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Both heat and ice are viable options when it comes to treating an injury, but knowing which one is appropriate for what type of injury is important. Below are some guidelines to help patients determine if ice or heat is best to treat a foot or ankle injury.

Ice Treatments

When it comes to an injury that causes swelling or is acute (this means the injury is recent or the pain or inflammation is intense), ice is usually the best treatment. It reduces swelling, inflammation, and pain.

Swelling and inflammation are vital parts of the healing process. However, if left untreated, swelling can cause further damage. For an injury that has occurred within the past 48 hours that has inflammation, icing is therefore important to aid healing.

There are a variety of different ice packs, including gel packs that can be bought at a drugstore. However, bags of ice or frozen vegetables can be just as effective. To apply an ice pack properly, follow the guidelines below.

  • Never place the ice pack directly on the skin. This can cause frostbite or other skin damage. Make sure there is a barrier such as a thin towel between the pack and the skin.
  • Never ice for longer than 15 to 20 minutes. Again, this can cause damage to the skin. It’s possible to ice more than once a day, but limit those times to 15 to 20 minutes each.
  • Remove the ice pack if it causes a tingling sensation or turns the skin bright red.

Heat Treatments

These treatments are often used for chronic conditions (injuries that are persistent or have been around for a long time). The heat promotes blood flow to the affected area and loosens stiff joints or tight muscles.

Using heat treatments effectively and safely is important to reduce burns and to ensure that joints or muscles are properly loosened to reduce pain. Items that can be used to apply heat include a towel that has been placed in the dryer, a heating pad (preferably with various heat settings), or bags that are filled with rice, wheat, or other ingredients that are heated in the microwave (be careful these don’t catch fire!).

Knowing whether to use heat or ice for foot and ankle injuries will depend on whether the pain comes from an acute injury or a chronic one. Talking to a podiatrist such as Sheldon Nadal, D.P.M., can help determine which treatment is best.


Feet are an incredibly important part of the body. They enable us to walk and move, and when they hurt, it’s hard to get around. There are a variety of different ailments that can impact feet, and one of them is a neuroma.

While this condition can happen to either men or women, it is more commonly found in women. A neuroma is a benign growth on nerve tissues, usually between the third and fourth toes, that causes pain, tingling, numbness, or a burning sensation in the ball of the foot or between the toes. Sometimes, it is referred to as a pinched nerve.


The exact cause of a neuroma is unknown, but there are several factors that may contribute to its development. These include flat feet or high-arched feet, which contribute to instability around the toe joints. Shoes that squeeze toes together or put pressure on the front part of the foot, such as heels taller than 2 inches, can lead to the development of a neuroma. An accident or trauma to this part of the foot that causes nerve damage can also result in a neuroma. Repeated stress may also lead to the formation of a neuroma.

Diagnosis and Treatment

Determining whether or not a neuroma has developed is best left to a podiatrist. However, it’s possible to find some relief in a variety of other ways until you have a confirmed diagnosis. These include the following:

  • Make sure shoes have room for toes to move so that they aren’t  squeezed together
  • Avoid shoes with heels that are over 2 inches tall since this puts pressure on the front part of the foot
  • Use a toe insert for added cushioning or make sure the soles of shoes are thick and cushioned to reduce pressure on the foot
  • Rest and massage the foot, and use an ice pack, to help alleviate some of the pain from a neuroma

If these measures don’t relieve the symptoms associated with a neuroma, there are some other methods that can be tried. These include the following:

  • Use tape or padding to relieve pressure on the front part of the foot
  • Take over-the-counter anti-inflammatory medications to reduce swelling and discomfort
  • Wear custom orthotics to reduce the pain and discomfort associated with this ailment

If none of these treatments work and a neuroma continues to make life miserable, it may require surgical intervention. Talk to a podiatrist as Sheldon Nadal, D.P.M, to determine the best course of treatment.


We all train for various reasons: to keep fit, to increase our distance, to compete in a number of different racing platforms, or to just have a more active lifestyle. Whatever category you fall into, we just all want to achieve one thing: to reach our goal injury-free!


We find that a lot of injuries occur due to repetitive stress – when soft tissues (muscles or tendons) are loaded repetitively or incorrectly. This creates an increased force over a tendon, joint or ligament for prolonged periods and it can ultimately cause these structures to fail.

Fortunately, there are some clever training tips and shoe advice that can help us achieve that one goal when it comes to running training. Check out these tips to stop repetitive forces from ruining your run:



When you are running, make sure to throw in some sprint training into your runs. You can also mix up a long distance run with some interval training which can help you strengthen your stamina. You can also take yourself to a track and just focus purely on interval training.



If, for instance, you continually run the same route, then this means that you are continually running that same road with the same camber, and the same hill at the same time in the whole course of your runs. This also means that you are undergoing the same force patterning every time you run on that route. You can try and change routes once in a while.



When you are running, do you swap the surfaces you run on? Or perhaps you continually run on the pavement, or the grass, or even on the sand? Studies have found that trail runners basically experience less repetitive stress runs than other runners. Why? Because their terrain changes all the time, and so their force input changes as well.



