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The feet's important function
is to act as shock absorbers whilst walking and running.
With the flat foot disorder, the schock-absorbing mechanism
is impaired, and may cause not only pain in the foot,
but also in the ankles, knees, hips, back, and even
headaches.
Caring for your feet is essential to your
well-being. Small problems with your feet can be fixed
efficiently and quickly by your podiatrist.
In the mean time, here is information about common foot
disorders, their symptoms, causes, and how your podiatrist
cures them.
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 DEFINITION
– Achilles tendonitis is an inflammation due to
overstressing of the Achilles tendon. This tendon (also
called “heel cord”) runs from the heel to
the calf muscles. It is the thickest and strongest tendon
in the body needing sometimes to withstand up to 12
times a person’s body weight. Achilles tendonitis
is a soreness and stiffness that comes on gradually
and continues to worsen until treated.
Common symptoms are:
mild pain after exercise that gradually worsens,
pain along the tendon during and after running,
swelling and limited ankle flexibility.
The Achilles tendon will feel sore when
lightly pinched between the forefinger and the thumb.
It is a common injury amongst middle and long distance
runners. Repeated or continued stress on the Achilles
tendon increases inflammation and may cause it to rupture.
Partial or complete rupture results in traumatic damage
and severe pain, making walking virtually impossible
and requiring a long recovery period.
CAUSES – Multiple causes often
contribute to the same Achilles tendon injury. These
causes can be:
Excessive pronation: when walking, many people have
their feet rolling in (pronating). This causes the arch
to collapse, and the heel bone to roll internally. The
Achilles tendon is therefore stretched sideways instead
of in a straight direction, which
puts much stress at the point where it attaches to the
heel.
Poor athletic condition, infrequent exercise, bad warming-up
before exercise
Activities that involve sudden stops and starts and
repetitive jumping (e.g., baseball, basketball, football,
tennis, running, dancing)
Inappropriate footwear (high heels which shorten the
tendon).
Physical activity that produces the symptoms
should be discontinued. If pain develops even with proper
stretching and training techniques, the patient should
consult a podiatrist to check for excessive pronation
and the prescription of custom
orthotics (also called “arch supports”)
which will give controlled support to the arch and hence
neutralise abnormal foot pronation, maintain good foot
alignment and eliminate pain.
The amount of support necessary will differ
from one person to the other and a podiatrist will be
best able to measure the exact amount of support necessary
for each individual. If necessary, the podiatrist may
prescribe a small heel raise to temporarily help take
the pressure off the heel bone. Orthotics need to be
worn between 75 and 80% of the time when weight bearing,
to be effective.
Prevention is best achieved with
checking for pronation, an overall good shape, effective
warm-ups and stretches before exercise. Learn
more about orthotics on the orthotics information page.
For any questions about achilles
tendonitis, orthotics, or our treatment procedures,
give us a call.
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In certain cases, back pain essentially
occurs because of a poor position of the joints, from
the feet up. Flat feet are therefore the main factor.
Flat feet or 'over-pronation' occurs when
the feet roll in so that the arches are turned closer
to the ground. This incorrect position of the joints
of the feet and ankles causes the lower leg to rotate
internally.
As a result, the pelvis is forced to tilt
forward, which can cause an increased curvature of the
lower back. Especially after standing up-right for longer
periods the curvature in back will cause tightness and
stiffness of the lower back muscles.
In time, the hurtful position of the joints
can also cause inflammation and pain.
Back pain can be cured and prevented by
correcting the movement of the knee cap, pelvis, and
therefore, spine. Your podiatrist will do this by supporting
the feet with a type of insole called 'orthotics'
into a normal, aligned position, and the re-alignment
of upper joints in the leg, pelvis, and back will subsequently
follow.
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DEFINITION – A bunion is a protuberance of bone
or tissue around a joint, usually at the base of the
big toe but can also occur at the base of the little
toe (“bunionette” or “tailor’s
bunion”). It is often associated with the big
toe deviating at an angle (“Hallux Valgus”)
and a widening of the angle between the 1st and 2nd
metatarsals (long bones which connect to the toes).
Bunions are often
painful to various degrees and the skin and deeper tissues
around a bunion can also be swollen, red or inflamed
and painful. Because of the big toe pushing in toward
the lesser toes, the other toes can be indirectly affected
by a bunion: the smaller toes may overlap, develop corns
and become bent and toenails may begin to grow into
the sides of the nail bed.
