Commonly seen in a foot doctor’s office are ingrown toenails, heel and ankle pain, ankle sprains, fractures, and wounds. Surgery of the foot and/or ankle is also provided by a foot doctor. Surgically we treat an assortment of foot ailments, including bunions, ingrown nails, fungal nails, heel surgery, impinged nerve surgery, which is also known as a neuroma, hammertoe surgery, and bone spur removal.

We can treat a variety of fractures in the foot with either below knee casting, surgical shoes, or below the knee walkers. There are times when fractures of the foot need fixation through means of screws or pins. Other forms of treatments are prescribing medication, whether it’s antibiotics, antifungal medications, and medications after surgery.

Podiatry is not just about cutting toenails, there are so many other problems that we can treat to get you back on your feet in no time at all.

Do runners lose flexibility as they age? Not necessarily. The more you exercise the more flexible your muscles are. The more flexible your muscles are the longer you can run. Stretching routinely will provide you the ability to continue running with minimal cramping and discomfort. Normal aging probably won't decrease flexibility. However, if a person decreases their exercise regiment their ability to run will decrease from loss of muscle tone.

Routine stretching before and after running are important for the ability to run. As we age muscle atrophy, or muscle break down, occurs if we stop using certain muscles. Stretching exercises to prevent muscle breakdown is very important.

Flexibility and ability to run is not truly age dependent, but dependent on several factors: muscle tone, muscle use, and proper stretching both before and after exercise. If possible never lead a sedentary life and always develop a plan to stretch and strengthen your muscles.

If you have thick nails it may be caused by a fungal infection or an injury. The nail may become thick, yellowish, ridged, or brittle, and it can be very painful to wear footwear. In some cases the nail may completely fall off.

Nails are the protector of our skin on both our hands and feet causing them to endure a lot of abuse. Sometimes we are the cause of this abuse by doing things such as biting. Broken nails are very common also by catching them on something or exposing them to chemicals.

Minor nail problems will typically heal as the nail grows out and usually require little treatment. Sometimes a covering is necessary for proper healing. Here are a few of the most common nail problems.

Fungal infections: The nail plate can have a thickened, yellow, or cloudy appearance. The nails can become rough and crumbly, or can separate from the nail bed. We suggest that if you are suffering from this to come into the office. We typically recommend a product called Formula 3 to treat fungus which is a clear nail polish. It is a FDA approved medicine to treat toenail fungus. Formula 3 is made with Tolnafate, a synthetic topical thiocarbamate antifungal agent. Formula 3 is an oil and requires no drying time. It is odorless and does not stain.

It absorbs in seconds. It is residue free and will not blacken the nail. Formula 3 has a unconditional patient-direct money back guarantee. We have these in all of our offices for you convenience.

Color changes: Nails may change in color as a result of injury, medications, nutritional imbalances and skin conditions. If the color of your nails has noticeably changed, it is a good idea to check with a podiatrist.

Hangnails: The skin around your nails can become irritated and infected from biting or chewing, minor injuries, or exposure to water and chemicals. We have all endured the nagging pain of a hangnail. It is often sore and can develop into an infection. If this occurs we recommend you see a podiatrist immediately.

Ingrown nails: This is one of the most common complaints brought into our office simply because they are so painful. They are often caused by improper cutting of the nail or wearing footwear that is too tight. If you have an ingrown toenail, do not try to treat it yourself as you can make matters much worse. We are able to quickly treat and you will be pain free. We have an on site shoe store of shoes that will fit your foot properly as to not cause an ingrown again.

If you have something going on with your nail that is painful or that you are unfamiliar with it is usually a good idea to contact a podiatrist so you can be back to normal in no time.

(NAPSI)-While many boots today may win high fashion awards, they can be less than kind to your feet. According to a survey by the American Podiatric Medical Association (APMA), 27 percent of women who experienced heel pain reported their footwear as the chief cause.

