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Sunshine Podiatry

203-496-4580





Relieving Pain and Discomfort of the Feet, Ankles, and Lower Extremities

Prevent, diagnose, and treat foot disorders with the help of Sunshine Podiatry.

Contact Us





Our Services

From routine checkups to treatments for particular problems, Sunshine Podiatry in North Haven, Connecticut is equipped to handle all your podiatric needs. To help you understand your options, we've included descriptions of some of our leading services on this page.

  • A serious commitment to continued learning. The doctor regularly attends lectures and educational courses throughout the year. This allows us to remain current and to be sure that we provide the best care possible for our patients.

  • We offer custom orthotics or insoles as well as prefabricated, over-the-counter insoles.

  • Dr. Eswarathasan has specialized training in Osteopathic Manipulation of the foot and ankle. This is used extensively in our office for mechanical problems such as heel pain, ankle sprains and neuromas. It has helped us avoid surgery in many instances. We are one of the few offices to have this specialized training.

  • We are very kid-friendly and offer diagnosis and treatment of common pediatric foot ailments including making custom orthotics for flat, painful feet, and painless treatment of warts and ingrowns.
  • We offer house calls to those who qualify.

  • Prompt scheduling: same day appointments are often available.

  • Emergencies are seen as soon as possible.

  • We usually run on time with our appointments - emergencies can sometimes happen causing a backup in the office but this is a rarity. If there any delays, our staff lets you know and offers alternatives.

  • Fully computerized and electronic insurance claim submission for patient convenience.

  • The doctor actually listens and does not rush you out.

A Partial List of the Conditions We Treat

  • Achilles Tendinitis
  • Ankle Instability
  • Ankle Sprains
  • Arthritis of the Foot and Ankle
  • Athlete's Foot
  • Bunions
  • Calluses
  • Corns
  • Crush Injuries
  • Diabetic Foot Problems
  • Flat Feet
  • Fungus Toenails
  • Geriatric Foot Troubles
  • Hammertoes
  • Heel Spurs
  • Ingrown Toenails
  • Injuries
  • Neuromas
  • Plantar Fasciitis
  • Warts

Descriptions of Conditions

Achilles Tendonitis

Achilles tendonitis, also sometimes called Achilles tendinitis, is a painful and often debilitating inflammation of the Achilles tendon (heel cord). The Achilles tendon is the largest and strongest tendon in the body. It is located in the back of the lower leg, attaches to the heel bone (calcaneus), and connects the leg muscles to the foot.


The Achilles tendon gives us the ability to rise up on our toes, facilitating the act of walking, and Achilles tendonitis can make walking almost impossible.


There are three stages of tendon inflammation:


Peritenonitis is characterized by localized pain during or following activity. As this condition progresses, pain often develops earlier on during activity, with decreased activity, or while at rest.


Tendinosis is a degenerative condition that usually does not produce symptoms (i.e., is asymptomatic). It may cause swelling or a hard knot of tissue (nodule) on the back of the leg.


Peritenonitis with tendinosis results in pain and swelling with activity. As this condition progresses, partial or complete tendon rupture may occur.

Arch Pain

The term arch pain (often referred to as arch strain) refers to an inflammation and/or burning sensation at the arch of the foot.


Cause

There are many different factors that can cause arch pain. A structural imbalance or an injury to the foot can often be the direct cause. However, most frequently the cause is a common condition called plantar fasciitis.


The plantar fascia is a broad band of fibrous tissue located along the bottom surface of the foot that runs from the heel to the forefoot. Excessive stretching of the plantar fascia, usually due to overpronation (flat feet), causes plantar fasciitis. The inflammation caused by the plantar fascia being stretched away from the heel often leads to pain in the heel and arch areas.


The pain is often extreme in the morning when an individual first gets out of bed or after a prolonged period of rest. If this condition is left untreated and strain on the longitudinal arch continues, a bony protrusion may develop, known as a heel spur. It is important to treat the condition promptly before it worsens.

Arthritis

Arthritis is a disease characterized by the inflammation of the cartilage and lining of the body's joints. Inflammation causes redness, warmth, pain, and swelling. There are about 40 million Americans who suffer from arthritis. The National Institute of Arthritis and Musculoskeletal and Skin Diseases, estimates that by the year 2020, about 60 million Americans will have arthritis.

The primary targets for arthritis are people over the age of 50. Arthritis is a major cause of foot pain because each foot has 33 joints that can become affected by the disease.


