Bay Area Podiatry

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(281) 412-6008Call Visit WebsiteVisit Website Map & DirectionsDirections2017 Broadway StPearland, TX 77581 Write a ReviewWrite Review

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AKA

Koepsel, Kirk A, Dpm - Bay Area Podiatry Assoc

Bay Area Podiatry Assoc

Bay Area Podiatry Association

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http://bayareapodiatry.com

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Physicians & Surgeons, Podiatrists, Physicians & Surgeons, Physicians & Surgeons, Dermatology, Physicians & Surgeons, Orthopedics, Physicians & Surgeons, Pediatrics, Physicians & Surgeons, Sports Medicine, Physicians & Surgeons, Surgery-General, Sports Medicine & Injuries Treatment

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Phone: (281) 412-6008

Address: 2017 Broadway St, Pearland, TX 77581

Website: http://bayareapodiatry.com

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Bay Area Podiatry

General Practitioners

Warts
Arthritis
Plantar Fasciitis
Pediatric Care
One common myth is that children have "growing pains". Growth is not painful and soreness and cramping in the feet and legs are not normal. This generally is the result of muscle imbalance or flat feet, which strains the muscles in the feet and legs that are trying to support the foot. A family history of foot problems is significant since many foot problems are hereditary. Often parents are told that their children may "grow out of it." This may be true in some cases but a level of reassurance from a specialist can go a long way in easing a parents' concern. We at Bay Area Podiatry are sensitive to parent's concerns. If you have concerns about your child's feet, please make an appointment and let's discuss your concerns and evaluate your child. We have a special pediatrics room for children and a friendly staff to ease any anxiety that you or your child may have.
Diabetic Foot Care

Neurology
Harris County Podiatric Surgical Residency CME Evening Program: Neurology Assessment and Neurological Disorders. Houston, TX April, 6, 1999, 4 CME credits
Multiple Sclerosis
Charcot joint disease was originally described in patients with tertiary syphilis and absent sensation. However, once penicillin was discovered, the incidence of syphilis dropped dramatically. In general, any disease process that results in loss of sensation in the lower extremity can lead to Charcot joint disease. Today, the leading cause of Charcot joint disease is diabetes mellitus. It is estimated that 1 out of 700 patients with diabetes will develop Charcot joint. Other entities, which can lead to Charcot joint, include: chronic alcoholism, leprosy, hereditary insensitivity to pain, syringomyelia and multiple sclerosis.

Anxiety

Endocrinologist

Diabetes Care

Ultrasound
What is Ultrasound? Most people know about ultrasound to image a baby or a gallbladder, but it has growing application in musculoskeletal disorders. Ultrasound is based on sound waves. Sound waves are emitted from a transducer probe that is applied to the body and these sound waves will past into the body and then are reflected back to the transducer probe to be recorded. The recorded image is based on the density of the object that the sound waves encounter. An object with a high density appears white or brighter on the recorded image, while objects of low density will appear black or dark on the image. Intermediate densities will appear gray. The sound waves are recorded back to the machine, which will produce the image. This image will appear on our ultrasound screen and you the patient can immediately see the area that the doctor is scanning and help to understand the problem you are having. This helps in directing the appropriate treatment for your condition.
MRI
Use of Ultrasonography versus magnetic resonance imaging for tendon abnormalities around the ankle. Rockett, M. S., Waitches, G., Brage, M. A., Sudakoff, G. S. Foot and Ankle International, 19:604-612, 1998.
Radiology
Sources: American Heart Association., Center for Disease Control and Prevention, National Institute of Health, Society of Cardiovascular and interventional Radiology, Vascular Disease Foundation, World Health Organization
X-Rays
Computed Tomography
Rockett, M. S., Brage, M. A. "Navicular body fractures: Computed tomography findings and mechanism of injury." Journal of Foot and Ankle Surgery 36(3): 185-191, 1997.
Interventional Radiology

