Foot Infections and Wounds
There are many types of foot infections and they can be from a host of causes having to do with biomechanics of the feet and underlying health conditions. Patients with foot wounds often have diabetes, peripheral vascular disease, or other metabolic conditions. However, foot infections can also result from traumatic injuries or tissue loss, leading to contamination by foreign materials and bacteria formation. Over time, treatment approaches to foot infections have evolved, influenced by advancements in pharmacology and medical technology with the goal of preserving limbs. Plastic and reconstructive procedures have revolutionized the management of certain foot infections. The primary objectives now include restoring functionality and significantly reducing the need for amputations. These developments represent a promising shift in the management of foot infections, offering hope for improved outcomes in patients facing these challenging conditions. If you have a foot infection or wound, it is suggested that you make an appointment with a podiatrist as soon as possible to determine the cause of the wound and the best way to deal with it.
Wound care is an important part in dealing with diabetes. If you have diabetes and a foot wound or would like more information about wound care for diabetics, consult with Dr. Barbara Davis from Gilbert Podiatry. Our doctor will assess your condition and provide you with quality foot and ankle treatment.
What Is Wound Care?
Wound care is the practice of taking proper care of a wound. This can range from the smallest to the largest of wounds. While everyone can benefit from proper wound care, it is much more important for diabetics. Diabetics often suffer from poor blood circulation which causes wounds to heal much slower than they would in a non-diabetic.
What Is the Importance of Wound Care?
While it may not seem apparent with small ulcers on the foot, for diabetics, any size ulcer can become infected. Diabetics often also suffer from neuropathy, or nerve loss. This means they might not even feel when they have an ulcer on their foot. If the wound becomes severely infected, amputation may be necessary. Therefore, it is of the upmost importance to properly care for any and all foot wounds.
How to Care for Wounds
The best way to care for foot wounds is to prevent them. For diabetics, this means daily inspections of the feet for any signs of abnormalities or ulcers. It is also recommended to see a podiatrist several times a year for a foot inspection. If you do have an ulcer, run the wound under water to clear dirt from the wound; then apply antibiotic ointment to the wound and cover with a bandage. Bandages should be changed daily and keeping pressure off the wound is smart. It is advised to see a podiatrist, who can keep an eye on it.
If you have any questions, please feel free to contact our office located in Gilbert, PA . We offer the newest diagnostic and treatment technologies for all your foot care needs.
What Is a Good Foot Care Routine?
In the bustling rhythm of daily life, our feet often bear the brunt of our activities, yet they are often neglected when it comes to self care. Establishing a robust foot care routine, however, unveils a cascade of remarkable benefits. Regular exfoliation and moisturization not only soften the skin but also prevent unsightly issues such as calluses and cracked heels. This routine is not just about aesthetics, as it nurtures the foundation of our body's mobility. A soothing foot soak not only relaxes tired muscles but promotes blood circulation, enhancing overall well being. A well maintained foot care routine can improve posture and alleviate potential joint pain. If you would like to learn more about the benefits of practicing every day foot care routines, it is suggested that you consult a podiatrist who can provide you with important information.
Everyday foot care is very important to prevent infection and other foot ailments. If you need your feet checked, contact Dr. Barbara Davis from Gilbert Podiatry. Our doctor can provide the care you need to keep you pain-free and on your feet.
Everyday Foot Care
Often, people take care of their bodies, face and hair more so than they do for their feet. But the feet are a very important aspect of our bodies, and one that we should pay more attention to. Without our feet, we would not be able to perform most daily tasks.
It is best to check your feet regularly to make sure there are no new bruises or cuts that you may not have noticed before. For dry feet, moisturizer can easily be a remedy and can be applied as often as necessary to the affected areas. Wearing shoes that fit well can also help you maintain good foot health, as well as making it easier to walk and do daily activities without the stress or pain of ill-fitting shoes, high heels, or even flip flops. Wearing clean socks with closed shoes is important to ensure that sweat and bacteria do not accumulate within the shoe. Clean socks help to prevent Athlete’s foot, fungi problems, bad odors, and can absorb sweat.
