December 2019
Bunions
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.
Dealing With Bunions

A bunion, or hallux valgus, is a deformity that occurs when a bony bump forms at the base of the big toe pushing it outward. From this movement, the tip of the big toe is pulled toward the smaller toes. Activities, including walking and standing, can lead to stiffness, foot pain, swelling, and redness. Calluses may develop where the big toe and the second toe touch or on the ball of the foot. Ill-fitting shoes, that are narrow or tight, or prolonged standing may lead to bunions or make them worse. Bunions can also be a result of one’s foot shape or an underlying condition, such as arthritis. Smaller bunions, also known as bunionettes, can form on the joint of the smaller toe. Bunions most often happen to elderly people and women. One can try bunion pads, better-fitting shoes, or toe spacers to help reduce the pain of bunions. If these things do not work, one can have bunion surgery, or a bunionectomy. If you have a bunion, it is a good idea to visit a podiatrist who can provide the best treatment options for you.
If you are suffering from bunions, 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?
A bunion is formed of swollen tissue or an enlargement of boney growth, usually located at the base joint of the toe that connects to the foot. The swelling occurs due to the bones in the big toe shifting inward, which impacts the other toes of the foot. This causes the area around the base of the big toe to become inflamed and painful.
Why Do Bunions Form?
Genetics – Susceptibility to bunions are often hereditary
Stress on the feet – Poorly fitted and uncomfortable footwear that places stress on feet, such as heels, can worsen existing bunions
How Are Bunions Diagnosed?
Doctors often perform two tests – blood tests and x-rays – when trying to diagnose bunions, especially in the early stages of development. Blood tests help determine if the foot pain is being caused by something else, such as arthritis, while x-rays provide a clear picture of your bone structure to your doctor.
How Are Bunions Treated?
- Refrain from wearing heels or similar shoes that cause discomfort
- Select wider shoes that can provide more comfort and reduce pain
- Anti-inflammatory and pain management drugs
- Orthotics or foot inserts
- 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 care needs.
Rare Foot Conditions
A podiatrist will be able to address a variety of rare foot conditions, particularly the ones that affect children. The most common are Kohler’s disease, Maffucci syndrome, and Freiberg’s disease. They can be properly diagnosed by having an X-ray taken, but in more serious cases an MRI may be needed. Kohler’s disease generally affects younger boys and bone deterioration may result from an interruption of blood supply. Children who have Kohler’s disease may find relief when the affected foot is rested, and a special boot is worn. Benign growths in the long bones of a child’s foot may lead to the development of bone lesions, and this is known as Maffucci syndrome. People who have this condition find mild relief when custom-made orthotics are worn. Freiberg’s disease targets the ball of the foot and can typically affect pre-teen and teenage girls. The metatarsal bone becomes deteriorated and flattened, and common symptoms include swelling and stiffness. A cast is often necessary to wear with this disease as it can help to reduce existing pain. Erythromelalgia is a rare foot condition, and its cause is unknown. Symptoms of this disease can include intense burning pain and the feet may appear red or feel warm. Relief may be found when the affected foot is immersed in ice water. It can also be beneficial to elevate the foot frequently. If your child complains of foot pain, it is strongly suggested that you consult with a podiatrist who can diagnose and treat rare foot conditions.
Facts About Charcot-Marie-Tooth Disease

Charcot-Marie-Tooth disease, CMT, is an inherited nerve condition that attacks muscles in the feet, legs, arms, and hands. The disease, which is named after the three doctors who first described it, is progressive and incurable. It is thought to be caused by a disorder in a particular gene that controls the peripheral nervous system. In short, the peripheral nerves have trouble sending the correct messages to the extremities. Symptoms often are noticed in the feet and legs first, causing weakness and balance problems. Often, sufferers may think they are clumsy or accident-prone. Charcot-Marie-Tooth disease also causes the ankles to become weakened. This further affects the gait, and falling is prevalent. A visit to a podiatrist for an examination and diagnosis is suggested, because there are some ways to treat the symptoms. People with CMT can benefit from custom shoes and leg braces, along with other walking aids to improve mobility and balance. In some cases, surgery can correct bone abnormalities. For more information, contact a podiatrist.
