Foot and Ankle
Ankle Care | Foot Care | Ankle and Foot Surgery
Ankle Surgery & Care
We’re on our feet all the time. Whether it’s for our occupation, sports, or just day-to-day life, our ankles and feet are put under a great deal of stress. That constant stress can lead to chronic ankle and foot pain, as can a variety of other health conditions. Let us help you treat that pain! You can learn more about some of the conditions we treat by selecting the items found below:
Ankle sprains are caused by an unnatural twisting or force on the ankle bones of the foot, often resulting in one or more ligaments on the outside of the ankle to be stretched or torn. If not properly treated, ankle sprains could develop into long-term problems.
Ankle Sprain Treatment
Ankle sprain 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.
Athlete’s foot is a skin disease caused by a fungus, usually occurring between the toes. The fungus usually attacks the feet as shoes create a warm, dark, and humid environment that encourages fungus growth. The warmth and dampness of areas around swimming pools, showers, and locker rooms can also be breeding grounds for fungi.
There are other conditions that can mimic Athlete’s foot. Malfunctions of the sweat mechanism, reaction to dyes or adhesives in shoes, eczema, and psoriasis, are not due to fungus but may manifest themselves in a similar fashion.
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.
How can you prevent Athlete’s foot?
- Avoiding walking barefoot. Use shower shoes.
- Reducing perspiration by using talcum powder.
- Wear light and airy shoes.
- Wear socks that keep your feet dry (change them frequently if you perspire heavily).
While fungicidal and fungistatic chemicals are usually used to treat Athlete’s foot problems, they may not be successful in treating the fungi in the lower layers of the skin.
Bunions are common disorders treated by podiatrists. Bunions cause the base of your big toe (Metatarsophalangeal Joint) to enlarge and protrude. The skin over it may become red and tender. A typical cause is wearing tight, narrow shoes over a period of time.
Wearing any type of shoe may be painful when you have a bunion. The joint involved flexes with every step you take. The bigger your bunion gets, the more it hurts to walk. Bursitis (inflammation) may also set in. Your big toe may angle towards your second toe, or even move all the way under or over it. The skin on the bottom of your foot may also become thicker and painful.
Pressure from your big toe may force your second toe out of alignment, sometimes causing it to overlap your third toe. If your bunion gets too severe, it may cause difficulty in walking. Your pain may become chronic and you may develop arthritis.
How are Bunions Treated?
Most bunions can be treated conservatively with wider and softer shoes, and pads to relieve the pressure and/or medications. If this does not help, surgical treatment may be necessary.
Bunion surgery, or bunionectomy, realigns the bone, ligaments, tendons and nerves so your big toe can be brought back to its correct position. The bump on the inside of the joint is removed as well.
A foot callus is an area of hard, thickened skin that can occur across the ball of the foot, on the heel, or on the outer side of the big toe. While many consider them a skin problem, they actually are systemic of a problem with the bone.
Foot 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.
Foot 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 foot 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.
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.
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 foot corns are usually located on the top of the toe or on the side of the small toe. Soft foot corns resemble open sores and develop between the toes as they rub against each other.
Foot Callus Treatment
Calluses can be trimmed and comfortable padding can 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.
There are over-the-counter callus treatments that may be effective when used properly. Some 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.
How 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.
Improperly fitting shoes are a leading cause of foot corns. Toe deformities, such as hammertoes or claw toes, also can lead to foot 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.
According to the American Diabetes Association, about 15.7 million people (5.9 percent of the United States population) have diabetes. Nervous system damage (also called neuropathy) affects about 60 to 70 percent of people with diabetes and is a major complication that may cause diabetics to lose feeling in their feet or hands.
Foot problems are a big risk in diabetic patients. Diabetics must constantly monitor their feet or face severe consequences, including amputation. With a diabetic foot, a wound as small as a blister from wearing a shoe that’s too tight can cause a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal. When your wound is not healing, it’s at risk for infection. As a diabetic, your infections spread quickly. If you have diabetes, you should inspect your feet every day. Look for puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts and nail problems. If necessary, get someone to help you, or use a mirror.
Basic advice for taking care of diabetic feet:
- Always keep your feet warm.
- Don’t get your feet wet in snow or rain.
- Don’t put your feet in front of the fireplace.
- Don’t smoke or sit cross-legged. Both decrease blood supply to your feet.
- Don’t soak your feet.
- Don’t use antiseptic solutions, drugstore medications, heating pads or sharp instruments on your feet.
- Trim your toenails straight across. Avoid cutting the corners. Use a nail file or emery board. If you find an ingrown toenail, contact our offices.
- Use quality lotion to keep the skin of your feet soft and moist, but don’t put any lotion between your toes.
- Wash your feet every day with mild soap and warm water.
- Wear loose socks to bed.
- Wear warm socks and shoes in winter.
- When drying your feet, pat each foot with a towel and be careful between your toes.
- Buy shoes that are comfortable without a “breaking in” period. Avoid pointed-toe styles and high heels.
- Don’t lace your shoes too tightly or loosely.
