Ingrown Toenails
Ingrown toenails can be painful, making it hard to stand or walk and it can even become infected. Signs of an ingrown toenail are pain, redness, warm to the touch and can feel hard and swollen.
This foot condition develops when the corner of the toenail grows down into the skin and usually affects the big toe. Ingrown toenails often happen when people cut their toenails too short, or too rounded at the corner. The toenail curves with the shape of the toe and can grow into your skin. Other causes can be from improperly fitting shoes, tearing the corner of the nail, toe trauma (such as stubbing your toe) and congenital (your foot shape) when the nail is larger comparatively with your toe causing the surrounding tissue of the nail border to grow around the nail.
Ingrown toenails are common and anyone can get one, but treatment is fairly straightforward. Our Chiropodist can remove it and take steps to prevent it from happening again.
If you have an ingrown or infected toenail, see our Chiropodist Lada Milos Lee for complete care!
Diabetes and Foot Care
Diabetes is a chronic condition that affects millions of people worldwide. As Chiropodists, we want to emphasize the significant impact diabetes can have on your feet and the importance of proactive foot care to prevent complications.
Here are some key points to consider:
- Diabetes and Foot Complications: Diabetes can lead to nerve damage (neuropathy) and reduced blood flow (peripheral vascular disease) in the feet. This combination puts individuals at a higher risk of developing foot complications, such as foot ulcers, infections, and even amputation if not addressed promptly.
- Daily Foot Care Routine: Establishing a daily foot care routine is crucial for individuals with diabetes. We recommend washing your feet with warm water and mild soap, drying them thoroughly (especially between the toes), and moisturizing to prevent dryness and cracking. Remember to inspect your feet regularly for any signs of redness, swelling, cuts, or sores.
- Proper Footwear: Investing in appropriate footwear is essential for diabetic foot care. Choose shoes that provide ample support, have a wide toe box, and are made of breathable materials. Avoid high heels, tight shoes, and open-toed sandals that can increase the risk of foot problems. Custom-made orthotics can also play a vital role in ensuring proper foot alignment and reducing pressure points.
- Regular Professional Check-ups: Regular visits to your Chiropodist are crucial for individuals with diabetes. We can perform comprehensive foot assessments, including checking your foot sensation, circulation, and identifying any potential risk factors. Our expertise allows us to detect problems early on and provide necessary interventions to prevent complications.
- Prevention is Key: Prevention is the cornerstone of diabetic foot care. Along with maintaining healthy blood sugar levels, it’s vital to quit smoking, manage blood pressure, and adopt a balanced diet. Engaging in regular physical activity promotes circulation and helps control diabetes, ultimately benefiting your overall foot health.
Our Chiropodist Lada Milos Lee is here to assist in your care.
Bunions
Banishing Bunions: How a Chiropodist Can Help
Summer is upon us, and that means it’s time to dig out those sandals and enjoy the warmer weather. But if you’re one of the millions of people dealing with bunions, you might be dreading the thought of showing off your feet. Don’t worry, though, because we’re here to discuss how a Chiropodist can help you with your bunion troubles.
Understanding Bunions:
Bunions are a common foot condition characterized by the enlargement of the joint at the base of the big toe. They usually develop gradually, with the big toe leaning toward the other toes and a bony protrusion forming on the side of the foot. Bunions can be painful, cause discomfort while walking, and even lead to other foot problems.
How Can a Chiropodist Help?
A Chiropodist, also known as a podiatrist, specializes in diagnosing and treating various foot conditions, including bunions. They are highly trained healthcare professionals who can provide expert care and advice to help you manage your bunion symptoms effectively.
Here’s how they can assist you:
- Diagnosis and Assessment: A Chiropodist will examine your feet, assess the severity of your bunions, and identify any underlying causes.
- Pain Relief: Chiropodists can recommend and provide pain relief options such as orthotic devices, padding, or taping to alleviate discomfort caused by bunions. They may also suggest appropriate footwear modifications to reduce pressure on the affected area.