CAUSES – When walking, many people
have their feet rolling in (also called “excessive
pronation”). When the foot pronates, excessive
weight is put on the big toe and its joint when the
foot pushes off. Over time the joint becomes bigger
to cope with the added weight.
 Some
bunions are caused by arthritis or trauma (fractures
or breaks into the joint). Footwear is not the common
cause as generally promoted but is only a contributing
factor: when wearing high heels, the person’s
weight is not distributed over the whole foot but nearly
only over the ball of the foot and especially on the
big toe.
Women tend to develop bunions more than men because
proportionally their feet have to carry more weight
than men. Similarly, overweight people will more easily
develop bunions.
Bunions can run in a family but are not
hereditary as it is the biomechanical structure that
is hereditary and passed through the family.
  Bunions
cannot be reversed, except through surgery. They can
only be relieved by custom
orthotics (also called “arch supports”)
which neutralize abnormal foot pronation and reduce
the load on the forefoot area. Proper weight distribution
and biomechanical activity are re-established which
may prevent or reduce the gradual growth of a bunion.
Sometimes surgery (“bunionectomy”)
may be indicated when a bunion is at a tertiary stage,
however, custom
orthotics must be worn after surgery to prevent
any reoccurrence. For the custom orthotics to be effective,
it is necessary to wear them between 75 and 80% of the
time when weight bearing.
For any questions about flat feet, orthotics,
or our treatment procedures, give
us a call.
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Ball of Foot Pain
(Metatarsalgia or Morton's Neuroma) |
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 DEFINITION
– Metatarsalgia (pronounce "Met-a-tar-sal-jia")
is pain in the ball of the foot, the area just before
the toes. It is a common disorder that causes a burning
sensation, a bruised feeling and generally speaking
pain over the whole area of the ball of the foot. Sometimes
a callous develops in the centre of the ball of the
foot and footwear may wear out in a similar spot.
Commonly associated with Metatarsalgia,
is Morton’s Neuroma. The symptom of Morton’s
Neuroma is a localized pain in the ball of the foot,
between the 3rd and 4th toes. It can be sharp or dull,
and is worsened by wearing tight fitting shoes and by
weight bearing. Morton’s Neuroma may also cause
numbness, tingling and discoloration of the 3rd and
4th toes (lesser toes).
CAUSES – Metatarsalgia commonly
occurs from rolling in of the foot (“excess pronation”)
along with rotation and dropping of the bones between
the arch and the ball of the foot (“metatarsal
bones”) resulting over time in weakening of the
soft tissue structures (ligaments and muscles), causing
pressure and pain. In the Morton’s Neuroma, the
3rd and 4th metatarsals pinch the nerve running between
them, causing the pain.
Custom
orthotics also called “arch supports”
will very effectively treat Metatarsalgia and Morton’s
Neuroma by preventing excess pronation, realigning and
lifting the bones of the ball of the foot to their neutral
position and maintaining them there. The amount of correction
necessary will differ from one person to the other and
a podiatrist will be best able to measure the exact
amount of correction necessary for each individual.
The patient will also be instructed to
wear shoes with wide toe boxes and avoid shoes with
high heels. In the beginning, when wearing the orthotics,
the muscles and ligaments of the feet and whole body
need to get used to the new correct position of the
feet. To do this smoothly, the wearing time of the orthotics
needs to be gradually increased over a 1 week period.
Orthotics need to be worn between 75 and 80% of the
time when weight bearing to be effective and it will
take approximately 3 months for the body to be fully
used to the new correct position of the feet. Learn
more about orthotics on the orthotics page.
For any questions about ball of foot pain,
orthotics, or our treatment procedures, give
us a call.
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Callous is a patch of abnormally hard
and thick skin, usually on the hands or feet. It forms
as a natural reaction to repetitive friction and pressure,
producing this hard protective surface. But when it
forms in bulk and excessively thick quantities, callous
may cause pain when pressure is applied.
Callous will only begin malforming if
the feet undergo unusual pressure from flat-foot
or high arches, or from badly fitting footwear.
Your prodiatrist will therefore treat
this disorder by correcting the position of the feet
with prescribed insoles called 'orthotics' or healthier
footwear, in order to cancel the abnormal walking movement.
Orthotics
provide support for the foot at all times and re-align
and re-balance the joints of the foot into a natural
position.
