Peroneal Tendinosis: Causes, Symptoms And Treatment

by Administrator 24. April 2017 10:26

Inflammation and irritation in the peroneal tendons that run around the outer and back side of the foot lead to a condition known as Peroneal Tendinosis. The tendons join the muscles to the bones and overusing them can cause too much stress leading to discomfort and pain. Movements involving excessive rolling out of foot can overstretch the peroneal tendon and cause soreness in the foot.


  • Sudden increase in level of physical training
  • Inappropriate footwear
  • Poor training techniques
  • Frequently running along slopes
  • Sports that require quick pivoting movements such as basketball and football
  • Abnormal foot position wherein the heel is turned slightly inwards
  • Recurrent ankle sprains
  • Tightness or weakness in calf muscles


  • Pain around the back and outside of foot
  • Tenderness in the affected area
  • Pain tends to increase with activity
  • Extreme pain in the morning
  • Discomfort while turning the foot inwards


  • The foot specialist will note down the history of the patient and the severity of symptoms
  • Various postures of the heel are observed for proper diagnosis
  • Imaging tests such as X-Rays and Ultrasound might be ordered by the doctor to have a clear look at the tendons
  • Imaging tests can also reveal any abnormal structures or tears in the foot
  • A Magnetic Resonance Imaging (MRI) test can also be conducted for further diagnosis


Most of the cases of Peroneal Tendinosis heal on their own without surgery.

Non-surgical methods

  • Rest is important for proper healing of the injury
  • Application of ice packs or cold therapy can provide temporary relief from painful symptoms
  • Compression and elevation of the affected foot can also help in reducing inflammation
  • A peroneal tendinosis brace can be recommended by the specialist doctor to protect the area and provide warmth to the affected tendon
  • Taping of the ankle can also provide support and protection
  • Non-steroidal anti-inflammatory drugs (NSAIDs) might be prescribed to the patient for reducing pain and inflammation
  • Stretching exercises can also prove to be useful for providing relief from pain associated with peroneal tendinosis.
  • Deep tissue sports massage is another effective technique to reduce tension in the tendon

Surgical methods

  • Surgery may be required if the pain does not go away with rest or any of the above mentioned treatment methods
  • Surgery can involve cleaning and repairing the affected tendon
  • In case of a tear, the foot and ankle surgeon can deepen the groove in the back of the bone of the fibula and provide more space to the tendons for healing
  • In cases where the condition of the tendon is very bad, resurrecting it is the only option left.

For complete treatment of Peroneal Tendinosis, visit Dr. Heier, a renowned orthopedic doctor in Carrollton, TX. To schedule an appointment, call at (972) 492 – 1334.

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Ankle Dislocation: Orthopedic Treatment In Carrollton

by Administrator 27. March 2017 06:21

Tibia and fibula of the leg join with the talus of the foot to form an ankle joint. A sudden blow to the ankle may hamper the normal positioning of these bones leading to a disturbed anatomic relationship. This condition is referred to as Ankle Dislocation and is generally associated with a fractured tibia or fibula.

Types of Ankle Dislocations –

  • Posterior – Talus moves backward in relation to tibia
  • Anterior-   Talus is pushed in the forward direction
  • Lateral- It occurs when the ankle gets inverted or everted
  • Superior - The force moves the talus in the upward direction between tibia and fibula


  • Twisting or rolling of the ankle
  • Falling or tripping
  • A sudden impact during a car accident
  • Symptoms
  • Severe Pain
  • Swelling and bruising
  • Tenderness
  • Difficulty in bearing weight
  • Ankle may seem to be out of place


The doctor may check the appearance of patient’s ankle and conduct a thorough physical examination to determine the abnormality in the joint. He may also evaluate sensations experienced in the foot. An imaging test such as an X-ray may be recommended for a clearer view of the condition.


Initial treatment of Ankle Dislocation is to apply R.I.C.E principles.

