My Blog

October 02, 2017
Category: Foot Pain
Tags: arch pain   Foot Pain   Foot Care  

Do you feel pain in your foot?

Take a close look at where the pain is coming from. Could it be arch pain? Arch pain can affect even the other areas of your foot like the heel and the ball of your foot.

Know Your Arch

Your arch is made up of your tarsal and metatarsal bones, as well as the supporting tendons and ligaments. Together they help absorb stress that is directed to your foot, stabilize your body so you can stand, walk, and run. Your arches also help you adapt to sloping and uneven surfaces.

When the bones, tendons, or ligaments that make up your arches are injured or weakened due to overuse or wear and tear due to aging, you might experience pain in your arch.

Sometimes arch pain can also be a symptom of a specific foot ailment like plantar fasciitis or excessive pronation. You can set up an appointment with Sheldon Nadal, DPM to find out whether you are suffering from any of these foot conditions. If none of these apply, it is also possible that you have a condition known as posterior tibial tendon dysfunction.

You should never ignore arch pain as it can progress and cause other ailments such as:

- Plantar Fasciitis

- Knee Pain

- Lower Back and Hip Pain

- Achilles Tendonitis

- Stress Fractures

- Shin Splints

- Hammertoes

- Foot and Leg Pain

Treatment and Prevention

Arch Supports can help relieve some of your pain and discomfort. First, you need to find out your arch type (whether you have low, medium, or high arches) because the height and shape of your arch support would need to match your arch type.

Shoe inserts or orthotics can support your arch, ease stress on your posterior tibialis tendon, and stabilize your heel. You can also find really comfortable and supportive shoes with insoles that can fully support the arch.

You can work on strengthening your tibialis posterior muscle. You should also stretch your Achilles tendon. These two are instrumental in  reducing arch pain. The wearing of night splints can also help alleviate pressure on your arches as night splints  can keep  your muscles in proper position.

You can also try cold therapy. Use wraps and other forms of cold therapy to relieve you of some discomfort and pain.

Of course, consulting with our podiatrist Sheldon H. Nadal, DPM can greatly help you! Call us at your earliest convenience.


September 25, 2017
Category: Uncategorized
Tags: Untagged


If you are a runner or someone who wants to start running, you need to know all about plantar fasciitis and the surgical options for this problem.


Why does  plantar fasciitis surgery appeal to a lot of patients?

Okay, perhaps we should change that question to “Why does surgery appeal to you?” Come to think of it, thoughts of getting surgery surface when people are starting to feel frustrated when other treatments fail to work. So we assume that at this point, you have already tried other approaches and you are now looking for a quick and sure fix.


Unlike complex machines, such as vehicles, if a part of your foot or leg malfunctions, you cannot just decide to replace it with a new one. If your knee gives you constant pain, yes, you can get a knee replacement, but you have to keep in mind that while it is a good option, it is still artificial, and you cannot expect it to work as well as it used to.


So, why is surgery recommended? It is because there are conditions that conventional non-surgery measures cannot cure and only surgical solutions are the best options. There are various surgical procedures that can treat chronic plantar fasciitis. As a runner, you need to understand the difference between those procedures, so you can make an educated decision.


Open Plantar Fascia Release Surgery

This is the most commonly done surgery on the plantar fascia. In fact, it is likely it has been performed more times than other types of plantar fasciitis surgical procedure. This is an “open” procedure, meaning an incision is made on the bottom or the side of the foot to gain access to the plantar fascia. The goal with this particular surgery it to cut through the portion of the plantar fascia with the most tension. This is meant to relieve the tension and the pain over time.


Minimally  invasive Plantar Fascia Release Surgery

This is similar to the “open” procedure but with a smaller incision. The idea is for the patient to experience less pain and swelling and  to get back to their normal activities sooner.

Endoscopic Surgery on the Plantar Fascia

Endoscopic surgery is similar to arthroscopic surgery technique-wise. The difference is that it’s performed on the soft tissue instead of within a joint. The incisions are smaller, too,  similar to minimally  invasive surgery. It makes use of an instrument with a camera that is inserted through one side of the food and on the other side, an instrument with a scalpel is inserted.


Risks of Surgery

There are risks of surgery that range from simple pain to death. The latter is unlikely but it does happen, so we still say there’s a risk. The biggest risk perhaps, or at least the one athletes have heard about most is complete rupture of the plantar fascia. There are cases where the plantar fascia rips or tears all the way across the foot, even if only a portion of it has been released. When that happens, your plantar fascia won’t be able to support your foot anymore.


A collapse of the arch can also be a serious problem, especially for a runner. Although the patient would be able to run again, there will be a definite change in his running form as well as his running experience.


If you are considering surgery, make sure that you understand all the potential complications. Also, discuss your goals after the surgery. If you have questions, you can reach out to us at Bayview Medical Center, and our podiatrist, Sheldon H. Nadal, DPM will gladly answer your inquiries!

September 20, 2017


If you have been really uncomfortable or hurt because of a hammertoe, you are probably considering getting a hammertoe surgery, right? If so, you probably have a few questions on your mind about the procedure. This article is perfect for you! Let us answer some of those questions for you today.


“What is a hammertoe?”

It is a condition wherein the toe is bent upward in the middle part of the joint in such a way that it somewhat resembles a hammer. It can either be flexible or stiff. It can also cause significant pain. Needless to say, a hammertoe can have a big effect on the quality of life of those who are suffering from it.


“How do I know that I need a hammertoe surgery?”

It is understandable that a lot of people want to avoid hammertoe surgery  . Stretching shoes or wearing padding around the area may help a little. However, if these and/or other treatments prove ineffective in relieving discomfort, you are a probable candidate for a surgery. Podiatrists like Sheldon H. Nadal, DPM can help you determine the best way to deal with this foot condition.


