Frequently Asked Questions

Why Does It Feel Like I Have A Stone In My Shoe?

Some say it feels like a stone in your shoe, others a marble, others a bunched up sock, but all have the sensation of something that doesn’t belong there irritating your foot. There are a couple of possible causes for this.

The first is a neuroma. This is a benign thickening of a nerve that causes feelings of numbness or pain. It usually occurs when a nerve between a couple of smaller toes is pinched by bones or tendons that have moved out of position.

Another possibility is capsulitis or bursitis—both inflammatory conditions—in the second metatarsalphalangeal joint where the bones of the second toe and metatarsal (foot bone) meet.

Both have similar symptoms—numbness and/or pain in the toes or ball of the foot—but a good podiatrist won’t jump to conclusions too quickly. At Sierra Foot & Ankle we take the time to ask questions and examine your foot to pinpoint the exact reason for the feelings you describe. Then we will try conservative remedies, and most of the time they will be successful.

Next time you have these symptoms, call our office at (775) 783-8037 for an appointment.

How Long Does It Take To Recover From A Torn Achilles Tendon?

The recovery and rehabilitation time for a torn Achilles tendon, also called an Achilles tendon rupture, can vary based on factors such as the severity of the initial injury, the treatment procedure selected, and how well you follow your doctor’s guidelines for rehabilitation.

For many Achilles ruptures, you have a choice to make between conservative treatment (immobilization via a cast or walking boot, allowing the tendon to heal on its own) or surgical tendon repair. The recovery time can be similar for both treatments, although full rehabilitation may be faster with surgery.

In either case, you’ll probably need to wear a cast or walking boot for about 6-8 weeks while the tendon injury heals. After that, you’ll gradually return to more weight-bearing activity and perform rehabilitation exercises. The average time for a full return to your previous sports or level of activity is around 6 months, although it can vary quite a bit (4-12 months).

Achilles ruptures are serious injuries that need immediate attention in order to get you the best long-term outcome. To make an appointment with Dr. Victoria Melhuish please call (775) 783-8037 or use the website contact page

Why Do My Ankles Curve In?

Typically ankles curve in because your arches are too low or have fallen. Without the arch in the proper position, the ankle angles inward, adding stress to the foot. Sometimes naturally flat feet don’t have any painful symptoms. Often though, the strain on the midfoot and the ankles can bring pain along the arch and in the heel. Adult acquired flatfoot is a more serious problem. Part of the bone structure in your foot suffers damage and allows the arch to collapse. Usually you are left with discomfort along the posterior tibial tendon, the outside of the ankle joint, or in the midfoot.

If your ankles curve or angle in, have our expert staff examine your feet, even if you aren’t experiencing pain yet. This condition is easiest to treat when it is caught early. Don’t wait until discomfort keeps you sitting down—contact Sierra Foot & Ankle, for an appointment or more information by calling (775) 783-8037 or using the website contact page.

Is Ingrown Toenail Surgery Painful?

Ingrown toenails happen when the edge of the nail grows into the skin surrounding it. They can be visually unappealing, but more than that, they can cause discomfort and pain. In some cases, they can lead to bleeding, swelling of the skin, and infection. When conservative treatments are unsuccessful, surgery may have to be considered. Is ingrown toenail surgery painful? You won’t feel a thing! During surgery, a local anesthetic is usually injected into the area around your toe. This will numb your foot and prevent you from feeling the procedure as it occurs. The nail will be freed from the skin and removed if needed. After the operation, be sure to keep your foot raised and rested. You might receive over-the-counter or prescription painkillers to relieve any soreness you’re feeling. To stop ingrown toenails from returning, and to remove any harmful pressure on the foot, be sure to wear comfortable shoes and avoid overly trimming your toenails. Surgery is a successful way to stop your ingrown nails from hurting, and to keep ingrown toenails from coming back!

Dr. Victoria Melhuish can explain more about ingrown toenails and how to take care of your feet. Contact us at Sierra Foot and Ankle by calling (775) 783-8037, or visit our office in Carson City today!

What is Swift Therapy?

Swift therapy is a revolutionary new therapy proven to effectively remove plantar warts that have formed on the bottom of a patient’s feet. These warts can be painless or they can cause considerable discomfort. Most patients elect to have them removed rather than wait for them to go away on their own, which can take months or years. 

