General Foot Care

Services

At Falcon Yard Podiatry / Chiropody we treat many different conditions related to the feet. Below is a list of common podiatry treatments, procedures and conditions treated at the clinic.

Callus

Calluses (Hyperkeratosis) is a build up of thick skin on the foot caused by friction in high pressure areas of the foot. This complaint is often accompanied by corns and can be mildly uncomfortable to painful and debilitating. Calluses often appear on the bottom of the foot around the forefoot, as well as the heel and around the sides and tips of the toes. If Calluses are left untreated, they can interrupt the blood (vascular) supply to the area and ulceration may result. It is recommended that people with diabetes are regularly screened and treated accordingly to prevent the development of a callus that can cause ulcerations.

Callus-2

We provide the following solutions:

  • Complete removal
  • Advice to prevent the reoccurrence of this complaint

Corns

Corns (Heloma Dura & Heloma Molle) are painful lesions/spots of thickened skin on the foot caused by friction in high pressure areas of the foot.

Hard Corns (Heloma Dura) appear on the top and sides of toes often secondary to footwear pressure and also along the bottom of the foot. Soft Corns (Heloma Molle) in most cases appear between the fourth and fifth toes. These have an unbearable stinging sensation and are extremely uncomfortable.

If Corns are left untreated, they can become very painful and may interrupt the blood (vascular) supply to the area and cause an ulcer. It is recommended that people with diabetes are regularly screened and treated accordingly to prevent the development corns that can cause ulcerations.

corn1

We provide the following solutions:

  • Complaint removal
  • Advice to prevent the reoccurrence of this complaint

Cracked Heels

Deep cracks, bleeding and pain in the heel are signs of heel fissures. These are caused by thick and dry skin.

cracked_heels

We provide the following solutions:

  • Remove the dry, cracked skin
  • Prescribe appropriate emollients to relieve the complaint
  • Advice to prevent the reoccurrence of this complaint

Fungal Nails

Fungal toenails (onychomycosis) are thickened, discoloured nails with debris/buildup beneath them. This is a very common complaint among senior clients.

This complaint can be confused with a thickened toenail (onychogryphosis/onychauxis). This complaint is caused by damage to the nail bed secondary to trauma of some type. The treatment of this complaint is different, therefore the correct diagnosis is essential.

fungal-nail-infection

We provide the following solutions:

  • Determine the appropriate antifungal medication to remove the complaint
  • Advice to prevent the reoccurrence of this complaint

Athletes Foot

Athletes Foot (Tinea Pedis) is a common fungal infection of the skin caused by the tinea pedis microbe. The signs of this complaint include itchiness, redness and peeling skin between the toes. Tinea Vesiculare is another fungal complaint of the foot that often presents with small blisters under the arch of the foot.

athletes-foot-700px

We provide the following solutions:

  • Recommend appropriate antifungal medication to remove the complaint
  • Advice to prevent the reoccurrence of this complaint

Verrucae / Plantar Warts

Verrucae pedis (plantar warts) are benign lesions that occur on the bottom of the foot in both children and adults. They are caused by the Human Papilloma Virus (HPV), which is one of the more common viruses and is the same virus that leads to warts on the hands and other areas. The virus is believed to be transported via water molecules and transmitted to others through tiny cuts and breaks in the skins surface. Walking barefoot in public amenities, locker rooms and swimming in public swimming pools are among the more common reasons people come in contact with the virus.

They can be painful and feel like a rock under the foot when walking if they are on a pressure point of the foot. Their appearance is also quite unpleasant with a plantar wart having a cauli-flowered appearance with tiny pigments throughout. The full extent of a plantar wart extends deep below the skins outer layer and explains why these lesions on the foot are more difficult to treat than a wart that appears on the hand.

verruca1

We provide the following solutions:

  • Falcon Yard Podiatry has a strict veruccae/wart treatment protocol developed over many years of sucessful treatment. We use a combination of three different techniques which evidence based research and our own experience has demonstrated to be most effective. This treatment regime is repeated once a month until resolution. Cryotherapy (liquid nitrogen) is one of the three techniques employed and is very effective when combined with all three treatments. In most cases, the sooner the wart is treated after it appears the quicker it will resolve.
  • Advice to prevent the reoccurrence of this complaint.

In-growing Toenails

An ingrown nail will occur when a portion of the nail forms a jagged edge (spicule) and begins to protrude into the surrounding tissue as the nail grows. Ingrown toenails are one of the most common reasons a client seeks the services of a podiatrist. They may occur as a result of poor nail cutting, direct trauma to the area, running in poorly fitted footwear or they may be due to a genetic predisposition which means the nails are too wide or too curled (involuted).

