
Treating Tarsal Tunnel Syndrome
Tarsal tunnel syndrome is a condition in which the tibial nerve, located in the tarsal tunnel in the foot, is compressed. The tibial nerve can become compressed from injury, such as an ankle sprain, flat feet, and lesions. Arthritis, diabetes, and varicose veins can also cause swelling and thus result in nerve compression.
Symptoms of tarsal tunnel syndrome include several different sensations in the sole of the foot, inside the ankle, and around the tibial nerve. These sensations include shooting pains, numbness or reduced sensation, pins and needles, burning, and tingling. Symptoms tend to worsen with greater activity to the area. In rare and severe occasions, this can change the muscles in the foot.
If you suspect you have tarsal tunnel syndrome, you should consult with your podiatrist. He or she will examine your medical history to see if you have a history of diabetes, arthritis, or flat feet. They will also check to see if you have suffered an injury to the area recently. An electrical test will be conducted to check if the nerve has been damaged. A simpler Tinel’s Test might also be used. This includes simply tapping the nerve to create a sensation. An MRI scan of the area may also be used.
Treatments vary greatly for tarsal tunnel syndrome. Treatments include both nonsurgical and surgical options depending upon the severity of the condition. Nonsurgical options include anti-inflammatory medication and steroid injections to the area. Orthotics, such as a splint or brace that immobilizes the foot, is another noninvasive option. For those with flat feet, custom shoes can be made to offer better foot support. Surgical options include a tunnel tarsal release, in which an incision is made behind the ankle down to the arch of the foot. This releases the ligament and relieves pressure off the nerve. Some doctors use a more minimally invasive surgery, where smaller incisions are made in the ankle and the ligament is stretched out.
If you are suffering from painful sensations in your foot, see a podiatrist who can determine if you are experiencing tarsal tunnel syndrome. Tarsal tunnel syndrome that is left unchecked can cause permanent nerve damage to the foot.
Addressing Congenital Foot Disorders

Newborns come into the world with a sense of wonder and curiosity, but some may also have foot deformities that require attention and care. One common condition is congenital talipes equinovarus, commonly known as clubfoot. This causes the baby's foot to twist inward. This congenital foot condition can be detected through having a prenatal ultrasound performed. Metatarsus adductus is another deformity where the baby's foot curves inward, often due to positioning in the womb, but it usually resolves naturally. In-toeing and out-toeing, where the feet point inward or outward, are relatively common problems that often correct themselves as a child grows. Early detection and intervention are essential in addressing these conditions. Performing gentle stretching exercises, casts, and sometimes surgery can help correct deformities like clubfoot. It is beneficial for parents and podiatrists to work together to ensure the best possible outcome. If your child has been born with a congenital foot condition, it is strongly suggested that you have this type of doctor as part of your child's healthcare team.
Congenital foot problems require immediate attention to avoid future complications. If you have any concerns, contact Dawn Miles, DPM of Florida. Our doctor can provide the care you need to keep you pain-free and on your feet.
Congenital foot problems are deformities affecting the feet, toes, and/or ankles that children are born with. Some of these conditions have a genetic cause while others just happen. Some specific foot ailments that children may be born with include clubfeet, polydactyly/macrodactyly, and cleft foot. There are several other foot anomalies that can occur congenitally. What all of these conditions have in common is that a child may experience difficulty walking or performing everyday activities, as well as trouble finding footwear that fits their foot deformity. Some of these conditions are more serious than others. Consulting with a podiatrist as early as possible will help in properly diagnosing a child’s foot condition while getting the necessary treatment underway.
What are Causes of Congenital Foot Problem?
A congenital foot problem is one that happens to a child at birth. These conditions can be caused by a genetic predisposition, developmental or positional abnormalities during gestation, or with no known cause.
What are Symptoms of Congenital Foot Problems?
Symptoms vary by the congenital condition. Symptoms may consist of the following:
- Clubfoot, where tendons are shortened, bones are shaped differently, and the Achilles tendon is tight, causing the foot to point in and down. It is also possible for the soles of the feet to face each other.
- Polydactyly, which usually consists of a nubbin or small lump of tissue without a bone, a toe that is partially formed but has no joints, or an extra toe.
