Category Archives: Blog

  • 1

Diabetes and Foot Care

Category : Blog

Diabetes can be a devastating disease which affects the entire body.  Uncontrolled sugar can lead to damage to the kidneys, eyes, and the cardiovascular system.  Many people are unaware however, that elevated sugar levels can lead to problems with the feet as well.  Loss of peripheral sensation can cause burning pains in the feet known as peripheral neuropathy.

Follow some of these tips from Healthy Medicine to keep you feet in great shape.

And if you do develop a foot related complication from diabetes, please call us here at 352-376-5112.  We are here to help you!

  • -

Albert Pujols Plantar Facial Tear: Could it Happen to You?

As I have previously written, plantar fasciitis is the most common

complaint which walks through my door. It does not just afflict the old or

the out of shape, but affects athletes as well.  It appears that Albert Pujols

has had an ongoing issuewith his plantar fascia.  And based on this article,

he has developed a devastating injury which may sideline him for up to a



But really how bad is a plantar fascial tear?  Well honestly I would be

surprised if Albert misses a year.  Commonly plantar fascia can tear after

multiple cortisone injections and by many I mean five or more in the

course of less than six months.  A large strain on the fascia such as after a

big fall or in ahyperextension of the foot may also lead to a tear.  Otherwise,

it is a fairly uncommon injury and I have only seen a few cases in over 17

years of practice.


However if your fascia has actually torn what happens?  First its going to

hurt.  A lot.  Initially it will be black and blue and swollen and treatment

may be started with ice and immobilization.  But likely over the

course of a few weeks or months the pain should resolve.  And if you had

plantar fasciitis prior to a tear, it should also resolve.  Because essentially a

tear of the fascia CAN mimic surgery for plantar fascial surgery where the

fascia is released.  There is a chance however that the fascia may still need

to be fully released depending on the extent of the tear.  Rarely would I

expect this to be repaired or sewn together.

If you think you may have a plantar fascial tear, or plantar fasciitis, please call.  We are here to help!


  • 1

Working out…in high heels!

Would you work out in heels of 2, 3 or even 4 inches?  Sorry…I’m only addressing this blog to my female patients.  If you’re a guy and your wearing high heels…well…lets not go there.

I just finished reading an article on yahoo about workouts in high heels.  You can read it here.    OK.  First, I thought that’s just crazy.   Who would want to risk stress fractures, ankle sprains, or even a broken ankle by working out in heels?  stress fractures and ankle sprains of high heels







I also checked out Gainesville’s biggest gym, Gainesville Health and Fitness, and was glad to see that there were no classes being offered for this ridiculous type of workout.

Don’t get me wrong, I love seeing a woman in heels.  In a very un-scientific poll, I found that women just say it makes them feel sexier.  And if you are going out for the evening or wearing heels on occasion, there shouldn’t be much of a problem.  But for everyday use there are risks.  Women who are overweight, have arthritis, or have high or flat arches, will experience more frequent foot and ankle problems (most common are tendon and muscle strains, hammertoes, bunions, and stress fractures-though long-term high heel wearers could suffer from tendinitis, severe ankle sprains, and torn ligaments and tendons), but many women encounter symptoms after extended high-heel wear. Pain is your body’s way of warning you that something is wrong, and that you should stop wearing the shoes.

One of my postop surgical patients sent me a picture of the shoes she wants to get into after she heals.

high heeled shoe








And I hope we can get her into those.  But if after a night out, you find yourself in pain, take these steps:  Ice is your best friend.  This will decrease pain and swelling.  Add an OTC NSAID such as ibuprofen.  And if your pain does not get better, call us at Family Podiatry.  We’re here to help YOU!

  • 2

Are You Ready for the Superbowl…Injuries?

Category : Blog , Foot Injuries

Football is an intensive, high impact sport that requires speed and quick moves.    Its no surprise that foot injuries and ankle injuries are common.

Super Bowl XLVII is hours away.
While we enjoy the pre-game festivities, players will be conditioning and practicing.  What foot and ankle injuries may they face?

Key Foot Injuries

An injury known as the Lisfranc injury received a lot of attention this fall when three players suffered from it within the course of a week.  This injury involves mid-foot ligaments, and may happen when the foot gets tangled up while playing on artificial turf.

