What is podiatry?
Podiatry is the modern word for Chiropody. A podiatrist is a health professional who deals with the prevention, diagnosis, treatment and rehabilitation of medical and surgical conditions of the feet and lower limbs. He or she provides a medical service for the feet and foot related conditions. Podiatrists have skills in general foot treatments and Podiatrists such as Brendan Forde have developed particular specialisms in nail surgery, biomechanical assessments and foot posture related pathologies.
Podiatry/chiropody is a medical treatment, not a cosmetic service. After treatment, however, the feet will often look much better, and feel more comfortable as well.
A podiatrist is a health professional who deals with the prevention, diagnosis, treatment and rehabilitation of medical and surgical conditions of the feet and lower limbs. He or she provides a medical service for the feet and foot related conditions. A podiatrist has skills in general foot treatments but may have developed particular specialisms in nail surgery, biomechanical assessments and foot posture related pathologies.
So podiatry/chiropody is a medical treatment, not a cosmetic service. After treatment, however, the feet will often look so much better, and feel more comfortable as well.
At the Clinic, we work closely with colleagues in other, related disciplines, such as physiotherapy, osteopathy, podiatric surgery and dermatology. The extensive facilities of the Clinic mean that medical and nursing support are available on site.
What is the difference between a podiatrist and a chiropodist?
The simple answer is that the word chiropody has been declining over the last 10 years in favour of the word podiatry. Podiatry is now the recognised professional term in the medical world and with consumers and clients in the UK and abroad.
Both terms refer to practitioners who specialise in diagnosis and treatment of foot conditions. Chiropody/chiropodist have been titles used chiefly in the UK while podiatry/podiatrist are used in the rest of the English-speaking world. Increasingly, the term podiatrist is being used in Britain.
Since July 2005 both terms have been protected titles which means that they can only be used by practitioners who are registered with the Health Professions Council. Registration is itself dependent upon successful completion of a recognised course of training and a commitment to continued professional education.
Brendan Forde is a registered, experienced practitioner so you can have confidence in the treatment and advice you receive.
What conditions can be managed in the Martinstown Chiropody and Podiatry Clinic?
Treatment, assessments & advice related to:
General:
- corn and callous
- verrucae (plantar warts)
- skin disorders/infections
- nail pathology
- footwear advice
- foot health education and self-care advice
Specific:
- nail surgery
- cryotherapy
- biomechanical assessments
- Podopaediatrics
- sports injury management
- orthotic devices
- advice on systemic disorders that may affect the feet including diabetes, arthritic conditions, and those affecting the circulatory, nervous and musculoskeletal systems.
Sports:
- foot pain and injuries including sprains, heel pain, metatarsal pain, Achilles tendinopathy
- foot / posture related injuries such as ankle, shin, knee, low back pain
What areas can home visits be provided to?
Home visits are available on request for those who are house bound and cannot travel to the practice. We cover areas Ballymena, Broughshane, Clough, Cushendall, Glenariff, Cargan, Newtowncrumlin and Martinstown.
What does a general foot treatment appointment involve?
This appointment type attends to any nail pathologies/conditions. All nails are trimmed and filed and treated where needed. Skin conditions, cracked heels, corns and calluses are assessed and reduced. The treatment is finished with a foot moisturiser leaving your feet revitalised.
Chiropody is a medical service not cosmetic however often your feet will look and definitely feel better.
Also available are more specialised treatments for the permanent correct of ingrowing toenails or the treatment of structural problems in the foot.
Why do patients with Diabetes tend to have problems with their feet?
People with diabetes are prone to many foot problems, often because of two complications of diabetes: nerve damage (neuropathy), poor blood circulation. Neuropathy causes loss of feeling in your feet, taking away your ability to feel pain and discomfort, so you may not detect an injury or irritation. Poor circulation in your feet reduces your ability to heal, making it hard for even a tiny cut to resist infection.
When you have diabetes, you need to be aware of how foot problems can arise from disturbances in the skin, nails, nerves, bones, muscles, and blood vessels. Furthermore, in diabetes, small foot problems can turn into serious complications. You can do much to prevent amputation by taking two important steps: Follow the proactive measures discussed below—and see your Podiatrist regularly.
Having diabetes puts you at risk for developing a wide range of foot problems:
- Infections and ulcers (sores) that don’t heal. Because of poor circulation in the feet, cuts or blisters can easily turn into ulcers that become infected and won’t heal. This is a common and serious complication of diabetes and can lead to a loss of your foot, your leg, or your life. An ulcer is a sore in the skin that may go all the way to the bone.
- Corns and calluses. When neuropathy is present, you can’t tell if your shoes are causing pressure and producing corns or calluses. Corns and calluses must be properly treated or they can develop into ulcers.
- Dry, cracked skin. Poor circulation can make your skin dry. This may seem harmless, but dry skin can result in cracks that may become ulcers.
- Nail disorders. Ingrown toenails (which curve into the skin on the sides of the nail) can go unnoticed because of loss of feeling. If they’re not professionally treated, they can lead to ulcers.
- Hammertoes and bunions. Motor neuropathy (nerve damage affecting muscles) can cause muscle weakness and loss of tone in the feet, resulting in hammertoes and bunions. If left untreated, these deformities can cause ulcers.
- Brittle bones. Neuropathy and circulation changes may lead to brittle bones (osteoporosis). This makes you susceptible to breaking a bone, even without a major blow or injury occurring.
- Charcot foot. This is a complex foot deformity. It develops as a result of loss of sensation and an undetected broken bone that leads to destruction of the soft tissue of the foot. Because of neuropathy, the pain of the fracture goes unnoticed and the patient continues to walk on the broken bone, making it worse. This disabling complication is so severe that amputation may become necessary.
