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Fungal Infections

Toenail fungus, or onychomycosis, is an infection underneath the surface of the nail caused by fungi. When the tiny organisms take hold, the nail often becomes darker in color and smells foul. 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. If ignored, the infection can spread and possibly impair your ability to work or even walk. The resulting thicker nails are difficult to trim and make walking painful when wearing shoes. Onychomycosis can also be accompanied by a secondary bacterial or yeast infection in or about the nail plate.

Toenail fungus is often ignored because the infection can be present for years without causing any pain. The disease is characterized by a progressive change in a toenail’s quality and color, which is often ugly and embarrassing.

Ingrown Toenails

Ingrown toenails are a common condition in which the corner or side of a toenail grows into the soft flesh. The result is pain, redness, swelling and, sometimes, an infection. Ingrown toenails usually affect your big toe. Often you can take care of ingrown toenails on your own. If the pain is severe or spreading, your doctor can take steps to relieve your discomfort and help you avoid complications of ingrown toenails. If you have diabetes or another condition that causes poor blood flow to your feet, you’re at greater risk of complications of ingrown toenails.

Ingrown toenail symptoms include:

  • Pain and tenderness in your toe along one or both sides of the nail
  • Redness around your toenail
  • Swelling of your toe around the nail
  • Infection of the tissue around your toenail

When to see a doctor

See your doctor if you:

  • Experience severe discomfort in your toe or pus or redness that seems to be spreading
  • Have diabetes or another condition that causes poor blood flow to your feet and you experience any foot sore or infection

Source: http://www.mayoclinic.org/diseases-conditions/ingrown-toenails/diagnosis-treatment/treatment/txc-20273059

Plantar Wart

Plantar warts are small growths that usually appear on the heels or other weight-bearing areas of your feet. This pressure may also cause plantar warts to grow inward beneath a hard, thick layer of skin (callus). Plantar warts are caused by HPV. The virus enters your body through tiny cuts, breaks or other weak spots on the bottom of your feet.

Most plantar warts aren’t a serious health concern and usually go away without treatment eventually. You may want to try self-care treatments or see your doctor to have the warts removed.

Plantar wart signs and symptoms include:

  • A small, fleshy, rough, grainy growth (lesion) on the bottom of your foot, usually the base of the toes and forefoot or the heel
  • Hard, thickened skin (callus) over a well-defined “spot” on the skin, where a wart has grown inward
  • Black pinpoints, which are commonly called wart seeds but are actually small, clotted blood vessels
  • A lesion that interrupts the normal lines and ridges in the skin of your foot
  • Pain or tenderness when walking or standing

When to see a doctor

See your doctor for the lesion on your foot if:

  • The lesion is bleeding, painful or changes in appearance or color
  • You’ve tried treating the wart, but it persists, multiplies or recurs
  • Your discomfort interferes with activities
  • You also have diabetes or poor sensation in your feet
  • You also have a weakened immune system because of immune-suppressing drugs, HIV/AIDS or other immune system disorders
  • You aren’t sure whether the lesion is a wart

Source: http://www.mayoclinic.org/diseases-conditions/plantar-warts/home/ovc-20319385

Athlete’s foot

Athlete’s foot – also called tinea pedis – is a contagious fungal infection that affects the skin on the feet and can spread to the toenails and sometimes the hands. The fungal infection is called athlete’s foot because it’s commonly seen in athletes.

Athlete’s foot isn’t serious, but sometimes it’s hard to cure. However, if you have diabetes or a weakened immune system and suspect that you have athlete’s foot, you should call your doctor immediately


There are many possible symptoms of athlete’s foot. You may experience one or more of the following symptoms:

  • itching, stinging, and burning between the toes
  • itching, stinging, and burning on the soles of the feet
  • blisters on the feet that itch
  • cracking and peeling skin on the feet, most commonly between the toes and on the soles
  • dry skin on the soles or sides of the feet
  • raw skin on the feet
  • discolored, thick, and crumbly toenails
  • toenails that pull away from the nail bed

Source: http://www.healthline.com/health/athletes-foot

Nerve Disorders


A neuroma is a painful condition, also referred to as a “pinched nerve” or a nerve tumor. It is a benign growth of nerve tissue frequently found between the third and fourth toes. It brings on pain, a burning sensation, tingling, or numbness between the toes and in the ball of the foot. The principal symptom associated with a neuroma is pain between the toes while walking. Those suffering from the condition often find relief by stopping their walk, taking off their shoe, and rubbing the affected area. At times, the patient will describe the pain as similar to having a stone in his or her shoe. The vast majority of people who develop neuromas are women.


