What Skin Cancer on the Leg Can Look Like: Actinic Keratosis and Squamous Cell Carcinoma

Skin cancer on the leg may start as a rough white patch or turn into a growing red bump. Learn the warning signs and when to see a podiatrist or dermatologist.

Skin cancer is often associated with the face, shoulders, or arms—but skin cancer can also develop on the legs, especially in areas exposed to the sun over time. Unfortunately, many people ignore early warning signs because the skin changes may seem minor at first.

In this article, we’ll explain what skin cancer on the leg can look like, including a common precancerous condition called actinic keratosis**, and how it may progress into squamous cell carcinoma.

What Does Skin Cancer on the Leg Look Like?

Skin cancer on the leg can appear in many forms, including:

* A white or pale patch

* A scaly or crusty spot

* A lesion that feels rough, like sandpaper

* A thickened area of skin

* A red bump that grows over time

* A sore that doesn’t heal

Sometimes skin cancer starts subtly, and patients may assume it is just dry skin, a rash, or irritation.

White or Rough Patches Could Be Actinic Keratosis

One of the most common early warning signs we see is a whitish or rough patch on the skin.

If you notice whiteness on top of a spot, especially on the leg, it may be actinic keratosis (AK).

Actinic keratosis is a precancerous skin condition caused by long-term sun exposure. These lesions often develop slowly and may appear as:

* A white, pink, or reddish patch

* A dry, scaly surface

* A rough or crusty texture

* A spot that comes and goes

Many people describe it as a patch that “just won’t go away.”

Why Actinic Keratosis Should Be Taken Seriously

While actinic keratosis is not always cancer, it is considered a warning sign. AK lesions can potentially progress into a type of skin cancer known as **squamous cell carcinoma**.

That’s why early evaluation is important.

Even if the lesion looks small, actinic keratosis is a sign that the skin has been significantly damaged by UV exposure, and additional lesions may develop.

When Actinic Keratosis Turns Into Squamous Cell Carcinoma

In some cases, actinic keratosis can develop into squamous cell carcinoma (SCC).

Squamous cell carcinoma may appear as:

* A big red bump

* A raised growth

* A thick, crusty patch

* A firm lump that keeps enlarging

* A sore that bleeds, scabs, and reopens

Patients often notice that the area becomes more irritated, more inflamed, or begins to grow rapidly.

A larger red bump on the leg, especially one that is new or changing, should never be ignored.

Warning Signs That You Should See a Doctor Immediately

You should schedule an evaluation with a podiatrist or dermatologist if you notice:

* A patch that is white and scaly

* A lesion that feels rough or crusty

* A spot that is getting thicker

* A bump that is red and growing

* Bleeding, tenderness, or pain

* A wound that does not heal within a few weeks

* A lesion that changes in size, shape, or color

Early diagnosis is key. Squamous cell carcinoma is very treatable when caught early, but it can become more serious if left untreated.

Why a Podiatrist Can Help

Many people don’t realize that podiatrists diagnose and treat skin conditions of the lower extremities every day—including suspicious lesions on the leg, ankle, and foot.

If you notice a concerning spot on your leg, your podiatrist can examine it and help determine whether further testing, treatment, or referral is needed.

Don’t Wait: Get Checked Now

If you see a spot on your leg with whiteness on top, rough scaling, or a big red bump, it may be more than just dry skin.

Actinic keratosis can be an early warning sign, and in some cases it can turn into squamous cell carcinoma.

The best step you can take is simple:

See your podiatrist or dermatologist now.

Schedule an Appointment

If you are concerned about a skin lesion on your leg, foot, or ankle, we can help.

Call (239) 430-3668 (FOOT) to schedule an appointment.

Dr. Kevin Lam: Founder & CEO of Family Foot & Leg Center Serving Naples and Multiple Locations Across SWFL

When it comes to foot and ankle care, experience, skill, and leadership matter. Meet Dr. Kevin Lam, a highly respected podiatrist with over 20 years of clinical experience and the Founder & CEO of Family Foot & Leg Center, a trusted practice that has expanded from its roots in Downtown Naples to multiple locations across Southwest Florida.

