Tuesday, 15 April 2025 00:00

Geriatrics and Podiatry

Bone density loss, dry skin, poor circulation, and rough and brittle nails are some of the common problems that can occur as people age. The effect that these problems has on foot health should be of particular concern in comprehensive geriatric care.

Feet that are diseased or injured have a negative effect on overall health and safety. Painful feet limit a person’s willingness and ability to stay active. Poor foot health can also cause gait change, which can lead to falls and accidents. Even though recovery time from health problems naturally slows as we age, many foot problems can be avoided altogether with regular prophylactic care.

Feet should be thoroughly washed in warm water daily. Care must be taken to dry the feet well, making sure to dry between and under the toes. Any left-over moisture can cause problems like foot fungus. After cleaning feet carefully check for problems such as cracked skin, bruises, swelling, cuts, corns, or other irregularities.

Examine toenails for ingrown, jagged, or split nails. Long toenails should be cut straight across. Never cut toenails at an angle or down the side as this may lead to ingrown nails.

Cracked and dry feet should be treated once or twice a day with a non-greasy moisturizer. Rub the moisturizer into the skin and allow it to dry before putting on socks and shoes. Sweaty feet can be dusted with a small amount of talcum powder. Avoid putting talcum directly into shoes as this may make feet slip within the shoe and cause a serious fall.

Wear clean dry socks each day. Not only do clean socks feel better on the feet, but socks worn for longer periods may harbor disease and odor-causing bacteria. Socks should not be tight around the top as they can leave marks on the leg. Socks that are too small can bring about bruising caused by pressure against the toes.

Wear comfortable and well-fitting shoes. If possible, consult a professional footwear specialist when purchasing shoes. Do not walk around barefoot as this exposes the feet to possible injury and bacteria.

Good foot health allows a more active lifestyle, which improves blood flow. Good circulation aids in recovery from injury or illness. It is also important for maintaining overall health.

Serious health problems can manifest themselves as symptoms in the feet. The elderly should seek professional help from a podiatrist if experiencing foot problems like tingling, numbness, pain, infection, or a sore that does not heal. Taking care of these problems right away can prevent the development of severe cases.

Tuesday, 08 April 2025 00:00

Ingrown Toenail Care

Ingrown toenails occur when the edges of a toenail grow into the surrounding skin, causing pain, redness, and swelling. This condition is often seen in the big toe and can sometimes lead to infection. One of the key causes of ingrown toenails is improper nail trimming, such as cutting nails too short or rounding the edges. Other factors include wearing tight shoes that crowd the toes or injure the nail. Toenail thickening, often caused by fungal infections, can also increase the risk of ingrown nails by altering the shape of the nail and making it more likely to dig into the skin. Ingrown toenails may improve with care such as soaking and proper trimming, but severe cases require professional treatment. A podiatrist can safely remove part of the nail, treat any infection, and provide advice on proper nail care and footwear to prevent recurrence. If you have an ingrown toenail, it is suggested that you schedule an appointment with a podiatrist.

Ingrown toenails can become painful if they are not treated properly. For more information about ingrown toenails, contact Luis Esquerdo Cruz, DPM of Dr. Esquerdo Podiatry and Laser Center . Our doctor can provide the care you need to keep you pain-free and on your feet.

Ingrown Toenails

Ingrown toenails occur when a toenail grows sideways into the bed of the nail, causing pain, swelling, and possibly infection.

Causes

  • Bacterial infections
  • Improper nail cutting such as cutting it too short or not straight across
  • Trauma to the toe, such as stubbing, which causes the nail to grow back irregularly
  • Ill-fitting shoes that bunch the toes too close together
  • Genetic predisposition

Prevention

Because ingrown toenails are not something found outside of shoe-wearing cultures, going barefoot as often as possible will decrease the likeliness of developing ingrown toenails. Wearing proper fitting shoes and using proper cutting techniques will also help decrease your risk of developing ingrown toenails.

Treatment

Ingrown toenails are a very treatable foot condition. In minor cases, soaking the affected area in salt or antibacterial soaps will not only help with the ingrown nail itself, but also help prevent any infections from occurring. In more severe cases, surgery is an option. In either case, speaking to your podiatrist about this condition will help you get a better understanding of specific treatment options that are right for you.

