Author Archive

Partnering with your Podiatrist for the Best Diabetic Foot Care

August 6th, 2015 by Blue Ridge Foot and Ankle

If you or a family member has diabetes, you understand the importance of good foot care. Diabetics face a double challenge when it comes to foot issues. First, diabetes causes nerve damage or neuropathy. Neuropathy results in a loss of feeling in your feet making it more difficult to notice pain and discomfort and, therefore, minor foot problems often become major because lack of sensation doesn’t allow them to be detected in the early stages. Second, people with diabetes often have poor circulation, which reduces the ability to resist infection and to heal once an injury or infection occurs. At Blue Ridge Foot & Ankle Clinic we believe that your podiatrist can play a key role in helping keep diabetic feet healthy. A diabetic patient should have regular check-ups with a foot doctor. In addition to preventative care, our board certified podiatrists, Dr. Stewart M. Chang and Dr. Kevin P. Murray will be watchful for many conditions that are of particular concern to diabetic patients, including:

Infections and sores (ulcers)—Even a seemingly minor cut or small blister can develop into a very serious danger for diabetic patients. Infections can quickly develop on the surface and progress down to the bone.

Dry, cracked skin—Diabetic patients are more prone to dry, cracked skin than other patients, due to poor circulation. If not kept under control, this can become an entry point for bacteria to enter and an opportunity for sores to form.

Corns and calluses—Neuropathy makes it difficult to tell if your shoes are putting pressure on your feet and causing corns or calluses, which, if left untreated, can develop into ulcers.

Hammertoes and bunions—Muscle weakness and loss of tone in the feet, also caused by nerve damage, can lead to hammertoes and bunions, both of which can cause ulcers.

Nail disordersIngrown toenails and fungal infections are more common and more threatening among diabetic patients.

Charcot foot—This is a complex foot deformity that occurs when a broken bone goes undetected and, because the patient doesn’t feel the pain and continues to walk on it, soft tissue destruction occurs. Charcot foot is a severe and disabling condition that surgery may become necessary.

One way to ensure healthy feet if you are a diabetic is to set up a consultation with one of our podiatrists and establish good habits of care, as well as a regular schedule of visits to examine and care for your feet. Call either our Fishersville or Charlottesville office today or schedule an appointment online.

Could You Have Flexible Flatfoot?

July 28th, 2015 by Blue Ridge Foot and Ankle

Do you experience any of the following: aching or fatigue in your feet or legs, pain in your heel, ankle, arch, or along the outside of your foot, shin splints, low back, hip or knee pain? Do you find that you are prone to rolling your ankle? If so, you may have flexible flatfoot.

What is It?

At Blue Ridge Foot & Ankle Clinic, we treat many cases of flexible flatfoot every year. It is a complex disorder which can take several forms, all of which exhibit a partial or total collapse of the arch of the foot. Flexible flatfoot is one of the most common types. The name “flexible” refers to the fact that the foot is flat when you are standing on it but the arch returns when you are not bearing weight on your foot. It typically begins in childhood and continues progressing in severity into adulthood. Usually both feet are affected. As the deformity worsens, the tendons and ligaments of the arch can stretch or tear and become inflamed, causing pain and difficulty walking. You are more likely to develop bunions and hammertoes as well if you have flexible flatfoot.

How is Flexible Flatfoot Diagnosed and Treated?

Dr. Stewart M. Chang and Dr. Kevin P. Murray will do a complete examination of your foot and observe how it looks when you stand and sit. Usually digital x-rays will be ordered (which can be done in either our Fishersville or Charlottesville office) so the podiatrist can see how severe the disorder is. If it is determined that you have flexible flatfoot, your foot doctor may recommend any or all of the following:

  • Modify your activities—avoid long periods of walking and other activities that keep you on your feet
  • Relieve pain and inflammation– nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can lessen discomfort
  • Lose weight—if you are overweight, losing weight will lessen the strain on your arches and may reduce your symptoms
  • Use orthotics—custom made orthotic devices to put in your shoes can give needed support to your arches
  • Do physical therapy—ultrasound and other physical therapy regimens may bring some relief

In more severe cases it may be necessary to use a walking cast or avoid weight bearing all together for a period of time. When pain is not relieved by other methods, your podiatrist may recommend surgery. If you think you may have flexible flatfoot, schedule an appointment online or by phone with one or our podiatrists.

