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Steven Shlonsky, DPM
149 Thierman Ln
Louisville, KY 40207
(502) 897-6343 We make house calls

Featured

Tuesday, 27 July 2021 00:00

A bunion is an enlargement of the base joint of the toe that connects to the foot, often formed from a bony growth or a patch of swollen tissues. It is caused by the inward shifting of the bones in the big toe, toward the other toes of the foot. This shift can cause a serious amount of pain and discomfort. The area around the big toe can become inflamed, red, and painful.

Bunions are most commonly formed in people who are already genetically predisposed to them or other kinds of bone displacements. Existing bunions can be worsened by wearing improperly fitting shoes. Trying to cram your feet into high heels or running or walking in a way that causes too much stress on the feet can exacerbate bunion development. High heels not only push the big toe inward, but shift one's body weight and center of gravity towards the edge of the feet and toes, expediting bone displacement.

A podiatrist knowledgeable in foot structure and biomechanics will be able to quickly diagnose bunions. Bunions must be distinguished from gout or arthritic conditions, so blood tests may be necessary. The podiatrist may order a radiological exam to provide an image of the bone structure. If the x-ray demonstrates an enlargement of the joint near the base of the toe and a shifting toward the smaller toes, this is indicative of a bunion.

Wearing wider shoes can reduce pressure on the bunion and minimize pain, and high heeled shoes should be eliminated for a period of time. This may be enough to eliminate the pain associated with bunions; however, if pain persists, anti-inflammatory drugs may be prescribed. Severe pain may require an injection of steroids near the bunion. Orthotics for shoes may be prescribed which, by altering the pressure on the foot, can be helpful in reducing pain. These do not correct the problem; but by eliminating the pain, they can provide relief.

For cases that do not respond to these methods of treatment, surgery can be done to reposition the toe. A surgeon may do this by taking out a section of bone or by rearranging the ligaments and tendons in the toe to help keep it properly aligned. It may be necessary even after surgery to wear more comfortable shoes that avoid placing pressure on the toe, as the big toe may move back to its former orientation toward the smaller toes.

Tuesday, 20 July 2021 00:00

Toenail fungus is a frustrating problem that affects many people. It can be persistent and hard to get rid of. As many different types of fungi are present throughout the environment, it is very easy to contract toenail fungus.  

The feet are especially susceptible to toenail fungus because shoes and socks create the ideal dark and moist environment that fungal infections thrive in. While fungal infections of the nail plate are quite common, if left untreated they can spread beyond the toenail and into the skin and other parts of the body.

Signs of toenail fungus include a thickened nail that has become yellow or brown in color, a foul smell, and debris beneath the nail. The toe may become painful due to the pressure of a thicker nail or the buildup of debris.

Treatment for toenail fungus is most effective during the early stages of an infection. If there is an accumulation of debris beneath the nail plate, an ingrown nail or a more serious infection can occur. While each treatment varies between patients, your podiatrist may prescribe you oral medications, topical liquids and creams, or laser therapy. To determine the best treatment process for you, be sure to visit your podiatrist at the first signs of toenail fungus.

Tuesday, 13 July 2021 00:00

An ingrown toenail is a nail that has curved downward and grown into the skin.  This typically occurs at either the nail borders or the sides of the nail.  As a result, pain, redness, swelling, and warmth may occur in the toe.  If a break in the skin forms due to the ingrown nail, bacteria may enter and cause an infection in the area; this is typically characterized by a foul odor and drainage.

Ingrown toenails have multiple reasons for developing.  In many instances, the condition is a result of genetics and is inherited.  The most common cause, however, is improper trimming; cutting the toenails too short forces the skin beside the nail to fold over.  An ingrown toenail can also develop due to trauma, such as stubbing the toe, having an object fall on the toe, or participating in activities that involve repeated kicking or running.  Wearing shoes that are too tight or too short can also cause ingrown toenails.

Treatment for an ingrown toenail varies between patients and the severity of the condition.  In most cases, it is best to see your podiatrist for thorough and proper treatment.  After examining your toe, your podiatrist may prescribe oral antibiotics to clear the infection if one is present.  Surgical removal of either a portion of the nail or the entire nail may also be considered.  In some cases, complete removal or destruction of the nail root may be required.  Most patients who undergo nail surgery experience minimal pain afterward and can return to normal activity the following day.

Ingrown toenails can be prevented with proper nail trimming and by avoiding improper-fitting shoes.  When cutting the toenails, be sure that you are cutting in a straight line and avoid cutting them too short.  Shoes should not be too short or tight in the toe box.

