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Heartland Foot and Ankle Associates
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You’ve Got Questions About Foot Problems. We’ve Got Answers

Don’t wait to get answers to some of the most common questions about foot pain. Find them in this FAQ for fast tips to help your feet get healthy.

  • Page 1

    What are custom orthotics?
    Orthotics are a custom molded insert for your shoe which correct your biomechanics.  These are mainly used to keep your foot and lower extremity functioning properly.

    Will orthotics correct my foot problem?
    Orthotics can alleviate the pain associated with your foot problem. They correct the foot problem while you are wearing them, but as soon as you take them off the same problem is still there. If patients wear their orthotics on a regular basis most foot pain is usually alleviated.

    Will orthotics fit into all of my shoes?
    There are different types of orthotics. Athletic orthotics will switch from shoe to shoe as long as they have a removable insole. Dress orthotics will fit into most of your dress shoes but not all of them. Patients who find success with orthotics often purchase multiple pairs!

    Can orthotics be used for athletic activities?
    Absolutely! orthotics can be used for all athletic activities. Many athletes could not perform without their orthotics, due to the discomfort associated with medical problems

    Why should I get a custom orthotic when I can buy a prefabricated custom orthotic at a pharmacy for a lot less money?
    Orthotic steps bought the local store only offer comfort.  Medical grade, custom orthotic inserts are tailored to each foot to provide both SUPPORT and COMFORT. 


    What shoes do you recommend for infants and toddlers?
    Children who are not yet walking do not need to wear shoes. Little feet grow fast so we want them to be as free to move as possible. A light sock is good for infants <1 year of age.

    For toddlers, a shoe with a strong sole and a flexible, wide toe box is essential. We like the following brands:

    1. Asics
    2. New Balance
    3. Pediped

    How often should my child have his foot measured?
    At least 4 times per year! Measuring your child’s feet seasonally will ensure an accurate, proper fit when choosing new shoes.

    Can I use hand me down shoes?
    For those ‘dress up’ occasions, absolutely. For every day play, NO WAY! Kids are rough on clothes and shoes! It’s important to replace frequently to limit the possibility of foot problems down the road.

    My child has a flatfoot. What can I do?
    It depends on two factors – age and pain. Children will naturally look like they have a flatfoot when they are between the ages of 1 ½ and 4. It’s important to have an annual biomechanical foot exam to look for problems before they cause pain.

    Foot pain is NEVER normal. If your child is complaining of foot pain, please call our office immediately to schedule an appointment!

    Does my child need inserts for his shoes?
    Sometimes yes! After evaluating your child’s gait, we can make recommendations based off of their complaint or foot type in order to help support and change any functional defects that are noticed. We use the following orthotics and medical grade inserts in our practice:

    1. Icon Orthotics
    2. Powerstep PowerKids Medical Grade Inserts

    What is an “orthotic outgrowth policy”?
    We pride ourselves at Heartland Foot and Ankle Associates at providing the most comprehensive care possible to all our patients – so we developed the Pediatric Orthotic Outgrowth Policy to allow children the opportunity to receive and enjoy custom orthotics and minimize the long term cost to parents. 


    How can I avoid an ingrown toenail?

    Ingrown toenails can be avoided by trimming your nails straight across. If the shape of your nail is curved, trimming along that curve is acceptable (straight across the curve itself). It is never okay to dig into the corners of your nails. If you find you are making your toes bleed when you are trimming the nails, please Contact Us immediately for an appointment.

    My mom had ingrown toenails, is that why I have one?

    The shape of your nails is genetically predisposed, but it doesn't mean that you will definitely have an ingrown toenail. The most common reason people suffer from an ingrown toenail is because the skin has 'taken over' nail territory. Digging out the corner will only prolong the problem!

    What can parents do to help children who are suffering from an ingrown toenail?

    First, please try to have them not pick at an ingrown nail! As the mom of a young daughter, I know that can be very hard! Secondly, schedule an appointment today - we have all the tools and tricks to distract and make the experience as pleasant as possible. We love helping families get better! Finally, don't try to trim it yourself at home - screaming kid + sharp instrument usually = upset and frustrated mom and dad.

    What happens when I come into the office for an ingrown toenail?

    We have taken the worry out of the experience! Our office provides a warm, home like atmosphere combined with state of the art equipment and instrumentation. We make it easy with snacks, beverages, and even our signature squishy feet stress balls to keep your mind at ease about any procedure. Please check out our Ingrown Toenail Procedure page for more info!

