Our ServicesAt The Foot Intitute, we offer a variety of services to relieve any pain or discomfort you might feel in your feet. To see a service, click the link below for more information.
Achilles tendonitis, also sometimes called Achilles tendinitis, is a painful and often debilitating inflammation of the Achilles tendon (heel cord). The Achilles tendon is the largest and strongest tendon in the body. It is located in the back of the lower leg, attaches to the heel bone (calcaneus), and connects the leg muscles to the foot.
The Achilles tendon gives us the ability to rise up on our toes, facilitating the act of walking. Achilles tendonitis often begins with mild pain that worsens with continued activity, and can make walking almost impossible.
Causes of achilles tendonitis may include:
- Activities that involve sudden stops and starts and repetitive jumping.
- Overuse resulting from the natural lack of flexibility in the calf muscles.
- Training on poor surfaces
- Wearing improper footwear
Other symptoms include:
- Difficulty walking
- Fullness in your leg.
- Mild or severe swelling.
Treatment normally involves:
- Non-steroidal anti-inflammatory medication.
- Orthoses, which are devices to help support the muscle and relieve stress on the tendon such as a heel pad or shoe insert.
- Rest and switching to another activity until condition improves
In severe cases, surgery is performed to remove the fibrous tissue and repair any tears.
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Ankle Sprains and are one of the most common injuries treated by podiatrists and orthopedists. Each year, approximately 2 million patients are treated for ankle sprains and strains.
Ankle injuries usually involve a sudden, unexpected, loss of balance that results in a sharp twist of the ankle. A strain occurs when a muscle or tendon overstretches. A sprain, which is more serious, occurs when strong connective tissue that connects one bone to another (ligaments) become overstretched. If not properly treated, ankle sprains could develop into long-term problems.
Treatment includes resting the ankle and applying ice to reduce swelling. Compressive bandages also may be used to immobilize and support the injury. More serious ankle sprains, particularly in competitive athletes, may require surgery to repair to tighten the ligaments.
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Arthritis affects more than more than 21% of American adults (over 46 million people) have arthritis. Nearly two-thirds of arthritis patients are under 65 years old and more than 60% of arthritis patients are women. Disease rates are similar for whites and African-Americans; these rates are higher than those for Hispanic people. It is estimated that by 2030, the number of people with arthritis is expected to rise to 67 million, reflecting a 40% increase.
Arthritis is an inflammation and swelling of the cartilage and lining of the joints, generally accompanied by an increase in the fluid in the joints. The feet have 26 bones and 33 joints that can be affected by arthritis. The pains of arthritic feet are only increased with the weight that you place on your feet with every step. Arthritic feet can result in loss of mobility and independence, but that may be avoided with early diagnosis and proper medical care.
- Early morning stiffness.
- Limitation in motion of joint.
- Recurring pain or tenderness in any joint.
- Redness or heat in a joint.
- Skin changes, including rashes and growths.
- Swelling in one or more joints.
Arthritis can be treated through the use of:
- Physical therapy and exercise.
- Orthoses or specially prescribed shoes
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Athlete's foot is a very common skin infection of the foot caused by fungus. When the feet stay moist, warm, and irritated, this fungus can thrive and infect the skin. Fungal infections can occur anywhere on the body, including the scalp, trunk, extremities (arms and legs), hands, feet, nails, groin, and other areas.
The fungus that causes athlete's foot can be found on many locations, including floors in gyms, locker rooms swimming pools, nail salons, and in socks and clothing. The fungus can also be spread directly from person to person or by contact with these objects. Up to 70% of the population may have athlete's foot at some time during their lives.
Symptoms of athlete's feet include drying skin, itching scaling, inflammation, and blisters. Athlete's foot may spread to the soles of the feet and to the toenails, and can spread to other parts of the body, including the groin and underarms.
To Prevent Athlete's Foot:
- Avoid walking barefoot. Use shower shoes.
- Reduce perspiration by using talcum powder.
- Wear light and airy shoes.
- Wear socks that keep your feet dry, and change them frequently if you perspire heavily.
A bunion is generally considered as an enlargement of the joint (a lump of bone) at the base and side of the big toe - (specifically, the first metatarsophalangeal joint). Bunions form when the toe moves out of place. As the big toe bends towards the others this lump becomes larger and the bunion can become painful - arthritis and stiffness can eventually develop. Hallux valgus or hallux abducto valgus (HAV) is the name used for the deviated position of the big toe and a bunion refers to the enlargement of the joint - most of the time the two go together and can just be referred to as 'bunions'.