Tuesday, 06 July 2021 00:00

Arthritis is an inflammation of the joints and it can occur at any joint in the body, especially in the foot. It generally effects those who are older, however, it can occur at any age. Although there are many different forms of arthritis, there are three main types that occur in the foot. The three types are osteoarthritis, rheumatoid arthritis, and gout.

The primary cause of osteoarthritis is aging. As you age, cartilage degenerates around the joints which causes friction and pain. Obesity can cause osteoarthritis through mechanical stress. Injuries that damage joints can increase the probability as well. Finally, a family history of osteoarthritis can also increase chances of having it.

Rheumatoid arthritis occurs when the immune system attacks the joint linings and weakens them over a long time. While there is no known cause of rheumatoid arthritis, obesity and smoking can increase your chances of getting it. Women are also more likely to get it than men.

Gout is a form of arthritis that occurs when there is too much uric acid in your blood and painful crystals form in your joints. Men are more likely to have gout than women. People who are obese or drink alcohol often are also more likely to develop gout. Furthermore, having diabetes, heart disease, high blood pressure, high cholesterol, gastric bypass surgery or a family history of gout may increase your likelihood of developing the condition.

Symptoms of arthritis include pain, stiffness, swelling in the joints. These symptoms can make it harder and more painful to walk. Physical activity can increase pain and discomfort. Furthermore, joint pain can worsen throughout the day for osteoarthritis. Gout attacks generally last several days with the first few being the worst.

Diagnosis of gout includes either a joint fluid test or a blood test. X-ray imaging can detect osteoarthritis but not gout. On the other hand, there is no blood test for osteoarthritis. Rheumatoid arthritis is difficult to diagnosis. Doctors utilize family and personal medical history, a physical examination, and antibody blood tests to determine if you have rheumatoid arthritis.

Treatment varies for the different kinds of arthritis. Anti-inflammatory medication or steroids can help reduce pain from inflammation of the joints. Changing shoe types can help with some symptoms. Wider shoes can help with discomfort from gout and osteoarthritis. High heels should be avoided. Shoes with proper arch support and that take pressure off the ball of the foot can help with rheumatoid arthritis. Drinking lots of water can also help rid uric acid from the blood. Losing weight, improving your diet, and limiting alcohol and smoking can also help prevent or lessen the symptoms of arthritis.

If you are having trouble walking or pain in your feet, see a podiatrist to check if you have arthritis.

Tuesday, 29 June 2021 00:00

Heel spurs are calcium deposits that cause bone protrusions on the heel bone. Heel spurs are usually associated with plantar fasciitis, which occurs when the plantar fasciitis in the foot becomes inflamed. Typically, heel spurs don’t cause any symptoms. However, they can produce chronic or intermittent heel pain. Those who have had the condition often describe the irritation as a stabbing pain.

There are risk factors that may make you more likely to develop heel spurs. People who have abnormal walking gaits, run and jog on hard surfaces, are obese, or wear poorly fitting shoes are more likely to develop heel spurs.

Fortunately, there are precautions you can take to avoid developing heel spurs. One of the best ways to do this is by wearing well-fitting shoes with shock-absorbent soles. Another preventative technique is to choose running shoes if you plan on running, and walking shoes if you plan on walking. Shoes are made for different activities and it is important to research a shoe before you purchase a pair.

The pain associated with heel spurs often decreases the more you walk. However, a recurrence of pain after an extended period of rest or walking is likely to occur with this condition. Those with severe heel spur pain may opt to go the surgical route for treatment.  However, more than 90% of those with the condition get better without surgical treatment. If you have a heel spur and want to know if surgery is right for you, you should go to your podiatrist and he or she will be able to conduct a pre-surgical test or exam to determine if you are an optimal candidate for surgery.

Tuesday, 22 June 2021 00:00

Over half of all runners encounter at least one injury per year. The reason for this is because many runners do not train properly. Injuries are almost inevitable due to the physical stress that running causes. While our bodies are great at adapting to the stress, it can only handle it in small doses. Injuries occur when the stress is applied too quickly for the body to handle, causing something within it to break down. With each step you take, your leg is absorbing two or three times your body’s weight.

Some of the most popular running injuries are shin splints, plantar fasciitis, Achilles tendinitis, and stress fractures. Shin splints cause pain along the inside or outside of the shins, and this pain is usually felt at the beginning of a run. The condition itself is defined as an inflammation of the muscles or tendons located around the shinbone. To treat shin splints, it is advised that you ice the shin area and stretch the calf muscles. To prevent this injury, you should slowly increase the distance you plan on running, instead of jumping into a more strenuous routine.