    Does it hurt to have an ingrown toenail procedure done?

    When you come into a doctor's office with something that already hurts, it is natural to be nervous and even afraid. My team at Heartland Foot and Ankle Associates works together to make the experience as painless as possible. In general, you will feel between 30 and 60 seconds of pain when I put the numbing medication into your foot. After that, the rest is virtually painless. (And if it isn't, our motto here is "I always have more numbing medication". We don't do any procedure until you are completely comfortable and ready!).

    When can I expect to feel better after an ingrown toenail procedure?

    Right after our procedure, you typically feel very good. Your toe might feel 'big and fat'. That is due to the numbing medication which wears off between 2 and 4 hours after the procedure. If there was an infection, I may prescribe antibiotics which will also make you feel better very quickly. Generally, ingrown toenails feel better within 24 hours and are healed between 2-4 weeks after the procedure.

    What do I do if I get home and my foot/toe is throbbing? Help!!

    The bandage we put on in the office (you even get to pick the color!) is very tight for a reason. You will have some bleeding after the procedure and we want to minimize that. Throbbing is from the bandage, so simply performing your first dressing change will relieve it quickly!

    Are ingrown toenails from cutting my nails wrong?

    Ingrown toenails develop for various reasons: heredity, trauma, and improper trimming. Improper trimming is the most common cause of ingrown toenails due to cutting the nail too short. Wearing poorly-fitting shoes, especially tightness in the toe box and loose shoes, can also cause pressure on the toes which can cause ingrown toenails.

    Can I get ingrown nails from not cutting my nails often enough?

    Ingrown toenails are normally not caused by prolonged cutting of the nail, but more so frequently cutting the nails shorter.

    Is it true toenails should be cut straight across?

    Yes. Toenails should be cut in a straight line and not too short. The general rule of thumb is they are too short if you can’t get your fingernail under the sides and end of the nail.

    Can I just cut out my ingrown toenails at home?

    It is not recommended. There is a myth that cutting a “v” in the corner of the nail will cause the nail to correct itself and most people perform this when cutting out an ingrown toenail at home. In fact that “v” does nothing for new growth of the toenail except for continuing to curve downward and cause a more painful ingrown toenail.

    Can I get an ingrown toenail from a pedicure?

    Yes, you can get an ingrown toenail from the toe nail not being properly trimmed during a pedicure

    Does an ingrown toenail procedure hurt?

    No, the ingrown toenail procedure does not hurt. Numbing medication is injected into the toe before the procedure so you don’t feel any pain. There is a little pinch when the medication is injected.

    Do I need to take medicine for my ingrown toenail?

    It depends. If you are in pain you can take over the counter (OTC) pain medication. The only time medication would be prescribed would be if it became infected, in which case we would prescribe an antibiotic.

    What is the post-op care for an ingrown toenail procedure?

    You will use the Amerigel post-op take home kit that includes wound wash to irrigate the wound, gauze to pat dry, Amerigel wound dressing, and band aids to keep the wound covered. Also, you will get a gel toe cap that will be worn to cover the wound dressing and keep the toe protected from your shoe.

    Why does my toe throb after the numbing medicine wears off when I have had an ingrown toenail removed?

    Your toe throbs after the numbing medication has worn off because we have wrapped it tightly to apply a good amount of pressure to stop any bleeding that may occur.

    What is the difference between a temporary nail avulsion and a permanent nail avulsion?

    A temporary nail avulsion is removing the corner of the toenail that is ingrown, a permanent nail avulsion is removing the part of the toenail that is ingrown and putting chemical into the corner of the nail bed to prevent the nail from growing back ingrown.

    How do I use the Amerigel post op kit?

    Use the wound wash to irrigate the wound and then use a piece of gauze to pat dry. Apply Amerigel wound dressing and place a band aid over the wound to help keep it protected.

    What is the gel toe cap for?

    The gel toe cap acts as a barrier to help keep the toe protected from things such as your shoe.

    Does the nail grow back after a permanent nail avulsion?

    No, the nail does not grow back after a permanent nail avulsion. A chemical is applied to the inner corner of the nail to prevent it from growing back.

    Do I have my whole nail removed if I have an ingrown toenail?