Osteoarthritis

There are many different types of arthritis. The most common type is called osteoarthritis. Osteoarthritis causes excessive strain and the wearing away of cartilage in the joints of the foot. Movement becomes very difficult and painful. The pain and swelling worsens while standing or walking, and stiffness usually occurs after periods of rest.


Gout

Gout is another form of arthritis that also leads to foot complications. Excess uric acid crystals collect in and around the joints of the big toe. The big toe joint is commonly the focal point due to the stress and pressure it experiences during walking and other weight bearing activities. This often leads to severe pain in the big toe. Men are more likely to develop gouty arthritis than women.


Rheumatoid Arthritis

Another type of arthritis is rheumatoid arthritis. It can develop at any age and there is no known cause for this condition. Rheumatoid arthritis is the most crippling form of the disease that can affect people of all ages. It can cause severe deformities of the joints with associated fatigue of the entire body. People who suffer from rheumatoid arthritis often develop severe forefoot problems such as bunions, hammer toes, claw toes, and others.


Cause

There are many causes of arthritis. Heredity plays a major role. However, arthritic symptoms can develop due to many other factors. Some of these include bacterial and viral infections, prescription and illegal drugs, traumatic injuries, and bowel disorders such as ileitis and colitis.


Forefoot problems such as hammer toes, claw toes, mallet toes, and bunions often develop as a result of arthritis, particularly Rheumatoid arthritis. Problems can also develop in the heel and ankle area due to the erosion of the involved joints.

Ankle Sprains

Ankle sprains are caused by an unnatural twisting or force on the ankle bones of the foot, often resulting in one or more ligaments on either side of the ankle to be stretched or torn. If not properly treated, ankle sprains could develop into long-term problems.

Athlete's Foot

Athlete's foot is a fungal infection that causes red, dry, flaking skin, sometimes accompanied by pain or itching. The condition usually occurs between the toes or on the soles or sides of the feet. In its acute stage, the infected foot exhibits blisters that itch or "weep". Athlete's Foot can spread to the toenails, causing chronic fungal infections. Often when a patient thinks the feet are only dry and cracking, Athlete's Foot is responsible for the problem.


Cause

Fungal infections like Athlete's Foot are often contracted in showers, gyms, dressing rooms, swimming pool lockers, or other warm, damp areas where fungus can thrive. The name of the condition comes from the fact that athletes spend the most time in these environments and therefore are at a higher risk of fungal infection.


Once fungal spores are present on the feet, they can enter fissures or sores and remain there to spread, unless the feet are carefully washed and thoroughly dried after exposure.


Athlete's Foot can spread from the toes to the toenails. If the patient touches or scratches the infection and then touches other parts of the body, the fungus can spread to fingernails or other parts of the body, including the groin or underarms.


Like any foot condition, Athlete's Foot is of special concern to people with diabetes and compromised immune systems who are more susceptible to developing infections that can lead to serious medical problems.

Bunions

Bunions, referred to in the medical community as Hallux Valgus, are one of the most common forefoot problems. A bunion is a prominent bump on the inside of the foot around the big toe joint. This bump is actually a bone protruding towards the inside of the foot.


With the continued movement of the big toe towards the smaller toes, it is common to find the big toe resting under or over the second toe. This causes a common forefoot condition called overlapping toes. Some of the symptoms of bunions include inflammation, swelling, and soreness on the side surface of the big toe. The discomfort commonly causes a patient to walk improperly.


Another type of bunion which some individuals experience is called a Tailor's Bunion, also known as a Bunionette. This forms on the outside of the foot towards the joint at the little toe. It is a smaller bump that forms due to the little toe moving inwards, towards the big toe.


Cause

Bunions are a common problem experienced mostly by women. The deformity can develop from an abnormality in foot function, or arthritis, but is more commonly caused by wearing improper fitting footwear. Tight, narrow dress shoes with a constrictive toe box (toe area) can cause the foot to begin to take the shape of the shoe, leading to the formation of a bunion.


Women who have bunions normally wear dress shoes that are too small for their feet. Their toes are squeezed together in their shoes causing the first metatarsal bone to protrude on the side of the foot.


It is important for men and women to realize that wearing dress shoes and boots, which are tapered in the toe area, can cause the bunion to worsen to the point where surgery is necessary.

