Posts for: May, 2013

Charcot foot affects the nerves and blood supply of the foot, these systems are damaged and as a result the bones and joints become weakened and possibly damaged. The foot can become misshapen due to the bones collapsing, and there can be a lack of feeling in the foot due to the nerve damage. The common symptoms to look for include redness, swelling, pain, instability of the joints, loss of feeling and deformity. 

Charcot foot is seen in patients who have been diagnosed with diabetes mellitus and sometimes in patients diagnosed with peripheral neuropathy. Many times Charcot foot goes undiagnosed because the patient has no feeling in their foot and they don’t notice that anything is wrong. However if you do notice any of the above symptoms it is important to make an appointment with your local podiatrist at Affiliated Foot and Ankle Care in Edison and Monroe NJ.

When you go to see your podiatrist they will diagnose Charcot foot by taking x-rays and performing function and sensation exams. Sometimes Charcot foot can mimic other diseases and can be difficult to diagnose, however your podiatrist can diagnose it properly if it is caught early! Catching this disease in its early stages is very important to prevent serious injury and damage to the foot.

The most important thing when treating Charcot foot is to stabilize the joints. This can be done by immobilization with a cast or walking boot, crutches to prevent weight bearing and custom shoes and braces can be used. In severe cases surgery may be required to fix the joints and deformities. Surgery can be done to remove excess bone or cartilage; it can also be done to realign different parts of the foot that may have moved from their original position. After surgery immobilization is very important for the foot to heal.

By Nrupa Shah


In your calf there are deep layers of muscles; one of these muscles is known as the tibialis posterior muscle. The tendon of this muscle attaches the muscle to the bones on the inside of the foot. This tendon functions to support the arch of the foot, and to support the foot while walking.  If the tendon simply becomes inflamed, you will most likely be diagnosed with posterior tibial tendonitis. In some occasions the tendon can actually tear. A posterior tibial tear is the most common reason for an adult’s flatfoot.

The common symptoms of this tendonitis include pain on the inside of the foot and ankle, this area may also be swollen, and the pain will get worse with activities like walking or running. Sometimes there can also be pain on the outside of the ankle due to the heel bone shifting outwards due to the inflammation of this tendon. This injury is common in runners, basketball players and tennis players. Also women are more likely to get this than men, and people over the age of 40 are at a higher risk for developing this.

If you are experiencing any of these symptoms it is important to make an appointment with a podiatrist at Affiliated Foot and Ankle Care in Edison and Monroe NJ to get a proper diagnosis. Your doctor will do a few things to confirm this diagnosis; they will look for swelling in the indicated area, a change in shape of the foot due to the heel bone moving and a very important test they will do is ask you to stand on your tip toes on one let at a time. When this tendon is healthy anyone should be able to do that without a problem, but when there is tendonitis trying to do this will be painful and most likely won’t be able to do it.

After a diagnosis is made your podiatrist will recommend rest, ice and Tylenol to help with the pain and inflammation. Your doctor will also recommend custom orthotics to help relieve the stress off the tendon so it can heal. In severe cases steroid injections or braces may be required to help the tendon heal.

By: Varun Gujral


I’m sure most of you have never heard of a Salter Harris fracture before unless you, a sibling or one of your own children has had one. Salter Harris fracture is different from other common fractures because the fracture occurs at the growth plate; so that makes this fracture special to pediatric patients! There are 9 types of this fracture, 5 are more common, and 4 of them are very rare. We will discuss the 5 more common types. Type I is a transverse fracture through the growth plate, this fracture basically separates the bone in two by splitting the growth plate. Type II is a fracture through the growth plate and through the “neck” part of the bone above the plate. This is the most common form seen! Type III is a fracture through the growth plate and the part of the bone below the plate. Type IV is a fracture through the growth plate and the “neck” above and the area below the plate. Type V is a compression fracture through the growth plate, the fracture doesn’t separate the bone in two like a Type I, the distance of the plate is reduced making the bone “shorter”.

