Conditions

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All Conditions

Ankle Instability | Ankle Sprain | Athlete’s Foot | Blisters | Bone Spurs | Bone Spur under Nail | Bunions | Corns and Calluses | Curled Fifth Toe | Degenerative Disease | Flat Feet | Fractures | Fungal Nails | Hammertoe: General Description | Hammertoe: Flexible | Hammertoe: Rigid | Heel Spur | Nail Problems | Ingrown Nail: Partial | Ingrown Nail: Complete | Injuries | Neuromas | Plantar Fasciitis | Peripheral Neuropathy | Shin Splints | Warts

Ankle Instability

Chronic lateral ankle pain is recurring or chronic pain on the outside part of the ankle that often develops after an injury such as a sprained ankle.

Signs and symptoms include:

  • Ankle instability.
  • Difficulty walking on uneven ground or in high heels.
  • Pain, sometimes intense, on the outer side of the ankle.
  • Repeated ankle sprains.
  • Stiffness.
  • Swelling.
  • Tenderness.

Although ankle sprains are the most common cause of chronic lateral ankle pain, other causes may include:

  • A fracture in one of the bones that make up the ankle joint.
  • Arthritis of the ankle joint.
  • Inflammation of the joint lining.
  • Injury to the nerves that pass through the ankle. In this case, the nerves become stretched, torn, injured by a direct blow, or pinched under pressure.
  • Scar tissue in the ankle after a sprain. The scar tissue takes up space in the joint, putting pressure on the ligaments.
  • Torn or inflamed tendon.

Treatments for chronic lateral ankle pain include:

  • Over the counter or prescription anti-inflammatory medications to reduce swelling. Note: Please consult your physician before taking any medications.
  • Physical therapy, including tilt-board exercises that focus on strengthening the muscles, restoring range of motion, and increasing your perception of joint position.
  • Ankle braces or other supports.
  • Steroid medication.
  • Immobilization to allow the bone to heal (in cases of fractures).

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Ankle Sprain

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.

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.

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Athlete’s Foot

A chronic infection caused by various types of fungus, Athlete’s foot is often spread in places where people go barefoot such as public showers or swimming pools. The condition ranges from mild scaling and itching to painful inflammation and blisters. It usually starts between the toes or on the arch and may spread to the bottom and sides of the foot.

General Treatments:
Depending on the type of infection you have, various kinds of medication may be used in treating your fungal problem. Successful treatment usually involves a combination of medication and self-care.

If your condition is not serious, over-the-counter and prescription powders, lotions, or ointments can often help treat scaling, itching, and inflammation. Consult us before taking any medication. Foot soaks may help dry excessive perspiration, but you should contact our office first. If your Athlete’s foot does not improve, we may prescribe stronger medication.

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Blisters

Most blisters on the feet are caused by friction and do not require medical attention. New skin will form underneath the affected area and the fluid built up in the blister is simply absorbed back into the tissue. You can soothe ordinary blisters with Vitamin E ointment or an aloe-based cream.

Do not puncture a blister unless it is large, painful, or likely to be further irritated. If you have to pop a blister, use a sterilized needle or razor blade. Wash the area thoroughly, then make a small hole and gently squeeze out the clear fluid. Apply a dab of hydrogen peroxide to help protect against infection. Do not remove the skin over a broken blister. The new skin underneath needs this protective cover. Cover the area with a bandage and mild compression.

If the fluid is white or yellow, the blister is infected and needs medical attention.

Preventing Blisters
You can prevent blisters by breaking in new shoes gradually, and putting petroleum jelly or an adhesive bandage on areas that take the rub—before the blister happens.  Wear socks that have heels instead of tube socks (they bunch up and cause blisters). Acrylic and other synthetic-fiber socks are good choices. Be sure to wash and dry your feet daily to prevent bacterial infections, such as Athlete’s Foot.

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Bone Spur

A bone spur, or overgrowth of bone, may occur alone or with a hammertoe. Bone spurs have a variety of causes. Usually, they result in pain, interfere with the use of your foot, and detract from its appearance.

Treatment: Minimal Incision Surgery.
In this technique, a small incision is made and a small rasp (similar to a dental burr) is inserted to smooth the bone.

Follow-up Care:
A follow-up visit is necessary to remove any stitches, and to check the results of your surgery.

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Bone Spur under Nail

An overgrowth of bone under the toenail can press up into the tissue underneath the growth plate, deforming the nail above. This condition is painful, especially when you’re wearing shoes. Many people also find that weight-bearing is difficult.