Treating a Rupture of the Achilles Tendon

July 22nd, 2015 by Blue Ridge Foot and Ankle

The Achilles Tendon, sometimes called the “heel cord,” is the band of tissue that connects the calf muscle to the heel bone. If you’ve ruptured it, most likely you’d know it. When the tendon is stretched beyond its capacity due to forceful jumping or pivoting or sudden acceleration when you’re running, it can tear. At Blue Ridge Foot & Ankle Clinic, we often see this injury in “weekend warriors,” those less-fit adults who decide to go full force running, exercising, or participating in a sport. The tendon can also rupture as the result of tripping or a fall. If you’ve ruptured your Achilles Tendon you will probably experience one or more of the following:

  • Sudden stabbing pain in the back of the ankle or calf that may subside to a dull ache
  • A popping or snapping sensation
  • Swelling between the heel and the calf
  • Difficulty walking (especially upstairs or uphill) and an inability to rise up on your toes

Seek Treatment

If you believe you have ruptured your Achilles Tendon, call our Fishersville office at 540-949-5150 or our Charlottesville office at 434-979-8116 immediately. Prompt medical attention is necessary to prevent further damage. Until you are able to see the doctor, follow the RICE (Rest, Ice, Compression, Elevation) regimen.

Our board certified podiatrists, Dr. Stewart M. Chang and Dr. Kevin P. Murray will conduct a thorough examination of the foot and ankle, which will involve checking for range of motion and comparing the injured foot to the uninjured one. Our podiatrists will also want to know how the injury occurred and, in some cases, may order an MRI or other advanced imaging tests.

There are both non-surgical and surgical treatment options for a ruptured Achilles Tendon. Your podiatrist will determine the best treatment plan for you, based on the severity of the injury and your level of activity.

What to Do About an Ingrown Toenail

July 14th, 2015 by Blue Ridge Foot and Ankle

An ingrown toenail, or as it’s officially known, Onychocryptosis, happens when the nail plate penetrates the skin. This very painful condition can affect any nail but it is most often seen with the nails of the big toes. At Blue Ridge Foot & Ankle Clinic we treat many cases of Ingrown Toenails.

Common Causes

There are several different possible causes of ingrown toenails. A trauma to the nail can cause it to grow in an irregular fashion so that it starts to grow inward, penetrating the skin. Deformed nail beds or plates due to genetics or disease are also more likely to lead to ingrown nails. Even improper trimming of the nails (hint: don’t make them too short or file them in an overly round shape so that the nail is not right up against the skin) can lead to this painful condition. Beware too of shoes that are too tight and compress the toes as this also can cause nails to start to ingrow.

How Do You Know if You Have an Ingrown Nail?

The most obvious sign of an ingrown toenail is pain and redness around the edge of the nail on the toe. Ingrown toenails are highly susceptible to infection and you may see swelling at the base or sides of the nail and it will be warm to the touch. You may see pus draining from the irritated area as well.


If the ingrown toenail is mild and you are not seeing signs of infection, you may try a home remedy first of soaking the foot in warm water with some Epsom’s salt. However, this is not advised if you have diabetes, nerve damage, or poor circulation as the risk of developing an infection with these conditions can have very serious detrimental effects. If your ingrown toenail is getting worse instead of better, it’s time to make an appointment with one of our board certified podiatrists. Dr. Stewart M. Chang and Dr. Kevin P. Murray have extensive experience treating ingrown toenails. A minor surgical procedure can be performed to permanently remove the border of the nail that is ingrown.

If you would like to get relief from an ingrown toenail, make an appointment at either our Fishersville or Charlottesville office today.

