Frequently Asked Questions And Helpful Tips

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Heel pain is generally the result of faulty biomechanics (walking gait abnormalities) which place too much stress on the heel bone and the soft tissues that attach to it. The stress may also result from injury or a bruise incurred while walking, running, or jumping on hard surfaces; wearing poorly constructed footwear; or being overweight.

The heel bone is the largest of 26 bones in the human foot, which also has 33 joints and a network of more than 100 tendons, muscles, and ligaments. Like all bones, it is subject to outside influences that can affect its integrity and its ability to keep us on our feet. Heel pain, sometimes disabling, can occur in the front, back, or bottom of the heel.

• Ingrown toenails are caused by the side of the nail growing into the skin around the nail

• This creates pressure and can become very painful

• If left untreated the toe can become infected

• Nails being trimmed improperly

• Wearing shoes that are to small

• Repeated trauma from everyday activities

Because diabetes is a systemic disease affecting many different parts of the body, ideal case management requires a team approach. The podiatric physician, as an integral part of the treatment team, has documented success in the prevention of amputations, one of the most serious conditions that they treat. The key to amputation prevention in diabetic patients is early recognition and regular foot screenings from a podiatric physician. At a minimum, yearly check-ups are recommended.

In addition to these check-ups, there are warning signs that you should be aware of so that they may be identified and called to the attention of the family physician or podiatrist. They include:

• Skin color changes
• Elevation in skin temperature
• Swelling of the foot or ankle
• Pain in the legs
• Open sores on the feet that are slow to heal
• Ingrown and fungal toenails
• Bleeding corns and calluses
• Dry cracks in the skin, especially around the heel

In general, the term "hammer toes" describes a buckling of any of the toe joints. Joints at the end or middle of the toe, as well as the joint near the ball of the foot, may be affected. Toe joints usually curl because of a muscle imbalance or tight tendons. Hammer toes vary in severity and in the number of joints and toes involved.

Physical Exam

Your doctor will examine all your toes, testing whether or not buckled joints can be moved. Your feet will also be checked for any skin changes. Corns (a buildup of dead skin cells) often form between curled toes or on top of buckled joints where shoes rub.

If irritated, corns may turn into open wounds and become infected.

Types of Hammer Toes

Hammer toes may be flexible or rigid, depending on the joint's ability to move. A flexible joint may become more rigid as you age.

Orthotics are shoe inserts that are intended to correct an abnormal, or irregular, walking pattern. Orthotics are not truly or solely "arch supports," although some people use those words to describe them, and they perhaps can best be understood with those words in mind. They perform functions that make standing, walking, and running more comfortable and efficient, by altering slightly the angles at which the foot strikes a walking or running surface.

Doctors of podiatric medicine prescribe orthotics as a conservative approach to many foot problems or as a method of control after certain types of foot surgery: their use is a highly successful, practical treatment form.

Orthotics take various forms and are constructed of various materials. All are concerned with improving foot function and minimizing stress forces that could ultimately cause foot deformity and pain.

Foot orthotics fall into three broad categories: those that primarily attempt to change foot function those that are primarily protective in nature, and those that combine functional control and protection.

Although they may develop on the fifth (little) toe, bunions usually occur at the base of the big toe. Bunions are often caused by incorrect foot mechanics. The foot may flatten too much, forcing the toe joint to move beyond normal range. In some cases, joint damage caused by arthritis or an injury produces a bunion. And some people are simply born with extra bone near a toe joint. If you're at risk for developing a bunion, wearing high-heeled or poorly fitting shoes makes the problems worse.

Fungal infection of the nail, or onychomycosis, is often ignored because the infection can be present for years without causing any pain. The disease is characterized by a progressive change in a toenail's quality and color, which is often ugly and embarrassing.

In reality, the condition is an infection underneath the surface of the nail caused by fungi. When the tiny organisms take hold, the nail often becomes darker in color and foul smelling. Debris may collect beneath the nail plate, white marks frequently appear on the nail plate, and the infection is capable of spreading to other toenails, the skin, or even the fingernails. If ignored, the infection can spread and possibly impair one's ability to work or even walk. This happens because the resulting thicker nails are difficult to trim and make walking painful when wearing shoes. Onychomycosis can also be accompanied by a secondary bacterial or yeast infection in or about the nail plate.

