Items filtered by date: April 2025
Tarsal Tunnel Syndrome
Tarsal tunnel syndrome is a condition in which there is a compression of the posterior tibial nerve. The posterior tibial nerve runs along the inside of the ankle into the foot. Tarsal tunnel syndrome is named for the tarsal tunnel, which is a thin space along the inside of the ankle beside the ankle bones. This space contains various nerves, arteries, and tendons, and includes the posterior tibial nerve. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome the tibial nerve is compressed, causing tingling or burning, numbness, and pain.
Common causes of tarsal tunnel syndrome involve pressure or an injury. Injuries that produce inflammation and swelling in or around the tunnel may place pressure on the posterior tibial nerve. Direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or trauma to the tibial nerve, can result in tarsal tunnel syndrome. Diseases that damage nerves, such as diabetes or arthritis, may cause tarsal tunnel syndrome. Those with flat feet are at risk for developing the condition, as the extra pressure and strain placed on the foot may compress the posterior tibial nerve.
Feeling different sensations in the foot at different times is a common symptom of tarsal tunnel syndrome. An afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of the affected leg. Symptoms are primarily felt on bottom of the foot and/or the inside of the ankle. Symptoms can appear suddenly and may occur due to overuse of the foot.
To diagnose tarsal tunnel syndrome, your podiatrist may examine the foot and tap the posterior tibial nerve to see if symptoms surface. He or she may also order an MRI to determine if a mass is present.
Treating tarsal tunnel syndrome will depend on the decision of your podiatrist. Multiple options are available, however, and can include rest, ice, immobilization, oral medications such as anti-inflammatory drugs (NSAIDS), physical therapy, injection therapy, orthotics, supportive shoes, braces, and surgery.
Tarsal Tunnel Syndrome Diagnosis
Some afflictions of the foot occur when a local nerve is damaged or strained, which can result in complications in the feet. Tarsal tunnel syndrome is one such foot affliction. This condition occurs in an individual when the tissue surrounding the tarsal tunnel aggravates the posterior tibial nerve. This nerve is located in the lower calf and runs to the heel of the foot. When this nerve aggravation occurs, the patient can feel pain when walking. By working with a podiatrist, a patient can receive a diagnosis of tarsal tunnel syndrome. There are different ways in which a podiatrist might go about making a diagnosis. In some cases, a podiatrist might conduct a simple examination of the affected foot. In other cases, the podiatrist might use nerve conduction studies. These studies essentially use electrical currents to measure the speed with which a nerve can produce impulses. If the posterior tibial nerve being studied produces impulses at a very slow rate, this can indicate the presence of tarsal tunnel syndrome. Regardless of how a diagnosis of tarsal tunnel syndrome is performed, it can be very helpful to reach out to a podiatrist who will be able to best help you identify and treat this condition.
Tarsal tunnel syndrome can be very uncomfortable to live with. If you are experiencing tarsal tunnel syndrome, contact Dr. Ronald Sheppard of Warren-Watchung Podiatry Center. Our doctor can provide the care you need to keep you pain-free and on your feet.
Tarsal Tunnel Syndrome
Tarsal tunnel syndrome, which can also be called tibial nerve dysfunction, is an uncommon condition of misfiring peripheral nerves in the foot. The tibial nerve is the peripheral nerve in the leg responsible for sensation and movement of the foot and calf muscles. In tarsal tunnel syndrome, the tibial nerve is damaged, causing problems with movement and feeling in the foot of the affected leg.
Common Cause of Tarsal Tunnel Syndrome
- Involves pressure or an injury, direct pressure on the tibial nerve for an extended period of time, sometimes caused by other body structures close by or near the knee.
- Diseases that damage nerves, including diabetes, may cause tarsal tunnel syndrome.
- At times, tarsal tunnel syndrome can appear without an obvious cause in some cases.
The Effects of Tarsal Tunnel Syndrome
- Different sensations, an afflicted person may experience pain, tingling, burning or other unusual sensations in the foot of the affected leg.
- The foot muscles, toes and ankle become weaker, and curling your toes or flexing your foot can become difficult.
- If condition worsens, infections and ulcers may develop on the foot that is experiencing the syndrome.
A physical exam of the leg can help identify the presence of tarsal tunnel syndrome. Medical tests, such as a nerve biopsy, are also used to diagnose the condition. Patients may receive physical therapy and prescriptive medication. In extreme cases, some may require surgery.
