Archive for the ‘Diabetic Foot’ Category

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

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.


October 8th, 2014 by Dr.Chang

Benefits of Exercise Walking

Metabolically, walking helps control weight, blood sugar, and cholesterol levels. A brisk walk can burn up to 100 calories per mile. Walking is the perfect complement to a sensible diet to lose weight and keep it off.
Walking improves cardiovascular fitness. As an aerobic exercise, walking gets the heart beating faster to transport oxygen-rich blood from the lungs to the muscles. The heart and lungs grow more efficient with a regular walking regimen, reducing blood pressure and the resting heart rate. Walking is even a central element of medical rehabilitation including cardiac rehabilitation programs.
Psychologically, walking generates an overall feeling of well-being, and can relieve depression, anxiety, and stress by producing endorphins, the body’s natural tranquilizer. A brisk walk will relax you and stimulate your thinking.
If you have any problems with weight, respiration, blood pressure, pulse rate, or cholesterol, check with your doctor before walking. The same goes for diabetics, smokers, or people with pre-existing injuries or a family history of heart problems.
*Based on a document produced in cooperation with the: American Podiatric Medical Association.
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Blue Ridge Foot and Ankle Clinic

887 A Rio East Court Charlottesville, VA 22901
 417 South Magnolia AveWaynesboro, VA 22980
New office in Fishersville will open early 2015 @
66 Parkway Lane Suite #102
Fishersville, VA 22939
Blue Ridge Foot and Ankle Clinic has been a part of the Waynesboro and Charlottesville communities for over 20 years. Podiatrists Dr. Kevin Murray and Dr. Stewart Chang offer services in sports podiatry, foot and ankle problems and diabetic foot care. Our friendly, accommodating team of Certified Podiatric Medical Assistants look forward to welcoming you to our practice.

The New Fishersville Office Construction

August 28th, 2014 by Dr.Chang














Walls going up! 10.8.14

Walls are going up! 10.8.14


8.25.14 SAMSUNG

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

Blue Ridge Foot and Ankle Clinic has been a part of the Waynesboro and Charlottesville communities for over 20 years. Podiatrists Dr. Kevin Murray and Dr. Stewart Chang offer services in sports podiatry, foot and ankle problems and diabetic foot care. Our friendly, accommodating team of Certified Podiatric Medical Assistants look forward to welcoming you to our practice.



February 11th, 2014 by Dr.Chang

Ingrown nails

One of the more common and less glamorous conditions we see is ingrown toenails.   Sometimes there is an associated infection but many times it is pain along the nail border that brings patients to our office.  Many people suffer with ingrown nails for years not knowing anything can be done.  There is a simple, pain relieving procedure for this problem!   The procedure has been around for many years and most of the time offers a permanent solution.  The offending nail edge is removed.  A chemical is then applied to destroy the root.  This simple procedure is done in the office and requires no down time.  Daily cleansing of the area along with a band aid for 3 – 4 weeks is all that is needed.

