These toes are a result of a triathlon event. The toes show some bruising and one shows swelling and nail bed inflammation. The pressure from the liquid building up under the nail and unable to escape can cause severe pain to the toe, specially if there is any extra pressure added such as pressure from footwear or bed sheets.

The toenail needs removed and pressure release and another new healthy nail will grow.

Osgood Schlatters and Severs is a painful condition that affects growing children usually between the ages of 11 and 16. In the past it has been more common in boys than girls however now we see an even distribution between boys and girls mainly due to girls having more chance to play sport.

The pain that occurs at the front of the knee and the back of the heel happens when the growth plate is inflamed. In a growing child the growth plate is slightly detached as this is where the growth of the bone occurs in length and when the child is very active this already inflamed growth plate can become angered and become very painful immediately after sports. It can be as painful as a broken bone. Rest and cool compresses immediately after sport will always help. However the children that are sporty off and do not want to rest and asking them to have time away from sport is very difficult and emotionally traumatising for them if they’re not playing sport every day. So this painful condition is a series of events. Firstly the child is always very active and sporty secondly the child will be going through an intense growth fees for example if you look at the lines behind their knees you will see a few of these lines where there should only be one in an adult these growth lines were sure how much they have grown in recent months. And thirdly the Inability to rest I am for a few weeks to allow the inflammation to go down exacerbates the condition. There is usually a structural issue that makes the problem worse for example the feet leaning and can cause extra pressure on the calf muscle to attach with the Achilles tendon into the back of the heel bone. Children with high arches off and develop more pain in their knees due to the very strong pull of the anterior tibialis muscle into the toes which attaches to below the front of the knee and this is where the growth plate exists.

When there is damage to the plantar fascia band that inserts into the heel bone, the calcaneal nerve can become pressurised causing the pain to increase. If the plantar fascia continues to pull on the heel bone for more than 1 to 2 years, a heel spur or spike will begin to grow. This heel spur can press on the calcaneal nerve if the enlargement is great. This is a very rare case but it is a possibility to be checked with a 3-D CT scan or contrast MRI.

In Dubai is very common for men and women to suffer from heel cracks. The skin becomes dry and papery and there is a white powdery appearance to the skin. The skin loses its elasticity and begins to split.

A medical pedicure can remove a lot of the excess skin on the feet and then deep penetrating antifungal gel is placed on the feet. The main cause of heel fissures is a dry fungal infection which actually gets worse the more you moisturise your feet.