According to the American Diabetes Association (ADA), diabetes is a condition that affects approximately 23.6 million Americans. Around 750,000 new cases are diagnosed each year, and the disease’s most common form, Type 2 diabetes, makes up for 90 to 95 percent of these cases. Type 2 diabetes is especially prevalent among older Americans, those who are obese, and those who lead sedentary lifestyles.
Complications of the disease may lead to several foot and ankle-related conditions. The loss of nerve sensation, or neuropathy, can cause diabetics to lose feeling at the bottom of the feet and therefore leave them unaware of pain, pressure, and heat. Decreased circulation is another complication of diabetes that can slow down the healing of wounds and injuries; this can lead to the development of foot ulcers.
To prevent foot ulcers from forming, diabetics should examine their feet every day for small cuts and wear shoes that curtail pressure. Constant monitoring for the risk factors associated with ulcer formation can allow for early detection and therefore lessen the possibility of ulcers or, even worse, amputation. The removal of calluses and ingrown toenails should be left to the podiatrist to avoid improper removal and possible infection.
Diabetic patients may also experience foot deformities due to complications in their feet, such as limited joint mobility, muscle atrophy, and decreased fat padding. These complications can increase pressure in certain areas of the foot, which in turn can cause certain deformities, such as hammertoe, to form. Another deformity, Charcot foot, develops due to the collapsing of microfractures in the bones of the feet. The resulting deformity is a foot that is flattened and wider in appearance.
To help minimize pressure and prevent the development of these diabetes-related foot and ankle conditions, your podiatrist may consider using orthotics or special shoes. Charcot foot may be treated using walkers, custom orthotic insoles, or non-weight-bearing or rigid weight-bearing casts or braces. In more serious cases, surgery may be considered to treat more developed deformities. Ulcers can be further cared for with the help of proper diet, medication to control glucose, intensive wound care, and infection treatment.

Diabetes can lead to a range of serious foot problems due to its impact on circulation and nerve function. One of the most common complications is neuropathy, which causes tingling, numbness, or pain and reduces the ability to feel injuries. Peripheral artery disease can further restrict blood flow, slowing healing, and increasing the risk of infection. Foot ulcers may develop from unnoticed cuts or pressure points and can become severe without prompt care. Diabetic blisters, although painless, can appear suddenly and may become infected if not treated properly. Additionally, edema, or swelling in the feet and ankles, is another frequent issue and may indicate worsening circulation. If you have diabetes, it is strongly suggested that you consult a podiatrist who can provide proper foot care and regular checkups, which are essential for managing diabetes and preventing long-term complications.
Diabetic foot care is important in preventing foot ailments such as ulcers. If you are suffering from diabetes or have any other concerns about your feet, contact Vincent, Vess from Fourth River Foot & Ankle. Our doctor can provide the care you need to keep you pain-free and on your feet.
Diabetic Foot Care
Diabetes affects millions of people every year. The condition can damage blood vessels in many parts of the body, especially the feet. Because of this, taking care of your feet is essential if you have diabetes, and having a podiatrist help monitor your foot health is highly recommended.
The Importance of Caring for Your Feet
- Routinely inspect your feet for bruises or sores.
- Wear socks that fit your feet comfortably.
- Wear comfortable shoes that provide adequate support.
Patients with diabetes should have their doctor monitor their blood levels, as blood sugar levels play such a huge role in diabetic care. Monitoring these levels on a regular basis is highly advised.
It is always best to inform your healthcare professional of any concerns you may have regarding your feet, especially for diabetic patients. Early treatment and routine foot examinations are keys to maintaining proper health, especially because severe complications can arise if proper treatment is not applied.
If you have any questions please feel free to contact our offices located in Pittsburgh, White Oak, and McKeesport,PA . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.

A hammertoe develops when the middle joint of one of the smaller toes bends downward, often due to muscle and tendon imbalances in the foot. It is commonly linked to wearing high-heeled or narrow shoes. People with long toes, flat feet, bunions, or a family history of foot deformities may also be more likely to have a hammertoe. Early symptoms include discomfort, swelling, and the formation of corns where the toe rubs against footwear. A podiatrist can examine the foot and use imaging tests to determine if the toe is still flexible or has become rigid. For flexible hammertoes, medical treatment may include switching to shoes with a wide toe box or using custom orthotic devices to support the foot and relieve pressure. When the deformity becomes fixed or painful, surgery may be recommended. Procedures to restore alignment include tendon lengthening, tendon transfer, or arthrodesis, which involves removing part of the joint to fuse the bones and straighten the toe. If you experience pain from a hammertoe deformity, it is suggested that you schedule an appointment with a podiatrist for regular treatment.
