Conditions

experience matters

Helping you stand on your own two feet

Millions of Americans experience foot and ankle problems, and because these are very complex structures, Dr. McDonald’s experience and expertise are vital to developing a complete treatment plan that gets to the root of the problem.

 

This is why Dr. McDonald believes it’s important to take time to properly diagnose your condition, recommend appropriate treatment, and guide you through your rehabilitation. Often, he can provide non-surgical solutions to successfully manage your conditions. If surgery is needed, Dr. McDonald provides the highest quality of care combined with the most advanced surgical techniques available. He is absolutely committed to delivering the best in superior, patient-centered care.

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Conditions we treat

From the treatment of arthritis to hammertoe and bunions to total ankle replacements, Dr. McDonald is dedicated to professional patient care using the most advanced techniques possible for your particular condition.

Foot & Ankle Arthritis

Arthritis is a condition characterized primarily by inflammation in the joints, which causes pain and stiffness.  While there are over 200 different conditions that fall under that umbrella, the most common form of arthritis is osteoarthritis, which is generally associated with aging

 

In arthritis, progressive joint deterioration occurs and the smooth "cushioning" cartilage in joints is gradually lost, resulting in the bones wearing against each other. Soft tissues in the joints also may begin to wear down. Arthritis can be painful and eventually can result in limited motion, loss of joint function, and deformities in the joints affected.

 

Treatment

There are many treatment options - both surgical and nonsurgical - that can either diminish the inflammatory reaction or mechanically address the underlying joint structure, in an effort to diminish or eliminate the pain associated with arthritis.

 

Non-surgical options include orthotics, shoe inserts, bracing, physical therapy, anti-inflammatory drugs to reduce joint swelling, pain relievers, and steroid injections.

 

Depending on the extent of your condition, surgical options can include arthroscopic surgery, fusion surgery, or total ankle replacement.

Ankle Instability

Ankle instability is a condition where the ankle has too much motion (“looseness”) and easily “gives out.” People with ankle instability commonly complain of twisting their ankle easily, especially on uneven ground or when playing sports.

 

The most common cause of ankle instability is recurrent ankle sprains. Although most ankle sprains will heal with nonsurgical treatment, repeated sprains can cause the ligaments to heal stretched out, which causes them to lose their ability to provide stability.

 

Based on the severity of your condition, Dr. McDonald may recommend either nonsurgical or surgical treatment. Nonsurgical treatment can consist of options such as bracing the ankle during at-risk activities, special exercises, or physical therapy.

 

If Dr. McDonald recommends surgery, it usually consists of either a procedure to tighten the existing ligaments or one that uses a separate tendon graft to reconstruct the ligaments. If you have a high arch, he may also recommend realigning the foot with additional procedures to decrease the risk of instability coming back after surgery.

Fractures & Breaks

Foot and ankle fractures and breaks can happen to anyone at any time. Most commonly, a fracture or break occurs when there is a direct impact to the bone or a sharp twist that goes beyond the ankle’s allowed range of motion. If swelling and bruising develop immediately, a crack or snap is heard, and/or you cannot bear weight on the ankle, it is important to get immediate medical attention. Please note that the ability to bear weight on the injured ankle does not rule out a fracture. Even if you can walk on it, you may have a fracture and medical attention should be sought out.

 

There are many types of fractures, ranging from small hairline fractures to traumatic bone breaks. Although minor fractures can typically heal on their own, more serious fractures will require surgery to heal properly.

 

The type of surgery Dr. McDonald recommends will depend on a number of different factors, including the location of the fracture, and whether there are any complications such as arthritis or nerve damage.

Bunions

A bunion (also known as a hallux valgus) forms on the joint at the base of your big toe when the skeletal structure of your foot causes your big toe to lean toward the second toe rather than pointing straight ahead.

 

While this is often an issue that begins with an internal faulty structure in the foot, it is often made progressively worse by numerous other factors related to a patient’s lifestyle and footwear choices. Genetics also play into the development of bunions as well, as foot type is hereditary—those with flat feet and low arches often have a higher instance of bunion occurrence.

 

Typically, a bunion is easily visible as a pronounced bump on the side of the big toe. You may experience any combination of the following: pain, soreness, inflammation, redness, a burning sensation, or numbness on or around the bunion. Any shoe that crowds the toes or pushes your weight onto the ball of your foot will often aggravate those symptoms considerably.

