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Diabetic Foot Care

How do I perform a diabetic foot exam?

Daily foot self-exams are a critical component of a healthy lifestyle for those with diabetes. Checking your feet every day will help you identify problems quickly, allowing you the time to seek professional care. This could quite possibly prevent an amputation that could substantially and permanently reduce quality of life.

How to perform a diabetic foot exam:

  • While seated in a well-lit room, visually inspect your entire foot, including the soles and between the toes. Use a mirror (or a caregiver) if you need help seeing those hard-to-reach spots. Note anything that looks potentially troublesome—blisters, corns, redness, swelling, scratches, bruises, cracked heels, or other breakdowns.
  • Use your hands to feel the tops and bottoms of your feet, checking for bumps or temperature changes. Squeeze your toes gently and check whether color returns in 5 seconds or less.
  • Check toes carefully for signs of redness or swelling along a toenail edge, or any discoloration, thickening, or deformation in the nail.
  • Keep a written or visual record of your exam so you can compare day-to-day findings.

If you notice new problems emerging or old problems struggling to get better, don’t take any unnecessary risks—set an appointment with diabetic foot and wound care experts at Advanced Foot and Ankle Specialists of Arizona by calling (480) 963-9000.

Why does it feel like there is a stone in my shoe? 

If you feel like you’re walking on a stone, but nothing is in your shoe, you may have developed a Morton’s neuroma. This is an uncomfortable swelling and thickening of the nervous tissue between two metatarsal heads in the ball of the foot. Typically, this appears between the third and fourth digits. The more pressure you place on the ball of your foot, the more uncomfortable the neuroma will feel. Often you develop problems like tingling, numbness, and burning pain that radiates into your toes, in addition to the feeling of standing on a rock.

If you’re experiencing nerve pain in your lower limbs, you shouldn’t ignore it. Nerve damage—and the pain that goes with it—can become permanent if not treated promptly. Let our team of experts here at Advanced Foot & Ankle Specialists of Arizona take care of your Morton’s neuroma pain.

Heel and Arch Pain

How does PRP Therapy work?

The theory behind PRP therapy is that it provides extra of what your body needs at the site of an injury to repair cells or help grow new ones. Platelet-rich plasma (PRP) is your own blood that is processed aseptically to concentrate the number of platelets in a small amount of plasma. These platelets contain proteins and growth factors that stimulate your natural healing process when they are injected into damaged tissues.

PRP is often used for heel pain from Achilles tendinitis or plantar fasciitis, but the improvement doesn’t happen immediately. The therapy may jump-start healing, but damaged tissues still need time to repair and grow. Over the next weeks and months, you should see a marked improvement in pain levels and gradually regain function in your feet and ankles. If you want to learn more about this therapy and whether it may be the answer for your chronic heel pain, call our foot experts at Advanced Foot & Ankle Specialists of Arizona.

How long does it take for tendons to heal?

Tendon healing time depends on your specific injury. Tendinitis involves the inflow of white blood cells in an area following trauma, which causes warmth, inflammation, and pain. It is fairly rare, but you are likely to recover quickly with proper treatment and see improvement in a couple of weeks or so.

Tendinosis is the result of repeated overuse and causes changes in the makeup of the fibers of the tendon due to an abnormal buildup of protein. This type of injury takes longer to heal—three to six months is common. If the tendon is torn or needs surgery, expect even more time for your tendon injury to heal.

Recovery requires rest, but not total inactivity. Try alternative movements that don’t stress the tissue (biking instead of running, for example). Certain exercises may also help to strengthen the tendons (like heel drops for your Achilles).

Be patient. Take the time you need to heal, because re-injury is common when healing is not complete.

Can I treat a bone spur at home?

There are limited home treatments for a bone spur that will only help relieve any pain or discomfort associated with the condition. A bone spur (our office usually sees and treats the type known as heel spurs) is excess bone tissue that the body produces, often to defend against persistent pressure or friction.

Some of the at-home treatment methods that you may try include stretching, over-the-counter pain relievers, and changing footwear to models that fit better. Additionally, icing the affected area can help decrease the level of pain you are experiencing. Given that a bone spur is a progressive condition, it will not get better on its own.

When you experience the pain and discomfort that accompanies a heel spur, make an appointment with Advanced Foot & Ankle Specialists of Arizona. We can examine your situation and develop an effective treatment plan.

What is a bone spur?

