At Next Step Podiatry, we are committed to patient education.  Dr. Golub and his associates strongly believe that the more informed a patient is, the better their overall outcome will be. To that end, we have compiled some general information here about the following topics related to foot and ankle health:

  • Gout: An Overview and Guide to Eating - Downlaod PDF
  • Stretching Exercises to Increase Flexibility & Avoid Injury in the Feet - Downlaod PDF
  • Cantharone for the Treatment of Warts - Downlaod PDF
  • Follow up Care After Nail Surgery - Downlaod PDF

Gout: An Overview and Guide to Eating

Uric acid is a byproduct that is created when the body breaks down purines, which are chemical compounds naturally present in the body as well as in certain foods. Gout is a form of arthritis caused by excess amounts of uric acid in the bloodstream. In normal cases, uric acid dissolves through the blood, and is expelled from the body by way of the kidneys and urine. 

This process does not work properly in people with gout. Excess uric acid does not flush out in the urine, but accumulates in the blood and forms into hard crystals in and around joints (most commonly the big toe). These crystals cause pain and inflammation in the affected joint.

It is believed that 1/3 of the uric acid in a person’s body comes from their diet. That is why it is important to limit, or eliminate the following high-purine foos and drinks:

Meat: beef, pork, lamb, organ meats, meat-based gravy

Seafood: shellfish, fish eggs, anchovies & sardines, cod, herring, haddock and trout

Vegetables: mushrooms, spinach, cauliflower, peas, asparagus

Grains: breads, oats, cereals and snack bars that are high in sugar and/or not made with whole grains

Legumes: lentils, dried beans

Condiments: any condiment or jarred sauce that contains a high amount of sugar

Drinks: alcoholic drinks, as well as carbonated drinks and juices containing high fructose content

Stretching Exercises to Increase Flexibility & Avoid Injury in the Feet

Keeping your muscles stretched and flexible in your calf, thigh, and plantar fascia can reduce the potential for damage and injury. Below are a few basic stretches you can do in the comfort of your own home. These stretches will help keep the leg muscles from being tight, which can lead to excess stress on the plantar fascia (band of tissue on the bottom of the foot, from the heel to the toes).


There are two major muscle groups in the calf: the gastrocnemius and the soleus. The following exercises will help keep these muscles flexible and limber:

Gastrocnemius Stretches:

Against the wall:

Stand at an arm’s length from a wall. Place both palms against the wall, and stand with one foot back, pointing straight. The front leg should be bent at the knee. In order to feel the stretch the back leg’s calf muscles, lean forward with a straight back, putting your weight on the front leg. Hold this position for 10-15 seconds before releasing. Repeat 6-8 times, and then reverse the legs to stretch the other leg. 

On the stairs:

Stand with both feet on a step. Heels should be off of the step, with the ball of the feet on the step. While holding on to the banister for support, slowly raise both feet up on the toes as high as possible, and then lower them down until you feel the stretch in the calf. Hold for 1-2 seconds and then repeat 10-12 times.

Soleus Stretches:

Stand at an arm’s length from a wall. Place both palms against the wall, and stand with one leg behind the other, feet facing forward, and the buttocks dropped. Lean into the wall gently while bending both knees, and keeping the heels on the ground. Put more weight on the back leg until you feel a stretch in the lower part of the calf, and hold for 30 seconds. Repeat 2-3 times and then switch legs.


The hamstring is a muscle in the thighs running from the buttocks to just below the knee. It is responsible for helping to bend the knee and lift the leg. A tightened hamstring can add excessive pressure and strain on the plantar fascia and heel bone.

Hamstring Stretch:

Lie with your back flat on the floor. Bend one leg and, grabbing the back of the thigh with both hands, pull up the thigh until it is at a 90% angle with the floor. Then, slowly straighten the knee. Repeat this exercise on the other leg. 


The plantar fascia is a thick band of tissue running on the sole of the foot, connecting the heel bone with the toes. As a person walks, the plantar fascia tissue lengthens and then shortens. If the plantar fascia is not flexible enough, its fibers may become damaged, inflamed, and even torn. 

There are several stretches you can do to keep the plantar fascia flexible and sufficiently elastic:

On a chair:

Sit on a chair or bedside and cross the right leg over the other. Using the right hand, pull the toes of the right foot back at the base—towards the shin—while keeping the leg steady. You should feel a stretch in the bottom of the foot. Repeat 5 times before switching legs. This exercise is particularly effective in the morning (before you take your first steps of the day), or after periods of inactivity.

Rolling stretch:

Sitting on a chair or the edge of a bed, place a ball, or plastic bottle filled with cold water under one foot. Roll the object under the foot slowly while applying pressure to it. Do this for 30-60 seconds. Repeat 5 times, and then switch to the other foot. This exercise is most effective when performed 3 times a day.


These exercises will strengthen muscles and remove stress from the plantar fascia. They should be performed barefoot. 

Towel curls:

Lay a towel on the floor. Place one foot on the towel, keeping the heel on the floor. Curl the toes, pulling the towel back until it is bunched up under the arch. Repeat 10 times and then switch feet.

Toe walking

Clasp your hands behind your back and stand erect. Pointing both feet forward, walk on your toes, allowing the heel to rise as high as possible each time the foot is placed down (before pushing off). Walk around the room with very short steps. Repeat this exercise with the toes pointed outward 30° and then inward 30°.

Cantharone for the Treatment of Warts

Warts are viral infections that cause growths to form on the skin. They typically can spread from person to person either through direct contact or from indirect exposure to infected surfaces and objects. 

Cantharone, also called Cantharidin, is a solution that treats warts topically, with no permanent scarring. The treatment process is as follows:

  • Cantharone is applied to the wart and covered with a non-porous tape. 
  • After a minimum of 4 hours, the tape should be removed and the area should be washed with a mild antibacterial soap or water, and then protected with a loose bandage.
  • Within 24 hours, a blister should form on the wart which breaks down only the top layer of skin cells, to get to the wart and cut off its blood supply.
  • Within a few days’ time, the blister will dry, crust over, and the wart will fall off.

Depending on the size and number of warts being treated, additional applications may be needed to completely destroy the wart so it does not return.

Follow-up Care After Nail Surgery

If you have had nail surgery to treat an ingrown or fungal toenail, it is important to follow your podiatrist’s instructions for after care. 

Your podiatrist may suggest you take the following steps to care for your nail at home after surgery may include:

  1. Removing the surgical bandage 24 hours after surgery. AMERIGEL Saline Wound Wash may be used with the bandage in place to minimize discomfort during removal
  2. Cleansing the wound with AMERIGEL Saline Wound Wash after showering or bathing
  3. Applying AMERIGEL Hydrogel Wound Dressing 
  4. Applying gauze directly over the surgical site
  5. Applying a bandage by securing the gauze in place with fabric flex tape in a “ring” fashion, without applying too much pressure.
  6. Changing your dressing once a day

Your podiatrist may also suggest staying off of your feet as much as possible the day after surgery, and wearing open toe footwear. It is normal to experience numbness, slight discoloration or bleeding, minor swelling and drainage following nail surgery. You can help alleviate some of these symptoms by elevating your feet and taking over-the-counter pain killers as directed by your podiatrist. If minor symptoms do not improve, or worsen, contact your podiatrist’s office.

Stretching Exercises

Gout Diet

Nail Surgery Instructions

Wart Instructions


Connect With Us