Taking everything above into account, changing the shoes you wear for your different training scenarios is also a must. For instance, if you are constantly running in just one pair of shoes, then your force input and loading are the same for your every run. You should look for shoes that have a thicker midsole, and a higher heel height. You need such shoes if you are doing long distance running if you want to get more miles under your belt. Smaller, lighter weight shoes with reduced heel stack racing will work better for faster runs or speed work.


If you need more help on which footwear you should look at for your different training needs, then our podiatrist, Sheldon H. Nadal, DPM, can surely help you out! Setup an appointment with him today.



Oftentimes, it takes a lot of effort to get sufficient information from our kids about how their legs and feet are feeling. And most of the time it is much harder to consider the proper and effective questions to ask! Keep in mind though, it is also hard for our kids to express how their legs and feet are feeling too.


To makes things a bit easier for kids and parents alike, we have come up with a couple of helpful hints to guide you into knowing if your kid needs a visit to the podiatrist:


#01. Your Child Avoids Activities That Involve Running, Standing or Walking

While your child might not be a natural-born athlete, he or she should not actively avoid walking, running or standing. If he or she does, then you should consider seeing a podiatrist. Able-bodied children are known to participate in a physical play. If your child, however, does not show interest even in light play, or he or she specifically decline it, then you might need to visit a podiatrist.


#02. Your Child Complains of Sore or Tired Legs

Leg discomfort and fatigue can result from foot misalignment, gait issues and other podiatry problems. It is important to see a podiatrist if your child experiences multiple strains or sprains, develop shin splints or cannot stand due to leg soreness.


#03. Your Child Complains of Foot Pain or Discomfort

Similarly, foot pain and discomfort can also result from flat feet, improper shoes and a number of other podiatry-related issues. If your child complains that his or her feet, toes and ankles hurt often, then you should consult Sheldon H. Nadal, DPM.


#04. Your Child Exhibits Disordered Standing or Walking Behaviours

Observe how your child walks and stands. Any motion should appear comfortable and natural. Take your child to see a podiatrist if you notice any of these behaviours:


*Knock knees or bowed legs

*Constant shifts from one foot to another when he or she is standing in place

*Flat feet

*Constant toe walking or tiptoeing

*Toes turned in when standing or walking


While it is true that your child may grow out of some of these behaviours, such as tiptoeing everywhere she or he goes, other behaviours might only become more pronounced over time. Flat feet, bowlegs, and other podiatry issues, when left untreated, can cause pain, reduced mobility and diminished flexibility.


#05. Your Child Sustains a Lower Limb or Foot Injury

Children can experience a range of injuries while growing up, from bumps and bruises to broken bones. Some injuries are serious and must have professional medical attention. If your child sustains a strain, a sprain, tendonitis, shin splints, a broken leg or foot or other lower extremity injuries, then you should consult a podiatrist.


Onychomycosis is known today as a major cosmetic concern. It is rarely seen for patients with nail fungus to have any pain—although quite often, these same patients will present themselves to a clinic with the concern of an unpleasant looking, discoloured and thickened nail; or they are just merely concerned that the fungus might spread.


Adverse Effects of Onychomycosis

Be that as it may, what kind of negative outcome can nail fungus have on someone’s overall health? Even though onychomycosis by definition is some type of an infection, clinical studies show no serious detrimental effects caused by this condition. Yet, for many years, there have only been limited success rates on treating nail fungus with conceivably toxic and harmful oral medications.

In the immense majority of cases studied, toenail fungus proves to be cosmetic. What happens if onychomycosis is left alone and goes untreated? Simple—the nail becomes worse. The development of lysis comes into place and the nail becomes bulky and crumbly with slightly more discolouration. It is really up to them if people want to move on through life with a discoloured or thickened nail. Help and treatments are always available for those who want to have a clear nail.

In the interim of the primary consultation for onychomycosis, the condition is usually broken down by type and severity of fungus. In addition, the condition is categorized into three levels—mild, moderate or severe—in order to simplify it. Most of the time, a superficial white onychomycosis is included in a mild nail fungus, but this should not be confused with nail dehydration. An ordinary nail fungus may occupy at least 20% of the nail and is usually thicker and discoloured with a noticeable presence of minimal lysis and subungual debris. On the other hand, patients that reveal a rather severe nail fungus have 60 to 100% involvement of nail that extends to the matrix, malodor, lysis, and subungual debris.


Possible Treatments for Onychomycosis

A nail polish holiday is usually performed as a treatment protocol for mild nail fungus until such time that the condition has cleared; followed by topical antifungal medication—efinaconazole, ciclopirox, or other antifungals. Mild Onychomycosis may go away with these kinds of treatments. If the problem persists, laser treatment may be recommended. Avoid nail salons during these treatments.

A treatment program is often utilized for moderate and severe nail involvement. This program involves everything that has been discussed for mild nail fungus treatment with the addition of a home program, oral medication, and/or lasers.


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