    No, you will not have to have the whole nail removed. Part of the nail will be cut out so that it will no longer be ingrown.

    Can I do anything to make the side of my nail look better after the toe has healed from an ingrown toenail procedure?

    Yes, we offer Keryflex, a non porous nail that can be applied over your nail to make it more appealing.

    What is an ingrown toenail?

    An ingrown toenail is a nail that grows in and curves downward growing into the skin on the sides of the nail. This often creates pain, redness, discomfort, swelling, and sometimes warmth to the toe.

    Still don't have the answer you were looking for?

    We are happy to assist you! Simply fill out a
    Contact Us form or give our office a call at 309.661.9975!

    Go back to Ingrown Toenails homepage.


    What’s the difference between Achilles Tendonitis and Plantar Fasciitis?

    Achilles Tendonitis is back of the heel pain. Plantar Fasciitis is heel pain located on the bottom of the heel.

    What is Plantar Fasciitis?

    Plantar fasciitis is an inflammation of a ligament on the bottom of your foot. It generally occurs at the ligament’s attachment point on the bottom of your heel bone.

    What are the causes of Plantar Fasciitis?

    Plantar fasciitis is caused primarily by a mechanical default – basically your foot type! – and overuse.

    • It happens frequently in active people because they are using their muscles and legs often and may not know about how their foot type works to get them around.
    • It is made worse by a tight Achilles tendon. This tendon attaches to the back of your heel bone and is very strong (the strongest tendon in the body!) The Achilles tendon will get a mechanical advantage if it is tight this will lead to it pulling up and back on your heel bone. The area of least resistance where all that pressure will go is to the attachment of the plantar fascia ligament on the bottom of your heel bone.

    How is Plantar Fasciitis diagnosed?

    Plantar fasciitis is diagnosed through:

    • A thorough clinical examination - checking how tight that Achilles tendon is as well as checking as to where the pain is felt on your heel
    • Careful history taking - does it hurt at the first step of the day? Have you begun exercising lately? Did you wear unsupportive shoes recently for a long time?
    • Diagnostic toolsx-rays can sometimes show a ‘spur’ on the bottom or back of the heel bone (this spur is the result of the pulling of the plantar fascia, not the cause!) diagnostic ultrasound can show the amount of inflammation in the fascia and if there are any tears in the fascia.

    How is Plantar Fasciitis treated?

    We treat plantar fasciitis in 2 main ways:

    1. Address the Inflammation with:

    • Regular icing and use of topical medications like BioFreeze
    • Anti-inflammatory medications
    • Laser or physical therapy
    • Cortisone Injections or pills (if needed!)

    2. Address the Faulty Mechanics with:

    • Proper stretching techniques and the timing of stretches (before you get up!)
    • Powerstep Medical Grade Inserts
    • Stretching splint that can be worn for 20-30 minutes/day to further stretch the plantar fascia and Achilles tendon
    • Athletic strappings and orthotics if needed
    • Physical therapy
    • Surgery (this is very rare!)

    How will changing shoe gear help treat heel pain?

    When shoes are brand new, they're providing the support that they were designed and intended to. However, as shoes wear down, they lose this support. There are also shoes that didn't have much in the way of proper support to being with.

    By changing shoe gear and transitioning into a more supportive shoe, you're providing your foot with a solution to any mechanical irregularities in the way that you walk. The shoe will support your arch and cause less stress on your tendons, which decreases pain. It will also prevent further complications such as fallen arches.

    How will losing weight help treat heel pain?

    Your feet have to support and carry your entire body weight. Extra pounds put extra stress on the plantar fascia.

    What if stretching, icing, and convenience items don't help?

    Stretching and icing are just the 'basics' in regards to heel pain treatment. If you have tried stretching, icing, stretching splint, shoe modifications, anti-inflammatory medications, and conveniences items but are still experiencing pain we have additional treatment options, including:

    • Custom Orthotics which change biomechanical imbalances in your foot, the causes the heel pain.
    • Steriod injections reduce inflammation and relieve pain.
    • Walking boots can immobilize the foot for a short period of time, allowing it to rest and heal. Walking boots keep the foot at and angle, constantly stretching the plantar fascia so it does not tighten and cause pain.
    • Physical therapy offers a wide range of intense exercises to loosen the plantar fascia.
    • In severe cases, surgical options are also available.

    Still don't have the answer you were looking for?

