Ingrown nails result from a change in the relationship between the nail plate and the nail groove. Sharp spikes (spicules) of the nail develop and are gradually driven into the dermis of the nail groove. The nail acts as a foreign body and gradually gets forced deeper and deeper into the dermis. An inflammatory response occurs in the area of penetration, leading to redness (erythema), swelling (edema), purulence, and development of granulation tissue. In addition in increasing pain, development and spread of infection is the major risk.

In most cases ingrown nails are typically caused by improperly fit footwear, incorrect nail cutting or, trauma to the nail. If managed early on it can be relatively straight forward however, once infection develops the management becomes more complex.

A fungal nail (Onychomycosis) refers to a fungal infection that affects the toenails. Typically nails become thick, deformed, change colour and emit a foul odour. This is not life threatening, but it can cause pain, discomfort, and disfigurement and may produce serious physical and professional limitations. Psychosocial and emotional effects resulting from this infection are prevalent and may have a significant impact on quality of life. Nail fungus can spread to surrounding toes and even to other individuals. It is important to have the condition diagnosed and treated as soon as possible to prevent further damage to the nail and to prevent spread.

Often times, people have difficulty caring for their toes nails. This can be for a variety of reasons such as, older age, difficulty reaching, impaired vision, lack of strength and, difficult or hard to cut toe nails to name a few. Although people sometimes neglect their toe nails it is important to understand that if not properly maintained they can eventually cause serious medical problems. Many people visit nail salons or pedicurists for routine nail care but this can sometimes be dangerous. It is important to ensure that all instruments used on your nails have been properly sterilized as often times fungal infections can be transferred due to improper sterilization techniques. We suggest you see a qualified foot specialist, such as Omni Foot Clinic, to ensure you are protected and cared for by trained medical professionals.

Corns, like callouses, are basically the formation and accumulation of dead, thick and hard skin. The major difference is that a corn results from a more focused and specific area of pressure. This causes the corn to have a cone shaped core that penetrates deep into the skin. As a result a corn is often much more painful than a callous. With respect to the foot corns can be found all over the foot including; the soles, sides, toes, and even in between the toes. Due to the fact the corns penetrate deep into the skin they can be very dangerous and result in ulceration, bursas, and many other serious complications.

Cause
All corns are formed from high pressure or friction. Possible causes of this pressure or friction many include; improper footwear (too tight or high-heels), a biomechanical problem, foot deformity, diminished fat pad, or many other factors.

Treatment and Prevention
The first step in treating corns is to determine the cause or else the corn will simply return. We recommend starting with a biomechanical assessment to determine any abnormalities in normal foot function. These biomechanical problems can often be addressed by adding support or a custom made foot orthotic. Additionally a footwear assessment to determine if the style, size, and fit are adequate and not detrimental should be performed.

Once the cause has been determined we can treat the corn with the likely hood of it not returning. Treatment includes mechanical debridement and enucleation (removal of the core). Often application of a topical agent will help to soften the area. Please do not attempt to remove the corn on your own as they can be quite deep and bleeding may often occur.

Please contact our office to book an appointment for an assessment and a customized management plan for this condition.

Definition
Callous, or hyperkeratosis, is basically the formation and accumulation of dead, thick and hard skin. The body naturally forms a callous as a way to protect an area of high pressure or friction on the skin. With respect to the foot callouses are often found on the balls of the foot and on the heel. A callous is often a good indication of excessive pressure and it is essentially your body telling you that the pressure needs to be redistributed.

Cause
All callouses are formed from high pressure or friction. Possible causes of this pressure or friction many include; improper footwear (too tight or high-heels), a biomechanical problem, foot deformity, diminished fat pad, or many other factors.

Treatment and Prevention
The first step in treating callouses is to determine the cause or else the callous will simply return. We recommend starting with a biomechanical assessment to determine any abnormalities in normal foot function. These biomechanical problems can often be addressed by adding support or a custom made foot orthotic. Additionally a footwear assessment to determine if the style, size, and fit are adequate and not detrimental should be performed.

