Next Step Foot & Ankle Centers

Products And Services

• Bunions

  Bunions are one of the most common foot disorders treated by Ankle & Foot Surgeons of the Midwest. In fact, bunions are one of the most common disorders treated by most podiatrists across the country. More than half the women in America have bunions, a common deformity often blamed on wearing tight, narrow shoes. Bunions cause the base of your big toe (Metatarsophalangeal Joint) to enlarge and protrude. The skin over it may be red and tender. This can be acquired through time or it can be congenital (you got it from your family). Wearing any type of shoe may be painful when you have a bunion. The joint involved flexes with every step you take. The bigger your bunion gets, the more it hurts to walk. Bursitis (inflammation) may also set in. Your big toe may angle towards your second toe, or even move all the way under or over it. The skin on the bottom of your foot may also become thicker and painful. Learn about a new non-surgical treatment option for Heel Pain Relief using Clarix Flo Pressure from your big toe may force your second toe out of alignment, sometimes causing it to overlap your third toe. If your bunion gets too severe, it may cause difficulty in walking. Your pain may become chronic and you may develop arthritis. Most bunions can be treated conservatively with wider & softer shoes, pads to relieve the pressure and/or medications. If this does not help then surgical treatment is indicated. Bunion surgery, or bunionectomy, realigns the bone, ligaments, tendons and nerves so your big toe can be brought back to its correct position and the bump on the inside of the joint removed. Many bunion surgeries are performed on a same-day basis (no hospital stays) using a local anesthesia. During your recovery it is common to have pain and swelling. This swelling and stiffness may be persistent for several months.

  Link: Bunions

• Calluses and Corns

  A callus is an area of hard, thickened skin that can occur across the ball of the foot, on the heel, or on the outer side of the big toe. While many consider them a skin problem, they actually are systemic of a problem with the bone. Calluses have painful nerves and bursal sacs (fluid-filled balloons that act as shock absorbers) beneath them, causing symptoms ranging from sharp, shooting pain to dull, aching soreness. Calluses form from repeated friction and pressure, as the shoe (or ground) rubs against a bony prominence (bone spur) on the toe or foot. The skin thickens in response to this pressure. Small amounts of friction or pressure over long periods of time cause a corn or callus. A great deal of friction or pressure over shorter periods of time can cause blisters or open sores. Calluses typically develop under a metatarsal head (the long bone that forms the ball of the foot) that is carrying more than its fair share of the body weight, usually due to it being dropped down or due to its longer length. Calluses can be treated with over-the-counter callus removers that have strong acids that peel this excess skin away after repeated application. You should be careful with these products as they can cause chemical burns when not used correctly. Begin by soaking your feet in warm soapy water and gently rubbing away any dead skin that loosens. A pumice stone or emery board is then used to “file” this thickened skin. Apply a good moisturizer to the hardened areas to keep them softer and relieve pain. Non-medicated corn pads or moleskin (a thin fuzzy sheet of fabric with an adhesive back) can relieve calluses, but should be removed carefully to avoid tearing the skin. If you need assistance relieving calluses, contact one of our offices and schedule an appointment with Dr. Barth. Calluses can be trimmed and comfortable padding can applied to these painful areas. In addition to medication to relieve inflammation, cortisone may be injected into the underlying bursal sac to rapidly reduce pain and swelling. A plantar callus forms when one metatarsal bone is longer or lower than the others, and it hits the ground first, and with more force than it is equipped to handle, at every step. As a result, the skin under this bone thickens like a rock in your shoe. Plantar calluses that are recurring are sometimes removed surgically in a procedure called an osteotomy, which relieves pressure on the bone. A condition called Intractable Plantar Keratosis (IPK) is a deep callus directly under the ball of the foot. IPK is caused by a “dropped metatarsal,” which happens when the metatarsal head drops to a lower level than the surrounding metatarsals and protrudes from the bottom of the foot. This results in more pressure being applied in this area and causes a thick callus to form. A “dropped metatarsal” can either be a congenital abnormality, a result of a metatarsal fracture, or a structural change that may have occurred over time. How to prevent calluses: Switch to better shoes, or even an orthotic device. Buy socks with double-thick toes and heels and nylon hose with a woven cotton sole on the bottom of the foot. Corns are calluses that form on the toes because the bones push up against the shoe and put pressure on the skin. The surface layer of the skin thickens and builds up, irritating the tissues underneath. Hard corns are usually located on the top of the toe or on the side of the small toe. Soft corns resemble open sores and develop between the toes as they rub against each other. Improperly fitting shoes are a leading cause of corns. Toe deformities, such as hammertoe or claw toe, also can lead to corns. In a visit to our office, your corns can be shaved with a scalpel. Self care includes soaking your feet regularly and using a pumice stone or callus file to soften and reduce the size of the corn. Special over-the-counter non-medicated donut-shaped foam pads also can help relieve the pressure.

