Traitements offerts

Definition

Diabetes is a serious disease that can develop from lack of insulin production in the body or due to the inability of the body’s insulin to perform its normal everyday functions. Insulin is a substance that helps process the food we eat and turn it into energy.

Diabetes affects approximately 16 million Americans and is classified into 2 different types: Type 1 and Type 2. Type 1 is usually associated with juvenile diabetes and is often linked to heredity. Type 2, commonly referred to as adult onset diabetes, is characterized by elevated blood sugars, often in people who are overweight or have not attended to their diet properly.

Many complications can be associated with diabetes. Diabetes disrupts the vascular system, affecting many areas of the body such as the eyes, kidneys, legs, and feet. People with diabetes should pay special attention to their feet.

Causes

Neuropathy
Diabetic Neuropathy can cause insensitivity or a loss of ability to feel pain, heat, and cold. Diabetics suffering from neuropathy can develop minor cuts, scrapes, blisters, or pressure sores that they may not be aware of due to the insensitivity. If these minor injuries are left untreated, complications may result and lead to ulceration and possibly even amputation. Neuropathy can also cause deformities such as Bunions, Hammer Toes, and Charcot Feet.

It is very important for diabetics to take the necessary precautions to prevent all foot related injuries. Due to the consequences of neuropathy, daily observation of the feet is critical. When a diabetic patient takes the necessary preventative footcare measures, he or she reduces the risks of serious foot conditions.

Poor Circulation
Diabetes often leads to peripheral vascular disease that inhibits a person’s blood circulation. With this condition, there is a narrowing of the arteries that frequently leads to significantly decreased circulation in the lower part of the legs and the feet. Poor circulation contributes to diabetic foot problems by reducing the amount of oxygen and nutrition supplied to the skin and other tissue, causing injuries to heal poorly. Poor circulation can also lead to swelling and dryness of the foot. Preventing foot complications is more critical for the diabetic patient because poor circulation impairs the healing process and can lead to ulcers, infection, and other serious foot conditions.

If you are a diabetic, you should be particularly alert to any problems you may be having with your feet. If you have diabetes and are experiencing a foot problem, immediately consult your foot doctor.

Definition

Pregnancy triggers many different changes in a woman’s body. Many women have common complaints throughout their pregnancy. One of these complaints, often overlooked, is foot pain. Due to the natural weight gain during pregnancy, a woman’s center of gravity is completely altered. This causes a new weight-bearing stance and added pressure to the knees and feet.

Two of the most common foot problems experienced by pregnant woman are over-pronation and edema. These problems can lead to pain at the heel, arch, or the ball-of-foot. Many women may also experience leg cramping and varicose veins due to weight gain. Because of this, it is important for all pregnant women to learn more about foot health during their pregnancy to help make this nine month period more comfortable.

Causes

There is a hormonal surge that causes ligaments in the pelvis to relax allowing for the delivery of the baby. Unfortunately, the ligaments in the feet also relax. This leads to the arch flattening out upon weight bearing and the feet roll inward when walking, known as over-pronation. This can create extreme stress or inflammation on the plantar fascia, the fibrous band of tissue that runs from the heel to the forefoot.

Over-pronation can make walking very painful and can increase strain on the feet, calves and/or back. The reason many pregnant women also suffer from over-pronation is the added pressure on the body as a result of weight gain. Over-pronation is also very prominent in people who have flexible, flat feet or in people who are obese.

Edema, also referred to as swelling in the feet, normally occurs in the latter part of pregnancy. Edema results from the extra blood accumulated during pregnancy. The enlarging uterus puts pressure on the blood vessels in the pelvis and legs causing circulation to slow down and blood to pool in the lower extremities. The total water fluid in the body remains the same as before pregnancy, however it becomes displaced. When feet are swollen, they can become purplish in color. Sometimes extra water is retained during pregnancy, adding to the swelling. If there is swelling in the face or hands, a doctor should be contacted immediately.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Recommend specific exercises and nutritional regimens.
• Recommend appropriate shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. Custom-made foot orthotics relieve stress from compromised joints, ligaments, and muscles. Deforming forces acting on the foot are diminished. Follow the link to find out more about orthotics.
• Recommend long-term control and prevention techniques.
• Initiate total medical team approach, which may include your family doctor or specialist.

Symptoms

Due to excessive inward rotation of the foot, the legs internally rotate which forces the pelvis to tilt forward resulting in increased curvature of the lower back. This causes tightness and stiffness in the lower back. It may also cause poor posture. If there is poor shock absorption in the feet/heels leads to lower back pain.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request an X-ray, bone scan, CT, MRI or other imaging studies.
• Recommend exercise regimens.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. Follow the link to find out more about orthotics.
• Prescribe appropriate medications.

