Tag: Achilles Tendonitis

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blog Swollen Ankles

Why Are My Ankles Swollen?

A Podiatrist’s Checklist

You take off your socks at the end of the day and see a deep indentation around your ankle. Or perhaps you look down and realize your favorite shoes suddenly feel tight.

Is it heart failure? Is it a blood clot? Or did I just eat too much salt?

Edema (the medical term for swelling) is incredibly common, but it is also one of the top symptoms that sends people into a “WebMD Panic Spiral.” At New England Podiatry, we believe knowledge is the best antidote to such anxiety. While swelling is always a signal from your body, it isn’t always an emergency. Read on for a checklist to help you decode what your swollen feet are trying to tell you.

The “Don’t Panic” Checklist (Common & Manageable Causes)

If your swelling matches these descriptions, the cause is likely lifestyle-related or structural. While you should see a podiatrist to fix it, you probably don’t need to rush to the ER.

The “Gravity” Test

  • The Sign: Your feet are normal in the morning but puffy by 5:00 PM.
  • Likely Cause: Dependent Edema. If you sit or stand all day for work, gravity pulls fluid down. Your veins just need a little help pumping it back up.
  • The Fix: Compression socks and movement breaks.

The “Salty Meal” Effect

  • The Sign: You notice mild, squishy swelling in both feet after a weekend of eating out or holiday meals.
  • Likely Cause: Sodium Retention. Your body is holding onto water to dilute the salt.
  • The Fix: Hydrate aggressively to flush the system.

The “Summer Sausage” Toes

  • The Sign: Your fingers and toes feel swollen on a hot, humid day.
  • Likely Cause: Heat Edema. Your blood vessels dilate (open wide) to cool you down, allowing fluid to leak into nearby tissues.

The “Call Us Now” Checklist (Structural & Vein Issues)

These signs suggest a problem that won’t go away with just water and rest. You need an appointment!

The “Dent” Test (Pitting Edema)

  • The Sign: If you press your thumb into your swollen ankle for 5 seconds and it leaves a pit or “dent” that stays there, this is Pitting Edema.
  • What it Means: This often signals Venous Insufficiency. Your vein valves are weak and failing to close properly, allowing blood to pool permanently in your legs. This requires medical management to prevent ulcers.

The “One-Sided” Swelling

  • The Sign: Your left ankle is huge, but your right ankle looks fine.
  • What it Means: Asymmetry is a major red flag. It could be a structural injury (like a sprain you didn’t notice), a blocked lymph node, or a tendon issue.

The “Emergency” Red Flags (Go to the ER)

If your swelling comes with these friends, do not wait.

  • Sudden Heat & Redness: If the swollen area feels hot to the touch or looks red/purple.
  • Shortness of Breath: Swelling + trouble breathing can indicate heart issues or a clot that has traveled to the lungs.
  • Chest Pain: Never ignore this combination!

Get Answers, Not Anxiety

Stop guessing with your health. If you are tired of wondering why your shoes don’t fit, let’s find the root cause. Whether it’s weak veins, a medication side effect, or just “gravity,” we can create a plan to get the swelling down and keep you moving comfortably.

Dr. Catherine Jacobs, Dr. Zachary Sax, Dr. Joshua Oulette, Dr. Ronald Etskovitz, and Dr. Raymond Murano III of  New England Podiatry Associates provide comprehensive medical and surgical care for a wide spectrum of foot and ankle conditions. Contact us today to schedule an appointment!

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blog EPAT Shockwave Therapy

Stay in the Game: Shockwave Therapy for Athletic Foot & Ankle Injuries

As an athlete, nothing is more frustrating than being sidelined by chronic foot & ankle injuries. And when rest, ice, and stretching aren’t enough, it might feel like your options are limited.

The good news? An advanced, non-invasive technology called EPAT (Extracorporeal Pulse Activation Technology) is helping athletes heal faster and get back to their sport without surgery. In this blog, New England Podiatry breaks down the benefits, particularly for the competitors among us!

What is EPAT (Shockwave Therapy)?

EPAT is a treatment that uses acoustic pressure waves to target injured soft tissues. This isn’t an electrical shock; rather, it’s a form of sound energy that stimulates the body’s own natural healing processes.

By delivering these pulses to the painful area, EPAT helps to:

  • Enhance blood circulation
  • Accelerate tissue repair and cell growth
  • Reduce pain and inflammation

It’s a non-surgical method designed to jump-start healing in stubborn, chronic injuries that have stopped responding to traditional care.

Your Questions About EPAT, Answered

What disorders can be treated?

