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Tag: foot deformity

Ingrown Toenails: Treatments and Five Things You Can Do

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Ingrown toenails can be one of the most painful foot conditions one can experience. But did you know that ingrown toenails can sometimes be treated with home remedies? Here, we’ll discuss what you should do and when it is appropriate to seek professional attention for ingrown toenail treatment. 

Ingrown Toenail TreatmentsWhat exactly is an ingrown toenail?

As the name implies, you would assume the nail is cutting into your flesh and getting buried into the skin. However, this is not the case. It simply means the hard nail is being an irritant to the skin next to it and in some cases, it can actually cause a breakdown in your skin. If the toenail is not clean, it is likely that bacteria will get into the skin where the breakdown occurs.

What causes an ingrown toenail?

Tight fitting shoes could start the problem,  so make sure you do not wear shoes that are too narrow or too short.  Proper sizing is important.

Trauma – If you drop something heavy like a frozen turkey on your toenail it may cause it to injure the flesh around it, thus causing the nail to dig in.  You could also lose the nail in which case it may grow back deformed and then grow in.

Congenital nails – Ingrown nails may be caused by genetics factors than most would expect. It is not uncommon to hear patients say they are getting an ingrown nail just like their dad did when he was their age. 

Improper trimming – It’s important to be careful when trimming your nails. It is true that you should trim your nails straight across. However, you must be careful not to leave a sharp corner on the nail; it is okay to round that corner slightly in some cases. Also, trimming your nails too short should be avoided.   

Fungus – A fungal infection of the nail can deform it. The nail can become more curved and grow in on the side. Or it may be thickened, and this can also cause more pressure in the middle or sides of the nail.

Foot deformities – If you have toes that deviate, such as a hammertoe or a bunion, the nail may grow in as a result of this. The big toe rubbing against the second toe in the case of a bunion, is a great example. 

What should you do if you have an ingrown nail?

Early treatment is important. At first, if the pain is minimal with little to no redness along the side of the nail, you should start treatment. Here are some things you can do to control it:

Soak your foot in soapy water three to four times a day for 10-20 minutes. Dry your foot well and apply an antibiotic cream such as Neosporin.

Get out of your closed shoe as much as possible if it is possible.

Try to gently massage the skin, always from the nail edge. Using coconut oil would be ideal when you do this. 

If it is just the tip of the nail edge digging in, you might be able to lift the nail up and use dental floss. It is important to consider using waxed floss. 

ingrown toenail

When to seek medical attention?

If you made the attempts I have suggested, and the pain persists, then it is time to get a professional opinion on your ingrown toenail treatment. Also, there is no deadline as to when you can see the doctor. If your toe is very painful; either red, hot or draining pus, you must make sure you call your podiatrist. No amount of the home care I have suggested may help in this situation. 

If you are a diabetic or have problems with poor circulation or have a medical condition that has negative effects on your nervous system, you must immediately see a doctor. 

What will the doctor do at the office visit? 

In a situation where the edge of the nail is digging, the nail edge may need to be removed. A portion of the nail border or borders may need to be removed. When the edge is removed, in most cases, a chemical is applied that kills the cells that form the nail. No sutures and incisions are used, and most patients do not take medication for pain. In most cases, the patient may go back to work the next day and can work full time. 

There is a possibility of a fungal nail. If the nail is not infected and not as severe in many cases, treating the fungus may restore more normal nail growth and therefore reduce the thickness and nail deformity. There are several treatment options the doctor may speak to you about. This includes the use of topicals, oral medication or laser nail treatment. Of these three,  laser nail treatment is the most successful. Be aware that not all podiatrists offer to do a laser treatment. So you may consider that when getting a professional opinion of your ingrown nail, especially if you have yellow,thickened and deformed nails.    

Now that you know all about ingrown toenail treatment, you will have a more informed plan of action if this happens to you. 

What Are the Benefits of Wearing Orthotics?