    We are happy to assist you! Simply fill out a
    contact us form or give our office a call at 309.661.9975!

    Go back to Heel Pain main page.


    Why do I have hammertoes on my feet?

    Hammertoes are formed by the pulling and stretching of the tendon in your foot. When one tendon gets more use than the other, a deformity called hammertoe can form. Hammertoes can be formed from different chemical imbalances such as stroke, arthritis, diabetes, and other neuromuscular conditions. Previous foot injuries are another factor that can lead to hammertoes.


    Does a hammertoe form because of tight shoes?

    While shoes don’t actually cause the hammertoe, yes, when someone wears shoes that are too tight, it can make your hammertoe worse. The squeezing of the toes and tendons from the narrow, pointy-toes shoes or heels can cause extra aggravation on your hammertoe.


    What are the best shoes to wear with hammertoes?

    We always recommend shoes from our shoe catalogs. They best shoe depends on the severity of the patient’s foot deformity. We recommend a shoe that can fit your hammertoe comfortably. Lycra shoes are a good bet for any deformity because they stretch around the foot not constricting or irritating the hammertoe.


    What over the counter products help hammertoes?

    We have a variety of over the counter products to help hammertoes. Dr. Jill’s Hammertoe Cushions are adjustable gel crest pads that lift, support and straighten bent toes while standing and walking. Dr. Jill’s also has toe separators to help separate over crowdedness hammertoes often display. Aetrex Sandalista Sandals offer Mozaic Customization Technology that offloads the tender hammertoe area. Biofreeze is the #1 selling cold therapy pain relief in the U.S. Dr. Comfort Slippers, PowerStep medical grade inserts, thera-band foot roller and thera-band kit are all available in office to purchase as well as custom molded orthotics. All these products can relieve pain associated with hammertoes as well.   


    Is it covered by insurance?

    Laser treatment for fungal toenails is not allowed by insurance carriers because it is such a new and innovative technology. But we offer competitive pricing and even ‘lay away’ or prepayment options for your convenience!


    How much does it cost?

    Check out our Fungal Toenail Laser Treament Packages here.


    How many treatments will I need?

    Some people start to see improvement in as little as 1 treatment, but for best results we always perform all 3 treatments. We always recommend topical antifungal treatments to be used in conjunction with laser treatments for best results.


    Does it work?

    Hundreds of successful studies have been performed showing the efficiency of the laser therapy. Our office individually has seen vast improvement with the treatment.


    Is it guaranteed?

    We offer a 100% Satisfaction Guarantee with our Platinum Laser Package. Comprehensive care is essential in the treatment of onychomycosis and as such we guarantee clinical clearing with our platinum package.


    Do we accept credit cards for payment?

    We accept Visa, Mastercard, and Discover credit card payments, as well as cash and check.


    Is there any maintenance after treatment?

    Fungus is a condition that can come back so we recommend maintenance to prevent reoccurrence. Our maintenance program offers a $99 yearly laser touch up, as well as weekly use of Clarus Antifungal Solution to all nails to prevent recurrence.


    How long have we done laser treatment?

    Our office has had the laser since December 2012. Even in the short amount of time we’ve had this technology in the practice, we have seen significant results.


    Are you responsible for copayments?

    Your copayment does not apply to the laser treatment because it is not billable towards insurance benefits. Laser treatment for fungal toenails is not allowed by insurance carriers because it is such a new and innovative technology. But we have offer competitive pricing and even ‘lay away’ or prepayment options for your convenience!


    Does it hurt?

    The laser treatment is virtually painless. You may just feel a little warmth, in which case the medical assistant will proceed to the next toenail. The warmth is common and nothing to worry about. The laser beam is directed specifically at fungus and the warmth you may feel is your body’s natural reaction to the laser wavelength.


    When should I start seeing results?

    You should start to see results from Fungal Nail Laser Therapy within 8-12 weeks. It varies person to person depending on how fast your toenail grows. You will start to see a fungal free crescent moon shape at the bottom of the toenail start to form. It will take 9-12 months to see a completely clear nail, as it takes that long for the nail to completely grow out.


    Why doesn’t topical alone help?

    In order to properly attack and fight fungus, you need to attack it comprehensively from both inside and outside. We use the laser for internal treatment and the topicals and/or oral medication for external treatment. The topical medication alone is about 30% effective, while when paired with laser therapy is over 95% effective.