If you have any questions please feel free to contact our office located in San Juan, PR . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Ingrown Toenails
Tuesday, 08 April 2025 00:00

Ingrown Toenails

An ingrown toenail is a nail that has curved downward and grown into the skin.  This typically occurs at either the nail borders or the sides of the nail.  As a result, pain, redness, swelling, and warmth may occur in the toe.  If a break in the skin forms due to the ingrown nail, bacteria may enter and cause an infection in the area; this is typically characterized by a foul odor and drainage.

Ingrown toenails have multiple reasons for developing.  In many instances, the condition is a result of genetics and is inherited.  The most common cause, however, is improper trimming; cutting the toenails too short forces the skin beside the nail to fold over.  An ingrown toenail can also develop due to trauma, such as stubbing the toe, having an object fall on the toe, or participating in activities that involve repeated kicking or running.  Wearing shoes that are too tight or too short can also cause ingrown toenails.

Treatment for an ingrown toenail varies between patients and the severity of the condition.  In most cases, it is best to see your podiatrist for thorough and proper treatment.  After examining your toe, your podiatrist may prescribe oral antibiotics to clear the infection if one is present.  Surgical removal of either a portion of the nail or the entire nail may also be considered.  In some cases, complete removal or destruction of the nail root may be required.  Most patients who undergo nail surgery experience minimal pain afterward and can return to normal activity the following day.

Ingrown toenails can be prevented with proper nail trimming and by avoiding improper-fitting shoes.  When cutting the toenails, be sure that you are cutting in a straight line and avoid cutting them too short.  Shoes should not be too short or tight in the toe box.

Wearing the right shoes while using a treadmill is essential for comfort, injury prevention, and performance. Cushioning and shock absorption help reduce the impact on joints, making each step smoother and protecting the feet from strain. Stability ensures proper foot alignment, reducing the risk of ankle rolling or discomfort during movement. Good arch support provides balance and helps prevent issues like plantar fasciitis. Breathability is also important, as it allows airflow to keep the feet cool and dry, reducing the risk of blisters and discomfort. Additionally, comfort plays a key role in maintaining endurance during workouts, ensuring that the feet remain relaxed and well-supported. If you exercise on the treadmill and have developed foot pain, it is suggested that you consult a podiatrist who can guide you toward the correct shoes to wear.

You should always make sure your running shoes fit properly in order to avoid injury. For more information, contact Luis Esquerdo Cruz, DPM from Dr. Esquerdo Podiatry and Laser Center . Our doctor can provide the care you need to keep you pain-free and on your feet.

Choosing the Right Running Shoe for Your Foot Type

Improper shoe sizing can cause a myriad of problems for your feet. Shoes that don’t fit you properly can lead to muscular imbalances in your body, which can result in foot, knee, and hip injuries.

Tips for Finding the Right Running Shoe

  • Make sure you have a thumb’s width of wiggle room between the end of your longest toe and the front of the shoe.
  • There should be little to no slipping at the heel
  • Don’t assume your size in one shoe brand will be your size in another
  • Do not lace up your shoes too tightly
  • Walk around in the store with your new shoes before you buy them

If you have any questions please feel free to contact our our office located in San Juan, PR . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Differences between Walking and Running Shoes

Both running and walking are great exercises, but should a person wear the same shoes for both activities? The answer is no, because there is a difference between the way a person’s feet hit the ground when they are walking and when they are running. Therefore, the shoes for each activity are designed differently. Before you begin any exercise program it is always recommended that you speak with your doctor or podiatrist.

Walking is a low impact exercise that is often recommended by doctors to their patients. While walking is a simple activity, it still requires some degree of preparation. If you think about walking and how your feet strike the ground as you move, you will notice that your heel hits the ground first before your foot continues to roll forward and your next step begins. Because of this rolling motion, walking shoes are designed to be more flexible than running shoes. This flexibility helps the walker push off with each step taken.

Because the heel hits the ground first when you walk, walking shoes are designed to absorb most of the shock. Walking shoes should therefore have a beveled or angled heel. The angle of the heel helps absorb the shock and reduces pressure from the ankles. This is especially important for speed walkers, as their feet will hit the ground twice as often as the normal walker.

