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Gregory Loo, DPM Board Certified Podiatrist and Surgeon

August 2020

Monday, 31 August 2020 00:00

Ingrown Toenails

Ingrown toenails (onychocryptosis) are a common foot ailment and it is very unpleasant to experience. The condition is caused by an increase in pressure from the ingrowth of the nail edge into the skin of the toe. Ingrown toenails commonly cause pain in those who experience them. In some cases, the skin surrounding the ingrown toenail may break which may lead bacteria to enter through and cause an infection. Common symptoms of this ailment include pain, redness, swelling, and warmth around the toe.

An imbalance between the size of the nail and the enlargement of the nail skin edge causes ingrown toenails. This condition is often caused by improperly trimming the toenails. If you are trying you cut your nails, you should always try to trim straight across instead of in a rounded shape. Ingrown toenails can also be an inherited condition and they may also be caused by improper shoe fitting.

Another common cause of the condition is wearing shoes that are either too small or too large. Other causes include poor foot hygiene, obesity, diabetes, arthritis, edema, and fungal infections. There are many risk factors that may make a person more likely to develop an ingrown toenail. Athletes who play “stop and start” sports such as tennis, soccer, and basketball are most likely to have ingrown toenails.

People who have diabetes, a compromised immune system, or poor circulation should immediately seek care from a podiatrist if they have an ingrown toenail. It is also recommended to seek professional assistance if at-home remedies are not successful within a week or if there is persistent pain.

Monday, 24 August 2020 00:00

Ankle Sprains

Ankle sprains occur when ligaments that support the ankle stretch beyond their limits and tear. These types of injuries are very common and can occur in people of all ages. Sprains may range from mild to severe, depending on how much damage is done to the ligaments. If a sprain goes untreated, a more severe sprain may occur which can further damage the ankle. Repeated ankle sprains can lead to chronic ankle pain.

There are some risk factors that can increase your risk of suffering a sprained ankle. Those who participate in sports, walk on uneven surfaces, have a prior ankle injury, are in poor physical condition, or wear improper shoes are more likely to get a sprained ankle.

There are a few symptoms to look out for if you suspect you are suffering from a sprained ankle. Some common symptoms are swelling, bruising, tenderness, and instability of the ankle. In cases where the tearing of the ligaments is severe, there may be a “popping” sound when the strain occurs.

The RICE method is proven to be effective in treating ankle sprains. RICE stands for Rest, Ice, Compression, and Elevation. Rest is important for treatment, especially within the first 24 to 48 hours. You should also ice your sprained ankle for the first 48 hours for 20 minutes at a time. A small piece of cloth should be placed between the ice and the affected area. For the compression step, you should wear a brace that is snug, but not too tight that it cuts off circulation. When choosing a brace, be sure to choose one that is suitable for the type of ankle sprain you have. Lastly, you should elevate your foot above the heart as often as possible.

After you treat a sprain, you should go through rehabilitation to prevent the injury from occurring again. There are three phases to the rehab process. The first phase involves resting, protecting, and reducing the swelling of the injury. The second phase consists of restoring the ankle’s flexibility, range of motion, and strength. The third phase consists of slowly returning to activity and maintenance exercises.

If you suspect you have an ankle sprain, you shouldn’t hesitate to consult with your podiatrist. Your podiatrist will be able to give you a proper diagnosis and a suitable treatment option for your condition.

Monday, 17 August 2020 00:00

Bunions

A bunion is an enlargement of the base joint of the toe that connects to the foot, often formed from a bony growth or a patch of swollen tissues. It is caused by the inward shifting of the bones in the big toe, toward the other toes of the foot. This shift can cause a serious amount of pain and discomfort. The area around the big toe can become inflamed, red, and painful.

Bunions are most commonly formed in people who are already genetically predisposed to them or other kinds of bone displacements. Existing bunions can be worsened by wearing improperly fitting shoes. Trying to cram your feet into high heels or running or walking in a way that causes too much stress on the feet can exacerbate bunion development. High heels not only push the big toe inward, but shift one's body weight and center of gravity towards the edge of the feet and toes, expediting bone displacement.

A podiatrist knowledgeable in foot structure and biomechanics will be able to quickly diagnose bunions. Bunions must be distinguished from gout or arthritic conditions, so blood tests may be necessary. The podiatrist may order a radiological exam to provide an image of the bone structure. If the x-ray demonstrates an enlargement of the joint near the base of the toe and a shifting toward the smaller toes, this is indicative of a bunion.

Wearing wider shoes can reduce pressure on the bunion and minimize pain, and high heeled shoes should be eliminated for a period of time. This may be enough to eliminate the pain associated with bunions; however, if pain persists, anti-inflammatory drugs may be prescribed. Severe pain may require an injection of steroids near the bunion. Orthotics for shoes may be prescribed which, by altering the pressure on the foot, can be helpful in reducing pain. These do not correct the problem; but by eliminating the pain, they can provide relief.

