Services Offered

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Custom orthotics

In our office we perform a biomechanical evaluation with you sitting, standing, and walking. Then we proceed with a 3d digital scan of your feet using updated modern software. The scan is sent to a lab where the orthotics are constructed. Custom modifications are made to each orthotic according to what the doctor prescribed. Feet can often be asymmetrical, so why would your orthotics be the same? We then dispense the orthotics in the office to make sure they fit, explaining how to break them in and wear them in your shoes. 

Orthotics can be life changing if properly made. The earlier you start wearing them in life – the better. If one foot is flatter than the other, then your knees, hips, and back may not be even. This can lead to arthritis down the road. The sooner your foot conditions are supported and balanced, the sooner you can get back to life and lower your risk of developing serious conditions in the future.

Foot care

At On the Move Podiatry we perform a thorough assessment of your feet and take the time to carefully handle your toenails and calluses – whether you have diabetes or not. Since we do not bill Medicare, you can have foot care performed as often as you like. There are no harsh stipulations that you can only be seen every 9 weeks.

Fat pad injection

On the Move Podiatry offers fat pad injections into the foot to help cushion any areas causing pain. A common area is the ball of the foot. As we age, the fat pad in the ball of the foot tends to thin out, or atrophy. This can cause pain along the prominent bones when walking, or it can cause painful corns and calluses. Toe deformities can also cause thinning of skin leading to pain or corns. Fat pad fillers can be injected into either of these areas. They can also be administered to areas prone to ulceration in order to decrease risk of ulcer recurrence. The injection we use is a matrix which is safe and a clinically proven solution to help with foot pain that doesn’t require steroids or surgery!

Cosmetic toenail reconstruction

If you have a severely damaged toenail that is beyond repair or already failed multiple forms of treatment, then cosmetic toenail reconstruction may be for you. We use a cosmetic nail restoration system that uses polymer resins to cover up embarrassing toenails. It has special activators to create a natural looking artificial nail. This is different from an acrylic nail you would get in a salon. The system we use is made of a flexible resin which allows the nail to bend with the natural movement of the toe. It is applied in sanitary conditions under the supervision of a trained medical doctor. It’s natural flexibility ensures that the nail doesn’t suffer more trauma with repetitive motion such as walking. It is non-porous which doesn’t allow moisture to build up between the toenail and prosthetic nail, thus helping you to avoid chance of fungal infection. Your toenail underneath will still be allowed to grow naturally. 

First we evaluate your toenails and determine if you are a candidate for the nail restoration. We prepare the area by removing dead, damaged, or infected tissue from your toe (this is not painful). The resin is then applied to the residual toenail and allows for sculpting and contouring of the area. A sealant is applied followed by UV light to harden the substances into a flexible artificial nail. Cosmetic toenail reconstruction is not recommended if you do not have more than 20% of your residual toenail, suffer from circulation problems, have suspicious pigmented lesions, and/or infection. 

After the procedure is done you can treat the reconstructed nail like your natural toenail, which includes painting it with nail polish. It is best to avoid wearing tight shoes that could put extreme pressure on the nail. The toenail can last about an average of 6-8 weeks.

Microdrilling and Laser Treatment for Fungal Toenails

Fungal toenails can be a stubborn and frustrating issue to deal with on a day-to-day basis. The most common treatments today include daily application of a topical polish or an oral medication. The topical must be applied every day for months on end and can still have less than a 20% success rate. Not to mention the most effective topicals can be expensive and difficult to get coverage through insurance. The oral medication can be more effective and cheaper however the pills are processed by the liver. It requires 3 months of the oral medication, so prior to and halfway through the process you have to get blood work to assess your liver enzymes and ensure there have been no changes. If you are someone who takes many medications (especially those metabolized by the liver, such as cholesterol medication) it is usually advised to not take the oral medication. Therefore, you are not left with any great treatment options. At On the Move Podiatry we offer a cutting edge service that is effective, non-invasive, and doesn’t include oral medication.

