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Kevin F Gallagher, DPM
Board Certified in Foot and Ankle Surgery
(724) 941-4330


Featured

Monday, 21 September 2020 00:00

Hammertoes are painful deformities that frequently form on the second, third, or fourth toe. The condition is often caused by an issue in foot mechanics. This can be caused by the person’s specific gait or the manner in which they walk, or by shoes that do not comfortably fit the deformity.  Hammertoes can be formed after wearing shoes that are too narrow or short for the foot or have excessively high heels. Shoes that are not properly sized will force the toes into a bent position for long periods of time. This can cause the muscles to shorten and toes to bend into the deformity of a hammertoe.

Hammertoe can also be caused by complications from rheumatoid arthritis, osteoarthritis, trauma to the foot, heredity, or a cerebral vascular accident. Pain and difficult mobility of the toes, deformities, calluses, and corns are all symptoms of a hammertoe.

Someone who suspects they have the symptoms of a hammertoe should consult with a physician—particularly a podiatrist. Podiatrists diagnose and treat complications of the foot and ankle. If the podiatrist discovers that the affected toes are still flexible, treatment for the hammertoe may simply involve exercise, physical therapy, and better-fitting shoes. Treatment for hammertoes typically involves controlling foot mechanics, such as walking, through the use of customized orthotics.

For more serious cases in which the toes have become inflexible and rigid, surgery may be suggested. During the operation, the toe would receive an incision to relieve pressure on the tendons. A re-alignment of the tendons may then be performed by removing small pieces of bone to straighten the toe. In some cases, the insertion of pins is needed to keep the bones in the proper position as the toe heals. The patient is usually allowed to return home on the same day as the surgery.

If surgery is performed to repair a hammertoe, following the postoperative directions of your doctor is essential. Directions may include several stretches, picking up marbles with your toes, or attempting to crumple a towel placed flat against your feet. Wear shoes that have low heels and a wide amount of toe space to maintain comfort. Closed-toe shoes and high heels should be avoided. Shoes with laces allow the wearer to adjust how fitted he or she may want the shoes to be and also allow for greater comfort. To provide adequate space for your toes, select shoes that have a minimum of one-half inch of space between the tip of your longest toe and the inside of the shoe. This will also relieve pressure on your toes and prevent future hammertoes from forming.

Other preventative measures that can be taken include going shopping for new shoes in the middle of the day. Your feet are its smallest in the morning and swell as the day progresses. Trying on and purchasing new shoes midday will give you the most reliable size. Be sure to check that the shoes you purchase are both the same size. If possible, ask the store to stretch out the shoes at its painful points to allow for optimum comfort.  

Wednesday, 16 September 2020 00:00

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.  

Tuesday, 08 September 2020 00:00

Gout, typically found in diabetic patients, is an unusually painful form of arthritis caused by elevated levels of uric acid in the bloodstream. The condition typically strikes the big joint on the big toe. It has also been known to strike the knees, elbows, fingers, ankles and wrists—generally anywhere that has a functioning, moving joint.

The high level of uric acid in a person’s bloodstream creates the condition known as hyperuricema—the main cause of gout. Genetic predisposition occurs in nine out of ten sufferers. The children of parents who suffer gout will have a two in ten chance of developing the condition as well. 

This form of arthritis, being particularly painful, is the leftover uric acid crystallizing in the blood stream. The crystallized uric acid then travels to the space between joints where they rub, causing friction when the patient moves. Symptoms include: pain, redness, swelling, and inflammation. Additional side effects may include fatigue and fever, although reports of these effects are very rare. Some patients have reported that pain may intensify when the temperature drops, such as when you sleep.

Most cases of gout are easily diagnosed by a podiatrist’s assessment of the various symptoms. Defined tests can also be performed. A blood test to detect elevated levels of uric acid is often used as well as an x-ray to diagnose visible and chronic gout.

Treatment for gout simply means eliminating symptoms. Non-steroid anti-inflammatory drugs or NSAIDs (Colchicine and other corticosteroid drugs, etc.) will quell the redness, the swelling, and the inflammation. However, managing your diet, lifestyle changes, and using preventative drugs are all helpful toward fully combating the most severe cases.

