Popular methods to manage bunion pain and slow progression are wearing supportive well-fitting shoes that align your foot properly for walking, using orthotics or a gel pad to cushion the area when wearing shoes and wearing a splint at night.

There are a variety of available orthotics (or orthoses) including over-the-counter or off-the-shelf commercial products and, as necessary, custom-molded orthotics that are generally prescribed medical devices.

Bunion surgery may be needed

Moderate or severe bunions and can involve cutting the joint at the big toe and then aligning it properly. In more severe cases, the entire joint may be replaced with metal plates and screws.  See a video animation of how surgery corrects the bunion. 

Don’t ignore bunion pain

If you let a bunion become too severe, you are likely to run out of non-surgical options for pain relief and may even need to consider a more involved surgical procedure such as replacing a joint in your toe or fusing bones together. This equates to a longer and more complex recovery time, not to mention prolonging your pain unnecessarily by not seeing a doctor and making a treatment plan. If you’ve had pain for a year or more, it’s definitely time to see a doctor to review your options.

Recovery takes time
The most common kind of bunion surgery is on an out-patient basis and takes around two months to recover. Your doctor will work with you to create a recovery plan which may include a special boot, rest, stretching and/or physical therapy. Active adults who want to return to load bearing exercise like running and jumping may need longer to get back in the action – but that’s time well spent if they can return to their activities bunion and pain free.

Learn more about your bunion treatment options with one of our podiatric surgeons:

Best Foot and Ankle Surgeons

Keith Jacobson, DPM

Dr. Keith Jacobson


Alan Ng, DPM

Dr. Alan Ng


Scott Resig, MD

Dr. Scott Resig


Bunion treatment

Spring Has Sprung! Are your feet sandal-ready? Why you shouldn’t put off bunion treatment.

Denver – bunion treatment can be the difference between walking with a spring in your step or nagging bunion pain that has you walking on egg shells. Bunion pain affects approximately one-third of the population and disproportionately impacts those who’s occupation requires long periods of standing or walking.

What is a bunion?

Bunions – bony bumps that form at the base of the big toe and produce a wider than usual foot profile  – are the result of excess bone growth or bone misalignment that causes the big toe to press against the second toe, causing rubbing of the bump in shoegear.

What causes bunions and bunion pain?

There’s a good reason why bunion pain can be so significant: because we wear shoes.

There are many factors that lead to bunions but they all share a common trait: they progressively worsen over time. Arthritis, trauma, or skeletal structure may produce a bunion but frequently bunions can be traced to your family tree. Bunions are more common in females (who are nearly 10 times more likely to develop bunions) because many female shoes place feet in tight, unnatural, and structurally unstable positions.

Bunion treatment:  How do I treat bunion pain?

Bunion treatment ranges from conservative options to surgery. The most common conservative bunion treatment involves modifying footwear, reducing swelling and managing pain. Changing footwear to provide your expanded foot more room or incorporating foot pads and inserts to better distribute the stress and pressure can help more moderate bunion pain. Applying ice after long periods of on your feet also helps reduce swelling; and pain medications and anti-inflammatories ranging from over the counter options like ibuprofen, to cortisone injections focus on delivering much-needed pain relief.

How do I know if I need bunion surgery?

Bunions are easy see at the base of the big toe, or on the side of your foot. The condition is progressive – meaning that they typically get worse, not better over time and these changes may be visibly apparent. If your bunion pain is impacting your daily life, it’s time to get an expert diagnosis. To provide a comprehensive evaluation, your orthopedic/podiatric surgeon will do a physical exam, and also take x-rays to see the severity of your bunion and any change over time.

Depending on the progression of your bunion, your surgeon will work with you to determine the best treatment plan, which may include bunion surgery.

If surgery is the best resolution for your bunion pain, your doctor will outline what the procedure entails, which could involve removing bone, or may require bone realignment or permanent bone fusion.



How long does bunion surgery recovery take?

Recovery, like surgical treatment options, varies by patient. While some patients can walk immediately after surgery, most have a weeks or months-long recovery that is determined by patient condition, age, fitness and how involved of a surgical treatment was required to provide relief. But with a full recovery, bunion patients typically experience total relief from their bunion pain and full return to activity.

If you invest in bunion surgery, be sure to protect your feet during and after recovery and know that supportive footwear is a must.

