December 2024
Aging Athlete Injury Prevention in Pickleball

Pickleball’s dynamic nature makes it a popular choice for aging athletes, but it also increases the risk of lower extremity injuries. These injuries are predominantly musculature, affecting tendons, ligaments, and muscles due to the rapid, repetitive movements involved in gameplay. Sports-specific factors like improper equipment, uneven court surfaces, or poor technique contribute significantly to injury risks. Wearing pickleball-specific shoes designed for lateral support and shock absorption can reduce strain on the ankles and knees. Playing on well-maintained courts minimizes trip hazards, while mastering proper techniques, such as turning instead of backpedaling, can prevent unnecessary stress on joints and muscles. Warm-ups and regular strength training further protect aging bodies, improving flexibility and resilience. If you have sustained an injury from playing pickleball that persists or limits your mobility, it is suggested that you contact a podiatrist for prompt care so you can stay active while minimizing risks.
Proper foot care is something many older adults forget to consider. If you have any concerns about your feet and ankles, contact Dr. Scott Shrem from Garden State Foot & Ankle Center. Our doctor can provide the care you need to keep you pain-free and on your feet.
The Elderly and Their Feet
As we age we start to notice many changes in our body, but the elder population may not notice them right away. Medical conditions may prevent the elderly to take notice of their foot health right away. Poor vision is a lead contributor to not taking action for the elderly.
Common Conditions
- Neuropathy – can reduce feeling in the feet and can hide many life-threatening medical conditions.
- Reduced flexibility – prevents the ability of proper toenail trimming, and foot cleaning. If left untreated, it may lead to further medical issues.
- Foot sores – amongst the older population can be serious before they are discovered. Some of the problematic conditions they may face are:
- Gouging toenails affecting nearby toe
- Shoes that don’t fit properly
- Pressure sores
- Loss of circulation in legs & feet
- Edema & swelling of feet and ankles
Susceptible Infections
Diabetes and poor circulation can cause general loss of sensitivity over the years, turning a simple cut into a serious issue.
If you have any questions please feel free to contact our office located in Hazlet, NJ . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Elderly Foot Care
As you grow older, you will start to notice more problems with your feet due to wear and tear. This may also happen because the skin will start to become thin and lose elasticity. Some signs of aging feet are regular aches and pains, bunion development, and clawed toes.
Fortunately, there are ways you can improve comfort, relieve pain, and maintain mobility in your feet. One of the best ways to deal with aging feet is to exercise. If you keep active, your muscles will become toned which will then strengthen the arches in the foot and stimulate blood circulation.
It is important that you practice proper foot care to protect your aging feet. You should wash your feet in warm water on an everyday basis. Afterward, the feet need to be dried well and it is important to dry between the toes. Your toenails should be trimmed and kept under control; nails that are poorly cut may become ingrown. At the end of each day, performing an inspection of your feet will allow you to detect any ailments in their early stages.
As you grow older, it becomes more important that you wear comfortable shoes. Your shoes should be secure, and they should provide decent arch support. If you are looking to buy a new pair of shoes, it is best to look for a pair that are made from a breathable material. It is also helpful to have shoes that have a bit of extra room at the top of the shoe, especially if you suffer from swollen feet.
The most common foot problems that elderly people will encounter are bunions, calluses, corns, hammertoes, heel pain, and foot problems related to diabetes. Some other issues include arch pain, tarsal tunnel syndrome, Achilles tendonitis, and Morton’s neuroma
An annual foot examination is a great way for you to ensure that you do not have any serious health problems with your feet. You should talk to a podiatrist about the available treatment options for whichever foot issue you are dealing with.
Ingrown Toenail Care

Ingrown toenails occur when the edges of a toenail grow into the surrounding skin, causing pain, redness, and swelling. This condition is often seen in the big toe and can sometimes lead to infection. One of the key causes of ingrown toenails is improper nail trimming, such as cutting nails too short or rounding the edges. Other factors include wearing tight shoes that crowd the toes or injure the nail. Toenail thickening, often caused by fungal infections, can also increase the risk of ingrown nails by altering the shape of the nail and making it more likely to dig into the skin. Ingrown toenails may improve with care like soaking and proper trimming, but severe cases require professional treatment. A podiatrist can safely remove part of the nail, treat any infection, and provide advice on proper nail care and footwear to prevent recurrence. If you have an ingrown toenail, it is suggested that you schedule an appointment with a podiatrist.
Ingrown toenails can become painful if they are not treated properly. For more information about ingrown toenails, contact Dr. Scott Shrem of Garden State Foot & Ankle Center. Our doctor can provide the care you need to keep you pain-free and on your feet.
