While not a serious issue, toenail fungus, or onychomycosis, can be an embarrassing and uncomfortable condition to experience. Toenail fungus is often caused from public areas that harbor fungi and improper cleaning/drying of the foot. Once infected, the fungus grows deeper into the nail and can be very hard to get rid of.

There are different types of fungus that cause toenail fungus. Dermatophytes, yeasts, and molds are the most frequent forms of fungus to infect the toenail. Dermatophytes are the most common among the three. Symptoms associated with fungal nails include the discoloration of the toenail, brittleness, and in some circumstances, a smell. Pain is rarely a symptom caused by toenail fungus.

Diagnosis of fungal nails is generally a rather quick process. However podiatrists will make sure that the cause is not another condition such as lichen planus, psoriasis, onychogryphosis, or nail damage. Podiatrists will make use of fungal cultures and microscopy to verify that it is fungus.

While over-the-counter ointments are readily available, most are ineffective. This is due to the fact that the nail is very protective and that the fungus slips in between the nail plate and bed. Podiatrists can offer oral medication which currently provides the best results.

Ultimately, prevention is the best line of defense against toenail fungus. Avoid unsanitary public showers. If you do use a public shower, use shower shoes to provide your foot with protection. Once you are finished showering, make sure to thoroughly dry your feet. Fungi thrive in warm, dark, and moist places like sweaty, warm feet that are left dark in shoes all day.

There are several systemic diseases, or diseases that affect the whole body, that either display symptoms in the feet or affect the health of the feet. Common systemic diseases that affect the overall health of the feet, and the patient’s ability to walk comfortably, include gout, diabetes mellitus, neurological disorders, and arthritis, among others.

In gout, which is caused by an excessive buildup of uric acid in the body, the most common symptoms of pain, inflammation, and redness occur at the metatarsal/phalangeal joint at the base of the big toe. Any excess levels of uric acid crystallize and are deposited in tendons, joints, and surrounding bone and muscle tissue. Gout is commonly treated with NSAIDs to relieve pain and inflammation and other drugs to lower uric acid levels in the body. Gout most commonly affects those who are overweight, have low protein diets and lead a more sedentary lifestyle.

Diabetes mellitus is an increase in the level of blood sugar in which the body cannot counteract with naturally occurring insulin in the body. The three types of diabetes, Type I, Type II and Gestational Diabetes, are all signs the body is either not producing enough insulin or is not efficiently using the insulin that is produced. Gestational diabetes only affects women who are pregnant and have never, prior to pregnancy, exhibited symptoms of the disease.

There are two main issues that affect the feet that are commonly caused by diabetes. They include diabetic neuropathy and peripheral vascular disease. Diabetic neuropathy can lead to damaged nerves and affect the feet through numbness and loss of sensation. Peripheral vascular disease restricts the flow of blood to the foot and can, in extreme cases, lead to the necessity of amputating the foot. Peripheral issues that are caused by diabetes and can affect the foot include athlete’s foot, nail infections, corns, blisters, bunions, severe dry skin, plantar warts and ingrown toenails. These can all be attributed to the decrease of blood flow to the foot.

Neurological disorders and rheumatoid arthritis can also have severe impact on the health of the feet. Neurological disorders can affect the nerves in the main structure of the foot and cause loss of sensation and possible decreased muscle response. Rheumatoid arthritis can affect the bones and joint structures of the foot, making it impossible to walk normally without serious pain.

All systemic diseases that affect the foot can effectively be treated to minimize joint and muscle damage if they are diagnosed early and treated with medication and lifestyle therapy. Diabetes patients must monitor their blood sugar levels and work with their physician to keep their levels as close to normal as possible. Rheumatoid arthritis patients should work with their physician to ensure the proper medications are being taken to reduce the amount of damage to the joints of the body.

Podiatry is a branch of medicine that deals with the study, diagnosis, and treatment of foot and ankle conditions. There are various subdivisions in podiatry; biomechanics is one of them. Biomechanics is the way in which the bones, muscles, and joints of the feet and lower limb interact with each other.

Our feet play crucial roles in the way we move, and it is rare to have feet that are completely symmetrical. Common biomechanical issues include high or low arches or uneven leg heights. Excessive pronation often leads to fallen arches, or flat feet, and is a common cause of running injuries. People whose feet are over-pronated tend to have flexible and unstable feet. Pain is usually experienced during walking and running.

At times, people may be able to adapt to these abnormalities without any difficulties, but in other cases, these issues can cause a great deal of pain. This pain occurs because the joints, muscles, ligaments, and tendons are put under an excess amount of stress during movement. Common symptoms of biomechanical problems stemming from the feet include hip pain, knee pain, leg cramps, ankle pain, lower back pain, weak ankles, tripping, heel pain, Achilles pain, and shin splints.

