What are flat feet?

Flat feet is a common condition, also known as flat foot, in which that arches on the inside of the feet flatten when pressure is put on them.

When tendons, ligaments, or bones of the feet are deformed or damaged, the arch flattens out. This places too much tension on the structures of the feet, creating further damage and pain.

Being flat-footed is common for children, but usually, the condition resolves by adulthood. When it’s not resolved, it can cause significant pain and altered mobility.

You may walk on the inner side of your foot, putting you at risk for other foot, ankle, and lower leg conditions. Surgery may be required to relieve pain and restore your ability to walk normally.

What are the symptoms of flat feet?

Ankle and arch pain often result from flat feet due to strained muscles and connecting ligaments. You may also feel pain in your:

  • Calves

  • Knees

  • Hips

  • Lower back

  • Lower legs

Your provider performs a thorough evaluation of your gait and may order screening tests, such as an MRI or X-rays, to determine whether flat feet or another disorder is causing your pain.

What causes flat feet?

Flat feet may develop from:

  • Obesity

  • Aging

  • Diabetes

  • Injury

  • Birth defect

  • Stretched or torn tendons

  • Damaged ankle, heel, or leg tendons

  •  Fractured or malformed bones

  •  Nerve conditions

  •  Rheumatoid arthritis

How are flat feet treated?

Once the cause is determined, your provider creates a plan of care that will help resolve your flat feet. Usually, treatment begins with nonsurgical options like:

  • Rest

  • Immobilization

  • Shoe inserts

  • Physical therapy

  • Specialized braces

When these treatments don’t resolve the pain or improve mobility, surgery may be indicated. 

What are the surgical interventions for flat feet?

Surgery may be an option to repair ligaments and tendons or it may require reconstruction, especially if the arch is collapsed. Options for surgery include:

Medializing calcaneal osteotomy

This procedure is used when the heel bone has shifted out from underneath the leg.

Lateral column lengthening

This is performed when the foot outwardly rotates.

First tarsal-metatarsal fusion

This procedure, also known as a medial cuneiform dorsal opening wedge osteotomy, helps when the arch collapse leads to the big toe side of the foot being raised above the ground.

Tendon and ligament procedures

These procedures correct a stretched and dysfunctional posterior tibial tendon.

Double or triple arthrodesis

Your provider may recommend this procedure in the later stages of flat feet, when the deformities are inflexible and arthritis may be present. It involves the fusion of one or more of the foot joints.

For expert treatment for flat feet and pain relief, call Arizona Foot Health or book an appointment online today.

Foot and Ankle Fractures:

Foot and ankle fractures can range from small to severe, A fracture where the bone is completely separated and misaligned is called a displaced fracture. A fracture where the bones remain intact is called and remain in their correct position and alignment are called a non-displaced fracture. A fracture and are a break are one in the same.

Fractures may present as a:

Lateral malleolus fracture

The knobby bump located on the outside of the ankle is known as the lateral malleolus. If you experience an ankle fracture. This is the most common ankle fracture.

Bimalleolar ankle fracture

The knobby bump located on the inside of the ankle is known as the medial malleous . A Bimalleolar ankle fracture occurs when you break in both the lateral malleolus and the medial malleolus.

Trimalleolar ankle fracture

A Trimalleour is when you break three sides of the ankle.

Pilon fracture

A Pilon fracture through the “roof” of the ankle (the central portion of the lower tibia). This type of fracture is usually caused by a fall.

What are stress fractures?

Stress fractures are usually caused by repetitive motion. These type of fracture doesn’t go all the way across the bone. If immediate treatment conducted is could potentially get worse.

Stress fractures are most common in the metatarsals, these bones are located at the top of your foot.

What are the symptoms of a foot or ankle fracture?

Depending on the type and location of the fracture usually will determine the range of pain. The range could be minimal or mildly annoying to completely debilitating,. If you have a fracture, it hard to bear weight on your foot or ankle. It may also result in swelling and bruising .

