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Bunions are caused by your big toe joints becoming incorrectly aligned. This causes the first bone at the base of the your big toe to slant outward (or be prominent inside the foot) and the great toe to angle toward your other toes. Your joints then begin to swell. It causes a bump of bone on the foot that can become very painful if left untreated. It will also cause pain in most shoes and many activities.
Bunions can be hereditary, but also can be aggravated by shoes that aren’t a good fit. Surgery is often recommended as the only way to correct the problem. Most bunions can be treated, however, without surgery by wearing protective pads to cushion the painful area, orthotics to change the foot functioning to reduce pressure in this area and of course, avoiding ill-fitting shoes in the first place.

The most frequent source of heel pain in children between the ages of 7 and 16, cauldron is Calcaneal Apophysitis. It is caused by an inflammation of the apophysis (growth plate) in the back of the heel due to Achilles tendon pull on the bone in the area of the growth plate with activity. This condition is most often seen in children who participate in athletics and has been seen in our office in everything from dance and gymnastics to basketball, baseball, football and soccer. This used to be only seen in boys and only in soccer, but as stated above, we are seeing it in all physical related activities. With this condition pain is usually felt at the back and side of the heel bone, bottom of the heel or even in the ankle. Pain usually worsens when the heel bone is squeezed or when the child is running or jumping. It causes a significant limp and may even feel like a broken foot or ankle. Podiatrists are trained to treat patients of all ages and it is important to have your child examined if they are complaining of heel pain or limping. The goal of treatment for this condition is to eliminate pain while keeping the child active.

As is the case with the knee or elbow, the foot also has a bursa to pad the ankle joint. A bursa, or a fluid-filled sac, can be found behind the heel bone that acts as a cushion and a lubricant between muscles and tendons sliding over bones in this area. Repetitive or over use of the ankle can cause the bursa to become inflamed or irritated leading to heel bursitis. The condition is often mistaken for Achilles Tendonitis. Symptoms include pain in the heel, especially when walking, running, or jumping or when the area is touched. The skin around the back of the heel may be red and warm to the touch, and the pain may worsen when standing on tiptoe or when climbing stairs. It is commonly seen in people who are just starting an aggressive exercise routine, or have changed to a flatter style of shoe. Since bursitis is typically just an inflammation of the bursa, conservative treatments can often resolve the problem once diagnosed.

 The Achilles tendon is the largest tendon (a band of tissue that connects muscle to bone) in the human body and is very strong, but is also the tendon we most often rupture. This rupture is problematic when you consider this is the strongest tendon of the body. Everyone who is active can suffer from Achilles Tendonitis, a common overuse injury and inflammation of the tendon. Symptoms of Achilles tendonitis include mild pain after exercise or running that gradually worsens, a noticeable sense of sluggishness in your leg, and episodes of diffuse or localized pain, sometimes severe, along the tendon during or a few hours after activity. Symptoms also include tenderness, or sometimes intense pain, when the sides of the tendon are squeezed. Other symptoms can be swelling, morning tenderness in the Achilles tendon, or morning stiffness that generally diminishes as the tendon warms up with use. Often simple conservative treatments are beneficial.

Carpal tunnel syndrome is an often well understood condition of the wrist. The foot and ankle have a similar, less common condition called Tarsal Tunnel Syndrome. The tarsal tunnel is a tight space in the foot that lies between bones and tough fibrous tissue extending from the ankle into the foot. A nerve called the posterior tibial nerve lies within the tarsal tunnel. If this nerve becomes compressed or squeezed, tarsal tunnel syndrome can result. Some common causes of compression can include constriction of the space, injury to the surrounding tissues, injury to the nerve, artery or vein problems (including varicose veins), or masses in the area. Symptoms include numbness over the bottom of the foot and/or pain, burning and tingling over the base of the foot and heel. Often these symptoms can be quite severe and treatment should be considered.

 Metatarsalgia is foot pain in the ball of your foot which is the area between your arch and your toes. In this condition one or more of the metatarsal joints becomes inflamed and possibly painful. People often develop a callus under the affected joint. There are many causes of Metatarsalgia including injuries, arthritis, poorly fitting shoes, and working on very hard surfaces. Sometimes changing your shoes will fix the problem. We may also recommend orthotics or implants.

