Innovative Foot & Ankle

Products And Services

• Achilles Tendon Problems

  The Achilles tendon is the largest tendon in the human body and can withstand forces of 1,000 pounds or more. But it also the most frequently ruptured tendon. Both professional and weekend athletes can suffer from Achilles tendonitis, a common overuse injury and inflammation of the tendon. Events that can cause Achilles tendonitis may include: Hill running or stair climbing; Overuse resulting from the natural lack of flexibility in the calf muscles; Rapidly increasing mileage or speed.Starting up too quickly after a layoff; Trauma caused by sudden and/or hard contraction of the calf muscles when putting out extra effort such as in a final sprint. Achilles tendonitis often begins with mild pain after exercise or running that gradually worsens. Other symptoms include: Recurring localized pain, sometimes severe, along the tendon during or a few hours after running; Morning tenderness about an inch and a half above the point where the Achilles tendon is attached to the heel bone; Sluggishness in your leg; Mild or severe swelling; Stiffness that generally diminishes as the tendon warms up with use. Treatment normally includes: A bandage specifically designed to restrict motion of the tendon; Non-steroidal anti-inflammatory medication; Orthoses, which are devices to help support the muscle and relieve stress on the tendon such as a heel pad or shoe insert; Rest and switching to another exercise, such as swimming, that does not stress the tendon; Stretching, massage, ultrasound and appropriate exercises to strengthen the weak muscle group in front of the leg and the upward foot flexors; In extreme cases, surgery is performed to remove the fibrous tissue and repair any tears.

  Link: Achilles Tendon Problems

• Ankle sprains and tendon injuries

  are one of the most common joint injuries runners experience. The injury can occur when one rolls over a rock, lands off a curb, or steps in a small hole or crack in the road. Usually the sprain is only mild, but on occasion it may seriously injure the ligaments or tendons surrounding the ankle joint. Management of this injury relies on early and accurate diagnosis, as well as an aggressive rehabilitation program directed toward reducing acute symptoms, maintaining ankle stability, and returning the runner to pre-injury functional level. Treatment includes resting the ankle and applying ice to reduce swelling. Compressive bandages also may be used to immobilize and support the injury. More serious ankle sprains, particularly in competitive athletes, may require surgery to repair to tighten the ligaments.

