Foot Problems

 

Little Feet

The pitter-patter of little feet is more important than what you thought

Children’s feet differ from those of adults, as they are not yet fully formed. The last bone doesn’t begin to form until children are about three years old are not fully formed until age 18.Children’s feet are soft and pliable making them more prone to damage from abnormal pressure such as shoes and socks.

YOUR CHILD’S FOOT DEVELOPMENT

Birth

Around 10cm long at birth, the feet will double in size by the time your child is one year old. At 6 months of age the foot is still mostly cartilage, by 18 years, most of the bones (one quarter of all the bones in the body) are fully formed.

Baby

By 6 months your baby will be aware of and begin to play with both feet. The only footwear babies need are socks for warmth, as they are not constrictive and allow the feet to grow normally.

Walking

At around 12 months most children begin standing and walking. Those first steps are always exciting but just imagine – your toddler will probably walk the equivalent of four times around the world in a lifetime! Rapid growth during childhood may require changing the size of your child’s socks and shoes every few months.

Play

By the age of three, children are learning to jump, skip, hop, kick a ball and pedal a bicycle. Running, a more complex task than walking, is now also being mastered. Shoes should offer protection from injury or cold and still allow freedom and mobility. Make sure there is enough depth, length and width to accommodate the foot. Laces or straps that hold the shoe securely to the foot reduce slippage when walking.

School

By the age of six, children’s feet will have a quite grown-up appearance and their walking will resemble the pattern of an adult. Teach them to tie their shoelaces – a skill they’ll need for school. Keeping feet clean and dry and wearing thongs or sandals around the swimming pool helps to prevent tinea and warts – two common skin infections.

TAKING CARE OF LITTLE FEET NOW

Children’s feet are not simply little adult’s feet – they have a unique developmental pattern of their own. A check-up with a Podiatrist is recommended if:

  •  You notice uneven shoe wear
  •  You notice any skin rashes, hard skin, lumps or bumps onthe feet
  •  Your child complains of recurrent pain in the feet or legs
  •  Your child is constantly tripping and falling
  •  Or you have any other concerns about your children’s feet
Achilles

The Achilles tendon is the largest and strongest tendon in the body.  It connects the 2 large calf muscles (the gastrocnemius and soleus) to the back of the heel bone (calcaneus).  The tendon gives us the ability to rise up onto our toes and is very important in facilitating walking and running

 

What Causes Achilles Pain:

Achilles pain is usually a result of tendinitis caused by tight or fatigued calf muscles which transfer too much of the burden of walking or running to the Achilles tendon.  If the tendon is placed under too much stress then it will tighten and become over worked.  The tendon becomes inflamed and over time can produce a covering of scar tissue which is less flexible than the tendon.   If an inflamed Achilles continues to be stressed, it can tear or rupture.

Not stretching the calves properly, excessive hill running or speed work, both of which stress the Achilles more than other types of running, can bring on Achilles tendinitis.

Running in shoes that are too stiff can overload the Achilles, while shoes that are too flexible allow the Achilles tendon to twist and  in some cases can contribute to Achilles pain.   People who over-pronate (their feet roll too far inward on impact) are most susceptible to Achilles tendinitis.

The pain can be a dull or sharp pain anywhere along the back of the tendon, but usually close to the heel.   Often there is limited ankle flexibility with redness or heat over the painful area.   A nodule of scar tissue can often be felt in the tendon.   Sometimes you can hear a cracking sound (scar tissue rubbing against tendon) when the ankle moves.

To help prevent Achilles tendinitis stretching the calf muscles is important.  Wearing the right shoes and orthotics to address any biomechanical abnormality is important to help the normalise the strain on the tendon.  Rest until the Achilles is pain free then ease back into any running or walking program.  Avoid hill work, speed work and sand.  Remember to incorporate rest into your future training schedule.

 

Get started on resolving your lower limb pain today and book and appointment with The Podiatrist

Ankle Sprains

Ankle sprains and strains can happen every day. Early attention is important. Whenever you sustain a foot or ankle injury, you should seek immediate treatment from a podiatrist.

Anyone can experience an ankle sprain, from the fittest athlete to the most sedentary person. Usually, the cause is accidental. However, people who are overweight and those who wear high-heeled shoes are at an increased risk.