The symptoms of a fracture can be quite similar to those of a sprained ankle. It is often hard to diagnose yourself so if you are experiencing any of these symptoms, please call our office and make an appointment. We will conduct testing and imaging to properly diagnosis and treat you.

What is the treatment for foot and ankle fractures?

It is imperative that you get treatment for a suspected fracture as soon as possible. The sooner you get treatment, the better your chance of avoiding future complications, such as ankle arthritis.

In many cases, your treatment may not require surgery. You may need a splint or orthotics or a cast to help your bones heal naturally. An important part of the recovery process is rest. Over use during the healing process may result re-injury. Limiting exercise is also advise before you’re fully healed.

Displaced fracture of the foot or ankle, you require surgery. During surgery your provider will reset and align your bone and supports it with a splint or cast. Displaced fractures as with stress fractures, it’s important that you adhere to all of your recovery guidelines for optimal healing.


What is a hammertoe?

A hammertoe is a result of an imbalance in the soft tissue surrounding your toe, including your tendons, ligaments, and muscles.

Hammertoes usually develop in your second and third toes and cause your toe to bend upward at the middle joint. The condition is progressive, and in its most advanced stages, your toe can become frozen into a hammer-like position, preventing you from straightening it back out.

Hammertoes can also cause painful corns and calluses to form on top of your joint as it comes into increasing contact with your footwear.

What causes hammertoe?

Hammertoes can develop for several reasons, chief among them:

  • High-heeled shoes with pointy toes

  • A natural imbalance in your soft tissue

  • Trauma to your toe

There are also several factors that may put you more at risk of developing hammertoes, including:

  • Sex — women are more prone to the condition

  • Age — the older you get, the more vulnerable you are to hammertoe

  • Toe length — longer second and third toes are more prone to hammertoe

  • Pre-existing diseases — arthritis and diabetes

If you develop a hammertoe, it’s important that you seek help quickly as possible to prevent the condition from progressing and creating secondary problems, such as corns and calluses.

How is hammertoe treated?

During your visit, your doctor will assess the extent of your hammertoe and come up with a treatment plan that may include one or more of the following:

  • Changes in footwear

  • Custom orthotics

  • Stretching exercises

Keep in mind that wear the correct shoes prior to and especially after being diagnosed with hammer toe will reduce the chances of it getting worse.

Also if your hammertoe has progressed to the point where you’re unable to straighten your toe surgery may be the only option to release the tendon that is causing this issue.

Achilles Tendonitis

What is the Achilles Tendon?.

The Achilles tendon also called the Calcaneal Tendon is the largest tendon in the body. It is a strong fibrous cord that connects the muscle in the back of your calf to your heel. It is used for various physical activities such as walking, running, sprinting and jumping.

This tendon can withstand a lot of stress and due to this its not uncommon for it to become irritated or inflamed. Because it can withstand great stress, it is particularly prone to develop inflammation, resulting in Achilles tendon pain. This inflammation and pain is called Tendonitis. Athletes, long distance runners and sprinters are proned to getting Achilles tendonitis or even worse, Achilles rupture.

There are two types of Achilles tendonitis:

  • Mid substance or Non Insertional Achilles Tendonitis – Occurs in the middle portion of the tendon

  • Insertional Achilles Tendonitis – Occurs where the large tendon connects to the heel bone

Symptoms of Achilles Tendonitis:

  • Pain – Aching, stiffness, or soreness within the Achilles tendon. The pain may occur anywhere from the calf to the heel. Pain that worsen with exercise or feel worse in the morning.

  • Tenderness – Moderate to severe pain when the two sides of the tendon are squeezed or touched.

  • Bone Spur (insertional tendonitis)

  • Nodule(s) behind the damaged tissue may form when the disorder progresses to degeneration.

  • Tendon Thickening – Thickening of the Achilles tendon.

