All Specialty Services & Treatments

Plantar Fasciitis (Heel Pain)

The main symptom of plantar fasciitis is heel pain when you start to walk. This pain typically occurs first thing in the morning after you get out of bed, when your foot is placed flat on the floor. The pain occurs because you are stretching the plantar fascia. There are a wide range of treatment options available for plantar fasciitis - our doctors can recommend the best treatment for you.

Foot Surgery

The doctor will recommend if you need foot surgery and the best setting based on the surgery you will have, your age, medical history, and health plan.

A Look at Common Foot Surgeries

 

Surgery for Bunions

  • Positional bunionectomy: A positional bunion is a bony growth on the base of the big toe. It enlarges the joint. In a positional bunionectomy, the doctor will remove the bump and may release soft tissue that has tightened. Afterward, the doctor may recommend that you ear a special surgical shoe or splint.
  • Metatarsal head osteotomy: Structural bunions occur when the angle between the first and second toe bones increases beyond normal. Sometimes bony growths may form, resulting in irritation and swelling. A surgeon performs a metatarsal head osteotomy to cut and reposition the bone. Any bumps are remodeled. Afterward, the doctor may recommend that you wear a surgical shoe or cast for about six weeks until the bone heals.
  • Metatarsal base osteotomy: Severe structural bunions result when the angle between the first and second toe bones is excessive. To treat these, a surgeon may conduct a metatarsal base osteotomy. A wedge of bone is removed from the base of the big toe bone and the bone is repositioned. Wires or screws may be inserted to stabilize the bone. Afterward, your doctor may put your foot in a cast.
 

Surgery for Hammertoes

  • In treating a flexibile hammertoe, the doctor repositions the tendons to allow the toe to lie flat. Afterward, he/she may recommend that you wear a surgical shoe for several weeks.
  • For a rigid hammertoe, several types of treatments are available:
    • Arthroplasty: The doctor removes a portion of the joint and straightens the toe.
    • Fusion: Cartilage between the two toe bones is removed and the bones fuse to form one longer bone.
    • Implant: In some situations, a portion of the bone is removed and replaced with an implant.
 

Surgery for Arthritis

  • Arthritis is a condition characterized by inflammation and swelling of the joint lining and degeneration of the cartilage. Fluid usually accumulates in the joints. Arthritis can affect the big toe joint, causing pain and reduced motion. A bunion-like protrusion also may be present. There are a variety of surgical procedures to treat this condition.
 

Surgery for Neuromas

  • When the nerves are compressed between two toe bones, the nerve becomes enlarged. A benign growth, called a neuroma, results. When a neuroma is removed or "excised," a small portion of the nerve is cut out.
 

Surgery for Ingrown Toenails

  • A nail is ingrown when it curves down at the sides and grows into the skin. With a partial surgical matricectomy, the doctor removes a section of the toenail and the underlying nail matrix (cells that make the nail). This can be done through surgical excision, chemical, or laser destruction.
 

When to call the doctor:

  Follow your doctor's instructions for continued care of your foot and remember that every individual recovers differently. Call your doctor if you have any of these symptoms:
  • Blood appears on the bandage (a small amount is to be expected)
  • Your dressing becomes tight or your foot is cold or numb
  • You develop a temperature of 101 degrees or more
  • Your cast or bandages get wet
  • You experience persistent pain
 

General Foot Care/Podiatry

Feet and ankles are prone to a number of problems at different stages of life. Our doctors are fully prepared and highly trained to care for, diagnose, and treat all of your foot and ankle needs ranging from pediatric to geriatric care.

Gait Analysis

In the gait analysis lab, the FScan computer software is teamed with four closed-circuit TV cameras, to provide full-body analysis of your gait from various angles. Paper-thin sensors are placed in the shoes you wear. As you walk, reactive forces between your foot and the shoe are recorded, allowing the evaluation of alignment and biomechanical position.

