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McKinney Podiatrist | McKinney Foot Disorders | TX | VIVIAN ABRAMS, D.P.M. & DENNIS SHAW, D.P.M. |


4201 Medical Center Dr, Ste 290
McKinney, TX 75069

Foot Specialists
Caring for people....not just feet

(972) 548-0002
Fax: (972) 562-5556

Foot Disorders

Common Disorders of the Foot

Heel spur
Ingrown nails
Morton's Neuroma


BUNIONS (Hallux Abducto Valgus)

Bunions are a common deformity of the foot. The first metatarsal bone and the big toe become misaligned.  The incidence of bunions is much higher in women than men. This is thought to be due to shoe fashion. Other factors may be heredity, injury, and arthritis. Wearing narrow toed and high heeled shoes can greatly accelerate the formation of a bunion.

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· Redness, swelling, or pain in the big toe joint
· Moderate to severe discomfort at the bunion when wearing shoes, particularly if tight fitting .
· A painful callus may develop over the bunion
· There may be a painful corn on the adjacent sides of the first and second toes.
· Skin over the bunion may break down causing an ulceration, which can become infected.
· Abnormal foot function is probably the most common cause
· Family history of bunions.
· Narrow toed dress shoes and high heels may contribute to the formation of a bunion.
· Rheumatoid and Psoriatic arthritis.
· Limb length inequality can cause a bunion on the longer limb.
· Injury to the foot
What You Can Do
· Wear shoes with a wide and deep toe box. You should be able to "dimple" the the leather over your bunion.
· Avoid all high heeled shoes.
· If your bunion becomes painful, red, and swollen try elevating your foot and applying ice for about 20 minutes every hour.
· If symptoms persist, consult your podiatrist.
What the doctor may do
· Recommend commercially available or custom made shoes.
· Prescribe orthotics (arch supports) to correct faulty foot function, and help prevent worsening of the deformity.
· Recommend bunion surgery to correct the deformity.



The most common cause of  pain in the bottom of the heel, is plantar fasciitis (inflammation of the plantar fascia). The plantar fascia is a band of fibrous tissue which runs along the bottom of the foot, from the heel to the toes. It is just below the skin and helps support the arch. Inflammation over a period of time causes the body to deposit calcium where the plantar fascia inserts into the heel bone. This results in the appearance of a bony heel spur on x-ray. The spur itself is not the source of the pain. Heel pain should be evaluated by your podiatrist.


· Sharp pain on the bottom of the heel

· Often worse on arising in the morning and after resting 

· Aggravated by  weight bearing and walking

· Pain may limit activities

· Most common in middle-aged and overweight adults


· Excessive load on the foot from obesity

· Excessive flattening of the arch on weight bearing

· Tight plantar fascia

· Over pronation of the foot (a complex motion including outward rotation of the heel and inward rotation of the ankle).

What you can do

· Application of ice to the heel area after prolonged activity

· Wear supportive shoes with a stiff heal counter (the part of the shoe which wraps around the heel) and a good arch. A well made running or walking shoe is a good example.

· Sometimes a shoe with a moderately high heel will relieve pressure on the fascia

· Stretching and strengthening exercises will stretch the plantar fascia and strengthen the small intrinsic muscles which stabilize the arch. This should not be attempted when the heel is sore.

· Over the Counter anti-inflammatory medications containing ibuprofen or aspirin when tolerated

What the doctor may do

· Prescription doses of anti-inflammatory medication

· Inject powerful anti-inflammatory medication to calm inflammation around the painful area

· Apply taping and padding to relieve strain on the plantar fascia

· Administer physical therapy (eg. ultrasound, cold laser)

· Control foot function with an orthotic

· Prescribe special splints to help stretch the fascia

· Surgical release of the plantar fascia and excision of the heel spur (rarely required).

Other causes of heel pain

· Various types of arthritis

· Trauma to the heel

· Inflammation of the tendons around the heel

· Heel Neuroma (benign tumors of the nerves around the heel)

· Abnormality in the shape of the heel bone

· Foreign body in the heel (eg. splinter)



Ingrown toenails

Ingrown toenails are one the more common foot problems treated by the Podiatrist. They can be very painful, with people limiting their activity to keep off their sore feet. Ingrown toenails are caused by impingement of the skin along the margins of the nail by the nail plate. Some ingrown toenails are chronic, with repeated episodes of pain and infection. Pain can be present without infection, and occasionally infection is present without pain. The usual signs of infection include; redness (erythema), swelling (edema), increased warmth (calor), and pain (dolor).


  • Pain along the margin(s) of the toenail
  • Aggravated by wearing shoes, particularly those with narrow toes.
  • May be sensitive to any pressure, even the weight of the bed clothes.
  • There may be signs of infection.
  • There may be drainage of pus, or a watery discharge tinged with blood.


  • Improper trimming of toenails
  • Tight fitting shoes which compress the toes together
  • Hose or socks that are too tight
  • Abnormally shaped nail plate
  • Other toenail deformities (eg. excessively thick nail plate)
  • Trauma to the nail plate or toe

What you can do

  • Cut toenails straight across, and leave slightly longer then the end of the toe
  • Avoid tight fitting foot wear
  • If discomfort develops try soaking the foot in a basin of warm water two or three times a day. If you are diabetic or have poor circulation the water should never be more than 95 degrees Fahrenheit. Contact your podiatrist or physician immediately.
  • An infected ingrown nail requires prompt professional attention.

What the doctor may do

  • Trim a small spicule of nail to relieve the pressure. Callus (dead skin) may have accumulated in the nail groove, which needs to be removed. Routine ingrown toenail care may need to be done periodically.
  • Elevate the end of the nail plate to prevent impingement on the soft tissues
  • Surgically drain an infection
  • Prescribe special soaks and/or antibiotics
  • Surgically correct a chronic ingrown toenail
  • Completely remove a deformed toenail so it will not grow back.

Complications of an ingrown toenail

  • Infection, if present, may spread to foot and leg, or into blood stream.
  • Loss of nail plate from infection or inflammation of the nail bed.
  • Chronic in-growing nails can cause deformity of the nail plate and/or surrounding soft tissues.
  • A small benign tumor called a granuloma can form along the nail margin.
  • Diabetics and those with poor circulation to the feet must never attempt to treat an ingrown toenail at home, consult with a podiatrist or physician immediately
McKinney Podiatrist VIVIAN ABRAMS, D.P.M. & DENNIS SHAW, D.P.M. is a poidiatry office providing Foot Disorders, orthopedic, pain, diabetes, bunions and much more in McKinney, TX. We also do Allergic Contact Dermatitis , Athlete's Foot, Brachymetatarsia, Bunions, Calluses, Diabetic Foot Care, Flatfoot (Fallen Arches), Ganglions, Haglund's Deformity, Hallux Rigidus, Hammertoes, Heel Pain/Fasciitis, Infections, Injuries, Ingrown Toenails, Metatarsalgia, Morton's Neuroma, Onychomycosis, Osteoarthritis, Pediatric Foot Care, Plantar Warts, Plantar Fasciitis, Posterior Tibial Dysfunction, Rheumatoid Arthritis, Running Injuries, Sesamoiditis, Sprains/Strains, Tarsal Tunnel Syndrome, Tailor's Bunion, Tendonitis, Toe Deformities, Xerosis and all work related in the 75069 area and surrounding areas in McKinney