Achilles tendinitis is another common injury and it feels like pain along the back of the leg, toward the heel. This condition is defined as an inflammation of the Achilles which is the largest tendon in the body. The Achilles is responsible for connecting your calf muscles to the heel bone and it is caused by tight calf muscles. If you want to treat this injury, you should take a break from running to cross train with a low-impact activity.

There are a lot of common mistakes runners make that are causing them to experience injury. One mistake is stretching too much prior to warming up. If you plan to go on a run, you should warm up with a gentle 3-5-minute walk followed by a 5-minute run-walk.  Another common mistake is jumping into a routine too quickly. Consequently, you should incorporate cross-training into your routine. If you are looking to get active, you should slowly weave running into an activity you are currently participating in. For example, you can try bike riding for 40 minutes followed by a 10-minute run.

Another way to prevent running injuries is to choose shoes that are appropriate for running. There are certain things you should look for when buying a new pair of running shoes. An important factor in these sneakers is flexibility. Running shoes should be capable of bending and flexing at the forefoot. However, you should not be able to bend the entire shoe in half with ease because this is a sign that the shoe does not have enough structure. Additionally, you should look for the fit of the running shoes you want to purchase. It is best to visit a specialty running shoe store to have your feet properly sized. Choosing shoes that fit properly can prevent many foot ailments.

If you are suffering from any pain from running injuries, you should make an appointment with your podiatrist to discover the underlying cause of your pain. He or she will be able to help treat your condition in the best way possible.

Tuesday, 15 June 2021 00:00

Elderly Americans are very susceptible to falls as they get older. Everyone experiences decreases in flexibility, balance, strength, and the senses as they age. This correlates to some eye-opening statistics. 1 in 4 Americans aged 65 and older fall each year. An elderly American is being treated for a fall in an emergency room every 11 seconds, and every 19 minutes, an older person dies from falling. In light of these striking statistics, one can see the importance of taking steps to prevent falls.

Finding an exercise program for the elderly is an excellent way to reduce the likelihood of falls. Look for an exercise program that improves strength and balance. Elderly people who live a more sedentary lifestyle, with little physical activity, are at an increased risk of falling. Wearing well-fitted footwear that provides good foot support and cushion will help prevent falls from poorly fitted shoes. Talking to a podiatrist about your susceptibility to falls and about inspecting your prescriptions will help to avoid any medication that could make falls more likely. Due to a decline in the senses among the elderly, having your eyes and hearing checked is recommended.

Around half of all falls occur in the household. Removing tripping hazards in the home and making it more accommodating to older persons can significantly reduce falls. Some notable household changes include increasing lighting around the house, installing grab bars in the shower and bathroom, and making sure the floor is clear of clutter. Other smart options include installing a shower chair, using rubber-bottomed rugs, and placing railings on both sides of stairwells.  

Finally, discuss with a doctor and your family about your fear of falling. This will help to increase awareness among the population on the need for fall prevention. A lack of awareness on the matter, and a downplaying of importance are what increase the risks of falling. Following these tips can help to reduce the risk for yourself and your loved ones.

 

Tuesday, 08 June 2021 00:00

Tarsal tunnel syndrome is a condition in which the tibial nerve, located in the tarsal tunnel in the foot, is compressed. The tibial nerve can become compressed from injury, such as an ankle sprain, flat feet, and lesions. Arthritis, diabetes, and varicose veins can also cause swelling and thus result in nerve compression.

Symptoms of tarsal tunnel syndrome include several different sensations in the sole of the foot, inside the ankle, and around the tibial nerve. These sensations include shooting pains, numbness or reduced sensation, pins and needles, burning, and tingling. Symptoms tend to worsen with greater activity to the area. In rare and severe occasions, this can change the muscles in the foot.

If you suspect you have tarsal tunnel syndrome, you should consult with your podiatrist. He or she will examine your medical history to see if you have a history of diabetes, arthritis, or flat feet. They will also check to see if you have suffered an injury to the area recently. An electrical test will be conducted to check if the nerve has been damaged. A simpler Tinel’s Test might also be used. This includes simply tapping the nerve to create a sensation. An MRI scan of the area may also be used.

