My Blog

By Michael Guerra, DPM
July 24, 2020
Category: Foot Condition
Tags: Footwear   Hammertoe  
HammertoesWhile tight, cramped shoes and those towering high heels may not immediately show you the damage that’s being done to your feet, over time you will certainly notice changes in the structure and function of your feet. Along with bunions, a common foot deformity, hammertoes are another deformity that causes the toes to bend downward at the middle joint. If the problem isn’t corrected, this simple and rather uncomfortable deformity can become severe. Here’s how to determine whether you may have hammertoes and what you can do about it now to prevent it from getting worse.

Wear Appropriate Footwear
You need to make sure that any shoes you wear properly fit your feet. While this might sound silly, many people are guilty of wearing shoes that are too narrow and put too much pressure on the toes. Look for shoes with a wide toe box that allows your feet enough room to wiggle freely. If your toes are bunched up in any of the shoes you have (particularly high heels or shoes with pointed toes) then you will want to avoid these types of shoes whenever possible.

Consider Shoe Inserts
While it’s important to find shoes that cushion and support your foot structure, sometimes people with hammertoes, bunions, and other foot problems that can cause pain can benefit from prescription shoe inserts (also known as orthotics). Orthotics can be crafted to fit the shape of your feet and also to address the issues you’re having (aka alleviating pressure on the toes when standing or walking).

Apply Protective Padding
A hammertoe causes the toe to bend down like a claw. This means that the toe’s joint is sticking out. As you may already know, this causes shoes to rub against the joint, causing a callus to develop. One way to prevent this from happening is to apply a non-medicated pad over the toe joint before putting on shoes.

Practice Pain Management
If your hammertoe starts to ache or hurt, you may want to apply ice to the area throughout the day to help alleviate pain and swelling. If the pain is intense or persistent then you may want to consider taking a nonsteroidal anti-inflammatory medication such as ibuprofen, which can help with both pain and swelling; however, if your symptoms are severe, you must see a podiatrist about your hammertoe.

Do I need surgery for a hammertoe?
If the hammertoe is flexible (meaning that you can straighten the toe out) then you won’t need surgery; however, if the hammertoe becomes rigid and causes pain and problems with mobility then surgery is recommended.

If you are dealing with hammertoes or other foot problems, you must have a podiatrist that you can turn to for regular and immediate care.
By Michael Guerra, DPM
June 25, 2020
Category: Foot Care
Tags: Podiatrist  
PodiatristAre you wondering whether you should be turning to a podiatrist for care?
 
We don’t often think about the health of our feet until they start to cause us problems. Once foot pain, swelling and other problems set in, it is most likely a good time to visit a podiatrist to find out what’s going on. While minor pain and swelling may be alleviated through rest and home care, you should visit a podiatrist if you are dealing with:
  • Ingrown toenails
  • Chronic heel pain
  • A broken foot or ankle
  • Numbness, tingling or loss of sensation in the feet
  • Severe pain
  • Difficulty bearing weight on a foot or ankle
  • A visible foot deformity
  • Signs of infection (e.g. redness; swelling; fever)
  • An ulcer or open wound
Need to come in for an evaluation? If so, here’s what to expect when you come into our podiatrist’s office for care,
 
We’ll go through your medical history
 
It’s important to understand your current health status as well as any conditions that could cause further problems for your feet and ankles. For example, patients with diabetes are more at risk for foot-related complications; therefore, it’s important to know all the details of your medical history so we can provide you with more effective care.
 
We will examine your foot
 
Next, we will perform a thorough physical examination of the affected foot and ankle. We will look for everything from visible deformities such as bunion and hammertoes, to issues with blood flow or changes in the color of your skin. A physical exam of your feet and ankles can tell us a lot about what might be going on.
 
We will determine if imaging tests are needing
 
Sometimes a physical examination is all that’s needed to be able to determine what’s going on. This is often the case with outward problems such as ingrown toenails or fungal infections; however, problems that affect the bones, ligaments and muscles of the foot may require imaging tests such as MRIs or X-rays to make a proper diagnosis.
 
We will map out a treatment plan
 
Once we’ve determined the cause of your symptoms, we can create your individualized treatment plan. The treatment options we recommend will depend on the type and severity of your condition. Acute and minor conditions will heal with rest and proper home care while more severe or chronic conditions may require long-term maintenance, therapies and medication. This is something that our podiatrist can discuss with you at length during your appointment.
 
If you are looking for someone to provide you with specialized foot and ankle care then a podiatrist is the right doctor for you.
By Michael Guerra, DPM
June 22, 2020
Category: Foot Care
Tags: Heel Pain   Foot Doctor  

While heel pain can sometimes be managed with rest and proper home care, it’s also important that you don’t just ignore the problem. After all, many conditions responsible for heel pain such as plantar fasciitis and Achilles tendonitis can get worse or become chronic if not properly cared for. So, when should you turn to our Burlington, VT, podiatrist Dr. Michael Guerra to treat your heel pain?

You don’t know the cause

Maybe this is the first time you’ve ever dealt with a bout of heel pain. In this case, you may not even understand what might be causing your pain. So, how can you properly treat the problem when you don’t know what it is? Our goal as your Burlington, VT, podiatrist is to provide you with treatment that won’t just manage your symptoms but also treat the underlying cause. If you’re not sure what’s causing your heel pain then you should see a doctor for a diagnosis.

Heel pain is severe

If you are dealing with severe heel pain, or even severe swelling of the heel, it’s a good idea to visit a foot doctor right away. While plantar fasciitis and Achilles tendonitis-related heel pain can be rather uncomfortable, pain shouldn’t be so severe that it’s debilitating. If you experience heel pain even when sitting or resting then you should see a doctor as soon as possible.

