My Blog

By Michael Guerra, DPM
December 07, 2018
Category: Foot Care
Tags: Sesamoid   Sesamoiditis  

What is Sesamoiditis?

Sesamoids are small bones that are only connected to tendons or surrounded in muscle. This only appears in a few places in the body, one of which is the foot. Two very tiny sesamoids are found in the underside of the foot near the big toe. One is on the outer side of the foot and the other bone is close to the middle of the foot. This structure provides a smooth surface for the tendons to slide over, which helps the tendons move muscles. They help with weight bearing and also help to elevate the bones of the big toe. So now that you know what sesamoids are, you might be wondering what sesamoiditis is and what its symptoms are.


Just like any other bone, sesamoids can unfortunately fracture. The tendons surrounding the sesamoids may also become irritated or inflamed and this is what sesamoiditis is. Sesamoiditis is also a form of tendonitis and is a common condition among ballerinas, runners, and baseball catchers due to the pressure that is constantly placed on their feet.

Symptoms of Sesamoiditis

Symptoms of Sesamoiditis may include:

  • Pain under the big toe or ball of the foot

  • Swelling and/or bruising

  • Difficulty in bending and straightening the big toe

Treating Sesamoiditis

Treatments include:

  • Resting and stopping any activity that could be causing pain and inflammation

  • Anti-inflammatories, such as ibuprofen and aspirin only after consulting your physician

  • Icing the sole of the foot

  • Wearing soft-soled and low-heeled shoes

  • Cushioning inserts in the shoes

If symptoms persist after treatments, you may need to wear a removable brace for 4-6 weeks to help the bones heal. Call your podiatrist today to ask any questions about sesamoiditis and get on your way to pain-free feet once again!

By Michael Guerra, DPM
November 01, 2018
Category: Foot Care
Tags: toenail fungus  

Treating toenail fungus

Toenail fungus--it's one of the most common podiatric problems children, teens, and adults have. Causing thickened, yellow, brittle nails, onychomycosis (the medical name for toenail fungus) spreads easily and can be stubborn to treat. If you see one or more of your toenails changing shape, color, and texture, see your foot doctor right away. They have the expertise and treatments to give you ten clear toenails once again.

How toenail fungus starts

The micro-organism thrives in dark, moist environments--sweaty socks and sneakers being prime candidates. Additionally, shared towels, nail clippers, shower room floors, and pool decks breed toenail and Athlete's Foot fungus. In fact, if you suffer periodic outbreaks of itchy, uncomfortable Athlete's Foot, you're more prone to onychomycosis, says the American Academy of Dermatology.

Conquering toenail fungus

Your foot doctor sees scores of patients with toenail fungus. Visual inspection is the main diagnostic tool, and for mild cases of onychomycosis, the podiatrist may recommend creams or ointments applied topically. Oral medications are an option as well.

Additionally, modern podiatry offers innovative laser treatments which kill the micro-organism right where it lives. Painless and very effective, laser treatments are applied to all ten toenails to prevent re-infection.

Unfortunately, toenail fungal infections can become quite severe and spread to the nail bed. When infection is severe, the podiatrist may advise complete removal of the toenail to prevent further problems.

Prevention is best

Of course, if you can avoid toenail fungus, your feet and nails will look and feel their best, and you won't be embarrassed to wear open-toed shoes or sandals in the warm weather. However, some people are more prone to this common infection--diabetics, those with poor peripheral circulation and individuals who are immunosuppressed.

Regardless, your podiatrist recommends these preventive measures for healthy, fungus-free nails:

  1. Wash your feet with soap and water daily, and dry them with a clean towel.
  2. Clip your toenails straight across with a clean clippers.
  3. Wear clean socks daily.
  4. Change your gym shoes after a workout. In fact, alternate pairs if possible, letting your footwear dry out between wearings.
  5. Wear flip-flops or shower sandals in the locker room and poolside, too.
Look after those feet and nails
They're the only ones you have. For ongoing care of your feet and ankles, see your foot doctor each year for a routine examination. He or she will get to know you and your podiatric health needs well so you stay active and feel great.
By Michael Guerra, DPM
October 30, 2018
Category: Foot Issues
Tags: Heel Pain  

Heel PainHeel pain can cause daily activities to be extremely uncomfortable. Whether your heel pain is due to an injury or some other condition, activities such as walking about or standing for extended periods can further aggravate the injury or condition and lead to increased pain and discomfort. The good news is there are treatments that can help by alleviating the pain, while also helping the injury or condition to heal. At Burlington Podiatry, Dr. Michael Guerra is your podiatrist for the treatment of heel pain in Burlington, VT.

Causes and Types of Heel Pain

There are several possible causes of heel pain, including injuries sustained during sports, working out, or other activities. Additionally, performing repetitive motions can put too much strain on the heel and result in pain. For example, the extensive pounding of the feet against the ground when jumping rope or running can cause inflammation, which can lead to pain and discomfort. If there is insufficient cushioning in the shoes to absorb some of the impact of running or jumping, the feet can be more vulnerable to injury and heel pain.

