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Are Your Feet Ready For Summer?

14 Jun


The word alone inspires images of swimming, vacations in warm, exotic places, feeling the soft grass underfoot, sticking your feet in a cool stream on a hot day, going barefoot.

How do you feel about that last phrase, going barefoot? Do you have visions of friends and family – even strangers – reacting in all kinds of embarrassing ways when you take your shoes off?

perfect feet

She either has a parent who’s a podiatrist, has never been pregnant, or weighs little more than a feather.

No one’s feet are perfect – that is, no one who’s been pregnant, has walked, run, played, gained weight, lost weight, worn shoes that looked fabulous but didn’t really fit, or in short, lived a life over 30 years. After all, those puppies at the bottom of your legs have carried you through it all, even though you’ve paid little attention to their needs. Heck, you’ve downright abused them at times (can you believe some of those shoes you used to wear?)

Most of us neglect our feet, it’s true. What’s more, we frequently inherit abnormal bone structure, faulty tendons and muscles, or less-than-perfect biomechanics from our parents. Throw all of this together and we frequently end up with bunions, a tendency toward  fungal infections like athlete’s foot or toenail fungus, overlapping toes, crossover toes, corns and calluses, ingrown toenails, premature arthritis, you name it. End result is that we keep our feet covered in public when we desperately want to wear sandals, flip-flops, or roam the world – or even our patio deck – in bare feet.

A regular visit to a podiatrist can solve a lot of your foot hangups. Trained intensively and exclusively in the medical treatment of foot and ankle conditions, a podiatrist can resolve pain, discomfort, and aesthetic issues for most patients without surgery. The first part of a treatment program may include suggestions for changes in footwear, custom designed orthotics, exercises specifically geared to your foot problem, and weight management if necessary. These seemingly small changes can make a big difference to your feet.

So go on – take your shoes off, let your toes hang out, and show the world how beautiful your feet are.

My Foot Hurts On The Side Near My Big Toe

5 Jun

Pain, soreness and an ever-growing lump on the side of your foot, just below your big toe – specifically in the big toe joint – is a sure sign that you have a bunion, or you’re about to.



In medical terms, a bunion, known as hallux valgus, is a bony bump that forms around the joint at the base of your big toe. The bump is caused by the head of the first metatarsal bone behind the big toe angling out from your foot. This causes the toe joint to swell, pushing the big toe in towards the adjacent toes.

As the bump on the side of your foot enlarges, pain comes with it and the skin over the bump will become swollen or irritated from the pressure of your shoes. You may even see marks or bulges on the side of your shoe as the bunion tries to wear through. Adding to your headaches (or foot aches) are the fact that bunions are frequently accompanied by crossover toeshammer toes, corns, calluses, and ingrown toenails.

What causes a bunion?

You inherit traits like flat feet, low arches, abnormal bone structure, or loose ligaments and tendons from your parents. These are biomechanical variations in your feet, outside of normal function. When combined with footwear like high heels, rigid shoes, pointy shoes, shoes that squeeze our toes together, shoes that don’t support our feet properly, careers that require a lot of time on our feet, pregnancy, or obesity, this weakness in our foot structure may lead to the formation of bunions.

How is a bunion treated?

First of all, bunions do not go away once formed – the bone has permanently shifted in the joint. If left untreated, it will only get worse. The good news is, modern surgical techniques offer faster recovery times and minimal to no pain, and no hospital stay is required.

Your podiatric surgeon will x-ray and then evaluate your bunion. As each case is different, there is no singular treatment for each patient. But without a doubt, the first thing your podiatric surgeon will recommend is for you to change your footwear and buy shoes which allow plenty of wiggle room for your toes: No heels or low heels and good arch support (a nice argument for wearing only athletic shoes if you can get away with it).  This simple change in what you strap on your feet can relieve a substantial amount of pain from your bunions, as these better choices in shoes will cause less rubbing on the skin over the bony protrusion. Additionally, custom orthotics to be worn in-shoe will be suggested to shift your weight off of the sore area, and padding added between the bunion and the shoe. If you’re carrying too many pounds for your build, then weight management will also be recommended.

If these non-invasive treatments still leave you with considerable pain, then bunion surgery will be recommended.

For more information on bunions, visit our website which we like to call “all about bunions” – Bunion Center Of  The LehighValley.

What is the benefit of custom foot orthotics?

