December 2019
Different Types of Heel Pain

Heel pain is a common issue that can have various causes, often related to mechanical factors. The location of the pain can provide clues for diagnosis. Plantar fasciitis, a prevalent condition, leads to medial plantar heel pain, especially during the first steps in the morning or after rest. Other causes of plantar heel pain include calcaneal stress fractures, nerve entrapment, heel pad syndrome, neuromas, and plantar warts. Posterior heel pain is often due to Achilles tendinopathy, while pain at the tendon's insertion point is related to other tendinopathies. Haglund deformity, a protrusion of the calcaneus, can cause pain between the calcaneus and Achilles tendon. In children, Sever’s disease, a calcaneal apophysitis, may be the cause. Medial midfoot heel pain, especially with weight-bearing, might be linked to tarsal tunnel syndrome, caused by nerve compression. Sinus tarsi syndrome leads to lateral midfoot heel pain. If you have heel pain, it is suggested that you schedule an appointment with a podiatrist for a diagnosis of the problem so that the proper treatment can be provided.
Many people suffer from bouts of heel pain. For more information, 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.
Causes of Heel Pain
Heel pain is often associated with plantar fasciitis. The plantar fascia is a band of tissues that extends along the bottom of the foot. A rip or tear in this ligament can cause inflammation of the tissue.
Achilles tendonitis is another cause of heel pain. Inflammation of the Achilles tendon will cause pain from fractures and muscle tearing. Lack of flexibility is also another symptom.
Heel spurs are another cause of pain. When the tissues of the plantar fascia undergo a great deal of stress, it can lead to ligament separation from the heel bone, causing heel spurs.
Why Might Heel Pain Occur?
- Wearing ill-fitting shoes
- Wearing non-supportive shoes
- Weight change
- Excessive running
Treatments
Heel pain should be treated as soon as possible for immediate results. Keeping your feet in a stress-free environment will help. If you suffer from Achilles tendonitis or plantar fasciitis, applying ice will reduce the swelling. Stretching before an exercise like running will help the muscles. Using all these tips will help make heel pain a condition of the past.
If you have any questions please contact our office located in Boerne, . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Bunions
A bunion is a bump that forms at the base of the big toe. Bunions form when the big toe pushes against the next toe, which forces the big toe joint to get bigger and stick out. As a result, the skin over the bunion may start to appear red and it may feel sore.
There are risk factors that can increase your chances of developing bunions. People who wear high heels or ill-fitting shoes are more likely to develop them, in addition to those who have a genetic history of bunions or have rheumatoid arthritis.
The most obvious way to tell if you have a bunion is to look for the big toe pushing up against the toe next to it. Bunions produce a large protrusion at the base of the big toe and may or may not cause pain. Other symptoms are redness, swelling, and restricted movement of the big toe if you have arthritis.
Nonsurgical methods are frequently used to treat bunions that aren’t severe. Some methods of nonsurgical treatment are orthotics, icing and resting the foot, taping the foot, and pain medication. Surgery is usually only required in extreme cases. However, if surgery is needed, some procedures may involve removing the swollen tissue from around the big toe joint, straightening the big toe by removing part of the bone, or joining the bones of your affected joint permanently.
Your podiatrist will diagnose your bunion by doing a thorough examination of your foot. He or she may also conduct an x-ray to determine the cause of the bunion and its severity.
Types of Bunion Surgery

Bunions, a common source of discomfort in the big toe, can often lead to surgical solutions. With an array of over 150 bunion surgeries available, it is beneficial to comprehend the prevailing procedures in use today. The bunionectomy is a foundational method. It involves removing the bony outgrowth at the base of the big toe that is responsible for the bunion and realigning the surrounding muscles, tendons, and ligaments. Osteotomy, another prevalent technique, necessitates cutting the toe bone to reposition the affected joint. It may also involve securing the bone with pins or screws for sustained correction. Arthrodesis is employed in cases of significant joint damage. This procedure entails fusing the surrounding bones with screws, wires, or plates. Arthroplasty is reserved for severe cases. The damaged portion of the joint is replaced with an implant, aiming to restore joint function. Integral to all bunion surgeries is soft tissue repair, ensuring the equilibrium of tendons and ligaments surrounding the joint to deter deformity recurrence. If you have a bunion that is causing extreme pain, it is suggested that you schedule an appointment with a podiatrist for a full examination and suggestions for treatment options.