Calluses

The formation of calluses is caused by an accumulation of dead skin cells that harden and thicken over an area of the foot. This callus formation is the body's defense mechanism to protect the foot against excessive pressure and friction.


Calluses are normally found on the ball of the foot, the heel, and/or the inside of the big toe. Some calluses have a deep seated core known as a nucleation. This particular type of callus can be especially painful to pressure. This condition is often referred to as Intractable Plantar Keratosis.


Cause

Calluses develop because of excessive pressure at a specific area of the foot. Some common causes of callus formation are high-heeled dress shoes, shoes that are too small, obesity, abnormalities in the gait cycle (walking motion), flat feet, high arched feet, bony prominences, and the loss of the fat pad on the bottom of the foot.

Claw Toes

A claw toe is a toe that is contracted at the PIP and DIP joints (middle and end joints in the toe) and can lead to severe pressure and pain. Ligaments and tendons that have tightened cause the toe's joints to curl downwards. Claw toes may occur in any toe, except the big toe.


There is often discomfort at the top part of the toe that is rubbing against the shoe and at the end of the toe that is pressed against the bottom of the shoe. Claw toes are classified based on the mobility of the toe joints.


There are two types—flexible and rigid. In a flexible claw toe, the joint has the ability to move. This type of claw toe can be straightened manually. A rigid claw toe does not have that same ability to move. Movement is very limited and can be extremely painful. This sometimes causes foot movement to become restricted leading to extra stress at the ball-of-the-foot, and possibly causing pain and the development of corns and calluses.

CMT

Charcot-Marie-Tooth, or CMT, is inherited peripheral neuropathy and is found worldwide among all races and ethnic groups. Discovered in 1886 by three physicians, Jean-Martin Charcot, Pierre Marie, and Howard Henry Tooth, CMT affects an estimated 2.6 million people.


CMT usually isn’t life-threatening and almost never affects brain function. It is not contagious, but it is hereditary and can be passed down from one generation to the next.


CMT patients slowly lose normal use of their extremities as nerves degenerate and muscles weaken because the affected nerves no longer stimulate the muscles. Many patients also have some loss of sensory nerve functions.


Symptoms

Although there are many different genetic causes of CMT, all types tend to have remarkably similar symptoms.

  • A high arched foot is generally one of the first signs of this disorder, although in some instances extremely flat feet are also typical of CMT.

  • As the disease progresses, structural foot deformities take place. The patient may develop a pes cavus (high-arched) foot and hammertoes.

  • The progressive muscle wasting of CMT also leads to problems with walking, running, and balance. Ankle weakness and sprains are common, and many patients develop foot drop.
  • Later in the course of the disease, hand function may become affected. Tasks requiring manual dexterity become difficult. The loss of nerve function is often accompanied by tingling and burning sensations in the hands and feet. This usually causes little more than mild discomfort, but some people experience severe neuropathic pain and require medication to control it.

  • Weakness of the respiratory muscles is in rare in people with CMT, but when present, it can cause life-threatening problems. If shortness of breath is an issue, a patient should be checked by a respiratory specialist to see if the use of a ventilator is recommended. 

It is important to note that the severity of symptoms can vary greatly from patient to patient, even within the same family. A child may or may not be more severely disabled than his/her parent. Some family members may experience significant impairment and require bracing while others have no noticeable symptoms but are found to have CMT upon examination by EMG or nerve conduction studies.

Cause

Claw toes result from a muscle imbalance which causes the ligaments and tendons to become unnaturally tight. This results in the joints curling downwards. Arthritis can also lead to many different forefoot deformities, including claw toes.

Corns

Corns like calluses develop from an accumulation of dead skin cells on the foot, forming thick, hardened areas. They contain a cone-shaped core with a point that can press on a nerve below, causing pain.


Corns are a very common ailment that usually form on the tops, sides and tips of the toes. Corns can become inflamed due to constant friction and pressure from footwear. Corns that form between the toes are sometimes referred to as soft corns.

Cause

Some of the common causes of corn development are tight fitting footwear, high heeled footwear, tight fitting stockings and socks, deformed toes, or the foot sliding forward in a shoe that fits too loosely. Soft corns result from bony prominences and are located between the toes. They become soft due to perspiration in the forefoot area. Complications that can arise from corns include bursitis and the development of an ulcer.

Diabetic Foot Problems

There are four main types of diabetic neuropathy. You may have just one type or symptoms of several types. Most develop gradually, and you may not notice problems until considerable damage has occurred.