Topical agents are usually ineffective at penetrating the nail plate to reach the active infection underneath (between the skin and the toenail). Our treatment includes drilling micro holes in the nail plate with innovative and specially designed micro burrs. These act like tunnels for the antifungal solutions to seep through to the active infection under the nail. The topical medication is applied in the office, and then daily thereafter, by you in the comfort of your own home. As you walk, your foot wear presses against the toenail, and the medication continues to spread through the nail and underneath. Lastly, this is followed up by MLS class IV Laser Therapy. We apply a painless, FDA approved laser to the affected nail for approximately 10 minutes. This light is beneficial because it helps break down the fungal cells, increases the permeability of the medication all the way down to the skin, and also increases the clarity of the toenail. There have been many research studies showing that the most effective laser wavelengths include 635nm, 830nm, and 970nm. Our MLS laser actually emits 3 wavelengths- 635, 808, and 905nm!  Overall, we are combining multiple forms of alternative treatments to help drastically increase the efficacy rates and get rid of your toenail fungus!

How many treatments does it take? The first day we do a thorough trimming and debridement of the affected nails, followed by micro-drilling and topical medicine application. The MLS laser is applied.

We then recommend the MLS laser treatment be performed once a week for a total of 4 weeks.

At 6 weeks we bring you back and reassess the toenail. If needed, we perform another round of micro drilling and another 4 weeks of laser treatments. You continue to apply the topical medication at home on a daily basis

Am I a candidate? If you have thickened, discolored, crumbly, distorted, breaking toenails you are likely a candidate. The only patients we advise on not proceeding with treatment are those whose fungus extends all the way back to the cuticle, because this means the fungus has extended past the toenail and all the way down into the nail matrix itself (the cells where the nails grow out of). Treatment can still be performed however the success rate is not as high. You will likely have improvement but there may still be some persistent fungus present.

Bracing for ingrown toenails

On the Move Podiatry does offer an alternative treatment that is not offered anywhere else in this area. We use a nail correction system which is a nonsurgical treatment option for involuted and ingrown toenails. A composite is applied to the toenail that hardens and provides a “brace-like structure” for the toenail. This brace maintains the normal curvature of the nail and helps hold it straight as the nail grows out without any tension or pain. This is a good option for those where a surgical procedure may be contraindicated (such as a diabetic or someone with poor blood flow lacking healing capabilities).

MLS laser therapy

MLS laser therapy is one of the safest and most effective methods of treating a variety of foot and ankle pain. The MLS laser is FDA approved and is a noninvasive and convenient treatment for those suffering from pain. It accelerates healing of tissues, reduces scar tissue, increases blood flow, and decreases inflammation. Light energy enters damaged cells and stimulates intercellular activity. This reduces pain in the area and speeds recovery of damaged cells. The light energy does the following: stimulates cells to remove toxins, allows oxygen and food into the cell, blocks pain signals in the brain and releases endorphins and encephalin (a natural pain killer), increases the production and cell growth bringing blood flow into the area, and jump starts healing by stimulating the mitochondria in the cells. 

A single treatment takes less than 15 minutes and is completely painless and comfortable, creating a warm soothing feeling. Some of the most common conditions we treat with MLS include:  tendonitis, ankle sprains, pinched nerves and neuropathy, arthritis, ulcers, and skin conditions. Acute injuries heal much faster as laser therapy is applied close to the time of injury. It can also speed up healing following a surgery and reduce post op pain levels. The treatment protocol varies depending on what diagnosis is being treated.

Radial Shockwave Therapy

Radial shockwave therapy (RSWT) is a method for the treatment of orthopedic disorders developed over the past 20 years. A projectile accelerated in the handpiece generates a mechanical pressure wave, which is transferred to the human body by an applicator head and which radiates out in the tissue.
The mechanical energy is absorbed by the tissue and triggers reactions in the tissue that have a positive influence on a wide range of orthopedic and neurological conditions.
RSWT stimulates healing, improves blood flow, breaks down scar tissue, and decreases pain. It works wonders for plantar fasciitis, achilles tendonitis, sprained ligaments, neuromas, joint pain, and so much more. There is approximately an 85% success rate depending on the diagnosis. Do not underestimate the power of this device- it is strong enough to break up kidney stones. This is a great alternative to surgery!

Biomechanical exam

Nowadays it can be difficult to find a specialist who has the time to thoroughly evaluate your foot structure and the way you walk. At On the Move Podiatry we make sure to take the time to do so. It is important to assess for any issues that can contribute to foot deformity, pain, or future injury. Our feet all function in a unique way depending on our foot structure and joint movement. Often times our limbs are not symmetrical, leading to imbalances that can throw off your knees, hips, and back leading to arthritis in the future. Therefore, having a thorough individual assessment makes sense. We evaluate your feet when sitting down, standing, and walking. We can measure your legs for limb length discrepancy (unequal leg lengths). Then we come up with a plan which typically includes orthotics and in severe cases, bracing. 

