Conditions

What We Treat

Scroll below to read about a selection of foot and ankle conditions we treat, as well as informative explanations about those conditions. Many of our patients have questions about the pain or injury they are experiencing in their feet. We’re happy to provide a brief overview of these conditions, common symptoms, why they occur, and some treatment methods to remedy the issue.

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Achilles tendinitis is a condition which causes extreme pain, swelling and stiffness to the Achilles tendon.  The Achilles tendon connects the heel bone to the respective calf muscles. Achilles tendinitis is causes by repetitive small injuries to the tendon, this repeated trauma can also induce a complete rupture.

Symptoms include pain just above the heel bone, behind the heel bone or in the back of the leg.  Tenderness and stiffness are present in the morning, accompanied by swelling, and difficulty flexing the foot or pointing the toes. Wearing shoes with a closed back also causes discomfort and pain. Treatment includes physical therapy, heel lifts, and sometimes use of a CAM walker boot in more severe cases.  Restriction of motion and weight bearing activities is required for the improvement of the tendinitis. Should there be a full rupture of the Achilles Tendon, surgical repair is required.

An ankle sprain is an injury to one or more ligaments in the ankle, usually on the outside of the ankle. Ligaments are bands of tissue that connect one bone to another and bind the joints together. The ligaments of the ankle provide stability by limiting side-to- side movement.

Sprained ankles often result from a fall, a sudden twist, or a blow that forces the ankle joint out of its normal position. Ankle sprains commonly occur while participating in sports, wearing inappropriate shoes, or walking or running on an uneven surface. Sometimes ankle sprains occur because of weak ankles, a condition that some people are born with. Previous ankle or foot injuries can also weaken the ankle and lead to sprains. The level of instability is dependent on the number of the injured ligaments and severity of the tear.

The signs and symptoms of ankle sprains may include:

  • Pain or soreness
  • Swelling
  • Bruising
  • Difficulty walking
  • Stiffness in the joint
  • Unsteady gait

An ankle fracture can vary in severity and should always be treated by a podiatrist as it may be misinterpreted as a sprain. Depending on the alignment of the fracture, it may require either conservative treatment or surgery.

An ankle fracture also known as a broken ankle is a break or multiple breaks in one or more of the bones in the ankle joint. It is usually caused by a rotational injury but can also be caused by an impact, such as from a fall or automobile collision.

The most common form of arthritis is osteoarthritis also known as degenerative joint disease. This type of arthritis causes wear and tear of the joints. The foot and ankle joints may be affected by age, trauma, shoe gear, and every day repetitive use.

Inflammation and injury to the joint cause a breaking down of cartilage tissues, resulting in pain, swelling, and deformity. The changes in osteoarthritis usually occur slowly over many years, though there are occasional exceptions.

The diagnosis of foot and ankle osteoarthritis most likely will involves a lower extremity exam, medical history and x-rays in office. Other imaging such as MRI or CT may be ordered based on examination findings.

There are different modalities to treat osteoarthritis. Initially arthritis may be treated with conservative care such as oral anti-inflammatories, immobilization, inserts, alteration of shoe gear and activities. Further treatment may include cortisone injections, and surgery.

Arthritis Joint Surgery is used to reduce pain and improve joint function for those who are still experiencing issues despite non-invasive treatments to the area. With 33 joints in each foot, there are many opportunities for this disease of inflammation to strike, causing pain and swelling. Depending on the affected area, you may qualify for Debridement or Fusion surgery to improve your arthritis-related foot pain.

Athlete’s Foot is a common skin infection on the foot caused by fungus, and occurs most often between the toes.  It can be caused by walking barefoot in public places as well as wearing non-moisture wicking socks.  Traumatic injuries to the nail may lead to exposure to fungal components due to the exposure of the nail root.  Symptoms include itching, stinging and burning between the toes; cracking and peeling skin on the feet as well as blisters on the feet that itch.

Athlete’s Foot is not a serious condition, but sometimes can be difficult to cure. In minor cases, Athlete’s Foot can be treated with over the counter antifungal medications. In more severe cases, doctors may prescribe oral and/or topical antifungal medications. In either case, when infected, keep feet dry and clean.

