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Medical & Surgical Treatment of Foot & Ankle

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Category Archives: Foot Care

The Painful Ingrown Toenail


Dr. Hirt working on Dr. Holdren Otis’ ingrown nail

Doctors have foot problems too!

An ingrowing nail is a common problem that can effect people of all ages.  An ingrown nail occurs when the toenail is pushing on or digging into the skin at the side or end of the toe.  It typically starts as a mild redness, inflammation, or pain. Usually it will get worse with time and can become infected.  If left untreated, in can progress into an abscess, infection, and in rare occasions serious bone infection requiring surgery.   It is critical to get the nail evaluated as soon as possible to prevent complications. Added pressure or trauma to the nail can cause it to become a problem. It can also be hereditary, or the way the nail itself grows that can make it painful.



A procedure can be done to make your toe feel better and not come back!

Cutting your nails straight across can leave sharp corners that dig in. Oral antibiotics and soaking the infected ingrown nail can make them better for a little while but ultimately the nail border needs to be removed from the skin. A procedure can be done in the office where the toe is anesthetized.   Once the toe is numb, the nail corner can be trimmed back with special instruments and the sharp edge of the nail can be removed with no discomfort. To permanently fix the nail corner a special medicine is applied to the “root of the nail” so that the problem doesn’t return.

After the procedure you are free to do whatever you can tolerate. Dr. Holdren Otis was able to walk her dogs and enjoy this warm November weather we are having.

November is Diabetes Awareness Month.

Diabetic Shoe

Diabetic Shoe

Diabetes is a disease affecting many parts of the body.  While there is no cure for diabetes, there is hope. With proper diet, exercise, medical care, and careful management at home, a person with diabetes can enjoy a full and active life.
Of the more than 28 million people in the US with diabetes, about half will develop neuropathy, a loss of feeling in the lower extremities. This nerve damage means an open sore or injury on the foot may go unnoticed until it becomes infected, which can eventually lead to the need for partial or full amputation of the foot or lower leg. In fact, diabetes is the leading cause of non-traumatic lower-limb amputation.  Your Fenton Foot Care podiatrist is an integral part of the treatment team that prevents unnecessary complications including amputations.
The doctors and staff at Fenton Foot Care and Brighton Family Foot Care encourage individuals to schedule a Comprehensive Diabetic Foot Exam.  This simple, painless examination helps diagnose the onset of diabetes and foot related problems due to the disease.
Call us for convenient appointment times:
Fenton Footcare
14229 Torrey Rd Suite #1
Fenton, MI 48439
Brighton Family Footcare
7990 Grand River Rd Suite D
Brighton MI 48114
Your feet tell a story…We are here to listen!

Do you have dry, itchy or scaly feet?


Dry feet happen commonly in the winter

Dry and itchy scaly, feet are common in the fall and winter in the Midwest as we start to use the heat and the air dries out. The treatment of dry feet includes a good skin lotion that is ointment based instead of water based. The effective lotions tend to be thicker. When applied at night and covered with socks it allows the lotion to soak in and moisturize the feet and legs.


When normal lotion doesn’t take care of your problem you may have athlete’s foot.

Athlete’s foot, also known as tinea pedis, is caused by a common fungus. This infection affects the skin in between the toes and the bottom of the foot. It does not have to itch, but usually does. It is seen in people who wear closed toed shoes during the day and cannot allow their feet to breathe. Athlete’s foot can be caused by walking barefoot in a place someone with foot fungus has already walked. Changing your socks daily or when they get wet, can help prevent athletes foot. Wearing shoes or sandals at the gym, pool and lake is also helpful in the prevention of contracting foot fungus. Sometimes an infection is too much for an over-the-counter medication. At that point you need to come see a professional who is knowledgeable in treating this infection. The fungus that causes athlete’s foot also can affect the toenails. The importance of treating athletes foot properly is so that thick and discolored effects of toenail fungus do not occur. Other things that can cause dryness and scaling include psoriasis and eczema. A skin scraping biopsy sent to a pathology lab can determine what is causing your problem and dictate how to treat it.

