Portsmouth Foot & Ankle - Blog

By Dr. Baczewski
December 05, 2017
Category: Injury

Subungual Hematomas

Let me guess ... you dropped something on your toe? ... or stubbed it on a piece of furniture? Fortunately, after the inital pain, these clumsy little mishaps generally cause no further discomfort. However, sometimes the trauma will cause painful bruising (subungual hematoma) under a nail.

Subungual hematomas usually occur as a result of trauma or jamming. Jamming is seen a lot in athletes and can be called “runner’s toe”. The injury causes blood to pool underneath the nail between the nail plate (your actual nail) and the nail bed (the soft tissue the nail plate attaches to). Just a small portion of the nail can be involved or the entire nail can become bruised.

The underlying bruising can cause infection or pain. Subungual hematomas that are painful or affect greater than 50% of the nail should be removed so that a new nail can grow in without issue. When the nail is not removed a new nail will grow in causing the old, bruised nail to become loose and fall off on its own. If a high force trauma occurred there may even be an underlying fracture of the bone and should be ruled out through an x-ray. 

A new nail will take up to 6-12 months to come in. So unfortunately, it is going to be a while before your toe looks normal again.

Remember that no foot pain is normal!

If you’ve developed bruising under your nail and are concerned please give us a call (or Appointment Request) for an evaluation today. 

Read More: 

Dr. Natasha Baczewski |  Embarrassing Toenails? Brittle? Yellow?  | How To: Trim Toenails  |  Ingrown Nails |  Injury Report: Turf Toe |  Yikes I Think I Broke my Toe!

By Dr. Clark
November 13, 2017
Category: Health & Wellness
Tags: bunion   surgery   recovery  

What can I expect with bunion surgery?

This is not a cosmetic procedure.  It is performed with the goals of improving function and reducing pain in the foot. That being said, patients are often very satisfied with how their foot looks after the procedure.  The foot is in a better position afterward and scars are no different than surgeries elsewhere in the body. 
Bunions are a deformity where the great toe joint is out of alignment and requires realignment. This is a process that requires time off of the foot, walking in an immobilization boot, physical therapy, and multiple follow up visits to the podiatrist. 
Bone takes approximately 6-8 weeks to heal in a normal healthy person.  Bunion surgery involves cutting of bone and fixation into better alignment with hardware that may remain in the body indefinitely.  Most types of hardware these days are low profile and will not be felt under the skin nor set off the alarms at the airport security.  
After surgery you will most likely need to stay off the foot for at least 2-4 weeks, depending on the type of procedure.  After that, it is at the surgeon’s discretion to when you may begin putting weight on the foot in an immobilization boot.  Physical therapy is begun as soon as it is safe to move the toe joint in order to prevent freezing of the joint, muscle atrophy, and to decrease swelling. In general the time from beginning of surgery to walking in a regular shoe again is around 3 months to 1 year. This is because not everyone takes the average time to heal.  

Things to take note of:  

1. Only one foot is done at a time so you are not completely incapacitated for an elective procedure. 
2. Be prepared to take plenty of time off from work in case you are not allowed to wear the boot at work. 
3. If surgery will be performed on your right foot you will not be able to drive until you can put weight on the foot without a boot. Uber is kinda fun. 
4. This is elective outpatient surgery that is often done in a morning or afternoon so be prepared to spend half the day at the hospital or surgery center. 
Much of this article is meant to inform you of what to expect, not to scare you away. Bunion surgery is highly successful with the majority of patients leaving satisfied with their results. 
By Dr. Baczewski
October 25, 2017
Category: Foot Pain
Tags: cyst   mucoid   ganglion   blister   little toe  



... a mucoid cyst!cyst

Growths, or cysts, on the little toes are a somewhat common problem that we see here in the office. Most often these appear in middle aged and elderly people, and more often than not they occur in women. These pesky nodules can cause a lot of pain in shoe gear or if they are touched. 
They are similar to a Ganglion Cysts in that a stalk from the underlying joint capsule allows a balloon or sac to fill with fluid. If the underlying stalk isn’t removed the cyst will likely come back. Ganglion cysts (a group of benign masses) are common throughout the foot, but on the toes the cyst is often referred to as a mucoid, myxoid, or mucous cyst and are typically smaller than other ganglion cysts.
The cyst is often somewhat translucent, like a blister, but unlike a blister they are difficult to 'pop' because the tissue is deeper. Although they may sometimes drain, these cysts often remain intact (think of a deflated balloon) under the skin. 
There are two primary treatment options, Draining -  A mucoid cysts can be drained in the office and a compressive dressing applied but unfortunately they often will recur. They will often drain a thick, yellow fluid or even cause a sore or ulcer if the top is removed. Surgery - Surgical excision is more effective because it allows us to get a wide and appropriate resection of the cyst. If the cyst recurs after a surgical excision then the underlying joint may need to be fused in order to prevent recurrence. 
Additional Links:

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!



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.