Numerous scientific studies have been performed that demonstrate orthotics perform three major functions:

Orthotics help disperse forces across your foot so one specific area is not getting overloaded. They help slow down pathologic motion, such as overpronation (too much inward roll) or oversupination (not enough inward roll).

Orthotics also help improve what is called proprioception, which is your foot’s awareness of its position in relation to the ground. This is a subconscious, neurological pathway, and one reason orthotics usually feel good when you put them in your shoes.

Although over-the-counter orthotics work, custom orthotics work better and are more comfortable. At Mirage Podiatry we usually recommend custom orthotics because they are made of higher-grade materials that last longer. When a custom orthotic is necessary, it is crucial that a podiatrist is involved, as the wrong type of orthotic can make a condition worse or even cause a different problem.

Nothing last forever… but wear out of orthotics depends on your type of activity. The more running one does, the quicker the orthotic will wear out. Over-the-counter orthotics typically last about one year. Custom orthotics usually last three to five years – sometimes longer. With children, we usually replace orthotics every one to two shoe sizes, depending on comfort.

Most insurances offer custom orthotic as a benefit when prescribed by a doctor. At Mirage Podiatry we will check with your insurance plan and provide you with the explanation of benefits as provided by your insurance carried however we still recommend that you contact your insurance company yourself to confirm what your plan will pay for.

Corticosteroids have many functions, the most potent and primary function being their anti-inflammatory properties.

When cells are injured, they release products called phospholipids. Enzymes called phospholipases convert phospholipids to arachidonic acid. Arachidonic acid (AA) is the chemical mediator of inflammation in the body. AA goes through several different chemical reactions (called oxygenation) to produce several chemical mediators of inflammation (leukotrienes, prostaglandins, and thromboxane). These chemicals have many effects which include blood platelet aggregation, increased cell permeability (swelling), further recruitment of inflammatory chemicals (histamine, serotonin, bradykinin), and recruitment of cells called macrophages (these cells remove damaged tissue but their byproduct is scar tissue).

Corticosteroids are phospholipase inhibitors that prevent phospholipids from converting to AA, thus stopping inflammation at the beginning of the process. Corticosteroids have what is called a catabolic or “breakdown” effect, which is how they decrease scar tissue. The mechanism of this effect is unknown.

Corticosteroids are very safe and effective in low doses. Side effects occur in less than one percent of patients and usually involve facial flushing, insomnia, increased irritability, and increased pain.

Steroid injections are more effective because the potent anti-inflammatory is administered directly into the painful area. Absorption is slow, so side effects are rare. The injections, however, can be painful but at Mirage Podiatry we utilize many techniques to minimize the pain during an injection. The oral form of steroids are not painful, but they have more side effects and do not work directly on the painful area.

Although it is known that too much cortisone is harmful, an absolute maximum number of injections has never been established. If the injections are providing a therapeutic benefit, a series of 3-6 injections are well-tolerated (most people only need one to two injections).

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen and naprosyn are safe and effective, but only work on certain portions of the inflamed area. They do not have any effect on scar tissue. Tylenol is not an anti-inflammatory.

The foot is the first structure to hit the ground bearing weight. Your foot/ankle joints have to disperse greater force than any other joints in the body. After an injury or surgery, it can take a long time for the foot and ankle to be able to handle normal weight loads without pain or further damage.

Foot and ankle surgery works very well when the correct procedures are chosen for specific problems. The more focus on pain relief as the primary reason for surgical intervention, the higher chance of success. Patient satisfaction after foot and ankle surgery is well over 90 percent.

All surgical procedure have potential complications but most complications after foot and ankle surgery are minor and do not affect final outcome. These can include swelling, numbness, excessive scar tissue, superficial infections, and acute pain. Some complications can affect the outcome of surgery. These include, but are not limited to continued pain, worsened pain, recurrence of the problem or deformity, delayed or nonunion of bone correction and hardware failure.

Generally, foot and ankle surgery is not tremendously painful provided you follow postoperative instructions. A numbing medicine is placed around your foot/ankle after surgery. You may not have any pain for four to 24 hours after surgery. The more your foot is elevated above heart level after surgery, the better you will feel. We give painkilling medications after surgery, but most people do not need to use these medications longer than a week.

For most procedures, you cannot get your surgical site wet until the stitches are removed. This is usually done 14-21 days after surgery. You can purchase a cast bag to keep the surgical area protected while showering or bathing. If there is external hardware, you cannot get your foot wet until the hardware is removed, usually about six weeks after the procedure. After the stitches or hardware are removed, it is recommend that you avoid soaking your foot in a bath tub, hot tub or swimming pool for an additional two weeks.

That depends. Some procedures only require a protective shoe postoperatively. Others require a postoperative cast for one to two weeks, followed by a removable walking cast or boot.

You need someone to bring you to your surgery and take you home. You should avoid driving for the first week after surgery and if your are taking pain medications. After that, driving depends on your transmission and which foot was operated on. As a general rule for right foot surgery, if you are instructed to not place weight on your foot then you should not drive during the entire non-weight-bearing period.

If your job can accommodate non-weight-bearing use of your leg, then you can usually return to work three to five days after surgery, depending on your pain. If your job will not accommodate non-weight-bearing use of your leg, you will have to be off work during this recovery period and need to have modified duties when you return until you are out of your protective boot.

Physical therapy (PT) is patient and procedure-specific. Usually, PT is necessary for major reconstructive procedures and in situations where transient complications such as excessive scar tissue or stiff joints occur.

Anesthesia is based on the length of procedure, type of tourniquet used and your anesthesia wishes. The options include local anesthesia, regional blocks (popliteal/spinal) or general anesthesia. All local and regional anesthesia is accompanied by conscious sedation so that you are unaware of the procedure. At Mirage Podiatry, our primary goal is to provide you the safest, pain-free anesthesia.

Depends on the type of surgery performed, most surgeries are done on an outpatient basis and you can go home the same day as your surgery.

Most foot and ankle surgery are considered elective surgery. However, if surgery being done to reduce pain and dysfunction, most insurance plans have good coverage for elective foot and ankle surgery. At Mirage Podiatry our surgery scheduler usually gets pre-authorization for the surgical procedures from your insurance company and can provide you with your out of network cost. In addition to your surgeon’s fees, there are usually anesthesia charges and facility fees that come with using the operating room.

Your surgeon will give you contact information and be available to answer questions after surgery. During office ours you can call the office staff with questions or concerns and they will notify your surgeon. After ours or weekends call the office number and select the option for On-Call Provider, and you will be connected to the On-Call Doctor.