Your Best Foot Forward

MARCH 2018

YOUR BEST issue01

FOOT FORWARD

NEVILLE FOOT & ANKLE CENTERS PRACTICE MAGAZINE

tohveePrcro3o0umdylmeyuanriSsteyr fvionrg MEDICALSP&ECIASLIUZINRG IGN TIHCE AL CARE
of
diseases, deformities, and disorders of the foot and ankle

 DR. ELDEWEARD  D CR.U STRARCYEY DNRE. VROILBELRET DPRA. TSUENLI LADNR.G EAUGNESNAE N RODRD. RMIIGGUUELEZ

WHAT WE DO WHY WE DO IT

We Specialize in the Our practice was founded with one
moef ddiicsaelaasensd, sduerfgoircmalitcieasr,e intention; To help our patients get
and disorders of the foot
bmaocbkiltiotye!nTjohyaitnmg atnhteriar liisvaess twriuteh
and ankle today as it was 34 years ago!

WHERE WE DO IT

W O O DT HLEA N D S SPRING TRAILS CONROE

1120 Medical Plaza Drive Ste. 180 28533 Spring Trails Ridge Ste. 105 1222 N. Loop 336 West
The Woodlands, TX 77380 Spring, TX 77386 Conroe, TX 77304

281.364.9041 281.364.7301 936.760.3736

INSURANCE PLANS ACCEPTED

PREFERRED PROVIDER OF MOST ALL INSURANCE PLANS & MEDICARE

AETNA AEXCEL POS II • AETNA AXCEL OPEN ACC • AETNA CHOICE POS II • AETNA MCR HMO PREMIER • GEHA
AETNA MANAGED CHOICE • AETNA MCR PPO • AETNA MERITIAN HEALTH • AETNA OPEN ACCESS • AETNA SELECT 

AETNA OPEN CHOICE PPO • AETNA SELECT •  AETNA SIGNATURE PPO • ASSURANT HEALTHCARE
BCBS HMO (ZGK, ZGN, ZGI, ZGY) • BCBS HEALTH SELECT (JEA) • BCBS BLUE ESSENTIALS ACCESS PPO • BCBS BLUE

CHOICE PPO BOON CHAPMAN - MONT COUNTY PPO • CIGNA OPEN ACCESS • GILSBAR CIGNA • GREAT WEST
GROUP AND PENSION HARVARD PILGRIM COMPANY • HEALTHSCOPE PPO • HUMANA CHOICE CARE PPO

HUMANA MCR ADV (TRS ONLY) • HUMANA NPOS • MEDICARE • MEM HERM PPO • PROVIDENCE HEALTH PLAN 
MEMORIAL HERMANN BRONZE • MEMORIAL HERMM GOLD 2000-2500 PPO • MEM HERMM SILVER PPO

MERITIAN HEALTH • NALC • PHCS MULTIPLAN • STARMARK PPO • TRICARE STANDARD • UHC AARP MCR ADV
UHC ALL SAVERS • UHC CARE IMPROVEMENT (GROUP) • UHC CHOICE EPO • UHC CHOICE PLUS

UHC CHOMPASS EXCHANGE • UHC MCR PPO • UHC OPTIONS PPO • UMR • WEB TPA WELLNET (AETNA)

PpoewlueoriaptsrhleeerptSeuhsTteuAaltSNtisOoDntLoo.E.n.. CareCredit accepted here! Love your Foot Doc?
Give them a 

5-STAR Review at 
NevilleReview.US

Your Best Foot Forward 03

contentsissue 01
March 2018

03
A NOTE FROM THE OWNER

Why for some people, Podiatry isn't a job.

04
INNOVATION

The 5 most innovative foot and ankle
technologies that are changing the industry

07
RUNNER'S FEET

Whether you are a sprinter, a distance runner or just
a casual jogger, check out these tips from Dr. Lee

10
LAB MATTERS

Lab Reports are often considered to be confirmation
of an physician diagnosis, but better/more
information may shape the treatment options for
more affordable and faster results!

14
5 REASONS TO TREAT
DIABETIC FEET

The more you know about your Diabetic feet.

"Your feet SHOULD NOT HURT and pain indicates something is wrong!"

A Note From the Owner "Podiatry isn't just
my career,
For Dr. Robert Neville, podiatry isn't a career, it's a calling! From the day he it's my passion!"
opened his first practice, his mission was to assemble the most talented and
dedicated team of experts that share his passion for mobility and wellness. And -Dr. Robert E. Neville
that's exactly what he did!

"If you've ever had a foot injury, you understand the impact it makes to your daily
mobility. Simple, yet important tasks can be made difficult which can have a
drastic effect on one's quality of life."

The foot and ankle is one of the most critical elements of mobility, yet one of the
most under appreciated. As a result, it they don't receive the proper care and
maintenance.

"When I began my journey into medicine, I wanted to help people in a profound
way. Whether it's to help a child play sports or a dad walk his daughter down the
isle, mobility plays an important role in many of our unique experiences is life."

For over 30 years, Dr. Neville and his staff have helped people from all "walks of
life" get back on their feet again!

DR. ROBERT NEVILLE

Providing Professional Care for the Community for 34 Years

1stCLASS ✓ BOARD CERTIFIED PODIATRIC PHYSICIAN AND SURGEON, ABPS
✓ FELLOW, AMERICAN COLLEGE OF FOOT & ANKLE SURGEONS
SURGICAL CARE ✓ DIPLOMATE, AMERICAN BOARD OF PODIATRIC SURGERY
✓ ASSOCIATE, AMERICAN ACADEMY PODIATRIC SPORTS MEDICINE
✓ “TOP DOC” PODIATRIC MEDICINE & SURGERY, H-TEXAS MAGAZINE
✓ “ATTENDEE OF THE YEAR” HOUSTON PODIATRIC SURGICAL RESIDENCY
✓ PAST PRESIDENT, HARRIS COUNTY PODIATRIC MEDICAL SOCIETY
✓ SURGICAL INSTRUCTOR, HOUSTON PODIATRIC SURGICAL FOUNDATION
✓ MEDICAL/SURGICAL DIRECTOR, FOOT & ANKLE HEALTHCARE CENTERS
✓ CHIEF OF PODIATRY, MEMORIAL HERMANN HOSPITAL (THE WOODLANDS)
✓ MEMBER, TEXAS AND AMERICAN PODIATRIC MEDICAL ASSOCIATIONS]

Memorial Hermann Surgical Centers

Dr. Robert Neville and his professionals greatly enjoy and have weekly surgical block time, as Memorial Hermann Surgery Centers
Woodlands Parkway. It is accredited by The Accreditation Association of Ambulatory Health Care, Inc., The Joint Commission. For over
twenty five years, the Surgery Center has been providing first class surgical services for the local community in a safe, comfortable and
welcoming environment; one in which we would be happy to treat our own families.

