An ingrown toenail is a nail that has curved downward and grown into the skin. This typically occurs at either the nail borders or the sides of the nail. As a result, pain, redness, swelling, and warmth may occur in the toe. If a break in the skin forms due to the ingrown nail, bacteria may enter and cause an infection in the area; this is typically characterized by a foul odor and drainage.
Ingrown toenails have multiple reasons for developing. In many instances, the condition is a result of genetics and is inherited. The most common cause, however, is improper trimming; cutting the toenails too short forces the skin beside the nail to fold over. An ingrown toenail can also develop due to trauma, such as stubbing the toe, having an object fall on the toe, or participating in activities that involve repeated kicking or running. Wearing shoes that are too tight or too short can also cause ingrown toenails.
Treatment for an ingrown toenail varies between patients and the severity of the condition. In most cases, it is best to see your podiatrist for thorough and proper treatment. After examining your toe, your podiatrist may prescribe oral antibiotics to clear the infection if one is present. Surgical removal of either a portion of the nail or the entire nail may also be considered. In some cases, complete removal or destruction of the nail root may be required. Most patients who undergo nail surgery experience minimal pain afterward and can return to normal activity the following day.
Ingrown toenails can be prevented with proper nail trimming and by avoiding improper-fitting shoes. When cutting the toenails, be sure that you are cutting in a straight line and avoid cutting them too short. Shoes should not be too short or tight in the toe box.
Plantar warts are described as small growths that appear on the heels or other areas of the feet that bear a large amount of weight. The pressure in these areas causes plantar warts to hide behind thick layers of skin called calluses. In most cases, plantar warts are not a serious health issue, and they usually go away without treatment. However, it is still important be mindful of them.
Plantar warts are caused by infections with human papillomavirus (HPV) in the outer layer of skin on the soles of the feet. The plantar warts then develop when the virus enters the body through weak spots at the bottom of the feet, such as tiny cuts and breaks. Plantar warts are not guaranteed for all who encounter the virus. Everyone responds differently to the affects of HPV.
Plantar warts are most common in the following groups: children and teenagers, people with weakened immune systems, people with history of plantar warts, and people who walk barefoot. Exposure to HPV is common in environments such as locker rooms or pool areas.
One of early signs to look out for is a callus, since many plantar warts hide behind them. You can also locate these warts by looking for small, fleshy, rough, grainy growths near the base of the toes and the heel. Early signs of plantar warts are shown by black pinpoints, which are small, clotted blood vessels. Lesions that interrupt normal lines and ridges in the skin of your foot may also be a sign of plantar warts. Any feeling of pain while walking or standing can also be a symptom of plantar warts.
Although most cases are not serious, some conditions may require a visit to your podiatrist. If you are uncertain that your lesion is a wart, if you have diabetes, or if you are experiencing bleeding, you may need to see a seek professional treatment. Your doctor may offer treatments such as prescribing stronger peeling medicine or using cryotherapy by applying liquid nitrogen to the wart. More serious cases may require minor surgery or laser treatment.
There are simple solutions available to help prevent plantar warts. One common task is to avoid walking barefoot in swimming pool areas and locker rooms, as this is where HPV is commonly present. Keeping your feet clean and dry, while changing shoes and socks daily can also help prevent future plantar warts. If you know someone who has plantar warts, it is important to avoid direct contact with their warts. You should also refrain from picking or scratching your wart if you happen to develop one.
Our bones are important aspects of our body and they are constantly changing. The heavier the workload for a bone, the more likely it is that calcium will be placed in it. When a bone isn’t used often, there won’t be much calcium within it. When stress from repetitive loads prevent the bone from being able to repair itself, cracks will start to form. Stress fractures are defined as cracks in a bone that result from repetitive force, such as overuse.
The most common cause of stress fractures is a sudden increase in intensity and duration of physical activity. For example, if you begin to run long distances without working your way into doing so, you will be more likely to develop a stress fracture.
Common symptoms of stress fractures are pain and swelling near the weight bearing area on the injured bone. When initial x-rays are performed, it is possible that the fracture will not show up. However, once the stress on the area continues, the damage will increase, and the fracture will be severe enough to show up on an x-ray. Certain parts of the foot are more likely to develop stress fractures than others. Areas that typically have these fractures are: the metatarsals, the navicular bone, the calcaneus, tibia, and fibula.
