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.
But here's something you might not know. While this condition affects your toenail, it might start with other parts of your foot. That's why I look at your whole foot health to treat ingrown toenails. And that process starts by understanding why ingrown toenails develop.
How Do You Get An Ingrown Toenail?
So many people believe improper toenail cutting causes ingrown nails. But that is usually not the main culprit. For many people, the real problem is a wide toenail and a narrow nail bed.
Why? That combination puts pressure on the side of your toe. Then, if any more pressure occurs, the inflammatory reaction begins. And pain, swelling, and redness follow.
Where would pressure come from? It could be from an injury, such as stubbing your toe, or from wearing tight shoes. Sometimes, the pressure doesn't come from outside. Instead, it's because of the way your foot is built. And that's why an often overlooked cause of ingrown toenails is pronation.
What 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. But some people pronate too much. And that causes lots of foot and ankle complaints.
If you overpronate, your feet will angle out when you walk. That puts excessive pressure on your great toe as it pivots into the next step. It also pushes your 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. And it may begin to ingrow.
People with flat feet are more likely to pronate, so you should watch for ingrown toenail if you have low arches. Remember, there are two types of flat feet: rigid and flexible. (The latter is more common.) But both can cause other foot conditions, too.
Somtimes, your flat foot can lead to plantar fasciitis (heel pain.) That's because a flatter arch over-stretches your plantar fascia (the band of connective tissue on the bottom of the foot). Runners with flat feet have a higher risk for shin splints. That's because your lower leg muscles have to work harder to hold up your arch while you pump your legs and stride. Finally, you may also notice flat feet leave you with knee and back pain. But so can the opposite foot structure: high arches, which leads to supination.
What is Supination?
When you supinate, it means you walk with your weight on the outside of your feet. That makes your ankles roll out too much when you move.
People with high arches are more likely to supinate. With this foot type, you're also more likely to have heel pain. Pain in the ball of your foot could also be a problem. If you wear high heels and have a high arch, the risk goes way up. So proper foot wear is a must. But you should also think about adding extra support with orthotics.
Whether you have flat feet or high arches, ingrown toenails may be a problem. The same is true if you've ever injured your toe. So, if you know your risk for ingrown nails, you should explore custom orthotics.
Custom Orthotic to Manage Ingrown Toenail and Arch Problems
Of course, I can always manage an ingrown toenail. In fact, it's one of the common procedures I perform in my Houston podiatrist's office. But, unlike me, many doctors, don't recommend custom orthotics when you have ingrown toenails. And that's too bad, since correcting hyperpronation could keep your toenail from ingrowing.
Now, that's bad enough on it's own. But the problem gets worse when you consider this fact. Because an ingrown toenail may be the first symptom of your excessive pronation. Which means, if you don't deal with the problem, other symptoms will pop up soon.
As I reviewed, hyperpronation is the underlying cause for many foot and ankle issues. Besides the ones I mentioned, you may also get bunions and hammertoes. if you overpronate. Achilles tendon pain, and other soft tissue overuse injuries, such as tendonitis, may also develop. That's why I always start a conversation about orthotics. Because the most effective treatment for overpronation is the fabrication of a custom foot orthotic.
So, what is a custom orthotic? Quite simply, it's a prescription shoe insert we make from a mold of each patient's foot. First, we take many measurements along your entire foot and ankle. We do these measurements while you sit and stand, so we can account for changes in your arch height.
During your orthotic fitting, we also conduct a thorough gait analysis. (We use visual and digital observations.) That way, we can assess the improper motion of the foot during gait. So we can target the problem source and correct overpronation.
Once that's accomplished, we'll be able to manage the abnormal motions and pressures. And that should help prevent your ingrown toenail formation. It should also help prevent the many other issues that can develop when you overpronate.
What do I want you to take away from this read? The next time you are in the office for an ingrown toenail, or any other foot or ankle issue, don't just treat the problem. Instead, be sure to ask your Houston podiatrist if you could benefit from a custom orthotic. Already experiencing any foot or ankle pain? Contact Tanglewood Foot Specialists in Houston right away. We'll schedule you for an immediate appointment with Dr. Andrew Schneider. And examine your foot and ankle structure to see if you need the support of orthotics.