From his first day in practice to leading a multi-location network, Dr. Lam’s mission has remained the same: helping patients walk, run, and live comfortably through expert, compassionate foot care.

A Career Built on Expertise and Compassion

Dr. Lam has dedicated more than two decades to mastering the treatment of foot and ankle conditions. His extensive experience allows him to treat a wide range of issues, from heel pain and plantar fasciitis to bunions, ingrown toenails, diabetic foot care, Achilles tendon pain, and sports injuries.

Patients trust Dr. Lam not only for his technical skill but also for his personalized approach, ensuring every treatment plan is tailored to the individual. His philosophy is simple: treat every patient like family and provide care that truly makes a difference.

Founder & CEO: Growing a Trusted Practice Across Southwest Florida

Dr. Lam founded Family Foot & Leg Center with a vision: provide high-quality, patient-focused podiatry care that is accessible and consistent. What began as a single clinic in Downtown Naples has now grown into multiple locations across Southwest Florida, allowing more patients to access expert foot and ankle care close to home.

As Founder & CEO, Dr. Lam oversees a team of experienced podiatrists and staff, ensuring that every clinic maintains the same high standard of care, advanced treatments, and compassionate service that earned Family Foot & Leg Center its reputation.

Why Choose Family Foot & Leg Center?

* 20+ years of podiatry expertise

* Founder-led, patient-first care

* Multiple convenient locations across SWFL

* Advanced treatments for all foot and ankle conditions

* Same-day appointments available

📍 Downtown Naples Location: 730 Goodlette-Frank Road, Suite 102

📞 Call today: 239-430-3668 (FOOT)

🌐 Visit: naplespodiatrist.com 

Whether you’re dealing with chronic pain, a sports injury, or a complex foot condition, Dr. Lam and his team provide expert care that gets you back on your feet safely and comfortably.

Experience matters. Leadership matters. Results matter. Your feet deserve the best — and Dr. Kevin Lam delivers it across Southwest Florida.

Same-Day Appointments: Why Speed Matters in Wound Care

When it comes to wound care, time isn’t just important—it’s critical. Every day that a chronic or complex wound goes untreated increases the risk of infection, tissue damage, hospitalization, or even amputation. As a podiatrist and wound care specialist, I’ve seen firsthand how fast action can change the outcome for patients. That’s why we offer same-day appointments for wound care: because delaying treatment is never worth the risk.

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Why Delays Are Dangerous

Many patients hope a wound will heal on its own. Unfortunately, foot and ankle wounds—especially in people with diabetes, vascular disease, or neuropathy—rarely improve without professional care. Waiting even a few extra days can allow infection to spread or tissue to break down further. In severe cases, a small wound can quickly escalate to a limb-threatening condition.

Complications that can result from delayed treatment include:

• Infection spreading into the bone (osteomyelitis)

• Gangrene that may lead to amputation

• Sepsis, a life-threatening systemic infection

• Chronic pain and mobility loss

The bottom line? Time is tissue. The sooner a wound is addressed, the better the chances of saving the affected area—and in many cases, preserving overall health.

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The Benefits of Same-Day Wound Care

1. Infection Prevention
Early cleaning, debridement, and protective dressings can dramatically reduce infection risk. Quick intervention creates a cleaner wound bed, which is essential for healing.

2. Faster Healing
The sooner advanced wound therapies are started, the greater the likelihood of full recovery. Treatments such as advanced dressings, biologic grafts, and negative pressure wound therapy work best when applied early.

3. Pain Reduction
Immediate attention often means less swelling, reduced pressure, and improved mobility. Patients frequently report decreased discomfort after even the first treatment.

4. Avoiding Hospitalization
By treating wounds aggressively at the clinic level, we can prevent the need for hospital admissions, which are costly, stressful, and sometimes risky.

5. Peace of Mind
Knowing that a specialist has evaluated your wound right away provides reassurance and a clear treatment plan, reducing anxiety for both patients and families.

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Advanced Wound Care Close to Home

At Naples Podiatrist, we use the latest technology—advanced dressings, bioengineered skin grafts, vascular evaluations, and more—to treat wounds effectively. Our podiatry team is skilled in recognizing early warning signs that others may miss, which can make all the difference in outcomes.