Hammertoe
Hammertoes can be a painful condition to live with. For more information, contact Vincent, Vess from Fourth River Foot & Ankle. Our doctor will answer any of your foot- and ankle-related questions.
Hammertoe is a foot deformity that affects the joints of the second, third, fourth, or fifth toes of your feet. It is a painful foot condition in which these toes curl and arch up, which can often lead to pain when wearing footwear.
Symptoms
- Pain in the affected toes
- Development of corns or calluses due to friction
- Inflammation
- Redness
- Contracture of the toes
Causes
Genetics – People who are genetically predisposed to hammertoe are often more susceptible
Arthritis – Because arthritis affects the joints in your toes, further deformities stemming from arthritis can occur
Trauma – Direct trauma to the toes could potentially lead to hammertoe
Ill-fitting shoes – Undue pressure on the front of the toes from ill-fitting shoes can potentially lead to the development of hammertoe
Treatment
Orthotics – Custom made inserts can be used to help relieve pressure placed on the toes and therefore relieve some of the pain associated with it
Medications – Oral medications such as anti-inflammatories or NSAIDs could be used to treat the pain and inflammation hammertoes causes. Injections of corticosteroids are also sometimes used
Surgery – In more severe cases where the hammertoes have become more rigid, foot surgery is a potential option
If you have any questions please contact our offices located in Pittsburgh, White Oak, and McKeesport,PA . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Hammertoes are painful deformities that frequently form on the second, third, or fourth toe. The condition is often caused by an issue in foot mechanics. This can be caused by the person’s specific gait or the manner in which they walk, or by shoes that do not comfortably fit the deformity. Hammertoes can be formed after wearing shoes that are too narrow or short for the foot or have excessively high heels. Shoes that are not properly sized will force the toes into a bent position for long periods of time. This can cause the muscles to shorten and toes to bend into the deformity of a hammertoe.
Hammertoe can also be caused by complications from rheumatoid arthritis, osteoarthritis, trauma to the foot, heredity, or a cerebral vascular accident. Pain and difficult mobility of the toes, deformities, calluses, and corns are all symptoms of a hammertoe.
Someone who suspects they have the symptoms of a hammertoe should consult with a physician—particularly a podiatrist. Podiatrists diagnose and treat complications of the foot and ankle. If the podiatrist discovers that the affected toes are still flexible, treatment for the hammertoe may simply involve exercise, physical therapy, and better-fitting shoes. Treatment for hammertoes typically involves controlling foot mechanics, such as walking, through the use of customized orthotics.
For more serious cases in which the toes have become inflexible and rigid, surgery may be suggested. During the operation, the toe would receive an incision to relieve pressure on the tendons. A re-alignment of the tendons may then be performed by removing small pieces of bone to straighten the toe. In some cases, the insertion of pins is needed to keep the bones in the proper position as the toe heals. The patient is usually allowed to return home on the same day as the surgery.
If surgery is performed to repair a hammertoe, following the postoperative directions of your doctor is essential. Directions may include several stretches, picking up marbles with your toes, or attempting to crumple a towel placed flat against your feet. Wear shoes that have low heels and a wide amount of toe space to maintain comfort. Closed-toe shoes and high heels should be avoided. Shoes with laces allow the wearer to adjust how fitted he or she may want the shoes to be and also allow for greater comfort. To provide adequate space for your toes, select shoes that have a minimum of one-half inch of space between the tip of your longest toe and the inside of the shoe. This will also relieve pressure on your toes and prevent future hammertoes from forming.
Other preventative measures that can be taken include going shopping for new shoes in the middle of the day. Your feet are its smallest in the morning and swell as the day progresses. Trying on and purchasing new shoes midday will give you the most reliable size. Be sure to check that the shoes you purchase are both the same size. If possible, ask the store to stretch out the shoes at its painful points to allow for optimum comfort.

Plantar fasciitis is one of the most common causes of heel pain, affecting people of all ages. It occurs when the plantar fascia, the thick band of tissue running along the bottom of your foot, becomes inflamed. Causes include overuse, wearing poor footwear, high-impact activities, or having either flat feet or high arches. Symptoms typically include a sharp, stabbing pain in the heel, especially with the first steps in the morning or after long periods of rest. The pain often improves with movement, but may return after standing or walking for long periods of time. A podiatrist can help by diagnosing the condition through a physical exam and imaging. Treatment includes custom orthotics, stretching exercises, a night splint, or anti-inflammatory medication. In some cases, injections, or even surgery, may be recommended to reduce inflammation and promote healing. If you have this condition, it is suggested that you schedule an appointment with a podiatrist for appropriate treatment.
