Onychomycosis (fungal infection of the toenails)

Onychomycosis is a very commonly encountered fungal infection of the nails seen in Podiatric practices. 

 

Generally, the first sign of a fungal nail is a yellow discoloration of the nail. Depending on the severity of the infection, nails can also become thickened or brittle, loose, and present with a generally rough texture. A distal subungual infection is the most common type. This simply means the infection often takes place at the end of the nail, and under it. The causative agents of onychomycosis are usually Dermatophytes (most often Trichophyton Rubrum). Yeast infections may also present in about 5% of patients due to a Candida Albicans infection.
Onychomycosis is generally a very straight forward and simple nail condition to treat. Podiatric physicians have found that oral and topical anti-fungals are often very effective in treating fungal infections. 

 

Dr. Michael Garvin of Port St. Lucie Florida is a board certified Podiatrist with a great deal of experience in treating fungal infections of all types. If you are looking for more information regarding fungal nails visit Dr. Garvin’s website here. You may also find information to schedule an appointment with Dr. Garvin here.

 

Plantar Warts

Plantar Warts are characterized by a rough, often cauliflower like lesion on the plantar surface of the skin. The lesion can be a variety of shapes and sizes, and can be solo or present in a cluster known as mosaic verrucae. Often times the lesion appears to have pinpoint bleeding marks, and the edges of the lesion can be elevated due to hyperkaratosis (excessive skin formation) although, not to be confused with a corn or callus. Warts are technically known as verrucae and can be exceedingly difficult to eliminate. Warts (the non-sexually transmitted type) that present on the superficial skin are due to infection by human papillomavirus (HPV), serotypes 1,2 & 4. Generally the young and the old are most susceptible to non-sexually transmitted warts. The most common age group affected by warts is 5-16 years of age. The hand is the most common site of manifestation, followed by the plantar surface (sole) of the foot.

Warts can be transmitted via direct or indirect contact through tiny cuts or invisible abrasions present on the skin. They can also be transmitted to different sites on an individuals body once infected by certain behaviors such as biting finger nails and/or skin alongside the nails; this is known as autoinoculation. Not only can warts be unsightly, but they can also cause pain during walking if present at inopportune sites of the feet.

If you have a lesion you might suspect is a wart on your foot, please visit Dr. Michael Garvin’s website for more information regarding warts and treatments. Dr. Garvin is based in Port St. Lucie, Florida and accepts new patients. Call his East office at 772-335-7171, or the West office at 772-871-6020 to schedule an appointment today!

Claw Toe

A claw toe is a deformity of the toe that is due to a soft tissue (musculature) imbalance. Claw toes most often present with a callus and/or pain at the ball of the foot, and on top of the toe at the most proximal joint.  The imbalances that cause this physical change in shape of the toe are extension at the metatarsophalangeal joint, flexion at the proximal phalangeal joint and flexion at the distal phalangeal joint. Normally, in healthy toes, there should be no extension or flexion at any toe joint during relaxation. However, in the claw toe, these series of musculature contractures are seen due to underlying pedal or bodily pathologies. These pathologies can include, but are certainly not limited to severe flat foot deformity (pes planus), excessive pronation, trauma to the foot, diabetes mellitus, Charcot-Marie-Tooth disease, multiple sclerosis, rheumatoid arthritis, cerebral palsy and more. 

If you think you have a claw toe(s), or suffer from any of the aforementioned diseases you should have your feet checked out by a podiatrist. Dr. Michael Garvin of Port St. Lucie, Florida has been practicing for years and has great experience at treating claw toes and many other pedal pathologies. His aim is always to treat the underlying cause of foot pain with minimally invasive techniques. Visit Dr. Garvin’s website for more information regarding his practice and treatment options.