Prevent the Spread of MRSA, Giants’ Daniel Fells Hospitalized for Infection

american-football-field-green-32220703Dr. Holdren Otis

Methicillin Resistant Staph Aureus, also known as MRSA (Mer-sah), is a bacteria that has developed a resistance to antibiotics. This means that the normal penicillin used to treat staph infections no longer will kill the bacteria. The New York Giants tight end, Daniel Fells has a MRSA infection in his right ankle and has had multiple surgeries in the last week to clean it out. Reports say that he is being cared for in the intensive care unit.
Daniel Fells injured his toe and ankle and was given a cortisone injection, which helps calm down inflammation in the area. Despite the injection the pain in his ankle continued along with high fevers and he found himself admitted into the hospital 10 days ago. Fells has played for 7 years in the NFL but with the infection, his career is being seriously threatened.


Staph infections generally start as painful and swollen red bumps which may surgery to be drained. These infections can quickly become deep and potentially life threatening.

The Giants have carefully sanitized their locker rooms and equiptment and retrained their players and staff on how to prevent the spread of MRSA.

You can prevent MRSA infection by washing your hands frequently. This includes scrubbing for at least 15 seconds and drying them with a disposable towel. If you cannot get to the sink, hand sanitizer will do the trick as well. Also keep your breaks in the skin clean and covered. In athletics, shower immediately after contests, especially contact sports. Use soap and water and do not share towels. Wash clothes after each time they are worn on the hottest setting, use bleach if possible and dry them in a hot dryer.


MRSA is treatable  with intravenous antibiotics if recognized early. Dr. Holdren Otis will be following Daniel Fells’ story and wishes him the best possible outcome. The Giants dedicated their win and took play to the next level for Fells, who received the game ball from his teammates yesterday.

The Truth About Plantar Warts

As school starts and schedules get busy, don’t forget to check your kids feet and hands for warts.

Shoes or sandal recommended when by the pool and locker room

Shoes or sandals are recommended when by the pool and in the locker room

Warts, or verruca is the medical term, are caused by a virus. This virus is very common and can be picked up at the pool, the beach, the shower or in the gym. The microscopic virus enters the skin of your hands and feet through tiny breaks in the skin. Dr. Holdren Otis most commonly sees them in children, specifically ones who like to go barefoot, like gymnasts. Warts are not always painful but when they are on a weight-bearing surface they can build up a thick skin layer and feel like walking on a pebble. Warts usually have a white thick covering with pinpoint black dots representing the capillaries that supply blood to the wart itself. Warts can also be seen on the tops of hands and feet as well, but are not as painful.

It is important to treat warts when they are first noticed so they do not spread or get larger. A larger wart can be more difficult, more painful and may take more treatments than a smaller one. Plantar (bottom of the foot) warts can be very frustrating to treat and over the counter medications may not be strong enough. If over the counter medication fails for your family’s warts please come see Dr. Hirt and Dr. Holdren Otis at Fenton Footcare. We have the latest treatment for warts.
How can you prevent warts? Lysol or other agents that kill viruses are used in the shower and can help it from spreading to other family members. Avoid picking at warts so they do not spread.  Sandals and shoes are recommended in public places like the pool, gym and locker room. Keeping your feet clean, dry and changing shoes and socks daily is always helpful.

Are “Growing Pains” a Myth?

Dr. James Hirt explains

Growing pains in children’s legs have been debated for hundreds of years. Through the history of medicine growing pains have been attributed to multiple incorrect theories such as, rheumatic fever, psychological disorders, and even hair and eye color. In the 1930’s researchers proposed a link between orthopedic foot conditions and growing pains but it did not gain much traction and was dismissed. Over the next 80 years many studies have been done linking foot deformity to growing pains. Dr. James Hirt firmly believes growing pains are a myth and the real reason for the pain is abnormal foot function affecting the lower leg muscles.

In a recent study published in Podiatry Management, eleven children age 5-15 were fitted with functional orthotics to control their excessively flat feet and all eleven children had complete resolution of their “growing pains”. Functional orthotics are inserts placed in the shoes that are made to fit an individual’s feet. They allow the foot and leg to function is a more neutral and natural position.