EPAT is highly effective for common overuse injuries that plague athletes. It’s an excellent solution for chronic conditions, including:

  • Plantar Fasciitis / Heel Pain
  • Achilles Tendonitis
  • Other forms of tendon pain in the foot and ankle

What is the treatment like?

The procedure is simple and performed right in our office.

  • We apply a coupling gel to your skin over the injured area, then deliver the pressure waves using a handheld applicator.
  • Sessions are quick, typically lasting only 5-10 minutes. Most treatment plans involve 3-5 sessions, scheduled about a week apart.
  • Best of all, there is no downtime, allowing you to continue with your daily activities immediately.

What are the expected results?

Many athletes experience significant pain relief after just a few treatments.

  • The beneficial effects of EPAT are often cumulative, meaning you may continue to see improvement weeks after your final session.
  • Success rates are high, with many studies reporting over 80% of patients treated experiencing pain relief and improved function.

It’s a proven method for getting athletes back on their feet!

Are there any side effects?

 The side effects of this non-invasive treatment are minimal.

  • You might experience some minor discomfort or redness in the treated area, which typically resolves quickly.
  • There are none of no risks associated with injections or surgery.

Questions? Concerns? Give us a call. Together, we’ll determine if EPAT is right for you.

At New England Podiatry Associates, Dr. Ronald Etskovitz, Dr. Raymond Murano III, Dr. Catherine Jacobs, Dr. Joshua Ouellette, and Dr. Zachary Sax are always pleased to assist. We offer convenient locations in Norfolk, Suffolk, and Middlesex Counties. Contact our Chestnut Hill office at 617-232-1752 and our Newton-Wellesley office at 617-630-8280 to schedule an appointment.

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blog Tendonitis

What Is Tendonitis (And How Do You Know You Have It?)

When you’re active, you ache. When you wake up, there’s morning stiffness in your ankle. And when you move your foot too quickly, a sharp pain runs through it. What’s going on?

One likely explanation: your body is signaling that you have tendonitis. This common inflammation can impact your comfort and limit your mobility, so don’t just hope it will vanish on its own. Below, New England Podiatry explains signs, symptoms, and more. Read on so you know what to watch for!

Tendon Talk: What Exactly Is Tendonitis?

Tendons are tough, flexible cords connecting muscles to bones, crucial for movement. Tendonitis occurs when these hard-working tendons become inflamed or irritated, usually due to overuse, repetitive strain, or an acute injury.

 Common areas in the foot and ankle include:

  1. The Achilles tendon (back of heel)
  2. The posterior tibial tendon (inner ankle/arch)
  3. The peroneal tendons (outer ankle)

Spotting the Signs: How Do You Know If It’s Tendonitis?

Tendonitis symptoms can vary, but they often include:

  • A Dull Ache or Pain: This is often the primary symptom, typically localized to the affected tendon. The pain might worsen with activity or after prolonged use.
  • Tenderness to Touch: The specific tendon involved will likely be sore or tender if you press on it.
  • Stiffness: You might notice stiffness in the affected joint or tendon, especially in the morning or after periods of rest.
  • Mild Swelling or Warmth: Some inflammation can cause noticeable swelling or a feeling of warmth around the tendon.

Less commonly, some experience a grating sensation (crepitus) when the tendon moves.

The Danger of Delay: Why Ignoring Tendonitis is Risky

“Walking it off” is rarely a good strategy. Neglecting early signs can lead to:

  1. Chronic Tendonitis (Tendinosis): Unaddressed inflammation can become chronic, leading to tendon degeneration (microscopic tears). This stage, tendinosis, is often more challenging to treat.
  2. Increased Risk of Tears or Rupture: A chronically inflamed, degenerated tendon is weaker and more susceptible to partial or complete tearing, a much more serious injury that could require surgery.
  3. Compensatory Pain: Altering your gait to avoid pain can stress other areas, potentially causing new pain in your other foot, knees, hips, or back.

Accurate Diagnosis is Key

While these symptoms suggest tendonitis, other conditions, such as stress fractures or arthritis, can cause similar pain. An accurate diagnosis from a podiatrist, sometimes involving imaging like an X-ray or ultrasound, is crucial to ensure you receive the most appropriate care!

Dr. Catherine Jacobs, Dr. Zachary Sax, Dr. Joshua Oulette, Dr. Ronald Etskovitz, and Dr. Raymond Murano III of  New England Podiatry Associates  provide comprehensive medical and surgical care for a wide spectrum of foot and ankle conditions. Contact us today to schedule an appointment! 