Since the growth plate is involved in this fracture, your podiatrist's main concern will be figuring out how this will affect the growth of the child. For Type I and II growth disturbance is usually uncommon with no functional limitations. A Type III however usually results with the child having a chronic disability, but there is usually no growth deformity. A Type IV is similar to a Type III in the fact that is causes a chronic disability, but it also can cause a deformity of the joint because of the bones fusing together. Type V is a little more difficult to diagnose because the growth plate isn’t necessarily being fracture, it is being compressed. Since the growth plate is being compressed it can cause problems in growth for the child, it can cause the growth plate to fuse earlier than it normally would.

If your child falls and you think that they may have fractured one of their leg bones, make an appointment to visit one of the podiatrists at Affiliated Foot and Ankle Care, located in both Monroe and Edison, NJ to get a diagnosis! The only way to diagnose these fractures is by x-ray; and most of these fractures will require surgery to fix and rehab will be required to regain strength of the foot and leg.

By Varun Gujral


What exactly is this? It is just extra bone growing off of normal bone. This seems like a strange thing to happen in our bodies, so how does bone that’s not supposed to be there, grow? These spurs grow in response to pressure, rubbing or stress on the normal bone. In the foot this typically happens in places where tendons attach to the foot and “pull” on the bone, causing new bone to grow. This is a common sports injury in professional basketball players.  Both Kobe Bryant, of the Los Angeles Lakers and Deron Williams, of the Brooklyn Nets, suffer from bone spurs.

When people think of spurs they normally think of harmless, smooth, rounded “bumps” of bone, and this is normally what bones spurs are. But sometimes these spurs can be sharper or rubbing against tendons or muscles and can be painful. In the foot a very common place for this to happen is in the heel; this is called a heel spur. This can form from the tendons attaching to the heel being used heavily in exercise; they are also very common in women who wear high heels frequently!

Most people who have bone spurs don’t even know it, and could have them their entire lives and never need them treated. However in some cases, like Kobe’s and Deron’s, the bone spur causes a lot of pain and needs to be taken care of. The way to find out if a bone spur is the cause of your foot is pain is to make an appointment  at your local  podiatrist and get an x-ray.  The doctors at Affiliated Foot and Ankle Care, located in Edison and Monroe NJ, can help make the proper diagnosis for your foot pain!

If a bone spur is the cause of your pain there are three ways to approach the problem. The treatment can be directed at what is causing the bone spur, the symptoms or the bone spur itself can be treated. Excessive weight and strain on the tendons of your feet are common causes, so a treatment based on causes could be weight loss or reduced or changed activity. To treat the symptoms can be done by NSAIDs or shoe inserts to relieve the stress off your foot. And lastly to actually treat the spur itself your podiatrist can surgically remove the spur.

By:  Varun Gujral


I’m sure everyone has heard about Kobe Bryant’s devastating injury, and the fact that his season, maybe even career is over. So what exactly happened to him? Kobe ruptured his Achilles tendon. If you feel at the back of your ankle, you feel a long hard thing that is your Achilles tendon. This is where your calf muscles attach to your heel bone to keep your foot and ankle stable.

A rupture/tear of this tendon can occur by suddenly pointing your toe up or down and landing on the foot in a weird position. There is an area of this tendon called the watershed area; this is a weak area of the tendon because it doesn’t receive as much blood supply as the rest of the tendon so it is more likely to be injured there. It is very common for this injury to occur in athletes playing basketball or football.

The common signs and symptoms of this injury include swelling and pain at the back of the ankle, hearing a “popping” noise when the injury occurs, and a positive Simmonds test.  When you see your podiatrist, he will perform the Simmonds test, which is when he squeezes your calf muscles and looks at the movement of your foot.  It is considered a positive test when there is no movement of the foot, and the patient is unable to point his toes downward.

Your local podiatrist at Affiliated Foot and Ankle Care in Edison and Monroe NJ can take care of you if you feel that you have experienced this kind of injury. The first thing the podiatrist will do is look at the ankle and perform tests like the above described Simmonds test, and then he will order an MRI to confirm his diagnosis.

If an Achilles tear is diagnosed, surgery will be required. The tendon will be stitched back together and then stabilized for a few months to allow the tendon to repair. After surgery physical therapy will be required to regain strength in the foot and leg. Kobe Bryant will require surgery and a lot of rehab therapy if he wants to return to the Lakers anytime soon!

 by Varun Gujral