Pain deep in the back of the ankle may come from a small extra bone called the os trigonum. This bone develops when a small section of the talus, the main ankle bone, remains separate as a child grows. Most people with this extra bone never experience symptoms. However, an ankle injury or repeated downward pointing of the toes may pinch the bone and nearby tissue. The resulting irritation is called os trigonum syndrome. Ballet dancers, soccer players, and runners face increased risk because their activities repeatedly place the ankle in positions that squeeze this area.

Symptoms include pain behind the ankle, swelling, and tenderness. Pointing the toes or pushing off the foot usually makes the discomfort worse. Some patients also notice stiffness that limits ankle movement. Pain may develop gradually with repeated activity or appear after an ankle sprain. Because these symptoms resemble Achilles tendon problems and other ankle injuries, an accurate diagnosis is important. A podiatrist reviews the patient's activities and injury history before examining the painful area. The examination includes checking ankle movement and locating tenderness. X-rays reveal the extra bone, while an MRI provides more detail about inflammation and nearby tissue. Finding an os trigonum on an X-ray alone does not prove it causes the pain.

Treatment focuses on relieving pressure and settling inflammation. A podiatrist may prescribe a walking boot to restrict painful ankle movement and protect the irritated area. Treatment also includes assessing whether a brace would provide appropriate support. Follow-up visits help the podiatrist track healing and guide a gradual return to activity. When symptoms persist, surgery to remove the extra bone offers another option. The podiatrist explains the procedure and expected recovery based on the patient's condition and activity goals. If you have symptoms of os trigonum syndrome, it is suggested that you schedule an appointment with a podiatrist for a diagnosis and appropriate treatment.

Some foot conditions may require additional professional care. If you have any concerns, contact Katie Besselman, DPM of Advanced Podiatry. Our doctor can provide the care you need to keep you pain-free and on your feet.

Rare Foot Conditions

The majority of foot conditions are common and can be treated by a podiatrist.  Standard diagnostic procedures are generally used to identify specific conditions and treatment can be rendered. A podiatrist also treats rare foot conditions which can be difficult to diagnose and may need extra attention and care. 

There are many rare foot conditions that can affect children. Some of these can include:

• Freiberg’s disease
• Kohler’s disease
• Maffucci syndrome

Freiberg’s disease - This can be seen as a deterioration and flattening of a metatarsal bone that exists in the ball of the foot. It typically affects pre-teen and teenage girls, but can affect anyone at any age. Symptoms that can accompany this can be swelling, stiffness, and the patient may limp. 

Kohler’s disease - This often targets the bone in the arch of the foot and affects younger boys. It can lead to an interruption of the blood supply which ultimately can lead to bone deterioration. The patient may limp or experience tenderness, swelling, and redness.

Maffucci syndrome - This affects the long bones in a child’s foot leading to the development of abnormal bone lesions. They are benign growths and typically develop in early childhood and the bones may be susceptible to breaking. 

A podiatrist can properly diagnose and treat all types of rare foot conditions. If your child is affected by any of these symptoms or conditions, please don’t hesitate to call our office so the correct treatment method can begin.

If you have any questions, please feel free to contact our office located in Saint Peters, MO . We offer the newest diagnostic and treatment technologies for all your foot care needs.

Heel pad syndrome develops when the natural fat pad beneath the heel becomes irritated, worn, or less able to absorb impact. This cushioning normally protects the heel bone from pressure during walking and running. When the heel pad does not provide enough protection, each step can feel uncomfortable. A common symptom is deep pain in the middle of the heel. Many people describe the sensation as feeling like a bruise on the bottom of the foot. Pain may become more noticeable after standing or walking on hard surfaces.

Several factors increase the risk of heel pad syndrome. Age is an important factor because the heel pad can become thinner and less flexible over time. Foot structure may also affect how pressure is distributed during movement. Running, prolonged standing, and walking on hard surfaces can repeatedly load the heel pad. Wearing unsupportive footwear may further increase pressure and reduce natural cushioning.

Symptoms can vary depending on how much stress the heel experiences. Deep heel pain may appear after exercise or a long day on your feet. The center of the heel may feel tender when pressed, especially after repeated impact. Rest may reduce symptoms, but pain can return when normal activity resumes. Recognizing these changes early helps prevent ongoing irritation and makes it easier to protect the heel during daily activities.

A podiatrist will examine the heel and determine whether heel pad syndrome is causing your pain. The evaluation may include checking tenderness, foot structure, and footwear. Imaging may be recommended when another heel problem needs to be ruled out. Treatment options include wearing cushioned footwear, heel cups, and methods to reduce pressure. A podiatrist may also recommend gradual changes to exercise and daily routines while the heel recovers. If you have persistent heel pain, it is suggested that you consult a podiatrist who can accurately diagnose and treat heel pad syndrome. 

Many people suffer from bouts of heel pain. For more information, contact Katie Besselman, DPM of Advanced Podiatry. Our doctor can provide the care you need to keep you pain-free and on your feet.

Causes of Heel Pain

Heel pain is often associated with plantar fasciitis. The plantar fascia is a band of tissues that extends along the bottom of the foot. A rip or tear in this ligament can cause inflammation of the tissue.

Achilles tendonitis is another cause of heel pain. Inflammation of the Achilles tendon will cause pain from fractures and muscle tearing. Lack of flexibility is also another symptom.

Heel spurs are another cause of pain. When the tissues of the plantar fascia undergo a great deal of stress, it can lead to ligament separation from the heel bone, causing heel spurs.

Why Might Heel Pain Occur?

