My Blog
By Foot and Ankle Associates, LLP
December 04, 2017
Category: Foot Care
Tags: Footwear  

While high-heeled shoes may look stylish or complement your favorite outfit, they are rarely the best option for a woman's feet. According to a study by the American Podiatric Medical Association, 39 percent of women wear high heels every day; of the women who wear heels daily, three out of four reported foot problems. Despite these numbers, many women continue to underestimate the health risks associated with high heels.

High-heeled shoes disrupt the body's alignment, crowd the toes and force the body's weight onto the ball of the foot. Wearing heels can contribute to a variety of foot and ankle problems, including:

  • Achilles tendonitis: The Achilles tendon and calf muscles tighten and shorten as the front of the foot moves down in relation to the heel. This causes stress and painful inflammation of the Achilles tendon.

  • Bunion:. Narrow-toed shoes can cause a bony growth on the joint at the base of the big toe. The bunion forces the big toe to slant in toward the other toes, resulting in discomfort, blisters, corns and calluses.

  • Hammertoes: A narrow toe box crowds the smaller toes into a bent, claw-like position at the middle joint.

  • Metatarsalgia: Continued high heel wear can lead to joint pain in the ball of the foot as a result of heels forcing the body's weight to be redistributed.

  • Ankle injuries: Because heels impair balance and increase the risk of falling, ankle sprains and fractures are common.

  • Pump Bump: The rigid back of a pump-style shoe can cause pressure that irritates the heel bone, creating a bony enlargement known as Haglund's deformity.

  • Neuromas: A narrow toe box and high heel can compress and create a thickening of tissue around a nerve between the third and fourth toes, leading to pain and numbness in the toes.

Still not willing to ditch the heels? There are ways to relieve some of the damaging effects of high heels.

  • Avoid heels taller than 2 inches

  • Choose thicker, more stable heels. Thicker heels are still stylish, plus they lessen the stress on your feet and provide better shock absorption.

  • If you must wear heels, wear your gym shoes or flats for commuting and change into your heels once you arrive to your destination.

  • Stretch and massage your calf, heel, and foot muscles. This helps relax the muscles and tendons and prevents them from tightening and shortening.

  • Avoid shoes with pointed toes

High heel shoes can cause pain and foot deformities that can last a lifetime. So the next time you go to slip on your heels for a long day at work or a night out, consider the consequences and rethink your options. If foot pain persists, visit us for treatment.

By Foot and Ankle Associates, LLP
November 16, 2017
Category: Foot Care
Tags: poor circulation  

Are your feet and ankles just simple body parts? Think again. Your podiatrists at Foot and Ankle Associates in Greenville and Newark, DEpoor circulation and Kennett Square, Jennersville and Boothwyn, PA tell their patients that the lower extremities keep you balanced and moving. As such, your foot doctors urge you to take care of the circulation in your feet--that is, the blood supply that nourishes and oxygenates you. Learn some important how-to's here.

Effects of poor circulation

When your feet and ankles receive an inadequate blood supply and its life-giving nutrients and oxygen, a number of things occur, and none of them are good. Look at your feet daily, and watch for:

  • Swellling
  • Discoloration
  • Numbness and tingling
  • Cold skin temperature
  • Sores and blisters
  • Excessively dry skin
  • Pain and soreness

Unfortunately, these localized symptoms often indicate systemic disease, such as hypertension, diabetes, high lipid levels and more. Additionally, symptoms often escalate and cause dramatic lifestyle changes as people become more sedentary due to their discomfort.

Detecting poor circulation

Your podiatrist in Greenville, Newark, Kennett Square, Jennersville and Boothwyn may suspect a number of issues causing your poor circulation. When you come to Foot and Ankle Associates, he or she will examine your feet, noting the condition of the nails, skin color and temperature, mobility and other factors. A simple check of the blood pressure in lower extremities is tell-tale for Peripheral Artery Disease, says the American Podiatric Medical Association. PAD is a common circulatory problem related to plaque build-up within oxygen-carrying blood vessels.

The doctor's findings also could point to poor venous circulation. Our veins contain tiny valves which regulate blood flow back to the heart. These valves deteriorate due to age, obesity and sedentary lifestyle. Finally, diabetes, and its high blood glucose levels, constricts blood flow to the feet, making them more prone to infection, neuropathy (nerve pain), and limited blood flow.

