Foot and Ankle Doctor Blog Space

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Ganglion Cysts- Foot Lumps

If you are noticing a fluid like lump on your foot, you probably have a ganglion cyst. Ganglion cysts are not cancerous and do not spread to other areas, however cysts may appear at multiple locations. They commonly appear on the hands and wrists and feet. Ganglion cysts form lumps beside joints or tendons and is filled with a viscous fluid. Irritation at a joint or tendon is believed to cause the formation of a ganglion cyst. They may grow in size or disappear spontaneously.

At Foot& Ankle Doctors, Inc we offer a variety of treatment options, which include:

  • Monitoring – if the cyst is painless intervention may not be needed since it may disappear completely on its own

  • Aspiration – placing a needle into the cyst to remove fluid and allow the cyst to decompress

  • Shoe modifications – padding may be used to reduce irritation and pressure of the cyst

  • Surgery – involves removing the cyst and a portion of the joint capsule or tendon sheath

It is important to note that regardless of the treatment option ganglion cysts may return, even with surgery.

Dr. Dardashti

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Turf Toe.. More Serious Than You Think

Turf toe sounds like a minor injury that only involves a single toe, however it can be a career ending injury like it was for Deion Sanders. It commonly occurs in athletes who play sports on artificial turf, hence the name “turf” toe. This injury occurs when athletes bend their big toe beyond its normal flexibility. Cleats often get stuck in divots in artificial turf leading to hyper extension of the toe. Hyper extension of the big toe can take place every time the athlete pushes off with their toes to start running. This motion occurs multiple times during every game and practice eventually over time the big toe becomes sprained.

The severity of the injury is graded from 1 to 3

Grade

Injury

Treatment

1

Mild sprain

  • RICE – rest, ice, compress, elevate

  • Taping the toe to restrict movement

  • Non-steroid anti-inflammatory medication

2

Partial tear of the capsule and ligaments

  • Same as Grade 1 + walking boot to immobilize the big toe joint

3

Complete tear of the capsule and ligaments

  • Same as Grade 1 + walking boot or cast for immobilization

 

Physical therapy should also be implemented to prevent stiffness in the joint and gain adequate range of motion. Surgery is often not needed, but is an option for some cases.

Foot& Ankle Doctors, Inc recommend athletes who return to sports should have their shoes modified with a steel shank or stiff insoles to restrict hyper extension of the toe.

Dr. Nejad

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What is a neuroma?

What is a neuroma? “-Neur” is root for nerve and “-oma” is root for swelling or tumor.

Neuroma is a benign over growth of nerve tissue. Neuromas commonly occur in the interspace between the 3rd and 4th toe and are referred to as a Morton’s Neuroma.

Overgrowth of the nerve in the small interspace leads to compression in that area creating pain and irritation. Symptoms include a tingling, burning or numbing sensation, and pain in the ball of the foot.

Shoes are the culprits when it comes to neuromas, especially high heeled shoes or shoes that cause the toes to be squished together. With repeated irritation the nerves become swollen and inflamed leading to the development of a neuroma.

Treatment options for neuromas include: cortisone injections, sclerosing injections, custom orthotics, shoe modifications, padding, and in severe cases surgical removal.

If you think you have a neuroma come visit one of our doctors at Foot & Ankle Doctors.

Dr. Dardashti

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My Child Has Heel Pain

Severe’s disease AKA calcaneal apophysitis is a growing pain at the back of the heel in young adolescents between the ages of 8 to 14. The heel bone contains a growth plate where the Achilles tendon attaches. Sever’s disease can occur for various reasons such as:

 The heel bones growth quicker than the ligaments that attach to it causing inflammation and pain

 A tight heel cord

 The undeveloped heel bone becomes stressed from repeated forces such as running and pounding on hard surfaces

 Obesity

 Biomechanical problems

Regardless of the etiology, children will often complain of pain at the back of their heel during sports, when they stand for too long or from shoes that rub at the back of their heels.

Diagnosis can be made based on the child’s symptoms and by performing a squeeze test. A positive squeeze test is defined as elicited pain when the child’s heel is squeezed from side to side.