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blog Heel Pain

5 Ways That Athletes Run Into Heel Pain

Heel pain is a common complaint among athletes that can sideline even the best of them for weeks. But “heel pain” isn’t a single diagnosis!

Several different conditions can cause discomfort in this crucial area, each stemming from different structures and requiring a specific diagnosis. In this blog, New England Podiatry Associates will break down 5 conditions that are often at fault.

1.) Plantar Fasciitis 

Plantar Fasciitis is a leading cause of heel pain in athletes. Inflamed tissues along the bottom of the foot connect to the heel bone, so during and after physical activity, athletes will feel sharp or intense pain under the heel.  

  • Runners are particularly susceptible to plantar fasciitis due to constant pressure on the back of their feet. Athletes with tight calf muscles or who haven’t trained in a while are also at risk.  

2.) Achilles Tendonitis 

The Achilles tendon connects the calf to the heel, so it is technically a cause of heel pain. You’ll hear about a major athlete sustaining a major Achilles injury almost monthly. Tiger Woods just ruptured his in March!

  • Inflammation of this tendon causes a dull ache or stiffness at the back of the heel, or slightly higher up the lower leg. Like plantar fasciitis, it’s often worse in the morning or after rest and can intensify after activity.

3.) Heel Spurs  

Heel spurs are often mistaken for plantar fasciitis because of their similar symptoms, but they are actually bony growths of calcium that form on the underside of the heel bone. 

  • Heel spurs themselves are often painless, but when pain is present, it’s usually because the spur is irritating the surrounding plantar fascia tissue. Athletes develop heel spurs over a long period due to chronic strain on foot muscles and ligaments, often as a secondary response to long-standing plantar fasciitis. 

4.) Sever’s Disease:

 Sever’s Disease is one of the most common causes of heel pain for active young children between the ages of 8 and 12.

  • It’s an inflammation of the heel bone’s growth plate (where the Achilles attaches) that causes pain at the back of the heel during and after activity. 

5.) Heel Pad Contusion:

A deep bruise to the fatty pad under the heel that usually occurs from a hard landing.

  • We see this a lot in basketball players, cross-country runners, and other sports that involve jumping. Over time, continued stress on the heel pad can cause heel fat pad syndrome.  

Does any of the above sound uncomfortably familiar? We can help! Get in touch and step toward relief today.

Dr. Catherine Jacobs, Dr. Zachary Sax, Dr. Joshua Oulette, Dr. Ronald Etskovitz, and Dr. Raymond Murano III of New England Podiatry Associates provide comprehensive medical and surgical care for a wide spectrum of foot and ankle conditions. Contact us today to schedule an appointment! 

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Ankle Conditions blog

5 Common Ankle Problems Podiatrists Treat

Everyone knows the terrible feeling of rolling your ankle, but that’s just the tip of the iceberg of what can happen to it. From sudden twists to overuse injuries, ankle problems are some of the most common we see at New England Podiatry Associates.

Today, we’ll explore 5 types of ankle afflictions, including their causes, symptoms, and treatment options.

1. Ankle Sprains

According to a 2019 PubMed study, about 2 million people each year sprain their ankle. This is not a surprise to us, as ankle sprains are injuries we commonly see. Not only are they ubiquitous in sports, but what’s so tricky about them is that they can occur during everyday activity. The ankle is fragile, and any sudden twists or turns can leave you on the ground writhing in pain.

2. Achilles Tendonitis

Here’s a shocking stat: nearly 1 in 5 athletes will sustain an Achilles tendonitis injury in their lifetimes. That’s because the Achilles tendon is susceptible to vigorous movement and repetitive strain from activities like running, jumping, or cutting.

3. Ankle Fractures

Often mistaken for ankle sprains, ankle fractures involve a break in one or more bones in the ankle joint, typically caused by falls, forceful impacts, or twisting injuries. The symptoms are classic: severe pain, swelling, bruising, and an inability to stand on the ankle. But the good news is that, depending on the severity, you may not require surgery.

4. Arthritis

According to the Arthritis Foundation, osteoarthritis of the ankle is fairly rare, affecting only about 1 to 12% of people. But that doesn’t mean arthritis of the foot is as hard to find. Generally, degenerative joints in the lower extremities can cause pain across the foot complex.

5. Chronic Ankle Instability

This condition often develops after repeated ankle sprains, which leads to persistent instability or a feeling of the ankle “giving way.” It can cause pain, recurrent sprains, and falls. However, physical therapy, bracing, or surgery to repair damaged ligaments are all valid treatment options.