Biomechanics & Orthotics

BioMechanics

Pedorthics is the science of evaluating, fabricating, and delivering footwear to prevent or improve foot and ankle conditions both congenital and acquired. At FASMA, pedorthists, or "shoe fitting specialists" will use technology to produce high quality orthotics or customize the fit of your shoes. Customizing the fit of the shoe can often solve the foot problem. Orthopedic shoe modification by trained staff can aid in providing you with the help you need. It is a fact that the position of bones in the feet actually changes as we age. Moreover, research shows that many back problems result from foot imbalance or from one leg being longer than the other. Something as simple as a lift in or on the shoe can be an effective solution.  

Orthotics

FASMA incorporates the latest computer technology to fabricate orthotics. We have partnered with PedAlign to offer our patients the most technologically advanced system available.

This technology allows us to capture the shape and contour of the foot for the best treatment results and the highest quality orthotics. It is much more accurate and reliable than information captured by stepping on a mat or pressing the foot into a foam box.

PedAlign is the only infrared optical scanning system that uses true foot contours and arch height measurements in order to produce a high-quality orthotic. The digital cast and prescription is electronically transmitted to the lab. This means that your orthotics can be ready for you in days, rather than weeks.

 

Hammertoes

The main cause of hammertoe deformities is genetics. Symptoms can be caused, however, by wearing tight shoes or high heels that crowd the toes. Hammertoe may also be brought on by injury or by bunions pushing the big toe against the smaller toes. In some cases, surgery may be required. Our doctors can recommend the best treatment for you.

Bunions

A bunion is a bony prominence on the side of the foot, at the base of the big toe joint. This enlargement of the joint, spurring, bump or lump can be aggravated by sports and tight shoes. In some cases, surgery may be suggested. Our doctors can recommend the best treatment for you.

Acute and Chronic Tendon Rupture

Trauma

Diabetic Foot Care

According to the American Diabetes Association, about 15.7 million people (5.9% of the U.S. population) have diabetes. Neuropathy, nervous system damage, affects about 60-70% of people with diabetes and is a major complication that may cause diabetics to lose feeling in their feet. Diabetics must constantly monitor their feet or face severe consequences, including amputation.

Having diabetes, a wound as small as a blister could cause a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal and when a wound is not healing, it's at risk for rapidly spreading infection. If you have diabetes, you should inspect your feet every day. Look for  puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts and nail problems. Get someone to help you, or use a mirror to inspect daily.

Here's some basic advice for taking care of your feet:
  • Always keep your feet warm.
  • Don't get your feet wet in snow or rain.
  • Don't put your feet on radiators or in front of the fireplace.
  • Don't smoke or sit cross-legged. Both decreased blood supply to your feet.
  • Don't soak your feet.
  • Don't use antiseptic solutions, drugstore medications, heating pads or sharp instruments on your feet.
  • Trim your toenails straight across. Avoid cutting the corners. Use a nail file or emery board. If you find an ingrown toenail, contact one of our offices.
  • Use quality lotion to keep the skin of your feet soft and moist, but don't put any lotion between your toes.
  • Wash your feet every day with mild soap and warm water.
  • Wear loose socks to bed.
  • Wear warm socks and shoes in winter.
  • When drying your feet, pat each foot with a towel and be careful between your toes.
  • Wear appropriate shoes:
    • Buy shoes that are comfortable, without a "breaking in" period.
    • Check how your shoe fits in width, length, back, bottom of heel, and sole.
    • Avoid pointed-toe styles and high heels.
    • Try to get shoes made with leather upper material and deep toe boxes.
    • Wear new shoes for only two hours or less at a time.
    • Don't wear the same pair of shoes every day.
    • Inspect the inside of each shoe before putting it on.
    • Don't lace your shoes too tightly or loosely.
  • Choose socks and stockings carefully:
    • Wear clean, dry socks every day.
    • Avoid socks with holes or wrinkles.
    • Thin cotton socks are more absorbent for summer wear.
    • Square-toe socks will not squeeze your toes.
    • Avoid stockings with elastic tops.

Sports Medicine

Wound Care

For most people, cuts and scratches heal within days or weeks, but for those whose natural healing process is hampered, such as in the case of diabetes, a simple sore can become a complex medical problem, requiring specialized care.

Doctors of the Foot & Ankle Specialists of the Mid-Atlantic specialize in the care of lower extremity wounds. Using state-of-the-art wound care therapies, and surgery when necessary, FASMA doctors can help you to heal your wound.