Causes or Risk Factors for Achilles Tendonitis

Achilles tendonitis is usually not caused by a specific injury. It typically occurs due to repetitive stress on the Achilles tendon. Repetitive stressful motion, exercise or over exertion within a short amount of time could put too much stress on the tendon causing tendonitis.

However, there are other risk factors that may cause Achilles tendinitis to develop, including:

  • Bone growth or spur – Extra bone growth where the tendon attaches to the heel, which can rub against the tendon and cause pain.

  • Tight calf muscle(s) – Having tight calf muscles to begin with and abruptly starting an aggressive exercise program.

Treatment Options for Achilles Tendinitis:

The good news is that there are several non-surgical treatment options for Achilles tendonitis:

  • Immobilization – May include the use of a cast or removable brace that will help with healing.

  • Ice – Applying ice on and off may help to reduce the inflammation and swelling of the Achilles tendon. ( 2o minute intervals )

  • Medications – There are several OTC medications such as nonsteroidal anti-inflammatory medications (NSAIDs) that useful in reducing swelling and inflammation.

    . Orthotics or Inserts – These are especially for those who suffer from overpronation of the foot, which is caused by having abnormal gait or uneven body weight distribution that presses down on the foot causing pain.

  • Splinting – Splinting at night to stretch the Achilles tendon during sleep. This will help decrease morning pain associated with Achilles tendonitis.

  • Physical Therapy (PT) – Stretches and exercises focused on rehabilitation of the Achilles tendon.

Surgical Treatment Options for Achilles Tendonitis & Achilles Rupture

If non-surgical procedures have not worked, surgery maybe an option. Surgical repair of the tendon may depend on the extent of the injury. Other factors may need to be considered like the age of the person or the persons activity.

Surgery and Immobilization are necessary when the Achilles tendon ruptures. However, immobilization is also a common treatment option, using a cast, splint, brace, walking boot, or other device keeps the lower leg and ankle from moving. This allows for the ends of the Achilles tendon to reattach and heal. While surgery and immobilization are often very successful options for a ruptured Achilles tendons. Usually after this surgery a future rupture is less likely to occur. That is why this option is recommended over the immobilization method.

Surgery for Mid substance or Non insertional Achilles Tendonitis

The recommendation mid substance or non insertional Achilles tendonitis is surgery. This surgery will focus on removing the bad portion of the tendon. Surgery will consist of removing the tendon that goes to the big toe to support the Achilles tendon. During surgery, the surgeon will examine the Achilles tendon and calf muscles, if he determines that they are too tight, he or she surgery may also focus on lengthening them.

Surgery for Insertional Achilles Tendonitis

During this type of surgery diseased tissue is removed. The tendon is repaired down to the heel bone. The surgeon will remove any bone spurs smoothing out the bone. This procedure will prevent spur from rubbing against the Achilles tendon and irritating it or causing damage. Also located in this area under the Achilles tendon is fluid filled sack called a Bursa. When this becomes inflamed it is called Bursitis, this will also cause severe pain. During surgery this sac may also be removed, reducing your pain.

What is Plantar Fasciitis?

At the very base of your foot is a band of tissue called the plantar fascia, This tissue runs from the base of your toes to your heel. This tissue is pulled extremely taut, which is what gives you the springy support along the bottom of your foot and in your arches.

When this tissue becomes inflamed, it is known as plantar fasciitis. Plantar faciitis causes severe, stabbing pain in your heels and along your foot, especially during your first few steps in the morning or when you get up after a long period off your feet. The pain usually only lasts for a few steps as your inflamed plantar fascia stretches back out.

What causes plantar fasciitis?

While the cause of plantar fasciitis is tiny tears or stresses in the tissue that leads to swelling, what’s behind those tears and damage in the tissue is usually tied back to:

  • Structural irregularities in your feet

  • Spending long periods on your feet

  • Engaging in concussive activities, like running

  • Carrying extra weight

  • Age (the older you get, the more prone your tissue is to wear-and-tear)

While plantar fasciitis isn’t necessarily a dangerous condition, the pain it causes can be moderate to severe. These condition usually dont go away on its own unless you seek professional help.

