Other Conditions of the Foot and Ankle

Ingrown toenail
If you trim your toenails too short, particularly on the sides of your big toes, you may set the stage for an ingrown toenail. Like many people, when you trim your toenails, you may taper the corners so that the nail curves with the shape of your toe. But this technique may encourage your toenail to grow into the skin of your toe. The sides of the nail curl down and dig into your skin. An ingrown toenail may also happen if you wear shoes that are too tight or too short.

When you first have an ingrown toenail, it may be hard, swollen and tender. Later, it may get red and infected, and feel very sore. Ingrown toenails are a common, painful condition--particularly among teenagers. Any of your toenails can become ingrown, but the problem more often affects the big toe. An ingrown nail occurs when the 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. Redness, pain and swelling at the corner of the nail may result and infection may soon follow. Sometimes a small amount of pus can be seen draining from the area.

Ingrown nails may develop for many reasons. Some cases are congenital--the nail is just too large for the toe. Trauma, such as stubbing the toe or having the toe stepped on, may also cause an ingrown nail. However, the most common cause is tight shoe wear or improper grooming and trimming of the nail.

Ingrown toenails should be treated as soon as they are recognized. If they are recognized early (before infection sets in), home care may prevent the need for further treatment. Begin with soak for the foot in warm water 3-4 times daily, keeping the foot dry during the rest of the day. Wear comfortable shoes with adequate room for the toes. Consider wearing sandals until the condition clears up. If there is no improvement in 2-3 days, or if the condition worsens, or if excessive inflammation, swelling, pain and discharge are present, the toenail may be infected and should medical treatment is necessary. You may need to take oral antibiotics and the nail may need to be partially or completely removed Definitive surgery is effective in eliminating the nail edge from growing inward and cutting into the fleshy folds as the toenail grows forward. Permanent removal of the nail may be advised for children with chronic, recurrent infected ingrown toenails. It may take 3-4 months for your nail to regrow.

Unless the problem is congenital, the best way to prevent ingrown toenails is to protect the feet from trauma and to wear shoes and hosiery (socks) with adequate room for the toes. Nails should be cut straight across with a clean, sharp nail trimmer without tapering or rounding the corners. Trim the nails no shorter than the edge of the toe. Keep the feet clean and dry at all times.

Modified from the AAOS
 

Corns and calluses
Every day, the average person spends several hours on their feet and takes several thousand steps. Walking puts pressure on your feet that's equivalent to 2-3 times your body weight. No wonder your feet hurt! Actually, most foot problems can be blamed not on walking but on your walking shoes. Corns, for example, are calluses that form on the toes because the bones push up against the shoe and put pressure on the skin. The surface layer of the skin thickens and builds up, irritating the tissues underneath. Hard corns are usually located on the top of the toe or on the side of the small toe. Soft corns resemble open sores and develop between the toes as they rub against each other. Thus, the cause of corns are shoes that don't fit properly, toe deformities, such as hammer toe or claw toe, and other abnormalities of the foot and ankle regions.

Corns can usually be easily seen. They may have a tender spot in the middle, surrounded by yellowish dead skin. Treating foot problems like corns is a team effort. The corn may be shaved by removing the dead layers of skin off with a scalpel, restoring the normal contour of the skin and relieving pain. This should be done by a professional. If an underlying problem, such as a toe deformity, is present, this may require surgical correction to prevent recurrence. In addition, between visits you can soak your feet regularly and use a pumice stone or callus file to soften and reduce the size of corns and calluses. Wearing a donut-shaped foam pad over the corn will also help relieve the pressure. Use non-medicated corn pads; medicated pads may increase irritation and result in infection. Lamb's wool (not cotton) between your toes may help to cushion soft corns.

Modified from the AAOS
 

Orthotics
A foot pad or heel insert purchased at your local pharmacy or sporting goods store is an orthotic device. So is a custom-molded, individually designed shoe insert or ankle brace. Orthotic devices like these are frequently used to treat various conditions of the foot and ankle. They are often very effective in relieving common complaints. Orthotic devices may be recommended for several reasons, including aligning and supporting the foot or ankle, preventing, correcting or accommodating foot deformities, and improving the overall function of the foot or ankle.

Modified from the AAOS