Our same-day scheduling means if you notice a wound that isn’t healing—or if you have redness, swelling, drainage, or odor—you can call and be seen immediately. We believe in removing barriers to care, because waiting for weeks to see a specialist isn’t an option when your health is at stake.

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When to Seek Same-Day Wound Care

Call us immediately if you notice:

• A wound that hasn’t improved in 1–2 weeks

• Signs of infection (redness, swelling, warmth, pus, or odor)

• Increasing pain around a wound

• Changes in skin color near the wound (black, blue, or pale skin)

• Numbness or tingling in the foot or ankle

These signs often indicate a worsening wound that requires urgent podiatric evaluation.

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Don’t Wait—Your Health Depends On It

If you or a loved one is dealing with a stubborn foot or ankle wound, remember: every day matters.

Same-day appointments could mean the difference between saving a foot—or losing it.

Call (239) 430-3668 today or visit woundhealingexperts.com to schedule your same-day appointment and take the first step toward healing.

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Dr. Kevin Lam is a board-certified podiatrist and wound care specialist dedicated to advanced treatments for diabetic foot ulcers, vascular wounds, and complex podiatric conditions in Southwest Florida.

How AI is Revolutionizing My Practice as a Podiatrist

When I first began practicing podiatry over 20 years ago, I never imagined that artificial intelligence would become valuable tool in my day-to-day clinical work. At the time, my focus was on treating heel pain, bunions, diabetic foot ulcers, and the occasional sports injury. My tools were a combination of clinical training, diagnostic imaging, patient history, and intuition. But in recent years, the integration of AI into podiatry has transformed how I diagnose, treat, and manage patient care.

I want to share how this technology is enhancing our ability to deliver more accurate diagnoses, offer personalized treatments, and improve overall outcomes – while saving time and reducing human error.

AI  Diagnostic Imaging

One of the most immediate ways AI is helping podiatrists is through imaging. Whether it's an X-ray, MRI, or CT scan, reading and interpreting these images is a critical part of diagnosing foot and ankle problems. With the help of foot and ankle problems. With the help of AI-driven image analysis, I can now detect subtle fractures, joint abnormalities, or soft tissue injuries that might have been easy to overlook with the naked eye. 

AI algorithms trained on thousands of annotated images can spot patterns consistent with plantar fasciitis, osteoarthritis, or even early signs of Charcot foot in diabetic patients. These tools act as a second set of eyes, confirming my suspicions or occasionally flagging something I might have missed. This has made the diagnostic process faster and more reliable.

Predictive Modeling for Diabetic Foot Care

As podiatrists,  we pay special attention to diabetic patients because they are at high risk of developing ulcers and infections that can lead to amputations. One of the biggest challenges has always been predicting which patients are at the highest risk so we can intervene early.

Now, AI systems are helping us do just that. Using data from patient records – such as wound history, blood sugar levels, vascular status, and gait analysis – AI models can calculate the probability that a patient will develop a foot ulcer. This predictive capability enables us to tailor preventive strategies more effectively, such as recommending custom orthotics, adjusting footwear, or scheduling more frequent follow-ups.

We're no longer simply reacting to problems; we're anticipating them.

Gait Analysis and Biomechanics

Biomechanical assessment has always been a core part of podiatry. AI-powered gait analysis tools are now giving us new insights. These systems use cameras and sensors to track a patient's walking pattern and compare it against vast datasets of normal and pathological gaits. 

In the past, gait analysis was largely subjective – based on our visual observation and perhaps some video playback. Today, AI can quantify asymmetries, measure joint angles in real-time, and even suggest orthotic modifications. For patients recovering from injury or surgery, we can use this technology to monitor their progress objectively and fine-tune rehabilitation plans.

Custom Orthotics

Designing custom orthotics is part science, part art. AI is helping refine both. With digital foot scanning and AI algorithms, I can create a detailed 3D model of a patient's foot, taking into account pressure points, arch height, and gait characteristics. The AI can then suggest orthotic designs that are biomechanically optimized for the patient's condition.

Not only does this result in better-fitting and more effective orthotics, but it also reduces turnaround time. Instead of waiting weeks for a lab to mold and return a product, we can now use in-office 3D printing integrated with AI design tools to produce orthotics in days- sometimes even hours.

