Black-and-Blue Toenails (Hematoma) Unlike with yellow toenails,

 black-and-blue toenails are not actually caused by a change in the color of the nail enamel itself. Black-and-blue toenails are caused by an injury to the skin beneath the toenail. As blood and fluid collect beneath the nail plate the nail itself, which is somewhat translucent, begins to appear black. In athletes, black-and-blue toenails, often referred to as simply black toenails, are usually the result of wearing athletic shoes that do not have adequate space in the toebox causing the toes to repeatedly bang against the top, front, and sides of the shoe during physical exertion. This repetitive stress to the toe causes a blood blister to form beneath the toenail. The condition occurs most frequently among runners and soccer players because their toes are subjected to the roughest impact and the effect of toebox impact can be more pronounced in athletes who do not trim their toenails frequently enough. To prevent or decrease the discomfort of black toenails you may wish to switch to an athletic shoe with a roomier toebox. If you're certain that improperly fitting athletic footwear is not causing the problem, the other common cause of black toenails is a sudden violent impact to the toe such as jamming your foot in a door or getting your toe smashed by a heavy object. In rare cases a toenail may appear black when no injury has occurred. You should then see a doctor immediately as this can be a symptom of melanoma (skin cancer

Black-and-Blue Toenail Symptoms The big toe is most often affected. Bruised, broken blood vessels cause the black, blue, and deep purple colors under the nail. Particularly with a blood blister, the fluid buildup can irritate the toe itself causing it to redden, swell, and throb. If the black toenail is the result of a blood blister the painful symptoms should decrease within 24 hours. If your toe remains painful and swollen there is a danger that it may have become infected and you should see a podiatrist. In fact, it's usually a good idea to see a podiatrist anyway as a precaution to rule out a toe fracture as the underlying cause of the damage. As the skin beneath toenail heals it is not uncommon for the toenail to become separated from the nail bed causing your toenail to fall off. If your black toenail falls off it usually takes about four or five months for the toenail to fully grow back

Evaluating Black-and-Blue Toenails Your podiatrist will talk with you about your symptoms and physical activities. He or she may palpate (press) the area at the end of the toe to determine the extent of pain. Your toe and foot are examined for any signs of infection. If a fracture or bone spur is suspected, x-rays may be needed. If small black spots are present under the nail, other problems may need to be ruled out

Black-and-Blue Toenail Treatment

If pain is severe you should see a podiatrist immediately to determine whether your require treatment. A podiatrist may decide to remove the black toenail or to drill a hole in the nail to allow drainage and relieve the pressure. Pain may also be relieved with prescription medications, or by soaking or icing the area.

If pain is not severe, you probably won't need to see a podiatrist for treatment. The nail can be thinned or left alone to fall off. A new nail will grow in its place, but you may wish to reevaluate your athletic footwear choices to ensure that the problem does not reoccur.

Thickened Toenails   The most common cause of abnormally thick or crumbling nails is toenail fungus. Thickened toenails can also be caused by toe injuries, pressure from shoes, and conditions such as diabetes, psoriasis, or vascular disease. If you have thickened toenails you should see a podiatrist to determine their underlying cause. Thickened toenails usually don't occur spontaneously. They are a symptom of another disease or foot condition or else they are a sign that excessive pressure is being placed on the toes. If left untreated, thickened toenails may loosen and fall off

Thickened Toenail Symptoms .Along with thickening, the nail may appear ridged, brittle, or yellowish. The nail may also feel painful when pressure is put on it

Evaluating Thickened Toenails. Since thickened nails may be a symptom of an underlying medical condition, it is important for your podiatrist to look at your medical history for possible related problems. To check for a fungal infection, a culture may be done. The thickness and color of the nail are also examined carefully to determine possible infections or other conditions

