Archive for July, 2014

Blisters, Ingrown Toenails and Athletes Foot

July 28th, 2014 by Dr.Chang

INGROWN1Blisters are a result of the abrasion between your skin and sock or shoe. Because they can arise suddenly, it is important to take preventative measures to ensure your foot’s comfort. Preventing blisters begins with well fitting shoes, not too snug yet not too lose. Your socks should be snug fitting and made out of synthetic wicking material and with seams that cause minimal abrasion. Even after taking such precautions, many runners and athletes get blisters. If you find that you are prone to blisters, try regularly applying moisturizer to your feet, as dry skin is prone to friction, leading to blisters. Additionally, you may want to try rubbing your feet with Vaseline before a run if dryness is a problem for you, using foot powders to decrease moisture if your feet sweat too much, or wearing two pairs of socks so that they rub together instead of rubbing against your skin. You podiatrist may also prescribe prescription antiperspirants for more effective drying.

The rule of thumb is to leave small blisters intact so that the outer layer will protect the skin underneath. If you do get a blister on or off the trail, and it is large enough to see fluid inside, the best thing to do is to drain it and avoid it popping during activity. First, wash the affected area with soap and water. Sterilize a needle by rinsing it and soaking it in rubbing alcohol. Do not put the needle in a flame for sterilization as this method can lead to getting infectious carbon bits in your skin. Next, make a hole in the blister and squeeze out the fluid. Avoid removing the skin over a blister, because it provides padding and protection for the new skin growing underneath.  Finally, use hydrogen peroxide to prevent infection and wrap the area with antibiotic ointment and a bandage. You may want to use products like Second Skin or Band-Aid Blister Blocks, or soak your foot in Epsom salts to draw out fluid when you take off the bandages. If you find your blister is emitting yellow or green discharge, swell or reddens, you will want to see your doctor, as it is most likely infected. Additionally, if your blister is under or at the base of the toenail, see your podiatrist for treatment. Home removal of the toenail can cause infections and other complications, but your podiatrist will know how to drill a hole in the nail with an electric file.

ingrownIngrown toenails are one of the most commonly treated ailments. These are nails that are incorrectly shaped, so that they curve and grow into the skin, usually at the sides of the nail. This irritates the skin, causing pain, redness, swelling and warmth in the toe. Your toe may incur an infection if the nail breaks the skin, allowing bacteria to enter and cause an infection (indicated by a foul odor and a discharge of discolored fluids).  Ingrown toenails can be caused by a number of factors. While they are often hereditary, they can be the result of traumatic injuries, improper trimming, poorly fitting footwear, and nail conditions (such as fungal problems).

INGROWN3Home treatment of ingrown toenails should be limited to consistently cutting and filing the nail straight across and soaking the nail in Epsom’s salt. Never cut notches in the nail, do not repeatedly trim the nail borders, and do not place materials (such as cotton) beneath the nail, as all of these methods increase the likelihood of bacterial infection. Over-the-counter topical medications only relieve pain but do not cure the symptoms. “Home surgery” on your ingrown nails is not recommended, since repeated cutting of the nail can cause the condition to worsen over time. If your nail does not improve, visit your podiatrist for a simple procedure. Dr. Chang and Dr. Murray can easily perform a minor surgical procedure. They will take off the small offending border that is causing pain and permanently remove it so that it does not grow back into your skin. Note that they do not remove the entire nail, so this simple procedure can alleviate your pain with minimal recovery time.

Athlete’s foot, officially known as tinea pedis, is a fungal infection between the toes and on the soles of the feet. With this infection the skin on your foot may feel itchy or painful, will have scales redness and blisters. Podiatrists will recommend the applications of a fungicide such as Desenex, Tinactin, Lotrimin or Lamisil. Using these products a few times a day for two weeks to a month will help remedy the irritation and other symptoms. If symptoms reoccur, be sure to rotate the fungicide you use so that the fungus does not build up a tolerance to one brand. You may want to try additional remedies for the itching, such as soaking your feet in a baking soda and water solution, removing the dead skin with a pumice stone, or rubbing fine sandpaper along the bottoms of the feet (and disposing of the sandpaper after use!).


Blue Ridge Foot and Ankle Clinic
887 A Rio East Court Charlottesville, VA 22901
417 South Magnolia Ave Waynesboro, VA 22980

Rick, who is a Crozet native and UVA grad, recently started working in our Charlottesville location. Our patients and staff really enjoy his sense of humor and dedication to our practice.

Courtney, our newest employee, graduated from Blue Ridge Community College and works in our Waynesboro office. She brings a smile to work every day and is fitting in wonderfully.
We are very excited to have Courtney and Rick working for us and look forward to their contributions to the team. Thanks and welcome to Blue Ridge Foot and Ankle Clinic.