- Vertical talus, where the talus bone forms in the wrong position causing other bones in the foot to line up improperly, the front of the foot to point up, and the bottom of the foot to stiffen, with no arch, and to curve out.
- Tarsal coalition, when there is an abnormal connection of two or more bones in the foot leading to severe, rigid flatfoot.
- Cleft foot, where there are missing toes, a V-shaped cleft, and other anatomical differences.
- Macrodactyly, when the toes are abnormally large due to overgrowth of the underlying bone or soft tissue.
Treatment and Prevention
While there is nothing one can do to prevent congenital foot problems, raising awareness and receiving neonatal screenings are important. Early detection by taking your child to a podiatrist leads to the best outcome possible.
If you have any questions please feel free to contact one of our offices located in Palatka and Saint Augustine, FL . We offer the newest diagnostic tools and technology to treat your foot and ankle needs.
Congenital Foot Problems
A congenital foot problem is a problem affecting the feet, toes, and/or ankle that a child is born with. Several issues with a child’s feet can occur congenitally. Such problems include clubfoot, vertical talus, tarsal coalition, polydactyly, macrodactyly, and cleft foot. Some of these problems have a genetic basis, with someone in their family history having a gene causing the condition, and some are simply an anomaly.
The following are specifics about a few of these conditions:
- Clubfoot, also called congenital talipes equinovarus or talipes equinovarus, is When the tendons of the foot shorten, the bones are of an unusual shape, and the Achilles tendon is tight, causing an inward and downward pointing of the foot. The soles of the feet might also face each other. In most cases of clubfoot, both feet are affected. If not treated, the affected child will walk on the sides of their feet or ankles.
- Polydactyly is a condition where the child has more than five fingers or toes on either or both feet. Presentation usually consists of a nubbin or small lump of tissue without a bone, a toe that is partially formed but has no joints, or an extra toe.
- Vertical talus is where the talus bone forms in the wrong position, other bones in the foot do not line up properly, the front of the foot points up, and the bottom of the foot is stiff, has no arch, and usually curves out. This can occur in one or both feet and if left untreated, can lead to serious disability or discomfort as the child grows.
- Tarsal coalition is when there is an abnormal connection of two or more bones in the foot leading to severe, rigid flatfoot. The tarsal bones, located toward the back of the foot and in the heel, are the ones affected. This condition is often present at birth, but signs of the disorder usually come on in early adolescence.
- Cleft foot is a rare condition where the foot has missing toes, a V-shaped cleft, and other anatomical differences. Surgery can often help improve the foot’s function since the heel remains normal and is what is most needed for walking. The main issues with this affliction are whether the affected foot can fit into a shoe and the shape and appearance of the foot.
- Macrodactyly is when the toes are abnormally large due to overgrowth of the underlying bone or soft tissue. Having this condition makes it harder for the child to use the affected foot for certain activities.
What is a Podiatrist?
The branch of medicine that is focused on the treatment, diagnosis, and study of disorders of the lower leg, ankle and foot is referred to as podiatry. Because people often spend a great deal of their time on their feet, many problems in this area can occur. A person seeks help from the field of podiatry when they need treatment for heel spurs, bunions, arch problems, deformities, ingrown toenails, corns, foot and ankle problems, infections, and problems with the foot that are related to diabetes and additional diseases.
To treat problems of the foot, ankle or lower leg, a podiatrist may prescribe physical therapy, drugs, perform surgery, or set fractures. Individuals may also be recommended to wear corrective shoe inserts, custom-made shoes, plaster casts and strappings in order to correct deformities.
When trying to gather information on a patient problem, a scanner or force plate may be used in order to design orthotics. During this procedure, patients are told to walk across a plate that is connected to a computer; the computer then takes a scan of the foot and indicates weight distribution and pressure points. The computer readouts will give the podiatrist information to help them determine the correct treatment plans.
Diagnosis is also provided through laboratory tests and x-rays. Through the foot, the first signs of serious problems such as heart disease, diabetes and arthritis can show up. For example, individuals that have diabetes may frequently have problems such as infections and foot ulcers because they experience poor circulation in the foot area. A podiatrist can then have consultations with patients when symptoms arise. Referrals will then be made to specialists that handle the greater health problems.