The symptoms of a neuroma include the following:

  • Pain in the forefoot and between the toes
  • Tingling and numbness in the ball of the foot
  • Swelling between the toes
  • Pain in the ball of the foot when weight is placed on it

Peripheral Neuropathy symptoms usually start with numbness, prickling or tingling in the toes or fingers. It may spread up to the feet or hands and cause burning, freezing, throbbing and/or shooting pain that is often worse at night.

The pain can be either constant or periodic, but usually the pain is felt equally on both sides of the body-in both hands or in both feet. Some types of peripheral neuropathy develop suddenly, while others progress more slowly over many years.


  • A sensation of wearing an invisible “glove” or “sock”
  • Burning sensation or freezing pain
  • Sharp, jabbing, shooting, or electric-like pain
  • Extreme sensitivity to touch
  • Difficulty sleeping because of feet and leg pain
  • Loss of balance and coordination
  • Muscle weakness
  • Muscle cramping/twitching
  • Difficulty walking or moving the arms
  • Unusual sweating

Symptoms such as experiencing weakness or not being able to hold something, not knowing where your feet are, and experiencing pain that feels as if it is stabbing or burning in your limbs, can be common signs and symptoms of peripheral neuropathy.

The symptoms of peripheral neuropathy may depend on the kind of peripheral nerves that have been damaged. There are three types of peripheral nerves: motor, sensory and autonomic. Some neuropathies affect all three types of nerves, while others involve only one or two.

The majority of people, however, suffer from polyneuropathy, an umbrella term for damage involving many nerves at the same time.

Source: https://www.foundationforpn.org/what-is-peripheral-neuropathy/symptoms/

Nerve Entrapment


Heel pain is one of the most common foot problems podiatrists encounter. Typically, the culprit is plantar fasciitis a condition caused by inflammation of the plantar fascia. However, several less-common conditions cause heel pain and masquerade as plantar fasciitis.

Heel pain that presents as plantar fasciitis, but does not respond to treatment, may be plantar nerve entrapment. High impact activities like running or ballet, which involve repetitive motions and significant stress to the arch and heel, are the primary cause. Researchers have found that individuals with flat feet are particularly prone to nerve entrapment, since the arch is less effective in absorbing and distributing impact.Nerves at risk for entrapment include the main plantar nerve, also known as the calcaneal nerve, as well as the medial plantar nerve (which runs along the inside, central part of the arch) and lateral plantar nerve (which runs along outside, central part of the arch).


Unlike plantar fasciitis, the hallmark of plantar or calcaneal nerve entrapment is constant, chronic pain – even when resting and without weight bearing. Other symptoms of plantar nerve entrapment include the following:

  • A burning sensation on the underside of the heel
  • Tenderness and pain to the touch where the nerve is entrapped
  • Pain that is worse at night in contrast, (the pain from plantar fasciitis is typically worse in the morning)
  • Pain that gets worse with stretching (in contrast,, and responds positively to stretching) Severe pain from standing and physical activity.

Source: https://heelthatpain.com/heel-pain/nerve-entrapment

Foot Deformities



A bunion is a painful bony bump that develops on the inside of the foot at the big toe joint. Bunions are often referred to as hallux valgus.

Bunions develop slowly. Pressure on the big toe joint causes the big toe to lean toward the second toe. Over time, the normal structure of the bone changes, resulting in the bunion bump. This deformity will gradually increase and may make it painful to wear shoes or walk.Anyone can get a bunion, but they are more common in women. Many women wear tight, narrow shoes that squeeze the toes together-which makes it more likely for a bunion to develop, worsen and cause painful symptoms.In most cases, bunion pain is relieved by wearing wider shoes with adequate toe room and using other simple treatments to reduce pressure on the big toe.