 

Not all bunions require or indicate the need for surgery. Dr. McDonald surgeon can assess whether your specific condition would benefit from surgery after methods such as changes in shoe wear, anti-inflammatory medication, icing, injection therapy, padding, and/or orthotic devices have been unsuccessful in attaining long-term symptom relief. As with many other orthopedic conditions, when a bunion begins to interfere with daily activities, it is always a good idea to discuss other options with your physician.

 

When surgery is indicated, there are a number of options available, including some minimally invasive options. Dr. McDonald will be happy to go over all your options and answer any questions you may have.

Hammertoe

Hammertoe is an abnormality that occurs in the second, third, and fourth toes that causes an abnormal bend in the middle joint of a toe. This occurs when there is an imbalance in the muscles, tendons or ligaments that usually do the work of holding the toe straight.

 

Hammertoe can develop for numerous reasons but is typically thought to occur most often due to the continuous wear of improper footwear, a misaligned foot structure, trauma or injury, and/or certain disease processes like arthritis or diabetes. That said, in most cases, the development of hammertoe is largely avoidable if diagnosed early and steps are taken to avoid further progression.

 

Hammertoe generally begins with the toe maintaining some flexibility, but the tendons will contract and tighten over time, resulting in a permanently bent toe. While the toes are still flexible, physical therapy and other non-surgical methods can help. Wearing properly fitted shoes with good support is also a must. Dr. McDonald may also recommend the use of orthotics or spacers, spreaders, and stretchers, depending on the severity of the case.

 

Surgery is recommended if the hammertoe is causing pain or interfering with day-to-day activities. There are several surgical options available, including some that are minimally invasive. Dr. McDonald will discuss all your options with you.

Neuromuscular Imbalance

Neuromuscular disorders affect the nerves that control voluntary muscles and the nerves that communicate sensory information back to the brain. Nerve cells (neurons) send and receive electrical messages to and from the body to help control voluntary muscles. When the neurons become unhealthy or die, communication between the nervous system and muscles breaks down. As a result, muscles weaken and waste away (atrophy).

 

Two of the most common orthopedic neuromuscular disorders are foot drop caused by stroke or some other neuromuscular condition, and equinus.

 

Foot drop is a general term for difficulty lifting the front part of the foot. If you have foot drop, the front of your foot might drag on the ground when you walk. This can cause you to raise your thigh when you walk, as though climbing stairs (steppage gait), to help your foot clear the floor. This unusual gait might cause you to slap your foot down onto the floor with each step. In some cases, the skin on the top of your foot and toes feels numb. Foot drop is treated with exercises, electrical nerve stimulation, or surgery.

 

Equinus is a condition where the upward bending motion of the ankle joint is limited. Someone with equinus lacks the flexibility to bring the top of the foot toward the front of the leg. Equinus can occur in one or both feet. Nonsurgical treatment options include splinting, heel lifts, arch supports or orthotic devices, and physical therapy to help stretch calf muscles. In some cases, surgery may be needed to correct the cause of equinus (i.e., a tight tendon or a bone blocking ankle motion).

Tendon Disorders

The foot and ankle are comprised of many different bones, ligaments, and tendons all working together to enable balance and movement. Tendons are those bands of tissue that attach the foot and ankle muscles to the bones. When tendons become injured or torn, the result is pain, swelling, foot and ankle weakness, and discomfort when walking, standing, or playing sports.

 

Dr. McDonald is highly experienced in treating tendon disorders through both surgical and non-surgical options. These disorders include:

 

Achilles ruptures: The Achilles tendon is a band of thick, fibrous tissue connecting the calf muscles to the heel bone. If the tendon fibers break completely or partially, it is called an Achilles rupture and needs immediate attention.

 

Peroneal tendon disorder: Peroneal tendon disorder is inflammation in one or both of the tendons that connect your lower leg to your foot. It’s usually due to overusing the tendons, but it can also be the result of a sudden injury such as an ankle sprain. 

 

Posterior tibial tendon dysfunction: The posterior tibial tendon serves as one of the major supporting structures of the foot, helping it to function while walking. Posterior tibial tendon dysfunction (PTTD) is a condition caused by changes in the tendon, impairing its ability to support the arch. This results in flattening of the foot.

Dr. McDonald will often first try conservative treatments such as activity modification, anti-inflammatory medications, corticosteroid injections, custom bracing and/or orthotics, and physical therapy.

 

When surgery is indicated, Dr. McDonald will use the least invasive technique possible that will give the best results. Tendon repair surgery typically involves making a small incision in the area above the tendon through which Dr. McDonald will remove the damaged tissue using specialized surgical tools. He may then take a tendon from another area of the body and graft it to the damaged tendon in order to strengthen and repair it.

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