  • Rest – Sufficient rest may allow the scar tissues to connect the muscles and heal the damaged ligaments we well as tendons.
  • Icing – Applying ice after every 15-20 minutes may help to reduce inflammation.
  • Compression - In order to reduce edema caused by deposition of fluid from damaged capillaries, compression may be suggested.
  • Elevation – Keeping the injured feet elevated may help to reduce swelling and bruising.

The doctor may also prescribe certain anti-inflammatory medication and painkillers to alleviate pain. In case any dislocation has occurred due to a fracture, surgical treatment may be recommended. In this, the orthopedic surgeon may use screws and metal plates to restore the position and stability of the ankle joint. He may also ask the patients to wear casts and crutches to immobilize ankle and ensure fast recovery after surgery.

If you are looking for the treatment of Ankle Dislocation, visit Dr. Heier in Carrollton, TX. He is an experienced and board certified ankle specialist. To schedule an appointment with the orthopedic surgeon, you can call at (972) 492 – 1334.

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Fat Pad Contusion: Foot Injury Carrollton

by Administrator 26. October 2016 08:25

The heel bone, also known as calcaneus bone, bears constant pressure throughout the day due to various activities like standing, walking and running. It also acts a shock absorber and provides cushioning to the foot. When this bone receives excess pressure or strain due to repetitive activities, it may lead to a condition called Fat Pad Contusion. Commonly known as Bruised Heel, the injury requires medical attention by an orthopedic doctor.


  • Improper Footwear: Wearing poorly cushioned or worn-out shoes may cause pressure on the heel bone.
  • Excessive Body Weight: Being overweight may place additional strain on the heel bone, which increases the risk of developing Fat Pad Contusion.
  • Age Factor: The bones tend to get brittle with increasing age, which makes elderly people more prone to bone-related injuries.
  • Sports Injuries: Athletes involved in contact sports like football, rugby or basketball can suffer the injury due to heavy landings and falls. In addition, running on hard surfaces may also increase the chances of suffering from Fat Pad Contusion.


  • Pain and swelling in and around the heel area
  • Pain may increase while walking, running or jumping
  • The affected area may be tender to touch


An orthopedic foot doctor may first perform a visual inspection of the injured foot. He may then ask the patient questions regarding the mode and time of the injury. Clinical examination such as palpation, X-ray as well as MRI may be conducted to confirm the condition. Accordingly, a treatment plan may be devised.


Conservative Treatment Methods

  • RICE Therapy: This therapy may help to reduce swelling as well as pain. It may include:
  1. Rest: Adequate rest must be provided to the affected area. This may help to reduce swelling as well as pain.
  2. Icepacks: Applying ice packs at frequent intervals may be beneficial in alleviating pain and swelling.
  3. Compression: An elastic bandage may be used to reduce inflammation.
  4. Elevation: Keeping the foot above the level of heart may help to improve circulation.  
  • Supportive Shoes: Wearing cushioned shoes may provide support to the feet and relieve the pressure from the heel. It may help to stabilize the foot and decrease discomfort.     
  • Rehabilitation Exercises: The doctor may recommend specific exercises which may help to promote healing. These exercises can reduce stiffness and improve the range of motion.  
  • Medications: Non-steroidal anti-inflammatory medications may be prescribed by the doctor. In case of severe pain, cortisone injections may be administered.

For comprehensive treatment of Fat Pad Contusion, visit Dr. Heir. To schedule an appointment with the foot and ankle surgeon in Carrollton, you can call at (972) 492 – 1334.

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Ankle Arthritis: Causes, Symptoms And Treatment

by Administrator 24. May 2016 06:30

The human foot comprises of 28 bones and 30 joints which enable it to move, stabilize the body and absorb external shocks. The bones are further supported by strong tendons, ligaments, muscles, cartilage and fluid filled lining called the synovium. Degeneration of the bones, cartilage and other constituent parts of the joint may lead to Ankle Arthritis. There are three main types of Arthritis that may affect the ankle joint.