Haglund’s Deformity

Haglund’s deformity is characterized by pain on the back of the lateral heel. This is due to bony enlargement of the calcaneus, which in turn causes soft tissue swelling when rubbed against shoe gear. Often times in a Haglund’s deformity retrocalcaneal bursitis is present. This is simply irritation of a small fluid filled sac that lies between the Achilles tendon and the calcaneus. As previously stated, patients suffering from Haglund’s deformity generally present with symptoms of pain, redness and swelling on the back of the outside heel. 

Haglund’s deformity is sometimes referred to as a “pump bump” due to its presence being accredited to the “pump” style shoe that often cause it. However, Haglund’s deformity doesn’t only manifest due to calcaneal irritation from pump shoes. Mens dress shoes, ice skates, and any shoes with a rigid back can also cause this soft tissue swelling.
 
If Haglund’s deformity is a condition that parallels something you’re currently experiencing please visit Dr. Michael Garvin’s website for more information, or if you’re in the Port Saint Lucie, Florida area, schedule an appointment at one of his offices.

The Significance of Biomechanics

Biomechanics and a patient's foot health have a strong correlation. Biomechanics can be defined as the science of internal and external forces and their affect on the human body. An example of an internal force would be an individual's body weight. An example of an external force would be the ground's forces upwards on the foot during an individual's gait. 

 

Biomechanics have a strong correlation with an individual’s foot health because these aforementioned forces must be compensated for, so that the human foot properly adapts to this energy. If the foot is not able to adapt to these forces and improperly absorbs the energy created from gait, many pathological manifestations can occur. To name a few of the possible conditions derived from improper biomechanics: plantar fasciitis, shin splints, bunions, hammer toes, stress fractures, claw toes, and the list goes on. 

 

If you are experiencing pain during walking, running, jumping etc.. and think you may have any irregularities in your biomechanical processes, please contact one of Dr. Michael Garvin’s offices in Port Saint Lucie, Florida. Dr. Garvin has been analyzing patients biomechanics for many years and always seeks to treat and correct the underlying causes of pain. To obtain further information regarding your biomechanics and foot health please visit his website!


*This schematic depicts forces applied to the human skeleton that are experienced during normal walking.

Orthotics 101

An orthosis is a device used by podiatrists to correct an abnormality in a patient's gait, or provide additional cushion and control for a surgically corrected condition. Orthotics can be made out of a variety of different materials, and many times are made by a podiatrist in office. The materials chosen for fabrication of the device are generally contingent upon the condition being treated and cost effectiveness. Orthotics are often times one of a podiatrists favorite tools as it allows them to treat an extremely broad variety of foot-related ailments with a minimally invasive technique. Once the orthosis is made it can simply be placed into the patients shoe similarly as an insole would be.     

Most insurance companies will cover the cost of an orthotic and they’re often times the best treatment for patients. Especially patients who can’t afford to spend time off their feet with any kind of surgical recovery. Some conditions that are commonly treated with an orthotic, but certainly not limited to are bunions, tailors bunions, hallux limitus and rigidus, ankle equinus, plantar fasciitis, digital subluxations, Morton’s Neuroma, high arched feet/Pes Cavus, Diabetes related conditions, and many more. 

If you have any kind of foot related pain, or think you might be a candidate for an orthotic, don’t hesitate to call one of Dr. Michael Garvin’s offices in the Port Saint Lucie area in southeast Florida. 772-335-7171  Dr. Garvin has been practicing for years and has spent this time perfecting the art of healing and controlling patients foot problems with orthoses. 

Morton’s Neuroma

Morton’s Neuroma is classified as a nerve compression syndrome involving the common digital nerves found alongside the toes.  A neuroma is a growth or tumor of nerve tissue that can develop due to habitual pressure and irritation. This tumor that develops at the affected nerve is known as perineural fibrosis. Morton’s neuroma is most commonly seen at the 3rd common digital nerve, in the 3rd interspace of the forefoot near the toes. This condition is most common in women, and during middle age. The etiology of Morton’s neuroma surrounds nerve compression due to impingement of the nerve by a deep ligament, or the adjacent metatarsal heads. The compression that is the primary cause of this nerve irritation is generally caused by, but not limited to; shoes that have a narrow toe box, high heeled shoes, or pathologies that stem from irregularities in the gait cycle. 

