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Medical & Surgical Treatment of Foot & Ankle

Your best choices for your family's foot care needs

May is Arthritis Awareness Month

Arthritis is an inflammation and swelling of the cartilage and lining of the joints, generally accompanied by an increase in the fluid in the joints. It is a disabling and occasionally crippling disease afflicting almost 50 million Americans.

Dr Hirt and Dr Holdren

The podiatrists and staff of Fenton Foot Care and Brighton Family Foot Care would like you to know that there is usually no need to endure years of painful ambulation because of arthritic feet.  Most conditions can be diagnosed and treated either conservatively or surgically by our team.


Symptoms of arthritis in the foot and ankle include:

  •       Early morning stiffness.
  •       Limitation in motion of joint.
  •       Recurring pain or tenderness in any joint.
  •       Redness or heat in a joint.
  •       Skin changes, including rashes and growths.
  •       Swelling in one or more joints.


If you are experiencing foot pain, take time to schedule an exam today. Early detection and treatment of problems help keep you on your feet and active.

Preparing for Summer!

IMG_3773Summer is coming, we can feel it! With summer comes a change in activity and a change in shoe gear. Most people feel uncomfortable in how sweaty shoes in the summer and transition to bare feet or sandals. Here are some things to remember about foot health in the warm coming months:

  1. Wear something on your feet when around and by the pool. Athlete’s foot (foot fungus) and plantar warts are commonly found in places where people are barefoot. Make sure to wear sandals when not enjoying the pool.
  2. If you will be walking around a lot outside make sure to pick a sandal that is supportive. This means one with arch support and a good sole.
  3. If doing yard work/carpentry/cutting the grass- USE YOUR SHOES! Many minor injuries like scratches and lacerations can be prevented with the proper shoe gear. Major injury can be reduced just by wearing your normal shoes.
  4. Wear sunscreen on your feet. The feet and lower legs can be easily forgotten but can be very painful with a red sunburn. Sun damage to any area of your skin can put your skin at risk for problems later on.
  5. If your shoes get wet make sure that they are completely dry before putting them back on. This will help to prevent bacteria and fungus from staying in your favorite pair of tennis shoes.
  6. Drink lots of water! This can prevent swelling of the feet and ankles.
  7. If you have pain in your foot or ankle contact Fenton Foot Care or Brighton Family Foot Care to take care of it soon. A chronic problem can take more time to treat than one you have just noticed.

Frostbite Prevention


Multiple layers, socks and boots are recommended when going out in the cold weather.

Frostbite is a serious tissue destroying disorder.  It is something that is not often anticipated during relatively mild winter temperatures. The doctors and staff at Fenton Foot Care encourage everyone to stay alert and take precautions to avoid the unnecessary distress of frostbite.


Frostbite can occur in as little as 30 minutes even in temperatures from 30 °F to 40 °F.


Depending on the severity of the exposure, frostbite can affect the skin or underlying tissue, especially in your arms, legs and feet.  In most cases the area becomes numb and feels frozen.  Skin will appear waxy, white or grayish.  Any exposure should be evaluated and treated by a physician.


Avoiding frostbite is easier than treating it. If you must go out in the cold, be prepared.

  • Dress in light, loose, layered clothing for ventilation and insulation.  Water-repellent fabric is a good overlay.
  • Make sure that your head, hands and feet are properly covered. Mittens are warmer than gloves, and two pair of socks (wool over lightweight cotton) will help keep your feet warm.
  • Avoid alcohol, caffeine and nicotine prior to, and while, you are outside.  These things leave the skin more prone to thermal injury.
  • If you get wet, remove wet clothing as quickly as possible and get to a warm location.
  • Check yourself every half-hour or so for signs of frostbite. If your toes, fingers, ears or other body parts feel numb, get inside.