Ingrown toenails should be treated as quickly as possible as infection often occurs. Whilst antibiotics may sometimes be required, antibiotics alone are generally not a long term solution for the problem. The nail spicule must be removed, as leaving it will not allow the wound to close and the area is likely to become infected or painful again.

treat-an-ingrown-nail-1

We provide the following solutions:

  • Removal of the spicule. Following this, nail retraining is required to help the nail grow out past the skin fold or the problem will reoccur some months later. Thus, retraining of the problem nail is a vital part of solving the problem permanently.
  • In persistent and severe cases nail surgery or a partial nail avulsion may be required. This is a minor surgical procedure conducted under local anaesthetic in the podiatry rooms. A narrow problematic portion of the nail is removed using a strong alcohol solution to prevent any nail regrowth in the problem area. This is a permanent solution and has a success rate of over 95%.
  • We also offer advice to prevent recurrence of the problem.

Bunions

Bunions refer to the deviation of the great toe towards the outside of the foot. This deviation occurs from the great toe joint and causes the foot to become broader and the great toe does not function properly. Discomfort often occurs secondary to footwear pressure on the bunion prominence or due to degenerative changes in the great toe joint itself.

Causes of bunions include: genetic predisposition, poor footwear and hypermobile, flattened feet.

bunion

We provide the following solutions:

  • Antinflammation advice
  • Footwear advice
  • Night splinting to improve joint position and reduce discomfort
  • Forefoot padding and strapping techniques and
  • Use of orthotics

Forefoot Pain

Metatarsalgia / bruised metatarsals / stress fractures.

Symptoms often include localised sharp shooting pain in the long bones or the balls of the feet. Pain is often greatest when walking barefoot or on hard surfaces, such as tiles or concrete. The region can be hot to touch and pain is worse during and after activity. If a stress fracture is present pain may prevent further activity. Symptoms occur when the outer layer of bone becomes inflamed and damaged when exposed to excessive, repetitive stress.

problems-forefoot

We provide the following solutions:

  • Treatment to remove the pressures from the bones that are causing repetitive stress. This may require temporary forefoot padding and strapping techniques.
  • A client may also be prescribed orthotics with appropriate forefoot padding or we may take a selection of a clients own footwear (high heels) and place forefoot protection in the shoes for pain relief. Different regimes are necessary for different clients.

Mortons Neuroma (Neuromas)

Neuromas in the foot are a benign enlargement of the digital nerves that often affects the nerves between the 3rd and 4th digits. Symptoms usually include burning, shooting pains in the toes with some numbness. Pain is often worse when wearing footwear and walking.

Neuromas can be associated with hypermobility (excessive flexibility) of the foot joints. Excessive movement of the joints in the forefoot results in bones rubbing the nerves and causing them to get thicker. As the irritation persists, the nerve continues to enlarge and symptoms become more intense and occur more frequently.

We provide the following solutions:

  • Temporary forefoot padding and strapping techniques can help in the short term
  • Long term treatment using precise orthotic therapy has proven to be an effective method of controlling symptoms
  • In some cases, surgical removal of the neuroma is required

Sesamoiditis

This is a painful inflammatory complaint that affects the two small bones directly under the big toe joint. This is caused when the joint is exposed to too much pressure and is a common complaint among physically active clients and clients with high arches or dropped metatarsal.

Sesamoiditis

We provide the following solutions:

  • Pressure removal i.e. temporary forefoot padding and strapping techniques and use of orthotics and footwear
  • Advice to prevent the reoccurrence of this complaint

Flat Feet

Flat feet is a common term to describe a foot that pronates or rolls in too much at the ankle and midfoot. The arch height in many of these feet is lower to the ground than what is considered average. Looking at these feet it is often apparent that a large bulging is present at the inside of the ankle joint. All feet pronate and flatten, it is how the body naturally absorbs shock/pressures from the ground as you walk. However, if the foot flattens too much or at the wrong time during the natural walking cycle, this can be problematic. An important point is that a foot can appear to have a normal arch height when a person is standing, but still pronate or flatten excessively.

Flat / excessively pronated feet are associated with a number of lower limb overuse syndromes/pains including heel pain, ankle pain and shin pain. However, having a flat foot or a foot that pronates excessively is not a problem on its own, it is a combination of the flat foot and the activity level/type that may cause injury or pain. If you have a flat foot and you are suffering symptoms related to the flat foot, that is when treatment should be initiated in most individuals. Having said that, there are a category of clients who do display foot mechanics so extreme that we recommend treating a flat foot in the absence of symptoms, particularly if they choose activities that put them at greater risk such as running, football, netball etc. This judgement is made based on a thorough walking/running biomechanical assessment in conjunction with a clients own activity levels and types.

Appropriate footwear and orthotics are very helpful at managing any negative effects of a flat foot. Both not only solve many acute injuries, but can also promote a lifetime of comfort when exercising while also reducing the chance of an injury reoccurring.

Heel Pain (Plantar Fasciitis / Arch Pain / Heel Spur)

Once referred to as a ‘heel spur’, this is not a bone injury but a soft tissue injury to the plantar fascia, a band of tissue that runs under your foot from your heel to the toes. The plantarfascia acts as a rubber band to absorb shock as you walk and stand, constantly elongates and contracts. This constant stretching can result in a tear in the soft tissue, most often at the heel. Pain is often greatest in the morning or after periods of rest. It is common in those with a flattened arch as the stretching on the plantar fascia is more significant but it can occur in any foot type. This problem is often misdiagnosed and confused with a heel fat pad syndrome. Both are treated differently so correct diagnosis is very important.