Those Pesky Bunions and What to Do About Them

July 9th, 2015 by Blue Ridge Foot and Ankle

The telltale sign of a bunion is a bump on the side of the big toe. But the bump that you see is actually only an outward reflection of the real problem: changes in the bony framework of the front part of the foot. Bunions may or may not be painful but they are a progressive condition that requires medical attention. At Blue Ridge Foot & Ankle Clinic our board certified podiatrists, Dr. Stewart M. Chang and Dr. Kevin P. Murray will take the time to conduct a thorough examination of your foot to diagnose a bunion.

Signs and Symptoms

In addition to the bump on the side of the big toe, there are other symptoms which may occur at the site of the bunion:

  • Inflammation and redness
  • Soreness or pain
  • Numbness
  • Burning sensation

You may notice the symptoms more when wearing shoes that have a tight toe box or high heels that force your toes to be compressed in the front of the shoe. Even with all of these symptoms and the bump, our podiatrists may also order a digital x-ray to determine the extent of the deformity.


There are treatments that are aimed at reducing the pain and discomfort of bunions. These include: wearing shoes with a wide toe box that won’t cramp the toes, padding the bunion, reducing standing time, orthotics, and oral nonsteroidal anti-inflammatory drugs, such as ibuprofen. Icing the bunion may also provide relief. All of these treatments, however, will not correct the underlying problem. If your bunion is severe and impacting your ability to function on a daily basis, our podiatric doctors may recommend surgery.

If you are suffering with a bunion, don’t wait. Contact us at our Fishersville or Charlottesville office to schedule a consultation today. You’ll be glad you did.

Fixing a Broken Toe

July 2nd, 2015 by Blue Ridge Foot and Ankle

How many times have you heard it said, when someone thinks they may have broken a toe, “No sense going to the doctor, there’s nothing they can do for a broken toe.” That’s a myth! In fact, not treating a fractured toe correctly can lead to serious complications including: a deformity of the bone structure which may limit mobility or make it hard to find comfortable shoes, arthritis, chronic pain, and possibly long-term dysfunction requiring surgery to correct. At Blue Ridge Foot & Ankle Clinic, we want you to know the facts about toe fractures. Toe fractures, or breaks fall into two categories.

Traumatic Fractures

Also known as acute fractures, traumatic fractures are the result of a direct impact or blow, such as dropping something heavy on your toe or stubbing it really hard—you usually know when it happens. You may hear a breaking sound at the time the incident occurs and have serious pain on impact that lasts a few hours (the pain may go away after several hours but that does not mean the toe isn’t fractured). There may be bruising and swelling the next day and the toe may appear misshapen or out of place.

Stress Fractures

Stress fractures may not be so obvious. These small, hairline breaks have symptoms that can come and go. There may be pain at the site when touched and swelling of a particular area without bruising. Pain usually comes after activity but goes away when resting. Oftentimes stress fractures result when athletes over do it and try to increase their activity level too quickly. They can also be caused by improper footwear, deformities in foot structure, or certain diseases like osteoporosis.

Diagnosis and Treatment

Just because you can still walk on your foot is not proof that your toe isn’t broken. If you experience any of the symptoms above, it’s important that one of our board certified podiatrists examine your toe promptly. Dr. Kevin P. Murray and Dr. Stewart M. Chang will first conduct a thorough exam of your toe and foot, which may include digital x-rays. Depending on the type and severity of the fracture, several treatment options are available:

  • Splinting the toe to keep it in a fixed position until it heals
  • “Buddy taping” the broken to another toe is sometimes appropriate
  • Wearing rigid or stiff-soled shoes to protect the toe from further damage and keep it in the proper position
  • Surgery may be required if the break is severe or the bone is badly displaced.

If you believe you may have a fractured toe, don’t delay. Make an appointment today at one of our two conveniently located offices in Fishersville or Charlottesville.

Overcoming Chronic Ankle Instability

June 21st, 2015 by Blue Ridge Foot and Ankle

If you characterize yourself as having “weak ankles,” and find your ankle giving way or turning when you are walking, running, playing golf, tennis, basketball, or other sports, you may suffer from chronic ankle instability. At Blue Ridge Foot & Ankle Clinic, we frequently treat patients for this condition. Other symptoms of chronic ankle instability include persistent discomfort and swelling of the ankle, pain or tenderness, and just a general feeling that the ankle is wobbly and unstable.

