
What to Do With Thick Toenails

Thick toenails are a common condition where the toenails become abnormally thick, often appearing yellowish or discolored. This condition can be caused by fungal infections, aging, trauma to the toenail, or underlying health conditions like diabetes or psoriasis. The symptoms of thick toenails include visible thickening, discoloration, and sometimes crumbling or brittle edges. The toenails may also become painful, especially when pressure is applied, or when wearing tight shoes. In severe cases, the nail may lift from the nail bed or become misshapen. Treatment for thick toenails depends on the cause. If caused by a fungal infection, antifungal medications, either topical or oral, are typically used. In some cases, a podiatrist may recommend trimming or debriding the toenail, or using laser therapy to treat fungal infections. A podiatrist can diagnose the underlying cause and provide effective treatments for thick toenails. If you are experiencing this condition, it is suggested that you make an appointment with a podiatrist.
If left untreated, toenail fungus may spread to other toenails, skin, or even fingernails. If you suspect you have toenail fungus it is important to seek treatment right away. For more information about treatment, contact Pasquale Cancelliere, DPM of Candria Foot and Ankle Specialists. Our doctor can provide the care you need to keep you pain-free and on your feet.
Symptoms
- Warped or oddly shaped nails
- Yellowish nails
- Loose/separated nail
- Buildup of bits and pieces of nail fragments under the nail
- Brittle, broken, thickened nail
Treatment
If self-care strategies and over-the-counter medications does not help your fungus, your podiatrist may give you a prescription drug instead. Even if you find relief from your toenail fungus symptoms, you may experience a repeat infection in the future.
Prevention
In order to prevent getting toenail fungus in the future, you should always make sure to wash your feet with soap and water. After washing, it is important to dry your feet thoroughly especially in between the toes. When trimming your toenails, be sure to trim straight across instead of in a rounded shape. It is crucial not to cover up discolored nails with nail polish because that will prevent your nail from being able to “breathe”.
In some cases, surgical procedure may be needed to remove the toenail fungus. Consult with your podiatrist about the best treatment options for your case of toenail fungus.
If you have any questions, please feel free to contact our offices located in Londonderry, NH and Salem, NH . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Treating Toenail Fungus
Fungal infection of the toenail, or onychomycosis, typically appears as a gradual change in a toenail’s texture and color that involves brittleness and darkening. The fungal infection itself occurs beneath the surface of the nail. Aside from discoloration, other symptoms include the collection of debris beneath the nail plate, white marks on the nail plate, and a foul odor emanating from the nail. If ignored, the infection can spread into other nails and the skin; in severe cases, it can hinder one’s ability to work or walk.
The toenails are particularly vulnerable to contracting infection in moist environments where people are likely to be walking barefoot, such as around swimming pools, public showers, and locker rooms. Fungal infection may also be more likely to occur in nail beds that have been injured, and sufferers of chronic diseases such as diabetes, circulatory problems, or immunodeficiency conditions are particularly prone to developing fungal nails.
Fungal nails can be primarily prevented by practicing proper hygiene and regularly examining the feet and toes. Carefully washing the feet with soap and water and thoroughly drying the feet afterwards are essential. Other tips include wearing shower shoes in public areas, changing shoes and socks daily, keeping toenails clipped at a short length, wearing breathable shoes that fit properly, wearing moisture-wicking socks, and disinfecting home pedicure tools and instruments used to cut nails.
Fungal nail treatment may vary between patients and the severity of the condition. Your podiatrist may suggest a daily routine of cleansing that spans over a period of time to ease mild infections. Over-the-counter or prescription antifungal agents may also be prescribed, including topical and/or oral medications. Debridement, or the removal of diseased nail matter and debris, may also be performed. In more severe cases, surgical treatment may be needed. In some instances, the temporary removal of the fungal nail allows for the direct application of a topical antifungal to the nail bed. In other cases, a chronically painful fungal nail that has not responded to other treatments may be permanently removed; this allows the infection to be cured and avoids the growth of a deformed nail.