If you have any questions please feel free to contact one of our offices located in Marlboro and Watchung, NJ . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Plantar Fibroma
A plantar fibroma is a knot in the arch of the foot. It can cause pain when repeated pressure is applied by walking barefoot or wearing tight shoes. While plantar fibromas can appear in anyone, men who are middle-aged or older are said to be more susceptible. The main symptom of a plantar fibroma is a firm lump on the arch of the foot. If there is pain, it can be intensified by putting pressure on the nodule. The lump can stay one size or grow larger. You may have one or more fibromas in the feet and there tends to be a high incidence of recurring plantar fibromas. Generally, a plantar fibroma can be treated without surgery. Treatment might include steroid injections to help shrink the lump, orthotics to help redistribute weight away from the nodule, plantar fascia stretching, or physical therapy to help use anti-inflammatory medication on the lump. If a lump grows larger or more painful, a podiatrist can be consulted to confirm the diagnosis. The doctor will palpate the lump and this may cause pain that can be felt all the way to the toes. An X-ray, MRI, or biopsy might be done if further evaluation is necessary. A lump in the arch of the foot might be something other than a plantar fibroma, such as cysts, nerve or fatty tumors, swollen tendons, or an infection in the foot. It is important to see a podiatrist for proper diagnosis and treatment of plantar fibromas.
How to Manage Pain From a Plantar Fibroma
A bump on the bottom of the foot may be indicative of a foot condition known as plantar fibromatosis. This ailment develops on the plantar fascia which is the band of tissue that runs along the bottom of the foot. Its function is to connect the heel to the toes, in addition to supporting the arch. A plantar fibroma can form when nodules grow in the plantar fascia, and can cause pain and discomfort. Research has shown there is no cure for this condition, and existing patients often look to manage the pain. This can be done by performing specific foot stretches that can help to strengthen the foot. A calf stretch is effective in relieving pain from the plantar fascia, and this is done by standing on a step, and lowering the heel until a gentle stretch is felt. Patients may find that performing a marble pick up is helpful in strengthening the arch. This is a simple stretch, and may take some practice to perfect it. This is done by placing several marbles on the floor next to a towel, and picking one marble up at a time with your foot. If you would like more information about how to relieve pain from a plantar fibroma, please consult with a podiatrist.
A plantar fibroma may disrupt your daily activities. If you have any concerns, contact Dr. Ronald Sheppard of Warren-Watchung Podiatry Center. Our doctor can provide the care you need to keep you pain-free and on your feet.
Plantar Fibroma
A plantar fibroma is a fibrous knot in the arch of the foot. It is embedded in the plantar fascia which is a band of tissue that extends from the heel to the toes along the bottom of the foot. There can be multiple plantar fibromas in the feet at the same time. There are no known causes for this condition. If you have a plantar fibroma, there will be a bump in the arch of your foot that cannot be missed. Any associated pain is most often due to a shoe rubbing against the nodule. Non-surgical options, such as steroid injections, physical therapy, and orthotics should be tried first. Surgery is a last resort and is the only thing that will remove a plantar fibroma entirely. Consult with a podiatrist for a proper diagnosis and to determine the treatment regimen that is right for you.
What Causes a Plantar Fibroma?
While there are no specific causes identified, a plantar fibroma can possibly come from genetic predisposition or the formation of scar tissue that forms from healing the tears in the plantar fascia.
What Are the Symptoms of a Plantar Fibroma?
There will be a noticeable lump in the arch of the foot that may or may not cause pain. If pain is felt, it is typically because a shoe is rubbing up against the lump or when walking or standing barefoot.
Treatment and Prevention
A plantar fibroma will not disappear without treatment, but it can get smaller and be a non-issue. If pain persists, a podiatrist examines the foot and when the arch of the foot is pressed, pain can be felt down to the toes. An MRI or biopsy might be performed to help diagnose or evaluate the plantar fibroma. The following non-surgical options are generally enough to reduce the size and pain of these nodules:
- Steroid injections
- Orthotics
- Physical therapy to help apply anti-inflammatory creams on the bump
Surgery is considered if the mass increases in size and the patient continues to feel pain after non-surgical methods are tried.
If you have any questions please feel free to contact one of our offices located in Marlboro and Watchung, NJ . We offer the newest diagnostic tools and technology to treat your foot and ankle needs.
Why Live with Pain and Numbness in Your Feet?
Suffering from this type of pain? You may have the foot condition known as Morton's neuroma. Morton's neuroma may develop as a result of ill-fitting footwear and existing foot deformities. We can help.