In addition to the visible bump on the inside of the foot, symptoms of a bunion may include:

  • Pain and tenderness
  • Redness and inflammation
  • Hardened skin on the bottom of the foot
  • A callus or corn on the bump
  • Stiffness and restricted motion in the big toe, which may lead to difficulty in walking

Source: http://orthoinfo.aaos.org/topic.cfm?topic=a00155



A hammer toe is a deformity that causes your toe to bend or curl downward instead of pointing forward. This deformity can affect any toe on your foot. It most often affects the second or third toe. Although a hammer toe may be present at birth, it usually develops over time due to wearing ill-fitting shoes, such as tight, pointed heels, or arthritis. In most cases, a hammer toe condition is treatable.


A hammer toe causes you discomfort when you walk. It can also cause you pain when you try to stretch or move the affected toe or those around it. Hammer toe symptoms may be mild or severe.

Mild Symptoms:

  • a toe that bends downward
  • corns or calluses
  • difficulty walking
  • inability to flex your foot or wiggle your toes
  • claw-like toes

Severe Symptoms

See your doctor or podiatrist right away if you develop any of these symptoms.

Source: http://www.healthline.com/health/hammer-toe


Flat Feet


Surgery for flat feet is separated into three kinds: soft tissue procedures, bone cuts, and bone fusions. Depending on the severity of the flat foot, a person’s age, and whether or not the foot is stiff determines just how the foot can be fixed. In most cases a combination of procedures are performed.

With flexible flat feet, surgery is geared at maintaining the motion of the foot and recreating the arch. Commonly this may involve tendon repairs along the inside of the foot to reinforce the main tendon that lifts the arch. When the bone collapse is significant, bone procedures are included to physically rebuild the arch, and realign the heel. The presence of bunions with flat feet is often contributing to the collapse and in most situations requires correction.

With rigid flat feet, surgery is focused on restoring the shape of the foot through procedures that eliminate motion. In this case, motion does not exist pre-operatively, so realigning the foot is of utmost importance. The exception, are rigid flat feet due to tarsal coalition (fused segment of bone) in the back of the foot where freeing the blockage can restore function.

Source: http://bunionsurgeryny.com/procedures/flat-foot-surgery/


High Arches


Babies and toddlers appear to have flat feet when they are standing because their feet have fat pads. A slight arch may appear when the child sits or stands on tiptoes. Children are born this way; doctors refer to it as flexible flat foot. Usually it’s painless and doesn’t interfere with a child’s ability to walk or play sports. Most children outgrow it eventually as their feet get larger, their baby fat disappears and their foot muscles strengthen with weight bearing activity such as walking.


Although painless in young children, flat feet in older children and adolescents can cause an aching pain. Sometimes the pain only occurs during or after sports or other physical activity. Sometimes the child complains that his foot, ankle or leg is tired or that he has aching pain at night. If the Achilles tendon (at the back of the ankle) is involved, it may become red and painful. Sometimes there are calluses under the sagging arches.

Call an orthopedic foot and ankle specialist if your child complains of foot pain, the ankle is red, the feet or ankles feel tired, or calluses are forming under the arches. Be sure to take your child’s shoes along to your appointment so the specialist can examine the pattern of wear. Adolescents who still have flat feet and complain of pain should also be evaluate.

Source: http://www.aofas.org/footcaremd/conditions/ailments-of-the-midfoot/Pages/Flat-Feet-High-Arches.aspx


Poor Circulation


There are many different types of symptoms which can indicate poor circulation. Apart from the discomfort a person may feel each day, there are potentially more serious consequences, so it is important to look into this properly. Here’s more information:


There are even more symptoms than these mentioned here, but some of the most common ones include the following:

  • Cold feet and toes – not just in winter time
  • Cold hands and fingers
  • Feeling numb in certain parts of the body especially the extremities
  • Feeling tired or having a lack of energy much of the time
  • Some hair loss can be because of bad blood flow
  • Having regular dizzy spells
  • If your skin gets dry even though you drink plenty of water
  • Swelling and water retention – especially in the feet
  • Lumps in blood vessels and varicose veins
  • Some headaches can be due to this
  • Cramps and pins and needles
  • Feeling short of breath at times
  • Blotches and blemishes in the skin

Poor blood flow to the brain may affect memory

Source: http://www.poorcirculation.org/symptoms-and-causes.html#section2

Venous Insufficiency


Normally, valves in your deeper leg veins keep blood moving forward toward the heart. With long-term (chronic) venous insufficiency, vein walls are weakened and valves are damaged. This causes the veins to stay filled with blood, especially when you are standing.