Dr. Neville is the #1 surgical case provider for Podiatric surgical services, and has been a provider of The Center from it’s opening in The
Woodlands. The Surgery Center is a quality, cost-effective, personalized, same-day (out-patient) surgical environment close to home.

The staff are well-trained, friendly, compassionate, caring, and
highly professional. Memorial Hermann Surgery Center The
Woodlands Parkway is an in-network provider and accepts
most major insurance plans including Medicare. Patients who
do not have insurance plans or insurance coverage may
consider options of cash, major credit cards, cashier’s checks,
or Care Credit.

YBFF The Center is located just off The Woodlands Parkway near
Six Pines. Our professional staff are dedicated to providing
the highest quality of individualized care to each of our
patients. We want to make your surgical experience as
pleasant and comfortable as possible. Our patient-focused
approach is intended to promote long-term health and well-
being, resulting in a high degree of patient satisfaction.
Neville Foot and Ankle Surgeons are active staff Physician
Providers of hospitals in the commuNniOtyM. A D I C | 2 4

OUR SERVICES

SCHEDULE YOUR APPOINTMENT
RIGHT FROM YOUR PHONE!

COMPLETE FOOT & ANKLE SCREENING & TREATMENT PEDIATRIAC, ADULT, SENIOR &
ENDO/ARTHROSCOPIC FOR VASCULAR DISEASE ARTHRITIC CARE
SURGERY

DIGITAL  X-RAY IMAGING ANKLE & FOOT PHYSICAL MLS LASER INFLAMMATION & 1) OPEN YOUR CAMERA
SERVICES THERAPY & REHABILITATION  PAIN TREATMENT THERAPY 2) AIM AT THIS CODE
3) CLICK ON THE LINK

WORKS WITH MOST SMARTPHONES. YOU CAN ALSO VISIT
WWW.NEVILLEFEET.COM TO SCHEDULE APPOINTMENT

KERNYEFWLEX

COMPUTERIZED GAIT DIABETIC ROUTINE AND PINPOINTE LASER FUNGAL
ANALYSIS & FOOT SCANNING WOUND CARE TREATMENT NAIL THERAPY

DIAGNOSTIC ULTRASOUND, RECONSTRUCTIVE SURGERY, ROUTINE FOOT CARE SERVICES NAIL COSEMETIC AND
CT & MRI SERVICES TRAUMA & SPORTS FOR ALL AGES RESTORATION SERVICES
MEDICINE
OUR SPECIALITIES

• HEEL PAIN • TENDONITIS • INGROWN TOENAILS • FALLEN ARCHES • WOUNDS • CYSTS
• PLANTAR FACIITIS • ARTHRITIS • WARTS
• BUNIONS • FLAT FEET • GAIT ABNORMALITIES • ARCH PAIN • NUMBNESS • ULCERS
• FUNGUS NAILS • FOOT PAIN • TUMORS
• HAMMER TOES • HEEL SPURS • INFECTIONS • ANKLE PAIN • NEUROMAS • GOUT
• BONE SPURS • ANKLE SPRAINS • GROWTH DISORDERS • WALKING DISORDERS • ORTHOTICS • BURSITIS
• INJURIES • CLAW TOES
• SPRAINS/STRAINS
• FRACTURES • RX SHOES
• CORNS/CALLUSES

! Take the Check-upUNSURE IF YOU NEED PODIATRIC SERVICES?
ON PAGE 7 OF THIS MAGAZINE

NOMADIC | 24

SCORE RESULTS TAKE THE

1-2 CHECKED: SEE A FOOT SPECIALIST CFOHOETCHKE-UAPLTH
2-4 CHECKED: SEE A FOOT SPECIALIST NOW

5+ CHECKED: YOU GOT THE HIGH SCORE!

ANY CHECK SHOULD PROMPT A CALL TO OUR
OFFICE FOR A CONSULTATION AND
EXAMINATION.

The bottom of my heel hurts, especially first thing in the morning. I have a protruding lump or growth on top of my foot.

I have a deep burning pain with numbness in the ball of my foot. I have a bothersome knot on the bottom of my foot.
I have a painful bump behind my big or little toe. I have annoying corns and calluses that build up on my feet.
My toenails dig into the surrounding skin. I have a limb length discrepancy.
My ankles feel weak an I easily tend to sprain them. I am in need of special shoes.
I have a painful red swollen joint in my foot. I have tried inserts and orthotics, but can't use them.
I have arthritic pain to my feet. I have had an amputation to a part of my foot.
My toes are crooked, cocked-up or bent.
I injured my foot or ankle and it won't get better. I had poor results with a previous foot/ankle surgery
I think I broke my toe. I have pain in my foot that just won't go away.
My arch is flattening and is easily fatigued. I have a weakness to my ankles.
My toenails are brittle, discolored, or deformed. I have hardware in my foot or ankle that bothers me.
My child has not developed an arch. I need a good "second opinion" about my foot problems.
I can't find any shoes that provide a comfortable fit. I can no longer take care of my toenails or feet.
My skin gets dry, cracked, itchy or inflamed. I stepped on something and it embedded in my foot
I have numbness or electrical shooting pain to my feet. I can no longer wear closed-back shoes.
I stubbed my toe and it is black and blue. I had to give up running because of my feet.
My feet tend to develop blisters or open wounds. I feel like I'm losing circulation & feeling to my feet.
My child walks "pigeon-toed" (in-toed). My arch is collapsing and falling down.
I have an infection to my foot.

My child walks "like a duck" (out-toed). I have a deformity or scar to my foot.
I stubbed my toe and injured my toenail. I have swelling to my foot.
I have an open wound, ulcer, cut or burn to my foot. I have fungus toenails or discolored toenails
I limp, compensate or favor my gait. I have sweaty, smelly feet.

I have a weakness in my legs or feet. I have a bone that won't heal in my foot.

I must lose weight, but can't exercise because my feet hurt. I have no fat left on the ball of my foot.
"When my feet hurt, I hurt all over". I have an extremely high or low arched foot
I injured my foot or ankle in sports or exercise I need prescription shoes, inserts, prosthetics or orthotics.
I am knock-kneed (knees turn in) or bow-legged (knees turn out) I need prescription shoes, inserts, prosthetics or orthotics.
My feet are getting worse as I get older. I am a diabetic and concerned about ANY foot problem.

NOMADIC | 24

5 INNOVATIONS

THE 5 MOST SOOn LThUeTMIOarNkeSt TODAY
INNOVATIVE

FOOT & ANKLE

Most advancements in podiatry is known within its inner circles and it stands to reason. There's not a lot of public demand for marketing materials for
tools used to improve Podiatric results. However, we believe that understanding innovations can help patients make more educated decisions for their
own wellness. Here's the top 5 most disruptive products as compiled by Neville Foot & Ankle Centers, an industry leader in Podiatry.

