Preventing toenail fungus may not be at the top of your to-do list, but perhaps it should be. Fungi are nearly everywhere in our environment, and they really love dark, moist, warm places, like the inside your shoes. You definitely need to be aware of any changes in color or texture- both an indication that you could have a nail fungus.
 
What Exactly is Nail Fungus?
Toenail fungus is an infection that makes its way into your skin through cuts or cracks. Toes are a great environment for the fungus because they are very often warm and damp. There are different kinds of fungi that can, in some cases, spread to other toenails, skin, or even your fingernails.

A Guide to Symptoms
Thicker than normal, warping and odd shaped nails could all be symptoms of nail fungus. Sometimes the nails will break very easily, and they can look yellow.  A white dot can also appear on the nail and then grow larger. When fungus builds up under your nail, it can loosen and even separate the nail from the bed. The fungus can also spread to the skin around your nail.
 
Who Gets Toenail Fungus?
Almost anybody can get toenail fungus. Although, certain groups are more prone. Men – are much more likely to get it than women. Age - the older you are the better the odds you will get toenail fungus. Also, there’s an increased risk for people who have diabetes, athlete's foot, weak immune system, smoke, or whose family members have it as well. Prior injuries to toenails are also a risk factor.
 
When Should You Seek Help?
Since there are different types of toenail fungus, and the infection can look like other conditions, it’s really best to get a diagnosis as soon as possible. A podiatrist can in all likelihood diagnose very quickly, but may need to take a small sample of the infected area to confirm the diagnosis.
 
Treatment
A variety of treatments may be needed, and that’s another reason to have a podiatrist make the diagnosis. A podiatrist can also determine the severity of the problem and immediately recommend the best treatment or combination of treatments.
Treatments might Include:

• Topical cream that goes directly on the nail
• Topical nail lacquer
• Antifungal prescription pill
• Nail smoothing
• Laser therapy
• Shoe treatment
• In some cases, oral antibiotics may be prescribed
• Removing the damaged area of the nail or skin
• Finally, there is a possibility of surgery to remove the nail

Prevention
Here below is a list of the best ways to avoid toenail fungus.

• Cleanliness- Use soap and water to wash your feet, and dry well, including between toes. Wear shower shoes in wet public places like locker rooms and swimming pools.
• Keep Feet Dry. Choose socks that wick moisture away. Change them regularly.
• Trim nails straight across, not at an angle and to the proper length (shorter than the end of your toe).
• Use clean tools. Nail clippers and files should be washed with soap and water, and wiped down with rubbing alcohol.
• Take a break from nail polish. The nail bed needs to "breathe," to allow the fungus to go away.

 
If you notice changes in color or texture, have pain or notice any of the other symptoms described above, then it’s time to contact us for a diagnosis and the best in recommended care.
Contact our offices Laurel Foot & Ankle Center or Northern Virginia Foot & Ankle Associates and schedule an appointment today.
To learn more about Diabetes and your feet, go to Heel Pain Institute of America or Laurel Foot & Ankle Center or Northern Foot & Ankle Associates.

The two main foot problems that affect people with diabetes are:

Diabetic Neuropathy
Over time, diabetes can cause nerve damage that makes it hard for people to feel sensation in their extremities.
This condition also makes it difficult for a person to feel a foot irritation or notice when their shoes are rubbing. This lack of sensation and awareness leads to an increase in the risk of cuts, sores, and blisters developing.

Peripheral Vascular Disease
Diabetes leads to changes in the blood vessels and arteries. In peripheral vascular disease, fatty deposits block these vessels beyond the brain and heart. It tends to affect the blood vessels leading to and from the extremities, reducing blood flow to the hands and feet.
Reduced blood flow can lead to pain, infection, and slow healing wounds. Severe infections may lead to amputation.