    Can I get re-infected?

    There is always a chance of re-infection. Fungus likes dark moist areas so it is always around! We have a product in office we recommend to all of our patients called Shoe Shield. This product helps in preventing cross contamination between your shoes. Another way to get re-infected is by using nail polish that doesn’t have antifungal microbe properties. We use Dr’s Remedy, which is a great product to use to help not cross contaminate other people’s toenails when getting a pedicure. We also recommend wearing sandals at the pool or in the showers at the gym to prevent picking up the fungus from someone else.


    What maintenance is needed?

    Fungus is everywhere, so to keep it at bay we recommend continued treatment with either laser, topicals, or oral medication. Maintenance laser treatments are usually only required once per year, while maintenance topical treatments are usually only needed once per week.


    Still don't have the answer you were looking for?

    We are happy to assist you! Simply fill out a Contact Us form or give our office a call at 309.661.9975!

    Go back to Fungal Nails main page.


    What are the most common podiatric complications a diabetic can develop?

    Patients with diabetes can develop peripheral neuropathy, musculoskeletal problems, sores (Ulcerations), infections, and may need amputations or other surgery due to those problems.


    What is neuropathy?

    Peripheral neuropathy is a disease wherein the nerves sending signals to the extremities (hands and feet) no longer work as well as they used to. This causes numbness and tingling in the extremities. In diabetic patients, this is caused by high sugar levels in the blood affecting the sheath that surrounds the nerves.


    What is HgA1C?

    HgA1C is a blood test that assesses the red blood cell’s (RBC) ability to process glucose over a 3 month period. It provides a long term snapshot of how well controlled a diabetic patient’s sugars are.


    What is a normal value of a HgA1C and blood sugar?

    Normal fasting blood sugars (FBS) should be <100mg/dl. You may be considered diabetic with a FBS > 126mg/dl. Normal HgA1C is <5mg/dl. A diabetic with good sugar control should aim for <7mg/dl for their 3 month HgA1C checks.


    How often can I get my nails, corns, and calluses trimmed?

    Most insurance plans allow these services to be performed every 9 weeks. If you wish to receive these services any sooner you would be considered self pay, you would need to pay out of pocket at the time of service.


    Why do you need to know who my primary care physician (PCP) is and the date of service ( DOS-last time seen by the physician)?

    We ask for this information so that we can make sure we have all of your information up to date, including your PCP and the date you last were seen in their office. Also, if we have any concerns regarding medications or therapy we can consult with your physician if needed.

    What can I do to care for my nails at home between my 9 week visits?

    You can have a family member or friend assist you to file them down. Also, putting lotion on your feet daily will help keep them healthy. Or you can have a licensed pedicurist at Healing Steps Spa cut your nails, and provide a therapeutic foot soak and massage between visits with the doctor.


    What can I do to care for my corns/calluses at home between my 9 week visits?

    You can wear a u-shaped pad or an oval shaped pad to help relieved any pressure on these spots while walking. You can also use Kera 42 cream to help keep the areas soft and to help reduce the pain that can be cause when these areas become hard and crack. You can purchase any of these products during normal business hours.


    What are some common signs of athlete's foot?

    Athlete's foot typically occurs in between the toes. A few signs of athlete’s foot include a red scaly rash that can cause itching, stinging, and burning. Sometimes athlete's foot can be mistaken for dry skin or eczema. Some types of athlete's foot can include blisters and ulcers. It is contagious and can be spread by contaminated floors, towels, clothing, and showers. It can also spread to your hands if you scratch or pick at the infected parts of your feet.


    What causes athlete's foot?

    Athlete’s foot is caused by the same type of fungus that causes jock itch and ring worm. A few condition that assist the organisms' growth include damp socks and shoes and warm, humid conditions.


    How do I treat my athlete's foot?

    Athlete's foot can be treated with over the counter (OTC) antifungal medications purchased at the drug store, but the infection often reoccurs. Podiatry offices typically carry a line of stronger OTC medications. Our office recommends Clarus Antifungal Cream and MaceRx, both of which are sold in the office.


    When should you get it checked out by a physician?

    If you have the rash or any of the signs of athlete's foot and you have tried self treatment for a few weeks it is recommended to see a doctor. You should seek medical advice sooner if you are diabetic or notice excessive redness, swelling, drainage, or fever as these can be signs of infection.