Once the cause has been determined we can treat the callous with the likely hood of it not returning. Treatment includes mechanical debridement and smoothing with a vacuum drill. Often application of an emollient product will help to prevent the callous from reforming. Once we have removed the callous, routine maintenance with an emery board or pumice stone is something that can be done by the patient at home, with caution.

Please contact our office to book an appointment for an assessment and a customized management plan for this condition.

Plantar warts (verruca pedis) are a common infection of the skin. It is caused by the HPV virus. Plantar warts grow on the bottom (plantar) aspect of the foot. They tend to be found in areas of pressure such as the heel and ball of the foot. Plantar warts often grow into the deeper layers of skin. Warts can be localized or can spread to various satellite locations. Warts have an incubation period from anywhere from 1-20 months, thus it is difficult to tell exactly when the virus was introduced into the body.

Plantar warts may cause pain, particularly when walking. There are a myriad of treatment options including laser, cryotherapy and, topical solutions. Some treatments are painful while others are virtually painless. At Omni Foot Clinic we offer a wide variety of treatment options.

Definition
Athlete’s foot, known as Tinea Pedis, is a fungal infection that causes red, dry, flaking skin, often accompanied by pain, burning or, itching. This condition affects the skin on the soles of the feet and between the toes. The fungus can spread to other aspects of the foot such as nails, or even to other individuals. If an individual touches the fungal spores they can then transfer the fungus to other parts of their body that they touch.

Cause
Athlete’s Foot is usually contracted in communal showers, gyms, dressing rooms, swimming pools, etc. People with moist sweaty feet or people that do not change their socks frequently can also contract this condition as fungi thrive in moist and dark environments.

Treatment and Prevention
There are many topical medications that are quite effective at eliminating fungus. In addition maintaining good hygiene and removal of dead skin is a key to healing.

Tips to avoid Athletes Foot

• Wash and dry feet daily (esp. between the toes)
• Wear dry, airy shoes and socks.
• Change socks and shoes after sports or other sweaty activities
• Do not borrow footwear or socks from others
• Wear sandals or flip-flops in public showers
• Clean all shoes with a fungicidal agent
• Bleach shower to avoid spreading to other family members

Once an infection has occurred, it is important to seek help in managing this condition quickly.

Please contact our office to book an appointment for an assessment and a customized management plan for this condition.

Definition
Toenail fungus (Onychomycosis) is a common condition that affects many individuals. Fungal infections occur when microscopic fungi gain entry through a small portal in the nail. The environment is warm, moist, and dark; this is perfect for the proliferation of the fungal spores. Usually the nails become yellow/brown, thick, brittle and, very smelly. This infection is contagious and can spread to other toes and even to other people.

Cause
Nail fungus is usually contracted in communal showers, gyms, dressing rooms, swimming pools, etc. People with moist sweaty feet or people that do not change their socks frequently can also contract this condition as fungi thrive in moist and dark environments. Athletes and people who wear tight-fitting shoes or tight hosiery that cause trauma to the toes or keep the feet from drying out are at higher risk.

Treatment and Prevention
Treatment generally involved reduction of the thickened nail with a vacuum nail drill. Topical agents will only work once the nail is reduced and all of the dead/thick aspects have been removed. Occasionally nail surgery is required, and we can perform this procedure in our office. This condition is easier and more effectively managed in the early stages, so if you suspect that you may have this condition it is important to have it addressed ASAP.

Please contact our office to book an appointment for an assessment and a customized management plan for this condition.

Hyperhidrosis is basically excessive sweating and usually begins in either childhood or adolescence. Although any site on the body can be affected, the feet are one of the most common sites. This condition may be idiopathic or secondary to other diseases, metabolic disorders, or medication use. Hyperhidrosis exists in 3 forms: emotionally induced (in which it affects the palms and soles), localized, or generalized. The condition often causes great emotional distress for the patient, regardless of the form. At Omni Foot Clinic we have various methods in which to help patients control this condition.