The symptoms that generally present with a Morton’s neuroma are pain that radiates to the toes, or more proximally into the foot, burning, numbness and tingling. Additionally, the pain is often times described as sharp. Many patients will describe the feeling or sensation of having a pebble or sock bunched up under the ball of their foot. Pain usually worsens with walking, and is almost always further exacerbated by wearing shoes that cause compression at the metatarsal heads.

The diagnosis of a Morton’s neuroma is based upon clinical presentation. A podiatrist like Dr. Michael Garvin will use a variety of minimally invasive techniques to accurately diagnose this nerve condition, so patients can get back to being pain free as soon as possible. If any of these aforementioned symptoms sound similar to pain you’re currently experiencing do not hesitate to contact one of Dr. Garvin’s offices in Port Saint Lucie, Florida, or browse through his website for additional information.

A Look at The Gait Cycle & its Importance

The gait cycle can be defined as the interval of time from heel strike of a foot, to heel strike of that same foot, on the next step. In example, the gait cycle consists of a single footstep of say, the left foot that would take place during normal walking. To accomplish that single footstep made by the left lower extremity, the entire gait cycle must be executed. This is in addition to a great deal of other things that must take place for an individual to walk, but for simplification purposes we will only focus on the pedal aspects of the gait cycle. In essence, anytime an individual is walking they are repetitively carrying out the full gait cycle with each step that the individual takes.

The gait cycle is comprised of two major components; stance phase which is also known properly as closed kinetic chain, and the swing phase which is also known as open kinetic chain motion. To be precise, 62% of the gait cycle is occupied by the stance phase, or when the foot is in contact with the ground (weight bearing portion). The other 38% of the gait cycle is naturally comprised of swing phase, or when the foot is not in contact with the ground.

In podiatry it is imperative to dissect, and analyze these two major components of the gait cycle, and the gait cycle in whole. This allows a doctor to understand, diagnose, and treat all of the lower extremity pathologies that exist due to irregularities in an individual’s gait cycle.

To further review these components of the gait cycle, stance phase, or the weight bearing portion of the gait cycle can be sub-divided into three phases. Those are the contact period (when the foot initially strikes the ground), mid-stance, and toe-off (also known as propulsion). During contact period, the heel of the foot being observed is striking the ground, and almost simultaneously the forefoot of the same foot, is loaded with the force that is being transferred from the hind-foot to forefoot (this is when the majority of pronation* occurs). Next, mid-stance is immediately taking place. This is a transitional period that takes place after the contact period, but before the same heel lifts off the ground, and toe-off (propulsion) occurs. Supination** of the foot starts during mid-stance period, and does not end until immediately after toe-off. Lastly, propulsion or toe-off occurs. This is the third portion of the stance, or weight bearing phase of the gait cycle. Throughout toe-off the foot is being supinated, and the momentum of the lower extremity and the upper body is being directed forward to make forward progress (walking or running).

After these three sub-phases of the stance phase have occurred, the foot is immediately carried into swing phase. During swing phase the foot is elevated from the ground, and is being carried forward by a variety of the lower extremity musculature. This non-weight bearing portion of the gait cycle is where the most visually evident portion of forward progress is made.

To summarize, the complete gait cycle consists of stance phase and swing phase. Stance phase is further divided into contact, mid-stance and toe-off periods. Again, immediately after toe-off, swing phase takes place, and ends once the heel of this same foot strikes the ground again, to start the whole process over, hence the term gait cycle. Walking or running simply consists of the complete gait cycle alternating between the two limbs of an individual. In essence, the gait cycle of each foot has a converse relationship. For example, while the left foot is in stance phase, the right foot is in swing phase. This succinct process occurs throughout every step that is taken and most people have no idea it even exists. To clarify any potential confusion, there are certainly short periods in most gait cycles where both feet may be contacting the ground, or especially in running, both feet are not in contact with the ground. Yet, in general, the cycle occurring at each foot is alternating in a conducive manner for walking or running.