  Link: Ankle sprains and tendon injuries

• Common Foot Problems

  Athlete’s foot Athlete’s Foot is a fungal infection that usually starts between the toes or on the bottom of the feet. The fungus can, however, spread to other parts of the body. Signs of athlete’s foot include itchy, scaly skin, and thick, white nails. Ward off infection by washing your feet daily with soap and warm water; drying carefully, especially between the toes; and changing shoes and socks regularly to decrease moisture. A podiatrist will discuss treatment and may prescribe medications. Blisters Blisters are caused by skin friction. Don’t break them because you may create an opening for bacteria. Instead, apply a moleskin pad for protection, keep your feet as dry as possible and wear thick socks for extra padding. When the blister pops, leave the broken skin in place, but keep the area clean and apply an antibiotic cream. Cover it with a sterile bandage. A podiatrist may drain the blisters in a sterile manner therefore reducing infection. Bunions Bunions are misaligned big toe joints that can become swollen and tender. The deformity causes the big toe to slant inward and a bump deformity on the outside. Bunions tend to run in families, but the tendency can be aggravated by ill-fitting shoes that are too narrow in the forefoot and toe area. Wearing wide shoes and protective pads can ease the pressure, but surgery is often required to correct the problem. Corns and Calluses Corns and calluses are caused by underlying bone problems that cause excessive irritation. Where shoes repeatedly rub, dead skin cells pile up, creating calluses on the bottom of the foot and corns on the toes. You should never attempt to cut or dissolve corns or calluses at home because it can lead to infection. Your podiatrist can trim or protect them if they become painful, but they usually grow back unless the underlying problem is corrected surgically. Foot Odor Foot Odor results from excessive perspiration from the more than 250,000 sweat glands in the foot. Daily hygiene is essential to keep feet clean. Air out shoes daily to evaporate moisture, and change your socks a couple of times a day. Foot powders, antiperspirants, and soaking in vinegar and water can help lessen odor too. Hammertoes Hammertoes buckle into a claw-like position and corns form at the bent joint when these toes rub against the tops of shoes. Claw toes are the result of an inherited muscle imbalance, too-small shoes or a bunion-bearing big toe that slants inward. Usually, the second toe bends into this unnatural shape, but any of the other three smaller toes can be affected as well. Square, open-toed, or prescription shoes may increase comfort. Surgical correction may be required. Ingrown Nails Ingrown nails result when the corners or sides of nails dig painfully into the skin. They are frequently caused by improper nail trimming, but also by shoe pressure, injury, fungus infection, heredity, and poor foot structure. Use toenail clippers to trim nails with a slightly rounded edge. Leave nails slightly longer than the end of the toe and don’t cut into the corners. Often these become infected and become quite painful. A quick office procedure can alleviate this problem quickly. Recurrent ingrown nails can be treated permanently. Neuroma Neuroma is a condition that occurs when two metatarsal bones — most frequently the third and fourth ones — rub together and irritate a nerve. The resulting enlargement of the nerve can produce pain, burning, tingling, or numbness between the toes and in the ball of the foot. Conservative treatment includes orthotic devices (shoe inserts that help realign the foot and distribute body weight evenly) and cortisone or sclerosing alcohol injections, but surgical removal of the growth is sometimes necessary. Warts Warts are caused by a virus that enters the skin through small cuts. Children, especially teenagers, tend to be more susceptible to warts than adults. Most warts are harmless and benign, though they are unsightly and may be painful. Warts often come from walking barefoot on dirty surface. A podiatrist can dissolve warts painlessly with topical acid treatments or remove them surgically. Heel Pain/Heel Spurs Heel pain/Heel Spurs is usually caused by a walking stride that exerts excessive stress on the heel bone. Discomfort can also result from poorly made shoes, obesity, a stress fracture of the heel bone, bruises of the fat pad under the heel, or a disease such as rheumatism or gout. Heel spurs refer to heel pain due to bone irritation. A ligament or muscle may be pulled from the heel. To ease heel pain try wearing well-fitted shoes with soft, shock-absorbent soles. Orthotic devices may absorb some of the impact on the heels. A doctor may also prescribe nonsteroidal antiinflammatory drugs, exercises, cortisone injections, and/or suggest applying heat and/or cold to the heel.