Blue Ridge Foot and Ankle Clinic
887 A Rio East Court  Charlottesville, VA 22901
417 South Magnolia Ave  Waynesboro, VA 22980
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Achilles Tendonitis and Achilles Tendonosis

July 21st, 2014 by Dr.Chang

Achilles Tendonitis and Achilles Tendonosis

The Achilles tendon connects the calf muscle to the heel bone and is the thickest and strongest tendon in the body in humans. While helping raise the foot off the ground with each step, the Achilles tendon can receive a load stress 3.9 times body weight during walking and 7.7 times body weight when running. Despite its ample strength, the Achilles tendon is prone to injury. The most common Achilles injuries are Achilles tendonitis and tendonosis, the former being inflammation of theachil Achilles tendon and the latter being degeneration of Achilles tendonitis. The inflammation from Achilles Tendonitis is usually short-lived. Over time, if tendonitis is not treated, it can degenerate into a worse condition called tendonosis, marked by tears in the tendon. In rare cases, chronic degeneration with or without pain may result in rupture of the tendon.

Repeat after me: I will not run through my Achilles injury. The Achilles will not heal if you keep running on it. When you hurt your Achilles, it is time to start cross training and being gentle with it. The most common risks to the Achilles are sudden increases of repetitive activity without giving it enough time to repair itself. Intense activity causes micro-injuries in the tendon fibers, which require time to heal. Additionally, athletes and runners with inconsistent workout schedules, such as weekend warriors and those who increase their workout intensity and volume too quickly, are prone to Achilles injuries. Achilles injuries may also be due to physiological reasons such as excessive pronation and flat feet, which put extra pressure on the tendon while walking or running.

Achilles tendonitis and tendonosis will result in pain, aching and tenderness along the tendon’s path, increasing when the sides of the tendon are squeezed, but with less pain in the back of the tendon. To diagnose Achilles injuries, your podiatrist will examine the foot, its range of motion, and conduct further assessment with imagining techniques such as X-rays. Initial treatment will include rest. Using heal lift inserts on both feet, or wearing high-heeled shoes with an open back, can help relax the tendon and give it the rest it needs.

Treatment plans will focus on reducing force on the Achilles tendon by means of a cast or walking boot, reducing swelling with ice and oral medications, long term preventative strategies such as custom-made orthotics and night splints, and gradually building a physical therapy regimen that includes stretching and strengthening exercises, soft-tissue massage and mobilization, and ultra-sound therapy. Eccentric stretching and strengthening of the Achilles – that is, elongating the Achilles while doing exercises – are key to long-term rehab. Examples include, first, doing calf stretches in a small lunge with your hands pressing against a wall, second, sitting with one leg straight in front of you while flexing and pointing your toe, or, finally, doing toe raises at the edge of a step or stair. You may even want to consult your podiatrist and physical therapist about working on your gait and stride while running, as gait abnormalities can lead to Achilles tendon and other injuries.

To prevent Achilles tendon injuries, be sure that you strengthen and stretch your calf muscles daily, maintain proper footwear, and use custom-made orthotics if you have flat feet or pronate.


Construction Pictures

July 16th, 2014 by Dr.Chang

Work has started on our NEW Fishersville podiatry clinic. Stay tuned for more exciting news and progress pictures.











Construction 10.22.14

Construction 10.22.14

Fishersville Office 10.22.14

Fishersville Office 10.22.14

The internal walls are framed.

The internal walls are framed.

OFFICE 10.13.14.small.2


Walls are going up! 10.8.14

Walls are going up! 10.8.14


August 2014

BRFAA Fishersville Map2

66 Parkway Lane Fishersville, VA


July 2014


July 2014


July 2014



After 10 long years on South Magnolia Ave in Waynesboro, we are moving into our new office in Fishersville, VA. Construction starts this month at the end of Parkway Lane near Augusta Health Hospital. Our new facility will offer more space, easier access, and more parking.  Dr. Murray and Dr. Chang are excited about our new facility and the conveniences it offers our patients.

Parking and handicap accessibility is a constant issue with our current office.  The new location will have it’s own parking lot with handicap accessible sidewalks and entrance way.  Inside, our hallways and doors will be wide enough to comfortably accommodate wheelchairs.

With the new office comes new equipment. The most notable, a digital x-ray machine. This machine makes the whole experience of getting an x-ray quicker and easier. Digital images have a higher resolution and can be burned to a CD for your convenience. Also, there is less radiation exposure because images are more consistently reliable .     


For more information about our new office visit us on Facebook.

If you or a loved one are experiencing foot & ankle pain, we hope you will consider our practice.  Please CONTACT us to make an appointment.  We are accepting new patients and referrals.



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Monticello Community Surgery Center

Augusta Health

Martha Jefferson