Chronic venous insufficiency is a long-term condition. It is most commonly due to malfunctioning (incompetent) valves in the veins. It may also occur as the result of a past blood clot in the legs.

Risk factors for venous insufficiency include:

  • Age
  • Family history of this condition
  • Female gender (related to levels of the hormone progesterone)
  • History of deep vein thrombosis in the legs
  • Obesity
  • Pregnancy
  • Sitting or standing for long periods
  • Tall height


Pain or other symptoms include:

  • Dull aching, heaviness, or cramping in legs
  • Itching and tingling
  • Pain that gets worse when standing
  • Pain that gets better when legs are raised

Skin changes in the legs include:

  • Swelling of the legs
  • Irritated or cracked skin if you scratch it
  • Red or swollen, crusted, or weepy skin (stasis dermatitis)
  • Varicose veins on the surface
  • Thickening and hardening of the skin on the legs and ankles (lipodermatosclerosis)
  • Wound or ulcer that is slow to heal on the legs or ankles

Source: https://medlineplus.gov/ency/article/000203.htm




If you notice swelling in your feet or legs, you should definitely tell your primary care doctor, says Cleveland Clinic Vascular Medicine specialist Leslie Gilbert, MD. Swelling, or edema, can be caused by many things and it,s important to try to understand what is causing it.

“If people see any redness, blistering or swelling in the legs, especially if it is getting worse, they definitely need to see their doctor,” she says. Take note of what makes it better or worse. Your doctor will want to know how long has it has been present and whether there has been any change to the pattern of the swelling.


Some patients get referred to the Doctor for evaluation of their swelling. At the first visit, she goes into a bit of a detective mode to determine what might be the cause.

“I ask a lot of questions about their medical history. Do they have heart issues, kidney problems, liver or thyroid problems? Arthritis? Is the swelling in one leg or both? Could this be from a medication?” she says. “Is the swelling painful?”

She examines the legs and asks what time of day the swelling is worse, what seems to trigger it and what helps relieve it. Where is the location of the swelling? Does it affect the foot and toes or does it start at the ankle? How far up the leg does it extend? Is there a change over the course of the day and improvement overnight?

Other questions she typically asks:

  • Sleep: How long do you sleep at night? Do you sleep in bed? Some people sleep in a recliner but that means they are not really elevating their legs at night, which reduces swelling. If you sleep eight hours, do you do all eight in a row or do you get up and watch TV awhile before going back to bed?
  • Activity levels: Do you spend the entire day sitting at a computer or watching TV with your legs down? Does walking leave you short of breath? “A lot of people develop trouble walking as they age and will only take a few steps from room to room. This means they are not using their calf muscle, which helps pump fluid out of the legs,” she says.
  • Are you overweight? Obesity can make swelling worse, and it can make you more likely to be sedentary, perhaps even ride a scooter in public. “Many people gain weight as soon as they start using a scooter,” she says.
  • Salt intake: You may not add salt to your food, but do you know many foods are very high in salt? “Do you eat many things out of a can? What about ketchup? Cold cuts? Hot dogs? Hamburger Helper or Rice-A-Roni? That is all loaded with salt,” she says.
  • Medication changes: Some medications can cause swelling, especially if it is in both legs.
  • Hormones: If you are a younger woman, does the swelling happen at certain times in your monthly cycle?

Source: https://health.clevelandclinic.org/2015/07/what-you-should-know-about-swelling-in-your-legs/


Foot & Ankle Trauma & Injury

Achilles Tendon Injuries


Archilles Tendinopathy is a chronic, yet common condition in sports people and recreational athletes. In the past treatment options have been limited due to a poor understanding of its cause; however recent research has revealed valuable information that has provided further treatment options. Until recently Achilles Tendinopathy was referred to?as Achilles Tendinitis. However, research has found that this type of injury does not involve inflammation and is most likely due to a series of microtears (tendinosis) that weaken the tendon.


