The Schottenstein Center
Contact Us Now!
The Schottenstein Center treats a variety of conditions centered around ensuring optimum foot and ankle health. Our clinic is comprised of a team of professionals with numerous years of experience in treating a multitude of conditions. We assist patients with identifying the condition along with providing the best treatment option available. Our staff is proactive in staying on top of changing guidelines and techniques to treat current conditions and prevent future ones. Many of these conditions are common conditions in podiatry including athlete’s foot, corns, calluses and many more. Below is a list of some of the podiatric conditions we treat:
Medical and surgical treatment of:
Chronic Ankle Instability is a condition characterized by a feeling of recurring ‘giving way’ of the outer (lateral) side of the ankle. This condition often develops after repeated ankle sprains that do not heal or are not rehabilitated completely. Each subsequent sprain can lead to further weakening (or stretching) of the ankle ligaments, resulting in greater instability and increased risk of developing additional problems in the ankle. There is both non-surgical and surgical treatment for ankle instability.
Dr. Schottenstein can help determine which treatment is best suited for you based on the severity of the instability and your activity level.
Athlete’s foot (tinea pedis) is a fungal infection of the skin of the feet that is a form of ringworm. Fungal infections commonly occur on the feet because fungus thrives in warm, moist, and dark environments like shoes. Athlete’s foot usually presents as itchy, dry, and scaling skin on the soles of the feet and in between the toes. When the condition worsens, inflammation, cracks, and blisters may occur, and the area may even become infected with a bacteria. The fungus can also spread to other areas of the body, including toenails leading to a condition called onychomycosis. Many people who have Athlete’s foot on their feet don’t even realize that they have the condition. Many patients try to treat Athlete’s Foot using the counter products. While these may temporarily relieve symptoms, they may not address the underlying cause, and the condition can easily return. Seeing a specialist is important when a patient has any kind of infection so the problem can be properly treated so it does not persist or worsen.
A bunion (hallux valgus) is a common foot problem where abnormal bony bump develops at the joint of the big toe. The big toe can become stiff and lean towards the second toe and the joint can swell outward and become painful. As the joint becomes more deformed, wearing shoes and walking can become more difficult. Although bunions are not usually a serious condition, they usually grow larger and more painful over time.
Bunions most often occur as a result of an inherited foot type. In some cases, bunions may also develop because of an injury, arthritis or neuromuscular disease. While tight shoes don’t cause bunions, the crowding of toes can make them worse over time.
Although much less common, bunions can also occur on the fifth metatarsal bone where they are referred to as bunionettes. Similar to the bunion near the great toe, bunionettes are often caused by an inherited foot type and can be aggravated by certain shoe gear. Bunions are diagnosed through physical examination, but X-rays are also administered to determine the type and extent of the bone deformity.
There are many non-surgical and surgical treatment options for bunions. Dr. Schottenstein can help to advise you on the best treatment for you based on the extent of your deformity, your symptoms, x-ray findings, age, activity level, and other factors.
Burning feet can be caused by many different medical conditions. Burning feet is most frequently caused by peripheral nerve damage (neuropathy) experienced by patients who are diabetic. Other causes of burning feet can include thyroid dysfunction, back problems, gastric restriction in morbidly obese people, heavy use of alcohol, and nerve problems, such as neuromas and tarsal tunnel syndrome.
While feet may ache or burn at the end of a long day, when the problem is present on an ongoing basis, burning feet can be a symptom of a more serious health problem. In the case of diabetic peripheral neuropathy, without protective sensation, damage to the feet can occur unknowingly and lead to the development of wounds or ulcers.
A callus, also known as hyperkeratosis, refers to an area of hard, thickened skin that can occur across the on the heel, ball of foot, or on the toes because of chronic pressure or rubbing that occurs across a bony prominence. Although many consider calluses to be a skin problem, they are actually indicative of a problem with the bone.
Calluses can irritate nerves and develop bursal sacs (fluid-filled balloons that act as shock absorbers) beneath them, causing symptoms that range from sharp, shooting pain, to dull, aching soreness. Dr. Schottenstein can talk to you about the treatments for your calluses, and even provide options for helping to alleviate the pressure that is leading to the development of the callus to help prevent them from forming in the future.
Corns can develop when there is consistent pressure on one area of skin on your foot or toe. The body will form a hard surface (a corn) in order to protect itself from the chronic pressure in the area. Corns are shaped like cones and are usually found along toe bones where the tip of the corn can press against a nerve causing sharp pain. Attempts to remove a corn at home with medicated corn pads can cause serious infections, so a consultation with a podiatrist is the best way to identify and treat different types of corns safely.
