Miami Feet offers a full array of podiatric services to help you maintain healthy feet. You can read more on this page about specific services:
- Achilles Tendon
- Ankle Instability
- Ankle Sprains and Fractures
- Arthritic Foot & Ankle Care
- Athletes Foot
- Calluses (Painful)
- Crush Injuries
- Diabetic Feet Evaluation and Treatment
- Laser Treatment
- Flat Feet
- Fungal Nails
- Geriatric Foot Care
- Heel Spurs and Cracked Heel Syndrome
- Ingrown Toenails Permanent Treatment
- Plantar Fasciitis
- Tendon ruptures
- Wound Care
Ankle sprains are caused by an unnatural twisting or force on the ankle bones of the foot, which may result in excessive stretching or tearing of one or more ligaments on the outside of the ankle. The severity of the sprain can impact the degree of damage as well as the type and duration of treatment. If not properly treated, ankle sprains may develop into long-term problems.
Primary symptoms of ankle sprains are pain following a twist or injury, swelling, and bruising.
Treatment includes resting and elevating the ankle and applying ice to reduce swelling. Compressive bandages also may be used to immobilize and support the injury during healing. Serious ankle sprains, particularly among competitive athletes, may require surgery to repair and tighten the damaged ligaments.
To prevent ankle sprains, try to maintain strength, balance, and flexibility in the foot and ankle through exercise and stretching, and wearing well-fitted shoes.
A bunion is a bone deformity caused by an enlargement of the joint at the base and side of the big toe (metatarsophalangeal joint). Bunions form when the toe moves out of place. The enlargement and its protuberance cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward the other toes, sometimes overlapping a third toe (known as Hallux Varus). 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 Varus. Bunions can also lead to other toe deformities, such as hammertoe.
Many people with bunions suffer from 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—all contributing to chronic pain.
Wearing shoes that are too tight is the leading cause of bunions. Bunions are not hereditary, but they do tend to run in families, usually because of a faulty foot structure. Foot injuries, neuromuscular problems, flat feet, and pronated feet can contribute to their formation. It is estimated that bunions occur in 33 percent of the population in Western countries.
Treatment for Bunions
Because they are bone deformities, bunions do not resolve by themselves. The goal for bunion treatment is twofold: first, to relieve the pressure and pain cause by irritations, and second to stop any progressive growth of the enlargement. Commonly used methods for reducing pressure and pain caused by bunions include:
- The use of protective padding, often made from felt material, to eliminate the friction against shoes and help alleviate inflammation and skin problems.
- Removal of corns and calluses on the foot.
- Changing to carefully fitted footwear designed to accommodate the bunion and not contribute toward its growth.
- Orthotic devices—both over-the-counter and custom made—to help stabilize the joint and place the foot in the correct position for walking and standing.
- Exercises to maintain joint mobility and prevent stiffness or arthritis.
- Splints for nighttime wear to help the toes and joint align properly. This is often recommended for adolescents with bunions, because their bone development may still be adaptable.
Depending on the size of the enlargement, misalignment of the toe, and pain experienced, conservative treatments may not be adequate to prevent progressive damage from bunions. In these cases, bunion surgery, known as a bunionectomy, may be advised to remove the bunion and realign the toe.
Flat feet are a common condition of the foot structure. In infants and toddlers, prior to walking, the longitudinal arch is not developed, and flat feet are normal. Most feet are flexible and an arch appears when children begin standing on their toes. The arch continues to develop throughout childhood, and by adulthood most people have developed normal arches.
Flat feet are generally associated with pronation, a leaning inward of the ankle bones toward the center line. Shoes of children who pronate, when placed side by side, will lean toward each other (after they have been worn long enough for the foot position to remodel their shape).
Many people with flat feet do not experience pain or other problems. When pain in the foot, ankle, or lower leg does occur, especially in children, the feet should be evaluated.