- Conservative Treatments: In many cases, bunions can be managed without surgery. Chiropodists can advise you on conservative treatment options like stretching exercises, physical therapy, and custom-made orthotics to improve the alignment of your feet and slow down the progression of the condition.
- Footwear Guidance: Your Chiropodist can provide valuable advice on selecting appropriate footwear that accommodates your bunions and minimizes discomfort. They may recommend shoes with wide toe boxes, low heels, and good arch support to relieve pressure on the affected area.
- Surgical Referral: If your bunions are severe and conservative treatments have not provided sufficient relief, a Chiropodist can refer you to a foot and ankle surgeon for further evaluation. They will work in collaboration with the surgeon to ensure you receive the best possible care.
Prevention and Self-Care:
While Chiropodists can provide expert guidance and treatment, there are also steps you can take to prevent bunions or minimize their impact:
- Choose footwear wisely, opting for comfortable, well-fitting shoes that allow your toes to move freely.
- Avoid high heels or narrow-toed shoes that squeeze the toes together.
- Maintain a healthy weight to reduce stress on your feet.
- Perform regular foot exercises and stretches to improve foot strength and flexibility.
- If you notice any changes in your foot shape or experience foot pain, consult a chiropodist promptly.
Take a Step Towards Healthy Feet:
If bunions are causing you discomfort and affecting your quality of life, don’t suffer in silence. Schedule an appointment with our Chiropodist, Lada Milos Lee, and take the first step towards healthier, pain-free feet.
Medical Pedicures by a Chiropodist
Many people associate pedicures with a luxurious spa treatment, but they can also be an important part of maintaining foot health. Pedicures can help prevent the buildup of calluses and corns, which can be uncomfortable and even painful. But for those with foot conditions such as diabetes, circulation issues, or neuropathy, pedicures can be risky and potentially harmful if not done by a qualified professional.
This is where a medical pedicure, performed by a licensed Chiropodist, comes in. A Chiropodist is a healthcare professional who specializes in diagnosing and treating conditions of the feet and lower limbs. They are trained to identify and treat foot problems, as well as provide preventative care. Additionally they are held to a higher standard of care and insure proper sterilization techniques are used.
During a medical pedicure, the Chiropodist will use specialized tools and techniques to gently remove dead skin, calluses, and corns, without causing damage to the surrounding tissue. They will also trim and shape the toenails. And during the procedure the Chiropodist will inspect your feet for any signs of infection or other problems, and provide advice on how to maintain foot health. They may also recommend additional treatments such as ingrown nail surgery or wart removal when necessary.
Lateral Ankle Sprain
How many of us have rolled our ankle and damaged a ligament at some point in our life?! The answer is many of us. Approximately 2 million ankle ‘sprains’ (the word used to describe a ligament that has been over-stretched or torn) occur in the US every year alone, which gives you an idea of how many happen worldwide! Whilst many of these sprains occur in the sporting world, there are surprising amounts that occur in the general population. This shows us that we don’t have to be an elite sportsperson to be at risk of rolling our ankles. It’s an injury that can literally happen to any one of us… Picture Joe Bloggs walking down the street and slipping unexpectedly off the curb. Ouch!
What is a ligament sprain?
Let’s start at the beginning… Ligaments hold bone to bone. Two bones held together become a joint. Ligaments are responsible for providing a joint with stability (along with the muscles and tendons surrounding it), ensuring the bones of a joint do not move away from each other and dislocate. Ligaments are thick, strong bands of tissue that can withstand the majority of the large forces that run through our bodies when we move. Sometimes the force placed upon a ligament is too great for it to withstand, and this is when damage (or a sprain) occurs. Ligament sprains are generally categorized into the following grades:
- Grade 1: A mild sprain with only damage seen at a microscopic level and no joint instability.
- Grade 2: A moderate sprain where some, but not all, of the ligament fibres are torn. There may be very mild joint instability (or none) associated with this grade.
- Grade 3: A severe sprain where all of the ligament fibres are torn leaving the joint unstable.
Why is a sprain of the outside of the ankle so common?