Ingrown Toenails
Ingrown toenails occur when a toenail grows sideways into the bed of the nail, causing pain, swelling, and possibly infection.
Causes
- Bacterial infections
- Improper nail cutting such as cutting it too short or not straight across
- Trauma to the toe, such as stubbing, which causes the nail to grow back irregularly
- Ill-fitting shoes that bunch the toes too close together
- Genetic predisposition
Prevention
Because ingrown toenails are not something found outside of shoe-wearing cultures, going barefoot as often as possible will decrease the likeliness of developing ingrown toenails. Wearing proper fitting shoes and using proper cutting techniques will also help decrease your risk of developing ingrown toenails.
Treatment
Ingrown toenails are a very treatable foot condition. In minor cases, soaking the affected area in salt or antibacterial soaps will not only help with the ingrown nail itself, but also help prevent any infections from occurring. In more severe cases, surgery is an option. In either case, speaking to your podiatrist about this condition will help you get a better understanding of specific treatment options that are right for you.
If you have any questions please feel free to contact our office located in Hazlet, NJ . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Ingrown Toenail Care
An ingrown toenail is a nail that has curved downward and grows into the skin. This typically occurs at the nail borders, or the sides of the nail. As a result, pain, redness, swelling, and warmth may occur in the toe. If a break in the skin forms due to the ingrown nail, bacteria may enter and cause an infection in the area; this is typically characterized by a foul odor and drainage.
Ingrown toenails have multiple reasons for developing. In many instances, the condition is a result of genetics and is inherited. The most common cause, however, is improper trimming; cutting the toenails too short forces the skin beside the nail to fold over. An ingrown toenail can also develop due to trauma, such as stubbing the toe, having an object fall on the toe, or participating in activities that involve repeated kicking or running. Wearing shoes that are too tight or too short can also cause ingrown toenails.
Treatment for an ingrown toenail varies between patients and the severity of the condition. Milder cases that don’t involve infection or other medical conditions can benefit from soaking the feet in room-temperature water and gently massaging the side of the nail. In most cases, however, it is best to see your podiatrist for thorough and proper treatment. After examining your toe, your podiatrist may prescribe oral antibiotics to clear the infection if one is present. Surgical removal of either a portion of the nail or the entire nail may also be considered. In some cases, complete removal or destruction of the nail root may be required. Most patients who undergo nail surgery experience minimal pain afterward and can return to normal activity the following day.
Ingrown toenails can be prevented with proper nail trimming and by avoiding improper-fitting shoes. When cutting the toenails, be sure that you are cutting in a straight line and avoid cutting them too short. Shoes should not be too short or tight in the toe box.
Understanding Achilles Tendonitis

Achilles tendonitis is an injury that affects the Achilles tendon, the large tendon located at the back of the ankle, connecting the calf muscles to the heel bone. This condition occurs when the tendon becomes irritated or inflamed due to overuse or excessive strain. Common symptoms of Achilles tendonitis include pain and swelling along the back of the heel, which may worsen with physical activity, especially running or jumping. Individuals may also experience stiffness and discomfort in the morning. The main causes of Achilles tendonitis are repetitive stress on the tendon, sudden increases in physical activity, or wearing improper footwear. Athletes, particularly runners, are at higher risk, as well as individuals who have tight calf muscles or abnormal foot mechanics. If you have incurred an Achilles tendon injury, it is suggested that you consult a podiatrist who can accurately diagnose and treat this condition.
Achilles tendon injuries need immediate attention to avoid future complications. If you have any concerns, contact Dr. Scott Shrem of Garden State Foot & Ankle Center. Our doctor can provide the care you need to keep you pain-free and on your feet.
What Is the Achilles Tendon?
The Achilles tendon is a tendon that connects the lower leg muscles and calf to the heel of the foot. It is the strongest tendon in the human body and is essential for making movement possible. Because this tendon is such an integral part of the body, any injuries to it can create immense difficulties and should immediately be presented to a doctor.
What Are the Symptoms of an Achilles Tendon Injury?
There are various types of injuries that can affect the Achilles tendon. The two most common injuries are Achilles tendinitis and ruptures of the tendon.
Achilles Tendinitis Symptoms
- Inflammation
- Dull to severe pain
- Increased blood flow to the tendon
- Thickening of the tendon
Rupture Symptoms
- Extreme pain and swelling in the foot
- Total immobility
Treatment and Prevention
Achilles tendon injuries are diagnosed by a thorough physical evaluation, which can include an MRI. Treatment involves rest, physical therapy, and in some cases, surgery. However, various preventative measures can be taken to avoid these injuries, such as:
- Thorough stretching of the tendon before and after exercise
- Strengthening exercises like calf raises, squats, leg curls, leg extensions, leg raises, lunges, and leg presses
If you have any questions please feel free to contact our office located in Hazlet, NJ . We offer the newest diagnostic tools and technology to treat your foot and ankle needs.