Painful progressive flatfoot, otherwise known as tibialis posterior tendonitis or adult-acquired flatfoot, refers to inflammation of the tendon of the tibialis posterior. This condition arises when the tendon becomes inflamed, stretched, or torn. Left untreated, it may lead to severe disability and chronic pain. People are predisposed to tibialis posterior tendonitis if they have flat feet or an abnormal attachment of the tendon to the bones in the midfoot.
Nonsteroidal anti-inflammatory medications, icing, physical therapy, supportive taping, bracing, and orthotics are common treatments for painful progressive flatfoot. Note: Please consult your physician before taking any medications. In some cases, a surgery may need to be performed to repair a torn or damaged tendon and restore normal function. In the most severe cases, surgery on the midfoot bones may be necessary to treat the associated flatfoot condition.
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.
Causes of hammertoe include improperly fitting shoes and muscle imbalance.
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.
Diabetic Foot Care
According to the American Diabetes Association, about 15.7 million people (5.9 percent of the United States population) have diabetes. Nervous system damage (also called neuropathy) affects about 60 to 70 percent of people with diabetes and is a major complication that may cause diabetics to lose feeling in their feet or hands.
Foot problems are a big risk in diabetics. Diabetics must constantly monitor their feet or face severe consequences, including amputation. With a diabetic foot, a wound as small as a blister from wearing a shoe that’s too tight can lead to a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal. When a wound is not healing, is at risk for infection and infections spread quickly in diabetics.
When a diabetic foot becomes numb, it may be at risk for deformity. One way this happens is through ulcers. Small, unattended cuts become open sores, which may then become infected. Another way is the bone condition CharcotFoot. This is one of the most serious foot problems diabetics face. It warps the shape of the foot when bones fracture and disintegrate, and yet, because of numbness there is no pain, and the individual continues to walk on the foot. Our practice can treat diabetic foot ulcers and early phases of Charcot (pronounced «sharko») fractures using a total contact cast and prevent more serious damage or deformity. This treatment allows the ulcer to heal by distributing weight and relieving pressure. For Charcot Foot, the cast controls foot movement and supports its contours
If you have diabetes, you should inspect your feet every day. Look for puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts, and nail discoloration. Get someone to help you, or use a mirror.
Here’s some basic advice for taking care of diabetic feet:
- Always keep your feet warm.
- Don’t get your feet wet in snow or rain.
- Keep feet away from heat (heating pads, hot water pads, electric blankets, radiators, fireplaces). You can burn your feet without knowing it. Water temperature should be less than 92 degrees. Estimate with your elbow or bath thermometer (you can get one in any store that sells infant products).
- Don’t smoke or sit cross-legged. Both decrease blood supply to your feet.
- Don’t soak your feet.
- Don’t use antiseptic solutions (such as iodine or salicylic acid) or over-the-counter treatments for corns or calluses.
- Don’t use any tape or sticky products, such as corn plasters, on your feet. They can rip your skin.
- Trim your toenails straight across. Avoid cutting the corners. Use a nail file or emery board. If you find an ingrown toenail, contact our office for treatment.
- Use quality lotion to keep the skin of your feet soft and moist, but don’t put any lotion between your toes.
- Wash your feet every day with mild soap and warm water.
- Wear loose socks to bed.
- Wear warm socks and shoes in winter.
- When drying your feet, pat each foot with a towel and be careful between your toes.
- Buy shoes that are comfortable without a «breaking-in» period. Check how your shoe fits in width, length, back, bottom of heel, and sole. Avoid pointed-toe styles and high heels. Try to get shoes made with leather upper material and deep toe boxes. Wear new shoes for only two hours or less at a time.
- Don’t wear the same pair of shoes everyday. Inspect the inside of each shoe looking for foreign objects, protruding nails, or any rough spots inside before putting them on. Don’t lace your shoes too tightly or loosely.
- Choose socks and stockings carefully. Wear clean, dry socks every day and always wear socks with shoes. Avoid socks with holes or wrinkles. Thin cotton socks are more absorbent for summer wear. Square-toes socks will not squeeze your toes. Avoid stockings with elastic tops or garters.
- Never wear sandals or thongs (flip-flops) and never go barefoot, indoors or out.