If you have any questions please feel free to contact our office located in Gilbert, PA . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Definition and Causes of a Foot Stress Fracture
Foot stress fractures are common injuries that can significantly impact daily life and physical activities. It's essential to understand the basics of these fractures to prevent and manage them effectively. Stress fractures occur due to repetitive stress on the bones, often seen in athletes and runners, especially those who suddenly increase their activity levels. They are tiny cracks in the bone that can be difficult to detect initially, as symptoms may start mild and gradually worsen. Common signs include localized pain, swelling, and tenderness in the affected area. Resting and elevating the affected foot is crucial in the early stages of managing a stress fracture. Seeking prompt medical attention and avoiding weight-bearing activities can prevent further damage. Wearing proper footwear, implementing gradual exercise progression, and incorporating rest days into the routine are essential preventive measures. Understanding foot stress fractures empowers individuals to take proactive steps in maintaining foot health and avoiding potential complications. If you have a foot stress fracture, it is suggested that you speak to a podiatrist who can effectively treat this condition.
Activities where too much pressure is put on the feet can cause stress fractures. To learn more, contact Dr. Barbara Davis from Gilbert Podiatry. Our doctor can provide the care you need to keep your pain free and on your feet.
Dealing with Stress Fractures of the Foot and Ankle
Stress fractures occur in the foot and ankle when muscles in these areas weaken from too much or too little use. The feet and ankles then lose support when walking or running from the impact of the ground. Since there is no protection, the bones receive the full impact of each step. Stress on the feet can cause cracks to form in the bones, thus creating stress fractures.
What Are Stress Fractures?
Stress fractures occur frequently in individuals whose daily activities cause great impact on the feet and ankles. Stress factors are most common among:
- Runners
- People affected with Osteoporosis
- Tennis or basketball players
- Gymnasts
- High impact workouts
Symptoms
Pain from the fractures occur in the area of the fractures and can be constant or intermittent. It will often cause sharp or dull pain with swelling and tenderness. Engaging in any kind of activity which involves high impact will aggravate pain.
If you have any questions please feel free to contact our office located in Gilbert, PA . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Are Bunions Affecting Your Everyday Life?
Have you noticed a bony protrusion on the side of your big toe? If so, you may have developed the foot condition known as a bunion. Don't let bunions interfere with your daily activities.
Eczema and Blisters on the Feet
Foot dyshidrotic eczema, also known as pompholyx, is a skin condition characterized by small, intensely itchy blisters that appear on the soles of the feet and edges of the toes. This condition tends to flare up for a few weeks and in some cases, can be chronic. It is most common in adults aged 20-40, with a higher prevalence among females. Symptoms of foot dyshidrotic eczema include a burning or prickling sensation on the skin, followed by the sudden eruption of tiny blisters that may weep and become infected. This condition can cause pain, itching, fluid-filled blisters, sweaty skin, dry and flaky skin after blisters clear, and possible dark spots for individuals with darker skin tones. The exact cause of foot dyshidrotic eczema is unknown, but it is thought to be genetic and can be linked to hypersensitivity to certain allergens, such as exposure to metals or fungal infections like athlete's foot, and excessively sweaty feet. Stress and warm weather may also lead to flare-ups. If you have anything resembling this condition, it is strongly suggested that you make an appointment with a podiatrist as soon as possible for a proper diagnosis and treatment.
Blisters may appear as a single bubble or in a cluster. They can cause a lot of pain and may be filled with pus, blood, or watery serum. If your feet are hurting, contact Dr. Barbara Davis of Gilbert Podiatry. Our doctor can provide the care you need to keep you pain-free and on your feet.
Foot Blisters
Foot blisters are often the result of friction. This happens due to the constant rubbing from shoes, which can lead to pain.
What Are Foot Blisters?
A foot blister is a small fluid-filled pocket that forms on the upper-most layer of the skin. Blisters are filled with clear fluid and can lead to blood drainage or pus if the area becomes infected.
Symptoms
(Blister symptoms may vary depending on what is causing them)
- Bubble of skin filled with fluid
- Redness
- Moderate to severe pain
- Itching
Prevention & Treatment
In order to prevent blisters, you should be sure to wear comfortable shoes with socks that cushion your feet and absorb sweat. Breaking a blister open may increase your chances of developing an infection. However, if your blister breaks, you should wash the area with soap and water immediately and then apply a bandage to the affected area. If your blisters cause severe pain it is important that you call your podiatrist right away.