The most obvious one is pain above your heel, especially when you stretch your ankle or stand on your toes. It may be mild and get better or worse over time. If the tendon ruptures, the pain is instant and severe. The area may also feel tender, swollen, and stiff. If your Achilles tendon tears, you may hear a snapping or popping noise when it happens. You could have bruising and swelling, too. You may have trouble pointing your toes if the tendon tears completely.



Exercising is good for you, but sometimes you can injure yourself when you play sports or exercise. Accidents, poor training practices, or improper gear can cause them. Some people get hurt because they are not in shape. Not warming up or stretching enough can also lead to injuries.

The most common sports injuries are

  • Sprains and strains
  • Swollen muscles
  • Achilles tendon injuries
  • Pain along the shin bone
  • Fractures
  • Dislocations

If you get hurt, stop playing. Continuing to play or exercise can cause more harm. Treatment often begins with the RICE (Rest, Ice, Compression, and Elevation) method to relieve pain, reduce swelling, and speed healing. Other possible treatments include pain relievers, keeping the injured area from moving, rehabilitation, and sometimes surgery. NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases




Athletes in all contact sports have many opportunities to get a muscle contusion (bruise). Contusions are second only to strains as a leading cause of sports injuries.

Most contusions are minor and heal quickly, without taking the athlete away from the game. But, severe contusions can cause deep tissue damage and can lead to complications that may keep the athlete out of sports for months.


Contusions cause swelling and pain, and limit joint range of motion near the injury. Torn blood vessels may cause bluish discoloration. The injured muscle may feel weak and stiff.

Sometimes a pool of blood collects within damaged tissue, forming a lump over the injury (hematoma).

In severe cases, swelling and bleeding beneath the skin may cause shock. If tissue damage is extensive, you may also have a broken bone, dislocated joint, sprain, torn muscle, or other injuries.

Source: https://orthoinfo.aaos.org/en/diseases–conditions/muscle-contusion-bruise/


Work Comp Injuries


Each year, worker injuries account for millions of dollars and countless hours of lost time that can never be recovered. It is the focus of numerous studies and efforts to both limit such injuries and appropriately return these workers to productive status on a timely basis. At Northwest Surgical Specialists that is exactly what we do.


Diabetic Foot Care



Two complications people with diabetes may be at risk for are poor circulation and the absence of sensation, according to John Giurini, DPM, Chief, Division of Podiatry at Beth Israel Deaconess Medical Center. (Beth Israel Deaconess Medical Center is an affiliate of the Joslin Diabetes Center). People with these diabetes complications may not be aware of whether or not their shoes fit correctly, so their feet must be properly measured and fitted before purchasing shoes.

Tips for Buying Shoes with Diabetes

  • Have feet measured periodically, because feet change over time.
  • Shop later in the day, because feet swell throughout the day, especially if you have heart disease and kidney problems.
  • Have shoes fitted with the socks you’ll be wearing with those specific shoes. That way you’ll know they will fit properly.
  • The distance between your longest toe and the tip of the shoe should be 1/2 of your thumb’s width, so you have the right amount of space to fit your feet.

When you buy a new pair of shoes, break them in before wearing them for a long period of time. Wear them for one to two hours, then check your feet for any cuts or blisters. Wear them three to four hours the next day, and so on, until they feel comfortable, Giurini says.

Important Shoe Features for People with Diabetes

  • Shoes should be made of soft leather, because they can stretch.
  • Choose a cushioned sole over a thin, leather sole, because the shock absorption is better.
  • The back of the shoe should not collapse to one side or the other, because it won’t provide good support.
  • Choose laced shoes over loafers, so they fit better and provide better support.

People with diabetes and specific foot deformities should buy shoes that match the width of their foot, perhaps with extra depth. Those with diabetes and severe foot deformities can get a custom molded shoe made, but only do this if it’s absolutely necessary.