With a vast majority of the pathologies that podiatrists like Dr. Michael Garvin see, certain portions of a patients gait cycle have abnormalities that cause improper force transfer, and eventually translate to some type of disease manifestation-“something has to give”. These abnormalities of the gait cycle can occur for a great variety of reasons. These causes are all hugely important in the overall treatment, and prevention of further injuries to the patient’s foot, and their overall health. Dr. Garvin recognizes this, and does his best as a Podiatric physician to observe, listen, address, and heal his patients. 

If you feel you have an abnormal gait, or you have any kind of pain while walking, do not wait until you injure yourself to see a doctor. Call Dr. Garvin’s office and make an appointment at the East office- 772-335-7171, or the West office-772-871-6020, in Port St. Lucie Florida. Or e-mail him at info@doctorgarvin.com .

Below is a schematic of the gait cycle.

 
Below is a list of pathologies commonly seen in the lower extremity that often times manifest due to poor biomechanics (abnormalities in the gait cycle):

• Hallux Valgus (Bunion)
• Tailor’s Bunion
• Plantar Fasciitis
• Hammer Toe(s)
• Claw Toe(s)
• Generalized Heel pain
• Morton’s Neuroma
• Hallux Rigidus (“Pump Bump”)
• Shin Splints
• Tarsal Tunnel Syndrome

*pronation consists of tri-plane motion of the foot; dorsiflexion, eversion & abduction of the foot.
**Supination consists of tri-plane motion of the foot; plantarflexion, inversion & adduction of the foot.

All About Those Bunions

Is your big toe crowding the rest of your toes?  Is there a firm lump on the side of your big toe?  Do you have pain from the pressure of your shoes causing you to flinch while walking? Is finding a shoe that fits comfortably difficult? If you are experiencing any of these symptoms then you may have a bunion.

Bunions, also called hallux valgus or hallux abducto valgus (HAV), form a firm bump on the inside edge of the foot at the base of the big toe.  This causes the big toe to move out of place.  When a bunion forms on the big toe, the toe moves toward the other toes and causes the lump to become bigger and can create pain.  Pain occurs because pressure from the shoe on the bunion or from pressure inside the joint.

A main factor for bunion growth is wearing footwear that is too tight.  When you wear tight footwear your toes are squeezed together and create unnecessary pressure.  Not only footwear, but faulty foot mechanics and a combination of the way you walk can cause bunions.  And of course foot injuries, people with neuromuscular problems and activities such as ballet dancing can also be linked to the formation of bunions.     

There are non-surgical and surgical treatments for bunions, but your options would depend on the severity of your feet.  Changing your shoes to provide more room, taping and padding your foot into a normal position, and having shoe inserts or orthotics can help reduce symptoms and prevent bunions from becoming worse.  

However, discussing your options and having your feet looked at can help in making the right decision for treatment.  It’s important to get bunions looked at immediately as other issues can develop such as hammer toes, corns, calluses and ingrown toenails.  

If you are experiencing bunion symptoms and pain call our office to set up an appointment with Dr. Garvin at www.doctorgarvin.com

Aging Feet: Can You Turn Back the Clock?

Let’s face it, we are all getting older.  Imagine the wear and tear on your feet from years of use and as our population ages, people are living longer and continue to be active.  Mobility is an area in life that is important to every age, but especially important to our aging population.  However, if foot problems make it difficult or impossible for our aging population to continue an independent lifestyle then it becomes a problem. And so far no one has found the ability to turn back the clock and restore our youthful years. 

Your feet can be the window to a podiatrist seeing symptoms of other conditions such as diabetes, arthritis, and circulatory disorder of the foot.  Crazy that our feet and their health can help prevent and warn us about other ailments in our body.  Foot problems can also lead to knee, hip, and lower back pain, which ultimately affect mobility.  