A bunion is a bone deformity caused by an enlargement of the joint at the base of the big toe (metatarsophalangeal joint. The growing enlargement or protuberance then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists, which is known as Hallus Abducto Valgus. Bunions can also lead to other toe deformities, such as hammertoe.  Foot injuries, neuromuscular problems, flat feet, and pronated feet can contribute to their formation.

A bunion deformity may lead to discomfort and pain from the constant irritation, rubbing, and friction of the enlargement against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, bursitis or arthritis may set in, the skin on the bottom of the foot may become thicker, and everyday walking may become difficult.

Corns and calluses are hard, painful areas of skin that often develop on the feet in response to pressure or friction. Very common among individuals who wear improper shoe and may develop due to bony deformities. Majority of callus and corns may be treated with a pumice stone however if treatment at home is not sufficient, it may need podiatric attention.

Calluses and corns are not normally harmful, but sometimes they may lead to infections or ulcerations of the skin, especially among people with diabetes and those with poor circulation in the feet.

A bunion deformity may lead to discomfort and pain from the constant irritation, rubbing, and friction of the enlargement against shoes. The skin over the toe becomes red and tender. Because this joint flexes with every step, the bigger the bunion gets, the more it hurts to walk. Over time, bursitis or arthritis may set in, the skin on the bottom of the foot may become thicker, and everyday walking may become difficult.

The APMA says that Including a podiatrist in your diabetes care can reduce the risk of lower limb amputation up to 85 percent and lowers the risk of hospitalization by 24 percent. Care includes treating the swelling of the foot and joints, improving circulation, and treating open sores, ingrown or fungal toenails, bleeding corns, calluses and dry cracks in the skin.

The condition is caused by damage to the central nervous system and poor blood circulation that stems from diabetes. An insulin deficiency leads to loss of feeling in the foot, and causes other problems that can be difficult to treat. These conditions cause make nail debridement on oneself difficult and run the risk of bleeding in infection.

Due to the delicate nature of these conditions, it is extremely important to pay attention to all of the warning signs, including new or lasting numbness in the foot, swelling, loss of hair on legs and feet, pain, hard skin, open wounds, and similar symptoms. Some patients with diabetes have a lack of hot, cold, or painful sensations. Other patients hurt their foot without realizing it, and the poor blood circulation makes it harder for the body to heal and fight off disease. In diabetic patients, small sores can easily turn into big infections, which is why it is crucial to constantly observe the health of the feet.

Flatfeet are characterized by collapsing of the arch that comes into a complete or a nearly complete contact with the ground.  Flatfeet be hereditary or be caused by stretched or torn tendons.  Symptoms include pain in the heel and the arch of the foot. Treatment includes strengthening exercises, shoe gear modifications, and custom orthotics.  In some instances, surgical intervention is required. In such situations, the surgeon evaluates the appropriate corrective procedure for the affected foot.

Toenail fungus, or onychomycosis, is an infection underneath the surface of the nail caused by fungi. When the tiny organisms take hold, the nail often becomes darker in color and smells foul. Debris may collect beneath the nail plate, white marks frequently appear on the nail plate, and the infection is capable of spreading to other toenails, the skin, or even the fingernails. If ignored, the infection can spread and possibly impair your ability to work or even walk. The resulting thicker nails are difficult to trim and make walking painful when wearing shoes. Onychomycosis can also be accompanied by a secondary bacterial or yeast infection in or about the nail plate.

Because it is difficult to avoid contact with microscopic organisms like fungi, the toenails are especially vulnerable around damp areas where you are likely to be walking barefoot, such as swimming pools, locker rooms, and showers, for example. Injury to the nail bed

may make it more susceptible to all types of infection, including fungal infection. Those who suffer from chronic diseases, such as diabetes, circulatory problems, or immune-deficiency conditions, are especially prone to fungal nails. Other contributing factors may be a history of athlete’s foot and excessive perspiration.

