Patient Education

Dr Richard A Keh would like to be your partner in health care. Feel free to ask your questions and share your concerns with us. We will work with you to develop a wellness program for the care and treatment you need.

We welcome you to our practice and look forward to caring for you.

Dr Richard A Keh provides a full range of medical services including the following:


Achilles Tendonitis

Achilles tendonitis (also tendinitis) is an inflammation of the Achilles tendon, the strong band of tissue that connects the calf muscle to the heel. This condition occurs when excessive stress is put on the tendon. Achilles tendonitis is usually a painful but short-lived condition. It not treated, however, Achilles tendonitis can increase the risk of Achilles tendon rupture, a serious injury requiring immediate medical attention. Most cases of Achilles tendonitis can be prevented by beginning an exercise regimen slowly, with preparation, and by increasing an exercise program gradually and with care. ...


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Athlete's Foot

Athlete's foot (tinea pedis) is a common fungal infection that develops in the moist area between the toes or on the soles of the feet. It causes itching, stinging and burning, and, if left untreated, can cause the skin to peel and crack, which, in turn, can lead to bacterial infection. Athlete's foot can also affect the toenails, palms and fingers. It is caused by a variety of fungi that belong to the group "dermatophyte," which also causes ringworm, diaper rash and jock itch (dhobi itch). ...


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Blisters

A blister, also known as a bulla, is a bubble of fluid that forms beneath a thin layer of damaged skin. The fluid inside is composed of water and protein that have oozed from the damaged tissue. Commonly, blisters form as a result of irritation caused by rubbing, such as that caused by ill-fitting or new shoes. They generally involve only epidermis, the top layer of the skin. Blisters such as these usually resolve on their own fairly quickly, and do not lead to complications or scarring. Blisters may, however, development for a number of other reasons, some of which can be more serious. All blisters should be watched because even seemingly innocuous blisters can become infected easily. ...


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Bunions

A bunion (hallux valgus) is a common foot problem in which an abnormal bony bump develops at the joint of the big toe, causing the joint to swell outward and become painful. As a result of the enlarged joint, the big toe may become stiff and turn inward. The more deformed the joint becomes, the more it can lead to difficulty walking and to the development of ingrown toenails, corns and calluses. Although bunions are not usually a serious condition, they can be painful and unsightly. Left untreated, they will usually grow larger and more painful over time. ...


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Claw Foot

Claw foot is so named because of the abnormal appearance of the affected foot. A patient with this condition has a deformity in which the toe joint nearest to the ankle bends upward and the other toes bend downward in a fixed contracture. A claw foot is not necessary harmful and may not require treatment, but it can cause pain, result in development of other troubling disorders, or be a sign of a more serious underlying condition. ...


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Clubfoot

Clubfoot is a common congenital abnormality in which the foot is turned inward. The condition derives its name from the resemblance of the curved foot to the head of a golf club. Clubfoot is an anomaly that can affect one or both feet. It is usually an isolated condition, although it is occasionally associated with other skeletal abnormalities, such as spina bifida. While a clubfoot does not, in itself, cause pain or other symptoms during infancy, the condition must be addressed soon after birth since, left untreated, it can result in serious medical problems once the child begins to walk. ...


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Corns and Calluses

Corns and calluses are thickened layers of skin that develop on the feet as a result of the skin protecting itself from friction and pressure. Corns and calluses do not often cause serious medical problems, but they may be painful, especially when walking. Many people are also bothered by the appearance of these growths, as they appear as hard, raised bumps or thick, rough areas of skin. ...


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Diabetic Foot Care

Because of their distance from the heart and because of the force of gravity, the feet and legs are more at risk for difficulties with circulation and healing than other parts of the body. In patients with diabetes, these risks are exacerbated by the disease since diabetes can lead to: impaired circulation, nerve damage (neuropathy), and a damaged immune system. Not only is the diabetic patient less able to fight off infection, but is also frequently unaware of injuries because of neuropathy and impaired vision. ...