"Whether you're wearing them for protection from rain or snow or for style, it is vastly important to pay attention to how a boot fits," said Dr. Ronald Jensen, APMA president.
These tips from podiatrists may help you pull on your most stylish boots without harming your tootsies:

• Have feet measured, as foot size can change throughout life. Keep in mind, too, that your boot size may not be the same in all styles and brands.
• Try boots on in the afternoon--feet tend to swell during the day.
• Most people's feet are not the exact same size. Get boots that fit your larger foot.
• Carry an insole for arch support when boot shopping. Insert when trying on.
• Boots should feel comfortable when tried on in the store; there shouldn't be a "break-in" period.
• Different styles and materials can affect how your feet feel. Synthetic materials trap in heat and moisture, causing odor. A boot constructed of natural materials, such as leather, will keep feet dry and comfortable.
• Choose a boot with plenty of toe room, a firm heel counter, and traction to ensure stability.
• Snow boots can become slick in inclement weather. Select a pair with rubber soles and deep grooves for proper traction.
• Trendy ankle boots often lack enough ankle support. Coupled with a high heel, this can cause an imbalance. Select a heel no more than two inches high and avoid walking long distances in them.
• Narrow and very high heels on boots transfer your weight onto the ball of your foot and can cause pain and numbness. Select a lower heel or stacked style of heel for additional support.

Get more shoe or boot buying advice and foot care tips by visiting the American Podiatric Medical Association's Web site at www.apma.org.

Your slippers may be comfortable at the end of a hard day but according to new research, wearing them too regularly could cause joint problems in later life.

Sandals and high-heels were also found to be the biggest causers of future joint problems, whereas trainers were least likely to cause any conditions.

The research, carried out on behalf of the American College of Rheumatology, examined the link between joint problems and footwear. Amongst women, scientists could pinpoint a correlation between 'poor shoe choices' - such as high heels - and arthritis.

But with men, who tend to wear more comfortable shoes, there was no such link. Less than two per cent of men wear 'unhealthy' shoes.

The researchers estimate that foot and toe conditions are among the top 20 reasons patients aged 65 to 74 visit their GP in the States. And improper footwear could be one of the causes, they warn.

In total, more than 1,400 men and 1,900 women were questioned about feet problems and footwear.

Quoted in The Telegraph, the authors said: 'While more research is needed, young women should make careful choices regarding their shoe type to avoid hindfoot pain later in life, or perform stretching exercises to alleviate the effect of high heels on foot pain.'

Orthotics are custom-made inserts that fit inside the shoe. They are developed from a mold made of your specific foot and made to fix your exact walking pattern or structural issue. We offer several styles, which can be worn comfortably in most types of shoes.

Foot and ankle pain will affect most Americans at some point in their life. In fact, a recent American Podiatric Medical Association poll discovered that half of all working Americans have missed at least one day of work due to a foot problem. When you consider how much time is spent on your feet, the stress put on them, and the complex nature of them, this should really be no surprise.

The human foot is a marvelously complicated and efficient machine. It is comprised of over 100 working parts, including as many as 28 bones working in conjunction with ligaments, tendons and muscles. These parts work to support and balance our entire body. In the course of normal walking our feet bear up to one and a half times our body weight per foot. This pressure is enormous, and with the average foot traveling 1,000 miles a year there are many foot and ankle injuries.

The feet act as shock absorbers for the entire body. In the course of a one-hour strenuous workout they will cushion nearly one million pounds of pressure. As a result, many people feel the pain of this stress, usually caused by foot imbalance. This pain shouldn't be ignored, as it is not a normal result of foot function.

Orthotics are one of the most common ways to treat the majority of foot problems. They come in many forms and functions depending on your foot problem or injury. The most common foot orthotics are arch supports, cushion insoles, and more specific orthotics such as cushions for the heel or ball of the foot.

Regardless of the type or model, the goal of these orthotic inserts is to help keep the feet in proper balance by offering support and aiding in shock absorption. They also help to improve the biomechanical function of the foot, as well as the other joints of the lower body including the knees, hips and lower back.

The importance of proper foot function cannot be over stressed. When the foot fails, not only is there increased strain, and ultimately pain to the joints in the foot, but also in the ankle, knee and hip. These imbalances can lead to many other painful conditions but spur from the feet.