A bone spur is a hard projection that develops on the edge of a bone. It usually grows when that portion of the bone is under stress and pressure. Depending on how and where one develops, you may never notice symptoms from it. Other times, spurs can make walking and other normal foot functions very uncomfortable. One of the most common sources of spurs is from chronic plantar fasciitis. The plantar fascia band attached to the heel pulls on the bone, causing pain—and providing the stress and pressure needed to allow a spur to grow under the connective tissue.

Another common places for spurs is the back of the heel, where the Achilles tendon attaches and pulls on the bone. Sometimes spurs can even grow out of joints with severe arthritis. The grinding in the joint causes the spur to grow. If you have a spur that’s causing you pain, don’t ignore it. Let Advanced Foot & Ankle Specialists of Arizona relieve the pain.

Skin and Nail

What can I do to treat my foot odor?

Foot odor is a common problem, but home care can help. Smelly feet are the result of your sweat mixing with the bacteria that live on the surface of your skin and in your shoes. Dealing with the sweat can help reduce or eliminate the unpleasant scent. Wear moisture-wicking, fitted socks made from breathable materials. Make sure your shoes allow air to circulate—skip the plastic kind in favor of those made with canvas, leather, or mesh. Wash and dry your feet daily to keep them clean, and avoid wearing the same pair of shoes two days in a row. If you sweat heavily or participate in athletics, change your socks during the day to minimize how much moisture stays trapped against your skin. Apply antiperspirant deodorant, sprays, or powders to your feet and footwear; these can help with both the moisture and the smell.

If you continue to struggle with smelly feet, let our staff at Advanced Foot & Ankle Specialists of Arizona help you with more intensive ways of managing foot odor.

How do I get an ingrown toenail?

You can get an ingrown toenail in many different ways. Shoes that squeeze your toes and press down on your nails can cause them to curl. Cutting your nails too short or clipping the corners may allow the tissue to grow into the skin. Dropping a heavy object on your foot or kicking something too hard can damage the nail and influence its growth. Your natural nail shape may play a role as well. Some people have curved nails that may be more prone to ingrowing.

However your nail problem developed, taking care of it promptly can help eliminate the pain and prevent infections. While some conservative measures may help, having the offending edge cut away and the toe treated for bacteria is the best way to truly deal with the problem. If you develop an ingrown nail, Advanced Foot & Ankle Specialists of Arizona is here to help.

Can a podiatrist treat an ingrown toenail?

Sometimes it’s easy to shrug off certain foot and ankle problems. Having an ingrown toenail is a great example of this – you may think that the situation will resolve itself given time, or that an ingrown toenail is just not that big of a deal.

And for the most part, you’re right! Most people are able to get rid of ingrown toenails by simply letting the problem take its course. But the truth is, in other cases, a simple ingrown toenail can keep you from being active, and may even present serious health risks.

In fact, there are three typical situations when seeking the help of a podiatrists to treat ingrown toenails is an absolute must:

  1. When you have tried self-care measures at home, but the problem persists or keeps returning.
  2. When you have a condition like diabetes, a compromised immune system, or poor blood flow that slows down healing.
  3. If you suspect you’ve developed an infection.

Diabetic patients should always stay ahead of the game when it comes to the health of their lower limbs. Ignoring a “harmless” ingrown toenail could result in painful ulcers, infections, and even the need for amputation. So it’s imperative that any and all concerning lower limb symptoms be addressed right away in order to avoid catastrophic complications.

And the good news is getting rid of ingrown toenails and preventing them from returning doesn’t have to be hard! From changes in footwear to practicing good nail trimming habits, most conservative treatments are enough to find the relief patients need.

Though medical care often involves some level of minor surgery, this is done as an outpatient procedure and recovery is extremely comfortable – in fact, most patients usually experience relief right away!

Surgery for ingrown toenails entail a temporary removal of the corner of the nail or the edge that is ingrown, or removal of a whole section of the nail. For a severe and recurring problem, we may apply a solution to the root (matrix) to prevent the nail from growing back again. (We will administer a local anesthetic before starting, so there’s no need to worry about pain or discomfort during the procedure.)

Once we are done, we will bandage the toe and you can walk right out the door. It’s that easy!

Should I cut off a plantar wart?

While it’s okay to use some types of at-home treatment for both top-of-the-foot and plantar warts, you should not try to cut one off yourself. Warts are viral infections in your skin. Cutting off the top of the fleshy bump won’t eliminate the infection or cure the problem. Instead, it may just damage your skin and make it more likely you’ll develop secondary infections.