If you have any questions, please feel free to contact our office located in Gilbert, PA . We offer the newest diagnostic and treatment technologies for all your foot care needs.
What Are Plantar Warts?
Plantar warts are small, rough growths on the sole of the feet caused by HPV, or the human papillomavirus, entering the skin through minor cuts or abrasions. These warts can be painful, especially when walking or standing. They may appear as single growths or in clusters. Over-the-counter treatments, like salicylic acid patches or gels, can be effective in gradually dissolving plantar warts over time. However, some cases are stubborn and necessitate professional intervention. If you or your child have a plantar wart that is painful or will not go away, it is suggested that you make an appointment with a podiatrist for treatment options that might include freezing the wart, laser therapy, or a minor surgical procedure to permanently remove it.
Plantar warts can be very uncomfortable. If you need your feet checked, contact Dr. Barbara Davis from Gilbert Podiatry. Our doctor will assist you with all of your foot and ankle needs.
About Plantar Warts
Plantar warts are the result of HPV, or human papillomavirus, getting into open wounds on the feet. They are mostly found on the heels or balls of the feet.
While plantar warts are generally harmless, those experiencing excessive pain or those suffering from diabetes or a compromised immune system require immediate medical care. Plantar warts are easily diagnosed, usually through scraping off a bit of rough skin or by getting a biopsy.
Symptoms
- Lesions on the bottom of your feet, usually rough and grainy
- Hard or thick callused spots
- Wart seeds, which are small clotted blood vessels that look like little black spots
- Pain, discomfort, or tenderness of your feet when walking or standing
Treatment
- Freezing
- Electric tool removal
- Laser Treatment
- Topical Creams (prescription only)
- Over-the-counter medications
To help prevent developing plantar warts, avoid walking barefoot over abrasive surfaces that can cause cuts or wounds for HPV to get into. Avoiding direct contact with other warts, as well as not picking or rubbing existing warts, can help prevent the further spread of plantar warts. However, if you think you have developed plantar warts, speak to your podiatrist. He or she can diagnose the warts on your feet and recommend the appropriate treatment options.
If you have any questions please feel free to contact our office located in Gilbert, PA . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Stretching May Help to Prevent Running Injuries
Anyone who enjoys running needs to be aware that an injury can interrupt their daily exercise routine. Many people who have endured a running injury will continue to run making the injury worse. It is helpful to implement effective strategies that can help to prevent running injuries. These can consist of stretching before and after running. Additionally, gradually increasing duration and speed as this can provide the body with flexibility. Strength training is essential to practice, which is an efficient method for building and maintaining muscle strength. Research has shown it is beneficial to eat healthy and balanced foods that have adequate nutrients and vitamins. Running injuries often affect the feet and many people can endure a broken foot or ankle. If you would like more information about how to practice effective methods to prevent running injuries, please confer with a podiatrist.
All runners should take extra precaution when trying to avoid injury. If you have any concerns about your feet, contact Dr. Barbara Davis of Gilbert Podiatry. Our doctor will treat your foot and ankle needs.
How to Prevent Running Injuries
There are a lot of mistakes a runner can make prior to a workout that can induce injury. A lot of athletes tend to overstretch before running, instead of saving those workouts for a post-run routine. Deep lunges and hand-to-toe hamstring pulls should be performed after a workout instead of during a warmup. Another common mistake is jumping into an intense routine before your body is physically prepared for it. You should try to ease your way into long-distance running instead of forcing yourself to rush into it.
