December 2019
Unraveling the Facts About Adult Flat Feet

Flat feet, also known as fallen arches, are a prevalent condition that affects adults worldwide. Understanding the facts surrounding adult flat feet is crucial for proper management and maintaining foot health. Flat feet occur when the arches of the feet collapse, leading to the entire sole making contact with the ground. While some individuals are born with flat feet, others may develop the condition over time due to factors such as aging, injury, or excessive strain on the feet. Contrary to popular belief, flat feet are not always symptomatic. Many people with flat feet experience no discomfort or limitations in daily activities. However, some individuals may encounter pain, swelling, or a feeling of tiredness in the feet. Fortunately, conservative measures such as wearing supportive footwear, orthotic inserts, and performing foot strengthening exercises can alleviate symptoms and enhance foot function. In more severe cases, medical interventions may be necessary. By dispelling myths and knowing the facts, adults with flat feet can proactively care for their feet and maintain an active, pain-free lifestyle. If you have flat feet, it is suggested that you are under the care of a podiatrist who can help you to manage this condition.
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.
Biomechanics in Podiatry
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.
Managing Foot Drop

A condition known as foot drop is characterized by the inability to clear the ground while taking a step. Instead, the toe drags along the ground when you walk, causing the need to lift the foot in a march-like stance. Foot drop is caused by a weakness or paralysis of the muscles that lift the foot. It can be the result of injury or damage to the nerves in the leg. It also can be the result of a neurological condition, such as multiple sclerosis. Other conditions linked to foot drop include stroke and peripheral neuropathy. In some cases, foot drop can be managed if not cured. Certain exercises can help to strengthen muscles in the feet and lower legs. Removing loose rugs in the home that can cause tripping or falling is another measure that can reduce the effects of foot drop. An ankle-foot orthosis on the lower part of the leg can help to direct control of the foot and ankle. A change in footwear to shoes with adjustable straps and lower heels may also be needed. To find out more about ways of dealing with foot drop, it is suggested that you make an appointment with a podiatrist.
If you have any concerns about your feet, contact Dr. Robert Graser from Graser Podiatry and Bunion Surgery Institute. Our doctor can provide the care you need to keep you pain-free and on your feet.
Biomechanics in Podiatry
Podiatric biomechanics is a particular sector of specialty podiatry with licensed practitioners who are trained to diagnose and treat conditions affecting the foot, ankle and lower leg. Biomechanics deals with the forces that act against the body, causing an interference with the biological structures. It focuses on the movement of the ankle, the foot and the forces that interact with them.
A History of Biomechanics
- Biomechanics dates back to the BC era in Egypt where evidence of professional foot care has been recorded.
- In 1974, biomechanics gained a higher profile from the studies of Merton Root, who claimed that by changing or controlling the forces between the ankle and the foot, corrections or conditions could be implemented to gain strength and coordination in the area.
Modern technological improvements are based on past theories and therapeutic processes that provide a better understanding of podiatric concepts for biomechanics. Computers can provide accurate information about the forces and patterns of the feet and lower legs.
Understanding biomechanics of the feet can help improve and eliminate pain, stopping further stress to the foot.
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.
What Are Bunions?
Bunions are large bony bumps at the base of the big toe. Medically known as hallux valgus, a bunion is a misalignment of the metatarsophalangeal joint, or big toe joint. The misalignment will generally worsen with time if left untreated.
The exact cause of bunions is unknown, with genetics seen as a potential cause. High heels and poorly-fitted footwear, rheumatoid arthritis, and heredity all seem to be potential factors behind the exacerbation of bunions. Women have been found to be more likely to develop bunions in comparison to men.
Bunions do not always produce symptoms. The best way to tell is if the big toe is pushing up against the next toe and there is a large protrusion at the base of the big toe. You may or may not feel pain. Redness, swelling, and restricted movement of the big toe may be present as well.
Podiatrists use a variety of methods to diagnose bunions. If there are symptoms present, podiatrists will first consider that it is a bunion. If not, a physical examination will be conducted to check function of the big toe. Finally, an X-ray may be taken to view the extent of the bunion and confirm it is a bunion.
Typically, nonsurgical methods are used to treat bunions, unless the bunion has become too misaligned. Orthotics, icing and resting the foot, roomier and better fitted shoes, taping the foot, and pain medication are usually utilized first. If the bunion doesn’t go away or causes extreme pain, surgery may be required. Surgeons will either remove part of the swollen tissue or bone to straighten the toe out.
If you have a bunion, it is recommended to see a podiatrist. The longer it is left untreated, the worse it may get. Podiatrists can properly diagnose and treat a bunion before it gets worse.
Causes and Treatment of Bunions

