Ingrown Nail

Ingrown nails are caused by either an abnormally shaped nail or, more often, by inflamed tissue being impinged by the nail. Improperly trimming the nail or aggressive pedicures are usually the cause of ingrown nails. The nail unit forms a protective barrier against bacteria and fungus. Disrupting the cuticle or trimming the nail into the nail groove will break the barrier and allow fungus or bacteria to enter, thus creating the infection. The nail bed is very vascularized. If the nail groove or nail bed is injured, when trimming the nail, a small clot of blood, called a granuloma, will develop. Bacteria will grow on this granuloma and an infection will develop. Soak the toe in white vinegar in Epsom salt water and irrigatewith alcohol. Call the office for an appointment. A portion of the nail will most likely need to be removed. This will be performed with either a topical anesthetic or small amount of local anesthesia

             Plantar Wart

Plantar wart are skin lesions which grow on the bottom of the foot and are caused by a human papillomavirus. Plantar warts are frequently caused by minor skin trauma, such as having previously stepped on a splinter. Warts can grow under callouses. In fact, the wart virus causes an overgrowth of keratin, which is the protein which makes up the outer layer of skin, causing the callous. Warts can spread. It is important to not share towelsor wear other people's shoes. Sometimes warts may resolve without treatment. However, if they don't resolve or are painful, they can be treated in the office by trimming the hard outer layer and application of a topical medication. Additional treatment to treat warts and/or prevent the spread of warts is to control excess moisture and reduce friction

          Fungal Nails

Thick discolored nails are not always caused by fungus. Discolored nails can be caused by local nail and skin disease, nail trauma, chemicals from a pedicure or from a systemic disease. Nail disorders are sometimes the "window" to other more serious problems. In order to properly diagnose a fungal nail, a sample of the nail needs to be properly removed and sent to the lab for testing. If the diagnosis is fungus, then either topical or oral medication will be necessary for treatment. Fungus grows in dark, warm and moist environments, so the shoe is a perfect source for the growth of fungus. It is important to not wear moist socks and shoes. Keeping the toe webspaces dry with a tissue after showering ad and application of an antifungul powder are helpful to prevent and/or treat a skin fungal infection and nail fungus.

Heel Pain/ Plantar Fasciitis
 

Wellness and Exercise

 

Wellness and Exercise

Exercise is one of the six dimensions of wellness, as defined by the National Wellness Institute.  Wellness is defined as “the act of practicing habits on a daily basis to attain better physical and mental health outcomes”.   Exercise for health has been a popular topic in the medical literature for several years.  Regular daily physical exercise, such as exercise walking or yard work, has been shown to greatly improve our physical and mental health.    Daily exercise can help prevent problems which can occur in patients with diabetes and heart disease. Exercise can greatly improve bone health and balance, reducing the risks of falls, and improve cognition and mental health.  However, there are many people who suffer foot and ankle pain affecting their ability to walk and thus prevent them from participating in a daily exercise routine.

There is much written on how our occupations and associated ergonomics has affected our physical health.  Our feet are the foundation to our body.  Most problems we see in the feet are a result of overuse injuries which can be associated with our work and/ or recreational activities.  Standing on concrete floors for many hours, climbing and standing on ladders and walking carrying loads are examples of work related causes of foot pain.  Shoes have played a major role in how our feet respond to the surfaces we have stood.  Women wearing high heel shoes or men or women wearing work boots for prolonged periods of time, are examples of shoe gear which has impacted our feet. The result, unfortunately, is foot pain, particularly when we  want to participate in recreational sports, exercise walking, yard work or other outdoor activities such as hiking.

As a sports medicine podiatrist, I have the knowledge and experience to assess and treat patients who have suffered from overuse injuries to the foot.  I utilize a corrective exercise approach as part of a treatment plan.  Corrective exercise is a “prescription” exercise program designed individually, based upon a functional and biomechanical examination of the kinetic chain (hip to feet).  Most overuse injuries, such as plantar fasciitis, achilles tendonitis, “neuroma” like symptoms and midfoot joint pain are a result of muscle imbalances and joint restrictions within the lower extremity and respond very well to a corrective exercise program.

For the recreational athlete, overuse injuries can greatly impact your ability to enjoy and progress in your sport.   I have found that many overuse injuries in runners and tennis players are caused by muscle imbalances and faulty biomechanics.  This directly affects jumping and running mechanics and agility on the tennis courts.  In addition to a corrective exercise prescription and foot gear modification, I also prescribe a sports performance enhancement program to improve functional mechanics designed based upon the individual activity.

I look forward to seeing you and working with you to improve your physical wellness.

The most common cause of heel pain, seen in the active population is plantar fasciitis.  The plantar fascia is a thick ligamentous structure on the bottom of the foot which originates on the heel bone and inserts within the ball of the foot and toes.  It functions as a support for the intrinsic foot muscles and helps to maintain stability of the foot arches.  When the intrinsic foot muscles are overworked and fatigued an "overuse" injury can result.  Pain is usually felt to be the worse when first standing in the mornings and after prolonged rest.  The reason for this is that during the night the  foot is in a downward position, tightening the achilles tendon and calf muscles.  When you stand the heel is being pulled upward by the tight achilles tendon, thus placing tension on the bottom of the heel, at the insertion of the plantar fascia.  Therefore, stretching the calf muscles prior to standing is helpful to reduce stress to the plantar fascia. However, I have found that the long term management for plantar fasciitis is implementation of a corrective exercise program for the patient.  This includes soft tissue trigger point release, stretching of overactive and tight muscles and strengthening of underactive muscles. 

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