Bunions cause the base of your big toe (Metatarsophalangeal Joint) to enlarge and protrude. The skin over it may be red and tender. Wearing any type of shoe may be painful. This joint flexes with every step you take. The bigger your bunion gets, the more it hurts to walk. Bursitis may set in. Your big toe may angle toward your second toe, or even move all the way under it. The skin on the bottom of your foot may become thicker and painful.
Pressure from your big toe may force your second toe out of alignment, sometimes overlapping your third toe. If your bunion gets too severe, it may be difficult to walk. Your pain may become chronic and you may develop arthritis.
Bunions are often treated with wider shoes, pads, splints, and orthoses. These all help to reduce the symptom of pain and slow down the progression of the bunion deformity but they don't "get rid" of the condition.
Calluses have painful nerves and bursal sacs (fluid-filled balloons that act as shock absorbers) beneath them, causing symptoms ranging from sharp, shooting pain to dull, aching soreness.
Calluses form from repeated friction and pressure, as the shoe (or ground) rubs against a bony prominence (bone spur) on the toe or foot. The skin thickens in response to this pressure. Small amounts of friction or pressure over long periods of time cause a corn or callus. A great deal of friction or pressure over shorter periods of time can cause blisters or open sores. Calluses typically develop under a metatarsal head (the long bone that forms the ball of the foot) that is carrying more than its fair share of the body weight, usually due to it being dropped down or due to its longer length.
Calluses can be treated with over-the-counter callus removers that have strong acids that peel this excess skin away after repeated application. You should be careful with these products as they can cause chemical burns when not used correctly. Begin by soaking your feet in warm soapy water and gently rubbing away any dead skin that loosens. A pumice stone or emery board is then used to "file" this thickened skin. Apply a good moisturizer to the hardened areas to keep them softer and relieve pain. Non-medicated corn pads or moleskin (a thin fuzzy sheet of fabric with an adhesive back) can relieve calluses, but should be removed carefully to avoid tearing the skin.
If you need assistance relieving calluses, contact our office. Calluses can be trimmed and comfortable padding applied to these painful areas. In addition to medication to relieve inflammation, cortisone may be injected into the underlying bursal sac to rapidly reduce pain and swelling.
A plantar callus forms when one metatarsal bone is longer or lower than the others, and it hits the ground first-and with more force than it is equipped to handle-at every step. As a result, the skin under this bone thickens like a rock in your shoe. Plantar calluses that are recurring are sometimes removed surgically in a procedure called an osteotomy, which relieves pressure on the bone.
A condition called Intractable Plantar Keratosis (IPK) is a deep callus directly under the ball of the foot. IPK is caused by a "dropped metatarsal," which happens when the metatarsal head drops to a lower level than the surrounding metatarsals and protrudes from the bottom of the foot. This results in more pressure being applied in this area and causes a thick callus to form.
A "dropped metatarsal" can either be a congenital abnormality, a result of a metatarsal fracture, or a structural change that may have occurred over time.
To Prevent Calluses
- Switch to better shoes, or even an orthotic device.
- Buy socks with double-thick toes and heels and nylon hose with a woven cotton sole on the bottom of the foot.
Chronic lateral ankle pain is recurring or chronic pain on the outside part of the ankle that often develops after repeated ankle sprains.
While ankle sprains are the most common cause of chronic lateral ankle pain, other causes may include:
- Ankle fractures
- Inflammation of the joint lining.
- Torn or inflamed ligaments or tendons
Signs and symptoms include:
- Ankle instability.
- Difficulty walking on uneven ground or in high heels.
- Pain, sometimes intense, on the outer side of the ankle.
Treatments for chronic lateral ankle pain involve:
- Over the counter or prescription anti-inflammatory medications.
- Physical therapy
- Ankle braces or other supports.
Corns are calluses that form on the toes because the bones push up against the shoe and put pressure on the skin. The surface layer of the skin thickens and builds up, irritating the tissues underneath. Hard corns are usually located on the top of the toe or on the side of the small toe. Soft corns resemble open sores and develop between the toes as they rub against each other.
Improperly fitting shoes are a leading cause of corns. Toe deformities, such as hammertoe or claw toe, also can lead to a corns. In a visit to our office, your corns can be shaved with a scalpel. Self care includes soaking your feet regularly and using a pumice stone or callus file to soften and reduce the size of the corn. Special over-the-counter non-medicated donut-shaped foam pads also can help relieve the pressure.