Ingrown toenail


April 10th, 2013 by Dr.Chang

          Bunions are enlargements of the joints at the big toe (hallux valgus) or little toe (Tailor’s Bunionette). However, bunionsbunion before are more than just bony protrusions: they are structural abnormalities in the foot, misalignments caused by hereditary factors or lifestyle habits such as wearing narrow shoes, high heels, and tight sporting or dance shoes. The structural change causes the “V” shape, or “valgus” of the big toe, that is marked by an enlarged joint.
          Especially because your feet support the weight and movement of your entire body each day, it makes sense that any sort of disturbance to the structure of your bunionfeet can cause considerable pain. However, the “V”ing of your first toe joint places considerably more stress on the joint than when the bones in the joint connect in a straight line. Bunions can therefore be excruciatingly painful. Luckily, treatment 
and surgery for bunions are highly effective means to limiting your pain and allowing you to return to your daily activities!
          Initial, non-invasive treatments for bunions include side lining your tight-fitting shoes in favor of comfortable, well-fitted footwear (shoes that do not bunch your toes together or cause pressure on your toe joints). Splints and orthotics can also do wonders for repositioning your toes. Bunions caused by arthritis in the joint are treated well by medications that can reduce pain and swelling. If these methods do not improve your foot pain, your podiatrist may suggest surgery, which is a highly effective form of addressing the structural misalignment in your foot.
          The main goal of bunion surgery is to improve your ability to walk and do other activities on your feet. Bunion surgery straightens the structural misalignment of the bones in your foot, decreasing the pressure on the joints. As a result of your surgery, your pain will be drastically improved, if not eliminated.
          Bunion surgery involves work on the soft tissue and/or bone of the big toe joint in order to relieve the pain in the joint, and to restore normal alignment to the joint. Not all bunions are created equally, and, as follows, not all patients with bunions will receive the same sugery. In fact, there are over one hundred kinds of bunion surgery!
Common types of bunion surgery include:
*Removal of the metatarsal head (the part of the foot that is bulging out toward the center of your body). This is called an “exostectomy” or “bunionectomy.”
*Realignment of the soft tissues (ligaments) around the big toe joint.
*Removal of a small wedge of bone from the foot (metatarsal osteotomy), or from the toe (phalangeal osteotomy).
*Removal of bone from the end of the first metatarsal bone, which joins with the base of the big toe (metatarsophalangeal joint). At this joint, both the big toe and the metatarsal bones are reshaped (resection arthroplasty).
*Fusion (arthrodesis) of the big toe joint
*Fusion of the joint where the metatarsal bone joins the mid-foot (Lapidus procedure)
*Implant insertion of all or part of an artificial joint
Bunion after 
          The more involved the bunion is, the more complex the surgery. In the case that the joint is severely deformed, a surgeon may stabilize the re-alignment with wires, stitches, screws, or plates. Depending on your foot misalignment, your surgeon will suggest the optimal procedure for you.
          Bunion surgeries are most frequently conducted as an outpatient operation, and take about one hour. Most often, patients receive local anesthetics with IV sedation (twilight anesthisa). You will be required to have a follow up visit to take your stitches out in two weeks.  In most cases the healing process takes about 6 weeks.
          Unfortunately, there are many distressing myths about bunion surgery that you may find while browsing the internet. Let us help to quell your fears by assuring you that an overwhelming number of bunion surgeries (over 90%!) are successful in relieving pain and properly realigning the joint.
          While surgery can be painful, bunion surgery is no more painful than any other invasive procedure. The greatest cause of pain, in fact, is the swelling after surgery.  Remember that, because your foot is below your heart, it is more difficult for your veins to fight gravity in order to return blood from your foot to your heart. Therefore, the swelling can often throb, and you will have to consistently elevate your foot. Furthermore, your feet have an incredible amount of nerves without much soft-tissue padding around them. The swelling can aggravate the nerves and cause pain. However, in the long run, bunion surgery vastly reduces pain that bunions cause with walking and standing for long periods of time.
          Another myth is that bunions can reemerge after surgery. While reoccurrence is possible, it is not likely. Furthermore, a bunion would come back over time and due to a lack of change in lifestyle and habits that caused your bunion in the first place. Go into the surgery aware of the fact that you will have to stay committed to the health of your feet! Side-lining your high heels and prioritizing comfortable shoes and time for foot exercises will be necessary for the longevity of the surgery.
          Finally, depending on your specific surgery, you won’t necessarily have to take a lot of time off of work. Most patients can return to a desk job after two weeks, and to an active job after two months. Additionally, over 90% of our patients report an amazing decrease in pain and increase in function after their surgeries!
          Depending on the surgery, you may be placed in a surgical boot and able to walk within two weeks of the surgery. With more complex surgical procedures, you may be required to wear a cast or splint, and walk on crutches.
          In order to best maintain the results of your surgery, it will be important for you to continue to be dedicated to the health and wellbeing of your feet. Committing to lifestyle changes, such as not wearing tight shoes and doing prescribed exercises and stretches for your toes and feet, will drastically increase the benefits of surgery, and reduce the likelihood of any future pain.
            Dr. Chang and Dr. Murray to have decades of experience successfully treating and operating on bunions. Remember that treatment and surgeries are most successful when you address and treat your bunion early. So contact us at Blue Ridge Foot and Ankle – we can help you solve your foot pain!
Comment on this post to share your thoughts or contact Blue Ridge Foot and Ankle Clinic. We’d love to hear from you!
Blue Ridge Foot and Ankle Clinic
Charlottesville Podiatrist Location: 887 A Rio E Ct., Charlottesville VA, 22911 (434) 979-8116
Waynesboro Podiatrist Location: 417 S. Magnolia Waynesboro,VA 22980       (540) 949-5150
Blue Ridge Foot and Ankle Clinic has been a part of the Waynesboro and Charlottesville communities for over 20 years. Podiatrists Dr. Kevin Murray and Dr. Stewart Chang offer services in sports podiatry, foot and ankle problems and diabetic foot care. Our friendly, accommodating team of Certified Podiatric Medical Assistants look forward to welcoming you to our practice.