Your podiatrist will also
remove the callous by gently and painlessly paring the
hard dead skin away with a scalpel, until the skin returns
to a normal and comfortable thickness.
For any questions about callous,
orthotics, or our treatment procedures, give
us a call.
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| Children's Heel Pain
(Sever's Disease) |
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DEFINITION – Also known as children’s
heel pain. It most commonly affects children and teenagers
between the ages of 10 and 14 years. Affected children
will complain about pain at the back, side or underpart
of one or both heels upon walking or standing and sometimes
after sporting activities. Pain is
alleviated when walking on the toes.
CAUSES – Between the ages
of 8-14 years, children’s bones are still in the
growth stage. The end of the heel has “growth
plates”, i.e. cartilage that will ossify (turn
into bone). The Achilles tendon is attached to this
heel bone. Sever’s disease occurs when damage
or a disturbance in the area of growth of the heel bone
appears.
Sever’s disease is due to
a combination of 3 factors:
“excessive pronation”:
when walking, many people have their feet rolling in
(pronating). This causes the arch to collapse, and the
heel bone to roll internally. The Achilles tendon (heel
cord), which is inserted into the heel bone, is therefore
stretched sideways instead of in a straight way, which
puts much stress at the point where it attaches to the
growth plate.
an imbalance of growth spurts
in soft tissue and osseous growth.
overuse or repeated minor trauma happening with a lot
of sporting activities.
Cutting back on sporting activities, as
often recommended by doctors, will help in the short
term to alleviate the symptoms, but for long term relief
from Sever’s disease, consulting a podiatrist
is essential. Neutralising abnormal foot pronation with
the help of custom
orthotics also called “arch supports”
works very well with Sever’s disease.
As their name indicates, they support
the arch, preventing it from collapsing and hence stabilizing
the foot and the heel bone and its growth plate. If
necessary, the podiatrist may prescribe a small heel
raise to help take the pressure off the heel bone. Orthotics
need to be worn between 75 and 80% of the time when
weight bearing to be effective. Learn
more about orthotics on the orthotics page.
For any questions about flat
feet, orthotics, or our treatment procedures, give
us a call.
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| Children's Knee Pain
(Osgood Schlatter's Disease) |
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DEFINITION – Also known as children’s
knee pain. It most commonly affects young people, particularly
boys, between the ages of 8 and 15 years who play games
or sports that include frequent running and jumping.
It is a common form of “growing pain”. It
is characterised by swelling and enlargement of the
tibial tubercle, a raised area just below the kneecap,
especially painful when pressed. The hinge motion of
the knee is not affected.
 CAUSES
– Osgood-Schlatter lesion is due to abnormal tractional
forces on the tibial tubercle which is where the thigh
muscle attaches to the shinbone through the kneecap
tendon. These abnormal tractional forces can be due
to a combination of 3 factors:
“excessive pronation”: when walking, many
people have their feet rolling in (pronating), which
causes the tibia (shin bone) to rotate internally. At
the level of the tibial tubercle, the kneecap tendon
is pulled sideways instead of in a straight way, which
puts much stress at the point where it attaches to the
bone.
an imbalance of growth spurts in soft tissue and osseous
growth
overuse or repeated minor trauma happening with a lot
of sporting activities.
As these three conditions occur,
disruption of the tibial growth plate takes place (part
of the shin bone which, because the child is still growing,
is made of cartilage which will slowly turn into bone)
and the child or teenager will experience secondary
swelling and pain.
Osgood-Schlatter lesion may be temporarily
relieved by anti-inflammatories and rest from sport
activities, as often recommended by doctors, but consulting
a podiatrist is essential to treating the problem. Neutralising
abnormal foot pronation with the help of custom
orthotics also called “arch supports”
works very well with Osgood-Schlatter lesion.
As their name indicates, they support
the arch, preventing it from collapsing and hence preventing
the foot and the shin bone from rolling in. This in
turn reduces the tractional forces placed on the knee
joint and growth plate of the child. Orthotics need
to be worn between 75 and 80% of the time when weight
bearing, to be effective. Learn
more about orthotics on the orthotics information page.
For any questions about flat
feet, orthotics, or our treatment procedures, give
us a call.
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| Corns
Corns are simply areas of callous
which have become moulded into a thick and hardened
nucleus. Inside a corn is a cone-shaped core, the point
of which can press on a nerve, hence causing pain.
