A nueroma is a thickening of nerve tissue that most commonly develops in the foot and is referred to as Morton's Neuroma.  This type of neuroma occurs between the third and fourth toes, but can also occur in other locations in the foot.

Anything that causes compression or irritation of the nerve can lead to the development of a neuroma.  The most common offender is wearing shoes that have a tapered toe box or high-heeled shoes that cause the toes to be forced into the toe box.  Other potential causes are activities that involve repetitive pressure to the ball of the foot, such as running or court sports.  An injury or other type of trauma to the area may also lead to a neuroma.

Symptoms may vary from numbness and tingling to sharp, aching, burning, and/or radiating pain.

Injection therapy is a nonsurgical method used at our office in treating chronic nerve pain associated with Morton's type neuromas.

• Local Anesthetic Block can be used to provide some diagnostic information, but has not been shown to be therapeutic.
• Corticosteroid Injections help reduce  inflammation and relieve pain.  This type of injection can provide months to years of relief when used properly.
• Alcohol Injections involve the injection of alcohol into the affected nerve under the guidance of an ultrasound scan. Some studies have shown this to be as effective as surgery and there is an 89% success rate, with 82% of patients achieving complete relief of symptoms.  Usually, (4 to 6 injections to a  maximum to 10) of 30% alcohol is administered every two weeks.

Surgery may be considered in patients who have not responded adequately to non-surgical treatments.  However, the best time to see your foot and ankle specialist is early in the development of symptoms to determine the best approach for your condition.

Get your feet ready in "tip-top" shape for the New Year!  Here are some foot safety tips while working out at the gym:

*  Gradually start new workouts - Stretching your muscles before and after workouts prevents overuse injuries such as stress fractures or tendon strains and sprains.  Untreated or repeated ankle sprains may lead to chronic ankle instability and can cause persistent pain and a "giving way" of the ankle.

*  Wear a well-fitting shoe and sock - Wear athletic shoes that are designed for the exercise or sport.  Shoes that don't support the arch of the foot and provide cushion for the heel - can cause heel pain (plantar fasciitis).  Neuroma or a thickening of the nerve tissue can be caused by shoes that fit too small and your foot may require injections, medication or physical therapy.

*  Good Exercise Form - Poor exercise techniques can result in injury to the tendons or ligaments in your feet and ankles.  Incorrect posture or misuse of exercise equipment can cause decrease stabilization in the foot and ankle, leading to joint and muscle sprains.

*  Protect Yourself from Bacteria - Sweaty shoes, public showers, exercise equipment and pool deck at the gym are breeding grounds for fungus, viruses and bacteria, including drug-resistant strains like MRSA.  Never go barefoot in public places and wear water shoes around wet surfaces.  Also, always cover cuts and cracks in the skin since these can act as entry point for bacteria.

*  Consider Prescription Orthotics - Custom orthotics that fit inside your workout shoe can treat many foot conditions, including chronic heel pain, severe pronation (arch problems), knee pain and abnormal gait.

Make sure your feet stay healthy and in "tip-toe" shape for the holidays.  Here are some preventive tips for you:

• Don't compromise comfort and safety when selecting the right shoes to wear when hitting the dance floor or shopping malls.  Try to stay away from shoes that are not worn very often or have overly hi
  gh-heels and narrow fitting.  These type of shoes can cause blisters, calluses, and swelling and severe ankle injuries.  Selecting a shoe that has a low heel and fits your foot in length, width, and depth while you are standing is a wiser choice.
• Try not to overindulge in holiday cheer - your feet will feel the effects of overdoing it.  Certain foods such as shellfish, red meat, red wine and beer can trigger extremely painful gout attacks.  Uric acid can build up and crystallize in and around your joints triggering gout.
• Be cautious at the pedicure salons.  Nail salons can be a breeding ground for bacteria, including MRSA.  To reduce your risk of infection, choose a salon that follows proper sanitation practices and is licensed by the state.  You may also want to bring along your own pedicure instruments to your appointment.
• Watch for ice and snow.  Wearing a shoe or boot with a traction sole will prevent serious ankle injuries if you incur icy, snowy walking conditions.  Ice accelerates the fall and often causes more severe trauma, because the foot can move in any direction after it slips.
• Listen to your feet - don't let foot pain ruin your holiday fun.  If you notice any pain, swelling or signs of problems, contact your podiatrist. 

Tampa Bay Buccaneers guard Carl Nicks was diagnosed with MRSA in August and the infection has returned in his left foot.  MRSA (Methicillin-Resistant Staphylococcus Aureus) is by definition a strain of Staphylococcus aureus that is resistant to a large group of antibiotics that include penicillins and cephalosporins.  Staphylococcus aureus is a common bacterium that often lives harmlessly on the skin or in the nose. When introduced into the body through a cut or medical incision, it can cause anything from minor skin lesions to life-threatening bloodstream infections, pneumonia or organ damage.

An NFL physicians survey stated that there were 33 MRSA staph infections league-wide from 2006-2008 - 11 a season among 32 teams.  Carl Nicks had an infected blister on the side of the foot and at one point, the infection spread to one of his arms, however, currently he is responding well to treatment.

