Carmel Valley Foot & Ankle Surgery
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Common Foot & Ankle Conditions


Plantar fasciitis or heel spur syndrome commonly results from inflammation of the band of fibrous connective tissue (fascia or "ligament") running along the bottom surface of the foot, from the heel to the ball of the foot. The condition occurs when the plantar fascia is strained over time beyond its normal extension, causing the soft tissue fibers of the fascia to tear or stretch at points along its length. This commonly leads to inflammation, pain, and possibly the growth of a bone spur where it attaches to the heel bone. The condition is most often successfully treated with conservative measures such as use of anti-inflammatory medications and ice packs, stretching exercises, and orthotics devices.

Custom Orthotics or Custom Sandals: these are custom arch supports that help in correcting abnormal or irregular walking pattern. Orthotics perform functions that make standing, walking, and running more efficient and comfortable by altering the mechanism by which the foot strikes a walking or running surface. Doctors of podiatric medicine take a plaster mold of your foot to make custom orthotics or sandals. The device is a conservative approach to many foot problems and is a method of control or prevention of further foot problems. Orthotics change foot function and therefore minimize stress forces that could ultimately cause foot deformity and pain. Most foot and ankle conditions may benefit from the use of orthotics.

Ankle sprains are the most common athletic injury. Nearly 85% of ankle sprains occur laterally, or on the outside of ankle joints. Sprains on the inside ligaments are less common. An ankle sprain occurs when the ankle rolls causing the ligaments to be stretched or torn. Many sprains occur when participating in sports, or by twisting the ankle when walking on an uneven surface. Some individuals, due to their bone structure or foot type, are more prone to ankle sprains. Although ankle sprains often heal without need for surgery, it is important to consider the problem as a partial dislocation of the ankle joint and treat it accordingly. Early treatment is key in preventing further sprains, painful joints, or fractures in the future.

Achilles tendonitis can cause inflammation and degeneration of the achilles tendon. The pain caused by achilles tendonitis can develop gradually without a history of trauma. Achilles tendonitis is aggravated by activities that repeatedly stress the tendon, causing inflammation. It is a common problem often experienced by athletes, particularly distance runners. The most common cause is over-pronation (flat feet). This occurs because the arch collapses upon weight bearing, adding stress on the achilles tendon. Other factors that lead to achilles tendonitis are improper shoe selection, inadequate stretching prior to engaging in athletics, a short achilles tendon, direct trauma (injury) to the tendon, and heel bone deformity.


Foot & Ankle Trauma/Fractures: Toe fractures, midfoot fractures, as well as rearfoot/ankle fractures. These can be caused by acute trauma from sports, accidents, or other activities. You may also get stress fractures from overuse. See your foot and ankle specialist right away to treat injuries and prevent future arthritic conditions.

Hammertoes: Tendon imbalance is the major cause of toe deformities in adults. The tendons may stretch or tighten to compensate for imbalance of the foot. Thus, people with abnormally long toes, flat feet or high arches have a greater tendency to develop toe deformities. Over time, the toe may become permanently deformed and arthritic changes may develop. Patients can benefit from custom orthotics or may need surgery to illeviate the pain and deformity.

Ingrown Toenails occur when the curvature of the nail pushes down the side of the toe and goes into the skin. This causes pain and discomfort and, in many cases, can result in infection. The leading cause of ingrown toenails is inheritance, although the way the patient trims his or her nails can be a contributing factor. Improper nail spa services can also lead to an ingrown toenail. There are both conservative and permanent methods to help in both treating the current condition and preventing future recurrences.

Many diabetics are at risk for developing a serious foot condition at some time in their life which can result in hospitalization. Most of these problems are preventable through proper care and regular visits to a foot and ankle specialist. Common serious problems include infection, ulcerations, or gangrene that may lead, in severe cases, to amputation of a toe, foot or leg.

The key to amputation prevention in diabetic patients is early recognition and regular foot screenings, at least annually, from a podiatric physician. Furthermore, many diabetics may be eligible for custom shoes and that may help prevent many of the problems associated with diabetes. Early warning signs may include:

  • Skin color or temperature changes
  • Swelling or pain in foot/ankle or legs
  • Open sores that are slow to heal
  • Ingrown toenails
  • Bleeding or cracks in the skin

Diabetic Wounds/Ulcerations: Foot ulcers are sores that occur on the feet of people with diabetes or other conditions that cause peripheral neuropathy. Up to 25% of people with diabetes develop foot problems. Diabetic foot ulcers usually occur on the bottom of the foot and are the leading cause of leg amputations in the United States. However, the sooner diabetic foot ulcers are treated, the better the outcome. If undetected, the sore may become larger and infected. Leading causes of ulceration are:  Neuropathy (decreased feeling in your feet), peripheral arterial disease, venous disease, improper shoes, foot deformities, decreased vision, and/or smoking.

If you experience sores or blisters on the foot or lower leg, fever, skin redness or swelling, or other signs of infection, see your podiatrist immediately.

Peripheral Neuropathy: numbness or lack of protective pain sensation can be caused by various conditions such as: Diabetes or high blood sugar (can lead to ulcerations), neurovascular factors leading to blood vessel damage that carry oxygen and nutrients to the nerves, autoimmune factors that cause inflammation in nerves, mechanical injury to nerves such as tarsal tunnel syndrome, genetic factors leading to nerve disease, or smoking/alcohol use. Extremity symptoms may be described as: numbness, tingling, or pain in the toes, feet, legs, hands, arms, and fingers. Individuals with peripheral neuropathy may also get wasting of the muscles of the feet or hands.