More Tips for Preventing Injury
- Incorporate Strength Training into Workouts - This will help improve the body’s overall athleticism
- Improve and Maintain Your Flexibility – Stretching everyday will help improve overall performance
- “Warm Up” Before Running and “Cool Down” Afterward – A warm up of 5-10 minutes helps get rid of lactic acid in the muscles and prevents delayed muscle soreness
- Cross-Training is Crucial
- Wear Proper Running Shoes
- Have a Formal Gait Analysis – Poor biomechanics can easily cause injury
If you have any questions, please feel free to contact our office located in Gilbert, PA . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Complications of Peripheral Neuropathy
Peripheral neuropathy is a condition frequently associated with diabetes and is caused by damage to the nerves that send messages to the lower legs and feet. Symptoms include numbness, tingling, and a loss of sensation in the feet. Peripheral neuropathy can be caused by sustained high levels of sugar in the blood, from a viral infection, or by excessive smoking and drinking. In some cases, the effects of peripheral neuropathy can be reduced by treating the underlying condition. But in many cases, especially among diabetics, an unattended sore on the foot can become infected or develop into an ulcer. This complication is dangerous in that an ulcerated sore can turn into gangrene. If not treated, a foot ulcer that develops into gangrene may result in amputation. Peripheral neuropathy can also cause blood circulation problems as well as changes to heart rhythm. The main way to deal with peripheral neuropathy as it affects the feet is to inspect them carefully each day for cuts, sores, blisters, or any other abnormality that could become infected. For more information, it is suggested that you make an appointment with a podiatrist.
Neuropathy
Neuropathy can be a potentially serious condition, especially if it is left undiagnosed. If you have any concerns that you may be experiencing nerve loss in your feet, consult with Dr. Barbara Davis from Gilbert Podiatry. Our doctor will assess your condition and provide you with quality foot and ankle treatment for neuropathy.
What Is Neuropathy?
Neuropathy is a condition that leads to damage to the nerves in the body. Peripheral neuropathy, or neuropathy that affects your peripheral nervous system, usually occurs in the feet. Neuropathy can be triggered by a number of different causes. Such causes include diabetes, infections, cancers, disorders, and toxic substances.
Symptoms of Neuropathy Include:
- Numbness
- Sensation loss
- Prickling and tingling sensations
- Throbbing, freezing, burning pains
- Muscle weakness
Those with diabetes are at serious risk due to being unable to feel an ulcer on their feet. Diabetics usually also suffer from poor blood circulation. This can lead to the wound not healing, infections occurring, and the limb may have to be amputated.
Treatment
To treat neuropathy in the foot, podiatrists will first diagnose the cause of the neuropathy. Figuring out the underlying cause of the neuropathy will allow the podiatrist to prescribe the best treatment, whether it be caused by diabetes, toxic substance exposure, infection, etc. If the nerve has not died, then it’s possible that sensation may be able to return to the foot.
Pain medication may be issued for pain. Electrical nerve stimulation can be used to stimulate nerves. If the neuropathy is caused from pressure on the nerves, then surgery may be necessary.
If you have any questions, please feel free to contact our office located in Gilbert, PA . We offer the newest diagnostic and treatment technologies for all your foot care needs.
What Can Cause Flat Feet in Adults?
Flat feet are exactly what its name implies. The bottom of the foot lies flat on the ground, due to having little or no arch. Most babies are born with flat feet, and the arch typically develops during the teenage years. Adults with flat feet may have endured a foot injury or been born with an abnormal foot structure. Additionally, obesity, diabetes, high blood pressure, or rheumatoid arthritis may cause flat feet, as well as genetic reasons. Some patients who have flat feet and experience pain in various parts of the foot and ankle may choose to wear orthotics for mild relief. Severely flat feet may affect balance, and the feet may become stiff. If you have flat feet, it is suggested that you consult with a podiatrist who can offer you relief options that are suitable for you.
Flatfoot is a condition many people suffer from. If you have flat feet, contact Dr. Barbara Davis from Gilbert Podiatry. Our doctor will treat your foot and ankle needs.
What Are Flat Feet?
Flatfoot is a condition in which the arch of the foot is depressed and the sole of the foot is almost completely in contact with the ground. About 20-30% of the population generally has flat feet because their arches never formed during growth.
Conditions & Problems:
Having flat feet makes it difficult to run or walk because of the stress placed on the ankles.
Alignment – The general alignment of your legs can be disrupted, because the ankles move inward which can cause major discomfort.
Knees – If you have complications with your knees, flat feet can be a contributor to arthritis in that area.
Symptoms
- Pain around the heel or arch area
- Trouble standing on the tip toe
- Swelling around the inside of the ankle
- Flat look to one or both feet
- Having your shoes feel uneven when worn
Treatment
If you are experiencing pain and stress on the foot you may weaken the posterior tibial tendon, which runs around the inside of the ankle.
