With summer right around the corner comes the season of sandals, beaches, and therefore exposed toes.  Toenail fungus often discourages many from wanting to expose their toes by causing a series of changes to the nails.  Toenail fungus is a very common condition referred to as onychomycosis.  Onychomycosis may start out as just a small area of yellow or white discoloration of the nail.  As the fungus spreads the discoloration may spread and worsen and the nail may thicken.  There may also seem to be an accumulation of material under the nail and possibly an odor.  The condition may eventually become painful as well.

There are a variety of risk factors for developing onychomycosis.  First of all, fungi best survive in dark and damp areas.  With that said, public places such as pools and showers are very common places for fungi to grow and be transmitted.  As well personal footwear can influence the development of onychomycosis.  Wearing shoes and socks and perspiring or having wet feet can also encourage development.  Trauma also leaves the nail susceptible to invasion by fungi.  Onychomycosis is often also seen in aging populations often due to decreased blood supply.

To diagnose onychomycosis your physician will first evaluate the toes clinically.  A sample may be taken to undergo laboratory testing such as a potassium hydroxide smear or a periodic acid-schiff stain.  Once the diagnosis is confirmed treatment will begin.  It often takes months to make sure the fungus is completely eradicated.   Atlantic Foot and Ankle Associates offer several options for the treatment of onychomycosis.  Medications for toenail fungus can be topical or oral.  One of the most common methods of treatment is the oral medication terbinafine (Lamisil).  This medication has to be taken for approximately 90 days.  We also offer a topical treatment called Formula 3, which is available at all four of our offices located in Palm Coast, Daytona Beach, Port Orange, and Orange City, Florida.   There is also a new, FDA approved treatment for onychomycosis called laser therapy.  Please visit the Florida Laser Center website to learn more about laser therapy, which is now available in our Daytona Beach location.

Onychomycosis can be prevented by taking actions such as keeping feet dry or allowing ventilation when wet as well avoiding being barefoot in areas where fungi are likely to grow.  If you are one of the 30 million Americans suffering with toenail fungus, please do not hesitate to get treatment so you can get back to the beach and show off your beautiful toes!

By Dr. Sona Ramdath Jr.

Recently several athletes such as Penn State’s Devon Still, Baltimore Ravens’ Ray Lewis and Lardarius Webb, and New Orleans Saints’ Mark Ingram have been suffering from a common injury known as turf toe.  Although turf toe often affects football players, it can happen to anyone.  Turf toe refers to an injury to the ligaments and joint capsule of the first (big) toe.  Often for athletes, this injury occurs when wearing flexible shoes on a hard surface like turf.  The specific injury to the first toe typically involves hyperextension (hyperdorsiflexion) beyond its range of motion.  To explain, when walking the heel lifts up and places pressure on the ball of the foot.  Typically, the toes will then aid in propulsion; however, if the first toe fails to aid in propulsion and remains planted to the ground, then there is a risk of turf toe.   The injury can also occur with jamming or stubbing of the toe.  The symptoms of turf toe are pain which may last for a couple of weeks, swelling, bruising, decreased range of motion of the first toe joint, and sometimes even a pop can be felt or heard upon injury. 

There are three grades of turf toe.  Grade 1 is characterized by stretching of the joint capsule.  Grade 2 has an incomplete tear of these soft tissue structures, and grade 3 turf toe has a complete tear.  Pain, tenderness, swelling, and bruising typically increase with higher grades.  At Atlantic Foot and Ankle Associates, turf toe is treated depending on the grade of the injury, starting with RICE (rest, ice, compression, and elevation).  Often anti-inflammatory medications will be taken as well.  It is extremely important to avoid bearing weight on the toe for approximately 2-4 days and resting an additional 3-4 weeks.  If the injury is more severe and a higher grade, crutches or a cast and toe spica may be needed.  Extremely severe injuries may even require surgery.

If you’ve suffered an injury such as turf toe, do not hesitate to come into one of our four offices located in Orange City, Daytona Beach, Palm Coast and Port Orange.  Remember, this type of injury does not only affect athletes, it can happen to anyone. 

By Dr. Sona Ramdath Jr.

Recently singer Chely Wright has been recovering from surgery on various foot problems including what podiatrists call Morton’s neuroma.  Morton’s neuroma refers to a swelling or thickening along the nerve between the third and fourth toes.  Morton’s neuroma can be a very painful condition but may also be associated with feelings of tingling and numbness.  Often this pain is localized to the area around the ball of the foot.  At first the pain may be periodic or only with activities that irritate the foot and place pressure on the ball of the foot such as running and jumping.  The pain may also occur when wearing shoes that constrict the toes.  The pain may increase in frequency and magnitude with time.

An exact cause of Morton’s neuroma has not been identified; however, certain risk factors have been.  One of the risk factors for Morton’s neuroma is wearing shoes that are very narrow in the toe box as well as high heels that tend to place pressure on the toes.  People with certain foot conditions are also shown to have a higher chance of having Morton’s neuroma including those with bunions, flat feet, and hammerdigits.   Foot injuries can also lead to an increased chance of Morton’s neuroma.

A Morton’s neuroma can be treated in a variety of ways, often depending on the extent of pain.  For less severe cases of Morton’s neuroma treatment can include a change in shoe wear with a wider toe box or lower heel and possibly padding or orthotics to reduce the pressure placed on the nerve.   Anti-inflammatory drugs may also help reduce pain.  In more severe cases, corticosteroid or alcohol shots may be added to alleviate the pain.  If these attempts are not successful, surgery is an option. 

If you are suffering from pain associated with Morton’s neuroma, schedule an appointment with Atlantic Foot and Ankle Associates to find out which treatment option works best for you.  Atlantic Foot and Ankle has four convenient office locations in Palm Coast, Daytona Beach, Port Orange, and Orange City, Florida.  Ditch those Kim Kardashian heels and let us help you find comfort for your feet!

By, Dr. Sona Ramdath