The outside (or lateral aspect) of the ankle joint is one of the most commonly sprained regions of the body. The two leg bones (the tibia and fibula) run down the leg from the knee and slot in with the ankle bone, or ‘talus’ (pronounced ‘tay-luss’). The fibula bone runs down the outside of the leg and the tibia runs down the middle/inside of the leg. The very ends of these bones are enlarged lumps (known as malleoli… ‘mal-ee-oh-lie’). You can feel these lumps either side of the ankle. Where the malleoli meet the talus is where the outside (lateral) and inside (medial) ligaments are found. The medial ligaments are much stronger than the lateral ligaments which result in the lateral ligaments being injured more commonly. A simple roll of the ankle can cause an over-stretching or tearing of the ligaments here, depending on the force being placed on the ankle as it rolls outwards. In a normal healthy ankle, the ability to roll the ankle outwards is greater than that of rolling inwards… Another reason why lateral ankle sprains tend to occur more often.
Risk factors
One of the biggest risk factors for a lateral ankle sprain is having a history of ankle sprains. If you have done it previously, you are more likely to sprain it again! Other risk factors include:
- Being hyper-mobile or having excessive range of motion at the ankle joint due to naturally looser ligaments.
- Playing sports where turning, twisting and pivoting at high speed are a large part of the game (i.e. netball, basketball, football (any form), and racket sports)
- Being taller and heavier in weight
- Having wider feet
Signs and symptoms
Sometimes when you roll your ankle, the force placed on the ligament is not great enough to damage it. In these instances, you may experience no symptoms at all. For instances where the force is great enough to damage the ligament, you can expect to experience any or all of the following (depending on the severity of the injury):
- Pain (possibly preceded by an audible click or pop) over and around the affected ligament
- Swelling
- Bruising
- Limping on the affected side when walking
- Reduced movement of the affected ankle
- Instability of the ankle joint (i.e. excessive movement) if severe enough
After a severe injury you may not be able to walk immediately. The more severe the sprain, the more likely other structures in and around the ankle may be affected, including the possibility of fracture and/or dislocation (if the force is great enough).
Treatment
Most cases of lateral ankle sprains that enter our clinic are mild to moderate in nature. More severe injuries are often dealt with initially at an emergency department (i.e. if it has been necessary to rule out a fracture/dislocation), but may present to our clinic for ongoing management once the acute injury has begun to heal.
The first goal of treatment for lateral ankle sprains is to regain a normal walking pattern, whilst reducing the risk of further injury. This is likely to mean zero participation in your chosen sport to begin with, especially if pivoting and turning play a large part. We will work on reducing pain by massaging the muscles of the leg and foot. We may also need to work on muscles higher up the body, such as your back, glutes, hamstring and quad muscles. Any stiffened joints will be mobilized gently to restore range of motion. Any swelling can be dealt with using drainage techniques of the lower limb.
When normal walking has resumed, you can progressively load the ankle by adding in strengthening, balance, and more multi-directional agility exercises. The end goal for a sportsperson is to return to training followed by full match play. A non-sportsperson will look to return to their normal daily life without pain or dysfunction. A mild to moderate ankle sprain will take approximately 6-8 weeks to heal. More severe injuries can take months.
If you have sprained your ankle and need some help, look no further than your trusty osteopath. Call us today on (416) 546-4887 or book online to book your appointment and begin treatment immediately.
References
1. Mackenzie, MH. et al. 2019. Epidemiology of Ankle Sprains and Chronic Ankle Instability. Journal of Athletic Training. 54 (6). 603-610. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6602402/pdf/i1062-6050-54-6-603.pdf
2. Physiopedia. 2021. Ligament sprains. [Online]. Available from: https://www.physio-pedia.com/Ligament_Sprain. [Accessed 08 March 2021]
3. Beynnon, BD. et al. 2002. Predictive Factors for Lateral Ankle Sprains: A Literature Review. Journal of Athletic Training. 37 (4). 376-380. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC164368/pdf/attr_37_04_0376.pdf
Lateral Ankle Sprain
How many of us have rolled our ankle and damaged a ligament at some point in our life?! The answer is many of us. Many sprains occur in the sporting world, but there are surprising amounts that occur in the general population. This shows us that we don’t have to be an elite sportsperson to be at risk of rolling our ankles. It’s an injury that can literally happen to any one of us… Picture Joe Bloggs walking down the street and slipping unexpectedly off the curb. Ouch!
