We'll Help Ease your Foot Pain

There are a few ailments that Rogue Valley Foot & Ankle Clinic, PC can help treat. If you have any question about those listed or anything that may not be listed, please contact us today 541-773-3338
Young woman suffering from an ankle injury - Foot and Ankle Clinic in Medford, OR

Heel Pain

Heel pain is most often caused by plantar fasciitis, a condition that is sometimes also called heel spur syndrome when a spur is present. Heel pain may also be due to other causes, such as a stress fracture, tendonitis, arthritis, nerve irritation, or, rarely, a cyst. Because there are several potential causes, it is important to have heel pain properly diagnosed. A podiatric foot and ankle surgeon is best trained to distinguish between all the possibilities and determine the underlying source of your heel pain.

What Is Plantar Fasciitis?
Plantar fasciitis is an inflammation of the band of tissue (the plantar fascia) that extends from the heel to the toes. In this condition, the fascia first becomes irritated and then inflamed resulting in heel pain.

The symptoms of plantar fasciitis are:
  • Pain on the bottom of the heel
  • Pain that is usually worse upon arising in the morning or after periods of rest.
  • Pain that increases over a period of months.

Causes of Plantar Fasciitis

Plantar fasciitis is caused by a number of different factors resulting in longitudinal stretch on the fascia. The most common cause of plantar fasciitis relates to faulty structure of the foot. For example, people who have problems with their arches either overly flat feet or high-arched feet, are more prone to developing plantar fasciitis. Wearing non-supportive footwear puts an abnormal strain on the plantar fascia and can also lead to plantar fasciitis. Obesity also contributes to plantar fasciitis.

Treatment Options
Treatment of plantar fasciitis begins with first-line strategies, which you can begin at home:

  • Stretching exercises. Exercises that stretch out the calf muscles help ease pain and assist with recovery.
  • Injection therapy. In some cases, cortisone injections are used to help reduce the inflammation and relieve pain.$ Avoid going barefoot. When you walk without shoes, you put undue strain and stress on your plantar fascia.
  • Ice. Putting an ice pack on your heel for 20 minutes in the evening helps reduce inflammation.
  • Limit activities. Cut down on extended physical activities to give your heel a rest.
  • Shoe modifications. Wearing supportive shoes that have good arch support and a slightly raised heel reduces stress on the plantar fascia. Your shoes should provide a comfortable environment for the foot.
  • Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful as an adjunct to other approaches and may help reduce pain and inflammation.
  • Lose weight. Extra pounds put extra stress on your plantar fascia.
  • Orthotic devices. Custom orthotic devices that fit into your shoe help correct the underlying structural abnormalities causing the plantar fasciitis.
  • Endoscopic plantar fascial release. Endoscopic plantar fascial release is a minor procedure performed to release stress on the fascia. Minimally invasive, this procedure is highly successful in solving this problem and recovery time is short -patients are usually back to normal shoe wear in one weeks time.

Long-term Care
No matter what kind of treatment you undergo for plantar fasciitis, the underlying causes that led to this condition may remain. Therefore, you will need to continue with preventive measures. If you are overweight, it is important to reach and maintain an ideal weight. For all patients, wearing supportive shoes and using custom orthotic devices are the mainstay of long-term treatment for plantar fasciitis.
Girl cuts a man ingrown toenail - Foot & Ankle Clinic in Medford, OR

Ingrown Toenail

When a toenail is ingrown, the nail is curved downward and grows into the skin, usually at the nail borders (the sides of the nail). This digging in of the nail irritates the skin, often creating pain, redness, swelling, and warmth in the toe. If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is often marked by drainage and a foul odor. However, even if your toe isn't painful, red, swollen, or warm, a nail that curves downward into the skin can progress to an infection.

What Causes an Ingrown Toenail?
Ingrown toenails can develop for various reasons. In many people, he tendency to have this common disorder is inherited. In other cases, an ingrown toenail is the result of trauma, such as stubbing your toe, having an object fall on your toe, or engaging in activities that involve repeated pressure on the toes, such as kicking or running. The most common cause of ingrown toenails is improper trimming. Cutting your nails too short encourages the skin next to the nail to fold over the nail. Another cause of ingrown toenails is wearing shoes that are tight or short. Certain nail conditions are often associated with ingrown toenails. For example, if you have had a toenail fungal infection or if you have lost a nail through trauma, you are at greater risk for developing an ingrown toenail.

Sometimes initial treatment for ingrown toenails can be safely performed at home. However, home treatment is strongly discouraged if you suspect you have an infection, or if you have a medical condition that puts your feet at high risk for example, diabetes, nerve damage in the foot, or poor circulation.

