Foot & Ankle

/Foot & Ankle
Foot & Ankle 2018-06-29T18:40:45+00:00

Meet Our Team

Eric Beights, DPM

George Fahoury, DPM

Aron Green, MD

Anatomy of the Foot & Ankle

The foot is a highly complex and evolved structure consisting of 28 bones, 35 joints, 3 arteries, 4 veins and 5 nerves that allow ambulation.

Some Common Foot Injuries & Conditions Are:

A common musculoskeletal injury in which the ligaments of the ankle partially or completely tear due to sudden stretching. This typically occurs when the ankle is suddenly “twisted” in a sports activity or by stepping off an uneven surface. The pain is initially severe and can be associated with a “popping” sensation. Immediate swelling over the area of injury often occurs as the injured blood vessels leak fluid into the local tissue. Partial tears retain some ankle stability, whereas complete tears lose stability because the ligaments no longer brace the ankle joint. Ankle sprains are common with approximately 27,156 occurring within the US each day.

An ankle sprain is the most common injury to the ankle and the long term consequences can even lead to premature ankle arthritis. The most common type is the inversion ankle sprain, in which the ankle rolls over on the outside. An ankle sprain is the stretching and tearing of ligaments- in the sprained ankle the most common damage is done to the talo-fibula ligament ( if the ankle sprain is worse, the calcaneo-fibula ligaments can also be damaged) sometime the tendons also get damaged.

Plantar Fascitis is one of the most common causes of heel pain. It involves pain and inflammation of a thick band of tissue, called the plantar fascia, which runs across the bottom of the foot, connecting your heel bone to your toes. Plantar fascitis causes stabbing pain that usually occurs with your very first steps in the morning. Once your foot limbers up, the pain of plantar fascitis normally decreases, but it may return after long periods of standing or after getting up from a seated position. It is the result of bone or nerve irritation from overuse. It is relatively easy to treat and can reliably get better.

Flat FeetYou have flat feet when the arch on the inside of your feet is flattened, allowing your entire foot to touch the floor when you stand up. A common and usually painless condition, flatfeet may occur when the arches don’t develop during childhood. In other cases, flatfeet may be caused by an injury or from the simple wear and tear stresses of age. Flatfeet can sometimes cause problems in your ankles and knees because the condition can force your ankles to turn inward and this throws off the alignment of your legs. If you aren’t experiencing any pain, no treatment is usually necessary for flatfeet. However, symptoms can indicate tendon injury which will progress and cause osteoarthritis of the foot so evaluation of flatfeet is essential.