Administrative Efficiency and Documentation

Though less glamorous, another huge benefit of AI is in administrative work. Clinical documentation, coding, and insurance claims take up a disproportionate amount of time. AI-powered voice transcription and smart EHR (Electronic Health Record) systems can auto-generate notes, suggest ICD-10 codes, and even flag incomplete records.

This allows me to spend less time on paperwork and more time focusing on patients. It also reduces the  chance of clerical errors that can lead to claim rejections or compliance issues.

Patient Education and Engagement

AI is also enhancing the way I communicate with patients. Chatbots and mobile apps powered by AI help educate patients about their conditions, remind them to perform stretches or exercises, and even monitor compliance. For example, an app might track a diabetic patient's daily foot checks and alert them – or me – if any issues arise.

This type of digital engagement keeps patients more involved involved in their care, leading to better outcomes and fewer complications.

Challenges and Looking Ahead

Of course, AI isn't a magic bullet. It requires quality data, careful implementation, and a strong understanding of its limitations. It will never replace the clinical judgement that comes form years of experience. But as a podiatrist, I see AI not as a replacement – but as an enhancement.

It's helping us become more precise, more proactive, and more patient-centered. In a field like podiatry,  where early detection and personalized care make all the difference, that's a game-changer.

AI is such a game-changer that this entire article and photos was AI generated!

The future of foot and ankle care is here – and it's intelligent. 

If you are experiencing foot pain, don't hesitate contacting Dr. Lam's office at (239) 430-3668 (FOOT) or visit www.NaplesPodiatrist.com to schedule an appointment.

Pain-Free and Walking Again: What to Expect After Ankle and Subtalar Joint Fusion Surgery

When chronic pain, instability, or severe arthritis in the ankle and hindfoot disrupt daily life, joint fusion surgery can offer lasting relief. One of the most effective solutions in these cases is a combined ankle and subtalar joint fusion, a procedure designed to stabilize the foot, correct deformities, and eliminate painful joint motion.

Here, we highlight a patient just three months after undergoing this type of fusion procedure. The outcome? No pain, restored stability, and a confident return to walking.

What Is Ankle and Subtalar Joint Fusion?

Ankle and subtalar joint fusion involves surgically joining the tibia (shinbone), talus (ankle bone), and calcaneus (heel bone). This eliminates the motion in arthritic or damaged joints to reduce pain and improve alignment. It’s a recommended approach for patients with:

• Advanced ankle and hindfoot arthritis

• Severe post-traumatic joint damage

• Failed previous surgeries or reconstructions

• Deformities caused by injury or neurological conditions
  
  
  

The Procedure: Precision and Stability

The surgery typically includes:

• Removal of damaged cartilage and bone from the affected joints

• Realignment of the bones to restore a proper walking position

• Stabilization of the fusion site using internal fixation (e.g., screws or plates)

• In some cases, arthroscopy is used to assist in preparing the joint surfaces

Additional small incisions may be made to address soft tissue concerns or remove foreign objects (such as glass) when applicable.

3-Month Recovery: Real Results

At the three-month follow-up, our patient was able to:

• Walk confidently and pain-free

• Show fully healed incisions

• Display proper alignment and stability during movement

• Report satisfaction with the surgical outcome

Imaging studies confirmed successful bone fusion, with no complications.

What to Expect After Surgery

Post-operative recovery includes:

• A period of non-weight-bearing (usually 6–8 weeks)

• Transitioning into a walking boot or brace as fusion progresses

• Physical therapy to rebuild strength and mobility

• Full recovery in approximately 3–6 months for most patients

The ultimate goal is to relieve chronic pain, restore function, and help patients return to an active lifestyle—without the discomfort they experienced before surgery.

Ankle and subtalar joint fusion is a proven procedure that can dramatically improve the quality of life for patients suffering from joint degeneration or deformity. As seen in this case, with expert care and a carefully managed recovery, patients can look forward to walking comfortably again—pain-free and stable.

If you're struggling with chronic foot or ankle pain, don’t wait. Reach out to our team to learn more about your options for long-term relief and lasting results.