If you have suffered any kind of crush injury to your foot or ankle, it is imperative that you have the condition evaluated by a podiatrist as soon as possible. Maybe the injury occurred while at work when heavy machinery fell on the foot, or maybe it was as simple someone stepped on your child’s foot during a sporting event. Crush injuries are considered to be a critical medical condition, and always require attention from a specialist to determine the extent of the injury and provide quick treatment to help avoid or lessen the potential for permanent complications. Untreated, crush injuries can lead to internal bleeding, broken bones, nerve damage, and compartment syndrome. If you have had a crush injury to your foot, ankle, or lower leg, make an appointment at The Schottenstein Center as soon as possible.
If you have diabetes, nerve damage, circulation problems, and infections can lead to serious foot problems. You can take precautions to maintain healthy feet. Managing your diabetes and maintaining a healthy lifestyle helps keep your feet healthy. This should include:
- regular medical exams, including foot checks at every visit and checking your ABCs (A1c, blood pressure, and cholesterol)
- monitoring your blood sugar daily
- regular exercise
- eating a balanced diet rich in fruits and vegetables
You can help prevent serious foot problems by following a good foot care regimen.
It is also called pes planus or fallen arches. It is a postural deformity in which the arches of the foot collapse, with the entire sole of the foot coming into complete or near-complete contact with the ground. Some individuals (an estimated 20–30% of the general population) have an arch that simply never develops in one foot (unilaterally) or both feet (bilaterally).
There is a functional relationship between the structure of the arch of the foot and the biomechanics of the lower leg. The arch provides an elastic, springy connection between the forefoot and the hind foot. This association safeguards so that a majority of the forces incurred during weight bearing of the foot can be dissipated before the force reaches the long bones of the leg and thigh.
In pes planus, the head of the talus bone is displaced medially and distal from the navicular. As a result, the Plantar calcaneonavicular ligament (spring ligament) and the tendon of the tibialis posterior muscle are stretched, so much so that the individual with pes planus loses the function of the medial longitudinal arch (MLA). If the MLA is absent or nonfunctional in both the seated and standing positions, the individual has “rigid” flatfoot. If the MLA is present and functional while the individual is sitting or standing up on their toes, but this arch disappears when assuming a foot-flat stance, the individual has “supple” flatfoot. This latter condition can be correctable with well-fitting arch supports.
It is a deviation from normal walking (gait). Watching a patient walk is the most important part of the neurological examination. Normal gait requires that many systems, including strength, sensation and coordination, function in an integrated fashion. Many common problems in the nervous system and musculoskeletal system will show up in the way a person walks.
Orthopedic corrective treatments may also manifest in gait abnormalities, such as lower extremity amputation, post-fracture, and arthroplasty (joint replacement). Difficulty in ambulation that results from chemotherapy is generally temporary in nature, though recovery times of six months to a year are common. Likewise, difficulty in walking due to arthritis or joint pains (antalgic gait) sometimes resolves spontaneously once the pain is gone. Hemiplegic persons have circumduction gait and those with cerebral palsy often have scissoring gait.
Gout is a disorder that results from the build-up of uric acid crystals in the tissues or a joint. It most often affects the big toe joint, but it can happen almost anywhere in the lower extremities. Patients who get gout may be producing too much uric acid, or their kidneys may unable to eliminate normal amounts of uric acid. The tendency to accumulate uric acid in the body is often inherited, but other contributing factors can include, high blood pressure, slight injury, diet, diabetes, and certain medications. When a gout attack occurs, it can be excruciatingly painful. Seeing a podiatrist is the best way to get out of pain fast and diagnose the condition. Schottenstein will get a medical and family history, perform imaging, and order lab tests to help arrive at an accurate diagnosis. When addressed immediately, gout usually resolves within a few days. In order to prevent recurrence, Dr. Schottenstein will also advise you on lifestyle changes to help prevent another attack and help prevent the buildup of uric acid over time that can lead to arthritic damage to the joints. When gout attacks continue to occur, patients may require daily medication as a maintenance treatment in addition to making certain lifestyle changes.
A hammertoe occurs when there is a contracture (bending) that occurs at one or both joints of the toe. Hammertoes can become painful when the abnormal bending puts pressure on the toes while wearing shoes. While there can be many causes for hammertoes, the most common is related to a muscular/tendon imbalance and a person’s foot type. Hammertoes may start out as a minor problem, but they can get worse over time eventually causing more irritation and inflammation. In the most advanced cases, irritation from hammertoes can create an open wound which can become infected. Many times non-surgical measures can be taken to alleviate the discomfort from hammertoes, but when the toe becomes rigid, very painful, or when an open sore develops, surgical treatment can become necessary.