Since women are at an increased risk of developing osteoporosis, they are twice as likely as men to sustain a stress fracture. Additionally, old age causes a decrease in bone mineral density which is why elderly people are also likely to develop these fractures.
It is important for you to be professionally diagnosed by a podiatrist if you suspect you have a stress fracture, because there are other injuries that can easily be mistaken for a fracture. Sprains, strains, shin splints, plantar fasciitis, and Morton’s neuroma can all easily be mistaken for stress fractures in the foot. Your podiatrist will likely ask you a series of questions to determine what type of pain you are experiencing. These questions will help your doctor identify whether you have a stress fracture.
The best method of treatment for a stress fracture is rest. Additionally, a walking boot, cast, or crutches, will help rest the area that is injured. The typical healing time for stress fractures is 4-12 weeks, however this depends on which bone is involved.
A podiatrist is a Doctor of Podiatric Medicine who treats the foot, ankle, and related structures of the leg. If you are having any pain, injuries, or abnormalities in these areas, it is best that you seek help from a podiatrist.
Podiatrists complete four years of training in a podiatric medical school. Their training is like that of other physicians, and they may go on to complete a fellowship training after a residency training. Some podiatrists are board certified meaning they have advanced training, clinical experience, and have taken an exam to prove their skills. Certifying boards for podiatry are the American Board of Foot and Ankle Surgery and the American Board of Podiatric Medicine. Podiatrists may work in private practices, hospitals, clinics, or they may even become professors at colleges of podiatric medicine.
While in college, those who want to be podiatrists often take biology, chemistry, and physics classes in preparation for podiatry school. In podiatry school, students study how the bones, nerves, and muscles work together to help you move around. Additionally, they study injuries and how to properly diagnose and treat them. Admittance into podiatric medical school requires the completion of 90 semester hours of undergraduate study with a good grade point average, and acceptable scores on the MCAT (Medical College Admission Test)
Podiatrists treat many different conditions such as: aching feet, ankle pain, bunions, corns, hammertoes, fungus, ingrown toenails, plantar fasciitis, sprains and more. Common forms of treatment for these conditions are physical therapy, drugs, or surgery. Podiatrists may also recommend corrective shoe inserts, custom-made shoes, plaster casts, and strappings to correct deformities.
Even if you are someone whose feet are in generally good condition, you should still visit a podiatrist to have your feet properly exfoliated and maintained, or to make sure you are looking after your feet properly.
Corns are thickened areas on the skin’s surface, to the point of being irritating and sometimes painful. Commonly found on the feet, corns are circular or cone-shaped. They develop where there are areas of pressure or friction, such as on the little toe when it rubs up against shoes, or on the ball of your foot.
Corns are often confused with a callus, but there is a difference between them. Corns can be raised bumps that are painful to the touch. They consist of a rough, thick area of skin that may be dry or waxy. Corns tend to be surrounded by skin that is inflamed, and are usually much smaller than calluses.
Removing the dead skin that has built up is the key in treating corns. Salicylic acid medication is most common in accomplishing this. The acid works by dissolving keratin, which is the protein that makes up the majority of corns. You can purchase salicylic acid over-the-counter in products such as wart removers. It comes in a variety of forms such as medicated pads, drops, or creams. However, people who are diabetic should not use salicylic acid, but should instead consult their doctor immediately.
According to the product directions, applying the medication directly onto the corn will treat it. The top layer of the corn will begin to turn white after use. When that occurs, the layers of skin can then be peeled away, making the corn smaller. Shaving off corns with razors or other pedicure equipment is never a good idea. This can lead to infection. If your corn gets infected, and is not treated immediately, a visit to the doctor will be necessary.
Another way to treat corns and help prevent their return is by using orthotic inserts, fitted by a podiatrist. Inserts fit right into your shoes and adjusts the way your foot fits into your shoes. This fixes the way you walk. This will lower your chances of getting corns, and eliminate current corns by reducing rubbing from friction.
Surgery is rarely used to treat corns, but does occur on occasion. Surgery actually deals with the underlying issue that causes corns. During surgery, the bone is shaved and any abnormalities are corrected, thus reducing the amount of friction that occurs during walking.
