Podiatry

You can sprain your ankle when you experience unnatural twisting or force on your ankle bones. This can stretch or tear the ligaments on the outside of your ankle. Sprains can be mild or severe, which affects the type and duration of your treatment. If not properly treated, your ankle sprain may develop into long-term problems.

The primary ankle sprain symptoms are pain following a twist or injury, swelling and bruising.

Treatment includes resting, elevating your ankle, and applying ice to reduce swelling. Compressive bandages (wraps) immobilize and support your injury during healing. Serious ankle sprains, particularly among competitive athletes, may require surgery to repair and tighten the damaged ligaments.

To prevent ankle sprains, try to maintain strength, balance, and flexibility in the foot and ankle through exercising, stretching, and wearing well-fitted shoes.

You may develop a bone deformity called a bunion if the joint at the base and side of your big toe is enlarged. Bunions form when your toe moves out of place. The enlargement causes friction and pressure as it rubs against your footwear. Over time, your big toe angles in toward your other toes and causes inflammation or irritation. It may rotate or twist. Bunions can also lead to other toe deformities, such as hammertoe.

You may suffer from discomfort and pain from the bunion’s constant irritation, rubbing and friction against your shoes. This joint flexes with every step, so the bigger the bunion gets, the more it hurts to walk. Over time, you may develop bursitis or arthritis. The skin on the bottom of your foot may thicken, making it more difficult and painful to walk.

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% of the population in Western countries.

Treatment for Bunions

Because they’re bone deformities, bunions don’t resolve on their own. The goal of bunion treatment is twofold: first, to relieve the pressure and pain caused by irritation, and second, to stop the enlargement from growing bigger. Common methods for reducing bunion pressure and pain include:

• Applying protective padding, often made from felt material, to eliminate friction against shoes and alleviate inflammation and skin problems.
• Removing corns and calluses on the foot.
• Wearing carefully fitted footwear to accommodate the bunion and not contribute toward its growth.
• Using 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.
• Exercising to maintain joint mobility and prevent stiffness or arthritis.
• Wearing splints at night to help properly align the toe and joint. This is often recommended for adolescents with bunions, because their bone development may still be adaptable.

Surgical Treatment

Conservative treatments may not prevent progressive damage from bunions. Effective treatment depends on the size of the enlargement, misalignment of the toe, and pain experienced. In advanced cases, you may need bunion surgery to remove the bunion and realign the toe.

Flat feet are a common condition of the foot’s 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.  Most people develop normal arches by adulthood.

You may have flat feet without experiencing 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 (NSAIDs), icing, physical therapy, supportive taping, bracing, and orthotics are common treatments for painful progressive flatfoot. Note: You should always consult your physician before taking any medications. In some cases, you may need surgery 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.

Hammertoe is a deformity of the second, third, or fourth toes. In this condition, the toe is bent at the middle joint, so it resembles a hammer. Left untreated, hammertoes can become inflexible and require surgery. If you have hammertoe, you may have corns or calluses on the top of the toe’s middle joint or on the toe’s tip. You may also feel pain in your 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.

Diabetes is a lifelong chronic disease caused by high levels of sugar in your blood. It can decrease your body's ability to fight off infections, which is especially dangerous to your feet. Unless you properly control diabetes, you’re likely to experience organ damage and immune system impairment.

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 abnormal pressure on the skin, bones, and joints of the foot during walking and other activities. This can 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

With diabetes, there are several risk factors that increase your chances of developing foot problems and diabetic infections in the legs and feet. Poorly fitting shoes are one of the biggest culprits causing diabetic foot complications. If you have red spots, sore spots, blisters, corns, calluses, or consistent pain associated with wearing shoes, you’ll need new properly fitted shoes immediately. If you have common foot abnormalities such as flat feet, bunions, or hammertoes, you may need prescription shoes or orthotics from your podiatrist to further protect your feet from additional damage.

People who have long-standing or poorly controlled diabetes are also at risk for damage to the nerves in their feet, known as peripheral neuropathy. If you have nerve damage, you may be unable to feel your feet normally. 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.

Bone spurs are a very common foot problem. In the feet, they develop most frequently in the heel, near the toes, and on top of the big toe joint. The spurs are small outgrowths of bone. In and of themselves, they’re generally harmless. However, their location may cause friction or irritation from shoes or other foot structures, which can lead to other foot problems.

Heel spurs refer specifically to bone spurs in the heel. Heel spurs are growths of bone on the underside, forepart of the heel bone and occur when the plantar fibrous band pulls at its attachment to the heel bone. This area of the heel later calcifies to form a spur. With proper warm-up and the use of appropriate athletic shoes, strain to the ligament can be reduced.

Anti-inflammatory medications, cortisone injections, corrective shoes, and/or orthotics (special shoe inserts) are some of the common treatments for spurs. Note: Please consult your physician before taking any medication. Surgery may be prescribed if spurring around the joint becomes severe or leads to recurrent pain from persistent corns.

Corns are calluses that form on the toes because of bones that push up against shoes and build up pressure on the skin. The surface layer of the skin thickens, 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 corns. Self-care for corns includes soaking feet regularly and using a pumice stone or callus file to reduce the corn’s size. You can wear special over-the-counter, non-medicated, donut-shaped foam pads to help relieve pressure and discomfort. For large or lasting corns, you can make an appointment with our podiatry team. We can shave off the corns using a scalpel.

Athlete's foot is a skin disease caused by a fungus that usually occurs between the toes. The fungus attacks the feet because shoes create a warm, dark, and humid environment that encourages fungus growth. Warm, damp areas around swimming pools, showers, and locker rooms are also breeding grounds for fungi.

Symptoms of athlete's foot include drying skin, itching, scaling, inflammation, and blisters on and between the toes. Athlete's foot can spread to the soles of the feet and to the toenails as well as other parts of the body, which is why timely treatment is so important.

You can prevent athlete's foot by:

• Not walking barefoot, particularly in public pools and locker rooms.
• Reducing foot perspiration by using talcum powder.
• Wearing light and airy shoes.
• Wearing socks that keep your feet dry and changing them frequently if you sweat heavily.

While fungicidal and fungistatic chemicals are usually used to treat athlete's foot problems, they often fail to contact the fungi in the lower layers of the skin. For persistent athlete's foot, a prescription topical or oral antifungal drug may be needed. Note: Please consult your physician before taking any medications.