To help take the stress off of your overworked feet and to help avoid painful knee and hip conditions you should speak to a podiatrist or visit an online store to inquire about orthotics and inserts. There are many podiatrist recommended orthotics in the form of arch supports, insole cushions, gel insoles, gel cushions, arthritic and diabetic insoles. They can tremendously help your walking pattern, foot pain, or structural issues. Don't make your feet suffer any longer. Start protecting them so they can continue to serve you well for many years to come.

This can happen for a number of reasons. Shoes that don't fit properly are most commonly the cause ingrown toenails. This includes shoes that are too tight therefore not giving the nail enough room to grow. The added pressure on the nail causes it to grow abnormally. Women who wear high heels often have this problem because of the shift of weight towards the toes.

Other causes of ingrown toenails are due to cutting the nails improperly. Nails should be cut straight across, not rounded. If a nail is rounded it is more apt to grow improperly into the surrounding skin. If you receive pedicures often make sure that your nails are being cut properly every time. Injury to the nails can also turn into an ingrown due to the shift in pressure on the nail. Fungal nails, which often makes nails thicker is another cause of ingrowns.

If you start to experience pain on the nail it is important to seek help from a podiatrist. Signs that you may have an ingrown toenail is if the side of your toe is painful, red, and swollen. Often times a podiatrist will look at your nail to make sure that the pain you are feeling is due to an ingrown nail.

Usually a podiatrist will start to remove the infection by removing the ingrown part of the toenail. Anesthesia is used during this procedure. If the nail or surrounding skin was infected an antibiotic may sometimes be prescribed and the patient will be asked to soak the toe. After the infection is completely healed a podiatrist may recommend removing the portion of the ingrown nail all the way down to the root. This prevents the nail from growing in the same way that it previously did.

To prevent the reoccurrence of an ingrown toenail it is extremely important to wear shoes that fit properly. Podiatrists have many shoes to recommend that will give your toenails the maximum amount of room to prevent another infection. It's also important to cut your nails properly: Straight, not curved at the edges. If you follow these rules it will greatly decrease your risk of developing an ingrown toenail.

In a young child's feet the bones are soft and more apt to develop deformities with abnormal pressure. This includes wearing shoes that are too tight, which may halt development. In the first year of life a child's foot develops to almost half the size of an adult's foot. This first year is critical to their development.
While a child is growing it is very important to change shoes and socks sizes every few months. This gives their feet the room to grow and develop that they need. Shoes should also be flexible and comfortable for the child. You should be aware of your child's walking pattern in order to catch any underlying defect or condition. We are able to treat foot and ankle conditions and address any concerns you may have.

Sports injuries are on the rise in children as more and more become actively involved. One of the most common sports injuries are ankle sprains. X-rays are often the best way to detect any fracture or break, which can be treated with a fiberglass cast. There are other treatment options for ankle sprains such as soft casts and pneumatic walking splints that help treat both ankle and foot problems. Soft casts can be used for fractures and are more comfortable than fiberglass casts. It allows more movement, but still provides support. A pneumatic walking splint immobilizes the foot and ankle, but still allows the patient to walk with the splint on. After patients are taken out of a boot or a splint, a light or structurally sturdy ankle brace is usually dispensed to them.
After a full recovery from an ankle sprain the ligaments are still weakened. Custom made and over the counter orthotics can help provide the support needed to the weak ankle. Our over the counter orthotics can be dispensed directly to the patient. These orthotics are low cost if they are not already covered by insurance. Physical therapy is also an important step in the recovery process so that your child can get back onto the field as soon as possible.

Heel and arch pain is a major condition treated in the podiatric world. Heel and arch pain are usually symptoms of an underlying issue. Heel pain is often felt by 8-14 year olds because their feet are still growing and developing. During the growth their heel bone is weak and any stress put on it can often cause this pain. Heel and arch pain can be treated with orthotics. If this pain is not treated during childhood years later on they will experience worse pain. Treatment with orthotics is often a way to keep children with heel and arch pain from seeing an orthopedist for these problems later in life.
Limb length discrepancy is often a problem experienced by young children. This problem is simply when one leg is longer than the other leg. The difference can be anywhere from 1 centimeter to more than 6 centimeters. The greater the difference the more the patient has to compensate in their walking technique, posture, etc. Leaving this untreated can lead to many problems including back, ankle, and hip problems. Orthotics can help to correct any walking and posture changes. A simple adjustment to an orthotic can help to easily treat any length discrepancy.