The signs and symptoms of diabetic neuropathy vary, depending on the type of neuropathy and which nerves are affected.


Peripheral Neuropathy

Peripheral neuropathy is the most common form of diabetic neuropathy. Your feet and legs are often affected first, followed by your hands and arms. Signs and symptoms of peripheral neuropathy are often worse at night, and may include:

  • Numbness or reduced ability to feel pain or temperature changes
  • A tingling or burning sensation
  • Sharp pains or cramps
  • Increased sensitivity to touch — for some people, even the weight of a bed sheet can be agonizing
  • Muscle weakness
  • Loss of reflexes, especially in the ankle
  • Loss of balance and coordination
  • Serious foot problems, such as ulcers, infections, deformities, and bone and joint pain

Autonomic Neuropathy

The autonomic nervous system controls your heart, bladder, lungs, stomach, intestines, sex organs, and eyes. Diabetes can affect the nerves in any of these areas, possibly causing:

  • A lack of awareness that blood sugar levels are low (hypoglycemia unawareness)
  • Bladder problems, including urinary tract infections or urinary retention or incontinence
  • Constipation, uncontrolled diarrhea or a combination of the two
  • Slow stomach emptying (gastroparesis), leading to nausea, vomiting, bloating and loss of appetite
  • Difficulty swallowing
  • Erectile dysfunction in men
  • Vaginal dryness and other sexual difficulties in women
  • Increased or decreased sweating
  • Inability of your body to adjust blood pressure and heart rate, leading to sharp drops in blood pressure after sitting or standing that may cause you to faint or feel lightheaded
  • Problems regulating your body temperature
  • Changes in the way your eyes adjust from light to dark
  • Increased heart rate when you're at rest

Radiculoplexus Neuropathy (Diabetic Amyotrophy)

Radiculoplexus neuropathy affects nerves in the thighs, hips, buttocks or legs. Also called diabetic amyotrophy, femoral neuropathy or proximal neuropathy, this condition is more common in people with type 2 diabetes and older adults.


Symptoms are usually on one side of the body, though in some cases symptoms may spread to the other side. Most people improve at least partially over time, though symptoms may worsen before they get better. This condition is often marked by:

  • Sudden, severe pain in your hip and thigh or buttock
  • Eventual weak and atrophied thigh muscles
  • Difficulty rising from a sitting position
  • Abdominal swelling, if the abdomen is affected
  • Weight loss

Mononeuropathy

Mononeuropathy involves damage to a specific nerve. The nerve may be in the face, torso or leg. Mononeuropathy, also called focal neuropathy, often comes on suddenly. It's most common in older adults.


Although mononeuropathy can cause severe pain, it usually doesn't cause any long-term problems. Symptoms usually diminish and disappear on their own over a few weeks or months. Signs and symptoms depend on which nerve is involved and may include:

  • Difficulty focusing your eyes, double vision or aching behind one eye
  • Paralysis on one side of your face (Bell's palsy)
  • Pain in your shin or foot
  • Pain in your lower back or pelvis
  • Pain in the front of your thigh
  • Pain in your chest or abdomen

Sometimes mononeuropathy occurs when a nerve is compressed. Carpal tunnel syndrome is a common type of compression neuropathy in people with diabetes.


Signs and symptoms of carpal tunnel syndrome include:

  • Numbness or tingling in your fingers or hand, especially in your thumb, index finger, middle finger and ring finger
  • A sense of weakness in your hand and a tendency to drop things

When to See a Doctor

Seek medical care if you notice:

  • A cut or sore on your foot that doesn't seem to be healing, is infected or is getting worse
  • Burning, tingling, weakness or pain in your hands or feet that interferes with your daily routine or your sleep
  • Dizziness
  • Changes in your digestion, urination or sexual function

These signs and symptoms don't always indicate nerve damage, but they may signal other problems that require medical care. Early diagnosis and treatment offer the best chance for controlling symptoms and preventing more-severe problems.


Even minor sores on the feet that don't heal can turn into ulcers. In the most severe cases, untreated foot ulcers may become gangrenous—a condition in which the tissue dies—and require surgery or even amputation of your foot. Early treatment can help prevent this from happening.

Flat Feet

Flat feet are a common finding. In infants and toddlers, the longitudinal arch is not developed and flat feet are normal. The arch develops in childhood, and by adulthood, most people have developed normal arches. Occasionally, however, the ankles begin to "turn over" and cause further problems. 