  Link: Common Foot Problems

• Fractures

  What Is a Fracture? A fracture is a break in the bone. Fractures can be divided into two categories: traumatic fractures and stress fractures. Traumatic Fractures Traumatic fractures (also called acute fractures) are caused by a direct blow or impact—like seriously stubbing your toe. Traumatic fractures can be displaced or nondisplaced. If the fracture is displaced, the bone is broken in such a way that it has changed in position (dislocated). Treatment of a traumatic fracture depends on the location and extent of the break and whether it is displaced. Surgery is sometimes required. Signs and symptoms of a traumatic fracture include: You may hear a sound at the time of the break; “Pinpoint pain” (pain at the place of impact) at the time the fracture occurs and perhaps for a few hours later, but often the pain goes away after several hours; Deviation (misshapen or abnormal appearance) of the toe; Bruising and swelling the next day. It is not true that “if you can walk on it, it’s not broken.” Evaluation by the podiatric surgeon is always recommended. Stress Fractures Stress fractures are tiny, hairline breaks that are usually caused by repetitive stress. Stress fractures often afflict athletes who, for example, too rapidly increase their running mileage. Or they may be caused by an abnormal foot structure, deformities, or osteoporosis. Improper footwear may also lead to stress fractures. Stress fractures should not be ignored, because they will come back unless properly treated. Symptoms of stress fractures include: Pain with or after normal activity; Pain that goes away when resting and then returns when standing or during activity; “Pinpoint pain” (pain at the site of the fracture) when touched; Swelling, but no bruising. Sprains and fractures have similar symptoms, although sometimes with a sprain, the whole area hurts rather than just one point. Your podiatric surgeon will be able to diagnose which you have and provide appropriate treatment. Certain sprains or dislocations can be severely disabling. Without proper treatment they can lead to crippling arthritis. Consequences of Improper Treatment Some people say that “the doctor can’t do anything for a broken bone in the foot.” This is usually not true. In fact, if a fractured toe or metatarsal bone is not treated correctly, serious complications may develop. For example: A deformity in the bony architecture which may limit the ability to move the foot or cause difficulty in fitting shoes; Arthritis, which may be caused by a fracture in a joint (the juncture where two bones meet), or may be a result of angular deformities that develop when a displaced fracture is severe or hasn’t been properly corrected; Chronic pain and long-term dysfunction; Non-union, or failure to heal, can lead to subsequent surgery or chronic pain. Treatment of Toe Fractures Fractures of the toe bones are almost always traumatic fractures. Treatment for traumatic fractures depends on the break itself and may include these options: Rest. Sometimes rest is all that is needed to treat a traumatic fracture of the toe; Splinting. The toe may be fitted with a splint to keep it in a fixed position. Rigid or stiff-soled shoe. Wearing a stiff-soled shoe protects the toe and helps keep it properly positioned; “Buddy taping” the fractured toe to another toe is sometimes appropriate, but in other cases it may be harmful; Surgery. If the break is badly displaced or if the joint is affected, surgery may be necessary. Surgery often involves the use of fixation devices, such as pins. Treatment of Metatarsal Fractures Breaks in the metatarsal bones may be either stress or traumatic fractures. Certain kinds of fractures of the metatarsal bones present unique challenges. For example, sometimes a fracture of the first metatarsal bone (behind the big toe) can lead to arthritis. Since the big toe is used so frequently and bears more weight than other toes, arthritis in that area can make it painful to walk, bend, or even stand. Another type of break, called a Jones fracture, occurs at the base of the fifth metatarsal bone (behind the little toe). It is often misdiagnosed as an ankle sprain, and misdiagnosis can have serious consequences since sprains and fractures require different treatments. Your podiatric surgeon is an expert in correctly identifying these conditions as well as other problems of the foot. Treatment of metatarsal fractures depends on the type and extent of the fracture, and may include: Rest. Sometimes rest is the only treatment needed to promote healing of a stress or traumatic fracture of a metatarsal bone; Avoid the offending activity. Because stress fractures result from repetitive stress, it is important to avoid the activity that led to the fracture.

  Link: Fractures

• Fungal Nails

  Since fungal nails are usually more resistant and more difficult to treat than Athlete’s foot, topical or oral antifungal medications may be prescribed. After a fungal nail infection has cleared up, you can take steps to prevent the infection from coming back. Keeping the fungus under control will help prevent a fungal infection of the skin from reoccurring in 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.

  Link: Fungal Nails

• Gout

  Gout (gouty arthritis) is a condition caused by a buildup of the salts of uric acid – a normal byproduct of the diet-in the joints. The big toe joint and the ankle is commonly the affected areas, possibly because it is subject to so much pressure in walking; attacks of gouty arthritis are extremely painful, perhaps more so than any other form of arthritis. Men are much more likely to be afflicted than women. Research suggests that diet heavy in red meat, rich sauces, shellfish, and brandy is popularly associated with gout. However, other protein compounds in foods such as lentils and beans may play a role. The main symptom of gout is waking up in the middle of the night with an acute throbbing pain in the big toe, which is swollen. Usually only one of the big toes is affected. The pain lasts for around three or four hours and will then subside and usually not return for a few months. It can be controlled by prescribed medications. The application of ice or cooling lotions will help during an acute phase. This condition is quickly treated with injections and oral medication that can give immediate pain relief. Gout Diet Gout is a form of arthritis usually occurring in the cooler extremities of the body, like feet or toes. It results from excessive uric acid in the bloodstream which leaves needle-like crystal deposits in the joints causing redness, swelling and extreme pain. Normally the uric acid dissolves in the blood stream but there is a problem if: there is an increase in uric acid production; the kidneys are not functioning sufficiently to eliminate uric acid; there is an increased consumption of foods containing purines. Purine is a chemical found in certain foods that forms uric acid when broken down in the body. Gout Diet and Nutrition As Gout seems to be more prevalent in overweight people it is important to maintain a healthy body weight. Also extra fluid can help flush uric acid crystals out, but alcohol should be avoided. As well as prescribed medications it can be helpful to follow a low purine diet, avoiding foods that are high in purine and eating low purine foods moderately.