Definition

Achilles tendonitis is inflammation and degeneration of the achilles tendon. The achilles tendon is the large tendon located in the back of the leg that inserts into the heel. The pain caused by achilles tendonitis can develop gradually without a history of trauma. The pain can be a shooting pain, burning pain, or even an extremely piercing pain. Achilles tendonitis should not be left untreated due to the danger that the tendon can become weak and ruptured.

Achilles Tendonitis is aggravated by activities that repeatedly stress the tendon, causing inflammation. In some cases even prolonged periods of standing can cause symptoms. It is a common problem often experienced by athletes, particularly distance runners. Achilles Tendonitis is a difficult injury to treat in athletes due to their high level of activity and reluctance to stop or slow down their training.

Individuals who suffer from achilles tendonitis often complain that their first steps out of bed in the morning are extremely painful. Another common complaint is pain after steps are taken after long periods of sitting. This pain often lessens with activity.

Causes

There are several factors that can cause achilles tendonitis. The most common cause is over-pronation (inward rotation of the foot). Over-pronation occurs in the walking process, when the arch collapses upon weight bearing, adding stress on the achilles tendon.

Other factors that lead to achilles tendonitis are poor shock absorption, improper shoe selection, inadequate stretching prior to engaging in athletics, a short achilles tendon, direct trauma (injury) to the tendon, and heel bone deformity.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request an X-ray, bone scan, CT, MRI or other imaging studies.
• Recommend padding, dressing and friction-reducing measures.
• Recommend appropriate exercise regimens.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. Follow the link to find out more about orthotics.
• Prescribe appropriate medications.
• Perform surgery if necessary.

Definition

Heel pain is a common condition in which weight bearing on the heel causes extreme discomfort.

Causes

There are two different categories of heel pain. The first is caused by repetitive stress which results in soreness due to repeated impact on a specific area of the foot. This condition, often referred to as “heel pain syndrome”, can be caused by shoes with heels that are too low, a thinned out fat pad in the heel area, or from a sudden increase in activity.

Plantar fasciitis, a very common diagnosis of heel pain, is usually caused from over-pronation (over-rotation) also known as flat feet. Over-pronation can cause the tissue of the foot to be excessively stretched and inflamed, resulting in pain in the heel and arch areas of the foot. Often the pain will be most intense first thing in the morning or after a prolonged period of rest. The pain will gradually subside as the day progresses.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request an X-ray, bone scan, CT, MRI or other imaging studies.
• Recommend padding, dressing and friction-reducing measures.
• Recommend exercise regimens.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. Follow the link to find out more about orthotics.
• Prescribe appropriate medications.
• Administer injections.
• Perform surgery if necessary.

Definition

The heel bone is the largest bone in the foot and absorbs the most amount of shock and pressure. A heel spur develops as an abnormal growth of the heel bone. Calcium deposits form when the plantar fascia pulls away from the heel area, causing a bony protrusion, or heel spur to develop. The plantar fascia is a broad band of fibrous tissue located along the bottom surface of the foot that runs from the heel to the forefoot. Heel spurs can cause extreme pain in the rearfoot, especially while standing or walking.

Causes

Heel spurs develop as an abnormal growth in the heel bone due to calcium deposits that form when the plantar fascia pulls away from the heel. This stretching of the plantar fascia is usually the result of over-pronation (flat feet), but people with unusually high arches (pes cavus) can also develop heel spurs. Women have a significantly higher incidence of heel spurs due to the types of footwear often worn on a regular basis.

Treatment and Prevention

The key for the proper treatment of heel spurs is determining what is causing the excessive stretching of the plantar fascia.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request an X-ray, bone scan, CT, MRI or other imaging studies.
• Recommend padding, dressing and friction-reducing measures.
• Recommend exercise regimens.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. Prescribe appropriate medications.
• Administer injections.
• Perform surgery if necessary.

Definition

A ganglion cyst is a fluid-filled swelling of the lining of a joint or tendon. Although ganglions can form on any part of the foot, they most often appear on the ankle or top of the foot.

Causes

Repeated irritation can weaken the lining of a joint or tendon and lead to ganglions. People who wear boots are more vulnerable to ganglions, as this type of footwear puts stress on the foot and ankle. Bone spurs (bony outgrowths) may also cause ganglions by irritating the joints and tendons.

Ganglions tend to change in size and usually grow slowly. They also sometimes swell and their size can change with different activities or a change in weather.

Treatment and Prevention

The key for the proper treatment of heel spurs is determining what is causing the excessive stretching of the plantar fascia.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request X-ray, bone scan, CT, MRI or other imaging studies and future exams as needed. Fluid removal (needle aspiration) may be done to help determine the degree of swelling and to decrease pain. Prescribe anti-inflammatory medications.
• Perform friction-reducing measures.
• Perform surgery if necessary.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency.
• Recommend long-term control and prevention techniques.