Neuropathy is the most common complication of diabetes mellitus. Neuropathy causes great morbidity because the symptoms severely decrease patients' quality of life. While the primary symptoms of neuropathy may be highly unpleasant, the secondary complications such as falls, decreased function and, foot ulcers, can lead to fractures, amputations, and even death in patients with DM. There are 3 major types of neuropathy; sensory, motor and, autonomic. It is important to be aware of and understand how these will affect the body. We are constantly giving talks and advice about diabetes and diabetic neuropathy so please do not hesitate to contact us with any questions.

This is an assessment that helps to determine the extent of neuropathy that is present. These are non-invasive tests that should be carried out at least every 6 months. The trends observed over time can help design and modify management plans. If your foot care provider is not performing this test regularly then they are not adequately doing their job.

This is an assessment that evaluates the arterial and venous blood flow in the lower limb. Among other things, these non-invasive tests help to determine a patients potential for healing or risk of amputation. Although this should be performed regularly on patients with diabetes it is often performed on patients with various other conditions that affect circulation. If your foot care provider is not performing this test regularly then they are not adequately doing their job.

Ulcerations are very serious lesions, especially for individuals with conditions that decrease or inhibit their ability to heal. Typically neuropathic foot ulcers (DNFU) affect diabetic patients and if not managed properly can lead to infection and amputation. We can aid in the management of; DNFUs, Venous Ulcerations, Ischemic Ulcerations, Osteomyelitis, Cellulitis and, Gangrene. These are all extremely dangerous and if you believe that you are suffering from any of these conditions you should seek medical attention immediately. At Omni Foot Clinic, we provide wound care by means of surgical debridement and application of topical medications.

Definition
Metatarsalgia is a general term for pain in the area of the metatarsal heads (the balls of the feet). This condition is quite common and the pain can be short term, chronic or recurrent; but generally the pain becomes more intense with time.

Cause
Metatarsalgia is often caused by improper fitting footwear. Most commonly, tight and high heeled shoes can contribute to the cause of this condition. Footwear with a narrow toe box or footwear with other restrictive features often inhibit the normal function of the foot. This alteration in foot function negatively impacts the gait (walking) cycle causing improper function of the metatarsals; leading to metatarsalgia.

Another common cause of metatarsalgia is excessive pressure. This is usually seen in athletes that participate in high impact sports such as basketball, tennis, running, etc. Also, as people get older, the fat pad in their feet tends to thin out thus making them much more susceptible to pain in the metatarsal region.

Treatment
The first step in treating metatarsalgia is to determine the cause of the pain. We recommend starting with a footwear assessment to determine if the style, size, and fit are adequate and not detrimental. We also recommend off-loading this area to allow healing to occur. We have many products and techniques that will significantly reduce the pressure on the metatarsals. We recommend a full biomechanical examination to determine why there is an increase in pressure so we can effectively correct the problem.

Please contact our office to book an appointment for an assessment and a customized management plan for this condition.

Definition
Morton's Neuroma is a common foot problem experienced by many people, particularly women. This condition results in pain caused by pressure put on the nerves, particularly the nerve between the 3rd and 4th toes. Often patients feel a sharp pain, burning, or even numbness in the area.

Cause
Morton's Neuroma occurs as a result of lateral pressure across the foot causing the metatarsal bones to squeeze together. This pressure can be the result of footwear (high-heels or tight forefoot), or a biomechanical foot abnormality. The pain will usually occur during or after you have been placing significant pressure on the forefoot area for example; while walking, standing, jumping, or running.

Treatment and Prevention
The first step in treating a Morton’s Neuroma is to determine the cause. We recommend starting with a biomechanical assessment to determine any abnormalities in normal foot function. These biomechanical problems can often be addressed by adding support or a custom made foot orthotic. Typically a metatarsal pad will be implemented so as to remove the pressure from the painful area. Additionally a footwear assessment to determine if the style, size, and fit are adequate and not detrimental should be performed.

