Optimal Ankle & Foot

Patient Education

An investment in knowledge pays the best interest.

Patient Education

Our team of specialists and staff believe that informed patients are better equipped to make decisions regarding their health and well being. For your personal use, we have created an extensive patient library covering an array of educational topics. Browse through these diagnoses and treatments to learn more about topics of interest to you. Or, for a more comprehensive search of our entire Web site, enter your term(s) in the search bar provided.\n\nAs always, you can contact our office to answer any questions or concerns.

Resources
What is a Podiatrist?

A podiatrist, also called a doctor of podiatric medicine, is a specialist who provides medical diagnosis and treatment of foot and ankle problems, such as bunions, heel pain, spurs, hammertoes, neuromas, ingrown toenails, warts, corns and calluses. A podiatrist also renders care of sprains, fractures, infections, and injuries of the foot, ankle and heel. In addition to undergraduate medical school training, podiatrists also attend graduate school for a doctorate degree in podiatry. Podiatrists are required to take state and national exams, as well as be licensed by the state in which they practice.
According to the American Podiatric Medical Association, there are an estimated 15,000 practicing podiatrists in the United States. Podiatrists are in demand more than ever today because of a rapidly aging population. In addition, according to the association, foot disorders are among the most widespread and neglected health problems affecting people in this country.

Typically, podiatrists:
  • Consult with patients and other physicians on how to prevent foot problems.
  • Diagnose and treat tumors, ulcers, fractures, skin and nail diseases, and deformities.
  • Perform surgeries to correct or remedy such problems as bunions, clawtoes, fractures, hammertoes, infections, ruptured Achilles, and other ligaments and tendons.
  • Prescribe therapies and perform diagnostic procedures such as ultrasound and lab tests.
  • Prescribe or fits patients with inserts called orthotics that correct walking patterns.
  • Treat conditions such as: bone disorders, bunions, corns, calluses, cysts, heel spurs, infections, ingrown nails, and plantar fasciitis.
Blisters

Most blisters on the feet are caused by friction and do not require medical attention. New skin will form underneath the affected area and the fluid built up in the blister is simply absorbed back into the tissue. You can soothe ordinary blisters with Vitamin E ointment or an aloe-based cream.

Do not puncture a blister unless it is large, painful, or likely to be further irritated. If you have to pop a blister, use a sterilized needle or razor blade. Wash the area thoroughly, then make a small hole and gently squeeze out the clear fluid. Apply a dab of hydrogen peroxide to help protect against infection. Do not remove the skin over a broken blister. The new skin underneath needs this protective cover. Cover the area with a bandage and mild compression.

If the fluid is white or yellow, the blister is infected and needs medical attention.

Bunions

A bunion is a bone deformity caused by an enlargement of the joint at the base and side of the big toe (metatarsophalangeal joint). Bunions form when the toe moves out of place. The enlargement and its protuberance cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward the other toes, sometimes overlapping a third toe (known as Hallux Valgus). The growing enlargement or protuberance then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists, which is known as Hallus Abducto Valgus. Bunions can also lead to other toe deformities, such as hammertoe.

Many people with bunions suffer from discomfort and pain from the constant irritation, rubbing, and friction of the enlargement against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, bursitis or arthritis may set in, the skin on the bottom of the foot may become thicker, and everyday walking may become difficult—all contributing to chronic pain.

Wearing shoes that are too tight is the leading cause of bunions. Bunions are not hereditary, but they do tend to run in families, usually because of a faulty foot structure. Foot injuries, neuromuscular problems, flat feet, and pronated feet can contribute to their formation. It is estimated that bunions occur in 33 percent of the population in Western countries.

Treatment for Bunions

Because they are bone deformities, bunions do not resolve by themselves. The goal for bunion treatment is twofold: first, to relieve the pressure and pain caused by irritations, and second to stop any progressive growth of the enlargement. Commonly used methods for reducing pressure and pain caused by bunions include:

    • Protective padding, often made from felt material, to eliminate the friction against shoes and help alleviate inflammation and skin problems. Removal of corns and calluses on the foot.

    • Changing to carefully fitted footwear designed to accommodate the bunion and not contribute toward its growth.

    • Orthotic devices—both over-the-counter and custom made—to help stabilize the joint and place the foot in the correct position for walking and standing.

    • Exercises to maintain joint mobility and prevent stiffness or arthritis.

    • Splints for nighttime wear to help the toes and joint align properly. This is often recommended for adolescents with bunions, because their bone development may still be adaptable.