- Wear clean, dry socks every day. Avoid socks with holes or wrinkles. Thin cotton socks are more absorbent for summer wear. Avoid stockings with elastic tops.
When your feet become numb, they are at risk for becoming deformed. One way this happens is through ulcers. Open sores may become infected. Another way is the bone condition Charcot (pronounced “sharko”) foot. It warps the shape of your foot when your bones fracture and disintegrate, and yet you continue to walk on it because it doesn’t hurt. Diabetic foot ulcers and early phases of Charcot fractures can be treated with a total contact cast.
Many people don’t realize they have a fungal nail problem. Moreover, many people that do never seek treatment. Still, fungal toenail infections are a common foot health problem.
Fungal toenail infections can persist for years without ever causing pain. The disease, characterized by a change in a toenail’s color, is often considered nothing more than a mere blemish, but it can present serious problems if left untreated.
Also referred to as Onychomycosis, fungal nail infections are an infection underneath the surface of the toenail, which can also penetrate the nail. In addition to causing difficulty and pain when walking or running, fungal nail infections are often accompanied by a secondary bacterial and/or yeast infection in or about the nail plate.
A group of fungi called dermatophytes easily attack the nail, thriving off keratin, the nail’s protein substance. When the tiny organisms take hold, the nail may become thicker, yellowish-brown or darker in color, and foul smelling. Debris may collect beneath the nail plate, white marks frequently appear on the nail plate, and the infection is capable of spreading to other toenails, the skin, or even the fingernails.
Nail bed injuries may make the toenail more susceptible to all types of infection, including fungal infection. Those who suffer chronic diseases, such as diabetes, circulatory problems, or immune-deficiency conditions, are especially prone to fungal nails. Other contributory factors may be a history of Athlete’s foot and excessive perspiration.
How can fungal nail infections be prevented?
You can prevent fungal nail infections by taking these simple precautions:
- Exercise proper hygiene and regularly inspect your feet and toes.
- Keep your feet clean and dry.
- Wear shower shoes in public facilities whenever possible.
- Clip your toenails straight across so that the nail does not extend beyond the tip of the toe.
- Use a quality foot powder – talcum, not cornstarch – in conjunction with shoes that fit well and are made of materials that breathe.
- Disinfect home pedicure tools and don’t apply polish to nails suspected of infection.
Depending on the type of infection you have, over-the-counter liquid antifungal agents, while sometimes effective, may not prevent a fungal infection from recurring. A topical or oral medication may need to be prescribed, and the diseased nail matter and debris removed by a process called debridement.
In some cases, surgical treatment is prescribed, during which the infected fungal nail is removed. Permanent removal of a chronically painful nail, which has not responded to any other treatment, permits the fungal infection to be cured, and prevents the return of a deformed nail.
A 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 hammertoe surgery. People with hammertoes may have foot 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 hammertoes typically involves shoes with soft, roomy toe boxes and toe exercises to stretch and strengthen the muscles. Commercially available straps, cushions or non-medicated corn pads may also relieve hammertoe symptoms.
Heel pain is one of the leading problems that causes patients to visit David Wells, DPM. Plantar fasciitis is commonly traced to an inflammation on the bottom of the foot. Dr. Wells can evaluate your arch pain, and may prescribe customized shoe inserts called orthotics to help alleviate the heel pain you are experiencing.
Plantar fasciitis is caused by inflammation of the connective tissue 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. Also called “heel spur syndrome,” the condition can usually be successfully treated with conservative measures such as use of anti-inflammatory medications and ice packs, stretching exercises, orthotic devices, and physical therapy.
Ingrown toenails often are the result of trimming your toenails too short, particularly on the sides of your big toes.
While they are very common, ingrown toenails can also be very painful. When trimming your toenails, avoid tapering the corners so that the nail curves with the shape of your toe. The sides of the toenail will curl down and dig into your skin. Shoes that are too tight or short also may cause ingrown toenails.
Ingrown toenails start out hard, swollen and tender, and later, may become sore, red and infected. Your skin may start to grow over the ingrown toenail.
How do you treat an ingrown toenail?
Soaking your foot in warm, soapy water several times each day is usually a good way to treat an ingrown nail. We recommend that you visit our offices and let the doctor determine the best course of treatment for your ingrown toenail.
Antibiotics are sometimes prescribed if an infection is present. Part of your ingrown toenail (partial nail plate avulsion) may need to be surgically removed if an acute infection occurs. Ingrown toenail surgery involves injecting the toe with an anesthetic and cutting out the ingrown part of the toenail.
You can 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.
Your foot or ankle pain should not be ignored. The earlier you begin treatment, the more successful nonsurgical treatments will be, such as anti-inflammatory medicine, ice, heat, and massage techniques. We believe joint pain doesn’t have to slow you down, and we are dedicated to helping you get back your quality of life.
Ankle Surgery and Foot Surgery
There are a wide variety of issues that can cause pain in the foot or ankle, and unfortunately, some of them can only be treated surgically. If we determine surgery is the best course of action for you, we will ensure you are educated on the procedure and feel comfortable with the treatment plan. We know being off your feet for a while can be hard, but our Physical Therapy team will get you back to work and back to your life in no time.