Good Health Can Start at Your Feet

Are you aware of how your feet affect your health? With warmer weather bringing increased outdoor activity, it is a good time to be more mindful of our feet and how they affect our overall health.

Certain foot problems may be an indication of a health issue. For example, ridged or pitted toenails can be a sign of eczema or psoriasis, an inflamed skin condition. Pale or blue feet may be a sign of circulatory problems. Numbness and tingling may be a sign of diabetes. Be aware of the various foot conditions below to stay healthy and keep the spring in your step.

Because the feet are at the foundation for all we do, mechanical problems can occur such as hammertoes, heel pain/spurs, painful metatarsals, flat feet, nerve entrapment, sprains, strains, tendinitis, and fractures. Foot pain can even arise from wearing wrong-fitting shoes or being overweight. If you are experiencing foot pain, contact a board-certified orthopaedist today for a consultation.

Foot trauma
Foot injuries can occur during normal daily activities, on the job, while exercising, and while participating in sports and other physical activities. Many injuries can develop from your feet not functioning properly, including shin splints, stress fractures, heel pain, runner’s knee, and other lower extremity problems.

The foot is made-up of 26 bones, 107 ligaments and 19 muscles. With so much complexity, many things can happen. If you have pain, tenderness, bruising or swelling that does not resolve with rest, it is best to have your foot evaluated and properly treated by an orthopedic doctor.

If you have a bunion, you know it can be a painful enlargement at the joint of the big toe. The skin over the joint becomes swollen and is often quite tender. Bunions can be inherited as a family trait, can develop with no recognizable cause, or can be caused by shoes that fit poorly. An important part of treatment is wearing shoes that conform to the shape of the foot and do not cause pressure areas. This often alleviates the pain. In severe cases, bunions can be disabling. Several types of surgery are available that may relieve pain and improve the appearance of the foot. Surgery is usually done to relieve pain and is not meant for cosmetic purposes.

Heel pain
Heel pain is extremely common. It often begins without injury and is felt under the heel, usually while standing or walking. It is usually worst when arising out of bed. Inflammation of the connective tissue on the sole of the foot (plantar fascia) where it attaches to the heel bone is the most common cause of pain. It is often associated with a bony protrusion (heel spur) seen on X-ray studies.

Most cases will improve spontaneously. Heel and stretching, medication to reduce swelling of the soft tissues in your foot, and shoe inserts are quite helpful. If pain continues, steroid injections or walking casts are used. Only in the most troubling and prolonged cases is surgery recommended.

Corns and Calluses
Corns and calluses are caused by pressure on the skin of your foot. They may occur when bones of the foot press against the shoe or when two foot bones press together. Common sites for corns and calluses are on the big toe and the fifth toe. Calluses underneath the ends of the foot bones (metatarsals) are common. Soft corns can occur between the toes.

Treatment involves relieving the pressure on the skin, usually by modifying the shoe. Pads to relieve the bony pressure are helpful, but they must be positioned carefully. On occasion, surgery is necessary to remove a bony prominence that causes the corn or callus.

Hammertoes are one of several types of toe deformities. Hammertoes have a permanent sideways bend in your middle toe joint. The resulting deformity can be aggravated by tight shoes and usually results in pain over the prominent bony areas on the top of the toe and at the end of the toe. A hard corn may develop over this prominence. Treatment usually involves a shoe to better accommodate your deformed toe. Shoe inserts or pads also may help. If, after trying these treatments, you are still having marked difficulty, surgical treatment to straighten the toe or remove the prominent area of bone may be necessary.

Plantar Warts
Plantar warts occur on the sole of the foot and look like calluses. They result from an infection by a specific virus. They are like warts elsewhere, but they grow inward. The wart cannot grow outward because of weight placed on it when you stand. You may experience severe pain when walking, and can have just one or many plantar warts. Plantar warts are extremely difficult to treat, but success has been achieved with repeated applications of salicylic acid (available over the counter) to soften the overlying callus and expose the virus. Other treatments include injection of the warts with medication, freezing the warts with liquid nitrogen and, very rarely, surgery.

You do not have to suffer with foot pain, which can limit activity in your daily life. Depending on the problem and its severity, many orthopedic problems can be treated without surgery, often with corrective insoles, physical therapy, and activity modifications. Surgery can be provided by your orthopaedist in case conservative management doesn’t work.