  • Osteoarthritis- It is a painful condition caused due to wearing out of the protective cartilage with age. It causes the bones to rub against each other and may lead to the development of bone spurs.
  • Post-Traumatic Arthritis- injuries that cause severe damage to the joint surfaces may lead to the development of Arthritis over the years
  • Rheumatoid Arthritis- It is a chronic condition which occurs when the immune system attacks the body’s tissues.  It characteristically affects both the joints at the same time


  • Genetic factors
  • Obesity
  • Infections that may lead to auto-immune disorders
  • Ageing
  • Direct injury or trauma to the joint
  • Stretching or tearing of ligaments and tendons
  • Post-surgical effects
  • Ankle dislocation or fractures


  • Stiffness
  • Swelling
  • Pain which may aggravate during movement and weight bearing
  • Visibly deformed joint
  • Restricted range of motion
  • Change in gait and posture
  • The joint may feel tender when pressed
  • Redness and warmth


  • Detailed clinical evaluation of the affected joint
  • Analysis of gait and range of motion
  • Assessment of patient’s medical history and previous ankle injuries
  • X-ray imaging may be done to check bone placement and structure
  • CT scan and MRI may help diagnose soft tissue and ligament damage
  • Blood tests may be recommended to diagnose the type of Arthritis


  • Avoiding any activity that aggravates discomfort
  • Performing exercises that strengthen the supporting muscles
  • Anti-inflammatory medicines may be prescribed to relieve pain
  • Physical therapy may help to improve flexibility of the joint
  • Use of ankle-foot orthosis or a removable brace to provide support to the joint
  • Walking stick may be used to avoid weight bearing
  • Arthroscopic Debridement to remove bone spurs or damaged cartilage and synovium
  • Arthroplasty- surgical replacement of the ankle joint with an artificial implant
  • Arthrodesis or surgical fusion of the bones using pins, screws and rods to restrict movement between them and reduce pain

Dr. Heier provides complete diagnosis and treatment for Ankle Arthritis. To schedule an appointment with the foot and ankle specialist in Carrollton, TX, you can call at (972) 492 – 1334.

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Flat Feet: Orthopedic Carrollton

by Administrator 28. April 2016 10:14

Flat Feet is a condition which involves collapsing of the arches inside the feet. As a result, the soles of the feet touch the ground, causing discomfort. The condition may occur as a result of loosening of tendons in the foot when excessive pressure is exerted on it. If left untreated, the condition can lead to misalignment of the knees and legs. People with obesity and genetic foot problems are more likely to develop Flat Feet.


  • Foot injuries including fractures or dislocation
  • Structural deformity of the foot
  • Medical conditions such as Rheumatoid Arthritis, Diabetes, Cerebral Palsy etc.
  • Overstretching or tearing of tendons in the foot
  • Inflammation of the posterior tibial tendon


  • Pain, particularly in the arch and heel
  • Difficulty in walking
  • Swelling 
  • Inward rolling of foot
  • Weakness and numbness
  • Stiffness
  • Difficulty standing on the toes
  • Extreme tiredness


The foot doctor may physically examine the foot and evaluate the symptoms experienced by the patient. He may also check the soles of the shoes for any unusual patterns of wear and tear. Imaging tests such as X rays, MRI, CT scan and ultrasound may be conducted to determine the underlying cause of the condition.

Non-surgical Treatment:

  • Rest: Adequate rest must be provided to the affected area. The doctor may advise switching to low impact activities such as walking or swimming to aid the recovery process.
  • Orthotic devices: The doctor may recommend wearing orthotics or arch supports as it may help in reducing pressure on the foot.
  • Physical therapy: Doing specific exercises as suggested by the doctor can help in improving strength of the foot muscles. Physical therapy may also improve range of motion of the foot.
  • Medications: The doctor may prescribe anti-inflammatory medicines to reduce pain and discomfort. Cortisone injections may be recommended in case of severe pain.
  • Icing or heat therapy: Applying ice packs at frequent intervals can help to reduce swelling. Heat therapy may also be beneficial in relieving the symptoms.  