Thickened Toenail Treatment  . If the nail is not infected, your podiatrist may be able to thin it by trimming, filing, or grinding. If a topical antifungal cream may be needed. This can help prevent ulcerations under the nail while keeping the fungus from spreading to other nails. You may also wish to treat your shoes with an antifungal foot powder to kill the fungus inside the toebox. If pain is still present, the entire nail or part of it can be surgically removed. Do not remove the nail by yourself

Ingrown Toenails

An ingrown nail is the result of a nail growing into the skin that surrounds it. This often occurs at either edge of the big toe. Ingrown nails may be caused by improper trimming, inherited nail deformities, injuries, fungal infections, or pressure. - See more at: Ingrown Toenail Symptoms Ingrown toenails may cause pain at the tip of the toe or all the way to the base of the toe. The pain is often the worst while walking. An ingrown toenail may also lead to infection, inflammation, or a more serious condition. If the nail is infected, you might see pus or redness

Evaluating Ingrown Toenails. To determine the extent of your problem, your podiatrist examines and possibly palpates (presses) the painful area. If other problems are suspected, blood tests, cultures, or x-rays may be done as well

Ingrown Toenail Treatment .If the toenail isn't infected, your podiatrist may trim the corner of it to help relieve your symptoms. He or she may need to remove one side of your nail back to the cuticle. The base of the toenail is then treated with a chemical to keep the ingrown part from growing back. Severe infections or an ingrown nail may require antibiotics and temporary or permanent removal of a portion of the nail. To prevent pain, a local anesthetic may be used in these procedures. This treatment is usually done at your podiatrist's office. To find over-the-counter, medical quality products for treating ingrown toenails visit our ingrown toenails condition page

Preventing Nail Problems. Many nail problems. can be prevented by wearing healthy shoes and trimming your nails properly. To help avoid infection, keep your feet clean and dry. If you have diabetes, see a podiatrist at the first sign of foot injury. Diabetic feet are subject to an elevated risk of infection and complications from foot conditions

Healthy Shoes Keep Nails Healthy .The shoes you wear have a much greater impact on the health of your nails than most people realize. The most basic step you can take to prevent nail problems is to always wear shoes that fit. Even if you think you know your shoe size, particularly if you have had nail or foot problems in the past, get your feet measured before buying a new shoe. Your shoe size can change as you age. Pay attention to how a shoe feels the moment you try it on. The idea that there should be a break-in period before a new shoe can be comfortable is a myth. A new shoe should be comfortable the moment it goes on your foot. If it isn't, return it and try another shoe. Wear shoes that are supportive and roomy enough for you toes to wiggle. This serves two purposes. First, it prevents black toenails that occur when your toes are uncomfortably squished against the top and sides of your shoes. Second, it increases the circulation in your shoes keeping them fresh and dry. Moist, cramped shoes often become a breeding ground for bacteria increasing the likelihood of you contracting toenail fungus. You should also look for shoes made of natural materials, such as leather which allow your feet to breathe

Proper Trimming. Ragged, overly long toenails catch on things, attract fungi and other bacteria, and increase the risk of damaging the entire toenail matrix if you have to stop suddenly while walking or running. To avoid problems trim your toenails regularly. Trimming them straight across without cutting down into the corners decreases the likelihood of ingrown toenails. If you can't trim your own nails, ask your podiatrist to do so for you.

Plantar fasciitis

Plantar fasciitis:Plantar fasciitis causes pain under your heel. It usually goes in time. Treatment may speed up recovery. Treatment includes rest, good footwear, heel pads, painkillers, and exercises. A steroid injection or other treatments may be used in more severe cases.

What is plantar fasciitis? 

Plantar fasciitis means inflammation of your plantar fascia. Your plantar fascia is a strong band of tissue (like a ligament) that stretches from your heel to your middle foot bones. It supports the arch of your foot and also acts as a shock-absorber in your foot.

What causes plantar fasciitis?

Repeated small injuries to the fascia (with or without inflammation) are thought to be the cause of plantar fasciitis. The injury is usually near to where the plantar fascia attaches to your heel bone.

