The job of the podiatric physician includes the evaluation and treatment of dermatologic, neurologic, arterial, venous, musculoskeletal, and rheumatic pathologies.
Active diagnosis and treatment of risk factors leading to limb loss is essential. These include complications of diabetes mellitus such as symptomatic neuropathy, and other risk factors including edema, xerosis, fissuring, onychomycosis and tinea pedis. Also essential is recognizing peripheral arterial disease prior to overt manifestations of the disease.
Dr. Kerner provides gait and fall risk evaluation including an assessment of footwear.
Following are a few of the conditions that we treat.
sports injuries
Athletes can be prone to developing certain types of foot and ankle problems including plantar fasciitis and heel spurs. At our office, we offer many state-of-the-art treatments for our patients, including extracorporeal shock wave therapy (ESWT). This is an FDA approved therapy that is used by our doctor to treat patients who have plantar fasciitis and heel spurs, and who have not successfully had their injury successfully treated using more traditional treatment methods. Athletes are prone to developing plantar fasciitis when they run and jump on hard surfaces over an extended period of time. When a patient has plantar fasciitis, they have an inflammation of the tissues that run between the heel and spread out to the toes. ESWT is a noninvasive treatment that uses high intensity sound waves for the treatment of chronic foot problems. This innovative treatment has proven to be extremely helpful for treating patients with heel pain from plantar fasciitis or heel spur syndrome; Achilles tendinitis; and foot fractures that are proving quite stubborn in their healing. If you have had heel pain for at least six months, and other traditional treatments have not worked, our foot doctor may want to provide you with this treatment option. Other more conservative treatments for a sports injury of plantar fasciitis or heel spur often include: supportive taping or strapping; prescription custom biomechanical orthotics; cortisone injections; physiotherapy; below the knee casting; and night splints.
bunions
A bunion is a bump on the side of the foot behind the big toe, for which there are multiple causes. Of course, the bed rock for its foundation is genetic predisposition. If it runs in your family, there’s a good chance that lifestyle choices can further nurture growth of these troublesome enlargements. Affected by over-pronation? Improper biomechanics can also contribute. They can cause the phalangeal joint—located within the metatarsal—to destabilize. Footwear doesn’t cause bunions, but they can worsen the symptoms. So make sure you don’t wear anything overly snug that practically chokes the life out of your gentle feet. Some other (not so common) contributors to bunion include: neuromuscular disorders (Charcot-Marie-Tooth disease or polio), trauma (nerve injuries, sprains, and fractures), and limb-length discrepancies (one leg longer than the other). Of course, don’t settle for a self-diagnosis. Treatments runs the gamut of conservative care to surgical correction.
Ice, rest and wearing comfortable shoes can provide bunion relief. Custom biomechanical orthotics, which are transferable from shoe to shoe, are also available. If the bunions become extremely restrictive, surgery is another option and can relieve bunions permanently.
I hope this sample provides you with some usable information. If you feel that we may be of help to you, please call Dr. Jay Kerner - Dr. Daniel Zilberbrand - South Nassau Heel Pain. Then schedule an appointment so you can be well on the way to feeling better.
Heel Pain
At South Nassau Heel Pain, we specialize in the diagnosis, evaluation, and treatment of heel pain. We're pleased to offer various types of methods to address your problem, including shock way therapy, one of the most advanced technologies available today. But by far, when it comes to the relief of heel pain, an effective, safe, treatment is with our custom biomechanical orthotics that are worn in transferable from shoe to shoe.
The two most common reasons for suffering with heel pain are plantar fasciitis and heel spurs, two conditions that can occur exclusive of each other or in conjunction with each other. Plantar fasciitis happens when the band of tissue that connects the heel to the toe becomes abnormally stretched. This leads to strain, and can include tiny tears. Swelling and inflammation are typical. It tends to hurt just to stand sometimes, let alone walk or run. Among the possible contributing factors to plantar fasciitis are that your footwear is not supportive enough. Also, having flat feet may be part of the equation. While purchasing more supportive shoes is a fairly easy solution, correcting flat feet is not. But in either instance, our custom biomechanical orthotics can be used in your shoes to reduce the pressure and the stress on your heel, which allows you to recover and the pain to subside. Heel spurs, which are calcium deposits that form under the heel bone, present similar challenges, and can likewise often be addressed with our custom orthotics.
Custom biomechanical orthotics may be an essential part of your treatment. Fiberglass casts are taken of both feet and sent to our lab for fabrication. These custom devices are tailored to your condition, activity and shoe gear. They are transferable from shoe to shoe. Occasionally, ‘off the shelf insoles may help, but for more severe conditions, custom devices are more effective.
Hammertoes
Hammertoes do not have to be a serious condition. But they can cause pain and soreness in the foot, and should be treated appropriately before they become worse. We provide treatment ranging from conservative to surgical correction
Hammertoes occur when there is an imbalance between the muscle and the ligament around the toe joint, causing the middle toe joint to bend into an awkward position. It becomes stuck in place and can be irritating and causes rubbing against the shoe and toe. Patients can perform hammertoe treatment by wearing shoes that are wide at the toe, and which give space between the toe and tip of the shoe. Refraining from high heels and wearing appropriate shoes is also ideal. Ice and aspirin can also be used to help relieve swelling.
blisters
A blister is a lesion which is filled with fluid. It is created when there is friction and pressure on the foot. Foot blisters can be caused by: poorly fitting shoes; shoes that are too stiff; socks that are wrinkled and press against the skin; excessive moisture on the feet; or even by certain foot deformities. While many patients are able to treat blisters at home, they can become a serious problem if you have diabetes, and have problems with healing on your feet. It’s important to prevent the blister from becoming infected. If you have a foot blister that does not begin to heal within a short time, we recommend that you seek treatment of your blister. Some recommended steps to help prevent blisters are to: keep your feet dry and toe nails trimmed; control excessive moisture on feet; keep your shoes comfortable by keeping tongues and laces of your shoes comfortably arranged; and check your feet regularly for any signs of rubbing by your shoes or socks.
Gout
Gout is a foot condition that can produce pain ranging from bothersome all the way to excruciating. At South Nassau Heel Pain, we want you to have every advantage to avoid it, and to get relief in the event that it does develop.
Gout is a form of arthritis. It is caused by an excess of uric acid in your blood. Symptoms associated with it include stiffness, swelling, and pain. The reason that you experience those signs are because the uric acid forms hard crystals in your joints. Gout can develop in various joints in your body, including in your arm (such as the elbow). But by far, the most common place that it forms is in your big toe. Typically, a gout attack will last anywhere from a day to a week or two, but even if it goes away, this does not mean that everything is fine and that you don't need to do anything about it. Many people get recurrences of gout, often frequently and regularly. It is not an isolate incident, and the more times it occurs, the more chance there is that you could end up sustaining damage to your joints affected by it, or the tendons, or other surrounding tissue. You could wait it out when you have an attack, but if you come in to see our foot doctor, there are treatments that can lead to greater comfort, including corticosteroid shots, and other medication. You can try taking ibuprofen for the pain, but avoid aspirin, which raises uric acid levels in the blood, adding to the problem at hand. Our foot doctor will also recommend a diet designed to limit the chances of recurrence. It is a good idea to avoid meat, seafood, and alcohol (especially wine and beer).