(516) 869-3300  -Manhasset
(631) 427-3678  -Huntington
(516) 681-8866  -Woodbury
(718) 639-0499  -Maspeth
(516) 741-3338  -Williston Park
(516) 741-3338  -Mineola

Posts for: August, 2019

By Dr Alison Croughan
August 30, 2019
Category: Foot Care


Some of our patients present to the office with a self diagnosis of "arthritis" or "old age."  Arthritis is a general term for an inflamed joint - it can be due to "wear and tear", inflammation, and even a high uric acid level.  Did I lose you?  The first two we hear about all the time, but the last - uric acid? What exactly is that?

Uric acid is a byproduct from breaking down the protein we eat each day.  Some people make too much and some do not excrete enough of it out.  What can happen when either one of these scenarios occurs?  Red, hot, swollen, painful joints and even difficulty walking.  Usually it is the big toe; however, gout can present in any bone, joint, even your knee, elbow and ear.  
Your blood levels may not always be elevated at the beginning of these symptoms.  Chronic infections make your threshold before an attack much smaller (meaning less of a spike in your uric acid will result in symptoms).  Too many attacks can lead to bone changes and even bone destruction and wounds.
What can trigger an attack? Your genes - yup, we cannot fight them, just need to work with them.  Your diet - red meat, alcohol, green leafy vegetables, beans (not always the bad stuff!).
What to do if you believe you are having an attack?  Call our office, let our team of experienced podiatrists and surgeons help treat your current symptoms and prevent future attacks or complications.

By Dr Evan Vieira
August 30, 2019
Category: Foot Care


When we think of bunions, hammertoes and other foot problems, we usually don't associate them with fancy celebrity types.  However, don't think that fame and wealth exclude them from the same problems as the rest of us.  

From Steven Tyler,  Sarah Jessica Parker, Jerry Seinfield to young people like Rhianna, they have the same issues we do!
A few years ago Jerry Seinfeld met with the faculty at the New York College of Pediatric Medicine in Manhattan to discuss his debilitating foot pain.  He even told them it was difficulty for him to watch episodes of his famous show because it brought back memories of the pain he was in.  
The point is, don't be embarrassed, don't suffer in silence.  We are all human and we all have the same issues.  If your feet are bothering you call us today for a consult.  We are here to help!

By Dr Tyler Miranda
August 30, 2019
Category: Foot Care
Tags: Fractures   and Nutcrackers   Sprains  
Injuries to the outside of the foot and ankle are very common and wide ranging in severity. Ankle sprains are by far the most common injury to this area of the body, registering roughly 3 million incidents every year. Most lateral foot and ankle injuries only involve soft tissue but in some cases there can be an injury to one or more bones. The fibula, talus, cuboid, and 5th metatarsal are all possible sites of bone injury. 
When an injury occurs an important piece of information a doctor will ask for is called the 'mechanism of injury' which describes the direction the foot and ankle moved or twisted, the position of the foot, and what activity was being performed at the time of injury. Sometimes patients will be able to describe in meticulous detail the mechanism of injury while other times patients will say "Doc it happened so fast I cant remember." Luckily the team at Advanced podiatry can use a careful physical exam, Xrays, and diagnostic ultrasound to investigate the injury. To evaluate the injury in real time we have an on-site C-arm flouroscopy to provide pinpoint diagnosis - this imaging tool lets the doctor and patient see the bony injury on the screen and also assess the motion of the bone at the same time.
The 5th metatarsal bone is particularly susceptible to compromise during a lateral foot trauma. Patients will come into the office limping, describing a mechanism of injury sometimes similar to an ankle sprain but with pain further down from the ankle along the outside of the foot. The 5th metatarsal bone can sustain multiple types of injuries. The most well known is a Jones fracture, a horizontal fracture of the bone near the middle of its shaft. Another type of injury is an avulsion fracture. This is were the tendon that pulls on the bone is stretched too quickly and removes part of the bone as it tears away from its insertion. These injuries can be treated with immobilization and/or surgical repair depending on their severity. 