Ulcer Care

An ulcer is a type of venous wound that is a sore which may develop on the feet or legs.  Conditions that effect circulation and sensation to the lower extremities, in particular diabetes may put a patient at greater risk of developing an ulcer. If ignored, an ulcer has the potential to become a limb threatening issue. Your Podiatrist will determine the root cause of the ulcer and provide a proper treatment plan.  

Ultrasound Diagnostic Imaging

Ultrasound imaging allows FASMA doctors to confirm a diagnosis in real time, and therefore prescribe a treatment plan faster than by traditional methods.

Ultrasound imaging can be used in the diagnosis of soft tissue problems, such as plantar fasciitis, soft tissue masses, foreign bodies, and neuromas, to name a few common conditions. Ultrasound can also be used to guide injections.

Noveon Nail Laser Therapy

Laser penetration can clear infected nails of fungal infections. This painless alternative is an excellent option for patients who do not want to take oral medication.

The first clinically proven laser device for the temporary increase of clear nail in patients with onychomycosis, or nail fungus.

Stop suffering the pain and embarrassment of unsightly nail fungus. PinPointe™ FootLaser™ is the easy and convenient treatment that helps to turn your discolored or disfigured nails into clearer, healthier-looking nails.

Safe and effective, this in-office treatment is pain-free, has no harmful side-effects, and, typically, takes only about 30 minutes to complete.

Pediatric Foot and Ankle Care

FASMA doctors are well trained and highly skilled in this specialty.

There are several types of children’s foot and ankle problems, both congenital and acquired, that FASMA doctors are highly qualified to diagnose and treat.

We offer both nonsurgical and surgical options for pediatric care including general care, orthopedics, and foot and ankle surgery.

Circulation Testing

Peripheral Arterial Disease (PAD) is a serious circulatory condition where clogged or narrowed arteries cause poor circulation to the arms, legs, brain or kidneys. It occurs most often in the lower extremities, causing decreased blood flow to the legs and feet. Just like build-up in the heart, clogged arteries in the lower extremities can cause a stroke or a heart attack. Eight to twelve million Americans have PAD and, if left untreated, it can be fatal.

Fortunately, today there is a non-invasive technology that can determine the presence of PAD. PAD-net™ is a PAD test that can be completed in 15 to 20 minutes during a regular office visit.

For patients with increased risk factors, including those of 65 years of age or older with a history of diabetes, high blood pressure, high cholesterol or smoking, being informed about this arterial disease is essential. Leg pain and discoloration of the toes or feet are possible symptoms of PAD. It is important to note, however, that many people with PAD do not experience any symptoms. Testing can help to determine whether you have PAD, and whether medical or surgical treatment is necessary.

Cosmetic Surgical Services

We employ plastic surgical techniques to correct unsightly foot deformities, such as bunions and hammer-toes. In addition, FASMA doctors are adept at revising unsightly scars caused by previous surgery.

Most importantly, feet should be functional and pain-free. 'Foot & Ankle Specialists of the Mid-Atlantic' truly understand patients' desire for a healthy balance between form and function. Feet can be beautiful, and FASMA doctors help patients to achieve their goals.

Clinical Research Department

The Baltimore office is affiliated with Chesapeake Research Group LLC. Dr. Gottlieb was the founder of this clinical trial site. They perform clinical trials, helping pharmaceutical companies and medical device manufacturers to develop the latest medications and devices.

FASMA doctors consult with CRG, and assist in the completion of these clinical trials.

Arthroscopic Surgery

Arthroscopy is a minimally invasive surgical procedure in which an examination and, sometimes, treatment of damage to the interior of a joint is performed, using an arthroscope, a type of endoscope that is inserted into the joint through a small incision.

Arthroscopic procedures can be performed either to evaluate or to treat many orthopedic conditions, including torn floating cartilage, torn surface cartilage, and to trim damaged cartilage.

The surgical instruments used are smaller than traditional instruments. Surgeons view the joint area on a video monitor, and can diagnose and repair torn joint tissue, such as ligaments and menisci or cartilage.

Ankle arthroscopy is a minimally invasive surgical procedure that orthopedic surgeons use to treat problems in the ankle.