It is a very common foot problem. The sufferer usually feels pain either under the heel (plantar fasciitis) or just behind it (Achilles tendinitis), where the Achilles tendon connects to the heel bone. Even though heel pain can be severe and sometimes disabling, it is rarely a health threat. Heel pain is typically mild and usually disappears on its own; however, in some cases the pain may persist and become chronic (long-term). There are 26 bones in the human foot, of which the heel (calcaneus) is the largest. The human heel is designed to provide a rigid support for the weight of the body. When we are walking or running it absorbs the impact of the foot when it hits the ground, and springs us forward into our next stride. Experts say that the stress placed on a foot when walking may be 1.25 times our body weight, and 2.75 times when running. Consequently, the heel is vulnerable to damage, and ultimately pain. In the majority of cases, heel pain has a mechanical cause. It may also be caused by arthritis, infection, an autoimmune problem trauma, a neurological problem, or some other systemic condition (a condition that affects the whole body).
A heel spur is caused by the displacement of calcium on the bone that forms on the underside of the heel; it may be one small bony protrusion or a collection of tiny, irregularly shaped growths on the bone of the heel, which is called the calcaneum. Heel spurs are sometimes painful — described as a knife digging into the heel — and other times, a heel spur goes unnoticed and is only detected by an X-ray.
Because knowledge about the symptoms of heel spurs is somewhat limited, it’s common that it’s mistakenly assumed to be plantar fasciitis. A heel spur is simply the presence of an extra protrusion on the bony surface of the heel, while plantar fasciitis is the inflammation of the plantar fascia — a thick connective tissue band that extends from the heel bone to the heads of the metatarsal bones, which are five long bones in the foot located between the heel and the toes.
Add Content Here
Ingrown toenails occur when the corners or sides of the nails dig into the soft tissue of nail grooves, causing pain, irritation, inflammation, and swelling. The big toe is the most commonly affected, but ingrown toenails can occur on any of the other toes as well. If the nail breaks the skin, bacteria may enter and cause an infection. Some of the causes of ingrown toenails include trauma, heredity, tight shoes, nail conditions, and improper trimming of the nails,
Most of the time, ingrown nail issues are self-limited and tend to resolve on their own, but any discoloration or infection on or about the nail that does not resolve on its own should be evaluated by a podiatric physician. In certain cases, the nail can just be trimmed, but other times, a small procedure may need to be performed to remove the sharp part of the nail, and the patient may be given an antibiotic to help prevent worsening of any infection.
Limb salvage is a surgical procedure that replaces a diseased bone and reconstructs a functional limb by using a metal implant, a bone graft from another person (allograft), or a combination bone graft and metal implant (allo-prosthetic composite).
The goal of this type of surgery is to remove the tumor with minimal complications while maintaining acceptable function, durability, and appearance of the limb.
During the procedure, the surgeon removes the tumor and affected tissue, as well as about one inch of healthy surrounding tissue. If part of a bone is removed during this time, it is replaced; often using synthetic metal rods, prostheses, or pieces of bone (grafts). Soft tissue and muscle from other parts of the body are then used to close the wound. Over time, the replacement bone fuses together with the original bone, making limb movement possible.
Nerve pain can be a symptom of many different conditions, including cancer, HIV, diabetes, and shingles. For some, nerve pain is frustrating; for others, nerve pain is devastating and life-changing.
Whether it feels like burning, pinpricks, or sudden shocks of electricity, nerve pain can disrupt your life at home and at work. It can limit your ability to get around. Over time, it can grind you down. Studies show that people with nerve pain have higher rates of sleep problems, anxiety, and depression.
When you have a serious medical condition such as cancer or HIV, dealing with the additional misery of nerve pain can be especially hard. But there is good news. While nerve pain can’t always be cured, it can be treated — and there are a lot of good options available.
A neuroma is a painful swelling of nerve tissue. In the foot, the most common place to develop a neuroma is between the third and fourth toes in the ball of the foot and the condition is usually caused by compression and irritation from the surrounding metatarsal bones, and injury, other foot deformities, or even from tight shoes. Symptoms can include pain, burning, tingling or numbness in one or more toes, or even the sensation that the sock is balled up in the shoe.
