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Posts for: March, 2018

By Affiliated Foot & Ankle Care
March 28, 2018
Tags: stress fracture   bunion  

Before March is history, we at Affiliated Foot & Ankle Care want to recognize Women’s History Month by offering some important podiatric health care information about conditions that particularly affect women.

  1. Bunions—this deformity is caused by a biomechanical problem that encourages the big toe to move out of place at the base joint and drift toward the second toe. Why, then, is this more of an issue for men than women? While both sexes may have the faulty foot structure (which is often inherited), women are far more likely to have the condition progress to the point where the telltale bump forms on the side of the foot causing pain and making it difficult to wear shoes. This is due largely to shoe choice. High heels and narrow, pointy toes forcibly squeeze the toes together and put pressure on the big toe, aiding in its dislocation. There are, however, both conservative and surgical measures that can help slow the progression or correct a bunion.
  2. Stress fractures—these tiny cracks in the surface of a foot bone, most often on the top of the forefoot, are frequently the way that a woman learns that she has osteoporosis. This condition will ultimately affect 1 in 2 women over the age of 50. Adequate amounts of calcium, as well as weight-bearing exercise done regularly, can help prevent this order. It’s important to realize that symptoms of a stress fracture may be intermittent and not appear very serious at first. Pain and swelling that cannot be explained by an injury require an evaluation by the foot doctor.
  3. Morton’s neuroma—this disorder is particularly prevalent among runners. Pain, tingling, and burning sensations in the ball of the foot or the feeling that there is a pebble in your shoe all the time are signs of this nerve irritation. What gives women runners a greater likelihood than men for developing this condition is that in addition to the repetitive stress on the ball of the foot from running, wearing platform or high heeled shoes also applies pressure to the same part of the foot.

In all of the above situations, there are measures that can be taken both proactively and in the early stages of the disorder that can greatly decrease the chance of disability or surgery. Let our podiatrists, Dr. Ben Gujral and Dr. Nrupa Shah examine your feet and diagnose your pain sooner rather than later. Contact our New Jersey offices in Edison, Monroe or Monmouth Junction at 732-662-3050.


By Affiliated Foot & Ankle Care
March 20, 2018
Category: heel pain
Tags: Plantar Fasciitis  

One of the most common foot problems that we see patients for at Affiliated Foot & Ankle Care is heel pain. Heel pain can be extremely disabling, making it difficult to participate in activities you enjoy and even to complete daily tasks. Tracking down the cause of heel pain, however, is not always easy. When pain is not the result of a visual or surface issue such as heel fissures or Haglund’s deformity but is felt deep within the heel, our podiatrists Dr. Varun (Ben) Gujral and Dr. Nrupa Shah will need to do some investigating to get to the source of the pain. The foot doctor will start by examining your feet and ankles and getting your complete medical history, including any previous foot or ankle injuries you may have had. The podiatrist may also want you to have an x-ray, MRI, bone scan, or other imaging studies to get a better look at the inside of your foot to pinpoint (or rule out) possible reasons for your pain. In addition, you may be asked questions about your work, daily, and leisure activities.

In many cases, heel pain is not directly caused by a problem in the heel. Below are three common causes of heel pain where this is the case:

Plantar Fasciitis—the plantar fascia is a long band of tissue that connects your heel to your toes. This band can become inflamed due to arch problems (overly high arches or flat feet), overuse issues, inappropriate shoe choice or being overweight. The strain on the plantar fascia puts stress on your heel, causing pain and discomfort. One telltale sign of plantar fasciitis is sharp, stabbing pain when you first get out of bed or after you’ve been sitting for a while.

Tarsal Tunnel Syndrome—with this disorder a compressed nerve is the source of heel pain. The tarsal tunnel is a structure at the inside base of your ankle that houses the posterior tibial nerve (along with arteries, veins, and tendons). When the tunnel is squeezed (either due to injury, a foreign or enlarged object in the tunnel, such as a cyst or varicose vein, or a biomechanical problem), the nerve gets compressed and causes heel pain.

Back Issues—if you are experiencing pain in both heels and the foot doctor cannot find a problem with your feet or ankles, another possibility is that the pain is being caused by a back issue. Nerves that go down to your heels can be affected by spine disorders.

