Posts for: April, 2016

By Affiliated Foot & Ankle Care
April 29, 2016
Tags: Turf Toe  

Spring has sprung and as more athletes take to the field, we at Affiliated Foot & Ankle Care see an increase of the injury known as turf toe. Turf toe is an injury that occurs when the big toe joint bends upward beyond its normal range. This can happen suddenly, such as when you stub your toe or it “jams” or it can happen gradually over time with activities that require repeated pushing off with the big toe. The disorder gets its name because athletes who play on artificial turf are more prone to this injury due to the fact that the foot tends to stick to the surface, increasing the likelihood of the toe jamming and the turf toe injury occurring.


If you have turf toe, you will most likely feel pain in the big toe joint. There may also be swelling and stiffness and it may be difficult to bend the toe. When turf toe is the result of a trauma or sudden injury, the symptoms will come on immediately and get worse over the 24 hours following the injury. If turf toe is caused by repetitive motion, the symptoms will usually be intermittent and gradually get worse. Sometimes, because the pain is not so bad, a person will continue playing on the injured toe, making the injury more severe.

Healing Turf Toe

If you are having pain in your big toe joint, our foot and ankle doctors, Dr. Varun Gujral and Dr. Nrupa Shah will do a complete examination of your big toe and your foot. The podiatrist will also take your medical history and ask questions about your activities and when you noticed the symptoms. X-rays or other imaging studies may be ordered to make sure the toe is not broken.

The treatment of turf toe follows the RICE regimen: Rest, Ice, Compression and Elevation. Once the injury has healed, the foot doctor may recommend modifications to your sports shoes or your activities to prevent turf toe from recurring.

If you think you may have turf toe or are experiencing pain or swelling anywhere in your foot, contact our Edison, Monmouth Junction or Monroe office for an appointment. The sooner your discomfort is diagnosed, the sooner you will be on the road to recovery.

By Affiliated Foot & Ankle Care
April 19, 2016
Tags: Morton's Neuroma  

Have you been experiencing pain in the ball of your foot? Does it sometimes feel like your sock is bunched up or that there’s a pebble in your shoe? If so, you may have a condition we treat often at Affiliated Foot & Ankle Care known as Morton’s Neuroma. Symptoms may come on gradually and be sporadic at first. There may be a burning or tingling sensation on the bottom of your foot between your third and fourth toe or the area may feel numb. As time goes on, however, the symptoms will get worse and will last for a few days or even weeks.

What’s Happening

A Neuroma occurs when nerves become irritated and inflamed due to excess compression or friction. This causes the nerves to enlarge and thicken and this growth is what causes the pain and discomfort in the ball of your foot. As the Neuroma grows, the symptoms get worse and will eventually lead to permanent nerve damage if not treated. Neuromas are typically caused by shoes that squeeze the toes. Patients with certain deformities, such as hammertoes and flatfeet are also more prone to Morton’s Neuroma.


If you suspect you are suffering with Morton’s Neuroma, our foot and ankle doctors, Dr. Varun Gujral and Dr. Nrupa Shah will start by asking questions about when you first noticed symptoms and how they have progressed.  The podiatrist will also want to know about your occupation and what sports and leisure activities you participate in frequently. A complete exam will then be conducted of your foot and various imaging studies may be ordered to confirm a diagnosis of Morton’s Neuroma.

Getting Relief

Once the foot doctor is sure that you have Morton’s Neuroma, there are several treatment options available aimed at providing relief and preventing the Neuroma from growing:

  • Icing—to reduce swelling
  • Medications—nonsteroidal anti-inflammatory medications, such as ibuprofen can help relieve pain and inflammation; cortisone injections may also be recommended for this purpose
  • Padding—can be  used to reduce pressure on the nerve
  • Orthotics—can give support to certain parts of the foot and thereby relieve compression on the nerve
  • Surgery—if non-surgical treatment techniques are not successful, your foot doctor may recommend surgery

For most patients, Morton’s Neuroma also requires modifications to activities to reduce the pounding and pressure put on the ball of the foot. To find out more about this condition, contact our Edison, Monroe or Monmouth Junction office by calling 732-662-3050. The health and comfort of your feet is our number one concern.

