Did Punxsutawney Phil See His Shadow?

I know that we are in the middle of winter, albeit a warm winter, but I thought today would be a great day to discuss malignant melanoma and the feet as the groundhog did not see his shadow meaning an early spring/summer. In our office, we have posters that show pictures of skin cancers of the feet and multiple times a day patients say to us “Wow, I didn’t know you can develop skin cancer on the feet.” I am here today to tell you, YES, you can develop skin cancer on the feet.

Keeping your Children OFF their Toes! Lonnie Kaplan DPM

A common pediatric foot and ankle abnormality is toe walking. Many people think that toe walking should be ignored and it will resolve on its own. Occasionally, it does resolve on its own but it is very important to have it evaluated by a podiatrist. There are many causes of toe walking in children. Some include cerebral palsy, muscular dystrophy as well as spinal cord problems. Once the neurological causes are ruled out, other diagnosis include idiopathic (unknown cause) toe walking which occurs commonly. Your podiatrist will complete a thorough developmental history including asking questions about strength, coordination, and bowel and bladder control. Other important findings that can help point to a diagnosis include whether the child was walking on the toes since birth or it developed over time and if the toe walking is occurring on one or both feet. Treatment options vary widely based on the root cause. Most include a team approach with a physical therapist specializing in pediatrics to work on stretching and strengthening. Sometimes, AFO (ankle foot orthotics) can be made which sometimes need to extend to the calf while in other cases, orthotics can be prescribed that go directly in the child’s shoes and do not need to extend past the ankle.

Call Quality Foot Care today at 215-230-9707 to visit with Doylestown’s community podiatrists. We will be happy to discuss the above and keep the entire family on their feet!


Keeping your Children Active! Lonnie Kaplan DPM

When most people think of a podiatrist, they think of someone who elderly people go and see to have their nails and calluses trimmed and diabetic shoes ordered. Most people do not realize how important it is for children to see a podiatrist as well. Children tend to be on their feet and are always running around the playground and chasing after friends. A lot of foot and ankle conditions start in childhood and progress through life. What is important to understand is that catching/ treating common foot conditions early in life will make for a world of difference in children as they get older. A lot of times people think that children will just out-grow their foot/ ankle issues and that there is no need for treatment. I have seen so many teens who come in with their parents having foot and ankle conditions (flat foot, in-toes) that could have been avoided or progression slowed down by having treatment earlier in life.

My next set of blogs will discuss lower extremity conditions that children tend to develop and discuss treatment options and when to see a podiatrist. Conditions will include flat feet, Severs Disease, warts, ingrown nails, in toes/out toes amongst many other conditions. It is my hope that after this set of blogs over the next few weeks, you will be better educated on when to bring your children to see a podiatrist to give them the best chance to live a healthy pain free life when it comes to the lower extremities!

Call Quality Foot Care Today at 215-230-9707 to visit with Doylestown’s community podiatrists. We will be happy to discuss the above in detail and help your family stay on their feet!

Heel Pain?

The adult foot is a complicated part of the body with many tendons, ligaments and bones. One of the most common foot complaints is heel pain. The most common cause of heel pain in adults is plantar fasciitis, which is an inflammation of the plantar fascia (a ligament connecting the heel to the toes that fans out under the bottom of the foot). This condition can be seen in people with either flattened or high arches and risk factors include obesity, standing for long periods of time, and certain exercises.

Most people with plantar fasciitis complain of pain when taking the first step in the morning as well as pain when standing, after sitting for long periods of time. Sometimes the pain is restricted to the heel area and sometimes it can fan out along the bottom of the foot. Luckily, treatment is typically non-surgical. Your podiatrist may recommend rest and ice to help with pain, stretching, custom orthotics, physical therapy, or corticosteroid injections. If none of the above relieve pain, surgery can be a last resort. This may entail cutting a small part of the plantar fascia and sometimes can even be done utilizing a minimally invasive technique with a small camera. Don’t let heel pain slow you down.

Call Quality Foot Care today at 215-230-9707 to Visit with Doylestown’s community podiatrists. We will be happy to discuss the condition in detail with you and get you back on your feet!


