Adult-acquired flat foot is a condition that results in a fallen arch and the foot pointed outward. This condition is most common in women over the age of 40. A variety of foot problems can lead to adult- acquired flat foot deformity, but the most common cause is a gradual stretching out of a tendon near the ankle bone, known as the posterior tibial tendon. This tendon is the main stabilizer of the foot arch. While the cause of the stretching is not fully understood, many doctors believe that wearing high heels and standing or walking for long periods may add to the problem. Other risk factors include obesity, hypertension, and diabetes.
People with flat foot experience different symptoms depending on the cause. Pain and swelling may be felt on the inside of the foot and ankle. This pain points to involvement of the posterior tibial tendon. The pain may increase with activity and high intensity activities such as running can be very difficult. As the condition worsens, the arch can collapse causing the heel bone to move placing pressure on the outside of the ankle. This can cause outside ankle pain and arthritis of the ankle joint.
The posterior tibial tendon is one of the most important tendons of the leg. It starts at a muscle in the calf and travels down the inside of the ankle and attaches to bones on the inside of the foot. The main function of this tendon is to support the arch. If the tendon becomes inflamed or torn, the arch will slowly collapse. Inflammatory arthritis can attach the ligaments, as well as, the cartilage in joints. Arthritis can cause pain and changes to the shape of the foot. Injury to the ligaments can cause joints to fall out of alignment and cause flat foot. The last major cause of adult-acquired flat foot is diabetes. People with diabetes or with nerve loss can have arch collapse.
Adult-acquired flat foot is a very common problem affecting the foot and ankle. The good news is orthotics and braces can help most people. Those who have tried orthotics and braces without any relief, surgery can be an effective way to reduce pain and deformity. Your podiatrist is specially trained in treating flat foot and will create a custom treatment plan.
Excessive sweating from the soles of the feet, known as palmoplantar hyperhidrosis, can affect both children and adults. This condition occurs when the eccrine (sweat) glands of the soles secrete inappropriately large amounts of sweat. It typically occurs due to unknown reasons, begins in childhood, and commonly runs in families.
Eccrine glands are found on almost all parts of the body but are most dense in the palms and soles. The glands have developed and work normal in patients with palmoplantar hyperhidrosis, they just work more than needed. These glands produce sweat in response to emotion and stress. This is the reason people do not notice sweaty feet as they sleep.
Diagnosis is obvious because the sweating is easily noticed. Various treatment options are available but each has limitations. Creams and sprays are a great way to limit the severity of sweat but do not cure the condition. These are time-consuming therapies because the cream must be applied nightly. Iontophoresis is the passage of an electrical current onto to the skin, and has long been used to treat hyperhidrosis. Iontophoresis consists of 30 min sessions for ten consecutive days followed by one or two maintenance sessions per week. Oral pills will achieve desired results but must be taken for long periods of time and have numerous side effects. Surgical treatment is an option to treat hyperhidrosis. Sympathectomy involves the surgical destruction of nerves in the soles. Although the procedure is effective, it is permanent and should be considered only after all other therapeutic options have been explored. It is important to visit a podiatrist for treatment of palmoplantar hyperhidrosis, as there are many treatment methods. Coastal Podiatry Associates can help determine which treatment method is best to restore normal function of the sweat glands.
Corns and calluses are thick, hard sections of skin found on the foot. These conditions aren’t serious, but they can result in severe pain. Corns and calluses are really an area of increased thickness of the skin formed by too much pressure or friction. They generally form at bony prominences of the foot where friction is greatest. Usually poor fitting shoes cause these areas of friction, but they can also form because of how the foot moves during walking.
Calluses are typically found on the bottom of the foot. Corns are actually calluses that occur on the toes when hammertoes have formed. (Hammertoes are toes that are always bent, forming an upside down V when looked at from the side.) These thick layers of dead skin cells are generally white or yellow patches of thick, tough skin. They may also look flaky, or seem like dry skin. Corns are generally small and round, with a very sore spot in the middle and yellowish skin surrounding. Calluses are commonly larger and may have a peak in the middle.