Definition

Heel fissures, also known as cracked heels can be a simple cosmetic problem and a nuisance, but can also lead to serious medical problems. Heel fissures occur when the skin on the bottom, outer edge of the heel becomes hard, dry and flaky, sometimes causing deep fissures that can be painful or bleed.

Causes

Heel fissures can affect anyone, but risk factors include:

• Living in a dry climate
• Obesity
• Consistently walking barefoot or wearing sandals or open-backed shoes
• Inactive sweat glands

Like many foot conditions, heel fissures can become more dangerous if they go untreated and become deep or infected. This is especially dangerous for people with diabetes or compromised immune systems.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Perform comprehensive manual debridement of heel fissures with precision and skill to its utmost importance. Here at M3 we have great success in the treatment of heel fissuring.
• Recommend topical moisturizing medication.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. Follow the link to find out more about orthotics.

Definition

Bunions, referred to in the medical community as Hallux Valgus, are one of the most common foot problems. A bunion is a prominent bump on the inside of the foot around the big toe joint. This bump is actually a bone protruding towards the inside of the foot. With the continued movement of the big toe towards the smaller toes, it is common to find the big toe resting under or over the second toe. Some of the symptoms of bunions include inflammation, swelling, and soreness on the side surface of the big toe. The discomfort commonly causes a patient to walk improperly.

Another type of bunion which some individuals experience is called a Tailor’s Bunion, also known as a Bunionette. This forms on the outside of the foot towards the joint at the little toe. It is a smaller bump that forms due to the little toe moving inwards, towards the big toe.

Statistics

• 8 out of 1,000 males have a bunion.
• 38 out of 1,000 females have a bunion.
• 55 out of 1,000 people aged 65 or older have a bunion.

Causes

Bunions are a common problem experienced mostly by women. The deformity can develop from an abnormality in foot function, or arthritis, but is more commonly caused by wearing improper fitting footwear. Tight, narrow dress shoes with a constrictive toe box (toe area) can cause the foot to begin to take the shape of the shoe, leading to the formation of a bunion. Women who have bunions normally wear dress shoes that are too small for their feet. Their toes are squeezed together in their shoes causing the first metatarsal bone to protrude on the side of the foot.

It is important for men and women to realize that wearing dress shoes and boots, which are tapered in the toe area, can cause the bunion to worsen to the point where surgery is necessary.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request X-ray, bone scan, CT, MRI or other imaging studies.
• Recommend padding, dressing and friction-reducing measures.
• Recommend exercise regimens.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. Follow the link to find out more about orthotics.
• Perform surgery as indicated.

Definition

A claw toe is a toe that is contracted at the PIP and DIP joints (middle and end joints in the toe), and can lead to severe pressure and pain. Ligaments and tendons that have tightened cause the toe’s joints to curl downwards. Claw toes may occur in any toe, except the big toe. There is often discomfort at the top part of the toe that is rubbing against the shoe and at the end of the toe that is pressed against the bottom of the shoe.

Claw toes are classified based on the mobility of the toe joints. There are two types – flexible and rigid. In a flexible claw toe, the joint has the ability to move. This type of claw toe can be straightened manually.

A rigid claw toe does not have that same ability to move. Movement is very limited and can be extremely painful. This sometimes causes foot movement to become restricted leading to extra stress at the ball-of-the-foot, and possibly causing pain and the development of corns and calluses.

Causes

Claw toes result from a muscle imbalance which causes the ligaments and tendons to become unnaturally tight. This results in the joints curling downwards. Arthritis can also lead to many different forefoot deformities, including claw toes.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request X-ray, bone scan, CT, MRI or other imaging studies, if needed.
• Perform trimming and padding, dressing and friction-reducing measures.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency.
• Perform surgery as indicated.

Definition

Many disorders can affect the joints in the toes, causing pain and preventing the foot from functioning as it should. A mallet toe occurs when the joint at the end of the toe cannot straighten. Excessive rubbing of the mallet toe against the top of the shoe can lead to pain and the development of a corn. The tip of the toe is often turned down against the shoe causing pressure and discomfort.

Causes

The development of mallet toes is often caused by bone and muscle imbalances. These imbalances become exaggerated in people with active lifestyles. For example, people who are constantly on their feet or participate in athletic activities are more likely to develop mallet toes.

Arthritis can also lead to many forefoot deformities including mallet toes. Mallet toes can cause extreme discomfort, and can be aggravated if restrictive or improperly fitting footwear is worn for a prolonged period of time.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request an X-ray, bone scan, CT, MRI or other imaging studies.
• Perform trimming and padding, dressing and friction-reducing measures.
• Recommend exercise regimens.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency.
• Perform surgery as indicated.

Definition

Morton’s Toe is a common forefoot disorder where the second toe is longer than the Big Toe (the Hallux).