Another common issue experienced by many children is called knock-knees which is when your knees touch but your ankles are not touching. This becomes apparent from age 2-3 and gets progressively worse until age 4. This can develop when a child is learning to walk and is trying to achieve balance. Sometimes it only occurs in one knee. Leaving knock-knees untreated can result in difficulty running and walking. Knock-knee can be treated with braces.

Often night braces are used to correct the position of the knee.

In toe and out toe are 2 of the most common gait issues. This type of gait, or walking, causes abnormal stresses on the foot and ankle as well as hip, knee, and back. Many deformities in the foot such as flatfoot and a high arch foot can cause a weakening of musculature. There are multiple types of braces can help a patient walk better. Sometimes the muscle of the upper leg and torso are weakened by the foot deformity; certain types of physical therapy and muscular strengthening exercises need to be addressed.

Toe walkers don't land on their heels when walking; because of it certain muscles in the back of the foot, leg and ankle area become very tight and certain stretching exercises will help along with certain types of braces. The shoe a child wears is extremely important to the way they land on their foot and need to be evaluated.

There are many common concerns over the type of walking pattern, pains, etc that children experience during growth. It is important to have these problems evaluated by a podiatrist so that this problem does not turn into a long-term malady. It's important to keep a close watch on these issues because often time there is a quick fix.

One of the fastest growing trends within the running community is one that many people find odd and dangerous. This new fad is called "barefoot running" in which people do not wear shoes at all during a run or wear a new type of shoe called "barefoot running shoes". Barefoot running shoes definitely sounds like an oxymoron, however, these shoes are a shoe that includes the philosophy of barefoot running without the added danger of cutting your feet on a rock, piece of glass, etc.

Barefoot running started to grab headlines because of Olympic athletes and marathon runners winning medals and breaking world records without shoes on. Many people say that this is a great way to run because our feet were developed before the advent of shoes and sneakers. On the contrary our feet were also here before the beginning of paved roads, which exerts extra stress on a runner's feet.

Bare feet are not meant to endure the stress of running on concrete and asphalt. Many people who support this type of running do so because they feel that their feet have more room to move around, not confined into the shape of a shoe. They also state that they have increased blood flow to their feet, less ankle sprains, less ingrown nails, etc. These problems are often the result of improper shoe gear. Many people have shoes that do not provide nearly enough arch support, which results in injury. Ingrown nails and decreased blood flow are often attributed to wearing shoes that are too tight. To prevent these types of injuries it is important to wear a shoe that is fitted to your specific foot. Many specialized shoe stores and podiatrists can recommend a sneaker that is custom fitted to your specific foot type. Running barefoot can also be very dangerous. There is a great increase in injuries from stepping on glass, rocks, and other materials that can cut or get stuck in the foot.

Another reason many people are running barefoot is because they say that it corrects the way they run and walk. The proper way to run is to land on the middle of the foot and propel yourself forward. Many people land on the heel which can lead to problems further down the road for your hips, knees, ankles, and feet. Barefoot running is said to correct this because "it is too painful to run improperly barefoot". A much easier and painless way to correct the way you walk and run is with a shoe insert called an orthotic. Orthotics can be matched to your foot type as closely as possible and dispensed over the counter. They can also be custom molded to your feet to give your exact foot type the maximum amount of support and correction possible. Orthotics are a great way to fix your running and walking pattern without having to endure the pain of barefoot running.

There is a lot of debate and hype regarding this new fad. It's important to weigh the positive and negative results. The majority of the negative connotations that come with wearing running sneakers are due to shoes that don't give enough support or shoes that are worn improperly. Specialized shoe stores and podiatrists are able to help you find a shoe that will eliminate these problems and give you the support and comfort that is so important for a good healthy run.