 

Ankle injuries usually involve a sudden, unexpected loss of balance that results in a sharp twist of the ankle. A strain occurs when a muscle or tendon overstretches. A sprain, which is more serious, occurs when strong connective tissue which connects one bone to another (ligaments) becomes overstretched.

 

 If you suffer an ankle sprain you can expect:

  • Pain, soreness and tenderness, from mild aching to intense pain
  • Swelling of the ankle, usually occurring very quickly after the injury
  • Inability to move the ankle or to stand and put pressure on it
  • Bruising
  • Ankle stiffness

 

Prevention is better than cure

  • If there is a tendency to roll over on the ankle, wearing snugly laced high-top shoes may provide some protection
  • Strengthen the calf muscles by doing heel raises and dips, and calf stretches
  • Wear supportive shoes – avoid platform soles, high heels, open shoes and sandals
  • Undertake a strengthening and stability training/re-training programme from a Podiatrist
  • Buy shoes that provide stability and support – custom orthotics may help provide ankle stability after an injury

 

 

Get started on resolving your lower limb pain today and book and appointment with The Podiatrist

Arthritis

Characterised by inflammation of the cartilage and lining of the body’s joints there are about 200 forms of arthritis.

The symptoms can affect many parts of the body – especially the feet. Because each foot contains 33 joints and bears a tremendous amount of weight and pressure, feet may be more susceptible to arthritis than other part of the body. When arthritis affects the feet, it makes standing and movement very uncomfortable.

There is no single cause, but several factors seem to increase the likelihood of getting the disease:

  • Age – uncommon before the age of 40
  • Gender – more common in women
  • Weight – being overweight increases the risk, especially in the knee
  • Injury – an injury, operation or repeated strain at a joint
  • Inherited factors – genetics do play some part in predisposing to arthritis
  • Infections in the joint

 

If you have arthritis in your feet, your joints may experience:

  • Swelling
  • Recurring pain or tenderness
  • Redness or heat
  • Limitation in motion
  • Early morning stiffness
  • Pain when walking

 

Care and management of arthritic feet

 

Shoes can also play a major part in the management of arthritis, the following are recommended:

  • Wear flat shoes, high heels push body weight forward on to the front of the foot thus increasing the pressure on these joints
  • Make sure there is enough room in around the toes – the area around the toes should be spacious enough so that no part of the shoe rubs
  • Natural fibres allow for better ventilation, which is healthier for the skin
  • Rubber soles provide extra shock absorption
  • Laces, velcro or buckles across the midfoot will hold the shoe firmly without squashing the toes – shoes that slip may rub against the skin
  • To provide support and stability for the feet wear shoes with an enclosed heel
  • Orthotic insoles and shoes specifically made to support your foot will increase cushioning or shock absorption, they can also direct pressure away from the more sensitive areas of the feet to make walking easier

Joint deformity caused by arthritis may create increased pressure and lead to skin lesions such as corns and calluses over the area. It is important not to let the hard skin build up as it often causes pressure and discomfort.

 

Get started on resolving your lower limb pain today and book and appointment with The Podiatrist

Blisters

Blisters are a small swelling or pocket of fluid in the upper layers of the skin.They are one of the body’s responses to injury, pressure or friction. Blisters on the feet are particularly common in runners, walkers and athletes. They can be caused by:

  • ill-fitting shoes
  • stiff shoes
  • wrinkled socks against the skin
  • excessive moisture
  • foot deformities

 

Blisters occur when feet get hot, sweaty and your socks stick to them. The sock and foot rub against each other and the inside of the shoe, leading to increased friction, which causes a blister. The result is a raised lump filled with clear fluid, which may or may not contain blood and the skin will be red and tender.

Blisters rarely need medical attention unless they are severe, recurrent or occur in people at risk of foot problems such as those with diabetes.

 

 

Prevention is better than cure

  • Wear shoes that fit properly
  • Keep feet as dry as possible
  • Wear sports socks when exercising or playing sports
  • If you become aware of a localised ‘hot’ area on your foot, stop your sport and tape the area immediately
  • If you are susceptible to blisters, visit a podiatrist, they will be able to advise on appropriate footwear, protective dressings and prevention measures

 

Get started on resolving your lower limb pain today and book and appointment with The Podiatrist

Bunions

A bunion is an enlargement at the base of the big toe joint caused by misalignment in the joint. Hallux valgus or hallux abducto valgus (HAV) is the name used for the deviated position of the big toe and a bunion refers to the enlargement of the joint – most of the time the two go together and can just be referred to as ‘bunions’.