Plantar fasciitis can be very painful and inconvenient. If you are experiencing heel pain or symptoms of plantar fasciitis, contact Vincent, Vess from Fourth River Foot & Ankle. Our doctor can provide the care you need to keep you pain-free and on your feet.
What Is Plantar Fasciitis?
Plantar fasciitis is the inflammation of the thick band of tissue that runs along the bottom of your foot, known as the plantar fascia, and causes mild to severe heel pain.
What Causes Plantar Fasciitis?
- Excessive running
- Non-supportive shoes
- Overpronation
- Repeated stretching and tearing of the plantar fascia
How Can It Be Treated?
- Conservative measures – anti-inflammatories, ice packs, stretching exercises, physical therapy, orthotic devices
- Shockwave therapy – sound waves are sent to the affected area to facilitate healing and are usually used for chronic cases of plantar fasciitis
- Surgery – usually only used as a last resort when all else fails. The plantar fascia can be surgically detached from the heel
While very treatable, plantar fasciitis is definitely not something that should be ignored. Especially in severe cases, speaking to your doctor right away is highly recommended to avoid complications and severe heel pain. Your podiatrist can work with you to provide the appropriate treatment options tailored to your condition.
If you have any questions please feel free to contact our offices located in Pittsburgh, White Oak, and McKeesport,PA . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
The plantar fascia is a connective tissue in the heel that stretches across the bottom length of your foot. Plantar fasciitis occurs when the connective tissue becomes inflamed, causing heel pain and discomfort during physical activity. Although the condition is completely treatable, traditional methods can take up to a year to start becoming effective.
Plantar fasciitis is caused by a number of everyday activities, so understanding the condition is important for managing and treating it. One of the most common causes of plantar fasciitis is excessive running, especially with improper fitting or non-supportive shoes. Too much exercise can lead to the plantar fascia being overworked and overstretched, which can cause tears in the tissue. Along with improper fitting shoes, pronation, the rolling of the feet inward, is a common cause of plantar fasciitis. If not treated properly, the plantar fascia becomes overstretched and starts to tear, causing inflammation.
Despite the common causes of plantar fasciitis, there are many different treatment options. For less severe cases, conservative home remedies include taking anti-inflammatory drugs to alleviate pain, applying ice packs to the bottom of your foot and heel, slowly stretching and exercising your feet to re-strengthen the tissue, and using orthotic devices are all ways to help manage your plantar fasciitis.
For more severe cases, shockwave therapy has become a common solution for plantar fasciitis. Shockwave therapy can effectively break up the tissue on the bottom of your foot which facilitates healing and regeneration. This fights the chronic pain caused by plantar fasciitis. Even if this doesn’t work, surgery is always a final option. Surgery on the tissue itself can be done to permanently correct the issue and stop the inflammation and pain in your heels.
No matter what the case may be, consulting your podiatrist is the first and best step to recovery. Even the slightest amount of heel pain could be the first stage of plantar fasciitis. Untreated symptoms can lead to the tearing and overstretching of tissue. Because the tearing of tissue can be compounded if it remains ignored, it can evolve into a severe case. The solution is early detection and early treatment. Talk to your podiatrist about the possibilities of plantar fasciitis if you’re experiencing heel pain.

Foot fractures can sometimes be mistaken for ankle sprains because both injuries cause pain, swelling, and difficulty walking. A fracture happens when a bone in the foot breaks, either from a sudden injury or repeated stress over time. An ankle sprain, on the other hand, involves stretched or torn ligaments. Since the symptoms can look very similar, it is easy to miss a fracture without proper evaluation. A podiatrist will ask how the injury happened and examine the foot for tenderness, bruising, and movement issues. Imaging tests like X-rays are usually needed to confirm whether a bone is broken. Missing a fracture can lead to delayed healing, ongoing pain, or long-term foot problems. If you have an injury that is not improving as expected, or the pain seems worse than a typical sprain, it is suggested that you see a podiatrist for an accurate diagnosis and appropriate treatment.
Broken ankles need immediate treatment. If you are seeking treatment, contact Vincent, Vess from Fourth River Foot & Ankle. Our doctor can provide the care you need to keep you pain-free and on your feet.
Broken Ankles
A broken ankle is experienced when a person fractures their tibia or fibula in the lower leg and ankle area. Both of these bones are attached at the bottom of the leg and combine to form what we know to be our ankle.
When a physician is referring to a break of the ankle, he or she is usually referring to a break in the area where the tibia and fibula are joined to create our ankle joint. Ankles are more prone to fractures because the ankle is an area that suffers a lot of pressure and stress. There are some obvious signs when a person experiences a fractured ankle, and the following symptoms may be present.