Surgical Treatment

Depending on the size of the enlargement, misalignment of the toe, and pain experienced, conservative treatments may not be adequate to prevent progressive damage from bunions. In these cases, bunion surgery, known as a bunionectomy, may be advised to remove the bunion and realign the toe.

 
Chronic Lateral Ankle Pain

Chronic lateral ankle pain is recurring or chronic pain on the outside part of the ankle that often develops after an injury such as a sprained ankle.

Signs and symptoms include:
  • Consult with patients and other physicians on how to prevent foot problems.
  • Diagnose and treat tumors, ulcers, fractures, skin and nail diseases, and deformities.
  • Perform surgeries to correct or remedy such problems as bunions, clawtoes, fractures, hammertoes, infections, ruptured Achilles, and other ligaments and tendons.
  • Prescribe therapies and perform diagnostic procedures such as ultrasound and lab tests.
  • Prescribe or fits patients with inserts called orthotics that correct walking patterns.
  • Treat conditions such as: bone disorders, bunions, corns, calluses, cysts, heel spurs, infections, ingrown nails, and plantar fasciitis.
Although ankle sprains are the most common cause of chronic lateral ankle pain, other causes may include:
  • A fracture in one of the bones that make up the ankle joint

  • Arthritis of the ankle joint

  • Inflammation of the joint lining

  • Injury to the nerves that pass through the ankle. In this case, the nerves become stretched, torn, injured by a direct blow, or pinched under pressure

  • Scar tissue in the ankle after a sprain. The scar tissue takes up space in the joint, putting pressure on the ligaments

  • Torn or inflamed tendon

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Treatments for chronic lateral ankle pain include:
    • Over the counter or prescription anti-inflammatory medications to reduce swelling.  Note: Please consult your physician before taking any medications
    • Physical therapy, including tilt-board exercises that focus on strengthening the muscles, restoring range of motion, and increasing your perception of joint position

    • Ankle braces or other supports

    • Steroid medication

    • Immobilization to allow the bone to heal (in cases of fractures)

Corns and Calluses

Corns and calluses are protective layers of compacted, dead skin cells. They are caused by repeated friction from skin rubbing against bony areas or against an irregularity in a shoe. Corns ordinarily form on the toes and calluses on the soles of the feet. The friction and pressure can burn or otherwise be painful and may be relieved by moleskin or padding on the affected areas.

Never cut corns or calluses with any instrument, and never apply home remedies, except under a podiatrist’s instructions.

Diabetes and Your Feet

Diabetes is a lifelong chronic disease that is caused by high levels of sugar in the blood. It can also decrease your body’s ability to fight off infections, which is especially harmful in your feet. When diabetes is not properly controlled, damage can occur to the organs and impairment of the immune system is also likely to occur.

With damage to your nervous system, you may not be able to feel your feet properly. Normal sweat secretion and oil production that lubricates the skin of the foot is impaired, which can lead to an abnormal pressure on the skin, bones, and joints of the foot during walking and other activities. This can even lead to the breakdown of the skin of the foot, which often causes sores to develop. If you have diabetes, it is important to prevent foot problems before they occur, recognize problems early, and seek the right treatment when a problem does happen.

Diabetic Complications and Your Feet When it comes to your feet, there are several risk factors that can increase your chances of developing foot problems and diabetic infections in the legs and feet. First of all, poorly fitting shoes are one of the biggest culprits of diabetic foot complications. If you have red spots, sore spots, blisters, corns, calluses, or consistent pain associated with wearing shoes, new proper fitted shoes must be obtained immediately. Additionally, if you have common foot abnormalities such as flat feet, bunions, or hammertoes, prescription shoes or orthotics from your podiatrist may be necessary to further protect your feet from other damage.

People who have long-standing or poorly controlled diabetes are also at risk for having damage to the nerves in their feet, which is known in the medical community as peripheral neuropathy. If you have nerve damage, you may not be able to feel your feet normally and you may also be unable to sense the position of your feet and toes while walking and balancing, which can cause even more harm to your feet.

Normal nerves allow people to sense if their shoes are too tight or if their shoes are rubbing on the feet too much. With diabetes, you may not be able to properly sense minor injuries, such as cuts, scrapes and blisters-all signs of abnormal wear, tear, and foot strain. The following can also compromise the health of your feet:

  • Poor circulation

  • Trauma to the foot

  • Infections

  • Smoking

Diabetes can be extremely dangerous to your feet, so take precautions now. You can avoid serious problems such as losing a toe, foot, or leg by following proper prevention techniques offered by your podiatrist. Remember, prevention is the key to saving your feet and eliminating pain.