Treatment: Subungual Exostosis.
The bone spur can be smoothed down with a tiny rasp. The rasp (which resembles a dental burr) is inserted through a small incision in the toe. This procedure is often performed along with partial or total matricectomy.

Follow-up Care:
Your incision is bandaged, and you can bear weight immediately. Often, you can wear your own shoes after surgery.

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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 on the same foot, sometimes overlapping another 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.

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.

Wearing shoes that are too tight does NOT cause bunions, but is a contributing factor to painful 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.

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:

  • The use of 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— 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.

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.

Bunion surgery View Video

Watch a treatment – (Part 1) Austin Bunionectomy

(Part 2) Austin Bunionectomy

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Corns & Calluses

These are accumulated layers of hard skin at points of pressure and should be treated by a podiatrist. Usually a mechanical foot imbalance is present, which causes these problems. Never cut a corn or callus with a razor, scissors, or any other instrument, nor pick at them with your fingernails. Again, never apply “corn cures” or other medication to them.

A common cause of thickened skin on the bottom of the foot is a misaligned, elongated or thickened metatarsal (bone in the foot). A surgical repair often involves making a “V” shaped cut into the metatarsal to lift the bone into place, thus relieving pressure.

Click to see diagram ‘Weil Lesser Metatarsal Osteotomy”

Watch Video: “Weil Lesser Metatarsal Osteotomy”

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Curled Fifth Toe

The little toe may curl inward underneath its neighbour, so that the nail faces outward. With this inherited problem, the fat pad on the bottom of the toe (normally used for walking) loses contact with the ground. Corns and pain may result.

Treatment: Derotation Arthroplasty.
A wedge of skin and bone is removed to uncurl (“de-rotate”) the toe.

Follow-up Care:
Care may involve follow-up visits and wearing a bandage, a splint, and sometimes a surgical shoe for several weeks following surgery.

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Degenerative Disease

A limited range of motion with stiffness, swelling and pain can be caused by arthritis or trauma to the big toe joint. This is referred to as “hallux limitus” or “hallux rigidus”. The joint can be repaired and remodelled, often returning motion and comfort to the joint.

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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.

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.

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.

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Fractures

Nearly one-fourth of all the bones in your body are in your feet. A broken (fractured) bone in your forefoot or in one of your toes is often painful, but rarely disabling. Most of the time, these injuries heal without operative treatment.

There are two types of foot fractures: stress fractures and general bone fractures. Stress fractures usually occur in the bones of the forefoot extending from the toes to the middle of the foot. Stress fractures are like tiny cracks in the bone surface. They can happen with sudden increases in exercise (such as running or walking for longer distances or times), improper training techniques, or a change in surfaces.

Most other types of fractures extend through the bone, and are called bone fractures. They may be stable, in which there is no shift in bone alignment, or displaced, in which the bone ends no longer line up properly. Bone fractures usually result from trauma, such as dropping a heavy object on your foot, or from a twisting injury. If the fractured bone does not break through the skin, it is called a closed fracture. If the fracture does break through the skin, it is called an open fracture.

Because of the complex structures in the foot, there are some other, more specific types of fractures that can occur. For example, the fifth metatarsal, known as the little or pinky toe, is susceptible to a variety of different fractures. The relationship between the ankle and the foot can be compromised by an ankle-twisting injury, which may tear the tendon that attaches to this bone and pull a small piece of the bone away. A more serious injury in the same area is known as a Jones fracture, which occurs near the base of the bone and disrupts its blood supply. This injury may take longer to heal or require surgery.

Common symptoms for any type of foot fracture includes pain, swelling, and sometimes bruising. Be sure to seek medical attention for any suspected foot fracture.

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Fungal Nails

Fungal nails (onychomycosis) are usually more resistant to treatment and more difficult to treat than Athlete’s foot, There are several treatments available for fungal nails.

1. Topical or oral fungal medications can be used. The topicals have a low rate of success and the oral medications can have serious side effects.

2. A more drastic treatment is permanent removal of the affected toenail(s).

3. Laser treatments are now available at Feetdocs. We carry the Pinpointe 1320nm laser.  It requires approximately 3 treatments  (depending on severity of the fungus) and has a high success rate. Results are noticed as the nail grows out with a healthy-looking nail taking as long as it takes for the nail to completely grow out. The treatment is virtually pain-free and patients can resume their normal activity right away.

After a fungal nail infection has cleared up, you can take steps to prevent the infection from coming back.

View our Before & After photos

Keeping the fungus under control will help prevent a fungal infection of the skin from reinfecting the nail. Before bed, thoroughly wash and dry your feet, and apply a non-prescription anti-fungal cream to the entire foot from the ankle down. Use the cream every night, then gradually apply it less often. Keep your feet dry. Dry feet are less likely to become infected. Apply powder to your dry feet after you take a shower or bath.