“Studies show that most Americans experience foot problems of a greater or lesser degree of seriousness at some time in their lives; nowhere near that many seek medical treatment, apparently because they mistakenly believe that discomfort and pain are normal and expectable.” 

It is not too late to take care of your aging feet.  Below are some tips to help you keep your feet healthy.

• Look at your feet often.  Make sure there are no cuts, blisters, or ingrown toenails.    
• If you are diabetic it’s important that you look at your feet every day.
• Dry feet thoroughly before you put socks or shoes on.
• Wear shoes that fit.  As you age your shoe size may change so it’s important to measure your feet before buying new shoes.  
• Take walks.  Walking is the best exercise for your feet.
• Trim or file your toenails straight across.
• Have your feet examined by a podiatrist twice a year.

If you would like to schedule an appointment to discuss how to keep your feet healthy and mobile please call our office. www.doctorgarvin.com

X-ray Machines 101

How do X-Ray Machines Work? 

An x-ray is an energetic wavelength of electromagnetic radiation that is emitted from within an x- ray machine at it’s generator. X-ray machines work very similarly to how light bulbs function. They receive their power from a wall outlet, as does a light bulb; through alternating current, or AC power. Through the use of a step-up, and step-down transformers, a diode (for conversion to direct current from alternating current), and a heating filament to boil off electrons; electrons are emitted from a cathode and directed towards a negatively charged anode by applying a strong potential difference in current. Once these electrons collide with a tungsten target found on the anode, photons are emitted and directed out of the x-ray machine and into the patient at their respective tissue. 

An example of a podiatric specific x-ray machine is pictured below.

Are x-ray machines safe? 

Before photons, in the form of x-ray radiation are absorbed by patient tissue they’re filtered, and aimed for precision and safety. A health care practitioners number one goal in using an x-ray machine is to maintain safety, all the while attempting to generate a high contrast image to be developed, and utilized in proper diagnosis of respective pathologies. To ensure that “soft radiation”, or low energy radiation (that is not useful for images) isn’t absorbed by the patient, aluminum filters are utilized. These filters are measured in millimeters, and are required by law to be used in all x-ray machines. In addition to the aluminum filter, lead aprons are worn by patients and x-ray technicians to prevent x-ray radiation from being absorbed unnecessarily, in relation to unaffected tissues. 

In short, yes, x-ray machines are made safe for use because physicians receive extensive education on how x-ray machines work, and what the ramifications of miss-use are. For example, the average podiatrist has received 2 years of radiology courses during podiatry school, 2 years of clinical experience in school under the observation of experienced physicians, and another 3-4 years during their tenure in residency programs to prepare them to use, and read x-ray machines and images known as radiographs. 

Why is it important for patients to have x-rays taken? 

Radiographs are extremely important in the diagnostic process that physicians 

must undergo to successfully treat a patient. Often times debilitating conditions pertaining to a patients foot, ankle, or lower leg are superficial, and an x-ray is not needed. However, once a physician is confident a condition is not diagnosable through superficial observation, percussion and palpation, x-rays are generally ordered to observe if a pathology exists in the bony tissue. 

Without a radiograph a physician would never be able to observe subcutaneous conditions 

affecting the bone, like foot and ankle fractures. A lack of radiographs would put all types of 

medicine back to an antiquated state that has not been prevalent since the early 1890’s, prior to Wilhelm Rontgen’s discovery of the x-ray. 

Sandal weather is here - Prepare your feet!

What are Corns and Calluses?

Corns and calluses are both formed by hyperkeratosis. This term simply means a thickening of the skin. These can form on many of the superficial surfaces of the body (most commonly on the feet!) for a variety of reasons. Typically, corns are sore and painful due to the friction that is occurring at the site, which is also their cause. Calluses are also caused by a thickening of the skin, but are more often associated with the excess synthesis of skin at a site as a protective mechanism. For example, many people develop calluses on their hands due to repetitive work like gardening. Calluses are also formed at areas of abnormal bony synthesis like bones spurs. 

