March 2023

A hammertoe is a deformity that develops at the middle joint of a toe and causes the tip of the toe to turn down, resembling a hammer or claw. This generally happens in the foot's second toe when it is longer than the first toe or when the foot's arch is flat. Hammertoes can be caused by ill-fitting shoes that crowd the toes, genetics or a bunion that can overlap and crowd smaller toes. If the hammertoe remains in a bent position for a prolonged time, the tendons can tighten and shorten and remain this way even if shoes are not worn. A hammertoe can cause pain or discomfort when walking, and the skin can thicken on the toe causing corns or calluses to form. It can also be challenging to find shoes that fit well. If you have a hammertoe and it is causing you pain, it is suggested that you see a podiatrist for an evaluation and treatment.

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.

The growth plate in the heel can grow faster than the surrounding muscles and tendons in children and young teenagers. This can indicate a condition called Sever’s disease, which may cause severe heel pain. It occurs in people in this age bracket who frequently participate in sporting activities, and additional symptoms can include walking on tiptoes or limping. Relief may be found when the activity that caused the condition is temporarily stopped, and the affected foot is elevated. Some patients find that performing specific stretches can be helpful in reducing pain and discomfort. These can include placing a rolled towel under the ball of the foot while sitting down, and pulling the towel forward until a gentle stretch is felt. If your child is active and has heel pain, it is suggested that you confer with a podiatrist who can diagnose and treat Sever’s disease.

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.

As with adults, if a baby’s nails are trimmed too short or left to grow too long, or if their shoes or socks are too tight, they can develop an ingrown toenail. An ingrown toenail is a nail that presses or grows into the skin on the corner or side of the toenail. While this can happen on any toe, it is most common on the big toe. An ingrown toenail can be red, swollen, and painful. If not promptly treated, an infection can result. It may help to soak the child’s foot in warm, soapy water a few times a day and have them wear looser-fitting shoes outdoors or go barefoot indoors. However, it is suggested that if you notice signs of an ingrown toenail in your child, you should not try to pry their nail away from the skin, but see a podiatrist as soon as possible.

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.

A stress fracture is a tiny, hairline crack in a bone, usually caused by overuse or repetitive actions. This injury is common among runners, dancers, gymnasts, and athletes involved in football, basketball and tennis. Stress fractures frequently develop when a sudden increase in intensity, frequency, and duration of activity occurs. Sometimes the muscles in the foot lack the strength to cope with the higher levels of training or activity. They may not be able to support the bones properly, increasing vulnerability and causing these tiny fractures. Factors that have been found to contribute to foot stress fractures include, gender, age, biomechanics, improper footwear, and bone density. More women than men incur foot stress fractures as the result of hormonal changes and osteoporosis. Flattening arches can cause the bones to absorb more of the force in activity. Stress fractures can be easy to ignore and difficult to detect because when the activity is ceased, the pain and possible swelling often recedes. A podiatrist, after taking a history of the patient’s activity levels, will often order an MRI to be taken, as these injuries can be difficult to see with an X-ray. For more information on stress fractures in the foot, it is suggested that you consult a podiatrist. 

Stress fractures occur when there is a tiny crack within a bone. To learn more, 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.

How Are They Caused?

Stress fractures are the result of repetitive force being placed on the bone. Since the lower leg and feet often carry most of the body’s weight, stress fractures are likely to occur in these areas. If you rush into a new exercise, you are more likely to develop a stress fracture since you are starting too much, too soon.  Pain resulting from stress fractures may go unnoticed at first, however it may start to worsen over time.

Risk Factors

• Gender – They are more commonly found in women compared to men.
• Foot Problems – People with unusual arches in their feet are more likely to develop stress fractures.
• Certain Sports – Dancers, gymnasts, tennis players, runners, and basketball players are more likely to develop stress fractures.
• Lack of Nutrients – A lack of vitamin D and calcium may weaken the bones and make you more prone to stress fractures
• Weak Bones – Osteoporosis can weaken the bones therefore resulting in stress fractures

Stress fractures do not always heal properly, so it is important that you seek help from a podiatrist if you suspect you may have one. Ignoring your stress fracture may cause it to worsen, and you may develop chronic pain as well as additional fractures.

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.