Causes of Chronic Ankle Instability

Most often, chronic ankle instability is the result of an ankle sprain or sprains that have not healed completely or were not rehabilitated fully after initial injury. When you sprain your ankle, the ligaments (connective tissues around the ankle) are over stretched and sometimes even torn, leaving them like a rubber band that has lost its ability to snap back. Physical therapy and exercises to properly rehabilitate the muscles around the ankle are necessary to strengthen them and retrain the tissues that are responsible for balance. If this rehabilitation does not happen, the likelihood of spraining the ankle again is greatly increased. With each additional sprain, the ligaments get weaker and additional ankle problems can develop.

Surgical and Non-surgical Treatments

After a thorough exam, which may include digital x-rays at one of our central VA locations, Dr. Stewart M. Chang or Dr. Kevin P. Murray will determine the best treatment for your chronic ankle instability based on your test results and level of activity. Common non-surgical treatments include:

  • Bracing: An ankle brace can provide support and keep the ankle from turning and thereby prevent another sprain.
  • Physical therapy: Exercises and other treatments can strengthen the ankle and retrain your muscles resulting in an improved range of motion and balance.
  • Medication: Ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed to relieve pain and inflammation.

In severe cases, or if you are not responsive to non-surgical treatments, our board certified podiatrists many recommend surgery. If you are experiencing chronic ankle instability and would like more information about your condition, call our Charlottesville office (434-979-8116) or our Fishersville office (540-949-5150) to schedule an appointment or use our online appointment request form.

What is a Sesamoid Injury?

June 17th, 2015 by Blue Ridge Foot and Ankle

Sesamoid Injuries

Perhaps you have never heard of a sesamoid, but at Blue Ridge Foot & Ankle Clinic we see many people who are experiencing foot pain as a result of sports and leisure activities that put pressure on the ball of the foot, such as basketball, running, football, golf, tennis, or ballet, which can result in a sesamoid injury.

What are Sesamoids?

A sesamoid is a bone embedded in a tendon. In the foot, the sesamoids are two pea-shaped bones located in the ball of the foot, beneath the big toe joint. Sesamoids act as a pulley for the tendons, helping the big toe move normally and also providing necessary leverage for the big toe when it pushes off during walking and running. These sesamoids are also the weight-bearing surface for the long bone connected to the big toe, called the metatarsal bone.

Sesamoid Injuries

Sesamoid injuries can involve the bones, tendons, and/or surrounding tissue in the joint. There are three main kinds of sesamoid injuries:

  • Turf Toe: This injury of the soft tissue surrounding the big toe joint usually occurs when the big toe is extended beyond its normal range. You may feel a “pop” at the moment of injury and will usually feel a sharp pain, followed by swelling.
  • Fracture: A break in a sesamoid bone can either be acute–caused by a trauma or impact to the bone–which results in immediate pain and swelling at the site of the break; or chronic–due to repetitive stress or overuse–which is characterized by ongoing pain that increases with activity and is relieved with rest.
  • Sesamoiditis: This injury is a chronic inflammation of the sesamoid bones and tendons that is usually caused by overuse and activities that put increased pressure on the sesamoids. Its symptoms are a dull, longstanding pain beneath the big toe joint that usually worsens with particular activities or certain shoes.

Diagnosis and Treatment

Our board certified foot and ankle surgeons, Dr. Stewart M. Chang and Dr. Kevin P. Murray are experts in the central VA area in diagnosing sports related injuries. After a thorough examination of the foot and big toe area, the doctor may evaluate your walking and the wear pattern of your shoes. Digital x-rays, which can be done in either our Charlottesville or Fishersville office, may also be ordered. Once the diagnosis is confirmed, there are a variety of non-surgical treatments available, with surgery reserved for those people who do not respond to those treatments.

If you suspect you may have a sesamoid injury, contact one of our offices today to make an appointment.



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