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Tendonitis Basics

tendonitis-basicsTendonitis is any inflammation of a tendon. Tendons are strong bands of tissue that connect muscles to bones. Inflammation is pain, swelling, and irritation due to injury, overuse, infection or disease. Tendons, unlike ligaments that attach bones to other bones, go through a lot more motion and movement. This increased amount of movement frequently makes them the first to be injured and sadly the last to heal.

There are a lot of tendons in the foot and ankle. Nine major tendons pass the ankle joint alone. Thankfully, we at the New Mexico Foot and Ankle Institute understand these and can customize treatments for each individual tendon or problem. Not every tendonitis can be treated with simple ice and rest. There are many treatments that can be used to not only manage the tendonitis, but to decrease pain and increase strength. Our huge variety of braces, shoes, orthotics and specialized pads can offer dramatic relief despite being simple additions to treatment plans. Our goal is to get patients back into 100% activity as fast as possible and to prevent tendonitis from ever happening again.

Don’t Live Life in Pain! Call us today for an appointment at 505.880.1000. We take care of your feet…so that they’ll take care of you!

Justin Ward, DPM

Foot Pain and the Brain

foot-pain-brainPains in the feet can present themselves in many different ways such as sharp, dull, shooting, numb, tingling, burning, aching, stabbing and throbbing. We use a lot of words to describe our pains because they can be different and just like we have lots of different pains, we can’t just treat all of them with the same single medication. This would be like the above 500 year old image of Hercules fighting the Hydra, a mythical beast with multiple heads that regenerate if you cut them off. Like the Hydra, if you fight pain with just one thing, you are usually going to lose.

As a caring doctor, I really wish I had a single magic pill or cream that could take all the pains away. Sadly, nothing like that exists. But with a combination approach, we can get very close to it. We fight pain from multiple levels. Our brain is the final spot where pain is sent from your toes through your legs, back and neck. We at the New Mexico Foot and Ankle Institute are keenly aware of this complicated process and we understand that there are a lot of areas where pain can be attacked and stopped. With a balanced approach with patient-comes-first care, we can provide individualized therapies and fight the “painful Hydras” in our feet.

Don’t Live Life in Pain! Call us today for an appointment at 505.880.1000. We take care of your feet…so that they’ll take care of you!

Justin Ward, DPM

What is a bunion and what causes it?

bunions-causesBunions are basically bumps on the inside of the foot. They are a common foot deformity that is frequently ignored and not treated early. Bunions cause the big toe to drift and point toward the second toe. They can cause arthritis as the bone loses its natural alignment, making it painful and less functional.

Bunions are progressive. Though there are many people who can go their entire life with a progressive pain-free bunion, many people have worsening deformity and pain. Once the bone has changed and moved over it does not naturally go back. Bunions are usually painful in later stages.

In short, bunions are an inherited deformity. Foot types cause abnormal range of motion on the back and middle part of the foot, which then in turn forces the bunion to develop or at least worsen. Bunions are less common in cultures that do not wear shoes. It is true that shoes can make a bunion get worse, especially tight or narrow shoes, but they do not likely cause bunions to form. Studies have shown that 58% to 80% of cases have a positive family history for the deformity.

There are lots of treatments for bunion and there is no need to suffer, especially since early treatment is usually the right treatment.

Don’t Live Life in Pain! Call us today for an appointment at 505.880.1000. We take care of your feet…so that they’ll take care of you!

Justin Ward, DPM

Sports for kids and avoiding injuries

avoiding-injury-kids-sportsDoctors are seeing more and more injuries in kids due to overuse. Overuse injuries are more gradual and are caused from a repetitive activity that does not allow the body enough time to heal between playing. In general, these types of injuries are more common because children today are frequently able to do their sport year around, where as decades ago, children usually played multiple sports that followed the seasons and weather.

Common injures in the foot and ankle:

  1. Pediatric heel pain (juvenile calcaneal apophysitis or “Sever’s disease) – the growth plate in the heel bone is injured
  2. Stress fractures – bones are breaking on a more microscopic scale
  3. Sprains and strains – muscles, tendons, and ligaments may be weakened or even torn


Early treatment is best. We at the New Mexico Foot and Ankle Institute can provide expert, individualized treatment plans.


In general, have your child do multiple sports, don’t be on multiple teams for the same sport, gradually have your child increase in activity (practice before season starts) and always take a stretching break after 10-15 minutes of light sport.

Don’t Live Life in Pain! Call us today for an appointment at 505.880.1000. We take care of your feet…so that they’ll take care of you!