What is a ligament sprain?
Let’s start at the beginning… Ligaments hold bone to bone. Two bones held together become a joint. Ligaments are responsible for providing a joint with stability (along with the muscles and tendons surrounding it), ensuring the bones of a joint do not move away from each other and dislocate. Ligaments are thick, strong bands of tissue that can withstand the majority of the large forces that run through our bodies when we move. Sometimes the force placed upon a ligament is too great for it to withstand, and this is when damage (or a sprain) occurs. Ligament sprains are generally categorised into the following grades:
- Grade 1: A mild sprain with only damage seen at a microscopic level and no joint instability.
- Grade 2: A moderate sprain where some, but not all, of the ligament fibres are torn. There may be very mild joint instability (or none) associated with this grade.
- Grade 3: A severe sprain where all of the ligament fibres are torn leaving the joint unstable.
Why is a sprain of the outside of the ankle so common?
The outside (or lateral aspect) of the ankle joint is one of the most commonly sprained regions of the body. The two leg bones (the tibia and fibula) run down the leg from the knee and slot in with the ankle bone, or ‘talus’ (pronounced ‘tay-luss’). The fibula bone runs down the outside of the leg and the tibia runs down the middle/inside of the leg. The very ends of these bones are enlarged lumps (known as malleoli… ‘mal-ee-oh-lie’). You can feel these lumps either side of the ankle. Where the malleoli meet the talus is where the outside (lateral) and inside (medial) ligaments are found. The medial ligaments are much stronger than the lateral ligaments which result in the lateral ligaments being injured more commonly. A simple roll of the ankle can cause an over-stretching or tearing of the ligaments here, depending on the force being placed on the ankle as it rolls outwards. In a normal healthy ankle, the ability to roll the ankle outwards is greater than that of rolling inwards… Another reason why lateral ankle sprains tend to occur more often.
Risk factors
One of the biggest risk factors for a lateral ankle sprain is having a history of ankle sprains. If you have done it previously, you are more likely to sprain it again! Other risk factors include:
- Being hyper-mobile or having excessive range of motion at the ankle joint due to naturally looser ligaments.
- Playing sports where turning, twisting and pivoting at high speed are a large part of the game (i.e. netball, basketball, football (any form), and racket sports)
- Being taller and heavier in weight
- Having wider feet
Signs and symptoms
Sometimes when you roll your ankle, the force placed on the ligament is not great enough to damage it. In these instances, you may experience no symptoms at all. For instances where the force is great enough to damage the ligament, you can expect to experience any or all of the following (depending on the severity of the injury):
- Pain (possibly preceded by an audible click or pop) over and around the affected ligament
- Swelling
- Bruising
- Limping on the affected side when walking
- Reduced movement of the affected ankle
- Instability of the ankle joint (i.e. excessive movement) if severe enough
After a severe injury you may not be able to walk immediately. The more severe the sprain, the more likely other structures in and around the ankle may be affected, including the possibility of fracture and/or dislocation (if the force is great enough).
Treatment
Most cases of lateral ankle sprains that enter our clinic are mild to moderate in nature. More severe injuries are often dealt with initially at an emergency department (i.e. if it has been necessary to rule out a fracture/dislocation), but may present to our clinic for ongoing management once the acute injury has begun to heal.
The first goal of treatment for lateral ankle sprains is to regain a normal walking pattern, whilst reducing the risk of further injury. This is likely to mean zero participation in your chosen sport to begin with, especially if pivoting and turning play a large part. We will work on reducing pain by massaging the muscles of the leg and foot. We may also need to work on muscles higher up the body, such as your back, glutes, hamstring and quad muscles. Any stiffened joints will be mobilized gently to restore range of motion. Any swelling can be dealt with using drainage techniques of the lower limb.
