Foot and Ankle Care

If you suffer from a foot or ankle condition, you know how painful it can be to stand or walk. Even a common problem such as a bunion, ingrown nail, callus or improper shoe fit can be debilitating.

Foot&AnkleONE is dedicated to providing expert diagnosis, treatment and rehabilitative care for all foot, ankle and lower extremity problems. Our specialized physicians are the leaders in providing foot care for infants, children and adults. The services we offer range from simple treatments for minor irritations all the way up to advanced procedures like Total Ankle for those with limited mobility. If foot or ankle pain is slowing you down, stop suffering and call Foot&AnkleONE. Take your first step toward better health.

Even the most common foot ailments can cause great pain and limit your mobility. At Foot&AnkleONE, we provide treatment for:

  • Insensitive (numb) feet
  • Diabetic ulcers
  • Hammertoes, claw toes, mallet toes
  • Bunions, corns, calluses & ingrown toenails
  • Plantar warts, heel pain and metatarsalgia (pain in the ball of the foot)
  • Morton’s neuroma
  • Achilles tendon injuries
  • Ankle deformities and clubfoot
  • Foot trauma
  • Athletic injuries

We encourage you to use the information provided here to learn more about your foot or ankle condition.

Because the entire weight of your body is supported by the ankle, it is especially vulnerable to injury. The ankle joint is comprised of ligaments, tendons and bones which may contribute to the pain and discomfort associated with a wide range of conditions, including the following.

Ankle Sprain

Ankle sprains are common sports injuries which occur when the ligaments in the ankle joint are overstretched. This results in tears to the ligaments, the degree of which determines the severity of the sprain. Any movement of the ankle joint or weight placed on the sprain will result in pain.

Achilles Tendonitis

The large tendon on the back of the heel is known as the Achilles tendon. Tendonitis results when the tendon is overused and small tears occur in the tissue. Sufferers of Achilles tendonitis experience swelling and pain in the back of the ankle.

Stress Fracture

A stress fracture is a small crack in the bone that occurs through overuse when the muscles in the ankle become fatigued and rather than absorbing shock, transfer it to the bone. With a stress fracture, pain occurs when direct pressure is placed on the bone or during any activity that puts additional stress on the injured site, such as jumping.

Arthritis

Both osteoarthritis (wear and tear) and rheumatoid arthritis of the ankle joint can cause pain to occur during activities or even at rest.

A bunion is painful enlargement of the joint at the base of the great toe. The bump occurs when the first metatarsal turns inward and the great toe turns outward causing the joint to become swollen and tender.

Causes

There is no single cause of bunion formation. Bunions can be inherited as a family trait or can result from an imbalance of the forces on the toe which cause a bunion to form over time. Other causes include:

  • too wide of an angle between the first and second metatarsal bones resulting in an overly-wide forefoot
  • spreading of the forefoot with age
  • improper shoe fit, especially in combination with flat feet
  • high heel and pointed-toe shoes, while not a primary cause of a bunion, do cause more pain and earlier appearance of a bunion.

Treatment

Proper shoe fit is an important factor in treatment. The goal of non-surgical treatment is to relieve the pressure over the bunion caused by footwear. This may be accomplished by:

  • relaxing the leather of the shoe over the bunion
  • wearing shoes with a wider toe box
  • wearing prescription shoes if the deformity is severe

If conservative treatment does not cause relief, surgery to realign and balance the great toe may be recommended. There are many different surgical procedures for the correction of bunions and the type performed depends on the severity of the condition. In most cases, surgery successfully relieves the painful symptoms. However, some joint stiffness, numbness or deformity can occur after surgery.

Soft corns are caused by pressure on the skin from a bony prominence on the next toe. Shoes with a pointed toe box squeeze the toes together and can cause the corn to develop.

Treatment

Do not try to remove the corn. Wear shoes with plenty of toe room and use lamb’s wool between the toes to separate them.

If these measures do not relieve pain, a simple outpatient surgical procedure can be performed to help make you more comfortable.

Hard Corns

These corns are commonly located on the outside aspect of the fifth toe and the upper aspect of the smaller toes where the skin is dry.

Hard corns are caused by an underlying bony prominence pushing against the shoe. Shoes with narrow and low toe boxes bunch up the toes causing these pressure areas. Hammer toe, claw toe and mallet toe deformities increase the likelihood of hard corm formation.

Treatment

Proper shoe fit is an important factor in treatment. Shoes with high and wide toe boxes usually relieve pressure on the corns. Shaving the corn and then using horseshoe- or doughnut-shaped pads may relieve pressure.