Causes

Morton’s toe leads to excessive pressure on the second metatarsal head (behind the second toe at the ball- of-the-foot) resulting in pain similar to the discomfort associated with metatarsalgia. The constant pressure placed on the longer second toe while walking or standing can lead to callus formation under the second metatarsal head due to this excessive pressure.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request an X-ray, bone scan, CT, MRI or other imaging studies to rule out other causes.
• Recommend padding, dressing and friction-reducing measures.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. Follow the link to find out more about orthotics.
• Prescribe anti-inflammatory medication.
• Administer cortisone injections.
• Recommend long-term control and prevention techniques.
• Perform surgery when indicated.

Definition

A hammer toe is a toe that is contracted at the PIP joint (middle joint in the toe), potentially leading to severe pressure and pain. Ligaments and tendons that have tightened cause the toe’s joints to curl downwards. Hammer toes may occur in any toe except the big toe. There is often discomfort at the top part of the toe due to rubbing against the shoe.

Hammer toes are classified based on the mobility of the toe joints. There are two types – flexible and rigid. In a flexible hammer toe, the joint has the ability to move. This type of hammer toe can be straightened manually. A rigid hammer toe does not have that same ability to move. Movement is very limited and can be extremely painful. This sometimes causes foot movement to become restricted leading to extra stress at the ball-of-the-foot, and possibly causing pain and the development of corns and calluses. Follow this link to learn more about hammer toe products.

Causes

Hammer toes result from a muscle imbalance which causes the ligaments and tendons to become unnaturally tight. This results in the joint curling downward. Arthritis can also lead to many different forefoot deformities, including hammer toes.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request an X-ray, bone scan, CT, MRI or other imaging studies.
• Perform padding, dressing and friction-reducing measures.
• Recommend exercise regimens.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. Follow the link to find out more about orthotics.
• Perform surgery as indicated.

Definition

Toenail fungus, known by physicians as Onychomycosis, affects about half of Americans by the age of 70. Fungus infections occur when microscopic fungi gain entry through a small trauma in the nail, then grow and spread in the warm, moist environment inside a person’s socks and shoes.

Symptoms of toenail fungus, include swelling, yellowing, thickening or crumbling of the nail, streaks or spots down the side of the nail, and even complete loss of the nail. Toenail color can vary from brown or yellow to white with this condition.

Fungal infections can affect the fingernails as well as the toenails, but toenail fungus is more difficult to treat because toenails are always in humid environements.

Causes

Toenail fungus can be picked up in damp areas such as public gyms, shower stalls or swimming pools, and can be passed among family members. Athletes and people who wear tight-fitting shoes or tight hosiery that cause trauma to the toes or keep the feet from drying out are at higher risk. The condition can also spread from one toe to another, or to other parts of the body.

Other risk factors include abnormal PH level of the skin, not drying off the feet thoroughly after bathing or exercise, and a compromised immune system in someone who has been exposed to a fungus. Diabetics have an increased risk of contracting a toenail fungus because their immune system is compromised. They should have their nails regularly trimmed and debrided by a podiatrist.

Treatment and Prevention

Treatment is to manually debride and clean the affected nail(s) with precision and skill to its utmost importance. Dr El-Onsi has great success in the treatment of toenail fungus. Because it is difficult to treat or eradicate toenail fungus, it is a good idea to try to prevent it. It helps to wear protective shoes or sandals in public showers, pool areas and gyms, and to avoid borrowing someone else’s shoes or sharing socks or towels with someone who has toenail fungus.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Perform unique comprehensive manual debridement or removal of the nail as indicated.
• Prescribe appropriate antifungal medication.
• Recommend long-term control and prevention techniques.

Definition

Known to physicians as onychocryptosis, ingrown toe nails are a common, painful condition that occur when skin on one or both sides of a nail grows over the edges of the nail, or when the nail itself grows into the skin. This condition is usually very painful and can be associated with infection of the toe. Some ingrown toenails are chronic, with repeated episodes of pain and infection. Irritation, redness, an uncomfortable sensation of warmth, as well as swelling can result from an ingrown toenail.

Causes

Ingrown toenails develop for many reasons. In some cases the condition is congenital, such as toenails that simply are too large. People whose toes curl, either congenitally or from diseases like arthritis, are prone to ingrown toenails. Often trauma, like stubbing a toe or having a toe stepped on, can cause a piece of the nail to be jammed into the skin. Repeated trauma, such as the pounding to which runners typically subject their feet, also can cause ingrown nails.

The most common cause is cutting your toenails incorrectly, causing them to re-grow into the skin. Tight hosiery or shoes with narrow toe boxes only make matters worse. If the skin is red, painful or swollen on the sides of the nail, an infection may be present. This occurs because the ingrown nail is often in a warm, moist and bacteria-rich environment. When the nail penetrates the skin, it provides a convenient entry for germs that can cause infection. Untreated, the nail can go under the skin, causing a more severe infection. In either case, the infection needs to be cured with sterile instruments and antibiotics.