If you believe that you are experiencing frostbite, or other foot concerns, we are here to help.  Call for an appointment today: 810-629-3338 (FEET)

What Your Podiatrist Can Do For You In 2016:

  1. Be there when you need them. Podiatrists treat conditions of both the foot and ankle. If you have pain or questions about your feet, they are well qualified. Each podiatrist goes to a medical school specifically for foot and ankle. Today’s podiatrist also does a three year surgical residency. If you have consistent pain or problems, you don’t have to just live with them. Come see us and we can answer questions and give surgical and non surgical treatment options for anything from discolored or ingrown nails to bunions and fractures.
  2. Treat your whole family. Our podiatrists are well qualified to treat feet and ankles from birth. If you have questions about flat feet or otherwise bring your child so they can be answered. Some things may be normal, while others can be treated easily so that they may have decreased pain and less problems later on in life. No question is silly when it comes to children. Similarly the elderly are treated for calluses/corns, bunions hammertoes and more! Difficulty with balance is evaluated and many times can be addressed at the level of the foot and ankle. Of course active people also have foot issues at times as well. All can be treated in the same spot!
  3. Keep you on the road to success. Once your pain or problems are improved with treatment, a plan is made to reduce the risk of your problem coming back. Your podiatrist will educate you and give you the tools to know how to recognize the problem sooner in the future. Little to no pain is great, but if a few simple things can keep it away, we will let you know.
    Fenton Foot Care patient room

    Fenton Foot Care patient room

  4. Prevent major issues in the future. If you are diabetic, speaking with your podiatrist can open your eyes and make you look more at your feet. Diabetes can affect many body systems including blood flow, nerves, kidneys, healing time and eyes. Decreased sensation and decreased healing time can be a very bad combination causing ulcerations and sadly, amputation. An appointment to evaluate your risk and give you the tools to prevent future issues is very important.
  5. Make your back, hips, knees and feet feel better.  Much of the way we feel and walk depends on our feet. If our feet are not supported correctly it can put strain on the joints of the foot, ankle, knees, hips and back. The podiatrist can evaluate your walk and look at the bones of your foot with an xray to determine what type of support you need. Support can come in a variety of different ways including over the counter inserts, different types of shoes, braces and custom made orthotics. The doctors will find a plan that you like, are comfortable with wearing and provide maximum relief.

Dr. James Hirt and Dr. Erin Holdren Otis are podiatrists at Fenton Foot Care and Brighton Family Foot Care. They are ready to help you with your footcare needs. 

Do I have fungal nails?

fungusAre your nails are discolored, white, yellow, green, brown or black? Are they thicker than normal, loosen easily, lift up at the ends or sometimes fall off?

Discoloration can be caused by many things including fungus, yeast, mold, other chemicals like nailpolish. Trauma to the nail by dropping something on top of it, or the nail hitting your shoe repeatedly while walking, can cause thickness and an abnormal looking nail.

Fungus is common and is not caused by not been washing your feet properly. Even the cleanest most meticulous person can end up with fungal nails. The most common fungus that you have come in contact with is the Trichophyton rubrum fungus and it has unfortunately made a home under your nail. Fungus thrives in damp, warm and dark places, which includes your shoes, showers and swimming pools. The same fungus that causes fungal nails also causes athlete’s foot. The fungus can find its way into your skin through small cuts and into the nails if there is any subtle separation between the skin and the nail.

It is important before starting a treatment plan to know what you have a microorganism growing in your nail. This way the correct medication can be picked and you are not treating something that isn’t there looking for results. This is where your podiatrist comes into play. The doctor can take a biopsy of your nail and send it to a lab to be analyzed for what is causing your nail problem. This is usually a painless process. A couple different tests are run, one that takes a few days and the second that takes a couple weeks. Both tests combined give an answer about what is causing your nail to be abnormal and what you can do about it.

Both topical (placing the medication directly on the nail itself) and oral medications (pills which treat fungus from the inside out) are options for treatment and it is important to discuss with your podiatrist which one is right for you based on your lifestyle and the other medication you are taking.

Written by Dr. Holdren Otis. 

Frostbite Warning Signs

In the Podiatry world, it’s the start of frostbite season. As the snow begins to fall and the temperature begins to drop, for many reasons we are drawn outdoors.