Typically chronic swelling that occurs in the foot and leg is due to fluid buildup. There are muscles within the veins of the leg that push blood back to the heart. As we age those muscles get tired and cannot push blood up to the heart as effectively as they should. Blood then becomes sluggish in the vein walls and swelling occurs. Swelling that is due to an inefficiency of foot and leg musculature of the veins is called venous insufficiency.

Venous insufficiency is a common problem that needs to be evaluated by a foot specialist or your primary care physician. If left untreated this could lead to clot in the leg called a deep vein thrombosis or a clot in the leg. A multitude of other problems can occur from a clot.

There are many simple treatments that can be performed within a podiatrist's office to diagnose this problem. There is a vein test that actually tests the muscles of the veins.

Once a diagnosis has been established treatment options are multiple depending on the diagnosis. There are oral medications to decrease fluid in the blood. There are also stockings that compress the foot and the leg and cause a constant pressure on the leg to keep swelling down at all times. There are even shoes which we stock in our office that accommodate daily swelling issues of the foot and ankle.

There are a multitude of ways to prevent fungal infections and the spread of the disease. Most importantly is moisture control by always wearing socks and changing them throughout the day when they become moist. Secondly spraying antifungal powder between the toes and on the top and bottom of the foot is quite important. Unfortunately while you wear a shoe there is usually a sweaty buildup and a fungal infection will occur in your shoes causing a chronic cycle of fungal infections in your foot. Antifungal powder should be sprayed or poured into your shoes after each wearing. There are many advanced treatments for fungal infections. These include prescription topical medications, oral medications, and even ultraviolet ray treatments of the inside of your shoe. If you have tried many of the methods of treatment outlined in this blog and you still have problems with this I would recommend following up with a foot specialist.

We commonly see this in diabetic patients who do not pay attention to their feet and present to the doctor's office with a swollen toe after weeks of bleeding and swelling. Most importantly we recommend being evaluated for this problem by a podiatrist. Multiple treatment options are available. Simple peeling of the corn can usually provide relief and a shoe gear change. Accommodative shoe gear is one way of conservatively treating the problem with an extra depth shoe or very wide sneaker. Many times the shoe is more the offending factor. If the toe is still swollen and painful after debridement we recommend possible cortisone injection. Lastly if conservative treatment fails we recommend a surgical procedure where we remove a small piece of bone and straighten the toe with very little post-op course.

Treatment varies from patient to patient. It is important to have x-rays to see if there is what we call spurring, or bony growths (also called degenerative joint damage), that occurs due to this foot type. Caves or high arched feet can be surgically corrected, but we usually try a conservative treatment, which is usually is the treatment of choice. Typically custom orthotics, which are custom casted to your feet, will provide relief for our patients. Another device we use is an ankle foot orthotic, a bulkier device that completely encapsulates the foot and ankle. Shoe gear that is not structurally sound for a high arched foot could be quite problematic. We recommend that if you have a cavus foot type that you be evaluated by a podiatrist. Lastly, if you have a child that has this type of foot it would be best if the patient is evaluated because early detection is the key to healthier and less problematic scenarios that will occur in the foot.

When patients that are young get heel pain; the diagnosis for this problem is calcaneal (heel bone) apophysitis. Treatment for this usually starts off with an x-ray. Once the diagnosis is established, a heel cup usually helps, but many times we recommend a conservative approach such as icing and biofreeze to be applied several times a day. If simple treatments do not provide relief, a custom made orthotic device in sneakers is recommended.

Mitchell Wachtel, DPM is a podiatrist with offices located in Lowell, Methuen, Bradford and North Andover in Massachusetts

As we move forward with our blog, we hope to promote podiatric awareness as a vital part of your healthy, active lifestyle. Here you will find a variety of articles and topics including the latest developments in podiatry, podiatric treatments and helpful foot care advice from Dr. Wachtel and his staff.

We hope you find our blog to be helpful, engaging and informational to ensure the long-term health of your feet.
As always, feel free to contact us with any questions or concerns.