What you can do

Whatever the status of your systemic health, you can improve the circulation in feet with some simple lifestyle modifications. Your podiatrist at Foot and Ankle Associates may recommend many of the following practices to keep your feet healthy and pain-free:

  • Lower your salt intake to reduce fluid retention in the feet and hands.
  • Exercise daily. Simple walking will do.
  • Elevate your feet when sitting.
  • Wear compression stockings to help venous blood flow.
  • Keep your blood pressure, cholesterol and blood sugars at healthy levels.
  • Don't cross your legs when you're seated.
  • Stretch your feet, legs and ankles. Your podiatrist will show you exercises appropriate for your age and fitness level.
  • Wear properly fitting shoes that are supportive but not too tight. Avoid narrow toe boxes and high heels.
  • Don't smoke as the toxins in cigarettes greatly reduce micro-circulation in the feet and hands and also increase plaque accumulation in the arteries.

Check in with us

Please call and make a routine appointment at Foot and Ankle Associates in Greenville and Newark, DE and Kennett Square, Jennersville and Boothwyn, PA. Our podiatrists will check your circulation and other aspects of your podiatric health.

By Foot and Ankle Associates, LLP
November 03, 2017
Category: Foot Care
Tags: Toenail Fungus  

Also known as onychomycosis, toenail fungus can be painful, irritating and embarrassing. When you experience trauma to your nail, the nail bed is lifted, allowing fungus to invade. Without treatment, this fungus can grow and spread, particularly in dark, warm, moist environments, such as socks and shoes.

Common signs and symptoms of toenail fungus include:

  • Discoloring or yellowing of the nail

  • Thickening or crumbling of the nail

  • Swelling around the nail

  • Disfigured nails

  • Streaks or spots down the side of the nail

  • Foul-smelling debris under the nail

  • Pain and discomfort

  • Complete nail loss

Prevention is Key

Fungal infections can affect the fingernails as well as the toenails, but toenail fungus is more difficult to treat because toenails grow more slowly. Because removal of the fungus is challenging, prevention plays an important role in treatment.

  • Keep nails neatly trimmed.

  • Practice good foot hygiene, including daily washing with soap and water, drying feet and toes, carefully, and changing shoes regularly.

  • Always wear shoes in public areas, such as showers, locker rooms and pools.

  • Wear comfortable shoes that aren't too tight.

  • Avoid wearing nail polish for long periods, as it prevents the nail from breathing and can seal in fungus.

Treatment of Toenail Fungus

If you do develop toenail fungus, especially if the infection has become painful, visit our office. People with a chronic illness like diabetes should always see a podiatrist if they notice any changes in their nails, as it may be an indication of a more serious issue.

To eliminate the fungus, a podiatrist may remove as much of the infected nail as possible by trimming, filing or dissolving it. Oral or topical antifungal medications may also be prescribed to treat the infection. Laser treatment options are also sometimes available.

It’s only for severe, chronic infections that surgical removal of the nail might be recommended. Our office can help diagnose the cause of your toenail troubles, and make the best recommendation for treatment.

By Foot and Ankle Associates, LLP
October 09, 2017
Category: Foot Condition

Maybe you've heard of carpal tunnel syndrome, a condition in the wrist that occurs when swelling or a change in position of the tissue within the carpal tunnel squeezes and irritates the median nerve. Similar to carpal tunnel syndrome is tarsal tunnel syndrome, an ankle condition that occurs from the compression of a nerve in a confined space.

What is Tarsal Tunnel Syndrome?

The tarsal tunnel is a narrow space located on the inside of the ankle next to the ankle bones. Protected by the tarsal tunnel are many arteries, veins, tendons and nerves, one of which is the posterior tibial nerve - the main focus of tarsal tunnel syndrome.

Tarsal tunnel syndrome is caused from a compression on the posterior tibial nerve. Causes include:

  • Injury to the ankle, which may produce swelling near the nerve.
  • Abnormal blood vessels or cysts that occupy space within the tunnel.
  • Scar tissue that press against the nerve.
  • Foot deformities, such as flat feet, which increase strain on the nerve.
  • Systematic diseases, such as diabetes or arthritis.

When patients visit us at our office with tarsal tunnel syndrome, they often experience one or more symptoms, usually felt on the bottom of the foot or the inside of the ankle. In some cases, the pain may extend to the heel, arch, toes and calf. Symptoms include:

  • Pain
  • Numbness
  • Burning or tingling sensation

We Can Help

If you experience pain, burning and tingling in your feet or toes, make an appointment with our office. Left untreated, tarsal tunnel syndrome could result in permanent nerve damage. Treatment for tarsal tunnel syndrome varies depending on the severity of your condition. Anti-inflammatory medications, cortisone injections, immobilization, rest and modifications in footwear are a few methods used to treat the damaged nerve and reduce the pain. When non-surgical treatments are unsuccessful, surgery may be recommended.

