General Practitioners

• Osteoporosis
• Warts
• Arthritis
• Plantar Fasciitis
  There are a number of predisposing factors, including foot pronation, obesity, poor fitting shoes, minor trauma, occupational risks and change in exercise program. Although everyone is at risk, plantar fasciitis is most commonly found in athletes, runners, overweight individuals, or those who are required to stand on hard surfaces for prolonged periods of time. Although approximately 2,000,000 Americans suffer from plantar fasciitis ESWT is an appropriate treatment option in approximately 5 to 10% of those cases, as the remainder of the cases can be adequately addressed with more conservative therapies.
• Emergency Care
  The structure of the foot is complex, consisting of bones, muscles, tendons, and other soft tissues. Of the 26 bones in the foot, 19 are toe bones (phalanges) and metatarsal bones (the long bones in the midfoot). Fractures of the toe and metatarsal bones are common and require evaluation by a specialist. A foot and ankle surgeon should be seen for proper diagnosis and treatment, even if initial treatment has been received in an emergency room.
• Diabetic Foot Care

Endocrinologist

• Diabetes Care

Radiologist

• X-Rays

Surgeons

• Arthroscopy
• Ankle Surgery
• Joint Replacement
• Bunions
  One of the more common conditions treated by podiatric surgeons is the painful bunion. Patients with this condition will usually complain of pain when wearing certain shoes, especially snug fitting dress shoes, or with physical activity, such as walking or running. Bunions are most commonly treated by conservative means. This may involve shoe gear modification, padding and orthoses. When this fails to provide adequate relief, surgery is often recommended. There are several surgical procedures to correct bunions. Selection of the most appropriate procedure for each patient requires knowledge of the level of deformity, review of the x-rays and an open discussion of the goals of the surgical procedure. Almost all surgical procedures require cutting and repositioning the first metatarsal. In the case of mild to moderate bunion deformities the bone cut is most often performed at the neck of the metatarsal (near the joint).
• Gangrene
  Ingrown toenails are due to the penetration of the edges of the nail plate into the soft tissue of the toe. It begins with a painful irritation that often becomes infected. With bacterial invasion, the nail margin becomes red and swollen often demonstrating drainage or pus. In people who have diabetes or poor circulation, this relatively minor problem can be become quite severe. In this instance, a simple ingrown toenail can result in gangrene of the toe. Patients with joint replacements or pace makers are at risk of bacterial spread through the blood stream resulting in the spread of infection to these sites. These patients should seek medical attention at the earliest sign of an ingrown toenail. There are several causes of ingrown toenails: a hereditary tendency to form ingrown toenails, improperly cutting the toenails either too short or cutting into the side of the nail, and ill-fitting shoes can cause them. Children will often develop ingrown toenails as a result of pealing or tearing their toenails off instead of trimming them with a nail clipper. Once an ingrown toenail starts, they will often reoccur. Many people perform "bathroom" surgery to cut the nail margin out only to have it reoccur months later as the nail grows out.
• Arthroscopy
• Ingrown Toenails
  Treatment for ingrown toenails is relatively painless. The injection to numb the toe may hurt some, but a skilled doctor has techniques to minimize this discomfort. Once the toe is numb, the nail margin is removed and the nail root in this area is destroyed. Most commonly, the doctor will use an acid to kill the root of the nail, but other techniques are also available. It may take a few weeks for the nail margin to completely heal, but there are generally no restrictions in activity, bathing, or wearing shoes. Once the numbness wears off, there may be some very mild discomfort but rarely does this require pain medicine. A resumption of sports activities and exercise is generally permitted the following day.
• Reconstructive Surgery

Dermatologists

• Corns
  The most common symptoms associated with this condition are pain on the side of the foot. Shoes will typically aggravate bunions. Stiff leather shoes or shoes with a tapered toe box are the prime offenders. This is why bunion pain is most common in women whose shoes have a pointed toe box. The bunion site will often be slightly swollen and red from the constant rubbing and irritation of a shoe. Occasionally, corns can develop between the 1st and 2nd toe from the pressure the toes rubbing against each other. On rare occasions, the joint itself can be acutely inflamed from the development of a sac of fluid over the bunion called a bursa. This is designed to protect and cushion the bone. However, it can become acutely inflamed, a condition referred to as bursitis.
• Calluses
• Fungus
  "Dr Remus is excellent! I've been going to him for many years. He has taken care of my ingrown toenails, fungus and traumatic toenail injuries. I very highly recommend him!"

