Portsmouth Foot & Ankle - Blog

By Dr. Allen Clark, PFA-Nashua
October 11, 2017
Category: Foot Care
Tags: toenail   nail care   nail trimming  

Dr. Clark is on the blog today answering... "How Do I Trim My Toenails?" Allen Clark, DPM

Toenail trimming may seem like a simple concept, but there are certain things you should do to prevent a disaster in your toes. 

Improper trimming of toenails can lead to ingrown toenails, pain, and infection. 

First and foremost, you should never “rip” the end of the toenail off.  Imagine picking at the small peeling edge of a strip of wallpaper only to find it becoming a much larger portion than you expected.  Tearing away an edge of toenail may track into the sides of the toe and expose the underlying flesh to infection and pain. This can also lead to ingrown toenails. 

Often I hear the question “How far should I clip into the sides?”    My answer: "do not clip into the sides of the toenails”. The end of the nail should either parallel the end of the toe or be straighter.  If there are sharp points on the edges left, a nail file should be used to round them over.  Clipping back into the corners or sides of the toenails may create a spike that digs into the toe as the nail grows forward (see picture).  Nail Spike Drawing

Ingrown toenails typically require a procedure to remove the offending spike of toenail. If you have highly curved toenails that dig into the sides of the toe, go see your podiatrist for evaluation.  

Always trim toenails with clean, sharp equipment. Dull nail nippers can cause splitting. 

In conclusion, proper nail trimming can save your toes from problems down the line.  If you are already experiencing pain from a toenail, visit your podiatrist. 

Read More: Dr. Allen Clark |  Ingrown Toenails |  Foot Check Friday

Portsmouth Foot & Ankle Blog | Contact Us

By Dr. Baczewski
September 19, 2017
Category: Miscellaneous


We were never taught how to tell our patients to wash their shoes in podiatry school but it’s a question I get asked ALL the time- and for good reason. Sneakers can get nasty. Let’s all face it our sneakers take a beating! Internally from all the sweat and externally they tromp through mud, dirt and grass. Two of my least favorite things are when I take my new sneakers out for a few runs and they look 6 months old and when my kids come home from school with their new sneakers completely filthy.

I’ve tried a few methods at cleaning my families’ sneakers and here are my personal tips for keeping your sneakers clean and looking new!

SPOT WASH - if there are just small areas to clean I use water mixed with laundry detergent and take a toothbrush or bristle brush and scrub it out. This is a good technique for marks on the soles but tougher on the deep dirt.

WASHING MACHINE - (this is my favorite) - unlace the shoes because junk builds up in the eyelets and put them in a pillowcase or laundry bag to prevent them from twisting around things. Get as much of the dirt and debris out of the soles as you can. Take the inserts out and throw your sneakers, inserts and bagged laces in with a couple old towels to prevent banging. Set the wash on delicate. Use liquid detergent and cold water.

DRYER? - To dry or not to dry… I personally like to air dry. I’ve put sneakers in the drying before (either with a special rack or with the towels) and I think it affects the material. Don’t get me wrong when my kids need there sneakers back quickly or I’m washing an old pair they go right into the dryer but I find the material shrinks down a bit and becomes weaker. I like to put the sneaker and inserts separately in the sun or on the counter and let them air dry.


Lace them up and it’s like you’ve got a brand new pair of sneakers! 

Dr. Natasha Baczewski works out of our Portsmouth Office 

If you liked this blog check out these other related topics:

Dr. B's Running Must-Haves  |  How to Find the Right Shoe  |  New Kicks For Kids  |  Powersteps! |  Shoes For Sports  |  Sweat Stop!



By Marketing Dept.
August 31, 2017
Category: Events

Upcoming Events and Dr. Baczewski & Dr. Sartori's Speaking Schedule

Heel Pain Doc Talk

September 7th, 2017 at 5:30 pm
Runner's Alley
104 Congress Street, Portsmouth, NH 03801

Our doctors are runners and competitors in a variety of athletic events. They understand the setbacks and frustrations that injuries bring about. We will primarily discuss heel pain and its treatment options. We will discuss what you can do on your own and what you can do at our office that has little to no "downtime" (which is ideal for runners and athletes). 

Plantar Fasciitis inflammation on the bottom of the foot.  If you experience severe heel pain in the morning you may have a common overuse injury called plantar fasciitis. The tough, fibrous band of tissue (fascia) that connects your heel bone to the base of your toes has become inflamed.

Insertional Achilles Tendonitis pain at the back of the heel bone, with this you'll experience morning stiffness and increasing soreness throughout the day. Usually patients have tight calf muscles and can develop a bone spur where the Achilles tendon inserts into the bone. 

We will also offer Q&A time with attendees to ask us any podiatry question that they may have!

9th annual CelebratePink 5k Walk/Run!

September 17th, 2017 at 9am
Portsmouth Middle School

Run, walk, jog, or dance your way to the finish line! This scenic downtown Portsmouth 5K is an annual favorite for runners & walkers of all ages and levels.Race benefits MY BREAST CANCER SUPPORT, an independent NH 501C3 non-profit organization that provides financial and emotional support to breast cancer patients throughout the Greater Seacoast area of New Hampshire and Southern Maine. Portsmouth Foot and Ankle is proudly sponsoring for the 4th time. We have a table at the event and would love to see some familiar faces stop by! 

Healthy, Happy Feet Doc Talk

Thursday, October 5 at 6:30pm
Portsmouth Regional Hospital

Foot pain can affect everyone from children to the elderly and when you experience foot pain it can be debilitating. The key is addressing the problem before it becomes a bigger issue. We'll cover common foot ailments including bunions, hammertoes, neuromas as well as the procedures that our podiatrists perform at Portsmouth Foot and Ankle. Join us to keep your pace steady and pain free! 