Some foot conditions may require additional professional care. If you have any concerns, 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.
Rare Foot Conditions
The majority of foot conditions are common and can be treated by a podiatrist. Standard diagnostic procedures are generally used to identify specific conditions and treatment can be rendered. A podiatrist also treats rare foot conditions which can be difficult to diagnose and may need extra attention and care.
There are many rare foot conditions that can affect children. Some of these can include:
- Freiberg’s disease
- Kohler’s disease
- Maffucci syndrome
Freiberg’s disease - This can be seen as a deterioration and flattening of a metatarsal bone that exists in the ball of the foot. It typically affects pre-teen and teenage girls, but can affect anyone at any age. Symptoms that can accompany this can be swelling, stiffness, and the patient may limp.
Kohler’s disease - This often targets the bone in the arch of the foot and affects younger boys. It can lead to an interruption of the blood supply which ultimately can lead to bone deterioration. The patient may limp or experience tenderness, swelling, and redness.
Maffucci syndrome - This affects the long bones in a child’s foot leading to the development of abnormal bone lesions. They are benign growths and typically develop in early childhood and the bones may be susceptible to breaking.
A podiatrist can properly diagnose and treat all types of rare foot conditions. If your child is affected by any of these symptoms or conditions, please don’t hesitate to call our office so the correct treatment method can begin.
If you have any questions please feel free to contact our office located in Boerne, . We offer the newest diagnostic tools and technology to treat your foot and ankle needs.
Plantar Fasciitis
The plantar fascia is a connective tissue in the heel that stretches across the bottom length of your foot. Plantar fasciitis occurs when the connective tissue becomes inflamed, causing heel pain and discomfort during physical activity. Although the condition is completely treatable, traditional methods can take up to a year to start becoming effective.
Plantar fasciitis is caused by a number of everyday activities, so understanding the condition is important for managing and treating it. One of the most common causes of plantar fasciitis is excessive running, especially with improper fitting or non-supportive shoes. Too much exercise can lead to the plantar fascia being overworked and overstretched, which can cause tears in the tissue. Along with improper fitting shoes, pronation, the rolling of the feet inward, is a common cause of plantar fasciitis. If not treated properly, the plantar fascia becomes overstretched and starts to tear, causing inflammation.
Despite the common causes of plantar fasciitis, there are many different treatment options. For less severe cases, conservative home remedies include taking anti-inflammatory drugs to alleviate pain, applying ice packs to the bottom of your foot and heel, slowly stretching and exercising your feet to re-strengthen the tissue, and using orthotic devices are all ways to help manage your plantar fasciitis.
For more severe cases, shockwave therapy has become a common solution for plantar fasciitis. Shockwave therapy can effectively break up the tissue on the bottom of your foot which facilitates healing and regeneration. This fights the chronic pain caused by plantar fasciitis. Even if this doesn’t work, surgery is always a final option. Surgery on the tissue itself can be done to permanently correct the issue and stop the inflammation and pain in your heels.
No matter what the case may be, consulting your podiatrist is the first and best step to recovery. Even the slightest amount of heel pain could be the first stage of plantar fasciitis. Untreated symptoms can lead to the tearing and overstretching of tissue. Because the tearing of tissue can be compounded if it remains ignored, it can evolve into a severe case. The solution is early detection and early treatment. Talk to your podiatrist about the possibilities of plantar fasciitis if you’re experiencing heel pain.
Plantar Fasciitis and Jumping Rope

There is a good chance that you might have heard of plantar fasciitis at some point in your life. This is because it is a leading cause of heel pain in many Americans, and can make a variety of physical activities significantly more challenging. Jumping rope is one such activity that can exacerbate or aggravate plantar fasciitis. Since this foot condition makes the band of tissue along the arch of the foot inflamed, jumping rope can cause an individual with plantar fasciitis pain. For example, when jumping rope, an individual with plantar fasciitis might feel a heightened sense of pain in the arches of the feet. Boxers ought to be particularly mindful of this possibility, as boxers will often jump rope in training for their sport. If you have plantar fasciitis or frequently jump rope, contact a podiatrist today for more information.