Why should you be concerned about a Corn or Callus?

Hyperkeratosis certainly isn’t a reason to visit the emergency room. However, it is an important concern because it means that excessive use, and abnormal friction is occurring at that localized area of epidermis (most outer layer of skin). This is not only a cosmetic issue, but is often times painful and debilitating depending on severity. More importantly than the buildup of skin itself though, is the actual cause of the localized hyperkeratosis. This excess production of localized dermis is generally due to things such as poor fitting shoes, abnormalities of the toes, like hammertoes, unusual bony prominences such as bunions, and abnormalities of an individual's gait. All of these conditions are great reasons to setup an appointment with Dr. Michael Garvin! His goal is to empathetically alleviate his patient’s foot ailments with as minimally invasive procedures as possible.

 

To make an appointment, simply call one of his offices, both located in Port St. Lucie, Florida; the East office- 772-335-7171, & the West office-772-871-6020, or e-mail him at info@doctorgarvin.com . http://doctorgarvin.com/contact.html

Ingrown Toenails

Onychocryptosis

An ingrown toenail, medically deemed onychocryptosis, is a very common complaint among patients in a podiatry office.  This condition usually begins with mild tenderness along the edge of a toenail where a portion of the nail border has penetrated the skin.  Over time, the toe may become increasingly painful to touch with localized redness and inflammation.  An infection may develop where the toe exhibits warmth, and pus begins to drain from the site where the nail has pierced the skin.

The severity of the nail’s appearance will vary.  Some will have a nail that appears incurvated and deeply embedded into the skin; others may have a small spike in a corner that penetrates down into the nail bed. Aside from penetrating the skin, a nail can apply pressure in the nail fold area without breaking the skin causing discomfort and mild pain.  This is not technically an “ingrown nail.”

Causes of ingrown nails range can from genetics to an improper shoe size wherein a shoe’s toebox can place pressure on the nail.  Direct trauma to the nail such as stubbing a toe, can alter the way in which the nail grows.  Nail fungus can alter the nails growth pattern as well. Preventative measures include proper nail trimming wherein the nail should be cut straight across without tapering the corners.  Proper fitting shoes can also help prevent ingrown nails.  It is best to seek advice from your podiatrist, and avoid “bathroom surgery.” 

Podiatric treatment for an ingrown nail that’s infected involves antibiotics in addition to soaking the foot in Epsom Salt.  It is important to keep an infection clean and monitor it daily for signs of worsening inflammation.  If a nail is simply ingrown but not infected, Dr. Garvin may trim the nail border to see if the nail will grow back properly.  In the case of reoccurring ingrown nails, Dr. Garvin will perform a simple surgical procedure that will remove the entire nail border permanently.

Our goal here at Foot and Ankle Specialist of the Treasure Coast is to keep you healthy and walking comfortably. There are often many conservative options for treatment with surgery typically the last one implemented. So stay healthy and keep your feet pain free!

Shin Splints

Shin Splits - What exactly are they? 

Have you ever had that sharp pain radiate through your leg after your daily run or walk?

That condition, which is commonly referred to as “Shin Splints” , is a slow healing and painful disorder in the shins usually caused by exercise such as: running, jumping, swimming, cycling, dancing or other high impact sports. In fact, 10-15% of all runners’ related pain or injuries are due to this syndrome.

There are two types of shin splints also known as medial tibial stress syndrome (MTSS), anterior and posterior. The most common shin splint is anterior. Anterior shin splints are often due to over striding or training at a pace that doesn’t allow for healing of the tibialis anterior muscle. Posterior shin splints (also called posterior tibial tendonitis) are a less common condition that is often due to pronation (flattening of the arch).