Please contact our office to book an appointment for an assessment and a customized management plan for this condition.

A bunion (hallux valgus) is a structural deformity of the bones and the joint between the foot and great toe. The term “bunion” refers to an enlargement of bone or tissue around the joint at the base of the big toe. Often, the big toe will progressively turn in toward the second toe while the tissues surrounding the joint may be swollen and tender. This deformity can be painful and limit function of the foot. Bunions are caused by a biomechanical abnormality, where certain tendons, ligaments, and supportive structures of the first metatarsal are no longer functioning correctly. This biomechanical abnormality may be caused by a variety of conditions intrinsic to the structure of the foot--such as flat feet, excessive ligamentous flexibility, abnormal bone structure, and certain neurological conditions. These factors are often considered genetic. Although wearing shoes that crowd the toes does not cause bunions to form, it sometimes makes the existing deformity progressively worsen and symptoms may arise sooner.

Definition
Arthritis is a general term given to a specific set of diseases that generally cause inflammation of the cartilage and lining of the joints in the body. Inflammation causes redness, burning, pain, and joint destruction. Arthritis is very common in the foot as there are 33 different joints that may be affected.

Osteoarthritis
This is likely the most common form of arthritis that affects the joints of the foot. Osteoarthritis is an overuse condition whereby there is excessive stress and wear and tear on the joint cartilage. Motion of the joints becomes very difficult and painful and in advanced cases joint motion becomes completely restricted. As the joints become more and more restricted other pain will often follow as the foot compensates by incorrectly distributing pressure and function to other joints.

Gout
Gout is another form of arthritis and can be extremely painful and debilitating. Gout is an excessive buildup of uric acid crystals in the joint space. In most cases gout occurs that the 1st MPJ joint (the base of the big toe). This condition usually affects men and evidence suggests that a high intake of purines, red meat, sea food and wine predispose people to this condition.

Rheumatoid Arthritis (R/A)
This is a form of arthritis that can affect people of all ages. Currently there is no known cause for this condition. R/A causes sever deformity of the joints in the body, particularly in the hands and feet. People often develop forefoot conditions such as bunions, hammer toes, claw toes, etc. This disease greatly impacts foot function and gait (walking) cycle.

Treatment and Prevention
Although in many advanced cases the major treatment option is surgery, there are still viable conservative management options. It is best to address this condition before it reaches the advanced stages.

Treatments include proper footwear orthotics, and/or forefoot supports. Therapies such as laser, ultrasound and hydrotherapy have shown significant success in decreasing pain. We have a wide variety of treatment options available.

Please contact our office to book an appointment for an assessment and a customized management plan for this condition.

Definition
A claw toe, hammer toe, and mallet toe are 3 categories of digital deformities. They are classified separately depending on which specific joints of the toe are contracted. Besides this difference the symptoms are relatively similar. In all 3 cases the ligaments and tendons in the foot tightened and this causes the various joints of the toe to contract. This condition can affect all of the lesser digits (every toe besides the big toe). This causes; parts of the toe to rub against the top of footwear, extra pressure at the balls of the foot, toes to become painful, corn or callous formation, and more.

Cause
Claw toes result from a muscle imbalance which causes the ligaments and tendons of the foot to become tight (flexed). This results in the toes taking a deformed looking position. Usually claw toes occur as a secondary condition, the result of another foot problem, including; diabetes, improper biomechanics, hallux valgus, arthritis, etc.

Treatment and Prevention
Generally speaking the treatment of toe deformities focuses on accommodation. Footwear can be altered and modified so as to create more room and padding for the toes. This will help to reduce corn or callous formation. In advanced cases special foot wear that stretches around the toes are helpful in accommodating the condition.

In sever cases sometimes the only option is to have surgery to physically straighten the toes.

Please contact our office to book an appointment for an assessment and a customized management plan for this condition.