Symptoms
Symptoms vary from person to person. Symptoms of diabetic foot problems can include the following:

• loss of feeling
• numbness or tingling sensation
• blisters or other wounds without painful
• skin discoloration
• skin temperature changes
• red streaks
• wounds with or without drainage
• painful tingling
• staining on socks
• deformed foot appearance

If an infection is present in a foot, a person may also experience some of the following:

• fever
• chills
• uncontrollable blood sugar
• shaking
• shock
• redness

Anyone who experiences any of the symptoms of an infection should seek emergency treatment.
Complications Diabetic neuropathy and peripheral vascular disease are serious conditions that must be monitored closely. Both cause complications that can have serious negative effects. These complications may include:

• foot ulcers, or wounds, that do not heal
• infections, including skin infections, bone infections, and abscesses
• gangrene, when an infection causes tissue death
• foot deformity
• Charcot's Foot (fractures or dislocations in the foot that may cause deformities)

When To See A Doctor

Seek immediate medical attention if there are changes to the feet such as skin color, persistent sores, tingling, and swelling of the foot or ankle.

People who have diabetes should see a doctor regularly as part of their care. Immediate medical attention should take place if any of the following is perceived:

• changes in foot skin color
• swelling in the foot or ankle
• temperature changes in the feet
• persistent sores on the feet
• pain or tingling in the feet or ankles
• ingrown toenails
• athlete's foot or other foot fungal infections
• dry and cracked skin on the heels
• signs of infection

Treatment Surgical and nonsurgical treatments for diabetic foot problems vary according to the severity of the condition.

Nonsurgical treatment Nonsurgical options are normally the first method of treatment for diabetic foot problems. Some of these include:

• keeping wounds clean and dressed
• immobilization devices, such as a cast boot or total contact cast
• close observation of gangrene toes until self-amputation occurs, when the toes fall off due to lack of blood flow

Surgical treatment When nonsurgical treatment fails to heal diabetic foot problems, surgery may be considered. Surgical options include:

• removal of decaying or dead tissue
• amputation, varying from toe or part of the foot to amputation of the leg below the knee, or above the knee in some cases
• surgical stabilization of Charcot's Foot
• arterial bypass for peripheral vascular disease, or endovascular surgery with placement of stents

 
Contact our offices Laurel Foot & Ankle Center or Northern Virginia Foot & Ankle Associates and schedule an appointment today.

To learn more about Diabetes and your feet, go to Heel Pain Institute of America or Laurel Foot & Ankle Center or Northern Foot & Ankle Associates.

Your ankle pain may be caused by Tarsal Tunnel Syndrome

What Is Tarsal Tunnel Syndrome?

Tarsal tunnel syndrome is a compression on the posterior tibial nerve that produces symptoms anywhere along the path of the nerve running from the inside of the ankle into the foot.  That narrow path is called the tarsal tunnel.
The tunnel is covered with a thick ligament that protects and maintains the structures contained within the tunnel—arteries, veins, tendons and nerves. One of these structures is the posterior tibial nerve.

Causes
Tarsal tunnel syndrome is caused by anything that produces the compression listed above:

• A flat-footed person is at risk for developing tarsal tunnel syndrome, because the outward tilting of the heel that occurs with fallen arches can produce strain and compression on the nerve.
  
• An enlarged or abnormal structure that occupies space within the tunnel can compress the nerve. Some examples include a varicose vein, ganglion cyst, swollen tendon or arthritic bone spur.
• An injury, such as an ankle sprain, may produce inflammation and swelling in or near the tunnel, resulting in compression of the nerve.

Systemic diseases, such as diabetes or arthritis, can cause swelling, which compresses the nerve.

Symptoms
Patients with tarsal tunnel syndrome experience one or more of the following symptoms:

• Tingling, burning or a sensation similar to an electrical shock
• Numbness
• Pain, including shooting pain 
  

Symptoms are typically felt on the inside of the ankle and/or on the bottom of the foot. In some people, a symptom may be isolated and occur in just one spot. In others, it may extend to the heel, arch, toes or the calf.
Symptoms are often brought on or aggravated by overuse of the foot, such as in prolonged standing, walking, exercising or beginning a new exercise program.