 Heel spurs are bony growths on the underside of the heel bone caused by tension from a tight plantar fascia ligament. Sometimes they are found in people with plantar fasciitis, but they are rarely the source of pain. In fact, plantar fasciitis and heel spurs are often confused and although they are related they are not always the same condition. Spurs result from strain on the muscles and ligaments of the foot, stretching of the plantar fascia, and repeated tearing away of the lining or membrane that covers the heel bone. The body, as a protective mechanism, creates a spur in this area to further support the plantar fascia and limit further tearing of the plantar fascia. Close to 70% of patients with plantar fasciitis have a heel spur that can be seen on an X-ray, but rarely are these painful. Current studies now show that heel spurs rarely need to be treated, and heel pain can be resolved even when leaving the spur untreated. 

It is the most common cause of pain to the heel and bottom of the foot.The plantar fascia (a ligament on the bottom of the foot extending from the heel to the toes) becomes inflamed and painful. This condition is most often caused by a tight Achilles tendon limiting the ankle motion and causing the foot to stress the plantar fascia with every step. It can also be caused by poor foot structure such as overly flat feet or high arches, by wearing non-supportive footwear on hard surfaces, spending long hours on your feet, or obesity (at least 3- 4 times your body weight passes through your foot with each step). The pain from plantar fasciitis is usually a sharp, stabbing pain on the inside of the bottom of the heel that can feel like a knife sticking into your heel. Pain from plantar fasciitis is usually most severe when you first stand on your feet in the morning. It will usually subside, but can return with prolonged standing or walking or getting up after long periods of sitting or after sleeping. As the pain progresses, it may become increasingly painful to the entire heel or may cause other pains as you walk differently (for example knee, hip or back pain may be caused initially by this heel pain). The good news with plantar fasciitis, however, is that it can and should be treated.

When you get an ulceration or wound on your foot, it means that many layers of skin and tissue have been breaking down. Sometimes this breakdown of tissue can go all the way to the bone.They can be caused by pressure to a weight bearing point on the foot, but they can occur on top of the foot or due to pressure from shoes or a bony spur. The risk of ulcer formation is higher in patients with decreased circulation or impaired blood supply to the legs and feet. Diabetics are prone to heel ulcerations, but they can be found in patients with high blood pressure, blood clots, varicose veins, and phlebitis as well.

Depending on the cause of the wound the treatment options will be different. The ultimate goal is always to close the wound from the inside out as quickly as possible. To this when the circulation to the area is adequate, dead tissue may be removed around the edges of the ulcer itself to promote healing. Other options include oral medications, compression and bed rest. New advances in wound care in recent years include the use of platelet-derived growth factor and the use of laser therapy to speed up the healing process.

Your foot will often swell after surgery and sometimes this can cause the ace wrap put on by the hospital to become rather tight. Loosening the ace wrap on the outside can help decrease the pain and give you more breathing room. As you do this, be sure to leave the gauze that is on the wound in tact so that your blood is able to clot and start to heal.

If the surgery site is bleeding more than normal you can always add more gauze under the ace bandage. Never take the gauze on there off, because this will only reopen the wound in the places it has already clotted and will make it bleed more. So, add the gauze on top of what is already on there. Also be sure to give us a call when you do this so we can determine what the next course of action is. 

We ask that you keep your foot dry for two weeks after surgery or until the stitches come out. You can do this by putting a plastic bag over your foot in the shower. This will help us make sure that the area under the skin doesn’t become infected.

If this is occurring, be sure to give us a call. We will be able to let you know what your other options are. Most of time this sick feeling goes away after the patient is prescribed nauseas medication. We may also have a completely different option for you entirely. 

The nerves in the foot after surgery can take up to a month to wake up. When they do wake up the patient may experience shooting pains.

If you are unable to ice the area directly, because of the wrapping, putting ice directly under the knee of the same leg will also help. The easiest way to do this is to use a frozen water bottle.

Bone takes 6-8 weeks to heal, but most patients are able to take the boot off at four. An x-ray will be taken at a follow-up appointment after surgery before the patient is cleared to do so.

We recommend that patients are walking as quickly as possible after surgery. Doing so helps them get their regular range of motion back more quickly. However, if you are having problems getting around a prescription for a knee scooter can be sent in.

Placing an icepack on the painful area for 20 minute intervals will help reduce swelling in that area. The easiest way to do this, if there are multiple areas on your foot that are hurting, is to freeze a plastic water bottle full of water and then proceed to roll your foot across it.

Popping a blister is fine when you make sure to do it carefully, keeping these steps in mind:

• Be sure to clean the area around the blister with antibacterial soap.
•  Sterilize your needle with rubbing alcohol.
• Drain the fluid inside by making a small puncture on one edge of the blister.
• Use antibiotic ointment and then cover it up with a fresh bandage.

If you are living with diabetes, it is also not advised that you treat your own skin injuries. Popping blisters can put you at risk for infection and serious complications. When you find a blister it is safer to make an appointment and have the doctor safely take care of it.