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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.

By Foot and Ankle Associates, LLP
September 08, 2017
Tags: Shin Splints  

Although a shin splint is commonly used to describe various pains between the ankle and the knee, it actually refers to a specific inflammatory condition of the tibia -- a condition called medial tibial stress syndrome.

A type of "overuse injury" to the legs, the most common causes of shin splints include excessive running, poor conditioning and over-pronation (flattening of the arch). The result is pain in the front or inside of the lower leg that usually gets worse with a sudden increase in distance or intensity of training. Shin splints are a common problem for many runners and athletes. Muscle weakness, non-supportive shoes and overtraining are also contributing factors.

To prevent shin splints, warm up and stretch muscles before starting any workout activity and choose supportive footwear. Begin workouts gradually and avoid over-training. All of these methods will go a long way in helping to prevent many lower leg problems. Conservative treatment for most shin splint pain includes rest, ice, compression and elevation. Strengthening exercises, anti-inflammatory agents and custom foot orthotics may also be recommended to reduce symptoms.

Shin pain isn't always indicative of a shin splint. Lower leg pain may actually signal a more serious problem, including a stress fracture, partial muscle tear and tendonitis, all of which require special treatment. Always seek the professional care of a podiatrist if:

  • You have severe pain in your shin following an injury.
  • Your shin is hot and inflamed.
  • Swelling in your shin increases.
  • Shin pain persists during rest.

Proper diagnosis of the cause of pain is necessary in order to administer the most appropriate treatment. If you suffer from shin pain, visit your podiatrist for an evaluation and proper treatment.

By Foot and Ankle Associates, LLP
August 30, 2017
Category: Foot Care
Tags: Healthy Feet  

Looking fabulous in your favorite pair of heels does have a price. In fact, shoes that fit poorly or have high heels frequently cause foot problems, including calluses, corns, bunions, and blisters, just to name a few.

All footwear eventually show signs of wear and tear. Inspect the condition of your own shoes. Do they appear stretched out or worn? Then you probably need a new pair. Creasing of the midsole is also a good indication that your shoes have lost their cushion and support.

Maximize Fit, Minimize Discomfort

The following tips can help you avoid purchasing a pair of shoes that may contribute to a long list of foot problems:

  • Try on shoes late in the day, when the feet tend to be a bit larger due to natural swelling
  • Women should opt for low, stable heels
  • Try on both shoes to be sure that they fit comfortably on both feet
  • Choose breathable shoe materials, such as leather, to prevent excessive sweating and blisters
  • Have your feet measured to ensure the best fit
  • Avoid pointy-toed shoes which cause bunions and hammertoes
  • Walk around the store with both shoes on to make sure the fit is comfortable
  • For athletes, choose shoes that are specific to the sport you play
  • Choose the right shoe for your foot type (e.g. if you have flat feet, select shoes with good arch support)

Still not ready to part with your favorite pair of sneakers or trendy heels? Not sure if the shoes you currently wear are right for your feet? A professional podiatrist can evaluate the condition of your feet, and work with you to find the best pair of shoes for you!

By Foot and Ankle Associates, LLP
July 13, 2017
Category: Foot Care
Tags: podiatrists  

Your podiatrists in Greenville and Newark, DE and Boothwyn, Jennersville and Kennett Square, PA care for every aspect of foot and ankle podiatristhealth. Do you sometimes wonder if you are taking proper care of your feet and if a trip to the foot doctor could help you feel better and optimize your daily activities? Yes, podiatric medicine improves your overall well-being. To further educate yourself on common topics related to foot care and health, read some FAQs our doctors receive and the answers from the outstanding team at Foot and Ankle Associates.

Frequently Asked Questions for Podiatrists

My heel hurts whenever I walk. Could I have a heel spur?

Your podiatrist can tell you if you have a little bony prominence on the front of your calcaneus, or heel bone. Your symptoms, visual inspection and an X-ray will confirm the diagnosis. According to physicians at the Cleveland Clinic, heel spurs are frequently caused by pressure from running or other sports that repeatedly impact the soles of your feet. An inflammatory condition known as Plantar Fasciitis (involving the connective tissue between the heel and the base of the toes) often co-exists with a heel spur. However, the doctors at Foot and Ankle Associates caution that heel pain may come from other sources; so make a trip to the office if you are experiencing this discomfort consistently.

What are orthotics?

Also called shoe inserts, customized orthotics are made of acrylic and support the arches of the foot. They correct problems with gait or cushion and protect deformities or conditions such as bunions, corns and callouses. The American Academy of Podiatric Medicine says that orthotics are a minimally invasive alternative to surgery and other medical treatments, relieving pressure and correcting foot problems for people of all ages.

How should I cut my toenails?

Soak your feet in warm water first to soften the nails. Then, trim them straight across the toe (with a nail clipper, not scissors) to avoid ingrown toenails and their associated pain and infection. The Centers for Disease Control in Atlanta says diabetics should be careful with how they cut their nails, and if manual dexterity or the ability to bend over to cut your nails is problematic, see your podiatrist for regular nail care.

When should I see a foot doctor in Greenville, Newark, Boothwyn, Jennersville or Kennett Square?

Routine podiatric care is a must for people with foot or ankle deformities, diabetes or poor circulation. As your grandmother would say, "An ounce of prevention is worth a pound of cure." Plus, if you experience sudden or recurring pain in your feet or ankles, come to Foot and Ankle Associates. You'll receive an expert physical examination, including a medical history, and X-rays and other imaging such as an MRI or CT scan as needed. The doctors are trained in all aspects of foot care, including attending to sprains and surgical intervention when required.

Please contact us

For experienced, compassionate foot care, contact us to arrange an appointment. We have several convenient locations including Newark, DE (302) 633-1300, Greenville, DE (302) 652-5767, Kennett Square, PA (610) 444-6520, Jennersville, PA (610) 345-0222, and Boothwyn, PA (610) 459-3288.

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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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