Symptoms of a Fractured Ankle
- Excessive pain when the area is touched or when any pressure is placed on the ankle
- Swelling around the area
- Bruising of the area
- Area appears to be deformed
If you suspect an ankle fracture, it is recommended to seek treatment as soon as possible. The sooner you have your podiatrist diagnose the fracture, the quicker you’ll be on the way towards recovery.
If you have any questions, please feel free to contact our offices located in Pittsburgh, White Oak, and McKeesport,PA . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Broken ankles or “ankle fractures” are injuries that occur when the bones that make up the ankle joint are broken. Ankle injuries are some of the most common bone and joint injuries. The ankle joint is made up of three bones that join. The tibia is the main bone, and it makes up the inside of the anklebone. The fibula is a smaller bone, and it makes up the outside of the anklebone. A membrane called the joint capsule is lined with a layer called the synovium, which covers the entire joint. The synovium produces synovial fluid which allows for the joint surfaces to move.
An ankle becomes broken when the joint is stressed beyond the strength of its limits. When an ankle is fractured, ligaments may also tear at the same time. Fractures often occur to the ankle rolling or twisting in an unusual way. At times, a fracture may even be caused by an extreme force applied to the joint.
Symptoms of a broken ankle include pain, swelling, bruising, discoloration, numbness, and an inability to move the toes. If you have a broken ankle, you may also hear something tear or snap when you initially suffered the injury. If you have pain from a broken ankle, beware that the pain will not always come from the exact area of the fracture; you may also experience pain from associated foot fractures. The swelling you may experience can suggest that soft tissue damage may have occurred due to the injury.
There are differences between an ankle fracture and an ankle sprain. The difference is that a fracture or break in the bone is required to classify an injury as a broken ankle. An ankle sprain occurs when there is a tear or disruption of ligaments in the ankle. In some cases, the prognosis of an ankle sprain may be worse than that of a fracture.
X-rays are the most common way to diagnose a broken ankle. X-rays show if the ankle is broken and where exactly the fracture is located. It will also show how many pieces of broken bone there are. A second method of testing to see if an ankle is broken is a stress test. To do this, the doctor will put pressure on the ankle and perform a stress test to determine if the fracture requires surgery. Other methods for diagnosis include CT scans and MRI scans.
If you are suffering from a broken ankle, consult with your podiatrist immediately to receive a proper diagnosis and treatment.

As people age, maintaining ankle strength and balance becomes essential for staying mobile and independent. Weakness in the feet and ankles can lead to instability, making everyday movements riskier and increasing the likelihood of falls. Gentle exercises that target the small muscles in the feet and the supportive structures surrounding the ankle can lead to noticeable improvements in strength, coordination, and confidence while walking. These exercises do not require special equipment and can often be done while sitting or holding onto a chair for balance. With regular practice, older adults may find they move with more ease, recover more quickly from stumbles, and feel more secure in navigating uneven surfaces. Strengthening this often-overlooked part of the body plays a valuable role in falls prevention and overall wellness. If you have sustained a foot or ankle injury, or are concerned about balance or ankle weakness, it is suggested that you see a podiatrist.
Preventing falls among the elderly is very important. If you are older and have fallen or fear that you are prone to falling, consult with Vincent, Vess from Fourth River Foot & Ankle. Our doctor will assess your condition and provide you with quality advice and care.
Every 11 seconds, an elderly American is being treated in an emergency room for a fall related injury. Falls are the leading cause of head and hip injuries for those 65 and older. Due to decreases in strength, balance, senses, and lack of awareness, elderly persons are very susceptible to falling. Thankfully, there are a number of things older persons can do to prevent falls.
How to Prevent Falls
Some effective methods that older persons can do to prevent falls include:
- Enrolling in strength and balance exercise program to increase balance and strength
- Periodically having your sight and hearing checked
- Discuss any medications you have with a doctor to see if it increases the risk of falling
- Clearing the house of falling hazards and installing devices like grab bars and railings
- Utilizing a walker or cane
- Wearing shoes that provide good support and cushioning
- Talking to family members about falling and increasing awareness
Falling can be a traumatic and embarrassing experience for elderly persons; this can make them less willing to leave the house, and less willing to talk to someone about their fears of falling. Doing such things, however, will increase the likelihood of tripping or losing one’s balance. Knowing the causes of falling and how to prevent them is the best way to mitigate the risk of serious injury.
If you have any questions, please feel free to contact our offices located in Pittsburgh, White Oak, and McKeesport,PA . We offer the newest diagnostic and treatment technologies for all your foot care needs.