For cases that do not respond to these methods of treatment, surgery can be done to reposition the toe. A surgeon may do this by taking out a section of bone or by rearranging the ligaments and tendons in the toe to help keep it properly aligned. It may be necessary even after surgery to wear more comfortable shoes that avoid placing pressure on the toe, as the big toe may move back to its former orientation toward the smaller toes.

Monday, 10 August 2020 00:00

What are Achilles Tendon Injuries

The Achilles tendon is the strongest tendon in the human body. Its purpose is to connect the lower leg muscles and calf to the heel of the foot. This tendon is responsible for facilitating all types of movement, like walking and running. This tendon provides an enormous amount of mobility for the body. Any injuries inflicted to this tissue should be immediately brought up with a physician to prevent further damage. 

The most common injuries that can trouble the Achilles tendon are tendon ruptures and Achilles tendinitis. Achilles tendinitis is the milder of the two injuries. It can be recognized by the following symptoms: inflammation, dull-to-severe pain, increased blood flow to the tendon, thickening of the tendon, and slower movement time. Tendinitis can be treated via several methods and is often diagnosed by an MRI. 

An Achilles tendon rupture is trickier to heal, and is by far the most painful injury. It is caused by the tendon ripping or completely snapping. The results are immediate and absolutely devastating, and will render the patient immobile. If a rupture or tear occurs, operative and non-operative methods are available. Once the treatment begins, depending on the severity of the injury, recovery time for these types of issues can take up to a year. 

Simple preventative measures can be taken as a means to avoid both injuries. Prior to any movement, taking a few minutes to stretch out the tendon is a great way to stimulate the tissue. Calf raises, squats, leg curls, leg extensions, leg raises, lunges, and leg presses are all suggested ways to help strengthen the lower legs and promote Achilles tendon health. 

Many problems arise among athletes and people who overexert themselves while exercising. Problems can also happen among those who do not warm up properly before beginning an activity. Proper, comfortable shoes that fit correctly can also decrease tendon injuries. Some professionals also suggest that when exercising, you should make sure that the floor you are on is cushioned or has a mat. This will relieve pressure on the heels. A healthy diet will also increase tendon health. 

It is very important to seek out a podiatrist if you believe you have an injury in the Achilles region. Further damage could result in severe complications that would make being mobile difficult, if not impossible.

Running may seem like a simple to do. However, running is actually a complex movement that puts stress on the ligaments, bones, and joints of the body.  Selecting the correct running shoe is important for increasing performance and avoiding risk of injury.  Running shoes should be selected based on your foot type.  Considerations such as trail versus road shoes are important. Your foot type dictates the degree of cushioning, stability and motion control you require.  The most accurate way to learn your foot type is to visit a local shop that specializes in running shoes.  Professionals can measure your arch type, stride and gait and help you with your shoe needs.

The design of running shoes is created around the idea of pronation.  Pronation is the natural rolling movement of your ankle from the outside to inside when your foot strikes the ground.  If you run properly you strike the ground on the outside of your heel and roll in the direction of your big toe before pushing off once more.  Pronation is beneficial because it assists the lower half of your body in absorbing shock and storing energy.  Those considered neutral runners pronate correctly and do not need running shoes that help correct their form.  Neutral runners can choose from a wide variety of shoes, including barefoot or minimal types.  However, those who have arch problems or who adopt an incorrect form while running may experience too much or too little pronation. They may require running shoes that offer additional support.

Those who overpronate experience an over-abundance of ankle rolling.  Even while standing, those who severely overpronate display ankles that are angled inward.  It is not uncommon for them to have flat feet or curved legs.  The tendency to overpronate may cause many injuries.  Areas that tend to become injured are the knees, ankles, and Achilles tendon.  If you find that you have a tendency to overpronate, you should look at shoes that provide extra stability and motion-control.  Motion-control shoes are straight and firm. Shoes of this type do not curve at the tip.  The restricted flexibility along the middle of the shoe prohibits the foot from rolling too far inward as your foot strikes the ground.

A less common problem is underpronation.  Underpronation, also called supination, is when the feet are unable to roll inward during landing.  Those who underpronate have feet that lack flexibility and high arches.  This prevents any kind of shock absorption, even though it does place less rotational stress on ankles and knees.  This added force can cause fractures, ligament tears, and muscle strains because the legs are trying to compensate for the impact.  Those who underpronate need shoes with more cushioning and flexibility.  If you have a tendency to underpronate, selecting stability or motion-control shoes may cause you more problems by continuing to prevent pronation.

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