- In the winter, wear warm socks and protective outer footwear. Avoid getting your feet wet in the snow and rain and avoid letting your toes get cold.
- Don’t file down, remove, or shave off corns or calluses yourself.
Contact our office immediately if you experience any injury to your foot. Even a minor injury is an emergency for a patient with diabetes.
Plantar fasciitis is the term commonly used to refer to heel and arch pain traced to an inflammation on the bottom of the foot. More specifically, plantar fasciitis is an inflammation of the connective tissue, called plantar fascia, that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone. Overpronation is the most common cause of plantar fasciitis. As the foot rolls inward excessively when walking, it flattens the foot, lengthens the arch, and puts added tension on the plantar fascia. Over time, this causes inflammation.
Also known as heel spur syndrome, the condition is often successfully treated with conservative measures, such as the use of anti-inflammatory medications, ice packs, stretching exercises, orthotic devices, and physical therapy. Note: Please consult your physician before taking any medications. In persistent cases, Extracorporeal Shock Wave Treatment (ESWT) may be used to treat the heel pain.
Haglund’s Deformity (also known as pump bump or retrocalcaneal bursitis) is a painful enlargement on the back of the heel bone that becomes irritated by shoes. It normally appears as a red, painful, and swollen area in the back of the heel bone. Women tend to develop the condition more than men because of irritation from rigid heel counters in shoes that rub up and down on the back of the heel bone.
Changing shoes, soaking feet, and anti-inflammatory medications often mitigate the symptoms of this problem. Note: Please consult your physician before taking any medications.
Heel calluses, also called plantar calluses, develop when one metatarsal bone is longer or lower than the others and it hits the ground with more force than it is equipped to handle. As a result, the skin under this bone thickens. The resulting callus causes irritation and pain.
In most cases, heel calluses can be treated without surgery. In severe cases, however, a surgical procedure, called an osteotomy, is performed to relieve the pressure on the bone. The procedure involves cutting the metatarsal bone in a «V» shape, lifting the bone and aligning it with the other bones. This alleviates the pressure and prevents formation of a heel callus.
Heel fissures is the term for cracking of the skin of the heels. This can be a painful condition that can cause bleeding. Open-backed sandals or shoes that allow more slippage around the heel while walking are often culprits that cause heel fissures. Skin conditions, such as eczema and psoriasis, can also lead to heel fissures. The skin thickens as a result of the friction. Wearing proper shoes and the use of deep skin moisturizers and lotions can reduce the dryness associated with the condition and allow the foot to heal
Corns and calluses are protective layers of compacted, dead skin cells. They are caused by repeated friction from skin rubbing against bony areas or against an irregularity in a shoe. Corns ordinarily form on the toes and calluses on the soles of the feet. The friction and pressure can burn or otherwise be painful and may be relieved by moleskin or padding on the affected areas.
Never cut corns or calluses with any instrument, and never apply home remedies, except under a podiatrist’s instructions.
Athlete’s Foot, also known as tinea pedis, is a skin disease caused by a fungus that usually occurs between the toes. The fungus attacks the feet because shoes create a warm, dark, and humid environment that encourages fungus growth. Warm, damp areas around swimming pools, showers, and locker rooms, are also breeding grounds for fungi.
Symptoms of Athlete’s Foot include drying skin, itching, scaling, inflammation, and blisters on and between the toes. Athlete’s Foot can spread to the soles of the feet and to the toenails as well as other parts of the body, which is why timely treatment is so important.
You can prevent Athlete’s Foot by:
- Not walking barefoot, particularly in public pools and locker rooms.
- Reducing foot perspiration by using talcum powder.
- Wearing light and airy shoes.
- Wearing socks that keep your feet dry, and changing them frequently if you perspire heavily.
While fungicidal and fungistatic chemicals are usually used to treat Athlete’s Foot problems, they often fail to contact the fungi in the lower layers of the skin. For persistent Athlete’s Foot, a prescription topical or oral antifungal drug may be needed. Note: Please consult your physician before taking any medications.