Ingrown Toenail Pain

Ingrown ToenailDo you have pain on the side of your toe and it looks like the nail has grown into the skin? Although common, ingrown toenails can be extremely painful. Trying to put a shoe on or even walk barefoot can cause pain. If the ingrown toenail is not taken care of it can actually lead to an infection. What can be done to take care of the toenail? Do you need to call your podiatrist?

Known as onychocryptosis in the medical world, this painful condition can become chronic. Repeated episodes can lead to infections, redness, and swelling. There are a number of reasons as to why a person can suffer from an ingrown toenail. Some people have this problem because it is congenital. A great example of congenial would be those whose toenails are just too large. People who have toes that curl tend to have more episodes of ingrown toenails. Stubbing your toe or any other type of trauma can also cause ingrown toenails. Having your foot stepped on or dropping something heavy on the foot can cause the nail to become jammed or stuck in the skin. Runners often have problems with ingrown toenails due to the constant pounding on the feet on long runs.

Ingrown Toenail- Most Common Cause

The most common cause of ingrown toenails is cutting them wrong. If the toenails are cut wrong they can grow into the skin. Tight socks and shoes can also make matters worse because the toenail is being pushed in. If you are suffering from an ingrown toenail and your toe is painful, swollen and red where the nail meets the skin, you may have an infection. Once the nail punctures the skin, it is the perfect port or entryway for germs that can cause infection. If the ingrown toenail is not treated the nail grows further under the skin and the infection can become much worse. The infection needs to be treated by your podiatrist and antibiotics. As soon as you notice that you have an ingrown toenail you should contact your foot doctor.

Until you can see your doctor the following tips will help to provide some relief:

  • Soak the foot in warm water with Epsom salt added.
  • Thoroughly dry your foot and make sure to get the area where it is painful.
  • Cover painful area with a mild antiseptic.
  • Put a bandage over the area.
  • Wear socks and shoes that give the toes extra room.

It is important that you learn to cut your toenails properly. Holding your nail clippers, cut the nails straight across and make sure the corners of the nails are visible. If the nail is cut too short or the edges are rounded the nail will want to grow into the skin. Once the nail begins puncturing the skin you are on your way to an ingrown toenail and possible infection.

If you go to the salon to have a pedicure be sure your toenails are cut as described above. Another great tip when visiting the salon for your pedicure is to bring your own pedicure kit. Using your own kit will also reduce the risk of infection.

What is Athlete’s Foot?



Athlete’s foot will usually begin as a rash that can cause intense itching. Athlete’s foot is also known as tinea pedis and usually starts between the toes. Athlete’s foot will usually strike those people who wear tight-fitting shoes and have feet that sweat. The more your feet sweat the worse the symptoms seem to be.

Signs of Athlete’s Foot

Most common signs of athlete’s foot are itching, burning and stinging. Athlete’s foot is also very contagious and can be picked up from floors, towels and showers. Anywhere that a person has walked barefoot that has athlete’s foot will be contaminated.

Athlete’s foot is related to a few other fungal infections including jock itch and ringworm. Athlete’s foot can be treated with over-the-counter antifungal medications. If you find that the over-the-counter antifungal medications are not working it is time to see your foot specialist. There are medications available that can be prescribed and will reduce the discomfort quickly. Athlete’s foot can cause your feet to hurt and bleed if it is not taken care of.

You may notice that athlete’s foot can become worse at night after taking your shoes and socks off. Some forms of athlete’s foot can become so severe that it will cause blisters and open sores. If you have blisters try not to scratch them and open them up. If you do touch your blisters or feet be sure to wash your hands right away. Athlete’s foot can spread to your hands.

Time to see your Foot Specialist

If you suspect you have athlete’s foot and you have diabetes then you need to see your foot specialist right away. If you notice swelling, redness and have a fever then put a call into your podiatrist. There is no need having to suffer when your doctor is a phone call away.

What Causes Athlete’s Foot

Caused by the same organisms as jock itch and ringworm, athlete’s foot thrives in damp places that are warm. Try to wear shoes that allow the feet to breath at all times. Try to wear white cotton socks over those that are heavier and do not allow your feet to breath.

