July 2019

There can be many different causes of ankle pain, ranging from an ankle sprain or fracture to chronic conditions such as arthritis. The degree of the ankle pain can vary and it can come on suddenly or slowly over time. The ankle joint consists of bones, muscles, cartilage, and tissues called ligaments and tendons. Any injury or disease that were to affect these structures, could very well lead to ankle pain. Some causes of ankle pain include sprains, tendonitis, arthritis and a bruise or break of the bone. It is important to know that you should visit a doctor if there is an inability to bend the ankle, swelling of the joint, signs of an infection, an inability to walk comfortably on the affected side and if you have ankle pain that occurs at night or while resting. Ankle pain can be diagnosed with an X-ray, medical exam or thorough physical examination. The RICE protocol is a 4-step process in which you may be able to treat your injury from the comfort of your own home. The first step is to rest. This will allow for the joint to relax and for any inflammation to subside. The next step is to ice. Ice should be applied at least 3 times a day for 15 to 20 minutes. This will allow for any swelling to go down and it will also soothe the pain. The third step is to add compression. Compression bandages, such as an ACE wrap will help support and immobilize the ankle joint. Be sure not to add too much compression as this can lead to numbness, tingling and swelling at the site of the pain. The final step is to elevate the ankle. Raising the ankle above the level of the heart, by way of propping your foot up on pillows, will help reduce any swelling for the first couple days after the injury has occurred. If you are suffering from any ankle pain, visit your podiatrist to see what treatment may be right for you.

Flat feet is a deformity that occurs when the arch of the foot collapses and comes into complete or near-complete contact with the ground. The condition occurs either at the time of birth or through injury and age. For the people that do develop flat feet, there are very few symptoms. They can include a limited range of motion, swelling along the inner ankle and arch of the foot, and unbearable pain when standing on your feet. The main cause of flat feet is excessive pronation of the foot. This means that the arch descends downward and inward as the foot strikes the ground. Due to the tendency for flat feet to over pronate, they are less able to absorb shock, placing persistent stress on the feet, ankles, and knees. If the inward tilt of the foot places further strain on the tendons and ligaments of the lower extremities, this can also result in Achilles tendinitis and chronic knee pain. Flat feet is most common in newborns and toddlers due to the arches on their feet not having developed yet. Imaging tests done to determine if someone has flat feet are X-rays, ultrasounds and MRIs. The treatments vary for children and adults. The most beneficial treatment for children would be walking barefoot during developmental years. For adults, the best forms of treatment are exercises that increase arch flexibility and strength such as foot gymnastics, a runner’s stretch, the yoga pose downward dog and therapeutic massages. If you feel you are developing flat feet, it is recommended to see a podiatrist so they can provide the best treatment option.

Flatfoot is a condition many people suffer from. If you have flat feet, contact Dr. Robert Graser from Graser Podiatry and Bunion Surgery Institute. Our doctor will treat your foot and ankle needs.

What Are Flat Feet?

Flatfoot is a condition in which the arch of the foot is depressed and the sole of the foot is almost completely in contact with the ground. About 20-30% of the population generally has flat feet because their arches never formed during growth.

Conditions & Problems:

Having flat feet makes it difficult to run or walk because of the stress placed on the ankles.

Alignment – The general alignment of your legs can be disrupted, because the ankles move inward which can cause major discomfort.

Knees – If you have complications with your knees, flat feet can be a contributor to arthritis in that area.  

Symptoms

• Pain around the heel or arch area
• Trouble standing on the tip toe
• Swelling around the inside of the ankle
• Flat look to one or both feet
• Having your shoes feel uneven when worn

Treatment

If you are experiencing pain and stress on the foot you may weaken the posterior tibial tendon, which runs around the inside of the ankle. 

If you have any questions please feel free to contact our office located in Boerne, . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Flip-flops are fun to wear when lounging out by the pool or when going to the beach. At the same time, they could be causing major stress and injury to the feet. Without any protective outer covering on your flip-flops, it can be easy for the feet to get cut or bruised. Also, due to the feet not being protected by socks in flip-flops, the skin on the feet is more prone to sunburn, as well as blisters from rubbing against the thong of the flip-flop. Flip-flops may seem easier to slip on than shoes, but this isn’t actually the case. The feet work a lot harder in order to keep the flip-flops on. This causes the toes to involuntarily curl up and the muscles on the feet to strain which can lead to bunions or hammertoes. In addition, the base of the flip-flop that is meant to support the foot isn’t doing that at all and instead is overworking the foot’s tendons and ligaments. This can cause overuse injuries such as shin splints, tendonitis and plantar fasciitis. Activities that aren’t meant to be done in flip-flops include hiking, biking, working with tools and sporting activities. Consult a podiatrist to get a better idea of when you should wear flip-flops. 

Flip-flops are not always the best choice of footwear. If you have any concerns about your feet or ankles, contact Dr. Robert Graser from Graser Podiatry and Bunion Surgery Institute. Our doctor will assist you with all of your foot and ankle needs.

Flip-Flops and Feet

When the weather starts warming up, people enjoy wearing flip-flops.  Flip-flops are comfortable, stylish, and easy to slip on and off; they're perfect for any summer beach goer.  However, these shoes can cause harm to the feet.