An experienced professional, however, like the physicians at Advanced Foot & Ankle Specialists of Arizona, can carefully remove the entire growth with a minor, in-office procedure. Usually more conservative methods are tried first, though. Topical medications, immune therapy, and liquid nitrogen are just a few of the wart-removal options available to you. Don’t risk seriously injuring the skin on the sole of your foot by cutting a wart off. Let Advanced Foot & Ankle Specialists of Arizona take care of it instead.

Sports Injuries

How does amniotic therapy work?

Amniotic therapy is an advanced form of treatment made from amniotic membranes. These membranes can be used to provide covering and a healing foundation for diabetic ulcers and other wounds. They can also be processed and reduced to an injectable form instead of covering an open area.

An amniotic therapy injection into soft tissues can aid in internal healing. Plantar fasciitis, osteoarthritis, and certain tendon injuries are among many conditions that can greatly benefit from accelerated healing and reduced pain via injectable treatment.

For more information on amniotic therapy and other forms of advanced treatment available at Advanced Foot & Ankle Specialists of Arizona, please call our Chandler office at (480) 963-9000. We have conservative and surgical options for a variety of different conditions, plus the experience and training to determine the best courses of action for our patients.

into an injectable form instead of covering an open area. An AmnioFix injection treatment into soft tissues is theorized to aid in internal healing as well. Conditions such as plantar fasciitis, osteoarthritis, and certain tendon injuries may see great benefits in recovery and reduction of pain. Clinical studies as to the effectiveness of the injections are ongoing, but promise is being shown.

How can I strenghthen my ankles?

There are several ankle strengthening exercises that can help build support and balance, which in turn helps prevent injuries. Here are several examples of moves you can work into parts of a routine:

Heel Raises – Sit with bent knees and feet flat on the floor. Gently push down on your thighs as you raise your heels upward, off the floor. This exercise can also be performed while standing.

Walk Variations – Turn the soles of your feet toward each other and walk 5-10 steps on your toes. Walk the same amount on your heels with your toes lifted, then shift to tip-toes. Increase your distance as you grow stronger.

Pillow Balance – Simply stand on a pillow with one leg, lifting the other up to improve balance. Have plenty of room around you in case you fall.

For more exercise suggestions, or to discuss problems you may have with your ankles, feel free to call Advanced Foot & Ankle Specialists of Arizona.

Why do my ankles keep giving out?

If you struggle with your ankle giving out when you’re active, you may have chronically unstable ankles. This is the result of damage to the ligaments that stabilize your ankle joint. Usually you develop this when a sprain doesn’t heal correctly. Repeatedly spraining the same joint can have the same effect. In both cases, the damaged ligaments aren’t able to hold your ankle steady under pressure, so the joint “gives out” and collapses to the outside.

Unfortunately, this is a self-perpetuating problem. An unstable ankle is more likely to twist and sprain when you’re active. The injury destabilizes the joint even further, making it even more likely that you will continue to hurt your lower limb. To stop this cycle and alleviate any pain, you’ll need to treat the problem and address your ankle instability. Our team at Advanced Foot & Ankle Specialists of Arizona in Chandler can help you do this.

How long does a heel fracture take to heal?

A heel fracture can be a serious break that requires extended healing time. It may need up to 10 – 12 weeks of no weight-bearing on the bone. Your foot will most likely be in a cast or boot to immobilize it. You will also need treatment to bring down the swelling. If your bone requires surgery, this takes place after the initial swelling has decreased and may add a few weeks to your recovery time. Even after the bone has recovered, you will be at risk for chronic problems like arthritis, so you may need additional therapies.

Failing to remedy the problem could lead to deformities and permanent weakness and pain, so seek immediate treatment. The sooner the problem is addressed, the more likely you will recover without severe complications.

Do I need surgery for a stress fracture?

In the vast majority of cases, you won’t need stress fracture surgery. Nearly all stress fractures can be treated conservatively. You’ll have to take time away from all hard impact activities and minimize the pressure on your foot for several weeks for the bone to heal. You may have to wear a special boot to keep your foot stable and immobile while the crack grows back together.

