A Step Ahead - Sole Foot and Ankle Specialists Blog

About Orthotics

Many of you will have heard of the word “orthotic”, seen people wear them in their shoes, and talk about them, but may not necessarily know what orthotic means. The term orthotic comes from the word origin “straight” or “make straight” and that is exactly what they are designed to do – straighten out an abnormal structure. When referring to foot orthoses, these are specially designed foot devices that go into your shoes, and are designed to provide support, and comfort to your specific feet.

What is the Purpose of an Orthotic?

The purpose of having orthotics to improve biomechanical function of your foot and ankle and/or provide specific accommodation for foot pathologies (accommodative orthoses). Improper biomechanics can be a result of many things such as: spine and hip deformities/malalignments, knee pathologies, and foot and ankle abnormalities. The reason these are important to treat is because having improper foot and ankle biomechanics can redirect your body weight to other areas on the foot not intended for it, and enable your foot to move in directions they are not meant to move. This can cause foot pathologies (plantar fasciitis, bursitis, ulcers, heel pain, tendinitis, etc.), which can make it difficult to walk without pain. What orthotics do for your feet is help correct for improper biomechanics, redistribute your body weight on your feet, prevent your foot from moving improperly, and help provide shock absorption.

Different Types of Orthotics Available

There are two primary categories for prescription orthotics and are targeted for specific issues, these include: Functional Foot Orthoses (FFOs) and Accommodative Orthoses.

  • Functional Foot Orthoses: These orthoses are designed to improve your biomechanical function by controlling improper foot motion and improve shock absorption when walking or standing; this can help treat foot pain cause by this abnormal motion


  • Accommodative Orthoses: These orthoses are designed to provide accommodation of specific foot pathologies and to accommodate patients with diabetic neuropathy. They are often softer and intended to provide patients with additional support and cushion; this is accomplished by reducing high pressure areas on the foot.

How Do I know What is Best for My Specific Feet?

The answer to this depends on the patient and their specific needs since each person’s foot is unique, and each person may have different goals (i.e. orthotics for athletes in running shoes or employees who want them in work shoes). When going in to your podiatrist’s office for a foot and ankle examine, depending on your specific needs and foot abnormalities, your podiatrist will prescribe an orthotic recommended for your specific feet. One of the best things about orthotics is the ability to transfer them between many different shoe types.

If you are experiencing foot or ankle pain or are interested in learning about orthotics for your feet, please do not hesitate to schedule an appointment with Dr. Gary N. Friedlander or Dr. Jay C. Larson at Sole Foot and Ankle Specialists in Glendale, Arizona, and have receive proper education on orthotics, and how they can provide pain relief, and correct for your specific foot abnormality.

Did you know that there over 7 million Americans unaware they have diabetes or are considered prediabetic? According to the American Diabetes Association (ADA) statistics, there were approximately 30 million people with diabetes in 2015, with nearly 25% of those people being 65 years or older and increasing each year. This year, March 27th is American Diabetes Association Alert Day, and the ADA uses this day to raise awareness about this debilitating disease, and provide individuals the opportunity to take a free Type 2 Diabetes Risk Test.

About Type 2 Diabetes

Diabetes is a disease that occurs when a person’s blood sugar levels are too high. Over time, having high blood sugar can lead to more serious health problems all over the body including: heart disease, kidney disease, dental disease, stroke, nerve damage, and foot problems. There are numerous types of diabetes, but the two most common are type 1 and type 2 diabetes. Type 2 diabetes is more common than type 1 and usually develops in adult life, whereas type 1  diabetes occurs more often in childhood. People who have type 2 diabetes often do not know they have it until a serious complication arises (i.e. heart attack, stroke, kidney failure, vision loss, foot ulcer formation, or even lower limb amputations).

There are numerous factors that increase the risk of a person developing type 2 diabetes such as: age, family history of diabetes, being inactive, having high blood pressure, poor diet, and weight control. The ADA created a simple, easy-to-use test to assess your risk of developing type 2 diabetes.  You can take the test by going to Type 2 Diabetes Risk Test

Why Diabetics Should See a Podiatrist

Your podiatrist plays a crucial role in managing serious side effects of diabetes and your foot health. Since the feet are the farthest structures from the heart, signs and symptoms of diabetes can appear first in the foot, such as peripheral neuropathy, and vascular issues. If your podiatrist suspects diabetes, they will perform specific neuro and vascular exams to determine the presence, or progression of diabetes complications. Signs and symptoms to lookout for include: loss of sensation in your feet, cold feet, changes in skin color, and wounds that do not seem to be healing. Your podiatrist can act as the first line of defense in detecting these changes and help protect and manage your feet from serious, life-threatening complications of diabetes.

