Heel pain can be common in children especially as they return to sports. We typically see girls between the ages of 8-12 and boys around 10-14. This increased incidence of heel pain at this time can be correlated with growth spurts or changes in activities. There is often a family history of heel pain as well from a parent or siblings. Unlike adults, very few children will have plantar fasciitis as the cause of heel pain. So, what are the main causes of heel pain in children? I will discuss a couple below.

Coalitions, these are where you have an abnormal connection between bones in the feet that should not be connected. Often, we see this type of pathology becoming painful after an injury, like an ankle sprain. Usually, an x-ray in needed to diagnosis this. This can differ based on location and there are two general locations of the coalitions. The two main locations are a calcaneal navicular and a talar calcaneal as the most common. The types of coalitions can vary, from bone to cartilage and even soft tissue.

Another common cause of heel pain in kids is Sever’s disease. This is basically an irritation of a growth plate that was first described by Dr Sever. This is especially common in cleated sports like soccer or football. There is usually a family history and common in flatfeet and kids with tight calf muscles. While this list is not exhaustive of all types of heel pain it is two of the most common, others can include a bone tumor, stress fracture or even a nerve irritation. Please make an appointment online or give us a call at 425-391-8666 if your child is having heel pain so we can help.

Bunion surgery is by far the most common foot surgery in the United States. The number of bunion surgeries performed per year in the U.S. is about 150,000. The majority of these bunion surgeries are done in an outpatient setting and take less than 1.5 hours.

What is a bunion?

Please watch the following video for more information on a bunion;

https://www.bestfootdoc.com/patient-education-videos

So, what is the most common bunionectomy to date? The answer is a distal osteotomy or cutting of the bone towards the head of the metatarsal. This procedure is called an Austin bunionectomy.

Please watch the following video to learn more about bunion procedures; https://www.youtube.com/watch?v=U_D0NhTZOyY

Bunion surgery does not need to be scary or overwhelming we are here to help.

Give us a call today at 425-391-8666 or make an appointment online. 

Fungal infection of the toenail, or onychomycosis, typically appears as a gradual change in a toenail’s texture and color that involves brittleness and darkening.  The fungal infection itself occurs beneath the surface of the nail.  Aside from discoloration, other symptoms include the collection of debris beneath the nail plate, white marks on the nail plate, and a foul odor emanating from the nail.  If ignored, the infection can spread into other nails and the skin; in severe cases, it can hinder one’s ability to work or walk. 

The toenails are particularly vulnerable to contracting infection in moist environments where people are likely to be walking barefoot, such as around swimming pools, public showers, and locker rooms.  Fungal infection may also be more likely to occur in nail beds that have been injured, and sufferers of chronic diseases such as diabetes, circulatory problems, or immunodeficiency conditions are particularly prone to developing fungal nails. 

Fungal nails can be primarily prevented by practicing proper hygiene and regularly examining the feet and toes.  Carefully washing the feet with soap and water and thoroughly drying the feet afterwards are essential.  Other tips include wearing shower shoes in public areas, changing shoes and socks daily, keeping toenails clipped at a short length, wearing breathable shoes that fit properly, wearing moisture-wicking socks, and disinfecting home pedicure tools and instruments used to cut nails.

Fungal nail treatment may vary between patients and the severity of the condition.  Your podiatrist may suggest a daily routine of cleansing that spans over a period of time to ease mild infections.  Over-the-counter or prescription antifungal agents may also be prescribed, including topical and/or oral medications.  Debridement, or the removal of diseased nail matter and debris, may also be performed.  In more severe cases, surgical treatment may be needed.  In some instances, the temporary removal of the fungal nail allows for the direct application of a topical antifungal to the nail bed.  In other cases, a chronically painful fungal nail that has not responded to other treatments may be permanently removed; this allows the infection to be cured and avoids the growth of a deformed nail.  

Numbness and tingling can be quite common in people experiencing forefoot discomfort. Most people will describe symptoms like burning, pinching, numbness and tingling. These are often associated with nerve type issues and can continue to get worse without treatment. The most common causes of this in the foot are neuromas and capsulitis.