Taking into consideration the physical examination, imaging tests, and the patient’s history of his or her symptoms, and patient’s lifestyle, Dr. Schottenstein will help determine the best course of treatment to help alleviate the pain from your neuroma and recommend ways to prevent symptoms from returning in the future.
It is a term that includes a range of conditions that may affect the bones, tendons, and muscles of the foot. Among those most frequently treated at HSS are cavus foot, tarsal coalition, clubfoot, accessory navicular, and juvenile bunion. Treatment of foot deformities in children can vary significantly from that needed in adults. Fortunately, pediatric orthopedists who specialize in this field can bring to bear a range of non-operative and operative techniques specifically developed to address the distinctive needs of children, which include special attention to preserving the integrity of the growth plate, allowing continued growth and development of the foot.
Plantar fasciitis is one of the most common reasons that patients come to see a Podiatrist. Plantar fasciitis is the most common cause of heel pain in the United States boasting over 2 million patients seeking treatment for this condition in the last year alone according to statistics published by the American Academy of Orthopaedic Surgeons (AAOS). Plantar fasciitis occurs when the plantar fascia, the strong band of tissue that supports the arch of your foot, becomes irritated and inflamed, usually after increased activity that causes injury to the fascia. As a result of the inflammation, the heel can become painful, feel hot, swell, or turn red.
Plantar fasciitis most commonly causes a stabbing pain that is felt with the first few steps in the morning. As the foot “warms up”, the pain of plantar fasciitis normally decreases, but it may return after long periods of standing or after getting up from a seated position. Many people with plantar fasciitis have a very tight calf muscle and they can also experience knee pain.
When plantar fasciitis is not treated, it can progress and become a chronic condition. When this happens patients may develop additional symptoms affecting the foot, knee, hip, and back because chronic plantar fasciitis can change the way a patient walks. Treatment options for plantar fasciitis are broken down into 2 categories: non-surgical and surgical. Most of the time plantar fasciitis responds very well to non-surgical treatment. When non-surgical treatments are exhausted, surgery may be necessary to give a patient relief from his or her symptoms. When surgery is indicated, Dr. Schottenstein uses a minimally invasive procedure to deal with the painful plantar fascia while still allowing the patient to walk, right after the procedure.
The sesamoids are two bones that are embedded in a tendon beneath the big toe joint. Sesamoiditis is an overuse injury that causes chronic inflammation of the sesamoid bones. Sesamoiditis typically presents gradually, starting as a mild ache, but as the discomfort and inflammation increases, the pain can increase into an intense throbbing. People who participate in activities and sports that involve repetitive, excessive loading of the ball of the foot such as dancing, sprinting or even walking often suffer from this condition. Additionally, people with ‘boney’ feet, higher arched feet, marked flat feet, or those who tend to run on the ball of their foot also tend to be more prone to developing sesamoiditis. With a physical examination, imaging studies, and patient symptom history, sesamoiditis can be diagnosed and steps can be taken to help alleviate the patient’s pain. Surgery is rarely indicated, but it may be necessary for sesamoid injuries that fail to respond to conservative treatments
Shin splints are used to describe a condition that causes pain and stiffness in the front of the tibia (shin) during and after exercise. Shin splints, also known as medial tibial stress syndrome, can be caused by having flat feet, tightness in the calf, using worn out or improper shoe gear, engaging in improper training techniques or even repetitive activities, such as running or walking. The pain is due to an overuse injury which causes muscles strains of one of two leg muscles: tibialis anterior (pain in the upper outside of shin) or tibialis posterior (pain in the lower inside of shin).
Shin splints is a common complaint amongst athletes, especially in running-based sports, soccer, rugby, and basketball. Sports that involve stopping, starting, and changing direction can place extra stress on the joints, muscles, and ligaments of the feet and legs which can cause or exacerbate shin splints.
In addition to Shin Splints being more prevalent in those engaging in certain sports, other contributing factors include inadequate supporting footwear, abnormal foot biomechanics, running on hard surfaces, a sudden change in intensity of an activity, and/or muscle tightness.
Dr. Schottenstein will help to determine the underlying cause of your shin splints by taking a comprehensive history and performing a physical and biomechanical examination. X-rays will also be taken to rule out the presence of a stress fracture, another common overuse injury. After diagnosing and discussing the causes of the Shin Splints, Dr. Schottenstein will employ a multi-pronged approach to treat the condition and prevent it from occurring again in the future.