  Link: Calluses and Corns

• Clubfoot

  What is a Clubfoot? Clubfoot is one of the most common non-life threatening major birth defects. It affects your child’s foot and ankle, twisting the heel and toes inward. It may look like the top of the foot is on the bottom. The clubfoot, calf and leg are smaller and shorter than normal. Clubfoot is not painful, is correctable, and your baby is probably otherwise perfectly healthy. Approximately one in every 1,000 newborns has clubfoot. Of those, one in three have both feet "clubbed". The exact cause is unknown. Two out of three clubfoot babies are boys. Clubfoot is twice as likely if you, your spouse or your other children also have it. Less severe infant foot problems are common and are often misdiagnosed as clubfoot. The goal of treating clubfoot is to make your newborn’s clubfoot (or feet) functional, painless and stable by the time he or she is ready to walk. Podiatrists start by gently stretching your child’s clubfoot toward the correct position. They put on a cast to hold it in place. One week later, they take off the cast and stretch your baby’s foot a little more, always working it toward the correct position. They apply a new cast, and one week later you come back and do it again. This process (called serial casting) slowly moves the bones in the clubfoot into proper alignment. Your physician will use X-rays to check the progress. Casting generally repeats for 6-12 weeks, and may take up to four months. About half the time, your child’s clubfoot straightens with casting. If it does, he or she will be fitted with special shoes or braces to keep the foot straight once corrected. These holding devices are usually needed until your child has been walking for up to a year or more. Muscles often try to return to the clubfoot position. This is common when your child is 2-3 years old, but may continue up to age 7. Sometimes stretching, casting and bracing is not enough to correct your baby’s clubfoot. He or she may need clubfoot surgery to adjust the tendons, ligaments and joints in the foot/ankle.

  Link: Clubfoot

• Diabetic Foot Care

  Did you know… Nearly 6% of the population has diabetes and the numbers continue to grow. Diabetes affects the foot primarily by its actions on the blood vessels and nerves. This often leads to hospital stays for infection and ultimately amputations. There were nearly 90,000 major amputations in the United States last year as the result of diabetes. However, it has been estimated that nearly 85% of limb loss can be prevented through educations and patient care plans. We also specialize in diabetic and wound care Our goal is to relieve pain, correct deformity and prevent the devastating consequences of loss of limb. Recommendations for the Diabetic Foot DO’s Inspect feet daily. Any redness, swelling, sores, blisters or any change in appearance call the office immediately. DO NOT WAIT UNTIL THERE IS PAIN. If you cannot see your feet have a friend or relative inspect them or try using a mirror. Wear white socks and inspect daily for blood or other drainage. Wash feet in warm water daily, dry well and apply lotion, but NOT on toes. Wear comfortable wide shoes. Your doctor can determine if you qualify for diabetic shoes. Inspect inside of shoes before wearing. DONT’S DO NOT ignore your feet. DO NOT soak feet in any temperature water. DO NOT trim nails or cut corns or calluses. DO NOT use corn or callus medication. DO NOT go barefoot. DO NOT use heating pads or hot water bottles. Other Recommendations for all Diabetics Exercise often and control weight. DO NOT smoke Have cholesterol levels and uninalysis performed yearly. Check blood pressure regularly. Have eyes examined yearly. Have hemoglobin A1C checked at least twice a year. Serious Foot Health Risks for Diabetics If/when your feet become numb, they are at risk for becoming deformed. One way this happens is through diabetic foot ulcers. Open sores may become infected. Another way is the bone condition Charcot (pronounced “sharko”) foot. This is one of the most serious foot problems a diabetic can face. It warps the shape of your foot when your bones fracture and disintegrate, and yet you continue to walk on it because it doesn’t hurt. Diabetic foot ulcers and early phases of Charcot foot fractures can be treated with a total contact cast. The shape of your foot molds the cast. It lets your ulcer heal by distributing weight and relieving pressure. If you have Charcot foot, the cast controls your foot’s movement and supports its contours if you don’t put any weight on it. To use a total contact cast, you need good blood flow in your foot. The cast is changed every week or two until your foot heals. A custom-walking boot is another way to treat your Charcot foot. It supports the foot until all the swelling goes down, which can take as long as a year. You should keep from putting your weight on the Charcot foot. Surgery is considered if your deformity is too severe for a brace or shoe.