By Affiliated Foot & Ankle Care
April 11, 2016
Tags: flatfeet  

The term “flatfeet” refers to not having an arch in the bottom of your foot. At Affiliated Foot & Ankle Care, we see this happening for several different reasons, not all of which are bad. In infants and toddlers who have not started walking, flatfeet are normal. Even in adults, if flatfeet are not causing any pain or discomfort, they may not require any treatment. When pain is associated with adult flatfeet it is most often caused by tibialis posterior tendonitis (PTTD).

The posterior tibialis is a tendon that runs down the back of your heel and it plays a key role in walking. When this tendon gets torn, stretched or inflamed, most often due to overuse in people who do an excessive amount of walking, running, or stair climbing, pain occurs. Depending on how far the tendonitis has progressed, the pain may be on the inside or the outside of the foot and the affected area may become red and swollen as well. Left untreated, PTTD can lead to arthritis in the foot and ankle.

Treatment Options

If you suspect that you have PTTD, it’s time to make an appointment with one of our foot doctors: Varun Gujral, DPM, or Nrupa Shah, DPM. In order to confirm a diagnosis of PTTD, the podiatrist will examine your foot both when you are standing and sitting. An x-ray will most likely be ordered as well to see how far the flatfoot has progressed. Then the appropriate treatment plan for you will be determined. There are several non-surgical options, including:

  • Immobilizing your foot to give the tendon time to heal
  • Reducing or avoiding activities that require you to walk or stand for long periods of time
  • Nonsteroidal anti-inflammatory medications, such as ibuprofen to relieve pain and inflammation
  • Orthotic inserts and arch supports for your shoes to help take the pressure off the tendon
  • Physical therapy
  • Losing weight if you are overweight to decrease the load placed on your arches

If you do not gain relief from any of these non-surgical treatments, your foot doctor may recommend surgery.  The sooner you start treatment, the better your chances of avoiding surgery. So don’t delay, contact our Edison, Monroe or Monmouth Junction office as soon as possible.

By Affiliated Foot & Ankle Care
April 02, 2016
Tags: Ingrown Toenail  

A painful condition that we see frequently at Affiliated Foot & Ankle Care is an ingrown toenail. A nail becomes ingrown when the side of the nail curves downward and begins to grow back into the skin surrounding the nail bed. When this occurs, the nail can actually penetrate the skin and eventually become infected.

Signs of Ingrown Toenails

A patient that is not in the habit of examining his or her toenails may not initially be aware of an ingrown nail. When it progresses to the point where the nail has actually broken the surface of the skin, however, then the affected toe will become very sore, red and swollen and may feel hard and warm to the touch. If an infection has developed, there may be drainage coming from the nail bed area as well.

Treatment and Prevention

Sometimes simply soaking the foot in warm, soapy water several times a day will loosen the skin around the nail enough that the ingrown nail can be worked out. If this does not work, make an appointment to see one of our podiatrists, Dr. Varun Gujral or Dr. Nrupa Shah who will examine your toenail and determine the proper treatment. If the nail has become infected, an antibiotic will most likely be prescribed. In extreme cases, a minor surgical procedure known as a partial nail plate avulsion may be necessary to remove all or part of the ingrown nail.

There are several factors that cause ingrown nails that you can take steps to avoid:

  • Cut your toenails straight across and don’t cut them too short. Improper trimming is one of the major causes of ingrown nails. If the nails are cut too short, the skin next to the nail is more likely to grow over it.
  • Make sure socks and shoes are not too tight. Repeatedly compressing the toenails can cause them to begin to ingrow. Even with properly fitting footwear, patients who run or participate in other high impact sports frequently or who have jobs that require them to be on their feet for long periods of time, may find that the constant pressure of the big toe pushing against the front of the shoe can cause an ingrown toenail.
  • Be watchful if you’ve injured your toe or have a fungal nail infection. Trauma and fungal infections can both lead to ingrown nails, so keep an eye on any nail that has been injured or infected.

Do not ignore an ingrown toenail. Left untreated, they will only get worse and an infection will most likely occur. Contact our Edison, Monroe or Monmouth Junction office for an appointment to get relief for this painful condition.