When To Replace Shoes

It’s a good idea to alternate your shoes everyday so you don’t wear one pair down too quickly, the heel doesn’t lose support and the sole doesn’t lose shock absorption. You should replace your shoes when:

  • the heel starts to collapse to one side or the other
  • the heel itself is worn down
  • the inner lining of the shoe is torn
  • the mid-portion of the shoes is worn down

It’s important that people with diabetes visit a podiatrist on a regular basis based on their risk for diabetes complications. If you’re at a higher risk for diabetes complications and already have foot problems, you should go more frequently.

Source: http://www.joslin.org/info/the_best_shoes_for_people_with_diabetes.html


Routine Foot Care


Inspect your feet every day, and seek care early if you do get a foot injury. Make sure your health care provider checks your feet at least once a year-more often if you have foot problems. Your health care provider should also give you a list and explain the do’s and don’ts of foot care.

Most people can prevent any serious foot problem by following some simple steps. So let’s begin taking care of your feet today.


Your health care provider should perform a complete foot exam at least annually – more often if you have foot problems.

Remember to take off your socks and shoes while you wait for your physical examination.

Call or see your health care provider if you have cuts or breaks in the skin, or have an ingrown nail. Also, tell your health care provider if your foot changes color, shape, or just feels different (for example, becomes less sensitive or hurts). If you have corns or calluses, your health care provider can trim them for you. Your health care provider can also trim your toenails if you cannot do so safely or if your nails are thick or painful. Because people with diabetes are more prone to foot problems, a foot care specialist may be on your health care team.

Source: http://www.diabetes.org/living-with-diabetes/complications/foot-complications/foot-care.html


Corns and Callus


The New York Times defines a corn as “a protective layer of dead skin cells that forms due to repeated friction.” Corns are cone-shaped and knobby, and pressure on them can cause sharp pain. They most often develop along the pinky toe, but they can also form on top of or between toes. They can be hard or soft, depending on how much sweating and moisture that part of the foot receives. Sometimes corns develop as the result of deformed or crooked toes, but they are most often formed by tight shoes that place too much pressure on the foot.

Though there are many over-the-counter remedies on the market, the NY Times states that these products are “not recommended for people with diabetes.” Medicated corn pads often use salicylic acid, which causes an open wound to form on the foot. Normally, the tissue would heal over the wound, but the nerve damage and limited circulation diabetics suffer causes these wounds to heal slower – which opens up the possibility for infection and ulceration. A trusted NY podiatrist can gently remove the corn in office and treat the small wound with a dermal matrix to protect it from infection.


“Calluses occur more often and build up faster on the feet of people with diabetes,” according to the American Diabetes Association. High-pressure areas under the foot may require the use of therapeutic shoes and inserts to keep a person’s weight more evenly distributed. A study published by Sage et al. in 2001 found that over 82% of patients with diabetic foot ulcers also had calluses on their feet that preceded ulcer formation. Calluses can get very thick, break down, and cause open sores. Calluses can also hide inflammation and developing ulcers.

Attempting to remove a callus yourself can cause infection, so it is very important that they be removed by a trained podiatrist. Once the callus has been removed, the American Diabetes Association says that it would be beneficial to use a pumice stone on wet skin and apply lotion every day to keep foot skin under control.

Source: https://healingfeet.com/diabetes/diabetes-foot-care-corns-calluses-treated/


Common Foot & Ankle Problems

Plantar Fasciitis


Heel pain is most often caused by plantar fasciitis, a condition that is sometimes also called heel spur syndrome when a spur is present. Heel pain may also be due to other causes, such as a stress fracture, tendonitis, arthritis, nerve irritation or, rarely, a cyst. Because there are several potential causes, it is important to have heel pain properly diagnosed. A foot and ankle surgeon is able to distinguish between all the possibilities and to determine the underlying source of your heel pain.


The symptoms of plantar fasciitis are:

  • Pain on the bottom of the heel
  • Pain in the arch of the foot
  • Pain that is usually worse upon arising
  • Pain that increases over a period of months
  • Swelling on the bottom of the heel

People with plantar fasciitis often describe the pain as worse when they get up in the morning or after they have been sitting for long periods of time. After a few minutes of walking, the pain decreases because walking stretches the fascia. For some people, the pain subsides but returns after spending long periods of time on their feet.

