Choosing a podiatrist

What you should know about …

 Dr. Jason Grossman and his office staff Dr. Jason Grossman and his office staff A podiatrist, D.P.M., doctor of podiatric medicine, is the only health care professional whose total training focuses on the foot, ankle and related body systems. As a specialist in foot care, the podiatrist receives extensive training in the diagnosis, treatment and prevention of foot and ankle disorders by medical and surgical means.

After obtaining an undergraduate degree, the podiatric student spends four years in a college of podiatric medicine to obtain a doctorate degree. Many podiatrists further their education by participating in a post-graduate residency program at an approved hospital or university.

Following their doctorate degree, each podiatrist must pass national and state examinations in order to be licensed by the state in which he or she will practice.

The podiatric physician cares for people of all ages, and treats any foot problems. The common disorders include bunions, heel pain/spurs, hammertoes, neuroma (nerve entrapments), ingrown toenails, warts, corns and calluses. The podiatric physician also renders care of sprains, fractures, infections, and injuries of the foot, ankle and heel. If your podiatric surgeon is certified by the American Board of Podiatric Surgery, he or she has successfully completed a credentialing and examination process and has demonstrated knowledge of podiatric surgery, including the diagnosis of general medical problems and surgical management of foot diseases, deformities, and trauma of the foot, ankle and related structures.

What causes foot and ankle problems?

There are many causes of foot and ankle problems: congenital, acquired, traumatic, infectious, neoplastic and arthritic. When foot and ankle problems occur at birth they are called congenital and are generally inherited. Acquired problems may result from improper footwear, physical stress, or small mechanical changes within the foot, which can slowly increase with aging. Traumatic problems are associated with injuries to the foot and ankle such as a sprain or broken ankle and fractures of the foot. Infectious problems are the result of bacterial, viral or fungal disorders that may affect superficial or deep tissues. Neoplastic disorders (tumors) are the result of abnormal growth of tissue and may be benign or malignant. Arthritis disorders may involve one or more joints and may be secondary to trauma or associated with systemic disease.

What are common foot problems?

 Heel pain. The most common cause of heel pain comes from moving your foot incorrectly while walking or running. This can place too much stress on the heel bone and the soft tissue around it. The result is pain.

Heel and arch pain can affect your health, comfort and attitude. When your feel hurt, it can be difficult to perform daily tasks and to exercise regularly. It’s hard to stay focused when each step is painful. Although the causes for the pain are many, highly effective ways are available to relieve it.

 Nail disorders. Nail problems are commonly caused by improper trimming, minor injuries or repeated trauma. Some nail disorders can also be congenital. Proper trimming on a regular basis can help keep the toenails in the pink, as can wearing well-fitted, low to moderately heeled shoes.

Painful ingrown nails may be congenital, caused by an over-curvature of the nail, or an imbalance between the width of the nail plate and the nail bed.

Various types of fungi are present everywhere in the environment. The dark, moist surroundings created by shoes and stockings make the feet especially susceptible to fungal infection. Most fungi are harmless until they penetrate the skin. A fungus can invade through minor cuts, or after injury or repeated irritation to the toes have caused the nail to separate from the bed. Fungal infections of the nail plate and nail matrix are common.

Fungus may cause the nail to thicken and become yellow or brownish, and as the fungus grows, foul smelling, moist debris can be seen. Pressure from a thickened nail or the build-up of debris may make the toe painful.

Treatment is best begun at the early stages of infection. The accumulation of debris under the nail plate can lead to an ingrown nail or to a more serious bacterial infection that can spread beyond the foot. To reduce pain associated with a thickened, infected nail, the podiatrist may reduce its thickness by filing the nail plate down with a surgical burr. Filing will not, however, prevent the infection from spreading. Oral and topical medications may be prescribed for treatment of fungal nails.

 Diabetic foot problems. Foot conditions in persons with diabetes are usually the result of three primary factors: neuropathy (diminished sensation), poor circulation, and a decreased resistance to infection. Also, foot deformities and trauma play major roles in causing ulcerations and infections in the presence of neuropathy or poor circulation. Neuropathy may cause pain and interfere with your sleep. Painful neuropathy usually causes burning or sharp pains in the feet. Neuropathy can also affect nerves that supply the muscles in your legs and feet. This motor neuropathy can cause muscle weakness or loss of tone in the thighs, legs and feet, and the development of hammertoes, bunions and other foot deformities.

Poor circulation, resulting in reduced blood flow to the feet, restricts adequate delivery of oxygen and nutrients that are required for normal maintenance and repair.

Persons with diabetes are generally more prone to infections than nondiabetic people. Due to deficiencies in the ability of white blood cells to defend against invading bacteria, diabetics have more difficulty in dealing with and mounting an immune response to the infection.

 Bunion deformity. A bunion is a prominent bump on the inside of the foot around the big-toe joint. This bump is actually a bone protruding toward the inside of the foot. With the continued movement of the big toe toward the smaller toes, it is common to find the big toe resting under or over the second toe.

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.

As a rule, bunion deformities should be recognized early and evaluated by your podiatrist. He or she can offer several suggestions for controlling the cause of the bunion deformity so that other symptoms do not occur or become more severe. The podiatrist can also evaluate the underlying weakness in the structure of your foot and make certain recommendations, including exercises, alteration of shoe gear, or custom molded orthotics, in an attempt to stabilize the weakness and improve the function of the foot. If the bunion deformity progressively increases, surgery may be recommended. Your podiatrist will perform a thorough evaluation of your circulation, muscle strength and alignment to determine if you are a candidate for bunion surgery.