How Can Flip-Flops Affect Me Long-Term?

• Ankle problems
• Hip problems
• Lower back problems
• Pain in the balls of the feet
• Problems with foot arches
• Changes in the way you walk

Are There Injuries Associated with Flip-Flops?

Yes.  Since flip-flops are relatively weak and do not provide the same amount of support as sneakers, people who wear flip-flops regularly are more susceptible to injuries. On top of that, the open nature of the shoe makes your feet more prone to other problems, such as cuts and even infections.  Common injuries and ailments include:

• Sprained ankles
• Blisters
• Infections
• Cuts and Scrapes

I like Wearing Flip-Flops. Are There Safe Alternatives?

When buying flip-flops, try to find ones that have sturdy soles and that are made of high-quality materials that will support for your feet.  These flip-flops will cost more but will also last longer as a result.

If you have any questions please feel free to contact our office located in Boerne, .  We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

The tarsal tunnel is a narrow space that is on the inside of the ankle next to the ankle bones. It is covered with a thick ligament that protects structures within the tunnel such as arteries, veins, tendons and nerves. Tarsal tunnel syndrome is a compression or squeezing on the posterior tibial nerve that produces symptoms from the inside of the foot into the ankle. Some symptoms of tarsal tunnel syndrome include numbness, a shooting pain, and tingling or burning sensations that are similar to an electric shock. Some causes are diabetes which can cause swelling on the nerve, an injury like an ankle sprain that can produce swelling in or near the tunnel, and flat feet due to the outward tilting of the heel. It is important to go see your local podiatrist if you feel you exhibit any of these symptoms. 

Tarsal tunnel syndrome can be very uncomfortable to live with. If you are experiencing tarsal tunnel syndrome, contact Dr. Robert Graser of Graser Podiatry and Bunion Surgery Institute. Our doctor can provide the care you need to keep you pain-free and on your feet.

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome, which can also be called tibial nerve dysfunction, is an uncommon condition of misfiring peripheral nerves in the foot. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome, the tibial nerve is damaged, causing problems with movement and feeling in the foot of the affected leg.

Common Cause of Tarsal Tunnel Syndrome

• Involves pressure or an injury, direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or near the knee.
• Diseases that damage nerves, including diabetes, may cause tarsal tunnel syndrome.
• At times, tarsal tunnel syndrome can appear without an obvious cause in some cases.

The Effects of Tarsal Tunnel Syndrome

• Different sensations, an afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of the affected leg.
• The foot muscles, toes and ankle become weaker, and curling your toes or flexing your foot can become difficult.
• If condition worsens, infections and ulcers may develop on the foot that is experiencing the syndrome.

A physical exam of the leg can help identify the presence of tarsal tunnel syndrome. Medical tests, such as a nerve biopsy, are also used to diagnose the condition. Patients may receive physical therapy and prescriptive medication. In extreme cases, some may require surgery.

If you have any questions please feel free to contact our office located in Boerne, . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Sever’s Disease describes when a child undergoing a growth spurt develops serious heel pain. It is common with boys between the ages of 10 to 15 and with girls between the ages of 8 to 13. This occurs because during a child’s growth spurt, the heel bone outgrows all of the muscles, tendons and ligaments within the leg. Since these parts of the leg are unable to catch up to the growth pace of the heel bone, they can become stretched too tightly. If this happens to a child that is very active, it can cause extra strain to the already overstretched tendons in the leg and lead to intense swelling and pain. Some symptoms of Sever’s Disease include trouble walking, running with a limp, tightness and tenderness in the backs of the heels and heel pain that increases after running or jumping. Although Sever’s disease can last up to a couple months, it presents no long term foot problems and the simplest treatment for it is rest. It is important for the child not to participate in physical activities until the heel is back to being pain-free. If your child exhibits any signs of Sever’s Disease, it is recommended that you take them to see a podiatrist. 

Sever's disease often occurs in children and teens. If your child is experiencing foot or ankle pain, see Dr. Robert Graser from Graser Podiatry and Bunion Surgery Institute. Our doctor can treat your child’s foot and ankle needs.

Sever’s Disease

Sever’s disease is also known as calcaneal apophysitis, which is a medical condition that causes heel pain I none or both feet. The disease is known to affect children between the ages of 8 and 14.

Sever’s disease occurs when part of the child’s heel known as the growth plate (calcaneal epiphysis) is attached to the Achilles tendon. This area can suffer injury when the muscles and tendons of the growing foot do not keep pace with bone growth. Therefore, the constant pain which one experiences at the back of the heel will make the child unable to put any weight on the heel. The child is then forced to walk on their toes.

Symptoms

Acute pain – Pain associated with Sever’s disease is usually felt in the heel when the child engages in physical activity such as walking, jumping and or running.

Highly active – Children who are very active are among the most susceptible in experiencing Sever’s disease, because of the stress and tension placed on their feet.

If you have any questions, please feel free to contact our office located in Boerne, . We offer the newest diagnostic and treatment technologies for all your foot and ankle injuries.