At Mid-South Foot & Ankle Specialists, we proudly offer: From routine checkups to surgical intervention, the physicians at Mid-South Foot & Ankle Specialists are equipped to handle all your podiatric needs. To help you understand your options, we’ve included descriptions of some of our leading services on this page.
At Mid-South Foot & Ankle Specialists, we proudly offer:
From routine checkups to surgical intervention, the physicians at Mid-South Foot & Ankle Specialists are equipped to handle all your podiatric needs. To help you understand your options, we’ve included descriptions of some of our leading services on this page.
Peroneal Tendon Dislocation/Dysfunction
The Peroneal tendons are two tendons whose muscles (Peroneus Brevis and Peroneus Longus) that originate on the outside of the calves. These two muscles allow you to roll to the outside of the foot while standing. Also called “stirrup” tendons because they help hold up the arch of the foot, the muscles are held in place by a band of tissue called the peroneal retinaculum. Injury to the retinaculum can cause it to stretch or even tear. When this happens, the peroneal tendons can dislocate from their groove on the back of the fibula. The tendons can be seen to roll over the outside of the fibula, damaging the tendons. Snow skiing, football, basketball, and soccer are the most common sports activities that can result in peroneal tendon dislocation. Ankle sprains have also known to lead to the condition. Patients usually have to use crutches after such an injury, in order to allow the strain to heal. Sometimes, a splint or compression bandage is applied to decrease swelling. Anti-inflammatory medications and ice also supplement treatment. Consult your physician before taking any medications. Surgery can be prescribed with moderate to severe injuries that cause the peroneal retinaculum to be torn or severely stretched to a point that the peroneal tendons will easily dislocate.
Xanthomas of the Achilles Tendon
Small lumps in the Achilles tendon are sometimes caused by high cholesterol levels, resulting in cholesterol deposits in the tendon itself. Aside from treating cholesterol itself, treatment for Xanthomas involves taking a biopsy of the lesion but leaving the nodules intact.
More than 25,000 people sprain their ankles every day, according to the American Orthopaedic Foot and Ankle Society. Ankle sprains are caused by an unnatural twisting or force on the ankle bones of the foot, often resulting in one or more ligaments on the outside of the ankle to be stretched or torn. If not properly treated, ankle sprains could develop into long-term problems. Treatment includes resting the ankle and applying ice to reduce swelling. Compressive bandages also may be used to immobilize and support the injury. More serious ankle sprains, particularly in competitive athletes, may require surgery to repair to tighten the ligaments.
Arthritis is a disabling and occasionally crippling disease afflicting almost 40 million Americans. In some forms, it appears to be hereditary. While the prevalence of arthritis increases with age, all people from infancy to middle age are potential victims. People over 50 are the primary targets. Arthritis is an inflammation and swelling of the cartilage and lining of the joints, generally accompanied by an increase in the fluid in the joints. It is often a part of complex diseases that may involve more than 100 disorders. If the feet seem more susceptible to arthritis than other parts of the body, it is because each foot has 33 joints that can be afflicted, and there is no way to avoid the pain of the tremendous weight-bearing load on the feet. Arthritic feet can result in loss of mobility and independence, but that may be avoided with early diagnosis and proper medical care.
* Early morning stiffness.
* Limitation in motion of joint.
* Recurring pain or tenderness in any joint.
* Redness or heat in a joint.
* Skin changes, including rashes and growths.
* Swelling in one or more joints.
Forms of arthritis:
Osteoarthritis is the most common form of arthritis. It is frequently called degenerative joint disease or “wear and tear” arthritis. Aging usually brings on a breakdown in cartilage, and pain gets progressively more severe, although it can be relieved with rest. Dull, throbbing nighttime pain is characteristic, and it may be accompanied by muscle weakness or deterioration. Overweight people are particularly susceptible to osteoarthritis. The additional weight contributes to the deterioration of cartilage and the development of bone spurs. Rheumatoid arthritis is a major crippling disorder, and perhaps the most serious form of arthritis. It is a complex, chronic inflammatory group of diseases, often affecting more than a dozen smaller joints during its course, and frequently in both ankles, or the index fingers of both hands. Arthritis can be treated in many ways, including:
* Physical therapy and exercise.
* Orthoses or specially prescribed shoes.
Athlete’s foot is a skin disease caused by a fungus, usually occurring between the toes. The fungus usually attacks the feet because shoes create a warm, dark, and humid environment that encourages fungus growth.