There are hard corns which occur on the
dorsum or on the tip end of toes as well as on the plantar
surface of the foot. Soft corns are always found between
the toes. They result from bony prominences and are
soft due to perspiration in the forefoot area. All too
often hard and soft corns are caused by tight fitting
shoes, high heels, deformed toes or the foot sliding
foreward in a shoe that fits too loosely. Basically
a corn is a reaction of the derm or skin, to stress
in a very defined area and is always indicative of concentrated
pressure in a specific site.
Seed corns are different. They are simply
hard beads or plugs of cholesterol and they have no
surrounding callous. They appear only on the sole of
the foot regardless of pressure from a bony part of
the foot and are frequently found in non-weight-bearing
areas. They may single or multiple.
The best way to prevent hard and soft
corns is to wear properly fitted footwear. The toe box
should be high and wide enough so as to not squash or
squeeze the toes. Shoes that are too tight or too loose
need to be avoided.
Orthotics
will help absorb shock and distribute pressure equally
over the whole foot.
Your podiatrist can of course gently pare
back the offending corn but without these preventative
measure, corns will inevitably reappear.
For any questions about corns, orthotics,
or our treatment procedures, give
us a call.
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| The Diabetic Foot
 DEFINITION
and CAUSES – Diabetes mellitus is a serious chronic
disease, generally defined as excessive glucose (sugar)
in the blood. When diabetes is present, either the body
produces less or no insulin (Type 1) or the body tissues
are resistant to the effects of insulin (Type 2). Insulin
is a hormone that helps the body deal with sugar (glucose)
in the diet. Diabetes therefore results in higher levels
of glucose in the blood, which can damage a whole range
of body tissues and organs.
EFFECTS – Diabetes can have important effects
on the feet, effects that can develop quickly or over
several years:
nerve
disease or neuropathy (loss of sensation), which
impairs sensation to the feet. This means that a diabetic
will no longer feel the pebble in his shoe or the corn
between his toes. This in turn can lead to injury, ulceration
and infection.
hypertension
and peripheral vascular disease among others,
leading to reduced blood supply. This “poor circulation”
means that the healing rate of skin or ulcers will be
slower.
CARE – Ulcers need to be taken very
seriously and treated promptly as they can otherwise
become infected and ultimately lead to amputation in
diabetics, whereas with proper care they are totally
preventable. Regular visits to a Podiatrist are paramount.
STATISTICS –
15
% of all people with diabetes will be affected by a
foot ulcer during their lifetime.
Up
to 85% of all amputations in relation to people with
diabetes are preceded by a foot ulcer.
50%
of the 2800 non-traumatic amputations that occur in
Australia each year are done on people with diabetes
because of poorly controlled diabetes!
It is therefore extremely important
for diabetics to:
Protect
their feet from injury by wearing well-fitting shoes
(soft, deep enough and broad enough,) by never walking
barefoot and always wearing socks with shoes.
Shake
out their shoes before wearing them.
Inspect
their feet daily (a podiatrist can show how).
See
a podiatrist every 3 to 6 months for a foot assessment
and to assist with corns, callouses and any nail problems
or if a wound or cut is not healing.
Cut
toenails carefully straight across and never cut into
the corners to avoid ingrowing toe nails; use an emery
board or file on sharp corners.
NEVER
use commercial corn cures. See a Podiatrist for corns
or callous.
Podiatrists have a very important
role to play in the prevention and management of complications
of the foot in those with diabetes. Regular foot care
from a Podiatrist is a key way to prevent problems from
developing in those who are at risk. When something
does go wrong, see a Podiatrist immediately. Waiting
a "few days to see what happens" may be the
difference between a good and poor outcome. The sooner
treatment is started the better.
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Flat feet or the lack of an apparent arch
when standing, may be genetic or due to lax ligaments
in the foot. Children until the age of 3 do not have
arches and always look as if they had flat feet.
For some people with flat feet, this is
just the shape of their feet. It just runs in the family.
For others, flat feet develop later in
life, due to arthritis, an injury or a ruptured tendon
of the foot.
For others again, flat feet may be due
to a loose ligament the the heel joint (subtalar joint)
or at the base of the big toe.
Rolling in of the foot is called "pronation"
and since the feet of these people roll in more than
normal, they are said to be "over-pronating".