Bunions are really only a symptom of faulty foot mechanics and are usually caused by the foot.

We inherit and inappropriate footwear use. As the big toe bends towards the others this lump becomes larger and the bunion can become painful – arthritis and stiffness can eventually develop.

Bunions can follow foot injuries and trauma and people with flat feet or pronated feet appear to have a higher incidence of bunions. Some activities, such as ballet dancing, put added pressure on the joint and may increase the chance of bunions developing. As the big toe begins to deviate the bunion can become painful – there may be redness, some swelling, or pain at or near the joint.

Corns and calluses can develop on the bunion, the big toe and the second toe due to the alterations in pressure from the footwear. The change in pressure on the toe may predispose to an ingrown nail.

Treatment options for bunions vary with the type and severity of each bunion and will also depend on what is causing the symptoms. Bunions are almost always progressive and tend to get larger and more painful with time – how fast this happens may be a function of the fit of the footwear.

 

When to see a Podiatrist

You cannot get rid of a bunion without surgery, however there are a number of things that can be done to alleviate the symptoms and your Podiatrist will be able to advise on the most appropriate treatment for you. This may include:

  • Applying padding to reduce pressure
  • Improving the range of motion
  • Treating corns and calluses
  • Wearing appropriate and correctly fitting footwear
  • Adjusting shoes to relieve pressure
  • Supplying orthotics to help with the instability about the joint
  • Exercises to maintain the mobility of the joint

Podiatrists have an important role to play in preventing and managing foot problems. Prompt action is important. Problems which are left without assessment or treatment may result in major health risks.

 

Get started on resolving your lower limb pain today and book and appointment with The Podiatrist

Corns and Callus

These are areas of thickened skin that forms at pressure points over bony prominences. They are one of the most common problems seen by Podiatrists and can occur on any part of the foot and vary in symptoms. A corn or callus is caused by one thing – too much pressure, usually in combination with some friction. In the foot, the skin will thicken up to protect itself where there are areas of high pressure. Corns and calluses do not have roots.

 

Too much pressure can be caused by:

  • Footwear that is too tight
  • Toe deformities, such as hammertoes
  • Bony prominences
  • Biomechanical or gait abnormalities

A corn or callus is a symptom of an underlying cause that needs to be assessed by your Podiatrist. A corn is a cone-shaped mass pointing down into the skin. A callus is a dispersed area of thickening that does not have the focal point of a corn. There are two main types of corn:

  • Hard corns which are concentrated areas of dry and hardened skin. They are the most common and often found on your fifth toe. They are sometimes called digital corns, and
  • Soft corns which are white and rubbery. They can be extremely painful and tend to develop between your toes.

Infection and ulceration of corns of the toe may occur. This can be a serious complication for those with poor circulation, peripheral neuropathy and the need for diabetes foot care.

Corns and callus that are not treated will become painful. They will not come right on their own unless the pressure that caused them is taken away.

 

Corns and callus are easy to prevent – just take away the cause. That cause is excessive pressure. Correct fitting of footwear around the toes, the use of pads to relieve pressure, surgical management of a bony prominence and regular podiatric care are the best options for prevention of corns and callus.

You should never try to cut out a corn yourself, however, there are other things you can do to help relieve the symptoms:

  • Use a pumice stone or a foot file to rub away the thickened skin, a little at a time (not if you’re a diabetic) – do this after you have soaked your foot in the bath for about 20 minutes so that your skin is softer
  • If the corn is between your toes, you can buy foam/silicone wedges that may help to relieve the pressure
  • Wear supportive shoes with a wide toe box and a low heel

The use of corn plasters in those who are at risk or have frail skin or poor circulation, are very likely to cause an ulcer (a breakdown of the skin), which could become infected.

Avoid remedies such as corn paint, cure or plasters as these will only treat the symptom of the corn and not the problem that causes it. In some cases, particularly for people with other health issues, some treatments can make the problem worse.

Get started on resolving your problem today and book and appointment with The Podiatrist

Plantar Fasciitis (Plantar Heel Pain)

This is ‘inflammation’ of the band of connective tissue which attaches to the heel bone and ends in the ball of the foot.

The plantar fascia acts like a bowstring and supports the arch and several muscles inside the foot.