The warmth and dampness of areas around swimming pools, showers, and locker rooms, are also breeding grounds for fungi. Not all fungus conditions lead to Athlete’s foot, however. Other conditions, such as malfunctions of the sweat mechanism, reaction to dyes or adhesives in shoes, eczema, and psoriasis, also may mimic Athlete’s foot.
Symptoms of athlete’s feet include drying skin, itching scaling, inflammation, and blisters. Athlete’s foot may spread to the soles of the feet and to the toenails, and can spread to other parts of the body, including the groin and underarms.
You can prevent Athlete’s foot by: Avoiding walking barefoot. Use shower shoes. Reducing perspiration by using talcum powder. Wearing light and airy shoes. Wearing socks that keep your feet dry, and changing them frequently if you perspire heavily. While fungicidal and fungistatic chemicals are usually used to treat Athlete’s foot problems, they often fail to contact the fungi in the lower layers of the skin. Instead, our practice may prescribe topical or oral antifungal drug.
Bunions are misaligned big toe joints that can become swollen and tender, causing the first joint of the big toe to slant outward, and the second joint to angle toward the other toes. Bunions tend to be hereditary, but can be aggravated by shoes that are too narrow in the forefoot and toe. Surgery by a podiatric physician is frequently recommended to correct the problem.
A callus is an area of hard, thickened skin that can occur across the ball of the foot, on the heel, or on the outer side of the big toe. While many consider them a skin problem, they actually are systemic of a problem with the bone.
Calluses have painful nerves and bursal sacs (fluid-filled balloons that act as shock absorbers) beneath them, causing symptoms ranging from sharp, shooting pain to dull, aching soreness.
Calluses form from repeated friction and pressure, as the shoe (or ground) rubs against a bony prominence (bone spur) on the toe or foot. The skin thickens in response to this pressure. Small amounts of friction or pressure over long periods of time cause a corn or callus. A great deal of friction or pressure over shorter periods of time can cause blisters or open sores. Calluses typically develop under a metatarsal head (the long bone that forms the ball of the foot) that is carrying more than its fair share of the body weight, usually due to it being dropped down or due to its longer length.
Calluses can be treated with over-the-counter callus removers that have strong acids that peel this excess skin away after repeated application. You should be careful with these products as they can cause chemical burns when not used correctly. Begin by soaking your feet in warm soapy water and gently rubbing away any dead skin that loosens. A pumice stone or emery board is then used to “file” this thickened skin. Apply a good moisturizer to the hardened areas to keep them softer and relieve pain. Non-medicated corn pads or moleskin (a thin fuzzy sheet of fabric with an adhesive back) can relieve calluses, but should be removed carefully to avoid tearing the skin.
If you need assistance relieving calluses, contact our office. Calluses can be trimmed and comfortable padding applied to these painful areas. In addition to medication to relieve inflammation, cortisone may be injected into the underlying bursal sac to rapidly reduce pain and swelling.
A plantar callus forms when one metatarsal bone is longer or lower than the others, and it hits the ground first-and with more force than it is equipped to handle-at every step. As a result, the skin under this bone thickens like a rock in your shoe. Plantar calluses that are recurring are sometimes removed surgically in a procedure called an osteotomy, which relieves pressure on the bone.
A condition called Intractable Plantar Keratosis (IPK) is a deep callus directly under the ball of the foot. IPK is caused by a “dropped metatarsal,” which happens when the metatarsal head drops to a lower level than the surrounding metatarsals and protrudes from the bottom of the foot. This results in more pressure being applied in this area and causes a thick callus to form.
A “dropped metatarsal” can either be a congenital abnormality, a result of a metatarsal fracture, or a structural change that may have occurred over time.
How to prevent calluses:
Switch to better shoes, or even an orthotic device.
Buy socks with double-thick toes and heels and nylon hose with a woven cotton sole on the bottom of the foot.
Corns are calluses that form on the toes because the bones push up against the shoe and put pressure on the skin. The surface layer of the skin thickens and builds up, irritating the tissues underneath. Hard corns are usually located on the top of the toe or on the side of the small toe. Soft corns resemble open sores and develop between the toes as they rub against each other.
Improperly fitting shoes are a leading cause of corns. Toe deformities, such as hammertoe or claw toe, also can lead to corns. In a visit to our office, your corns can be shaved with a scalpel. Self care includes soaking your feet regularly and using a pumice stone or callus file to soften and reduce the size of the corn. Special over-the-counter non-medicated donut-shaped foam pads also can help relieve the pressure.