A bunion is an unsightly and often painful deformity of the big toe, termed hallux valgus. This deformity starts in the bottom joint of the big toe, causing the bone to jut out sideways and push the top part of the toe toward the second toe. This can result not only in foot alignment issues but also problems with gait and weight bearing. A bunion is often very painful as the misshapen big toe rubs against the inside of the shoe and places more pressure on the ball of the foot. The major cause of bunions is believed to be genetic, but ill-fitting footwear and high-heeled shoes are other possible causes. In some cases, a bunion may be caused by rheumatoid arthritis. The first and simplest way of dealing with a bunion is changing footwear to accommodate the width of the foot and provide more cushioning. Bunion pads and toe spacers also may relieve some of the pain and pressure. In the worst cases, some form of surgery is an option to correct the deformity. The type of operation will be based on the severity of the bunion, along with other factors. For more information on treating a bunion, it is suggested that you make an appointment with a podiatrist.
If you are suffering from bunion pain, 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.
What Is a Bunion?
Bunions are painful bony bumps that usually develop on the inside of the foot at the joint of the big toe. As the deformity increases over time, it may become painful to walk and wear shoes. Women are more likely to exacerbate existing bunions since they often wear tight, narrow shoes that shift their toes together. Bunion pain can be relieved by wearing wider shoes with enough room for the toes.
Causes
- Genetics – some people inherit feet that are more prone to bunion development
- Inflammatory Conditions - rheumatoid arthritis and polio may cause bunion development
Symptoms
- Redness and inflammation
- Pain and tenderness
- Callus or corns on the bump
- Restricted motion in the big toe
In order to diagnose your bunion, your podiatrist may ask about your medical history, symptoms, and general health. Your doctor might also order an x-ray to take a closer look at your feet. Nonsurgical treatment options include orthotics, padding, icing, changes in footwear, and medication. If nonsurgical treatments don’t alleviate your bunion pain, surgery may be necessary.
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 care needs.
Obesity and the Feet
Obesity is a common problem in American society. Approximately one third of the U.S. population is obese. Obesity is defined as a body mass index greater than 30. Obesity has the power to affect different aspects of the body, and one of the most common problems it causes is foot pain. There have been many studies that found a connection between an increased BMI and foot problems. A simple activity such as walking up a flight of stairs can increase pressure on the ankle by four to six times.
Being overweight causes the body to compensate for the extra weight by changing the way it moves. Consequently, people who struggle with obesity commonly have arch problems in their feet. Obesity causes the arch to break by stretching the ligaments and tendons that hold the bones in the foot together. When the arch lowers, the foot may eventually fall flat. Collapsed foot arches fail to provide adequate shock absorption which eventually leads to foot pain. Other conditions that may be caused by flat feet are pronation, plantar fasciitis, weak ankles, and shin splints.
Foot problems that are caused by obesity may be treated by wearing proper footwear. Proper shoes will allow your feet to have better circulation around the arch and ankle. Additionally, those with obesity often discover that typical heel pain remedies are not effective for them. They will find that their plantar fascia is easily injured, and it is often inflamed. The best way to treat this problem is to implement lifestyle changes. A few good ways to improve your diet are to reduce calories, fill up on fruits and veggies, and to limit sugars.
Custom foot orthotics can prevent foot problems if you’re carrying excess weight or are trying to lose weight. The purpose of orthotics is to provide shock absorption to decrease the amount of stress on the joints to prevent arthritis.
The Connection Between Obesity and Falls in the Elderly