Diabetic Foot CareEvery week thousands of Americans have either a portion of their foot or an entire leg amputated due to complications of diabetes. One of the most common complications of diabetes is Peripheral Neuropathy. Peripheral Neuropathy is a loss of feeling in your feet. This sometimes starts as a burning and tingling sensation in the feet and legs often at night. Individuals often times complain that the bed sheets touching their feet are extremely painful. Loss of sensation can lead to foot ulcers when wearing poorly fitting shoes.
It is noted that only 1 out of 3 diabetics wear properly fitting shoes. The most important aspect of getting properly fitting shoes is having your feet measured correctly. Your feet should be measured both seated and standing because their shape changes depending on your position. Properly fitting, easy to wear shoes are a first line of defense in preventing foot deformity and amputation.
The Medicare Therapeutic Shoe Program pays for shoes for all diabetic patients that meet the following criteria:
- Have Medicare, a Managed Medicare Plan, or a Private Health Plan as primary insurance
- Be under the care of a doctor for your diabetes
- Have at least one of several common foot risks factors associated with diabetes
Your foot doctor uses great care to evaluate and measure your feet to properly fit you for shoes and shoe inserts to accommodate any foot deformity and prevent amputation. It is important to understand that caring for your feet is the responsibility of you, your family, and your foot doctor. At The Foot Institute; our goals are to educate to prevent tragedy and improve the quality of life of our community.
Flat feet are a common condition. In infants and toddlers, the longitudinal arch is not developed and flat feet are normal. Most feet are flexible and an arch appears when the person stands on his or her toes. The arch develops in childhood, and by adulthood most people have developed normal arches.
Most flat feet usually do not cause pain or other problems. Flat feet may be associated with pronation, a leaning inward of the ankle bones toward the center line. Shoes of children who pronate, when placed side by side, will lean toward each other (after they have been worn long enough for the foot position to remodel their shape).
Foot pain, ankle pain or lower leg pain, especially in children, may be a result of flat feet and should be evaluated.
Painful progressive flatfoot, otherwise known as Tibialis Posterior Tendonitis, is caused by inflammation of the tendon of the tibialis posterior. The tendon then becomes inflamed, stretched or suffers a partial or total tear. If left untreated, this condition may lead to severe disability and chronic pain. Some people are predisposed to this condition if they have flatfeet or an abnormal attachment of the tendon to the bones in the midfoot.
Nonsteroidal anti-inflammatory medications, ice, physical therapy, supportive taping and bracing, or orthotic devices are the common ways of treating painful progressive flatfoot. Contact your physician before taking any medication. In some cases, a surgical operation may need to be performed to repair the torn or damaged tendon and restore normal function. To prevent reinjury, orthotic devices may be recommended. In severe cases, surgery on the midfoot bones may be necessary to treat the associated flatfoot condition.
Fractures are broken bones. Bones may be broken partially, completely, or stressed. The most common cause of fractures is trauma for example, falling from a height. Other causes are weak bones (osteoporosis) and overuse injuries such as jogging.
- Popping, snapping, or cracking sound during activity
- Difficulty walking
Treatment usually involves rest, ice, compression, and elevation. We may use splints, casts, pins or other devices in order to keep the proper alignment of broken bones during the healing process. Healing often takes several weeks to months before you are able to return to your pre-injury activities.
Hammertoe is a deformity of the second, third or fourth toes. In this condition, the toe is bent at the middle joint, resembling a hammer. Left untreated, hammertoes can become inflexible and require surgery. People with hammertoe may have corns or calluses on the top of the middle joint of the toe or on the tip of the toe. They may also feel pain in their toes or feet and have difficulty finding comfortable shoes.
The most common cause of hammertoe is a muscle and tendon imbalance. This imbalance, which leads to a bending of the toe, results from mechanical (structural) changes in the foot that occur over time in some people. Improperly fitting shoes often times aggravate the condition.
Treatment for the condition typically involves proper shoes with roomy toe boxes, toe exercises to stretch and strengthen the muscles, and surgery in severe or longstanding cases.
Plantar fasciitis (or heel pain) is commonly caused by poor foot mechanics that led to an inflammation on the bottom of the foot. Often there is pain in the heel on taking the first several steps in the morning with the pain lessening as walking continues.
Plantar fasciitis is caused by inflammation of the soft tissue that stretches from the base of the toes, across the arch of the foot, to the heel bone. A heel spur may or may not be present and is rarely the source of the pain. Also called "heel spur syndrome," the condition can usually be successfully treated with conservative measures such as use of anti-inflammatory medications and ice therapy, stretching exercises, orthotic devices (shoe inserts), and physical therapy. When these conservative measures are unsuccessful we offer the most advanced surgical treatments such as endoscopic fasciotomy and shockwave therapy.