Justin Ward, DPM

Back to School? Make sure your kids put their best foot forward

back-to-school-shoesSummer is over and if your feet aren’t hurting a little, you may not have played hard enough. Even if your feet don’t hurt, back to school expenses might be painful. The beginning of the school year is when parents frequently have to make the tight budget of getting all school supplies and buying school clothes. Too frequently, shoes are the last thing left to be purchased. Parents also get discouraged when they finally buy a pair of nice, supportive shoes and find out that the child has outgrown them within a couple months. Shoes don’t have to be expensive to be quality, so here are some general tips that can help:

  1. Orthotics – A well made, padded, higher arched, stiffer shoe insert is surprisingly a cheap way to turn fair shoes into good shoes and good shoes into great shoes. Over-the-counter inserts are not expensive and they can be moved to different shoes. Come in to the clinic for personalized needs. Even if you don’t have an appointment, $40 can buy a supportive set of orthotics for your kids.
  2. Rubber – Buy a shoe with real rubber outsole. It is more rugged that the flimsy, degradable tread that is recently making shoes cheaper.
  3. Stiffer – Make sure the shoe is stiff in the middle and back. If it is limp, chances are it is not supportive and your child will likely feel it quickly.
  4. Cross trainer – Cross trainers are generally more supportive and are getting more fashionable. New Balance, Asics, and Saucony are usually good brands. The more common brands like Nike, Adidas, Sketchers and Reebok can be okay, but look for ones that have a removable insole.

Don’t Live Life in Pain! Call us today for an appointment at 505.880.1000. We take care of your feet…so that they’ll take care of you!

Justin Ward, DPM

Diabetes and the Shoe

shoe-removable-insertsA person is diagnosed with diabetes every 23 seconds in America. That is a lot of Americans with a disease that kills more people annually than breast cancer and AIDS combined. When I educate newly diagnosed patients about diabetes, I usually briefly recap the big risks that their primary care provider has discussed which should include eye, kidney, and heart disease risks. Once the big picture is established, I explain the importance of foot care and their shoes. Why talk about shoes when there are so many other problems with diabetes? Well, basically 82,000 Americans lose their foot or leg to diabetes and frequently it starts out as an innocent looking sore, callus, or wound. Many of which could have been prevented by a simple, properly fit shoe.

Diabetic shoes are designed to prevent wounds, amputation, and even pain. In general, diabetic shoes are smooth lined, well cushioned, wide, and padded.  They are made to be taller or deeper to allow for less friction and less pressure. An orthotic (removable shoe inserts) can be made specifically for the patient and provide pain relief as well as prevent problems. Diabetics with foot deformities are at increased risk for wounds and often need to be measured for appropriate size.

The American way of food and excess has brought rise to the diabetic plague, but thankfully also given rise a wide variety of shoes. Now, there are hundreds of fashionable diabetic shoes. Many of which are easily covered by insurance. So in short, we might not be good at controlling our diet and exercise, but at least we can have safe shoes in style.

Don’t Live Life in Pain! Call us today for an appointment at 505.880.1000. We take care of your feet…so that they’ll take care of you!

Justin Ward, DPM

Why are High Heels bad?

high-heel-xrayPodiatrists think high heels are terrible.  Fashion designers think that high heels are wonderful. Who is right? Answer: the podiatrist (in most cases)

When high heels or platform shoes were invented, the purpose was to increase height and status, especially with European nobility. These shoes were not made to make you walk better or more comfortably. As technology advanced, so did the ability to make stilettos and mass produce a wide variety of high heeled shoes. Today, high heels are ubiquitous and in mainstream fashion and women are literally pressured into wearing them.

Why do women and fashion designers like them?  High heels force the center of gravity up and forward, causing imbalance. The body compensates for this unnatural instability by tightening the calf muscles, flexing the lower back down pushing out the buttocks, which then in turn forces the chest out and ultimately makes you taller.  The benefits need no further discussion.  The risks, however, do.

High heels are more likely to cause osteoarthritis (25% increase in knee stress), bunion deformities, hammertoe deformities, neuromas (painful squished nerves) and painful corns. Sprained ankles, bad posture, and back pains are also higher because of them.  In short, heels are bad. Nine out of 10 podiatrists would not recommend them and the only 1 out of the 10 was likely asked the question late on a Saturday night.

Don’t Live Life in Pain! Call us today for an appointment at 505.880.1000. We take care of your feet…so that they’ll take care of you!

Justin Ward, DPM

What kind of shoe should I buy?

sport-shoeI get this question asked on a weekly, if not daily basis. Shoes are a big part of our life and culture. Barefoot running and walking can be fine, but with diabetes and pavement everywhere in the US, it is best for the vast majority of us to wear them.