Surgical treatment

If non-surgical treatments are ineffective, the doctor may recommend surgery.

  • Arthrodesis: The surgeon may fuse the foot and ankle bones together by using bone grafts.
  • Excision: The procedure involves removing bony growths or spurs in the foot to relieve pain and discomfort.


The condition can be prevented by wearing comfortable shoes that provide stability to the heel. You should avoid activities that puts excessive stress on the foot.

For comprehensive diagnosis and treatment of Flat Feet, consult Dr. Heier in Carrollton, TX. To schedule an appointment with the foot and ankle surgeon, you can call at (972) 492 – 1334.

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Clubfoot: Orthopedic Treatment In Carrollton

by Administrator 23. November 2015 12:53

Clubfoot (Talipes Equinovarus) is a foot deformity that affects nearly 1 out of every 1000 children in the USA. In the condition, the foot twists inwards and the toes point outwards. The tissues that connect the foot muscles to the bone are shorter than usual. Clubfoot can affect one or both feet and is usually congenital. It is recommended that the condition should be treated soon after the birth to avoid permanent foot deformities.


Clubfoot is idiopathic that is often the cause is not known. The abnormality may result due to following reasons:

  • Drugs or smoking during pregnancy
  • Spinal deformities or neuromuscular diseases
  • Less amniotic fluid during pregnancy


  • Top of the foot is twisted downward and inward
  • Toes pointing downwards
  • Tightening of the Achilles tendon
  • Abnormal shape of the foot
  • Rigidity in the foot
  • Inability to move the feet
  • The calf muscles remain underdeveloped
  • Affected leg is shorter than the normal leg
  • Tightening of the Achilles tendon


An orthopedic doctor may perform a physical examination to check for the symptoms. The shape and positioning of the infant’s feet may help the doctor to identify Clubfoot. He may also suggest X-ray and other imaging tests to confirm the disorder.


Clubfoot can be corrected surgically soon after the birth. The procedure involves moving the foot to the correct position and immobilizing it with the help of a cast. It is easy to reshape the foot soon after the birth, so there should not be any delay in the treatment. The surgeon stretches and casts the foot after regular intervals to improve the condition.  Once the foot is in positioned, the child may have to wear special brace for a few months. If the Achilles tendon is tightened, the surgeon will release it surgically.

In case of bone deformity, the surgeon may perform osteotomy that involves cutting the bones and fusing them to stabilize them. The surgery is often done once the child is ten years old.
Physiotherapy is important as it can help in correcting the foot by simple manipulations and exercises.

For diagnosis and treatment of Clubfoot, consult Dr. Heier in Carrollton, TX. To schedule an appointment with the foot and ankle surgeon, you can call at (972) 492 – 1334 or visit 4780 N. Josey Lane, Carrollton, TX 75010.

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Achilles Tendinitis: Causes, Symptoms And Treatment

by Administrator 26. October 2015 13:32

Achilles tendon is the largest tendon in the body that connects the calf muscle at the back of lower leg to the heel bone. Achilles Tendinitis occurs due to overuse or degeneration of this tendon. Athletes who participate in sports activities such as running, gymnastics, football, tennis etc. are at higher risk of developing this condition.


  • Strenuous activities
  • Bone spurs
  • Tightening of calf muscles
  • Wearing high heels
  • Symptoms
  • Pain along the back of the foot
  • Tenderness
  • Swelling
  • Stiffness
  • Difficulty pointing your toes


The doctor may perform X-rays to determine the severity of the condition. He may also conduct an MRI scan to check for any tear in the Achilles tendon.