5) No Pain, No....Pain MLS Laser Therapy is quickly becoming the standard of care in
alleviating both acute and chronic pain. This patented, FDA-
The MLS Laser is breakthrough technology because of its cleared technology has an 85% - 90% efficacy rate in relieving
ability to reduce inflammation and soreness using light energy pain and inflammation, eliminates risk from surgery and
which stimulates damaged cells inside the foot and ankle! The prescription pain killers, has no negative side effects, and
process is non-evasive and patients commonly see results restores patients’ lives.
within a couple of sessions

Neville Foot & Ankle Centers offers this amazing 
technology! Ask your Podiatrist for more information.

25,000AN ESTIMATED 4) Full Range Ankle Replacement? Woah! 
PEOPLE
The Scandinavian Total Ankle Replacement (STAR Ankle) is an implant replaces
A YEAR RECEIVE ANKLE FUSION painful arthritic ankle joints due to osteoarthritis, post-traumatic arthritis or

rheumatoid arthritis. The STAR Ankle differs from other ankle replacements in that
it uses a mobile bearing versus a fixed bearing and does not require the use of
bone cement during implantation. It's the first and only three-piece approved
mobile bearing ankle implant available in the United States.

3) A Breakthrough in Toenail Care! https://footankle.stryker.com

Tolcylen™ is the first antifungal, cosmetic, and nail renewal treatment, all in one 25% OF ADULTS WILL EXPERIENCE
product! It is available without a prescription and dispensed exclusively through SOME TYPE OF 
physicians. Why is it a game-changer? Because up until this point, it took 2-3
medications with different application times/processes to achieve what FUNGUS
Tolcylen™ can with a single daily application!
BY THE TIME THEY ARE 40 YEARS OLD

 http://marlinzpharma.com

2) Seeing is Believing!!

With 4096 sensors and a scan rate of 300 frames per second, GaitScan™ is the
industry leader in dynamic scanning capabilities which means we now have
access to a wealth of information that cannot be obtained with the naked
eye. The TOG GaitScan™ provides Neville Foot & Ankle Centers with a
comprehensive biomechanical analysis as well as clear, concise
images to assess the need for orthotic therapy.

http://www.tog.com

1) A BIG Alternative to Joint Fusion in a Small Package!

Cartiva synthetic cartilage provides an alternative to tissue-based treatments
without exposing the patient to the risk of viral transmission or an inflammatory
response because it does not contain substances derived from human or animal
tissue. It allows surgeons to provide an option to the decades-old joint fusion
procedure.
https://www.cartiva.net

Neville Foot & Ankle Centers proudly uses Cartiva with tremendous success!

The rankings are determined by a number of factors including but not limited to: effectiveness, number of people the product helps, our own experience with the product, cost of
the products and criticality of the issues the products resolves. Other factors include off-label utilization, ease of application, speed of results and pain reduction.

Steps for choosing The Perfect-fitting shoe:
the right running
With Custom Orthotics
3shoe
FROM THE SPECIALISTS
1. WHAT TYPE OF RUNNER ARE YOU?
Orthotics are orthopedic devices that are used to alter or modify foot function and are designed to treat, adjust,
Depending on whether you're a sprinter or and support various biomechanics foot disorders. The most effective orthotics are custom-made devices that are
distance runner, you may have different crafted to meet the specific needs of a particular individual. The finished orthotic is placed in the patient’s shoe
requirements. A Distance runner will often look to support the foot and eliminate abnormal foot biomechanics by keeping the foot properly aligned. Depending
for proper impact protection (cushion) while a on the patient’s needs, the orthotic may have padding to cushion the foot and make it more comfortable.
short-distance runner puts a premium on
weight of the shoe. Both need the proper fit! How Orthotics Work: One of the foot’s main functions is to absorb shock as the body’s weight shifts with each

2. HOW DO YOU RUN?   step. It does this through a complex process in which the arch of the foot flattens slightly. This absorbs and
distributes the weight throughout the entire foot. This coordinated motion is a complex process in which many
Your gait and stride can influence how your things can go wrong. If a structural problem is present, the foot can collapse under the body’s weight. Over time,
feet impact the ground. Pronation and
supination can require custom shoe inserts or stress on the feet can result in deformities. Running exerts much greater force on the feet than walking and
orthotics, but will save your feet over the long can lead to more severe injuries such as sprained ankles, shin splints, and fractures. A properly
term. designed orthotic controls how the foot strikes the ground, absorbs shock, and reduces stress in the
foot.
3. WHERE DO YOU RUN?
Who should use Orthotics? Almost anyone, from children to adults, can benefit from orthotics. Orthotics can
If you're running on a track, the street or
rugged terrain, you'll want different types of alleviate many common foot problems that cause pain and discomfort in otherwise healthy people.
shoes. You may sacrifice some weight for
protection for surfaces that are uneven and Low Impact Alternatives The average person takes more than 8,000 steps per day.
vice versa for consistent surfaces like a track. to Running Each step requires the orchestration of 52 bones, 66 joints,
In either case, getting the right equipment can 38 muscles, and 214 ligaments. When any of these are not
prolong your running career! For those looking to reduce the in ideal alignment, the body is prone to develop pain.
impact-related stress on the
NOTE: PAIN/NUMBNESS/WEAKNESS foot while keeping an active
IS NOT NORMAL AND CAN BE SIGNS lifestyle, consider one of these
OF A BIGGER ISSUE. IF YOU ARE
EXPERIENCING ANY OF THESE, ASK low-impact exercises:
YOUR PHYSICIAN ABOUT GETTING
AN EMG STUDY! Swimming, Cycling, Elliptical,
Yoga, Resistance Training,

Rowing, Tai Chi, Pilates,
Walking, Barre, Stair Stepper

Low Impact Exercise - A
workout in which at least one
foot remains in contact with the

ground at all times.  

Runners should see their Podiatrist once every 6 months due to the potential of repetitive stress injuries!

RUNNER'SH O W T O P R E V E N T
FEET

By Dr. Edward Lee

The term "runner's high" is ubiquitous, but what about "runner's SHOELACES
feet"? When it comes to running, the foot & ankle are critical body
parts to the process as they are receiving the impact and force of As tight as you can get them without cutting off circulation.  This helps
the movement.  prevent sliding feet within the shoe

Runner's have a cult-like connection with each other, often BRACES
providing anecdotal information on how they can prepare their
feet for the journey ahead.  If you're dealing with existing ankle injuries, you may consider an
ankle brace for increased protection. An ankle brace can restrict
The truth is, much of the information that is passed is great, but not over-supination/pronation of the ankle.
all. Here's some tips we recommend to protect your feet & ankles
for running: TERRAIN

SHOES We recommend running on soft surfaces: Grass, a track,
treadmills, etc. Concrete is unforgiving and causes increased
Get the right shoes for the type of running you'll engage in. Getting impact on the joints. However, if you're going to run on concrete,
a shoe with limited cushion is not idea for distances. You'll want to minimize the effects to your body by getting proper shoes that fit
increase the comfort of impact to decrease forces on your joints. and even adding an insert for more comfort
And it goes without saying, get the right fitting shoe!
YLOOURVFEEET A CUSTOM ORTHOTIC
Custom Orthotics or shoe inserts are important to correct a flat foot COULD MAKE RUNNING
or high arches for those that have biomechanics issues. This helps
distribute the weight of your body and forces incurred throughout MORE ENJOYABLE!
the entire foot correctly. 
A custom orthotic can help align joints              throughout the entire leg, creating a
SOCKS more natural running motion with less wear on joints. Additionally, the orthotic can
help evenly distribute the weight and impact on the foot which can reduce pain.
You'll want to invest in a sock that can wick away moisture to Ask your doctor about getting fitted for a custom orthotic!
prevent blisters. You don't want socks that are thick, the padding of
the shoe should be enough comfort. Use 100% cotton socks , not NOMADIC | 24
blended fabrics.