Add Content Here
Soft tissue tumors are cell growths that emerge nearly anywhere in the body: in tendons, muscles, ligaments, cartilage, nerves, blood vessels, fat, and other tissues. Patients commonly refer to these masses as lumps or bumps. Soft tissue tumors can be cancerous or benign. Benign masses are thought to occur 10 times more frequently than cancerous growths (referred to medically as sarcomas). Generally these growths are roughly round in shape, but they also can be or elliptical or elongated like a sausage. Masses greater than 5 cm (2 inches) carry the highest risk of being malignant and merit a medical evaluation. They can feel firm or soft. Benign masses are more likely to be painful to the touch, such as with an abscess. Benign tumors also tend to grow more slowly, and many are smaller than 5 cm (2 inches) at their longest point. Sarcomas (cancerous growths) more often are painless. Cancerous masses are more likely to grow rapidly, and to have fingerlets or satellite lesions around them.
Foot and ankle injuries are common among people who participate in certain sports. There are many reasons these injuries can occur, including not stretching or warming up properly, not wearing the proper type of shoes, injuries that occur during play, and not taping or providing other types of support for the ankle or foot. The most common foot and ankle injuries experienced by people involved in sports are ankle sprains, plantar fasciitis, and Achilles tendon damage or ruptures. If not treated properly simple injuries can become big problems that can lead to permanent disability.
Dealing with sports injuries these injuries can be relatively simple if they are diagnosed and treated early. Many athletes dismiss the initial aches and pains that are the early warning signs of injury as just soreness or tired muscles. When athletes try to ‘work through’ these pains, it can lead to serious problems. Many minor injuries are made far more serious when athletes continue to put strain and pressure on them and turn a mild strain into a serious strain and a minor tear into a rupture. Athletes should always have any unusual aches and pains evaluated by a skilled, licensed medical professional.
Every patient is different, every sport is different, and so the treatment of each patient will vary according to his or her lifestyle and feet and choice of activity. Dr. Schottenstein has extensive experience in treating athletes and sports injuries. She employs a team approach with other specialists to deliver a customized, sports specific treatment to get patients back in the game fast! Dr. Schottenstein can also recommend shoe gear which will suit the patient’s individual foot type, and provide advice on how to recover and get active again, while preventing future injury. Generally, the earlier the symptoms are treated the quicker you can get back to enjoying your favourite activities
A sprain is an injury where the ligaments that support a joint get stretched beyond their limits and tear either partially or completely. Sprains of the foot, ankle, and leg are common injuries that can occur in people of all ages. The severity of the sprain depends on the extent of the damage to the ligaments.
With ankle sprains, conservative treatment is often sufficient to deal with the problem. Sprains of the lateral ankle ligaments are the most common. Evaluation by a foot and ankle surgeon is always important to rule out the presence of a fracture or other injury that may have occurred at the same time which could lead to complications in the future. Additionally, it is important that rehabilitation for ankle sprains begin quickly after injury so that the ligaments can heal properly.
Surgical treatment for sprains are rare but may be necessary for injuries that fail to respond to nonsurgical treatment, and for patients who experience persistent pain and instability. Surgery often involves repairing or tightening the damaged ligament or ligaments. Dr. Schottenstein can help select the surgical procedure best suited for your case based on the type and severity of your injury as well as your activity level.
Tendinitis is inflammation of a tendon , the thick cord that attaches muscle to bone. Tendinitis often results from overuse sports injuries or repetitive movements, but it can also occur from biomechanical problems, metabolic conditions such as diabetes, or even different types of arthritis. Some types of tendinitis can occur suddenly, last for days or longer, and usually get better with rest or treatment. It is important to see a foot and ankle surgeon to evaluate your tendinitis, because without proper treatment, tendinitis can lead to tendonosis, damage to the tendon substance itself. When tendonosis occurs, it can eventually result in tendon rupture, which may necessitate surgery. Luckily, most of the time tendinitis resolves with rest and conservative treatment. When tendinitis persists, and calcium deposits are present, treatments like Extracorporeal Shock Wave Therapy (ESWT) can be used, as an alternative to surgical removal, to help break up these deposits, relieve pain, and enhance healing.
Plantar warts (Verruca Plantaris) are skin growths that are caused by the Human Papilloma Virus (HPV). Warts can develop anywhere on the foot, but they most commonly present as a hard, and often painful, thickened lesion on the sole of the foot. Dr. Schottenstein will examine the lesion, take a small biopsy, and then begin treatment as soon as the diagnosis is confirmed by the lab. Warts should be treated as soon as possible because they can easily be spread from person to person as well as to other places on the foot and elsewhere on the body. Surgical removal (excision) is rarely required for warts as there are numerous non-surgical treatments that are extremely effective at eliminating the lesion.