Dr. David Soomekh, Foot and Ankle Surgeon

Flat feet, also known as fallen arches or pes planus, is a condition where the arches of the feet collapse, causing the entire sole of the foot to come into contact with the ground. Normally, the arches of the feet provide support and distribute body weight evenly during activities like walking or running. However, in individuals with flat feet, the arches may not develop properly during childhood, or they may gradually flatten over time due to factors like aging, injury, or repetitive stress.

Ingrown Toenails are common! They occur when the edge of a toenail grows into the surrounding skin, leading to pain, redness, swelling, and sometimes infection. Several factors can contribute to ingrown toenails, including improper trimming of nails, wearing tight or ill-fitting shoes, trauma to the toe, or inherited nail shape.

Preventing ingrown toenails involves proper nail care, such as trimming nails straight across and avoiding cutting them too short. Wearing properly fitting shoes with ample toe room can also help. In cases of persistent or severe ingrown toenails, medical treatment may be necessary, which can include soaking the foot, gently lifting the nail, or even surgical removal of the ingrown portion. It's essential to address ingrown toenails promptly to prevent complications and discomfort.

A tailor's bunion, also known as a bunionette, is a bony bump that forms on the outside of the foot at the base of the little toe. Similar to a traditional bunion, which forms on the inside of the foot at the base of the big toe, a tailor's bunion develops due to the misalignment of the bones in the foot. This misalignment can result from various factors such as genetics, wearing narrow or ill-fitting shoes, or certain foot conditions like flat feet.

Tailor bunions can cause pain, swelling, redness, and difficulty wearing shoes comfortably, especially if pressure is applied to the affected area. Treatment options for tailor's bunions may include wearing wider shoes with more room in the toe box, using padding or cushions to alleviate pressure, applying ice to reduce inflammation, taking over-the-counter pain relievers, or using custom orthotic devices to help support the foot and correct alignment.

In severe cases where conservative measures fail to provide relief, surgical intervention may be necessary to remove the bony prominence and realign the bones in the foot.

Toenails protect 👣, support 🦶, and help with grip 🚶‍♂️. They also contribute to sensation 🤚. Proper care is essential! 💅

Prevent 🚫🌽:
Proper 👟 fit, Cushioning 🧽, Moisturize 💧, Socks 🧦, Nail care 💅

Treat 🩹:
Soak & exfoliate 🛁, Padding 🛡️, Salicylic acid 💊, Proper footwear 👞, Medical advice 🩺, 🚨 Seek help if painful or diabetic.

Happy Fourth of July! Let freedom ring and fireworks light up the night. 🎇

Orthotics are helpful for various individuals, including those with foot pain, athletes, people with pronation or supination issues, individuals with leg or back pain, diabetic individuals, those with structural foot deformities, and children with developmental issues.

Neuromas are painful nerve growths, often between the toes, caused by compression or irritation 🦶⚡. Treatment options include wearing proper footwear, padding or orthotics to relieve pressure, and corticosteroid injections to reduce inflammation. In severe cases, surgical removal of the neuroma may be necessary.

Bunions are primarily a genetic deformity. This means that most people who have a bunion inherited it from someone in their family before them. If someone is destined to acquire a bunion over time, they will form a bunion. However, there are factors that can increase the speed and severity at which the deformity will develop. Flat feet (pronation) are inherently unstable and tend to have loose ligaments around the 1st metatarsal leading to its shift. Significant use of high-heel shoes with their small toe box can push the big toe closer to the 2nd toe.

Sesamoids are small, round bones that are embedded within certain tendons, typically in areas of high stress, such as the hands, feet, and knees. In the feet, the two sesamoid bones are located beneath the big toe joint, where they help bear weight and provide leverage for the tendons that flex the toe. They act like pulleys, aiding in smooth movement and distributing pressure during activities like walking or running. However, they can also be prone to injury, especially in activities that involve repetitive stress or trauma to the forefoot.

Maintaining foot health in children is important for their overall well-being. Here are some tips:

Proper footwear: Ensure that children wear shoes that fit well, with enough room for toes to wiggle, and with good arch support. Avoid shoes that are too tight or too loose.

Encourage physical activity: Regular exercise helps promote healthy foot development and strengthens muscles and ligaments. Encourage children to engage in activities like walking, running, jumping, and playing sports.

Monitor foot growth: Children's feet grow rapidly, so it's essential to regularly check their shoe size and replace footwear as needed. Ill-fitting shoes can lead to foot problems like blisters, ingrown toenails, or even structural issues.

Regular check-ups: Schedule regular check-ups with a pediatrician or a podiatrist to monitor foot development and address any concerns early on.

Practice good hygiene: Teach children to wash their feet daily with soap and water, especially after activities that make them sweat. Keep toenails trimmed straight across to prevent ingrown toenails.

Encourage stretching exercises: Incorporate simple stretching exercises into children's daily routine to promote flexibility and prevent muscle tightness. Focus on stretches for the calf muscles and plantar fascia.

Be mindful of foot pain or discomfort: Pay attention to any complaints of foot pain or discomfort from your child, as this could indicate an underlying issue that needs attention.

Regular check-ups: Schedule regular check-ups with a pediatrician or a podiatrist to monitor foot development and address any concerns early on.

By following these tips, you can help promote optimal foot health in children and set the foundation for a lifetime of healthy habits.