When there is increased stress on the arch, microscopic tears can occur within the plantar fascia, usually at its attachment on the heel. This results in inflammation and pain with standing and walking and sometimes at rest.

Symptoms of Plantar Fascia

Plantar fascia usually causes pain and stiffness on the bottom of your heel although some people have heel spurs and suffer no symptoms at all. Occasionally, heel pain is also associated with other medical disorders such as arthritis (inflammation of the joint), bursitis (inflammation of the tissues around the joint). Those who have symptoms may experience:

  • ‘First step’ pain (stone bruise sensation) after getting out of bed or sitting for a period of time
  • Pain after driving
  • Pain on the bottom of your heel
  • Deep aching pain
  • Pain can be worse when barefoot

 

Get started on resolving your lower limb pain today and book and appointment with The Podiatrist

Ingrown Toenails (Onychocryptosis)

This occurs when part of the nail pierces the skin, often resulting in an infection. The severity of the appearance of an ingrown toenail will vary. Usually the side of the nail penetrates and it is difficult to see the edge of the nail. In some, the corner or a small spike of nail may penetrate the skin. This can result in an infection and the toe will then be red, inflamed and painful.

Poor nail trimming is often blamed for causing ingrown toenails, but there are several other factors involved:

  • The shape of the nail – a curved nail is more likely become ingrown than a flat one. The shape of the nail is usually inherited, but it can be influenced by trauma and/or shoe pressure
  • Improper nail trimming – rimming or tearing down the sides can cause an ingrown toenail
  • Leaving a sharp corner also puts pressure on the skin
  • Shoe pressure – tight footwear is more likely to increase pressure between the skin in the nail fold and nail
  • Trauma – this may alter the shape of the nail
  • Pressure from the toe next to the nail that has ingrown
  • A plump toe and those whose feet swell are more susceptible to ingrown toenails

 

Pain is the main symptom of an ingrown toenail, usually starting as minor discomfort and increasing to pain. The toe is not necessarily infected, but this can develop after the nail penetrates the skin to become ingrown. The infection can spread, making the toe red and inflamed (paronychia). Pus may also develop and large growths of skin can develop if it is left too long.

 

Prevention is better than cure

You can take some steps to help prevent the occurrence of ingrown toenails

  • Cut the toenails to the shape of the toe. This can be difficult if the nail is very curved down the side. In this case DO NOT dig down the sides – seek help from your Podiatrist
  • It is a myth that a V should be cut in the end of the nail to treat an ingrown toe nail
  • The shape of the nail is determined by the growing area at the base of the toe, not the end
  • Avoid wearing shoes and socks that are too tight
  • Keep feet clean to prevent the ingrown nail from becoming infected
  • Those with poor circulation or diabetes should not do any self-management of ingrown toenails but see a Podiatrist

 

Get started on resolving your pain today and book and appointment with The Podiatrist

Athlete's foot (tinea pedis)

is a common persistent infection

This is a common infection and does not only affect ‘athletes’. It is caused by a fungus that lives on dead tissue of the hair, toenails, and outer skin layers (dermatophyte), the fungi thrive in warm, dark, moist environments such as shoes, stockings, and the floors of public showers, locker rooms, and swimming pools.

Athlete’s foot is common and occurs more often in people who typically experience excessive sweating (athletes and non-athletes alike), and it is more common in warmer weather. It can be unusually persistent but should not be ignored and can be easily treated. If not treated it can can lead to cellulitis, a potentially serious bacterial infection.

 

Symptoms of Athlete’s foot

Athlete’s foot is characterised by itching of the skin on the sole of the foot or between the toes, scaling, peeling, redness, and the formation of small blisters. In general the lesions start between the toes and can extend to the borders and bottom of the foot. The skin between the toes may appear yellowish in colour and may have an unpleasant odour. The fungus has the potential to spread to the toenails and it can also be present in cracked heels.

The usual treatment is an over-the-counter antifungal cream, lotion, or powder containing antifungal agents. If the infection becomes systemic, stronger antifungal medication may be required. Tinea pedis infections can persist for years and may disappear spontaneously. Best results are usually obtained with early treatment before the fungal infection establishes itself firmly.