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.
Dealing with Stress Fractures of the Foot and Ankle
Stress fractures are small breaks in the bone that are caused by repetitive stress. They typically occur due to overuse, forcing the bones of the foot or ankle to continually absorb the full impact of each step taken. Stress fractures can also be caused by abnormal foot structure, osteoporosis, bone deformities, or wearing improper footwear during exercise.
Stress fractures are common for individuals whose daily activities cause high levels of impact on their feet and ankles. Those who run, play tennis or basketball, or practice gymnastics tend to experience these fractures more frequently. Anyone is susceptible to this problem, though. Individuals who are normally sedentary and suddenly begin an intense, high impact workout may sustain stress fractures. This is because their muscles are not yet strong enough to handle and cushion the intensity of their activity. Osteoporosis may also cause someone to get stress fractures, because the disease weakens an afflicted person's bones and makes it easier for them to break down.
Pain from stress fractures typically occurs in the general area of the fracture. Pain can also manifest as “pinpoint pain” or pain that is felt when the site of the injury is touched, and can be accompanied by swelling. It may occur during or after activity, and it may disappear while resting and return when standing or moving. Engaging in any kind of activity, high impact or otherwise, will aggravate the pain. If the intensity of the activity increases before the stress fracture has properly healed, it can cause a full fracture.
Treatment can vary depending on the individual and the degree of injury. The primary way to treat a stress fracture is to rest the hurt foot. Some fractures will heal quickly with only a little bit of rest, while others may require a long rest period and the use of crutches, immobilization, or physical therapy. Under certain circumstances, surgery may be required to install support pins around the fracture to assist in healing.
If you are undergoing a new exercise regimen in running or some other kind of high impact activity, set incremental goals on a weekly basis so you can build up muscle strength. Make sure to wear supportive shoes to better protect you feet.
If you begin to experience any symptoms of stress fractures, you should stop exercising and rest. If the symptoms persist, consult with your podiatrist. Remembering these tips can help you prevent stress fractures to your foot and ankle, and allow you to continue living normally.
Causes of Stress Fractures

Engaging regularly in high-impact activities, such as basketball, running, or professional dancing, may expose you to the discomfort of a foot stress fracture. This overuse injury involves hairline cracks in the weight-bearing bones of the foot. If left untreated, a stress fracture in the foot can escalate into a more serious concern. However, stress fractures are not always easy to diagnose. Pain upon weight-bearing activities that often subsides after rest is a primary indicator of stress fractures. Tenderness in the affected area, occasional bruising, and swelling around the ankle are other signs to be noted. Various factors contribute to the development of stress fractures in the foot. Overuse and repetitive stress, stemming from prolonged engagement in activities without adequate rest, can subject the foot bones to cumulative stress. Wearing inadequate footwear, whether ill-fitting or worn out, further elevates the risk by providing insufficient support and shock absorption. Suddenly increasing the intensity or duration of physical activity can overwhelm the bones, especially without sufficient time to adapt. Poor biomechanics, such as flat feet or high arches, also can redistribute pressure unevenly across the foot, contributing to stress fractures. If you believe you may have incurred a foot stress fracture, it is suggested that you schedule an appointment with a podiatrist for a thorough exam and suitable imaging tests. Treatment options appropriate to the severity of the injury will follow.
Activities where too much pressure is put on the feet can cause stress fractures. To learn more, contact Dr. Robert Graser from Graser Podiatry and Bunion Surgery Institute. Our doctor can provide the care you need to keep your pain free and on your feet.