Home care: If you don't have an infection or any of the above conditions, you can soak your foot in warm water (add Epsom's salt if you wish), and gently massage the side of the nail fold to help reduce the inflammation. Avoid attempting bathroom surgery. Repeated cutting of the nail can cause the condition to worsen over time. If your symptoms fail to improve, it's time to see a foot and ankle surgeon.

Physician care:
The foot and ankle surgeon will examine your toe and select the treatment best suited for you. Treatment may include:

  • Oral antibiotics. If an infection is present, an oral antibiotic may be prescribed.
  • Surgery. A simple procedure, often performed in the office, is commonly needed to ease the pain and remove the offending nail. Surgery may involve numbing the toe and removing a corner of the nail, a larger portion of the nail, or the entire nail.
  • Permanent removal. Various techniques may be used to inactivate or remove the nail root. This treatment prevents the recurrence of an ingrown toenail. Your surgeon will determine the most appropriate procedure for you.

Following nail surgery, a light bandage will be applied. Most people experience very little pain after surgery and may resume normal activity the next day. If your surgeon has prescribed an oral antibiotic, be sure to take all the medication, even if your symptoms have improved.

Preventing Ingrown Toenails
Many cases of ingrown toenails may be prevented by following these two important tips:

  • Trim your nails properly. Cut your toenails in a fairly straight line, and don't cut them too short. You should be able to get your fingernail under the sides and end of the nail.
  • Avoid poorly-fitting shoes. Don't wear shoes that are short or tight in the toe box. Also avoid shoes that are loose, because they too cause pressure on the toes, especially when you run or walk briskly.
Doctor bandaging patients leg - Foot & Ankle Clinic in Medford, OR

Ganglion Cyst

A ganglion cyst is a mass of tissue that is filled with a jelly-like fluid. The word Ganglion means knot and is used to describe the knot-like mass or lump of cells that forms below the surface of the skin. Ganglion cysts are among the most common benign soft-tissue masses. Although they most often occur on the wrist, they also frequently develop on the foot usually on the top, but elsewhere as well. Ganglion cysts vary in size, may get smaller and larger over time and may even disappear, only to possibly return later.

Signs and Symptoms
A ganglion cyst is associated with one or more of the following signs and symptoms:

  • A noticeable lump often this is the only symptom experienced
  • Tingling or burning, if the cyst is touching a nerve
  • Dull pain or ache, which may indicate the cyst is pressing against a tendon or joint
  • Difficulty wearing shoes due to irritation between the lump and the shoe

What Causes a Ganglion Cyst?
Ganglion cysts are usually caused by some type of injury. For example, a ganglion cyst might develop after something drops on the foot, if the foot was twisted while walking, or after too much stress was placed on a joint or tendon. For some patients, the trauma that triggers this condition is something they do not recall. Usually the cyst appears soon after the trauma occurs.

There are various options for treating a ganglion cyst on the foot:

  • Monitoring, but no treatment. If the cyst causes no pain and does not interfere with walking, the surgeon may decide it is best to carefully watch the cyst over a period of time.
  • Shoe modifications. Wearing shoes that do not rub the cyst or cause irritation may be advised. In addition, placing a pad inside the shoe may help reduce pressure against the cyst.
  • Aspiration and injection. This technique involves draining the fluid and then injecting a steroid medication into the mass. More than one session may be needed. Although this approach is successful in some cases, in any others the cyst returns.
  • Surgery. When other treatment options fail or are not appropriate, the cyst may need to be surgically removed. While the recurrence rate associated with surgery is much lower than that experienced with aspiration and injection therapy, there are nevertheless cases in which the ganglion cyst returns.
Bunion - Foot & Ankle Clinic in Medford, OR

Tailor's bunion

Tailor's bunion, also called a bunionette, is an enlargement of the fifth metatarsal bone at the base of the little toe. The metatarsals are the five long bones of the foot. The enlargement that characterizes a tailor's bunion occurs at the metatarsal Ahead, located at the far end of the bone where it meets the toe. Tailor's bunions are not as common as bunions, which occur on the inside of the foot, but both are similar in symptoms and causes. The symptoms of tailor's bunions include redness, swelling, and pain at the site of the enlargement. These symptoms occur when wearing shoes that rub against the enlargement, irritating the soft tissues underneath the skin and producing inflammation. Why do we call it tailor's bunion? The deformity received its name centuries ago, when tailors sat cross-legged all day with the outside edge of their feet rubbing on the ground. This constant rubbing led to a painful bump at the base of the little toe.