• Treatment for MRSA skin infection may include a special group of antibiotics and if necessary, surgical drainage.
• The best way to avoid MRSA infections is through hand washing, good hygiene, and avoid skin contact with possible infected individuals.
• At a minimum, hands should be cleaned before and after playing sports and activities such as using shared weight-training equipment, and when caring for wounds including changing bandages.  Note:  One study showed that players who shave their ankles prior to taping up, for instance, also have a greater incidence of staph, because the shaving creates little nicks for infection to enter."
• Cover up wounds that continue to produce pus or drain material.
• Avoid sharing personal items (towels, washcloth and clothing).  Wash linens in hot water and dry on a hot setting in the dryer.

This Halloween season treat your "spider veins" or (telangiectasias) and keep them from forming.  Spider veins are most common on your legs and thighs and appear in women after their childbearing years.  Dark-looking veins can develop in clusters like a spider's web on the surface of your skin in the foot and ankle area as well.

Spider veins are not dangerous, but they can be an eyesore and the risk factors include weight gain, pregnancy and prolonged standing.  Spider veins can be treated on your feet and ankles with the right combination of a daily routine which includes the following:

• Wear compression stockings to get rid of spider veins on your feet and ankles.  These stockings are strong support hoses that compress your dilated spider veins.  The hoses squeeze your ankles and get the blood moving back up through your legs and into your heart.  Compression stockings can be purchased at most drug stores and there are even Victoria Secret styled support stockings, so there is no excuse not to wear them.
• Elevate your legs.  When you are sitting or relaxing, elevate your feet above your heart level.  Your heart will pump faster and increase the circulation in your spider veins, which will reduce them in size.  A foot stand under your desk can help keep your legs elevated.
• Try to stand as little as possible.  Standing increases pressure on your valves and causes them to swell and create spider veins.  If you have to stand - then get on the tips of your toes by lifting your heels off the floor.  This action will help increase circulation in your spider veins.
• Massage your feet or get weekly foot massages to promote healthy circulation and drain lymphatics.  Massage oil in a circular motion into your legs and ankles and once in a while squeeze your feet and ankles hard to force the blood out of your spider veins.  This motion will help reduce the spider veins.
• Undergo Laser therapy.  Laser therapy is the most effective way to shrink and even get rid of spider veins. It is sometimes used as a complement to scierotherapy in order to maximize results.

Scierotherapy is an injection of sodium chloride that is applied with a needle directly in the spider vein.  The sodium chloride causes the blood vessel to swell up and stick together and eventually turns into scar tissue.  The tissue then fades from the surface of the skin.

Overall, it is important to reduce spider veins before they develop into varicose veins and a regular exercise program and weight loss can help relieve the symptoms of spider veins and varicose veins.

Whether you are enjoying a beautiful winter ski day with the family this coming season or doing jump turns above exposure, Orthotics are the first step in creating a proper fit inside your ski boots.  The orthotic holds your feet in their strongest, most stable position, and as a result you will be able to ski better, longer.

The goal of the ski boot is to transfer energy from the body to the skis.  Empty space inside the ski boot can result in a loss of energy and make turns more difficult to maneuver your way down the slopes.

Also many skiers assume that one pair of ski boots is the same as another and all are uncomfortable.  Much of the discomfort of ski boots in the past were a result of the arch collapsing as the skier gets on the inside edge.  However, our prescription orthotics can help create a more efficient, comfortable ski boot for you.  We are now using the latest technology that records three 
dimensional images of your feet.  Your foot is placed in its best functional position and then scanned using the scanner pictured to the left.

The images are used as a form to make the custom orthotics.  The doctor completes a unique prescription, depending upon your specific problem and foot type.  From this, the orthotic fits inside of your ski boot to change and improve the biomechanics of your gait.  The orthotic ultimately holds your foot in a powerful neutral pose, which in turn supports all of the muscles and ligaments of the foot.  Your foot will stay centered in the middle of the ski boot all day, supporting ankle bones and instep bones in a comfortable position.

As you tee off this weekend, make sure your feet are up to par and in good condition.  Hours spent walking and not positioning your feet properly during your golf swing can cause foot pain and severe problems for some golfers.

The most common golf-related injury is neuroma.  If the golfer swings the club right-handed, the neuroma occurs in the left foot and vice versa. The nerves in the toe joints can become pinched and irritated when shifting weight from one foot to another during your golf swing.  The symptoms include burning, numbness and shooting pain into the toes.

As your body transfers weight from one foot to the other during your swing, the nerves in the ball of your foot may also become compressed and overused, causing pain.  Overuse on your big toe joint by bending the back foot too far can possibly lead to painful arthritis.

Chronic heel pain and inflammation can lead to plantar fasciitis, which can prevent you from keeping a solid stance and ultimately affect your swing too.  Persistent actions can cause overuse of the injury and make the condition worse for you.

Any of these conditions can affect your overall golfing performance.   If you are experiencing continued pain and discomfort - it is best to discontinue playing right away and contact a Podiatrist for treatment. 

