Ingrown toenails are one of the most common reasons for toe pain, especially the big toe.  Ingrown toenails occur when the sides of the toenail grows into the skin.  The digging into the skin of the nail leads to a range of symptoms including redness and pain.  Often the skin on the affected side of the toe will appear swollen and may be firm. The skin may even start to grow over the nail.  In some cases there may be drainage from the toenail as well.

There are a couple of different possible causes of ingrown toenails including wearing shoes that are too tight and squeeze the toes.  As well cutting toenails too short or rounded can cause the nail to grow into the skin.  Injury like stubbing the toe can lead to an ingrown toenail.   Also some people are born with curved nails and are prone to develop ingrown toenails.

The condition needs to be treated in order to avoid infection, a common complication of an ingrown toenail.  Treatment at home consists of soaks and trimming the nail.  Sometimes at home treatments will not sufficiently remove the nail and can cause the condition to worsen.  Treatment by a podiatrist consists of removing the ingrown part of the nail through a procedure called a partial nail avulsion.  The doctor will first numb the toe then cut the edge of the toenail which is growing incorrectly.  The removed side of nail may take months to regrow.  It is also recommended following the procedure to wear sandals or avoid tight shoes.

If you are suffering from pain or infection caused by an ingrown toenail, make an appointment at one of our four offices located in Daytona Beach, Port Orange, Palm Coast, and Orange City, Florida.  The physicians at Atlantic Foot and Ankle Associates will treat your condition as conservatively as possible and get you back on your feet.

By Dr. Matthew Hentzel

Phil Mickelson has been treated for arthritis that surfaced just before the U.S. Open and left him in so much pain he couldn't walk. Arthritis is a problem that we treat at Atlantic Foot and Ankle Associates on a daily basis. Because the foot and ankle have 36 joints, the inflammation caused by arthritis can cause limitation, pain, swelling, and ultimately affects day-to-day life. We try to find not only the cause of the arthritis, but also give patient's solutions to get them back to their activity level, with conservative measures and straightforward treatment options.

Many causes of arthritis exist, but most commonly is day-to-day wear and tear. Arthritis is also caused by a sudden trauma or repetitive small trauma, and can be due to the shape of the foot which can cause jamming of the joints. Hereditary factors, bacterial and viral infections, and multisystem disorders can also cause a lead to arthritis. Also, arthritis in one joint can cause or worsen arthritis in another joint seen commonly in the foot with bunions, hammertoes, or even an arthritic ankle.

Arthritic conditions are initially diagnosed with symptomatology, x-ray findings, laboratory studies, and ruling out other common tendon and ligament issues in the foot. At Atlantic Foot and Ankle Associates we not only use these tests, but also our clinical experience to determine how to gear the proper treatment toward each patient. Treatments include padding and strapping of the foot, molded insoles, multiple anti-inflammatory medications both topical and oral, and in severe cases an injection. In some cases, surgical options may need to be entertained.

We Atlantic Foot and Ankle Associates are familiar with the management and treatment of arthritis of the foot and ankle. Often times, there is no permanent cure. However through palliative treatment, proper shoes and insoles, and careful working with other physicians, we can get you on your feet pain free. Don't be one of the 40 million people in America that suffers with this disease. Visit one of our four offices (Daytona Beach, Palm Coast, Port Orange, and Orange City) and let us help you with your arthritis today.

By Dr. Matthew Hentzel, DPM

Recently, a Kenyan collegiate runner in Alaska suffered severe frostbite and had to have both of his feet amputated.  A severe consequence of frostbite that often leads to amputation is gangrene.  However gangrene is not limited to frostbite.  Gangrene also occurs in the feet of diabetics. 

There are two major types of gangrene: dry and wet.  Dry gangrene occurs with diminished blood supply to a particular area.  Wet gangrene most often occurs when a bacterial infection affects blood flow.  Gas gangrene is a subset of wet gangrene in which anaerobic bacteria produce gas and poisons.

Symptoms of gangrene include a red line that delineates the gangrenous area from the healthy area.  Dry gangrene will become discolored, starting as a pale color and progressing to brown then black.  In wet gangrene including gas gangrene, the affected areas may feel heavy or painful.  As well there may be pus or a foul discharge as well as bubbles of gas noticed under the skin.  In wet gangrene, the skin may first appear blistered and red and then become brown or black.  Other symptoms include fever, loss of appetite, diarrhea, confusion, malaise, and low blood pressure.

Often with dry gangrene, the affected part will slough off or the affected part will be surgically removed.  Gas gangrene is much more of a serious medical situation.  Surgery and antibiotics will have to be administered promptly in order to stop the spread of infection.   In some cases the area may be exposed to hyperbaric oxygen in hopes to increase oxygen in the bloodstream and therefore to the affected area.  If the gangrene is allowed to progress to the point of the death of the affected tissues, often amputation will have to occur to remove the dead tissue.

We see a large number of diabetic patients at Atlantic Foot and Ankle Associates with locations in Daytona Beach, Orange City, Palm Coast, and Port Orange, Florida, and encourage them to inspect their feet every day.  Conserving good oxygenation and blood flow can prevent gangrene.  In the case of diabetes, ensuring a controlled blood glucose level and monitoring feet can also help avoid gangrenes. 

By Dr. Matthew J. Hentzel, DPM

The world’s former #1 golfer, Tiger Woods has recently missed approximately 1 year to a left leg and heel injury. The extent and severity of his ailment, much like many of our patients, can lead to long periods of pain and inactivity, as well as lifestyle changes.

It is estimated that Achilles tendonitis accounts for 11% of all running injuries. The Achilles tendon is the large tendon at the back of the ankle. It connects the large calf muscles (Gastrocnemius and Soleus) to the heel bone (Calcaneus) and provides the power in the push off phase of the gait cycle (walking and running).

Achilles tendonitis can be either acute, following an increase in training, or chronic which occurs over a longer period of time. In addition to being either chronic or acute, the condition can also be either at the attachment point to the heel or in the mid-portion of the tendon (typically around 4cm above the heel). Healing of the achilles tendon is often slow, due to its poor blood supply at certain areas of the tendon.

At Atlantic Podiatry Associates, we try to treat this injury as conservatively as possible. Initially, simple rest, ice, an anti-inflammatory, strapping or orthotics are used to take stress off the tendon. We make sure you have the right running or walking shoes for style or aggressiveness of activity.

If the tendon and injury progresses, cast or boot immobilization, and MRI’s are commonly employed to grade the extent of the damage. In cases of tears or ruptures, our physicians feel comfortable in fixing the problem surgically, coordinating rehabilitation, and getting the tendon back to normal strength.

Don’t let your Achilles heel drag you down like Tiger. Atlantic Podiatry Associates in Port Orange and Orange City, FL, have treatments and solutions to get you back on the playing field, with a path to keep the problem from coming back. 

By Dr. Matthew Hentzel