Ankle Instability
Ankle Sprain
Athlete's Foot
Blisters
Bone Spurs
Bone Spur under Nail
Bunions
Corns and Calluses
Curled Fifth Toe
Degenerative Disease
Flat Feet
Fractures
Fungal Nails
Hammertoe: General Description
Hammertoe: Flexible
Hammertoe: Rigid
Heel Spur
Nail Problems
Ingrown Nail: Partial
Ingrown Nail: Complete
Injuries
Neuromas
Plantar Fasciitis
Peripheral Neuropathy
Shin Splints
Warts
Corns & Calluses
These are accumulated layers of hard skin at points of pressure and should be treated by a podiatrist. Usually a mechanical foot imbalance is present, which causes these problems. Never cut a corn or callus with a razor, scissors, or any other instrument, nor pick at them with your fingernails. Again, never apply "corn cures" or other medication to them.
A common cause of thickened skin on the bottom of the foot is a misaligned, elongated or thickened metatarsal (bone in the foot). A surgical repair often involves making a "V" shaped cut into the metatarsal to lift the bone into place, thus relieving pressure.
*Note: The links below are alternative methods to the "V" Osteotomy
Click to see diagram 'Weil Lesser Metatarsal Osteotomy"
Watch Video: "Weil Lesser Metatarsal Osteotomy"
Back to top.
Degenerative Disease
A limited range of motion with stiffness, swelling and pain can be caused by arthritis or trauma to the big toe joint. This is referred to as "hallux limitus" or "hallux rigidus". The joint can be repaired and remodelled, often returning motion and comfort to the joint.
Back to top.
Heel Spurs
A heel spur is a bony outgrowth at the base of the heel bone near the plantar fascia. A spur may cause pain on the bottom of the heel when you stand. As with plantar fasciitis, the pain may decrease after standing or walking a short time. The pain you feel is not from the spur itself. Your heel hurts because the plantar fascia is being stretched, the spur pinches a nerve, or the spur presses against the plantar bursa. If the bursa becomes inflamed (bursitis), it may squeeze the plantar fascia.
Initial treatment usually involves treating the underlying biomechanical causes by means of orthotic devices. If pain persists, mechanical therapy,or anti-inflammatories may be used. If these methods are not successful, Shockwave Therapy can be used. You can find out more about Shockwave Therapy in our Treatments section
As a last resort, surgery can also be performed. Under local anesthesia a section of the plantar fascia is cut to release the pull created at the heel spur.
Back to top.
Bunions
A Bunion is an enlargment of the bone at the big toe joint. An inherited misalignment or weakness in the foot or leg can lead to this condition. It can be aggravated by tight shoes causing swelling, pain and skin irritation. There are varying degrees of severity of bunions with several types of surgical repairs available.
The angle between the first two metatarsals can be moderately (A) or greatly (B) increased as the bunion deformity progresses. (See Images)
Image A 
Image B
Surgical repair involves any combination of procedures to reduce the high angle and strengthen the toe. The protruding bump is also removed in cases where the side of the metatarsal has become enlarged. More info...
Back to top.
Nail Problems
Nail problems are common to those of all ages. If left untreated, nail problems could result in serious discomfort and therefore, should be treated immediately by your podiatrist. Below are descriptions of common nail problems:
1. Partially Ingrown Toenail
A nail is ingrown when one or both corners or sides of the nail grow into the skin of the toe. Irritation, redness, an uncomfortable sensation or warmth, swelling, pain, and infection can result from a partially ingrown toenail.
Treatment: Partial Matricectomy.
A wedge of the nail is removed and the growth cnter destroyed (by surgical excision or with chemical treatment. This simple procedure is brief.
Follow up care:
Expect minimal bleeding initially, and, with the chemical treatment, drainage. If chemicals were used, you will be instructed on soaking your toe.
Back to top.
2. Completely Ingrown Toenail
In severe cases, the whole nail grows into the skin on all sides, sometimes because the nail is curved from an injury or fungus infection. You may suffer pain and be unable to bear weight. Ingrown toenails can also affect your foot's appearance.
Treatment: Total Matricectomy or Bilateral Partial Matricectomy.
The entire nail and growth plate are removed either surgically of chemically. The body then produces a "false nail"-tough skin that mimics a real nail.
Bilateral Partial Matricectomy is when only the sides are removed with the middle section of nail continuing to grow.
Follow up care:
The area may bleed for a few days. Care is much the same as for partially ingrown toenails. The false nail usually grows in a few months after surgery.
Back to top.