Compression socks can help keep heat around the foot and ankle
which is ideal for soft tissues.

TOES

Clip your toenails to proper length. A long toenail can slam up against the
shoe and break during the run which can be extremely painful.  If you have
toes that rub together, you can use a lubricant like vaseline or even a
bandaid to prevent skin-to-skin friction.  about 2 minutes per side

LAB WHAT'S IN YOUR
REPORTS LAB REPORT

THAT IDENTIFY PATHOLOGY, TOXICOLOGY AND HISTOLOGY REPORTS ARE VITAL TO ENSURING
POSITIVE FOR THAT THE PROPER MEDICATION AND DOSAGE IS PRESCRIBED. LAB REPORTS ARE
DERMATOPHYTES
(TOE FUNGI) MORE THAN ANALYZING FOR POSITIVE OR NEGATIVE RESULTS, BUT CAN
IDENTIFY A SPECIFIC STRAIN OR FUNGI WHCH COULD MAKE A FUNDAMENTAL
WILL INFLUENCE THE
TREATMENT REGIMEN DIFFERENCE IN TREATMENT OPTIONS. 

FOR THE PATIENT THE PROCESS FOR GETTING A HISTOLOGY REPORT FOR TOENAILS (FOR EXAMPLE)
IS INCREDIBLY SIMPLE FOR THE PATIENT (A BIOPSY OF THE TOENAIL), HOWEVER IT
COMMON EXAMS IS AN IMMENSELY COMPLEX AND STRUCTURED SYSTEM OF OPERATIONS REQUIRED
FOR PODIATRY
TO DELIVER THE RESULTS CONSISTENTLY AND QUICKLY.  
MRI
X-RAY LAB RESULTS MATTER
ULTRASOUND
HISTOLOGY (FUNGAL)
VASCULAR (VEIN)
EMG (NERVE)

Do I need a test for Nerves? EMG

Peripheral Neuropathy is a common nerve problem resulting from damage to nerves of the EMG IS A HIGHLY EFFECTIVE TOOL THAT
peripheral nervous system. Nerves become damaged by complex biomechanics reactions PHYSICIANS USE TO IDENTIFY
associated with trauma or other diseases. Diabetes (Diabetic Neuropathy) is a common NEUROMUSCULAR DISEASES.
cause of peripheral neuropathy. Chronic alcohol consumption, circulatory problems,
medications, chemotherapy, various toxins such as heavy metals, AIDS, and other problems EMG IS USUALLY PERFORMED WITH
can lead to peripheral neuropathy. People with neuropathy are prone to ulcerations, ANOTHER ELECTRODIAGNOSTIC MEDICINE
infections, injuries, and amputations. TEST THAT MEASURES THE CONDUCTING

Are you at risk for Peripheral Neuropathy? FUNCTION OF NERVES. THIS IS CALLED A
Please review the symptoms to see if you could be at risk for Peripheral Neuropathy. A NERVE CONDUCTION STUDIES (NCS)
“YES” to any of these questions may qualify you for tests to evaluate the health of the
nerves in your back, legs, and feet. Talk to our health care professionals if you have
symptoms of neuropathy, because early treatment may delay further damage.

• Do you have feet that feel numb? • Do you get any sharp, stabbing, shooting pain in your feet?

• Do you have burning pain in your feet? • Do you consume excessive amounts of alcohol?

• Are your feet too sensitive to touch? • Do you have diabetes?

• Do you get muscle cramps in your feet? • Do your feet feel weak when you walk?

• Do you have prickling or tingling feelings in your feet? • Are your symptoms to your feet worse at night?

• Do your feet hurt at night when the covers touch your skin? • Do your feet hurt when you walk?

• When you get into the shower, are you unable to tell the hot water from the cold? • Is the skin on your feet so dry that it cracks open?

• Do you have electrical shock-like pain in your feet? • Do you not feel open wounds or injuries to your feet?

• Have you experienced an asleep feeling or loss of sensations in your feet? • Have you ever had prior testing of your nerves to confirm any concerns?

CALL 281.364.9041

gnidneP stnetaP elpitluM www.marlinzpharma.com

"The results our clients
experience speak for
themselves
which is why we
trust Tolcylen."
-Robert Neville, DPM

SPONSORED ADVERTISEMENT
Sponsored Advertisement

The First of it's kind!

Tolcylen™ is the first and only antifungal, cosmetic, and
nail renewal treatment, all in one product.  It is
available without a prescription and dispensed
exclusively through physicians. Tolcylen™ is the only
antifungal product of any kind to feature FDA
approved antifungal and proven cosmetic agents.  The
Tolcylen™ cosmetic and renewal agents are able to
rapidly improve nail appearance in compromised nails.
 Urea, Lactic Acid and Propylene Glycol softens, thins
and lightens brittle and discolored nails while acting as
penetrating agents for the other ingredients. Jojoba
Oil and Vitamin E can moisturize and revitalize nails,
while promoting healthy nail appearance and growth.
The patented delivery system is user friendly and the
applicator brush tip controls flow while effectively
dispensing medication on and around the edges of
nails.

PAGE 17

FAAunmgounsg Uson·y·cho·my·co·sis (ŏn’ĭ-kō-mī-kō'sĭs) n.

A fungal infection of the fingernails or toenails that results in thickening, roughness, and splitting of the nails.
It is usually caused by Trichophyton rubrum or T. mentagrophytes. Also called tinea unguium.