Physical Therapists

• Sports Medicine
• Physical Therapy
  Follow-up care. Your foot and ankle surgeon will provide instructions for care following surgical or non-surgical treatment. Physical therapy, exercises and rehabilitation may be included in a schedule for return to normal activities.
• Flatfoot Correction
• Heel Pain
• Ankle Sprain
  Another type of break, called a Jones fracture, occurs at the base of the fifth metatarsal bone (behind the little toe). It is often misdiagnosed as an ankle sprain, and misdiagnosis can have serious consequences since sprains and fractures require different treatments. Your foot and ankle surgeon is an expert in correctly identifying these conditions as well as other problems of the foot.
• Orthotics and Prosthetic Therapy

Podiatrists

• General Podiatry
  Dr. Birdwell was born and raised in the Philadelphia area. He attended Rutgers, The State University of New Jersey, where he earned his Bachelor of Arts in General Science. Upon graduation, he worked for the American Red Cross in Philadelphia, where he worked closely with medical doctors across the country in donor investigations and transfusion medicine. While exploring his own interests in medicine, he shadowed in the Temple University School of Podiatric Medicine clinic. There, he was instantly drawn to the complex mechanics of the lower extremity, the diverse array of conditions treated by the podiatric surgeon, and the reward of seeing a patient gain relief from treatment.
• Achilles Tendonitis
  We at the Foot & Ankle Specialists know the importance of a gentle touch and an accurate diagnosis. Because you want your visit to be a successful one, we will spend the time you need to ease your pain and care for your foot and ankle problems with the most advanced training and experience available today. We pioneered injections without needles, and the newest treatments for your heel pain. We were one of the first practices in the nation trained in Extracorporeal Shockwave therapy for curing Heel Pain and Achilles Tendonitis and have treated hundreds of patients without cutting or surgery using this amazing non-invasive therapy.
• Ankle Sprain
• Bunions Problems
  The classic bunion, medically known as hallux abductovalgus or HAV, is a bump on the side of the great toe joint. This bump represents an actual deviation of the 1st metatarsal and often an overgrowth of bone on the metatarsal head. In addition, there is also deviation of the great toe toward the second toe. In severe cases, the great toe can either lie above or below the second toe. Shoes are often blamed for creating these problems. This, however, is inaccurate. It has been noted that primitive tribes where going barefoot is the norm will also develop bunions. Bunions develop from abnormal foot structure and mechanics (e.g. excessive pronation ), which place an undue load on the 1st metatarsal. This leads to stretching of supporting soft tissue structures such as joint capsules and ligaments with the end result being gradual deviation of the 1st metatarsal. As the deformity increases, there is an abnormal pull of certain tendons, which leads to the drifting of the great toe toward the 2nd toe. At this stage, there is also adaptation of the joint itself that occurs.
• Calluses
• Diabetic Foot Care
  Dr. Belanger is available to treat foot and ankle ailments such as diabetic foot care, ingrown toenails, fungal toenails, warts and painful calluses. Our practice specializes in general foot care. Please call 732.643.5500 for an appointment.
• Hammertoes
  Following graduation, Dr. Birdwell completed his residency training at the University of Pennsylvania Penn Presbyterian Medical Center, a rigorous four-year podiatric surgical and medical residency which provided him with extensive training in all facets of foot and ankle surgery. He has special interests in foot and ankle trauma, post-traumatic deformity, ankle arthroscopy, congenital foot and ankle deformity, flatfoot and cavus foot reconstructive surgery, total ankle arthroplasty, external fixation, tendon and ligament injury repair, bunions, hammertoes, neurologic disorders, bone and joint infection, limb salvage, and local tissue flaps.
• Heel Spurs
