My Blog

April 18, 2018
Category: Foot surgery


One of the main podiatry services that our podiatrist, Sheldon Nadal, DPM, offers is minimally invasive foot surgery. These foot procedures can be performed through  very  small  openings in order to correct many painful foot conditions and diseases, including hammertoes, bunions, painful calluses, stiff big toe, diabetic foot ulcerations, warts, heel pain, and much more. In addition, minimally invasive foot surgery is an outpatient procedure, which means a patient can go home the same day.


What IS Minimally Invasive Foot Surgery?

First pioneered in by Dr. Morton Polokoff, this technique was developed as a system of sub dermal surgery with the use of very small instruments. In the decades that followed since then, further surgical advancements led to the current state-of-art procedures, making this technique much safer and more comfortable for the patients.


This type of foot surgery is done with a very small incision that requires little to no stitching. Through these incisions, podiatrists insert specially designed instruments in order to perform the operation. Interventions are also carried out through the same small incisions, and you can expect to have minimal exposure to the surgical field. This translates to  reduced trauma to the adjacent tissue. Minimally invasive surgery lets podiatrists  reduce a patient’s  postoperative pain and swelling and may get them back to normal activities quicker.


Note that these foot surgeries should only be performed only by trained practioners because they acquire these specialized  skills  with continuing education, extensive training, seminars, and fellowship within the minimally invasive foot surgery community.


What are the Benefits of Minimally Invasive Surgery (MIS)?

These surgeries provide many benefits such as:


*Less Injury – With MIS, there is less injury to the soft tissues compared to traditional open surgeries where long incisions are made. MIS uses much smaller incisions that disturb less tissue and lead to a quicker recovery time.


*Less Pain -   In many cases, patients of MIS report less pain than those patients who underwent traditional surgeries. As a result, the patients of MIS require less use of pain relievers.


*Shorter Surgery Time – Since there is an extremely small incision, surgery times for MIS procedures  may be shorter than traditional ones.


*Less anesthesia, more qualified patients – Due to the nature of MIS procedures, patients often remain awake during the surgery and after careful local anesthesia is applied to the foot area. This reduces the use of general anesthesia.


*Less scarring – As a result of MIS procedures’ smaller incisions, scars that are left by these procedures are also smaller and less noticeable.


If you are interested in knowing more about minimally invasive foot surgeries, setup an appointment with Sheldon H. Nadal, DPM today!

April 03, 2018
Tags: hammer toes   podiatrist   hammertoes   Foot Pain  


Have you noticed or felt an abnormality in one of your toes? Do you have a toe or two that looks slightly raised up or bent? Even if you are in pain or not, these little changes in how your toes look is worth the attention, and it could be an indication of a condition called hammertoes. This is a common toe problem that can be resolved with intentional care. Do not wait until your toes become stuck in this bent position because yes, it can happen. Once it does, you will have a difficult time wearing shoes and then, it can be painful.


What is a Hammertoe?

It is a deformity that may affect the second, third, fourth or fifth toes. When the middle joint of a toe becomes stuck in a bent position, it becomes a hammertoe. It can be caused by a muscle or tendon imbalance in the foot. This condition can also develop if the structure of the foot changes over time. For instance, you sustained a prior injury to your toe, or you have been wearing shoes that  squeeze or cramp your toes. It can also be caused by an inherited foot structure. Without the right intervention, hammertoes can become stiff and rigid over time.


Repairing the Damage

Your toes, as little as they are, are unable to function as they used to when the condition worsens. They can be painful, and you will find it difficult to carry out even minor daily tasks. Calluses and corns can also develop from the raised joints that rub against your shoes. Sheldon Nadal, DPM aims to find the source of your pain and work from there, once you consult him. The progression of the deformity should be stopped, and the discomfort you are feeling should be eliminated. How can it be done? The root of the problem should be determined.


Shoes play such a major role in the development of hammertoes, so Sheldon Nadal, DPM will work with you on finding the right shape and style that will help alleviate pressure on your toes. Having a second toe longer than the rest can definitely be a risk factor for this deformity, and if that is to be the case, then we want to make sure that your shoes have adequate room beyond the toe, so it will not be forced into a curled position.


If you have a pre-existing condition or a structural issue with your feet, then you might  benefit from custom orthotics to help stabilize and support your feet. They will also minimize the pull on the muscles and tendons in your toes. There are also some simple strengthening and stretching exercises that can work the muscles in your feet. They help counteract any imbalance, so your toes can lay  flatter. If your deformity is causing the pain and the conservative methods fail to improve the symptoms, there are surgical options that will address stiff joints and release the tightened tendons if necessary.


Set up an appointment with Sheldon H. Nadal, DPM today! You should not suffer in silence anymore.

March 27, 2018
Category: Foot Care


There are certain foot and ankle problems that are caused by chronic medical conditions such as diabetes or arthritis. Even everyday situations such as wearing poorly fitting shoes or overuse of the feet can lead to temporary acute pain. You are likely to get a speedier diagnosis and treatment from a podiatrist. They provide a wide range of medical care for problems of the ankle, foot, and lower leg.


Here are some of the reasons why you should consult a podiatrist:


#01. You feel joint pain in your ankles or feet.

Arthritis is one of the most common conditions that can affect adults. If the joints in your feet are often swollen, stiff, red or tender, it is best to see a podiatrist. Arthritis can be easily taken for granted, but it can also change the way the feet function and can even lead to disability.


#02. You have diabetes.