Stress fractures in the foot are tiny cracks in the bone caused by repetitive force or overuse 🦶💥. They're common in athletes or those who engage in high-impact activities. Symptoms include pain, swelling, and tenderness, especially during activity. Rest, ice, compression, and elevation (RICE) are often recommended, along with avoiding activities that worsen the pain. Severe cases may require medical attention, including immobilization with a cast or boot. Proper footwear and gradually increasing activity levels can help prevent stress fractures in the future 👟

There is an important nerve that travels near the ankle on the inside (medial) part of the foot called the Posterior Tibial Nerve. This nerve courses through a series of ligaments that act like a tunnel, protecting the nerve as it passes by the ankle. Once the nerve passes by the ankle, splits into 3 branches coursing through the bottom of the foot and the heel. These nerves supply sensation to the skin on the heel and the bottom of the foot. If the nerve becomes damaged and swollen, the tunnel in which it travels may then compress the nerve. As the nerve gets squeezed it cannot function correctly. This then will produce symptoms within the foot and heel. Tarsal tunnel syndrome is very similar to a problem in the hand called carpal tunnel syndrome.

Custom orthotics are inherently better than store-bought orthotics in that they are molded specifically to the patient's feet. A custom orthotic is made with specific materials and handmade following a specific individualized prescription by Dr. Soomekh. An over-the-counter orthotic will not have the specific parts that can control the specific needs of the patient. Orthotics are not meant to be “one size fits all.”

Conservative treatment for Achilles tendonitis:
Dr. Soomekh's conservative treatment plan focuses on pain reduction, inflammation control, and tendon stretching. This includes a 2 to 4-week home therapy protocol with ice therapy, NSAIDs, and rest. He may suggest supportive shoes, heel lifts, and stretching exercises to promote tendon healing and flexibility. Physical therapy sessions may also be recommended for comprehensive care.

When there is an initial injury to part of the body, platelets will rush to the area of injury to begin the healing process. When they reach the site of injury, they release their special growth factors. (This is part of what is called inflammation.) This is true for a new, or what is called “acute” injury. In cases of long-standing injury or “chronic” injury, there is less inflammation and a low concentration of platelets around the site of injury. In effect, the injury is not being aided by healing factors because it is now an “old” injury.

The idea behind injections of platelet-rich plasma therapy is to purposefully introduce an increased concentration of the patient’s own platelets into the site of injury. Once there are more platelets around the area, there are then more healing factors in the area, creating an environment that can promote healing. Additionally, the simple act of the needle being introduced several times into the site of injury will stimulate and injure the tissue. The body will think this area is now a new injury. Effectively taking an old chronic injury and changing it to a new acute injury, while at the same time introducing even more platelets. It now is the job of the patient’s own body to heal the injured site.

Laser therapy for toenail fungus offers several benefits, including:

Non-invasive treatment option: Laser therapy does not require surgery or medication, making it a non-invasive alternative for treating toenail fungus.
Effective results: Laser therapy targets the fungus directly, penetrating the nail and killing the fungal infection without damaging the surrounding tissue.
Quick and painless procedure: Laser treatment sessions are typically short and painless, with no downtime required afterward.
Minimal side effects: Laser therapy for toenail fungus is associated with minimal side effects, making it a safe option for many patients.
Improvement in nail appearance: As the fungal infection clears, patients often experience improved nail appearance, including reduced discoloration and thickening.
Overall, laser therapy offers an effective and convenient solution for addressing toenail fungus and restoring healthy nails.

Remembering the selflessness of our fallen heroes. 🇺🇸

Did you know...
Hammertoe typically appears as an abnormal bending or curling of the toe joints, causing the affected toe to resemble a hammer or claw.

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🦶🏃‍♂️ Managing foot pain from flat feet? Here are 3 tips to ease discomfort:

👟 Supportive Footwear: Invest in shoes with good arch support and cushioning.
💪 Strengthening Exercises: Strengthen foot and ankle muscles with toe curls and calf raises.
🧘‍♀️ Stretching Routine: Regularly stretch calf muscles and plantar fascia to improve flexibility and reduce pain.

Keep those feet happy and healthy!

Symptoms of a Retrocalcaneal Exostosis (Heel Spur) include deep, achy pain at the back of the heel, worsened with walking and activities. Visible extra bone mass and pain with direct pressure are common. Pain is often worse in the morning or after sitting, easing with more walking but worsening by the day's end. Footwear without support can exacerbate discomfort, and continued growth may lead to Achilles tendonitis.

👟 Supportive shoes are crucial for runners as they provide stability, cushioning, and alignment support, reducing the risk of injuries such as sprains and strains. They help absorb shock, distribute pressure evenly, and promote proper foot alignment, enhancing comfort and performance while reducing fatigue. Investing in high-quality, properly fitted running shoes can significantly improve running efficiency and contribute to overall foot health and injury prevention. 🏃‍♂️🏃‍♀️

Bunions can vary in severity, typically categorized as mild, moderate, or severe.

Mild bunions: In mild cases, the bony bump at the base of the big toe may be noticeable, but there might be minimal pain or discomfort. The big toe may angle slightly toward the second toe, but it's still relatively flexible.

Moderate bunions: Moderate bunions involve a more prominent bump at the base of the big toe, often causing discomfort or pain, especially with certain footwear. The big toe may begin to push against or overlap the second toe, leading to stiffness and limited movement.

Severe bunions: Severe bunions are characterized by a significant deformity of the big toe joint, with a large, painful bump that may make it difficult to find shoes that fit comfortably. The big toe may overlap or tuck under the second toe, causing further discomfort, inflammation, and difficulty walking.

Treatment options may vary depending on the severity of the bunion, ranging from conservative measures such as orthotics and shoe modifications for mild cases to surgical intervention for more severe deformities. It's essential to consult with a healthcare professional for an accurate diagnosis and personalized treatment plan.