Many biomechanical issues can be treated with orthotics. Orthotics are shoe insoles that are used to help control the way the foot operates.  They can provide relief from foot pain, heel pain, and knee pain. Depending on your specific case, you may need to purchase over-the-counter orthotics or custom orthotics to fit your feet. Your podiatrist will be able to prescribe the perfect orthotic for your feet to help you walk around with ease.

Gait is defined as the way we move our bodies from one point to another. This is usually done by either walking or running. Gait analysis is a method used to assess the way we walk or run to highlight biomechanical abnormalities. Gait analyses are a great way to take a detailed look at how you walk and how your foot moves while you walk. An examination of the feet will help your podiatrist understand why you are suffering pain in other parts of your body.

Foot and ankle injuries are common among athletes and those who exercise frequently. Most of these injuries are non-life-threatening and can heal in weeks with proper treatment and care. Serious injuries, however, require urgent medical treatment.

Common minor injuries include ankle sprains, ankle strains, Achilles tendonitis, plantar fasciitis, stress fractures, and turf toe. An ankle sprain is when the ligaments in the ankle have either become stretched or torn. When the muscle or tendon is stretched or torn, it is an ankle strain. When the big toe is sprained, it is known as turf toe. Achilles tendonitis is the overuse and inflammation of the Achilles tendon. Plantar fasciitis is the inflammation of the plantar fascia and generally occurs from overuse in athletics. Stress fractures are also caused from overuse and are small cracks in the bone.

Achilles tendon ruptures are common, but more serious. This injury occurs when the Achilles tendon, the largest tendon in the body, ruptures. In most cases, this causes severe pain and difficulty walking; some who have experienced this injury have reported, however, no signs or symptoms. A laceration is a deep cut that can occur anywhere on the body. Lacerations on the foot are rarer, but can occur from things like metal cleats landing on the foot.   

Treatment options cover a wide range of methods based upon the injury and its severity. Conditions like plantar fasciitis, stress fractures, Achilles tendonitis, turf toe and ankle sprains/ strains can heal on their own without immediate medical care, but seeing a podiatrist to monitor the injury is always recommended. Following the RICE (Rest, Icing, Compression, and Elevation) protocol is generally enough to treat minor injuries. This means resting the foot by either keeping pressure off the foot or not walking at all. Icing the injury will help reduce swelling and pain. Compressing the wound with a wrap will immobilize and help promote healing. Finally, keeping the wound elevated will also reduce swelling and also help the healing process.

It is important to note that even minor injuries can vary in severity, with grade one being a minor injury and grade three requiring urgent care by a podiatrist. Achilles tendon ruptures and lacerations on the foot generally require urgent medical care and treatment options that need a podiatrist. These could include imaging tests, stitches for cuts, rehabilitation, and casts or braces. Every case is different, however, so it is always recommended to see a podiatrist when pain in the foot does not disappear.

Blisters are small pockets of fluid that occur on the top layers of the skin for several reasons. Friction, burns, and diseases are all known causes of blisters.  Smaller blisters are known as vesicles, while larger blisters are referred to as bulla. The fluid inside the bubble can be blood, pus, or serum; which is a clear liquid that protects the skin. In most cases, blisters are not a major health issue, but they can be an indicator of a more serious condition.  

Causes of blisters vary. Blisters are commonly caused by wearing poorly fitted shoes that rub against the foot. However, there are many other causes besides from friction; including burns, sunburn, insect bites, frostbite, poison ivy/oak, chemical exposure, impetigo, eczema, viral infections, and more.

Most blisters heal by themselves and do not require immediate medical care. If you have a blister, do not pop it since this may cause infection; it is advised to put a bandage over the blister to protect it. If the blister is large, causes pain, or if you have a fever, it is recommended that you see a doctor who can provide proper care. Blisters are easy to diagnose, and if considered prudent by the doctor, can easily be drained of fluid with a sterile needle as well.

To prevent blisters on the feet, wear shoes that fit properly and don’t cause rubbing. Socks can help prevent friction and it is recommended that you wear them if you are wearing shoes. Hand blisters can be avoided by wearing gloves during activities that cause friction against the hand. If you have a blister that pops, do not remove the dead skin, wash the area, apply antibiotic ointment, and cover with a bandage. It is okay in most cases to not seek immediate medical care for a blister if it was just caused by friction. However, if the blister causes pain or does not go away, it is suggested that you see a doctor for a diagnosis.