At New England Podiatry Associates, Dr. Ronald Etskovitz, Dr. Raymond Murano III, Dr. Catherine Jacobs, Dr. Joshua Ouellette, and Dr. Zachary Sax are always pleased to assist. We offer convenient locations in Norfolk, Suffolk, and Middlesex Counties. Contact our Chestnut Hill office at 617-232-1752 and our Newton-Wellesley office at 617-630-8280 to schedule an appointment.

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blog Obesity

Feeling the Pressure: The Structural Injuries of Obesity

As obesity puts significant stress on the body, the feet and ankles especially bear the brunt. And while podiatrists commonly associate excess weight with diabetes, neuropathy, and other internal foot complications, not enough focus is placed on the structural problems and the mobility limit that occur because of weight gain.

In this article, we at New England Podiatry Associates are emphasizing these affects, along with the injuries that result from them.

The Impact of Obesity on Feet and Ankles

  • Increased pressure: Extra weight places additional pressure on the feet, leading to conditions like plantar fasciitis, heel pain, and metatarsalgia.
  • Joint stress: Obesity can accelerate joint degeneration, particularly in the ankles and feet.
  • Structural changes: Over time, excessive weight can lead to structural changes in the feet, such as flat feet or bunions.
  • Skin issues: Obesity can increase the risk of skin problems, including fungal infections and calluses.
  • Reduced mobility: Foot and ankle pain associated with obesity can limit physical activity, leading to further weight gain and a vicious cycle.

Common Foot and Ankle Injuries Linked to Obesity

With these challenges and changes due to obesity, certain injuries are bound to occur. For instance, ankle sprains become common due to the destabilization of the ankle joint. The added pressure on the heel, ankle, and forefoot can also lead to plantar fasciitis, metatarsalgia, and Achilles tendonitis.

For morbidly obese people, stress fractures are a possibility due to repetitive impact from walking or standing. The severe pressure on the feet can also lead to open sores that are slow to heal. And with limited mobility, they increase the risk of infection due to their inability to thoroughly clean affected areas.

Prevention

Preventing and managing these injuries often involves weight loss, proper footwear, and orthotics. If you experience persistent foot or ankle pain due to obesity, consult with a podiatrist for evaluation and treatment.

At New England Podiatry Associates, Dr. Ronald Etskovitz, Dr. Raymond Murano III, Dr. Catherine Jacobs, Dr. Joshua Ouellette, and Dr. Zachary Sax are always pleased to assist. We offer convenient locations in Norfolk, Suffolk, and Middlesex Counties. Contact our Chestnut Hill office at 617-232-1752 and our Newton-Wellesley office at 617-630-8280 to schedule an appointment today.

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blog EPAT Shockwave Therapy

Stuck in Pain? EPAT Shockwave Therapy Can Help!

Foot and ankle complications can leave you limping, frustrated, and limited, especially when they’re left untreated. The good news? Innovative new tools and methods are helping DPMs manage and resolve chronic conditions, so when more traditional treatments fall short, New England Podiatry wants you to know that you’ve still got options for keeping pain under control.

If you’re dealing with persistent foot or ankle pain that isn’t responding to other therapies, EPAT shockwave therapy might be the answer you’ve been searching for. This blog aims to educate and inform, explaining the ins and outs of how EPAT works and what kinds of problems it’s well suited to solve.

What is EPAT Shockwave Therapy?

EPAT stands for Extracorporeal Pulse Activation Therapy. It’s a non-invasive treatment that utilizes high-energy acoustic waves (sound waves) to promote healing in soft tissues.

  • These waves stimulate the body’s natural healing response, increasing blood flow to the injured area, reducing inflammation, and encouraging tissue regeneration.

When is EPAT a Good Option?

EPAT works well for stubborn foot and ankle conditions that feature chronic pain, including:

Benefits of EPAT Therapy

EPAT boasts several advantages:

  • No needles or incisions are involved, making it comfortable and well-tolerated.
  • EPAT treatments are typically performed in-office, requiring minimal downtime.
  • The benefits of EPAT therapy can be long-lasting, helping you maintain an active lifestyle.

Think EPAT might work well for you? There’s one way to find out: Give us a call!

At New England Podiatry, Dr. Catherine Jacobs, Dr. Zachary Sax, Dr. Joshua Oulette, Dr. Ronald Etskovitz, and Dr. Raymond Murano III  provide comprehensive medical and surgical care for a broad spectrum of foot and ankle conditions. Our practice has proudly served the Boston area since 1984. We utilize state-of-the-art diagnostic and treatment technology to find the best solution for each individual. Contact us today to schedule an appointment.