“Are there any instances where I should not have surgery?”

You might want to hold off on surgery if you have other foot issues, at least until those other conditions are solved. You should also think twice about having a surgery if you are suffering from poor circulation, any kind of infection, or if you are seriously ill. Of course, you would have to discuss with your podiatrist in full detail everything there is to know about your health, as well as the treatment options available to you.


“What’s going to happen after the surgery?”

Many patients find that they have to wear special footwear after their hammertoe surgery for a while for them to be able to walk. The length of your recovery period depends greatly on how extensive the surgery is. You can expect, though, that you are going to have to rest for the first few weeks following the surgery. Keeping your foot elevated can reduce the pain and swelling. As for the stitches, they usually come out two or three weeks after the hammertoe surgery.


Do you have any other questions or concerns regarding hammertoe surgery? Do you want to be scheduled for an examination to find out if a hammertoe surgery is the right approach to your particular situation? Get in touch with Sheldon Nadal, DPM. 416-486-9917. He will be more than happy to  explain everything you need to know about this procedure.

July 09, 2017
Category: shoes


Can you imagine how it must have been years and years ago when humans had to walk barefoot? Yes, it doesn’t matter what the terrain or the weather was like. These days, no one hardly leaves their home without any footwear. The fact that there’s a shoe store practically everywhere makes walking around without shoes simply unimaginable.


When you go online to look for shoes or try on pair after pair in a shoe store, all in your quest to find the perfect designer pumps for work, your health is probably the last thing on your mind. What most people do not know is that poorly-designed footwear or ill-fitting shoes can actually cause various health problems that may either be short- or long-term, and they can affect different parts of your body. That’s why it is very important that more than the style factor, we consider what we put on our feet for health reasons.


Here are some of the health problems that may be caused by the wrong choice of footwear:


Nail and Fungal Problems

Nail and fungal problems are quite common in Canada. Ingrown toenails are caused when the sides of your nails pierce their surrounding skin. They can be anything from a slight nuisance to something that’s really painful and uncomfortable. Fungal toenail infections can be unsightly, what with the discolouration and nail brittleness they cause. They can also cause further complications when the infections spread. You should avoid tight footwear and hosiery because these can both cause damage to your nail and create a moist environment, which we all know is what fungal spores need to thrive.



These are hard, dead skin that you might find over a joint or any bony prominence. They may be caused by prolonged pressure to a specific spot in your foot that happens when you wear ill-fitting footwear. If your shoes are a little loose, they may allow your feet to slide or put excessive pressure on specific areas of your feet.


Back Pain

Back pains are probably the last thing you’d think would be associated with your choice of footwear. The truth is, lumbar intervertebral disc compression which results from wearing poor footwear can cause lower back pain. So it’s best that you stick to low shoes whenever possible, and if you need to wear high heels, ensure that they are really well-made and that you do not wear them for extended periods.


Joint Pain

If your shoes do not provide sufficient support, they can ultimately lead to different sorts of joint problems, including knee pain and arthritis. This is because your knees have to bend more to compensate for the reduced shock absorbing at your feet when your heel hits the ground when you’re walking. Aside from that, your front thigh muscles also have to work harder for a better push off when walking.


These are just some of the most common health issues that are associated with wrong footwear choice. So when you go shoe-shopping next time, make sure you look beyond what’s in this season! 

July 05, 2017
Category: Sports

If you are a runner, then you know how hard your body works, putting it at risk of injuries. You should prepare yourself for those injuries, and prevent them if you can.


Here are some of the most common pains and aches that a lot of runners experience:



This may be caused by constant uphill running and shifting from high-heeled shoes to running shoes, as well as a really aggressive pace – meaning you’re running too fast for too long and too often. Achilles tendonitis is felt on the lower back calf muscles. You’d feel a dull ache, stiffness, and pain that is more prevalent in the morning. It would be wise to reduce mileage or even avoid running until the pain is gone.



Blisters are caused by friction, shoes that are too small, sweaty feet, or some foot abnormalities like bunions, hammertoes, and heel spurs, among others.  Blisters often appear on spots where your socks or shoes rub directly against your skin. To prevent blisters, make sure that you’re wearing shoes with a  good fit. Get yourself socks that are made specifically for running. You can also apply petroleum jelly on problem areas that are prone to blisters.



Do you feel soreness or a painful ache beside your big toe joint?  Is it associated a bulging bump?  That is probably a bunion.  Your big toe may also angle sharply in towards your other toes. If it becomes red and warm, make sure you consult us immediately. Bunions may be caused by high heels or any ill-fitting shoes. So make sure that you choose shoes with wide toe box to prevent this. To relieve pain, you may apply ice on the area.



If what you’re experiencing is a sharp pain in the heel during your first steps in the morning or at the end of the day, it could be plantar fasciitis. Prolonged standing, weight gain, the wrong shoes, over-pronation, and tight calf can all be the culprit. Make sure you always stretch before you go for a run. You can also get arch supports and night splints.



If the pain is on the outside of your upper leg or kneecap, you can try stretching that is specific for ITB. Reduce your mileage and hill work as well because this is often associated with running on roads or tracks with inclines. Aside from this, other causes may include supination, overuse, flat or rigid arches, weak buttock and pelvic muscles, and knee misalignment.



When you are beginning a training program, you may feel pain, tenderness, and even a mild swelling on the inner part of your lower legs. This may also occur when you are training too intensively and wearing unsupported shoes. Shin splints are also more common in flat feet and flexible feet. Make sure you replace running shoes every 300 to 500 miles, stretch, apply ice and have sufficient arch support. If you have shin splints, have them treated as they can lead to tibial stress fractures.


If you experience any of these common runner injuries, you can always give us a call and we can help you with the right treatment



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