Onychomycosis is an invasion of a toenail by fungus, mold or yeast. It is the most common disease of the nails and
constitutes about 50% of all nail disorders. It occurs almost exclusively in adults. 40% of adults over fifty years old suffer
from it, and one in two people over the age of 70 suffer from it.
Onychomycosis causes the nails to become thick, discolored, brittle, and disfigured. If left untreated, the skin underneath and around
the nail can become inflamed and painful. The incidence is increasing in adults with risk factors including increasing age, diabetes, nail
trauma, peripheral vascular disease, athlete’s foot, as well as sweaty feet in shoes with poor ventilation.
Other diseases such as psoriasis, contact dermatitis, a weakened immune system, and bacterial infections may imitate Onychomycosis.
Topical creams and lacers are the most conservative forms of treatment. However, topical treatments are usually slow to work because
they do not penetrate the nail plate very well. Regularly scheduled professional debridement of the nail is essential to allow effective
infiltration of the medicine into the nail plate and nail bed. Prescription oral tablets are available and are much more effective than use
of topical treatments alone.
The newest generation of these anti-fungal pills offer higher cure rates over a slower course of treatment. They also have fewer side
effects, and are now much more inexpensive than they were in the recent past. It is also imperative to take a nail biopsy (clipping or
swab) and understand the true pathogens of the nail before choosing an appropriate treatment option.
For patients with toenail fungal infections that have failed to improve with more conservative treatment, we encourage the use of
Tolcylen topical anti-fungal solution, oral medication with appropriate laboratory blood tests, temporary or permanent nail
debridement, KerryFlex, Nail Scrub, Dr. Remedy Nail Polish, or the PinPointe™ Laser. 

FACT

40% OF PEOPLE OVER 50 HAVE FUNGUS TOENAILS

PinPointe™  Laser Treatment

The first FDA cleared laser for the temporary increase of clear nail in patients with Onychomycosis.
Stop suffering the pain and embarrassment of unsightly nail fungus. PinPointe™ FootLaser® is the easy and convenient
procedure that helps turn your discolored and disfigured nails into clearer, healthier looking nails.

How long does it take?

This in-office procedure is virtually painless, has minimal side effects, and typically takes only about 30-minutes to complete.

How does it work?

The PinPointe™ FootLaser® targets the fungus that lives in and under the nail.
The laser light passes through the nail without causing damage to the nail or
the surrounding skin. At the time of the procedure, the toenail will not become
instantly clear— it takes time to grow out.

KILLING TOENAIL FUNGUS AT THE SPEED OF LIGHT

12 YBFF

THE DO's & DON'Ts 
of Diabetic Foot Care
DON'T DO

Don’t ever go barefoot, net even in your own home. Do practice daily hygiene. Wash feet everyday with soap, Fact: Diabetes is the leading cause
warm (not hot) water and pat dry making sure to dry of amputation of the lower limb.
Don’t do home surgery on yourself. Never use razor
blades, scissors, knives or medications to remove between toes. Use powder or creams approved by your Yet it is clear that as many as ½ of
calluses or corns. Don’t try to remove ingrown toenails. doctor. Do trim your toenails carefully. Avoid injury, don’t these amputations might be

Don’t Smoke! Enough said. dig into the corners. If you cannot care for your nails prevented through simple, but
properly, visit our diabetic foot care specialist routinely. effective foot care practices.
Don’t wear tight stockings, shoes, socks or panty hose. People with diabetes are
These can cut off blood flow to your feet. Also, avoid Do wear proper shoes and socks. Check the shoes for
crossing your legs for long periods. rough seams, pebbles or potential irritants inside. Proper vulnerable to nerve and vascular
Don’t use heating pads, hot water bottles or electric damage that can result in loss of
blankets! Don’t put your feet in water without testing it sized and fitted shoes are important. Visit our shoe protective sensation in the feet,
first with your hand, elbow or a thermometer. Diabetics specialist for a consultation. Wear thick soft socks, be sure poor circulation and poor healing
can easily burn themselves and not feel it.
a seam is not an irritant. Visit our diabetic sock and of foot ulcers. Diabetes can
diabetic shoe selections in the office. contribute to foot problems in two

Do keep your health good. Lose weight. People with ways: Neuropathy and
diabetes are commonly overweight which nearly doubles Vasculopathy.
the risk of complications. Obesity itself can cause insulin
resistance and lead to the onset of diabetes. Exercise to Diabetic Neuropathy is the
keep your weight down and improve circulation. Walk to decreased or loss of nerve
increase foot strength and flexibility. Just be sure to consult sensation to your feet. This
condition makes it hard for you to
with your doctor before starting any exercise program. feel injuries or sore sports that can
breakdown as open wounds,
ulcerations and infections. If left
untreated or if unresponsive to
treatment, these skin wounds can
lead to gangrene and amputation.

Don’t drink alcohol. Excessive use of alcohol can Do manage your diabetes. Monitor and control your blood Diabetic Vasculopathy is the
contribute to neuropathy (the loss of nerve sensation). sugar. Take medications as prescribed. Eat healthy foods. decreased or loss of blood
See members of our diabetic healthcare team for regular
Don’t ignore foot deformities. Protruding bones, circulation to your feet. This
thickened toenails, contracted or overlapping toes, checkups. condition ay cause your feet to
falling arches; all present potential for concern. When Do inspect your feet daily. Any concern to your feet is a become cold, discolored, painful
you have diabetes, it’s easier to prevent problems than potential serious problem. Look at your feet every day for
hotspots, blisters, cracks, ulcers, infections or injuries. If and again, vulnerable to skin
treat them later on. poor vision or arthritis makes it hard for you to do this breakdown. Your blood nourishes
yourself, have one of our specialists look at your feet.
THE INCIDENCE tissues and carries infection-
O DIABETES WARNING SIGNS fighting cells to those tissues that
OF DIABETES MELLITUS
S need them. With a change in the
[SUGAR DIABETES] blood flow, diabetics are at greater
T tee
WORLDWIDE HAS REACHED ALMOST EPIDEMICwS risk for infection, causing minor
O Any of these symptoms could spell DIABETES injuries like a blister or crack to
PROPORTIONS WITH NEARLY
N D IURETIC SYMPTOMS: The frequent urge to urinate advance into a serious life-
26 MILLIONPEOPLE AFFECTED BY THE DISEASE threatening concern.
T IN THE UNITED STATES ALONE!
Proper care, hygiene and
inspection of the feet are critical

for a person with diabetes. The
risks of developing foot problems
can be greatly reduced if you see
your doctor regularly and follow
the simple principles of foot care

outlined here.

C I NCREASED frequency of infections

A A BNORMAL weight loss
B LURRED and progressive loss of vision
F DON'T LET

E XCESSIVE thirst DIABETES GET
T XTREME hunger
SE  LOW to heal wounds and sores A FOOTHOLD
ON YOUR LIFE!

5 Reasons to Treat
Diabetic Feet
If you or someone you know is
5) The average cost for home care for an amputee is $34,700/year! Diabetic, prevention is key.
4) 15% of diabetic will develop a foot ulcer!
.) After amputation, 30% of patients lose other limb within 3 years. Make an appointment to visit Dr.
Curry today!

2) Type II Diabetics statistics can be worse!

1) After amputation 2/3 die within five years! DR. STACEY CURRY, DPM

Ingrown Toenails Did You Know

"We'll nail it down for you" 85% of Americans will suffer
a foot or ankle ailment
requiring medical care at

sometime during their life!