Treatment and Prevention

Ingrown toenails should be treated as soon as they are recognized. In many cases, people with uninfected ingrown toenails can obtain relief with the following simple regimen:

1. Soak the feet in luke warm salt water
2. Dry them thoroughly with a clean towel
3. Apply a mild antiseptic solution to the area
4. Bandage the toe
5. Seek podiatric help.

Cutting toe nails properly goes a long way toward the prevention of ingrown toenails. Using a safety nail clipper, cut the nails straight across, so that the nail corner is visible. If you cut the nail too short, you are inviting the nail corner to grow into the skin. It is the natural tendency, when the edge of the nail starts to grow in, to cut down at an angle at the nail edge, to relieve the pain. This does relieve the pain temporarily, but it also can start a downward spiral, training the nail to become more and more ingrown.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Perform the appropriate surgical removal of the offending portion of the nail when indicated.
• Recommend custom-made foot orthotics as needed to reduce stress from the inside of the toe for long-term prevention. Follow the link to find out more about orthotics.
• Recommend long-term control and prevention techniques.

Definition

Many disorders can affect the joints in the toes, causing pain and preventing the foot from functioning as it should. People of all ages can experience forefoot problems. Overlapping toes can occur in any of the toes and can cause extreme irritation if not corrected.

Causes

Many disorders can affect the joints in the toes, causing pain and preventing the foot from functioning as it should. People of all ages can experience forefoot problems. Overlapping toes can occur in any of the toes and can cause extreme irritation if not corrected.

Treatment and Prevention

Any problems that cause pain or discomfort in the toes should be given prompt attention. Ignoring the symptoms can aggravate the condition, and lead to a breakdown of tissue or even infection.

Conservative treatment (non-surgical treatment) of overlapping toes begins with accommodating the disorder.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request X-rays, bone scans, CT, MRI or other imaging studies.
• Recommend exercise regimens.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. Orthotics relieves stress from compromised joints, ligaments, and muscles. Deforming forces acting on the foot are diminished.

Definition

A blackened toenail is caused by pooling of blood, or a haematoma, beneath the toenail. Haematomas are very common result of an active lifestyle, especially among people who jog or play tennis.

Causes

• The repeated rubbing of the toes against the shoe (top, end or bottom).
• A fracture, especially after an injury (such as dropping a heavy object on the end of the toe).

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request Perform complete debridement and cleaning of affected blackened toenail.
• Prescribe appropriate medication.
• Recommend long-term control and prevention techniques.

Definition

Over-pronation, or over-rotation of the foot is referred to as flat feet. It is a common problem that occurs in the walking process when a person’s arch collapses upon weight. This motion can cause extreme stress or inflammation on the plantar fascia (a band of tissue in the foot), potentially causing severe discomfort and leading to other foot problems.

Causes

Over-pronation is very prominent in people who have flexible, flat feet. The framework of the foot begins to collapse, causing the foot to flatten and adding stress to other parts of the foot. As a result, over-pronation, often leads to Plantar Fasciitis, Heel Spurs, Metatarsalgia, Post-tib Tendonitis and/or Bunions.

There are many causes of flat feet. Obesity, pregnancy or repetitive pounding on a hard surface can weaken the arch leading to over-pronation. Often people with flat feet do not experience discomfort immediately, and some never suffer from any discomfort at all. However, when symptoms develop and become painful, walking becomes awkward and causes increased strain on the feet and calves.

Treatment and Prevention

Over-Pronation can be treated conservatively (non-surgical treatments) with custom orthotics. These orthotics should be designed with appropriate arch support and inward foot support to prevent the over-pronation.

Footwear should also be examined to ensure there is a proper fit. Footwear with a firm heel counter is often recommended for extra support and stability. Improperly fitting footwear can lead to additional foot problems.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request X-rays, bone scans, CT, MRI or other imaging studies.
• Recommend exercise regimens.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. Orthotics relieves stress from compromised joints, ligaments, and muscles. Deforming forces acting on the foot are diminished. Follow the link to find out more about orthotics.

Definition

Burning feet is a common foot complaint among many groups, most commonly in the older group over 50 years of age. There are many different causes of this condition.

Causes

• Allergic reaction to leather dyes or synthetic fiber material
• Alcohol abuse
• Diabetes
• Smoking
• Neuroma
• Gout
• Athletes foot
• Nutritional deficiencies
• Heavy metal poisoning ( Arsenic, Lead)
• Blood disorders
• Hereditary disorders
• Poison ivy
• Mechanical overload in foot (TTS, N)
• Reflex sympathetic dystrophy

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request an X-ray, bone scan, CT, MRI or other imaging studies.
• Perform trimming and padding, dressing and friction-reducing measures.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. Follow the link to find out more about orthotics.
• Recommend long-term control and prevention techniques.

Definition

The term arch pain (often referred to as arch strain) refers to an inflammation and/or burning sensation at the arch of the foot.

