What to Expect When Getting Yout Ingrown Toenail Removed

One of the most common procedures we perform on a daily basis in the office is the permanent

removal of an ingrown toenail. This simple in office procedure takes only minutes to remove a

problem you have been struggling with for months or years and it is a permanent fix. This

procedure is called a Chemical Matrixectomy.

The first step is making sure the toe is numb.I am always honest with patients and let them know

the shots are going to hurt but it is a quick process. In order to assure the toe will not feel the procedure

happening it is necessary to inject the toe in 4 seperate locations. Patients sometimes get confused by this

but I explain we have lots of little nerves that can be supplying that area of the toe and we do not want

them to feel anything! Below is a video showing how the toe is numbed.

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The procedure: After the toe is numb we go through the steps of performing an ingrown nail procedure. The nail is freed top and bottom from the nail bed and skin. Next the sliver or border of nail that is hurting is cut back all the way to underneath the skin where the nail originates at the nail matrix. Once that border of the nail is removed the medicine is applied using long q-tip applicators that will stop that border of the nail from growing again. The area is then cleansed with alcohol and a dressing is applied. The video below shows me performing this procedure.

Finally after care I tell patients this is their time to shine. If they can perform two soaking sessions a day in luke warm water and epsom and keep the toe covered with an antibiotic cream and band aid they will do awesome! I explain to patients the main goal is to keep the toe clean and the area moist. We do not want a scab to form or the toe will get red and painful.

Who gets this perfomed: we see all ages for this procedure. The summer is a particularly great time for kids to finally stop suffering from an ingrown toenail. Often a child will hide this problem from their parent until it is a total mess! But if your child has this problem you can assure them we can make it better in one office visit. We see lots of kids and adults for this problem and we always tell patients this is one of our favorite procedures to perform due to the patient satisfaction being very high after this procedure has been performed.

If you know someone suffering with an ingrown toenail and they live in Central Florida we would be happy to see them and help them with their problem by giving them a permanent solution! Make an appointment online here!

Top two injuries we see in young soccer players

Injuries in Young Soccer Players & How We Treat Them

As youth soccer programs across the country try to return to normalcy during a Covid Era, we acknowledge the top two injuries we see in these kids and how we treat them. Our youngest has coerced me, Dr. McGowan, to coach. I honestly said yes right away, but that was because I thought it would be cancelled. I know, mother of the year! Well we had our first practice under our belt last Friday and first game this Saturday coming up. This is happening! As you can see from the ridiculously unflattering picture Dr. Henne shared on social media of myself with our youngest on the soccer field Friday night, things are different. Luckily the children do not have to wear masks and it is my job to try to keep them apart, this is not the easiest task. Coaches have to wear masks, which I am totally cool with this, I just can't wait for it not to be 90 degrees at 6 pm on Fridays!!!!

Ingrown Toenail

Soccer is a sport of constant touch on the ball. In fact, the more touches you have on the ball the better you will get over time. But the repetitive microtrauma of the constant tapping in the toe box of the cleat and the occasional getting stepped by the cleat of someone else can lead to an ingrown toenail.  Ingrown toenail is best understood by the definition of the inside or outside of the toenail digging into the adjacent skin.  If the nail is not easily clipped out and has not relieved the person of the pain they may have an ingrown toenail.  This can progress to a more serious problem as the good tissue that has the nail stuck in it will perceive the nail as foreign body and will progress to a little infection.  If you are a parent of one of these little soccer players the fix may be as easy as you cutting the offended border of the nail back to where you can see it is ingrown and having them using a little antibiotic cream and band aid.  If the pain persists I would recommend going to see your podiatrist.  There is a simple in office procedure that can be performed to remove the border of the nail and place medicine in the area of the removed nail so you do not have to incur another ingrown nail.   This procedure we perform on children on a daily basis and they can usually go back to practice the very next day.  