Your orthopaedist is a medical doctor with extensive training in the diagnosis and nonsurgical and surgical treatment of the musculoskeletal system, including bones, joints, ligaments, tendons, muscles, and nerves.

Recognizing foot problems is important to your health. Sometimes, if you leave problems untreated, other parts of the body such as the knees and lower back can even be affected. Pay attention to any changes in your feet and get prompt medical treatment if you are unsure about what these changes mean.

What our patients have to say

This is our place to reflect and share. Since gratitude is a positive emotion correlated with healing, we have invited you to experience our patients feedback and responses to our procedures. We thank you for all your kind words and are so happy to be of help you in your healing process. We are adding to our testimonial section, video reviews. Please watch as Lawrence Gonnello shares his story with us



Orthopedic surgeries
by Lawrence Gonnello, October 2014
Lawrence Gonnello has had 15 orthopedic surgeries in his lifetime — and he wouldn’t trust anyone other than Dr. Marshall P. Allegra to treat him. He has now known Dr. Allegra for at least 20 years, and continues to appreciate his personal, attentive care and the fact that Dr. Allegra helps patients get the treatment they need right away so they don’t have to be in pain a moment longer than necessary.


Ac Joint reconstructive ligament surgery
by Abe R on Aug 30th, 2013
Dr Allegra is outstanding in his ability perform great results from my surgery. I was extremely pleased with the outcome., patient care, his follow up and the staff.

Satisfied Patient
Jun 8th, 2013
Doctor Allegra is knowledgeable and competent. I had a successful knee replacement (after a manipulation 5 weeks post op). His office staff is responsive to calls and concerns. Wait time for your appointment is minimal – respects patient’s time, not just doctor’s time. I would recommend (and have!) to anyone who is looking for a good outcome to an orthopedic problem.

My Rotator cuff and Dr. Allegra
by Nora Tupino on Feb 21st, 2013
In August I fell while training for a marathon. By September I could not raise my right arm. I went to Dr. Allegra (he had done my knee several years ago) After an MRI he diagnosed a torn rotator cuff. After giving me a great deal of information as to the surgery I would need, what my post-op recovery would be, I had surgery in October at Shrewsbury Surgical Center. Even though the recovery for me was tough, I felt Dr. Allegra was sensitive to my need for pain control. My follow up visits were informative. He was persistent in my having a minimum of 3 months of physical therapy. Now 4 months after surgery, I have almost 100% range of motion in my right arm and I am training for my 2nd half Iron Man Triathlon in June.

Excellent Surgeon
by Sharon Rothenberg on Feb 8th, 2013
On 1/28/2013, I had a total hip replacement. Dr. Allegra used the transverse method, a procdure that he invented. This procedure is much better than the standard posterior hip replacement, in that it offers a quicker healing time, and results in less pain. No heavy pain medications are needed, after the first night. In fact, as of 2/1, I was only using tylenol for pain. This doctor is terrific. I would not use any other orthopedic surgeon.

Great doctor
Dec 3rd, 2012
When you have a big problem , your Dr. Has to be good. Well Dr. Allegra is the best orthopedic Dr. On earth. Just can’t say enough about him. Kind , gentile and so very smart. A Dr.’s doctor. Whatever the wait in the office it is well worth it. Be patient , he is worth the wait , the best in his field. None better period.

Wouldn’t choose any other doctor
Mar 5th, 2012
I’m a 51 year old guy who unfortunately has not had very much luck with my joints. I’ve had ACL Surgery, two Rotator Cuff surgeries and a Meniscus procedure done. I tore my ACL and made an appointment with Doctor Marshall Allegra . After meeting with Doctor Allegra I decided to go through with the surgery. Today my knee is stronger then ever. When I tore my Meniscus and then both Rotator Cuffs I decided to go back to the doctor who I put on a pedestal ! Doctor Allegra has fixed me up each and every time . My Physical Therapist is always amazed with my recovery and I always tell him the same thing, ‘ I have Doctor Allegra to thank for my recovery !”..I would rate Doctor Allegra as THE Top orthopedic doctor in New Jersey ! ! ! Thank You Doctor Allegra !

Very Happy
Apr 20th, 2011
I was first impressed with Dr Allegra when he treated my husband for a serious leg injury. He was honest and explained every dtail of his coindition and how to treat it and care for my husband once he was home. When my knee became an issue he did all he could to treat it without surgery and once it was obvious that surgery was necessary he took Wonderful care of me. He is very blunt and to the point but on one visit I was very emotional and he sat with me and reassured me that I was recovering well and I would have days when I did not feel that I was making progress. His compassion made me feel so much better

What Is Minimally Invasive Surgery?