If you are experiencing heel pain, it’s important to make an appointment at our Edison, Monroe or Monmouth Junction office in New Jersey. We can help you find the cause of the pain and get started on a treatment plan that will alleviate it and prevent permanent damage. Contact us today by calling: 732-662-3050.


By Affiliated Foot & Ankle Care
March 15, 2018
Category: Nutrition

March is National Nutrition Month and at Affiliated Foot & Ankle Care, we want our patients to understand the direct relationship your weight has with the health and wellbeing of your feet and ankles. Being overweight significantly increases the risk and symptoms of many podiatric conditions including plantar fasciitis, arthritis and other joint disorders, flat feet, and metatarsalgia to name just a few. It’s simple: when you reduce your weight, you reduce the stress on all of your lower extremities. In addition, if you maintain a healthy weight, you are more likely to be active, which helps improve circulation, flexibility, and range of motion.

Adopting healthier eating habits doesn’t have to be difficult. Try some of these expert tips and slowly make over your family’s diet:

  • Increase nutrients in your menus and decrease waste by chopping up leftover vegetables and fruits, putting in bags and freezing. Pull out and add to soups, stews, stir-fries, and smoothies.
  • You don’t have to fully give up pasta, rice, and other carbohydrates, but choose whole grain instead of white flour versions and try this trick: place your lean protein and vegetables in the bowl first and then add a serving size of pasta. When you mix all ingredients together you tend to end up eating too much pasta.
  • Avoid the overly large portions at restaurants by ordering an appetizer or a la carte item off the menu and supplementing with a salad or side serving of steamed vegetables.
  • Get children involved by allowing them to pick out different and colorful vegetables, salad ingredients, and fruits at the grocery store. Let them help with preparing them as well.
  • Make some healthy swaps in your snack choices. Instead of puddings or ice cream, try dessert flavored yogurts that don’t have added sugars or artificial sweeteners, dried fruit instead of candy, and popcorn or baked tortilla chips in place of potato or corn chips.

If you are experiencing foot or ankle pain, contact our New Jersey offices in Edison, Monroe or Monmouth Junction. Our podiatrists, Dr. Ben Gujral and Dr. Nrupa Shah, will diagnose your disorder and advise you if weight loss or other lifestyle changes will help improve your condition. Call us at 732-662-3050.


A condition that we treat at Affiliated Foot & Ankle Care that many patients are unfamiliar with is tarsal tunnel syndrome. Below are some questions and answers to help you better understand this often common condition.

Q: What is tarsal tunnel syndrome?

A: Tarsal tunnel syndrome is similar to a condition that you may be more familiar with, carpal tunnel syndrome, which occurs in the wrist. Both conditions are the result of nerves being compressed or squeezed, which produces symptoms of pain, numbness, tingling, or burning.

Q: Where is the tarsal tunnel located?

A: The tarsal tunnel is found next to your ankle bone on the inside of the ankle. In addition to the posterior tibial nerve, it also houses arteries, veins, and tendons. The tunnel is covered with a thick ligament that protects the structures in the tunnel.

Q: How does the posterior tibial nerve get compressed?

A: The compression of the nerve can be caused by a number of different scenarios. Sometimes injuries to the ankle or systemic diseases, such as diabetes or arthritis, can lead to inflammation and swelling, resulting in the nerve getting squeezed. In other instances, an abnormal or enlarged structure may be taking up space in the tunnel, which causes the nerve to become compressed. These can include a ganglion cyst, varicose vein, bone spur, or swollen tendon. Patients with flat feet have a higher risk of tarsal tunnel syndrome due to pressure placed on the nerve from the outward rotation of the heel that is characteristic of this deformity.

Q: How will the podiatrist know if I have tarsal tunnel syndrome?

A: Our foot and ankle surgeons, Dr. Ben Gujral and Dr. Nrupa Shah, will start by examining your foot and ankle. Since tarsal tunnel syndrome can be caused by many different things, the foot doctor may order nerve conduction or imaging studies to try to determine what is causing the compression.

Q: What are the treatment options for tarsal tunnel syndrome?

A: In some cases, our podiatrist may recommend surgery to decompress the nerve. There are, however, a wide range of conservative options as well, including bracing, orthotics, injections, and physical therapy.

If you are concerned that you may have tarsal tunnel syndrome, schedule an appointment at our Edison, Monroe or Monmouth Junction office in New Jersey today by calling: 732-662-3050.