Dealing with Stress Fractures of the Foot and Ankle
Stress fractures occur in the foot and ankle when muscles in these areas weaken from too much or too little use. The feet and ankles then lose support when walking or running from the impact of the ground. Since there is no protection, the bones receive the full impact of each step. Stress on the feet can cause cracks to form in the bones, thus creating stress fractures.
What Are Stress Fractures?
Stress fractures occur frequently in individuals whose daily activities cause great impact on the feet and ankles. Stress factors are most common among:
- Runners
- People affected with Osteoporosis
- Tennis or basketball players
- Gymnasts
- High impact workouts
Symptoms
Pain from the fractures occur in the area of the fractures and can be constant or intermittent. It will often cause sharp or dull pain with swelling and tenderness. Engaging in any kind of activity which involves high impact will aggravate pain.
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.
How to Handle a Long Work Day on Your Feet
In 2014, the American Podiatric Medical Association surveyed 1,000 American adults and found that half of all respondents lived with foot pain. Fortunately, there are ways to avoid foot problems such as following a daily footcare routine and wearing proper footwear at work.
If you have a job that requires you to be on your feet, it is best that you do not wear flat sole shoes. Your heel should be slightly elevated (less than 2 inches, but at least ¼-inch) if you are going to be standing for a prolonged period. You should also make sure that the shoes you wear are not too small. Tight shoes may cut off circulation to your feet, which will result in pain and blisters. It is always best to purchase fitted shoes later in the day, because the feet tend to swell as the day progresses. It may also be helpful to buy shoes a half size larger if you plan on wearing custom orthotics or arch supports.
Your muscles may become stiff when you are constantly standing up. It is important to take breaks every hour to stretch and relax. One tip is to perform calf raises, because this exercise will help improve your circulation. To perform this stretch, you first need to stand on the edge of a step with your abdominal muscles pulled inward. You then need to grip the step with the balls of your feet with your heels hanging over the edge. Next, try to raise your heels above the step by a few inches while standing on your tiptoes; hold this pose for a second. You should then lower your heels back even to the platform. These calf raises should be done ten times for full effectiveness.
You should also take care of your feet while you are at home. One of the best ways to prepare your feet for a long day of work is to soak them in ice water. Doing so for 20 minutes will help fight the swelling and inflammation that results from being on your feet at work.
Nevertheless, if you are experiencing pain in your feet, you should seek help from your podiatrist. Your doctor will help treat any ailments you may have in addition to helping you prevent any other ailments from developing in the future.
A Guide to Choosing the Right Shoes for Work Environments

In the diverse landscape of workplaces, the importance of choosing the right shoes transcends mere fashion, it is a vital aspect of ensuring safety and protection. Different work environments demand varying levels of resilience from your footwear. Construction sites, for instance, call for sturdy, steel-toed boots to shield against potential impacts, while slip-resistant shoes are essential in restaurant kitchens to prevent accidents on slippery surfaces. For office settings, where comfort is often paramount, choosing supportive yet stylish shoes can enhance overall well-being. Understanding the specific hazards and demands of the work environment is key to selecting the appropriate footwear. Consider factors like arch support, toe protection, and sole grip to match the nature of the job. By investing in the right pair of shoes, individuals not only prioritize their safety but also pave the way for a more comfortable and productive work experience. If you would like more information about specific shoes to purchase for your work environment, it is suggested that you consult a podiatrist.
While working on the feet, it is important to take the proper care of them. For more information about working on your feet, contact Dr. Robert Graser from Graser Podiatry and Bunion Surgery Institute. Our doctor will treat your foot and ankle needs.
Working on Your Feet
Standing on your feet for long periods of time can cause stress and pain in your feet. Your whole body may experience change in terms of posture, back pain, bunions, callouses and or plantar warts. There are ways to avoid these conditions with proper foot care, smart choices and correct posture.
Positive Changes
Negative heeled shoe – Choosing this shoe type places the heel slightly lower than the ball of the foot. These are great for overall foot health. Find shoes that fit you correctly.
Go barefoot – Our feet were not designed to be enclosed for all hours of the day. Try to periodically expose your feet to air.