Dr. James Hirt has personal experience with “growing pains” with his own son who had severe flat feet. At the age of about 5 years old began complaining of knee and leg pain at night. “I immediately made the connection between the leg and knee pains and the foot deformity. I made my son a set of custom functional orthotics to put in his shoes and within days of wearing them the complaints of pain completed stopped. Occasionally the pains would return, but were a direct related to my son not wearing his orthotics. To this day I keep my son in orthotics and he has been pain free and happy.”

“I only wish when I was a child someone would have made the link between my flat feet and the horrible “growing pains” I had. I remember going to the doctor on multiple occasions complOrthotic Castaining of severe pain in my legs, and my mother was told it is just “growing pains he will grow out of it”. I wish I would have been referred to a podiatrist back then, I am sure it would have prevented many nights of me lying in bed unable to sleep due to the so called growing pains.”

Based on his own experience and the many children he has treated Dr. Hirt confidently concludes growing pains have a logical explanation. “Every child I have treated with the diagnosis of growing pains has had complete resolution of their pain once custom functional orthotics were made to control the abnormal foot function,” he explains. Flat foot is not the only foot deformity that can cause these pains; high arches, tight Achilles tendons, and many other foot and ankle deformities can cause the same symptoms. When the foot and ankle are not functioning correctly leg muscles get overused and fatigue easily, abnormal stress occurs to muscles tendons and bones this all results in pain in the legs and knees.

Heel Pain=Plantar fasciitis, Well Not Necessarily.

Heel PainDr. Holdren Otis

“You almost want to pee in your bed rather than go to the bathroom. It’s really painful in the morning,” Albert Puljos, a baseball player for the Angels, said it best in an interview with USA today in 2013.  Plantar fasciitis, also known as heel spur syndrome, is the most common cause of heel pain. It is seen in individuals  who are physically active or have increased their daily activity. The plantar fascia itself is a thick band of tissue attaching to the heel bone, the calcaneus. Tugging and pain are usually felt at this attachment, but pain can be in the arch as well. Pain in the morning and when getting up to walk after sitting for a period of time are common complaints.

Although plantar fasciitis is the most common cause of the heel pain, there are other more serious things that can cause pain in the same area. These things include a stress fracture of the calcaneus (heel bone), which occurs with increased activity as well. Also tarsal tunnel, very similar to carpal tunnel of the hand and wrist, can cause shooting pain, tingling and numbness to the foot. In children the closing of the growth plate can cause heel pain when running and jumping. Having your heel pain checked out by a doctor is very important to rule out the other diagnoses. In addition, your pain can be treated quickly and efficiently with all that the medical community has to offer. It is abnormal to have heel pain that does not go away. Call Fenton Footcare today to see one of our doctors.

SCIENCE: Can I have normal blood work and still have gout? Yes!

Dr. Holdren Otis

Dr. Holdren Otis DPM

Dr. Holdren Otis, DPM

Gout is a type of arthritis that affect joints making them red, hot, swollen and yes, PAINFUL. It occurs mainly in men but it doesn’t leave women completely out. A flare can occur out of nowhere, waking you up at night and even the light touch of the bed sheets can cause you to jump to the ceiling. The most common place to find gout is the in big toe joint but it can show up in the knee, ankle and little toes too.
Gout is an accumulation of uric acid crystals in and around a joint. These crystals can be removed from the joint and seen under a microscope, looking like shards of glass, which makes sense because that is exactly how it feels!
When blood is drawn to determine if you have gout, it measures the concentration of uric acid. It is normal to have some uric acid in your blood because it is a breakdown product of some types of foods that you eat. These foods include steak, seafood, beer and some fruits.
If your blood is drawn during an attack, looking for uric acid, it may register as normal. Why? The majority of uric acid is not in your blood, but is in the form of crystals in your joint! It only makes sense. It is better to draw blood a few weeks after the flare has resolved to see if you need to be on a longer term gout medication. It is important to keep this uric acid in check because gout is a type of arthritis and can cause permanent damage to your joints.
Do you have gout flares? If so, there are treatments in the office that can make you feel better quickly! You don’t have to suffer during a flare. Call Fenton Foot Care for an Appointment (810) 629-3338.