Podiatry / Chiropody Services

General Footcare

Footcare for all ages. Nail care and callus / dry skin reduction.

Callus

A question many of our patients have is why do I get hard skin on my feet. Well to simplify this answer, it all comes down to the high localised areas of pressure going through your feet as a direct cause of either poor choice of footwear, foot shape or foot/ lower limb function.

Essentially any area of friction caused to a certain part of your feet (mainly bony areas) will result in your body producing hard skin or callous as a defensive mechanism to stop the deeper layers of your natural skin from breaking down.

Callus is thickened skin in a discreet area. It is caused by an increase in cell production (hyper proliferation ) leading to increased layers of stratum corneum (hyperkeratosis).

Corns

Corn is a localised area with a deep centre nucleus. It usually occurs when the subcutaneous tissue is highly disrupted, which results in the stratum corneum to become thickened and form a nucleus of the corn.

The sharp cone shaped nucleus can often feel like a sharp pin digging into the foot. It often forms on the sole of the feet or even resides under the toenail.

There are many different types of corns:

Heloma Durum- hard corn, tense lesion found on exposed site of direct pressure.

Heloma Milliare- seed corn, found on the sole of the foot. It is hard and very small and found in clusters and can be very painful.

Heloma Molle- Soft corn, found in between toes. It is usually ring shaped with maceration. Outer edge is has a rubbery sensation.

Heloma Neurovasculare- neurovascular corn embedded with small blood vessels or nerves. Appears as tiny dots usually red or yellow. Tends to be painful and usually bleeds when removed.

Treatment of corns are by a method of enucleation (removal of nucleus) using a scalpel blade. We then address the mechanics of the foot to redistribute the pressure away from the corn with padding or insoles.

We do not recommend the usage of medicated corn plasters as this can cause damage to healthy skin tissue surrounding the corn, causing ulceration and infections.

Nail Cutting Service

Nail pathologies can be very difficult to treat at home. The most common nail pathologies we see are:

Onychauxic nail – Thickened nail plate caused by trauma, fungal infection, age or poor circulation. These factors cause a change to the nail matrix resulting in hypertrophy.

Onychogryphotic nail – Thickened nail plate with distorted direction of growth. Usually caused by trauma, neglect and genetics.

Onychomycotic nail- Fungal infection of the nail bed and plate. Caused by poor health, trauma, warm climate, immunosuppression and occlusive footwear.

Onychocryptotic nail- known as ingrowing toe nail. Nail becomes pierced into the epidermis of sulcus to the dermis. Common symptoms are pain, inflammation, exudate, malodour and hyper granulation tissue. The main causes of ingrowing toe nail are hyperhidrosis, poor nail cutting, trauma and involuted nails. Can be solved without nail surgery, but to prevent future reoccurrence nail surgery is the most promising.

Involuted nail – Curved nail. Caused by hyperhidrosis, trauma, local pressure, footwear or hereditary.

We also offer general foot care treatment for routine check up and nail cutting.

• Onychauxic nails (Thickened Nails) – caused my micro-trauma over the years.

• Onychogryphosis nails (Grossly thickened and deformed nails) – usually caused by macro trauma and microtrauma/genetics.

• Onychomycosis nails (fungal nails) – caused by airborne fungus. Very stubborn and difficult to remedy. We have treatment options however that reap superior results than most. Call us for a free discussion regarding this.

• Onychocryptosis nails (ingrowing toe nails) – can many times be solved without nail surgery, but nail surgery is the sure fire way to remedy this condition and to stop it from re-occuring.

Nail Surgery

Nail surgery is sometimes required in patients with ingrown toenails where part of the nail has grown into the surrounding skin. This can happen slowly or even overnight and if left for too long can result in a deep abscess or infection. It is therefore important to have your nail cut and debrided regularly from a podiatrist to prevent it from getting more serious.

Symptoms

Symptoms can be experiencing irritation and pain from a nail that may also be red, discoloured and swollen and growing into the skin.

Causes

Causes can be from previous injury to the toe, improper shoes, repetitive strain from athletic activity, bunions and from toe deformities. Thickened or fungal nails tend to also aggravate an ingrown toenail.

