My Blog

January 14, 2018
Tags: bunions   bunion   podiatrist   podiatry   Foot Pain   Foot Care  


A bunion is a physical deformity in which the big toe points toward the second toe, causing a bump on the outside edge of that big toe. It can gradually develop when there is constant pressure on the big toe joint.

This can be caused by some changes in the foot’s anatomy that may result in a person’s uneven weight shift on the foot’s joints and tendons.

Many believe that bunions are caused by tight-fitting (high-heeled) shoes perhaps due to the fact that bunions are more common in women than in men. However, you should know that footwear alone cannot cause the condition; although it may exacerbate an already existing bunion because of the way those shoes keep the big toe in the wrong position.

Bunions also seem to run in families, suggesting that there may be some genetic factors behind, including foot shapes and structures that eventually lead to bunions.

Some of the conditions that may contribute to the development of bunions include:

  • Low arches or flat feet
  • Loose joints and tendons
  • Marfan syndrome, Ehlers-Danlos syndrome, Down syndrome, and other connective tissue disorders
  • Neuromuscular disorders like Charcot-Marie-Tooth disease and cerebral palsy
  • Foot injuries

Bunion Symptoms

So you might be worried that you have a bunion, but you’re not sure. Here are some of its common symptoms:

  • Trouble walking normally
  • Pain (that gets worse) in the joint of the big toe
  • Inflamed skin along the outer edge of the big toe
  • Burning feeling
  • Numbness of the big toe
  • Calluses where the toes rub

Bunions may start off small and unnoticeable, but they can really grow over time if you leave them untreated. As they progress, they can become more and more painful and hard to walk. In some severe case, the big toe extends over or even below the second toe. This puts more pressure on the second toe that is pushed out of alignment and pressed against the third toe. Additionally, if left untreated, a bunion may escalate to other conditions like hammertoe, metatarsalgia, or bursitis.


Initially, the treatment of bunions is conservative, focusing on relieving symptoms. It can include wearing wide-toed shoes, using spacers or bunion pads, using padded shoe inserts, applying ice packs or warm soaks, and taking non-steroidal anti-inflammatory drugs, among others. If the patient experiences pain and feels like the bunion is disabling him or her, a surgery may be necessary.

If you need to know more about bunions, don’t hesitate to call Sheldon Nadal, DPM today!



January 11, 2018
Category: Laser Treatment


Laser therapy is considered a safe, effective, and solution for  many painful foot problems. Using specific light wavelengths, the laser is able to deliver a strong anti-edema and anti-inflammatory effect on tissues, enabling the cells of ligaments, muscles, and tendons to repair themselves faster. It also reduces inflammation and relieves pain quickly.

How Does It Work?

Therapeutic lasers work on the principle of biostimulation which speeds up the body’s natural ability to heal through mitochondrial ATP production. It can reduce inflammation and pain in the affected tissue in just one session!

The laser targets the problem area with light beams that penetrate the damaged cells with precision so the surrounding tissues will be unharmed. These wavelengths of light effectively stimulate cell activity and encourage inflammation reduction. They also interrupt pain messages going to your brain, eliminating further discomfort.

As the pain is being blocked, cell regrowth and repair are boosted. The laser light increases the energy in the cells so nutrients can be absorbed faster, and because circulation will be stimulated, blood can transport those nutrients faster, too. These processes accelerate the overall healing process and the patient  can recover more quickly.

Laser therapy is effective in treating heel pain due to plantar fasciitis, Achilles tendonitis, bursitis, arthritis, edema, joint pain, and non-healing wounds, among others. It also aids in the speedy recovery from various sports injuries such as muscle tears, sprains, and strains. Laser therapy has cumulative effects so a series of treatments may be prescribed, depending on the type and severity of the condition. Chronic conditions can be controlled when a patient is given ongoing and regular treatments. On the other hand, acute conditions usually get better  quickly, with results noticed after  as few as one treatment. Successive treatments may also be scheduled as needed.

In a nutshell, some of the benefits of laser therapy include:

  • Relief without the need for surgery
  • Medication-free reduction of pain and inflammation
  • Improvement in blood flow
  • Improvement in nerve function
  • Accelerated wound healing
  • Speedy recovery time

If you have been suffering from an injury or have been struggling for some time now due to chronic pain, do not hesitate to contact us at Bayview Medical Center to learn more about laser therapy and how it can greatly help you. You can also call and schedule an appointment so we can evaluate your condition. We can help you get back to your active and pain-free days! 

November 11, 2017
Category: Foot Care

If you have been suffering from acute or chronic pain, chances are, you have already heard of or read about shockwave therapy. If you haven’t, then this post is for you.

Shockwave therapy is a multidisciplinary approach that is used in various fields like sports medicine, orthopaedics, urology, physiotherapy, and veterinary medicine, among others. It’s best known for its ability to deliver speedy pain relief and restoration of mobility.

Shockwave therapy is an ideal method because of the fact that it’s non-surgical and there’s no need for painkillers but still speeds up recovery from acute or chronic pain.

Shockwave therapy makes use of acoustic waves with high energy peak that interacts with tissue. This is what causes accelerated tissue repair, analgesia, cell growth, and mobility restoration.

Patients who are suffering from chronic pains, and who have been through other types of treatments that have been unsuccessful, report that shockwave therapy has worked well with them.