 Those that lead an inactive lifestyle are at a higher risk for gout. Any amount of exercise decreases the probability of repeat encounters with the condition. Reducing your consumption of red meat, sea food, and fructose-sweetened drinks also reduces the likelihood of chronic gout as well.

Ingesting Vitamin C, coffee, and particular dairy products can help with maintaining a healthy lifestyle. There are new drugs out on the market that inhibit the body’s production of uric acid-producing enzymes. However, reducing or eliminating your overall levels of uric acid is the best remedy to ensuring you lead a gout-free life.

Monday, 31 August 2020 00:00

Millions of people are affected by diabetes each year. Diabetes damages blood vessels in all parts of the body, especially the feet. The legs and feet may develop slow blood flow, which causes neuropathy, or nerve damage. Once a diabetic patient develops neuropathy, it is important that the feet are well taken care of. Otherwise, the lower limbs may have to be amputated. This only happens in drastic cases, but it shows how seriously diabetic foot care should be taken.

It is very important to always wash and dry the feet thoroughly, especially in between the toes, if you’re a diabetic. Secondly, examining your feet and toes for redness or sores must be done, even if you do not feel pain.  You may also want to examine your feet from the bottom. Try to avoid wearing colored socks to prevent infections that may occur from the dye. Well-fitting socks are also highly recommended.

A diabetic’s physician should always monitor their blood levels to test how well blood sugars are being maintained. In addition to giving advice about everyday eating habits and foot care, a physician may prescribe medicine to help with the diabetic patient’s neuropathy. It is also advised to see a podiatrist if experiencing any feet conditions. Toenails may also need to be taken care of by a podiatrist. This prevents patients from cutting too deeply around their cuticles, which can lead to infection.

A person can take care of their feet at home by following the instructions of their physician. Using creams on one’s feet is also an effective way to heal dryness. Proceed with caution when using tools to remove calluses, as severe diabetics may not be able to feel pain on their feet. If any complications arise do not hesitate to contact a podiatrist.

On a daily basis, diabetic feet must be checked. If you are ever concerned about something, contact your health care professional. You never want to wait until a wound becomes too severe to treat. If left untreated, gangrene may develop. Gangrene is a serious infection that can lead to sepsis or amputation. It is also important for diabetics to be on the lookout for ulcers. Ulcers are sores that develop from tissue loss on the skin. They can be quite painful and require intensive treatment. Early treatment and everyday inspection are imperative to staying healthy.

Monday, 24 August 2020 00:00

Athlete’s foot, or tinea pedis, is a skin disease caused by a fungal infection.  The infection typically occurs between the toes, and the feet are most subject to this disease because shoes best create the warm, dark, and moist environment in which fungus thrives.  Other areas that create a similar environment, such as swimming pools, public showers, and locker rooms; can also promote fungi growth. 

Symptoms of athlete’s foot include dry skin, itching, scaling, inflammation, and blistering.  Sometimes, blisters can evolve into the cracks or breaks in the skin.  The exposed tissue can then create pain, swelling, and discharge.  The spread of infection can cause itching and burning as well.

While athlete’s foot commonly occurs between the toes, it may also spread to the toenails or soles of the feet.  Other parts of the body, such as the groin or underarms, can also become infected if they are touched after the original area of infection is scratched.  Aside from physical contact, athlete’s foot can also spread through the contamination of footwear, clothing or bedsheets.

Proper foot hygiene is essential in preventing athlete’s foot.  You can prevent the fungus from spreading by frequently washing your feet using soap and water, thoroughly drying the feet between the toes, changing shoes and socks every day to reduce moisture, and ensuring that bathroom and shower floors are disinfected.  Other tips include using shower shoes, avoiding walking barefoot in public environments, wearing light and airy shoes, and wearing socks that keep the feet dry.

While treatment for athlete’s foot can involve topical or oral antifungal drugs, mild cases of the infection can be treated by dusting foot powder in shoes and socks.  Any treatment used can be supplemented by frequently bathing the feet and drying the toes.  If proper foot hygiene and self-care do not ease your case of athlete’s foot, contact your podiatrist.  He will determine if the underlying cause of your condition is truly a fungus.  If that is the case, a comprehensive treatment plan may be suggested with the inclusion of prescription antifungal medications.

