Podiatry Solutions

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  • 04/10/2017 - Margaret Grace 0 Comments
    Golf and Podiatry

    Are your aches and pains interfering with your game?


    Pain in your, hips, knees and back can be linked to your foot mechanics. In golf, a proportion of the swing comes from the lower limbs. It is therefore crucial to address any lower limb related problems correctly.

    If you are experiencing pain in these joints or even the feet themselves, asking basic questions and taking simple measures can often be enough to address the problem.

    Ask yourself:
    1.  Do my shoes fit my feet correctly? Wearing shoes that are too tight is an obvious problem but wearing shoes that are too big can be just as bad. If a shoe is too big for the foot, the little muscle in the foot and even further up the skeletal system have to work really hard to keep the shoe on and maintain stability.

    2. Have I just recently purchased a new pair of golf shoes? If so, do they still need to be ‘broken in’? Shoes that are too stiff can rub against the skin creating blisters and chaffing. An easy way to break in new shoes is to wear them for short periods in the rain! Alternate your new shoes with your old ones until you’re ready to make a permanent switch.

    3. Am I wearing good quality golf socks made from natural fabrics? Do I change my socks during the day if I am playing golf in a hot climate? Are the seams of my socks causing irritation against my skin? Wearing comfortable, good quality socks is just as important as wearing good quality golf shoes.

    If you do have any soft tissue problems i.e. issues with your toes nails or skin (e.g. corns, callouses, athletes foot e.tc) seek professional advice from an HCPC registered podiatrist.

    If you have joint or muscle pains in the feet that cannot be relieved by addressing the above issues, you would probably benefit from an MSK (musculoskeletal) podiatry assessment.

    MSK podiatrists, including those at Podiatry Solutions, specialise in foot mechanics. If a foot turns incorrectly during the walking cycle, this can cause other muscles and joints in the feet, legs and back to compensate. Compensation often comes at a price since other muscles and joints end up working too hard – resulting in aches and pains. These aches and pains don’t disappear. Often they get worse and can affect the scorecard at the end of the day.

    MSK podiatrists often prescribe special medical insoles called orthotics. Orthotics are frequently prescribed to help prevent
    injuries in the first instance. This is because they improve lower limb mechanics and do not require other muscles to compensate – this therefore avoids over-use injuries. Orthotics work by supporting the foot in the places it needs it – they vary in thickness depending on what support is required.

    The orthotics prescribed by Podiatry Solutions are made from a material that compresses with the heat from the foot and therefore fits easily into any golf shoe.

    Research has shown that orthoses can actually reduce lower limb fatigue whilst playing. In some instances this may increase the distance
    the ball is hit.

    Other things worth considering that will help you.
    1. Increase the amount of time you play gradually
    2. Make sure you bend properly at the knees – continuously bending from the waist will aggravate the lower back
    3. Stretch before and after each round of golf

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  • 13/07/2017 - Margaret Grace 0 Comments
    Sporty Feet

    Sporty Feet

    Keeping yourself fit and active is crucial to maintaining good health. In order to ensure that you are motivated, it is necessary to engage in an activity that you really enjoy. Enjoyment, however, is one part of it though… avoiding injury is another important factor. Despite the obvious differences that exist between different activities, there are practical bits of advice that should be adhered to by all sporty or active
    people. This general advice is listed below. Following this, a description of the most common injuries and causes of lower limb pain is given.
    General Advice
    · Warm up. This is particularly relevant if your sport involves running or other high-impact
    cardio (e.g. boot camp, gymnastics, disco dancing, rugby etc.). If you go
    straight into the most intense part of the workout without easing into it, you
    put stress on your muscles, making you more susceptible to injury. Warming up
    allows more oxygenated blood to get into the muscles, preparing for what’s to
    come.
    · Don’t over train. Your body needs to rest! Sleep allows your body to recover, but you also
    need to avoid doing too much exercise that you’re not used to doing. Even
    professional athletes like Andy Murray have to have some down time!
    · Wear the correct shoes for the correct activity. Much has already been said about
    footwear in a previous feature. Sports shoe technology is so advanced – wearing
    the correct shoes really can make a difference between sustaining or avoiding
    an injury. Wearing a pair of fashion trainers to football just won’t do.
    · Make sure you stretch after your work out. It frustrates me that very few
    children are not taught to do this at school. Establishing good exercise habits
    that include a warm up and post workout stretch is so important. The stretching
    part of the routine allows you to avoid the dreaded DOMS (Delayed Onset Muscle
    Soreness). Think of walking like John Wayne for a couple of days!
    · Understand that there are times when you will be more susceptible to
    injury. Such times include:
    o Tiredness
    o Doing activities you’re not used to
    o Training when you are unwell or just don’t feel physically on form
    At these times you may still be able to exercise, but do so at a lower intensity to that which your body is used to.