  Link: Gout

• Aerolase Medical Aesthetic Lasers

  What is Aerolase Technology? Aerolase technology provides a new generation of laser technology that delivers higher power in gentler pulse duration, achieving best-in-class efficacy with new levels of patient comfort. Aerolase technology is patented advanced technology, the internally air-cooled medical aesthetic laser. This innovative breakthrough results in a uniquely compact device that generates higher power than any large stationary laser device; it also provides new levels of clinical versatility, patient comfort and cost effectiveness. Laser technology is FDA approved and is shown to be safe and very effective. Treatment is not considered medically necessary unless other factors are present such as diabetes, poor circulation, excessive pressure, pain, or lack of normal sensation. Aerolase technology provides a new generation of laser technology Benefits of Laser Treatment Reduce thickness Improves appearance Makes nail trimming easier Virtually pain free Immediate post recovery period No anesthesia necessary Common Podiatric Laser Treatments Onychomycosis (Toe nail fungus) Resistant warts Telangiectasias (Spider Veins) Scar Revision Laser Technology General Information How the treatment works: An Nd:YAG laser impulses high power energy that passes through the soft tissue. Recovery period: You may resume to all normal activities immediately. In some cases patients can even polish nails and get a pedicure immediately after treatment. Procedure length: Amount of time varies on degree of involvement. Overall, a visit for consultation and treatment usually takes about 30 minutes. Virtually pain free treatment: Most people do not feel any pain. Some patients may experience slight warmth or occasional snapping sensation during the procedure. The laser power can be decreased to eliminate discomfort. Insurance coverage: The procedure is considered cosmetic, and is not covered by health insurance. Innovative Foot and Ankle. Other Options Not having treatment and living with the condition. The use of medical prescriptions which can be costly and not guaranteed to help the condition. Some medications require blood tests to monitor for possible liver damage. Laser treatment – in many cases the nail is expected to improve with just one treatment. Consult with your physician for further information on Laser Treatment!

  Link: Aerolase Medical Aesthetic Lasers

• EPAT

  What is EPAT? EPAT stands for Extracorporeal Pulse Activation Treatment and is the most advanced and highly effective treatment method for musculoskeletal. The treatment is cleared by the FDA and uses a unique set of pressure waves that stimulate the metabolism, enhance blood circulation, and accelerate the healing process. This helps the damaged tissue gradually regenerate and eventually heal. What disorders can be treated? EPAT treats almost all musculoskeletal pains and injuries of the foot and ankle including but not limited to: Plantar fasciitis and heel pain Achilles Tendonitis Turf Toe Stress Fractures Posterior Tibial Tendonitis Neuroma Shin Splints Other Tendonitis in the foot and ankle Duration of treatment and Results Treatments typically take about 5-10 minutes, depending on the disorder being treated. Generally 3-5 treatments are needed, each about 1 week apart. The benefits are often seen after only 3 treatments with some patients experiencing immediate pain relief. Side Effects? The non-invasive EPAT treatments have virtually no risks or side effects. In some cases there can be some minor discomfort following the treatments. Certain medical conditions such as malignancies or DVT (deep vein thrombosis) might affect the determination to perform the treatment, so please let the doctor know of all medical conditions. EPAT treatments are performed at all of Innovative Foot and Ankle’s locations, so don’t hesitate to contact the office for an appointment to discuss the treatment further with one of the doctors.

  Link: EPAT