Causes

There are many different factors that can cause arch pain. A structural imbalance or an injury to the foot can often be the direct cause. However, frequently the cause is a common condition called plantar fasciitis.

Plantar Fasciitis is an inflammation caused by excessive stretching of the plantar fascia. The plantar fascia is a broad band of fibrous tissue which runs along the bottom surface of the foot, attaching at the bottom of the heel bone and extending to the forefoot. When the plantar fascia is excessively stretched, this can cause plantar fasciitis, which can also lead to heel pain, arch pain, and heel spurs.

Excessive stretching of the plantar fascia that leads to the inflammation and discomfort can be caused by the following:

• Over-pronation (flat feet) which results in the arch collapsing upon weight bearing. Over-pronation is the leading cause of plantar fasciitis. It occurs when a person’s arch collapses upon weight bearing, causing the plantar fascia to be stretched away from the heel bone.
• A foot with an unusually high arch.
• A sudden increase in physical activity.
• Excessive weight on the foot, usually attributed to obesity or pregnancy.
• Improperly fitting footwear.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request an X-ray, bone scan, CT, MRI or other imaging studies.
• Recommend padding, dressing and friction-reducing measures.
• Recommend exercise regimens.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. Follow the link to find out more about orthotics.
• Prescribe appropriate medications.
• Perform surgery if necessary.

Definition

Plantar Fasciitis is an inflammation caused by excessive stretching of the plantar fascia. The plantar fascia is a broad band of fibrous tissue which runs along the bottom surface of the foot, attaching at the bottom of the heel bone and extending to the forefoot. When the plantar fascia is excessively stretched, this can cause plantar fasciitis, which can also lead to heel pain, arch pain, and heel spurs.

Causes

Plantar Fasciitis often leads to heel pain, heel spurs, and/or arch pain. The excessive stretching of the plantar fascia that leads to the inflammation and discomfort can be caused by the following:

• Over-pronation (flat feet) which results in the arch collapsing upon weight bearing.
• A foot with an unusually high arch.
• A sudden increase in physical activity.
• Excessive weight on the foot, usually attributed to obesity or pregnancy.
• Improperly fitting footwear.

Over-pronation (flat feet) is the leading cause of plantar fasciitis. Over-pronation occurs in the walking process, when a person’s arch collapses upon weight bearing, causing the plantar fascia to be stretched away from the heel bone.

With Plantar Fasciitis, the bottom of your foot usually hurts near the inside of the foot where the heel and arch meet. The pain is often acute either first thing in the morning or after a long rest, because while resting the plantar fascia contracts back to its original shape. As the day progresses and the plantar fascia continues to be stretched, the pain often subsides.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request an X-ray, bone scan, CT, MRI or other imaging studies.
• Recommend padding, dressing and friction-reducing measures.
• Recommend exercise regimens.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. Prescribe appropriate medications.
• Administer injections.
• Perform surgery if necessary.

Symptoms

The patella (kneecap) should lie in a groove between the thigh and shinbones. Both types of the above gait can result in the supporting tendons or muscles to loosen or tighten the patella causing it to be thrown off track, resulting in different joint movement and pain. The pain can be towards the inside, the outside, under the kneecap, on top or under it. It can be felt while walking upstairs, getting out of the car, running and jumping. In addition to sharp pain, dull aching types of pain may also occur. Conditions such as Runner’s Knee, Osgoods-Schlatter’s, Weakened Quadricep Muscles, and Patella Tendinitis are a few that are commonly treated. If the improper alignment is left untreated, degenerative cartilage can result.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request an X-ray, bone scan, CT, MRI or other imaging studies.
• Recommend exercise regimens.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. Follow the link to find out more about orthotics.
• Prescribe appropriate medications.

In order to understand some causes of lower back pain, you must first be introduced to normal gait.

Normal

There are three major phases of gait, contact, midstance and propulsion.

• Contact begins with heel strike, on the mid-to outside border of the heel. The heel should hit the ground perpendicular to the ground.
• Upon midstance, the weight of the body is dispersed over the middle part of the foot (midtarsal joint). The joint separates the back of the foot (rearfoot) from the front (forefoot). The joint should be locked at midstance to help the foot gain stability.
• Propulsion – In order for you to move forward, your weight is transferred to the front of the foot (forefoot) and you propel yourself with your big toe. This is propulsion.

Biomechanical Abnormalities

If your heel strikes the ground more towards the outside, there is an increase in degree of inward rotation of the foot. This leads in the arch to “drop” or “flatten”. The weight is then transferred too far medially and the side of the big toe must push against the ground creating a greater amount of friction. The shinbone (tibia) rotates internally (inwards) and the femur (thighbone) rotates externally (outwards). In some cases, the opposite may occur, and the heel bone hits too much on the inside border, resulting in supination. The opposite of the above occurs.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request an X-ray, bone scan, CT, MRI or other imaging studies.
• Recommend exercise regimens.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. Follow the link to find out more about orthotics.
• Prescribe appropriate medications.