The Causes, Types, and Treatments of Achilles Tendon Injuries
Tendons are fibrous tissues that connect muscles with bone. The Achilles tendon is the largest tendon in the body. It connects the calf muscles at the back of the leg with the heel, and facilitates movements such as jumping, running, and walking.
Because the Achilles tendon is engaged so frequently and bears a great deal of pressure and stress throughout the day, it can become injured. Achilles tendon injuries cause the tissue to become irritated, inflamed, and swollen. Pain can come on gradually or be immediate, and will vary from mild to severe depending upon the injury. Where the pain occurs will vary as well, from just above the heel up through the back of the leg. There may also be stiffness in the tendon.
Achilles tendon injuries can often be caused by repetitive stress. They may also occur while running, playing tennis, gymnastics, football, basketball, dancing, soccer, baseball or other sports that require speeding up, slowing down, or pivoting quickly. Wearing high heels, falling from an elevation, stepping in a hole, having flat feet, bone spurs, tight leg muscles or tendons, wearing improper athletic shoes, exercising on uneven surfaces, or starting a new type of exercise can also cause Achilles tendon injuries.
The two most common Achilles tendon injuries are tendonitis and ruptures. Tendonitis causes painful inflammation and can occur in different parts of the tendon. Non-insertional Achilles tendonitis occurs when the fibers in middle of the tendon begin to break down, thicken, and swell. This condition typically affects younger, more active adults. Insertional Achilles tendonitis occurs where the tendon inserts into the heel bone. It is common for bone spurs to form with this type of injury. This condition can affect people of any age and level of activity.
Achilles tendon ruptures are a tear in the tendon. These breaks may be partial or complete. There may be an audible popping noise at the moment of injury and the pain will be sudden and severe.
An Achilles tendon injury can be diagnosed by your podiatrist after they examine you, check your range of motion, and possibly perform a calf squeeze test or review an X-ray or MRI. Depending on the type and severity of your injury, your podiatrist may treat your condition with rest/ice/compression/elevation (RICE), nonsteroidal anti-inflammatory medications, heel lifts, and stretching and strengthening exercises. If you have torn your Achilles tendon, treatment may include physical therapy, ultrasound, shockwave therapy, or possibly even surgery.
Heel Pain Can Be Treated!
Toe Pain
Toe pain can originate from corns, calluses, hammertoes, and bunions, as well as ingrown toenails, sprains, fractures, and dislocations. Corns develop as the toe rubs against the inside of a shoe which causes the skin to thicken as a form of protection. A corn is typically cone-shaped and has a small, hardened spot that points inward. When a corn is pressed into the skin, the toe becomes painful. Corns usually form on the top or side of the toe. A callus is also a thickened patch of skin that generally forms on the bottom of the foot. Calluses are the result of friction from the toe rubbing against the inside of a shoe. They may also occur by walking barefoot or having flat feet. A hammertoe is a bump on the knuckle of the second toe that is produced by wearing shoes that are too short for your feet. The bony protrusion rubs against the top of the shoe causing pain and irritation. A bunion is a malformation of the big toe. The base of the big toe pushes away from the smaller toes, forcing the top of the big toe to press toward the other toes. Bunions can be hereditary, or they can result from injury to the toe joint or from wearing high heels with a narrow toe box. The toe becomes inflamed, and a bump may develop at the end of the misplaced bone. Ingrown toenails typically affect the big toe and its surrounding skin. The nail will dig into the skin and become painful. Wearing tight or narrow shoes that compress the big toe causes the nail to grow into the fleshy part of the toe. Cutting toenails incorrectly can also add to the development of an ingrown toenail. A toe sprain originates from a torn or stretched ligament. Strapping the injured toe to the toe next to it for stabilization is common. A broken or fractured toe usually occurs from trauma like dropping a heavy object on it or bumping into something extremely hard and rigid. Osteoporosis, a thinning of the bones, can also bring about toe fractures.
Any of the conditions mentioned can lead to pain and irritation. While some are more serious than others, seeking an examination and diagnosis from a podiatrist is a good idea. A podiatrist can treat each ailment and get you back on your feet again without pain.
