Do you have thick, yellowish, brittle, and easily cracked or broken toenails without having injured them? They are likely discolored due to a fungal infection called onychomycosis, which is the most common disease of the nails.

The nail weakens as fungi continue to grow through the nail tissue. Since fungus grows faster than the nail, damage increases and the nail becomes more and more unsightly, with the infection spreading to the root or base of the nail.

Yeast and molds are also suspected to cause toenail fungus. These types of fungi exist in warm and moist environments, like shower areas, locker rooms, and swimming pools, and even your shoes (as toes are usually encased in shoes). Other factors include age, history of family infection or heredity, smoking, and heavy perspiration. People with circulatory problems, weak immune systems, or diabetes are at greater risk of developing fungal infections.

Nail fungus has been difficult to treat with success. The only options in the past have been topical or oral medications, which provide limited benefit. In addition, oral medication may cause liver damage. Now there is a safe, effective laser treatment for nail fungus. The laser destroys the fungus that causes onychomycosis with very little effect on the surrounding tissues. Treatment normally takes fewer than 20 minutes and there is no pain, although sometimes you may experience a warm or tingling sensation. There are no age or health restrictions for laser treatments.

Laser toenail treatment is considered aesthetic (cosmetic). Therefore, most health insurance plans do not cover treatment, and it can be costly. Consult with your podiatric physician to determine if this course of treatment is right for you.

There are some other preventive steps you can take to avoid reoccurrence of toenail fungus infection. They include keeping the toenails short and clean to stop the growth or worsening of the infection; following a scrupulous hygiene program; using anti-fungal spray on feet and shoes; avoiding going barefoot; keeping feet clean and dry; and changing socks daily.  If you suffer from nail fungus, contact Houston Foot Specialists and Dr. Bowman can help you be free from thick, brittle and yellowish nails!

Seeking medical attention from your podiatric physician is the first line of defense in treating heel pain. However, there are several steps you can take to avoid heel pain in the first place:

*Wear shoes that fit well and have shock-absorbent soles, rigid shanks (the part of the shoe that supports the foot and helps give a shoe its structure), and a supportive heel counter (the rear-most part of the shoe, at the back of the heel above the sole).

* Wear the proper shoes for each activity.

* Do not wear shoes with excessive wear on heels or soles.

* Begin exercises slowly. Consult with your podiatric physician before beginning a new exercise program.

* Wear athletic shoes with good shock support in the heels.

* Purchase shoes that fit.

* Avoid activities that may put constant strain on the foot.

* Avoid going barefoot on all surfaces.

* If obese, lose weight.

A variety of treatment solutions are available to provide short and long-term pain relief. Begin treating heel pain by avoiding all sorts of pressure or tension on the inflamed area, giving your feet ample rest. Applying ice and heat packs in alternating fashion will greatly accelerate the process of healing. Another option is the use of custom insoles that may be created by your podiatric physician. These may assist with treating active conditions of heel pain and likewise reduce the risk for reoccurrence. The custom insole will restore body balance and prevent the plantar fascia from experiencing strain when you walk. If all non-invasive treatment solutions do not work, surgery is probably the best next option, and often Endoscopic procedures or minimally invasive procedures are an option.

Regular exercise for calf muscles and the plantar fascia is necessary to alleviate pain and improve flexibility of the affected muscle. These exercises are advised for both legs even if the pain is in one heel only. Some of the most beneficial exercises are:

*Towel stretches – This exercise should be done every morning before you leave your bed. Make a loop with a towel and use it to pull your toes toward your body, while keeping the knee straight. Stretch each foot three times, and hold each stretch for 30 seconds, if possible.

*Stair stretches – Stand tall on a staircase with the balls of both feet on the edge of the step. Place hands on the railing or the wall for balance and support. Slowly lower heels toward the floor until you feel a stretch in your lower leg and heels. Maintain the stretch for 10 to 15 seconds. Repeat this exercise six times, and perform the stretches twice every day.

*Wall-Leaning Stretch – Stand an arm’s length away from a wall, place both hands on the wall at shoulder height, with the feet slightly apart and one foot in front of the other. Your front knee should be bent, but the back knee should be straight while you lean toward the wall. Hold the position for 10 seconds at a time for up to 15 or 20 repetitions per leg.

If you are unsure of the cause of your symptoms, if pain is severe, or if you have the following symptoms, call a podiatric physician immediately:

*Inability to bend your foot downward.

*Inability to rise on your toes.

*Inability to walk comfortably on the affected side.

*Swelling or discoloration of the back of the foot.

*Heel pain that occurs at night or while resting.

*Heel pain that persists beyond a few days.

Heel pain does not always subside quickly after medical attention is received. Unfortunately, it may take several months before the pain is actually gone. In most cases, heel pain can be treated at home under a podiatric physician’s supervision. If you are in need of a podiatrist, check out Houston Foot Specialists, we'd love to help you get rid of that heel pain!

You may have recently seen television ads regarding “Minimally Invasive Bunion Surgery” or “Mini Bunionectomy.”  This is a procedure available at Houston Foot Specialists performed by Dr. Jeffrey Bowman.

The first step in evaluating whether the Mini Bunionectomy is right for you is to understand what causes the bunion or “Hallux Abducto Valgus” deformity. The space between the first and second metatarsal bones (the long bones in your foot) is called the Inter-metatarsal angle or “IM angle”.  As the angle increases, so does the growth at the base of the big toe (Hallux) from shoe pressure.  The big toe usually drifts toward the second toe, sometimes overlapping or underlapping the second toe.  Some of the factors causing this include weak ligaments, trauma, improper fitting shoes, tight high heels, flat feet, and hereditary factors.  When bunion pain first starts, it should be treated conservatively.  If this fails, then surgery is usually indicated.