Prevention is better than cure

  • Keep your feet clean and be sure you dry your feet thoroughly, especially between the toes
  • After drying, apply antifungal lotion or foot powder
  • Choose ventilated shoes that allow your feet to breathe
  • Avoid wearing the same pair of shoes every day
  • When you can, go barefoot, the next best thing is to wear sandals or jandals
  • When you wear shoes, wear socks too – make sure you change them daily
  • Avoid sharing towels, clothing or footwear with others

 

Get started on resolving your problem today and book and appointment with The Podiatrist

Neuroma

A neuroma is often a painful condition which is like having a pinched nerve, swollen nerve or tumour in the ball of the foot. Anything that causes compression or irritation of the nerve can lead to the development of a neuroma. It may develop in various parts of the body, the most common neuroma in the foot is a Morton’s neuroma, which occurs at the base of the third and fourth toes. The result is pain, burning, tingling or numbness between the toes and in the ball of the foot.

People with certain foot deformities—bunions, hammertoes, flat feet, or more flexible feet—are at higher risk for developing a neuroma. An injury or other type of trauma to the area may also lead to a neuroma.

Early diagnosis of a neuroma greatly lessens the need for more invasive treatments and may avoid surgery.

Symptoms of Neuroma

The symptoms begin gradually and may go away temporarily by massaging the foot or by avoiding aggravating shoes. Over time the symptoms progressively worsen and may persist for several days or weeks. The symptoms become more intense as the neuroma enlarges and the temporary changes in the nerve become permanent. Symptoms may include:

  • Tingling, burning, or numbness
  • Pain
  • A feeling that something is inside the ball of the foot, or that there’s a rise in the shoe or a sock is bunched up

 

 

Get started on resolving your lower limb pain today and book and appointment with The Podiatrist

Warts (Verruca)

They are caused by a viral infection and over time, develop into a hard, rough growth on the surface of the skin. A wart is most commonly seen on the bottom of the foot (known as a plantar wart or verruca), but can also appear on the top. Most warts are harmless, but can often be painful.

If left untreated, warts can grow to 2cms or more in circumference and can form into clusters of several warts, these are called mosaic warts. Warts are spread by touching, scratching or even by contact with skin shed from another wart. Warts may also bleed – another avenue for spreading.

Warts may appear spongy, with tiny red, brown, or black spots. If left untreated, warts can spread to other parts of the foot. They can persist for years and occasionally may spontaneously disappear after a short time only to reoccur in the same spot.

Warts are sometimes mistaken for corns or calluses. When warts develop on the weight-bearing areas of the foot – the ball of the foot, or the heel, for example – they can be the source of sharp, burning pain. Pain occurs when weight is brought to bear directly on the wart, although pressure on the side of a wart can create equally intense pain.

Children, teens, and people with allergies or weakened immune systems are more vulnerable to the wart virus.

Prevention is better than cure

Avoid going barefoot in public places like showers, gyms, and locker rooms. It’s believed that the warts virus may spread easily in settings like these, it’s recommended you wear jandels in public bathing areas.

  • Change your shoes and socks daily and keep your feet clean and dry.
  • Avoid direct contact with warts – from other people or other parts of the body.
  • Do not ignore growths on, or changes in your skin. Visit your Podiatrist as part of your annual health checkup.

After your Podiatrist treats your warts, protect your feet from future infection by keeping them clean and dry.

 

Get started on resolving your problem today and book and appointment with The Podiatrist

A flat foot (pes planus)

This is sometimes referred to as fallen arches or pronation of the feet, and is a structural deformity resulting in the lowering of the instep/arch of the foot. A person with a flat foot needs assessment to determine whether they are at risk for long-term complications. People with flat feet may have ankle, knee or lower back pain.

Flat feet due to injury, disease, or normal aging are not preventable. In some cases, flat feet are caused by a physical abnormality, such as tarsal coalition (two or more bones in the foot that have grown together) or accessory navicular (an extra bone along the side of the foot).

The effects of diseases such as diabetes and rheumatoid arthritis can lead to flat feet. An injury (e.g., bone fracture, dislocation, sprain or tear in any of the tendons and ligaments in the foot and leg) can also cause flat feet.

Flat arches in children usually become proper arches and high arches while the child progresses through adolescence and into adulthood. If a child begins to walk oddly or clumsily, for example on the outer edges of the feet, or to limp during long walks, or complain about calf muscle pains or any other pains around the foot area, seek an assessment by The Podiatrist.

