North Colorado Springs Foot Clinic
1955 Dominion Way Suite 130, Colorado Springs, CO 80918



Ankle Sprains

An ankle sprain is the second most common athletic injury. The most common scenario for an ankle sprain is a twisting of the ankle which creates excessive stress and injury to the outside of the ankle. Reinforcing ligaments around the ankle are stretched beyond their capacity and this creates tearing and even complete rupture of the ligaments. This injury can produce a very unstable ankle which can lead to chronic pain and repeated further injury. Treatment for an ankle injury should start with a thorough exam and ankle x-rays. If a diagnosis of ankle sprain is determined then treatment will usually involve some type of immobilization using a tie up ankle brace or a below knee walking boot. The severity of the condition will determine what level of protection is required. Physical therapy to reduce the pain and inflammation and reestablish strength and stability is often required. Biomechanical problems in the feet can produce repeat ankle injuries and may need to be addressed with a combination of supportive shoes and arch supports (orthotic devices).



A bunion deformity is characterized by a crooked great toe which leans toward the other toes and a noticeable bump or bone prominence at the base of the great toe. Bunions are not caused by narrow shoes but they can be irritated by those shoes. Bunions are most commonly seen in feet which are too flexible and which lean inward and have arches which drop. There are no exercises, stretches or contraptions which can correct bunions. If the bunions are mild enough they can be treated by wearing supportive shoes and custom arch supports which are called custom orthotics. If the bunions are sore then they may require surgical correction. The aim of surgery is to remove the bone prominence, narrow the forefoot and realign the great toe. Success of bunion surgery is very good with long term maintenance of the correction and elimination of foot pain.


Growing Pains

Growing pains are a myth. Lower leg pain in youngsters from 3-16 years is commonly and mistakenly attributed to growing pains. Pain is not normal and it doesn't hurt to grow. Pain in the lower leg can be due to mechanical stress, juvenile arthritis, neurologic conditions or, very rarely, no known cause. Mechanical causes of lower leg pain account for 85-90% of all lower leg pain in youngsters. Pain in the lower leg commonly occurs at the end of the day or at night and can involve aching, cramping, tenderness and soreness. The pain tends to be worse with increased walking or running. The pain can also be worse when the youngster wears flip flops, sandals or flimsy shoes.

The condition most often occurs in youngsters who have flexible feet which pronate or roll inward excessively and in youngsters who have tight calves and a bouncy gait. Those biomechanical issues create stress on muscles which originate along the tibia in the lower leg. The constant tension on the muscles and their attachments on the tibia create irritation of the muscles and the bone. If the mechanical issues aren't addressed and the youngster continues to perform at a high level of activity, then a serious tibial stress fracture can develop. Treatment for growing pains starts with support of the feet. Youngsters should wear supportive athletic shoes instead of flimsy, flexible shoes. Additional support of the feet with orthotics is commonly required to realign the feet and relax the muscles. If the youngster has tight calves then stretching and heel lifts can be helpful. Ice, massage and physical therapy can reduce the symptoms more quickly. If the symptoms are chronic and last more than several months then the athlete may need to take a break from the sport in order to resolve the condition.



Hammertoe deformity is a common and often painful deformity of the 2nd through 5th toes of the foot. The toes develop a bend at a joint so that they become crooked. When the toes bend upward they can eventually become crooked side to side. Painful symptoms can occur from rubbing of shoes on the top of the toes or pressure at the tip of the toes or base of the toes. Hammertoes are not caused by shoes although they can be rubbed and irritated by shoes. Hammertoes are caused by foot instability. They are most commonly seen in feet that pronate (roll inward) excessively or in rigid, high arch feet. Crooked toes can't be straightened by exercises or splints. Treatment for hammertoes either involves conservative care in the form of supportive shoes with a roomy toe box, custom orthotics and padding or surgical correction to straighten and realign the toes.


Heel Pain

Heel pain is the most common condition that is seen by podiatrists. There are more than twenty possible causes of heel pain such as rheumatoid arthritis, bone tumors, stress fracture of the heel bone (calcaneus), radiating pain from the lower back (radiculopathy), gout, etc., but the most common cause of heel pain is plantar fasciitis. The plantar fascia is a dense soft tissue band which attaches to the bottom of the heel bone and extends forward through the arch area to the base of the toes. Injury to the plantar fascia most commonly occurs when the foot pronates or rolls in excessively. As a foot pronates the arch drops and this motion can produce excessive tension and a strain on the plantar fascia.

Plantar fasciitis often occurs when a walker or runner resumes their activity too quickly after a break or a person starts to walk barefoot more or wears flip flops instead of regular shoes. The heel pain is generally worse on first weight bearing or when getting back on the feet after sitting. Treatment of the heel pain has to start with supporting the feet. Wearing supportive running shoes is an important first step in treating the condition. Arch supports (orthotic devices) are vital in realigning the feet and relieving the strain on the plantar fascia. Heel pads are commonly used to raise the heel and relax a tight calf muscle. Stretching, ice to the area, massage, anti-inflammatories, physical therapy and cortisone injections are typically used to treat the condition. Modification of activity from running, walking and hiking to swimming and cycling can allow you to remain fit as you gradually resolve the condition.


Ingrown Toenail

An ingrown toenail is common and painful condition. The condition involves a bending down of the side of a toenail so that it produces pressure and toe pain. The nail deformity can be seen in patients from 2 to 102. The younger the patient the more likely that he or she has inherited the toenail condition. In older people, the toenail can become crooked due to chronic shoe pressure or repeated trauma to the nail. Once the toenail is crooked, it can produce chronic pain and even infection. Trimming the ingrown nail border out of the skin, also known as bathroom surgery, can be painful and unsuccessful. If a toe becomes infected then treatment of the infection with an oral antibiotic and local wound care is generally required. An ingrown toenail can be successfully corrected by way of a minor surgical procedure. The procedure is most often performed in the office under a local anesthetic block. The offending nail border is removed completely back to the nail root area and the corresponding nail root cells are destroyed by using a chemical process. The procedure can be performed with little to no pain post operatively and minimal if any disability. The success rate for such a correction ranges from 85-95%.


Orthotic devices are often used to treat a large variety of foot conditions such as heel pain, tendinitis, bunions, hammertoes, painful callouses, etc. Orthotics are devices which fit into shoes to realign and balance the foot. Orthotics can be broken down into three classes: over the counter devices, custom orthotics and accommodative orthotics. Over the counter (OTC) orthotics are devices which can be purchased in podiatrist's offices and they provide a measure of support to the feet which is better than the insoles which are typically included in most athletic shoes and hiking boots. The benefit of OTC orthotics is they can be incorporated into treatment immediately and they are fairly inexpensive.

Custom orthotics are truly custom made devices which are constructed to produce optimal realignment of the feet and legs. In order to create custom orthotics, measurements are taken of the feet and ankles to establish the best functioning position or the neutral position of the feet. A plaster cast is then taken of the feet while maintaining them in neutral position. The foot casts are then sent to an orthotics lab where the devices are fabricated according to the podiatrist's prescription to place the feet in the intended position. The benefit of custom orthotics is that they provide the best alignment of the feet and they can function well for 10-12 years. Accomodative orthotics are soft molded insoles which are typically placed in diabetic extra depth or custom molded shoes. The devices are constructed from cushion materials in multiple densities and they are intended to provide cushion and protection to the foot to help prevent foot wounds.