  Link: Diabetic Foot Care

• Hammertoes

  What is a Hammertoe? A Hammertoe is a deformity of the second, third or fourth toes. In this condition, the toe is bent at the middle joint, resembling a hammer. Left untreated, hammertoes can become inflexible and require surgery. People with hammertoes may have corns or calluses on the top of the middle joint of the toe or on the tip of the toe. They may also feel pain in their toes or feet and have difficulty finding comfortable shoes. Causes of hammertoe include improperly fitting shoes and muscle imbalance. Treatment for the condition typically involves shoes with soft, roomy toe boxes and toe exercises to stretch and strengthen the muscles. Commercially available straps, cushions or non-medicated corn pads may also relieve symptoms.

  Link: Hammertoes

• Heel Pain & Plantar Fasciitis

  What Causes Heel Pain & Plantar Fasciitis? Heel pain is one of the leading causes that patients visiting Nextstep Foot and Ankle Centers have treated. Plantar fasciitis (or heel pain) is commonly traced to an inflammation on the bottom of the foot. Our podiatrists can evaluate your arch pain, and may prescribe customized shoe inserts called orthotics to help alleviate the pain you are experiencing. Plantar fasciitis is caused by inflammation of the connective tissue that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone. Also called “heel spur syndrome,” the condition can usually be successfully treated with conservative measures such as use of anti-inflammatory medications and ice packs, stretching exercises, orthotic devices, and physical therapy.

  Link: Heel Pain & Plantar Fasciitis

• Ingrown Toenails

  What is an Ingrown Toenail? Ingrown toenails often are the result of trimming your toenails too short, particularly on the sides of your big toes. While they are very common, ingrown toenails can also be very painful. When trimming your nails, avoid tapering the corners so that the nail curves with the shape of your toe. The sides of the nail will curl down and dig into your skin. Shoes that are too tight or short also may cause ingrown toenails. Ingrown toenails start out hard, swollen and tender, and later, may become sore, red and infected. Your skin may start to grow over the ingrown toenail. Soaking your foot in warm, soapy water several times each day is usually a good way to treat an ingrown nail. We recommend that you visit our offices and let a podiatrist determine the best course of treatment for your condition. Antibiotics are sometimes prescribed if an infection is present. Part of your ingrown toenail (partial nail plate avulsion) may need to be surgically removed if an acute infection occurs. The procedure involves injecting the toe with an anesthetic and cutting out the ingrown part of the toenail.

  Link: Ingrown Toenails

• Pediatric Foot Care

  About Your Children's Feet Whether it’s a precious baby’s first steps or a quick maneuvering teenager’s winning soccer goal, healthy feet and sure-footedness make milestones in a child’s life possible. Starting at birth, paying close attention to your little one’s feet from proper grooming to gait will ensure a solid foundation as your youngster grows. After all, their feet are meant to last a lifetime! The human foot – one of the most complicated parts of the body – has 26 bones, including an intricate system of ligaments, muscles, blood vessels, and nerves. Because the feet of young children are soft and pliable, abnormal body forces can cause deformities. A child’s feet grow rapidly during the first year. For this, podiatrists consider this period to be the most critical stage of the foot’s development. Here are some suggestions to help ensure normal development: Look carefully at you baby's feet. If you notice something that does not look normal to you, contact a podiatrist. Many deformities will not correct themselves if left untreated. Keep your baby's feet unrestricted. No shoes or booties are necessary for infants. These can restrict movement and can inhibit toes and feet from normal development. Provide an opportunity for exercising the feet. Lying uncovered enables the baby to kick and perform other related motions which prepare the feet for weight bearing. Change the baby's position several times a day. Lying too long in one spot can put excessive strain on the feet and legs. Sports play a significant role in millions of American childrens’ lives, whether on a team or played as individuals. Parents should be mindful of sports that require a substantial amount of running and turning, or involve contact. These can easily translate into sports injuries. Protective taping of the ankles is often necessary to prevent strains or fractures. Parents should consider discussing these matters with their family podiatrist if they have children participating in sports. Sports-related injuries are on the rise as more children participate actively in sports. Here are some tips to help your child athlete: Make sure to buy sport-specific shoes. This will not only help improve your child's performance, but also helps keep them free from serious foot and ankle injuries. Don't forget the socks! Without the right socks even the best athletic shoe won't score points on or off the field. The right athletic sock should be made of a natural/synthetic fiber blend, as this helps wick away moisture best. The socks should also not contain any large seams which could cause blisters or irritation.

