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Monday, 25 June 2018 00:00

Symptoms of Toenail Fungus

The big toe is generally the first toe to be affected by toenail fungus. It’s considered to be a common foot ailment, and will typically affect half the population by the time people reach 70 years old. There are several symptoms that are indicative of this condition, including the nail appearing unusually thick and possibly yellow or white. This ailment may cause the nail to separate from the nail bed which is referred to as onycholysis. If the infection is mild, it may help to treat the area by thoroughly washing and filing the affected nail followed by utilizing a mentholated rubbing cream. For more severe infections, it’s suggested to consult with a podiatrist who can advise on how to properly treat toenail fungus. This advice may typically include information about oral or topical antifungal medications.

For more information about treatment, contact one of our podiatrists of InStride Foot & Ankle Specialists. Our doctors can provide the care you need to keep you pain-free and on your feet.

Toenail Fungus Treatment

Toenail fungus is a condition that affects many people and can be especially hard to get rid of. Fortunately, there are several methods to go about treating and avoiding it.

Antifungals & Deterrence

Oral antifungal medicine has been shown to be effective in many cases. It is important to consult with a podiatrist to determine the proper regiment for you, or potentially explore other options.

Applying foot powder on the feet and shoes helps keep the feet free of moisture and sweat.

Sandals or open toed shoes – Wearing these will allow air movement and help keep feet dry. They also expose your feet to light, which fungus cannot tolerate. Socks with moisture wicking material also help as well.

If you have any questions please feel free to contact one of our offices located in Mt Airy, Clemmons, Winston-Salem, and King, NC. We offer the newest diagnostic tools and technology to treat your foot and ankle needs.

Read more about Toenail Fungus

David Collard DPM MHA

Pitting Edema and Venous Ulcers

In my last post we talked mostly about varicose veins and the dangers that they can bring to your lower legs. Today I want to go more into Pitting Edema and Venous Leg Ulcers.

Pitting edema, like varicose veins described in the previous post, is often overlooked and its risks poorly appreciated. Several different things can cause pitting edema when it is in BOTH LEGS.

Firstly, edema is an accumulation of fluid in the soft tissues of the legs. There are several causes such as: heart disease, pulmonary hypertension, chronic kidney or liver disease, circulation problems, medications, or even bad diet.

Attempts to control edema are often focused on the root cause of why you have the problem; controlling with compression wraps or stockings, compression pumps in the case of lymphedema (when the lymph drainage system backs up), and even medication may help as an additional defense. Many of the patients I see with with edema have a great Primary Care Provider (PCP) who is modifying or prescribing new medication to help get the swelling out, but sometimes the swelling just needs a little more help getting out of the legs via stockings or wraps.

The dangers of uncontrolled swelling can be bad. We see several patients each week with open sores (ulcers) on their legs due to edema that got out of control. I mentioned in my previous post the analogy of the water balloon. If you played with water balloons as a kid, you probably tried to get the biggest one possible; you keep filling and filling until...POP! Now, legs usually don’t explode, but what does happen is that the skin blisters and cracks open so that the swelling can get out!

Prevention is the best treatment, but if you have found yourself in this situation, there is hope. We can usually get things under control, and with some work from us, your PCP and you, we can get things healed up. Healing involves using advanced wound care technology and techniques and--you guessed it--controlling the swelling.

The other problem that can also lead to various complications is Venous Leg Ulcers. Venous ulcers are when the varicose veins we talked about in the last post get really, really bad. The blood gets backed up, the veins get large, and the skin breaks down and you end up with a large wound on your lower leg.

As I discussed in the previous post, compression can work wonders to prevent these conditions from getting worse, and yes, there are some interventions that our friends in vascular surgery can do to help people as well.

Swelling causes pressure. Pressure is bad if you are trying to heal something long term. You break your arm or foot, you get a cast to help keep the pressure off and keep it from moving. You have a wound on the bottom of your foot? We have to take the pressure off. Pressure from swelling is no different, it's just pressure from INSIDE! I am constantly amazed when a patient comes into the office telling me that they have had a wound on their leg for weeks or even months, but after getting the swelling out, the problem quickly improves.

It’s also worth noting that while compression garments can (in most cases) prevent wounds and other circulation problems, they will also help your legs feel so much better in general. Your legs will feel lighter, your skin will look better, and your legs and feet won’t be as achy after being on them all day long. We carry a variety of compression garments in stock at our Mount Airy location, and our staff is prepared to measure and fit you for the socks that suit your needs. Feel free to pay us a visit and see what’s available.

If you have any signs of pitting edema, varicose veins, or an open wound on your lower legs, we are here for you. Don’t hesitate to schedule an appointment to consult with us!

Monday, 18 June 2018 00:00

What is a Heel Spur?

The definition of a heel spur is a bony protrusion that comes from the heel of the foot and grows into the arch. This condition is often the result of tears in the plantar fasciitis which is a thick band of tissue that runs along the sole of the foot. General symptoms may include pain and discomfort under the heel which may be worse in the morning and experiencing a tender feeling when the heel is touched. There may be several causes for heel spurs to develop, including excess weight the heel endures from being obese, certain sporting activities that puts pressure on the heels, and wearing shoes that do not fit correctly. Research has shown that reducing the activities that may cause this condition may aid in the treatment of heel spurs. Please consult with a podiatrist for treatment options which may include being fitted for custom made orthotics and night splints.