    · Nourish your body with a healthy nutritious diet that allows muscles to repair easier. The saying You are what you eat is so true. Not only is food delicious and create an opportunity to socialise, it serves to provide your body with all of the nutrients it needs to maintain health. Different nutrients (or chemicals) help to sustain different cells in your body. If you eat mostly junk food, your diet will be very low on nutrients, it will struggle to thrive and take longer for sports injuries to heal. If you eat healthy food, your body functions much better. Professional athletes understand that diet affects their performance – this is why many of them follow a strict diet plan. As well as eating a healthy diet, make sure you
    drink plenty of water – at least a couple of litres if you do high intensity exercise or are outside.
    Common Foot Problems
    Below is listed some common foot problems. The purpose of listing these is to raise awareness. Don’t rely on this list or Google, however, to diagnose. If your symptoms don’t go away or if they get worse, go and see an MSK podiatrist or other health professional that you feel may help.

    · Achilles Tendonitis / Tendanopathy. Tendons connect muscles to bones. The achilles tendon connects the calf muscle to the heel bone. It is named after the Greek god Achilles. It’s a common site of injury amongst sports people. If the part of the tendon that inserts into the heel is damaged, the condition is referred to as achilles tendonitis. If the injury occurs further up the achilles tendon, closer to the calf muscle, the condition is referred to as achilles tendanopathy. The treatment for this condition varies, depending on the location of the injury (tendonitis or tendanopathy), duration, severity and lifestyle. Most treatments include orthotics (medical insoles), wearing specific styles of shoes, physiotherapy and anti-inflammatory medication. In a few instances, surgery is required.
    · Plantar Fasciitis. The plantar fascia is a soft tissue band that runs from the heel up to the arch of the foot. If it is subjected to repeated trauma, it becomes inflamed and painful – plantar fasciitis. Most people with plantar fasciitis experience pain in the morning when they get out of bed. Once they start walking, it eases off. Factors contributing to the onset of plantar fasciitis includes abnormal foot mechanics (where your feet turn too much in the wrong direction or not enough whilst you walk); overweight/obesity; doing activities or exercise that you’re not used to; wearing shoes that don’t have enough support or shock absorption; doing too much of a particular activity. Sometimes mild plantar fasciitis can go away by itself, but often, if the cause is not addressed, it gets increasingly worse to the point that one is limping and in pain even if gentle pressure is applied to the sore part of the foot. The most effective treatment includes the use of orthotics. Orthotics are effective since they take the pressure off of the plantar fascia itself and also deal with any abnormal foot mechanics which will be causing the pain in the first place.
    · Metatarsalgia / Morton’s Neuroma. Metatarsalgia is a very broad term which is used to describe pain in the ball of the foot. It does not suggest a specific diagnosis and can be used to describe a number of different conditions. A fairly common cause of metatarsalgia is morton’s neuroma. A morton’s neuroma is a nerve at the ball of the foot which has become thickened. People with a morton’s neuroma tend to experience a sharp pain or numbness that can sometimes radiate to the top of the foot or the little toes. Factors contributing to the onset include obesity, wearing high heeled shoes, regular participation in high impact activities etc. Conservative treatments including orthotic therapy should be considered first.
    Surgery should only be carried out as a last option.
    · Bunions / Pain at the big toe. Bunions themselves are normally not a cause of joint pain. If pain does occur, it tends to be due to shoes irritating the prominent joint. Often pain at the big toe is due to a mechanical problem. Many people do not (or cannot) push through the big to adequately at the end of their walking cycle. This can contribute to pain whilst active and even in bed. Other causes of pain may include arthritis or even gout which is a build up of uric acid at the joint. Some people also experience inflammation of the little bones just below the big toe. This can also cause pain whilst walking. If you have any pain at the big toe joint, go and see an MSK podiatrist or your doctor. There can be so many different causes and the treatments vary depending on what’s going on.
    · Other sporty foot problems. In-grown toe nails, thickened nails, callouses, corns, athletes foot etc. can all create pain, discomfort and affect performance. Don’t let problems get out of hand. Go and see and HCPC registered podiatrist who will be able to provide the right treatment.
    Look after your lower limbs - don’t ignore injuries or other problems. Doing so will allow you to focus on enjoying whatever sport or activity it is that you do

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  • 02/07/2017 - Margaret Grace 0 Comments
    How Podiatry Can Help you Achieve a Better PB!

    How podiatry can

    help you achieve a better PB



    With all the advice that’s around, sometimes it’s easy to
    feel a bit over-whelmed! As a MSK podiatrist, I’d like to share some insights
    as to what podiatry is and how a podiatrist may be able to help you.
    Information is power… you can then use the knowledge you have to act in a way
    that meets your needs and to do what feels right for you!



    What is a podiatrist
    and how can a podiatrist help a runner?

    Podiatry is a field of medicine which focusses primarily on
    the feet and lower limbs. Some podiatrists, however, will consider problems
    further up the body, including the back, when addressing symptoms.



