The posterior tibial tendon is located on the inside of your ankle and plays a major role in supporting and maintaining the arch on the bottom of the foot. Due to the high demands of the tendon with every day life, it can result in overuse of the tendon. This overuse is referred to as posterior tibial tendon dysfunction. When this occurs, patients will eventually develop a flat foot deformity and loss of arch height due to the weakened tendon no longer being able to support the arch. This condition is commonly seen in middle-aged women. Those with diabetes also have an increased risk.
The major problem with posterior tibial dysfunction is that it is a progressive disorder. This means that it will get worse overtime. The initial symptoms of the condition are pain and tendonitis; however there is normally no decrease in strength of the tendon or loss of arch at this stage. As it worsens, the tendon will develop tears and the patient will eventually end up with a decrease in the arch height and a flat foot. With early diagnosis, the progression can normally be slowed, or halted, through the use of orthotics, bracing, immobilization and physical therapy. If the dysfunction is left untreated, or progresses, then it may eventually have to be treated with surgical intervention.
–Dr. Colleen Law
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If your child or adolescent develops heel pain, chances are it’s due to Sever disease, which is also known as calcaneal apophysitis. Sever disease is one of the most common sources of heel pain in adolescents and most commonly affects children between the age of 6-13 who are active and involved in sports. Sever is an irritation or inflammation of the heel bone growth plate which is a result of the heel bone growing faster than the surrounding muscles and tendons. Along with repetitive microtrauma, these tight tissues cause increased pull on the growth plate, which results in pain. It is commonly seen in soccer players. Traditionally Sever used to be more common in boys; however, due to the increasing number of girls involved in organized sports, it is becoming more common in the female population.
Sever disease will eventually resolve on its own without any long-term complications. All treatments are symptom based and some children may have to decrease or take off some time from sports until the pain goes away. In some severe cases, children may have to be immobilized in a walking boot for a couple of weeks until the pain subsides. Sever patients commonly have a tight Achilles tendon, so stretching exercises are very important to help try to decrease some of the pull on the growth plate. Anti-inflammatories and ice are also recommended. Return to activity is based on relief of symptoms and should be done gradually. When returning to play, gel heel cups can be used in the cleats or sneakers in order to help provide some cushion.
—Dr. Colleen Law
If you begin to develop a nagging pain without significant change in your mileage or training, you must consider your shoe gear. Running shoes typically are good for about 300-500 miles depending on running surfaces, experience, and size of the runner. These first few signs of a nagging pain is usually a way of your body telling you that you need a new pair of sneakers.
Another important way to prevent injuries when it comes to running shoes is to find a type of shoe that is most compatible with your foot structure. Everyone’s feet are different so a type of shoe that works well for your friend, may not work as well for you. People who have a flatter arch and overpronate need more of a motion controlled stability type shoe, whereas those who have a high arch and underpronate do better with more cushioned and neutral type shoe. Especially if you are new runner, I would recommend going to your local running store to help you find a pair of sneakers. These stores typically have experienced runners who will evaluate your foot type as well as running goals to help find you a shoe that would work the best for you. Once getting your new sneakers, make sure you take a couple of days walking around in them prior to running in order to help break them in. Also, another good tip is to buy two pairs at once and alternate running in them every other day in order to slow down the wear of an individual pair.
-Dr. Colleen Law
Heel spurs are a common injury that many runners experience along with plantar fasciitis. Below is a brief description of heel spurs, and how you may be available to avoid this uncomfortable injury.
Heel spur syndrome, related to plantar fasciitis, occurs after calcium deposits build up on the underside of the heel bone. Heel spurs form gradually over many months. Both plantar fasciitis and heel spurs can be avoided by proper warm-up that includes stretching the band of tissue on the bottom of the foot. The soft tissue injury is usually the cause of the pain, and not the spur itself. If you are having pain in this area of the foot, please give Blue Ridge Foot & Ankle a call!
Common Running Injuries-Plantar fasciitis
Plantar fasciitis is a common injury that many runners experience. Below is a brief description of the injury, and what you may be able to do to prevent plantar fasciitis.
Plantar fasciitis (arch pain)—Arch Pain is often caused by frequent stress on the plantar aspect, or the bottom of the foot. When the plantar fascia, a supportive, fibrous band of tissue running from the heel to the ball of the foot, becomes injured, pain on the bottom results. Forefoot or rear-foot instability with excessive pronation may result in plantar fasciitis. Overtraining may contribute. Shoes with good mid-foot stability may prevent plantar fasciitis. If pain persists, visit us at Blue Ridge Foot & Ankle!
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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.
Nail disorders—Ingrown 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.
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.
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
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.
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.
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.