Dr. Rodney Louis Tomczak, DPM

When a patient brings a problem that is ill-defined, such as this one, I approach it by looking at the possible systems involved. Unfortunately, your problem could involve the vascular system, the musculoskeletal system, and the neurologic system. I have excluded the dermatologic system.
Vascular System:
-lymphedema
-varicose veins
-poor circulation (arterial insufficiency)
Musculoskeletal System:
-insufficiency fracture
-capsulitis
-tendonitis
Neurologic:
-neuroma
-tarsal tunnel
-spinal compression of nerve root

This a partial list of the more common maladies. A physician and testing is needed to confirm a definite diagnosis.

Rod Tomczak, MD, EdD

I hate to be the bearer of bad news, but soaking your feet in Epson salt’s has virtually no effect on plantar fasciitis. The solution does not penetrate through the skin and although warm water me feel good it has no effect on the pathology.

Again may I suggest an arch support from the Dr. Scholl’s kiosk and if that is not effective then a visit to a foot and ankle orthopedist or a podiatrist would be in order.

You need to be seen by a physician, preferably a dermatologist. I would only be venturing a guess not knowing the answers to some vital questions and actually seeing the lesions. Pus is the accumulation of dead white blood cells present from an infection. Can you be sure it is an infection? Perhaps it is an allergic reaction and not an infection. It might be a contact dermatitis, it could be the result of coming into contact with something like poison ivy. Best bet is to see the dermatologist.

Rod Tomczak, MD, EdD

Your problem is a result of the previous ankle sprains that have resulted in complete tears of the three lateral (outside) ankle ligaments. When the tears are complete, the ligaments will not heal. Ultimately, the only way to correct the problem is to reconstruct the torn ankle ligaments surgically. There are a few different procedures and the correct procedure can be determined by an MRI. Conservative treatment can not result in the ligaments repairing themselves.

If you do nothing, ankle sprains will become more frequent. I have had patients who rolled their ankles because the stepped on a stone. Also, if you continue spraining your ankle, arthritis is the outcome and you would be looking at an ankle fusion or an implant. Both of these procedures result in some disability and inconvenience. Conservative treatment can not result in the ligaments repairing themselves.

You should find a surgeon who is Board certified and has performed numerous ankle stabilization procedures. There is little chance of performing a primary repair of the ankle ligaments because they have atrophied. A reconstruction with the peroneus braves tendon. After care involves a cast and 4-6 weeks of non-weightbearing followed by physical therapy.

Rod Tomczak, MD, DPM, EdD

This is a very complicated situation. One has to be sure that the problem is a sprain and not a fracture. Theoretically it is impossible to sprain and ankle if growth plate is still present. The ligament is stronger than the bone distal to the growth plate. That means that your brother may have actually displaced part of the bone rather than caring or stretching the ligament. If you are sure that there is a sprain, the best way to treat it is with cold for the first 24 to 48 hours, then 15 minutes of heat every hour along with range of motion exercises. For the first week it’s better to treat with an ace bandage and elevation and perform the range of motion exercises that way. The patient can begin weight-bearing when he can tolerate it.

Morning pain is often associated with plantar fasciitis. The plantar fascia is a band that runs from the metatarsal heads to the heel bone on the bottom of the foot. Sometimes there is a spur associated with plantar fasciitis but not always. Patients complain of pain when getting out of bed in the morning or after they've been seated for a while they get up and begin to walk.
An x-ray may show a spur but as I say the problem can be present without a spur. Other conditions that may MrMC plantar fasciitis can be the spur or a stress fracture or possibly a tumor in the heel bone. On occasion there may be a tarsal tunnel problem which is similar to a carpal tunnel in the hand and wrist.
The diagnosis is usually made by x-ray and excluding all other possibilities. If there are numerous treatments but since this is usually a self limited problem patience me he'll spontaneously.

This is rarely a problem arising from the feet or ankles. More often this is a problem with the veins and venous circulation. Sometimes it can be caused by problems with the heart.
You need to be evaluated by your primary care physician for a definitive systemic cause.

A thickened black nail is probably a fungal infection or mycotic nail. When the edges of the nail are removed, it opens the undersurface of the nail to the fungal infection. The best chance of cure is to remove the nail completely and take an oral antifungal medication supplemented with a topical nail antifungal preparation. This is a lengthy process and may take months to achieve a normal nail. The major side effect of this has been possible liver damage due to the antifungal oral medication.