5 Feb

Shoe inserts from a drug store or shoe store are not to be confused with custom made foot orthotics. Most everyone has tried over the counter shoe inserts at some time in their life, and most everyone has been disappointed with them. That’s because there’s no such thing as an “average foot”, so a one-size-fits-all solution for foot pain doesn’t exist.

custom made foot orthoticsOrthotics are custom made shoe inserts. They can only be ordered by a medical professional after an examination of your feet, your gait, your pronation, and an analysis of any pain you may be experiencing. Issues resulting from heel pain, bunions, plantar fasciitis, flat feet, high arches, abnormal biomechanics, or poor lower limb alignment can all be addressed with custom designed orthotics, which can be made to cushion sore areas and correct abnormalities. They can also be very helpful for athletes, especially runners who have recurring problems with their feet.

Orthotics are made from more durable materials than over the counter shoe inserts, and they last for years, not months. Orthotics are custom designed specifically for your foot to improve your running, walking, and balance by supporting the arch, cradling the heel and rotating your foot into a “neutral” position. This support and proper pronation helps the foot function at its maximum level. When your foot is balanced and supported correctly, you’re less prone to ankle or foot injury, knee pain, hip pain, and back pain as well. After all, your entire body is riding on your feet.

For athletes, foot orthotics can help reduce foot stress and fatigue, and may also increase agility. By balancing the foot, shock absorption will improve, diminishing before reaching your limbs.

How do I know if I’ll benefit from custom orthotics?
  • Look at the bottom of your shoes to see if they are worn evenly across the toe or heel area. Even wear-and-tear indicates your gait is normal, but if they wear out too quickly or unevenly, then you may benefit from orthotics
  • Do your feet hurt after being active? How about your ankles, knees, hips, or back?
  • Do you have unusually high arches?
  • Do you have flat feet?
  • Do you have tendonitis, shin splints, hammer toes?
  • Are your legs consistently tired or aching?
  • Do you have diabetic foot problems or a neuroma?
Only a podiatrist can tell if custom made orthotics are right for your feet, but most patients notice an immediate difference in comfort and stability, and their pain is sharply reduced or eliminated.

Should I see a Podiatrist or an Orthopedist?

18 Sep

fractured ankle bruising swellingWell, that explains the excruciating pain and the baseball-size swelling in your ankle after you jumped off the trampoline…

Your family physician just pointed to a dark line on your x-ray which shows a fracture of your ankle. She suggests you see a specialist, but will she recommend an Orthopedist or a Podiatrist? Which should you choose?

The difference between an orthopedist and a podiatrist

An Orthopedist is devoted to the diagnosis and treatment of your entire body’s musculoskeletal system: the interworkings of the bones, muscles, tendons, ligaments and joints. Some orthopedists specialize in treating the foot and ankle, while others focus on hands, shoulders, spine, hips, etc. If you choose an orthopedist, make sure that they specialize in foot and ankle.

A Podiatrist is a Doctor of Podiatric Medicine, who is trained intensively in the care of the feet, ankles, and lower legs. Podiatrists are also trained in the biomechanics of the foot and ankle and are trained to fit orthotics, custom shoes, braces, and similar devices. Additionally, some Podiatrists are Podiatric Surgeons, who can perform foot and ankle surgery in a hospital setting when necessary.

A Doctor of Podiatric Medicine (DPM) is the foremost medical and surgical specialist of the foot and ankle and is the only medical specialist educated, trained, licensed, and certified for exclusive treatment of the foot and ankle.

Podiatric Surgeons complete a 3 year hospital based residency which includes training in all aspects of foot and ankle surgery. There are some that choose to complete a 1 year fellowship to further focus on areas such as diabetic limb salvage or sports injuries of the foot and ankle. But not all Podiatrists choose to perform all types of foot and ankle surgery just as not all Orthopedic Surgeons choose to perform back surgery vs knee surgery.

Just as with any physician, you should always make your choice based upon their reputation.

The human foot and ankle is one of the most intricate and complex anatomical structures in your body, marrying the precision of a Swiss watch with the structural strength of a cantilever bridge. Your foot is a complex apparatus of 26 bones (one-quarter of all the bones in the human body), 33 joints and more than 100 ligaments and tendons, all linked and served by a vast network of nerves, muscles, blood vessels, soft tissue and skin. All of these parts work in unison to provide the support, strength, flexibility and resiliency needed for actions most of us take for granted, such as balance, walking, running and jumping.

Podiatric surgeons provide comprehensive medical and surgical care for a wide variety of common and complex foot and ankle conditions that affect children, adults and the elderly. They are uniquely qualified to detect the early stages of diseases that show warning signs in the toes, foot, ankle or lower leg, such as diabetes, arthritis and cardiovascular disease. Early diagnosis and treatment by podiatric physicians may save patients from amputation, restore mobility or prevent other serious health problems.

How to know when you need bunion surgery

16 Aug

In a previous post, how to know when you have a bunion, we talked about the signs of a bunion, how to relieve the pain of a bunion, and how not to get a bunion in the first place (assuming it’s not genetic). Now we’re going to talk about the actual bunion surgery.