Choosing the Right Running Shoes for Different Terrains

Selecting the right running shoes for your intended terrain is essential for comfort, performance, and injury prevention. For road running, choose lightweight shoes with adequate cushioning to absorb impact on hard, flat surfaces. Look for breathable materials and a snug fit to prevent blisters during longer runs. Trail running requires sturdier shoes with rugged soles for better grip on uneven, rocky, or muddy terrain. Waterproof or water-resistant materials can keep your feet dry in wet conditions. For treadmill running, focus on shoes with shock absorption and flexibility to handle the repetitive motion. Always consider your foot type, such as flat feet or high arches, when choosing shoes to ensure proper support and alignment. Worn or inappropriate shoes can lead to discomfort or injury. For expert guidance on choosing the right running shoes for yourself, it is suggested that you see a podiatrist to ensure your footwear matches your running needs.
If you are a runner, wearing the right running shoe is essential. For more information, contact Pasquale Cancelliere, DPM from Candria Foot and Ankle Specialists. Our doctor can provide the care you need to keep you pain-free and on your feet.
Choosing the Right Running Shoe for Your Foot Type
To increase performance and avoid the risk of injury, it is important to choose the right running shoe based on your foot type. The general design of running shoes revolves around pronation, which is how the ankle rolls from outside to inside when the foot strikes the ground.
- Neutral runners are able to choose from a wide variety of shoes, including minimalist shoes or even going barefoot.
- Runners who overpronate, or experience an over-abundance of ankle rolling, should choose shoes that provide extra motion control and stability.
- Runners who underpronate, or supinate, have feet that have high arches and lack flexibility, preventing shock absorption. They require shoes with more flexibility and cushion.
If you have any questions please feel free to contact our offices located in Londonderry, NH and Salem, NH . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Choosing the Right Running Shoe for Your Foot Type
Running may seem like a simple to do. However, running is actually a complex movement that puts stress on the ligaments, bones, and joints of the body. Selecting the correct running shoe is important for increasing performance and avoiding risk of injury. Running shoes should be selected based on your foot type. Considerations such as trail versus road shoes are important. Your foot type dictates the degree of cushioning, stability and motion control you require. The most accurate way to learn your foot type is to visit a local shop that specializes in running shoes. Professionals can measure your arch type, stride and gait and help you with your shoe needs.
The design of running shoes is created around the idea of pronation. Pronation is the natural rolling movement of your ankle from the outside to inside when your foot strikes the ground. If you run properly you strike the ground on the outside of your heel and roll in the direction of your big toe before pushing off once more. Pronation is beneficial because it assists the lower half of your body in absorbing shock and storing energy. Those considered neutral runners pronate correctly and do not need running shoes that help correct their form. Neutral runners can choose from a wide variety of shoes, including barefoot or minimal types. However, those who have arch problems or who adopt an incorrect form while running may experience too much or too little pronation. They may require running shoes that offer additional support.
Those who overpronate experience an over-abundance of ankle rolling. Even while standing, those who severely overpronate display ankles that are angled inward. It is not uncommon for them to have flat feet or curved legs. The tendency to overpronate may cause many injuries. Areas that tend to become injured are the knees, ankles, and Achilles tendon. If you find that you have a tendency to overpronate, you should look at shoes that provide extra stability and motion-control. Motion-control shoes are straight and firm. Shoes of this type do not curve at the tip. The restricted flexibility along the middle of the shoe prohibits the foot from rolling too far inward as your foot strikes the ground.
A less common problem is underpronation. Underpronation, also called supination, is when the feet are unable to roll inward during landing. Those who underpronate have feet that lack flexibility and high arches. This prevents any kind of shock absorption, even though it does place less rotational stress on ankles and knees. This added force can cause fractures, ligament tears, and muscle strains because the legs are trying to compensate for the impact. Those who underpronate need shoes with more cushioning and flexibility. If you have a tendency to underpronate, selecting stability or motion-control shoes may cause you more problems by continuing to prevent pronation.
What Is Sever’s Disease?

