Page 16 - 2020 Winter CMTA Report

FOOT SURGERY
(continued from page 14)

Correction of the heel defor-
mity can be formidable. The classic
way to correct the abnormal posi-
tion is by cutting through the heel
with a power saw (I know it
sounds horrible but that is what
foot and ankle orthopedics is all
about) and shifting the weight-
bearing part of the heel laterally
(away from the other foot). The
goal is to create a more balanced
stance. With more severe in-turn-
ing we also take a wedge of bone
out of the heel (shaped like a pie
slice). This is called a Dwyer
osteotomy and allows a further
shift of the heel into a valgus posi-
NEW VIDEO SERIES SPOTLIGHTS tion. The cut bone is held with
two screws inside the bone that
EXERCISES FOR CMTERS can’t be felt and rarely have to be
removed.
fter attending the CMTA Physical Therapy Workshop in late The problem is that the
A 2017, CMTA Board Member Steve O’Donnell realized the classic correction is often not
tremendous need for a series of CMT physical therapy-centered enough. Several years ago, the
exercise videos. An avid and committed workout enthusiast, Steve CMTA gave me a research grant
has seen first-hand the crucial role that fitness plays in slowing the to address this difficult problem.
progression of CMT symptoms. We won a national award from
Steve partnered with renowned physical therapist/neurologic the American Academy of Ortho-
clinical specialist Mike Studer to create a comprehensive fitness pedic Surgeons for research “most
program for all levels and abilities, focusing on flexibility, balance, likely to change orthopedic care
strength, endurance and function.
The videos are full of tips and information and can be done at in the future.” Using 3D model-
different levels as one progresses. The balance video, for example, ing from a CMT patient, we
demonstrates how the brain can be retrained so that sensory cues showed that a bone cut, with a
can be picked up from some source other than the feet, which don’t Dwyer osteotomy and a complex
give CMT patients good information. rotation of the heel achieved the
According to Steve, the most important thing is to start and keep best correction of significant
going. “If you’re tired, rest, but don’t stop because if you continue to varus. With this technique, a
work at this, your life will change.” The program “will enable you to fusion is rarely required. It is
do more than you think you can do,” he added. important to ask your surgeon
about what approach he or she
uses to correct heel varus.
In the next installment of
this series, I’ll discuss muscle
imbalance and tendon transfers.
In the meantime, you can
follow me on Instagram at
@Charcotmarietoothsurgery. h
The videos focus on increasing flexibility, Dr. Pfeffer is an orthopedic foot and ankle
balance, strength, endurance and function. surgeon and co-director of the CMTA’s Cen-
Watch the videos at www.cmtausa.org/pt-exercise. ter of Excellence at Cedars-Sinai Medical
Center, Los Angeles. He is also a member of
the CMTA’s Advisory Board.

16 THE CMTA REPORT WINTER 2020