Posts for: March, 2016
At New England Foot and Ankle Specialists, patients frequently come to us complaining of discomfort from a callus. The problem is they often don’t come in soon enough. It may surprise you to know that a callus is not actually a skin issue, although the pain does often seem to be on the surface of the bottom of the foot, the heel or the outside of the big toe. A callus most often indicates a bone problem.
Appearance and Causes
A callus (known in the podiatric world as a hyperkeratosis) usually appears as a thick, hard patch of skin. Even though the cause of the callus may not be immediately apparent, it forms because a bone is protruding or a bone spur has formed and the repeated pressure and friction from walking and wearing shoes results in the skin build up. The bone issues may happen as a function of a deformity, such as a bunion or hammertoe or other mechanical issue, like flatfeet. Left untreated in the early stages, nerves become inflamed and bursa sacs fill up until the patient begins to feel pain ranging from a dull ache or soreness to a sharp, stabbing pain at the site of the callus.
The best time to come into our Reading office is when you first notice a callus forming. Our foot doctors, George A. Abboud, D.P.M., Brian D. Tedesco, D.P.M., Carl Conui, D.P.M., and Kimberly Thurmond, D.P.M. will take the time to examine your callus and get detailed information about when you first noticed it forming, your activities and any other elements of your medical history that will help track down why the callus is present.
Knowing what the reason for the callus is important in determining the correct treatment for you. The podiatrist will usually take a two-pronged approach to eliminating your callus: first, using padding, physical therapy or other means to correct the underlying problem. Then the callus itself can be gently and gradually removed. Properly applied, padding can help reduce pain and discomfort and keep further damage from occurring.
Contact one of our offices for an appointment if you notice a callus on your foot.
With the occasional warm days and first hint of spring in the air, many of our patients at New England Foot & Ankle Specialists are putting on their sneakers and heading out for a run. In your enthusiasm, however, make sure you don’t overdo it and go too far, too fast or you may find yourself suffering from shin splints. Although the pain from shin splints is in your lower leg, this is an issue for your podiatrist because the root of the problem is often in the feet.
Our podiatrists, George A. Abboud, D.P.M., Brian D. Tedesco, D.P.M., Carl Conui, D.P.M., and Kimberly Thurmond, D.P.M. are experienced in evaluating sports injuries and conditions associated with exercise. Shin splints are usually recognized by their characteristic pain in the front and sides of the lower leg, which can be accompanied by swelling. This inflammation in the shin is a result of the repeated pulling of the muscle in leg from the shin bone. Possible reasons for shin splints include:
- Flat feet
- Tightness in the calves
- Poorly fitting or worn out footwear
- Muscle imbalance
- Incorrect training or warm ups
- Walking or running on uneven surfaces
Treatment and Prevention
Fortunately, shin splints are usually easily alleviated. The foot doctor will most likely ask you to rest from activities that cause the pain and swelling. This, combined with icing the affected area and taking a non-steroidal anti-inflammatory drug, such as ibuprofen will usually take care of this condition. Going forward, be sure to stretch well before starting your walk or run to help prevent shin splints. If flat feet are the cause of your shin splints, the podiatrist may prescribe orthotics that will provide arch support.
Never continue to exercise through the pain of shin splints. This can result in a stress fracture. If you have pain in your feet or lower legs after exercising, make an appointment at either our Reading office and find out how you can be fit without pain.
A common cause of pain in the ball of the foot and toe joint that we see frequently at New England Foot & Ankle Specialists is Capsulitis. This is an inflammation of the ligaments that surround the joint at the base of the big toe and usually occurs in the second, third or fourth toe. This will result in pain and swelling at the base of the big toe, making wearing certain shoes uncomfortable and possibly limiting the range of motion of the toe. Since these symptoms can indicate other disorders such as Morton’s Neuroma or sesamoiditis, it’s important to get a correct diagnosis of your condition before treatment can begin to alleviate the symptoms.
Our podiatrists: Dr. George A. Abboud, Dr. Brian D. Tedesco, Dr. Carl Conui, and Dr. Kimberly Thurmond will start by taking a complete medical history and then examining your toe. The foot doctor will check for range of motion and may order an x-ray or other tests to rule out other disorders. The podiatrist will want to know about your lifestyle—jobs or activities that require extensive squatting or climbing can overstretch the ligaments, causing inflammation. Certain structural abnormalities, such as bunions or one toe longer than another can also make you more prone to developing Capsulitis.
