| Heel Pain | Bunions | Hammertoes | Toenail Disorders |

| Calluses | Athlete's Foot Tendonitis | Flatfoot | Fractures |

| Ankle Sprains | Plantar Warts

  Heel Pain... Heel pain is one of the most common afflictions we see here at Family Foot and Ankle Clinic. Life simply keeps us on our feet a great deal of the time, and most of that time is on hard surfaces such as cement floors. The heel takes the brunt of most of that pressure. Let's face it, the bottom of our foot is not flat, and most of the surfaces that we walk on are flat. So guess which one usually wins out in the end? The ground!  Much of heel and arch pain is caused by this losing battle between the hard ground and our feet. Your heel and arch tries to compensate for and absorb the shock of every step, not to mention the strain of standing for long periods of time. We have 28 bones in each of our feet and joints connecting all those bones. These joints along with the muscles, tendons, and ligaments that connect them, work together to attempt to absorb this tremendous shock. If your foot is relatively inflexible, you may have less shock absorption which may translate into bruising of the heel bone and the formation of calluses under the great toe and outside of the foot. If your foot is too flexible, you may have a relatively high degree of strain on the muscles and ligaments in your heel and arch leading to a variety of inflamed conditions of the foot including Plantar Fasciitis and Tendonitis. A flexible foot that has an arch that flattens may also lead to a strain and compression of a nerve that courses through this area. This condition is known as Tarsal Tunnel Syndrome.

 
Bunions.....  "Bunion" is a common term describing a condition of the foot in which there is a enlargement or prominence of the big toe joint on the inside of the foot. The word "bunion" is derived from the French word meaning "turnip". Many people with a bunion can develop a reddened swollen inflamed "sack" over the bunion which gives the appearance of a turnip. There are strong hereditary factors in the development of a bunion. This is tied into the overall biomechanics of the foot and the resultant lack of stability at this great toe joint. Appropriate shoes and Orthotics may help to stabilize the arch and help in the treatment of the bunion. Surgical correction is a common outpatient procedure to reduce this bunion deformity and straighten the great toe so that it may function better.

  Hammertoes...   Hammertoes as they are commonly known are toes that have acquired a contraction at one or more of the small joints within the toe. This gives the toe a bent appearance. Toes that are bent will naturally lead  to increased rubbing against the shoes causing discomfort and the formation of hyperkeratosis, or the common "corn". The formation of this hard skin material is the result of the toe shape caused be the bone and joint underneath it. Many people simply attempt to treat the corn only by using "corn pads". This is only a "band-aid approach" to treating the problem, as it does not address the underlying cause of the problem. Wearing more appropriate shoes and accomodating the area with padding is a first step in reducing the pressure. Many times this is unsuccessful, and more permanent means are needed to address the problem.  A common surgical procedure to straighten the toe is sometimes necessary to completely relieve the pressure causing the corn. This is performed by Dr. Sommer in the convenience and comfort of an outpatient surgery center, usually under local anesthetic.

 
Toenail Disorders.......Toenail problems come in many assorted shapes and sizes. Many people are familiar with the "fungus toenail".  This fungus is an organism that causes the familiar "athlete's foot" infection. In the case of toenails, the fungus grows underneath the nail near the "root" of the nail. This makes it difficult to treat with anti-fungal creams and liquids since the medicine has difficulty getting under the nail. More recently there have been more successful anti-fungal medicines in pill form. These are able to get a higher concentration of medicine to the "root" of the problem. This medicine is prescribed by Dr. Sommer typically for three months, though the final results of the medicine are not seen until six to eight months. Sometimes, because of a severe deforming of the nail caused by the fungus, it is necessary to permanently remove the toenail so the it does not cause continued pain and worse infection. Toenails do not have to have a fungus to have other problems. A good example is the ingrown toenail. This is wear the edges of the nail have curved and protruded into the skin, sometimes cutting through the skin which can lead to an ingrown nail infection. This is treated in the office under local anesthesia whereby the edge of the nail is removed. This is a relatively pain-free procedure, almost never requiring prescription pain medication. Future care can then be taken to trim the toenails straight across and not trimming them too short.