Causes of a Tailor's Bunion
Often a tailor's bunion is caused by an inherited faulty mechanical structure of the foot. In these cases, changes occur in the foot's bony framework that result in the development of an enlargement. The fifth metatarsal bone starts to protrude outward, while the little toe moves inward. This shift creates a bump on the outside of the foot that becomes irritated whenever a shoe presses against it. Sometimes a tailor's bunion is actually a bony spur (an outgrowth of bone) on the side of the fifth metatarsal head. Heredity is the main reason that these spurs develop. Regardless of the cause, the symptoms of a tailor's bunion are usually aggravated by wearing shoes that are too narrow in the toe, producing constant rubbing and pressure. In fact, wearing shoes with a tight toe box can make the deformity get progressively worse.

Non-surgical Options
Treatment for tailor's bunion typically begins with non-surgical therapies. Your foot and ankle surgeon may select one or more of the following options:

  • Shoe modifications. Wearing the right kind of shoes is critical. Choose shoes that have a wide toe box, and avoid those with pointed toes or high heels.
  • Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help relieve the pain and inflammation.
  • Injection therapy. Injections of corticosteroid are commonly used o treat the inflamed tissue around the joint.
  • Padding. Bunionette pads placed over the area may help reduce pain. These pads are available from your foot and ankle surgeon or at a drug store.
  • Icing. An ice pack may be applied to reduce pain and inflammation. Wrap the pack in a thin towel rather than placing ice directly on your skin.

When Is Surgery Needed?
Surgery is often considered when pain continues despite the above approaches. Surgery is highly successful in the treatment of tailor=s bunions. In selecting the procedure or combination of procedures for your particular case, the foot and ankle surgeon will take into consideration he extent of your deformity based on the x-ray findings, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.
Injured toenail - Foot & Ankle Clinic in Medford, OR

Hammer Toe

Hammertoe is a contracture or bending of one or both joints of the second, third, fourth, or fifth (little) toes. This abnormal bending can put pressure on the toe when wearing shoes, causing problems to develop. Common symptoms of hammertoes include:

  • Pain or irritation of the affected toe when wearing shoes.
  • Corns (a buildup of skin) on the top, side, or end of the toe, or between two toes. Corns are caused by constant friction against the shoe. They may be soft or hard, depending upon their location.
  • Calluses (another type of skin buildup) on the bottom of the toe or on the ball of the foot. Corns and calluses can be painful and make it difficult to find a comfortable shoe.

But even without corns and calluses, hammertoes can cause pain because the joint itself may become dislocated. Hammertoes usually start out as mild deformities and get progressively worse over time. In the earlier stages, hammertoes are flexible and the symptoms can often be managed with noninvasive measures. But if left untreated, hammertoes can become more rigid and will not respond to non-surgical treatment. Corns are more likely to develop as time goes on and corns never really go away, even after trimming. In more severe cases of hammertoe, open sores may form. Because of the progressive nature of hammertoes, they should receive early attention. Hammertoes never get better without some kind of intervention.

What Causes Hammertoe?
The most common cause of hammertoe is a muscle/tendon imbalance. This imbalance, which leads to a bending of the toe, results from mechanical (structural) changes in the foot that occur over time in some people. Hammertoes are often aggravated by shoes that don't fit properly for example, shoes that crowd the toes. And in some cases, ill-fitting shoes can actually cause the contracture that defines hammertoe. For example, a hammertoe may develop if a toe is too long and is forced into a cramped position when a tight shoe is worn. Occasionally, hammertoe is caused by some kind of trauma, such as a previously broken toe. In some people, hammertoes are inherited.

Non-Surgical Approaches
There are a variety of treatment options for hammertoe. The treatment your podiatric foot and ankle surgeon selects will depend upon the severity of your hammertoe and other factors. A number of non-surgical measures can be undertaken:

  • Trimming corns and calluses. This should be done by a healthcare professional. Never attempt to do this yourself, because you run the risk of cuts and infection. Your podiatric surgeon knows the proper way to trim corns to bring you the greatest benefit.
  • Padding corns and calluses. Your podiatric surgeon can provide or prescribe pads designed to shield corns from irritation. If you want to try over-the-counter pads, avoid the medicated types. Medicated pads are generally not recommended because they may contain a small amount of acid that can be harmful. Consult your podiatric surgeon about this option.
  • Changes in shoewear. Avoid shoes with pointed toes, shoes that are too short, or shoes with high heels conditions that can force your toe against the front of the shoe. Instead, choose comfortable shoes with a deep, roomy toe box and heels no higher than two inches.
  • Orthotic devices. A custom orthotic device placed in your shoe may help control the muscle/ tendon imbalance.
  • Injection therapy. Corticosteroid injections are sometimes used to see pain and inflammation caused by hammertoe.
  • Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are often prescribed to reduce pain and inflammation.
  • Splinting/strapping. Splints or small straps may be applied by the podiatric surgeon to realign the bent toe.