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As a podiatrist, we often recommend orthotic devices as they can be of great benefit for the wearer. Before we dive into the benefits of wearing orthotics, let’s answer the question of what an orthotic is, from a podiatrist point of view.

benefits-of-orthotics

In today’s world, it seems like everyone is marketing their orthotics. You see them in retail stores, shoe stores, ski shops, and even Facebook ads. As a podiatrist, the whole concept of what an orthotic is has been muddied. My opinion is shared by my colleagues- podiatrists believe there is a non-weight-bearing, neutral-point position of the foot. And so, whatever technique is utilized to fabricate an orthotic, an impression of the foot should be taken in this position.

The foot is positioned at its optimal functional position. Any kind of orthotic that is made from a technique that involves any partial or full weight-bearing, we feel is not done accurately. There are small, torsional abnormalities, sometimes between the front half and rear foot, that are not taken into account when the foot is bearing weight. A podiatrist’s orthotic is much more precise and is able to support and control excessive motion in the foot more accurately. That is not to say that an orthotic made from a weight bearing technique won’t work, but the chances are greatly reduced. It is a common story of patients we treat.

Benefits of Orthotics

I am writing this blog at a time where some advocate barefoot running, or running in minimalist shoes. So hear me out from a foot specialist’s point of view. Outside the office, when someone finds out I’m a podiatrist, I’m often asked what types of shoes are best. Using tact, I’ll make the point that it’s like asking an optometrist what lens prescription they should have. We expect that kind of precision for our eyes, but medicine seems to not think the same rules apply to the feet.

If one has excellent foot structure, I’m not opposed to the idea of barefoot running. My point is that it all starts with what foot type you’ve inherited. It has been observed that 70% of people may have feet that overpronate. Pronation is simply the motion that involves the flattening of your feet. The foot will flatten the arch and abduct, or move away from the other foot. A more ideal foot type does not overpronate, and the actual bony structure helps stabilize and support the foot. There is a locking mechanism that takes place in the bones in the midfoot area. Those that have feet that are much more flexible, or pronates more easily, are thought to have a foot where the bones do not lock and support the foot. Therefore, soft tissue needs to. This can cause excessive stress on structures such as tendons, joints, nerves and other soft tissue structures such as fascia. So, how do you know if custom orthotics might be useful? The following are some tips and specific conditions you should know about.

If you keep getting the same type of injury or foot pain over and over, or if you’ve had that injury for an extended period of time, it may be time to look into orthotics. Especially if you’ve already tried resting, anti-inflammatories, and icing the area. This could also be an indication that your foot type lends itself towards having specific issues.

Soft tissue problems

  • Plantar fasciitis and Achilles tendinitis
    • One of the more common problems is plantar fasciitis commonly referred to as heel pain. Orthotics will reduce the stress of the plantar fascia pulling on the bottom of the heel. For Achilles tendonitis the stress on the Achilles will be reduced.
  • Foot deformities
    • Bunions may also be helped with orthotics. If you have an enlargement on the inside of your big toe you may benefit especially in the early stages of the deformity.

Nerve problems

  • Neuromas and tarsal tunnel syndrome
    • Neuromas are a nerve enlargement that can occur in the ball of the foot. If you’re experiencing burning, tingling and numbness on the bottom of your foot, you may have tarsal tunnel syndrome.
  • Joint pain
    • Arthritis in the foot can also be treated with orthotics and it’s a safer, drug free approach. This may include big toe joint pain commonly referred to as Hallux limitus. Also, ankle pain and pain in the small joints in your arch.

Final Thoughts

  • You may save money as you’ll quit shopping for shoes to solve your foot problems. The orthotic can be taken from shoe to shoe and will neutralize the less optimal shoe as it’s designed precisely for your foot.
  • You’ll avoid injuries as certain foot structures lend themselves to certain injuries
  • You could lose weight and sleep better as you become more active.

If you yourself frustrated with your inability to stay active, please consider a consultation with us to truly understand more about the foot structure you have and how it may be the issue that no one has explained to you. There are many benefits of wearing orthotics, so it’s time you discover for yourself!