Frostbite is the freezing of skin and other soft tissues. It occurs most frequently to exposed areas, but even toes and feet covered with boots are susceptible. Why?

Prolonged exposure to cold causes the tiny arteries that supply blood to our skin to constrict. They can constrict so much that blood can no longer pass. Without blood, the skin and soft tissues lack oxygen, called hypoxia, and begin to suffer.  Frostbite is the first sign. If the cold exposure continues, frostbite may progress to much more serious conditions such as gangrene.

Signs of frostbite are redness of the exposed skin or numbness of covered body parts.

Initial treatment of frostbite should be moving indoors to a warm place. Affected body parts should initially be warmed with body heat (ie. warm hands, arm pits, etc.).  Following this initial warming, a warm water bath should be used.

Avoid the following:

  1. Do not rub or massage the area.
  2. Do not walk on frostbitten feet until they are warmed.
  3. Do not use a heating lamp or pad.

You should be concerned if after a few hours of warming, the affected body part still demonstrates numbness or has a slight white or grey discoloration. If this is the case, medical treatment should be sought.

We are available and are experts in caring for frostbite of the feet. You can make an appointment by calling 810-629-3338 (FEET)

Peyton Manning-Bad Plantar Fasciitis vs Partial tear?

Dr. Holdren Otis

IMG_3289 (1)

The plantar fascia is a ligament on the bottom of the foot that goes from the heel bone to the bases of the toes

Manning is currently listed on the injury report as right shoulder, rib and left foot injury. There are differing reports about what caused him to leave the game Sunday after throwing 5 passes and 4 interceptions again the Kansas City Chiefs. Peyton Manning has struggled with plantar fasciitis over the season. 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. This tugging can cause microtears or worse a partial rupture of the fascia itself.  Pain in the morning and when getting up to walk after sitting for a period of time are common complaints. The heel is often painful when a person has to push off on the toes.

Treatment for microtears of plantar fasciits is much different from treatment of a partial or complete tear of the fascia. Microtears are treated with a decrease in activity, especially what causes the pain. The foot and arch itself needs to be supported with an arch strap or insert in the shoes so that the fascia doesn’t have to stretch so much with each step. The longer the symptoms have been around the longer it takes to make the pain go away. If the pain is not going away with diligent care for 6 months then a surgical procedure can be done through a scope to lengthen the fascia.

A partially torn plantar fascia is an uncommon injury but can be done with one forceful planting of the foot. Sometimes a pop is felt or heard with associated pain.  It is not possible to repair the plantar fascia surgically. Time and rest with gentle stretching are the main treatments.  Soft tissue, such as the plantar fascia, can take up to 8 weeks to fully heal. Immobilization with a walking boot or cast can help to heal it faster and is recommended for a fully ruptured plantar fascia. Once the fascia is healed light stretching and slowly getting back into activities is the best way to prevent a re-rupture. Peyton’s brother Eli Manning tore his fascia completely in 2009. There is no genetic link to pathology of the plantar fascia but they may have a similar foot type, along with high level athletics that would predispose them both to this issue.

Peyton Manning broke the record for the most passing of all time earlier in the game. For the sake fans of the Broncos and Peyton Manning hopefully microtears of the fascia along with the shoulder and ribs kept him out of the game and not something more serious like a partial or complete rupture.

The staff of Fenton Foot Care would like to thank all the veterans that have served on this Veterans Day.

Dr. Hirt in Boot Camp

Dr. Hirt in Boot Camp

A little history about Veterans Day: The day was first recognized as Armistice Day. It was the day an agreement was made to end World War I at 11:00 am on November 11, 1918.  The name was changed to Veterans Day and it was recognized a federal holiday in 1954. It is recognized as a day to honor all the men and women that have served in the armed forces in the US.


We would also like to thank Dr. James Hirt for his service in the Army National Guard.

Picture of Dr. Hirt’s graduating boot camp class, I bet no one can pick out Dr. Hirt.

Picture of Dr. Hirt’s graduating boot camp class, I bet no one can pick out Dr. Hirt.