Long-term over-pronation can easily lead
to Arch
Pain, Plantar
Fasciitis, Heel
Spurs, Bunions,
Knee Pain,
and/or Back
Pain. Flat feet are therefore guilty of causing
the majority of skeleto-imbalance-related ailments,
since the feet are the foundation of the body, and just
as in constructing a building, when the foundation is
imbalanced, so will the rest of the framework.
The effects of flat feet develop slowly,
and result from flat feet's long-term damage on the
body's joints. Some lucky people with flat feet never
will suffer any discomfort at all. However for those
who do, walking can become awkward and painful.
Orthotics, especially if they are custom-made,
will provide correct support to the arch of the foot
and medial rearfoot posting at all times and prevent
the rolling in of the foot.
Orthotics
provide support for the foot at all times and re-align
and re-balance the joints of the foot and higher joints
of the knees, pelvis, and spine into a natural position.
By encouraging a more comfortable
and correct position of the body's joints, the orthotics
therefore cure a vast range of foot
problems that occur because of a damaging position
of the joints. See
what orthotics can do for you by visiting the orthotics
page.
For any questions about flat
feet, orthotics, or our treatment procedures, give
us a call.
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| Fungal infections
Fungal infections are extremely common
on the skin of the feet and can also invade the nails.
Boots and closed in shoes create the necessary
conditons of moisture and warmth between the toes making
it easier for fungal infections to spread, especially
when public swimming pools and showers are used since
fungal infections are highly contagious.
The clinical diagnosis of a fungal infection
can be confirmed by microscopic examination of skin
or nail scrapings and the type of fungus can be identified
by culture of the scales. Treatment can be difficult
and lengthy, so it is a good idea to try to prevent
the infection by taking some simple measures.
Athlete's foot
This type of fungal infection causes red,
dry and flaking skin and can sometimes be painful or
itchy. It occurs mainly between the toes or on the soles
or sides of the feet. But the fungal spores can also
spread to other parts of the body such as the groin
or the underarms.
Prevention of Athlete's foot is possible
with careful foot hygiene. Thorough daily washing of
the feet and careful drying, especially between the
toes is essencial. Also important, are the wearing of
dry airy shoes and socks and the use of foot powder.
It is also recommended to not borrow footwear from others
and to wear protective shoes when using public showers
or pools.
In order to clear an existing infection,
your pdoiatrist will recommend a general topical treatment
to be used twice daily. If the infection becomes chronic,
an oral anti-fungal medication may be necessary, and
very strict foot hygiene will have to be followed.
Toenail Fungus
This type of fungal infection is rare
in children but very frequent with adults. All that
is needed is a small entry point for the microscopic
fungi such as a small trauma in the nail. From then
on, the infection will more than likely grow and spread
thanks to the ideal warm and moist conditions in the
socks and shoes.
The infected toenail will start to thicken
or to crumble. It will change colour to a yellowish,
brown or white colour. Streaks or spots may appear.
It is a difficult and lengthy condition
to treat. Toenail infections may take more than 18 months
to clear as the drug is incorporated only into newly
formed nail. A higher success rate will be achieved
through oral medication rather than topical applications.
Until the infection has been cleared,
the infected person should not go barefoot in places
where they would expose others to the fungi, i.e. changing
rooms and public swimming pools or showers and should
not allow anyone else to used their towels, shoes and
socks. A non-absorbent bath mat should be used and cleaned
with disinfectant. Anti-fungal powders or sprays should
be used regularly inside the shoes.
For any questions about toenail fungus,
athlete's fungus, orthotics, or our treatment procedures,
give us a call.
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| Heel and Arch Spurs
(Plantar Fasciitis) |
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DEFINITION – Plantar Fasciitis is
an inflammation of the Plantar Fascia. The Plantar Fascia
is a ligament that runs on the bottom of the foot connecting
the heel bone to the ball of the foot. It supports the
arch and can become inflamed due to excessive stretching.
This common foot pain is often felt near the inside
of the foot where the heel and arch meet. The pain is
often acute first thing in the morning after getting
out of bed or after a long rest and tends to subside
within a few minutes of weight bearing. Often the pain
is described as “moving around”.
CAUSES – Plantar fasciitis is generally
due to walking gait abnormalities. When walking, many
people have their feet rolling in (also called “excessive
pronation”). When the foot pronates, the arch
structure collapses, which stretches the plantar fascia
and places too much stress on the heel bone or the ball
of the foot where the plantar fascia is attached to.
