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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.

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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.

Ankle Sprains

Ankle sprains are caused by an unnatural twisting or force on the ankle bones of the foot, which may result in excessive stretching or tearing of one or more ligaments on the outside of the ankle. The severity of the sprain can impact the degree of damage as well as the type and duration of treatment. If not properly treated, ankle sprains may develop into long-term problems. Primary symptoms of ankle sprains are pain following a twist or injury, swelling, and bruising.

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Treatment includes resting and elevating the ankle and applying ice to reduce swelling. Compressive bandages also may be used to immobilize and support the 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.

Athlete's Foot (tinea pedis)

Athlete's Foot, also known as tinea pedis, 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 perspire 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.

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.

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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.

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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.

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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.

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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.

Diabetic Care

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.

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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

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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.

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.

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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.

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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.

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.

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

Spurs

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 are generally harmless. However, their location may cause friction or irritation from shoes or other foot structures, which can lead to other foot problems.

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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.

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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.

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