If you have any questions please feel free to contact our office located in Gilbert, PA . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Are You Suffering From Ingrown Toenails?
If left untreated, an ingrown toenail can lead to more serious concerns, such as an infection. Knowing proper nail care can help in the prevention of an ingrown toenail. Give us a call, and get treated!
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Symptoms of a Broken Foot
There are 26 bones in each foot that can easily be injured from falls, sports injuries, or repetitive pressure or force. A broken foot, or foot fracture, is usually from a direct injury to the foot and can be caused by high-impact activities, like running or jumping, auto accidents, falls, repetitive stress or overuse, or straightforward trauma. Things that might contribute to one sustaining a foot fracture include wearing shoes that do not properly support the feet, a Vitamin D deficiency, or having structural foot problems. Symptoms of a broken foot include pain, difficulty bearing weight, swelling, bruising, altered walking, and immobility of the toes, foot, and ankle. It is highly suggested that anyone who suspects they have broken their foot see a podiatrist as soon as possible for a proper diagnosis and a treatment plan.
A broken foot requires immediate medical attention and treatment. If you need your feet checked, contact Dr. Barbara Davis from Gilbert Podiatry. Our doctor can provide the care you need to keep you pain-free and on your feet.
Broken Foot Causes, Symptoms, and Treatment
A broken foot is caused by one of the bones in the foot typically breaking when bended, crushed, or stretched beyond its natural capabilities. Usually the location of the fracture indicates how the break occurred, whether it was through an object, fall, or any other type of injury.
Common Symptoms of Broken Feet:
- Bruising
- Pain
- Redness
- Swelling
- Blue in color
- Numbness
- Cold
- Misshapen
- Cuts
- Deformities
Those that suspect they have a broken foot shoot seek urgent medical attention where a medical professional could diagnose the severity.
Treatment for broken bones varies depending on the cause, severity and location. Some will require the use of splints, casts or crutches while others could even involve surgery to repair the broken bones. Personal care includes the use of ice and keeping the foot stabilized and elevated.
If you have any questions please feel free to contact our office located in Gilbert, PA . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Is Athlete’s Foot Contagious?
The medical name for the foot condition that is known as athlete’s foot is tinea pedis. It is an uncomfortable foot rash and is considered to be contagious. Common symptoms that are associated with athlete’s foot can consist of dry and itchy skin between the toes and on the sole of the foot. The fungus that causes this ailment lives and thrives in warm and wet environments, such as locker rooms, public swimming pools, and similar areas. It is beneficial to wear flip-flops or water shoes while in these types of places, and doing this may prevent people from getting athlete’s foot. This condition will generally not improve without medical attention. Permanent relief may be found when prescribed medicine is taken and appropriate shoes are worn which may help to prevent re-infection. If you have the above symptoms, it is strongly suggested that you visit a podiatrist who can effectively diagnose and prescribe the medication needed to treat athlete’s foot.
Athlete’s foot is an inconvenient condition that can be easily reduced with the proper treatment. If you have any concerns about your feet and ankles, contact Dr. Barbara Davis from Gilbert Podiatry. Our doctor will treat your foot and ankle needs.
Athlete’s Foot: The Sole Story
Athlete's foot, also known as tinea pedis, can be an extremely contagious foot infection. It is commonly contracted in public changing areas and bathrooms, dormitory style living quarters, around locker rooms and public swimming pools, or anywhere your feet often come into contact with other people.
Solutions to Combat Athlete’s Foot
- Hydrate your feet by using lotion
- Exfoliate
- Buff off nails
- Use of anti-fungal products
- Examine your feet and visit your doctor if any suspicious blisters or cuts develop
Athlete’s foot can cause many irritating symptoms such as dry and flaking skin, itching, and redness. Some more severe symptoms can include bleeding and cracked skin, intense itching and burning, and even pain when walking. In the worst cases, Athlete’s foot can cause blistering as well. Speak to your podiatrist for a better understanding of the different causes of Athlete’s foot, as well as help in determining which treatment options are best for you.