 

Symptoms of Flat Feet

The primary symptom of flat feet is the absence of an arch when standing. Other symptoms may include:

  • Foot pain
  • Pain or weakness in the lower legs
  • Pain or swelling on the inside of the ankle
  • Uneven shoe wear

 

Get started on resolving your lower limb pain today and book and appointment with The Podiatrist

Hammertoe

Is a painful deformity wherein a toe bends unnaturally

Hammertoe is a painful deformity where the toe or toes bend in an unnatural position. They can develop on any of the toes, but generally affects the middle three and, most often, the second toe.

When unusual stress is applied over a period of years, the joints and tendons of your foot can cease to function in a balanced manner and toes, in an effort to compensate, can begin to bend into the hammertoe shape. Hammertoes tend to run in families.

Hammertoe is caused when muscles fail to work in a balanced manner and the toe joints bend to form the hammertoe shape. If they remain in this position, the muscles and tendons supporting them tighten and stay that way.

Causes of hammertoe can include:

  • Squeezing into a too-small or ill-fitting shoe or wearing high heels that jam your toes into a tight toe box
  • An injury such as badly stubbing your toe
  • Arthritis
  • Nerve and muscle damage from diseases such as diabetes

 

The most obvious sign of hammertoes are bent toes, other symptoms may include:

  • Pain and stiffness during movement of the toe
  • Painful corns on the tops of the toe or toes from rubbing against the top of the shoe’s toe box
  • Painful calluses on the bottoms of the toe or toes
  • Pain on the bottom of the ball of the foot
  • Redness and swelling at the joints

 

Prevention is better than cure

As long as hammertoe causes no pain or any change in your walking or running gait, it isn’t harmful and doesn’t require treatment.

The key to prevention is to wear shoes that fit you properly and provide plenty of room for your toes. Here’s how to get the right fit:

  • Have your feet properly measured
  • Make sure that, while standing, there is a centimetre (½ thumb) of space for your longest toe at the end of each shoe
  • Buy shoes that fit the longer foot
  • Shop at the end of the day, when foot swelling is greatest.
  • Don’t go by numbers – sizes vary by brand, so make certain your shoes are comfortable
  • Wear wide shoes with resilient soles
  • Avoid shoes with pointed toes
  • Certain exercises such as moving and stretching your toe gently with your hands and picking up small or soft objects such as marbles or towels can keep your toe joints flexible, simple exercises can stretch and strengthen your muscles
  • Limit high-heel use, well-designed flat shoes will be more comfortable than high heels
  • Don’t wear shoes that are too short or too narrow, or too shallow – this is especially important for children going through periods of rapid growth, the toe area should be high enough so that it doesn’t rub against the top of your toes

 

Get started on resolving your lower limb pain today and book and appointment with The Podiatrist

Podiatrists have an important role to play in preventing and managing foot problems. Prompt action is important. Problems which are left without assessment or treatment may result in major health risks.

 

Nail Fungus Infections

Often called onychomycosis (on-i-ko-my-ko-sis), it is caused primarily by organisms called dermatophytes and is extraordinarily common. Yeasts and moulds also can be responsible.

Fungal nail infection has little to do with personal cleanliness. Something as simple as banging a toe or finger, trimming your nails too closely or wearing tight shoes is enough to weaken the nail and expose the underlying nail bed to infection.

Toenails are most vulnerable to infection, since they spend much of their day surrounded by dark, warm and often moist shoes and socks.

An infection may begin as a white or yellow spot under the tip of your toenail. As the nail fungus spreads, it may cause your nail to discolour, thicken and develop crumbling edges. You may feel pain in your toes and detect a slightly foul odour.

Thick toenails, in particular, may cause discomfort in shoes and may even make standing and walking uncomfortable for some people.

The infection can spread to other nails, and possibly to other people. That’s why it is important to seek treatment as soon as you think you have an infection. Your Podiatrist can diagnose and identify the fungus.

Ageing is a common risk factor for nail fungus for several reasons, including:

  • Diminished blood circulation
  • More years of exposure to fungi
  • Nails may grow more slowly and thicken with age, making them more susceptible to infection

 

Other factors that can increase your risk of developing nail fungus include:

  • Perspiring heavily
  • Working in a humid or moist environment
  • Wearing socks and shoes that hinder ventilation and don’t absorb perspiration
  • Walking barefoot in damp public places, such as swimming pools, gyms and shower rooms
  • Having athlete’s foot (tinea pedis)
  • Having a minor skin or nail injury, a damaged nail, or another infection
  • Having diabetes, circulation problems or a weakened immune system

 

Prevention is better than cure

  • Keep your feet as clean and dry as possible. Regularly use an anti-fungal talcum foot powder
  • Use shower shoes when walking in public swimming and shower areas
  • Clip your toenails straight across so that your nail does not extend beyond the tip of your toe
  • Wear comfortable shoes that fit properly

 

Get started on resolving your problem today and book and appointment with The Podiatrist

Sever's Disease (Calcaneal Apophysitis)

It is thought to be a traction injury, where the Achilles tendon and Plantar fascia pull in opposite directions. Sever’s occurs in children aged 8 to 16 years old.