Sever's disease, also known as calcaneal apophysitis, is a common cause of heel pain in growing children, particularly those who are active in sports. This condition occurs when the growth plate at the back of the heel becomes irritated due to repetitive stress or overuse. It is often seen in children between the ages of eight and 14, especially those who participate in activities that involve running or jumping. Symptoms of Sever's disease include pain, tenderness, and swelling at the back of the heel, which may worsen during or after physical activity. Management of this condition typically involves rest and elevation to reduce inflammation. Stretching and strengthening exercises for the Achilles tendon and calf muscles can also help to relieve symptoms, and wearing cushioned shoes or using orthotic insoles may provide additional comfort. If your active child has heel pain, it is suggested that you consult a podiatrist who can accurately diagnose and treat Sever’s disease.
Sever's disease often occurs in children and teens. If your child is experiencing foot or ankle pain, see Pasquale Cancelliere, DPM from Candria Foot and Ankle Specialists. Our doctor can treat your child’s foot and ankle needs.
Sever’s Disease
Sever’s disease is also known as calcaneal apophysitis, which is a medical condition that causes heel pain I none or both feet. The disease is known to affect children between the ages of 8 and 14.
Sever’s disease occurs when part of the child’s heel known as the growth plate (calcaneal epiphysis) is attached to the Achilles tendon. This area can suffer injury when the muscles and tendons of the growing foot do not keep pace with bone growth. Therefore, the constant pain which one experiences at the back of the heel will make the child unable to put any weight on the heel. The child is then forced to walk on their toes.
Symptoms
Acute pain – Pain associated with Sever’s disease is usually felt in the heel when the child engages in physical activity such as walking, jumping and or running.
Highly active – Children who are very active are among the most susceptible in experiencing Sever’s disease, because of the stress and tension placed on their feet.
If you have any questions, please feel free to contact our offices located in Londonderry, NH and Salem, NH . We offer the newest diagnostic and treatment technologies for all your foot and ankle injuries.
Sever's Disease
Sever's disease, also known as calcaneal apophysitis, is a medical condition that causes heel pain in children’s feet while they’re growing. Sever's disease occurs most commonly in boys and girls between the ages of 8 and 14.
Sever's disease occurs when the child’s growth plate, or the calcaneal epiphysis, an area attached to the Achilles tendon, is injured or when the muscles and tendons of the growing foot do not keep pace with bone growth. The result is constant pain experienced at the back of the heel and the inability to put any weight on the heel. This forces the child to bear weight on their toes while walking. When a toe gait develops, the child must change the way they walk to avoid placing weight on the painful heel. If this is not properly addressed, this can lead to further developmental problems.
The most common symptom of Sever's disease is acute pain felt in the heel when a child engages in physical activity such as walking, jumping or running. Children who are active athletes are among the group most susceptible to experiencing Sever's disease. This is due to the extreme stress and tension placed on their growing feet. The rolling movement of the foot during walking or running and obesity are both additional conditions linked to causing Sever's disease.
The first step in treating Sever's disease is to rest the foot and leg and avoid physical activity. Over the counter pain-relieving and anti-inflammatory medications can be helpful for reducing the amount of heel pain. A child with Sever's disease should also wear shoes that properly support the heel and the arch of the foot. Consider purchasing orthotic shoe inserts which can help support the heel and foot while it is healing. Most patients with Sever's disease symptoms report an eventual elimination of heel pain after wearing orthotic insoles that support the affected heel.
Sever's disease may affect either one heel or both. It is important for a child experiencing heel pain to be examined by a foot doctor who can apply the squeeze test. The squeeze test compresses both sides of the heel in order to determine if there is intense pain. Discourage any child diagnosed with Sever's disease from going barefoot as this can intensify the problem. Apply ice packs to the affected painful heel two or three times a day for pain relief.
Exercises that help stretch the calf muscles and hamstrings are effective at treating Sever's disease. An exercise known as foot curling has also proven to be very effective at treating Sever's disease. When foot curling, the foot is pointed away from the body, then curled toward the body to help stretch the muscles. The curling exercise should be done in sets of 10 or 20 repetitions and repeated several times throughout the day.