Some podiatrists have their own independent, private practices or clinics where they have a small staff and administrative personnel. Many podiatrists work within group practices. They usually spend time performing surgery in ambulatory surgical centers or hospitals, or visit patients in nursing homes. Podiatrists typically spend between 30 to 60 hours of week working. Some podiatrists specialize in public health, orthopedics, surgery, or primary care. Other fields include specialties in geriatrics, dermatology, pediatrics, diabetic foot care and sports medicine.
Some podiatrist specialists complete extra training in the area of foot and ankle reconstruction that results from the effects of physical trauma or diabetes. There are also surgeons that perform surgery of a cosmetic nature to correct bunions and hammertoes.
Athlete's Foot
Athlete’s foot is an extremely contagious infection caused by a fungus that results in itching, burning, dry, and flaking feet. The fungus that causes athlete’s foot is known as tinea pedis and thrives in moist, dark areas such as shower floors, gyms, socks and shoes, commons areas, public changing areas, bathrooms, dormitory style houses, locker rooms, and public swimming pools. Athlete’s foot is difficult to treat as well because of the highly contagious and recurrent nature of the fungus.
Tinea is the same fungus that causes ringworm, and is spread by direct contact with an infected body part, contaminated clothing, or by touching other objects and body parts that have been exposed to the fungus. Because the feet are an ideal place for tinea to grow and spread, this is the most commonly affected area. It is, however, known to grow in other places. The term athlete’s foot describes tinea that grows strictly on the feet.
The most commonly infected body parts are the hands, groin, and scalp, as well as the feet. Around 70% of the population suffer from tinea infections at some point in their lives, however not all of these cases are athlete’s foot. Just like any other ailment, some people are more likely to get it than others, such as people with a history of tinea infections or other skin infections, both recurring and non-recurring ones. The extent to which a person experiences regrowth and recurrent tinea infections varies from person to person.
Sometimes people will not even know that they are infected with tinea or that they have athlete’s foot because of a lack of symptoms. However, most experience mild to moderate flaking, itching, redness, and burning. However, some of the more severe symptoms include cracking and bleeding skin, intense itching and burning, pain while walking or standing, and even blistering.
Because of the recurring nature of the tinea fungus and the athlete’s foot it causes, the best way to treat this condition is with prevention. You can take some preventative measures such as wearing flip flops or sandals in locker rooms and public showers to reduce contact with the floor. It also helps to keep clean, dry feet while allowing them to breathe. Using powders to keep your feet dry is a good idea, as well as keeping your feet exposed to light and cool air, to prevent the growth of tinea. If you do happen to get athlete’s foot, opt for using topical medicated creams, ointments or sprays. These treatments help eliminate and prevent it from coming back.
Fall Prevention Exercises for Older Adults and Those at Risk

For older adults or those with medical issues, the risk of falling is a concern, as it can lead to severe injuries. Regular exercise can help prevent falls by strengthening foot and leg muscles, improving balance, and increasing endurance. One can perform balance exercises during everyday activities, such as standing on one foot while waiting in line or sitting down and standing up without using the hands. For stronger calves and ankle muscles, the toe stand exercise can be done where one holds onto a solid support, like a chair, for balance, with the back straight and both knees slightly bent. Then push up onto the tiptoes as high as possible and lower both heels to the floor. Walking, especially on uneven surfaces, and Tai Chi are beneficial for improving strength and balance. Swimming pool exercises can also help. Start slowly and breathe easily during exercise. If pain or dizziness occurs, stop immediately. If you are concerned about falling and seek additional fall prevention tips, it is suggested that you make an appointment with a podiatrist.
Preventing falls among the elderly is very important. If you are older and have fallen or fear that you are prone to falling, consult with Dawn Miles, DPM from Florida. Our doctor will assess your condition and provide you with quality advice and care.
Every 11 seconds, an elderly American is being treated in an emergency room for a fall related injury. Falls are the leading cause of head and hip injuries for those 65 and older. Due to decreases in strength, balance, senses, and lack of awareness, elderly persons are very susceptible to falling. Thankfully, there are a number of things older persons can do to prevent falls.