Pain that is felt beneath the heel and into the arch of the foot is typically due to a condition known as plantar fasciitis. This type of heel pain develops when the planter fascia tissues along the bottom of the foot become inflamed. Plantar fasciitis often develops in people who overpronate when walking or running. Overpronation occurs when the foot rolls inward too much, which causes the foot to flatten and the arch to lengthen. Overpronation places extensive tension and stress on the plantar fascia tissues, causing inflammation and pain.

Another condition that can develop in conjunction with plantar fasciitis is is heel spur syndrome. This condition is associated with the formation of calcium deposits, also called heel spurs, on the bottom of the heel. Pressing the foot down to walk, run, or stand puts pressure on the heel spurs and can result in extensive pain and discomfort. Fortunately, several podiatry options are available for treating plantar fasciitis and heel spur syndrome.


Several options are available for treating heel pain in Burlington, VT. A podiatrist can recommend an appropriate treatment or combination of treatments for your specific type of heel pain. Some things you can do at home to help alleviate heel pain include resting the feet and wearing supportive footwear. Podiatry treatments for heel pain include:

  • Surgery
  • Physical therapy
  • Stretching exercises
  • Anti-inflammatory drugs
  • Orthotic foot supports
  • Extracorporeal Pulse Activation Technology (EPAT)

A variety of options are available for treating your heel pain. A podiatrist can identify the cause of your heel pain and recommend a suitable treatment plan. For treatment of heel pain in Burlington, VT, schedule an appointment with Dr. Guerra by calling Burlington Podiatry at (802) 862-8666.

By Michael Guerra, DPM
October 03, 2018
Category: Foot Care
Tags: Foot Care   Heel Spurs  

Have you been experiencing any heel pain or bothersome tenderness without any obvious cause? Although heel spurs themselves sometimes do not cause acute discomfort, they are frequently associated with the painful inflammation known as plantar fasciitis, a condition commonly described as feeling like a knife is wrenching through your foot. Read below for more information on the typical causes, symptoms, and treatments of heel spurs.

What is a Heel Spur?

A heel spur is often the result of overstraining foot muscles and ligaments, overstretching the plantar fascia (the thick band of tissue that connects the heel bone to the toes), and repeatedly tearing the heel bone membrane. From these actions arises a calcium deposit on the underside of the heel bone. Risk factor for developing the condition include:

  • Possessing any walking gait abnormalities

  • Regularly running or jogging on hard surfaces

  • Wearing poorly fitted or overly worn shoes

  • Wearing shoes that lack arch support

  • Being excessively overweight or obese

What are The Symptoms?

Heel spurs do not carry many symptoms by themselves. However, they are often related to other afflictions, most typically plantar fasciitis. The most common sign of this combo of conditions is a feeling of chronic pain along the bottom or back of the heel, especially during periods of walking, running, or jogging. If you are experiencing this recurring inflammation, it is a good idea to visit your local podiatrist's office and inquire about undergoing an x-ray or ultrasound examination of the foot.

What are the Treatment Options?

The solutions to heel spurs are generally centered around decreasing inflammation and avoiding re-injury. They include:

  • Applying ice on the inflammation

  • Performing stretch exercises

  • Wearing orthotic devices or shoe inserts to relieve pressure off of the spur

  • Taking anti-inflammatory medications such as ibuprofen to relieve pain

  • In extreme cases, surgery can be performed on chronically inflamed spurs

If you are dealing with symptoms of heel spurs or pain in your feet, turn to a podiatrist so that we can get you back on your feet. Don't ignore your pain.

By Michael Guerra, DPM
September 07, 2018
Category: Foot Care
Tags: Athlete's Foot   Dry Feet  

What your foot doctor in Burlington, Vermont wants you to know


Athlete's Foot XrayAthlete’s foot can be embarrassing and uncomfortable. Your feet itch uncontrollably. You don’t want to remove your shoes because of your red, scaly feet. The good news is, you can do a lot to prevent athlete’s foot, and if you do get athlete’s foot, there are several effective treatments to make your feet feel better. Dr. Michael Guerra at Burlington Podiatry in Burlington, Vermont wants to share the facts about athlete’s foot.

If you spend a lot of time in or around public pools, public showers, gyms, or locker rooms, there is a good chance you may experience athlete’s foot. That’s because the condition is caused by a fungus which thrives in moist, warm places. It also spreads quite easily.

You can prevent the itch by always wearing flip-flops or sandals in public areas. Avoid going barefoot on warm, moist floors. You should also keep your feet as dry as possible by changing your socks and shoes frequently if you sweat. Also avoid sharing linens, towels, socks, and shoes with others to avoid spreading the problem.

You will be able to recognize if you have contacted the fungus and acquired athlete’s foot because your feet will:

  • Itch uncontrollably
  • Appear red and scaly
  • Possibly have blisters and sores

Your feet will continue to itch and may grow worse when you remove your socks and shoes. You can try some easy home remedies to provide relief. Consider:

  • Using antibacterial soap to wash your feet every day
  • Trying over-the-counter antifungal cream and applying it daily
  • Changing your socks frequently to help your feet stay dry

If your athlete’s foot doesn’t respond to home therapies, Dr. Guerra can help. He may recommend prescription-strength oral antifungal medications along with prescription-strength topical antifungal cream.

You don’t have to let athlete’s foot affect your life. Get some help for the itch and the redness by calling Dr. Michael Guerra, your foot doctor at Burlington Podiatry in Burlington, Vermont today!

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