The foot and ankle support the body and allow it to perform a wide range of activities both simple and complex, from standing and walking to pivoting, jumping, and running. When wear and tear, injury, or disease causes discomfort, it can severely impact your quality of life. Dr. Shane M. Hollawell, board certified podiatric/foot and ankle surgeon, offers some of the most advanced treatment available for essentially an entire range of foot and ankle conditions/injuries. He emphasizes conservative and surgical options when indicated that are designed to help athletes and non-athletes alike, return to the highest level of function or pre-injury activity as quickly as possible.
For more information about the foot and ankle conditions Dr. Hollawell treats, please follow the links below. If you have additional questions, or if you would like to schedule a consultation, please contact our practice today.
- Achilles Tendon Injuries
- Ankle Sprain
- Fractures & Dislocations
- Hallux Limitus/Rigidus
- Lisfranc Sprains & Fractures
- Nerve Abnormalities
- Osteochondral Injuries
- Plantar Fasciitis
- Chronic/Non-Healing Wounds
Achilles Tendon Injuries
The Achilles tendon is a long, tough, and fibrous piece of tissue that stretches from the heel of each foot and connects to the calf muscles. Essential for running, jumping, walking, and balance, the Achilles tendon can become injured a number of ways. Achilles tendonitis is the most common injury. It occurs when the tendon becomes inflamed, typically as a result of overuse. The Achilles can also tear (partially or fully). Treatment for Achilles tendon injuries typically will be conservative and include rest and some form of physical therapy; however, a tendon rupture may require surgery.
A sprain occurs when the ligaments of the ankle are torqued to the point of being over stretched and/or tearing (partially or fully), which can cause considerable pain, swelling, and difficulty walking. This common injury usually involves the outside (lateral) ligaments; but can happen on the inside (medial side) as well. Treatment for ankle sprains will vary depending on the severity of the injury, with most cases requiring ice, rest, and immobilization for a period of time, as well as physical therapy.
There are dozens of types of arthritis, which is a disorder that causes inflammation, pain, and stiffness in the affected joint. One of the most common forms is osteoarthritis, a degenerative condition that results from the regular wear and tear of the joint over time. Arthritis can also develop following a fracture, sprain or dislocation. This type of arthritis is referred to
post-traumatic arthritis. There are many treatments for arthritis available; however, there is no cure. Dr. Hollawell can provide a customized plan of treatment that may include prescription medications, rest, cortisone injections, or other treatment modalities. In some cases, surgery may be indicated.
A bunion (hallux abducto valgus) is a deformity of the first metatarsal phalangeal joint characterized by a misaligned joint. The deformity develops as the big toe (hallux) deviates toward the second digit over time leading to a medial prominence/protrusion of the first metatarsal head. Decreased range of motion, in addition to joint discomfort, are common symptoms. Bunions are typically an inherited trait and generally are not caused by wearing a particular shoe type; however, certain types of shoes can exacerbate the condition and cause more pain. Conservative treatment options for bunions can include orthotics, medication, injection, and shoe modification. In moderate to severe cases, surgery can be used to correct the joint alignment and toe position, and to reduce or eliminate pain.
Flatfeet, also known as fallen arches, are extremely prevalent among both children and adults, affecting as much as 50 percent of the population. Flatfeet develop as a result of excessive pronation. Pronation is when the foot widens or splays as it responds to the ground reactive forces. This can put significant strain on the arch and the associated tendons and ligaments in the midfoot, causing pain and progressive weakness. There are multiple causes of flatfeet. Adult-acquired flatfoot is typically caused from breakdown or degeneration of the posterior tibial tendon. It can lead to a serious and often very debilitating condition of the foot if not addressed. Treatment for flatfeet include non-surgical and surgical options, depending on the severity of the disorder.
