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Dr. Scott Biggerstaff, MD

Foot and ankle problems can range from annoying to life-changing. Dr. Scott Biggerstaff, an orthopedic surgeon specializing in foot and ankle, answers questions about conditions that commonly cause pain, stiffness and even odd sounds.

My ankle often pops in the morning. Is that normal?

As long as popping in the ankle isn’t painful, then it isn’t too much to worry about. Most likely, popping is caused by two tendons on the side of your ankle called the peroneal tendons. Sometimes these two tendons slide past each other and “pop.”

Your tendons relax while you are asleep, and then they shorten, or contract, when you stretch or start walking. When the peroneal tendons contract, they may slide past each other and feel like a pop.

These tendons can also slide out of the groove behind the ankle bone and then slide back. This scenario may cause a popping sound/feeling.  

It’s a different situation when the popping is painful. If the popping becomes painful, then is important to have your orthopedic foot and ankle specialist evaluate the situation.

Specific to the Achilles tendon, a popping feeling could be tendonosis, scarring and micro-tearing of the tendon. Seek care from a foot and ankle specialist if you experience any persistent or recurring pain in the Achilles.

What can you do about large, hard calluses on the ball of your foot?

Callouses can for several reasons and can be painful. Identifying the cause of your callouses will help determine the right method of treatment.

Callouses typically result from increased pressure on the ball of the foot. This increased pressure can result from a toe deformity like bunions or hammertoes or from other issues like high arches.

Diabetes can also lead to callouses in this region of the foot. It is important to ensure that any patient with diabetes, specifically diabetic neuropathy, does not have an underlying ulcer before proceeding with treatment.

Making sure your shoes fit appropriately can help relieve pressure on callouses. Consulting an orthopedic foot and ankle specialist is also a great starting place to start to address callouses. An initial evaluation will include a thorough patient history, physical exam and x-rays.  

Sometimes I will shave down the callouses and then put padding in the patient’s shoe to help relieve pain. Custom orthotics can also help relieve pain from callouses.

I experience pain and cramping when I point my toes. What causes this?

Most of the time cramping in the foot and toes is not caused by anything worrisome. Ill-fitting shoes, dehydration, tight muscles and medications are all common causes.

To avoid dehydration, make sure you stay well-hydrated, especially in hot weather and when exerting yourself. Stretch tight muscles to prevent cramps and pay attention to the side effects of any medications you take.

What treatment options are available for arthritis in the foot and ankle?

Treating foot and ankle arthritis depends primarily on where the arthritis is located.

We always begin with conservative treatment measures like bracing, orthotics, anti-inflammatory medications or physical therapy. We also frequently use cortisone injections to help relieve arthritis symptoms.

If pain and stiffness persist following conservative treatment, then we will consider surgical intervention. Your orthopedic foot and ankle surgeon will help you determine the best surgical treatment depending on which joint is affected.

The ankle and the big toe, or great toe, are two of the most common sites for arthritis. The ankle can be treated surgically by fusion or by ankle replacement, and the great toe is treated by shaving down bone spurs or possible fusion.

Hear more from Dr. Biggerstaff and other OrthoCarolina foot & ankle specialists about the issues that affect you most. Watch the Foot & Ankle episode of our Orthopedic Anatomy Series: Exploring the Body from the Inside Out.

Ready to see a foot & ankle specialist? Make an appointment today.

Dr. Scott Biggerstaff, MD, is a foot & ankle surgeon at OrthoCarolina Kernseville and Winston-Salem.


March 15, 2021

Dr Biggerstaff and his staff have been super great. Out of 4 surgeries done on both feet, this has been the most painless, healing fast and on my way to getting my shoes on again ( that match). lol. But yes, He is a great doctor and I wouldn't change for the world. you can count on him and his staff always.
- Pat Swaim
Reply From: OrthoCarolina

March 16, 2021

Thank you Pat