Extracorporeal Shock Wave

Extracorporeal Shock Wave Therapy (ESWT) is used to treat chronic heel pain (plantar fasciitis). “Extracorporeal” means “outside of the body.” During this noninvasive procedure, sonic waves are directed at the area of pain using a device similar to that currently used in nonsurgical treatment of kidney stones.

Extracorporeal Shock Wave Therapy is prescribed for patients who have experienced plantar fasciitis for an extended period of time — six months or more — and have not benefited from other conservative treatments. The brief procedure lasts about 30 minutes and is performed under local anesthesia and/or “twilight” anesthesia. Strong sound waves are directed at and penetrate the heel area to stimulate a healing response by the body. ESWT is performed on an outpatient basis. Although there are no bandages, someone will need to drive the patient home.

People who are not candidates for ESWT include pregnant women and individuals with neurological foot disease, vascular foot disease, pacemakers, or people taking medications that interfere with blood clotting (such as Coumadin).

This therapy is a safe and effective alternative treatment for heel pain and only requires a short recovery time. Clinical studies show a 70 percent success rate for treatment of plantar fasciitis using Extracorporeal Shock Wave Therapy.

Fitness And Your Feet

Your feet are one of the most overlooked body parts when it comes to exercise. As you exercise, pay attention to what your feet are telling you.

Consult your physician before beginning any fitness program. This includes a complete physical and foot exam. This is especially important for those who are overweight, smoke, or haven’t had a physical exam in a long time.

Proper fitness requires wearing the right clothes and shoes. Wear loose-fitting, light-colored and loosely woven clothing in hot weather and several layers of warm clothing in cold weather.

The American Podiatric Medical Association stresses the importance of foot care in exercising. People don’t realize the tremendous pressure that is put on their feet while exercising. For example, a 150-pound jogger puts more than 150 tons of impact on his feet when running three miles.

Improper foot care during exercise is a contributing factor to some of the more than 300 foot ailments, according to the APMA.

The following are common ailments caused by improper foot care during exercise:

  • Athlete’s foot;

  • Blisters;

  • Corns and calluses; and

  • Heel pain (including heel spurs).

Flat Feet

Flat feet are a common condition of the foot structure. In infants and toddlers, prior to walking, the longitudinal arch is not developed, and flat feet are normal. Most feet are flexible and an arch appears when children begin standing on their toes. The arch continues to develop throughout childhood, and by adulthood most people have developed normal arches.

Flat feet are generally 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).

Many people with flat feet do not experience pain or other problems. When pain in the foot, ankle, or lower leg does occur, especially in children, the feet should be evaluated.

Painful progressive flatfoot, otherwise known as tibialis posterior tendonitis or adult-acquired flatfoot, refers to inflammation of the tendon of the tibialis posterior. This condition arises when the tendon becomes inflamed, stretched, or torn. Left untreated, it may lead to severe disability and chronic pain. People are predisposed to tibialis posterior tendonitis if they have flat feet or an abnormal attachment of the tendon to the bones in the midfoot.

Nonsteroidal anti-inflammatory medications, icing, physical therapy, supportive taping, bracing, and orthotics are common treatments for painful progressive flatfoot. Note: Please consult your physician before taking any medications. In some cases, a surgery may need to be performed to repair a torn or damaged tendon and restore normal function. In the most severe cases, surgery on the midfoot bones may be necessary to treat the associated flatfoot condition.

Fractures

Nearly one-fourth of all the bones in your body are in your feet. A broken (fractured) bone in your forefoot or in one of your toes is often painful, but rarely disabling. Most of the time, these injuries heal without operative treatment.

There are two types of foot fractures: stress fractures and general bone fractures. Stress fractures usually occur in the bones of the forefoot extending from the toes to the middle of the foot. Stress fractures are like tiny cracks in the bone surface. They can happen with sudden increases in exercise (such as running or walking for longer distances or times), improper training techniques, or a change in surfaces.

Most other types of fractures extend through the bone, and are called bone fractures. They may be stable, in which there is no shift in bone alignment, or displaced, in which the bone ends no longer line up properly. Bone fractures usually result from trauma, such as dropping a heavy object on your foot, or from a twisting injury. If the fractured bone does not break through the skin, it is called a closed fracture. If the fracture does break through the skin, it is called an open fracture.