By Foot and Ankle Associates, LLP
September 26, 2017
Category: Foot Care
Tags: heel pain  

Mostly, you take your feet for granted, except when they hurt. Heel pain bothers and impairs thousands of people of all ages. Your heel painpodiatrists at Foot and Ankle Associates, in Greenville and Newark, DE and Kennett Square, Jennersville and Boothwyn, PA diagnose and treat heel pain. From Achilles tendonitis and plantar fasciitis to heel spurs, calluses and fissures, your foot doctor will help you feel better and enjoy life. Read here about common sources of heel pain and how to treat them.

Plantar fasciitis

The American Orthopedic Foot & Ankle Society says that people suffering from plantar fasciitis, or pain forward of the heel, just use their feet too much. Running and tennis, with their repetitive bouncing motions, and simply standing on your feet all day long, lead to inflammation of the connective tissue or plantar fascia. The plantar fascia extends from the heel bone to the base of each toe. Calcifications called heel spurs add to the sometimes extreme discomfort.

Fortunately, your Greenville, Newark, Kennett Square, Jennersville and Boothwyn podiatrist can control this kind of heel pain. Simple rest, ice and elevation reduce acute flare-ups as do stretching exercises and anti-inflammatory medications such as ibuprofen. Even when a heel spur accompanies plantar fasciitis, surgery to correct the bone malformation is rarely necessary. However, the team at Foot and Ankle Associates does deliver a state-of-the-art treatment for particularly stubborn plantar fasciitis.

It's called Extracorporeal Shock Wave Therapy in which the foot doctor uses high-energy sound waves to relax the connective tissue and reduce inflammation. A minimally-invasive treatment, ESWT allows patients to get back to their normal routines the next day. Sometimes, more than one treatment is required.

Achilles tendonitis

Usually thought of as a sports injury, achilles tendonitis affects people of all ages and walks of life. Like plantar fasciitis, it's an overuse problem of the long fibrous tendon which connects the calf muscles to the heel bone. As such, the back of the heel hurts and becomes inflamed.

Your foot doctor usually recommends shoe inserts (custom orthotics), ice, rest and elevation to alleviate pressure on the tendon. Wearing open-backed shoes relieves pressure on the tendon and speeds healing. Sometimes surgery becomes necessary when range of motion limitations and pain continue.

Heel calluses and fissures

These skin conditions of the heel really hurt. Calluses, or hardened areas of thick skin, form from pressure on one or more of the metatarsal bones of the foot when it repeatedly strike the heel. Shoe padding or customized orthotics relieve this pressure, but sometimes the podiatrist advises surgery to modify the bone.

Also, heel fissures are painful. This deep cracking of the skin causes bleeding and immobility. Poor shoe fit at the heel which allows too much movement of the foot within the shoe lead to fissures as do eczema and psoriasis. Most patients find relief using moisturizing lotions and creams.

Don't neglect heel pain

Why suffer? Please contact Foot and Ankle Associates for an appointment. We have five offices to serve you in Greenville and Newark, DE and Kennett Square, Jennersville and Boothwyn, PA.

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"Experienced, intelligent, and takes time to explain procedures. Dr. Guggenheim is extremely professional and knowledgeable. I cannot say enough positive attributes! A wonderful doctor."


- Leslie T.

"I just completed 12 treatments for neurapathy and I am thrilled with the results. When Dr. Iannucci recommended the MLS Laser Therapy I wasn't sure what to expect but I knew that I didn't have much to loose trying it. I am almost 70 years old and have had this condition for many years. I would say that I pretty much had foot pain all of my waking hours and it even woke me up two or three times each night. After completing the laser treatments I am thrilled to report that I have little to no pain at all. I have said on numerous occasions lately -- "my feet don't hurt!" In fact, I have even gone back to my old exercise DVD "Sweatin' to the Oldies" now that the pain isn't my constant companion. I encourage anyone with this constant pain to give the MLS Laser Therapy a try. It is painless and effective, and I thought the cost was well worth it. I am grateful to Dr. I for recommending it and plan on going back in the summer to get some treatments for plantar fasciitis."


- Beryl S.

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