Diabetic Foot Care
Buy shoes late in the day. Never buy shoes that need “breaking in.” They should be immediately comfortable. Request shoes with deep toe boxes and made of leather upper material. Do not wear new shoes more than two hours at a time. Rotate your shoes. Do not wear the same ones every day.
Contact our office immediately if you experience any injury to your foot. Even a minor injury is an emergency for a patient with diabetes.
Do not file down, remove or shave calluses or corns yourself.
DO NOT SMOKE. It decreases the blood supply to your feet.
Ask about soaking your feet
Do not trim your own toenails.
Do not use any chemicals or strong antiseptic solutions on your feet. Iodine, salicylic acid, corn/callus removers are dangerous.
Do not wear stockings or socks with tight elastic backs and do not use garters. Do not wear any socks with holes. Always wear shoes with socks.
Don’t use any tape or sticky products such as corn plasters on your feet. They can rip your skin.
Examine your feet daily for redness, warmth, blisters, ulcers, scratches, cuts and nail problems from shoes or other sources. Look at the bottoms and between toes. Use a mirror or have someone else look for you.
Examine your shoes for foreign objects, protruding nails and rough spots inside before putting them on.
If the circulation in your feet is impaired, contact our office.
In the winter, wear warm socks and protective footwear. Avoid getting your feet wet in the snow and rain and avoid letting your toes get cold.
Keep feet away from heat (heating pads, hot water pads, electric blankets, radiators, fireplaces). You can burn your feet without knowing it. Water temperature should be less than 92 degrees. Estimate with your elbow or bath thermometer (you can get one in any store that sells infant products).
Lubricate your entire foot if your skin is dry, but avoid putting cream between toes.
NEVER walk barefoot, neither indoors nor out.
Never wear sandals or thongs.
Flat feet are a common condition. In infants and toddlers, the longitudinal arch is not developed and flat feet are normal. The arch develops in childhood, and by adulthood, most people have developed normal arches. Most feet are flexible and an arch appears when the person stands on his or her toes. Stiff, inflexible or painful flat feet may be associated with other conditions and require medical attention. Most flat feet usually do not cause pain or other problems. Flat feet may be associated with pronation, a leaning inward of the ankle bones toward the center line. Shoes of children who pronate, when placed side by side, will lean toward each other (after they have been worn long enough for the foot position to remodel their shape). Foot pain, ankle pain or lower leg pain, especially in children, may be a result of flat feet and should be evaluated. Painful progressive flatfoot, otherwise known as Tibialis Posterior Tendonitis, is caused by inflammation. The tendon becomes inflamed, stretched or suffers a partial or total tear. If left untreated, this condition may lead to severe disability and chronic pain. Some people are prone to this condition if they have flatfeet or an abnormal attachment of the tendon to the bones in the midfoot. Nonsteroidal anti-inflammatory medications, ice, physical therapy, supportive taping and bracing, or orthotic devices are the common ways of treating painful progressive flatfoot. Consult with your physician before taking any medications. Surgical intervention involves repairing the torn or damaged tendon to restore normal function. To prevent re-injury, orthotic devices or show inserts may be recommended. In severe cases, surgery on the midfoot bones may be necessary to treat the associated flatfoot condition.
Many people don’t realize they have a fungal nail problem. Moreover, many do don’t seek treatment. Still, fungal toenail infections are a common foot health problem. Such infections can persist for years without ever causing pain. The disease, characterized by a change in a toenail’s color, is often considered nothing more than a mere blemish, but it can present serious problems if left untreated. Also referred to as Onychomycosis, fungal nail infections are an infection underneath the surface of the nail, which can also penetrate the nail. In addition to causing difficulty and pain when walking or running, fungal nail infections are often accompanied by a secondary bacterial and/or yeast infection in or about the nail plate. A group of fungi called dermophytes easily attack the nail, thriving off keratin, the nail’s protein substance. When the tiny organisms take hold, the nail may become thicker, yellowish-brown or darker in color, and foul smelling. Debris may collect beneath the nail plate, white marks frequently appear on the nail plate, and the infection is capable of spreading to other toenails, the skin, or even the fingernails. Nail bed injury may make the nail more susceptible to all types of infection, including fungal infection. Those who suffer chronic diseases, such as diabetes, circulatory problems, or immune-deficiency conditions, are especially prone to fungal nails. Other contributory factors may be a history of Athlete’s foot and excessive perspiration.
You can prevent fungal nail infections by taking these simple precautions:
* Exercise proper hygiene and regularly inspect your feet and toes.
* Keep your feet clean and dry.