Eliminate Pain
Foot Exercises – Performing simple exercises, incorporating yoga and doing stretches are beneficial. This will allow increased blood flow to the area and muscles of the foot.
Achilles tendon – Stretching the foot out flat on the floor will relax the calf muscles and tendon. These exercises can be performed almost anywhere. Make sure you add these exercises to your daily regimen.
With a little bit of this information and knowing more about foot health, you will notice changes. Foot stretches and proper footwear will help with pain and prevent further issues.
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.
Diabetic Foot Care
Diabetes can cause two problems that can potentially affect the feet: Diabetic neuropathy and Peripheral Vascular Disease. Diabetic neuropathy occurs when nerves in your legs and feet become damaged, which prevents you from feeling heat, cold, or pain. The problem with diabetic neuropathy is that a cut or sore on the foot may go unnoticed and the cut may eventually become infected. This condition is also a main cause of foot ulcers. Additionally, Peripheral vascular disease also affects blood flow in the body. Poor blood flow will cause sores and cuts to take longer to heal. Infections that don’t heal do to poor blood flow can potentially cause ulcers or gangrene.
There are certain foot problems that are more commonly found in people with diabetes such as Athlete’s foot, calluses, corns, blisters, bunions, foot ulcers, ingrown toenails, and plantar warts. These conditions can lead to infection and serious complications such as amputation. Fortunately, proper foot care can help prevent these foot problems before they progress into more serious complications.
Each day you should wash your feet in warm water with a mild soap. When you finish washing your feet, dry them carefully especially between your toes. You should also perform daily foot inspections to ensure you don’t have any redness, blisters, or calluses. Furthermore, if you are diabetic, you should always wear closed-toed shoes or slippers to protect your feet. Practicing these tips will help ensure that your feet are kept healthy and away from infection.
If you have diabetes, contact your podiatrist if you have any of the following symptoms on your feet: changes in skin color, corns or calluses, open sores that are slow to heal, unusual and persistent odor, or changes in skin temperature. Your podiatrist will do a thorough examination of your feet to help treat these problematic conditions.
Diabetes and Foot Problems

Living with diabetes involves unique challenges, particularly in foot care. Reduced blood supply and nerve function increase the risk of foot damage, including peripheral neuropathy and structural issues such as clawed toes. Regular annual podiatrist checkups play an essential role in monitoring diabetic foot health, assessing blood supply, nerve function, and detecting structural changes early on. Daily self-examinations for cuts, blisters, and structural changes are important, and it may help to use a mirror to see the bottom of your foot. Simple measures, such as moisturizing the feet and wearing appropriate footwear are effective in preventing more severe complications. Balanced blood glucose levels, using gloves with household cleaners, and cautious bathing habits contribute to skin health. Post bathing care, including applying unscented creams and soaps, helps to lock in moisture. Prompt medical attention for skin problems, such as wounds that will not heal, ensures timely intervention and management from a podiatrist. For preventing diabetic complications and promoting overall foot health, it is suggested that you schedule regular appointments with a podiatrist who is trained to manage the complications of diabetes.
Diabetic foot care is important in preventing foot ailments such as ulcers. If you are suffering from diabetes or have any other 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.
Diabetic Foot Care
Diabetes affects millions of people every year. The condition can damage blood vessels in many parts of the body, especially the feet. Because of this, taking care of your feet is essential if you have diabetes, and having a podiatrist help monitor your foot health is highly recommended.
The Importance of Caring for Your Feet
- Routinely inspect your feet for bruises or sores.
- Wear socks that fit your feet comfortably.
- Wear comfortable shoes that provide adequate support.
Patients with diabetes should have their doctor monitor their blood levels, as blood sugar levels play such a huge role in diabetic care. Monitoring these levels on a regular basis is highly advised.
It is always best to inform your healthcare professional of any concerns you may have regarding your feet, especially for diabetic patients. Early treatment and routine foot examinations are keys to maintaining proper health, especially because severe complications can arise if proper treatment is not applied.
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.
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