Orthopedics
Rockett, M. S., Walter, J.W. "Introduction to fracture management and forefoot fractures - Traumatology Book # 2." Pennsylvania College of Podiatric Medicine, Department of Orthopedics, 1993.
Wound Care
Make an Appointment Today with one of our wound care specialist today for evaluation, consultation and treatment plan.
Ankle Surgery
"The use of bone grafts in the management of nonunions." Mendicino, S.S., Rockett, A. K., Wilbur, M. R. The Journal of Foot and Ankle Surgery, 35:452-457, 1996.
Joint Replacement
If the condition progresses to the point of spurring around the joint, surgery may be indicated. Depending upon the degree of degeneration of the joint, surgery may consist of simply removing the bone spurs around the joint, a decompresion osteotomy or may require a total joint replacement or joint fusion ( See surgery of Hallux limitus ). Following surgery, the use of a functional orthotic is useful to improve the joint function.
Metatarsal Surgery
There are numerous over the counter treatments for corns and calluses. Some of these remedies have an acid in them that burn the callous off. Care should be taken when using these medications. If used incorrectly they can cause a chemical burn to the skin. Additionally these remedies are only temporary because the source of the pressure has not been alleviated. Professional treatment consists of using a special shoe insert called a functional orthotic that corrects foot function. In certain instances surgery may be recommended. Surgery is directed at correcting the alignment of the offending bone. Cutting out the callous will only make the condition worse if the underling boney problem is not corrected. Metatarsal surgery is discussed in another section.
Orthopedic Surgery
"The Use of Ultrasonography for the Detection of Retained Wooden Foreign Bodies in the Foot." University of Chicago, Department of Orthopedic Surgery Grand Rounds, Chicago, Illinois, December 20, 1995.
Bunions
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.
Gangrene
Diabetic ulcerations are by far the most common form of ulceration of the feet. These ulcerations occur in areas of the foot that are exposed to excessive pressure or irritation from the rubbing of the shoes on the skin. corns and calluses develop as a result of excessive pressure over bony areas of the foot. Over time the thickened callus that forms can act as an irritant that breaks down the skin under the callus, forming an ulceration. This is more likely to occur if the person with diabetes also suffers from diabetic neuropathy. Diabetic neuropathy is a condition that most commonly affects the nerves of the hands and feet. Diabetic neuropathy causes a loss or alteration in the ability to perceive pain associated with excessive pressure, heat or cold, sharp and dull, vibration and position sense. As a consequence, corns and calluses which would normally be painful do not cause pain and over time, breaks down the skin causing ulceration. Quite often, an infection will also occur which can result in bone infection (osteomyelitis) or deep tissue infection. If the person also has poor circulation, gangrene can develop.
Heel Surgery
Hysterectomy
Factors that contribute to the onset of gout are alcohol, red meats, asprin and certain medications for high blood pressure. Gout occurs most frequently in men. Women will not get gout until after menopause unless they have had a hysterectomy. Patients with long standing diabetes who may have kidney damage due to their disease, and patients who have kidney disease from other causes can develop gout. These patients may exhibit atypical forms of gout. In these instances, more than one area may be affected; the tops of both feet, for example, may develop gout.
Ingrown Toenails
To prevent ingrown toenails it is recommended to wear properly fitting shoes and to trim the toenails straight across and not too short.
Reconstructive Surgery
When foot and ankle deformity develops, custom orthoses and special shoes may be necessary to prevent foot ulcerations and provide stability during ambulation. When ulcerations develop and resist conservative treatment, surgery may be necessary to prevent loss of the foot. Additionally, if there is severe instability, reconstructive surgery of the foot and ankle may be necessary to provide a stable platform for ambulation and to avoid lower leg amputation.

Plastic Surgeons

Plastic Surgery
Hammertoe Surgery
Home treatment should be directed at reducing the pressure between the toes with cotton or a foam cushion and using an antibiotic ointment to reduce the risk of infection. Over the counter corn removers should never be used in this area because of the risk of increased damage to the skin resulting in infection. Professional treatment consists of removing the irregular shaped bone that causes the development of the corn. Some patients prefer that the doctor simply trim down and pad the calloused areas. This is a common form of treatment in patients with diabetes. See correcting soft corns, removing bone spurs, and hammertoe surgery.

Corns
Soft corns are areas of white moist skin between the toes. They most commonly occur between the fourth and fifth toes. They can be very painful and if not treated can form small ulcerations or sinus tracts that can become infected. Acute athlete's foot can mimic the soft corn. The soft corn is due to an irregularity in the shape of the bone in the fourth or fifth toes.
Cyst
Ulcer
Calluses
The most common area for the formation of calluses on the bottom of the foot is in the area of the ball of the foot. This is a weight bearing area where the long bones behind the toes called metatarsals, bear the greatest amount of weight and pressure. If one or more of these long bones (metatarsals) is out of alignment then excessive pressure is generated in the area producing a callous. The callused area can be very discreet and have a "core" or they can be more dispersed covering a larger area. These areas can become quite painful as the skin thickens. People who have diabetes are at risk of these areas breaking down producing sores or ulcerations that can become infected. People with diabetes should not try home remedies and should see a doctor for the treatment.
Fungus
The diagnosis of tenia pedis is generally made based upon the clinical presentation. A definitive diagnosis is made by taking a scraping of the skin and culturing it. It may take up to three weeks for the culture to grow the fungus. In some instances the culture may present a false negative result because the skin scraping was inadequate. Some doctors may perform a KOH prep of a skin scraping. This is examined under a microscope and may reveal elements that can make the diagnosis.
Lesions
Athlete's foot is caused by a fungal infection of the skin on the foot. The majority of these infections are caused by one of three fungal agents called dermatophytes. Athlete's foot is by far the most common fungal infection of the skin. The infection can be either acute or chronic. The recurrent form of the disease is often associated with fungal-infected toenails. The acute form of the infection most often presents with moist, scaling between the toes with occasional small blisters and/or fissures. As the blistering breaks, the infection spreads and can involve large areas of the skin on the foot. The burning and itching that accompany the blisters may cause great discomfort that can be relieved by opening and draining the blisters or applying cool water compresses. The infection can also occur as isolated circular lesions on the bottom or top of the foot. As the skin breaks down from the fungal infection, a secondary bacterial infection can ensue.
Psoriasis
Treatment should be directed at controlling the fungal infection and treating any secondary bacterial infection with oral antibiotics. Soaking the feet in Epsom salts and warm water is helpful. Wearing sandals to reduce moisture accumulation and heat generated by closed shoes will also help in the control and spread of the infection. Other conditions that mimic acute athlete's foot are contact dermatitis and pustular psoriasis.
Burns