Over time these tractional forces can result in inflammation
of the fascia and surrounding tissue, thus causing pain
in the arch, heel or ball of the foot. The heel bone
may sometimes respond by developing a bony growth in
its middle, called “heel spur”. Plantar
fasciitis is the forerunner to a heel spur.
Plantar fasciitis may be temporarily
relieved by anti-inflammatories, but consulting a podiatrist
is essential to treat the problem at the root. Plantar
fasciitis is best treated by neutralizing abnormal foot
pronation with the help of custom orthotics also called
“arch supports”. As their name indicates,
they will give controlled support to the arch. The amount
of support necessary will differ from one person to
the other and a podiatrist will be best able to measure
the exact amount of support necessary for each individual.
In the beginning, when wearing the
orthotics, the muscles and ligaments of the feet and
whole body need to get used to the new correct position
of the feet. To do this smoothly, the wearing time of
the orthotics needs to be gradually increased over a
1 week period. Orthotics need to be worn between 75
and 80% of the time when weight bearing to be effective
and it will take approximately 3 months for the body
to be fully used to the new correct position of the
feet. Learn
more about orthotics on the orthotics page.
For any questions about flat
feet, orthotics, or our treatment procedures, give
us a call.
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Ingrowing toenails happen when a sharp
nail, often the big toe nail, grows incorrectly and
cuts into the skin. As the nail grows and penetrates
deeper into the flesh, an inflammation often occurs,
and eventually becomes infected. The skin then appears
very red, swollen and tender to the slightest pressure.
Causes of Ingrown Toenails
Ingrown toenails are often caused by ill-fitting
footwear, a poor nail-cutting technique, and keeping
the feet in wet conditions for too long.
Shoes that are too narrow (or too shallow)
force the sides of the nail to fold and grow into the
toe. Flat-feet
(rolling in of the foot) increases the pressure on the
toe when walking, so that the nail pushes into the flesh
of the toe.
Incorrect nail cutting techniques such
as nails cut too short allow the nail to embed itself
into the protruding soft tissues. Nails cut obliquely
around the corners of the nail encourage the nail to
embed itself into the grooves on the sides of the nail.
Treatment of Ingrown Toenails
If the ingrown toenail is not infected,
your podiatrist will remove the part of the nail that
is ingrowing with fine nippers. The edge of the nail
will then be carefully smoothed with a special file,
and the cut flesh will be disinfected and thoroughly
dried.
From then on, your podiatrist will demonstrate
a proper nail cutting technique, and suggest the use
of orthotics
for a well-positioned foot, as well as properly
fitting footwear.
Ingrown Toenail Surgery
Nail
surgery may be necessary if in the long term the
nail keeps ingrowing, despite conservative treatment.
Surgery will consist of painlessly cutting the nail
away partially or completely. This is done under local
anaesthetic. The offending part of the nail will be
carefully cut off, so that the rest of the nail's surface
is flat.
The podiatrist will then use a chemical
solution to kill the part of the nail bed where the
ingrowing edge was growing from, so that the nail will
not re-grow from there again. The cavity will then be
packed and covered with an antiseptic dressing. The
patient will now be free to walk out pain-free, relieved,
and with a new-found comfort in their feet!
Three to four days after the surgery the
podiatrist will need to see the patient again to renew
the dressing and check the healing progress. Although
it will probably be much more comfortable to walk soon
after the surgery compared to before, it is necessary
to rest the foot as much as possible.
For any questions about ingrown toenails,
nail cutting, or our treatment procedures, give
us a call.
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Sharp pain
in the knee or outside the knee usually occurs during
or after excercise.
Knee pain often develops because of flat-feet
or 'plantar
fasciitis'. The misalignment in the foot and ankle
causes the knees to turn inwards, which leads to an
improper movement of the knee cap.
In time, the hurtful position of the joints
causes inflammation and pain.
Knee pain can be cured by correcting the
movement of the knee cap. Your podiatrist will do this
by supporting the feet with a type of insole called
'orthotics'
into a normal, aligned position, and the re-alignment
of upper joints in the leg and pelvis will subsequently
follow.
Orthotics: the Solution
Orthotics
provide support for the foot at all times and re-align
and re-balance the joints of the foot and higher joints
of the knee and pelvis into a natural position.