Because it is difficult to avoid contact with microscopic organisms like fungi, the toenails are especially vulnerable around damp areas where people are likely to be walking barefoot, such as swimming pools, locker rooms, and showers, for example. Injury to the nail bed may make it more susceptible to all types of infection, including fungal infection. Those who suffer from chronic diseases, such as diabetes, circulatory problems, or immune deficiency conditions, are especially prone to fungal nails. Other contributing factors may be a history of athlete's foot and excessive perspiration.

Ulceration is a common occurrence with the diabetic foot, and should be carefully treated and monitored by a podiatrist to avoid amputations. Poorly fitted shoes, or something as trivial as a stocking seam, can create a wound that may not be felt by someone whose level of skin sensation is diminished. Left unattended, such ulcers can quickly become infected and lead to more serious consequences. Your podiatric physician knows how to treat and prevent these wounds and can be an important factor in keeping your feet healthy and strong. New to the science of wound healing are remarkable products that have the appearance and handling characteristics of human skin. These living, skin-like products are applied to wounds that are properly prepared by the podiatric physician. Clinical trials indicate that when applied to wounds, even those that are hard to heal, such products achieve impressive success rates.

Warts are one of several soft tissue conditions of the foot that can be quite painful. They are caused by a virus, which generally invades the skin through small or invisible cuts and abrasions. They can appear anywhere on the skin, but, technically, only those on the sole are properly called plantar warts.

Children, especially teenagers, tend to be more susceptible to warts than adults; some people seem to be immune.

Most warts are harmless, even though they may be painful. They are often mistaken for corns or calluses-which are layers of dead skin that build up to protect an area which is being continuously irritated. The wart, however, is a viral infection.

It is also possible for a variety of more serious lesions to appear on the foot, including malignant lesions such as carcinomas and melanomas. Although rare, these conditions can sometimes be misidentified as a wart. It is wise to consult a podiatric physician when any suspicious growth or eruption is detected on the skin of the foot in order to ensure a correct diagnosis.

Plantar warts tend to be hard and flat, with a rough surface and well-defined boundaries; warts are generally raised and fleshier when they appear on the top of the foot or on the toes. Plantar warts are often gray/brown (but the color may vary), with a center that appears as one or more pinpoints of black. It is important to note that warts can be very resistant to treatment and have a tendency to reoccur.

Athlete's foot is a skin disease caused by a fungus, usually occurring between the toes. The fungus most commonly attacks the feet because shoes create a warm, dark, and humid environment which encourages fungus growth. The warmth and dampness of areas around swimming pools, showers, and locker rooms, are also breeding grounds for fungi. Because the infection was common among athletes who used these facilities frequently, the term "athlete's foot" became popular.

Not all fungus conditions are athlete's foot. Other conditions, such as disturbances of the sweat mechanism, reaction to dyes or adhesives in shoes, eczema, and psoriasis, also may mimic athlete's foot.

Some signs of athlete's foot are drying skin, itching, scaling, inflammation, and blisters. Blisters often lead to cracking of the skin. When blisters break, small raw areas of tissue are exposed, causing pain and swelling. Itching and burning may increase as the infection spreads.

Athlete's foot may spread to the soles of the feet and to the toenails. It can be spread to other parts of the body, notably the groin and underarms, by those who scratch the infection and then touch themselves elsewhere.

The organisms causing athlete's foot may persist for long periods. Consequently, the infection may be spread by contaminated bed sheets or clothing to other parts of the body.

The arch of your foot is its main supportive structure. If this arch loses strength, the bony framework begins to collapse, causing your foot to flatten. Like a sagging bridge, the weakness in the middle strains the joints at both ends of your foot.

Causes

There are many causes of flat feet. Some people are born with them. Others acquire flat feet as a result of arthritis, trauma, or musculoskeletal disorders. Overuse or repeated pounding on hard surfaces can also weaken the foot's arch.

Symptoms

Discomfort from flat feet often doesn't appear for years. At some point, pain may be felt and walking may become awkward as increasing strain is put on your feet and calves.

Related Problems

The excess strain from flat feet can cause other foot problems, such as hammertoes, bunions, heel spurs, arch strain, corns, neuromas, and sagging joints. Flat feet can also affect other parts of the body, causing fatigue, pain, or stiffness in the ankles, knees, hips, and lower back.