Plantar warts are caused by the human papillomavirus virus (HPV). The virus thrives in warm, moist environments and usually enters the body through a cut, abrasion, or small tear in the skin. This virus can be highly contagious either through skin contact or contact with something that someone else’s wart has touched.

Swift therapy was developed in the United Kingdom and has received FDA approval. Swift is a type of immunotherapy, which means that its purpose is to trigger a response from the patient’s immune system. By targeting the underlying cause of plantar warts—the virus itself—the immune system receives a signal to begin fighting it off. In turn, the warts also start to disappear. The eradication of the viral infection prevents not only the warts from returning but also new warts from forming. 

Swift involves the use of a specialized probe designed to release precise doses of microwave energy. The microwave energy is applied to the affected areas on the feet. Some patients may experience minor pain or discomfort when the second or third doses are delivered, but it quickly subsides. This makes Swift ideal for those with low pain tolerance, as well as for people of all ages, including children. 

What makes this treatment especially appealing to patients and podiatrists alike is that it is non-invasive. Unlike conventional plantar wart removal methods, such as cutting, burning, and freezing, Swift’s state-of-the-art method does not break the surface of the skin. As a result, patients can resume their normal activities after their treatment session has concluded.

On average, patients should expect to undergo two to four treatment sessions total. A severe outbreak, however, may necessitate additional sessions. Sessions are typically spread out across two-week intervals to give the patient’s immune system an adequate amount of time to respond and for favorable results to appear. 

If you are interested in learning more about Swift or would like to utilize this amazing therapy, contact Sierra Foot & Ankle by calling (775) 783-8037 for an appointment or contact us online.

What Are The Risk Factors Of Flat Feet?

The risk factors for flat feet are plentiful. However, that fact is not necessarily something that should create alarm. Some people don’t experience any painful symptoms or problems from a flattened arch, which means that they don’t need treatment. On the other hand, some people do experience pain and need help. It’s best to know the risk factors so you can quickly act on your pain, if it happens.

Obesity puts a lot of weight on the tendons in your foot, which may cause them to stretch out. This is one the reasons that arches collapse. High blood pressure and diabetes also put you more at risk for developing this foot structure.

A traumatic injury to the muscles, tendons, and joints in the foot might cause the onset of flat feet. Conditions associated with aging, including osteoarthritis and rheumatoid arthritis, might cause your arches to fall over time.

If you have any pain from your flat feet, call Sierra Foot & Ankle at (775) 783-8037

Why Is My Toenail Turning Black?

You can develop a black toenail for several different reasons. The most common culprit is trauma. This could be small, repetitive bumps to the ends of the toes over time—like hitting the insides of your shoes over and over again while running. It could also be the result of suddenly stubbing your toe or dropping something heavy on it. In either case, the trauma causes an injury in the nail bed, which leaks blood. This stains the underside of the keratin, causing that dark color.

Occasionally a black toenail is caused by something else. It might be a side-effect of a fungal infection, particularly if there’s a buildup of debris under the nail. A large dark patch, or a dark streak instead of a splotch, may actually be signs of cancer. Malignant melanoma, the most deadly of skin cancers, can sometimes grow underneath a toenail and make it appear black. If the dark splotch doesn’t seem to be growing out with your hard keratin, have it checked right away. Contact Dr. Victoria Melhuish at Sierra Foot & Ankle in Carson City to discover what caused your nail problem. Call (775) 783-8037 to make an appointment.

Why Do I Keep Getting Ingrown Toenails?

A returning ingrown toenail is a surprisingly common problem. It has to do with how your nail grows. Your toenail becomes ingrown when it grows sideways and outward into the skin around it, pinching or piercing the soft tissue. If your footwear squeezes your toes, it can influence the nail to curl. Sometimes changing your shoes may be enough to relieve the pressure on your toes so that the nail grows straight. However, a nail growth abnormality may mean your nail is unable to grow correctly. In that case, you may need a procedure to permanently remove the offending portion of the nail so it isn’t able to grow inward again.

If you’re struggling with a painful, returning ingrown toenail, you do need to change something for long-term relief. Contact Sierra Foot & Ankle for an appointment or more information about taking care of your toenails. You can reach our Carson City, NV office by calling (775) 783-8037 or filling out the online contact form.

How Is Achilles Tendinitis Treated?