The onset of shin splints is most common after exercise, caused by high impact training, excessive training, poor technique, or improperly fitting shoe wear. Dr. Garvin can determine if you require properly fitting footwear or an orthotic to prevent a re-occurrence of shin splints.

Interestingly some studies have suggested that shin splints are actually more common in women possibly caused by decreased physical fitness, smaller muscle size or standing for long periods of time and wearing high-heeled shoes.

If you are suffering from shin splints make an appointment to see Dr. Garvin as soon as possible by calling his office at 772-335-7171. Dr. Garvin will immediately address the inflammation of soft tissue known as shin splints with ice, non-steroidal anti-inflammatory drugs and physical therapy. Patients may also be advised to decrease the duration or intensity of their exercise, change their footwear or add an orthotic, then slowly build back up their exercise routine.

Bunions

A bunion is an enlargement of bone or tissue around the joint at the base of the big toe. The big toe generally turns in toward the second toe and the tissues surrounding the joint becomes swollen, tender and often painful. Bunions occur more commonly in women and can sometimes run in families, making some individuals genetically pre-disposed to this condition. People born with abnormal bones in their feet are more likely to form a bunion. Wearing narrow-toed, high-heeled shoes can also lead to the development of a bunion. The condition may become painful as extra bone and a fluid-filled sac grows at the base of the big toe.

Most common reasons for the development of a bunion:                  

• If the foots shape puts too much pressure on the big toe joint.
• Because bunions can run in families, some experts believe that the inherited shape of the foot makes some people genetically pre-disposed to developing a bunion.
• If the foot rolls inward or pronates too much when walking. 
• Flat Feet.
• Wearing shoes that are too tight.

Any of these situations can apply significant pressure on the big toe joint, which over time; will force the big toe out of alignment, bending it toward the other toes.

Early diagnosis is critical. When a bunion first begins to develop, taking a few simple steps such as wearing foam pads on the foot to protect the bunion, or devices called spacers to separate the first and second toes at night can help avoid a worsening of the condition.

If the bunion gets worse, resulting in severe deformity or pain, surgery is the most effective approach to realign the toe, relieve the pain and remove the bony bump (bunionectomy). There are many different surgical techniques that can be used to treat this condition depending on the individual’s situation.

To help our patients get relief from bunion pain Dr. Garvin might recommend, wearing wider shoes, orthotics, or foot pads. Treatment such as oral anti-inflammatories and injections can also help to relieve discomfort. However, Dr. Garvin can perform same day procedures, which will have patients comfortable after just a few weeks of recovery.

Warts on your feet?

Commonly known as plantar verrucae, the plantar wart is caused by the Human Papillomavirus. The virus attacks the skin through direct contact, entering through possibly tiny cuts and abrasions in the outermost layer of the skin. Infection typically occurs from moist walking surfaces such as showers or swimming pools. After the infection, warts may not become visible for several weeks or months. Because of pressure on the sole of the foot, the wart is pushed inward and a layer of hard skin may form over the wart. Depending on where the warts are located, some may cause pain when walking. A common misconception about plantar warts is that they have roots which can grow deep into the tissues and attach to the bone. This is not true. A wart only grows in the top layer of skin and although the wart may extend slightly deeper, this is generally due to walking, putting pressure on the affected area and pushing the wart deeper into the tissue.

Because plantar warts are spread by contact with moist walking surfaces, they can be prevented by not walking barefoot in public areas such as showers or communal changing rooms (wearing flip flops or sandals helps), not sharing shoes and socks, and avoiding direct contact with warts on other parts of the body or on other people. Humans build immunity with age, so infection is less common among adults than children. The virus can survive many months without a host, making it highly contagious. There are many different treatments for warts including topical acid, freezing, laser and surgery to name a few.

Warts on the bottom of the foot can look a lot like calluses, so when in doubt, it is best to have it looked at by a Dr. Garvin. So if you or a loved one is suffering with a painful wart that just won’t go away, call Dr. Garvin’s office today at 772-335-7171 and schedule an appointment. 