INGROWN TREATED NEUROMAS

WHEN A TOENAIL IS INGROWN, IT IS CURVED AND "THE AGONY OF DE-FEET"
GROWS INTO THE SKIN. THIS "DIGGING IN" OF THE
NAIL BORDER IRRITATES THE SKIN, OFTEN A neuroma is a painful growth of nerve tissue in the foot.
CREATING PAIN, REDNESS, SWELLING, AND WARMTH The most common neuroma in the foot is a Morton’s
IN THE TOE. IF AN INGROWN NAIL CAUSES A BREAK Neuroma, which occurs between the third and fourth
IN THE SKIN, BACTERIA MAY ENTER AND CAUSE AN
INFECTION IN THE AREA WHICH IS OFTEN MARKED toes. It forms when bones in the feet press together and
BY DRAINAGE AND FOUL ODOR. CAUSES OF irritate a nerve. The resultant inflammation causes a
INGROWN TOENAILS INCLUDE: HEREDITY, TRAUMA,
IMPROPER TRIMMING, INAPPROPRIATE SHOE GEAR bulbous swelling to the nerve sheath which produces a
AND FUNGUS TOENAILS. AVOID PERFORMING tumor-like growth.
"BATHROOM SURGERY" AT HOME; CUTTING A NOTCH
IN THE NAIL PLATE, PUSHING COTTON UNDER THE A neuroma (nerve tumor) is the final result of this
NAIL BORDER, USING OVER-THE-COUNTER compression leading eventually to permanent nerve
MEDICATIONS OR JUST SIMPLY BY LIVING WITH THE damage. Anything that causes compression or irritation
CHRONIC PROBLEM. MINOR SURGICAL OFFICE of the nerve can lead to the development of a neuroma.
PROCEDURES ARE QUITE EFFECTIVE IN TREATING One of the most common offenders is wearing shoes
THIS COMMON CONCERN. SO DON'T GET "COLD that have a tapered toe box or high-heeled shoes that
FEET", YOU'LL BE "SOLE" GLAD YOU VISITED US FOR
THIS PROBLEM! cause the toes to be forced into the toe box.

WHAT A NEUROMA LLIOKOEKS People with certain foot deformities: bunions,
hammertoes, flatfeet, or more flexible feet are at higher
 NEUROMA NORMAL NERVE
risk for developing a neuroma. Other potential causes
are activities that involve repetitive irritation to the ball of

the foot, such as running or court sports. An injury or
other type of traumata the ball of the foot may also lead

to a neuroma.

As a neuroma gets worse, it can cause a lot of pain and
keep you from activities you enjoy. Symptoms of a

neuroma often start slowly. As the nerve irritation gets
worse, you may feel burning, shooting, electrical pain to

the ball of the foot, especially when walking. Many
people try to ease the pain by rubbing their foot. Some
people will experience tingling or numbness between the
toes or in the ball of the foot. A feeling that you have a
stone bruise or a painful clicking lump in the ball of the
foot may also develop. Our doctors will diagnose your

concern and talk about conservative and surgical
treatment options. Early diagnosis and treatment greatly

lessens the need for more invasive treatments. If left
untreated, neuromas often get worse.

Sponsored Advertisement

Neville Foot & Ankle Centers Proudly offer the
Cartivia Synthetic Cartilage Implant Solution!

Avoiding Fusion of Joints

A solution for arthritis

Dr. Edward Lee

One of the most common causes of foot pain is arthritis. As we get older, Arthritis can
develop not only in our hands and knees, but also in our feet. Statistics show that over 80%
of patients over the age of 55 have some form of arthritis. In our foot, one of the most
common areas of arthritis is our big toe joint, otherwise known as the 1st Metatarsal
Phalangeal Joint (MPJ). The 1st MPJ, like all other joints in our body, is composed of
articular cartilage surrounded by a joint capsule filled with synovial fluid, which allows our
joints to move smoothly and pain free. While age plays a major role, many other factors
can contribute to the development and progression of arthritis, including genetics,
previous injuries, altered biomechanics, and overuse of the joints.

Patient with 1st MPJ arthritis may experience symptoms like stiffness that improves within
30 minutes of walking, pain and swelling that increases with activity or is worse at the end
of the day, or enlargement of the joint due to bony changes. Patients may also experience
worse pain and stiffness in the morning that again subsides within 30 minutes of walking.
With severe 1st MPJ arthritis, patients may notice a decrease in range of motion to the big
toe joint as well as a “clicking” in the joint known as crepitus.

Our cartilage is made of up Hyaline cartilage, which is composed of type II collagen.
As arthritis increases in our joints, more and more of the Hyaline cartilage becomes
damaged and is eventually stripped off the surfaces of our bones. When this occurs, our
bodies are not capable of repairing or rejuvenating the hyaline cartilage. As the cartilage is
stripped away, bone begins to rub on bone, causing patients pain and bony changes in the
joint.

Although we cannot regenerate Hyaline cartilage in our joints, there are several other
treatment options for 1st MPJ arthritis. Depending on the degree of damage, patients can
be treated with injections, physical therapy, and custom molded orthotics to provide relief.
For the advanced arthritic patients, there are many surgical options with excellent
outcomes, including subchondral drilling, joint replacements, joint resurfacing, and joint
fusion.

As medical advances are made, more and more advanced treatment options for arthritis
are being developed. One such option is the Cartiva implant. The Cartiva implant is a
biocompatible organic polymer that resembles and functions like our naturally occurring
hyaline cartilage. The Cartiva implant replaces the damaged articular surface, providing
improved joint space and range of motion. The need for a fusion,
which locks the joint in place, is avoided and the joint is salvaged.

                                               Dr. Edward Lee is a Cartiva trained physician. If you have
                                               questions about arthritis in your feet or treatment options,
                                               including Cartiva, contact Dr. Edward Lee at Neville Foot & Ankle
                                               Centers.

have"8s0o%mOe vseorrtthoef aargtehorfit5is5"

What is a Podiatric Surgeon?
(asking for a friend)

I am a Podiatric surgeon. There are over 14,000 podiatrist in the United States and yet many people still wonder what a Podiatric surgeon is. Well, let me tell you
what we do and how we can help you and your family. We are the experts in all aspects of the foot and ankle disorders. We train for many years to give our
patients the very best treatment possible. We treat everyone from babies to the elderly. We treat everything from aches and pains to sprains to disfiguring
deformities and open wounds of the diabetics. We treat these aliments by using medicine, orthotics, surgery and even lasers.

With the increased emphasis on living a healthier lifestyle, there is a natural yearning for people to expand their exercise routine which requires
mobility. This trend has also led to an increase in injuries to the foot and ankle. Unfortunately, when our feet hurt with every step we take,
our whole body hurts and life is difficult. Thus, we look for someone to relieve our pain and get us back to performing at an optimal level.
The joy of helping our patients achieve pain-free mobility is indescribable! We live for the satisfaction of healing everyone’s pain. Allow us
to help you live life to the fullest.