An ingrown toenail is a painful condition of the toe. Any toenail can become ingrown, but the condition is usually found in the big toe. It occurs when a sharp corner of the toenail digs into the skin at the end of or side of the toe.
Pain and inflammation at the spot where the nail digs into the skin occurs first. Later, the inflamed area can begin to grow extra tissue or drain yellowish fluid. Ingrown toenails are common in adults but uncommon in children and infants. Teenagers and young adults are most at risk. If left untreated, an ingrown toenail can progress to an infection or even an abscess that requires surgical treatment.
Treatment involves removing the offending nail border. This is a procedure that is performed in our office and usually takes about ten minutes. You will be able to leave our office most time with the shoes you wore in to the office. Aftercare includes daily foot soaking and topical antibiotic treatment for approximately one week. You will be able to resume most of your daily activities after the procedure.
Prevent Ingrown Toenails By
- Trimming your toenails straight across with no rounded corners.
- Ensuring that your shoes and socks are not too tight.
- Keeping your feet clean at all times.
Metatarsalgia is foot pain in the "ball of your foot" - the area between your arch and the toes. The pain usually centers on one or more of the five bones (metatarsals) in this mid-portion of the foot.
Also known as "dropped metatarsal heads," metatarsalgia can cause abnormal weight distribution due to over-pronation.
Metatarsalgia causes one of metatarsal joints to become painful or inflamed. People often develop a callus under the affected joint. Metatarsalgia can also be caused by arthritis, foot injury (sports, car accidents, repeated stress), hard surfaces (cement or tile floors) and specific footwear (rigid soled work boots). Inappropriate shoes will only aggravate the condition.
A simple change of shoes may solve the problem. In more severe cases, full-length custom-molded foot inserts may need to be prescribed.
Laser therapy is the use of specific wavelengths of light to treat painful and debilitating conditions such as: tendon and ligament injuries, sore muscles, arthritis, pre & post surgical pain, neurological conditions and general pain and swelling. Light energy enters the damaged cells and stimulates inter-cellular activity which reduces pain and speeds recovery, MLS Laser Therapy is painless and takes approximately 8 minutes.
MLS Laser Therapy recover is immediate. Most patients experience a positive result in 1-3 treatments, with an average course of treatment being 7 to 10 treatments. The effects of Laser therapy are cumulative; therefore ,expect to see improvement as you proceed through your treatment plan.
A neuroma is a benign growth of nerve tissue that can develop in various parts of your body. Morton's neuroma occurs in a nerve in your foot, often between your third and fourth toes. The condition involves a thickening of the tissue around one of the nerves leading to your toes. Morton's neuroma causes a sharp, burning pain in the ball of your foot. Your toes also may sting, burn or feel numb.
Common treatments for Morton's neuroma include changing footwear or using arch supports. Sometimes, corticosteroid injections or surgery may be necessary.
Peripheral neuropathy, in its most common form, causes pain and numbness in your hands and feet. The pain typically is described as tingling or burning, while the loss of sensation often is compared to the feeling of wearing a thin stocking or glove.
Peripheral neuropathy can result from such problems as traumatic injuries, infections, metabolic problems and exposure to toxins. One of the most common causes of the disorder is diabetes.
In many cases, peripheral neuropathy symptoms improve with time - especially if it's caused by an underlying condition that can be resolved. Medications initially designed to treat other conditions, such as epilepsy and depression, are often used to reduce the painful symptoms of peripheral neuropathy.
Peripheral vascular disease is the medical name given to a group of problems that causes poor circulation to the feet and legs. The most common cause of this is hardening of the arteries in which there is a gradual thickening and hardening of the walls of the arteries (the blood vessels that bring blood to the extremities from the heart).
Diabetes is the most common cause of peripheral vascular disease, but lack of physical activity, smoking, high blood pressure, and high cholesterol are also causes. Poor circulation can be treated by your doctor in a number of ways: controlling blood sugar level or addressing other underlying causes, medication to prevent blood clotting, and surgical correction.
Sweaty feet (hyperhydrosis) and smelly feet (bromohydrosis) are two very common, annoying conditions of the feet. While some cases of excessive smelling or sweating of the feet are systemic (throughout the whole body) in nature, such as anemia (low blood count) or hyperthyroidism (overactive thyroid), these conditions are usually of a local cause.