How to Prevent Falls
Some effective methods that older persons can do to prevent falls include:
- Enrolling in strength and balance exercise program to increase balance and strength
- Periodically having your sight and hearing checked
- Discuss any medications you have with a doctor to see if it increases the risk of falling
- Clearing the house of falling hazards and installing devices like grab bars and railings
- Utilizing a walker or cane
- Wearing shoes that provide good support and cushioning
- Talking to family members about falling and increasing awareness
Falling can be a traumatic and embarrassing experience for elderly persons; this can make them less willing to leave the house, and less willing to talk to someone about their fears of falling. Doing such things, however, will increase the likelihood of tripping or losing one’s balance. Knowing the causes of falling and how to prevent them is the best way to mitigate the risk of serious injury.
If you have any questions, please feel free to contact one of our offices located in Palatka and Saint Augustine, FL . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Falls Prevention
Elderly Americans are very susceptible to falls as they get older. Everyone experiences decreases in flexibility, balance, strength, and the senses as they age. This correlates to some eye-opening statistics. 1 in 4 Americans aged 65 and older fall each year. An elderly American is being treated for a fall in an emergency room every 11 seconds. In light of these striking statistics, one can see the importance of taking steps to prevent falls.
Finding an exercise program for the elderly is an excellent way to reduce the likelihood of falls. Look for an exercise program that improves strength and balance. Elderly people who live a more sedentary lifestyle, with little physical activity, are at an increased risk of falling. Wearing well-fitted footwear that provides good foot support and cushion will help prevent falls from poorly fitted shoes. Talking to a podiatrist about your susceptibility to falls and about inspecting your prescriptions will help to avoid any medication that could make falls more likely. Due to a decline in the senses among the elderly, having your eyes and hearing checked is recommended.
Around half of all falls occur in the household. Removing tripping hazards in the home and making it more accommodating to older persons can significantly reduce falls. Some notable household changes include increasing lighting around the house, installing grab bars in the shower and bathroom, and making sure the floor is clear of clutter. Other smart options include installing a shower chair, using rubber-bottomed rugs, and placing railings on both sides of stairwells.
Finally, discuss with a doctor and your family about your fear of falling. This will help to increase awareness among the population on the need for fall prevention. A lack of awareness on the matter, and a downplaying of importance are what increase the risks of falling. Following these tips can help to reduce the risk for yourself and your loved ones.
Pain or No Pain With Flat Feet

The majority of babies are born with flat feet, and the arch generally develops during childhood years. The arch runs lengthwise along the bottom of the foot, and it may not become developed in adults for various reasons. These may include genetic reasons, or it may not form if an injury has occurred. Additionally, there may be existing medical conditions which may cause flat feet, such as rheumatoid arthritis or diabetes. Many people do not have pain with flat feet, and there are some patients who have pain from wearing shoes that do not fit correctly. There may also be changes in the work environment, which may involve standing on different surfaces. There are specific stretches that can be performed which may help people who have flat feet. A calf stretch can be effective in strengthening the lower part of the leg. This is done by standing on a step and lowering one heel at a time until a gentle stretch is felt. If you have flat feet, it is suggested that you are under the care of a podiatrist who can prescribe custom-made orthotics for relief, if needed.
Flatfoot is a condition many people suffer from. If you have flat feet, contact Dawn Miles, DPM from Florida. Our doctor will treat your foot and ankle needs.
What Are Flat Feet?
Flatfoot is a condition in which the arch of the foot is depressed and the sole of the foot is almost completely in contact with the ground. About 20-30% of the population generally has flat feet because their arches never formed during growth.
Conditions & Problems:
Having flat feet makes it difficult to run or walk because of the stress placed on the ankles.
Alignment – The general alignment of your legs can be disrupted, because the ankles move inward which can cause major discomfort.
Knees – If you have complications with your knees, flat feet can be a contributor to arthritis in that area.
Symptoms
- Pain around the heel or arch area
- Trouble standing on the tip toe
- Swelling around the inside of the ankle
- Flat look to one or both feet
- Having your shoes feel uneven when worn
Treatment
If you are experiencing pain and stress on the foot you may weaken the posterior tibial tendon, which runs around the inside of the ankle.
If you have any questions please feel free to contact one of our offices located in Palatka and Saint Augustine, FL . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.