Source: https://www.foothealthfacts.org/conditions/heel-pain-(plantar-fasciitis)


Heel Pain


Heel pain is most often caused by plantar fasciitis, a condition that is sometimes also called heel spur syndrome when a spur is present. Heel pain may also be due to other causes, such as a stress fracture, tendonitis, arthritis, nerve irritation or, rarely, a cyst.

Because there are several potential causes, it is important to have heel pain properly diagnosed. A foot and ankle surgeon is able to distinguish between all the possibilities and to determine the underlying source of your heel pain.


The symptoms of plantar fasciitis are:

  • Pain on the bottom of the heel
  • Pain in the arch of the foot
  • Pain that is usually worse upon arising
  • Pain that increases over a period of months
  • Swelling on the bottom of the heel


Bone Spur


A heel spur is a calcium deposit causing a bony protrusion on the underside of the heel bone. On an X-ray, a heel spur can extend forward by as much as a half-inch. Without visible X-ray evidence, the condition is sometimes known as “heel spur syndrome.”

Although heel spurs are often painless, they can cause heel pain. They are frequently associated with plantar fasciitis, a painful inflammation of the fibrous band of connective tissue (plantar fascia) that runs along the bottom of the foot and connects the heel bone to the ball of the foot.


Heel spurs often cause no symptoms. But heel spurs can be associated with intermittent or chronic pain — especially while walking, jogging, or running — if inflammation develops at the point of the spur formation. In general, the cause of the pain is not the heel spur itself but the soft-tissue injury associated with it.

Many people describe the pain of heel spurs and plantar fasciitis as a knife or pin sticking into the bottom of their feet when they first stand up in the morning — a pain that later turns into a dull ache. They often complain that the sharp pain returns after they stand up after sitting for a prolonged period of time.

Source: http://www.webmd.com/pain-management/heel-spurs-pain-causes-symptoms-treatments#1




Arthritis is inflammation of one or more of your joints. It can cause pain and stiffness in any joint in the body, and is common in the small joints of the foot and ankle.

There are more than 100 forms of arthritis, many of which affect the foot and ankle. All types can make it difficult to walk and perform activities you enjoy.

Although there is no cure for arthritis, there are many treatment options available to slow the progress of the disease and relieve symptoms. With proper treatment, many people with arthritis are able to manage their pain, remain active, and lead fulfilling lives.


The symptoms of arthritis vary depending on which joint is affected. In many cases, an arthritic joint will be painful and inflamed. Generally, the pain develops gradually over time, although sudden onset is also possible. There can be other symptoms, as well, including:

  • Pain with motion
  • Pain that flares up with vigorous activity
  • Tenderness when pressure is applied to the joint
  • Joint swelling, warmth, and redness
  • Increased pain and swelling in the morning, or after sitting or resting
  • Difficulty in walking due to any of the above symptoms


Pediatric Foot Care



Some parents (and even some pediatric specialists) believe children will outgrow a foot problem, and though this may happen, you should not take a chance with your child. If you suspect a pediatric foot problem, have us or a competent podiatrist check your child’s feet.

Common Pediatric Children’s Foot Problems

Pediatric foot problems are referred to by podiatrists as podopediatrics. Foot problems in your child may appear at birth, shortly thereafter, or once your child is walking. Walking abnormally is often the first sign that something is wrong with your child’s foot or their feet.

Adolescents and teenage children may develop foot or ankle problems and these should not be ignored. It is important to watch for any foot deformities or limping in your adolescent or teenage child, and see our podiatrists or an expert in pediatric podiatry if you notice any foot issues.

Pediatric Heel Pain

Heel pain in a child is a common problem. One of the first signs you may notice is your child limping. Pediatric heel pain is differs from adult heel pain in that the child’s foot is still growing, and as a result, more flexible.

Your child’s heel pain may be due to an abnormality of the heel bone’s growth area. In these cases, the growth area of the heel bone becomes inflamed, and pain worsens when your child tries to walk or participate in sports. Other heel pain causes include a fracture, bone tumor, bursitis or infection.

If you notice your child limping or complaining of heel or arch pain, you should have the child’s evaluated by one of our podiatrists as soon as possible.