  A common foot complaint is pain in the bottom of the heel. This is often referred to as heel spurs or plantar fasciitis. It commonly is painful the first few steps in the morning or after rest. It tends to get worse the longer one stands during the day. It is caused by subtle changes in foot structure that occurs over time. These changes result in the gradual flattening of the arch. As this occurs a thick ligament (the plantar fascia) that is attached to the bottom of the heel and fans out into the ball of the foot is stretched excessively. This ligament acts as a shock absorber while walking. As the foot flattens it stretches. If it stretches too much it gets inflamed and causes pain. Over time the pull of the ligament creates a spur on the heel bone. It is important to realize that it is not the spur that causes the pain and therefore the spur does not need to be removed in most cases. This condition may also cause generalized arch pain called plantar fasciitis. This is an inflammation of the plantar fascial ligament.
• Heel Pain
• Foot Pain
• Ingrown Toenails
  There are very few complications associated with this procedure. Reoccurrence of the ingrown toenail can occur a small percentage of the time. Continuation of the infection is possible which can be controlled easily with oral antibiotics. On occasion, the remaining nail may become loose from the nail bed and fall off. A new nail will grow out to replace it over several months. With removal of the nail margin, the nail will be narrower and this should be expected.
• Foot Injuries
• Foot Orthotics
  If the heel pain persists your foot doctor may suggest a cortisone injection, taping the foot to support the arch, night splints to stretch the calf muscles at night while you are sleeping or functional foot orthotics. On occasion surgery may be required to cure this condition. Orthotics should be tried before surgery and should be used following the surgical procedure.
• Pediatric Foot Care
  Dr. Remus attended Dickinson College where he lettered and was a starter on the football team as a wide receiver. He graduated with a BS in Biology. His interest in medicine grew out of his involvement in collegiate athletics. Following completion of his undergraduate studies he attended the Temple University School of Podiatric Medicine and received his Doctor of Podiatric Medicine Degree in 2001. Upon graduation he further completed his medical/surgical training at the University of Maryland Medical Center in Baltimore, Maryland. This three-year residency specialized in Reconstructive Foot and Ankle Surgery. During the final year of residency he served as chief resident and was a dedicated fellow under the direction of a renowned Foot & Ankle Orthopedic Surgeon. In that environment he performed advanced level trauma surgery, sports medicine procedures, ankle/foot fracture repair, multi-level foot/ankle reconstructions, pediatric foot surgery and diabetic limb salvage. He is well trained in the latest minimally invasive surgical techniques including Endoscopic Plantar Fasciotomy and Ankle Arthroscopy. He also specializes in total joint replacement of the 1st MTPJ (Great Toe Joint) and Lapifusion Bunionectomy procedures.
• Plantar Fasciitis
  The plantar fascia is a band of connective tissue on the plantar surface of the heel that plays a large role in maintaining the normal architecture of one’s foot. Plantar fasciitis is a common clinical condition caused by overuse or injury of the plantar fascia and is defined as traction degeneration of the plantar fascial band at its origin on the medial tubercle of the calcaneus. Inflammation, fibrosis, and decreased vascularization of the fascia occur, causing symptoms of heel pain. Other symptoms that may occur include burning in the sole of the foot, recurring foot pain that is especially aching in the morning or after sitting, or heel pain after beginning a new exercise routine.
• Podiatric Surgery
  Dr. Remus is part of a small percentage of Podiatric Surgeons across the country that have earned double board certification in both Foot Surgery and Reconstructive Rearfoot/Ankle Surgery. He is also a member/associate in the American College of Foot and Ankle Surgery and is currently on the active staff at Jefferson/Aria Health System and St. Mary's Medical Center.