There are multiple approaches to treating Achilles tendinitis, depending on the ultimate underlying cause of your pain and extent of tendon injury. Fortunately, the vast majority of cases will resolve with conservative care. Some common approaches include:

RICE therapy. That means rest (avoiding vigorous activity while you heal), followed with ice, compression, and elevation to combat swelling and pain. Physical therapy. Stretching and strengthening exercises for calves and ankles relieve tightness and pain, as well as build resistance to re-injury.

Supportive Taping or Bracing. Support is very important even with normal daily walking activities to allow rest and prevent further injury while the tendon is inflamed.

Custom orthotics. Quite often structural biomechanics is an issue. Interestingly both flat feet and well-arched feet develop tendinitis issues because of alignment deviations to the heel bone.  A custom orthotic will align the heel bone thus supporting and relieving strain on the Achilles tendon. Our office is unique with an onsite lab enabling precise fitting and individual customization of orthotics on site.

Don’t let Achilles tendinitis keep you from enjoying your activities—or just getting though your day without pain. Achilles tendinitis if left untreated, not improving or getting worse, can weakening the achilles Tendon and lead to tears or rupture. If the back of your heel or lower Achilles tendon is hurting and hasn’t improved after a few days, make an appointment with Dr. Victoria Melhuish at Sierra Foot & Ankle in Carson City, NV. Reach us at (775) 783-8037.

What Do Plantar Warts Look Like?

​​Plantar warts are often difficult to detect because they grow inward. You won’t see a large growth sticking out of the skin because the hard points that cause pain are inside the foot. What you will see on the surface often starts as a small, circular spot that crosses through the natural grooves in the bottom of your foot. 

You may think you have a callus developing at first, but with time, internal growth can lead to mild or moderate pain when you put weight down on the foot. This discomfort and pain is what leads many people to seek help for plantar warts. 

When you look closely at plantar warts, you will notice they are different from a callus. Some things you might notice include the following: 

  • Rough or grainy surface skin
  • Thick, callused skin
  • Small black dots
  • Pain when the spot is pressed

Those small black dots may look like tiny seeds. They’re small blood vessels that clot and develop as part of the wart. The surface of the wart typically remains flat, but you can often see the small black dots and grainy, rough nature of the skin. 

The development of pain and discomfort is often the final determination that you’re dealing with plantar warts rather than a harmless callus. 

Most warts are skin growths caused by a strain of the human papillomavirus (HPV) that settles into the weight-bearing pads of your feet, which causes a wart

People generally don’t want to live with the discomfort, pain, and limited mobility for any length of time. And warts can spread if not treated properly, so it’s best to come and see our doctor if you believe you have a plantar wart, regardless of pain level. 

You can try many home remedy treatment options to remove the wart, but if the wart becomes painful or doesn’t go away using home remedies, please give our office a call. 

You should see our doctor about warts if you have diabetes, poor circulation or lack of feeling in your feet, signs of infection, or a weakened immune system.

Call our office at (775) 783-8037 for an appointment or contact us online.

How Can I Treat Heel Pain?

When you first feel heel pain, there are luckily some immediate things you can do to relieve your discomfort. The first treatment for heel pain is rest. Stop what you’re doing, whether that’s walking, running, hiking, or playing tennis, and start icing the affected area.

Before you undertake cross-training (to take weight off the inflamed area, of course), play with some arch stretches. Grab over the fronts of your toes and pull toward you until you feel a stretch in the bottom of your foot. It’s important to keep your calf muscles limber, too. You can also explore the runner’s stretch—leaning toward a wall with front knee bent and back leg straight—for a good stretch in the calves and hamstrings.

We can’t stress this enough: wear good shoes! A pair that’s rigid everywhere but the toes, provides ample cushioning in the soles, and offers good arch support will get you through the discomfort. You may also benefit from heel pads and custom orthotics from Sierra Foot & Ankle.

If the pain last for more than two weeks, call Victoria L. Melhuish, DPM, in Carson City, NV, at (775) 783-8037. You may need physical therapy or other advanced treatment.

Can What You Eat Affect Your Feet?

Yes! Just as with the rest of your body, what you eat affects your feet. A good diet promotes healthy, strong, durable feet that resist pain, disease, and injury.