When normal walking has resumed, you can progressively load the ankle by adding in strengthening, balance, and more multi-directional agility exercises. The end goal for a sportsperson is to return to training followed by full match play. A non-sportsperson will look to return to their normal daily life without pain or dysfunction. A mild to moderate ankle sprain will take approximately 6-8 weeks to heal. More severe injuries can take months.
If you have sprained your ankle and need some help, look no further, our team can help you get back and running. Our osteopaths can help with treatment and rehab, whilst our chiropodist can help out with alignment corrections and shoe recommendations. Call us today on (416) 546-4887 or book online at beachealth.janeapp.com to book your appointment and begin treatment immediately.
References
1. Mackenzie, MH. et al. 2019. Epidemiology of Ankle Sprains and Chronic Ankle Instability. Journal of Athletic Training. 54 (6). 603-610. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6602402/pdf/i1062-6050-54-6-603.pdf
2. Physiopedia. 2021. Ligament sprains. [Online]. Available from: https://www.physio-pedia.com/Ligament_Sprain. [Accessed 08 March 2021]
3. Beynnon, BD. et al. 2002. Predictive Factors for Lateral Ankle Sprains: A Literature Review. Journal of Athletic Training. 37 (4). 376-380. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC164368/pdf/attr_37_04_0376.pdf
Athlete’s Foot
The term “athlete’s foot” can be very misleading because you don’t have to be an athlete to suffer from this condition. Athlete’s foot (tinea pedis) is a common contagious fungal infection affecting the skin and nails of the feet, which cause itching and irritation.
Athlete’s foot is caused by a fungal infection that manifests in a scaly, red rash on the foot that itches, especially at night. Blisters or ulcers may also appear. Athlete’s foot can affect one or both feet and can spread to your hands if you scratch or pick the infection.
Having sweaty feet confined in tight-fitting shoes or coming into contact with someone who has the conditions. Communal showers, locker rooms, and pool decks are common places where the infection can be contracted if you are not taking precautions, like wearing shower shoes.
You are at an increased risk of athlete’s foot if you’re:
- Male
- Wear damp socks or tight-fitting shoes
- Share mats, rugs, bed linens, clothes or shoes with someone who has an infection
- Walk barefoot in public areas, like locker rooms, saunas, swimming pools, and communal showers
- Have a weakened immune system’
Prevention & Treatment:
There are over-the-counter creams that can usually effectively treat and eliminate the infection within two weeks.
You can also prevent the spread of Athlete’s foot by wearing sandals in public locker rooms and around swimming areas. Be sure to maintain clean showers and floors at home where you frequently walk barefoot and cover your feet with socks or shoes until the infection has dissipated. Also, keep your feet clean and dry if you choose to wear socks and shoes for long periods of time.
Don’t forget to continually disinfect your footwear to ensure you will not accidentally reinfect yourself.
When To Seek Care:
If these treatments don’t work, or if you have increasing pain, fever, swelling of the foot, blisters or open sores, it’s time to seek treatment for a possible bacterial infection. A more aggressive course of treatment may be prescribed by chiropodist (your foot specialist) at our clinic. Please call us, or book online with our chiropodist Lada Milos Lee.
Compression Stockings
Our foot specialist, Lada Milos Lee is proud to offer Ofa Bamberg line of compression therapy. Compression therapy is achieved using gradient compression, which has the greatest pressure at the base, and reduces pressure as the compression garment goes up the leg. This helps encourage the movement of fluids, including blood circulation and the lymph fluid circulation. The gentle pressure helps blood vessels and lymph vessels absorb fluids more easily, providing relief for tissues. This helps to relieve pain by reducing swelling and preventing accumulation of fluid buildup. Venous disorders are very common and it is estimated that 20% of men and 30% of women suffer from some form of venous disorder.
- Do you suffer from tired, aching legs at the end of your day?
- Do you suffer from spider or varicose veins?
- Do you travel long distances frequently?
- Do you sit or stand for prolonged periods of time?
- Are you pregnant?
- Do you struggle with some excess weight?
If you answers “YES” to any of these questions, compression stockings may be helpful in alleviating pain, reducing swelling and preventing chronic venous disorders.