Plantar fasciitis is a common foot condition that is often caused by a strain injury. If you are experiencing heel pain or symptoms of plantar fasciitis, 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.
What Is Plantar Fasciitis?
Plantar fasciitis is one of the most common causes of heel pain. The plantar fascia is a ligament that connects your heel to the front of your foot. When this ligament becomes inflamed, plantar fasciitis is the result. If you have plantar fasciitis you will have a stabbing pain that usually occurs with your first steps in the morning. As the day progresses and you walk around more, this pain will start to disappear, but it will return after long periods of standing or sitting.
What Causes Plantar Fasciitis?
- Excessive running
- Having high arches in your feet
- Other foot issues such as flat feet
- Pregnancy (due to the sudden weight gain)
- Being on your feet very often
There are some risk factors that may make you more likely to develop plantar fasciitis compared to others. The condition most commonly affects adults between the ages of 40 and 60. It also tends to affect people who are obese because the extra pounds result in extra stress being placed on the plantar fascia.
Prevention
- Take good care of your feet – Wear shoes that have good arch support and heel cushioning.
- Maintain a healthy weight
- If you are a runner, alternate running with other sports that won’t cause heel pain
There are a variety of treatment options available for plantar fasciitis along with the pain that accompanies it. Additionally, physical therapy is a very important component in the treatment process. It is important that you meet with your podiatrist to determine which treatment option is best for you.
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.
Toe Pain
Toe pain can originate from corns, calluses, hammertoes, and bunions, as well as ingrown toenails, sprains, fractures, and dislocations. Corns develop as the toe rubs against the inside of a shoe which causes the skin to thicken as a form of protection. A corn is typically cone-shaped and has a small, hardened spot that points inward. When a corn is pressed into the skin, the toe becomes painful. Corns usually form on the top or side of the toe. A callus is also a thickened patch of skin that generally forms on the bottom of the foot. Calluses are the result of friction from the toe rubbing against the inside of a shoe. They may also occur by walking barefoot or having flat feet. A hammertoe is a bump on the knuckle of the second toe that is produced by wearing shoes that are too short for your feet. The bony protrusion rubs against the top of the shoe causing pain and irritation. A bunion is a malformation of the big toe. The base of the big toe pushes away from the smaller toes, forcing the top of the big toe to press toward the other toes. Bunions can be hereditary, or they can result from injury to the toe joint or from wearing high heels with a narrow toe box. The toe becomes inflamed, and a bump may develop at the end of the misplaced bone. Ingrown toenails typically affect the big toe and its surrounding skin. The nail will dig into the skin and become painful. Wearing tight or narrow shoes that compress the big toe causes the nail to grow into the fleshy part of the toe. Cutting toenails incorrectly can also add to the development of an ingrown toenail. A toe sprain originates from a torn or stretched ligament. Strapping the injured toe to the toe next to it for stabilization is common. A broken or fractured toe usually occurs from trauma like dropping a heavy object on it or bumping into something extremely hard and rigid. Osteoporosis, a thinning of the bones, can also bring about toe fractures.
Any of the conditions mentioned can lead to pain and irritation. While some are more serious than others, seeking an examination and diagnosis from a podiatrist is a good idea. A podiatrist can treat each ailment and get you back on your feet again without pain.
What Causes Burning Toes?

The sensation of burning in the toes can be caused by a number of conditions, many of which may need immediate and long-term treatment. Among the many possible causes of burning toes, diabetes, joint disease, and nerve pain top the list. If any of these serious health conditions are ignored, they can affect your quality of life and ability to carry out daily activities. Another common cause of burning in the toes is from wearing shoes that do not fit properly. In addition, hot toes can be the result of an injury or a blood circulation disorder. If the blood flow is blocked or oxygen-depleted, the result can be felt in the toes. Blood clots and inflammation of the veins and arteries can result in burning toes. Extreme cold can also damage the peripheral nerves, which can cause a burning sensation. If you frequently experience the sensation of burning in the toes, it is wise to seek the counsel of a podiatrist who may be able to determine the root cause and offer treatment suggestions.
Toe pain can disrupt your daily activities. If you have any concerns, 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 Causes Toe Pain?