So which ones are best for me? This is not always an easy question, but here are some general guidelines:

  1. TRY THEM ON ~ Use the shoe fitting device at the shoe store to find your size by putting your full weight on the device. You will frequently need to get the half size bigger.
  2. CROSS TRAINERS ~ For moderate activity, most of us would benefit from cross trainer shoes: these are wider on the heel and stiffer in the midsole.
  3. BUY THE SHOE FOR THE JOB ~ Consider the activity and there is likely a special shoe available.
  4. RUGGED/RUBBER OUTSOLE ~ wear the shoe with the goal to wear it out in healthy, active living.
  5. ORTHOTIC COMPATIBLE ~ get a shoe that has a removable insert. If it doesn’t chances are it is not a supportive or quality shoe.

With thousands of shoes to choose from, buying shoes for life is not easy. But with the help of a podiatrist, it may make the choice easier.

Don’t Live Life in Pain! Call us today for an appointment at 505.880.1000. We take care of your feet…so that they’ll take care of you!

Justin Ward, DPM

I Was Told I Have Arthritis. What Does That Mean?

ArthritisWith over a hundred different types of arthritis and over 300 joints in the human body, the general term of arthritis can quickly get complicated and confusing.  It doesn’t have to be that way.  Arthritis, in simple terms, is any type of disease or damage that makes a joint not work right.  When your doctor tells you that you have arthritis, it doesn’t necessarily mean that you are destined to have terribly deformed and chronically painful joints.  Flashbacks of your early childhood looking at your great aunt’s twisted hands and incessant bizarre complaints may give you a feeling of hopelessness.  Thankfully, arthritis is usually much more mild and more manageable, and even if it is severe, there are a lot more wonderful treatments available today than decades ago.  As a podiatrist I am lucky enough to help people feel better and literally get back on their feet, regardless of what type of arthritis they have.

So let’s find out more about arthritis. There are three basic kinds of arthritis and they can be simplified as follows:

#1 Non-flammatory arthritis — This is the “wear and tear” arthritis. The most common type is osteoarthritis, which is frequently diagnosed by x-ray and clinical exam.  Bunions and hammertoes are deformities in the foot that frequently cause the joint to break down and become painful, thus causing arthritis.  As we age, our joints should be moving, strengthened, and supported by good shoes and orthotics (arch supports).

#2 Inflammatory arthritis — This kind of arthritis is commonly a result of immune system problems or other diseases in the body.  Rheumatoid arthritis is the most common form of inflammatory arthritis. Though there is no cure, newer medications and treatment options are available to help patients. In the foot and ankle, anti-inflammatory injections  and orthotics can provide relief and even prevent the need for surgery.

#3 Connective tissue disease — This classification is for the more rare leftovers including lupus, sclerosis, and Sjogren’s syndrome.

There are many ways that we can treat arthritis from orthotics, medications, and injections to complicated reconstructive surgery. We are excited to help you along the path to improving your function and decreasing pain.

Don’t  Live Life In Pain!  Call us at 505.880.1000 today to make an appointment.

Justin Ward, DPM

Gout! Why Me?

Gout1015Oftentimes, when one thinks of gout, they think of their grandma seated with her leg up in the air and a big red toe with a heating pad on it.  This is a common misconception.  Gout can actually occur as early as your late 20’s or early 30’s.  It is more common though from age 40-50.  Statistically speaking, it is more common in men.  We also know that genetics, as with most things, plays a role in gout.

I have an older brother who struggles with gout.  He has mentioned on many occasions the significant amount of pain he suffers during an acute attack.  All of my patients agree!  It will usually manifest itself as a red, hot, swollen, painful joint.  Most commonly it is the big toe joint which is why podiatrists are so well acquainted with the disease.  It can also manifest in the ankle, hands, wrists, and less commonly in other areas of the body.  These locations make perfect sense if you understand the physiology of gout.

Gout is an excess of uric acid circulating in the blood.  Why?  Some people simply over-produce uric acid while other people’s bodies can’t get rid of it fast enough.  The uric acid circulates through the entire body in the blood.  But when it gets to joints that are furthest from the heart and therefore, coolest, the uric acid crystallizes causing a red, hot, swollen, and very painful joint.  What’s further from the heart than the toes?  Hence the foot is the most common place for an attack.

This month, we’ll be discussing gout prevention and treatment so stay tuned.

Don’t  Live Life In Pain!  Call us at 505.880.1000 today to make an appointment.

Jonathan Williamson, DPM