Prevention of Varicose Veins
When the valves of the veins are damaged or do not function properly, blood pools and the increased volume causes pressure within the wall of the veins. This can then cause veins to bulge and distend. Over time, the veins loose their ability to bounce back, causing “spider” veins ( in the small superficial veins), and “varicose” veins ( in the larger veins). Compression therapy is effective in preventing the veins from becoming damaged and noticeable.
Sports
Studies have shown that wearing compression stockings during exercise helps reduce muscle soreness.
Travel
Long-distance travel wether by car, train or airplane, can be associated with the leg discomfort and increased risk of DVT (deep vein thrombosis). Lack of leg movement due to prolonged sitting and cramped spaces gives way to swelling of the feet and legs. The swelling contributes to leg fatigue, discomfit, and a heavy sensation in the leg. Studies have shown that a traveler not wearing a graduated compression stockings is 12.5 times more likely to develop DVT.
Wearing gradient compression stockings appeared to be effective in reducing the risk of DVT and prevent overall swelling during frequent or long travel.
Pregnancy
As the baby grows, the enlarged uterus applies pressure on the vena cava, which returns blood to the heart. The pressure can cause stasis and valve damage, which results in swelling, leg discomfort, and even varicose veins. On average 23% of pregnant women will have venous disorders as early as their first pregnancy, and this number rises to 31 % by their fourth pregnancy. Compression hosiery helps to relieve leg fatigue and discomfort by helping to prevent the superficial veins from becoming distended with blood. It also helps to reduce pressure in the tissue underneath the skin.
Are You Covered?
Compression stockings with a pressure of 20-30, or 30-40 mmHg are covered by most insurance plans on an annual basis. A physician prescription is required.
Consultation 
A 20-min initial consultation is required. The appointment should be scheduled at the beginning of the day to ensure the best measurements. Styles and materials will also be discussed to determine the best product for your needs.
Orthotics
Do I need orthotics? What kind?
Many people come to the clinic complaining of foot pain from conditions such as bunions, hammertoes, a pinched nerve (neuroma), or heel pain (plantar fasciitis). I perform a thorough evaluation and examination, and together we review the origin, mechanics, and treatment plan for the specific problem.The patient usually asks if they need and orthotic and, if so, which type would be best.
I recommend a foot orthotic if muscles, tendons, ligaments, joints, or bones are not in an optimal functional position and are causing pain, discomfit, and fatigue. Foot orthotics can be made from different materials, and may be rigid, semirigid, semi flexible, or accommodative, depending o your diagnosis ad specific needs.
Different types of orthotics
There are few types of foot orthotics: over-the-counter/off-the-shelf (OTC) orthotics; “kiosk-generated” orthotics; and professional custom orthotics. OTC orthotics are widely available and can be chosen based on shoe size and problem. Kiosk orthotics are based on the scan of your feet. A particular style or size of orthotics is recommended for you based on a foot scan and the type of foot problem you are experiencing.
For custom prescription orthotics, a health professional performs a thorough health history, including an assessment of your height, weight, level of activity, and any medical conditions. A diagnosis and determination of the best materials and level of rigidity/flexibility of the orthotics is made, followed by casting mold of your feet. This mold is then used to create an orthotic specifically for you. The difference between OTC/ kiosk and custom made orthotics may be likened to the difference between over-the-counter and prescription reading glasses.
Which type of orthotic is right for you?
A person of average weight, height, and foot type and with a generic problem such as heel pain, usually does well with OTC or kiosk orthotic. They are less expensive, however you may have to replace them more often. Someone with a specific need, or a problem such as severely flat foot, may benefit from custom prescription orthotics. These also last longer.
Another important fact is that your foot specialist will be able to educate you about proper footwear. You may be surprised to learn that many people have not had their feet professionally measured in years. As we age our foot length and width changes, and sizing may not be consistent between brands.
In my experience, certain groups of people benefit from an examination performed by foot specialist, and prescription for custom orthotics. These may include people with diabetes who have lost a feeling in their feet, people with poor circulation, and people with severe foot deformities caused by different foot misalignments and medical conditions.