Lisfranc Ligament Injury

 Dr. Kevin Lam's video discusses Lisfranc ligament injuries, which involve a critical ligament in the midfoot. This type of injury is often underdiagnosed but can have significant consequences, such as long-term pain and dysfunction if not treated properly. Dr. Lam emphasizes the importance of early diagnosis and appropriate treatment, which may include surgery, depending on the severity of the injury. This condition is common in athletes and people who experience high-impact trauma to the foot. Proper recovery and rehabilitation are essential for optimal outcomes.

For more details, you can watch the full video here

Understanding Lisfranc Injuries: Causes, Symptoms, and Treatment

A Lisfranc injury occurs in the midfoot where the Lisfranc ligament connects bones, providing stability. These injuries can range from ligament sprains to fractures and dislocations. Often misdiagnosed, they are common in athletes and can result from direct trauma, such as a fall or high-impact sports injury.

Symptoms:

- Pain in the midfoot

- Swelling and bruising

- Difficulty bearing weight

Treatment:

For mild injuries, rest, ice, and immobilization may suffice. Severe cases might require surgical intervention to stabilize the bones and ligaments, followed by rehabilitation to regain foot function.

Prevention & Recovery:  

Proper footwear and strength training can help prevent Lisfranc injuries. Early diagnosis is crucial to avoid long-term damage, and rehabilitation plays a key role in recovery.

If you suspect a Lisfranc injury, consult a specialist for a thorough evaluation.

Stump neuroma cured!

 

A 69 year-old female patient, she had a history of neuroma surgery here, you can see the scar and she comes in with significant pain? 

"Yes."

How much pain did you have before? 

"I couldn't walk. I couldn't walk a half a block without it totally hurting and one to ten, it was a nine.

And then you had surgery. After surgery, how much pain did you have?

After three months, the neuroma grew back. And the pain was the same as it was  before, within four or five months.

Okay so that is the complication of a neuroma surgery, it happens, we don't know why, but it happens. So that's why I tend not to do that. But this is a good example of a patient coming in with after neuroma surgery and having more pain.

So now we went to a radiofrequency ablation and with the radiofrequency ablation pretty much I stuck a probe in through here and went in and burned the nerve for you so I did not have to remake the incision. Basically, I numbed you up and burned it. So we did two treatments one month apart.

"Yes."

So after the first treatment, how much improvement have you had?

"At least 50% and the pain from the foot being squeezed was totally gone"

So this pain being squeezed is gone as you are saying? 

"It's totally gone, yes." 

Okay because sometimes when you do this you aggravate that nerve. So, with that, pain is gone.  

"That pain was totally gone. Still hurt a little bit on the bottom. Okay and then we did surgery two."

The RFA number two? 

"Right."

Radiofrequency number two we did about a month later. How much pain did that take away?

"Right now after four weeks almost there's no pain. I mean it's just I wear my shoes, the one that I am supposed to wear and when I go out at night or go out for dinner I do change and wear normal shoes."

Okay, well overall would you rate the radiofrequency as very good, very happy versus the surgery?

"Excellent versus surgery."

Good, well you still have some swelling to go believe it or not so you'll have some more healing to do and I think you'll do a lot better. 

"Thank you."

You know you've done awesome, any words of wisdom for people thinking about radiofrequency or surgery etcetera?

"I would do the radio frequency again before the surgery. I went to Boston to do the surgery at no -- did I go to Boston -- no, I went to ...I forgot where I went"[laughs] I went up north to get it done because they were supposed to be really good and the surgery was terrible."

Well, it's unpredictable, I always tell my patients, no matter who does the surgery, it's not dependable. It's not predictable.

"No, it wasn't." 

Same surgeon, same hands, same technique we can't predict. 

"Right, no."

So radiofrequency we really have no side effects to it and patients do well.

"No side effects -- I drove myself home after the surgery and just you know, started walking again without pain."

Well excellent. Well, thank you for the testimonial and a lot of people ask what to expect, so you're a perfect example, you're two months out now, you're 2 radiofrequencies in and the scar's not ours, the scars were you came in with, but look at that, she's moving good, she's recovering well and she's back to life again.

"Yes, and do the physical therapy, it helps."

Physical therapy is very important afterwards to break up the scar tissue especially if you have previous surgery.