Other tips:

  • Don’t share nail clippers or nail files with others.
  • Don’t share shoes or socks with others.
  • Try not to injure your nail, such as by cutting it too short (trauma to the nail may lead to infections).
  • Wear dry cotton socks, and change them two or three times a day if necessary.
  • Wear dry shoes that allow air to circulate around your feet (tight, enclosed, moist shoes contribute to fungal toenail infections).
  • Wear shower sandals or shower shoes when you are at a public pool or shower.

Prevention
Follow basic foot care guidelines and you more than likely can head off most common foot fungus problems.

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Hammertoe: General Description

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.

The primary causes of hammertoe include foot imbalances and heredity. An inherited muscle imbalance or abnormal bone length can make one or more small toes buckle under, causing their joints to contract. This in turn causes the tendons to shorten. Corns (build-up of dead skin cells where shoes press and rub) often form on top of the contracted joints, and may become irritated and infected. Hammertoes can be aggravated by improperly fitting shoes.

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.

Watch Video: Hammertoe Procedure

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Hammertoe: Flexible

When hammertoes are flexible, you can straighten the buckled joint with your hand. Flexible hammertoes may progress to rigid hammertoes over time. Corns, irritation, and pain are common symptoms and function is often limited as well. A recurring Callus is often located on the end of the toe, which can also lead to ulceration.

Treatment: Tenotomy Capsulotomy.
To release the buckling, the top and bottom tendons and the joint capsules may be cut.

Follow-up Care:
You can bear weight immediately, but may need a small bandage, a splint, and a surgical shoe, for one to three weeks after surgery.

For more information:  View Video

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Hammertoe: Rigid

A rigid hammertoe is fixed; you can no longer straighten the buckled joint with your hand. Corns, irritation, pain, and loss of function may be more severe for rigid hammertoes than for flexible ones.

Treatment: Arthroplasty.
A portion of the joint is surgically removed and the toe is straightened. The “gap” fills in with fibrous tissue.

Follow-up Care:
You can bear weight immediately, but may need to wear a wooden shoe for a few weeks as the toe heals.

For more information: View This Video

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Heel Spur

A heel spur is a bony outgrowth at the base of the heel bone near the plantar fascia. A spur may cause pain on the bottom of the heel when you stand. As with plantar fasciitis, the pain may decrease after standing or walking a short time. The pain you feel is not from the spur itself. Your heel hurts because the plantar fascia is being stretched, the spur pinches a nerve, or the spur presses against the plantar bursa. If the bursa becomes inflamed (bursitis), it may squeeze the plantar fascia.

Initial treatment usually involves treating the underlying biomechanical causes by means of orthotic devices. If pain persists, mechanical therapy,or anti-inflammatories may be used. If these methods are not successful, Shockwave Therapy can be used. You can find out more about Shockwave Therapy in our Treatments section

As a last resort, surgery can also be performed. Under local anesthesia a section of the plantar fascia is cut to release the pull created at the heel spur.

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Nail Problems

Nail problems are common to those of all ages. If left untreated, nail problems could result in serious discomfort and therefore, should be treated immediately by your podiatrist. Below are descriptions of common nail problems:

1. Partially Ingrown Toenail
A nail is ingrown when one or both corners or sides of the nail grow into the skin of the toe. Irritation, redness, an uncomfortable sensation or warmth, swelling, pain, and infection can result from a partially ingrown toenail.

Treatment: Partial Matricectomy.
A wedge of the nail is removed and the growth cnter destroyed (by surgical excision or with chemical treatment. This simple procedure is brief.

Follow up care:
Expect minimal bleeding initially, and, with the chemical treatment, drainage. If chemicals were used, you will be instructed on soaking your toe.

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Ingrown Nail: Partial

A nail is ingrown when one or both corners or sides of the nail grow into the skin of the toe. Irritation, redness, an uncomfortable sensation or warmth, swelling, pain, and infection can result from a partially ingrown toenail.

Treatment: Partial Matricectomy.
A wedge of the nail is removed and the growth center destroyed (by surgical excision or with chemical treatment. This simple procedure is brief.

Follow up care:
Expect minimal bleeding initially, and, with the chemical treatment, drainage. If chemicals were used, you will be instructed on soaking your toe.

For more information: View Video

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Ingrown Nail: Complete

In severe cases, the whole nail grows into the skin on all sides, sometimes because the nail is curved from an injury or fungus infection. You may suffer pain and be unable to bear weight. Ingrown toenails can also affect your foot’s appearance.