Calcium and Vitamin D are two important minerals that help maintain strong bones. Because of the high amount of weight, pressure, and stress you place on your feet every day, foot bones are often the first to crack or break due to osteoporosis (brittle bones).

On the flipside, too much refined sugar, trans fats, saturated fats, and other less healthy substances can cause inflammation and pain in the feet, and they can also damage your peripheral nervous system. Often the first nerves to be affected are the ones in the feet, leading to tingling, burning, shooting pain, numbness, cramping, and other symptoms.

If your feet are hurting, a healthy diet is often part of a long-term recovery and prevention program. To learn more, please schedule an appointment with Sierra Foot and Ankle in Carson City, NV by calling (775) 783-8037 today.

What Are Foot And Ankle Biomechanics?

In short, biomechanics refers to how your body moves, including all the structures (such as bones, joints, muscles, tendons, and ligaments) that contribute to locomotion and how they interact with each other. Foot and ankle structures such as flat feet, high arches, or tight calves can affect your biomechanics significantly, and because your feet are the body’s foundation point, faulty biomechanics in the feet can pull your entire body out of alignment, all the way up the spine.

Unfortunately, modern society makes walking with good biomechanics difficult, leading to poor posture and chronic pain. We spend almost all our time walking on hard, flat surfaces with no forgiveness, while gravity is constantly pulling us down and wearing out the natural spring of our arches. The good news is that custom orthotics from our on-site lab can help support your arch, align your joints, and retrain your muscles to establish healthy biomechanics and posture and relieve pain. If you’re struggling with chronic foot pain due to fault biomechanics, let Sierra Foot & Ankle in Carson City, NV help. Set up your appointment by dialing (775) 783-8037 today. 

When Is Surgery Necessary For My Foot Problem?

There are essentially two general situations when surgery is necessary for a foot problem – if the condition is unresponsive to conservative care or it is progressive.

Our goal at Sierra Foot & Ankle is always to address your lower limb issue with the use of nonsurgical care. We will make every effort to avoid surgery if this is your request. Unfortunately, sometimes conservative treatment is simply not enough. In cases like these, we will recommend surgical procedures so you can have relief from pain and be able to use your foot as intended.

Progressive conditions, like bunions, are ones that will continue to worsen over time—especially if left untreated—and cannot be corrected with conservative methods. Now, sometimes we can provide relief and keep the condition from worsening without resorting to surgery, but this is not always the case.

If you need expert foot and ankle care, whether conservative or surgical, come see us at our office in Carson City, NV and we will provide the treatment you need. Call us at (775) 783-8037 or request your appointment online so you can get back to doing the things you love!

What Causes Heel Pain?

Heel pain can make it difficult to walk, stand, and participate in sports or other physical activities you enjoy. If you are experiencing heel pain, it could be caused by a variety of different heel problems.

Plantar Fasciitis

Plantar fasciitis is the leading cause of heel pain. Plantar fasciitis develops when the plantar fascia—the ligament that connects your heel bone to the ball of your foot—sustains tears or tissue damage. This happens when high stress or pressure is placed upon the plantar fascia, especially during repetitive movements such as running and jumping.

Achilles Tendinitis

The largest tendon in the body, the Achilles tendon connects your calf muscles to your heel bone. This tendon is prone to becoming irritated or inflamed due to overuse. Achilles tendonitis can also develop in people who are obese or have flat feet.

Heel Spurs

A bony-like growth that appears on the bottom of your heel is called a heel spur. This growth is a calcium deposit that starts at the bottom of your heel and can potentially spread to your arch. Most heel spurs are caused by repetitive stress on the muscles and ligaments within your feet, as well as tears within the membrane covering your heel bone.


Bursae, which are fluid-filled sacs that prevent your bones from rubbing or sliding against tendons, bones, and muscles, are located throughout the body. In the foot region, bursae are located behind the heels. Heel pain caused by bursitis is the result of inflammation and/or irritation of the bursae.

Sever’s Disease in Children

The most common cause of heel pain in children is caused by Sever’s Disease. This disease, also known as calcaneal apophysitis, occurs when the growth plate in the back of the heel becomes inflamed, which is often caused by regular exercise or participation in sports. Sever’s Disease is common during periods of rapid growth.

If you or someone you know has any of the above heel pain causes, or are unsure what is causing the heel pain, contact our office to get treatment and relief started as soon as possible!

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Carson City, NV 89701

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