Treatment methods can continue for at least 2 weeks and as long as 2 months before the heel pain completely disappears. A child can continue doing daily stretching exercises for the legs and feet to prevent Sever’s disease from returning.
Ankle Impingement Explained

Ankle impingement occurs when soft tissues, such as ligaments or tendons, become pinched between the bones of the ankle joint, leading to pain and restricted movement. This condition often develops due to repetitive ankle use or trauma, such as a sprain, making it common among athletes, dancers, and individuals with occupations requiring repetitive ankle motion. People with ankle impingement typically feel a sharp, localized pain at the front or back of the ankle. The pain may worsen with certain movements, like deep squats, running, or jumping. Stiffness, swelling, and a clicking sensation might also accompany the discomfort. Diagnosing ankle impingement involves a physical exam, patient history, and imaging like X-rays or MRI scans to identify structural changes. Treatment ranges from rest and targeted exercises to cortisone injections or, in severe cases, surgery to relieve the pressure and restore mobility. If you have ankle pain, it is suggested that you schedule an appointment with a podiatrist for a proper diagnosis and treatment.
Ankle pain can have many different causes and the pain may potentially be serious. If you have ankle pain, consult with Pasquale Cancelliere, DPM from Candria Foot and Ankle Specialists. Our doctor will assess your condition and provide you with quality foot and ankle treatment.
Ankle pain is any condition that causes pain in the ankle. Due to the fact that the ankle consists of tendons, muscles, bones, and ligaments, ankle pain can come from a number of different conditions.
Causes
The most common causes of ankle pain include:
- Types of arthritis (rheumatoid, osteoarthritis, and gout)
- Ankle sprains
- Broken ankles
- Achilles tendinitis
- Achilles tendon rupture
- Stress fractures
- Tarsal tunnel syndrome
- Plantar fasciitis
Symptoms
Symptoms of ankle injury vary based upon the condition. Pain may include general pain and discomfort, swelling, aching, redness, bruising, burning or stabbing sensations, and/or loss of sensation.
Diagnosis
Due to the wide variety of potential causes of ankle pain, podiatrists will utilize a number of different methods to properly diagnose ankle pain. This can include asking for personal and family medical histories and of any recent injuries. Further diagnosis may include sensation tests, a physical examination, and potentially x-rays or other imaging tests.
Treatment
Just as the range of causes varies widely, so do treatments. Some more common treatments are rest, ice packs, keeping pressure off the foot, orthotics and braces, medication for inflammation and pain, and surgery.
If you have any questions, please feel free to contact our offices located in Londonderry, NH and Salem, NH . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Ankle Pain
The ankle joint is the point at which the bones of the leg and foot join. This joint is crucial because it is responsible for the foot’s mobility. Ankle pain is typically the result of inflammation from an injury to bones, joint space, cartilage, ligaments, tendons, or muscles in the area. Commonly associated symptoms with ankle pain are bruising, redness, numbness, stiffness, weakness, and tingling.
The most common causes of ankle pain are sprains and injuries. Ankle sprains are one of the most common musculoskeletal injuries. Sprains occur when the ligaments of the ankle become partially or completely torn due to sudden stretching. Sprains can occur on either the inner or outer sides of the ankle joint. Usually, these injuries occur when the ankle is twisted in an activity by stepping off an uneven surface. More specific causes include rheumatoid arthritis, gout, osteoarthritis, and Achilles tendonitis.
If you are experiencing ankle pain, you should consult with your podiatrist to choose the best method of care. Your doctor will conduct an examination of your ankle to determine the underlying cause of the pain.
Can Poor Foot Circulation Be Improved?