Another alternative, depending on the
extent of the misalignment, is to wear a knee strap.
Consult a FootWise
podiatrist about the treatment relevant to your
specific condition.
The pain itself can be relieved with anti-inflammatories,
but the disorder must be treated by a podiatrist to
avoid further damage to the knee joints.
For any questions about knee pain, orthotics,
or our treatment procedures, give
us a call.
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Definition – During walking, the
foot rolls in (or pronates) to a certain extent and
the arch flattens out to absorb shock when the heel
strikes the ground and to assist with balance during
mid-stance. This is normal and necessary for the foot
to adapt to the ground.
Over-pronation though, or excessive rolling
in of the foot can be problematic and painful since
the arch flattens out too much and soft tissues over-stretch.
Joint surfaces then function at unnatural angles to
eachother. This can first cause fatigue, and as things
worsen will strain the muscles, tendons and ligaments
of the foot and lower leg, making them painful.
Tell-tale signs of over-pronation:
Foot rolls in
Knees are often turned in
Increased curvature in the lower back
Bunions
Shoes may wear out very quickly at the level of the
big toe joint
Often a small inward kick of the heel (“abductory
twist”) is noticeable when walking
Common complaints relating to over-pronation:
Heel
pain, Sever’s disease
Ball of the foot pain (Metatarsalgia) and Moreton’s
Neuroma
Arch
pain (Plantar
fasciitis)
Back Pain
Shin splints
Knee pain,
Osgood-Schlatter’s disease
Achilles tendonitis
Bunions
or stiff 1st toe joint
Hammer toes
Ankle sprains
Hip pain
Flat feet
Corns and
callous
Custom
orthotics (also called “arch supports”)
are the best way to treat and prevent over-pronation.
They are custom-made shoe inserts which will give controlled
support to the arch and hence neutralise abnormal foot
pronation, maintain good foot alignment, prevent the
soft tissues in the foot from stretching and eliminate
pain.
The amount of support
necessary will differ from one person to the other and
a podiatrist will be best able to measure the exact
amount of support necessary for each individual. Orthotics
need to be worn between 75 and 80% of the time when
weight bearing, to be effective. Learn
more about orthotics on the orthotics page.
For any questions about flat
feet, orthotics, or our treatment procedures, give
us a call.
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| Plantar warts
Plantar warts (or warts affecting the
sole of the feet) are one of the most common viral infections
of the skin. They are very infectious and can easily
be transferred from one person to another in public
swimming pools, sports centres and gymnasia.
There can be considerable variations in
the appearance of plantar warts. In the early stages
they may be mistaken for hard corns or small areas of
callous, but warts have a much more rapid development
than corns and they can occur at any site whereas corns
mainly occur on sites of compression and friction.
Warts can occur as single or multiple
infections (mosaic warts). The mosaic wart tends to
be shallow and pain-free while the deep plantar wart
can be extremely painful.
Normally there is an immunological response
of the body to this infection leading to a spontaneous
regression of the wart or warts usually within 6 to
8 months of onset. Persistence of the wart beyond this
time or pain or disability are indications that an active
treatment should be undertaken by a podiatrist. Some
people have been shown to have a defect of cell immunity
and for them treatment may last longer than usual.
Treatment of Warts
Treatment consists in destructive techniques
to destroy the virus infected tissue and thus remove
the lesion. The two main techniques for destroying the
wart are chemical and cryosurgical.
Chemical
cautery: different types of acids can be used
by the podiatrist. It is extremely important that the
surrounding normal skin be carefully masked so as not
to be burned with the acid when applied to the wart
which can be best done by a podiatrist. It is essential
to see the podiatrist within a week or so for him to
gently remove the destroyed tissue under antiseptic
conditions. Oer or several further applications of acid
may be necessary until the wart becomes necrotic.
Cryosurgical
technique: with this technique the podiatrist
will freeze the wart or warts. The applicator which
is held in contact with the skin, reaches a temperature
of -55°C. The affected area will turn white and
temporary, visible changes in the intensity of pigmentation
may occur following treatment. Cryotherapy sometimes
gives rise to blisters. Some infections may require
a series of fornightly treatments. With cryotherapy
the uppermost layer of the skin, together with the infected
tissue, will disappear and will be replaced by a new,
healthy layer of skin in 10 to 14 days.
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