A daily routine of cleansing over a period of many months may temporarily suppress mild infections. White markings that appear on the surface of the nail can be filed off, followed by the application of an over-the- counter liquid antifungal agent. However, even the best over-the- counter treatments may not prevent a fungal infection from treatments may vary, depending on the nature and severity of the infection. Your foot and ankle physician can detect a fungal infection early, culture the nail, determine the cause, and form a suitable treatment plan, which may include prescribing topical or oral medication, and debridement (removal of diseased nail matter and debris) of an infected nail. 

Ingrown toenails are most common on the big toe and occur because the nail grows at an angle, rather than straight and within its natural borders.

An untreated ingrown toenail eventually becomes embedded in the tissue surrounding the toenail and could cause a significant infection. An untreated infection could spread, involving the tissues and bones of the foot and leg and eventually reach your bloodstream.

Gout is a painful type of inflammatory arthritis that usually affects the big toe, but can develop in any joint, including the ankle. It usually forms when your body has high levels of uric acid. Your body produces uric acid when it breaks down purines. There are two types of individuals with gout. Patients may be an over producer of uric acid or under excreter. Once confirmed with blood work medication is recommended dependent if you are an over excreter or under producer. Once can also find purines in several types of food, especially red meat and some seafood, as well as alcohol and some sugar-sweetened drinks therefore if diagnosed with gout its best to stay clear from these foods.

Treatment is usually conservative with or anti-inflammatories, gout medication. Sometimes depending on the severity, one may need a cortisone injection or surgical attention.

Because it is difficult to avoid contact with microscopic organisms like fungi, the toenails are especially vulnerable around damp areas where you are likely to be walking barefoot, such as swimming pools, locker rooms, and showers, for example. Injury to the nail bed

may make it more susceptible to all types of infection, including fungal infection. Those who suffer from chronic diseases, such as diabetes, circulatory problems, or immune-deficiency conditions, are especially prone to fungal nails. Other contributing factors may be a history of athlete’s foot and excessive perspiration.

A daily routine of cleansing over a period of many months may temporarily suppress mild infections. White markings that appear on the surface of the nail can be filed off, followed by the application of an over-the- counter liquid antifungal agent. However, even the best over-the- counter treatments may not prevent a fungal infection from treatments may vary, depending on the nature and severity of the infection. Your foot and ankle physician can detect a fungal infection early, culture the nail, determine the cause, and form a suitable treatment plan, which may include prescribing topical or oral medication, and debridement (removal of diseased nail matter and debris) of an infected nail. 

Ingrown toenails are most common on the big toe and occur because the nail grows at an angle, rather than straight and within its natural borders.

An untreated ingrown toenail eventually becomes embedded in the tissue surrounding the toenail and could cause a significant infection. An untreated infection could spread, involving the tissues and bones of the foot and leg and eventually reach your bloodstream.

Plantar fasciitis is a condition when the band on the bottom of the foot called the plantar fascia becomes inflamed and painful.  This band runs from the bottom of the heel to the ball of the foot. Plantar fasciitis is often most painful the first step one takes in the morning or after a period of rest.

 

Chronic plantar fasciitis can lead to a buildup of calcium to form where the fascia connects to the heel bone. This is called a heel spur and often causes the pain that prompts people to seek treatment.

 

Conservative treatment includes anti-inflammatories, stretching exercises, alteration of shoe gear and inserts.  For patients who are unsuccessful with relieving the pain and symptoms of Plantar Fasciitis with non-invasive therapies, surgery may be necessary by releasing part of the plantar fascia. Dr. Garzon performs an endoscopic plantar fasciotomy to relief the plantar fasciitis. This procedure is a minimally invasive and minimally traumatic surgical treatment for the common problem of chronic plantar fasciitis which allows the patient to ambulate immediately after surgery.

Hammertoe is an imbalance of the foot muscles that causes the middle joint of the toe to bend and become stuck in the bent position. It can be hereditary or may be caused by tendon imbalance, ill-fitting shoes, as well as injury. Symptoms include, pain on top of the contracted toe as well as swelling when wearing shoe gear.  

Hammertoes may be treated conservatively with shoe gear modifications, oral anti-inflammatories and a crest pad. However, often times conservative treatments are unsuccessful and surgical intervention is required. In such instance a small piece of the bone, perform a joint implant procedure or joint fusion procedure.  Tendon transfer surgery, joint resectioning or a fusion procedure can effectively correct the issue. 