Fractures & Dislocations
Any of the bones in the foot can be broken (fractured) as result of twisting, rolling, crushing, or another type of traumatic or stress injury. Ankle and foot fractures can involve one or several bones, and may affect the tendons, ligaments, and other soft tissues as well. A dislocation is a condition where the bone is forced outside of its normal position. Depending on the severity of the break or dislocation and the bone affected, treatment for fractures and dislocations of the foot and ankle may include ice, rest, bracing and other non-surgical techniques, although Dr. Hollawell may advise surgery to address misalignment or other concerns that may impact immediate or future function.
A form of arthritis, hallux limitus is characterized by loss of motion and pain in the first metatarsophalangeal joint. Hallux rigidus is a progression of the condition in which you lose most or all motion of the joint. Once the great toe (hallux) becomes rigid or stiff, surgery likely will be necessary to address the problem. Treatment for hallux limitus can include conservative care, but in many cases it will progress to hallux rigidus regardless.
Hammertoe is characterized by a clawing or general contracture of the lesser toes. This condition is often caused by a tendon or combination of soft tissue imbalances of the lesser toes. This condition can cause problems with shoe wear in the form of irritation to the skin and rubbing of the shoe on the knuckle of the toe. This condition is often progressive with contracture deformity worsening overtime and many instances involves a weakening or a tear of the plantar plate of the lesser metatarsophalangeal joint.
The plantar plate is a cartilage like ligament structure on the undersurface of the lesser metatarsal head that attaches to the base of the lesser toe. It helps maintain stability of the metatarsophalangeal joint (joint where the toe meets the metatarsal). When there is a tear in this structure, the ball of the foot is often painful and exercise and/or walking can be difficult. Treatment for a hammertoe can include a number of non-surgical techniques or, in severe cases, surgery to straighten the digit, correct the joint alignment, and repair of the plantar plate may be indicated.
Lisfranc Sprains & Fractures
The Lisfranc joint complex is located where the midfoot meets the forefoot. Injuries to this area can be simple or complex and may include fractures (broken bones), ligament and tendon tears, or both. When compromised, this joint injury can cause pain and stability problems with even regular walking. Non-surgical treatment can be helpful if there are no fractures; however, treatment of Lisfranc injuries will likely include surgery if bones have broken and joint dislocation has occurred. The joints must be realigned and the bones placed in proper position to restore full function.
Numbness, burning, tingling, and/or pain are all symptoms of nerve abnormalities. Patients suffering from these effects know they can significantly impact quality of life. There are many causes of nerve pain and nerve damage, such as diabetes; however, in some cases the cause is not always fully known. Tarsal tunnel syndrome, Morton’s neuroma, and drop foot are some of the more common nerve conditions/abnormalities of the lower extremity.
Dr. Hollawell can evaluate your concerns and develop a customized treatment plan for nerve abnormalities or injuries that includes a variety of surgical and non-surgical therapies.
Trauma causing a severe ankle sprain can also lead to an osteochondral injury. This condition happens when the cartilage on the surface of the bone suffers an abrasion or fracture. A significant enough abrasion or fracture can result in the joint locking and feeling unstable. As a result, moving the ankle can be painful. Physical therapy and immobilization are common treatments for osteochondral injuries, although in some cases surgery may be recommended.
The plantar fascia is a fibrous band of tissue that stretches from the heel to the ball of the foot. Plantar fasciitis is the most common inflammatory condition of the foot. It occurs when this tissue becomes inflamed, usually as a result of repetitive walking, running, or chronic standing. Conservative treatment for plantar fasciitis includes non-surgical and non-invasive therapies such as physical therapy and orthotics. Most cases will resolve over time without the need for surgical intervention.
We offer advanced care for chronic, traumatic, infected, and diabetic wounds at our state-of-the-art facility. These wounds can be complex and often require specialized modalities.
Dr. Hollawell will carefully evaluate each patient’s case to optimize healing results and reduce the risk of infection. Treatment for wounds will vary depending on the type, severity, depth and duration the wound has been present. Local wound therapies will be emphasized, and surgery will only be recommended in the most serious cases of an infected or non-responsive wound.
We’re here to provide additional information as needed for you to make the best health care decisions regarding your ankles and feet. Contact us today with any questions or to schedule a consultation with Dr. Hollawell.