3. Bone Spur Under the Nail
An overgrowth of bone under the toenail can press up into the tissue underneath the growth plate, deforming the nail above. This condition is painful, especially when you're wearing shoes. Many people also find that weight-bearing is difficult.
Treatment: Subungual Exostosis.
The bone spur can be smoothed down with a tiny rasp. The rasp (which resembles a dental burr) is inserted through a small incision in the toe. This procedure is often performed along with partial or total matricectomy.
Follow-up Care:
Your incision is bandaged, and you can bear weight immediately. Often, you can wear your own shoes after surgery.
Back to top.
Hammertoes
Hammertoe is a deformity of the second, third, or fourth toes. In this condition, the toe is bent at the middle joint, causing it to resemble a hammer. Left untreated, hammertoes can become inflexible and require surgery. People with hammertoe may have corns or calluses on the top of the middle joint of the toe or on the tip of the toe. They may also feel pain in their toes or feet and have difficulty finding comfortable shoes.
The primary causes of hammertoe include foot imbalances and heredity. An inherited muscle imbalance or abnormal bone length can make one or more small toes buckle under, causing their joints to contract. This in turn causes the tendons to shorten. Corns (build-up of dead skin cells where shoes press and rub) often form on top of the contracted joints, and may become irritated and infected. Hammertoes can be aggravated by improperly fitting shoes.
Treatment for the condition typically involves wearing shoes with soft, roomy toe boxes and toe exercises to stretch and strengthen the muscles. Commercially available straps, cushions, or nonmedicated corn pads may also relieve symptoms.
In severe cases, hammertoe surgery may be recommended to correct the deformity.
Various ways to correct them surgically are shown below:
Watch Video: Hammertoe Procedure
* Note: We do not use fusion in our procedure.
Back to top.
1. Flexible Hammertoes
When hammertoes are flexible, you can straighten the buckled joint with your hand. Flexible hammertoes may progress to rigid hammertoes over time. Corns, irritation, and pain are common symptoms and function is often limited as well. A recurring Callus is often located on the end of the toe, which can also lead to ulceration.
Treatment: Tenotomy Capsulotomy.
To release the buckling, the top and bottom tendons and the joint capsules may be cut.
Follow-up Care:
You can bear weight immediately, but may need a small bandage, a splint, and a surgical shoe, for one to three weeks after surgery.
Back to top.
2. Rigid Hammertoes
A rigid hammertoe is fixed; you can no longer straighten the buckled joint with your hand. Corns, irritation, pain, and loss of function may be more severe for rigid hammertoes than for flexible ones.
Treatment: Arthroplasty.
A portion of the joint is surgically removed and the toe is straightened. The "gap" fills in with fibrous tissue.
Follow-up Care:
You can bear weight immediately, but may need to wear a wooden shoe for a few weeks as the toe heals.
Back to top.
Curled Fifth Toe (Digiti Quinti Varus)
The little toe may curl inward underneath its neighbour, so that the nail faces outward. With this inherited problem, the fat pad on the bottom of the toe (normally used for walking) loses contact with the ground. Corns and pain may result.
Treatment: Derotation Arthroplasty.
A wedge of skin and bone is removed to uncurl ("de-rotate") the toe.
Follow-up Care:
Care may involve follow-up visits and wearing a bandage, a splint, and sometimes a surgical shoe for several weeks following surgery.
Back to top.
Bone Spur
A bone spur, or overgrowth of bone, may occur alone or with a hammertoe. Bone spurs have a variety of causes. Usually, they result in pain, interfere with the use of your foot, and detract from its appearance.
Treatment: Minimal Incision Surgery.
In this technique, a small incision is made and a small rasp (similar to a dental burr) is inserted to smooth the bone.
Follow-up Care:
A follow-up visit is necessary to remove any stitches, and to check the results of your surgery.
Back to top.
Peripheral Neuropathy
Diabetic neuropathy is a peripheral nerve disorder caused by diabetes or poor blood sugar control. The most common types of diabetic neuropathy result in problems with sensation in the feet. It can develop slowly after many years of diabetes or may occur early in the disease. The symptoms are numbness, pain, or tingling in the feet or lower legs. The pain can be intense and require treatment to relieve the discomfort. The loss of sensation in the feet may also increase the possibility that foot injuries will go unnoticed and develop into ulcers or lesions that become infected. In some cases, diabetic neuropathy can be associated with difficulty walking and some weakness in the foot muscles. (Thanks to National Institutes of Health (NIH) for this information)
Back to top.
Warts
These are often mistaken for calluses. A wart is a skin growth which has a blood and nerve supply of its own. Warts are caused by a virus, and may be quite painful. They tend to spread if left untreated. Again, professional attention should be sought.
Back to top.