You are more likely to injure your plantar fascia in certain situations. For example:

• If you are on your feet for a lot of the time, or if you do lots of walking, running, standing, etc, when you are not used to it. (The condition is sometimes called 'policeman's heel', as policemen 'walking the beat' were said to be commonly affected.) Also, people with a sedentary lifestyle are more prone to plantar fasciitis.
• If you have recently started exercising on a different surface - for example, running on the road instead of a track.
• If you have been wearing shoes with poor cushioning or poor arch support.
• If you are overweight - this will put extra strain on your heel.
• If there is overuse or sudden stretching of your sole. For example: athletes who increase running intensity or distance; poor technique starting 'off the blocks', etc.
• If you have a tight Achilles tendon (the big tendon at the bottom of your calf muscles above your heel). This can affect your ability to flex your ankle and make you more likely to damage your plantar fascia.

Often there is no apparent cause for plantar fasciitis, particularly in older people. A common wrong belief is that the pain is due to a bony growth or 'spur' coming from the heel bone (calcaneum). Many people have a bony spur of the heel bone but not everyone with this gets plantar fasciitis.


How common is plantar fasciitis?
Plantar fasciitis is common. Around 1 in 10 people will get plantar fasciitis at some time in their life. It is most common in people between the ages of 40 to 60 years. However, it can occur at any age. It is twice as common in women as it is in men. It is also common in athletes.

What are the symptoms of plantar fasciitis?

Pain is the main symptom. This can be anywhere on the underside of your heel. However, commonly, one spot is found as the main source of pain. This is often about 4 cm forward from your heel, and may be tender to touch.The pain is often worst when you take your first steps on getting up in the morning, or after long periods of rest where no weight is placed on your foot. Gentle exercise may ease things a little as the day goes by, but a long walk or being on your feet for a long time often makes the pain worse. Resting your foot usually eases the pain.Sudden stretching of the sole of your foot may make the pain worse - for example, walking up stairs or on tiptoes. You may limp because of pain. Some people have plantar fasciitis in both feet at the same time.

How is plantar fasciitis diagnosed?

Your doctor can usually diagnose plantar fasciitis just by talking to you and examining your feet. Rarely, tests are needed if the diagnosis is uncertain or to rule out other possible causes of heel pain. These can include X-rays of the heel or an ultrasound scan of the fascia. An ultrasound scan usually shows thickening and swelling of the fascia in plantar fasciitis.

What is the initial treatment for plantar fasciitis?

Usually, the pain will ease in time. 'Fascia' tissue, like 'ligament' tissue, heals quite slowly. It may take several months or more to go. However, the following treatments may help to speed recovery. A combination of different treatments may help. Collectively, these initial treatments are known as 'conservative' treatments for plantar fasciitis.

Rest your foot

This should be done as much as possible. Avoid running, excess walking or standing, and undue stretching of your sole. Gentle walking and exercises described below are fine.

Footwear

Do not walk barefoot on hard surfaces. Choose shoes with cushioned heels and a good arch support. A laced sports shoe rather than an open sandal is probably best. Avoid old or worn shoes that may not give a good cushion to your heel.

Heel pads and arch supports

You can buy various pads and shoe inserts to cushion the heel and support the arch of your foot. These work best if you put them in your shoes at all times. The aim is to raise your heel by about 1 cm. If your heel is tender, cut a small hole in the heel pad at the site of the tender spot. This means that the tender part of your heel will not touch anything inside your shoe. Place the inserts/pads in both shoes, even if you only have pain in one foot.

Pain relief

Painkillers such as paracetamol will often ease the pain. Sometimes anti-inflammatory medicines such as ibuprofen are useful. These are painkillers but also reduce inflammation and may work better than ordinary painkillers. Some people find that rubbing a cream or gel that contains an anti-inflammatory medicine on to their heel is helpful.An ice pack (such as a bag of frozen peas wrapped in a tea towel) held to your foot for 15-20 minutes may also help to relieve pain.

