Foot Conditions

Bunions

Bunions and pain at the big toe joint are common conditions seen at Ankle & Foot Associates. What causes bunions? Bunions are boney prominences on the inside of the foot behind the big toe. It may look like an enlargement of the bone, but it is the normal bone, only in an abnormal position. Pain is often associated with this deformity, making shoes very uncomfortable and at times even walking becomes difficult. If Over time, the big toe moves toward the other toes, which forces the bone behind it to move the other way. This produces the bump on the inside of your foot behind the big toe. Studies show that bunions affect men and women equally, but women are more likely to seek care for this condition. This is because the tighter, high-heeled shoes that women wear make bunions more likely to be painful.

What is a Neuroma?

A neuroma is a thickening of nerve tissue. In the foot, it most commonly occurs at the base of the third and fourth toes. This condition is called Morton’s neuroma or intermetatarsal neuroma. Neuromas may also occur in other locations in the foot and are caused by compression and irritation of the nerve, producing swelling and possible permanent nerve damage.

A major risk factor is wearing shoes with a tight toe box, or high-heeled shoes that force the foot into the toe box. Women who run, play racquet sports or participate in physical activities that exert repetitive stress on the forefoot are prone to develop neuromas. The combination of repetitive stress activities and wearing tight fitting shoes increases the risk for women.

Neuromas enlarge as the condition progresses, causing tingling, burning pain and numbness of the toes. Patients often complain it feels as if something is stuck inside the ball of the foot. The symptoms may go away temporarily by massaging the foot, wearing wider shoes with low heels, and avoiding activities that exert stress on the forefoot. Symptoms become more intense as the nerve enlarges and the temporary damage becomes permanent. Therefore, it’s best to seek treatment if discomfort persists for more than a few days. A neuroma isn’t detectable by x-ray, so the diagnosis is based on symptoms and a physical examination during which a physician attempts to reproduce the symptoms by manipulating the foot.

Plantar Fasciitis

Plantar fasciitis is the most common cause of heel pain that podiatrists see in their offices.  Plantar fasciitis is literally inflammation of the ligament on the bottom of the foot that runs from the heel across the arch and attaches into the ball of the foot. Symptoms include Pain when first getting out of bed in the morning that may improve after taking several steps only to recur with or after being on your feet all day. A pain on the bottom of the heel or even a burning or tearing type of sensation in the arch area when standing, walking or running.

The most common cause of planter fasciitis is an instability in your feet or instability in the way the foot functions.  If the arch flattens a little too much upon walking, the planter fascia or ligament on the bottom of your foot stretches excessively like a rubber band with every step that you take.  So, all day long the ligament is constantly being stretched excessively and it becomes irritated and painful.  When you sit down or you go to bed at night, inflammation builds up along the irritated ligament and most commonly right where the ligament attaches to the heel bone.

So, when you first step down in the morning, all that inflammation is right there at the heel and is very painful.  After some stretching or after walking a few steps, you pump some of the inflammation away from the foot and heel and the pain eases up somewhat, but the more you’re on your feet the worse the pain gets.

If you, or someone you know, struggle with Plantar Fasciitis, please contact our office.  We would be happy to assist you at Ankle & Foot Associates.

Achilles Tendinitis

Achilles tendinitis is inflammation of the Achilles tendon or thick ligament that inserts into the back of the heel. Symptoms include: Pain and sometimes swelling in the back of the heel or along the Achilles tendon between the heel bone and the calf muscle, and occasionally along the tendon between the heel bone and the calf muscle. If the tendon has been chronically inflamed, an area of enlargement of the tendon is often noted.

Tendinitis can result from an injury or over-use. Improper stretching prior to exertion or incorrect form during physical activity can also contribute to the development of tendinitis. Some people, including those with “flat feet,” tight tendons or arthritis, are particularly prone to tendinitis.

If the pain doesn’t go away with ice and rest, or if the pain persists beyond a week, it’s time to see a podiatrist.  We would be happy to assist you at Ankle & Foot Associates.

Pediatric Foot Care

Contrary to popular belief with kid’s feet, children don’t outgrow their foot problems. To keep kid’s feet healthy, prevention and early treatment of foot problems in children and adolescents is extremely important. Regular foot examinations for kid’s feet throughout the growing years are important in identifying problems before they become painful or lead to other more complicated foot conditions down the road.

Many abnormal foot conditions in children are not painful, so you may not hear them complain. But even a non-painful condition can lead to problems when they grow into adults, such as bunions, hammertoes, and heel and arch pain later in life. That is why regular foot examines are critical for children.

If you are concerned about your child’s feet, please call our office to set up an appointment.

Stress fracture

A stress fracture, often called a hairline fracture is a crack in a bone, usually a metatarsal, but could be another bone like your heel bone, that is not caused by one single traumatic event, but is a result of imparting excessive and or repetitive stresses through the bone.  They can happen when someone increases their exercises or runs faster than the body can adapt to these forces.  The bone fatigues and cracks resulting in pain.  Pain from a stress fracture is present with every step that is taken and can be considerably painful.

Symptoms include:
• Pain usually with every step

Tarsal Tunnel Syndrome

We’ve all heard of Carpel Tunnel Syndrome; a condition brought on by typing at your desk all day, causing pain, tingling and numbness in your fingers.  It’s close cousin, Tarsal Tunnel Syndrome, is the foot and ankle version of Carpel Tunnel.
Tarsal Tunnel Syndrome can cause tingling, burning, shooting sensations, numbness and pain from the inside of your ankle to the bottom of your feet, even extending into your toes.  The Tarsal Tunnel is the narrow space behind your ankle bone, where the major nerve to the bottom of your foot courses, along with tendons, arteries and veins.