If you continually develop a stress fracture in the same place, the original injury doesn’t heal well with time, or the crack is in a difficult-to-treat place, then you might need surgery to completely recover. Surgery is used to pin the cracked bone back together, so it grows new tissue to join the split. This is not normal for a stress fracture, but it can happen. Don’t let fear of surgery keep you from getting the foot care you need. Contact Advanced Foot & Ankle Specialists of Arizona in Chandler for an appointment as soon as you think you have a problem.


What can I expect from surgery?

Knowing what to expect from foot surgery will help you prepare yourself. Here are some guidelines for surgery and recovery:

- You’ll need to stop smoking and taking certain meds, and arrange for someone to take you home.

- You need to have reasonable expectations as to results, and your own body’s structure and healing properties will have an impact on how successful the surgery is.

- You may have some pain, swelling, discoloration, and possible joint stiffness from the surgery. You may also need to wear a cast or protective boot and use crutches. Plan on time off work and non-weight bearing for at least several weeks.

- Recovery can’t be rushed. A rule of thumb is fair healing in 3 months, good healing in about 6, and a year until you’re fully back to normal.

- Physical therapy will be needed to regain range of motion and conditioning in your feet.

At Advanced Foot & Ankle Specialists of Arizona, we do all we can to prepare you for surgery and help you through recovery.

How do I know if I need surgery? 

Our priority at AFASAz is to ensure all conservative measures have been exhausted prior to surgery whenever possible.

We have many revolutionary non-surgical advanced treatments available including Amniotic Therapy, MLS Laser Therapy, and PRP Injections. However, there are still cases when surgery may be the best or only option.

Rest assured our doctors are highly trained and board-certified in many advanced surgical procedures to help you find the relief you deserve. We will always take the time to fully discuss your options and answer all questions you may have about treatments, surgical procedures, and recovery.

How long does it take to recover from bunion surgery?

Recovery time depends on the exact procedure performed. Many can expect recovery time to take 4-6 weeks while more advanced cases can take up to 6-8 weeks.

Your actions during recovery can have a significant impact on how well and quickly you heal from your procedure. Please follow all post-surgical instructions as closely as possible, and always contact us right away if you any questions or concerns arise during your recovery.


What are the causes of overlapping toes?

The reason one toe lies on top of another can be hard to pin down if the deformity is present at birth. Some believe it can develop from the baby’s position in the womb; others point out the heredity factor, since it often runs in families.

Other causes of overlapping toes may be the foot arch type you inherit, which can cause toes to move out of position and overlap an adjacent one (as when a bunion develops). Diseases like arthritis can also cause bones in a joint to move out of position, and diabetes and neurological conditions can cause nerve damage that results in a muscle imbalance in the toes.

Then there are injuries, such as a fracture, dislocation, or tendon tear that doesn’t heal correctly. Cramming your toes into tight shoes that force the toes out of position can also make them more likely to lift up and over another toe.

If your overlapping toe is causing discomfort and making it difficult to walk, please set up an appointment with Advanced Foot & Ankle Specialists of Arizona.

What are my treatment options for bunions?

When it comes to bunions, there are two broad treatment options: conservative or surgical.

Conservative treatments are geared toward symptom management and preventing the bunion from growing worse. Although they won’t get rid of your bunion, they could very well relieve your pain and allow you to return to active, pain-free living. Conservative treatment options include footwear modifications, custom orthotics, pads to relieve pressure and prevent corns, night splints, and more.

Surgical intervention is typically only recommended in cases with significant pain, and when conservative treatment proves ineffective. Depending on the severity of the bunion and your personal goals, we’ll select an appropriate surgical procedure.

Early detection and treatment increases the likelihood that conservative care will be effective, so don’t wait! Make your appointment with the team at Advanced Foot & Ankle Specialists of Arizona.

What is the benefit of a gait anaylysis?

We are talking about a medical gait analysis, not the superficial one in a specialty store to determine shoe choice. A full analysis includes observing your stride with a trained eye, statistical measurements, and video of running on a treadmill, among other things. The goal is to get a true picture of your total movement patterns, not just your pronation style.

You employ many habits while standing, walking, running or doing any other activity which are affected by your body’s level of stability (balance), flexibility, and muscle strength. Very few people have a perfect gait—most of us compensate for an abnormality in some way or other.

A full analysis can help us pinpoint those areas of compensation. The podiatrists at Advanced Foot & Ankle Specialists of Arizona can use this information to look for treatments like orthotics, physical therapy or other remedies that can help realign your bones and make your movements more efficient and less painful.

If you suffer from foot pain, this type of analysis may help.