Another injury that has artificial turf as a contributing factor is turf toe.  This injury is actually a sprain of the largest joint (the MTP) of the big toe.  Surgery is not normally necessary, but there can be long-term effects such as pain and joint stiffness.

Ankle sprains are another common football injury.  As a player moves to block and tackle, their ankle may roll causing a lateral ankle sprain.   Tackled players may also get their foot stuck in the pile-up resulting in a high ankle sprain.  The severity can range from some swelling to ligaments that are completely torn.  Overuse injuries and fractures are also a threat to football players.

Foot Injuries for Us Average Folks

Elite Athletes aren’t the only ones who can suffer from traumatic foot and ankle injuries.  Weekend warriors or those  of us who train on a regular basis develop plantar fasciitis and stress fractures as well.  Dont let your injury keep you out of the game.  Call us at (352)-376-5112 at Family Podiatry and Vein Care and stop that pain now!

  • -

New Years Resolutions!

Category : Blog , Foot Injuries

Have you made a New Year’s Resolution?  Have you stuck with it or given up already?

If you are like many of the patients I see, your resolution is to diet, lose weight, and begin an exercise program.  That’s great!  Because we have a huge (pun intended) obesity problem in this country.

One of the most common exercises people start with is walking.  Hopefully its not a stroll to the local ice cream store.   But for many people the new exercise program can lead to foot and ankle issues.  Starting too much, too often, and without the proper shoe gear can lead to ankle injuries, plantar fasciitis, achilles tendonitis, or even a metatarsal stress fracture.

What can you do to minimize your risk of foot or ankle injuries?

  • Don’t pound out the miles in a brand new shoe.  Break them in a bit first, and make sure they’re not too tight leading to blisters.





  • Start slow!  Maybe you’re ready for 5 miles the 1st day.  But maybe you should start with only 1/2 mile.  Exercise isn’t a sprint (unless you’re doing sprints).  Its a marathon.  You can always go a little further tomorrow.






  • Ignore the saying “no pain, no gain.”  While its OK to be a bit sore the next day, pain is your body’s way of saying STOP!  Maybe you just need an anti-inflammatory or some ice, but it could be more severe.









  • Consider some arch supports or even orthotics.  They provide you with a lot better support than what comes in the shoe.



  • If you have any issues with your foot or ankle, and its not getting better, come see us at Family Podiatry.  Your feet aren’t supposed to hurt!

  • 1

What Can Stop Alabama’s Eddie Lacey? Turf Toe.

Turf Toe sidelined Eddie Lacey

Turf Toe might be the only thing to stop the Crimson Tide’s Eddie Lacey

Common foot problems can plague any of us, even elite athletes. For example, our beloved Florida Gators faced a tough Alabama Crimson Tide team on Oct 1st 2011 and were beaten badly. One Alabama player that they didn’t have to contend with though was 5’10” 220 pound running back Eddie Lacey. The week prior, Lacey was sidelined with a painful and somewhat common foot injury known as Turf Toe. As strong and as fast as Lacey is, he was stopped in his tracks by this painful injury that affected only his big toe.

What Kind of Foot Injury is Turf Toe?

Turf toe is essentially a ligament sprain. It occurs when the big toe is bent back forcefully or jammed in a way that stretches tendons. It can also occur when athletes perform high intensity exercises like sprinting or jumping. When you walk, run or jump you push off with your toes and drive your body weight forward. The bones in your big toes and their supporting ligaments bear the most weight and pivot as you shift your weight. If you hyperextend those ligaments with enough force, you can injure them and that injury is Turf Toe.

Symptoms of Turf Toe

People suffering from turf toe generally have an inability to put any weight down on the front of the injured foot. Specifically, they experience difficulties with pushing off or applying pressure with their big toe. This painful foot injury is usually accompanied by swelling and bruising and will exhibit tenderness in the area of the big toe. This of course, limits the range of movement and makes this one of the most dreaded foot injuries within organized competitive sports.


Common treatments for Turf Toe includes the familiar acronym R.I.C.E. (rest, ice, compression and elevation) and can include mild pain medications. Avoid placing weight on the injured foot and in severe cases, surgery might be required to repair the ligament damage.