* Wear shower shoes in public facilities whenever possible.
* Clip your nails straight across so that the nail does not extend beyond the tip of the toe.
* Use a quality foot powder – talcum, not cornstarch – in conjunction with shoes that fit well and are made of materials that breathe.
* Avoid wearing excessively tight hosiery, which promotes moisture. Socks made of synthetic fiber tend to “wick” away moisture faster than cotton or wool socks, especially for those with more active life styles.
* Disinfect home pedicure tools and don’t apply polish to nails suspected of infection.
Depending on the type of infection you have, over-the-counter liquid antifungal agents, while sometimes effective, may not prevent a fungal infection from recurring. A topical or oral medication may need to be prescribed, and the diseased nail matter and debris removed by a process called debridement. In some cases, surgical treatment is prescribed, during which the infected nail is removed. Permanent removal of a chronically painful nail, which has not responded to any other treatment, permits the fungal infection to be cured, and prevents the return of a deformed nail.
Geriatric Foot Care
Experts say that problems with our feet can be the first sign of more serious medical conditions such as arthritis, diabetes, and nerve and circulatory disorders. Here are some foot care tips for older people:
* Practice good foot care. Check your feet regularly, or have a member of your family check them.
* It also helps to keep blood circulating to your feet as much as possible. Do this by putting your feet up when you are sitting or lying down, stretching if you’ve had to sit for a long while, walking, having a gentle foot massage, or taking a warm foot bath.
* Avoid pressure from shoes that don’t fit right.
* Avoid exposing your feet to cold temperatures.
* Don’t sit for long periods of time (especially with your legs crossed).
* Don’t smoke because it decreases blood supply and increases the chance of swelling and other circulatory problems.
* Wear comfortable shoes that fit well. This can prevent many foot problems.
Hammertoe is a deformity of the second, third or fourth toes. In this condition, the toe is bent at the middle joint, resembling a hammer. Left untreated, hammertoes can become inflexible and require surgery. People with hammertoe may have corns or calluses on the top of the middle joint of the toe or on the tip of the toe. They may also feel pain in their toes or feet and have difficulty finding comfortable shoes. Causes of hammertoe include improperly fitting shoes and muscle imbalance. Treatment for the condition typically involves shoes with soft, roomy toe boxes and toe exercises to stretch and strengthen the muscles. Commercially available straps, cushions or non-medicated corn pads may also relieve symptoms.
Plantar Fasciitis (Heel Spur)
Plantar fasciitis (or heel pain) is commonly traced to an inflammation on the bottom of the foot. Our practice can evaluate arch pain, and may prescribe customized shoe inserts called orthoses to help alleviate the pain. Plantar fasciitis is caused by inflammation of the connective tissue that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone. Also called “heel spur syndrome,” the condition can usually be successfully treated with conservative measures such as use of anti-inflammatory medications and ice packs, stretching exercises, orthotic devices, and physical therapy.
Ingrown nails are nails whose corners or sides dig painfully into the skin, often causing infection. They are frequently caused by improper nail trimming, but also by shoe pressure, injury, fungus infection, heredity, and poor foot structure. Toenails should be trimmed straight across, slightly longer than the end of the toe, with toenail clippers. If they become painful or infected, contact our office. We may remove the ingrown portion of the nail and if the condition reoccurs frequently, may permanently remove the nail.
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 at the base of the third and fourth toes. It is sometimes referred to as an intermetatarsal neuroma. “Intermetatarsal” describes its location—in the ball of the foot between the metatarsal bones (the bones extending from the toes to the midfoot).Neuromas may also occur in other locations in the foot. The thickening, or enlargement, of the nerve that defines a neuroma is the result of compression and irritation of the nerve. This compression creates swelling of the nerve, eventually leading to permanent nerve damage. Regardless of whether you’ve undergone surgical or nonsurgical treatment, your podiatric surgeon will recommend long-term measures to help keep your symptoms from returning. These include appropriate footwear and modification of activities that cause repetitive pressure on the foot.
A wart is a small growth on the skin that develops when the skin is infected by a virus. Warts can develop anywhere on the foot, but typically they appear on the bottom (plantar side) of the foot. Plantar warts most commonly occur in children, adolescents, and the elderly. The foot and ankle surgeon may use topical or oral treatments, laser therapy, cryotherapy (freezing), or surgery to remove the wart. Although there are many folk remedies for warts, patients should be aware that these remain unproven and may be dangerous. Patients should never try to remove a wart themselves — this can do more harm than good.