Treatment for Severe’s disease is simple and mainly involves resting. It is advised that children take time off from sports and physical activity, stretch the leg muscles, ice the heel and take anti-inflammatory medications if needed to help reduce the swelling and alleviate pain. Gel inserts and orthotics may be recommended to support the heel. In severe cases a short leg cast may be applied to immobilize the foot and ankle and allow healing to occur.

If your child experiences symptoms of Sever’s disease come see our staff at Foot & Ankle Doctors, Inc.

 

Dr. Nejad

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Toenail Fungus

Our staff at Foot & Ankle Doctors, Inc. understand that toenail fungus is an embarrassing problem. It can lead to thickened brittle yellow discolored nails that may be painful. Fungal nails are also referred to as onychomycosis and are caused by microscopic fungi, yeasts and molds. A sample of the infected nail should be taken and sent to a lab to determine the causative agent. There are a variety of treatment options available, however fungal infections are difficult to treat and can return after treatment has finished.

The different treatment options include:

 Oral medications – required to be taken for 6-12 weeks

 Topical nail lacquer – can be used twice a day for up to 4 weeks, but is often ineffective in severe cases

Laser therapies – involve multiple sessions to achieve clearance

We will help you determine the best course of action to treat your toenail infection. It is advised during treatment to discard old shoes, which may house fungi and use antifungal spray or powder to prevent reinfection.

 

Dr. Dardashti

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Choosing a Top Quality Nail Salon

We all want to look our best and do a little self pampering and what better way to pamper ourselves than with a manicure and pedicure.

Nail salons provide services to hundreds of people and it’s important to choose a high quality salon with adequate hygiene to avoid accidental exposure to fungus, bacteria and viruses. To avoid a nail salon nightmare follow this guide:

1. Licensing – Make sure the salon is licensed and the staff has proper training. Podiatrist commonly see infected ingrown toe nails as a result of nail technicians that were too aggressive with their nail trimming.

2. Open cuts – avoid the salon if you have any open cuts or wounds on your feet or legs. Exposing any open wound to an environment like a salon that has a high volume of customers sharing the same chairs and whirlpools may lead to.

3. Whirlpools – avoid soaking your feet in whirlpools or the water basin connected to the chair. These are often difficult to clean and harbor bacteria. You can ask to have your feet soaked in a separate tub or use a disposable liner in the whirlpool.

4. Tools – ask the salon if the tools used are autoclaved or if disposable instruments are used. You can bring your own tools with you and clean them yourself to avoid the spread of warts.

5. Bring your own nail polish – salons use the same polish brush for each of their customers and this can result in the spread of nail fungus. Bringing your own polish will avoid any cross contamination and reduce your risks of developing a fungal infection.

Podiatrists commonly see infected ingrown toenails, plantar warts and fungal infection as a consequence from nail salons. If you think you have any of these infections come see one of our doctors at Foot & Ankle Doctors, Inc.

 

Dr. Farshid Nejad

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Kim Kardashian Has Psoriasis

Kim Kardashian has publicly announced on her reality TV show, “Keeping Up With the Kardashians” that she suffers from psoriasis, a genetic skin condition.

Psoriasis forms dry red patches covered with thick silvery scales that can be itchy and sometimes painful. These patches are commonly found on the elbows, knees and soles of the feet. Picking at the silvery scales leads to pin point bleeding a classic hallmark of psoriasis known as an Ausptiz’s sign.

Psoriasis of the feet can be painful and sometimes misdiagnosed as a plantar wart. Our doctors at Foot & Ankle Doctors, Inc. can correctly diagnose you with psoriasis by taking a small sample of the affected area for testing. Complications of psoriasis include psoriatic arthritis that commonly affects the small joints of the feet. Psoriasis cannot be cured, however mild cases can be treated with topical creams, and more severe cases can be controlled with oral medication.

 

Dr. Dardashti

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Podiatrists Preventing Falls

Fall related injuries are a serious burden on the public health system. More than a third of older adults fall each year and injuries can result in fractures, head traumas, decreased function and loss of independence in the elderly. Podiatrists can help reduce fall related injuries by evaluating your gait (the way you walk), your strength and your balance.