Fungal Toe Nail

Nail fungus is a common condition that begins as a white or yellow spot under the tip of your fingernail or toenail. As the fungal infection goes deeper, nail fungus may cause your nail to discolor, thicken and crumble at the edge. It can affect several nails but usually not all of them.

If your condition is mild and not bothering you, you may not need treatment. If your nail fungus is painful and has caused thickened nails, self-care steps and medications may help. But even if treatment is successful, nail fungus often comes back.


Nail fungus is also called onychomycosis (on-ih-koh-my-KOH-sis) and tinea unguium. When fungus infects the areas between your toes and the skin of your feet, it's called athlete's foot (tinea pedis).

Ganglion

A ganglion is a soft tissue mass that most commonly occurs on the wrist in women between 25 and 45 years of age. They are also seen commonly on the foot. A ganglion is a firm, rubbery mass that occurs on the top of the foot. On the foot, the most common area of involvement is in front of the ankle or on the outside of the ankle.


A common characteristic of a ganglion is that they will enlarge and then shrink is size. They generally occur without any apparent cause. Ganglions arise spontaneously from a weakness in the soft tissue covering of a joint or tendon sheath. Ballooning out of the tissue occurs and it fills with a thick mucoid fluid.


In many instances, ganglions are not painful until they reach a size that causes irritation from shoe pressure. On occasion they will compress a nearby skin nerve and cause tingling into the top of the toes. Tapping on the ganglion will often result in this same tingling sensation into the toes. Other common masses on the foot are giant cell tumors, fibromas, and lipomas.

Hammertoes

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. This can lead to painful cons and difficulty wearing shoes. 

Heel Fissures

Heel fissures, also known as cracked heels can be a simple cosmetic problem and a nuisance, but can also lead to serious medical problems. Heel fissures occur when the skin on the bottom, outer edge of the heel becomes hard, dry and flaky, sometimes causing deep fissures that can be painful or bleed.


Cause

Heel fissures can affect anyone, but risk factors include: Living in a dry climate, obesity, consistently walking barefoot or wearing sandals or open-backed shoes, and inactive sweat glands.


Like many foot conditions, heel fissures can become more dangerous if they go untreated and become deep or infected. This is especially dangerous for people with diabetes or compromised immune systems.

Heel Pain

Heel pain is a common condition in which weight bearing on the heel causes extreme discomfort.


Cause

There are two different categories of heel pain. The first is caused by over-use repetitive stress which refers to a soreness resulting from too much impact on a specific area of the foot. This condition, often referred to as "heel pain syndrome," can be caused by shoes with heels that are too low, a thinned out fat pad in the heel area, or from a sudden increase in activity.


Plantar fasciitis, a very common diagnosis of heel pain, is usually caused from a biomechancial problem, such as overpronation (flat feet). The plantar fascia is a broad band of fibrous tissue that runs along the bottom surface of the foot, from the heel through the midfoot and into the forefoot.


Overpronation can cause the plantar fascia to be excessively stretched and inflamed, resulting in pain in the heel and arch areas of the foot. Often the pain will be most intense first thing in the morning or after a prolonged period of rest. The pain will gradually subside as the day progresses.

Ingrown Toe Nail

Known to physicians as onychocryptosis, ingrown toe nails are a common, painful condition that occur when skin on one or both sides of a nail grows over the edges of the nail, or when the nail itself grows into the skin. This condition is usually very painful and can be associated with infection of the toe.


Some ingrown toenails are chronic, with repeated episodes of pain and infection. Irritation, redness, an uncomfortable sensation of warmth, as well as swelling can result from an ingrown toe nail.

Metatarsalgia

Metatarsalgia is a general term used to denote a painful foot condition in the metatarsal region of the foot (the area just before the toes, more commonly referred to as the ball-of-the-foot). This is a common foot disorder that can affect the bones and joints at the ball-of-the-foot.


Metatarsalgia (ball-of-foot-pain) is often located under the 2nd, 3rd, and 4th metatarsal heads, or more isolated at the first metatarsal head (near the big toe).


Cause

With this common foot condition, one or more of the metatarsal heads become painful and/or inflamed, usually due to excessive pressure over a long period of time. It is common to experience acute, recurrent, or chronic pain with metatarsalgia. Ball-of-foot pain is often caused from improper fitting footwear, most frequently by women's dress shoes and other restrictive footwear.