Monday, 10 August 2020 00:00

Shockwave therapy is one treatment option for plantar fasciitis, a condition that causes heel and foot inflammation and pain. This type of injury is often caused by overworking the feet. Heel pain is most common in people that exercise often, individuals who are overweight, and people whose profession require them to stand for long periods of time.

Heel pain can be caused by a number of problems including ill-fitting shoes, strenuous exercise routines or work hazards. Simple treatment options involve buying new shoes, taking ibuprofen, doing heel and foot exercises, and resting your feet. For severe cases, shockwave therapy can be considered a more viable form of treatment.

Shockwave therapy should be considered for patients that have had unsuccessful treatment or whose heel pain has lasted for more than six months. In shockwave therapy, a device delivers shockwaves to the patient’s body, which jumpstart the body’s repair mechanisms. These mechanisms then begin working more effectively to repair damage done to the heel area.

Shockwave therapy also helps eliminate pain in the heel area. When the body’s natural repair mechanisms are triggered, tissue healing in the body is sped up. This leads to pain reduction after pain transmission nerves are stimulated.

Shockwave therapy eliminates the risk factors associated with surgery, such as the use of anesthetics, and is less invasive. Since this technique also helps improve the body’s natural healing techniques, recovery time should be shorter than surgical procedures.

Discomfort issues can also be a side effect of treatment. Short-term issues normally include skin bruising, minor pain during and after treatment, swelling of the heel, and discolored tissue. However, these side effects of shockwave therapy usually disappear after a few days. The fast recovery time of shockwave therapy makes it easy for patients to return to their daily routines.

Like most types of treatments, surgeries, and medications, shockwave therapy is not for everyone. Potential patients with heart conditions and people with pacemakers should not be considered for this technique. People on certain types of medications, usually medications affecting blood clotting, would be ineligible for shockwave therapy. Children and pregnant women should avoid this treatment option as well.

Overall, shockwave therapy could be a great option for heel pain. It is less invasive than surgery, helps trigger natural healing mechanisms, and should be considered by people who have had long bouts of heel pain or tried conventional treatment options that were unsuccessful.

Monday, 03 August 2020 00:00

Corns and Calluses are both hardened layers of thickened skin that develop because of friction. Both ailments are typically found on the feet and may be unsightly. Although they have similarities, corns and calluses are different from each other.

Some causes of corns and calluses may be wearing ill-fitting shoes and not wearing socks. If you wear tight shoes, your feet will constantly be forced to rub against the shoes, causing friction. If you fail to wear socks, you are also causing your feet to endure excess friction.

There are some signs that may help you determine whether you have one of these two conditions. The first symptom is a thick, rough area of skin. Another common symptom is a hardened, raised bump on the foot. You may also experience tenderness or pain under the skin in addition to flaky, dry, or waxy skin.

There are also risk factors that may make someone more prone to developing corns and calluses. If you are already dealing with bunions or hammertoe, you may be more vulnerable to having corns and calluses as well. Other risk factors are foot deformities such as bone spurs, which can cause constant rubbing inside the shoe.

Corns tend to be smaller than calluses and they usually have a hard center surrounded by inflamed skin. They also tend to develop on the parts of the body that don’t bear as much weight such as the tops and sides of toes. Corns may also be painful for those who have them. On the other hand, calluses are rarely painful. These tend to develop on the bottom of the feet and may vary in size and shape.

Fortunately, most people only need treatment for corns and calluses if they are experiencing discomfort. At home treatments for corns and calluses should be avoided, because they will likely lead to infection. If you have either of these ailments it is advised that you consult with your podiatrist to determine the best treatment option for you.

Monday, 27 July 2020 00:00

Diabetics must be wary of all wounds, regardless of depth or size. Diabetes, a chronic disease in which the body cannot properly use glucose the way it normally would, causes various complications that make wounds difficult to heal. Nerve damage or neuropathy will cause diabetics to have trouble feeling the pain of a blister or cut until the condition has significantly worsened or become infected. A diabetic’s weakened immune system can make even the most minor of wounds easily susceptible to infection. Diabetics are also more prone to developing narrow, clogged arteries, and are therefore more likely to develop wounds.