Ingrown toenail is a common condition that occurs when the sides of the toenails grow into the surrounding skin. When the edges of the nail break through the skin, the ingrown toenail can cause pain, redness, swelling, tenderness and, if not properly cared for, an infection. Most frequently, this condition affects the large toes, but it can happen on other toes as well.

Depending on the severity of the ingrowing nail, it may be recommended to remove a part of the toenail temporarily versus permanent. These procedures are common and performed under a local anesthetic in office.

Metatarsalgia is described as pain and inflammation in the ball of the foot.  This can be as a result of ill-fitting shoes or decreased fat-pad in the ball of the foot. Overuse, often due to intense training or activity can also be a cause for metatarsalgia. Symptoms include pain in the ball of the foot as well as tingling or numbness in the toes.

Metatarsalgia may be treated conservatively with shoe gear modifications, and custom orthotics.  Surgical intervention to repair the underlying biomechanical deformity is sometimes necessary.

A morton’s neuroma (most common in the foot) is a thickening of nerve tissue which occurs at the base of the third and fourth toes. Neuromas may also occur in other locations in the foot.

Neuromas are the result of compression and irritation of the nerve between two bones. This compression creates swelling of the nerve, eventually leading to permanent nerve damage.

Symptoms include: tingling, numbness, burning sensation and the feeling of a bunched-up sock under the ball of the foot when walking.

Tarsal Tunnel Syndrome is a painful condition caused by the impingement of the posterior tibial nerve. It causes burning pain in the foot along with pins and needles and pain radiating in the arch of the foot. Many factors can cause tarsal tunnel syndrome such as:  osteoarthritis, diabetes, overpronation of the foot, presence of a cyst/ganglion, as well as a bony coalition. Conservative treatment includes rest, ice therapy, oral anti-inflammatories, as well as physical therapy. X-Rays, MRI, and nerve conduction studies are sometimes needed.  Should conservative measures fail, a surgery to decompress the entrapped nerve or for the removal of the cyst/bony spur becomes necessary.

Plantar warts are growths on the soles of your feet caused by a virus. The growths may look like calluses, causing the skin in the affected area to thicken and harden in a similar fashion. These types of lesions may cause pain and discomfort especially upon ambulation. If over the counter treatment is exhausted Dr. Garzon utilizes an acid in office to remove the painful lesion.

In-toe and out-toe gait is a condition where the child has a twist at the top of the femur (by the hip joint), at the top of the shin, or even in the foot. The child may grow out of the condition, but it often causes some issues along the way, such as walking delays, poor balance, tripping, and an improper walking motion of the foot, to name a few.

Metatarsus Adductus refers to this condition when the foot itself is curved inward (more commonly referred to as pigeon toed). To correct it, the doctor may recommend special shoes, splints to be worn at night or, on occasion, surgery.

External Tibial Torsion Out-Toeing is an outward twisting of the leg bone that affects adolescents, typically leading to pain in the knee. On occasion, osteotomy (a surgical procedure), may be recommended to fix the bone.

Internal Tibial Torsion is one of the causes of in-toeing. It happens when the tibia (shin bone) twists inward, causing in-toe gait. It is actually present at birth, but may not be noticeable until the child begins walking. Most children grow out of these deformities, but on occasion, require therapy or even surgery to correct the issue if it does not resolve on its own. In the shin bone, this is referred to as Tibial Derotational Osteotom.

MTA is a condition where the metatarsal bones in the feet are pointing inward, forcing the front part of the foot to bow inward. This condition is present at birth. It is also referred to as being “Pigeon Toed”. For many, the condition “rights” itself out over time, but in some cases, exercises, casts or even surgery may be needed to correct the deformity.

Toe-walking may begin when a child learns to walk. The child favors walking on the ball of their feet without placing the heel on the ground. Most children grow out of this by age 2. If they have not, tight muscles and tendons may be to blame. Though there are other underlying conditions that may also cause this, it’s critical to rule out any physiological reason by seeing a pediatric podiatrist first. A period of casting or bracing is used to help encourage loosening of the muscles and tendons so that a normal gait can be achieved.