First things first – make sure that your podiatric surgeon has a strong reputation for success. Stay away from doctors who make claims like:

  • 90 percent of my patients have pain free surgery
  • My patients never require crutches
  • Surgery is performed in our own surgery center
  • I created a better bunion surgery
bunion before surgery

This patient definitely has a bunion requiring surgery. She showed little relief from changing footwear, pain medication, orthotics, or icing. Click for larger image.

To take these in order: Well yes, your bunion surgery will be pain free because you’re under anaesthesia. You’ll also receive a pain blocking medication that will last for a day or two after you go home. But after that, you will definitely feel some pain. How much depends on the severity of your bunion and how much work the surgeon did on your foot to remove the growth and straighten your toe.

In almost every case, a patient who receives a bunionectomy cannot put weight on that foot for at least a week or two after surgery. Therefore, you’ll require crutches for a short time as well as a medical boot to cushion the foot and protect it. The medical boot will stay on the foot for up to 8 weeks after surgery.

Ask a lot of questions if a physician tells you that they perform surgery in their own surgery center.  Physicians who perform surgery in the hospital must pass a credentialing process and be re-evaluated on a regular basis to perform individual surgical procedures. This insures that the surgeon is qualified to perform your bunionectomy. A physician may be deemed not qualified to perform a procedure in the hospital but this does not stop him/her from performing procedures in his/her own surgery center.

This last one is a doozy – a better bunion surgery for whom? Bunion surgery always must take into account foot shape, ligament tightness, biomechanics and other factors. There is definitely no “one size fits all” approach. Besides, if a physician did indeed develop a better bunion surgery, it would be adopted by the larger medical community.

bunion post surgery

Patient’s foot about one week after surgery. Click for larger image.

You should also be wary of any physician who wants to perform a bunionectomy too quickly. If on your first visit he/she recommends surgery, see another podiatrist for a second opinion. A competent podiatrist will always attempt to correct the bunion pain first through the use of orthotics, different footwear, icing, over the counter medications and other pain relief techniques before suggesting surgery.

If you’d like to know more about bunions, download this free booklet written by Dr. Teichman of PA Foot And Ankle Associates, the ten secrets to relieving bunion pain.

Why does the top of my foot hurt?

27 Jun

Pain on the top of your foot can be excruciating, making it difficult or impossible to walk even a few steps.

pain in top of foot

Assuming there is no visible injury, and you can’t attribute the pain to falling, twisting your ankle, barefoot running, or dropping furniture on your foot, the cause could be anything from an ingrown toenail to Gout.  A podiatrist would have to do a thorough examination to determine the specific cause, but here are the most common reasons you might have pain in the top of your foot.

Nerve Entrapment

Your shoes have quite an affect on the health of your foot. Shoes that are too tight, including athletic footwear, can cause Nerve Entrapment – also known as a “pinched nerve”. Repeated pressure on one area irritates the nerve and can cause a surprisng amount of pain. Ice, rest, and a change to less constricting footwear should resolve the pain.

Midtarsal fault

The arches in your feet are meant to absorb the shock of running, walking, and standing. When the arches fall and you suffer with flat feet, the tarsal bones can become compressed, which leads to damaged joints, bone spurs, and irritation.  The top of your foot may be slightly swollen, have red spots, and pain will increase with activity. Improper footware is one of the main causes of this condition.

Metatarsal Stress Fracture

Stress on the metatarsal bones (the five long bones in the front of the foot) can cause tiny cracks in the bones. This is a very common injury for athletes, dancers, and those who return to exercising after a long layoff.

Extensor Tendonitis

The Extensor Tendons lie just under the skin on the top of the foot. Their job is to pull the toes up away from the ground, and when they become irritated, the pain can be excruciating and often confused with a fracture. The most frequent cause of this complaint is once again, footwear that’s too tight.

Other reasons for pain in the top of the foot may include

  • Bone spurs
  • Sprain
  • Ganglion Cyst
  • Aging (arthritis)
  • Hammertoes
  • Gout

Pain on the top of the foot could indicate a mild irritation to your nerves or tendons from tight shoes, or a more serious condition. If rest, ice, and over the counter anti-inflammatory medications do not relieve the symptoms, call podiatrists at PA Foot and Ankle Associates for an immediate examination. We will determine the cause of your pain and create a customized treatment plan for you.

My foot hurts on the bottom – what’s wrong?