Exercises

Regular, gentle stretching of your Achilles tendon and plantar fascia may help to ease your symptoms. This is because most people with plantar fasciitis have a slight tightness of their Achilles tendon. If this is the case, it tends to pull at the back of your heel and has a knock-on effect of keeping your plantar fascia tight. Also, when you are asleep overnight, your plantar fascia tends to tighten up (which is why it is usually most painful first thing in the morning). The aim of these exercises is to loosen up the tendons and fascia gently above and below your heel. Your doctor may refer you to a physiotherapist for exercise guidance.

The following exercises can be used to help treat plantar fasciitis:

 

• Stand about 40 cm away from a wall and put both hands on the wall at shoulder height, feet slightly apart, with one foot in front of the other. Bend your front knee but keep your back knee straight and lean in towards the wall to stretch. You should feel your calf muscle tighten. Keep this position for several seconds, then relax. Do this about 10 times then switch to the other leg. Now repeat the same exercise for both legs but this time, bring your back foot forward slightly so that your back knee is also slightly bent. Lean against the wall as before, keep the position, relax and then repeat 10 times before switching to the other leg. Repeat this routine twice a day.
• Stand on the bottom step of some stairs with your legs slightly apart and with your heels just off the end of the step. Hold the stair rails for support. Lower your heels, keeping your knees straight. Again you should feel the stretch in your calves. Keep the position for 20-60 seconds, then relax. Repeat six times. Try to do this exercise twice a day.
• Sit on the floor with your legs out in front of you. Loop a towel around the ball of one of your feet. With your knee straight, pull your toes towards your nose. Hold the position for 30 seconds and repeat three times. Repeat the same exercise for the other foot. Try to do this once a day.
• Sit on a chair with your knees bent at right angles and your feet and heels flat on the floor. Lift your foot upwards, keeping your heel on the floor. Hold the position for a few seconds and then relax. Repeat about 10 times. Try to do this exercise five to six times a day.
• For this exercise you need an object such as a rolling pin or a drinks can. Whilst sitting in a chair, put the object under the arch of your foot. Roll the arch of your foot over the object in different directions. Perform this exercise for a few minutes for each foot at least twice a day.

Are there any other treatments?

If the above treatments are not helping to relieve your symptoms, or if you are someone such as an athlete who needs a quick recovery, other treatments are available. There is no one specific treatment that appears to stand out as the best.

Steroid injections

A steroid (cortisone) injection is sometimes tried if your pain remains bad despite the above 'conservative' measures. It may relieve the pain in some people for several weeks but does not always cure the problem. It is not always successful and may be sore to have done. Steroids work by reducing inflammation. Sometimes two or three injections are tried over a period of weeks if the first is not successful. Steroid injections do carry some risks, including (rarely) tearing (rupture) of the plantar fascia.

Extracorporeal shock-wave therapy

In extracorporeal shock-wave therapy, a machine is used to deliver high-energy sound waves through your skin to the painful area on your foot. It is not known exactly how it works, but it is thought that it might stimulate healing of your plantar fascia. One or more sessions of treatment may be needed.

This procedure appears to be safe but it is uncertain how well it works. This is mostly because of a lack of large, well-designed clinical trials. You should have a full discussion with your doctor about the potential benefits and risks.

In studies, most people who have had extracorporeal shock-wave therapy have little in the way of problems. However, possible problems that can occur include pain during treatment, skin reddening, and swelling of your foot or bruising. Another theoretical problem could include the condition getting worse because of rupture of your plantar fascia or damage to the tissues in your foot. More research into extracorporeal shock-wave therapy for plantar fasciitis is needed.

Other treatments

Various studies and trials have been carried out looking at other possible treatments for plantar fasciitis. Such treatments include injection with botulinum toxin and treatment of the plantar fascia with radiotherapy. These treatments may not be widely available.