Physical Therapists

Sports Medicine
You should choose your athletic shoes with care and be timely in replacing them when they wear out. A good pair of over-the-counter insoles is often useful for minor areas of foot irritation. Following a particularly rigorous workout, areas of soreness are often eased with the use of an over-the-counter anti-inflammatory such as Tylenol, Advil or Alieve. Icing the area can also be useful. If your pain persists, make an appointment and allow us to evaluate your condition and make recommendations for your treatment. Many sports medicine problems are also treated with orthotics.
Physical Therapy
Initially, the patient with Achilles tendonitis will be asked to modify their activities to decrease their running and jumping activities and do alternative physical activities, such as swimming, which don't put as much stress on the Achilles tendon. As the tendon starts to feel better, the podiatrist will allow a gradual return to normal running and jumping activities. If normal return to activities is not possible within a few weeks, then many times the podiatrist may additionally prescribe physical therapy and/or functional foot orthotics to help the tendon heal more rapidly. The foot orthotics generally are used during both the sports activities and walking activities to allow for more normal foot and Achilles tendon function. If the physician is concerned about a partial tear of the tendon the patient may be placed in a below the knee cast. It can take several weeks or even months for the tendon to heal depending upon the severity of the injury to the tendon. It is not uncommon for a patient to return to activities too quickly and re-injure the tendon. Careful monitoring of a return to full activity is important and the patient must have patience during this period of time.
Flatfoot Correction
Heel Pain
Orthotics and Prosthetic Therapy

General Podiatry
Dr. Matthew S. Rockett was born and raised in the central Pennsylvania town of Lebanon. He attended Lebanon Senior High school and graduated from Washington & Jefferson College in Washington, PA with a Bachelor of Arts degree in Biology. He then graduated from the Pennsylvania College of Podiatric Medicine with honors and went on to the complete a 3-year Reconstructive Foot and Ankle Surgical residency at the University of Chicago Hospitals and Clinics. Dr. Rockett is married and lives in League City with his wife, Dr. Andrea Rockett and their two sons.
Achilles Tendonitis
The most common form of injury to the Achilles tendon is called Achilles tendonitis, which is an inflammatory condition causing pain in the Achilles tendon. Achilles tendonitis generally occurs in people who are active in sports activities. Types of sports that commonly are associated with Achilles tendonitis are basketball, tennis, running, football, soccer, volleyball and other running and jumping sports.
Ankle Sprain
In many instances the treatment of sports related injuries begins with understanding the underlying biomechanics of their cause. There is such an array of these injuries that space does not permit outlining all of them. The more common injuries include shin splints, arch pain, heel pain, Achilles tendonitis, ankle injuries, stress fractures, tendon injuries about the ankle and rear foot, toenail injuries, nerve injuries, and blistering of the skin, to list just a few.
Bunions Problems
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).
Calluses
Diabetic Foot Care
As the patient develops diabetic neuropathy, they have a greater risk of developing skin ulcerations and infections. Areas of corns and calluses on the feet represent areas of excessive friction or pressure. These areas, if not properly cared for by a foot specialist, will often break down and cause ulcerations. Ulcerations and infection can form under the callused area. These callused areas may not be painful. As a result, they can progress to ulceration without being noticed. Ingrown toenails can progress to severe infections in people with neuropathy. Simple things like trimming the toenails present a risk to these patients because they may accidentally cut the skin and not feel it. People with neuropathy must be very cautious and inspect their feet daily. They should not soak their feet in hot water or use heating pads to warm their feet. This can result in accidental burns to the skin. Barefoot walking should be avoided because of the risk of stepping on something sharp and not being aware of it. The inside of the shoes should be inspected before putting the shoes on to insure that no foreign object is inside the shoe ( see Do's and Don'ts-Diabetic Foot Care Tips ).
Flat Feet
Fungus Toenails
Hammertoes
They tend to slowly get worse with time and frequently flexible deformities become rigid. Treatment can be preventative, symptomatic or curative. (For information on hammertoe of the big toe see Hallux hammertoe)
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
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
Metatarsalgia
Foot Neuroma
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 ( See surgical treatment of plantar heel pain ).
Pediatric Foot Care
Plantar Fasciitis
"Atypical Presentation of Plantar Fasciitis Secondary to Soft-Tissue Mass Infiltration" Ng, A., Beegle, T., Rockett, A.K. Journal of the American Podiatric Medical Association. 91:89-92, 2001.
Podiatric Surgery
"Treatment of the Neglected Tendo Achilles Rupture" Harris County Podiatric Surgery Residency Thursday evening lecture, Houston, Texas, July 31, 1996.

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