When Is Surgery Needed?
In some cases, usually when the hammertoe has become more rigid, surgery is needed to relieve the pain and discomfort caused by the deformity. Your podiatric surgeon will discuss the options and select a plan tailored to your needs. Among other concerns, he or she will take into consideration the type of shoes you want to wear, the number of toes involved, your activity level, your age, and the severity of the hammertoe. The most common surgical procedure performed to correct a hammertoe is called arthroplasty. In this procedure, the surgeon removes a small section of the bone from the affected joint. Another surgical option is arthrodesis, which is usually reserved for more rigid toes or severe cases, such as when there are multiple joints or toes involved. Arthrodesis is a procedure that involves a fusing of a small joint in the toe to straighten it. A pin or other small fixation device is typically used to hold the toe in position while the bones are healing. It is possible that a patient may require other procedures, as well especially when the hammertoe condition is severe. Some of these procedures include skin wedging (the removal of wedges of skin), tendon/muscle rebalancing or lengthening, small tendon transfers, or relocation of surrounding joints. Often patients with hammertoe have bunions or other foot deformities corrected at the same time. The length of the recovery period will vary, depending on the procedure or procedures performed.
Extreme flat feet problems with fallen arches - Foot & Ankle Clinic in Medford, OR


Flatfoot is often a complex disorder, with diverse symptoms and varying degrees of deformity and disability. There are several types of flatfoot, all of which have one characteristic in common partial or total collapse (loss) of the arch. Other characteristics shared by most types of flatfoot include:

A Toe drift, where the toes and front part of the foot point outward. The heel tilts toward the outside and the ankle appears to turn in. A short Achilles tendon, which causes the heel to lift off the ground earlier when walking and may act as a deforming force.

Bunions and hammertoes may occur in some people with flatfeet. Health problems such as rheumatoid arthritis or diabetes sometimes increase the risk of developing flatfoot. In addition, adults who are overweight frequently have flatfoot.

Flexible Flatfoot
Flexible flatfoot is one of the most common types of flatfoot. It typically begins in childhood or adolescence and continues into adulthood. It usually occurs in both feet and generally progresses in severity throughout the adult years. As the deformity worsens, the soft tissues (tendons and ligaments) of the arch may stretch or tear and can become inflamed. The term flexible means that while the foot is flat when standing (weight-bearing), the arch returns when not standing. In the early stages of flexible flatfoot arthritis is not restricting motion of the arch and foot, but in the later stages arthritis may develop to such a point that the arch and foot become stiff. Symptoms, which may occur in some persons with flexible flatfoot, include:

  • Pain in the heel, arch, ankle, or along the outside of the foot
  • A Turned-in ankle Pain associated with a shin splint
  • General weakness/fatigue in the foot or leg

Treatment Options
If you experience symptoms with flexible flatfoot, the podiatric surgeon may recommend various treatment options, including:

  • Activity modifications. Cut down on activities that bring you pain and avoid prolonged walking and standing to give your arches a rest.
  • Weight loss. If you are overweight, try to lose weight. Putting too much weight on your arches may aggravate your symptoms.
  • Orthotic devices. Your podiatric surgeon can provide you with custom orthotic devices for your shoes to give more support to the arches.
  • Immobilization. In some cases, it may be necessary to use a walking cast or to completely avoid weight- bearing.
  • Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce pain and inflammation.
  • Physical therapy. Ultrasound therapy or other physical therapy modalities may be used to provide temporary relief.
  • Shoe modifications. Wearing shoes that support the arches is important for anyone who has flatfoot.
  • Surgery. In some patients whose pain is not adequately relieved by other treatments, surgery may be considered.

Flatfoot Surgery
A variety of surgical techniques is available to correct flexible flatfoot. Your case may require one procedure or a combination of procedures. All of these surgical techniques are aimed at relieving the symptoms and improving foot function. Among these procedures are tendon transfers or tendon lengthening procedures, realignment of one or more bones, joint fusions, or insertion of implant devices. In selecting the procedure or combination of procedures for your particular case, the podiatric surgeon will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.