Diabetes can make a person significantly more prone to foot problems. Such issues can range from something as simple as dry skin to something as complex as severe infections. If you have diabetes, it is best to have a foot exam performed by a podiatrist at least once a year.


#03. You have a stubborn ingrown toenail.

When a toenail grows into the skin, it can cause an infection. Ingrown toenails often affect the big toe. If your toenail is very red or  if there is drainage, make sure to visit a podiatrist for treatment.


#04. Heel pain is limiting your activities.

There are many causes as to why a person suffers from heel pain. You may have a heel spur, a bony growth on the heel. One of your tendons or ligaments that connects to your heel may also be inflamed. If you are experiencing persistent heel pain, see a podiatrist immediately.


#05. You are in need of foot surgery.

Surgery is often the last resort a podiatrist might recommend for many foot conditions. Should you need it, a podiatrist may perform surgery on the ankle and foot. Foot conditions that may require surgery include recurring ingrown toenails, bunions, hammertoes, and broken bones, among others.


#06. You have bothersome callus or corns.

Corns and calluses are some of the most common reasons why people see a podiatrist. These areas of built-up skin, if they get too thick, can be quite painful and cause discomfort.


#07. You have painful bunion.

If you have a bump at the base of your big toe, then you might have a bunion. This condition occurs when the bone or joint of the big toe is out of place. They tend to get worse unless they are treated.


These are just some of the top reasons why a person should visit a podiatrist. If you are suffering from any foot condition, set up an appointment with Sheldon H. Nadal DPM today!


March 21, 2018
Category: Ingrown toenails


Many people suffer from the pain and frustration of having ingrown toenails. Unfortunately, some cases are much worse than others’. Although uncommon, those cases often lead to surgery to remove a part of the nail – or all of it! The question now is, how do you determine if surgery is necessary for the condition of your toenail?


Here are some steps that would help you determine if surgery is necessary for your ingrown toenail before seeing Sheldon H. Nadal, DPM:


*Use a well-lit magnifying mirror (a lighted mirror and magnifying glass also work) and examine the toe. What you need to check is if the nail is improperly or irregularly curved. You want to find out this information as it can indicate the reason for the ingrown nail. If the skin is red or hot to touch, it means that the surrounding tissue of the toe might be inflamed. You should also check if the toe is swollen as this indicates possible infection. You should also check the exact location where the nail might be ingrown into the skin.


*The next thing you should determine is the pain level of the toe and its surrounding area. Rate the pain on a scale of 1 to 10, with 1 being mild and 10 being the worst you have ever felt.


*Try determining what might have caused the ingrown toenail. Common causes or wearing footwear or socks that do not fit properly or that are too tight; incorrect cutting of the nails and/or grooming methods; injury to the toe such as “stubbing” or “jamming” it. These factors will be taken into consideration by your podiatrist when deciding whether or not a surgery is necessary. For instance, you can make corrections with regards to the footwear you wear by choosing properly fitting shoes. If possible causes of the ingrown toenail are situations that can be changed, then make those changes and see if they help to improve the overall situation.


*If the situation does get worse and you find it painful or uncomfortable to do your usual routine, then setup an appointment with Sheldon H. Nadal, DPM armed with as much information as you can. Make a note of your symptoms and make sure to list any possible causes for the problem. You can also prepare a list of questions that you may have so you can ask our podiatrist at the time of your visit.


March 09, 2018
Category: Foot surgery


There are foot problems that cannot be relieved with “conservative” or non-invasive management. Podiatrists are able to determine when a surgical intervention may be helpful. Often when a deformity or pain persists, surgery may be the appropriate solution to alleviate discomfort or to be able to restore the function of your foot.



One common deformity of the foot  is bunions. A bunion is an enlargement of the tissue and bone around the joint of the big toe. Heredity plays a major role in the occurrence of bunions, as well as in other foot conditions. If you have symptomatic bunions, the affected area may become red, swollen, and inflamed. This makes wearing shoes and walking uncomfortable, painful, and difficult. Our podiatrist, Sheldon H. Nadal, DPM will determine the type of surgical procedure that is best suited for your deformity based on a series of examinations.



Another common deformity is hammertoes. This foot deformity  refers to contracture of the toe or toes, often caused by an imbalance in the tendons or joints of the toes. Hammertoes may become painful due to the “buckling” effect of the toe or toes, and the pain can be increased by footwear irritation and pressure. Corn and callus formation may also occur as a hammertoe becomes more rigid overtime, making it more difficult to wear shoes. Sheldon H. Nadal, DPM may suggest correction of this deformity through a surgical procedure that will realign the toe or toes.


Bone Spurs

Another foot deformity is bone spurs. This condition is an overgrowth of bone as a result of trauma, pressure, or reactive stress of a ligament or a tendon. This growth can also cause pain and can even restrict motion of a joint – depending on its size and location. Spurs can develop under the toenail plate, causing nail deformity and pain. A surgical treatment or procedure will be based on the location, size, and symptoms of the bone spur. Sheldon H. Nadal, DPM will also be able to determine the surgical method best suited for your condition.



Neuroma, a benign enlargement of a nerve segment, may be produced due to an irritation of a nerve. This is commonly found between the third and fourth toes. There are several factors that can contribute to the formation of a neuroma such as arthritis, trauma, high-heeled footwear, or an abnormal bone structure. Symptoms include burning or tingling in the ball of the foot or sometimes in the adjacent toes, as well as numbness. Other symptoms are swelling between the toes, and pain in the ball of the foot especially when weight is placed on it.


If you have further inquiries on foot surgery, feel free to contact us today at 416.486.9917.




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