Avoiding Athlete’s Foot

  • Wear shoes that allow your feet to breath.
  • Do not share mats, bed linens, towels, socks or shoes with someone who has athlete’s foot.
  • Do not walk barefoot in public areas including public showers. Wear flip-flops to protect your feet when in public areas.

Athlete’s foot that is not taken care of can spread to other parts of your body including your nails, your hands and your groin area.

What to Expect From Your Foot Doctor

Your foot doctor will examine your feet. You will be asked when this rash started. Does any other family member have athlete’s foot? Have you been in public showers, swimming pools or other areas where athlete’s foot may have spread?

If you have questions about athlete’s foot be sure to ask your doctor. The better informed you are the less chance of contracting this type of rash again.

Foot Safety on Ice and Snow

Foot Safety on Snow and IceWelcome to the winter that does not want to give up. It has recently been reported that 94 million Americans have had enough of this winter. For many of us the thought of warm weather makes us smile, but in the meantime we have to be sure that there are no falls and we stay upright. Walking on snow and ice can be tricky and even when taking our time there can be slipping and sliding. Falling is one of the major injuries reported in the winter and with the added snow and ice this year the injuries are rising.

Tips for Foot Safety on Snow and Ice

  1. Remain Vigilant– Although pavement that has been cleaned off may look like it is safe be cautious. Consider all areas that are wet to be a slipping hazard. There may be a thin sheet of ice that you do not see and when you start to slip it is hard to catch yourself.
  2. The Penguin Walk– Sounds funny, but it really does work! By pointing your feet out slightly and walking you are changing your center of gravity. Bending slightly at the knees and walking like a penguin will get you across any icy areas safer.
  3. Take Your Time– It seems we are always in a hurry and trying to multitask, now is the time to slow down a bit. How many times have you left a building and while walking across a parking lot you are fishing the keys out of your bag? This is where slips and falls can happen because your attention is not on the ice and snow that is under your feet. Foot safety on ice and snow is much better when you are concentrating on just the walking.
  4. Leaving a Vehicle– Be careful when stepping out of vehicles and use the vehicle for support.
  5. Where to Walk– When entering a building be sure to walk only in the areas that have been cleaned. Follow the path or walkway where there has been salt put down.
  6. Where Appropriate Shoes– Do not wear any type of shoe that has a smooth bottom. Try to wear boots and shoes that have raised patterns or large treads. If you have to wear dress shoes for work just put them in a bag and change once you are in the safety of the building. For extra grip, there are traction devices that can be purchased and attached to your shoes. There are also boots available with cleats for better traction while on the snow and ice.
  7. Outside Stairways– Always hold onto the handrail even if you have been up and down the same stairs a million times.
  8. Melting Ice and Snow– When the temperature goes above freezing watch for water on top of the ice and snow. The melting can cover the ice that is still present and may not be seen in time.

There will just be times when a slip on the ice is something that you did not see coming. If you do slip and hurt your foot or ankle then it is best to have it checked by your local foot specialist. The longer you let the injury go unattended means the more damage that can happen.

Blisters: Doylestown Podiatrist Ken Lefkowitz Talks About This Annoying Problem

By Dr. Ken Lefkowitz

Everything about your new shoes is perfect—that is, until you begin to feel the throbbing pain on the side of your toe that announces the appearance of a nasty blister. Tight shoes that rub against the foot during movement can cause these painful bumps, which appear as fluid-filled bubbles on the skin. This is why “breaking in” a new pair of shoes is a common cause of blisters.

