December 2019
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.
Causes of Big Toe Joint Pain

One of the most important components of your foot is the big toe joint, scientifically known as the first metatarsophalangeal joint, or first MPJ. When issues arise within this joint, they can significantly impact your daily life, ranging from walking to overall body posture. Hallux limitus is a condition that pertains to the limited range of motion in the big toe joint. One of the main causes of this condition is inflammatory arthritis. Your big toe joint plays a critical role in walking and maintaining proper balance. When this joint loses its range of motion it can lead to significant difficulties in walking and cause pain during each step. This can alter the gait and in turn affect the knee, hip, and back. If arthritis is a contributing factor, disease specific medications can be prescribed. In severe cases, surgical intervention may be needed. Procedures can range from cleaning out the joint to more advanced surgeries, such as joint fusion or joint replacement. For an accurate appraisal of the problems involving your big toe pain, it is suggested that you make an appointment with a podiatrist.
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.
Flip Flops and Feet
Flip flops are often a popular choice of footwear for many people. Flip flops allow your feet to breathe and give your toes the freedom of movement. They are easy to slip on and can be worn with virtually any style of clothing. Flip flops, however, despite their many benefits, can be detrimental for your foot health.
Despite their comfortableness, frequently wearing flip flops can create problems in the lower body over time. Issues mainly stem from the fact that people walk differently in flip flops compared to other footwear, such as sneakers. This is due to a change in one’s natural gait, which therefore creates stress in different parts of the body while hindering the body’s natural posture. Problems can also arise in the arches and balls of the feet. Flip flops provide little to no support to these areas.
Aside from long-term problems, flip-fops can also create short-term issues as well, such as ankle sprains and blisters. Weak materials that are flexible and bendable are generally used to manufacture flip flops. These materials make its wearers prone to both tripping and injuring their ankles. Flip flops can create blisters as the material rubs against the foot. People are much more at risk for infection while wearing flip flops due to their openness. This also makes it easier to scrape and cut the foot since there is a lack of protection. If these cuts are left untreated and uncovered, the risk then becomes greater.
To prevent the aforementioned occurrences, purchase a pair of flip flops that offer significant protection. The soles of the flip flops should not be floppy, but sturdy and firm, and should not significantly bend or wiggle when lifted from the floor. Flip flops made of high-quality materials will not be affected by this problem. While higher quality flip flops may be more expensive, they will last longer and provide better protection compared to a cheaper pair. Brand name flip flops sold from a quality manufacturer are a dependable option.
There is no problem in wearing your favorite pair of flip flops so as long as you do not wear them daily or for extended periods of time. Flip flops should be replaced every 3-4 months to ensure that they provide your feet with the best protection.
Fungal and Bacterial Infections From Wearing Flip-Flops

Wearing flip-flops leaves your feet vulnerable to various infections, from bacteria to viruses. When your feet are exposed in public places, harmful organisms, such as staphylococcus, can cling to them. This bacterium can cause skin irritation, and in extreme cases, serious foot conditions may emerge. The risk increases if you have open sores or even small wounds from recent pedicures. Another concern is athlete's foot, which is a contagious fungal infection that causes itching. Walking with minimal footwear increases the chances of encountering and contracting this fungus. You also risk exposure to the virus responsible for warts, which is HPV, while wearing flip-flops. If you enjoy wearing flip-flops, it is suggested that you make an appointment with a podiatrist to discuss similarly easy and comfortable footwear alternatives that are healthier for your feet.
Flip-flops can cause a lot of problems for your feet. 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
Flip-flops have managed to become a summer essential for a lot of people. While the shoes may be stylish and easy to slip on and off, they can be dangerous to those who wear them too often. These shoes might protect you from fungal infections such as athlete’s foot, but they can also give you foot pain and sprained ankles if you trip while wearing them.
When Are They Okay to Wear?
Flip-flops should only be worn for very short periods of time. They can help protect your feet in places that are crawling with fungi, such as gym locker rooms. Athlete’s foot and plantar warts are two common fungi that flip-flops may help protect your feet against.
Why Are They Bad for My Feet?
These shoes do not offer any arch support, so they are not ideal for everyday use. They also do not provide shock absorption or heel cushioning which can be problematic for your feet. Additionally, you may suffer from glass cuts, puncture wounds, and stubbed toes since they offer little protection for your feet.
More Reasons Why They Are Bad for Your Feet
- They Slow You Down
- May Cause Blisters and Calluses
- Expose Your Feet to Bacteria
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.