 
Calluses... Not to be confused with a plantar wart, a callus is simply a build-up of hyperkeratosis or hard material produced by the skin as a result of excessive pressure or irritation on a small area of the skin on the bottom of the foot. This is almost always due to the underlying "architecture" of the bone beneath the callus. These calluses can be periodically trimmed here in the office (it is dangerous and never recommended that you do this yourself). These calluses can also be specially padded or treated with Orthotics specifically fitted by Dr. Sommer for you to help evenly redistribute the weight away from this callused area. In some cases, when these calluses continue to be painful and unresponsive to care , it is necessary to surgically correct the underlying cause of the uneven pressure. Again, this is a local anesthetic procedure that Dr. Sommer performs in an outpatient surgery center.

 
Athlete's Foot .... You don't need to be an athlete to suffer from athlete's foot infection. Caused by a small variety of funguses, athlete's foot is typically very easily treated with topical anti-fungal creams. For chronic and severe athlete's foot it is sometimes necessary to use an oral anti-fungal medicine. It is important to have an accurate diagnosis of athlete's foot, as some other skin problems can mimic athlete's foot. Follow-up care includes several steps that Dr. Sommer will explain so that that chances of recurrence can be kept to a minimum.

 
  Tendonitis.... There are many tendons in the human foot, anyone of which can develop an inflammation through being strained or overworked. Many times, when we take up a new sport or work activity, our tendons need time to adapt to this new activity. When that doesn't happen, the tendon may respond by becoming inflamed, swollen and painful. Specific treatments can be prescribed by Dr. Sommer in the general areas of resting, icing, compression, elevation and anti-inflammatory medication. These treatments need to be very specific to the tendon inflamed, since there is a difference between your Achilles tendon and the tendon on top of your big toe.

 
Flatfoot.... Even though it usually does not keep you out of the Army these days, flatfoot can still cause many a problem. In very general terms, having a flat foot leads to poor alignment of the joints in your foot and ankle which can lead to everything from localized arthritic conditions to muscle and ligament strain. Dr. Sommer can prescribe the necessary support for your feet as well as discuss the right shoes for you and the appropriate stretching and strengthening exercises for you feet.

 
Fractures....  There are 28 bones in your foot, anyone of which can suffer a fracture, or broken bone. Though most commonly this is caused by some type of sudden trauma, a fracture can also occur through short-term overuse. This is the case with a "stress fracture". It is otherwise known as a "march fracture as it is known to soldiers going on long marches.  The bone in your foot cracks, though you nay not perceive it happening. It becomes painful and swollen with activity as you continue to walk on it over the next days and weeks. Unless it is properly diagnosed and treated, it will continue to cause pain.

 

Ankle Sprains ....Ouch! Ankle sprains sure can hurt. Most of us at one time or another have experienced an ankle sprain to some degree. Sprains vary from mild sprains causing mild temporary discomfort to severe sprains causing pain, swelling, bruising and the possibility of fractures. This second type of sprain should always receive medical care. After examining and x-raying the ankle, Dr. Sommer is then able to assess the degree of injury. Depending on the severity, he may prescribe an ankle brace or even a cast if necessary.

The recovery phase of an ankle sprain is crucial to the long-term outcome of an ankle injury. Ankle ligaments may be stretched and possibly ruptured. Strengthening and range of motion exercises or necessary to try to restore complete function to the ankle. When joints are injury, they can lose their sensory ability to control their own coordination. This is called a loss of proprioception. Strengthening and flexibility plans can help to restore proprioception to the ankle joint.

 

 
Plantar Warts... Plantar warts have nothing to do with peanuts or things that grow in the ground.  These little calluses are caused by a virus that infects the skin and causes the epithelial skin cells to produce a hard materaial called hyperheratosis. Often times you may hear of "seed warts." This expression came from the tiny black dots sometimes seen on a plantar wart. These are not seeds at all but very small blood vessels called capillaries that grow out from the wart and are clotted at the end giving the appearance of a black dot.  Plantar warts can sometimes be difficult to cure with over-the-counter liquids and patches. These warts may be very thick and require professional paring down of the callus so that topical remedies can be more effective. Sometimes even this is not enough to eliminate the wart. Surgical excision and/or cauterization of the wart are common treatments Dr. Sommer uses to remove the plantar wart. This is most often done in the convenience of his office under local anesthetic. If there are rather large or many warts on the foot, sometimes this surgery is more comfortably performed under sedation at an outpatient surgery center.