Ill-fitting shoes can cause black toenails

Black or darkened toenails are essentially bruised nails and can result from a variety injuries or problems. Darkened nails may occur as a result of the toe hitting the end or the top of the shoe toe area. Sometimes, the bruise can lead to a fungal nail infection.

Treatment may include trimming the nail back and applying a topical anti-fungal medication. If the skin under the nail is ulcerated, a topical antibiotic ointment should be applied.

Diabetic patients should contact our office for evaluation if they experience any change in the color of toenails. The pressure causing the bruised nail may lead to a small sore under the toenail, which can lead to infection.

We’ve compiled a lit of helpful tips for buying the right show to avoid black toenails and other issues resulting in bad shoe fit for running, hiking or walking.

Heel
Your heel should fit snug, but not tight. Laced up (but not tied), you should be able to slide your feet out. Lacing your shoes up through the final eyelet minimizes slippage. There will be some heel movement, but it shouldn’t be uncomfortable. Any irritation you feel in the store will be amplified once you are out and about.

Instep
A shoe’s upper should feel snug and secure around your instep. If you feel pressure and tightness, you need more space. If an otherwise great shoe has hot spots or pressure under the laces, try some alternative lacing techniques before moving on to the next shoe.

Width
Your foot should be able to move side-to-side in the shoe’s forefoot without crossing over the edge of the insole. You should be able to pinch a quarter inch of upper material along the widest part of your foot. If the shoe is too narrow, you’ll feel the base of your little toe sitting on the edge of the shoe last.

Length
Feet swell and lengthen over a run, so make sure there’s a thumb’s width of space between your longest toe (which might not be the big toe) and the end of a shoe. A shoe fitter can measure this while you stand with your shoes laced up. Your toes should also wiggle freely up and down. Wiggle room protects against front-of-the-foot issues like black toenails.

Flex
Check the flex point before you put on the shoe. You can do this by holding the heel and pressing the tip of the shoe into the floor. The shoe should bend and crease along the same line your foot flexes. An improperly aligned flex point can lead to arch pain or plantar fasciitis. A lack of flexibility can lead to Achilles tendon or calf strain.

Feel
You need to pinpoint shoes that match your foot’s contours and movements. You can’t get a good feel by just standing. So, take your shoes for a quick jog, either on a store’s treadmill, or just down a hallway. Back off the amount of support if you feel your arch cramping. Your shoe should support your stride, not try to alter it.

Tight-fitting shoes lead to blisters and black toenails. Play the piano with your toes, meaning the fit should be roomy enough in the forefoot, but not sloppy.

Contact our offices Laurel Foot & Ankle Center or Northern Virginia Foot & Ankle Associates and schedule an appointment today.

To learn more about Black toenails, go to Heel Pain Institute of America and Laurel Foot & Ankle Center or Northern Virginia Foot

What the heck is with the pain on my heel?!!

Do I have a Heel Spur?
Let’s first define what a heel spur is for you. A heel spur is a pointed bony outgrowth of the bone of the heel. Heel spurs can be located at the back of the heel or under the heel, beneath the sole of the foot. A heel spur protrusion can extend forward by as much as a half-inch.
Many people describe the pain of heel spurs and plantar fascilitis as a knife or pin sticking into the bottom of their feet when they first stand up in the morning -- a pain that later turns into a dull ache.
 
Causes
Heel spurs occur when calcium deposits build up on the underside of the heel bone, a process that usually occurs over a period of many months. Heel spurs are often caused by strains on foot muscles and ligaments, stretching of the plantar fascia, and repeated tearing of the membrane that covers the heel bone. Heel spurs are especially common among athletes whose activities include large amounts of running and jumping and people that lift heavy objects regularly.