To prevent corns, the first step is reducing friction. Always wear shoes that fit well and don’t rub your feet. Pads can be purchased if you notice rubbing developing. These pads can be purchased over-the-counter, and can be simply placed on the irritated area. Wearing cushioned insoles in your shoes can always reduce the friction, and making sure to wear well-fitting shoes. This will ensure that your foot is not being squeezed awkwardly, and prevent corns from forming in the first place.
Broken ankles or “ankle fractures” are injuries that occur when the bones that make up the ankle joint are broken. Ankle injuries are some of the most common bone and joint injuries. The ankle joint is made up of three bones that join. The tibia is the main bone, and it makes up the inside of the anklebone. The fibula is a smaller bone, and it makes up the outside of the anklebone. A membrane called the joint capsule is lined with a layer called the synovium, which covers the entire joint. The synovium produces synovial fluid which allows for the joint surfaces to move.
An ankle becomes broken when the joint is stressed beyond the strength of its limits. When an ankle is fractured, ligaments may also tear at the same time. Fractures often occur to the ankle rolling or twisting in an unusual way. At times, a fracture may even be caused by an extreme force applied to the joint.
Symptoms of a broken ankle include pain, swelling, bruising, discoloration, numbness, and an inability to move the toes. If you have a broken ankle, you may also hear something tear or snap when you initially suffered the injury. If you have pain from a broken ankle, beware that the pain will not always come from the exact area of the fracture; you may also experience pain from associated foot fractures. The swelling you may experience can suggest that soft tissue damage may have occurred due to the injury.
There are differences between an ankle fracture and an ankle sprain. The difference is that a fracture or break in the bone is required to classify an injury as a broken ankle. An ankle sprain occurs when there is a tear or disruption of ligaments in the ankle. In some cases, the prognosis of an ankle sprain may be worse than that of a fracture.
X-rays are the most common way to diagnose a broken ankle. X-rays show if the ankle is broken and where exactly the fracture is located. It will also show how many pieces of broken bone there are. A second method of testing to see if an ankle is broken is a stress test. To do this, the doctor will put pressure on the ankle and perform a stress test to determine if the fracture requires surgery. Other methods for diagnosis include CT scans and MRI scans.
If you are suffering from a broken ankle, consult with your podiatrist immediately to receive a proper diagnosis and treatment.
Our feet are arguably the most important parts of our bodies because they are responsible for getting us from place to place. However, we often don’t think about our feet until they begin to hurt. If you have pain in your feet, you need to first determine where on the foot you are experiencing it to get to the root of the problem. The most common areas to feel pain on the foot are the heel and the ankle.
Heel pain is most commonly attributed to a condition called plantar fasciitis. Plantar fasciitis occurs when the plantar fascia, which is the band of tough tissue connecting the heel bone to the toes becomes inflamed. Plantar fasciitis pain is usually worse in the morning, and it tends to go away throughout the day. If you have plantar fasciitis, you should rest your foot and do heel and foot muscles stretches. Wearing shoes with proper arch support and a cushioned sole has also been proven to be beneficial.
Some common symptoms of foot pain are redness, swelling, and stiffness. Foot pain can be dull or sharp depending on its underlying cause. Toe pain can also occur, and it is usually caused by gout, bunions, hammertoes, ingrown toenails, sprains, fractures, and corns.
If you have severe pain in your feet, you should immediately seek assistance from your podiatrist for treatment. Depending on the cause of your pain, your podiatrist may give you a variety of treatment options.
Foot and ankle injuries are common among athletes and those who exercise frequently. Most of these injuries are non-life-threatening and can heal in weeks with proper treatment and care. Serious injuries, however, require urgent medical treatment.
Common minor injuries include ankle sprains, ankle strains, Achilles tendonitis, plantar fasciitis, stress fractures, and turf toe. An ankle sprain is when the ligaments in the ankle have either become stretched or torn. When the muscle or tendon is stretched or torn, it is an ankle strain. When the big toe is sprained, it is known as turf toe. Achilles tendonitis is the overuse and inflammation of the Achilles tendon. Plantar fasciitis is the inflammation of the plantar fascia and generally occurs from overuse in athletics. Stress fractures are also caused from overuse and are small cracks in the bone.