DiabetesDiabetes can be dangerous to your feet – even a small cut or a pressure pain can produce serious consequences. Diabetes causes nerve damage that takes away the feeling in your feet called Neuroproxy. Diabetes also reduces blood flow to the feet, making it harder to heal an injury or resist infection. Because of these problems, you may not notice a foreign object in your shoe. As a result you could develop a blister or a sore. This could lead to an infection or a non-healing wound that could put you at risk for an amputation. To avoid serious foot problems that could result in losing a toe, foot or leg, follow these guidelines. Inspect your feet daily. Check for cuts, blisters, redness, swelling, or nail problems. Be gently when bathing your feet. Cut your nails carefully. If you have concerns about your nails, consult your doctor. Never treat corns or calluses yourself. Visit your doctor for appropriate treatment. Always wear clean, dry socks and change them daily. Remember, your feet may not be able to feel a pebble or other foreign object, so always inspect your shoes before putting them on. Never walk barefoot, not even at home! Always wear shoes or slippers. You could step on something and get a scratch or cut. Take care of your diabetes. Keep your blood sugar levels under control. Don’t smoke. Smoking restricts blood flow to your feet. Get periodic foot exams. Seeing your foot and ankle surgeon on a regular basis can help prevent the foot complications of diabetes.
Bunions, referred to in the medical community as Hallux Valgus, are one of the most common forefoot problems. A bunion is a prominent bump on the inside of the foot around the big toe joint. This bump is actually a bone protruding towards the inside of the foot. With the continued movement of the big toe towards the smaller toes, it is common to find the big toe resting under or over the second toe. This causes a common forefoot condition called overlapping toes. Some of the symptoms of bunions include inflammation, swelling, and soreness on the side surface of the big toe. The discomfort commonly causes a patient to walk improperly, leads to pain, deformity, joint dislocation and arthritis. Bunions can be congenital, or acquired secondary to poor shoe wear selection. 88% of women will wear inappropriate shoes at some point in time. The earlier a bunion is treated the better the outcome.
Rheumatoid Arthritis can have significant effects on the feet and the ankle. The foot is commonly the first structure affected by rheumatoid arthritis. These range from swelling of the toe joints to severe destruction of the joints of the foot and the ankle. The process of joint inflammation begins with an inflammation of the lining of the joints called the capsule. As the capsule becomes inflamed, the joint fills with fluid and becomes painful. The cartilage lining of the joint then wears and becomes severely damaged. Treatment can be anything from shoe wear modification to joint fusion or even joint replacement.
Achilles Tendinosis is simply degeneration of the tendon, and in most cases is caused by excessive training over an extended period of time. Achilles Tendon Rupture, on the other hand, is a tear of the tendon, and usually occurs as the result of a sudden or unexpected force. In the case of a complete rupture, the only treatment available is to place the lower leg in a plaster cast for 8 weeks or more, or surgery. Tendinosis is treated conservatively at first but may require more aggressive treatment if it does not get better.

Achilles Tendinosis


The primary purpose of shoes is to protect your feet and prevent injury. Poorly fitted shoes can cause discomfort, injury and permanent deformity. Understanding the components of a shoe and the proper fit can help you make sensible shoe purchases. The most important quality to look for in shoes is durable construction and a good fit.

A shoe is composed of different parts. The toe box is the tip of the shoe that provides space for the toes. It can be rounded or pointed. The vamp is the upper middle part of the shoe where the laces are commonly placed. Sometimes Velcro is substituted instead of laces. The sole consists of both an insole and an outsole. The insole is on the inside and the outsole contacts the ground. The softer the sole, the greater the ability to provide shock absorption. The heel is the rear of the shoe that can provide some form of elevation. The higher the heel, the greater the pressure on the front of the foot. The lower the heel, the greater the tension on the Achilles tendon. The last is the part of the shoe that curves in slightly near the arch of the foot and will conform to the foot’s shape.

The material from which a shoe is made can affect fit and comfort. Where softer materials decrease the amount of pressure a shoe places on the foot while stiff materials can cause blistering and callus formation.

Foot size should be measured every two years. The human foot can change size as frequently as every two years. Fits should be measured at the end of the day because feet tend to expand at the end of the day. The shoes should be fitted to your longer and wider foot. Almost no one has two feet that are identical in size. Shoes should be fitted carefully to heel and toes to prevent too much sliding around and creating blistering and causing other damage. If a shoe feels too tight, do not buy them. There is no such thing as a break in period for shoes. If one of your feet is considerably larger than the other, an orthotic or insole can be added. Always remember, fashionable shoes can be comfortable as well.

Shoe Recommendation

Children do not generally need shoes until they begin walking usually at around the age of 12-15 months. Up until that point, socks or booties are enough to protect a child’s feet and keep them warm

Most men’s shoes conform to the shape of the feet and have a roomy toe box with sufficient horizontal and vertical space and a low heel. If you stand for an extended period of time shoes with soft pliable soles will protect your feet and help keep them comfortable.

Low heeled shoes, generally 1.5 inch or lower with a wide toe box are ideal.  An ample toe box can accommodate the foot. Another part of the foot that is important is the heel in determining fit.

Work shoes are generally tailored specifically to a particular occupation and particular needs with protection in the toe box as well as different soles to protect different levels of traction.

The purpose of athletic shoes is to protect the feet from the specific stressors encountered in a given sport as well as to maximize the amount of traction provided by a shoe.

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