Risk factors for heel spurs include:

• Walking gait abnormalities, which place excessive stress on the heel bone, ligaments, and nerves near the heel
• Running or jogging, especially on hard surfaces
• Poorly fitted or badly worn shoes, especially those lacking appropriate arch support
• Excess weight 
  
  
• Treatment
  Anti-inflammatory medications, cortisone injections, corrective shoes, and/or orthotics (special shoe inserts) are some of the common treatments for spurs. Note: Please consult your physician before taking any medication. Surgery may be prescribed if spurring around the joint becomes severe or leads to recurrent pain from persistent corns.
  Contact our offices Laurel Foot & Ankle Center or Northern Virginia Foot & Ankle Associates and schedule an appointment today.
  To learn more about Exercise and Your Feet, go to Heel Pain Institute of America and Laurel Foot & Ankle Center or Northern Virginia Foot & Ankle Associates
  ​

Flat Feet (Fallen Arches)

Flat Feet is a very common condition that afflicts 1 out of every 4 Americans according to the American Foot and Ankle Orthopedic Society. One in four people translates to an estimated 60 million Americans.
The paradox is that the majority of people who have flat fee don’t know it, as they have not yet had any symptoms. They are born with a congenital flat foot condition, and sometimes it takes years for pain or discomfort to develop. However, it’s important to note, that some people develop flat feet even when t
have normal arches.
​
What Is It?

​When an individual has no arch in the sole of the foot, it causes the foot to be flat while in a standing position. The sole of each foot would be partially, or completely, touching the floor.

Congenital Flat Foot Condition
​
Babies are sometimes born with what’s called Pediatric Flexible Flat Foot.  Flexible refers to cases where an arch is visible until weight is borne by the foot and the arch disappears. These are cases where one is predisposed to the condition from birth.

Acquired Flat Foot

Over time, many people for a variety of reasons develop flat feet. Interestingly, one of the most common ways stems from the effect of tightness in the Achilles’ tendon. This can cause the foot to point downward – a condition called plantar flexion. This misalignment may trick the body into behaving like one leg is “longer” than the other. The body, a master of compensation, will flatten the arch to make up for the perceived additional length.  

​What Are Other Causes of Flat Feet?

The foot literally carries the weight of the entire body. Consider the simple act of walking.  The body’s weight is multiplied 3 to 4 times on each foot.  So any misalignment or extra weight can be very punishing on the feet and arches. Over time, the arch of the metatarsal can literally become flattened out causing flat feet.  

Other Factors. 

Family history
Weak arches
Arthritis
Diabetes
Injury
Ruptured tendon
Pregnancy

When to Call Our Office for Treatment.  

If you have foot or leg pain, our doctors at Laurel Foot & Ankle Center or Northern Virginia Foot & Ankle Associates can help provide relief. We will provide you with a proper diagnosis and design a treatment plan that will work for you.

Please Contact Us Today If You Are Experiencing Any Of The Following. 

Painful feet despite wearing of well-fitting shoes
Shoes get easily worn out
The flatness of feet is worsening
Numbness, stiffness or weakness of the feet

Contact our offices Laurel Foot & Ankle Center or Northern Virginia Foot & Ankle Associates and schedule an appointment today.
To learn more about Flat Feet, go to Heel Pain Institute of America and Laurel Foot & Ankle Center or Northern Virginia Foot

Heel Pain

Our feet put up with a lot. After all, we ask them to carry the load of our entire bodies, engage in all sorts of activities including exercise and sports, and we often force them into a variety of ill-fitting shoes! In short, our feet are expected to do a lot.
The foot is a complex body part with 26 bones, 33 joints and more than 100 tendons in each one and the very largest bone in the foot lives at the heel. So it is no wonder that heel pain is an exceptionally common condition. The bad news is it can be incredibly uncomfortable and sometimes debilitating. But the good news is that heel pain is treatable and preventable. 

Why Does It Hurt?

In general, there are two primary categories of heel pain.
The first is called “Heel Pain Syndrome” and is caused by over-use and/or repetitive stress. A soreness in the heel area resulting from too much impact develops.  Typically “Heel Pain Syndrome can be attributed to one of the following factors.

• ·         Shoes with heels that are too low.
• ·         A thinned out fat pad in the heel area.
• ·         A sudden increase in activity.