Jones Fracture

5th Metatarsal Avulsion Fracture

Nutcracker Fracture of Cuboid


The cuboid is a less commonly fractures bone. When a fracture does happen it is important that it is identified and treated as soon as possible. Sometimes these fractures are not easily visible on conventional X-rays and will require C-arm flouroscopy or CT scan for an accurate assessment. One type of cuboid injury is known as the Nutcracker fracture. The mechanism of injury is forced abduction of the forefoot: where the front of the foot is pushed outwards and the cuboid is crushed like a nut between the calcaneus (heel bone) and the 4th and 5th metatarsals. This injury will require time to heal in cast or CAM boot immobilization and may require surgery with internal or external fixation. 
The take home message here is that if you have an injury to the outside of the foot or ankle go get it checked out. If you think you simply sprained your ankle but that pain is lingering or even getting worse there may be a more serious injury present. 

By Dr Tyler Miranda
August 14, 2019
Category: Foot Care
Tags: NFL   Fall Sports  


As the summer winds down and fall sports step to the forefront many people are getting excited for football season. Those closely following the NFL may have noticed a curious story that has been circulating in the news involving a prominent player sustaining a rather bizarre injury to his feet. Oakland Raiders wide receiver Antonio Brown suffered a frostbite injury to the bottom of his feet after undergoing a treatment know as cryotherapy. Whole body cryotherapy is a treatment meant to aid in recovery and healing. It involves exposing an individual to cold air for a period of 2-4 minutes either in an enclosed room or a chamber. The cold temperature is achieved with the use of liquid nitrogen or refrigerated coiled air. While it is used by many professional athletes and celebrities the jury is still out in terms of it being supported by scientific research. It is extremely important for those undergoing the treatment to be aware of the necessary precautions prior to undergoing the treatment. Proper shoes, gloves, and sometimes face masks are needed to mitigate risks of injury to the cold and the fumes produced. The treatment should always be done under the supervision of a medical professional.

Now while the average person may not be heading to a cryotherapy chamber on a regular basis there is a take home point here for all of our patients. That point is that even though your exercise, treatment, or training regimens have benefits for your overall health, ensure that you know your risks and prepare yourself before hand. Stretching before and after a work outs, warming up, staying hydrated, wearing the proper shoes and attire for the activity, and using proper form when stretching and exercising are all ways to ensure that you stay injury free as you exercise. So whether you are gearing up for a leisurely hike to enjoy the colors of fall or preparing for another grueling season as an elite professional football player make sure to prepare yourself appropriately for your activities. Enjoy the rest of the summer and take great care of yourself!

By Dr. Shabana Chowdhury
August 14, 2019
Category: Foot Care
Tags: Freiberg  


Freiberg disease is an osteochondrosis of the metatarsal heads. It most commonly affects the 2nd metatarsal head, although the other metatarsal such as the 3rd and  4th may also be affected. This condition mainly affects females between the ages of 10-18 years with a male to female ratio of 1:3.

Clinically these patients present with pain on weight-bearing with swelling and tenderness.

The cause of Freiberg infraction is controversial and is probably due to several factors. 

The two most popular theories re from trauma and vascular compromise. Trauma can be associated with either acute injury or something that is repetitive in nature, such as dance. Vascular compromise can be due to an elongated 2nd metatarsal. Since this is mainly seen in women, particularly during adolescence, high-heeled shoes have been theorized as a possible causative factor.

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Advanced Podiatry of Manhasset at the Americana

Manhasset, NY Office
Advanced Podiatry
2110 Northern Blvd.
Manhasset, NY 11030

(516) 869-3300

Huntington, NY Office
Advanced Podiatry
181 Main St.
Huntington, NY 11743

(631) 427-3678

Coram, NY Office
Advanced Podiatry
100 Middle Country Rd.
Coram, NY 11727

(631) 696-9636

Woodbury, NY Office
Advanced Podiatry
20 Crossways Park North Suite 304
Woodbury, NY 11797

(516) 681-8866

Mineola, NY  Office
Advanced Podiatry
155 Mineola Boulevard, Suite B 
Mineola, NY 11501

(516) 741-3338

Maspeth, NY  Office
Advanced Podiatry
70-01 Grand Ave
Maspeth, NY 11378

(718) 639-0499

Williston Park, NY Office
Advanced Podiatry
479 Willis Ave,
Williston Park, NY 11596

(516) 741-3338

Plainview, NY Office
 *Recently Moved to Woodbury