If you would like more information about diabetes, you can visit the following websites that provide valuable information:

American Diabetes Association

National Institute of Diabetes and Digestive and Kidney Diseases

American Podiatric Medical Association (APMA) - Diabetes Awareness

Diabetes Care Education

Diabetes Self-Management Patient Education

If you or someone you know has diabetes, or thinks they might be at risk, please do not hesitate to schedule an appointment with Dr. Gary N. Friedlander or Dr. Jay C. Larson  at Sole Foot and Ankle Specialists in Glendale, Arizona, and have all your treatment options presented to you to ensure your feet stay healthy.

In the Valley, we have some of the best weather in the United States.  However, some people might have family in cooler climates or may want to take their family to Flagstaff to enjoy skiing, sledding, and building snowmen with their kids. For those choosing to go to cooler climates, developing frostbite should be a notable concern since it can cause permanent damage to the skin, nerves, arteries, and muscles of the affected area. Therefore, it is important to take precautions in avoiding frostbite on your feet and hands.

About Frostbite

Frostbite is a condition that can result in destruction and death of tissues and occurs when temperatures are below freezing (32°F or 0°C). At colder temperatures, the smaller blood vessels in the skin decrease their diameter, and this allows heat loss to be minimized in order to maintain body temperature. However, even though it helps maintain the body temperature, it also bypasses areas of the body that need blood as well, especially the toes, fingers, and ears. Frostbite is sometimes used as a general term, but it has three (3) degrees of severity: 1st degree (frost nip), 2nd degree (superficial frostbite), 3rd degree (deep frostbite):

  • 1st Degree – Frost Nip – the least severe and involves superficial freezing of the skin with redness, itching, and minimal swelling. Can be treated by rewarming the area without tissue damage.

  • 2nd Degree – Superficial Frostbite – involves superficial and subcutaneous freezing of the skin. The deeper structures beneath the skin are not affected, but blisters occur on the skin, and the old skin will slough off within a few weeks. Rewarming the affected areas can prevent long-term damage, but sometimes patients can develop a cold-sensitivity.

  • 3rd Degree – Deep Frostbite – This is the most severe form of frostbite and results in tissue destruction and ulcerations, as well as loss of deep tissues, and possibly bone. Rewarming the area will help prevent further tissue injury, but skin will have a loss of sensation due to tissue destruction. If the digits have turned black, dry, and hard, then more aggressive treatment such as amputation of the toes (or foot) might be necessary to prevent the infection and further injury.

How Do I Prevent Frostbite?

The simplest way to avoid frostbite is to take precautions when going out into cooler temperatures (i.e. snow, mountains, lakes). The following are safety tips for you and your family to consider when going outside in colder temperatures:

  • Be aware of the amount of time spent outside in the cold and try to keep it minimal

  • Wear layers of warm, loose clothing to provide insulation against the cold

  • Wear moisture-wicking socks to provide insultation for your feet and prevent cold exposure

  • Wear shoes that are well-insulated or have minimal porous capability such as boots – cold fluid (such as melted snow) can enter shoes and still cause frostbite

  • Ensure you wear a hat and gloves to cover your ears and hands – these are highly sensitive to cold temperatures

  • Watch for any signs of frostbite: red or pale skin, numbness, prickling in the toes or fingers

If you have suffered a toe or foot injury due to frostbite or want more information on preventing frostbite, please do not hesitate to schedule an appointment with Dr. Gary N. Friedlander or Dr. Jay C. Larson at Sole Foot and Ankle Specialists in Glendale, Arizona, and have all your treatment options presented to you and ensure you and your family maintain warm and healthy feet.

Whether this is your first child, or you have many, newborn babies start new chapters in life. During pregnancy, the body undergoes many changes to accommodate the new bundle of joy, including the feet. Natural weight gain occurs, and this alters the mother’s traditional weightbearing stance into a new stance due to a change in the woman’s center of gravity. As a result, additional strain is added to the knees and feet and a pregnant woman may turn her feet outwards for stability. As a result, this adds unnecessary stress to the muscles, ligaments, and tendons in the feet and cause pain, inflammation, or other foot problems. Therefore, it is important for pregnant women to pay extra attention to their feet during pregnancy and after the birth.