Swelling of the Feet
There are many reasons why patients experience swelling of the feet. It is rather common and may be a side effect of pregnancy or from sitting and standing for most of the day. Gravity could also play a role in the development of swollen feet. It is known that the weight of blood volume in our bodies is exerted on the veins in the legs and feet. The veins may not work as efficiently during the aging process, and this could make the blood flow backward causing swollen feet. Relief may be found when obese patients lose weight, and it may help to engage in compression therapy by wearing compression socks, stockings, or athletic sleeves. This method can release pressure on the feet and ankles which may help to reduce existing swelling. There are patients who have controlled their swollen feet by implementing healthy lifestyle changes. These can consist of reducing salt intake, incorporating a gentle exercise regime into the daily routine, and drinking plenty of fresh water. Swollen feet may be a temporary condition that affects people who travel via airplane or automobile, so it is beneficial to walk as frequently as possible even though it can be difficult. Swelling of the feet can also be indicative of other health issues so it is important to pay attention to any type of chest pain, mental confusion, dizziness, or fever. If you consistently have swollen feet, it is strongly suggested that you consult with a podiatrist who can help determine the cause and how to effectively treat it.
Various Reasons Feet Can Swell

Swollen feet, also known as edema, is a common condition that can affect individuals of all ages. This ailment presents as an abnormal accumulation of fluid in the feet and ankles, causing them to appear larger than usual and often accompanied by discomfort. There are numerous reasons why feet may become swollen, ranging from minor to more serious causes. Among the most common triggers are prolonged sitting or standing, particularly in hot weather, which can lead to fluid retention. High salt intake, obesity, and certain medications can exacerbate this effect. Injuries and strains, such as a twisted ankle, may also result in localized swelling. Underlying health conditions, such as heart, kidney, or liver disease, can contribute to generalized edema throughout the body, including the feet. Furthermore, issues like deep vein thrombosis and lymphedema can cause foot swelling. Pregnancy, too, often leads to edema due to hormonal changes and increased blood volume. It is important to differentiate the cause of swollen feet, as some instances can indicate underlying health problems. If you have swollen feet, it is suggested that you confer with a podiatrist who can help you determine the cause and offer effective relief options.
Swollen feet can be a sign of an underlying condition. 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.
Swollen feet are a common ailment among pregnant women and people who stand or sit for extended periods. Aging may increase the possibility of swollen feet and patients who are obese often notice when their feet are swelling too. There may be medical reasons why swollen feet occur:
- Phlebitis - A condition that causes the veins to become inflamed and can also cause leg pain.
- Liver disease - This may lead to low blood levels of albumin which is a protein. This can cause fluid in the blood to pass into the tissues and several areas of the body can become swollen.
- Heart failure - When the heart doesn’t pump properly the blood that is normally pumped back to the heart can pool in the veins of the legs causing swollen feet.
- Kidney disease - One of the main functions of the kidneys is releasing excess fluid in the body. This type of condition can make it difficult for the kidneys to function properly, and as a result the feet may become swollen.
- Deep-vein thrombosis (DVT)- This is a serious condition where blood clots form in the veins of the legs. They can block the return of blood from the legs to the heart which may cause the feet to swell. It is important to be treated by a podiatrist if this condition is present.
Swollen feet can also be caused by bone and tendon conditions, including fractures, arthritis, and tendinitis. Additionally, there may be skin and toenail conditions and an infection may cause the feet to swell. Patients who take medicine to treat high blood pressure may be prone to getting swollen feet.
Many patients elevate their feet to help relieve the swelling and this is generally a temporary remedy. When a podiatrist is consulted the reason behind the swelling can be uncovered and subsequently treated.
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.
All About Broken Ankle
Broken ankles or “ankle fractures” are injuries that occur when the bones that make up the ankle joint are broken. Ankle injuries are some of the most common bone and joint injuries. The ankle joint is made up of three bones that join. The tibia is the main bone, and it makes up the inside of the anklebone. The fibula is a smaller bone, and it makes up the outside of the anklebone. A membrane called the joint capsule is lined with a layer called the synovium, which covers the entire joint. The synovium produces synovial fluid which allows for the joint surfaces to move.
An ankle becomes broken when the joint is stressed beyond the strength of its limits. When an ankle is fractured, ligaments may also tear at the same time. Fractures often occur to the ankle rolling or twisting in an unusual way. At times, a fracture may even be caused by an extreme force applied to the joint.
Symptoms of a broken ankle include pain, swelling, bruising, discoloration, numbness, and an inability to move the toes. If you have a broken ankle, you may also hear something tear or snap when you initially suffered the injury. If you have pain from a broken ankle, beware that the pain will not always come from the exact area of the fracture; you may also experience pain from associated foot fractures. The swelling you may experience can suggest that soft tissue damage may have occurred due to the injury.
There are differences between an ankle fracture and an ankle sprain. The difference is that a fracture or break in the bone is required to classify an injury as a broken ankle. An ankle sprain occurs when there is a tear or disruption of ligaments in the ankle. In some cases, the prognosis of an ankle sprain may be worse than that of a fracture.