Non-surgical Treatment:

  • Rest: A doctor may recommend the patient to take rest to provide relief from pain. He may also advice to avoid any vigorous activities such as running, jumping etc. until the condition improves.
  • Ice:  Applying ice at regular intervals on the affected area may help in reducing the swelling.
  • Compression: Using an elastic bandage can provide support and help in minimizing inflammation.
  • Elevation: Elevating your leg using a pillow may also help in the fast recovery of the condition.
  • Medication Anti-inflammatory medicines may be prescribed by the doctor to reduce pain and swelling.
  • Inserts: Wearing inserts in shoes can help your Achilles tendon from further stretching and help in fast recovery. Orthotics devices such as heel lifts reduce the strain on this tendon.
  • Strengthening Exercises: A physical therapist may recommend some specific exercises to increase flexibility and strength of the muscles.

Surgical Treatment

In severe cases of Achilles Tendinitis, the doctor may recommend any of the following surgical procedures to repair the damaged tendons:

  • Gastrocnemius Recession: The procedure involves lengthening of the calf muscles with the help of small incisions using an endoscope. This surgery is performed to treat patients who have difficulty in flexing their feet. It is done to provide flexibility to the ankle.
  • Debridement and repair: In this method, the surgeon removes the damaged Achilles tendon and repairs it with stitches.


  • Reduce uphill running as it can pressurize the Achilles tendon
  • Wear shoes with good support
  • Increased the intensity of exercises gradually
  • Avoid exercising, if you feel pain at the back of your calf

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Bunion: Non-Surgical Treatment In Carrollton

by Administrator 18. September 2015 13:54

A Bunion, also known as Hallux Valgus, is a condition that forces the metatarsal bone of the bone to protrude and causes the big toe to bend inwards while putting pressure on the toe next to it. Bunion can also lead to the development of a bursa over the joint and inflammation of the adjacent tissues. The condition causes deformity at the base of the big toe and can be formed due to genetics, aging, medical conditions such as Arthritis, foot structure or wearing ill fitted shoes. The orthopedic surgeon may physically examine the foot to determine a Bunion and devise a treatment plan after determining the severity of the condition.

Here are some non-surgical treatment options for Bunions:

  • Proper Shoes: Wearing comfortable shoes that have a wide toe area, low heel and proper arch support, can assist in relieving excessive pressure from the Bunion. It also provides space to the toes and offers comfort.
  • Orthotics: Wearing bunion pads or arch supports can assist in distributing the body weight evenly, realigning the bones and removing pressure off the big toe. Splints, worn over the toe, can assist in straightening it and prevent the Bunion from worsening. Toe spacers can also help to reduce the pain caused due to a Bunion. You can also consider wearing a splint during nighttime to keep the toe properly aligned and ease pain.
  • Patches: Wearing a felt patch or moleskin around the pressure area protects the affected toe from rubbing against the shoe. This, when placed on the Bunion, offers relief from pain.
  • Medication: The doctor may prescribe anti-inflammatory medication to offer relief from pain and swelling. Steroid injections may also be recommended to relieve severe Bunion pain.
  • Ice: Applying ice packs to the affected area can help to relieve pain and inflammation. It is recommended to apply ice packs for at least 10 to 20 minutes every hour or as directed by the foot doctor.
  • Physical Therapy: Exercises performed under the supervision of a physiotherapist can also reduce the symptoms of the Bunion. Physical therapy improves mobility and flexibility of the toe. The patient can grab a ball with the toes and perform a ‘grab and release’ motion.

For comprehensive diagnosis and treatment of Bunion, visit Dr. Heier. To schedule an appointment with the foot and ankle doctor in Carrollton, TX, you can call at (972) 492 – 1334.

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Common Risk Factors For Bunion

by Administrator 12. August 2015 11:04

A Bunion is the enlargement of the joint at the base of the big toe. In this condition, the big toe pushes itself onto the other toes and a bony lump is visible right next to it. People who develop a Bunion may experience difficulty in playing sports, walking, running and exercising. The common causes for this condition are genetics, wearing wrong shoes and Arthritis.


