Welcome to the Website of

Dr. Michael Zapf, DPM, MPH, FACFAS

 Thank you for visiting my website. I have been placing information and articles on this site for many years and have received millions of  hits during that time (and not that many of them were mine). I have designed it for people who like to read about their foot and ankle problems. Since I started the web site, I have added two associates to my practice, Dr. Darren Payne and Dr. Stephen Benson.  Since my site is filled with just my thoughts and opinions they are not, necessarily, shared by my colleagues. To see our less controversial (and less windy) practice web site, I offer you: www.ConejoFeet.com, the practice site for The Agoura Los Robles Podiatry Centers (ALRPC). The ALRPC practice site has a lot of material about our office, many of our policies and the registration forms to be filled out before your visit. I suggest all prospective patients visit www.ConejoFeet.com.

 I made the web site to give my patients the extra depth information that I don’t always have time to cover in the office visit. Visitors who are not my patients are welcome to browse the information found here. My younger colleagues are both under 50 and they, like many their age, do not favor in depth reading. They prefer their information presented to them in a few short, crisp bullet points. I, being of the, ahem, older generation, like to read about my ailments in greater depth. Here, I present the greater depth. If you ask a question about heel pain or bunions that I have not answered in my two monographs, I will quickly add it so that it is as complete as I can make it. If you agree with this philosophy, welcome to my page. If you correspond with me please let me know if you like the in depth reporting.

 Remember, this site is in no way intended to tell you how your own ailment or problem should be treated, only the approach I use when confronted with certain situations. Your problem may well be different from what you think it is and should always be evaluated by the appropriate professional, whether podiatrist, orthopedist or other authority. Please understand that I, nor anyone else, can offer you a proper diagnosis or treatment plan without seeing and feeling the problem at hand (foot?).  Happy reading.

 Sincerely, Michael Zapf, DPM, MPH, FACFAS, FACFAOM

 P.S. All the information in this web site is © by me and it is mine alone. No picture or any of the articles cannot be used by anyone without permission from me, personally.

01/08/2012

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July 22, 2007

Dear Dr. Zapf

I was reading your website.  It is very informative.  I have a question.  I am a 54 yr. old woman with severely pronated, flexible feet.  In the last year or two I have been experiencing more and more pain in my ankle and also in my Achilles tendon.  I have worn custom casted orthotics since I was 30 and have been in nothing but orthopedic shoes for the last 15 years. 

Now I have been fitted with AFO's but haven't worn them much as I haven't been able to find shoes to accommodate them.  My feet are 10AA without the braces, so I am trying to find men's shoes in order to wear them.

Recently I met with a couple of podiatrists who recommend fusing the bones in the back of my foot and doing something to release the AT.  I have had many surgeries:  bunionectomies, neuromas, hammer toes.  Some of these were successful, a few not as successful.  I fear I will end up in a wheelchair as my feet seem to get worse as the years go by.  I have almost no fat pad and my feet are very tender.  I also have a 5th ray amputation on the right foot.

I am skeptical about this surgery as it is so radical, but I don't want to pass up something that might really help me.  You mention this surgery on the website.

Any information or advice would be very much appreciated.

Pam, Oklahoma City

 P. S. My feet have been flat and pronated since birth but never really gave me any pain until age 30.

 Dear Pam,

Obviously these are tough questions. Sometimes the feet are so flat that you will develop excruciating arthritis of the bones of the feet and even develop calluses and ulcers on the bottom of the foot where the arch has collapsed. Your choices, as you know, are wearing in-shoe orthotics which help just a little, an ankle-foot-orthoses which helps more but must be worn in a tennis shoe or equivalent or surgery. The surgery is extensive and cumbersome but, ultimately, successful in most cases.

You will likely be in a non-weight bearing cast for two months and in a removable walking cast for one month more and this will be followed up by a month or two of physical therapy. You will be giving up almost half a year to the surgery – and this is just for one foot. The upside is that your foot will more resemble a regular foot and you can walk without the requirement for a brace, although it still might be helpful.

Because you are only 54 you are the best candidate for this surgery, assuming you are otherwise healthy. You have many years of walking ahead of you. I know you are concerned that things may go wrong with the surgery. But you know that the way your feet are not will never improve on their own thus you will probably not be worse off. I never advocate a surgery that is not truly needed, but yours seems quite needed.

Finally, there are many subtlety different ways to do this surgery so don’t be too concerned if two doctors give you somewhat different approaches to the surgery. Make sure you are comfortable with the surgeon. Also, make sure the surgeons you choose for this procedure are Board Certified in Foot and Ankle Surgery. If they are podiatrists, and many if not most doctors who are qualified to do this surgery are probably podiatrists, ask them if they are “boarded in rearfoot” to assure the highest quality.     

 Dr. Michael Zapf

Send mail to (zfootdoc at doctor dot com) with questions or comments about this web site.
Copyright © 2000 Michael A. Zapf, D.P.M., F.A.C.F.A.S., F.A.C.F.AOA.M.
Last modified: January 08, 2012