X-rays are the most common way to diagnose a broken ankle. X-rays show if the ankle is broken and where exactly the fracture is located. It will also show how many pieces of broken bone there are. A second method of testing to see if an ankle is broken is a stress test. To do this, the doctor will put pressure on the ankle and perform a stress test to determine if the fracture requires surgery. Other methods for diagnosis include CT scans and MRI scans.
If you are suffering from a broken ankle, consult with your podiatrist immediately to receive a proper diagnosis and treatment.
Common Ways to Break an Ankle

A broken ankle occurs when one of more of the three bones that make up the ankle joint is injured. This includes the tibia and fibula, which are calf bones and the talus, which is a web-shaped bone inside the joint. Following are common causes of a broken ankle. Car accidents can often be the source of crushing injuries that can result in an ankle fracture. Also, if you jump from a height and land on your feet, it can result in ankle bone injuries. When a heavy weight falls on your foot, it can break your ankle. Sometimes, when you miss a step while climbing up the stairs or walking down, you can break your ankle. The weight-bearing bones in your feet and ankles are prone to stress. Strong, repetitive forces or overuse, like running for long distances, can result in tiny cracks in them. Stress fractures and bone thinning conditions, such as osteoporosis, can also result in ankle bone injuries. Falling on slippery and wet surfaces, tripping, or stepping into a hole can cause ankle fractures and injuries. When you place the foot down in a wrong manner, twist the ankle, or apply excess pressure on your foot, you can break your ankle. If you believe that you have broken a bone in your ankle, it is strongly suggested that you seek immediate medical attention from a podiatrist.
Broken ankles need immediate treatment. If you are seeking treatment, 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.
Broken Ankles
A broken ankle is experienced when a person fractures their tibia or fibula in the lower leg and ankle area. Both of these bones are attached at the bottom of the leg and combine to form what we know to be our ankle.
When a physician is referring to a break of the ankle, he or she is usually referring to a break in the area where the tibia and fibula are joined to create our ankle joint. Ankles are more prone to fractures because the ankle is an area that suffers a lot of pressure and stress. There are some obvious signs when a person experiences a fractured ankle, and the following symptoms may be present.
Symptoms of a Fractured Ankle
- Excessive pain when the area is touched or when any pressure is placed on the ankle
- Swelling around the area
- Bruising of the area
- Area appears to be deformed
If you suspect an ankle fracture, it is recommended to seek treatment as soon as possible. The sooner you have your podiatrist diagnose the fracture, the quicker you’ll be on the way towards recovery.
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.
Sports Related Foot And Ankle Injuries
Foot and ankle injuries are common among people who participate in sports. Several factors contribute to this. They include failing to stretch or warm up properly, not wearing the proper type of shoe and not taping or providing other types of support for the ankle or foot. The most common foot and ankle injuries suffered by people involved in sports are plantar fasciitis, ankle sprains and Achilles tendon damage or ruptures. If not treated properly, they can lead to permanent disability.
Treating these injuries is relatively simple if they are identified and addressed early. Many athletes dismiss the initial aches and pains associated with injury as just soreness or tired muscles. Their first response is usually to try to work through it. This can lead to serious problems. Many minor injuries are made far more serious when athletes continue to put strain and pressure on them. That attitude can change a mild strain into a serious strain and a minor tear into a rupture. Athletes should have unusual aches and pains evaluated by a skilled medical professional.
Plantar fasciitis is a painful injury. It is inflammation of the plantar fascia, the thick band of tissue running from the heel to the base of the toes. If left untreated, it can lead to a degenerative disease called plantar fasciosis. There are several effective treatments for this ailment. Doctors often prescribe rest, massages, stretching, night splints, physical therapy, anti-inflammatory medication, corticosteroids or surgery, usually in that order. The most effective treatment for plantar fasciitis is orthotics, which offers foot support. Surgery is occasionally used as a last resort, but it comes with the risk of nerve damage and infection and often does not stop the pain.
The Achilles tendon is the largest tendon in the body. It connects the calf muscles to the heel bone. Running, jumping and walking all impact this tendon. Two common injuries to the Achilles tendon are tendonitis and a rupture of the tendon. Tendonitis is inflammation in the tendon often caused by an increase in the amount of stress placed on it. Non-surgical treatments include rest, ice or anti-inflammatory medication. A rupture (tear) of the Achilles tendon can be treated by placing the lower leg in a cast for several weeks or with surgery. Many physicians feel surgery is the better option because it lowers the risk of re-ruptures. Both methods require 4 to 6 months of rehabilitation.
Ankle sprains are the most common sports related foot and ankle injury. A sprain occurs when the ligament holding the ankle bones and joint stretches beyond its normal range. It can be treated non-surgically with a combination of rest, ice wrapped around the joint for 30 minutes immediately after injury, compression by a bandage and elevating the ankle above the heart for 48 hours. This combination is referred to as RICE. Severe ankle sprains in which the ligaments are torn may require reconstructive surgery followed by rehabilitation.
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