Are Custom Orthotics For Foot Problems Right For You?

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There are two basic principles to consider when dealing with your feet and your lower extremity pains that you may have. First, do you think you have a foot that over flattens, otherwise called pronation? As foot specialists, we have been trained in biomechanics and believe that most patients are born with different foot types. If you tend to overpronate the bony structure of your foot, you cannot adequately support the foot. This results in soft tissue structures being stressed more. Orthotics simply position the foot so that the joints can support the foot and demand less of other structures.

custom orthotics for foot problemsSecondly, do you have a condition that continues to plague you in spite of attempts with anti-inflammatories, icing, resting or maybe even physical therapy? Do you find that if you lay off from running or walking and return to it, the same problem occurs? If this is you, then this blog is right for you! Let’s find out if custom orthotics for foot problems are right for you.

Over-pronation

Let’s address your first concern. Over pronating is a very simple concept to understand. People tend to flatten their arch or roll their foot inward too much and too often. The old adage is, if you walk in the sand and you can’t see much of an arch, this could be an indication of pronation. This is somewhat true in most cases, but it may be more complex than that. Some people have an arch that doesn’t over flatten; but if you look at their heel from behind, their heel tends to roll in quite a bit. It does not stay perpendicular to the ground.

Different kinds of feet present different kinds of pronation. Sometimes, a professional is the best to tell you if you are an overpronator. If you have tried various treatments and you have had a problem that’s been persisting;  for over one, three, six or twelve months – it is an indication that your foot structure needs additional support. The following are some conditions that are oftentimes bettered or totally eliminated with the use of orthotic devices.

Achilles Tendonitis and Plantar Fasciitis

Pain on the bottom of the heel is referred to as plantar fasciitis. It’s one of the most common problems to be treatable. Tendon on the backside of your heel or running up the Achilles tendon, is, oftentimes, Achilles tendonitis. Orthotics can treat this a great deal. In many cases, treatment options such as anti-inflammatory stretching and physical therapy just don’t knock it away.

Bunions and Foot Deformities That Are Treated With Custom Orthotics

Bunions are a prime example of this, especially if it’s in early stages and not painful yet. There is a chance of a foot deformity where you can feel growth on the back of your heel; also called the Haglund’s deformity or pump bump. Patients can benefit from orthotics in this situation. In both cases, the biomechanics of your foot might allow you to have a progression of a bunion or progression of the bump on the back of heel.

Stiff Toe Joint

Also referred to as hallux limitus or hallux rigidus, this is an arthritic condition in its early stages and can be healed with orthotic devices.

Painful Ankle

The ankle in itself can have arthritis and orthotics may benefit that. There are stabilizers or stirrup tendons that help stabilize the outer side and the inner side of the ankle. If you have overpronation, these tendons tend to have to be overused because they’re trying to stabilize the foot that is unstable.

Knee Pain

Orthotics have a proven track record of helping what is called chondromalacia patella, which occurs when the kneecap is not centered over the knee joint, thereby causing arthritis between the knee joint and the femur bone. There are instances when people have a higher Q-angle and their knee angulates inward so the thigh and lower leg are not in a straight line. By supporting the foot more this can lessen the angulation at the knee with every step that is taken. The patella can then stay in better alignment and may be less likely to wear down the cartilage. If you have any of the above conditions or just simply have a problem that persists for a long time, orthotics may be just the way to go for you.

Finally if you find yourself in pain in the ball of your foot maybe you’re feeling like your sock is wrinkled but it isn’t. You may be suffering from a nerve enlargement called a neuroma (mortens neuroma) . Orthotics can help as they support the area to lessen the rubbing of a ligament against the nerve.

This blog will serve as a guideline for your consideration of custom orthotics for foot problems and what they are useful for. Depending on your condition, orthotics may be a part of the solution or the only treatment that is needed. So remember to consider if you think you’re an overpronator and are having difficulty getting rid of a chronic problem in the foot or ankle.