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Calcaneal Apophysitis(Sever's Disease)

Calcaneal apophysitis is an inflamed growth plate of the heel bone.  We sometimes sees this as early as 8 years old and can be seen in or recur usually up until about 14 years old.  It can occur up until the growth plate closes in the heel bone which is about 14 years old.  This is very common and we see this also on a daily basis in the office.  Often these children will complain of very significant pain in the heel. The repetitive stress that happens from playing sports like soccer causes motion and inflammation to the growth plate.  Usually the child will complain of pain on the back or the bottom of the heel, you may notice them limping or having difficulty participating in their sport. This happens in all kinds of youth sports like basketball, football, track and soccer.  Having played soccer for 20 years, I can attest to soccer cleats not having the most support or shock absorption that you may get in other athletic shoe gear, but that again goes back to the touch on the ball. Some of the world's best soccer players grew up playing barefoot in the street(which as a foot doctor I don't condone, lol). 

Treatment for this sometimes can be as simple as a little icing, anti inflammatory and more support on the foot on and off of the soccer field. Not going barefoot can help ease the pressure on the growth plate and help it heal faster.  I usually show these young athletes some simple calf stretches which can help decrease extra stress on the growth plate from the Achilles' tendon and could help them prevent other athletic injuries that are linked to a tight posterior lower leg muscle group.  If the simple treatment does not work it may be necessary to sit out a week or two from the sport and I usually place these young athletes in a cam walker boot. This will take a lot of pressure and strain off of the heel and helps them get to playing their sport quicker.  

Good luck to all athletes, coaches and parents trying their best to get their young athletes back to what they love to do.  Hoping we all can get through this season happy, healthy and back to a little fun and normalcy! 

Dr. Michele McGowan

Center for Ankle and Foot Care

3190 Citrus Tower Blvd Ste A

Clermont, Fl 34711

352-242-2502

centeranklefootcare.com

Don't ignore your ingrown nail, especially if you are diabetic!!

Trying to keep our patients out of the ER 

• There are problems that all of your specialist can handle right now to keep you out of the emergency room
• We treat many foot and ankle emergencies right in our office
• Many podiatrist have on-sight X-ray so they can diagnosis and treat your broken bone 
• You should never ignore bruising, swelling or unexplained redness on the lower extremity

Today we are discussing ingrown toenails

• If you have a toe that is red, and swollen like the picture to the right, you should not be trying to ride this out
• Ingrown nails are typically painful, but in our diabetic patients with neuropathy (unable to feel pain from an infection is one example of neuropathy)
• If left untreated this can be a much bigger problem, infection in the worst case scenario can lead to an amputation of a toe
• Treatment is a simple in office procedure

The Video below is an ingrown nail procedure

Ingrown nail surgery:

• The toe is anesthetized with 1% Lidocaine
• The offending border is freed from the nail bed 
• An instrument is used to only cut out the ingrown border
• After the bad part of the nail is removed, a topical medicine is used to stop the border of the nail from growing again
• If the patient does not have good blood flow, this procedure can not be performed but your podiatrist can most likely alleviate some of the problem and place you on an antibiotic
• The video above is us removing an ingrown nail on a patient

Not sure if you need to be seen in the office?  You can reach out for a Telehealth visit first at:
https://centeranklefootcare.com/telemedicine-request.html

Ingrown toenail, we can fix it so it never bothers you again at the Center for Ankle and Foot Care!!!

Ingrown toenail keeping you from really enjoying this Holiday Season?   Limping while looking for that ultimate Christmas gift for a loved one due to a painful toenail?  This does not have to happen!  At our office, The Center for Ankle and Foot Care, in Clermont Florida, we can fix that the same day. Like the video above says, Dr. McGowan and Dr. Henne are available daily and can get you in quickly to help you with whatever your foot or ankle problem may be.

Read on a little more to see if what you have is an ingrown nail.  If your symptoms sound familiar to below it would be wise to get in to see Dr. McGowan or Dr. Henne so you can continue to look for your gifts for friends and family without the pain!