Achilles tendon ruptures are common, but more serious. This injury occurs when the Achilles tendon, the largest tendon in the body, ruptures. In most cases, this causes severe pain and difficulty walking; some who have experienced this injury have reported, however, no signs or symptoms. A laceration is a deep cut that can occur anywhere on the body. Lacerations on the foot are rarer, but can occur from things like metal cleats landing on the foot.
Treatment options cover a wide range of methods based upon the injury and its severity. Conditions like plantar fasciitis, stress fractures, Achilles tendonitis, turf toe and ankle sprains/ strains can heal on their own without immediate medical care, but seeing a podiatrist to monitor the injury is always recommended. Following the RICE (Rest, Icing, Compression, and Elevation) protocol is generally enough to treat minor injuries. This means resting the foot by either keeping pressure off the foot or not walking at all. Icing the injury will help reduce swelling and pain. Compressing the wound with a wrap will immobilize and help promote healing. Finally, keeping the wound elevated will also reduce swelling and also help the healing process.
It is important to note that even minor injuries can vary in severity, with grade one being a minor injury and grade three requiring urgent care by a podiatrist. Achilles tendon ruptures and lacerations on the foot generally require urgent medical care and treatment options that need a podiatrist. These could include imaging tests, stitches for cuts, rehabilitation, and casts or braces. Every case is different, however, so it is always recommended to see a podiatrist when pain in the foot does not disappear.
A congenital foot problem is a problem affecting the feet, toes, and/or ankle that a child is born with. Several issues with a child’s feet can occur congenitally. Such problems include clubfoot, vertical talus, tarsal coalition, polydactyly, macrodactyly, and cleft foot. Some of these problems have a genetic basis, with someone in their family history having a gene causing the condition, and some are simply an anomaly.
The following are specifics about a few of these conditions:
- Clubfoot, also called congenital talipes equinovarus or talipes equinovarus, is When the tendons of the foot shorten, the bones are of an unusual shape, and the Achilles tendon is tight, causing an inward and downward pointing of the foot. The soles of the feet might also face each other. In most cases of clubfoot, both feet are affected. If not treated, the affected child will walk on the sides of their feet or ankles.
- Polydactyly is a condition where the child has more than five fingers or toes on either or both feet. Presentation usually consists of a nubbin or small lump of tissue without a bone, a toe that is partially formed but has no joints, or an extra toe.
- Vertical talus is where the talus bone forms in the wrong position, other bones in the foot do not line up properly, the front of the foot points up, and the bottom of the foot is stiff, has no arch, and usually curves out. This can occur in one or both feet and if left untreated, can lead to serious disability or discomfort as the child grows.
- Tarsal coalition is when there is an abnormal connection of two or more bones in the foot leading to severe, rigid flatfoot. The tarsal bones, located toward the back of the foot and in the heel, are the ones affected. This condition is often present at birth, but signs of the disorder usually come on in early adolescence.
- Cleft foot is a rare condition where the foot has missing toes, a V-shaped cleft, and other anatomical differences. Surgery can often help improve the foot’s function since the heel remains normal and is what is most needed for walking. The main issues with this affliction are whether the affected foot can fit into a shoe and the shape and appearance of the foot.
- Macrodactyly is when the toes are abnormally large due to overgrowth of the underlying bone or soft tissue. Having this condition makes it harder for the child to use the affected foot for certain activities.
As you grow older, you will start to notice more problems with your feet due to wear and tear. This may also happen because the skin will start to become thin and lose elasticity. Some signs of aging feet are regular aches and pains, bunion development, and clawed toes.
Fortunately, there are ways you can improve comfort, relieve pain, and maintain mobility in your feet. One of the best ways to deal with aging feet is to exercise. If you keep active, your muscles will become toned which will then strengthen the arches in the foot and stimulate blood circulation.
It is important that you practice proper foot care to protect your aging feet. You should wash your feet in warm water on an everyday basis. Afterward, the feet need to be dried well and it is important to dry between the toes. Your toenails should be trimmed and kept under control; nails that are poorly cut may become ingrown. At the end of each day, performing an inspection of your feet will allow you to detect any ailments in their early stages.