As we age, our physical abilities naturally decline, making us more susceptible to falls. This vulnerability is amplified in the elderly population due to age-related factors such as loss of skeletal muscle mass and strength, as well as the prevalence of various medical conditions. However, it is important to note that obesity further exacerbates the issue, as individuals carrying excess weight often struggle with balance and face a higher risk of falling. This risk is particularly pronounced among elderly individuals who are obese. The combination of obesity and age-related factors creates a perfect storm for increased fall risk, as it leads to compromised balance, decreased lower limb strength, and impaired postural stability. If you are elderly and carry excess weight, it is suggested that you make an appointment with a podiatrist for guidance on fall prevention strategies.
Obesity has become very problematic at this point in time and can have extremely negative effects on the feet. If you’re an obese individual and are concerned about your feet, contact Dr. Robert Graser from Graser Podiatry and Bunion Surgery Institute. Our doctor can provide the care you need to keep you pain-free and on your feet.
Obesity and Your Feet
Since your feet are what support your entire weight when standing, any additional weight can result in pain and swelling. Being overweight is one of the main contributors to foot complications.
Problems & Complications
Extra Weight – Even putting on just a few extra pounds could create serious complications for your feet. As your weight increases, your balance and body will shift, creating new stresses on your feet. This uneven weight distribution can cause pain, even while doing the simplest tasks, such as walking.
Diabetes – People who are overweight are at serious risk of developing type-2 diabetes, which has a drastic impact on the health of your feet. As you get older, your diabetes might worsen, which could lead to loss of feeling in your feet, sores, and bruises. You could also become more prone to various infections.
Plantar fasciitis – Pressure and stress that is placed on muscles, joints, and tendons can trigger plantar fasciitis, which is an inflammation of tissue that forms along the bottom of the foot.
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.
Ingrown Toenails
An ingrown toenail is a nail that has curved downward and grown into the skin. This typically occurs at either the nail borders or the sides of the nail. As a result, pain, redness, swelling, and warmth may occur in the toe. If a break in the skin forms due to the ingrown nail, bacteria may enter and cause an infection in the area; this is typically characterized by a foul odor and drainage.
Ingrown toenails have multiple reasons for developing. In many instances, the condition is a result of genetics and is inherited. The most common cause, however, is improper trimming; cutting the toenails too short forces the skin beside the nail to fold over. An ingrown toenail can also develop due to trauma, such as stubbing the toe, having an object fall on the toe, or participating in activities that involve repeated kicking or running. Wearing shoes that are too tight or too short can also cause ingrown toenails.
Treatment for an ingrown toenail varies between patients and the severity of the condition. In most cases, it is best to see your podiatrist for thorough and proper treatment. After examining your toe, your podiatrist may prescribe oral antibiotics to clear the infection if one is present. Surgical removal of either a portion of the nail or the entire nail may also be considered. In some cases, complete removal or destruction of the nail root may be required. Most patients who undergo nail surgery experience minimal pain afterward and can return to normal activity the following day.
Ingrown toenails can be prevented with proper nail trimming and by avoiding improper-fitting shoes. When cutting the toenails, be sure that you are cutting in a straight line and avoid cutting them too short. Shoes should not be too short or tight in the toe box.
Three Stages of an Ingrown Toenail

An ingrown toenail can be a potentially dangerous foot condition if medical attention is not promptly received. An ingrown toenail occurs when the nail grows into the skin instead of over it. It is a generally painful ailment, and severely ingrown toenails may bleed and become infected. This condition can be divided into three stages of development. The first stage causes mild inflammation, and it is often uncomfortable. A granuloma may form in the second stage, which can become more painful, and produce pus. This granuloma can grow over the nail in the third stage, and the entire toe may become inflamed. The most common cause of developing an ingrown toenail is improper foot care. This can range from wearing shoes that do not fit correctly to trimming the toenails in a curved fashion instead of straight across. If you have an ingrown toenail, it is suggested that you seek counsel from a podiatrist as quickly as possible who can perform minor surgery for permanent relief.
Ingrown toenails may initially present themselves as a minor discomfort, but they may progress into an infection in the skin without proper treatment. For more information about ingrown toenails, 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.
Ingrown Toenails
Ingrown toenails are caused when the corner or side of a toenail grows into the soft flesh surrounding it. They often result in redness, swelling, pain, and in some cases, infection. This condition typically affects the big toe and may recur if it is not treated properly.
Causes
- Improper toenail trimming
- Genetics
- Improper shoe fitting
- Injury from pedicures or nail picking
- Abnormal gait
- Poor hygiene
You are more likely to develop an ingrown toenail if you are obese, have diabetes, arthritis, or have any fungal infection in your nails. Additionally, people who have foot or toe deformities are at a higher risk of developing an ingrown toenail.
Symptoms
Some symptoms of ingrown toenails are redness, swelling, and pain. In rare cases, there may be a yellowish drainage coming from the nail.
Treatment
Ignoring an ingrown toenail can have serious complications. Infections of the nail border can progress to a deeper soft-tissue infection, which can then turn into a bone infection. You should always speak with your podiatrist if you suspect you have an ingrown toenail, especially if you have diabetes or poor circulation.
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 care needs.
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