When people decide to run as a hobby or for their health, they must first realize that running is a high impact exercise. If not done with the proper equipment, running may cause damage to the feet and legs. Running shoes are designed to be more lightweight and to have thicker soles. The thicker soles act as shock absorbers for the rest of the body. Walking shoes often do not have the proper arch support that running shoes do.

A proper fitting shoe can make or break a runner or a walker. If the shoes are too big, their feet will slide back and forth inside the shoe and cause blisters. Whether you will be running or walking, the right equipment can make all of the difference in the world.

Tuesday, 25 March 2025 00:00

Benefits of Ingrown Toenail Surgery

Ingrown toenail surgery is a procedure performed to relieve pain and prevent infection caused by a toenail growing into the surrounding skin. The procedure involves numbing the toe with a local anesthetic before carefully removing the affected portion of the nail. In some cases, the nail matrix is treated to prevent regrowth in the problematic area. Surgery is recommended when conservative treatments fail or when there is recurring pain, swelling, or infection. Common reasons for this condition include improper nail trimming, wearing tight footwear, and genetic predisposition. The benefits of surgery include long-term relief from pain, reduced risk of infection, and improved nail appearance. Healing typically occurs within a few weeks with proper care. If you have an ingrown toenail, it is suggested that you consult a podiatrist who can determine if this type of foot surgery is right for you.

Foot surgery is sometimes necessary to treat a foot ailment. To learn more, contact Luis Esquerdo Cruz, DPM of Dr. Esquerdo Podiatry and Laser Center . Our doctor will assist you with all of your foot and ankle needs.

When Is Surgery Necessary?

Foot and ankle surgery is generally reserved for cases in which less invasive, conservative procedures have failed to alleviate the problem. Some of the cases in which surgery may be necessary include:

  • Removing foot deformities like bunions and bone spurs
  • Severe arthritis that has caused bone issues
  • Cosmetic reconstruction

What Types of Surgery Are There?

The type of surgery you receive will depend on the nature of the problem you have. Some of the possible surgeries include:

  • Bunionectomy for painful bunions
  • Surgical fusion for realignment of bones
  • Neuropathy decompression surgery to treat nerve damage

Benefits of Surgery

Although surgery is usually a last resort, it can provide more complete pain relief compared to non-surgical methods and may allow you to finally resume full activity.

Surgical techniques have also become increasingly sophisticated. Techniques like endoscopic surgery allow for smaller incisions and faster recovery times.

If you have any questions please feel free to contact our office located in San Juan, PR . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about Foot Surgery
Tuesday, 25 March 2025 00:00

Foot Surgery

In most cases, foot surgery is often chosen as the last available option for conditions that have otherwise been unsuccessfully treated. Surgery may be necessary for several reasons, including the removal of foot deformities (e.g. bone spurs or bunions), arthritis problems, reconstruction due to injury, and congenital malformations (e.g. club foot or flat feet). Regardless of one’s age, foot surgery may be the only successful option for treatment for certain conditions.

The type of surgery one undergoes depends on the type of foot condition the patient has. For the removal of a bunion growth, a bunionectomy is necessary. If the bones in the feet need to be realigned or fused together, a surgical fusion of the foot is needed. For pain or nerve issues, a patient may require surgery in which the tissues surrounding the painful nerve are removed. Initially, less invasive treatments are generally attempted; surgery is often the last measure taken if other treatments are unsuccessful.

While in many cases surgery is often deemed as the final resort, choosing surgery comes with certain benefits. The associated pain experienced in relation to the particular condition is often relieved with surgery, allowing patients to quickly resume daily activities. The greatest benefit, however, is that surgery generally eliminates the problem immediately.

Podiatry history has shown that foot treatments continue to evolve over time. In the field of foot surgery, endoscopic surgery is just one of the many advanced forms of surgery. As technology vastly improves so too will the various techniques in foot surgery, which already require smaller and smaller incisions with the use of better and more efficient tools. Thanks to such innovations, surgery is no longer as invasive as it was in the past, allowing for faster and easier recoveries. 

Sunday, 23 March 2025 00:00

Gout Pain Can Be Managed

Gout is a painful, inflammatory form of arthritis. Those affected will typically feel an intense stiffness in the joints of their feet, particularly in the big toe. Schedule a visit to learn about how gout can be managed and treated.