In 1988, Dr. J. Barry McKernan, after making only a 10mm incision – (equivalent to 0.39 inches, less than half an inch) – inserted a miniature camera into a patient’s abdomen and removed a gall bladder. The patient recovered in days, rather than weeks or months. This was the first laparoscopic cholecystectomy performed in the U.S. and the beginning of the minimally invasive movement in surgery.

Twenty-six years later, minimally invasive procedures have changed the way people think about surgery. Patients who choose innovative minimally invasive procedures over conventional surgery usually have shorter hospital stays and quicker recovery. This means getting back sooner to the things that are important in life.

An orthopedic doctor may recommend minimally invasive surgery for many conditions, including orthopedic injuries and disorders.

More than 20 million Americans have had minimally invasive surgery, and time has proven it to be as effective as conventional surgery. When you have minimally invasive surgery, you’re likely to lose less blood and have less postoperative pain, fewer and smaller scars, and a reduced risk of infection than you would following conventional, or “open” surgery.

Minimally invasive laparoscopic surgery uses state-of-the-art technology to reduce damage to human tissue when performing surgery. For example, in most procedures, a surgeon makes several small incisions and inserts thin tubes called trocars. Carbon dioxide gas may be used to inflate the area, creating a space between the internal organs and the skin. Then the miniature camera (usually a laparoscope or endoscope) is placed through one of the trocars so the surgical team can view the procedure as a magnified image on video monitors in the operating room. Specialized instruments are placed through the other trocars to perform the procedures.

There are some advanced minimally invasive surgical procedures that can be performed almost exclusively through a single point of entry – meaning only one small incision. This is called single site laparoscopy, and is another approach to performing traditional laparoscopic surgery using the same tools. Orthopedic surgeons often perform single site laparoscopy to repair conditions of the hip and knee. These kinds of procedures are not for everyone, and only your doctor can determine if a minimally invasive surgery is right for you.

Highlights and News

Getting Back to Your Best with Minimally Invasive Surgery.

 Today we are living longer and fully expect to enjoy a long and active life. Minimally invasive orthopedic surgery is helping to keep us in the game of life, restoring function and range of motion in older athletes, relieving pain for individuals with arthritis or work-related conditions such as carpal tunnel syndrome, and helping anyone recovering from a traumatic accident or injury get back on their feet.

“Orthopedic technology advances in minimally invasive techniques, specialized tools and advanced imaging are helping to reduce and eliminate pain and restore functionality and range of motion to key areas of the body such as hips, knees, hands and shoulder joints,” says Dr. Marshall P. Allegra, M.D., an orthopedic specialist in Hazlet, New Jersey.

In an arthroscopic examination, an orthopedic surgeon makes a small incision in the patient’s skin and then inserts a pencil-sized instrument that contains a small lens and lighting system to magnify and illuminate the structures inside the joint. This enables the surgeon to visualize, diagnose and treat problems inside the joint.

“Partial join replacement has become a refined procedure, with sameday surgery, immediate rehab and quick recovery,” says Dr. Allegra. “Hip arthroscopy has emerged as a specialty in the last five or six years, as well as the ability to resolve soft tissue problems, bone spurs, ACL and other ligament repairs – treatments are now available for these conditions in same day surgical settings.”

Excellent outcomes are being achieved thanks to a full continuum of care supporting same day surgery patients. “Patients may receive a continuous pain block that lasts for two or three days after surgery, home care is available for patients who require it, and physical therapy begins almost immediately,” says Dr. Allegra.

“As you go along the age spectrum, a younger active person may have a soft tissue or ligament injury repaired arthroscopically, and an older person may have partial joint replacement. Either way, they can both be back to their normal routines very quickly,” says. Dr. Allegra. “Thanks to minimally invasive procedures and a supportive care environment, these injuries are not the setbacks they once might have been.”

The benefits of minimally invasive procedures include less blood loss, less post-operative pain, lower risk of infection, less damage to musculature and tissue, and earlier return to normal function, work and recreation. “The
techniques of minimally invasive surgery are ‘technically’ more demanding,” adds Dr. Allegra, “so it’s important to seek out surgeons with exceptional training and experience.”

Dr. Marshall P. Allegra, M.D.