  Link: Pediatric Foot Care

• Sports Injuries

  Whether you are a professional athlete or play sports just for fun, the demands made on your feet and lower limbs can lead to a range of injuries, including blisters, sprained ankles, torn ligaments, shin splints (leg pain), knee pain, low back pain and other joint or muscle problems. Added to these are common complaints such as corns, calluses and Athlete’s foot. Your running style, poor footwear and even minor limb length differences can also contribute to sports injury. Visiting a podiatrist like Dr. Lindsay Barth should be your fist step towards getting back on your feet after a sports injury. Dr. Barth can not only help treat your current foot or ankle pain, but also provide you with helpful tips to prevent future sports injuries. Here are some tips for athletic foot care: Wash your feet every day, and dry thoroughly. Wear only good-quality, well-fitting cotton socks. Always use the correct shoe for each sport and surface. Get in shape. Being overweight or out of shape places added stress on the feet. Condition yourself gradually with stretching exercises for 15-20 minutes before starting and after any activity (“warm-up” and “warm-down”). Wear correct shoes. Footwear should be given the same consideration as any other piece of sporting equipment. Sports shoes should protect as much as possible, be durable, and should be right for the sport and surface. If running, the shoe should have adequate cushioning in the mid-sole and a flared heel for stability.

  Link: Sports Injuries

• Toenail Fungus

  Many people don’t realize they have a fungal nail problem. Moreover, many people that do never seek treatment. Still, fungal toenail infections are a common foot health problem. Fungal toenail infections can persist for years without ever causing pain. The disease, characterized by a change in a toenail’s color, is often considered nothing more than a mere blemish, but it can present serious problems if left untreated. Also referred to as Onychomycosis, fungal nail infections are an infection underneath the surface of the nail, which can also penetrate the nail. In addition to causing difficulty and pain when walking or running, fungal nail infections are often accompanied by a secondary bacterial and/or yeast infection in or about the nail plate. A group of fungi called dermatophytes easily attack the nail, thriving off keratin, the nail’s protein substance. When the tiny organisms take hold, the nail may become thicker, yellowish-brown or darker in color, and foul smelling. Debris may collect beneath the nail plate, white marks frequently appear on the nail plate, and the infection is capable of spreading to other toenails, the skin, or even the fingernails. Nail bed injuries may make the nail more susceptible to all types of infection, including fungal infection. Those who suffer chronic diseases, such as diabetes, circulatory problems, or immune-deficiency conditions, are especially prone to fungal nails. Other contributory factors may be a history of Athlete’s foot and excessive perspiration. You can prevent fungal nail infections by taking these simple precautions: Exercise proper hygiene and regularly inspect your feet and toes. Keep your feet clean and dry. Wear shower shoes in public facilities whenever possible. Clip your nails straight across so that the nail does not extend beyond the tip of the toe. Use a quality foot powder – talcum, not cornstarch – in conjunction with shoes that fit well and are made of materials that breathe. Avoid wearing excessively tight hosiery, which promotes moisture. Socks made of synthetic fiber tend to “wick” away moisture faster than cotton or wool socks, especially for those with more active life styles. Disinfect home pedicure tools and don’t apply polish to nails suspected of infection. Depending on the type of infection you have, over-the-counter liquid antifungal agents, while sometimes effective, may not prevent a fungal infection from recurring. A topical or oral medication may need to be prescribed, and the diseased nail matter and debris removed by a process called debridement. In some cases, surgical treatment is prescribed, during which the infected fungal nail is removed. Permanent removal of a chronically painful nail, which has not responded to any other treatment, permits the fungal infection to be cured, and prevents the return of a deformed nail.

  Link: Toenail Fungus