• Wearing ill-fitting shoes                
• Wearing non-supportive shoes
• Weight change           
• Excessive running

Treatments

Heel pain should be treated as soon as possible for immediate results. Keeping your feet in a stress-free environment will help. If you suffer from Achilles tendonitis or plantar fasciitis, applying ice will reduce the swelling. Stretching before an exercise like running will help the muscles. Using all these tips will help make heel pain a condition of the past.

If you have any questions, please feel free to contact our office located in Saint Peters, MO . We offer the newest diagnostic and treatment technologies for all your foot care needs.

Plantar fasciitis develops when the plantar fascia becomes irritated. The plantar fascia is a strong band of tissue that runs along the bottom of the foot from the heel toward the toes. It helps support the arch and absorbs stress when standing or walking. Repeated strain on this tissue leads to heel pain and tenderness. Factors that contribute include long periods of standing, increased physical activity, and changes in foot structure. Shoes that lack proper support also place added stress on the plantar fascia. Pain is usually felt near the bottom of the heel. It is especially noticeable with the first steps after getting out of bed or after sitting for an extended period.

A podiatrist evaluates plantar fasciitis by examining the foot and identifying areas of pain or tenderness. An examination includes checking the arch, ankle movement, and foot flexibility. The podiatrist also observes how the patient stands and walks in order to identify movement patterns that could place added stress on the plantar fascia. Treatment is focused on reducing strain while improving foot support and function. Custom orthotics help distribute pressure more evenly and support the arch. A podiatrist may recommend shoes that provide appropriate cushioning and support. Targeted treatment also improves flexibility and addresses tight tissues that contribute to heel discomfort.

Plantar fasciitis makes standing, walking, and completing daily activities uncomfortable. Patients can change the way they walk to avoid pressure on the painful heel, which places additional stress on other areas of the foot. A podiatrist identifies these changes and develops a treatment plan based on the patient's symptoms and foot structure. Care is focused on reducing painful pressure and improving the way the foot functions. Treatment can be adjusted according to the patient's activity level and response to care. Addressing the factors that place strain on the plantar fascia supports more comfortable movement and better foot function. If you have symptoms of plantar fasciitis, it is suggested that you make an appointment with a podiatrist for diagnosis and treatment.

Plantar fasciitis can be very painful and inconvenient. If you are experiencing heel pain or symptoms of plantar fasciitis, contact Katie Besselman, DPM  from Advanced Podiatry. 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 office located in Saint Peters, MO . We offer the newest diagnostic and treatment technologies for all your foot care needs.

A foot ulcer is an open sore that develops on the skin of the foot and can extend deeper. These wounds can be difficult to heal when circulation or sensation is reduced. Common symptoms include redness, swelling, or an area that looks cracked or broken. An ulcer may begin as a blister or callus before becoming serious. Diabetic patients should pay close attention because nerve damage can make an injury difficult to feel.

Several risk factors can increase the chance of developing a foot ulcer. Diabetes, peripheral neuropathy, and previous ulcers are common concerns. Wearing ill-fitting shoes can create repeated pressure and friction. A hot spot is an area of the foot that feels unusually warm, irritated, or tender before the skin breaks down. Causes may include pressure from footwear, a callus, or prolonged walking. Identifying a hot spot early can help prevent a wound from developing.

Preventing foot ulcers starts with daily foot checks and properly fitted shoes. Keep feet clean and dry, moisturize dry skin without applying lotion between the toes, and avoid walking barefoot. Check for cuts, blisters, and hot spots. If you notice a wound, do not ignore it or attempt to remove surrounding tissue yourself. Prompt care can reduce complications.

A podiatrist will examine the ulcer, assess circulation and sensation, and determine how deep the wound is. Treatment may include cleaning the ulcer, removing unhealthy tissue, and reducing pressure with appropriate footwear or offloading devices. The podiatrist may also recommend imaging or coordinate care for infection, diabetes, or circulation problems when needed. Healing requires follow-up and careful home care. If you have a foot ulcer or a concerning hot spot, it is suggested that you are under the care of a podiatrist for effective relief and treatment solutions.

Wound care is an important part in dealing with diabetes. If you have diabetes and a foot wound or would like more information about wound care for diabetics, consult with Katie Besselman, DPM from Advanced Podiatry. Our doctor will assess your condition and provide you with quality foot and ankle treatment.

What Is Wound Care?

Wound care is the practice of taking proper care of a wound. This can range from the smallest to the largest of wounds. While everyone can benefit from proper wound care, it is much more important for diabetics. Diabetics often suffer from poor blood circulation which causes wounds to heal much slower than they would in a non-diabetic. 

What Is the Importance of Wound Care?

While it may not seem apparent with small ulcers on the foot, for diabetics, any size ulcer can become infected. Diabetics often also suffer from neuropathy, or nerve loss. This means they might not even feel when they have an ulcer on their foot. If the wound becomes severely infected, amputation may be necessary. Therefore, it is of the upmost importance to properly care for any and all foot wounds.

How to Care for Wounds

The best way to care for foot wounds is to prevent them. For diabetics, this means daily inspections of the feet for any signs of abnormalities or ulcers. It is also recommended to see a podiatrist several times a year for a foot inspection. If you do have an ulcer, run the wound under water to clear dirt from the wound; then apply antibiotic ointment to the wound and cover with a bandage. Bandages should be changed daily and keeping pressure off the wound is smart. It is advised to see a podiatrist, who can keep an eye on it.

If you have any questions please contact our office located in Saint Peters, MO . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.