Foot and Ankle Surgery
When conservative, noninvasive methods prove ineffective, surgery may be selected as the next course of action for the treatment of your foot or ankle condition. A wide number of foot and ankle surgical procedures exist, and it is up to your podiatrist to determine which intervention will be most appropriate and helpful for your case. Some surgical procedures include bunion surgery, fusion, hammertoe surgery, heel spur surgery, metatarsal surgery, nail surgery, neuroma surgery, reconstructive surgery, skin surgery, and tendon surgery. Typically, surgery is turned to as a definitive way to alleviate excessive pain or discomfort and to return your foot to full mobility.
Regardless of the location on the body, all surgical procedures require preoperative testing and examination to ensure the surgery’s success and preferred outcome. A review of your medical history and medical conditions will take place, as will an evaluation of any current diseases, illnesses, allergies, and medications. Tests such as blood studies, urinalyses, EKG, X-rays, and blood flow studies may be ordered. Because the procedure involves the foot and/or ankle, the structures of your feet while walking may also be observed by your podiatrist.
Care post-surgery will depend on the type of surgical procedure performed. Typically, all postoperative care involves rest, ice, compression, and elevation. To improve and ensure a safe recovery, your foot and ankle surgeon may also employ the use of bandages, splints, surgical shoes, casts, crutches, or canes. He will also determine if and when you can bear weight. A timely and thorough recovery is a priority for both you and your podiatrist, and carefully following postoperative instructions can help achieve this.
When to Have Foot Surgery
Making the decision about whether to undergo foot surgery is a difficult and highly personalized process. In consultation with a podiatrist and surgeon, you can receive the information you need to make an informed decision. Generally speaking, if you notice that a foot affliction you have is causing your skin to react negatively or your foot to become deformed, foot surgery might be a good option for you. Additionally, if you notice that your affliction is not responding to any medication your podiatrist has prescribed or any orthotics you might be wearing, then foot surgery might be a suitable last resort. There are a variety of conditions that may ultimately merit surgery. For example, particularly bad cases of Morton’s neuroma might require foot surgery. Specifically, the nerve that is affected between the toes because of Morton’s neuroma, may be successfully removed by foot surgery. Of course, foot surgery can also create detrimental consequences in some cases. There may be complications as a result of the surgery or your joint movement may be restricted. Alternatives to surgery might include performing specific exercises or adjusting footwear. You can make this difficult decision about undergoing surgery with the guidance and advice of your podiatrist.
Foot surgery is sometimes necessary to treat a foot ailment. To learn more, contact Dr. Ronald Sheppard of Warren-Watchung Podiatry Center. Our doctor will assist you with all of your foot and ankle needs.
When Is Surgery Necessary?
Foot and ankle surgery is generally reserved for cases in which less invasive, conservative procedures have failed to alleviate the problem. Some of the cases in which surgery may be necessary include:
- Removing foot deformities like bunions and bone spurs
- Severe arthritis that has caused bone issues
- Cosmetic reconstruction
What Types of Surgery Are There?
The type of surgery you receive will depend on the nature of the problem you have. Some of the possible surgeries include:
- Bunionectomy for painful bunions
- Surgical fusion for realignment of bones
- Neuropathy decompression surgery to treat nerve damage
Benefits of Surgery
Although surgery is usually a last resort, it can provide more complete pain relief compared to non-surgical methods and may allow you to finally resume full activity.
Surgical techniques have also become increasingly sophisticated. Techniques like endoscopic surgery allow for smaller incisions and faster recovery times.
If you have any questions please feel free to contact one of our offices located in Marlboro and Watchung, NJ . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Swelling of the Feet
There are many reasons why patients experience swelling of the feet. It is rather common and may be a side effect of pregnancy or from sitting and standing for most of the day. Gravity could also play a role in the development of swollen feet. It is known that the weight of blood volume in our bodies is exerted on the veins in the legs and feet. The veins may not work as efficiently during the aging process, and this could make the blood flow backward causing swollen feet. Relief may be found when obese patients lose weight, and it may help to engage in compression therapy by wearing compression socks, stockings, or athletic sleeves. This method can release pressure on the feet and ankles which may help to reduce existing swelling. There are patients who have controlled their swollen feet by implementing healthy lifestyle changes. These can consist of reducing salt intake, incorporating a gentle exercise regime into the daily routine, and drinking plenty of fresh water. Swollen feet may be a temporary condition that affects people who travel via airplane or automobile, so it is beneficial to walk as frequently as possible even though it can be difficult. Swelling of the feet can also be indicative of other health issues so it is important to pay attention to any type of chest pain, mental confusion, dizziness, or fever. If you consistently have swollen feet, it is strongly suggested that you consult with a podiatrist who can help determine the cause and how to effectively treat it.