Neuromas are a nerve irritation that occurs in the foot and usually is a female between the ages of 40-60. The nerves that run between the toes are sensitive and any increases pressure can cause pain. This pain is usually made worse with tight fitting shoes or high heels. Patients usually have pain to the 3rd and 4th digit and often is only on one foot. Most people will say that rubbing the front of their foot seems to help as well as removing their shoes.

Capsulitis is usually around the base of the 2nd toe. There is often an underlying deformity like a bunion or tight calf muscle. Patients will often experience swelling and tingling or digit. It is usually made worse with walking and relieved with icing.

Neuromas and capsulitis both can be challenging for the patient and the doctor. It is important to identify the root cause and an x-ray is warranted. The treatment options available are usually very successful. If you are having forefoot pain we can help, make an appointment today.

Give us a call at 425-391-8666 or make an appointment online today. 

Athlete’s foot is an extremely contagious infection caused by a fungus that results in itching, burning, dry, and flaking feet. The fungus that causes athlete’s foot is known as tinea pedis and thrives in moist, dark areas such as shower floors, gyms, socks and shoes, commons areas, public changing areas, bathrooms, dormitory style houses, locker rooms, and public swimming pools. Athlete’s foot is difficult to treat as well because of the highly contagious and recurrent nature of the fungus.

Tinea is the same fungus that causes ringworm, and is spread by direct contact with an infected body part, contaminated clothing, or by touching other objects and body parts that have been exposed to the fungus. Because the feet are an ideal place for tinea to grow and spread, this is the most commonly affected area.  It is, however, known to grow in other places. The term athlete’s foot describes tinea that grows strictly on the feet.

The most commonly infected body parts are the hands, groin, and scalp, as well as the feet. Around 70% of the population suffer from tinea infections at some point in their lives, however not all of these cases are athlete’s foot. Just like any other ailment, some people are more likely to get it than others, such as people with a history of tinea infections or other skin infections, both recurring and non-recurring ones. The extent to which a person experiences regrowth and recurrent tinea infections varies from person to person.

Sometimes people will not even know that they are infected with tinea or that they have athlete’s foot because of a lack of symptoms. However, most experience mild to moderate flaking, itching, redness, and burning. However, some of the more severe symptoms include cracking and bleeding skin, intense itching and burning, pain while walking or standing, and even blistering.

Because of the recurring nature of the tinea fungus and the athlete’s foot it causes, the best way to treat this condition is with prevention. You can take some preventative measures such as wearing flip flops or sandals in locker rooms and public showers to reduce contact with the floor. It also helps to keep clean, dry feet while allowing them to breathe. Using powders to keep your feet dry is a good idea, as well as keeping your feet exposed to light and cool air, to prevent the growth of tinea. If you do happen to get athlete’s foot, opt for using topical medicated creams, ointments or sprays. These treatments help eliminate and prevent it from coming back.

Achilles tendonitis or bone spurs in the Achilles tendon are common pathologies we see as foot and ankle surgeons. These two conditions are often started with over training or long-standing tight calf muscles. Both can lead to rupturing or a painful Achilles tendon with any sort of activity. It can be quite challenging to rest this area or rehab this tendon as it never really is inactive when ambulating.

Many patients will end up requiring surgical repair of their Achilles and new modern approaches can minimize down time. Previously all patients had required at least 6 weeks of non-weight bearing. However new techniques have improved outcomes and eliminated the need for non-weight bearings.

Achilles tendonitis usually presents around the mid substance of the Achilles. It is usually a painful bump that can swell with exercise. In the past patients requiring repair required a standard incisional approach with a long recovery. However, I have been utilizing the Tenex procedure which has almost no downtime and can be preformed without anesthesia if patients prefer. The Tenex stimulates new growth and repair of old tendon pathology. After the procedure patients can walk and return to activities shortly.

Bones spurs in the Achilles tendon have previously requires an extensive surgery to remove the bone and repair the tendon. I have been using Tenex on these cases as well and patients can walk immediately after the procedure and require no re-attaching of the Achilles tendon. If you are looking for a quick recovery, minimal down time or minimally invasive Achilles tendon surgery I can help. Give us a call today at 425-391-8666 or make an appointment online today.