August 2019

Tarsal tunnel syndrome is a condition in which there is a compression of the posterior tibial nerve. The posterior tibial nerve runs along the inside of the ankle into the foot. Tarsal tunnel syndrome is named for the tarsal tunnel, which is a thin space along the inside of the ankle beside the ankle bones. This space contains various nerves, arteries, and tendons, and includes the posterior tibial nerve. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome the tibial nerve is compressed, causing tingling or burning, numbness, and pain.

Common causes of tarsal tunnel syndrome involve pressure or an injury. Injuries that produce inflammation and swelling in or around the tunnel may place pressure on the posterior tibial nerve. Direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or trauma to the tibial nerve, can result in tarsal tunnel syndrome. Diseases that damage nerves, such as diabetes or arthritis, may cause tarsal tunnel syndrome. Those with flat feet are at risk for developing the condition, as the extra pressure and strain placed on the foot may compress the posterior tibial nerve.

Feeling different sensations in the foot at different times is a common symptom of tarsal tunnel syndrome. An afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of the affected leg. Symptoms are primarily felt on bottom of the foot and/or the inside of the ankle. Symptoms can appear suddenly and may occur due to overuse of the foot.

To diagnose tarsal tunnel syndrome, your podiatrist may examine the foot and tap the posterior tibial nerve to see if symptoms surface. He or she may also order an MRI to determine if a mass is present.

Treating tarsal tunnel syndrome will depend on the decision of your podiatrist. Multiple options are available, however, and can include rest, ice, immobilization, oral medications such as anti-inflammatory drugs (NSAIDS), physical therapy, injection therapy, orthotics, supportive shoes, braces, and surgery.

Hyperhidrosis of the feet, also termed plantar hyperhidrosis, is characterized by excessive sweating of the feet that can be onset by any cause, such as exercise, fever, or anxiety. Most people suffering from hyperhidrosis of the feet also experience hyperhidrosis of the hands, or palmar hyperhidrosis. Approximately 1-2% of Americans suffer from this disorder.

Sweating is a healthy process utilized by the body in order to cool itself and maintain a proper internal temperature, which is controlled by the sympathetic nervous system. In individuals with hyperhidrosis, the sympathetic nervous system works in "overdrive", producing far more sweat than is actually needed.

Plantar hyperhidrosis is considered primary hyperhidrosis. Secondary hyperhidrosis refers to excessive sweating that occurs in an area other than the feet, hands, or armpits, and this indicates that is related to another medical condition, such as menopause, hyperthyroidism, or Parkinson's disease.

Symptoms of hyperhidrosis of the feet can include foot odor, athlete's foot, infections, and blisters. Because of the continual moisture, shoes and socks can rot which creates an additional foul odor and can ruin the material, requiring shoes and socks to be replaced frequently. In addition to the physical symptoms, emotional health is often affected as this disorder can be very embarrassing.

If left untreated, hyperhidrosis will usually persist throughout an individual's life. However, there are several treatment options available. A common first approach to treating hyperhidrosis of the feet is a topical ointment. Aluminum chloride, an ingredient found in antiperspirants, can be effective at treating hyperhidrosis if used in high concentration and applied to the foot daily. Some individuals can experience relief this way, while others encounter extreme irritation and are unable to use the product. Another procedure is the use of Botulinum Toxin A, commonly referred to as Botox. This is injected directly into the foot, and is effective at minimizing the sweat glands in the injected area. These injections must be repeated every 4 to 9 months.

If these treatments are ineffective, oral prescription medications may be taken in an effort to alleviate the symptoms. Again, some will experience relief while others do not. Going barefoot reportedly provides relief for most sufferers.

A final approach to combating hyperhidrosis of the feet is through surgery. Surgery has been less successful on patients with plantar hyperhidrosis than on those with palmar hyperhidrosis. It is only recommended when sweating is severe and other treatments have failed to work. This kind of surgery usually involves going into the central nervous system, and cutting nerves to stop the transmission of signals telling the foot to sweat.

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.

Broken ankles are a serious injury that can lead to an inability to walk, function, and also cause a significant amount of pain. A broken ankle is a break in one of the three bones in your body that connect at the ankle joint: the tibia, the fibula, and the talus. The tibia and fibula are your two primary leg bones that connect at the knee, which sit directly upon the talus bone. This is protected by a fibrous membrane that allows for movement in the ankle joint. A broken ankle is usually caused by the foot rolling under or twisting too far, causing one of these three bones to snap.

A broken ankle is different from an ankle sprain, which occurs when the ankle ligaments are ripped or torn but no bones have been broken. A sprain can still be very severe, causing bruising in the foot and an inability to hold your own weight, much like a broken ankle would. If you’re unable to stand, and suspect that you have a broken ankle, the first thing to do would be to get an immediate X-ray to determine the severity of the break.

A common cause of broken ankles is when the ankle is rolled over with enough pressure to break the bones. This usually happens during exercise, sports, or other physical activity. Another common cause is a fall or jump from a tall height.

One immediate treatment for pain relief is elevating the foot above your head to reduce blood flow to the injured area. You can also apply ice packs to your ankle to help reduce swelling, redness, inflammation, and pain. After these initial steps, getting a cast and staying off your feet as much as possible will aid in the recovery of the broken ankle. The less movement and stress the ankle has to endure, the more complete it will heal. A doctor can determine if surgery is needed in order to heal correctly. In these cases, an operation may be the only option to ensure the ability to walk properly again, followed by physical therapy and rehabilitation.

It is highly important to determine if surgery is needed early on, because a broken ankle can become much more severe than you realize. If not professionally treated, the broken ankle will inhibit your walking, daily functioning, and produce a large amount of pain. Treating your broken ankle early on will help prevent further damage to it.

The Achilles tendon is the largest tendon in the body; it is a tough band of fibrous tissue that stretches from the bones of the heel to the calf muscles. This tendon is what allows us to stand on our toes while running, walking, or jumping, it is common for this tendon to become injured. In severe cases, the Achilles tendon may become partially torn or completely ruptured. However, this tendon is susceptible to injury because of its limited blood supply and the high level of tension it endures.

The people who are more likely to suffer from Achilles tendon injuries are athletes who partake in activities that require them to speed up, slow down, or pivot. Consequently, athletes who engage in running, gymnastics, dance, football, baseball, basketball, or tennis are more likely to suffer from Achilles tendon injuries. Additionally, there are other factors that may make you more prone to this injury. People who wear high heels, have flat feet, tight leg muscles or tendons, or take medicines called glucocorticoids are more likely to have Achilles tendon injuries.

A common symptom of an Achilles tendon injury is pain above the heel that is felt when you stand on your toes. However, if the tendon is ruptured, the pain will be severe, and the area may become swollen and stiff. Other symptoms may be reduced strength in the lower ankle or leg area, and reduced range of motion in the ankle. When the Achilles tendon tears, there is usually a popping sound that occurs along with it. People who have acute tears or ruptures may find walking and standing to be difficult.

If you suspect you have injured your Achilles tendon, you should see your podiatrist to have a physical examination. Your podiatrist will likely conduct a series of tests to diagnose your injury including a “calf-squeeze” test. Calf squeeze tests are performed by first squeezing the calf muscle on the healthy leg. This will pull on the tendon and consequently cause the foot to move. Afterward, the same test will be performed on the injured leg. If the tendon is torn, the foot won’t move because the calf muscle won’t be connected to the foot.