If these methods do not give sufficient relief, outpatient surgery can be performed to improve your comfort.

Hammer, mallet and claw toes are common and often painful deformities of the feet. All of these conditions can cause painful corns and calluses if they rub on shoes.Hammer toes are bent down at the middle joint and up at the joint closest to the foot. Mallet toes are bent down at the end joint only. Claw toes are toes that are bent down at both the middle and end joints and bent up at the joint closest to the foot.

Causes

These conditions are produced by muscle and tendon imbalances that cause the joints to bend. They may range in severity from mild and easily correctable to rigid and fixed.

These problems are most common in females. The high heels and small toe boxes of women’s shoes, worn over long periods of time are major contributing factors.

Treatment

Proper shoe fit is the most important factor in treating these conditions.

Wear shoes with high, wide and long enough toe boxes to avoid direct pressure over the sensitive areas. Soft insoles and soles of the shoe can relieve pressure at the end of the toe. If necessary, an extra-depth shoe can be purchased at a specialty store.

  • Cushion pressure spots with pads available at drug or shoe stores.
  • Shoe leather can be relaxed over the deformed toe to relieve pressure.
  • A special insole (orthotic) may be prescribed to decrease pressure at the end of your toe.
  • Surgical correction is sometimes indicated and is usually performed on an outpatient basis.

Pain in the heel is extremely common. With proper treatment, most patients can be relieved of their symptoms.

Plantar Fasciitis

The most common cause of heel pain is a pull on the heel bone exerted by the muscles and ligaments (plantar fascia shown in illustration above) that support the arch of the foot. This is an overuse condition similar to bursitis of the shoulder or tennis elbow.

Plantar fasciitis is typically very painful in the morning during the first few steps, after sitting and again at the end of the day.

Causes

Plantar Fasciitis can be caused by:

  • being overweight
  • shortened heel cord and calf muscles
  • relaxation of the arch of the foot
  • overactivity
  • infrequently, a heel spur forms at the attachment of the muscles to the heel bone; these heel spurs are not the cause of the pain.

Treatment

Treatment of plantar fasciitis is usually performed in stages according to the duration and degree of pain. Treatment may take many months if the condition has been longstanding.

Treatment usually begins with anti-inflammatory medication, shoe modification, temporary limitation of activities, weight loss and heel cord stretching. Also, night splints are often helpful to stretch the plantar fascia.

An arch support (orthotic) may also be helpful, especially if you have a flat foot. If the problem continues, the tender area occasionally may be injected with cortisone and a local anesthetic. For a difficult, chronic problem, a period of casting may be used to improve this condition.

Surgical treatment is rarely needed. If performed, it aims to partially release the plantar fascia and stimulate healing of the chronic inflammation. Removal of a heel spur, if it is large, may also be done at the time of surgery.

Painful Heel Pad Syndrome

Painful heel pad syndrome usually causes an aching discomfort under the heel bone (calcaneus) which is worse with standing, walking and toward the end of the day. More chronic fat pad pain results from walking on hard surfaces for long periods of time.

Causes

The fat pad can atrophy or waste away with age. An acute bruise of the fat pad can occur from a sudden increase in activiy on hard surfaces.

Treatment

Treatment can include:

  • modifying activity to take weight off of the heel
  • cushioning the heel as much as possible with running or walking shoes and heel pads
    no walking barefoot
  • Surgical treatment is not indicated for this condition. If the pain does not resolve with the treatment outlined above, sometimes a period of complete rest with crutches is necessary.

Until recently, the surgical options for severe ankle pain were limited. Now, those who suffer from arthritis or injury, have a new treatment designed to relieve pain and restore mobility. Foot&AnkleONE specialist, Dr. Scott D. Karr, is the region’s first surgeon to offer the INBONE™ Total Ankle procedure developed by Wright Medical Technology. In comparison to previous ankle replacements, the ONE Total Ankle procedure is a bone-conserving approach that is less invasive. Its design allows for more secure fixation, more precise implant fit and more natural movement. Initial recovery time is approximately six weeks, with little or no rehabilitation required. Thanks to the ONE Total Ankle procedure, patients who have undergone ankle fusion in the past can regain mobility and return to activities such as walking, riding a bicycle or simply wearing different shoe styles.

Patient Education Resources

At ONE, we strive to be your source for the latest information to help you fully understand your condition and treatment options. The links on this page connect you with other useful educational resources.

AAOS Foot & Ankle Articles

AOFAS Foot & Ankle Articles

“For the first time in 15 years, I can ride a bike.”
Sandra Thomas
“After years of pain, my ankle feels great!”
Earl Gerber