As you grow older, it becomes more important that you wear comfortable shoes. Your shoes should be secure, and they should provide decent arch support. If you are looking to buy a new pair of shoes, it is best to look for a pair that are made from a breathable material. It is also helpful to have shoes that have a bit of extra room at the top of the shoe, especially if you suffer from swollen feet.
The most common foot problems that elderly people will encounter are bunions, calluses, corns, hammertoes, heel pain, and foot problems related to diabetes. Some other issues include arch pain, tarsal tunnel syndrome, Achilles tendonitis, and Morton’s neuroma
An annual foot examination is a great way for you to ensure that you do not have any serious health problems with your feet. You should talk to a podiatrist about the available treatment options for whichever foot issue you are dealing with.
The forefoot is composed of five metatarsal bones and fourteen phalanges. Each toe has three phalanges except for the big toe which only has two. Our toes play an essential role to the walking process, which is why a broken toe could seriously disrupt one’s ability to move around. Toe fractures are common and can be very painful. Fortunately, these injuries rarely require surgery and usually heal with rest and a change in activity.
Broken toes typically result from a traumatic event such as falling, stubbing the toe, or dropping something on the toe. Traumatic toe fractures may be categorized as either minor or severe fractures. At times, one may hear a “pop” or “crack” sound when the bone breaks. Common symptoms of a traumatic toe fracture include pain, throbbing, bruising, swelling, and redness.
Another type of toe fractures is a stress fracture. These injuries usually appear in the form of small hairline breaks on the bone. Stress fractures develop after repetitive activity instead of a single injury. Stress fractures occur when the muscles in the bone become too weak to absorb impact. Consequently, the toe bone becomes vulnerable to any pressure and impact it endures. Symptoms for a stress fracture in the toe include swelling without bruising, tenderness to the touch, pain that goes away with rest, and pain after walking or running.
If you suspect that you have a broken toe, you should make an appointment with your podiatrist. He or she will likely diagnose you by performing a physical exam and an X-ray. Treatment for a broken toe may include the R.I.C.E. method, buddy taping, surgery, or antibiotics. The R.I.C.E. method (Rest, Ice, Compression, and Elevation) is a common treatment method for many injuries because it decreases pain. Buddy tapping involves wrapping the injured toe next to an adjacent toe to keep it supported and protected. These two methods have proven to be effective in the healing process for toe fractures. The estimated healing time for a broken toe is approximately four to six weeks. If the injury becomes infected or requires surgery, the estimated healing time may take eight weeks or more.
Ankles are joints that connect bones in the feet with bones in the lower leg. They are comprised of bones, ligaments, muscles, tendons, blood vessels, and nerves. The ankle joint allows the foot to move side-to-side, as well as up-and-down.
Ankle pain can be caused by a variety of conditions, but is most commonly due to soft tissue injuries such as ankle sprains and strains.
An ankle sprain occurs when one or more of the strong ligaments that support and stabilize the ankle become overly stretched or even torn if the ankle rolls, turns, or twists awkwardly. Depending on the grade of sprain (mild-moderate-severe), there will be varying degrees of pain, swelling, and restricted range of motion, along with tenderness, bruising, and ankle instability. There may even be an audible popping noise at the moment of injury.
Ankle strains can sometimes produce similar symptoms of pain, swelling, and loss of motion, however, they are due to overly stretched muscles and tendons—not ligaments. Ankle strains may also cause muscle cramps in the feet, calves and shins.
Ankle fractures are another common source of ankle pain and occur one or more of the three bones in the ankle become fractured (broken). These breaks can be stress fractures (due to repetitive stress) or traumatic fractures (due to an acute injury). Depending on where and how severe the fracture is, symptoms can include pain and swelling that can sometimes spread up to the knee, bruising or discoloration, and an inability to bear weight. A visible deformity or exposed bone may occur in severe fractures.
Various forms of arthritis may also cause ankle pain. Rheumatoid arthritis (RA) causes the immune system to attack healthy joints, like the ankle joint, by mistake, causing stiffness and swelling in both ankles. Osteoarthritis occurs when cartilage covering the ends of bones wears down, causing the bones to rub against each other. This results in pain, stiffness, and reduced range of motion in the ankle. Gout is a form of arthritis where excess amounts of uric acid in the bloodstream crystallize and build up on joints, causing severe pain and swelling. Reactive arthritis causes joint pain and swelling in the ankle in response to an infection in another part of the body.