Good Morning! As many of you know diabetes affects the health of your feet.  Many of the patients that we see daily are suffering from diabetes.  So, today we wanted to share some important information with you from our friends at the American Diabetes Association.  TODAY (Tuesday, March 22nd) is Alert Day and Americans are encouraged to take the risk test to see if they are at risk for developing diabetes.  We encourage you to take a few minutes out of your day today to take the test.  Here are more details from the American Diabetes Association:

Take the Risk Test TODAY!

Tuesday, March 22, 2011 is the 23rd annual American Diabetes Association Alert Day, a one-day, “wake-up” call  asking Americans to “Join the Million Challenge” by taking the Diabetes Risk Test and find out if they are at risk for developing type 2 diabetes and if they are at high risk, to speak with their health care provider.

At the end of 2010, the American Diabetes Association surpassed their goal of inspiring one million Americans to join the American Diabetes Association’s movement to Stop Diabetes®.  To continue this momentum, the Association is asking the public to “Join the Million Challenge” by rallying one million people to take the Diabetes Risk Test and find out if they are at risk for developing type 2 diabetes, beginning on Diabetes Alert Day on March 22, 2011 and ending April 22, 2011.

Diabetes is a devastating disease that affects nearly 26 million Americans including. A quarter of those affected by diabetes are not aware that they have the disease.  If current trends continue, one in three American adults will have diabetes by 2050. In addition, approximately 79 million, or one in three American adults have prediabetes, which means that their blood glucose (sugar) is higher than normal but is not high enough to be classified as diabetes.  Without intervention, individuals with prediabetes are at a much higher risk for developing type 2 diabetes.  Seeking to change the future of diabetes, the American Diabetes Association is using Diabetes Alert Day to help identify the undiagnosed and those at risk for type 2 diabetes by educating people about diabetes risk factors and warning signs.

Unfortunately, people with type 2 diabetes can live for years without realizing that they have this serious disease. While some people with diabetes exhibit noticeable symptoms (such as frequent urination, blurred vision and excessive thirst), most people diagnosed with type 2 diabetes do not experience these overt warning signs at the time that they develop the disease.  Often, type 2 diabetes only becomes evident when people develop one or more of its serious complications, such as heart disease, stroke, kidney disease, eye damage or nerve damage, which can lead to amputation.

2011 Diabetes Alert Day

“Studies have shown that type 2 diabetes can be prevented or delayed by losing just 7% of body weight (15 pounds if you weigh 200) through regular physical activity (30 minutes a day, five days a week) and healthy eating,” said Gina Perales Hethcock, Director of Communications and Hispanic Initiatives for the North Texas office. “The American Diabetes Association hopes that this American Diabetes Association Alert Day will encourage people to ‘Join the Million Challenge.’ By understanding your risk, you can take the necessary steps to help prevent the onset of type 2 diabetes.”

To help people determine their risk for type 2 diabetes, the American Diabetes Association provides the Diabetes Risk Test, which entails answering simple questions about weight, age, family history and other potential risk factors for diabetes. People at high risk are encouraged to speak with their health care providers.  You can “Join the Million Challenge” by getting your free Diabetes Risk Test (English or Spanish) at, 1-800-DIABETES (1-800-342-2383) or text JOIN to 69866 (Standard data and message rates apply).  Although Diabetes Alert Day is a one-day event, the Diabetes Risk Test is available year round.

The Association is also encouraging the public to help spread the word about Diabetes Alert Day by sending out messages on Facebook and Twitter.  You can download a Diabetes Alert Day application to post on your Facebook page or you can tweet about the importance of understanding one’s risk for type 2 diabetes and provide a link to the Diabetes Risk Test at

The primary risk factors for type 2 diabetes are being overweight, sedentary, over the age of 45 and having a family history of diabetes.  African Americans, Hispanics/Latinos, Native Americans, Asian Americans and Pacific Islanders are at increased risk, as are women who have had babies weighing more than nine pounds at birth.



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