People describe the pain as severe at times, and even describe difficulty sleeping due to the lightest touch like that of their sheet. Below are commonly described symptoms with an ingrown nail.

   The following symptoms may be present with ingrown toenails:

• Pain
• Redness and swelling
• Drainage
• Odor
• Prominent skin tissue (proud flesh)

At the Center for Ankle and Foot Care, just like in podiatrist offices across the country, we have a simple in office procedure that literally only takes minutes to correct your  problem forever! (Unless you start to wear bad shoes or have trauma to the area!) 

Don't wait until it gets too bad to get in.  On the right you can see we only take a small portion of the nail. We put a medicine under the skin so the offending border of nail no longer grows.  In most cases you can barely tell you even had this simple in office procedure performed! Once the nail is ingrown there are not too many things you can do for yourself at home to make this better.  Call your foot doctor and get in right away!

If you would like more information about our office or our doctors visit our website at

http://www.centeranklefootcare.com/index.html

Don't let an ingrown toenail slow you down!!!!

The Ingrown Toenail Blues

If you do not know what an ingrown toenail is be thankful.  If you "think" you know what an ingrown toenail is you probably do not.  People who have had an ingrown nail know the difference.  If hurts, bleeds, smells and ruins you white socks, you probably have an ingrown nail!  Very often the toe starts to, "bother you" and a week or two later you get one of these.  Most people spend weeks doctoring their toe before throwing in the towel and seeing the doctor.  But, from our experience, the more "bathroom surgeries" you perform, the worse this condition seems to get.  Below we will discuss some of the causes of an ingrown nail and our suggestions of the best way to get it better!

Why does one get an ingrown nail?  I tell everyone it is BAD LUCK.  Some people have an injury to the toe in some manner (kick something, drop a frozen chicken on it, or a clumsy dance partner steps on it). There are many causes of an ingrown nail but the two most common are trauma and aggressively trimming back the corner of ones nail. The definition of trauma is not someone hitting your toe with a bat! It is simply being in shoes that are too small and the toe continues to get beat up and the border of the nail ingrown in many instances.

But for our patients that are kids that come in sometimes it's their parents fault! That's right there was nothing you could have done to prevent it when there is a genetic predisposition for this condition.   Daily, I will see a child whose parents are explaining that "he cut the nail wrong and now here we are"!    I then ask mom and dad, "Have either of you ever had this problem before?" And guess what, most of the time one of them raises their hand.  I then have to opportunity to show the child whose fault this really is.  I explain that nails are like hair, (no really it is the same stuff) if you have straight or curly hair, no matter how you cut it, it grows back the same way.  (Not for me, but male pattern baldness is a whole different issue.)   Likewise, if you have a curly nail, no matter how you cut it it comes back the same way.

One of the most common conditions to walk into our office is an ingrown toenail.  People describe the pain as severe at times, and even describe difficulty sleeping due to the lightest touch like that of their sheet. Below are commonly described symptoms with an ingrown nail.

   The following symptoms may be present with ingrown toenails:

• Pain
• Redness and swelling
• Drainage
• Odor
• Prominent skin tissue (proud flesh)

At the Center for Ankle and Foot Care, just like in podiatrist offices across the country, we have a simple in office procedure that literally only takes minutes to correct your  problem forever! (Unless you start to wear bad shoes again!) 

Don't wait until it gets too bad to get in.  On the right you can see we only take a small portion of the nail.  So in most cases you can barely tell you even had this simple in office procedure performed! Once the nail is ingrown there are not too many things you can do for yourself at home to make this better.  Call your foot doctor and get in right away!

If you would like more information about our office or our doctors visit our website at

http://www.centeranklefootcare.com/index.html

Article written by Timothy Henne DPM Center for Ankle and Foot Care, Inc Clermont FL 34711