We see a variety of foot and ankle issues in my Houston podiatry practice. One of the most common conditions is ingrown toenails. An ingrown toenail occurs when there is pressure between the side of the toenail and the side of the skin. This can ultimately lead to pain, inflammation, and infection.
While many blame improper cutting of the toenail for causing ingrown nails, that is usually not the main culprit. In many cases, the toenail is simply too wide for the nail bed. Once their is pressure on the side of the toe, the inflammatory reaction begins and the pain, swelling, and redness follows. This pressure can be caused by an injury, such as stubbing the toe or wearing tight shoes. An often overlooked cause of ingrown toenails is pronation.
Pronation is the motion of the foot and ankle "rolling in" as the arch flattens. Everyone should have a normal amount of pronation, however those who excessively pronate can find themselves with a number of foot and ankle complaints. When someone walks with overpronation, the feet will angle out and excessive pressure will be placed on the great toe as it pivots into the next step. This pressure pushes the great toe towards the second toe with each step, forcing those two toes together. The pressure of the second toe on the great toe can lead to inflammation on the border of the great toenail, as it begins to ingrow.
All podiatrists are equipped to manage an ingrown toenail. It is likely the most common procedure that is performed at a Houston podiatrist's office. Many doctors, however may be hesitant to recommend custom orthotics to correct the hyperpronation that has led to the toenail ingrowing. This is a disservice to the patient! In fact an ingrown toenail may be the first symptom of the multiple issues that excessive pronation may cause.
Hyperpronation is an underlying cause for a number of foot and ankle issues. The most common of these include the formation of bunions and hammertoes, heel pain, Achilles tendon pain, and a number of soft tissue overuse injuries such as tendonitis. The most effective treatment for overpronation is the fabrication of a custom foot orthotic.
A custom orthotic is a prescription shoe insert that is made from a mold of each patient's foot. The orthotic made after a number of measurements are taken of the foot and ankle whole both sitting and standing. A thorough gait analysis is performed, both visual and digital, to assess the improper motion of the foot during gait. By reducing the excessive pronation, the custom orthotic also effectively manages the abnormal motions and pressures that lead to the formation of the ingrown toenail and the many other issues that can develop.
The next time you are in the office for an ingrown toenail, or any other foot or ankle issue, be sure to ask your Houston podiatrist if a custom orthotic could be useful in eliminating the problem and prevent it from returning. If you are currently experiencing any foot or ankle pain, contact Tanglewood Foot Specialists in Houston to schedule an immediate appointment with Dr. Andrew Schneider.