The second category is considered a biomedical problem caused by over-pronation, commonly referred to as “Flat Feet”. An issue that can cause Plantar Fasciitis which is when the plantar fascia is excessively stretched and inflamed resulting in pain.

NOTE: The plantar fascia is a broad band of fibrous tissue that runs along the bottom surface of the foot, from the heel through the midfoot and into the forefoot.

How to Treat Heel Pain

A variety of tools are available to treat heel pain. Our podiatrists at Laurel Foot & Ankle Center or Northern Virginia Foot & Ankle Associates will recommend ways to absorb shock, provide additional cushioning and change the position of the heel through elevation.
A heel cup, visco heel cradle, or an orthotic designed with materials that will absorb shock and force are just a few of the possibilities they may be recommended.  In addition, the right footwear is critical. Shoes with a firm heel counter, arch support, and proper heel height are all options our podiatrists will explore with you. 

Common Conditions.

At Laurel Foot & Ankle Center or Northern Virginia Foot & Ankle Associates we can diagnose your specific condition. Below are some of the most common diagnoses.

Plantar Fasciitis.

Too much pressure results in stiffness and pain in the plantar fascia ligament causing what is referred to as Plantar Fasciitis.

Sprains and strains.

 Common is the inevitable sprains and strains from a fall or physical activity. These can be minor or severe.

Fracture.

 A broken bone is a medical emergency.

Achilles Tendonitis. 

The tendon that attaches the calf muscles to the heel becomes inflamed…typically due to overuse. 

Bursitis. 

Bursae are fluid-filled sacs found about your joints. They surround the areas where tendons, skin, and muscle tissues meet bones.

When to Call Us.

Call Laurel Foot & Ankle Center or Northern Virginia Foot & Ankle Associates if you experience the following:

• ·         Severe Pain
• ·         Sudden Pain
• ·         Redness in your Heel
• ·         Swelling in your Heel
• ·         Difficulty Walking

Our podiatrists will talk with you about your activities and symptoms, then perform a physical exam which may include an X-ray. Once a diagnosis is determined, we will provide you with the proper and effective treatment. Sometimes, in order to help strengthen the muscles and tendons in your foot, we may prescribe physical therapy.  

If you are experiencing heel pain, or want to learn more about preventative care or treatments, please don’t hesitate to contact us for a diagnosis and the best in recommended care.

Contact our offices Laurel Foot & Ankle Center or Northern Virginia Foot & Ankle Associates and schedule an appointment today.

To learn more about Heel Pain, go to Heel Pain Institute of America and Laurel Foot & Ankle Center or Northern Virginia Foot

Playing sports is an American national pastime for both adults and children. From little league and pee wee ball all the way up to professional sports, there is literally something for everyone. While everyone agrees, playing sports and exercising can be fun, fulfilling, and good for you; it can also come with a multitude of injuries.  

With so many people in the game, the number of injuries has increased dramatically. Fortunately, the prevention and the treatments have also improved dramatically.

The best strategy to avoid injury is clearly Prevention. Take a look at what our doctors at Laurel Foot & Ankle Center or Northern Virginia Foot & Ankle Associates recommend.

Cornerstones of Prevention

• Get a Physical. Many things can show up on a routine physical.  
• Dress the Part. The right shoes, gear, and equipment are essential. Again, our doctors can advise you with the right shoes. This is especially critical for runners and other athletes that foot and ankle issues
• Hydrate. Then Hydrate Some More.
• Proper Warm Up & Stretching.

Techniques for warm up and stretch go a long way in preventing an injury and recovering from one. Stretching should also be incorporated into a daily fitness Plan.

• Strengthen muscles. Conditioning exercises strengthens muscles used in
• STOP when you are tired.  
• DO NOT attempt to “play through the pain”.

Injury Risks – The Three Most Common.

• Sprains (injuries to ligaments)
• Strains (injuries to muscles)
• Stress fractures (injuries to bones)

When excessive stress is placed on tendons, joints, bones and muscles, injury occurs. The most common sports injuries are strains and sprains. Sprains are injuries to ligaments, the tough bands connecting bones in a joint. Strains are injuries to muscle fibers or tendons, which anchor muscles to bones. Strains, often referred to as “pulled muscles” cause tears in the muscle fibers or tendons.