Sports and activity related injuries treated most often by podiatrists are called overuse/repetitive strain injuries. The development of these injuries is usually a combination of two or more of the following:

  • Sudden change in the sport/physical activity level
  • Sudden change in the sport/physical activity type
  • Poor muscle flexibility
  • Poor muscle strength
  • Inappropriate footwear for the sport/physical activity
  • Foot/ankle biomechanics

We provide the following solutions:

  • Anti inflammation advice
  • Strapping techniques to achieve immediate relief
  • Advice in relation to appropriate stretches
  • Advice in relation to appropriate strengthening
  • Biomechanical assessment and treatment using orthotics as necessary
  • Advice in relation to footwear
  • Advice in relation to activity types and return to activity levels after the injury has repaired

Fat Pad Syndrome (Bruised Heel)

This is heel pain that tends to be isolated to the heel bone itself. The pain can often be isolated to the middle of the heel bone with pressure. Pain is greatest when standing for long periods, especially on hard surface without shoes on. The problem is caused by too much stress to the heel bone itself, often because the existing fat pad begins to atrophy and fail to absorb shock as well as it once did. The problem often presents with plantar fasciitis, but requires a different approach to achieve complete resolution so correct diagnosis is important.

We provide the following solutions:

  • Anti inflammation advice
  • Strapping techniques to achieve immediate relief
  • Appropriate cushioning to protect the heel bone
  • Advice in relation to appropriate stretches
  • Advice in relation to appropriate strengthening
  • Biomechanical assessment and treatment using orthotics as necessary
  • Advice in relation to footwear
  • Advice in relation to activity types and return to activity levels after the injury has repaired

Nail Surgery

Fully licensed and qualified to administer local anaesthesia with HCPC

-The Diabetic Foot

The problems are related to the systemic effect of diabetes on the lower limb which include:

a) Decreased circulation to the feet (reduced blood supply)

Diabetes can affect the large arteries of the body by causing them to become narrower. If the large arteries of the leg are narrower less blood reaches the feet, which is a condition called peripheral vascular disease. Less blood means healing rates for wounds, cuts, abrasions is longer and therefore increases the risk of infections and makes it more difficult for the body to fight those infections.

b) Decreased sensory nerve function in the feet (reduced feeling in the feet)

Diabetes can affect the peripheral nerves of the body, in particular the sensory or feeling nerves. In a condition called peripheral neuropathy the nerves in the feet are less able to sense damage to the feet. If a person with peripheral neuropathy cuts the bottom of the foot they may not be aware of it and continue to walk on the injured area. The area may become increasingly damaged and infected with no warning signs that there is a problem.

Falcon Yard Podiatry provides comprehensive treatment and monitoring of diabetic feet.

Annual foot check-ups – A diabetic foot assessment occurs every 12 months or more often if required. This is a vascular and neurological assessment that enables us to determine your foot status and potential risks for you. Vascular testing includes doppler readings and other cursory tests.

Regular foot maintenance – Once your foot status is determined, regular foot care may be conducted by us on an ongoing basis. This can include cutting of nails to prevent cuts and ingrown nail problems, removal and debridement of problem corns or callus and other routine foot advice. For many, these services are claimable under Medicare.

- Rheumatoid Foot

Rheumatoid arthritis (RA) is the commonest type of inflammatory arthritis. Up to 90% of people with this condition will report associated foot problems. For some people, the foot is the first area of the body to present with signs and symptoms of RA. For others, it may be months, years or maybe never that the foot is a problem for them. The difficulties people can experience vary from soreness, warmth and swelling (a flare) of one or more foot joints that lasts a few days or longer, through to joint erosions, with joint instability, pain and associated changing foot shape. These changes can alter the individual’s walking ability. RA and some medications can also have an effect on the skin and underlying tissues, making them more vulnerable to damage and infection. RA can cause bursae and nodules to form that may be susceptible to rubbing. Shape changes in the front of the foot can create pressure sites that develop corns and calluses (hard skin). These may develop into areas of ulceration if not treated appropriately, so it is advisable to request podiatry guidance if hard skin or corns are present on your feet.

Some people can experience decreased blood supply to feet and legs associated with atherosclerosis (where the inner lining of arteries become progressively thickened and impair the blood supply) and vaso-spastic disorders (where spasms of the blood vessels occur and the diameter of the blood vessels is decreased) such as Raynauds, these are less common.

Treatment options include:

  • Palliative foot care of callus, corns and nails etc.
  • Specialist assessment and management of wounds / ulcers that can occur on the foot
  • Prescribing specialist orthoses for the feet e.g. insoles, splints. These vary from soft devices that cushion tender areas under the foot to firmer devices that realign the foot, encouraging it to function better. Often these principles are combined in a device. Assessment and advice about appropriate footwear choices, footwear adaptations and accessing specialist footwear services.
  • Patient advice / education relating to the lower limb including joint protection, management of acute and chronic inflamed joints, appropriate exercise and surgical options.