Common Foot Problems During Pregnancy

Did you know it is common to experience foot pain and swollen feet during pregnancy? This is often overlooked and should be addressed when it is noticed. Swelling of the feet commonly occurs since blood circulation, and hormone levels are increased during pregnancy. This causes the body to retain water and makes it possibly to deliver nutrient to your growing baby effectively. However, a side effect is swelling due to the smaller blood vessels in the foot, and ankle unable to handle the extra volume of fluid retained. Another foot problem associated with pregnancy is ligament laxity, which can loosen the ligamentous support of your feet. This is due to a hormone (Relaxin) that is released to help loosen the ligaments of the birth canal during delivery. However, this hormone targets other ligaments, and the foot and ankle ligaments can be affected. As a result, this can cause the foot to flatten abnormally (hyper-pronation), or collapse.

How to Minimize Foot Discomfort During Pregnancy

The effects of pregnancy on your feet do not have to keep you from your daily activities. The following are ways to help minimize the discomfort experienced in your feet during pregnancy:

  • Choose comfortable, stable shoes that help provide extra support, and shock absorption

  • Ensure your footwear is properly fitted to avoid constriction of blood circulation

  • Keep your feet elevated when you can

  • Drink plenty of water and minimize foods with a high salt content to help minimize fluid retention

  • Prescription orthotics

  • Exercise (as tolerated) to improve blood circulation and avoid it pooling in your legs

  • Foot massages can help aid circulation and reduce swelling

When Should I See a Podiatrist?

Most of the effects explained are normal, but can potentially lead to serious pregnancy complications. It is important to address any concerns early in the pregnancy to avoid any issues and help minimize discomfort throughout pregnancy. You should see a podiatrist for any of the following reasons:

  • Constant swelling that does not resolve

  • Receive regular foot measurements to ensure footwear is properly fitted

  • Obtain a prescription for custom orthotics

  • Treat any other associated foot problems causing consistent or unresolved pain

If you are pregnant and have been experiencing pain or discomfort, please do not hesitate to schedule an appointment with Dr. Gary N. Friedlander or Dr. Jay C. Larson at Sole Foot and Ankle Specialists in Glendale, Arizona, and have all your treatment options presented to you and ensure you and your newborn maintain healthy feet.

About Subungual Hematomas

Suppose you are moving to a new home, are moving heavy boxes around, and accidentally drop one of those heavy boxes on your toes. After walking off the pain, you notice big toe nail is getting darker color than the surrounding nail, and it still hurts.  This is a classic case of developing a subungual hematoma. Subungual Hematoma refers to bleeding beneath the nail plates and is most often associated with trauma, such as a crush injury. Subungual Hematomas occur due to blood accumulating under the nail.  When the nail suffers trauma, it allows the space under the nail to fill with blood, which causes increased pressure beneath the nail.

How do I know if I have a Subungual Hematoma?

If a patient has recently suffered a crush injury/trauma, notices a swollen toe, and says the pain is throbbing, it is likely nail bed damage, and a subungual hematoma is present. Since blood tends to accumulate in the potential space between the nail plate, the blood can be visually noticeable, and will appear as a dark red, or brown color on the nail. Since subungual hematomas tend to occur most with crush injuries, it is also likely more damage to the toes can be sustained. A few examples include: fracture to the toes, damage to the nail plate, and pushing the nail plate into the nail fold. Since these could occur, it is a good idea to have an x-ray taken to see if any underlying bone damage has occurred.

Treating your Subungual Hematoma

Treatment of a subungual hematoma can vary depending on how severe the bleeding is beneath the nail. If it is minor, such as a tiny line of blood, then it is likely the subungual pressure is not severe and will not need to be drained. However, if there is a lot of blood beneath the nail, and the pain is excruciating, then treatment will involve reducing the pressure underneath the nail. This can be accomplished using several different methods, all of which involve penetrating the nail plate to relieve the pressure. After having the pressure relieved, make sure you are extra cautious about keeping your toes from suffering trauma during recovery, and make sure you wear shoes that do not expose the affected toe (i.e. do not wear sandals or flip-flops).  

If you have recently suffered a trauma to your toes, are suffering from throbbing pain in your toes, and are concerned about a hematoma, please do not hesitate to schedule an appointment with Dr. Gary N. Friedlander or Dr. Jay C. Larson at Sole Foot and Ankle Specialists in Glendale, Arizona, and have all your treatment options presented to you.

This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.

Contact Us

Office Hours
Monday:07:30 AM - 05:00 PM
Tuesday:07:30 AM - 05:00 PM
Wednesday:07:30 AM - 05:00 PM
Thursday:07:30 AM - 05:00 PM
Friday:7:30 AM - 12:00 PM