Clinical Services and Patient Education
Visit us for any of the conditions and treatments below.
To Learn more about each condition, click on the hyperlink in the discription
Custom orthotics are medical devices prescribed by a foot and ankle surgeon. These are different from shoe inserts and arch supports in that they have two functions. Orthotics can be used to accommodate or offload a prominent area. This can be helpful for bursitis, calluses beneath bony prominences and ulcers. They can also help the foot function better in the case of hypermobility seen in tendonitis, fasciitis and other mechanically derived conditions. Orthotics can delay the need for surgery or help with pain caused by these conditions.
Bunions (also referred to as hallux valgus) are often described as bumps on the side of the big toe. But a bunion is more than that. The visible bump actually reflects changes in the bony framework of the front part of the foot. The big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment, producing the bunion’s bump. Bunions are a progressive disorder. They begin with a leaning of the big toe, gradually changing the angle of the bones. Symptoms usually appear at later stages.
Hammertoes are contracture (bending) deformities of one or both joints of the second, third, fourth or fifth (little) toes. This abnormal bending can put pressure on the toe when wearing shoes, causing problems to develop.
In the earlier stages, hammertoes are flexible and the symptoms can often be managed with noninvasive measures. But if left untreated, hammertoes can become more rigid and will not respond to nonsurgical treatment. Because of the progressive nature of hammertoes, they should receive early attention.
Unlike traditional fungus treatments which carry potentially dangerous side effects, laser treatment is a safe, non-invasive and effective way to treat toenail fungus. Laser treatment works by penetrating deep inside the nail and destroying fungus without causing any damage to the nail tissues. Laser therapy requires no medication and has no surgical downtime. This virtually painless procedure has helped countless individuals overcome the aesthetic and social discomforts associated with toenail fungus
Arthroscopy is a minimally invasive surgical procedure to visualize, diagnose, and treat problems inside the joint. Because it requires only tiny incisions, arthroscopy can be performed without a major, invasive operation and many procedures can be done on an outpatient basis. The word arthroscopy comes from two Greek words, "arthro" (joint) and "skopein" (to look) and literally means, "to look within the joint." Arthroscopy is performed using an arthroscope, a thin, fiberoptic scope fitted with a light source and a miniature camera connected to a TV screen.
Shoes for patients living with diabetes are made of special protective inserts and soft shoe materials to accommodate for conditions, such as neuropathy (numb feet), poor circulation and foot deformities (bunions, hammertoes, etc.). The shoes decrease the chance of foot sores (ulcers), which can be caused by friction and pressure. This may lead to infection, gangrene or even amputation. We can have the shoes made for patients at a specialty laboratory or give the patient a prescription to have the shoes custom made.
Flat Feet (PTTD)
The posterior tibial tendon serves as one of the major supporting structures of the foot, helping it to function while walking. Posterior tibial tendon dysfunction (PTTD) is a condition caused by changes in the tendon, impairing its ability to support the arch. This results in flattening of the foot. Although this condition typically occurs in only one foot, some people may develop it in both feet. PTTD is usually progressive, which means it will keep getting worse, especially if it is not treated early.
The Achilles tendon is a band of tissue that connects a muscle to a bone. It runs down the back of the lower leg and connects the calf muscle to the heel bone. Also called the heel cord, the Achilles tendon facilitates walking by helping to raise the heel off the ground. Achilles tendonitis is an inflammation of the Achilles tendon. Over time, if not resolved, the condition may progress to a degeneration of the tendon (Achilles tendonosis), in which the tendon loses its organized structure and is likely to develop microscopic tears.
Fungus of the toenails is a common problem that can affect people of all ages, although it most commonly affects individuals who are older.
Toenail fungus often begins as an infection in the skin called tinea pedis. The fungus often starts under the nail fold at the end of the nail. Over time, it grows underneath the nail and causes changes to its appearance, such as a yellow or brownish discoloration. It can also cause thickening and deformity of the toenail. Toenail fungus can be treated medication or laser treatment.
