Gerry L. Hash, D.P.M.
Board Certified Foot Surgeon
417 S. Landmark Ave.
Bloomington, IN 47403
812-339-2446
CONDITIONS AND TREATMENTS
EXTRACORPOREAL SHOCK WAVE
Nail fungus, otherwise known as Onychomycosis, has been recognized as being a very difficult type of fungal infection to treat. It is a cosmetic condition that most often affects the toenails. Risk factors for nail fungus include increased age, male gender, diabetes, nail trauma, hyperhydrosis, peripheral vascular disease, athlete's foot, immunodeficiency, poor hygiene, and chronic exposure of the nails to water. There are many species of fungus that can infect the nail. Often in nail infections several types of fungus will be present at the same time. All nail fungus infections result in thickened, discolored, and distorted nails.

Bunions are misaligned big toe joints that can become swollen and tender, causing the first joint of the big toe to slant outward, and the second joint to angle toward the other toes.
Flat feet are a common condition. In infants and toddlers, the longitudinal arch is not developed and flat feet are normal. The arch develops in childhood, and by adulthood, most people have developed normal arches.
Heel Spurs
Plantar fasciitis (or heel pain) is commonly traced to an inflammation on the bottom of the foot. Our practice can evaluate arch pain, and may prescribe customized shoe inserts called orthoses to help alleviate the pain.
Hammertoes
Hammertoe is a deformity of the second, third or fourth toes. In this condition, the toe is bent at the middle joint, resembling a hammer. Left untreated, hammertoes can become inflexible and require surgery.
Ingrown nails when the nail grows into the flesh instead of over it -- usually affect the toenails, particularly the big toe. People with curved or thick nails are most susceptible, although anyone can suffer from ingrown nails as a result of an injury, poorly fitting shoes, or because of improper grooming of the feet. Diabetics and people with vascular problems need to be aggressive in treating and preventing minor foot ailments such as an ingrown toenail because they can develop into serious medical problems such as loss of a limb.
Warts normally grow out of the skin in cylindrical columns. These columns do not fuse when the wart grows on thin skin such as the face. On thicker skin, the columns fuse and are packed tightly together giving the surface the typical mosaic pattern. Black dots can sometimes be seen in a wart. These are actually blood vessels that have grown rapidly and irregularly into the wart and have thombosed or clotted off.
Extracorporeal Shock Wave Therapy (ESWT) is used to treat chronic heel pain (plantar fasciitis). "Extracorporeal" means "outside of the body." During this noninvasive procedure, sonic waves are directed at the area of pain using a device similar to that currently used in nonsurgical treatment of kidney stones.
Extracorporeal Shock Wave Therapy is prescribed for patients who have experienced plantar fasciitis for an extended period of time -- six months or more -- and have not benefited from other conservative treatments. The brief procedure lasts about 30 minutes and is performed under local anesthesia and/or "twilight" anesthesia. Strong sound waves are directed at and penetrate the heel area to stimulate a healing response by the body. ESWT is performed on an outpatient basis. Although there are no bandages, someone will need to drive the patient home.
People who are not candidates for ESWT include pregnant women and individuals with neurological foot disease, vascular foot disease, pacemakers, or people taking medications that interfere with blood clotting (such as Coumadin).
This therapy is a safe and effective alternative treatment for heel pain and only requires a short recovery time. Clinical studies show a 70 percent success rate for treatment of plantar fasciitis using Extracorporeal Shock Wave Therapy.