  • Deformity: In cases of advanced bunion, the big toe may look severely deformed. It may lie over or under the second toe due to being inwardly pushed by the Bunion. In such cases, pain may be felt after wearing shoes and sometimes even walking may prove to be uncomfortable.
  • Exostosis: There may be growth of an additional bone or lump, called exostisis, right next to the big toe.
  • Pain And Redness: This condition may cause pain and redness in the affected toe. There may also be some inflammation with the thickening of the overlying skin.
  • Inability To Walk: There may be extreme discomfort while walking.

Risk Factors

  • Heredity: The condition is usually passed on in generations. Thus, if there is someone suffering from Bunion your family, you are more prone to acquire it.
  • Wearing Wrong Shoes: Bunion may be seen in people who wear narrow or high heeled shoes for long periods. Ballet dancers are more susceptible to the condition because of their differently shaped shoes that keep the feet in an unusual position and puts pressure on the big toe.
  • Arthritis: Certain degenerative conditions, such as Osteoarthritis or Rheumatoid Arthritis, may also increase the risk for a Bunion. When inflammation affects bones, one might have difficulty in walking which may lead to the development of this condition.
  • Age: As age progresses, chances of developing bunion may increase.
  • Nerve Condition: A nervous system disorder may also cause bunion to appear.
  • Gender: Bunions are more common in women than men, may be because wearing heels is one of the most common causes for it.

One must take precautions to reduce the chances of getting a bunion. This may be done by wearing wide toed, comfortable shoes that do not put undue pressure on the feet.

For treatment of Bunions, visit Dr. Heier in Carrolton, TX. To schedule an appointment with the foot and ankle surgeon, you can call at (972) 492 – 1334.

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Talus Fracture: Causes, Symptoms And Treatment

by Administrator 20. July 2015 07:21

The Talus is a small bone present right above the heel bone that makes up the lower part of the ankle joint. A high-energy force applied to the ankle can lead to a crack in this bone, causing Talus Fracture.

Types of Talus Fracture:

  • Displaced Fracture: In this fracture, the bone breaks and parts of it are moved from their anatomic positions.
  • Open Fracture: When the bone breaks through the skin, it is known as an open fracture.


  • Accidents: Certain motorcycle accidents or car collisions can cause trauma to the ankle and put pressure on the Talus bone. This can cause displacement of the bone.
  • Intense Injuries: Falling from a height or twisting of the ankle can lead to fracture in the talus bone.
  • Regular Activities: Application of high pressure on the anklebone can lead to the wear and tear, thus causing a fracture.
  • Weak Bones: Certain underlying health conditions such as Arthritis, which reduce bone strength, can also lead to a Talus Fracture.


  • Sharp and intense ankle pain
  • Limping
  • Inability to bear weight
  • Immobility
  • Swelling
  • Bruising
  • Numbness



The ankle doctor may diagnose a Talus Fracture by asking about the patient’s medical history and nature of injury. He may also perform a physical test, by examining the movements and intensity of the pain in the affected joint. The doctor may also ask the patient to undergo certain imaging tests such as X-ray, MRI or CT scan in order to determine the position of the bones and severity of the fracture.


  • Medication: The patient may be prescribed anti-inflammatory medications to minimize pain and inflammation in the affected joint. These can also help in reducing numbness and stiffness caused due to the injury.
  • Immobilization: The doctor may suggest the patient to rest the ankle for a period and use a cast to hold the bones in place. The patient may be recommended to avoid movement of the affected joint as resting can assist in speeding up the healing process.
  • Physical Therapy: Certain stretching exercises can help regain movement in the injured joint. The physiotherapist can minimize stiffness and assist the patient in returning to daily activities.
  • Surgery: In severe cases, the patient may be advised to undergo a surgical procedure to restore movement in the ankle.

For comprehensive diagnosis and treatment of Talus Fracture, visit Dr. Heier in Carrollton, TX. To schedule an appointment with the ankle doctor, call at (972) 492-1334.

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