Heel spurs can be incredibly painful and sometimes may make you unable to participate in physical activities. To get medical care for your heel spurs, contact one of our podiatrists from InStride Foot & Ankle Specialists. Our doctors will do everything possible to treat your condition.

Heels Spurs

Heel spurs are formed by calcium deposits on the back of the foot where the heel is. This can also be caused by small fragments of bone breaking off one section of the foot, attaching onto the back of the foot. Heel spurs can also be bone growth on the back of the foot and may grow in the direction of the arch of the foot.

Older individuals usually suffer from heel spurs and pain sometimes intensifies with age. One of the main condition's spurs are related to is plantar fasciitis.


The pain associated with spurs is often because of weight placed on the feet. When someone is walking, their entire weight is concentrated on the feet. Bone spurs then have the tendency to affect other bones and tissues around the foot. As the pain continues, the feet will become tender and sensitive over time.


There are many ways to treat heel spurs. If one is suffering from heel spurs in conjunction with pain, there are several methods for healing. Medication, surgery, and herbal care are some options.

If you have any questions feel free to contact one of our offices located in Mt Airy, Clemmons, Winston-Salem, and King, NC. We offer the latest in diagnostic and treatment technology to meet your needs.

Read more about Heel Spurs
Monday, 11 June 2018 00:00

How Does a Bunion Form?

A bunion is considered to be a foot deformity that occurs on the side of the big toe. It will often begin slowly as the big toe gradually leans toward the toe next to it. A change in the structure of the foot may be a result of this, and this misalignment causes a bony protrusion to form on the side of the toe. A common cause of this condition may be because of a genetic trait that produces specific foot types, and research has shown this may be a contributing factor in the development of bunions. Choosing to wear poorly fitting shoes could make an already existing case of bunions even worse. There are several symptoms associated with the formation of bunions, which are often felt as a burning or numbing sensation. Additionally, the toe may become sore, red and tender. If you have developed a bunion, it’s suggested to consult with a podiatrist to learn about correct treatment options.

If you are suffering from bunions, contact one of our podiatrists of InStride Foot & Ankle Specialists. Our doctors can provide the care you need to keep you pain-free and on your feet.

What Is a Bunion?

A bunion is formed of swollen tissue or an enlargement of boney growth, usually located at the base joint of the toe that connects to the foot. The swelling occurs due to the bones in the big toe shifting inward, which impacts the other toes of the foot. This causes the area around the base of the big toe to become inflamed and painful.

Why Do Bunions Form?

Genetics – Susceptibility to bunions are often hereditary

Stress on the feet – Poorly fitted and uncomfortable footwear that places stress on feet, such as heels, can worsen existing bunions

How Are Bunions Diagnosed?

Doctors often perform two tests – blood tests and x-rays – when trying to diagnose bunions, especially in the early stages of development. Blood tests help determine if the foot pain is being caused by something else, such as arthritis, while x-rays provide a clear picture of your bone structure to your doctor.

How Are Bunions Treated?

  • Refrain from wearing heels or similar shoes that cause discomfort
  • Select wider shoes that can provide more comfort and reduce pain
  • Anti-inflammatory and pain management drugs
  • Orthotics or foot inserts
  • Surgery

If you have any questions, please feel free to contact one of our offices located in Mt Airy, Clemmons, Winston-Salem, and King, NC. We offer the newest diagnostic and treatment technologies for all your foot care needs.

Read more about Bunions

As the aging process progresses, it may be difficult for elderly people to avoid blisters and infections concerning the feet. This may be a result of poor vision which may hinder proper foot care management. Many elderly people may benefit by having a caregiver trim the toenails to ensure they are cut to a proper length. Research has shown any tools that are used should be cleaned and sanitized, which is often accomplished by using boiling water. These may include nail clippers and metal files. Taking advantage of a foot bath may aid in helping cracked skin feel more comfortable, followed by utilizing a good moisturizer to maintain softness in the skin. Measuring the feet prior to purchasing shoes is recommended for a comfortable fit in addition to wearing clean and dry socks. Please consider speaking with a podiatrist if you would like additional information on how to properly care for elderly feet.

Proper foot care is something many older adults forget to consider. If you have any concerns about your feet and ankles, contact one of our podiatrists from InStride Foot & Ankle Specialists. Our doctors can provide the care you need to keep you pain-free and on your feet.

The Elderly and Their Feet

As we age we start to notice many changes in our body, but the elder population may not notice them right away. Medical conditions may prevent the elderly to take notice of their foot health right away. Poor vision is a lead contributor to not taking action for the elderly.

Common Conditions 

  • Neuropathy – can reduce feeling in the feet and can hide many life-threatening medical conditions.
  • Reduced flexibility – prevents the ability of proper toenail trimming, and foot cleaning. If left untreated, it may lead to further medical issues.
  • Foot sores – amongst the older population can be serious before they are discovered. Some of the problematic conditions they may face are:
  • Gouging toenails affecting nearby toe
  • Shoes that don’t fit properly
  • Pressure sores
  • Loss of circulation in legs & feet
  • Edema & swelling of feet and ankles

Susceptible Infections

Diabetes and poor circulation can cause general loss of sensitivity over the years, turning a simple cut into a serious issue.

If you have any questions please feel free to contact one of our offices located in Mt Airy, Clemmons, Winston-Salem, and King, NC. We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Elderly and their Feet
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