April 2021

In foot care, vascular testing may be required in the diagnosing and treatment of certain podiatric conditions. Vascular testing is particularly relevant for patients with high-risk diabetes, poor circulation, peripheral artery disease (PAD), and chronic venous insufficiency (CVI). Procedures typically involve the examination of blood vessels throughout the body for blockages or buildup.

Vascular testing is very important for the diagnosis of various conditions, including peripheral artery disease and chronic venous insufficiency, as these conditions can greatly affect one’s quality of life and cause pain in the lower limbs. Circulatory problems in the feet and ankles can reflect issues throughout the body, making testing of the blood vessels pertinent.

Testing methods vary between practitioners and can be specific to certain foot and ankle problems. Modern technology has brought about the ability to perform vascular testing using non-invasive methods, such as the cuff-based PADnet testing device. This device records the Ankle-Brachial Index (ABI)/Toe-Brachial Index (TBI) values and Pulse Volume Recording (PVR) waveforms. Contact your podiatrist to determine what vascular testing is available for your needs.

Corns are thickened areas on the skin’s surface, to the point of being irritating and sometimes painful. Commonly found on the feet, corns are circular or cone-shaped. They develop where there are areas of pressure or friction, such as on the little toe when it rubs up against shoes, or on the ball of your foot.

Corns are often confused with a callus, but there is a difference between them. Corns can be raised bumps that are painful to the touch. They consist of a rough, thick area of skin that may be dry or waxy. Corns tend to be surrounded by skin that is inflamed, and are usually much smaller than calluses.

Removing the dead skin that has built up is the key in treating corns. Salicylic acid medication is most common in accomplishing this. The acid works by dissolving keratin, which is the protein that makes up the majority of corns. You can purchase salicylic acid over-the-counter in products such as wart removers. It comes in a variety of forms such as medicated pads, drops, or creams. However, people who are diabetic should not use salicylic acid, but should instead consult their doctor immediately.

According to the product directions, applying the medication directly onto the corn will treat it. The top layer of the corn will begin to turn white after use. When that occurs, the layers of skin can then be peeled away, making the corn smaller. Shaving off corns with razors or other pedicure equipment is never a good idea. This can lead to infection. If your corn gets infected, and is not treated immediately, a visit to the doctor will be necessary.

Another way to treat corns and help prevent their return is by using orthotic inserts, fitted by a podiatrist. Inserts fit right into your shoes and adjusts the way your foot fits into your shoes. This fixes the way you walk. This will lower your chances of getting corns, and eliminate current corns by reducing rubbing from friction.

Surgery is rarely used to treat corns, but does occur on occasion. Surgery actually deals with the underlying issue that causes corns. During surgery, the bone is shaved and any abnormalities are corrected, thus reducing the amount of friction that occurs during walking.

To prevent corns, the first step is reducing friction. Always wear shoes that fit well and don’t rub your feet. Pads can be purchased if you notice rubbing developing. These pads can be purchased over-the-counter, and can be simply placed on the irritated area. Wearing cushioned insoles in your shoes can always reduce the friction, and making sure to wear well-fitting shoes. This will ensure that your foot is not being squeezed awkwardly, and prevent corns from forming in the first place.

A bunion is an enlargement of the base joint of the toe that connects to the foot, often formed from a bony growth or a patch of swollen tissues. It is caused by the inward shifting of the bones in the big toe, toward the other toes of the foot. This shift can cause a serious amount of pain and discomfort. The area around the big toe can become inflamed, red, and painful.

Bunions are most commonly formed in people who are already genetically predisposed to them or other kinds of bone displacements. Existing bunions can be worsened by wearing improperly fitting shoes. Trying to cram your feet into high heels or running or walking in a way that causes too much stress on the feet can exacerbate bunion development. High heels not only push the big toe inward, but shift one's body weight and center of gravity towards the edge of the feet and toes, expediting bone displacement.

A podiatrist knowledgeable in foot structure and biomechanics will be able to quickly diagnose bunions. Bunions must be distinguished from gout or arthritic conditions, so blood tests may be necessary. The podiatrist may order a radiological exam to provide an image of the bone structure. If the x-ray demonstrates an enlargement of the joint near the base of the toe and a shifting toward the smaller toes, this is indicative of a bunion.

Wearing wider shoes can reduce pressure on the bunion and minimize pain, and high heeled shoes should be eliminated for a period of time. This may be enough to eliminate the pain associated with bunions; however, if pain persists, anti-inflammatory drugs may be prescribed. Severe pain may require an injection of steroids near the bunion. Orthotics for shoes may be prescribed which, by altering the pressure on the foot, can be helpful in reducing pain. These do not correct the problem; but by eliminating the pain, they can provide relief.

For cases that do not respond to these methods of treatment, surgery can be done to reposition the toe. A surgeon may do this by taking out a section of bone or by rearranging the ligaments and tendons in the toe to help keep it properly aligned. It may be necessary even after surgery to wear more comfortable shoes that avoid placing pressure on the toe, as the big toe may move back to its former orientation toward the smaller toes.

Foot and ankle pain can be a nuisance in a person’s life, especially if it happens frequently. The best way to prevent this type of pain, is to exercise often. Regular exercise of the foot includes stretching and strength exercises. Stretching exercises can help prevent injuries such as a sprained ankle, while strength exercises can prevent ailments such as plantar fasciitis.

Stretching exercises can help improve flexibility and the foot and ankle’s range of motion. These exercises can certainly help with those who participate in high-energy activities such as sports. Many athletes routinely perform foot and ankle exercises to prevent injuries like sprained ankles, which are common injuries where the tendons in the ankle are over stretched. Strength exercises help develop foot muscles for better support and protection.

Most exercises are simple and can be done at home, either standing or sitting. One chair exercise is called “limber up”. In this exercise, a person would start by sitting down with their feet flat on the floor. Then lift one leg up so the feet are not touching the floor, then rotate your foot clockwise 15-20 times, and 15-20 times counterclockwise. Repeat the same process with the opposite leg. Another sitting exercise helps stretch the back of your heel and requires an exercise band. It begins by looping the band around a heavy piece of furniture, or something stable that will not be moved when the band is tugged or pulled. Then sit directly in front of it, and slide one foot into the loop, so that the band curves around the forefoot. Start by pulling the forefoot back and holding it for 5-10 seconds. Doing this 10-15 times on each foot, will stretch the back of your heel, increasing your flexibility.

Foot exercises that require standing are also just as easy and simple. Referred as the “Achilles Stretch”, this exercise stretches the Achilles tendon, making it more flexible, helping prevent foot, ankle, and leg pain. It begins by first standing and facing the wall, with the arms outstretched and the palms on the wall. Then place one foot behind another keeping the back leg straight, and the forward leg bending at the knee. Make sure both heels are flat on the floor and adjust your stance accordingly. With your hips, lean forward to feel the stretch, you can also adjust the distance from your feet to feel the stretch in various parts of the calf. Make sure to hold the stretch for about 30 seconds and repeat the same process 3 times with each leg. An even easier foot exercise is simply walking on sand. Walking barefoot on sand both strengthens and stretches your feet.

Doing these exercises regularly can help prevent many foot and ankle problems. Other foot exercises can even relieve pain. For example, those affected with plantar fasciitis can simply sit down on a chair, and then place a tennis ball below their affected foot. By rolling the ball under the foot, and increasing or decreasing pressure, pain will be relieved. With any exercise, it is always important to do a small warmup such as walking a few laps around the house to get the blood flowing. If after doing an exercise to relieve pain such as the tennis ball exercise, or are unsure that your execution is correct, be sure to contact a podiatrist for further instruction.