How is plantar fasciitis treated?

You doctor will examine your feet and review your symptoms to confirm if plantar fasciitis is the correct diagnosis. There are treatments designed to provide you with long-term relief.

With a combination of exercises that gently stretch your plantar fascia, orthotics, and splints Golub is able to address the immediate problem. For longer-term results, he goes a step further and offers amniotic growth factor injections to encourage tissue repair and rebuilding on a cellular level.

What is a sprained ankle?

Your ankle is a joint where three bones come together, which are supported by a host of soft tissue components, including:

  • Tendons

  • Muscles

  • Ligaments

While your ligaments are designed to allow movement, when they’re pushed past their breaking point, they can stretch or tear, which leads to a sprained ankle.

What causes a sprained ankle?

Most sprained ankles occur on the outside of your ankle and are often a result of:

  • Rolling your ankle to the outside

  • Landing incorrectly

  • Exercising on an uneven surface

  • Trauma to your ankle, like a collision on the playing field

Sprained ankles can occur at any time. Walking, running or simply stepping on or off a curb awkwardly can lead to a sprained ankle.

What are the signs of a sprained ankle?

The first thing you’ll likely notice is pain, especially when you place weight on your foot. You may also experience:

  • Swelling

  • Bruising

  • Tenderness

  • Limited range of motion

  • Inability to bear weight

These symptoms could develop quickly , or develop within over time.

How is a sprained ankle treated?

If you suspect that you have sprained your ankle, you should immediately apply the RICE method, which is:

  • Rest

  • Ice

  • Compression

  • Elevation and the appropriate treatment.


During your visit imaging of the injured area will be conducted to see the extent of the damage or if there another issues along with the sprain. If it is determined that it is just a sprain he may recommend one or more of the following treatments.

  • Continuing the RICE method

  • Medications for the pain and inflammation

  • Splinting, wrapping, or bracing

  • Crutches, if necessary

  • Physical therapy



What is an ingrown toenail?

An ingrown toenail is a condition in which the toenail, most often on your big toe, grows into the flesh along the outer edges, rather than up and over it. An ingrown toenail can cause inflammation and tenderness and pain that prevents you from wearing shoes of any kind. Ingrown toenails can become so painful that the slightest touch or bump can cause excruciating pain.

What causes an ingrown toenail?

  • Trimming your nails incorrectly

  • Shoes that crowd your toes

  • Unusually curved toenails

  • An injury to your toe

It is not uncommon for people to develop more than one ingrown toenail.

How are ingrown toenails treated?

The doctor will trim away a piece of the nail that is growing into into your flesh. They will numb the area with a local anesthetic so when the section of the nail is removed it will not cause you any discomfort.

If you have persistent with ingrown toenail problems, they may remove the root of the root of the nail so that it doesn’t grow back and become ingrown again. During this procedure the whole nail is not removed just the outer edges. This procedure leaves the rest of your toenail intact.

Why shouldn’t I treat an ingrown toenail on my own?

Ingrown toenails are very painful. If you try to remove it yourself you may cause more harm that good. If you clean the area and perform the procedure properly, you could damage the surrounding skin of the area could become infected which could lead to other serious issues.

This is especially important if you have a condition like diabetes, where any small problem in your feet can blossom into a major issue if not properly treated.


Lymphedema is swelling due to build-up of lymph fluid in the body. Lymph nodes act like a drain in your sink. If the drain is clogged, the fluid cannot drain. It usually happens in the arms or legs, but can occur in other parts of the body. Lymph fluid is part of the lymph system that carries fluid and cells that help fight infections throughout the body. Sometimes this swelling develops quickly, or it may develop slowly over several months.