Dr. Broderick of Broderick Podiatry in Canandaigua, NY, provides comprehensive foot services. He treats a variety of foot conditions.
What is a bunion? A bunion is a bump that builds at the joint where the big toe and the foot connect. The bump can also happen on the fifth metatarsal (baby toe), in which case it is called a bunionette. The big toe pushes outward on the metatarsal bone, which is the bone directly behind the big toe, to form the bunion.
Bunions are often painful because the joint supports body weight while walking. Certain shoes add uncomfortable friction and pressure, leading to calluses and bursitis.
Bunions can be hereditary and develop due to poor foot structure. Like most foot problems, bunions usually become painful during early adulthood and get worse with age, and over time arthritis can develop in the joint. Typically women are more susceptible to form bunions after years of wearing ill-fitting shoes – specifically high heels – that put the foot in a poor functional position.
What is a hammertoe? A hammertoe is when a toe bends or curls at the middle joint. Hammertoes can be flexible or rigid. This can happen for hereditary reasons, or because of arthritis or an injury. A hammertoe often comes from poorly fitted shoes that put too much pressure on the toes. The bent toe often becomes irritated from constantly rubbing against footwear and other toes.
Flexible hammertoes can still move at the joint, and can be treated several different ways. If untreated, they can become rigid and press the joint out of alignment. Rigid hammertoes are normally treated with surgery.
People with diabetes or poor circulation should seek treatment, as they have a greater risk of a hammertoe becoming a serious problem.
What is plantar fasciitis? Plantar fasciitis is a condition in which the ligament that connects your heel bone and your toes becomes strained. The plantar fascia supports the longitudinal arch of your foot. A strain can cause it to swell, become weak, or become irritated and inflamed, and that will cause the heel or bottom of your foot to hurt when you stand or walk. When the plantar fascia is strained repeatedly, tiny tears may form in the ligament, causing this inflammation and pain.
Many people with plantar fasciitis will have pain during their first few steps after sleeping or sitting for extended periods, and it may begin to go away after walking for a while. It may hurt after being on your feet for a long period of time, and hurt most when climbing stairs or standing still.
It is the most common form of heel pain and often occurs in people who are middle-aged, or people who spend a lot of time on their feet. It can occur in one or both of your feet. It is also common for people who:
Have high arches or flat feet
Have tight calf muscles
Roll their feet inward while walking
Walk, stand, or run on hard surfaces for extended periods
Wear ill-fitting or worn out shoes
Treatment options are mostly non-surgical, but in some cases surgery may be necessary.
What is a heel spur? Heel spurs are another common problem that affect about 10 percent of people, although they are not always painful. A heel spur is an abnormal growth on the bottom of your heel that can cause pain while standing or walking.
A heel spur can be caused by an abnormal gait, poor posture or walking, ill-fitting shoes, and some physical activities (such as running). Although people with plantar fasciitis can have heel spurs, the heel spurs do not cause plantar fasciitis. Someone with a high arch or a flat foot is more likely to suffer from a heel spur.
What are fungal nails? Fungal nail infections can occur when fungi invade the toenails or nail beds. A fungus attacks through small cuts in the skin around the nail or through the space where the nail and nail bed meet. Yeasts, molds, and several other types of fungi can cause an infection, and most are caused by the fungus that causes athlete’s foot.
Fungi can spread easily from person to person. They grow in warm, moist places, and can be contracted by being barefoot in a public shower or pool decks. Sharing personal items, such as shoes or nail clippers, is another way to spread a fungus. If you contract athlete’s foot, the fungus can spread into your nail. A fungus on your nail may spread to other nails and even to your skin.
A fungus can cause discoloration of the nail and it may become thickened, and turn yellow or white. The nail may also crumble and split as it separates from the skin. It can be painful and cause permanent damage to your nail or nail bed and cause ingrown nails. It may become uncomfortable or painful to wear shoes, or to stand and walk for long periods of time.
Fungal nails do not usually become serious for a healthy person. It is more urgent for someone with diabetes or a weak immune system. However, without treatment, a fungus will not go away and could possibly get worse. There are medications and creams available to treat a fungus, and the treatment process can take anywhere from a few months to a year. Once you have already had a fungus, it is much more likely to develop again. To prevent this from happening, or from contracting a fungus in the first place:
Do not share footwear or personal items such as nail clippers
Do not walk barefoot in wet public areas (locker rooms, showers, pools)
Treat excessive foot perspiration
Wash and dry your feet before bed
Wear dry shoes that allow moisture to escape
Wear socks and change them if they become sweaty, or use socks made from synthetic materials
Diabetic Foot Problems
What are diabetic foot problems? Diabetics can suffer serious foot problems after having too much sugar in their blood for long periods of time. Diabetic foot problems occur in mainly 2 ways; diabetic peripheral neuropathy and peripheral vascular disease.
Diabetes can damage nerves and result in the loss of feeling in legs, feet, and hands. A person with diabetes may not feel pain, heat, cold, or other sensations. If a diabetic person with diabetic peripheral neuropathy has a cut on their foot, it may go unnoticed, get worse, and become infected. Many diabetic people also develop foot ulcers as well. Pressure areas can break down with open sores which can be very difficult to heal.
Diabetes can also slow blood flow, which lengthens the time it takes for a cut, sore, or infection to heal. Peripheral vascular disease affects blood vessels away from the heart, particularly in the arms and legs. If an infection cannot heal due to lack of blood flow, an ulcer or gangrene can develop at the site of the wound.
With diabetes there is a higher chance of common foot problems (bunions, calluses, fungal infections) becoming much more severe, and they can sometimes even result in amputation. Routine foot care is crucial for people with diabetes.
What is nerve pain? Neuropathic pain occurs because of nerve damage. Nerve damage usually comes from compression or an injury, from certain medical conditions (such as diabetes), or it can be a side effect from some drugs or chemotherapy. Damaged nerves can send pain signals without any real reason, or they can cause a lack of sensation. Nerve pain can get better with treatment or on its own, but that can take months or even years, and even then sometimes it never gets better. It can stay the same or slowly worsen, and sometimes the damage cannot be reversed.
Many people experience nerve pain that cannot be explained, even after testing. This is called idiopathic neuropathy. Some experts have linked it to prediabetes and metabolic syndrome, which is a combination of high blood pressure, abnormal cholesterol levels, obesity, and prediabetes. Sometimes biomechanical factors cause pressure on the nerves and subsequent neuropathy.
What are flat feet? Flat feet occur when the arches, or the upward curves at the bottom of the feet, have fallen. The bones, tendons, and plantar fascia support the longitudinal arches of the feet.
Flat feet can occur for many reasons, including:
An abnormality that has existed since birth
Broken or dislocated bones
Inflammation or damage of the posterior tibial tendon
Some health conditions, like rheumatoid arthritis, or diabetes mellitus
Stretched or torn tendons
Obesity, diabetes, aging, and pregnancy can all increase the risk of developing flat feet. Flat feet do not always require treatment and often go unnoticed. Other people may experience one or more of the following:
Back, leg, and knee pain
Difficulty standing on toes and performing other movements