You notice signs of infection

This is another reason to pick up the phone and call your podiatrist right away. The sooner you get treated for a foot infection the better. Do not ignore the infection or hope that it goes away on its own, as this can lead to serious health complications. If you are dealing with fever, redness and skin that’s warm to the touch, these are all signs of an infection and they should be evaluated by a foot doctor.

Your heel pain persists for days

If despite proper rest, avoiding physical activities (especially high-impact exercises), taking pain relievers, your heel pain isn’t responding to home care after five days it’s also a good idea to see a podiatrist. Not providing your foot with the proper care it needs to heal now could to lead to more serious issues in the future.

For persistent cases, Shock Wave Therapy ( EPAT) may be used. EPAT is a non-invasive treatment option that uses shockwave therapy to treat chronic forms of heel pain caused by tendonitis and plantar fasciitis, the two most common causes of chronic heel pain. EPAT technology targets the inflamed and damaged areas to trigger the body’s natural healing response to improve circulation and blood flow to the areas, regenerate healthy tissue and to speed up the healing process.

If you are looking for a podiatrist here in Burlington, VT, that can address your heel pain, you’ve come to the right place. Call our office at (802) 862-8666 to schedule an evaluation.

By Michael Guerra, DPM
May 28, 2020
Category: Foot Care
Tags: toenail fungus  
Onychomycosis is the technical term for toenail fungus. It’s when fungus gets under the nail and causes an infection. You’ll notice that the nail changes color and starts emitting an odor. If left untreated, the infection can spread to the other toes and even the fingers. The best thing to do is to schedule an appointment with your local podiatrist. 
 
What Causes Toenail Fungus?
Your feet are vulnerable to fungi and bacteria due to their location on the body. This is especially true if you go barefoot in damp areas like locker rooms, showers, and swimming pools. Your feet come in direct contact with these pathogens. An injury to the nail bed also opens your body up to infection. Even the smallest cut provides an opening for bacteria. Other possible risk factors include pre-existing medical conditions like immune-deficiency, diabetes, circulatory problems, and other chronic illnesses. 
 
Podiatry Treatment for Toenail Fungus
Schedule an appointment with your podiatrist right away when you notice differences in the appearance of your toenail. This includes any thickening, discoloration, or deformity. Your podiatrist will first need to make a diagnosis before treatment starts. This is done through a simple lab test. 
 
The first line of treatment includes oral and topical antifungal. Topical antifungal medication or cream is applied directly to the nail. Oral antifungal is taken just like regular medication. These are also more effective. You will take the oral antifungal for approximately three months.
 
For severe cases, patients require surgery. That’s why it’s so important to seek treatment from your foot doctor right away. They can help you before it gets to this point. Otherwise, your podiatrist performs a temporary removal of the nail. This gives your doctor space to evenly apply the topical antifungal.  
 
Toenails that don’t respond to any treatment need permanent nail removal. This eliminates the fungal infection while getting rid of the damaged nail.
 
At-Home Solutions for Toenail Fungus
There are a few things you can do at home to help treat your toenail fungus. A strict cleaning regime can relieve mild infections. Patients have found success in filing off the white marks and then applying over-the-counter antifungal agents. These do not stop infections from coming back, which is why we encourage patients to seek treatment from a medical professional.
By Michael Guerra, DPM
April 29, 2020
Category: Foot Care
Tags: Shoes   Injuries  
The Right ShoesExercise is an important aspect of keeping our bodies healthy and happy. That’s why it’s so important to wear the correct shoes for certain activities. Whether you’re an athlete, workout buff, or enjoy walking and hiking, you need the proper footwear. It makes the difference between enjoying your favorite activities and sitting out with an avoidable injury. Talk to your podiatrist to have your feet evaluated for your future workout needs.
 
Essential Equipment
All exercise involves your feet, ankles, and knees. Placing pressure on them puts you at risk for strains, sprains, and wear-and-tear injuries. Find shoes made specifically for the activity you engage in while also providing a good fit. They should accommodate your body and activity level. 
 
Pay attention to the wear on your older shoes. The soles show where you need more support in the future. The right shoe also feels good from the start. Don’t believe the sentiment that a shoe needs to be broken in. This is not true and creates ongoing problems. 
 
Matching Your Shoe to Your Sport
Different types of exercise affect your feet in different ways. Your shoes need to support the high-risk areas. 
  • Running requires shoes with shock absorption. Your feet take on a lot of pressure and friction. Cushioning your shoes in the correct areas keeps you from feeling the pain. 
  • Traction is important in sports that need quick changes in direction and sprinting, like basketball. Traction should never be too high or low. The right shoes keep you from slipping on the floor while letting you move and pivot.
  • Ankle support is a must. It limits the side-to-side movement that knocks your ankle out of alignment. This kind of support keeps ankle sprains at bay. For sports like basketball, hockey, skiing, and skating, make sure that your shoes aren’t too high. Otherwise, they will dig into your Achilles tendon. You can also wear soft ankle braces.
  • Arch support varies for everyone. Your podiatrist can test your foot to determine your gait. Depending on the results, your podiatrist can recommend orthotics or special shoe inserts.
Remember to Replace Your Old Shoes
Pay attention to the state of your shoes to understand when to replace them. When the condition starts to decline, especially the arch support and sole, it’s time to go shopping. Start looking for a replacement when they become uncomfortable and wear differently. You don’t have to wear shoes for a long time for them to wear out either. If you are participating in sports or activity on an almost daily basis, your shoes are bound to wear out quickly. 




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