Podiatry

Biomechanics and Sports medicine

Biomechanics is the study of gait and the functional relationship between the various joints of the lower limb and foot. Any mal-alignments may lead to symptoms, such as hip pain, knee pain, ankle pain, shin splints or plantar fasciitis. In other words, if the foot and leg are not functioning at their optimum the body may have to compensate for this and over time this may lead to symptoms or injury. Sports injuries, such as repetitive overuse injuries, are a common consequence of poor biomechanics. With a biomechanical examination we are able to assess any abnormalities in foot function and correct these by means of orthotics or exercises.

Podiatrists are part of the multidisciplinary team, our work often complementing or enhancing the work of physiotherapy.

Orthotics:

Alpha orthotics:

Alphathotics are pre-formed podiatric orthoses. They are made from a unique blend of rubber and plastic which is firm but flexible giving gentle functional control. They are ideal for less severe podiatric conditions having a low profile and therefore easily accommodated in most footwear.

Semi- custom orthotics:

Everflex orthoses are a semi-custom device. They are fitted easily and quickly using a system of templates matched to the patients feet, giving a very close proximity to their natural foot contours. The lab will then apply the heel posts and any other additions precisely to the practitioner’s instructions and to the patient’s measurements. The main body of the orthotic, the shell, is made from a material that flexes but is firm, giving good functional control. It is also guaranteed never to break. It allows an affordable treatment with the effect comparable with functional orthotics.

Follow up review:

The patient will be reviewed within four weeks of being supplied the orthoses and usually six weeks after that to ensure the orthotics are functioning well and that symptoms are reducing. Changes will also be monitored such as the stretching of the calf muscles; the straightening of the pelvis and reduction of limb length difference. Children are reviewed yearly if they are growing fast in order to monitor that their normal developmental changes are taking place.

Ordinary review:

This is a review appointment that takes place after the initial treatment is complete and both patient and podiatrist are happy. It may occur a year later or three years later or more and is initiated by the patient.

Routine Treatment

A full range of routine treatments are carried out including nail cutting, callus removal and padding and strapping.

Diabetic assessment

Poorly controlled diabetes can give rise to many complications. By checking things such as sensation and blood flow many of these can be prevented or caught early before too much harm is done.

These tests are recommended for all diabetics.

Podiatrists monitor circulation and neurological status. In addition to carrying out routine treatment, padding and strapping is used to protect areas of high pressure that may be at risk of ulcerating. We also deal with wound management.

Nail surgery

Most nail problems can be treated conservatively, however, those that suffer recurrent infection or pain will require to be treated surgically under local anaesthetic.

Procedure:

Under aseptic conditions and depending on the type of nail or problem two options available:

1) Total Nail Avulsion or 2) Partial Nail Avulsion

nail1

1) Example of a nail that would require whole removal

nail2

2) Example of a nail that would require partial removal

Under a local anaesthetic, whole or part of the nail is removed and a timed application of 80% Phenol is used to destroy the nail bed. A sterile dressing is then applied, the patient is then seen regularly until healing, which may take another 5 visits.

Verruca

Caused by a viral infection warts can often be left alone, however, when they become painful, unsightly or if they spread they can be treated by various methods. Treatments used include chemical (70% salicylic acid) and freezing (cryotherapy.)