The Relationship Between Running and Swollen Feet
Swollen feet is undoubtedly an uncomfortable and unpleasant condition that can affect many people. While pregnant women and those who suffer from diabetes are famously prone to suffering from swollen feet, runners may experience this condition. Runners’ feet may swell both during and after runs for a number of reasons. First, tight and restrictive running shoes can contribute to swelling. Since ill-fitting shoes often squeeze the toes and heels, muscles in the feet become overwhelmed in trying to maintain balance while running, resulting in swelling. Be sure to select the right pair of comfortable running shoes that match your foot type to avoid this pitfall. Additionally, runners’ feet may swell up if they are simply running with poor technique. For example, if a runner lands on their heels instead of the balls of their feet during their runs, they can essentially place more pressure on the bottoms of their feet, which can lead to foot swelling. If you find yourself suffering from swollen feet after runs, you might try applying ice to your feet to reduce the swelling or even elevating your feet. A podiatrist may be able to help you manage this condition and help you mitigate its effects.
Swollen feet can be a sign of an underlying condition. If you have any concerns, contact Dr. Ronald Sheppard of Warren-Watchung Podiatry Center. Our doctor can provide the care you need to keep you pain-free and on your feet.
Swollen feet are a common ailment among pregnant women and people who stand or sit for extended periods. Aging may increase the possibility of swollen feet and patients who are obese often notice when their feet are swelling too. There may be medical reasons why swollen feet occur:
- Phlebitis - A condition that causes the veins to become inflamed and can also cause leg pain.
- Liver disease - This may lead to low blood levels of albumin which is a protein. This can cause fluid in the blood to pass into the tissues and several areas of the body can become swollen.
- Heart failure - When the heart doesn’t pump properly the blood that is normally pumped back to the heart can pool in the veins of the legs causing swollen feet.
- Kidney disease - One of the main functions of the kidneys is releasing excess fluid in the body. This type of condition can make it difficult for the kidneys to function properly, and as a result the feet may become swollen.
- Deep-vein thrombosis (DVT)- This is a serious condition where blood clots form in the veins of the legs. They can block the return of blood from the legs to the heart which may cause the feet to swell. It is important to be treated by a podiatrist if this condition is present.
Swollen feet can also be caused by bone and tendon conditions, including fractures, arthritis, and tendinitis. Additionally, there may be skin and toenail conditions and an infection may cause the feet to swell. Patients who take medicine to treat high blood pressure may be prone to getting swollen feet.
Many patients elevate their feet to help relieve the swelling and this is generally a temporary remedy. When a podiatrist is consulted the reason behind the swelling can be uncovered and subsequently treated.
If you have any questions please feel free to contact one of our offices located in Marlboro and Watchung, NJ . We offer the newest diagnostic tools and technology to treat your foot and ankle needs.
Biomechanics in Podiatry
Podiatry is a branch of medicine that deals with the study, diagnosis, and treatment of foot and ankle conditions. There are various subdivisions in podiatry; biomechanics is one of them. Biomechanics is the way in which the bones, muscles, and joints of the feet and lower limb interact with each other.
Our feet play crucial roles in the way we move, and it is rare to have feet that are completely symmetrical. Common biomechanical issues include high or low arches or uneven leg heights. Excessive pronation often leads to fallen arches, or flat feet, and is a common cause of running injuries. People whose feet are over-pronated tend to have flexible and unstable feet. Pain is usually experienced during walking and running.
At times, people may be able to adapt to these abnormalities without any difficulties, but in other cases, these issues can cause a great deal of pain. This pain occurs because the joints, muscles, ligaments, and tendons are put under an excess amount of stress during movement. Common symptoms of biomechanical problems stemming from the feet include hip pain, knee pain, leg cramps, ankle pain, lower back pain, weak ankles, tripping, heel pain, Achilles pain, and shin splints.
Many biomechanical issues can be treated with orthotics. Orthotics are shoe insoles that are used to help control the way the foot operates. They can provide relief from foot pain, heel pain, and knee pain. Depending on your specific case, you may need to purchase over-the-counter orthotics or custom orthotics to fit your feet. Your podiatrist will be able to prescribe the perfect orthotic for your feet to help you walk around with ease.
Gait is defined as the way we move our bodies from one point to another. This is usually done by either walking or running. Gait analysis is a method used to assess the way we walk or run to highlight biomechanical abnormalities. Gait analyses are a great way to take a detailed look at how you walk and how your foot moves while you walk. An examination of the feet will help your podiatrist understand why you are suffering pain in other parts of your body.