Plantar warts are small, rough growths that develop on the soles of the feet due to a viral infection. They are caused by the human papillomavirus, or HPV, which enters the skin through tiny cuts or abrasions. These warts often appear on weight-bearing areas, such as the heels or the balls of the feet, where pressure can cause them to grow inward, creating discomfort or pain while walking. The virus thrives in warm, moist environments, making public showers, around swimming pools, and locker rooms common places for exposure. People with weakened immune systems or frequent barefoot exposure to contaminated surfaces are at higher risk. Plantar warts can cause significant discomfort, and it may be difficult to complete daily activities. If you have developed this condition, it is suggested that you consult a podiatrist who can offer effective treatment solutions.

Plantar warts can be very uncomfortable. If you need your feet checked, contact Luis Esquerdo Cruz, DPM from Dr. Esquerdo Podiatry and Laser Center . Our doctor will assist you with all of your foot and ankle needs.

About Plantar Warts

Plantar warts are the result of HPV, or human papillomavirus, getting into open wounds on the feet. They are mostly found on the heels or balls of the feet.

While plantar warts are generally harmless, those experiencing excessive pain or those suffering from diabetes or a compromised immune system require immediate medical care. Plantar warts are easily diagnosed, usually through scraping off a bit of rough skin or by getting a biopsy.

Symptoms

  • Lesions on the bottom of your feet, usually rough and grainy
  • Hard or thick callused spots
  • Wart seeds, which are small clotted blood vessels that look like little black spots
  • Pain, discomfort, or tenderness of your feet when walking or standing

Treatment

  • Freezing
  • Electric tool removal
  • Laser Treatment
  • Topical Creams (prescription only)
  • Over-the-counter medications

To help prevent developing plantar warts, avoid walking barefoot over abrasive surfaces that can cause cuts or wounds for HPV to get into. Avoiding direct contact with other warts, as well as not picking or rubbing existing warts, can help prevent the further spread of plantar warts. However, if you think you have developed plantar warts, speak to your podiatrist. He or she can diagnose the warts on your feet and recommend the appropriate treatment options.

If you have any questions please feel free to contact our office located in San Juan, PR . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

Read more about What Are Plantar Warts?
Tuesday, 18 March 2025 00:00

What Are Plantar Warts?

Plantar warts are described as small growths that appear on the heels or other areas of the feet that bear a large amount of weight. The pressure in these areas causes plantar warts to hide behind thick layers of skin called calluses. In most cases, plantar warts are not a serious health issue, and they usually go away without treatment. However, it is still important be mindful of them.

Plantar warts are caused by infections with human papillomavirus (HPV) in the outer layer of skin on the soles of the feet. The plantar warts then develop when the virus enters the body through weak spots at the bottom of the feet, such as tiny cuts and breaks. Plantar warts are not guaranteed for all who encounter the virus. Everyone responds differently to the affects of HPV.

Plantar warts are most common in the following groups: children and teenagers, people with weakened immune systems, people with history of plantar warts, and people who walk barefoot. Exposure to HPV is common in environments such as locker rooms or pool areas.

One of early signs to look out for is a callus, since many plantar warts hide behind them. You can also locate these warts by looking for small, fleshy, rough, grainy growths near the base of the toes and the heel. Early signs of plantar warts are shown by black pinpoints, which are small, clotted blood vessels. Lesions that interrupt normal lines and ridges in the skin of your foot may also be a sign of plantar warts. Any feeling of pain while walking or standing can also be a symptom of plantar warts.

Although most cases are not serious, some conditions may require a visit to your podiatrist.  If you are uncertain that your lesion is a wart, if you have diabetes, or if you are experiencing bleeding, you may need to see a seek professional treatment. Your doctor may offer treatments such as prescribing stronger peeling medicine or using cryotherapy by applying liquid nitrogen to the wart. More serious cases may require minor surgery or laser treatment.

There are simple solutions available to help prevent plantar warts. One common task is to avoid walking barefoot in swimming pool areas and locker rooms, as this is where HPV is commonly present. Keeping your feet clean and dry, while changing shoes and socks daily can also help prevent future plantar warts. If you know someone who has plantar warts, it is important to avoid direct contact with their warts. You should also refrain from picking or scratching your wart if you happen to develop one.

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