Footwear with a narrow toe box (toe area) forces the ball-of-foot area to be forced into a minimal amount of space. This can inhibit the walking process and lead to extreme discomfort in the forefoot. Other factors can cause excessive pressure in the ball-of-foot area that can result in metatarsalgia. These include shoes with heels that are too high or participating in high impact activities without proper footwear and/or orthotics.


Also as we get older, the fat pad in our foot tends to thin out, making us much more susceptible to pain in the ball-of-the-foot.

Morton's Neuroma

Morton's Neuroma is a common foot problem associated with pain, swelling and/or an inflammation of a nerve, usually at the ball-of-the-foot between the 3rd and 4th toes. Symptoms of this condition include sharp pain, burning, and even a lack of feeling in the affected area. Morton's Neuroma may also cause numbness, tingling, or cramping in the forefoot.


Cause

Morton's Neuroma is a foot condition caused from an abnormal function of the foot that leads to bones squeezing a nerve usually between the 3rd and 4th metatarsal heads.


Symptoms of Morton's Neuroma often occur during or after you have been placing significant pressure on the forefoot area, while walking, standing, jumping, or sprinting. This condition can also be caused by footwear selection. 

Footwear with pointed toes and/or high heels can often lead to a neuroma. Constricting shoes can pinch the nerve between the toes, causing discomfort and extreme pain.

Neuropathy

Of the 16 million Americans with diabetes, 25% develop foot problems related to the disease. This is primarily due to a condition called neuropathy. Diabetic Neuropathy is a complication of diabetes that affects the nerves.


The most common type of diabetic neuropathy is called peripheral neuropathy and affects the peripheral nerves. Peripheral nerves are the nerves that go out from the brain and spinal cord to the muscles, skin, internal organs, and glands.


Peripheral neuropathy impairs proper functioning of these sensory and motor nerves. The most common symptoms of neuropathy include numbness and loss of feeling, usually in the feet and hands.


Cause

Diabetic Neuropathy can cause insensitivity or a loss of ability to feel pain, heat, and cold. Diabetics suffering from neuropathy can develop minor cuts, scrapes, blisters, or pressure sores that they may not be aware of due to the insensitivity.


If these minor injuries are left untreated, complications may result and lead to ulceration and possibly even amputation. Neuropathy can also cause deformities such as Bunions, Hammer Toes, and Charcot Feet.


It is very important for diabetics to take the necessary precautions to prevent all foot-related injuries. Due to the consequences of neuropathy, daily observation of the feet is critical. When a diabetic patient takes the necessary preventative footcare measures, he or she reduces the risk of developing serious foot conditions.

Overpronation

Overpronation, or flat feet, is a common biomechanical problem that occurs in the walking process when a person's arch collapses upon weight bearing. This motion can cause extreme stress or inflammation on the plantar fascia, potentially causing severe discomfort and leading to other foot problems.


Cause

Overpronation is very prominent in people who have flexible, flat feet. The framework of the foot begins to collapse, causing the foot to flatten and adding stress to other parts of the foot. As a result, overpronation, often leads to plantar fasciitis, heel spurs, metatarsalgia, post-tib tendonitis and/or bunions.


There are many causes of flat feet. Obesity, pregnancy or repetitive pounding on a hard surface can weaken the arch leading to overpronation. Often people with flat feet do not experience discomfort immediately, and some never suffer from any discomfort at all. However, when symptoms develop and become painful, walking becomes awkward and causes increased strain on the feet and calves.

Plantar Fasciitis

Plantar Fasciitis is an inflammation caused by excessive stretching of the plantar fascia. The plantar fascia is a broad band of fibrous tissue which runs along the bottom surface of the foot, attaching at the bottom of the heel bone and extending to the forefoot. When the plantar fascia is excessively stretched, this can cause plantar fasciitis, which can also lead to heel pain, arch pain, and heel spurs.

Cause


Plantar Fasciitis often leads to heel pain, heel spurs, and/or arch pain. The excessive stretching of the plantar fascia that leads to the inflammation and discomfort can be caused by the following: Over-pronation (flat feet) which results in the arch collapsing upon weight bearing a foot with an unusually high arch, a sudden increase in physical activity, excessive weight on the foot, usually attributed to obesity or pregnancy, and improperly fitting footwear.


Overpronation (flat feet) is the leading cause of plantar fasciitis. Overpronation occurs in the walking process, when a person's arch collapses upon weight bearing, causing the plantar fascia to be stretched away from the heel bone. With Plantar Fasciitis, the bottom of your foot usually hurts near the inside of the foot where the heel and arch meet.