If there is any type of compression on the nerve as it courses through the tunnel, it can lead to symptoms of Tarsal Tunnel Syndrome. If you have symptoms that sound like Tarsal Tunnel Syndrome, please contact our office.  We would be happy to assist you at Ankle & Foot Associates.

Toenail Conditions

What is causing your toenail to turn dark? Ankle & Foot Associates offers the latest in toenail fungus treatment for our patients.  Our doctors treat patients with the condition known as Onychomycosis or fungal toenails.  Onychomycosis is a fungal infection that lives on the bed of the toenail and between the layers of the nail. This infection can be difficult to get rid of. Up to 13% of people in the U.S. suffer from toenail fungus.

Tolcylen™ Antifungal Solution is the first and only antifungal, cosmetic, and nail renewal treatment, all in one product. It is available exclusively through a Podiatric physicians office. It is the only antifungal product of any kind to feature FDA approved antifungal and proven cosmetic agents.

Ingrown toenails, are a very common and often very painful condition seen in kids and adults alike.  The borders of the big toenails are most commonly affected and can be curved downward excessively. While poor trimming habits seem to get the blame for most ingrown nails, the most common culprit is heredity.  Usually, the nail border is excessively curved all the way back to the base of the nail, under the cuticle.  That means that the growth center for the nail, or nail matrix, is also excessively curved downward.  As the nail then grows out, it cuts into the skin like a knife, which can certainly be painful and lead to infection.

Ingrown or deformed toenail tissue may be severe enough to warrant surgical treatment. Removal of part or all the nail may be necessary, depending on the deformity. Sometimes soft tissue near or at the nail plate must be removed to adequately treat specific conditions of the toenail. Your podiatric physician will decide the surgical procedure best suited to treat your nail condition.

If you have a painful ingrown toenail, you don’t have to live with it! Make an appointment today so that you can take care of it once and for all!

Diabetic Foot Care

Diabetes is a serious disorder that can lead to blindness, amputation, kidney failure, stroke, and heart attacks. Marked by the inability to manufacture or properly use insulin, diabetes impairs your body’s ability to convert sugar, starches and other food into energy. The long-term effect is damage to the eyes, heart, kidneys, feet, nerves, and blood vessels. Proper foot care for people with diabetes is essential. It is very important that people with diabetes focus on proper foot care. A small problem in a healthy person could become a severe one to a person with diabetes. We can supply diabetic shoes which are covered by most insurance companies. Unlike other types of footwear, diabetic shoes are made specifically for the diabetic foot that ave decreased feeling.

Diabetes can affect your feet in a number of ways. Common foot problems associated with diabetes include:

• Infection
  Infection is one of the most common complications of the diabetic foot.  Because diabetes can reduce the immune response, a diabetic patient’s ability to fight infection is decreased.  Early treatment of infection is a critical component to success.  If neglected, infection of the foot can lead to ulceration, bone infection, and ultimately amputation.
• Neuropathy
  Neuropathy is numbness in the feet.  Elevated blood sugar levels can reduce the nerve’s ability to readily send pain signals that would normally let you know when there’s a problem, such as an area of an irritation or a wound.  This may cause a patient to underestimate or worse, not identify a foot problem.  When you lose the feeling in your feet, they are more prone to developing wounds or ulcers from areas of irritation that go unchecked.  Neuropathy may also be responsible for an absence of perspiration leading to dry, cracking skin that can more easily become infected.
• Foot Ulcers
  A break in the skin without proper treatment may become an ulcer. Foot ulcers are local skin defects with inflammation or infection.  Open sores may easily become infected as higher sugar levels reduce your body’s ability to fight infection.
• Charcot Joint Disease
  With Charcot Joint Disease, the joints in your foot break down, fracture and even disintegrate, and yet a person continues to walk on it because it may not hurt.  This is one of the most serious foot problems that people with diabetes can face.  However, most diabetic foot early phases of Charcot fractures can be treated simply with non-surgical measures.
• Poor Circulation
  Poor circulation is a decrease in blood supply to the feet and legs.  Symptoms of poor circulation may include pain, numbness, discolored skin, excessive dryness and breakdown of the skin leading to ulceration.  Treatment for poor circulation requires adequate daily exercise to help improve circulation, medications to improve blood flow and sometimes surgery is necessary to increase blood flow to the lower extremities. In our office we can perform testing for circulation with a short non invasive procedure.
• Calluses are a thickening of skin on the bottom of the feet that occur due to increased pressure beneath a boney prominence.  Calluses may not be painful, especially in the presence of neuropathy.  If calluses are not controlled and excessive pressures continue then calluses can break down into ulcerations or open wounds that can lead to infections.

Orthotics

Having heel pain? Foot orthotics to Relieve Heel Pain and Provide Overall Foot Support. Custom-made foot supports that are worn under your heel and the arch of your foot are referred to as custom-molded orthotics. These devices are molded to be anatomically matched to your foot and they do more than just provide support. Custom-molded orthotics are designed to realign your foot to a neutral or natural position to alleviate pain in your feet, legs and back, as well as to restore balance, improve sports performance, and relieve foot fatigue.These are ideal for runners, workers, and others who spend a great amount of time on their feet.

We identify your need for custom foot Orthotics through in-depth foot assessments, including x-rays and range of motion tests, and scanners. With this, we apply a device that highlights your specific pressure point areas to assist us in creating a custom mold of your foot to produce perfectly fitting orthotics.