 

Dr. Dardashti stresses the importance of finding the right shoes. When selecting shoes he evaluates the heel height, sole slip resistance, sole flexion point (does the shoe bend in the correct area), sole hardness and sole thickness. Finding the right shoe increases support when walking thus boosting confidence and decreasing the fear of falling. Custom orthotics can also improve balance and support by evenly distributing pressure and forces, realigning the body in a more anatomically correct position that improves stability and reduces the likelihood of falling.

 

Muscle weakness can reduce flexibility and balance contributing the falls. For these patients Dr. Dardashti recommends braces and AFO’s (ankle foot orthotics). It’s crucial to stretch the muscles of the leg, foot and toes to improve strength, balance and proprioception. The specialists at the Foot & Ankle Doctors, Inc can provide you with simple stretches you can perform at home to improve your strength and balance.

 

Certain foot problems are risk factors for falls that can be addressed by podiatrists such as lower extremity muscle weakness, limited ankle motion, foot deformities like bunions, toe deformities such as hammertoes and calluses. It’s important to see your podiatrist regularly to address any of these risk factors.

Dr. David Dardashti

 

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War with my wart..

Plantar warts are a nuisance. They are caused by a viral infection(the HPV- human papiloma virus) of the skin. They are often spread in communally shared areas such as locker rooms, swimming pools etc. They often require multiple treatments some of which can be painful. Warts can best be avoided by wearing shoes around swimming pools and locker rooms, changing your socks daily, keeping your feet clean and dry. The HPV virus enters the skin of the foot through cracks in dry skin, cuts or scrapes and thrives in moist areas. Common symptoms of a plantar wart include a small firm outgrowth that resembles a callus, pain when walking or standing or when squeezed from side to side, and or tiny black pinpoint dots. Warts are contagious so don’t pick at it. If you think you have a wart come see Dr. Nejad at the Foot & Ankle Doctors, Inc. Dr. Nejad will best select a treatment option based on the type of plantar wart you have. Plantar warts can present as a solitary wart (a single wart) that may increase in size or as a mosaic of warts – a cluster of several small warts in a local area which are often more difficult to treat. Treatment options include over the counter topical products, acid treatments and bleomycin injections.

Acid Treatments – medications with acids are applied to the wart to remove layers of it at a time. It may stimulate the body’s immune system to fight the wart once the wart is weakened. Multiple applications are commonly required

Bleomycin injection – Bleomycin is a medication that interferes with the growth of the virus destroying it over time. It is directly injected into the wart causing a blood blister to form turning black after a few weeks. The blister can either fall off or is removed by a physician. Injections may be given every 3-4 weeks until clearance is achieved.

Dr. Farshid Nejad

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Got a pump bump?

A Haglund’s deformity also known as “pump bump” is a bony enlargement at the back of the heel that becomes irritated when rubbed against the stiff heel counter of shoes. It commonly presents in women who wear high-heeled shoes (pumps) for long periods of time. The bump appears near the attachment of the Achilles tendon and becomes red and swollen. There is a fluid filled sac called a bursa that sits between the heel bone and the Achilles tendon, which becomes inflamed and very painful with constant aggravation.

Dr. Nejad first recommends taking your shoes off and resting while icing the back of your heel for 20 minutes. He also recommends placing heel pads in the back of your shoes to relieve the pressure from the area of discomfort. In most cases the shoes you are wearing is the culprit so try switching from closed back shoe to an open back shoes or shoes with a softer heel counter. If the pain persists come see Dr. Nejad at Foot & Ankle Doctors, Inc.

 

Other treatment options include shoe modifications, topical anti-inflammatory medications that can directly be applied to the heel, ultrasound treatments and steroid shots to reduce the inflammation. In some patients the Achilles tendon or heel cord is tight and can compress the bursa causing pain. Stretching exercises can reduce the tightness of the Achilles tendon and relief pressure off the bursa. Heel lifts added to the shoe can also reduce the tension from the Achilles tendon. Custom orthotics can aid in controlling abnormal motion of the foot contributing to symptoms. In more extreme cases a walking cast may be used immobilize the foot reducing pressure and allowing the inflammation to subside. If these treatment options don’t provide adequate relief, surgery may be required to remove the bony bump from the heel.

Dr. Farshid Nejad

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