So, awesome, well thanks for your information, I really appreciate it.

"Thank you." 

You're welcome.

Common Pickleball Injuries That Require a Podiatrist's Attention

Pickleball has gained immense popularity in recent years as a fun and accessible sport for people of all ages. However, like any physical activity, pickleball carries the risk of injury. While some injuries may be minor and self-treatable, others may require professional medical intervention. In this blog post, we will explore some common pickleball injuries that may necessitate a visit to a podiatrist.

 

1. Ankle Sprains:

Ankle sprains are among the most prevalent injuries in pickleball. The quick lateral movements and changes in direction can put significant stress on the ankle joint, leading to sprains. Podiatrists are well-equipped to diagnose and treat ankle sprains, providing options such as immobilization, physical therapy, and specialized footwear recommendations.

2. Plantar Fasciitis:

Plantar fasciitis is a condition characterized by inflammation and pain in the plantar fascia—a thick band of tissue that runs along the bottom of the foot. The repetitive jumping and pivoting motions in pickleball can strain the plantar fascia, causing micro-tears and inflammation. Podiatrists can offer various treatment modalities, including orthotics, stretching exercises, night splints, and recommendations for appropriate footwear.

3. Achilles Tendinitis:

Achilles tendinitis is the inflammation of the Achilles tendon, which connects the calf muscles to the heel bone. The explosive movements and sudden stops involved in pickleball can put excessive strain on this tendon, leading to pain and swelling. Podiatrists can provide treatment options such as physical therapy, stretching exercises, orthotic devices, and recommendations for modifying gameplay techniques to alleviate symptoms and promote healing.

4. Stress Fractures:

Pickleball involves repetitive jumping and rapid changes in direction, which can contribute to the development of stress fractures in the feet. Stress fractures are small cracks in the bone caused by overuse and excessive repetitive impact. A podiatrist can diagnose stress fractures through imaging techniques and may recommend rest, immobilization, and gradual return to activity protocols to allow for proper healing.

5. Blisters and Calluses:

Pickleball players often experience blisters and calluses due to the repetitive rubbing and friction caused by quick lateral movements and abrupt stops. While blisters and calluses can be managed at home, a podiatrist can provide professional care, including blister drainage, callus removal, and recommendations for preventive measures and footwear modifications to reduce recurrence.

While pickleball is generally a low-impact sport, injuries can still occur. It is essential to listen to your body and seek medical attention if you experience persistent pain, swelling, or any other concerning symptoms. Podiatrists specialize in foot and ankle injuries, and they can provide a tailored treatment plan to help you recover and get back to enjoying the game. Remember to prioritize proper warm-up, wear appropriate footwear, and practice good technique to reduce the risk of injuries while playing pickleball.

Secret of Heel pain, plantar fasciitis, heel spur syndrome what you need to know now

 

Plantar fasciitis is a common foot condition characterized by inflammation of the plantar fascia, a thick band of tissue that runs across the bottom of your foot, connecting your heel bone to your toes. This inflammation often leads to intense heel pain, especially with the first steps in the morning or after long periods of rest.

Several factors can contribute to the development of plantar fasciitis, including overuse or repetitive strain on the feet, improper footwear, high arches, flat feet, obesity, and tight calf muscles. Athletes, runners, and individuals who spend prolonged periods on their feet are particularly susceptible to this condition.

The symptoms of plantar fasciitis can vary in intensity, ranging from mild discomfort to severe pain that interferes with daily activities. Without proper treatment, the condition can worsen over time, impacting mobility and quality of life

If you're experiencing persistent heel pain or suspect you may have plantar fasciitis, it's essential to consult with a qualified healthcare professional for an accurate diagnosis and personalized treatment plan. Don't let plantar fasciitis hold you back – with the right approach, you can find relief and get back to enjoying life to the fullest. The Family Foot & Leg Center (FFLC) prides itself on its network of cutting-edge clinics strategically positioned throughout Collier, Lee, Charlotte, and Sarasota Counties, ensuring accessible expert foot and ankle care across Florida. Our goal is to swiftly and effectively address your foot and ankle challenges, enabling you to resume your active lifestyle promptly. Equipped with advanced treatment modalities and staffed by a team of devoted specialists, FFLC is dedicated to delivering top-notch care conveniently situated in your local community.