Athelete's Foot

Tinea Pedis (Athelete’s Foot)

Tinea pedis, otherwise known as athlete’s foot, is a fungal infection of the skin that causes itching, scaling and flaking on the bottom of the foot.  The infection is caused by Trichophyton, which are tiny microscopic organisms that live on the layers of dead skin our body produces.   Direct transmission occurs in damp, moist environments that are conducive to fungal growth where individuals tend to go barefoot.

It is important to maintain proper foot hygiene and recognize tinea pedis as it has the ability to spread to other crevices of the body, especially the groin.  Notably the bottom of one’s foot may exhibit redness and scaling.  Persistent itching and burning may ensue.  Scratching is discouraged as one can create breaks in the skin, allowing the individual to become susceptible to a secondary bacterial infection. 

Although there are many skin conditions that can mimic the appearance of tinea pedis, Dr. Garvin can readily diagnose this fungal infection through a simple laboratory test.  Treatment may be rendered with the daily use of antifungal creams and washes.  Coincided with a cream or wash, preventative care aims to make the infected area less suitable for fungal growth.  Feet should be washed daily with soap and water, drying thoroughly between the toes.  Excessive sweating should be controlled and treated.  Socks and shoes should be kept clean and dry.  Footwear that is breathable should be opted for.  Medicated powders are available for placement in more occlusive shoe types to help keep them dry.  Most importantly, avoid walking barefoot in public places such as showers, gym rooms, locker rooms and swimming pools, which are all high risk, fungal-loving environments.

Our goal here at Foot and Ankle Specialist of the Treasure Coast is to keep you healthy and walking comfortably.  So stay healthy and keep your feet pain free!

The Diabetic Foot: Common Questions Answered

Close to 24 million people in the United States have been diagnosed with diabetes and another 6 million people have it but are not yet aware they are afflicted with this disease. As the leading cause of non-traumatic, lower-limb amputations, diabetes is reaching epidemic proportions, now more than ever.  It can have a devastating impact on the body, affecting numerous parts of the body including the eyes, mouth and feet.  In fact, the feet, often overlooked at routine checkups, can reveal the first signs and symptoms of the disease.  Commonly forgotten, patients neglect to take off their shoes and socks and ask their health care providers to inspect their feet. Proper education on the signs and symptoms of diabetes and having your feet checked every time you visit the doctor are pertinent to the management of the disease.

1. Why should my doctor ask me to remove my shoes and socks?

The feet, can tell us a thousand words, including the warning signs of Diabetes such as numbness, tingling, or ulcerations.  Taking off your shoes and socks at every doctor’s visit is critical to the prevention and treatment of the manifestations of the disease.

2. Checking blood sugar often?

Since Diabetes is a disease attributed to hyperglycemia (high blood sugars) it is mandatory that you or a loved one make sure to check blood sugars on a daily basis. Most patients will say that since they “feel fine” that their blood sugars are controlled, but little do patients and loved ones know that with uncontrolled blood sugars, comes all the detrimental effects of Diabetes.

3. What can happen if diabetes is not detected in its early stages?

Many people do not find out they have the disease until they develop serious complications such as foot ulcers. In fact, six million Americans with diabetes have not been diagnosed. However, if left undiagnosed or untreated, it can damage the body and result in long-term complications such as lower-limb amputations, cardiovascular disease, stroke, blindness and kidney disorders.

5. Should I see a podiatrist if I have diabetes?

Treating diabetes requires a multi-disciplinary approach. A podiatrist is an integral part of the management and treatment team.  Your primary care doctor may refer you to a dietician, nurse educator, endocrinologist, and an eye doctor to help you manage the disease.


If you need additional information on Diabetes, please contact:
Dr. Michael Garvin
St. Lucie West Office150 SW Chamber Court, Suite 101
(Behind TD Bank Bldg.)
Port St. Lucie, Florida 34986
772-871-6020


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