Wounds should be taken care of immediately after discovery, as even the smallest of wounds can become infected if enough bacteria build up within the wound.  To remove dirt, wounds should be first rinsed under running water only. Soap, hydrogen peroxide, or iodine can irritate the injury and should be avoided. To prevent infection, apply antibiotic ointment to the wound and cover it with a bandage. The bandage should be changed daily. The skin around the wound may be cleaned with soap.

To prevent further exacerbation, see a doctor—especially if you have diabetes. Minor skin conditions can become larger problems if not properly inspected. As the wound heals, make sure to avoid applying pressure to the affected area.

Monday, 20 July 2020 00:00

Hammertoe is a foot deformity that occurs due to an imbalance in the tendons, muscles, or ligaments that are responsible for holding the toes in their normal position. This condition may be caused by poor footwear, foot structure, trauma, and disease. The most common solution for hammertoe is to relieve the pain by changing your footwear and wearing orthotics. In severe cases, surgery may be required.

The shoes that are most likely to cause hammertoe are high heeled shoes or shoes that are too tight in the toe box. Tight shoes will force your toes to crowd together in a curled position. This position will likely continue when you take your shoes off. Another cause is trauma. When you stub your toe, you are increasing the chance that you will develop hammertoe.

There are risk factors that may make you more likely to develop this condition. Women are more likely to have the condition compared to men, and it is also more likely to appear in those who are older in age.

Many different foot problems can be avoided by wearing shoes that have adjustability, adequate toe room, and low heels. Furthermore, if you want to buy new shoes, you should look to purchase them at the end of the day and make sure you know your correct size. The importance of buying shoes at the end of the day is that your feet swell as the day progresses. You should also ensure that you are wearing your correct size because your shoe size may change as you grow older.

To diagnose someone with hammertoe, your podiatrist will need to conduct a thorough examination of your foot. Your doctor may even order an x-ray to evaluate the bones and joints of your feet and toes.

If you have hammertoe, your podiatrist may recommend that you wear shoes that fit you better along with inserts to place inside them. Additionally, he or she may suggest special exercises for you to perform to stretch your toes. One helpful exercise it to pick up marbles with your feet or crumple a towel with your toes.

Prior to meeting with your podiatrist, it will be helpful to make a list of all the symptoms you are experiencing. You should also make a note of medications you are taking and important personal information about your medical history.

Monday, 13 July 2020 00:00

Ankle sprains occur when ligaments that support the ankle stretch beyond their limits and tear. These types of injuries are very common and can occur in people of all ages. Sprains may range from mild to severe, depending on how much damage is done to the ligaments. If a sprain goes untreated, a more severe sprain may occur which can further damage the ankle. Repeated ankle sprains can lead to chronic ankle pain.

There are some risk factors that can increase your risk of suffering a sprained ankle. Those who participate in sports, walk on uneven surfaces, have a prior ankle injury, are in poor physical condition, or wear improper shoes are more likely to get a sprained ankle.

There are a few symptoms to look out for if you suspect you are suffering from a sprained ankle. Some common symptoms are swelling, bruising, tenderness, and instability of the ankle. In cases where the tearing of the ligaments is severe, there may be a “popping” sound when the strain occurs.

The RICE method is proven to be effective in treating ankle sprains. RICE stands for Rest, Ice, Compression, and Elevation. Rest is important for treatment especially within the first 24 to 48 hours. You should also ice your sprained ankle for the first 48 hours for 20 minutes at a time. A small piece of cloth should be placed between the ice and the affected area. For the compression step, you should wear a brace that is snug, but not too tight that it cuts off circulation. When choosing a brace, be sure to choose one that is suitable for the type of ankle sprain you have. Lastly, you should elevate your foot above the heart as often as possible.

After you treat a sprain, you should go through rehabilitation to prevent the injury from occurring again. There are three phases to the rehab process. The first phase involves resting, protecting and reducing the swelling of the injury. The second phase consists of restoring the ankles flexibility, range of motion, and strength. The third phase consists of slowly returning to activity and maintenance exercises.

If you suspect you have an ankle sprain, you shouldn’t hesitate to consult with your podiatrist. Your podiatrist will be able to give you a proper diagnosis and a suitable treatment option for your condition.

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