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Hey guys, Dr. Lam. We are here to talk about plantar fasciitis and surgery for plantar fasciitis. Yes, surgery. You know, a small amount of patients will benefit from surgery. Most -- majority of patients, I will say 85 - 90 percent of our patients do well with conservative care. What is conservative care? Well, you have natural anti-inflammatories, you have stretching techniques, physical therapy is really big, inserts, injections, etcetera, there's also shockwave therapy but let's say all those things fail or you know, you can't afford to pay for shockwave therapy because it is not covered by by insurance but what we have that's a great alternative to that is endoscopic plantar fascial release. I'm gonna show you a little video of that later on of an actual case and I'll talk through it. It's a very short video following this explanation. So you have an idea. This is plantar fasciitis on the bottom of the foot, that's your heel. As you can see, it's nicely marked. So what we're gonna see later in the video, there's a camera going in through one side right about here and it's looking up, it's looking right up at this just as you're looking up but that's what you'd be seeing on the -- there you go, going into zoom so that's what you'd be seeing later on, you'll just be seeing this tissue, this band of tissue and then what you'll also see later on, a blade going in from this side just cutting this right about there, that's what you'll be seeing on the video and why is that important? What is plantar fasciitis? Plantar fasciitis is the inflammation of this rubber band down on the bottom of the foot It actually looks like a rubber band when we go into surgery so that's how I explain to my patients. So why does this cause a problem? Well number one is it's almost like a pinnacle  where your heel strike, number one. Number two, this tissue right here it could be -- you can have little micro tears or macro tears you can have a little tearing of this tissue as you step down wrong or you stepped out on an object, some Legos, anything. Poor choice of shoewear where it's not padded enough and you're getting a lot of injury -- repetitive injury to this, you're not letting it heal. Another theory is you can have some inflammation on the bone inside or what we call venous congestion in there, that's another theory behind that that's why we see a lot of inflammation on an MRI inside the bone or on the plantar fascia or both So obviously, typically we try to do the conservative thing first and if that doesn't work then we move on to more aggressive surgical care. So we're gonna go on to the video of the endoscopic plantar fasciectomy. I'm gonna go ahead and try to talk through it. It's really not much, again, it's a very short video so again you'll see me -- actually the camera is actually inserted on this side on the outside of the foot, 5th metatarsal side the cameras gonna be coming in this way while I cut this side that's what you're gonna see initially I would go in through this side right here to view everything but and then when we come to cutting I reverse the camera, I come in here, the camera's there to look, this is the camera now to look as I take the surgical blade now this is a surgical blade, let's see if I can get another pen here so as not to confuse anyone, this is a surgical blade, again the camera's looking and a surgical blade is right here and you cut, pull back and cut and that is what you're gonna see on the video, any questions let us know. This is a quick procedure, it's about 30 minutes or less from going into the operating room to them prepping, us giving a little anesthesia, to putting in the last stitch which is only about two so go on from there, any comments, concerns let me know. Hopefully this will explain one of our common procedures called endoscopic plantar fasciectomy for chronic plantar fasciitis or plantar fasciosis. Hey guys, this is Dr. Lam. We are going live on the video this is an actual EPF procedure -- endoscopic plantar fasciectomy this is again the camera going in from the outside of the foot, fifth metatarsal side looking at the medial side of the foot as you can see that is a nice curved blade this is all through a couple millimeters incision actually as you can see the fat is underneath on this down side right here and then the blade is cutting the plantar fascia which is this white tissue  right here you see the red underneath that is the muscle belly of the flexor tendon down there so a flexor muscle belly, so we cut until all the white portion is cut which is the plantar fascia we're only cutting a certain amount that is pre measured and you can see I'm moving around the probe just to -- this is just feeling make sure I have every fiber cut as you can see this is a thick fiber right here, this white is the plantar fascia, again the red is the muscle belly underneath there. In chronically inflamed plantar fasciitis you would see that thickened tissue requires a couple passes with that blade again it's all done endoscopically, the incisions are really small we're seeing on the screen as you see right here looks like it's getting a little blurry from the fog so that's it.