Diabetic Foot Care
According to the American Diabetes Association, about 15.7 million people (5.9 percent of the United States population) have diabetes. Nervous system damage (also called neuropathy) affects about 60 to 70 percent of people with diabetes and is a major complication that may cause diabetics to lose feeling in their feet or hands. At Step Ahead Foot and Ankle, Dr. Fiala provides preventative foot care (care of calluses and thickened toenails) and treatment for diabetic foot ulcerations and infections. Care of ulcerations with patients who have diabetes requires appropriate "offloading" (removing pressure, often with special shoes, orthotics, or casts). The resources provided at Step Ahead (diabetic shoes, casting, orthotics, in-shoe pressure measurement to assist with offloading, PADnet® ABI / PVR machine to test a patient's circulation) are paramount to ulceration healing, which is key to prevent infections. When infections do occur, though, Dr. Fiala is surgically skilled to manage these as well.
Ankle & Foot Surgery
Although Dr. Fiala favors a conservative treatment approach to most foot & ankle ailments, there are some conditions that are best treated surgically. These may include: foot & ankle fractures, some foot infections, severe foot deformities, painful bunions & hammertoes, chronic ankle sprains/instability, tendon tears, and foot and ankle arthritis. At Step Ahead Foot and Ankle patients are always given their options and are asked to play a role in their care, whether conservative or surgical.
Many sports are hard on the feet because of quick repetitive movements, constricting footwear, and/or increased exposure to injury or trauma. At Step Ahead Foot and Ankle, emphasis is placed on preventative medicine and appropriate biomechanical alignment. Dr. Fiala routinely favors a non-surgical approach to treating many athletic or overuse foot ailments, including: heel pain, neuromas, ball of foot pain, bunions, big toe joint pain, and Achilles tendon pain. Many times this involves the fitting of either pre-fabricated (oftentimes customized with adjustments) or custom foot orthoses.
Orthotics, also known as orthoses, refers to any device inserted into a shoe, ranging from felt pads to custom-made shoe inserts that correct an abnormal or irregular, walking pattern. Sometimes called arch supports, orthotics allow people to stand, walk, and run more efficiently and comfortably. While over-the-counter orthotics are available and may help people with mild symptoms (oftentimes with adjustments, performed right on-site at the time of appointment), they normally cannot correct the wide range of symptoms that prescription foot orthoses can since they are not custom made to fit an individual's unique foot structure.
Heel pain affects nearly everyone from time to time. However, when it persists for longer periods of time--after the uncomfortable shoes have been taken off and the feet have been rested after a busy day of strenuous activity or standing--and does not resolve on its own, it could be a sign of plantar fasciitis. The podiatrists at Step Ahead Foot and Ankle, LLC, wants to help you understand this potential source of your pain and will work with you to get back on your feet again, sooner than later. They are skilled to address the underlying biomechanical concerns that may have predisposed you to plantar fasciitis and will work with you to develop a program that meets your needs.
A bunion is a bone deformity caused by what appears to be an enlargement of the joint at the base and side of the big toe (metatarsophalangeal joint). Bunions form when the toe moves out of place. The enlargement and its protuberance cause friction and pressure as they rub against footwear. Over time, the movement of the big toe angles in toward the other toes, sometimes overlapping a third toe (known as Hallux Valgus). The growing enlargement or protuberance then causes more irritation or inflammation. In some cases, the big toe moves toward the second toe and rotates or twists, which is known as Hallus Abducto Valgus. Bunions can also lead to other toe deformities, such as hammertoe, and it's often a bunion that causes a biomechanical alteration to the entire front of the foot and leads to other symptoms such as metatarsalgia, neuromas, and 2nd MPJ capsulitis.
F-Scan Gait Analysis
Step Ahead Foot and Ankle offers a computerized gait analysis using the F-Scan® in-shoe pressure measurement system. This state-of-the-art system allows us to “see inside the shoe," giving us a better understanding of how a person’s foot interacts with their footwear and helping us provide the best, most advanced care in the area. The In-shoe pressure measurement system can be used to not only track areas of high pressure when one walks, or runs (or cycles even!), in his / her shoes, but it is also used to track center of mass fluctuations with gait and motion, and address any hindrances or "hold ups" to the fluid motion of this center of mass leading to foot pathology, and sometimes even pathology in other parts of the body.
Self-check-in kiosk system
It is the policy of Step Ahead Foot and Ankle, to collect all co-pays, co-insurances, and payments towards high deductibles at the time of service. If you are self-pay, payment for the entire fee (with 25% discount) is required at the time of service. Upon request, the approximate cost of your care may be relayed to you in advance. Please keep in mind that there may be some variation to your visit costs dependent on the Doctor's recommendations at the time of service (such as x-ray imaging or in office procedure). Please relay any questions you may have about the cost of your care to our Billing Specialist.