21 Jun

I frequently hear this question when a new patient is experiencing foot pain for the first time. The answer unfortunately is anything but simple and could lie anywhere between Metatarsalgia to a traumatic fracture. This assumes that there are no obvious signs of injury.

my foot hurts

A minor reason for pain on the bottom of the foot, particularly on the “ball” of your foot, is Metatarsalgia. That’s a very big word for a simple overuse injury. It’s called Metatarsalgia because it affects the Metatarsals, the largest bones in your feet. This condition may create a feeling that you’re walking with a pebble in your shoe, or may express itself as sharp pains in your toes, or pain just behind your toes. Rest, elevation and ice will relieve Metatarsalgia symptoms. If they persist or worsen, see a podiatrist for a diagnosis.

A more serious reason for pain in your foot could be a fractured bone. With 26 bones in the foot, plus 2 sesamoid bones which are very small, the chances for fractures are plenty, especially if you’ve gained a large amount of weight in the past year (pregnancy, obesity) or if you compete athletically. Many times these small fractures may only produce mild pain when they first occur, but may become very painful after a few days.

Usually the most comon reason for pain on the bottom of your feet is Plantar Fasciitis, which is an inflammation of the thick tissue which connects the heel bone to the toes and creates the arch of the foot. Plantar Fasciitis may start out as a mild burning sensation and stiffness in the heel, or create so much pain in your foot that you can barely walk. Only an examination by a trained podiatrist can determine if you have Plantar Fasciitis and what your treatment options may be. For more information on Plantar Fasciitis, check out my YouTube video.

If you experience any pain in the bottom of your feet, your best bet is to call the podiatrists at PA Foot and Ankle Associates for a thorough examination and a course of treatment customized just for you.

How do I know if I have a bunion?

24 May
Bunion is one of the most common conditions treated by a Podiatrist. They are most frequently seen in women and can be caused by wearing narrow-toed, high heeled footwear, but are frequently an inherited trait.

In fact, podiatrists sometimes treat bunions in multiple generations of the same family.

What is a bunion?

A bunion is an abnormal, bony bump that forms on the joint at the base of your big toe. It’s caused when your big toe pushes up against your other toes, forcing the big toe joint in the opposite direction, away from the normal profile of your foot. Over time, the stress enlarges your big toe joint, pushing the big toe even further against your smaller toes and causing pain. Bunions frequently form in early adulthood and worsen with age, especially if accompanied by arthritis.

Who is most likely to develop a bunion?

You’re a good candidate for bunions if:

  • Either of your parents had bunions
  • You’re a woman (women have a 50% chance of getting bunions)
  • You’re a woman who is or was a dancer
  • You suffered a foot injury at any point in your life
  • You wear tight, narrow, high heeled hoes
  • You have arthritis in your feet
How do I know if I have a bunion?

Look at your feet. On a normal foot, the big toe should point straight ahead and you should be able to draw a relatively straight line from your heel to your big toe.

If you see a bump – an outgrowth – on the side of your foot just below the joint of the big toe, you most likely have a bunion forming. It’s probably pretty small if you just discovered it, but eventually this bump may enlarge, forcing the big toe towards the smaller toes. If so, you’ll begin to experience pain in your foot and the skin over the bump will become swollen or irritated from the pressure of your shoes. You may even see noticeable marks on the side of your shoes as the bunion wears through.

Another type of bunion is called a Tailor’s Bunion, also known as a Bunionette. This is a smaller bump that forms on the outside of the foot towards the joint at the little toe. A Tailor’s Bunion is created when the little toe moves inwards towards the big toe and is usually caused by footwear that is too tight.

How do I relieve bunion pain?

Bunion pain can be relieved by wearing wide shoes to reduce the force on your toes. You can also add padding on the inside of the shoe over the bunion area. At drug stores, you can find toe spacers that will separate the big toe from the second toe to keep them from rubbing. If the pain continues, or if the bunion becomes worse, surgery will be needed to straighten the toe and remove the bunion. This surgical procedure is called a bunionectomy.

When should I call a podiatrist about my bunion?

A surgeon performs a bunionectomyWhen you first notice a bunion, you should contact your podiatrist for an evaluation. He or she will make an initial diagnosis, monitor your condition and make recommendations for treatment. Initial treatments may include custom orthotics (inserts in your shoe which are custom formed to your foot), bunion splints, bunion regulators, bunion cushions, ice, and rest.

If your pain persists or the bunion enlarges, a bunionectomy may be required.

How do I reduce my chances of getting a bunion?
  • Don’t force your feet into shoes that don’t fit
  • Choose shoes that comfortably conform to the shape of your foot
  • Choose shoes with wide insteps, broad toes and soft soles
  • Do not wear shoes that are too tight or sharply pointed
  • Do not wear shoes that have a heel higher than two inches
  • See your podiatrist on a regular basis

If you suspect you have a bunion or are experiencing any kind of foot pain, make an appointment today with PA Foot And Ankle Associates for a thorough diagnosis.

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