The foot and ankle are complex structures comprised of many bones, joints, and soft tissue structures.  Our feet are generally thought of as the foundation of the body, and we rely on them every day.  Even so, they are often forgotten about and neglected.  Healthy feet are essential to our overall well-being.

Healthy feet allow you to be active, and help maintain and improve your physical, emotional and mental health.  Appropriately cared for feet and ankles allow for proper foot mechanics, lessening the chance for falls and injuries.  Feet are often the first limbs to exhibit early signs of pertinent  health issues such as diabetes or circulatory problems.

At Tolboe Foot and Ankle our top priority is your health and well-being.  We are proud to offer services for every type of foot and ankle problem as well as a wide array of specialty services, including:

  • Custom Orthotics
  • In-Office X-Rays *For Most Insurances*
  • Diabetic Foot Exams
  • Athletic Injury Assessment and Treatment
  • Bunion Correction
  • Hammertoe Repair
  • Surgical and Non-Surgical Treatment of Neuromas
  • Heel Pain (Plantar Fasciitis)
  • Tarsal Tunnel

For patients with wound care needs, our office provides high-quality wound care with advanced biologics and surgical techniques in diabetic limb salvage. We close wounds through the use of biologics, highly effective grafts that accelerate healing time, and plastic surgery techniques. In addition to these advanced wound care techniques, we are also proud to be one of the few practices in the Central Valley to offer Cutera Laser, used to treat onychomycosis (nail fungus).


The Diabetic Foot

Nearly a quarter of Americans with diabetes experience foot problems related to poor circulation and neuropathy. Minor injuries are magnified and cause severe problems if not taken care of quickly.


Oftentimes, patients complain of numbness or insensitivity in their feet. The peripheral nerves carry signals from your brain to your muscles, skin, and internal organs and glands. Neuropathy affects these nerves and inhibits their function resulting in the loss of feeling, generally in hands and feet.

Diabetics experiencing foot neuropathy may not feel the pain of cuts and sores due to the lack of feeling in this area, and if left untreated, the wounds can ulcerate and eventually result in possible amputation. It’s important to make daily foot care and observation a priority.  

Poor Circulation

Those with diabetes often experience poor circulation caused by peripheral vascular disease. The arteries narrow, reducing the amount of oxygen circulating in the body. The lack of oxygen impairs the body’s ability to heal as quickly due to the insufficient amounts of nutrients feeding the skin and other tissues. If not treated immediately, wounds and other trauma issues can quickly lead to ulceration, infection and more critical conditions.


Bunions, a prominent, bony bulge at the joint of the big toe, are one of the most common forefoot problems. Caused by the big toe and the next toe colliding, the big toe moves out, protruding toward the inside of the foot.  This protrusion causes the big toe to veer toward the other toes and often overlaps them. The skin over the area may be red and sore from abnormal friction, causing the patient discomfort and improper walking often develops to accommodate the pain.

Bunions are commonly caused due to improper footwear restricting the toe area. The deformity can result through medical conditions, such as arthritis or as an inherited structural flaw.


A hammertoe is caused when the PIP (proximal interphalangeal joint or middle joint) of the second, third, fourth, or fifth toe is contracted and causes the toes to bend. This bony prominence can put pressure on the toes and rub when wearing shoes.  Left untreated, hammertoes become more rigid and less invasive, non-surgical measure are ineffective.

Hammertoes are caused by a muscle or tendon imbalance. It may be hereditary, caused by trauma or ill-fitting shoes.

Heel Pain

Heel pain has many sources such as a stress fracture, arthritis, nerve irritation or tendonitis. It’s important to have heel pain properly diagnosed so the true cause of the ailment can be identified.

Repetitive stress and overuse of a specific area can cause the fat pad in your heel area to thin out. This ailment is caused by shoes that are too flat, and the heel area develops soreness.

Most often, heel pain is caused when the fibrous band of tissue (plantar fascia) that extends from the heel to the toes becomes inflamed, diagnosed as plantar fasciitis. The most painful times often occur in the morning or after resting the foot for long periods of time, but it subsides throughout the day. For some, the pain returns after being on their feet for extensive amounts of time.

Those individuals with flat feet or high arches are more prone to developing plantar fasciitis, though unsupportive footwear on hard surfaces can strain the plantar fascia and cause inflammation as well.

Often associated with plantar fasciitis, heel spurs can cause heel pain as well.  Calcium deposits gather on the bottom of the heel and cause bony protrusions, known as heel spurs, seen only on x-rays.

Flat Feet

Flat feet, sometimes referred to as fallen arches, are caused by overpronation. In normal running or walking, the foot rolls slightly inward to accommodate movement. When the foot rolls inward more than normal, you see overpronation. Flat feet look as if the entire sole of your foot makes contact with the floor.

This condition is often related to other problems with lower back, hip, ankle and knee. This structural deformity in the foot can be caused by trauma, health problems, improper fitting shoes or run in the family.

Ingrown Toenails

Toenails that have grown into the surrounding tissue can be incredibly painful and generally include the  infection of the toe and repeated issues of irritation and pain.

Ingrown toenails can be caused by cutting your toenails too short or not cutting them straight across. They can also result from trauma, such as stubbing your toe, or in other cases wearing shoes that are too tight. People whose toes tend to curl or individuals who suffer from a disease such as arthritis are more susceptible to have ingrown toenails.

Toenail Fungus

Known as onychomycosis, toenail fungus is caused when microscopic fungi enter your toenail, generally through trauma, and thrive in the warm, moist environment it finds. Nails become thick and discolored and patients often experience pain and discomfort.

Incidents increase with age but toenail fungus can affect anyone at any point. Public areas, swimming pools, gyms and shower stalls or any warm, moist environment can enable fungus to thrive and be picked up or shared.


A neuroma is a condition in which the nerve is “pinched” or more specifically there is a benign growth of nerve tissue in the foot. This painful condition is frequently found between the third and fourth toes. It is often described as a burning sensation, tingling or a numbness between the toes and in the ball of the foot.
This condition can be caused by deformities in the foot, trauma or improper footwear. Additionally, repeated stress can aggravate a neuroma.


Caused by a virus, this soft tissue condition can be incredibly painful.  The virus enters through small cuts or abrasions and thrives in warm, moist environments. Left untreated, warts can spread into clusters and grow to an inch or more in circumference.

Contact through skin or blood can spread the virus, like any other infectious lesion. And though most warts are harmless, they are still considered a viral infection and are often uncomfortable.