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Flat Feet

Flat feet (pes planus) are extremely common. While usually just a normal anatomical variation that does not result in any serious difficulties, this condition, which causes the feet to lean inward, or pronate, can cause problems over time. Infants feet are naturally flat because of the pad of "baby fat" at the instep. As they grow and begin to walk, their feet normally develop arches. For some children this does not happen and their feet remain flatter than average. While this condition is usually inherited, there are many individuals who have normal arches as children and young adults, but develop flat feet, or "fallen arches," over time. These individuals are said to have acquired flat foot deformity (AFFD). ...


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Foot Sprains and Strains

Both foot sprains and foot strains are very common injuries, occurring as a result of sports accidents, falls, or other traumas. The difference between the two types of injuries is that sprains affect the ligaments, the thick strands of cartilage attaching one bone to another, and strains affect the muscles or the tendons, thick bands attaching muscle to bone. In both cases, the patient with the injury usually experiences pain (particularly upon movement), swelling, tenderness, bruising, weakness or muscle spasms. Foot sprains, the more serious injury, may also cause possible instability of the joint, most frequently the ankle. Depending on where on the foot the injury occurs, patients may be unable to bear weight until healing takes place. ...


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Hallux Rigidus

Hallux rigidus, meaning "stiff big toe," is a type of degenerative arthritis affecting the joint located at the bottom of the big toe (the metatarsophalangeal joint). This condition causes the joint to stiffen and become painful, eventually making it difficult to walk, stand up, bend, squat or run. Hallux rigidus may occur as a result of structural abnormalities, heredity, traumatic injury, or underlying disease conditions, such as rheumatoid arthritis or gout. ...


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Hammertoes

A hammertoe is an abnormally crooked, contracted toe that takes the shape of an inverted "V." This condition develops when a muscle or tendon imbalance causes the toe to buckle and eventually become stuck in a bent position. Hammertoes may occur for a number of reasons, including hereditary abnormalities, rheumatoid arthritis, traumatic injury, or the wearing of poorly fitted or high-heeled shoes. ...


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Heel Spurs

A heel spur is an outgrowth of bone, known as a bone spur or osteophyte, on the heel of the foot. Bone spurs form as the body attempts to repair damage caused by constant physical irritation, pressure or stress, and may form in various regions of the body. They develop in the heel for a variety of reasons. In many cases, the long ligament that runs across the bottom of the foot, called the plantar fascia, gets pulled too tightly and an inflammation known as plantar fasciitis results. As the body tries to repair the damage, a heel spur may form. ...


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Ingrown Toenails

Ingrown toenails are toenails that have grown into the skin of the toe, causing pain, swelling and, frequently, infection. Usually, it is the corner of the big toe that is affected by this condition, although the smaller toes can also develop this problem. Ingrown toenails may occur as a result of tight-fitting shoes, a curved growth pattern of the nail itself, an injury, or improper toenail cutting. If left untreated, an ingrown toenail is likely to develop an infection and may even require surgery to remove the nail. ...


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Lisfranc Injury

A Lisfranc injury is a trauma to the midfoot where the Lisfranc (tarsometatarsal) joint is located. This joint enables the articulation of the middle of the foot. A Lisfranc injury may vary in severity, involving a sprain, a torn ligament, a fracture or a dislocation. Lisfranc injuries are relatively rare and frequently misdiagnosed. Lisfranc injuries occur for a number of reasons, all of which involve suffering a crushing blow, falling or twisting the foot. Causes of Lisfranc injuries may include vehicular collisions, falls and sports injuries. ...


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Morton's Neuroma

Morton's neuroma is a painful condition in which excess fibrous tissue accumulates around a nerve in the ball the foot, usually between the third and fourth toes. Patients may experience pain, burning, tingling or numbness in the foot, radiating into the toes, and often report feeling as if they are walking on a pebble. Pain may be soothed by taking weight off the foot or by massaging the area. The pain of Morton's neuroma is likely to worsen over time, becoming more severe and more persistent. The condition is found more frequently in women than in men. ...


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Mycotic Nail Infections

Mycotic (fungal) nail infections are very common. Although they can occur on the fingernails, they are more commonly found on the toenails, because fungus grows more readily in warm, dark, moist areas like enclosed shoes. Infected nails appear discolored, thick and brittle and may at times be painful. Mycotic nail infections most frequently appear in adults. ...