Other forms of ankle pain include bursitis (an inflammation of a cushioning bursa sac between tendons and bone), scleroderma (a thickening of connective tissues), chronic ankle instability (caused by improperly healed ankle sprains), Achilles tendon injuries, flat feet, or an infection in the ankle.
Diabetes is the condition in which the body does not properly process food for use as energy. People with Type 1 diabetes cannot produce insulin, which is required for glucose to feed your body’s cells. It is typically caused by the immune system mistaking healthy cells for foreign invaders and destroying the insulin-producing cells in the pancreas. On the other hand, people with Type 2 diabetes cannot respond to insulin properly, and eventually cannot produce enough. The Centers for Disease Control and Prevention reports that over 30 million people in the United States have diabetes, with 1 in 4 having no idea they have it. Surprisingly, diabetes is the seventh leading cause of death in the US. The symptoms of diabetes include frequent urination, fatigue, hunger, and even blurry vision.
Diabetes can also affect the feet as well. Over time, diabetes can cause nerve damage to your feet, which could then lead to symptoms such as tingling, pain and numbness in the feet. Neuropathy can be very dangerous to a person with diabetes, since it prevents them from feeling injuries such as cuts or blisters in the feet, and if not detected early enough, may lead to infection. Neuropathy can also lead changes in the shape of your feet and toes. The best way for people with diabetes to prevent or delay neuropathy is keeping their blood glucose levels in their target range. This consists of eating right, having the correct amount of exercise, and taking medications.
Diabetes can also create calluses and foot ulcers as well. Calluses build up faster and occur more frequently with those affected by diabetes. If there are too many calluses, therapeutic shoes and inserts may be required. It is important to have calluses trimmed by a health professional, as doing it yourself may lead to infections. If these calluses continue to develop and thicken, they can lead to foot ulcers. Foot ulcers are open sores, that appear on the ball of the foot or on the bottom of the big toe. These ulcers can lead to future infections if not treated and may possibly result in losing a limb. It is important to report any ulcers to your podiatrist right away. Your doctor may take x-rays to examine the foot and clean out any dead and infected tissue.
Lastly, diabetes can also lead to poor circulation and peripheral arterial disease (PAD). The poor circulation in the feet and leg area is a result of diabetes narrowing and hardening, eventually slowing down the blood flow in that area. The best way to prevent this is to keep away from smoking and follow your doctor’s advice for maintaining blood pressure and cholesterol. PAD is similar to this complication. PAD is when blood vessels narrow or are blocked by fatty deposits. PAD also increases your risk of heart attacks and strokes and is a common condition to those affected by diabetes. The combination of both PAD and neuropathy may lead to infections and can result in amputation of certain limbs. PAD can be prevented with wearing the proper foot wear and regularly taking care of your feet.
If you want to take care of your feet, you should wash and dry them carefully and perform daily inspections to check for cuts, blisters, or swelling. Any physical activity you partake in should be approved by your health care provider. You should also be sure to wear special shoes if advised to do so by your doctor.
Diabetics must be wary of all wounds, regardless of depth or size. Diabetes, a chronic disease in which the body cannot properly use glucose the way it normally would, causes various complications that make wounds difficult to heal. Nerve damage or neuropathy will cause diabetics to have trouble feeling the pain of a blister or cut until the condition has significantly worsened or become infected. A diabetic’s weakened immune system can make even the most minor of wounds easily susceptible to infection. Diabetics are also more prone to developing narrow, clogged arteries, and are therefore more likely to develop wounds.
Wounds should be taken care of immediately after discovery, as even the smallest of wounds can become infected if enough bacteria build up within the wound. To remove dirt, wounds should be first rinsed under running water only. Soap, hydrogen peroxide, or iodine can irritate the injury and should be avoided. To prevent infection, apply antibiotic ointment to the wound and cover it with a bandage. The bandage should be changed daily. The skin around the wound may be cleaned with soap.
To prevent further exacerbation, see a doctor—especially if you have diabetes. Minor skin conditions can become larger problems if not properly inspected. As the wound heals, make sure to avoid applying pressure to the affected area.