Because of the complex structures in the foot, there are some other, more specific types of fractures that can occur. For example, the fifth metatarsal, known as the little or pinky toe, is susceptible to a variety of different fractures. The relationship between the ankle and the foot can be compromised by an ankle-twisting injury, which may tear the tendon that attaches to this bone and pull a small piece of the bone away. A more serious injury in the same area is known as a Jones fracture, which occurs near the base of the bone and disrupts its blood supply. This injury may take longer to heal or require surgery.

Common symptoms for any type of foot fracture includes pain, swelling, and sometimes bruising. Be sure to seek medical attention for any suspected foot fracture.

Fungal Nails

Since fungal nails are usually more resistant and more difficult to treat than Athlete’s foot, topical or oral antifungal medications may be prescribed. Permanent nail removal is another possible form of treatment for fungal nails.

After a fungal nail infection has cleared up, you can take steps to prevent the infection from coming back.

Keeping the fungus under control will help prevent a fungal infection of the skin from reinfecting the nail. Before bed, thoroughly wash and dry your feet, and apply a non-prescription anti-fungal cream to the entire foot from the ankle down. Use the cream every night, then gradually apply it less often. Keep your feet dry. Dry feet are less likely to become infected. Apply powder to your dry feet after you take a shower or bath.

Other tips:
  • Don’t share nail clippers or nail files with others.

  • Don’t share shoes or socks with others.

  • Try not to injure your nail, such as by cutting it too short (trauma to the nail may lead to infections).

  • Wear dry cotton socks, and change them two or three times a day if necessary.

  • Wear dry shoes that allow air to circulate around your feet (tight, enclosed, moist shoes contribute to fungal toenail infections).

  • Wear shower sandals or shower shoes when you are at a public pool or shower.

Prevention

Follow basic foot care guidelines and you more than likely can head off most common foot fungus problems.

 
Hammertoes

Hammertoe is a deformity of the second, third, or fourth toes. In this condition, the toe is bent at the middle joint, causing it to resemble 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.

Causes of hammertoe include improperly fitting shoes and muscle imbalance.

Treatment for the condition typically involves wearing shoes with soft, roomy toe boxes and toe exercises to stretch and strengthen the muscles. Commercially available straps, cushions, or nonmedicated corn pads may also relieve symptoms.

In severe cases, hammertoe surgery may be recommended to correct the deformity.

Heel Pain

Plantar fasciitis is the term commonly used to refer to heel and arch pain traced to an inflammation on the bottom of the foot. More specifically, plantar fasciitis is an inflammation of the connective tissue, called plantar fascia, that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone. Overpronation is the most common cause of plantar fasciitis. As the foot rolls inward excessively when walking, it flattens the foot, lengthens the arch, and puts added tension on the plantar fascia. Over time, this causes inflammation.

Also known as heel spur syndrome, the condition is often successfully treated with conservative measures, such as the use of anti-inflammatory medications, ice packs, stretching exercises, orthotic devices, and physical therapy.Note: Please consult your physician before taking any medications.In persistent cases, Extracorporeal Shock Wave Treatment (ESWT), Platelet Rich Plasma, Laser Pain Therapy, and open Surgery may be used to treat the heel pain.

Ingrown Nails

Ingrown nails are nails whose corners or sides dig painfully into the skin, often causing infection. They are frequently caused by improper nail trimming, but also by shoe pressure, injury, fungus infection, heredity, and poor foot structure.

Toenails should be trimmed straight across, slightly longer than the end of the toe, with toenail clippers.

If they become painful or infected, contact our office. We may remove the ingrown portion of the nail, and if the condition reoccurs frequently, we may permanently remove the nail.

What is Genicular Artery Embolization (GAE)?

Genicular Artery Embolization (GAE) is a cutting-edge, minimally invasive procedure designed to relieve chronic knee pain caused by osteoarthritis (OA). This treatment targets the genicular arteries—small blood vessels that supply the knee joint—by inserting a catheter through a small incision, typically in the groin area. Through this catheter, tiny particles (embolic agents) are released to block abnormal blood flow to inflamed areas of the knee. By reducing this excess blood supply, GAE helps to decrease inflammation and significantly alleviate knee pain associated with OA.

Benefits, Candidacy, and Recovery

GAE is an excellent option for individuals with moderate to severe osteoarthritis who have not found relief through traditional treatments and are not ready for or suitable candidates for total knee replacement. The procedure is performed under local anesthesia with light sedation and guided by real-time imaging to ensure precision. Patients benefit from a quick recovery—most can return to normal activities within 1–2 weeks. GAE provides targeted pain relief without systemic side effects and has shown lasting results, often for several months or longer. While generally safe, potential risks include skin ischemia and other catheter-related complications.