Spring is time to put the boots away, show off a new pedicure, and forget about bunion pain. The Advanced Orthopedics team can help you to put your best foot forward. Enjoy the weather, but take care of your feet. Schedule an appointment today with podiatrist and Denver foot and ankle surgery expert Dr. Keith Jacobson to put the spring back in your step!

podiatrist foot ankle pain

Foot or ankle pain? How to pick a qualified podiatrist.

Foot or ankle pain? How to pick a qualified podiatrist.

Did you know there are 28 bones in your foot and ankle? That’s a full quarter of all your bones in your feet! Not to mention there are dozens of joints and more than 100 muscles, ligaments and tendons. All of this is to say that when you have pain, you need a foot and ankle specialist, known as a podiatrist.

Podiatrists are physicians, but instead of seeing the initials “MD” after your doctor’s name, you will see the initials DPM. This stands for Doctor of Podiatric Medicine – an important area of specialty focused on feet and ankles.  What’s the difference between an MD and a DPM?

A medical doctor might be trained to diagnose or treat an array of medical problems, podiatrists are specifically trained in comprehensive medical and surgical treatment of the foot and ankle.

It goes without saying that keeping your feet and ankles healthy and pain free is essential for everyday activities, and as complex as those joints are, it’s essential to find a podiatrist that really knows their stuff.  Here are three things you should look for before you make an appointment with a podiatrist.

  1. Select a Doctor of Podiatric Medicine (DPM). Why?

Because only DPMs invest years of training to understand the complexities of the foot and ankle. This includes soft tissue, bones and how the foot and ankle function, along with how podiatric health relates to the rest of the body.

A DPM must complete specific medical school training as well as clinical rotations and a residency in both medicine and surgery – all focused on podiatry. To put this in context, other orthopedic doctors spend a few weeks focusing on the foot and ankle as part of their overall training.

Once DPMs go into practice, they also must complete ongoing continuing education to maintain board certification and stay informed on evolving treatment protocols and technical advances.

Why does all this matter? Because your podiatrist is uniquely qualified to evaluate, diagnose and treat your foot and ankle problems in the most comprehensive and effective way possible. This means you can be confident that you have all the options available to you when it comes to feeling better.

  1. Make sure they have extensive hands-on experience with all types of treatment. This is important for treatment of all surgical and non-surgical problems of the foot and ankle. Clinical experience is essential, and an experienced podiatrist will have diagnosed and treated many ailments of both the fore foot and rear foot. They know when to recommend a conservative treatment and how to help you navigate a more complex solution such as surgery. And hands-on clinicians will also tend to have better patient rapport, which makes for a better whole experience for you.
  1. Look for leaders in the specialty.

Podiatrists who are actively involved in their professional community often train other podiatrists, sit on the board for certifications, and even give the oral exams that are required of practicing DPMs. This means they are at the top of their profession and other doctors look to them for expertise and best practices.  If your podiatrist is a Fellow of the American College of Foot and Ankle Surgeons, you will see FACFAS next to their name. These highly-trained fellows have continued their foot and ankle surgical education beyond their residency to advance their expertise.

Advanced Orthopedic & Sports Medicine Specialists is proud to have two doctors of podiatric medicine who are at the top of the foot and ankle specialty. They treat Achilles tendon injuries, broken ankles, plantar fasciitis, bunions, total ankle reconstruction, and many other foot and ankle problems.

Dr. Alan Ng Dr. Ng DPM, FACFAS specializes in foot and ankle reconstructive surgery and trauma. He is heavily involved in the world of podiatric medicine, serving as a past president for the American Board of Foot and Ankle Surgery, and has been chair of the Oral Foot examination for Board Certification in foot surgery since 2009. Make an appointment today.

Dr. Keith Jacobson, DPM, FACFAS is a regional expert in foot surgery and reconstructive rear foot and ankle surgery, he specializes in foot and ankle trauma and reconstruction in both adults and pediatrics. Additionally, Dr. Jacobson is a current member of the Board of Directors for the American Board of Foot and Ankle Surgery and a Chair for the American Board of Foot and Ankle Surgery Computer-based Patient Simulation Committee. Make an appointment today.

Testimonials

Ryan L.

Dr. Ng, just wanted to give you a update on my ankle since surgery in October (25th). Last Saturday (15th), I ran a 50k in Copper Mountain. I was able to run in 6 hours and 26 mins placing 31 out of 82. Other than being slightly slower than I was previously, I feel that I’m back! Just wanted to share the success story.