Soy un cirujano podiatra. Hay más de 14,000 podólogos en los Estados Unidos y, sin embargo, muchas personas todavía se
preguntan qué es un cirujano podiatra. Bueno, déjame decirte lo que hacemos y cómo podemos ayudarte a ti y a tu familia.
Somos expertos en todos los aspectos de los trastornos del pie y del tobillo. Entrenamos durante muchos años para brindarles a
nuestros pacientes el mejor tratamiento posible. Tratamos a todos, desde bebés hasta ancianos. Tratamos todo, desde
dolores y dolores hasta esguinces, desfigurando deformidades y heridas abiertas de los diabéticos. Tratamos estos
alimentos usando medicamentos, plantillas, cirugía e incluso láseres.

Con el mayor énfasis en vivir un estilo de vida más saludable, existe un deseo natural de que las personas aumenten Dr. MSige uHeal bRloadrEisgpuaeñzol!
sus deseos de hacer ejercicio. Esta tendencia ha llevado a un aumento de las lesiones en el pie y el tobillo. Pero
cuando nos duelen los pies con cada paso que damos, todo nuestro cuerpo duele y la vida es difícil. Asi que
buscamos a alguien que alivie nuestro dolor. La alegría que nos da a ver a un paciente con dolor caminar sin dolor es
indescriptible. Vivimos por la satisfacción de sanar el dolor de todos. Permítanos ayudarlos a vivir la vida al máximo.

Se HablSae EHsapbalñaolE!spa

Arthroscopic Surgery SCOPE

for your Feet SHAVER

Ankle and foot arthroscopy has significantly advanced in recent years with the advent of
new instrumentation and techniques to allow better access to the joints and their treatment.
Direct benefits to arthroscopy over open approach include significantly lower morbidity, less
post-operative pain, better visualization of the cartilage following traumatic fractures, lower
infection rates, early return to work/sports, minimal scarring, and negligible disturbance to
surrounding tissue. It is typically performed in the outpatient setting under general
anesthesia due to its minimally invasive nature. Good to excellent results have been
reported in approximately 80% of patient undergoing routine arthroscopy. Although it is not
a cure all, arthroscopy has become a vital tool in modern medicine.

Arthroscopy is a common joint treatment and diagnostic tool. Experts from the medical
community have named arthroscopic surgery one of the most significant medical advances of
the 20th century. Similar to other larger joints in the body, the ankle and some foot joints are
amendable to arthroscopic surgery. As technology and techniques have advanced, so have
our capabilities to treat joint abnormalities that were once only accessible with large open
approaches. Typical incision or “portals” for the arthroscopy is approximately 5mm. Some
examples where we may employ arthroscopy include; loose bodies within the joint, disease
and inflammation of the inner joint lining, defects in the cartilage, arthritis, pain following
fracture,
bone spurs and infected joints. In addition, arthroscopy is a minimally invasive diagnostic tool
to evaluate the post traumatic joint or undiagnosed joint pain. Arthroscopy has made treatment
of all these problems easier, more effective and safer in the foot and ankle.

Neville Foot & Ankle Centers is a leading
provider of surgical and non-invasive foot and
ankle procedures.

The Importance of Post Surgical Rehabilitation

STAGE 1: After surgery or trauma, the body automatically goes through the process of healing to repair the injured tissues. In
INFLAMMATORY PHASE general, there are three phases of healing: the inflammatory phase, the proliferative phase and the maturation phase.
The inflammatory phase, which can last up to a week, is an essential process because without it no healing can occur.
LAST ABOUT A WEEK AND During the inflammatory phase, there is an increase in blood flow to bring nutrients to the injured tissues and start the
IS ESSENTIAL FOR THE inflammatory cascade. There is also increased swelling or edema due to the increased blood flow and leakage of fluid in
HEALING PROCESS. the interstitial spaces. Pain can be present during this phase and can be the result of localized swelling or edema which

STAGE 2: can put pressure on sensitive structures such as nerve endings.
PROLIFERATIVE PHASE The proliferative phase can last up to 3 weeks and it involves wound closure and tissue repair through collagen tissue
production. Excessive stress, wound infection and uncontrolled swelling on the injured site can lead to the production of
CAN LAST 3 WEEKS AND
BEGINS WOUND CLOSURE excessive amounts of collagen which is the precursor to adhesions. Adhesions may cause contractors which are fixed
deformities that can limit functional movement.
AND TISSUE REPAIR.
The maturation phase lasts for more than a year after the injury. in this phase, the physiologic processes in the injured
STAGE 3: area will start normalizing to pre-injury levels. Usually there is noted decrease in blood flow, reduction in swelling or
MATURATION PHASE
edema and restoration of function. The collagen on scar tissue doesn’t follow a specific pattern, instead it is disorganized
CAN LAST UP TO A YEAR as compared to the surrounding normal tissues which makes it inelastic and can restrict movement and function. This is
AND BEGINS THE PROCESS why early controlled movement is important to help reorganize the collagen tissue to a pattern close to the original tissue
OF NORMALIZING TO PRE- it is replacing.
The physical therapist is able to guide the patient with the appropriate exercises in order to limit or minimize the
INJURY LEVELS. formation of scar tissue based on the patient’s specific healing phase. They can also set specific goals for the
patient to achieve based on their current phase of healing.
In the inflammatory phase, the goals can include the reduction of pain and swelling through
gently controlled pain-free range of motion exercises, massage and pain modalities such as hydrotherapy, ultrasound,
electrical stimulation and ice. In the proliferative phase, goals will
have more emphasis on reducing the formation of scar tissue or the over production of collagen through manual
techniques such as deep friction massage, soft tissue mobilization and
moderate to aggressive stretching and strengthening exercises.
In the maturation phase, the goal is geared towards restoring the patient to pre-injury or functional levels. The physical
therapist can also act as a liaison between the patient and the doctor. The therapist reports to the doctor about progress
being made, but he can also notify the doctor if the patient experiences problems or complications in regards to their
recovery.
Eugene Lansangan is a licensed Physical Therapist solely dedicated to the patients and practice of Neville Foot and
Ankle Centers. Eugene specializes in trauma and surgical rehabilitation of the foot and ankle, sports medicine, exercise
physiology, physical and neurological dysfunction, gait abnormalities, geriatric and diabetic mobilization and injury
prevention. Having Eugene in our practice definitely keeps our patients “One Step Ahead”.

DID YOU KNOW?

Physical therapists are trained in massage, but it is not the
same as a massage you receive at the spa. A massage

performed by your therapist is used to reduce tightness and
work on tissue mobility of the muscle that is inflamed or in
pain. Physical therapy's treatments and exercises are done to

help relieve pain

Eugene Lansangan, P.T.

Preferred Podiatry Product Picks

Products we use and recommend within our practice are vetted and evaluated extensively. We believe in
providing our patients with the highest standard of care and pathway to quickest recovery which includes access
to our knowledge of products that achieve incredible results! All of the products listed below are readily available

for purchase at Neville Foot And Ankle Centers.