If you have any questions please feel free to contact our office located in Gilbert, PA . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Fixing Foot Pain
Foot pain is common. If your feet hurt and it is not from an injury you know you have sustained, it is important to try to get to the bottom of what might be going on. Your feet may simply feel sore and tired from everyday life. If this is so, it can help to rest, soak, and massage them. Foot massages can help to reduce tension and pain, as well as improve circulation and stimulate muscles. As part of a good foot care regimen, it is beneficial to examine your feet each day to see if any injuries have developed. Diabetic patients need to be particularly diligent when inspecting their feet as many of those with diabetes suffer from peripheral neuropathy. This condition can make it difficult to feel pain, therefore, sores and cuts may not be unnoticed. If your feet hurt and the pain continues or if you notice inflammation or sores, it is suggested that you visit a podiatrist for an examination and treatment.
Foot Pain
Foot pain can be extremely painful and debilitating. If you have a foot pain, consult with Dr. Barbara Davis from Gilbert Podiatry. Our doctor will assess your condition and provide you with quality foot and ankle treatment.
Causes
Foot pain is a very broad condition that could be caused by one or more ailments. The most common include:
- Bunions
- Hammertoes
- Plantar Fasciitis
- Bone Spurs
- Corns
- Tarsal Tunnel Syndrome
- Ingrown Toenails
- Arthritis (such as Gout, Rheumatoid, and Osteoarthritis)
- Flat Feet
- Injury (from stress fractures, broken toe, foot, ankle, Achilles tendon ruptures, and sprains)
- And more
Diagnosis
To figure out the cause of foot pain, podiatrists utilize several different methods. This can range from simple visual inspections and sensation tests to X-rays and MRI scans. Prior medical history, family medical history, and any recent physical traumatic events will all be taken into consideration for a proper diagnosis.
Treatment
Treatment depends upon the cause of the foot pain. Whether it is resting, staying off the foot, or having surgery; podiatrists have a number of treatment options available for foot pain.
If you have any questions, please feel free to contact our office located in Gilbert, PA . We offer the newest diagnostic and treatment technologies for all your foot care needs.
A Puncture Wound on the Foot
A puncture wound can be a small hole in the foot that can be caused by stepping on a sharp, pointed object. It often produces discomfort, and the foot can also become bruised and swollen. Additionally, some patients have difficulty moving the affected area, and it is beneficial to seek medical attention. An animal bite also may cause a puncture wound, and an X-ray may be taken that can determine the depth of the wound. It is important that the wound is properly cleaned, and this can begin with removing existing dirt and debris. This can be followed by applying medicine to the wound, which may help to prevent a bacterial infection. Symptoms may be managed by frequently elevating the foot and keeping it above heart level. This is often effective in reducing swelling and pain that may be present. If you have additional questions about how to perform proper wound care for the foot, it is suggested that you ask a podiatrist who can help you with useful information.
Wound care is an important part in dealing with diabetes. If you have diabetes and a foot wound or would like more information about wound care for diabetics, consult with Dr. Barbara Davis from Gilbert Podiatry. Our doctor will assess your condition and provide you with quality foot and ankle treatment.
What Is Wound Care?
Wound care is the practice of taking proper care of a wound. This can range from the smallest to the largest of wounds. While everyone can benefit from proper wound care, it is much more important for diabetics. Diabetics often suffer from poor blood circulation which causes wounds to heal much slower than they would in a non-diabetic.
What Is the Importance of Wound Care?
While it may not seem apparent with small ulcers on the foot, for diabetics, any size ulcer can become infected. Diabetics often also suffer from neuropathy, or nerve loss. This means they might not even feel when they have an ulcer on their foot. If the wound becomes severely infected, amputation may be necessary. Therefore, it is of the upmost importance to properly care for any and all foot wounds.
How to Care for Wounds
The best way to care for foot wounds is to prevent them. For diabetics, this means daily inspections of the feet for any signs of abnormalities or ulcers. It is also recommended to see a podiatrist several times a year for a foot inspection. If you do have an ulcer, run the wound under water to clear dirt from the wound; then apply antibiotic ointment to the wound and cover with a bandage. Bandages should be changed daily and keeping pressure off the wound is smart. It is advised to see a podiatrist, who can keep an eye on it.
If you have any questions, please feel free to contact our office located in Gilbert, PA . We offer the newest diagnostic and treatment technologies for all your foot care needs.