Circulatory Disorders

Peripheral Arterial Disease or poor blood supply to the lower extremity can cause discomfort or pain when you walk. The pain can occur in your hips, buttocks, thighs, knees, shins, or upper feet because PAD affects arteries that carry blood away from your heart to your limbs. You are more likely to develop PAD as you age. Smoking or having diabetes increases your chances of developing the disease sooner. You may not feel any symptoms from peripheral artery disease at first. The most common symptom is intermittent claudication (IC). IC is discomfort or pain in your legs that happens when you walk and goes away when you rest. You may not always feel pain; instead you may feel a tightness, heaviness, cramping, or weakness in your leg. PAD can lead to ulcerations.

Venous Disease/Varicose or spider veins: The squeezing of leg muscles pumps blood back to the heart from the lower body. Veins have valves that act as one-way flaps. These valves prevent the blood from flowing backwards as it moves up the legs. If the one-way valves become weak, blood can leak back into the vein and collect there. This problem is called venous insufficiency. Pooled blood enlarges the vein and it becomes varicose. Spider veins can also be caused by the backup of blood. Venous insufficiency can lead to lower extremity ulcerations.

Metatarsalgia or ball of foot pain is often caused by wearing shoes with thin soles and high heels. This puts extra pressure on the bones in the ball of the foot. Standing or walking on a hard surface for long periods also puts added pressure on the bones, causing pain. Bunions and hammertoes can make the problem worse. Sometimes high arches or arthritis can also cause metatarsalgia. The most common symptom is pain in the ball of the foot. You may benefit from orthotics, ask your foot and ankle specialist today.

Neuromas are a painful condition, also referred to as a "pinched nerve" or a nerve tumor. It is a benign growth of nerve tissue frequently found between the third and fourth toes that brings on pain, a burning sensation, tingling, or numbness between the toes and in the ball of the foot. The principal symptom associated with a neuroma is pain between the toes while walking. Those suffering from the condition often find relief by stopping their walk, taking off their shoe, and rubbing the affected area. At times, the patient will describe the pain as similar to having a stone in his or her shoe. The vast majority of people who develop neuromas are women. There are many treatment options including orthotics that may alleviate your symptoms.

Arthritis: osteoarthritis, rheumatoid arthritis, or gouty arthritis

Feet are especially prone to develop arthritis because they take a lot of pressure. Symptoms include aching or generalized pain in one joint or an entire area of your foot. There are certain types of arthritis which cause more deformity and pain.  Rheumatoid arthritis often causes moderate to severe bone changes in the feet, especially in the toes and the ball of the foot. The feet can become very painful and difficult to walk on. An arthritic joint, from osteoarthritis or previous trauma, will benefit from an evaluation from your foot and ankle specialist. Gout is a form of arthritis that occurs as a result of the build-up of uric acid in the body and the joint fluid. This accumulation of uric acid typically occurs when the body has difficulty processing certain protein substances that are found naturally in our diets. The tendency to accumulate uric acid is often hereditary. Gout usually starts with a sudden onset of intense pain in one or more joints, usually the big toe joint of the foot. The pain is accompanied by redness, swelling and warmth over the joint. All arthritic conditions may contribute to or result from bunion and hammertoes deformities. It is important to verify the amount of damage and protect the joint. orthotics or possibly surgery may help realign the forces or conditions that affect that particular joint.

Plantar Verrucae or warts are caused by a virus that enters the body through a break in the skin. The virus grows in warm, moist environments. Plantar warts often spread to other areas of the foot, increase in size, and can form into a cluster. They may be difficult to distinguish from calluses. However, what differentiates them from a callus is that they have tiny black dots on the surface layer which are ends of capillary blood vessels. Plantar warts can be very painful and tender. Although plantar warts may eventually disappear by themselves, you should seek treatment if they are painful or to prevent spreading.

Biopsy & Pathology: cancer screening of foot. Regular visits to your podiatrist can help in early diagnosis of skin and other deeper pathologies.

Nail/Skin Disorders such as fungal infections, bacterial infections, dermatological disorders, or trauma (bleeding under the nail). All can be safely diagnosed and treated by your foot and ankle specialist.

Plantar Fasciitis/Heel painOrthoticsAnkle SprainsAchilles TendonitisTrauma/FracturesBunionsHammertoes
Ingrown ToenailDiabetesWounds/UlcerationsPeripheral NeuropathyPeripheral Arterial DiseaseVenous Disease
Flat FeetMetatarsalgiaNeuromaArthritisPlantar VerrucaeBiopsy & PathologyNail/Skin Disorders

Dr. Noushin Shoaee is a podiatrist and associate of the American College of Foot & Ankle Surgeons practicing podiatry and podiatric medicine in San Diego CA offering digital x-ray services• orthotics and insoles• treatment of plantar fasciitis and heel pain• shockwave therapy• treatment of ankle sprains and fractures• bunions• hammertoes• ingrown toenail • diabetes• flat feet• neuroma• ulcers• foot surgery • ankle surgery • treatment of warts throughout San Diego CA. Foot doctor serving San Diego CA and neighborhoods: Carmel Valley CA • Torrey Hills CA • La Jolla CA • Rancho Santa Fe CA • Del Mar CA • Solana Beach CA • Encinitas CA • Carlsbad CA • Poway CA • Rancho Penasquitos CA • Rancho Bernardo CA • Scripps Ranch CA • Mira Mesa CA

Podiatric Surgeon San Diego CA  Address: 4765 Carmel Mountain Road, Suite 104 San Diego, CA 92130