Causes of Lumps and Bumps on the Toe

A lump on the toe can arise for any number of reasons and may vary in size, location, and texture. Probably the most common cause of a lump on the toe is a bunion, caused when the bones of the big or little toe shift out of place. Another cause, termed hallux rigidus, involves stiffness and bony growths on top of the big toe due to arthritis or wear and tear. Softer lumps, such as digital mucous cysts, are fluid-filled sacs that often form near joints and may result from injury or wearing ill-fitting shoes. Conditions like Morton’s neuroma, a nerve-related issue under the toes, or calluses and corns from pressure and friction, can also lead to lumps. Each condition requires a specific approach for relief and prevention of further complications. A podiatrist can provide an accurate diagnosis of the lump or bump on your toe. Treatment options include orthotics or minor surgical procedures depending on the cause. Guidance on footwear choices to alleviate discomfort may be offered. If you notice an unusual lump or bump on a toe, it is suggested that you schedule an appointment with a podiatrist for a diagnosis and treatment.
Toe pain can disrupt your daily activities. If you have any concerns, contact Dr. Scott Shrem of Garden State Foot & Ankle Center. Our doctor can provide the care you need to keep you pain-free and on your feet.
What Causes Toe Pain?
Most severe toe pain is caused due to a sports injury, trauma from dropping something heavy on the toe, or bumping into something rigid. Other problems can develop over time for various reasons.
Toe pain can be caused by one or more ailments. The most common include:
- Trauma
- Sports injury
- Wearing shoes that are too tight
- Arthritis
- Gout
- Corns and calluses
- Hammertoe
- Bunions
- Blisters
- Ingrown toenails
- Sprains
- Fractures (broken bones)
- Dislocations
When to See a Podiatrist
- Severe pain
- Persistent pain that lasts more than a week
- Signs of infection
- Continued swelling
- Pain that prevents walking
Diagnosis
In many cases the cause of toe pain is obvious, but in others, a podiatrist may want to use more advanced methods to determine the problem. These can range from simple visual inspections and sensation tests to X-rays and MRI scans. Prior medical history, family medical history, and any recent physical traumatic events will all be taken into consideration for a proper diagnosis.
Treatment
Treatments for toe pain and injuries vary and may include shoe inserts, padding, taping, medicines, injections, and in some cases, surgery. If you believe that you have broken a toe, please see a podiatrist as soon as possible.
If you have any questions please feel free to contact our office located in Hazlet, NJ . We offer the newest diagnostic tools and technology to treat your foot and ankle needs.
Understanding Debridement for Diabetic Foot Ulcers

Diabetic foot ulcers are open sores or wounds that can develop on the feet of individuals with diabetes due to poor circulation and nerve damage. These ulcers can become chronic, slow to heal, and prone to infection if left untreated. An important treatment for managing diabetic foot ulcers is debridement, a process where dead or infected tissue is carefully removed from the wound. Debridement is essential because it stimulates healthy tissue growth, reduces the risk of infection, and promotes faster healing by allowing the body’s natural repair processes to function effectively. By removing dead tissue, debridement helps improve blood flow to the area, which is vital for recovery in diabetic patients with circulation issues. If you suffer from diabetic foot ulcers, it is suggested that you schedule appointments with a podiatrist for regular debridement, to prevent complications, avoid further tissue damage, and ultimately protect the foot from severe infection or amputation.
Wound care is an important part in dealing with diabetes. If you have diabetes and a foot wound or would like more information about wound care for diabetics, consult with Dr. Scott Shrem from Garden State Foot & Ankle Center. Our doctor will assess your condition and provide you with quality foot and ankle treatment.
What Is Wound Care?
Wound care is the practice of taking proper care of a wound. This can range from the smallest to the largest of wounds. While everyone can benefit from proper wound care, it is much more important for diabetics. Diabetics often suffer from poor blood circulation which causes wounds to heal much slower than they would in a non-diabetic.
What Is the Importance of Wound Care?
While it may not seem apparent with small ulcers on the foot, for diabetics, any size ulcer can become infected. Diabetics often also suffer from neuropathy, or nerve loss. This means they might not even feel when they have an ulcer on their foot. If the wound becomes severely infected, amputation may be necessary. Therefore, it is of the upmost importance to properly care for any and all foot wounds.
How to Care for Wounds
The best way to care for foot wounds is to prevent them. For diabetics, this means daily inspections of the feet for any signs of abnormalities or ulcers. It is also recommended to see a podiatrist several times a year for a foot inspection. If you do have an ulcer, run the wound under water to clear dirt from the wound; then apply antibiotic ointment to the wound and cover with a bandage. Bandages should be changed daily and keeping pressure off the wound is smart. It is advised to see a podiatrist, who can keep an eye on it.
If you have any questions, please feel free to contact our office located in Hazlet, NJ . We offer the newest diagnostic and treatment technologies for all your foot care needs.
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