Health & Wellness Fair

Wednesday, November 8th at 11am
Portsmouth Naval Shipyard, Kittery, ME

This event allows us to connect with and serve our shipyard community by providing awareness regarding our services and access to our educational information. This event is closed to the public but we invite anyone who is able to attend to do so.

Walk With Us, Meetup Group    

*meets all year long!*

Meetup (website)
Usually meets 2x per month at 12:15pm

Over 600 locals have already joined, what are you waiting for? PFA hosts free walks all around the greater Portsmouth area. If you are looking for a way to meet new people, get some exercise and get outside make sure you check out our meetup group! 


By Dr. Christie
August 28, 2017
Category: Foot Pain
Tags: bunions   flat feet   hypermobility  

reid christie dpmHow Do My Flat Feet Affect My Bunions?

Part 2 in the Flat Feet Series by Dr. Christie (read part 1 here I Think I Have Flat Feet)

I had previously provided a list of the most common foot ailments that can be affected or worsened by flat feet.  I plan to take a deeper look into each of the diagnoses listed and further describe the pathomechanics that give rise to these painful symptoms.
So what do flat feet have to do with bunions anyway?  It is very common to have multiple foot complaints that cause painful symptoms, however what many patients may not realize is that these symptoms and complaints may all be connected when we look at the biomechanics of what is occurring.  Typically when examining flat feet there is a decent amount of flexibility noted.  The word that we most commonly use to describe this flexibility is “hypermobility” meaning excess motion.  When a foot has excess motion in specific areas it often leads to instability in certain joints, which can ultimately lead to the formation of bunion deformities.  I like to think of these overlapping biomechanical issues in a cascade or domino effect (i.e. if “x” happens, then “y” will be the result). 
So when flat feet are evaluated, one of the physical findings is something called forefoot abduction, which is when the front of the foot tends to move outward to the side instead of being straight.  When forefoot abduction is present, it usually goes hand in hand with forefoot varus which leads to an extremely hypermobile first ray.  The hypermobile first ray leads to a bunion formation via ground reactive forces acting on a weakened and unstable first metatarsophalangeal joint.  When the ground reactive forces push up against the foot it deviates the first metatarsal bone to an adducted position (inward) while the hallux (big toe) starts to drive laterally.  Because the adult acquired flatfoot is a progressive deformity, the bunion can be a progressive deformity as well, so the more that this foot type goes without proper support and correction, the deformities and symptoms associated with it will continue to progress. 
Quick recap of the cascade below:
Equinus ► Calcaneal Eversion ► Subtalar Joint Eversion ► Forefoot Abduction ► Forefoot Varus ► Hyupermobile First Ray ► Bunion Formation
The biggest point to be made is that with proper support in the right areas, many of the points along the cascade listed above can be counteracted and may prevent the formation of bunions associated with flat feet. To learn more about proper support read these: Boots & Bunions | How to Find the Right Shoe | Orthotics 101 |  Powersteps! |  Shoes For Sports | Corrective and Prescription Shoes
Dr. Reid Christie joined Portsmouth Foot and Ankle after completing his residency at St. Vincent Hospital in Indianapolis. Dr. Christie has trained extensively in forefoot and rearfoot surgery. He practices in Portsmouth on Tuesdays and Fridays. He works out of our Nashua office on Monday, Wednesday, and Thursday. He currently accepts new patients. Dr. Reid Christie  |  Appointment Request
By Dr. Clark
August 22, 2017
Category: Sports
Tags: running   big toe   orthotics   runners   gait analysis  

Big Toe = Big Part Of Running dr allen clark dpm

Today we introduce our newest physician to the blog, Dr. Allen Clark!
Dr. Clark works in our Nashua Office and he accepts new patients.

The great toe joint, aka the 1st metatarsophalangeal joint, has the job of bearing most of the weight of your body each time you push off your foot.  The joint undergoes a large amount of stress that is absorbed and supported by the ligaments and tendons that surround it.  The great toe joint is well designed for this. As you move through a step, the foot undergoes multiple joint angle changes allowing it to adapt to the ground surface.  As you project forward the foot joints must align properly in order for that stress to be focused in the correct areas. Misalignment of those joints may direct stress to other joints that are not designed to absorb the focus of that energy. This commonly results in injury and pain.  Common injuries would be turf toe, capsulitis, or traumatic arthritis. (read more about Injury Report: Turf Toe).

In order to align the foot for push-off through the great toe joint, the foot must be stabilized. This is normally achieved by the body with support of the arch and straightening of the heel.  When there is a lack of support in these areas, it can be supplemented with devices in the shoes such as over-the-counter inserts or orthotics (read more about Orthotics 101). 

A podiatrist can typically observe this proper foot alignment by examining a patient in the office This is done by performing a gait analysis and maybe a set of x-rays. If there is soft tissue injury an ultrasound may be used to evaluate the extent of damage. Runners should come into the office for gait analysis and to evaluate for any underlying issues that can lead to problems down the line.

If you experience any pain, redness, or swelling in the joint while running or walking, rest from the activity and come in for evaluation.  Often I hear of runners getting pain in the great toe joint with push-off. This is a sign of improper position of the foot prior to push off that may require functional orthotics. 

Treating athletes is an area that I specialize in, I invite you to check out my bio page Dr. Allen Clark and you can request and appointment with me here, Appointment Request


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