Some people benefit from wearing a special splint overnight to keep their Achilles tendon and plantar fascia slightly stretched. The aim is to prevent the plantar fascia from tightening up overnight. In very difficult cases, sometimes a plaster cast or a removable walking brace is put on the lower leg. This provides rest, protection, cushioning and slight stretching of the plantar fascia and Achilles tendon. However, the evidence for the use of splint treatment of plantar fasciitis is limited.

Surgery

This may be considered in very difficult cases. Surgery is usually only advised if your pain has not eased after 12 months despite other treatments. The operation involves separating your plantar fascia from where it connects to the bone; this is called a plantar fascia release. It may also involve removal of a spur on the calcaneum if one is present. Surgery is not always successful. It can cause complications in some people so it should be considered as a last resort. Complications may include infection, increased pain, injury to nearby nerves, or rupture of the plantar fascia.

What is the outlook (prognosis) for plantar fasciitis?

Most people have completely recovered from an episode of plantar fasciitis within a year. However, some of the treatments described above may help to speed up your recovery.

Can plantar fasciitis be prevented?

There are certain things that you can do to try to prevent plantar fasciitis, especially if you have had it before. These include:

• Regularly changing training shoes used for running or walking.
• Wearing shoes with good cushioning in the heels and good arch support.
• Losing weight if you are overweight.
• Regularly stretching the plantar fascia and Achilles tendon, especially before exercise.
• Avoiding exercising on hard surfaces.

 

Diabetic Footcare

People with Diabetes, too much Glucose in the Blood can cause serious Foot Complications

 

For people with diabetes, too much glucose in the blood

can cause serious foot complications

  

 

 

 

 

Diabetic neuropathy is a lack of feeling accompanied by tingling, burning, pain, or numbness in your legs and feet due to nerve damage

 

 

 

 

 

 

 

 

Peripheral vascular disease causes poor blood flow in the arms and legs that can affect the ability of a sore or cut to heal, leading to ulcers or gangrene.

 

  

 

 

 

 

 

 

 

Common foot problems of people with diabetes can lead to serious complications.

 

 

 

 

 

 

 

 

Athlete's foot is a fungus that causes itching, redness, and cracking

Nails that are infected with a fungus may become discolored, thick and brittle, and may separate from the rest of the nail. 

 

 

 

 

 

 

Calluses are a build-up of hard skin, usually on the underside of the foot caused by an uneven distribution of weight. 

 

 

 

 

 

Corns are a build-up of hard skin near a bony area of a toe or between toes

 

 

 

 

 

 

 

 

Blisters can form when your shoes rub the same spot on your foot

 

 

 

 

 

 

 

Bunions form when the big toe angles toward the second toe and becomes red and callused (where the big toe joins the rest of the foot).

Dry skin can crack, allowing germs to enter.

 

A foot ulcer is a break in the skin or a deep sore which can become infected

 

A hammertoe is a toe that is bent because of a weakened muscle that makes the tendons shorter, causing the toes to curl under the feet.

 

Ingrown toenails occur when the edges of the nail grow into the skin causing redness, swelling, pain, drainage, and infection.

 

Plantar warts look like calluses on the ball of the foot or on the heel and are caused by a virus that infects the outer layer of skin.

 

 

Learn how to prevent foot problems if you have diabetes

 

 

 

Take care of your diabetes by keeping your blood glucose level within the range recommended by your doctor.

 

 

 

Check and examine your feet every day

 

 

 

 Wash your feet every day and keep them nice and moisturized by applying lotion.

 

 

 

 

 

Smooth corns and calluses with an emery board or pumice stone.

 

 

 

 

 

 

Check and trim your toenails once a week.

 

 Wear socks or stockings and proper shoes at all     times. 

 

 

 

 

 

 

Put your feet up to maintain good blood flow.

 

 

 

 

 

Smoking can make blood flow problems worse

 

 

 

 

 

 

 

Visit your doctor or podiatrist for regular check-ups
on your feet, even if you don't have any foot problems.