Treatment: Total Matricectomy or Bilateral Partial Matricectomy.
The entire nail and growth plate are removed either surgically of chemically. The body then produces a “false nail”-tough skin that mimics a real nail.

Bilateral Partial Matricectomy is when only the sides are removed with the middle section of nail continuing to grow.

Follow up care:
The area may bleed for a few days. Care is much the same as for partially ingrown toenails. The false nail usually grows in a few months after surgery.

For more information: View Video

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Injuries

Many sports are hard on the feet because of quick repetitive movements, constricting footwear, and/or increased exposure to injury or trauma. Following is a brief overview of some of the most common injuries that result from particular sports.

Martial Arts and Kick Boxing
Injuries commonly seen as a result of martial arts and kick boxing include plantar fasciitis, Achilles tendonitis, sesamoiditis, and ankle sprains. Stretching is recommended to help prevent injury: specifically, a minimum of 15 minutes of stretching before performing any kicking or punching.

Aerobics
Impact forces from aerobics can reach up to six times the force of gravity, which is transmitted to each of the 26 bones in the foot. That is why proper shoes are crucial to successful, injury-free aerobics. Shoes should provide sufficient cushioning and shock absorption to compensate for pressure on the foot many times greater than found in walking. They must also have good medial-lateral stability.

Team Sports
Activities such as football, baseball, basketball, soccer, field hockey, and lacrosse often lead to ankle injuries as a result of play on artificial surfaces, improper footwear, and/or inadequate stretching.

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Neuromas

A neuroma is an enlarged, benign growth of nerves, most commonly between the third and fourth toes. Neuromas are caused by tissue rubbing against and irritating the nerves. Pressure from poorly fitting shoes or an abnormal bone structure can also lead to this condition. Symptoms may include sensations of thickness, burning, numbness, tingling, or pain in the ball of the foot.  Treatments generally include wearing corrective shoes or orthotics and/or receiving cortisone injections. In severe cases, surgical removal of the growth may be necessary.

Morton’s neuroma is a thickening of tissues around the nerve that leads to the toes. Morton’s neuroma usually develops between the third and fourth toes in response to irritation, such as that caused by wearing high-heeled or narrow shoes, or from trauma. Symptoms may include a burning pain that radiates from the ball of the foot to the toes or numbness in the toes. Conservative treatments usually resolve the pain or progressions of the condition, and range from wearing roomier, lower-heeled footwear or using orthotics to reduce the pressure on the nerve, to injections of corticosteroid medication to reduce swelling and inflammation.

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Plantar Fasciitis

Plantar fasciitis is the term commonly used to refer to heel and arch pain traced to an inflammation on the bottom of the foot. More specifically, plantar fasciitis is an inflammation of the connective tissue, called plantar fascia, that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone. Overpronation is the most common cause of plantar fasciitis. As the foot rolls inward excessively when walking, it flattens the foot, lengthens the arch, and puts added tension on the plantar fascia. Over time, this causes inflammation.

Also known as heel spur syndrome, the condition is often successfully treated with conservative measures, such as the use of anti-inflammatory medications, ice packs, stretching exercises, orthotic devices, and physical therapy. Note: Please consult your physician before taking any medications. In persistent cases, Extracorporeal Shock Wave Treatment (ESWT) may be used to treat the heel pain.

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Peripheral Neuropathy

Diabetic neuropathy is a peripheral nerve disorder caused by diabetes or poor blood sugar control. The most common types of diabetic neuropathy result in problems with sensation in the feet. It can develop slowly after many years of diabetes or may occur early in the disease. The symptoms are numbness, pain, or tingling in the feet or lower legs. The pain can be intense and require treatment to relieve the discomfort. The loss of sensation in the feet may also increase the possibility that foot injuries will go unnoticed and develop into ulcers or lesions that become infected. In some cases, diabetic neuropathy can be associated with difficulty walking and some weakness in the foot muscles. (Thanks to National Institutes of Health (NIH) for this information)

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Shin Splints

Shin splints refer to pain on either side of the leg bone that is caused by muscle or tendon inflammation. The problem is usually related to a collapsing arch, but may be caused by a muscle imbalance between opposing muscle groups in the leg.

Proper stretching before and after exercise and sports, corrective shoes, or orthotics (corrective shoe inserts) can help prevent shin splints.

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Warts

These are often mistaken for calluses. A wart is a skin growth which has a blood and nerve supply of its own. Warts are caused by a virus, and may be quite painful. They tend to spread if left untreated. Again, professional attention should be sought.

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