What is biomechanics?
A simple way of understanding the concept of biomechanics is to consider this analogy. A perfectly aligned car is far less likely to develop faults than one which has mechanical defects such as an uneven axle, a single flat tyre or tracking issue. The human body is also more likely to become injured if there is some form of mechanical misalignment. This could be the result of any one of many imbalances such as a leg length difference, stiff great toe or twisted vertebra!
Many practitioners simply assess a patient statically but many conditions are caused by the way an individual walks and runs. It is therefore essential that a comprehensive assessment is performed to analyse the movements (kinematics) and forces (kinetics) that may be causing abnormal tissue stress and injury.
What does a Biomechanical consultation involve?
A biomechanical consultation examines in detail the status of the lower limb. The individual will need to bring a pair of shorts and ideally a range of the footwear they use, the appointment takes about 1 hour.
A biomechanical assessment is carried out in four parts; The first part is an assessment of the medical history both general and local to your condition. The second is an assessment of the limbs non weight bearing and is carried out on the couch. The third part is carried out weight bearing and has the patient standing. The final assessment if necessary and appropriate is carried out on a treadmill to assess you in motion.
These four assessments are interpreted to identify the most effective way to manage your problem and the result of the biomechanical is discussed with yourself and a treatment plan started.
What is an orthotic?
Orthotics are inserts put into the shoe to re-align the foot, to take pressure off certain areas of the foot, or to increase comfort and function.
What are the different types of orthotics/insoles?
Insoles
Insoles can be simple constructions which aim to cushion support and relieve pressure from painful sites on the foot. They may be full-length devices or shorter versions as appropriate. They are useful as temporary solutions to acute problems/injuries or where control of joint motion is not required or possible e.g. in a very rigid foot. They are especially suitable for older patients where the ‘natural’ padding of the foot is thinner, protecting sites from painful pressure.
Temporary or ‘off-the-shelf’ orthotics
Mass produced orthotics are an economical and effective option for some conditions, especially for injury or pain that does not require specific or aggressive control of foot motion or for those conditions requiring only short-term use of orthotics. Depending on the materials involved, the average life span of ‘off-the-shelf’ orthotics is six to twelve months. They may be full or part-length depending on what is appropriate or will be better accommodated in footwear.
Semi-customised devices
These are ‘functional’ orthotics and are prescribed after a biomechanical assessment and/or gait analysis.
Greater accuracy of fit and prescription can be achieved using semi-customised orthotics than with temporary of the shelf orthotics. They can be modified within reason to the individual needs of the patient. These form a very cost effective way of achieving long term functional improvement for people who are not competing professionally or who have a reasonably normal foot type that does not require a casted device to be manufactured.
Prescription/custom made orthotics
These are functional’ orthoses that are prescribed after a biomechanical assessment and/or gait analysis has been carried out and are made to a plaster cast (mould) of your feet. They are made at a laboratory using your podiatrist prescription to align the structure of the foot in its most functionally efficient position. The orthotic, moulded from the cast, is designed to stabilise the foot and to prevent it from moving into an unbalanced position while walking or running. Prescription orthotics are usually made of a long lasting thermoplastic with a shock absorbing covering. This is the most specific and accurate way to have a controlling orthotic made but also the most expensive. They are used for foot deformities, severe foot posture disorders and for those wishing to have a custom made orthotic. Devices last for years and can be modified at any time.
Which sports shoes or trainers are best for my feet?
A number of sports shoes are available which have specialised features to control abnormally functioning feet. Brendan will happily discuss the trainer most suitable to your needs. Some general principles are;
Individuals who intend walking rather than running in their trainers should get those specifically designed for this function, walking trainers have the majority of the padding built around the heel of the shoe for shock absorption, rather than the forefoot as in a running shoe.
Running shoes should not have a large heel tab at the back as this can damage the Achilles tendon.
Those individuals with flat feet are often best suited to a stability trainer.
What footwear is suitable for orthosis?
Orthoses can be worn in most shoes that have an insole in them already as this can be removed and replaced with the orthosis. Any lace up, strap or Velcro fastening footwear should be able to except orthotics. The exceptions are footwear;
- that does not have a heel cup,
- with a heel height of more than an inch, and
- trainers that have a permanent build up to the arch (this type of trainer was common in the 90s but is seldom seen now.
A small piece of Velcro will keep the orthoses in place and allow it to be moved from shoe to shoe.
Are flip-flops good or bad for my feet?
This type of footwear is not ideal for feet as it offers very little support. Toes tend to “claw” as a result and the soft nature of the sole material often distorts very easily. Ladies who wear higher heels throughout the winter are more susceptible to injury if they then convert to a flat flip-flop for summer, because their calf muscles may not be able to tolerate the sudden increase in tension. This can lead to a variety of symptoms including arch pain, pain at the back of the heel and back pain.
What can I do to prevent foot problems?
- Properly fitted shoes are essential; an astonishing number of people wear shoes that
don’t fit right, and cause serious foot problems. Pressing down on the tip of the shoe, there should be the thickness of your thumb between the end of your longest toe and the end of the shoe. - Shoes with lace or Velcro fasteners should be worn most often.
- A shoe with a firm sole and soft upper is best for daily activities.
- Shop for shoes in the afternoon; feet tend to swell during the day.
- Walking is the best exercise for your feet.
- Do not wear constricting garters or socks.
- Never cut corns and calluses with a razor, pocket knife, or other such instrument.
- Trim or file your toenails straight across.