Capsulitis will only get worse if left untreated. In fact, without correction, the affected toe will eventually begin to drift toward the next toe and may become completely dislocated and overlap the next toe. Once Capsulitis progresses to this stage, surgery will be needed to correct it. That’s why seeking treatment in the early stages of the disorder is extremely important. There are several non-invasive options available that are effective when the disorder is diagnosed early. These include:
- Orthotics—shoe inserts custom designed for your feet can help correct foot structure issues and take the weight off the inflamed ligament and joint
- Taping and splinting—this will prevent the toe from moving out of place and alleviate pain
- Stretching—in some cases, a tight calf muscle is the cause of Capsulitis; exercises can stretch the muscle and greatly reduce symptoms
- Shoe changes—choosing shoes with stiff soles will reduce the pressure on the ball of the foot.
Make an appointment at either our Reading office sooner rather than later if your big toe or the ball of your foot is bothering you. Prompt attention can head off a more serious problem that will require much more extensive medical treatment in the future.
If you have a child who is an avid athlete and has started to complain of heel pain, a condition known as Sever’s Disease may be to blame. Also known as calcaneal apophysitis, Sever’s Disease is an inflammation of the heel’s growth plate. It most often affects children ages 8-15 because the growth plate is not fully developed then and the newly forming bone creates a weak area at the back of the heel.
Who is Susceptible to Sever’s Disease?
At New England Foot and Ankle Specialists, we see several risk factors that make a child more likely to get Sever’s Disease. These include:
- Sports participation—this is by far the most common cause, particularly for children who play sports that involve excessive amounts of pounding on the heel such as running, basketball, football, soccer and baseball. Cleats are also known to increase the aggravation to the heel area.
- Tight Achilles tendon—results in strain on the heel bone growth plate from the pulling done by tight tendon
- Overly high arch or flatfeet
- Being overweight
Our foot and ankle doctors, George A. Abboud, D.P.M., Brian D. Tedesco, D.P.M., Carl Conui, D.P.M., or Kimberly Thurmond, D.P.M., will conduct a thorough examination of your child’s foot, heel and lower leg to reach a diagnosis. The podiatrist will also ask questions about activities and symptoms. X-rays or other imaging studies may be ordered to rule out a heel fracture or other heel problem. Once Sever’s Disease is confirmed, the foot doctor will determine the correct treatment for your child.
The immediate aim of treatment is to relieve the pain and discomfort of Sever’s Disease. This means your child will have to take a break from whatever activity is causing the condition. In extreme cases, the heel may need to be immobilized for a period of time. Icing the heel and anti-inflammatory medications may be prescribed for pain. Depending on the cause of the heel growth plate inflammation, the podiatrist may prescribe heel pads to protect the inflamed area, orthotics to correct an arch problem or stretching exercises to loosen the Achilles tendon.
With this, or any other pain in the heel or foot that your child experiences, you should never encourage them to “play through it.” Make an appointment at either our Reading office today by calling (781) 944-4044.
Haglund’s deformity is an abnormal bony protrusion on the back of the heel. Since this bony enlargement sticks out, it can become inflamed when it rubs against shoes. In fact, a more common name for Haglund’s deformity is “pump bump” because the stiff backs of the pump style of shoes (as well as ice skates, men’s dress shoes and some work boots) aggravate the bump, causing it to become red, sore and swollen. Sometimes the pressure on the deformity can even lead to bursitis in that area.
People with certain foot structures are more likely to develop Haglund’s deformity. These include:
These biomechanical issues can be genetic.
Fortunately there are many conservative treatment approaches for Haglund’s deformity. These are aimed at reducing pain and inflammation caused by the irritation of the bony enlargement. At New England Foot & Ankle Specialists, one of our board certified podiatrists, George A. Abboud, D.P.M., Brian D. Tedesco, D.P.M., Carl Conui, D.P.M., or Kimberly Thurmond, D.P.M. will conduct a complete examination of your foot and ankle. An x-ray will most likely be taken so that the foot doctor can get a good look at the heel bone and the deformity. Once the extent and position of the enlargement are evaluated, treatment can be discussed. Options include:
- Icing and medication—oral nonsteroidal anti-inflammatory drugs (such as ibuprofen) and icing the back of the heel will help reduce inflammation and pain.
- Stretching exercises—can help with a tight Achilles tendon or heel cord
- Physical therapy
- Shoe modifications—using orthotics or padding in your shoes may shift pressure off the bony protrusion; choosing shoes with a soft or no back may also be helpful
These treatment methods will not reduce the size of the protrusion. In severe cases that do not respond to the above measures, surgery may be necessary. If you have trouble with Haglund’s deformity, make an appointment at either our Reading office and find out how you can best get relief.