Advanced Wound Care
Ulcers, which are open sores in the skin, occur when the outer layers of the skin are injured and the deeper tissues become exposed. They can be caused by excess pressure due to ill-fitting shoes, long periods in bed or after an injury that breaks the skin. Ulcers are commonly seen in patients living with diabetes, neuropathy or vascular disease. Ulcers are treated by removing the unhealthy tissue and performing local wound care, special shoes or padding, antibiotics if infection is present, and in severe cases surgery.
Ingrown toenail is a condition where the toenail is curved and grows into the skin, usually at the nail borders (the sides of the nail). This digging in of the nail irritates the skin, often creating pain, redness, swelling and warmth in the toe.
If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is often marked by drainage and a foul odor. However, even if the toe is not painful, red, swollen or warm, a nail that curves downward into the skin can progress to an infection.
Diabetic Foot Care
Diabetic foot care is extremely important to people living with diabetes. People with diabetes are prone to having foot problems, often because of two complications of diabetes: nerve damage (neuropathy) and poor circulation. Neuropathy causes loss of feeling in your feet, taking away your ability to feel pain and discomfort, so you may not detect an injury or irritation. Poor circulation in your feet reduces your ability to heal, making it hard for even a tiny cut to resist infection. Diabetescan turn small foot problems into serious complications.
An ankle sprain is an injury to one or more ligaments in the ankle, usually on the outside of the ankle. Ligaments are bands of tissue—like rubber bands—that connect one bone to another and bind the joints together. In the ankle joint, ligaments provide stability by limiting side-to-side movement. The severity of an ankle sprain depends on whether the ligament is stretched, partially torn or completely torn, as well as on the number of ligaments involved. Ankle sprains are not the same as strains, which affect muscles rather than ligaments.
A neuroma is a thickening of nerve tissue that may develop in various parts of the body. The most common neuroma in the foot is a Morton’s neuroma, which occurs between the third and fourth toes. It is sometimes referred to as an intermetatarsal neuroma. Neuromas may also occur in other locations in the foot. The thickening of the nerve that defines a neuroma is the result of compression and irritation of the nerve. This compression creates enlargement of the nerve, eventually leading to permanent nerve damage.
A corn is a small circular thickened lesion in the skin of the foot. It usually forms due to repeated pressure on the skin, such as the rubbing of a shoe. People with foot deformities, such as hammertoes, often suffer from corns because the tops of the bent toes rub against the tops of shoes. When corns get hard enough to cause pain, a foot and ankle surgeon will recommend the treatment option most appropriate for you. It is important to avoid trying to remove a corn at home or using medicated corn pads, as serious infection may occur.
Heel pain is most often caused by plantar fasciitis, a condition that is sometimes also called heel spur syndrome when a spur is present. Heel pain may also be due to other causes, such as a stress fracture, tendonitis, arthritis, nerve irritation or, rarely, a cyst.
Because there are several potential causes, it is important to have heel pain properly diagnosed. A foot and ankle surgeon is able to distinguish between all the possibilities and to determine the underlying source of your heel pain.
A fracture is a partial or complete break in a bone. Fractures in the ankle can range from the less serious avulsion injuries (small pieces of bone that have been pulled off) to severe shattering-type breaks of the tibia, fibula or both.
Ankle fractures are common injuries most often caused by the ankle rolling inward or outward. Many people mistake an ankle fracture for an ankle sprain, but they are quite different and therefore require an accurate and early diagnosis. They sometimes occur simultaneously.
A callus is a thickened area of skin on the foot caused by pressure and repeated rubbing, such as from a shoe or sock. The rubbing causes the skin to produce a layer of protective skin (a callus). Calluses vary in size and can become painful.
People who have calluses are cautioned against performing “bathroom surgery,” as this can lead to cuts and infection. A foot and ankle surgeon can evaluate the cause of the calluses and recommend the treatment most appropriate for your condition.