HEEL CUPS PAIN RELIEVER ANTI-FUNGAL SOLUTION SKIN CREAM ANTI-FUNGAL SOLUTION

Tuli's Heel Cups are the #1 "The Pain Stops Here"! The #1 Tolcylen™ Solution is the only Restores & protects your natural Tolcylen™ Solution is the only
Podiatrist recommended Heel clinically used and physician OTC product utilizing an alcohol moisture balance. This unique OTC product utilizing an alcohol
excipient formulation similar to deep penetrating formula softens excipient formulation similar to
Cups in the world. Nothing recommended topical analgesic callused and rough areas with a
works better or lasts longer than agent. Fast-acting cold therapy topical prescription products topical prescription products
your Tuli’s Heel Cups. They are for sore muscles, painful joints, which have been scientifically soft-as-velvet feeling. It which have been scientifically
literally shock absorbers for your proven and FDA approved to rejuvenates heel and foot for a proven and FDA approved to
sprains and strains, bursitis, penetrate and carry anti-fungal renewed feeling of comfort and penetrate and carry anti-fungal
feet! arthritis, tendonitis, and diabetic agents through the nail plate. vitality, never sticky or greasy. agents through the nail plate.

neuropathy.

SHOE SANITIZER ENRICHED NAIL POLISH COMPRESSION SOCKS ANKLE BRACE COMPRESSION SOCKS

Ultraviolet shoe sanitizer. A safe A unique enriched nail product Wave compression technology on One of the most popular ankle Wave compression technology on
and effective way to sanitize the unlike commercial nail polishes. It the plantar surface of the foot supports with coaches, trainers and the plantar surface of the foot
inside of your shoes. By using is enriched with naturally occurring physical therapists. The contoured provides a sustained stretch on
germicidal ultraviolet light inside provides a sustained stretch on the tongue provides exceptional fit and is
anti-fungal, antiviral, and plantar fascia. Provides relief from the plantar fascia. Provides relief
shoes, the Steri Shoe kills antibacterials to help kill harmful constructed of light-weight yet from plantar fasciitis discomfort by
99.9%microorganisms that cause germs. Safe for pregnant women plantar fasciitis discomfort by durable Cool Flex material.
promoting circulation, reducing promoting circulation, reducing
nail fungus, athlete's foot, and and around children. edema & foot fatigue, and relieving edema & foot fatigue, and relieving
shoe odor.
morning foot pain. morning foot pain.

COMPRESSION HOSE FOOT CARE PRODUCTS ORTHOTIC INSOLES ORTHOTIC INSOLES

Designed to provide circulation FungaSoap, Bunion-relief pads, A high-quality orthotic insoles that do ORTHOTIC INSOLES A high-quality orthotic insoles that do
support for a number of and a wide array of other foot more than just temporarily cushion more than just temporarily cushion
pain management products your feet. By combining balance, Soft gel, Self sticking, reusable and your feet. By combining balance,
lymphatic disorders. Sigvaris full makes PediFix one of the support, and cushioning, the long lasting cushions for the ball of support, and cushioning, the
line of styles and sizes for both industry leaders and trusted by podiatrist-designed orthotics relieve podiatrist-designed orthotics relieve
men and women are expertly our practice for over 34 years! foot pain, including Plantar Fasciitis. the foot designed to reduce foot pain, including Plantar Fasciitis.
pressure while walking or standing
crafted, and supported by
accurate medical research.

NAIL RESTORATION DAILY SUPPLEMENT CAST COVERS NAIL SCRUB CAST COVERS

KeryFlex is a Podiatric Nail A once-daily dietary supplement Guaranteed to last the life of the Topical lotion bleaches, debrides, Guaranteed to last the life of the
Restoration product that restores that increases nail strength, cast, it is the best cast protector cleanses and reduces discoloration cast, it is the best cast protector
the appearance of an individual's and bandage protector which is and bandage protector which is
natural nails in 15 minutes. Great reduces nail breakage, improves of nail surfaces. Available in a
for those who have damaged or nail structure, and smooths brittle easy to use and durable for plastic bottle with a nail brush easy to use and durable for
showering and water sport. showering and water sport.
fungal nails. ridges. applicator tip.

Painful Heel Syndrome
by Dr. Robert E. Neville

Heel Pain (Plantar Fasciitis) is the single most common foot ailment that we To just resolve the pain is not to resolve the problem. Long-term success
see in our practice. The word “plantar” means the bottom of your foot. “Fasciai”nvolves treatment and control over the mechanical instability. Evaluation by
is a thick, fibrous, ligament-like structure that is attached at the ball and heel our biomechanist to be supported by prescription orthotics is most
of the foot. The word “itis” means inflammation. When you put these words important. Depending on the severity of the problem, it may take several
together, Plantar Fasciitis is an inflammation of the band of tissue on the weeks or even months to completely heel the fascia band and feel the full
bottom of your foot. benefit treatment. For those who do not respond to corrective treatment,
surgery is indicated to relieve stress on the fascia band to improve the
Heel pain is often caused by plantar fasciitis, a condition that is sometimes chronic repetitive tearing. So whatever your concerns, we are heel experts to
also called heel spur syndrome, when a spur is present. Heel pain may also help you “heal thy heel”!
be due to other causes such as a stress fracture, cyst, tumor, arthritis, nerve
inflammation or tendonitis. Because there are several potential causes, it is
important to have heel pain properly diagnosed.

Plantar fasciitis develops in the foot as a result of fatigue to the plantar fascia
band. The stress causes a micro-trauma or tearing of the fascia band fibers
where they root into the heel bone. People who have an excessively high or
low arch, who stand for long periods of time on hard surfaces, who are
overweight or obese, who are athletic or active on their feet, who wear non-
supportive footwear, or who are prone to foot weakness due to aging or
genetics, are often those individuals that develop plantar fasciitis. Symptoms
of plantar fasciitis are: pain on the bottom of the heel, pain that is usually
worse upon arising or pain in the heel that persists over a period of months.
People with plantar fasciitis often describe the pain as worse when they get
up in the morning or after they have been sitting for long periods of time.
After a few minutes of walking, the pain decreases because walking stretches
out the fascia, but often results in a repetitive tearing of the band.

Plantar fasciitis is most often an acute and chronic concern. Appropriate
treatment must not only address the painful acute inflammatory condition,
but also the recurrent chronic condition. Reducing symptoms is always our
first goal in initiating the healing process. This may involve medication,
physical therapy, strapping, RICE (Rest, Ice, Compression, Elevation),
appropriate changes in shoe gear and activities, stretching, injections,
compression socks, night splints, inserts, as well as a thorough understanding

The most common foot injury seen in ourof the condition and need for home care. Once the acute inflammatory
practice is Plantar Fasciitis (Heel Pain)process has responded to treatment, it is imperative to treat the chronic

problem.