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

I love to run.  Running is my favorite way to relieve stress and spend time outdoors.  I am fortunate to live in Ormond Beach, Florida, where the scenery is breathtaking and the weather is amazing.  The hard-packed sandy beaches are great for running with an ocean view.  The bridges offer uphill challenges in an otherwise flat landscape.  I consider myself the typical hard-headed runner; I have over-trained and am suffering the consequences.  Luckily, I happen to work for an incredible group of foot and ankle physicians at Atlantic Foot and Ankle Associates with four offices located in Daytona Beach, Port Orange, Palm Coast, Orange City, Florida.

A few months ago, I began to experience heel pain, especially when I first got out of bed in the morning.  I learned that I was suffering from Plantar Fasciitis, a condition common to runners.  I went in to see Dr. James Rust in our Daytona Beach location, who carefully listened to what I had to say and took the time to explain my treatment options.  He explained that the physicians at Atlantic Foot and Ankle Associates initially treat patients with heel pain as conservatively as possible recommending: 

• rest or periods of immobilization
• icing the painful area
• heel stretching exercises 
• night splints to stretch the injured fascia and allow it to heal
• wearing shoes with good support and cushions
• non-steroidal or steroid-type medicines 
• steroid shots or injections into the heel
• in severe cases, surgical treatment may be necessary release the tight tissue

Dr. Rust recommended custom orthotics, stretching and icing.  The heel pain slowly began to decrease and I was able to continue running and interval training.  If you are suffering from symptoms such as heel pain, please do not hesitate to contact one of our podiatrists.  You do not have to suffer any longer!

By Marisa Aitken

Recently in different parts of the country including Alabama and California, there has been an outbreak of Hand, Foot, and Mouth Disease (HFMD).  Typically this condition affects children but also has the potential to affect adults as well.  Commonly the disease is seen affect classes of preschools or daycares.  HFMD can be caused by several viruses, commonly coxsackievirus A16.

Once the disease has been contracted it will take about three to seven days to see symptoms.  Signs and symptoms usually begin with fever and malaise.  A day or two after the onset of the fever, small red spots that will become blisters and then sores or ulcers will appear in the mouth.  Often with these lesions there can be associated sore throat and decreased appetite.  A rash will then appear on the skin on the palms of hands and soles of feet which may as well turn into blisters and sores.  The rash may also be present around the calf.

The disease spreads by direct contact often through oral secretions or stools and can even be spread weeks after the disease seems to have resolved.  Thorough washing of hands as well as avoiding close contact and sharing food or utensils with someone affected can help to prevent the spread of the disease or at least decrease the chances of contracting the disease.  

There is no certain treatment for the disease since it will commonly resolve on its own in about seven days.  However to alleviate pain and fever NSAIDs or Tylenol can be used.   Over the counter medicines and sprays can also be used to alleviate any pain of the throat.    As far as complications, one of the more common complications of the disease mostly in younger children is fingernail and toenail loss.  However the nails do grow back with time.

The physicians at Atlantic Foot and Ankle Associates treatpatients of all ages, ranging from pediatric to geriatric.  Please contact our office if you are suffering from any of the following:

• Persistent pain in your feet or ankles
• Severe cracking, scaling, or peeling on the heel or foot
• Blisters on your feet
• Changes in the nails or skin on your foot
• Heel Pain
• Toenail Fungus

With offices conveniently located in Palm Coast, Daytona Beach, Port Orange, and Orange City, our physicians will get you healthy and back on your feet again!

By Dr. Dennis McBroom

With summer right around the corner comes the season of sandals, beaches, and therefore exposed toes.  Toenail fungus often discourages many from wanting to expose their toes by causing a series of changes to the nails.  Toenail fungus is a very common condition referred to as onychomycosis.  Onychomycosis may start out as just a small area of yellow or white discoloration of the nail.  As the fungus spreads the discoloration may spread and worsen and the nail may thicken.  There may also seem to be an accumulation of material under the nail and possibly an odor.  The condition may eventually become painful as well.

There are a variety of risk factors for developing onychomycosis.  First of all, fungi best survive in dark and damp areas.  With that said, public places such as pools and showers are very common places for fungi to grow and be transmitted.  As well personal footwear can influence the development of onychomycosis.  Wearing shoes and socks and perspiring or having wet feet can also encourage development.  Trauma also leaves the nail susceptible to invasion by fungi.  Onychomycosis is often also seen in aging populations often due to decreased blood supply.

To diagnose onychomycosis your physician will first evaluate the toes clinically.  A sample may be taken to undergo laboratory testing such as a potassium hydroxide smear or a periodic acid-schiff stain.  Once the diagnosis is confirmed treatment will begin.  It often takes months to make sure the fungus is completely eradicated.   Atlantic Foot and Ankle Associates offer several options for the treatment of onychomycosis.  Medications for toenail fungus can be topical or oral.  One of the most common methods of treatment is the oral medication terbinafine (Lamisil).  This medication has to be taken for approximately 90 days.  We also offer a topical treatment called Formula 3, which is available at all four of our offices located in Palm Coast, Daytona Beach, Port Orange, and Orange City, Florida.   There is also a new, FDA approved treatment for onychomycosis called laser therapy.  Please visit the Florida Laser Center website to learn more about laser therapy, which is now available in our Daytona Beach location.

Onychomycosis can be prevented by taking actions such as keeping feet dry or allowing ventilation when wet as well avoiding being barefoot in areas where fungi are likely to grow.  If you are one of the 30 million Americans suffering with toenail fungus, please do not hesitate to get treatment so you can get back to the beach and show off your beautiful toes!

By Dr. Sona Ramdath Jr.

With the NCAA tournament well under way, players are most likely doing their best to avoid any type of injury.  An injury common in athletes refers to posterior tibial tendonitis; however, this injury can occur in nonathletes as well.  The posterior tibial tendon courses along the back of the leg then on the inside of the ankle to the arch of the foot.  It functions to support the arch of the foot.

Posterior tibial tendonitis can occur due to injury or overuse.  There are certain risk factors to the development of posterior tibial tendonitis including being overweight, diabetes, and flat feet.  When the tendon’s function is compromised the arch of the foot may drop placing even more pressure on the tendon which can lead to inflammation.

Symptoms of posterior tibial tendonitis include tenderness or pain on palpation of the course of the tendon.  There may also be pain on the inside of the foot and ankle in walking.  Standing on the tips of the toes may also elicit pain due to weakness.  These symptoms progress as the condition advances.   Treatment of the condition includes non-steroidal anti-inflammatory reactions, applying ice for about 20 minutes two times daily, and rest.  Increasing the arch support of the shoe or adding orthotics can also help control the condition. 

If untreated and with continued overuse, posterior tibial tendonitis can progress to posterior tibial tendon dysfunction (PTTD), causing a progressive flatfoot deformity.   In addition to the above symptoms this may lead to arthritis and a change in gait, or the way a person walks.  The change in gait may even lead to pain in other areas involved in mobilization such as the knees, hip, and back.   With this said, it is important once symptoms begin to seek medical attention and to follow physician instructions to avoid progression.

If you are suffering from posterior tibial tendonitis, please do not wait to see a podiatrist.  The physicians at Atlantic Foot and Ankle Associates take a conservative approach for all types of injuries.   Make an appointment at one of our four offices conveniently located in Palm Coast, Orange City, Daytona Beach, and Port Orange and get back to walking pain free!

By Dr. James Rust