Treatments vary greatly for tarsal tunnel syndrome. Treatments include both nonsurgical and surgical options depending upon the severity of the condition. Nonsurgical options include anti-inflammatory medication and steroid injections to the area. Orthotics, such as a splint or brace that immobilizes the foot, is another noninvasive option. For those with flat feet, custom shoes can be made to offer better foot support. Surgical options include a tunnel tarsal release, in which an incision is made behind the ankle down to the arch of the foot. This releases the ligament and relieves pressure off the nerve. Some doctors use a more minimally invasive surgery, where smaller incisions are made in the ankle and the ligament is stretched out.

If you are suffering from painful sensations in your foot, see a podiatrist who can determine if you are experiencing tarsal tunnel syndrome. Tarsal tunnel syndrome that is left unchecked can cause permanent nerve damage to the foot.

Tuesday, 01 June 2021 00:00

The Achilles tendon is the largest tendon in the body; it is a tough band of fibrous tissue that stretches from the bones of the heel to the calf muscles. This tendon is what allows us to stand on our toes while running, walking, or jumping, it is common for this tendon to become injured. In severe cases, the Achilles tendon may become partially torn or completely ruptured. However, this tendon is susceptible to injury because of its limited blood supply and the high tensions it endures.

The people who are more likely to suffer from Achilles tendon injuries are athletes who partake in activities that require them to speed up, slow down, or pivot. Consequently, athletes who engage in running, gymnastics, dance, football, baseball, basketball, or tennis are more likely to suffer from Achilles tendon injuries. Additionally, there are other factors that may make you more prone to this injury. People who wear high heels, have flat feet, have tight leg muscles or tendons, or take medicines called glucocorticoids are more likely to have Achilles tendon injuries.

A common symptom of an Achilles tendon injury is pain above the heel that is felt when you stand on your toes. However, if the tendon is ruptured, the pain will be severe, and the area may become swollen and stiff. Other symptoms may be reduced strength in the lower ankle or leg area, and reduced range of motion in the ankle. When the Achilles tendon tears, there is usually a popping sound that occurs along with it. People who have acute tears or ruptures may find walking and standing to be difficult.

If you suspect you have injured your Achilles tendon, you should see your podiatrist to have a physical examination. Your podiatrist will likely conduct a series of tests to diagnose your injury including a “calf-squeeze” test. Calf squeeze tests are performed by first squeezing the calf muscle on the healthy leg. This will pull on the tendon and consequently cause the foot to move. Afterward, the same test will be performed on the injured leg. If the tendon is torn, the foot won’t move because the calf muscle won’t be connected to the foot.

Monday, 24 May 2021 00:00

Trauma to the foot, especially the toes, can occur in many ways. Banging them, stubbing them, or dropping something on them are a few different ways this trauma can occur. Given the fact that toes are positioned in front of the feet, they typically sustain the brunt of such trauma. When trauma occurs to a toe, the result can be a painful break or fracture. Another type of trauma that can break a toe is repeated activity that places stress on the toe for prolonged periods of time.

Broken toes can be categorized as either minor or severe fractures. Symptoms of minor toe fractures include throbbing pain, swelling, bruising on the skin and toenail, and the inability to move the toe with ease. Severe toe fractures require medical attention and are indicated when the broken toe appears crooked or disfigured, when there is tingling or numbness in the toe, or when there is an open, bleeding wound present on the toe.

Generally, a minor toe break will heal without long-term complications. However, it is important to discontinue activities that put pressure on the toe. It is best to stay off of the injured toe and immediately get a splint or cast to prevent any more additional movement of the toe bones. You can also immobilize your toe by placing a small cotton ball between the injured toe and the toe beside it. Then, tape the two toes together with medical tape. Swelling can be alleviated by placing an ice pack on the broken toe directly as well as elevating your feet above your head.

Severe toe fractures may be treated with a splint, cast, and in some cases, minor surgery, especially when the big toe has been broken. Due to its position and the pressure the big toe endures with daily activity, future complications can occur if it is not properly treated. Pain associated with minor toe fractures can be managed with over-the-counter pain medications. Prescription pain killers may be necessary for severe toe fractures.

The healing time for a broken toe is approximately four to six weeks. In severe cases where the toe becomes infected or requires surgery, healing time can take up to eight weeks or more. While complications associated with a broken toe are immediately apparent, it is important to note that there are rare cases when additional complications, such as osteoarthritis, can develop over time. You should immediately speak with your podiatrist if you think you have broken your toe due to trauma. They will be able to diagnose the injury and recommend the appropriate treatment options. 

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