Treatment

Treatment can consist of non-prescription and prescribed antibiotic creams which are good for mild cases, however an oral antibiotic can also be prescribed for cases that are not. Usually the nail border causing the symptoms is removed. In more serious or stubborn cases nail surgery can also be carried out under local anaesthetic where the nail root is removed, and a special chemical is applied to hinder the nail corner from growing back.

Result

After surgery it can take a few weeks to recover in mild cases and a few months in serious cases. Proper wound care is explained and highly recommended to reduce the risk of infection, patients will have follow up appointments.

Please call or request an appointment online for our experienced podiatrist to examine which treatment is best for you.

Biomechanical Assessments

A biomechanical assessment involves an examination of the lower limbs, looking at their structure, alignment, strengths and weaknesses. The foot is a complex structure of 28 different bones, 214 ligaments and 38 muscles, bearing our body weight as we walk every day.

Are you suffering from pain in your feet, knee pain or low back pain?

Heel pain, aching arches or forefoot pain when walking or running?

We all expect our feet and legs to carry us around without giving much thought as to how they work but as soon as something causes us pain then this is an indicator that something is not right and a biomechanical assessment may be necessary to determine the cause of your problem and whether further investigations are needed.

Biomechanics is the study of how the foot and leg functions and a biomechanical assessment involves an examination of the lower limbs, looking at their structure, alignment, strengths and weaknesses.

An initial consultation is required to assess the cause of your problem during which time we will look at you standing and walking.

If your feet and legs are functioning well, perhaps shoe advice or a regime of stretching exercises may be all that is required, however if a problem is detected with the mechanics of your feet and legs then you may be advised to have Orthotic insoles.

Biomechanical Assessment

The Podiatrist will determine the best course of action for your particular needs by initially taking a medical history and then performing an examination of and around the chief complaint.

This will be followed by a more extensive examination which may include not only the foot but also ankle, knee, leg, thigh and even hip. Pain in one area may be an indicator of a problem elsewhere so it is important to examine the legs and feet as a whole.

You will then be examined standing and an analysis of your gait follows as it is invaluable to see how you walk and perhaps even run. Also included is an examination of muscle strength, balance and joint flexibility.

How long does a biomechanical assessment take?

A full biomechanical evaluation, gait analysis and discussion of the next course of action to be taken is usually 1 hour long.

What happens after the biomechanical assessment?

The Podiatrist is then able to determine the best course of treatment for your particular needs

depending on the results of the biomechanical evaluation.

• If the structual mechanics of your feet and legs are good then advice on footwear may be given.

• Physiotherapy may also be of benefit to improve flexibility and strengthen muscles.

• The best way forward is often Orthotic insoles which are custom made and carefully constructed to fit into your shoe and also designed to fit exactly against your feet.

• Sometimes referrals are made to your doctor for Xrays, MRI or CT scans or further referral to a rheumatologist.

• Occasionally you may be recommended for surgery if other more conservative approaches are not considered right for you.

What are Orthotic Insoles?

Orthotics are not arch supports which historically were used to give relief of symptoms. However arch supports did not deal with the prime cause of your problem.

Orthotic insoles work in close partnership with your shoes and feet to realign you skeletal posture by controlling your mechanical inefficiencies and so eliminating the specific causes of your symptoms.

Verruca Treatment

Warts / verrucas are small lumps on the skin that most people have at some point in their life. They usually go away on their own but may take months or even years.

Intensive Diabetic Care For Patients with Type 2 Diabetes

Diabetic Footcare / Screening and Assessments

People with diabetes are at higher risk for a variety of foot health problems. A diabetic foot exam checks people with diabetes for these problems, which include infection, injury, and bone abnormalities. Nerve damage, known as neuropathy, and poor circulation (blood flow) are the most common causes of diabetic foot problems.

Neuropathy can make your feet feel numb or tingly. It can also cause a loss of feeling in your feet. So if you get a foot injury, like a callus or blister, or even a deep sore known as an ulcer, you may not even know it.