Orthotics can be made uniquely for you to even out your gait and take stress off the joints, tendons, and ligaments. Orthotics do not make your muscles weaker, in fact they help preserve your muscle’s strength and help maintain the integrity of the tendons over time. We do a painless 3d foot scan in the office which only takes seconds. Those 3d scans are electronically sent to an orthotic lab where the orthotics are constructed. We can also assess your shoes and determine if they are appropriate for your foot type. If you have old orthotics we can assess those as well. Sometimes foot mobilization therapy can be prescribed too. X-rays can be a great way to assess your foot structure. We have the patient put their full weight on the foot while taking the picture. By doing so we can see what the bones in your foot look like during stance. If you have foot pain or maybe you are just concerned about your foot structure – give us a call and schedule a biomechanical assessment today!

Injections

All natural injections (no steroids): At On the Move Podiatry we feel it is of utmost importance to lower your pain and help you heal as quickly as possible without causing further damage using steroids. This is why we have several injectable options that do not contain steroids. We use homeopathic injectables (such as Traumeel and Zeel) that are made from all natural botanicals and minerals. No harmful or potentially hazardous side effecs are known. They are not known to interact with any other medications. There is no limit to how many injections you can receive, which is the case with steroids.

Sarapin: Sarapin is an all natural injection made from the pitcher plant. For over 50 years Sarapin has been used to treat the scope of nerve pain and muscular pain. All this time we have never known of a drug induced significant reaction. It is non-toxic, and is only contraindicated in areas of local infection. It can be very effective at lowering nerve pain, which is what we commonly use it for at On the Move Podiatry.

Prolotherapy: Prolotherapy is a non-invasive regenerative medicine therapy practiced for nearly a century by doctors. It is a treatment that involves the injection of a solution into a damaged or weakened area of the body to help regenerate and repair tissue by inducing the inflammatory response. The injection can often consist of dextrose (sugar), lidocaine, and sterile water. By initiating inflammation, it can cause production of fibroblasts (the body’s repair cells) which can deposit new tissue fibers and help with healing. Depending on the injury or joint involved, a series of 2-3 injections are performed about every 4 weeks. Fewer treatments may be needed depending on resolution of symptoms. Healing time is different for everyone, most people can expect to see improvement after 3-4 days of their visit, however, it can take weeks to see full results. The injection site may feel sore and achy for several days, often resolving after 3 days post injection. At the On the Move Podiatry we tend to use this treatment method often for joint arthritis.

 

Patient getting a steroid injection in his foot.

Amniotic stem cell injections: These injections are made from amniotic fluid. The fluid is collected from women undergoing a scheduled C-section. It is not a harmful intervention, and the fluid is typically discarded after the C-section. Once the fluid is collected and processed, the amniotic derived stem cells are isolated and removed. Amniotic injections can be used to successfully treat patients when other conventional treatments have failed. Amniotic stem cell injections offer the ability to heal damaged tissues naturally without using steroids. The stem cells have strong anti-inflammatory properties. While cortisone only provides temporary relief, stem cells actually restore degenerated tissue while also providing pain relief. The growth factors in the solution can replace damaged cells in your body. We use an ultrasound to guide the injection and ensure it is appropriately positioned in the joint or soft tissue. If you have failed conservative treatment, it is recommended to try an amniotic injection if indicated prior to proceeding with surgery.

Minimally Invasive Surgery

What is minimally invasive surgery?

Dr. Stouder performs minimally invasive surgery (MIS) of the foot and ankle. MIS allows for smaller incisions (about 3 mm) allowing for quicker healing and recovery while still correcting the deformity. It requires extensive training and specialized equipment. MIS is very technical and effective and is becoming more popular as patients and surgeons are understanding the need for quicker recovery. Dr. Stouder is currently one of the very few surgeons that is performing minimally invasive surgery in the office.

What conditions are addressed? Bunions and hammertoes are the most common deformities that are corrected by MIS however many other conditions can also be addressed, including tendon debridement and heel spurs.  

What are the benefits? Due to a smaller incision there is less post operative pain and swelling with minimal to almost no scarring. Immediate weight bearing is performed in specialized shoes. Same day surgery, no overnight hospital stays. Drastically reduced infection rates. Faster return to everyday activities. Typically, hardware is not needed. If you have a fast-paced life, this is a great modern solution to get you back on your feet!