In children, the heel bone is made up of 2 bones, with a growth plate of cartilage in between the sections, holding these 2 bones together. As the cartilage expands, the edges of it eventually turn to bone, and finally the gap closes. This usually occurs within the first 13-15 years of life. However, because these bones are connected by cartilage they are weaker than normal bones. This is why they are very vulnerable to injury.

Contraction of the calf muscles along with the rapid growth of the leg bone (tibia), decreases ankle motion and increases strain on the heel area. This puts strain on the Achilles tendon. Injury results from repetitive pulling through the heel bone by the Achilles and the traction forces from the plantar fascia.

Sever’s is recognized by pain in the back and lower regions of the heel. It usually starts during or immediately following the child’s growth spurt, and/or in very active individuals. The child will usually have pain during or following participation in sport, and will often be seen limping off the field or court.

 

Symptoms of Sever’s

  • Painful heel
  • No swelling or warmth
  • Night pain is absent
  • Pain is worse with increased activity
  • Pain which is usually relieved by rest
  • Children often hobble or limp from the sports field

 

Get started on resolving your lower limb pain today and book and appointment with The Podiatrist

Stress Fracture

Stress fractures are common injuries, especially among athletes and may develop over a period of many days, weeks or months. They are an ‘incomplete’ break in the bone, often do to overuse.

Stress Fractures are caused by excessive stress on the bones of the foot and can often be caused by a biomechanical imbalance or by a medical condition, such as osteoporosis, or medications, such a steroids.

Contributing factors to stress factures may include:

  • Low body weight
  • High training intensity
  • Poor nutrition, physical stress
  • Younger athletic children involved in multiple sports will be more prone to stress fractures

 

How to recognize and treat a stress fracture

The onset of pain and swelling is usually gradual and may hardly be noticeable at first. If it gets worse with activity and improves with rest, this may be a sign of a stress fracture.

 

Get started on resolving your lower limb pain today and book and appointment with The Podiatrist

Shin Pain

Shin pain is a very common lower leg complaint that usually manifests itself as shin splints. Shin splints are characterised by pain in the front or side of the lower leg. It is especially common among people involved in athletic pursuits such as running and walking, although non athletic activities such as standing all day at work can also lead to shin splints. Symptoms include tightness, tenderness to the touch along the edge of the shin bone (tibia) and throbbing of the shins during and after activity. The symptoms often disappear at rest then return as soon as activity is resumed.

 

Causes of Shin Pain

  • A sudden increase in activity is the most common cause either when first starting an exercise program or when increasing distances to quickly.
  • Exercising on hard surfaces.
  • Tight lower leg muscles.
  • Exercising in shoes with inadequate support and/or cushioning.
  • Biomechanical factors such as excessive pronation of the foot are considered to be significant contributing factors in the cause of shin pain. When the foot contacts the ground taking all our weight, it rolls inwards (pronates) to absorb the shock of our body weight hitting the ground. One of the important muscle groups helping to control this motion are the muscles in our shins. When the foot pronates too far or too fast these muscles are overworked and become fatigued and painful.
  • Shin pain can be a result of a stress fracture in one of the bones in the shin, the Tibia or Fibula.

 

Get started on resolving your shin pain today and book and appointment with The Podiatrist

Knee Pain

Knee Pain by Location

– Pain on the front of the knee can be due to bursitis, arthritis, or softening of the patella cartilage known as chondromalacia patella.

– Pain on the sides of the knee is commonly related to injuries to the collateral ligaments, arthritis, or tear to the meniscus.

– Pain in the back of the knee can be caused by arthritis or cysts, known as Baker’s cysts.  Baker’s cysts are an accumulation of joint fluid (synovial fluid) that forms behind the knee.

General knee pain can be due to bursitis, arthritis, tears in the ligaments or meniscus, osteoarthritis of the joint, or infection.