Poor circulation in the feet occurs when blood flow to the lower extremities is reduced, often leading to discomfort and other health concerns. This condition can be caused by various factors such as diabetes, smoking, obesity, or heart disease. The most common symptoms of poor circulation include cold feet, numbness, tingling sensations, swelling, and discoloration. In more severe cases, it can lead to wounds that heal slowly or even tissue damage. Improving circulation in the feet can be achieved through several methods. Regular physical activity, such as walking or swimming, promotes better blood flow and strengthens the heart. Elevating the feet, wearing compression socks, and avoiding tight footwear can also help enhance circulation. Maintaining a healthy diet, staying hydrated, and not smoking are essential for long-term circulation health. If you have symptoms of poor circulation in your feet, it is suggested that you consult a podiatrist who can offer you effective relief and treatment solutions.
Poor circulation is a serious condition and needs immediate medical attention. If you have any concerns with poor circulation in your feet contact Pasquale Cancelliere, DPM of Candria Foot and Ankle Specialists. Our doctor will treat your foot and ankle needs.
Poor Circulation in the Feet
Poor blood circulation in the feet and legs is can be caused by peripheral artery disease (PAD), which is the result of a buildup of plaque in the arteries.
Plaque buildup or atherosclerosis results from excess calcium and cholesterol in the bloodstream. This can restrict the amount of blood which can flow through the arteries. Poor blood circulation in the feet and legs are sometimes caused by inflammation in the blood vessels, known as vasculitis.
Causes
Lack of oxygen and oxygen from poor blood circulation restricts muscle growth and development. It can also cause:
- Muscle pain, stiffness, or weakness
- Numbness or cramping in the legs
- Skin discoloration
- Slower nail & hair growth
- Erectile dysfunction
Those who have diabetes or smoke are at greatest risk for poor circulation, as are those who are over 50. If you have poor circulation in the feet and legs it may be caused by PAD and is important to make changes to your lifestyle in order to reduce risk of getting a heart attack or stroke. Exercise and maintaining a healthy lifestyle will dramatically improve conditions.
As always, see a podiatrist as he or she will assist in finding a regimen that suits you. A podiatrist can also prescribe you any needed medication.
If you have any questions please feel free to contact our offices located in Londonderry, NH and Salem, NH . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Causes, Symptoms, and Treatment of Poor Blood Circulation in the Feet
Poor blood circulation in the feet and legs is often caused by peripheral artery disease (PAD), which is usually the result of a buildup of plaque in the arteries. Plaque buildup, or atherosclerosis, can be the result of excess calcium and cholesterol in the bloodstream. This restricts how much blood can flow through arteries. Reduced blood flow to a certain area of the body severely limits the amount of oxygen and nutrients that part of the body receives. This leads to degeneration in the muscles and other tissues. Sometimes, poor blood circulation in the feet and legs can be caused by other conditions, such as the damaging or inflammation of blood vessels, known as vasculitis.
The lack of oxygen and nutrients caused by poor blood circulation can restrict muscle growth and development, as well as cause muscle pain and cramps, weakness, and stiffness. Other common symptoms include numbness in the legs and feet, skin discoloration in the affected limbs, slower nail and hair growth, and erectile dysfunction in men. In more severe cases of PAD, pain can be present even when a person isn't exercising, and may range from mildly uncomfortable to completely debilitating.
Poor blood circulation in the feet and legs is more common in those who are overweight or obese, have diabetes, high blood pressure, high cholesterol, who smoke, or who have a family history of PAD or related conditions such as a heart attack, stroke, etc. Diabetes and smoking place a person at greatest risk for developing poor blood circulation, although advanced age, over 50, can also increase risk.
If you are experiencing poor blood circulation in the feet and legs caused by PAD, it is important to make changes to your lifestyle in order to reduce your risk of experiencing a heart attack or stroke caused by this condition. If you smoke, quit completely. This will increase the amount of oxygen in your bloodstream. Exercising and reducing the saturated fats in your diet. Saturated fats come from fatty meats, fried foods, whole milk, etc., can make a difference in improving blood circulation in feet. It is also important to avoid developing influenza and to carefully control your blood sugar if you have diabetes.
Your doctor may recommend combining lifestyle changes with a prescription medication regimen to improve blood circulation. The most commonly-used medications for PAD are called statins and work by blocking the amount of enzymes in your body that produce cholesterol. They are known by the brand names Zocor, Lipitor, Crestor, and others.