So, you’ve danced all night in those high heels that pinch your toes, and you’ve awoken to discover a bubble of skin on your toe that wasn’t there last night. It may feel tender to the touch. Stop where you are—no matter how tempting it may be, do not squeeze it and attempt to pop it with your fingers. The skin over a blister, when left unbroken, provides a natural barrier to bacteria, decreasing the risk of infection. If the blister isn’t causing you much pain, simply cover it with an adhesive bandage and leave it alone. Do not puncture it unless it is causing you discomfort, in which case you must perform the correct procedure to drain the fluid which is contained in the “bubble”. The goal is to drain this clear fluid while keeping the overlying skin intact. First, wash both your hands and the blister thoroughly, and swab it with rubbing alcohol. Next, sterilize a sharp needle by wiping it with the rubbing alcohol and use it to puncture the blister near its edge. Gently use a tissue to extract as much of the fluid as possible, and then apply antibiotic ointment and a bandage.

If you see signs of an infection (puss, redness, pain that is increasing, or warm skin) around a blister on your foot, call Quality Foot Care, your local Doylestown podiatry office, at 215-230-9707.

Hammer Toes: Doylestown Podiatrist Ken Lefkowitz Discusses This Nagging Problem

By Dr. Ken Lefkowitz

A hammer toe is a contracture (bending) of the toe at its first joint, the proximal interphalangeal joint. There are two types; flexible and rigid. Flexible hammer toes are less serious because they are still moveable at the joint. Rigid hammer toes, seen in patients who have arthritis or wait too long to seek professional treatment, are identified by an immobile toe joint. Hammer toes can be recognized by their likeliness to an upside-down V when viewed from the side. They are usually seen in the second through fifth toes, but any toe can be affected.

Females are more likely than males to develop hammer toes. Many celebrity women, such as Katie Holmes, are known to develop them because of the shoes they wear. Hammer toes are caused by tight shoes that squeeze the toes or an abnormal balance of the muscles in the toes. Some symptoms commonly associated with hammer toes are: pain at the top of the toe from pressure in the shoe, the formation of corns on top of the joint, redness and swelling of the joint where it bends, restricted motion of the toes, and pain in the ball of the foot at the base of the toe that is believed to be affected.

To prevent hammer toes, the best thing you can do is wear properly fitting shoes—NEVER wear shoes that are too small/narrow! Wearing custom orthotics made by your podiatrist will improve the mechanics of your foot and help with conditions such as flat feet. This can help balance the muscles in the toes and stop hammer toes from forming.

If you have hammer toes, you shouldn’t hesitate to visit a podiatrist. Leaving them untreated can cause less serious flexible hammer toes becoming rigid. If this happens, non-surgical treatments may not work and you will most likely need surgery. Call Quality Foot Care, conveniently located in Doylestown, at 215-230-9707 and make your appointment today.

Weird Sensations in Your Feet? A Podiatrist Talks About Neuromas

The tight shoes that rock climbers wear can cause Morton’s neuromas.

Have you ever had the sensation that you were standing on a pebble in your shoe or a fold in your sock? If the answer is yes, you may be suffering from a Morton’s neuroma. This is a painful condition that occurs in the ball of the foot, commonly between the third and fourth toes. Morton’s neuromas develop when the tissue leading to one of the nerves in your toes thicken, causing a sharp, burning pain in the ball of your foot. Other symptoms include stinging, burning, tingling, or numbness in your toes and a burning pain in the ball of the foot that radiates out to the toes.

The development of Morton’s neuromas has been linked to wearing high heeled shoes. Any kind of pressure or irritation to the nerves leading to the toes can incite the occurrence of this condition. Certain high-impact sports (such as jogging or running) that subject the feet to repetitive trauma can also cause Morton’s neuromas. Even sports that require wearing tight shoes, such as skiing and rock climbing, have been reported as catalysts for this condition.

Once your podiatrist has diagnosed you with a Morton’s neuroma, there are a few treatment options to consider. Depending on the severity of your symptoms, you could receive treatment ranging anywhere from arch support and foot pads to sclerosing/cortisone injections and surgery. This is why it’s important to visit your podiatrist at the first sign that something is wrong. A trained professional will not only be able to provide in-office treatment, but also at-home remedies (for Morton’s neuromas, these include anti-inflammatory medicines or better footwear).

Dr. Lefkowitz of Quality Foot Care specializes in the treatment of Morton’s neuromas. If you would like to make an appointment at his Doylestown office, call 215-230-9707 and get on your way to healthy feet today.