Women love their high heels, but what good is wearing the heels if later in the evening you are going to kick them off?  Many of today's high heels are designed with high platforms and unique wedge heel designs.

A survey conducted by the American Podiatric Medical Association showed some 42% of women admitted they would wear a shoe they liked even if it gave them discomfort; 73% admitted already having a shoe-related foot issue.

Your shoes should conform to the shape of your foot - feet should never conform to the shape of your shoes.  So what are some ways to protect and get the best fit possible for our feet in high heels?

First, get a snug, but not tight fit when selecting high heels.  Preferably look for narrow heels.  Stay away from heels that allow your feet to slide to the front, leaving a big gap behind your heel.  Sliding forward can create more pressure and pain on the toes.

Second, cushion up your heels especially if you know you will be standing for long periods of time.  Investing in prescription orthotics can help control pain.

Third, wear a thicker heel for stability.  A platform or thicker heel provides you with better balance and distributes the weight on your foot evenly.  Also, alternating between heel heights can prevent having problems with Achilles tendon.

Fourth, try to select a heel that is easy on your arch and might help relieve pain in the ball of the foot.  Some 4" heels have a straight drop down to the flatbed portion of the shoe.  You will want to look for a more gradual "slope or pitch" of the heel.

Fifth, wearing open-toe high heels helps relieve pressure on inflamed areas such as corns and calluses.  Make sure to see a podiatrist to have corns and calluses professionally removed.

So if high heels are an absolute must, it is best to wear them sparingly and follow the tips provided to prevent repetitive stress on your feet.

How would like a sock that tracks your running confidence, coaches you, and dispatches a message: Persistent heel-strike detected?  If so, Sensoria's Smart Fitness Socks, made by a company called Heapsylon could be a right fit for you. 

There is always the question among runners about foot-strike.  Should a runner hit the ground with the heel, the mid-foot, or the toe?  Also, how can runners lower their impact while running on concrete?

Sensoria's wearable device consists of a pair of sensor-stuffed socks, containing "e-textile technology."  The pressure sensors inside the socks assess which parts of your foot are taking the weight as you run.  There is also a clip-on Bluetooth 4.0 that contains an accelerometer, altimeter and calorie counter and attach's to the ankle of the sock with magnets.  You can then upload your data wirelessly to your computer or smart phone to track your progress. The socks are completely made of fabric and can go through the wash and dry cycles too.

The ulimate goal of the fitness sock is to help you lock in a new, safe running technique.  It can track your steps and provide advise on running style by doing a real-time gait analysis.  The sock basically helps you correct bad running habits and possibly reduce heelstriking on pavement or avoid excessive forefoot running that could lead to back pain or Achilles tendon injuries.

The sock is also a step tracker and can track inactivity.  It will notify you to take a screen break if your foot is stationary and can figure out if you are sitting down.  This feature could be useful for runners who have take a business call while out running.

Sensoria also has a real-time coaching application which can provide warnings of heel-strike or information on your overall running performance.  It can help you get into a running rhythm too by letting you select your desired stride frequency range and will cue you when needed.

Currently, Heapsylon is trying to raise $87,000 to produce the socks via its Indigogo fundraising site.  Sensoria is like a "personal trainer" in a sock.  The company says, it will allow you to see how well you exercise, walk or run - safely and pain free!

The fall season is approaching and every year, there is an increase in ankle injuries among young athletes.  Football, soccer, and basketball are the sports most likely lead to sprains, broken bones and other problems.

According to the U.S. Centers for Disease Control (CDC), nearly 30 million children and adolescents participate in youth sports in the United States and more than half of all sports injuries in children are preventable.  Children ages 5 to 14 account for almost 40 percent of all sports-related injuries treated in hospitals.  On average the rate of severity of injury increases with a child's age.

So how can parents be proactive and help protect their children from serious injuries in playing sports this fall?  Here are tips for staying healthy this season:

• Children should start the season with replacing their old shoes with new shoes.  Old shoes can wear down like an old tire and become flat and uneven on the bottom, causing the ankle to tilt because the foot can't lie flat.
• Always buy the right shoe for the specific sport. Players shouldn't mix soccer cleats with football shoes.
• Check the safety of the playing fields for dips and holes.  A foot can be broken if the child's foot gets lodged in a hole on a field.  Uneven surfaces on fields can also cause ankle sprains.   It is important that parents walk the field, especially when children compete in non-professional setting like public parks, for spots that could catch a player's foot and throw them to the ground.  Coaching officials should also be alerted to any irregularities.
• Encourage fun stretching and warm-up exercises.  Light jogging and calf stretches before competition helps warm up ligaments and blood vessels, reducing the risk for ankle injuries and foot problems.
• A supportive ankle brace may prevent a child's previously injured ankle from additional sprains.  So make sure and have old sprains checked by a podiatrist before the season starts. 
• Get ankle injuries treated right away.  What seems like a sprain is not always a sprain and other bones in the foot may have been injured without knowing it.  It is best to have a qualified podiatrist examine the injury.

Overall, families should be mindful of the risks associated with different sports and take important measures to reduce the chance of injury this fall.