The pain is often acute either first thing in the morning or after a long rest, because while resting the plantar fascia contracts back to its original shape. As the day progresses and the plantar fascia continues to be stretched, the pain often subsides.

PVD

Peripheral vascular diseases (PVDs) are circulation disorders that affect blood vessels outside of the heart and brain. PVD typically strikes the veins and arteries that supply the arms, legs, and organs located below your stomach. These are the blood vessels that are distant from the heart. They are known as peripheral vessels.


In PVD, blood vessels are narrowed. Narrowing is usually caused by arteriosclerosis. Arteriosclerosis is a condition where plaque builds up inside a vessel. It is also called “hardening of the arteries.” Plaque decreases the amount of blood and oxygen supplied to the arms and legs.


As plaque growth progresses, clots may develop. This further restricts the affected vessel. Eventually, arteries can become obstructed.


PVD that develops only in the arteries is called peripheral arterial disease (PAD). This is the most common form of PVD. Approximately 12 to 20 percent of people over age 65 have PAD.

PVD that develops in the deep veins in the body is usually caused from claudication and is called deep vein thrombosis (DVT).

PVD and PAD are often used to mean the same condition that affects the arteries. PVD may also be referred to as:

  • Arteriosclerosis obliterans
  • Arterial insufficiency of the legs
  • Claudication
  • Intermittent claudication

Sesamoiditis

Sesamoiditis is a common ailment that affects the forefoot, typically in young people who engage in physical activity like running or dancing. Its most common symptom is pain in the ball-of-the-foot, especially on the medial or inner side. The term is a general description for any irritation of the sesamoid bones, which are tiny bones within the tendons that run to the big toe.


Like the kneecap, the sesamoids function as a pulley, increasing the leverage of the tendons controlling the toe. Every time you push off against the toe the sesamoids are involved, and eventually they can become irritated, even fractured. Because the bones are actually within the tendons, sesamoiditis is really a kind of tendinitis—the tendons around the bones become inflamed as well.


Cause

Sesamoiditis typically can be distinguished from other forefoot conditions by its gradual onset. The pain usually begins as a mild ache and increases gradually as the aggravating activity is continued. It may build to an intense throbbing. In most cases there is little or no bruising or redness.


One of the major causes of sesamoiditis is increased activity. You've probably stepped up your activity level lately, which has forced you to put more pressure on the balls of your feet. Speed work, hill work, or even increased mileage can cause this. If you have a bony foot, you simply may not have enough fat on your foot to protect your tender sesamoids. Also, if you have a high arched foot, you will naturally run on the balls-of-your-feet, adding even more pressure.

Shin Splints

Shin splints are a common lower extremity complaint, especially among runners and other athletes. They are characterized by pain in the front or inside aspect of the lower leg due to overexertion of the muscles.


The pain usually develops gradually without a history of trauma, and might begin as a dull ache along the front or inside of the shin (Tibia) after running or even walking. Small bumps and tender areas may become evident adjacent to the shin bone.


The pain can become more intense if not addressed, and shin splints should not be left untreated because of an increased risk of developing stress fractures. Shin splints usually involve small tears in the leg muscles where they are attached to the shin bone.


The two types of shin splints are: anterior shin splints, in the front portion of the tibia; and posterior shin splints, occurring on the inside of the leg along the tibia.


Cause

Shin splints can be caused when the anterior leg muscles are stressed by running, especially on hard surfaces or extensively on the toes, or by sports that involve jumping. Wearing athletic shoes that are worn out or don't have enough shock absorption can also cause this condition.


Overpronated (flat feet) are another factor that can lead to increased stress on the lower leg muscles during exercise. People with high arched feet can also experience shin splint discomfort because this foot type is a poor shock absorber.

Warts

Plantar warts are hard, grainy growths that usually appear on the heels or balls of your feet, areas that feel the most pressure. This pressure also may cause plantar warts to grow inward beneath a hard, thick layer of skin (callus).

Plantar warts are caused by the human papillomavirus (HPV). The virus enters your body through tiny cuts, breaks or other weak spots on the bottom of your feet.


Most plantar warts aren't a serious health concern and may not require treatment. But plantar warts can cause discomfort or pain. If self-care treatments for plantar warts don't work, you may want to see your doctor to have them removed.

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