Symptoms

The excessive inward motion of the foot can lead to excessive stretching of the muscle and tendon along the shinbone, caused by a structural biomechanical problem.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request an X-ray, bone scan, CT, MRI or other imaging studies.
• Recommend exercise regimens.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. Follow the link to find out more about orthotics.
• Prescribe appropriate medications.

Definition

Post-Tib Tendonitis is a strain placed on the posterior tibial tendon. The posterior tibial tendon runs along the inside of the ankle and the foot. When there is post-tibial tendon disfunction, the tendon does not function to hold up the arch, resulting in flat feet. This can lead to heel pain, arch pain, plantar fasciitis and/or heel spurs. With post-tib tendonitis, pain will be more severe upon weight bearing, especially while walking or running.

Causes

Post-Tib Tendonitis occurs when the muscle is overused and the tendon (soft tissue) that connects the muscle to your bone is strained. Years of over-pronation (flat feet) can also lead to posterior tibial tendon dysfunction. If you keep overusing the muscle, damage to the tendon builds up and tendonitis develops. At first the pain or swelling may come and go quickly, but eventually the problem may become more permanent.

Treatment and Prevention

To treat post-tib tendonitis, you can reduce your symptoms by limiting activity to control the pain and swelling. Stay off your feet a few days, then slowly increase your activity. Rest allows the tissues in your foot to heal.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request an X-ray, bone scan, CT, MRI or other imaging studies.
• Recommend padding, dressing and friction-reducing measures.
• Recommend exercise regimens.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. Follow the link to find out more about orthotics.
• Prescribe appropriate medications.
• Administer injections.
• Perform surgery if necessary.

Definition

A wart is a growth in the skin caused by a viral infection. Children, especially teenagers, tend to be more susceptible to warts than adults.

It is possible that a variety of other more serious lesions, including carcinomas and melanomas (cancers), can be mistakenly identified as warts. Because of those identification problems, it is wise to consult a podiatrist about any suspicious growth or eruption on the skin of the feet. If warts are left untreated, they can grow and spread into clusters of several warts. Warts can be transferred to other parts of the body and can be transferred between people.

Causes

• Viruses cause warts, which typically invade the skin through small cuts and abrasions.
• Warts are commonly contracted in communal places such as swimming pools, showers and changing areas where people are more inclined to walk bare-foot.
• Excessive moisture or excessive dryness of the skin can lead to small crack in the skin which provides area of easy entry for the virus to enter the skin

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Recommend comprehensive manual debridement with appropriate wart treatment. There are different types of chemical treatments which are very unique to different patient’s situations.
• Recommend long-term control and prevention techniques.

Definition

Corns, like calluses, develop from an accumulation of dead skin cells on the foot, forming thick, hardened areas. They contain a cone-shaped core with a point that can press on a nerve causing pain. Corns commonly form on the tops, sides and tips of the toes. They can become inflamed due to constant friction and pressure from footwear.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Perform comprehensive manual debridement of corns with appropriate friction-reducing measures.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. An effective foot orthotic transfers pressure away from the “hot spots” or high pressured areas to allow the corn to heal. Follow the link to find out more about orthotics.
• Perform surgery as indicated.

Blisters are painful, fluid-filled lesions, often caused by friction and pressure.

Causes

• Ill-fitting shoes
• Stiff shoes
• Wrinkled socks against the skin
• Excessive moisture
• Foot deformities
• Biomechanical imbalances

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Prescribe appropriate medications, topical or oral.
• Recommend padding, dressing and friction-reducing measures.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency.

Definition

The formation of calluses is caused by an accumulation of dead skin cells that harden and thicken over an area of the foot. This callus formation is the body’s defence mechanism to protect the foot against excessive pressure and friction. Calluses are normally found on the ball of the foot, the heel, and/or the inside of the big toe.

Some calluses have a deep seated core known as a nucleation. This particular type of callus can be especially painful to pressure. This condition is often referred to as Intractable Plantar Keratosis.

Statistics

• 65 out of 1,000 people are afflicted with calluses or corns
• 37 out of 1,000 males are afflicted
• 91 out of 1,000 females are afflicted

Causes

Calluses develop because of excessive pressure at a specific area of the foot. Some common causes of callus formation are high-heeled dress shoes, shoes that are too small, obesity, abnormalities in the gait cycle (walking motion), flat feet, high arched feet, bony prominences, and the loss of the fat pad on the bottom of the foot.

Treatment and Prevention

Many people try to alleviate the pain caused by calluses by cutting or trimming them with a razor blade or knife. This is not the way to properly treat calluses. This is very dangerous and can worsen the condition resulting in unnecessary injuries. Diabetics especially should never try this type of treatment.