Anyone can develop a callus or corn from poor fitting shoes or the way their foot moves during walking. The podiatrists at Coastal Podiatry Associates can easily treat these painful areas. The fastest and easiest way to treat calluses and corns is to remove the areas of increased skin. Another method is to reduce the friction or irritation that caused the callus or corn. This can be accomplished by adding padding to the shoe to offload the pressure area or adding an orthotic. Orthotics are custom shoe inserts that help the foot move in its most natural path. Another important preventative step is to wear comfortable shoes to help protect the foot from corns and calluses.
Foot ulcers are the most common reason people with diabetes are hospitalized. Foot ulcers are sores on feet that involve just the skin’s surface or they can develop into more serious wounds, which may lead to bone infections. Leg and foot ulcers are especially a problem for people with nerve damage, with vascular concerns, atherosclerosis, and sickle cell anemia. However, diabetes is the most common cause of ulcers.
Those with diabetes are at an increased risk of developing an ulcer for two main reasons. The first is peripheral neuropathy. This common complication of diabetes is a general loss of feeling. The nerves lose their ability to detect pain, heat, and cold. If the foot is injured, nerve damage may prevent from noticing the damage. Poor circulation is the other main reason diabetics develop ulcers. Blood increases in thickness, slowing its flow, therefore, causing poor circulation.
A foot ulcer appears like a red sore, most commonly found on the ball of the foot or under the big toe. If the wound is infected, pus and a bad odor typically occur. It is important to see a podiatrist as soon as an ulcer is noticed. Untreated foot ulcers can progress into gangrene and may lead to amputation. Treatment for foot ulcers depend on the severity of the wound. It typically involves debridement, off-loading, and dressings. Debridement is the process of removing dead skin and tissue. Off-loading uses pads or special shoes to take pressure off the ulcer area. Proper dressing and bandages are important to protect the area and provide an optimal healing environment. Ulcers may take weeks or even several months to heal. This depends on the general health of the patient and the severity of the wound.
To have your feet evaluated for foot ulcers or any other painful foot and ankle condition call 843-449-FOOT.
Trimming toenails may seem like a simple task, but it shouldn’t be done carelessly. Most people do not need to have their nails trimmed by a podiatrist; those with diabetes are an exception. Diabetics should visit a specialist, like those at Coastal Podiatry Associates, to reduce the risk of future foot problems. When trimming toenails, it is important to use proper technique to avoid creating ingrown toenails or an infection. Ingrown toenails are nails that become lodged in the skin, instead of growing normally. They can cause pain and may lead to serious infection. Sometimes, nails just grow naturally into the skin, no matter what you do. 
Here are some simple techniques to properly cut the nails to avoid toenail pain.
Use appropriate toenail clippers. Larger nails need larger clippers. This is why toenail clippers are much larger than fingernails. Keep your clippers clean by wiping them with rubbing alcohol before each use.
Leave nails a little long. Cutting nails too short can also cause ingrown toenails. By doing so, it puts the nail at risk of infection.
Cut nails when they are dry. Wet nails are more likely to tear, bend, or cut poorly because they soften when wet.
Cut straight across. Nails shouldn’t dig down on the sides. Guide the clippers straight across, follow the shape of the nail, and then use the curve on the clippers to cut the nail’s edges.
Nail filing. If you like to file your toenails, do not drag the file back and forth. Gently move the nail file in one direction across the top of each nail. Try using a glass nail file. This offers more protection and is easy to clean.
Everyone’s nails grow at different speeds, so it’s important to keep an eye on the length of your nails. Make sure to trim them before they start rubbing against shoes and causing pain. Clean, well-cared for, and neatly trimmed toenails lead to comfortable, healthy feet.
If you suspect you have an ingrown toenail, please visit one of our locations in Myrtle Beach, Surfside Beach, Conway or Little River or to make an appointment call 843-449-FOOT.
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