There are numerous bunion procedures, and your podiatrist will take X-rays and perform a biomechanical exam to determine which procedure is the one that is correct for you.  The bone enlargement is removed in all procedures and the big toe is placed in a straighter position.  

Most bunion procedures are named after the surgeon who developed them.  One procedure that isn’t named after a doctor is the minimally invasive procedure called the “Mini-Tight Rope” procedure.  It is extremely important that a patient realize this procedure is not meant for everyone.  As with any surgical procedure, complications could develop.  Your podiatrist will determine whether you are a candidate for surgery and whether the “Mini-Tight Rope” procedure is right for you.  What does the “Mini-Tight Rope” procedure involve?  Two small incisions are made: one to remove the enlarged bone at the base of the big toe, and the second incision is placed over the second metatarsal.  Next, a very strong type of suture is placed into the first metatarsal then passed through the second metatarsal to pull the first metatarsal over toward the second, in essence narrowing the foot.  This is secured in place by two small “buttons” on either side of both bones.  A shift is needed in all procedures to help minimize any return of the foot deformity and again, your podiatrist will determine if this procedure or another is better to correct your bunion.

If you suffer from pain at the base of the big toe or Bunion Deformity, please see your podiatrist.  At Houston Foot Specialists, we perform and are experienced in all types of bunion procedures.  Contact us at www.houstonfootspecialists.com for details and ask a question on our “Contact Us” page.  Or, you may call Dr. Bowman at 713-467-8886, and one of our caring and friendly staff members will be glad to help.  Our goal is to stop your foot pain and get you back into all the shoes you want to wear with comfort!

One of the most common things I hear from patients is their feet are tired and hurt, and patients wonder why.  Usually, tired, sore feet are the result of flat feet.  Flat feet are a progressive collapse of the arches, which can be due to trauma, bone and joint malformations, ligament laxity, weakened muscle, or imbalance with biomechanical problems.  There is a strong genetic predisposition to having flat feet or “Pes Planus.”

Over time, the deformity gets worse. Patients start getting symptoms that range from tired feet to severe pain in the feet, ankles, legs, knees, and even lower back.  Many will notice their shoes are wearing out quicker or the heels of their shoes are slanted.  This is due to abnormal structural changes of the foot.

Flat Foot Deformity can start at an early age, and parents need to check not only their own feet but those of their children.  A simple way to check is to stand in front of a full length mirror and see if the inside of your ankle bone is slanted toward the floor.  Also, if you can’t put your index finger under your arch without lifting it, you may have flat feet.  Another simple test is to wet your feet and stand on paper and look at the shape of the imprint.  If the arch does not curve in, the foot is flat.  Also, have someone look at the back of your heels, and if the heels are slanted out while standing you likely have flat feet.

The pain may begin slowly, and other deformities may develop like bunions, hammertoes, bone spurs, plantar fasciitis, ankle pain or abnormal gait.  Dr. Bowman will take X-rays to determine the extent of the deformity, analyze your gait, and perform a biomechanical examination.  Treatment can be as easy as wearing proper shoes, physical therapy, or a custom made device for your shoes called Orthotics to control the structure of your foot and place it in its anatomically correct position.

In severe cases or when conservative treatment fails, surgery may be recommended to realign the muscles, ligaments, tendons, and bones which are meant to give the patient a more stable and functional foot without pain.

If you have this problem, or any of the symptoms mentioned, see your foot specialist for an evaluation and examination.  We urge parents not to wait because catching it early and treating with conservative methods may prevent many deformities from occurring.  Visit Dr. Bowman’s Web site and view the educational videos to learn more at www.houstonfootspecialists.com

As we get back into the cooler temperatures of the fall season, everyone puts away the sandals and  brings out the shoes again.  As you start looking for new shoes, you might be wondering if one brand is better than another.  If you are looking for a good shoe for everyday use or a good shoe for activities – there is a great solution.  At Houston Foot Specialists, we recommend New Balance.  “But aren’t all shoes just pretty much the same?” you might be thinking.  The answer is actually no, they aren’t.  Just like with many products out in the world, there’s always a difference in brands and if you chose a cheaper brand you will also get lesser quality.  For many of the less expensive brands, the companies use cheaper, less supportive and low quality materials to make their shoes.  Then of course there is the crazy expensive brands, some have a good quality shoe and some may not but are relying on their brand name to charge more. 

New Balance is a great mid-priced shoe brand that makes quality shoes.  They are durable and supportive, all while being comfortable shoes.  New Balance even makes shoes to help protect people who pronate, meaning they walk with most of their weight on the outside of their feet, or supinate, which is people who walk with most of their weight on the inside of their feet.  It protects their ankles from spraining by forcing their weight into the middle of their foot. The employees in New Balance stores have been trained to fit your feet correctly to ensure the right fit for you.  They even have been educated by podiatrists to fit shoes with orthotics too. 

If you are interested in visiting a New Balance Shoe store, you should search for the one closest to you on either Google Places or go to the New Balance website, which is http://www.newbalance.com.  Also if you are in the Houston area, there is a store on Post Oak near the Galleria.  We strongly urge you to go check it out.  If you have any questions on buying shoes, need to get a professional fitting for shoes, or have any additional questions as to which shoe would be right for you or your children, give us a call at 713-467-8886 or visit our website at http://www.houstonfootspecialists.com/.  Make sure you walk, run and play pain free!