To relieve the excessive pressure that leads to callus formation, weight should be redistributed equally with the use of custom-made dynamic foot orthotics (insoles). An effective foot orthotic transfers pressure away from the “hot spots” or high pressured areas to allow the callus to heal. The orthotic should be made with materials that absorb shock and shear (friction) forces. Women should also steer away from wearing high-heeled shoes.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Perform comprehensive manual debridement of calluses with appropriate friction-reducing measures.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help prevent the problem from recurring. Follow the link to find out more about orthotics.

Definition

Sesamoiditis is a general description for any irritation of the sesamoid bones, which are tiny bones within the tendons that run to the big toe. Like the kneecap, the sesamoids function as a pulley, increasing the leverage of the tendons controlling the toe. Every time you push off against the toe the sesamoids are involved, and eventually they can become irritated, even fractured. Because the bones are actually within the tendons, sesamoiditis is really a kind of tendinitis – the tendons around the bones become inflamed as well. It is a common ailment that affects the forefoot, typically in young people who engage in physical activity like running or dancing. Its most common symptom is pain in the ball-of-the-foot, especially on the medial or inner side.

Causes

The pain usually begins as a mild ache and increases gradually as the aggravating activity is continued. It may build to an intense throbbing. In most cases there is little or no bruising or redness. One of the major causes of sesamoiditis is increased activity. You’ve probably stepped up your activity level lately, which has forced you to put more pressure on the balls of your feet. Speedwork, hillwork, or even increased mileage can cause this. If you have a bony foot, you simply may not have enough fat on your foot to protect your tender sesamoids. Also, if you have a high arched foot, you will naturally run on the balls-of-your-feet, adding even more pressure.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request X-ray, bone scan, CT, MRI or other imaging studies and future exams as needed.
• Prescribe medications when indicated.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. Follow the link to find out more about orthotics.
• Recommend long-term control and prevention techniques.

Symptoms

This condition causes a burning sensation in the ball of the foot and can become very painful. Sometimes a callus develops in the center of the foot. This commonly occurs from rotation and dropping of the metatarsal bone along with excess pronation weakening the soft tissue structures.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request an X-ray, bone scan, CT, MRI or other imaging studies.
• Recommend exercise regimens.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. Prescribe appropriate medications.

Definition

Metatarsalgia is a general term used to denote a painful foot condition in the metatarsal region of the foot (the area just before the toes, more commonly referred to as the ball-of-the-foot). This is a common foot disorder that can affect the bones and joints at the ball-of-the-foot. Metatarsalgia (ball-of-foot-pain) is often located under the 2nd, 3rd, and 4th metatarsal heads.

Causes

With this common foot condition, one or more of the metatarsal heads become painful and/or inflamed, usually due to excessive pressure over a long period of time. These include shoes with heels that are too high or participating in high impact activities without proper footwear and/or orthotics, from improper fitting footwear, most frequently by women’s dress shoes and other restrictive footwear. Footwear with a narrow toe box (toe area) forces the ball-of-foot area to be forced into a minimal amount of space. This can inhibit the walking process and lead to extreme discomfort in the forefoot. Also as we get older, the fat pad in our foot tends to thin out, making us much more susceptible to pain in the ball-of-the-foot.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request an X-ray, bone scan, CT, MRI or other imaging studies to rule out other causes.
• Recommend padding, dressing and friction-reducing measures.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. Follow the link to find out more about orthotics.
• Prescribe anti-inflammatory medication.
• Administer cortisone injections.
• Recommend long-term control and prevention techniques.
• Perform surgery when indicated.

Definition

Morton’s Neuroma is a common foot problem associated with pain, swelling and/or an inflammation of a nerve, usually at the ball-of-the-foot between the 3rd and 4th toes. Symptoms of this condition include sharp pain, burning, and even a lack of feeling in the affected area. Morton’s Neuroma may also cause numbness, tingling, or cramping in the forefoot.

Causes

Morton’s Neuroma is a foot condition caused from an abnormal function of the foot that leads to bones squeezing a nerve usually between the 3rd and 4th metatarsal heads. Symptoms of Morton’s Neuroma often occur during or after you have been placing significant pressure on the forefoot area, while walking, standing, jumping, or sprinting. This condition can also be caused by footwear selection. Footwear with pointed toes and/or high heels can often lead to a neuroma.

What can a podiatrist do for you?

• Perform a physical exam and identify the source of problem and discuss treatment options.
• Request an X-ray, bone scan, CT, MRI or other imaging studies to rule out other causes.
• Recommend padding, dressing and friction-reducing measures.
• Recommend shoe gear changes and prescribe custom-made foot orthotics as needed for long-term control and prevention to help compensate for mechanical faults and stress and allow your feet to function with improved efficiency. Follow the link to find out more about orthotics.
• Prescribe anti-inflammatory medication.
• Administer cortisone injections.
• Recommend long-term control and prevention techniques.
• Perform surgery when indicated.