– Instability or the knee giving way is also another common knee problem. Instability is usually associated with damage or problems with the meniscus, collateral ligaments or patella tracking.

– Knee pain can also be caused by tendinitis which is inflammation, irritation and swelling of a tendon. Tendinitis pain in the knee is located in the front of the knee or the lateral side of the knee. The pain often gets worse when going up and down stairs or inclines. Tendinitis knee pain is common in runners, skiers and cyclists.

A biomechanical assessment will help to determine if your knee pain is caused by an alignment problem. Often an alignment problem in the knee starts from poor foot posture. As the foot moves on the ground, it sets up a chain reaction of movements throughout the body including the knee. Too much movement or the wrong type of movement at the wrong time can lead to the development of knee pain.

 

Get started on resolving your knee pain today and book and appointment with The Podiatrist

Cracked Heels

Cracked heels are a common foot problem often caused by dry skin around the heel, which can be further complicated by the presence of callous around the heel. If left untreated, a crack in the skin may develop into a fissure (open, deep crack). This may in turn cause pain and bleeding, as well as increasing the possibility of an infection in that area.

 

Dry skin and callous can be caused by a number of systemic conditions including diabetes and an under-active thyroid. Poor footwear is also a contributing factor, especially in shoes with open backs.

 

The pain associated with cracked heels may be very little to begin with. However if they develop into open wounds, then walking may become very uncomfortable as well as being unsightly.

 

Self management of cracked heels

 

  •  Following the advice of the podiatrist
  •  Proper fitting shoes with a closed back and good retaining medium
  •  Use of emollients such as Callusanor Gehwol creams to keep the skin in good condition

 

Podiatric treatment 

 

  •  Assessment to determine cause of cracked heels
  •  Removal of dry skin and callous; cracked heels may not heal if the overlying callous is not reduced
  •  Advice on footwear
  •  Advice on emollients like Callusan
  •    Treatment of open cracks along with advice on reducing the possibility of infection
  •  Cushioning insoles to relieve pain

 

Get started on resolving your problem today and book and appointment with The Podiatrist

Posterior Tibial Tendon Dysfunction (Adult Flat Foot)

What Is PTTD (adult flat feet)?

The posterior tibial tendon is one of the most important tendons of the leg. The posterior tibial tendon attaches the calf muscle to the bones on the inside of the foot. The main function of the tendon is to hold up the arch and support the foot when walking. Posterior tibial tendon dysfunction (PTTD) is a condition when the tendon becomes inflamed, elongated or torn. As a result, the tendon may not be able to provide stability and support for the arch of the foot, resulting in flatfoot.

Causes of PTTD

  • One of the most common causes of PTTD is tendon overuse
  • Symptoms usually develop following activities such as stair climbing, hiking, walking, and running.
  • An acute injury, such as from a fall, can tear the tendon or cause it to become inflamed.
  • High-impact sports, such as basketball, tennis, or soccer, may cause tears within the tendon from repetitive use

 

Possible risk factors for include:

  • Diabetes
  • Obesity
  • Elevated blood pressure
  • Previous trauma (e.g. certain types of ankle fracture)
  • Rheumatoid arthritis, psoriasis, and other inflammatory conditions
  • Steroid injections

 

Symptoms of PTTD

  • Pain, typically around the inside of the foot and ankle.
  • Swelling, warmth, and redness along the inside of the foot and ankle.
  • Pain that is worse during activity.
  • Flattening of the arch.
  • Inward rolling of the ankle.
  • Turning out of the toes and foot.

As the condition progresses, the symptoms will change.

Non-surgical Treatment

If treated early enough, your symptoms may resolve without the requirement of surgery. However if left  untreated PTTD may leave you with very flat feet can lead to painful arthritis in the foot and ankle and limit daily activities  such as walking and running

  • To give your arch the support it needs, your podiatrist may provide you with a custom orthotic device that fits into the shoe or an ankle brace
  • In some cases a short-leg cast or boot can be worn to allow the tendon to heal by immobilizing the foot or the patient may have to completely avoid bearing any weight on the leg for a while.
  • Exercises therapy may help heal the tendon and muscle after immobilization.
  • The Podiatrist may recommend changes to your footwear and may provide orthotics designed to improve arch support.

Get started on resolving your lower limb pain today and book and appointment with The Podiatrist

 

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