Will it hurt? There could be a little feeling of discomfort while the treatment is being performed. The level of pain that the patient is experiencing in the area would also be a factor on how intense the discomfort is. The good thing is, the treatment lasts for just around five minutes does not take long so patients are  able to tolerate whatever discomfort there is. Also, the intensity of the treatment may be adjusted during the session.

The number of treatments that you need depends on the indication and how your tissue would respond to it. Shockwave therapy has a cumulative effect, so you may need around three to five treatments. These treatment sessions are often performed three to ten days apart, again, depending on patient’s tolerance and tissue response.  You will probably experience immediate relief right after the first session. You also might experience soreness in the treated area within two to four hours after your treatment but it’s tolerable and won’t be very limiting. We recommend, however, that patients refrain from doing intense physical activities especially if it’s going to involve the part where you got the treatment for at least two days.

If you want to find out more about this treatment, or if you’re tired of having to deal with chronic pain, you can visit us at Bayview Medical Center and have a talk with Sheldon H. Nadal, DPM.



November 06, 2017

When you had your bunion surgery, a lump of bone was removed from the joint that connects your big toe to your foot to straighten that big toe. You can expect that there will be some swelling and it will be  tender but that will slowly improve in the next six weeks following your surgery. However, there are some patients who experience minor swelling and  tenderness that lasts up to six months.

Right after your surgery, you will have to wear a special shoe that will protect your toe and ensure that it stays in the right position in the coming weeks. The sutures or stitches will be removed by your  podiatrist in  two weeks post-surgery.

The length of recovery period varies from patient to patient. Still, there are things that you can do to get better  as quickly as possible. Here are some helpful tips:

Get Some Rest

You probably already know this but  we will tell you again – you should get some rest so you can recover faster. Avoid standing too long or walking too much. However, you should also ask your  podiatrist about rehabilitation exercises that you can do to strengthen your foot. Make sure to follow the instructions of your  podiatrist to avoid  problems.

Take Your Medicine

Your  podiatrist will let you know if you have to take medicine for the pain. If antibiotics are also prescribed you should also follow exactly what your  podiatrist says and take them for as long as needed. You shouldn’t just stop when you feel you’re already feeling better.


Take Care of the Incision Properly

After your surgery, you’ll have bandages to hold your toe in the correct position. You may  be allowed by your  podiatrist to remove the bandages on your own at home, but if you do, make sure your  podiatrist says it’s okay to get your foot soaked before you do.

Keep It Cool

To alleviate pain and swelling, you can apply a cold pack or ice on your foot for 10 minutes or so every hour. Have a piece of cloth between your skin and the ice. You should also prop up your leg on a pillow when you’re sitting or lying down for the next three days or so to reduce swelling.

Go to All Your Post-Surgery Appointments

You need to go to all the appointments set by your  podiatrist. If you experience any extreme discomfort or pain, do contact your  podiatrist, especially if you notice any symptoms that your  podiatrist has asked you to watch out for.

If you have a bunion that is bothering you, setup an appointment with Sheldon H. Nadal, DPM to find out if surgery is the best option for you.



October 27, 2017
Category: Foot surgery
Tags: foot surgery   flat feet   flat foot  

A flat foot is a terminology used to describe a collapsed arch. What most people do not know is that there are varying degrees of flatness and not all flat feet are actually problematic. There are times, however, when painful flat feet becomes more than a discomfort and gets in the way or even limit your activities.

There are two kinds of flat feet which are the flexible or mobile and the rigid or stiff. With a flexible flat foot, your foot retains motion and the arch can be recreated when there’s no weight on the foot. On the other hand, a rigid flat foot is in a way “stuck” in just a flat position, whether or not there is pressure on the foot.

The most common reasons patients look for treatment when the pain gets too much, when their flat feet interfere with their daily activities like walking, or when the appearance becomes somewhat unsightly.

Foot Lift (Flat Foot Surgery)

Flat foot surgery can be classified into three kinds – soft tissue procedures, bone fusions, and bone cuts. How the foot can be fixed largely depends on the severity of the flat foot, as well as the patient’s age and whether or not the foot is stiff. Sometimes, a combination of these procedures is performed.

For flexible flat feet, the surgery’s goal is to maintain the motion of the foot and the recreation of the arch. This could involve repairing the tendons along the inside of the foot so the main tendon lifting the arch can be reinforced. If the bone collapse is significant, bone procedures may have to be included to rebuild the arch, as well as realign the heel. Bunions also contribute to the collapse and need correction.

Tendon Transfers and Augmentations

There is a tendon inside the foot that can be injured, split, ruptured, or just weakened. This is the posterior tibial tendon – the main arch supporting tendon. Damage to this tendon can collapse the arch. If the case is mild, it can be restored to its strength and repaired. In most flat foot surgeries, a tendon augmentation is combined with other procedures to restore balance and structure to the foot.

Joint Spacers

This involves placing a metallic implant right at the junction where the ankle and the foot meets. This will prevent the collapse. It is a procedure that is applicable only for mobile feet and never used for rigid flat feet.

The Risks of Flat Foot Surgery

All surgeries have risks, and surgery for the flat foot is no exception. There can be complications that are neither your or your surgeon’s fault. It is important that you understand those risks. Those complications include pain, infection, swelling, bleeding, blood clot, hematoma, poor healing of the wound and/or the bone, nerve injury, disability, unsightly scar, weakness, and more.

Sheldon Nadal, DPM can help you understand what goes on during a flat foot surgery and what you can expect after. Do not hesitate to setup an appointment with him today!

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