The warm, moist environment inside shoes especially athletic shoes promotes bacterial growth on the feet. The interaction between your perspiration and the bacteria that thrive in your shoes and socks generates the odor. So any attempt to reduce foot odor has to address both your sweating and your footwear. The bacteria that are often found in foot odor are usually corynebacterium and micrococcus species. Fortunately, foot odor can usually be controlled with simple measures such as: keeping your feet clean and dry by applying baby powder or wearing clean cotton socks.
Onychomycosis is a fungal infection of the toenails or fingernails. Onychomycosis causes fingernails or toenails to thicken, discolor, disfigure, and split. At first, onychomycosis appears to be only a cosmetic concern. Without treatment, however, the toenails can become so thick that they press against the inside of the shoes, causing pressure, irritation, and pain.
Half of all nail disorders are caused by onychomycosis, and it is the most common nail disease in adults. Toenails are much more likely to be infected than fingernails. The incidence of onychomycosis has been increasing and is related to diabetes, a suppressed immune system, and increasing age. Adults are 30 times more likely to have onychomycosis than children. In fact, only 2.6% of children younger than 18 years are reported to have onychomycosis, but as many as 90% of elderly people have onychomycosis.
Treatment for Nail Fungus May Include
- Oral or topical medication
- Trimming nails regularly
- Surgical removal of nails
Most foot warts are harmless, even though they may be painful. They are often mistaken for corns or calluses - which are layers of dead skin that build up to protect an area which is being continuously irritated. A wart, however, is a viral infection.
More serious foot lesions such as malignant lesions can sometimes be mistaken as a wart. Children, especially teenagers, tend to be more susceptible to warts than adults; some people seem to be immune.
Plantar warts are one of several soft tissue conditions of the foot that can be quite painful. They are caused by a virus, which generally invades the skin through small or invisible cuts and abrasions. They can appear anywhere on the skin, but, technically, only those on the sole are properly called plantar warts.
Plantar warts tend to be hard and flat, with a rough surface and well-defined boundaries; warts are generally raised and fleshier when they appear on the top of the foot or on the toes. Plantar warts are often gray or brown (but the color may vary), with a center that appears as one or more pinpoints of black.
The plantar wart is often contracted by walking barefoot on dirty surfaces or littered ground. The virus that causes plantar warts thrives in warm, moist environments, making infection a common occurrence in public bathing facilities.
If left untreated, warts can grow to an inch or more in circumference and can spread into clusters of warts. Like any other infectious lesion, plantar warts are spread by touching, scratching, or even by contact with skin shed from another wart. The wart may also bleed, another route for spreading.
Occasionally, warts can spontaneously disappear after a short time, and, just as frequently, they can recur in the same location. It is important to note that warts can be very resistant to treatment and have a tendency to reoccur.
Plantar warts that develop on the weight-bearing areas of the foot - the ball of the foot, or the heel, can cause sharp, burning pain. Pain occurs when weight is brought to bear directly on the wart, although pressure on the side of a wart can create equally intense pain.
A wound is an injury where the skin is cut, torn, scraped, or punctured. Wounds are categorized by how they occur i.e. pressure or ischemic. This also determines how the wound is treated. Infections often times complicate the wound healing process and must be addressed.
Signs and symptoms of infection include color changes to the skin (red), temperature changes (hot), swelling, and pain. Infections are treated with antibiotic therapy, which could take several weeks to months to clear up. During this time, wound care is being administered by our surgeons to facilitate wound healing. The wound healing process occurs in three basic stages:
1. Inflammatory Stage
The inflammatory phase begins with the injury itself and last for about seven days. Here you have bleeding, immediate narrowing of the blood vessels, clot formation, and release of various chemical substances into the wound that will begin the healing process. Specialized cells clear the wound of debris over the course of several days.
2. Proliferative stage
Proliferative stage: Here the cell matrix is forms which starts about day five . On this matrix, new skin cells and blood vessels will form. It is the new small blood vessels (known as capillaries) that give a healing wound its pink or purple-red appearance. These new blood vessels will supply the rebuilding cells with oxygen and nutrients to sustain the growth of the new cells and support the production of proteins (primarily collagen). The collagen acts as the framework upon which the new tissues build. Collagen is the dominant substance in the final scar.
3. Remodeling stage
Remodeling stage: The remodeling stage or maturation stage starts about week three and could last for one to two years. Here the wound continues to contract and become stronger. Collagen is remodeled and epithelialization (the process of laying down new skin) occurs.
Wound Treatments Include:
- Comprehensive evaluation of the wound
- Patient education of the condition and treatment plan
- Application of a customized treatment plan per patient and wound
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