Most severe toe pain is caused due to a sports injury, trauma from dropping something heavy on the toe, or bumping into something rigid. Other problems can develop over time for various reasons.
Toe pain can be caused by one or more ailments. The most common include:
- Trauma
- Sports injury
- Wearing shoes that are too tight
- Arthritis
- Gout
- Corns and calluses
- Hammertoe
- Bunions
- Blisters
- Ingrown toenails
- Sprains
- Fractures (broken bones)
- Dislocations
When to See a Podiatrist
- Severe pain
- Persistent pain that lasts more than a week
- Signs of infection
- Continued swelling
- Pain that prevents walking
Diagnosis
In many cases the cause of toe pain is obvious, but in others, a podiatrist may want to use more advanced methods to determine the problem. These can range from simple visual inspections and sensation tests to X-rays and MRI scans. Prior medical history, family medical history, and any recent physical traumatic events will all be taken into consideration for a proper diagnosis.
Treatment
Treatments for toe pain and injuries vary and may include shoe inserts, padding, taping, medicines, injections, and in some cases, surgery. If you believe that you have broken a toe, please see a podiatrist as soon as possible.
If you have any questions please feel free to contact our office located in Boerne, . We offer the newest diagnostic tools and technology to treat your foot and ankle needs.
Three Grades of Ankle Sprains
An ankle sprain occurs when one or more ankle ligament gets overly stretched. Ligaments are strong bands of tissue that bind and support the bones and other structures that make up the ankle. In more severe ankle sprains, the ligament(s) tear—either partially or completely—and there may be an audible popping noise at the moment of injury.
Ankle sprains are quite common and can occur when the ankle rolls outwardly (eversion) or inwardly (inversion), causing the ligament(s) to stretch beyond normal limits, or even tear. Falls, twists, or blows to the ankle during sports or other activities can cause this injury, as well as wearing improper footwear, running on uneven surfaces, or having weak ankles.
Depending on the injury’s severity, an ankle sprain will be classified as Grade I, Grade II, or Grade III. Grade I sprains involve ligament(s) being overly stretched but not torn, with symptoms of mild pain, swelling, and ankle instability. There may also be some difficulty bearing weight. A Grade II sprain usually involves a partial tear of the ligament which brings more intensity in these symptoms, along with possible bruising. With a Grade III sprain, the ligament is completely torn, the symptoms are severe, and it may not be possible to put weight on the affected foot at all.
To diagnose and grade an ankle sprain, a podiatrist will perform a physical examination, checking for tenderness and range of motion in the ankle. For more severe sprains, X-rays or other imaging studies may be necessary.
It is vitally important to have an ankle sprain treated properly as improper healing often leads to future ankle sprains and possibly even chronic ankle stability. Treatment for an ankle sprain will vary, depending on its severity, and may include the RICE method (Rest/Ice/Compression/Elevation), physical therapy, bracing, medications, and possibly even surgery to repair a torn ligament. Rehabilitation is very important for the sprain to heal properly and to restore functionality.
Featured Articles
- July 2024
- June 2024
- May 2024
- April 2024
- March 2024
- February 2024
- January 2024
- December 2023
- November 2023
- October 2023
- September 2023
- August 2023
- July 2023
- June 2023
- May 2023
- April 2023
- March 2023
- February 2023
- January 2023
- December 2022
- November 2022
- October 2022
- September 2022
- August 2022
- July 2022
- June 2022
- May 2022
- April 2022
- March 2022
- February 2022
- January 2022
- December 2021
- November 2021
- October 2021
- September 2021
- August 2021
- July 2021
- June 2021
- May 2021
- April 2021
- March 2021
- February 2021
- January 2021
- December 2020
- November 2020
- October 2020
- September 2020
- August 2020
- July 2020
- June 2020
- May 2020
- April 2020
- March 2020
- February 2020
- January 2020
- December 2019
- November 2019
- October 2019
- September 2019
- August 2019
- July 2019
- June 2019
- May 2019
- April 2019
- March 2019
- February 2019
- January 2019
- December 2018
- November 2018
- October 2018
- September 2018
- August 2018
- July 2018
- June 2018
- May 2018