Good News for Eddie Lacey was that he recovered and was back to full speed this year. He will play an important role in the upcoming BCS championship game and Notre Dame will have to find another way to stop Alabama’s premiere running back.

Got Questions about a painful foot problem?

Come on in and ask Dr. Koppel about it today!


Photo by Associated Press /Chattanooga Times Free Press.

  • -

Ingrown Nails

Category : Blog

I had a professor in school who said he could treat people for ingrown nails the whole day, every day.  At the time, I thought it was a bit odd, but years later I get it.


Many times people come in to see me and they’re so scared of the injection to numb the toe.  Usually it’s because they had a bad experience somewhere else.  It takes a bit more effort on my part to win them over, but virtually all of the time they tell me there was almost no pain with the shots.  And once the injection is done, the rest is easy.


What is an ingrown toenail?  Simply, the side of the nail grows into the skin and causes pain and a localized infection.  Causes include tight shoes, trauma, improper cutting of the nail and fungal infections.


Many primary care doctors will treat this medically with antibiotics.  I almost never do this.  An ingrown nail is a SURGICAL problem that generally won’t clear up till the nail spicule is removed.

After treatment, you’ll be able to walk out without pain and in most instances return to normal activity the same or the next day.  So call and let us stop the pain today

  • -

Plantar Fasciitis, Runners, and Orthotics

Category : Blog , plantar fasciitis

As I mentioned in my last post, plantar fasciitis can be caused from overuse.  When you run, you place up to 5 times your body weight on the foot with each step.  This compares to 1-1.5 times your body weight on your foot with walking.  So naturally there are a share of runners out there who develop heel pain, or plantar fasciitis.

Unfortunately, one of the best things you can do to help decrease your pain is one of the last things you may want to do if you run:  stop running.

OK.  Now that I cant convince you to stop running lets move on.

Do you need custom orthotics?  Well that’s a definite maybe.  Certainly most of the over the counter supports out there are absolute junk.   I have had many, many people waste $50 or more on the Dr. Scholl’s “custom fit orthotics.”  These are not custom and most of the time they do not fit.  Many times, I will dispense my own OTC supports and for many people these can work out really well as adjunctive therapy for fasciitis. However, if you have a really high arch or you have a severe pronation problem (flatfoot), you may be much better off with a custom device.   The best way to tell which treatment is best for you is to come in for an evaluation.  Call 352-376-5112 or click here to have us contact you.   You really dont have to continue to live with foot pain.

  • -

Heel Pain

Category : Blog , plantar fasciitis

“What can I do for you today?”  I ask.  The response I typically get is “Fix my heel pain!!”

There is not a day that goes by that I don’t see at least one, and usually multiple people with heel pain.  It never fails to amaze me how uninformed patients and other physicians are about heel pain, so of course I’d like to devote my first blog to this topic.

Plantar fasciitis, heel spurs, heel pain syndrome.  No matter what you want to call it, it’s all the same.

On the bottom of the foot is a ligament called the plantar fascia.  It attaches to the heel bone or calcaneous and runs to the ball of the foot.  At the attachment to the heel bone, an inflammation of the ligament can develop leading to pain.  Simple.

But what about the heel spur?  Don’t worry about it.  If there is one, its there because of the ligament pain.  Its not the cause of the pain.

Causes of heel pain include overuse, weight gain, trauma and poor biomechanics which just means you have a bad foot type, i.e. flatfooted or high arched.

But what about treatment?  On your own, you can try some OTC ibuprofen or naprosyn, stretch and ice the heel, and try store bought arch supports.  I do caution you however that most of the product out there are a complete waste of money.  Dr. Scholl’s has a great marketing campaign, but thats about it.

If those things don’t make a significant difference, I would invite you to call me at 352-376-5112 for an evaluation or you can contact us here.  I would be more than happy to help you get back to a pain free life.

Podiatry Services

  • Comprehensive care of foot and ankle disorders
  • Lower extremity vascular evaluations
  • Diabetic foot care
  • Surgical and non-surgical treatment of athletic injuries, bunions, hammertoes, corns and calluses
  • Custom molded orthotics
  • Diabetic shoe program
  • Foot and ankle surgery
  • Work related injuries
  • Minor in-office surgical procedures
  • X-rays in office
  • Diabetic limb salvage
  • Ulcers and wound care

Request an Appointment