In-toeing or Out-toeing in Children

In-toeing is often referred to as walking pigeon-toed. Instead of the foot pointed straight-ahead, the foot turns inward. Sometimes in-toeing occurs with only one foot, or it may affect both feet. The child may limp, stumble or even trip and fall when running or walking. In-toeing may be due to a structural issue with the foot itself or related to the leg or hips.

Out-toeing is the reverse of in-toeing, where the child’s foot points outward when they are walking. Again, this problem can affect one or both feet, and it can cause the child to stumble or even fall when running or walking.

Both in-toeing and out-toeing are considered structural problems and when these problems are caught early they are easy to correct. Most parents are able to spot in-toeing or out-toeing in their child, usually shortly after the child begin to walk. If you suspect in-toeing or out-toeing, you should bring your child in for an evaluation with one of our podiatrists.

Toe-Walking in Children

Some toddlers or even older children may walk more on their toes or the front of the their foot, rather than putting their heel down on the ground. The child who toe-walks may appear to “bounce” as they walk.

This problem may be due to bone abnormality in the child’s foot or a neurologic issue, though more often is due to the tendon at the back of the leg, called the Achilles tendon, being too short.

Most of the time, a tight Achilles tendon can be treated conservatively, though in severe cases our podiatrists may do a small procedure to help lengthen the tendon.

Bunions in Children

Some people mistakenly believe bunions is an “old person’s” problem. The truth is many children develop bunions. Often a child develops a bunion secondary to another, more significant, deformity of the foot.

Most of the time, bunions in children can be treated without any type of surgery. It is important for parents to bring in their child as soon as they see a bunion beginning to form. In some cases, surgery may be necessary and our podiatrists may do a small out-patient surgery to correct the child’s bunion.

Flatfeet in Children

Flatfeet is called pes planus, and it is common foot problem our podiatrists treat. In basic terms, a flatfoot is a foot that has a very low arch or no height to the arch. A child with a flatfoot may or may not have pain.

Flatfeet are related to the development of all kinds of foot, ankle and leg pain and problems. Your child may have difficulty walking or may complain of “tired” feet.

Fortunately, treating flatfeet is easy. Often we make a simple arch support that molds to your child’s foot, called an orthotic. Orthotics are custom-made to your child’s foot and slip in your child’s shoes. Generally, the younger your child is when he or she begins wearing orthotics the better.

Ingrown Toe Nails in Children

Ingrown toe nails are common in people of all ages and children are no exception. Ingrown toe nails can be painful and cause your child to limp or avoid wearing their shoes. Our podiatrists treat ingrown toe nails just about every day. In fact, a painful ingrown toe nail is one of the most common problems our podiatrists treat.

Alleviating an ingrown toe nail is easy and fast when it is addressed promptly. It is important that you do not ignore an ingrown toe nail in your child’s foot as it can become infected and lead to other complications.

Plantar Warts

Plantar warts show up on the bottom of a child (or adult’s) foot, though warts can occur anywhere on the foot. Doctors had children where warts were under toe nails.

Warts are due to a virus and they tend to affect children’s feet more than adults. Plantar warts are easy to catch and they can spread rapidly – they are highly contagious. Worse, plantar warts can be irritating or even painful.

Parents who notice a plantar wart on their child’s foot should see our podiatrists immediately, before the wart spreads. Most of the treatments for plantar warts are easy and painless.

Source: http://www.friendlyfootcare.com/childrens-pediatric-podiatry-care/


Custom Orthotics



Custom orthotics are specially-made devices designed to support and comfort your feet. Prescription orthotics are crafted for you and no one else. They match the contours of your feet precisely and are designed for the way you move. Orthotics are only manufactured after a podiatrist has conducted a complete evaluation of your feet.


If you have serious pain or discomfort, however, schedule an appointment with a podiatrist. He or she will assess your overall health and look for any other contributing factors. Today’s podiatrists are specially trained to evaluate the biomechanics of the lower extremity.

Your podiatrist will examine your feet and how you walk. He or she will listen carefully to your complaints and concerns and assess the movement and function of your lower extremities. Some also use advanced technology to see how your feet function when walking or running.

The information gathered during the exam will help your podiatrist determine if shoe inserts might be helpful or if you need prescription orthotics. Your podiatrist might also suggest additional treatments to improve the comfort and function of your feet.