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Custom Orthotics

Orthotics are shoe inserts designed to correct the way the foot moves while standing, walking, running or playing a sport. Orthotics modify abnormal foot behavior during weight-bearing activities in order to alleviate pain and protect the feet from further damage. By providing support in areas where the foot is weak and by directing its movement, orthotics provide support while helping the foot to function more normally. ...


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Plantar Fasciitis

Plantar fasciitis is an inflammation of the plantar fascia, a band of fibrous connective tissue that runs along the bottom of the foot from the heel to the base of the toes. This band normally supports the muscles and the arch of the foot, functioning as a shock absorber, but if, after repeated stretching, it tears, inflammation and severe heel pain, exacerbated by standing or walking, result. Plantar fasciitis is the most frequent cause of heel pain and a common reason for the development of outgrowths of bone, called heel spurs, as well. It is more common in women and tends to occur as people age. ...


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Plantar Warts

Plantar warts are noncancerous growths that develop on the soles of the feet. Caused by the human papillomavirus (HPV), plantar warts are frequently found on the heels or balls of the feet, areas to which the most pressure is applied during standing or walking. While plantar warts are not a serious health threat, they may cause pain or tenderness and therefore need to be removed. ...


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Rehabilitation for Foot Conditions

Although the methods used to treat foot injuries vary, rehabilitation is always necessary after the initial treatment, to restore full movement and mobility to the foot and ankle and help the patient return to all usual activities. After the foot has healed from the initial treatment and patients can bear weight on the joint, a physical therapy regimen is implemented to strengthen muscles and increase mobility. Rehabilitation often takes three forms: ...


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Sesamoiditis

Sesamoiditis is an inflammation of two small bones, called sesamoids, situated below the first metatarsal joint of the big toe in the ball of the foot. Sesamoids, which are also located elsewhere in the body, are bones that, instead of being connected to other bones by joints, are connected only to tendons or are embedded in muscle. In the big toe, the sesamoids protect the tendons and help stabilize the foot during walking. ...


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Tarsal Tunnel Syndrome

Tarsal tunnel syndrome, also known as posterior tibial neuralgia, is a disorder of the foot that may result in significant pain. The tarsal tunnel, the canal that runs between the inner ankle and the band of ligaments that stretch across the foot, houses several vital arteries, nerves and tendons, which provide flexibility to the foot. Since the walls of this tunnel consist of either bone or tough fibrous material through which these blood vessels, tendons and nerves have to pass, the inflexibility of the walls may create a problem. ...


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Toe Fracture

A toe fracture, though very painful, is not usually a serious injury. Nonetheless, it must be appropriately treated to ensure proper healing. In most cases, a toe fracture, particularly of one of the small toes, can be treated nonsurgically, frequently by home remedies. At times, however, if the fracture is more severe, greater immobilization or surgery maybe required to prevent permanent damage. ...


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Turf Toe

Turf toe, which is a sprain of the soft tissue in the main joint in the big toe, is a common sports injury. Although it derives its name from the fact that it is frequently suffered by football players who play on artificial turf, it is also a common ailment of wrestlers, gymnasts, soccer players and dancers. Turf toe is usually caused by jamming or pushing the big toe while running or jumping, which results in swelling, pain and limited joint movement at the base of the toe. Typically, the injury to the toe is sudden (a "pop" may be felt), although it sometimes develops gradually after repeated trauma. Turf toe is diagnosed by physical examination. ...


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Advanced Wound Care and Dressings

Many patients with skin ulcers, burns and other types of wounds face difficulty with the healing process, especially patients who are diabetic. There are several different treatment options available for wounds resistant to conventional therapies. Some of these may include creams, ointments, synthetic skin grafts and other therapies that promote natural healing within the skin to avoid wound complications. ...


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Diabetic Reconstructive Foot Surgery

Diabetic patients with foot problems often experience pain, difficulty walking and other symptoms that may affect their overall quality of life. Surgery is often needed to correct these conditions, to keep the foot as healthy as possible and to prevent more serious problems. All too frequently, foot and ankle deformities in diabetic patients are the result of longtime neglect, complicated by the peripheral neuropathy and poor circulation common in diabetics. ...


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