The 7 Most Common Injuries.

1. Ankle sprain
2. Groin pull
3. Hamstring strain
4. Shin splints
5. Knee injury: ACL tear
6. Knee injury: Patellofemoral syndrome — injury resulting from the repetitive movement of your kneecap against your thigh bone
7. Tennis elbow (epicondylitis)

What to Do When Hurt?
Most importantly, STOP playing, as it can cause more harm. Treatment often begins with the RICE (Rest, Ice, Compression, and Elevation) to relieve pain, reduce swelling, and speed healing.
If pain, swelling and redness is present, podiatric medical treatment is recommended. Call our office for an evaluation to help identify the injury and the best course of treatment. We may prescribe additional pain relievers, stabilizing the injured area, rehabilitation and in some cases surgery.

If you think your may have a Sport or Exercise injury, or want to learn more about preventative care or treatments, please don’t hesitate to contact us for a diagnosis and the best in recommended care.

​Contact our offices Laurel Foot & Ankle Center or Northern Virginia Foot & Ankle Associates and schedule an appointment today.

To learn more about Sports Injuries, go to Heel Pain Institute of America and Laurel Foot & Ankle Center or Northern Virginia Foot

A bunion is an enlarged area of the inner portion of the joint located at the base of the big toe. The pronounced area is typically the result of a misalignment of the big toe joint, or in medical terminology – the metatarsal phalangeal joint (MTP Joint) The area can also, in some cases, contain additional bone.

The MTP joint can become red and inflamed and be very tender and quite painful. A small fluid-filled sac (bursa) adjacent to the joint can also become irritated leading to additional swelling, redness, and pain. This is referred to as bursitis. Untreated, the area may develop arthritis.

In addition, the misalignment causes the big toe to point outward and rotate toward the smaller toes. Untreated, this deformity will progress and increase with time although the painful symptoms may or may not. A less common bunion is called the bunionette. The bunionette is marked by its location - at the joint at the base of the smallest toe.

What Causes Bunions?

Bunions are thought to mainly come from over pronating. Pronation occurs as weight is transferred from the heel to the forefoot when walking or running and the foot naturally rolls inwards. A certain amount of this is natural but in many people the foot rolls in too much or over pronates.

Genetics seem to play a role. More specifically the genetic tendency towards over pronation can lead to development of bunions. Other causes which are less common include trauma, sprains, fractures, and nerve injuries. Also leg discrepancies (one leg being longer that the other) which results in over pronating can also be a determining factor.

Are Women or Men More Prone?

Women are the winners. Or should we say the losers. Bunions affect women nearly 10 times more frequently than men. Why is that? Look to women’s shoes for clues. Tight-fitting shoes, especially high-heel and narrow-toed shoes are the likely culprits putting women at higher risk for bunions.

Treatment

Pain and discomfort can often be managed by getting rest and wearing looser, roomier shoes or sandals. However, make sure that whatever shoe you wear, it has a supportive sole. Stay away from high heels and try roomier, supportive sneakers. 

The next step to manage pain and discomfort are often anti-inflammatory medications along with ice packs applied to the area. Custom insole orthotics can also be used to slow the progression of the bunion and address underlying biomechanical causes such as over pronation.

Injection of cortisone is a step up in treatment and then finally a surgical procedure may be required. A bunionectomy can correct the deformity and relieve pain and radically improve the way the foot functions. These procedures typically involve removing bony growth of the bunion while realigning the big toe joint.

If you think your may have a Bunion or want to learn more about preventative care or treatments, please don’t hesitate to contact us for a diagnosis and the best in recommended care.

Contact our offices Laurel Foot & Ankle Center or Northern Virginia Foot& Ankle Associates and schedule an appointment today.

To learn more about Bunions, go to Heel Pain Institute of America and Laurel Foot & Ankle Center or Northern Virginia Foot & Ankle