    There are many branches of podiatry which most registered
    podiatrists study whilst completing their university degree. Some of these
    branches included:

    ·
    Routine care (you may be familiar with what a
    ‘chiropodist’ does)

    ·
    MSK otherwise known as musculoskeletal (it’s a
    bit of a mouthful, hence we refer to MSK!)

    ·
    Paediatric

    ·
    Forensic

    ·
    Diabetic etc.



    Most people will appreciate that if you have a sore foot, it
    can seriously hamper your training. The two branches of podiatry that are of
    most relevance to runners are routine care and MSK. Since I am an MSK
    podiatrist, this article will focus mainly on that, however I will firstly
    touch on routine care podiatry.



    Routine Care

    When cutting your nails, make sure they are short and follow
    the contour of the nail. Don’t cut down the sides but also don’t cut straight
    across since this can leave sharp corners which can pierce the flesh.

    Deal with any signs of infections such as pus or open
    lesions by soaking your feet in salty water and applying antiseptic with a dry
    dressing. Your feet sweat a lot – running shoes are the perfect breeding ground
    for micro-organisms so don’t let small infections get out of hand.

    If you have a corn, it will feel like a small stone. Corns and
    hard skin occur over areas that are subjected to a lot of pressure. This
    pressure may be due to shoes, but it can also be due to poor foot mechanics
    (i.e. the way you walk). If you have a corn, do not use a corn pad – these pads
    contain an acid which can burn the healthy skin as well as the corn itself.



    Verrucae, on the other hand are simply warts that occur on
    the feet. These are caused by a virus and will therefore not necessarily occur
    in places that are subject to pressure. They tend to have little black dots in
    the centre and can be painful if squeezed. Sometimes verruca do not cause any
    discomfort and may disappear by themselves. If you think you have one, keep an
    eye on it… if it gets bigger, get it treated since they can be very painful and
    difficult to treat when they are bigger.



    If you have a skin or nail problem that’s troubling you or
    has the potential to get out of hand, go and see an HCPC registered podiatrist.
    Try also to figure out why you have a particular problem and deal with the
    cause to ensure it doesn’t reoccur.



    MSK Podiatry

    MSK podiatry concerns itself with the mechanics of the lower
    limbs. A person’s foot has many bones, muscles and other soft tissues which all
    work in harmony with each other, allowing the foot and ankle to move in
    different directions during the walking or running cycle.



    Little groups of these bones and muscles work together to
    move in precise directions during walking or running. Each joint has a
    particular range of motion. If these particular movements do not occur when
    expected, or if a joint is very stiff and can’t achieve its full range of
    motion, an individual will compensate for this problem. This is done by
    engaging and over-working other muscles and joints. These other muscles and
    joints that are being over-worked may not complain to start with, but
    eventually aches and pains occur!



    Many people go to see an MSK podiatrist when they are in
    pain, but other people like to seek advice before problems occur in an attempt
    to avoid injury. An assessment usually involves checking the range of motion at
    different joints and using an electronic scanner to determine how the foot
    moves and how pressure is distributed. Sometimes other technology including
    videos and treadmills are used.



    If the foot is moving in a direction that it shouldn’t be,
    medical insoles called orthotics may be prescribed. In some instances, footwear
    or lifestyle changes do the trick and orthotics are not necessarily required.
    It’s worth noting that if orthotics are recommended, it can take up to three
    months for them to work properly. Whilst they are starting to do their job,
    there are, of course, other things that can be done to help alleviate pain. Many
    people feel frustrated that there is no instant ‘quick fix’ – this is just how
    the body works.



    Why do aches, pains
    and injuries occur?

    Many experienced runners can run for years injury free then
    suddenly develop problems. Often, analysis of this person’s lower limb
    mechanics will reveal that their feet naturally have a tendency to move too
    much in a particular direction when they walk. The fact that this excessive
    movement has not created any problems in the past will likely be due to the
    fact that other muscles and joints have happily compensated.



    Aches and pains often occur when ‘something’ changes. That
    ‘something’ is often:

    ·
    A new pair of running (or other) shoes

    ·
    A change in training regime

    ·
    A new job

    ·
    Returning to training too soon after injury or
    sickness

    ·
    Physiological changes that naturally occur in
    the body due to ageing

    The first three points mentioned i.e. the new shoes or
    change of routine are the most common culprits. Often, however, any change may
    not evoke symptoms immediately – it can take weeks, sometimes a couple of
    months for the aches and pains to appear.



    Individuals who increase their distance too quick or who
    introduce a regime that their body is not used to, are particularly prone to
    injury. First time marathon runners often get into difficulty a month or two
    before the big day. Often by that stage their injuries force them to deviate
    from their training plan – sometimes having to pull out of the race altogether.



    The place for orthotics
    and other treatments

    It’s important that a runner can make an informed decision
    when it comes to support and rehabilitation. As someone who understands the
    power of orthotics and how they can aid (or even hamper) an athlete’s progress,
    I believe it is important to explain how they work.



    Basically an orthotic is an insole that has thicker bits
    stuck on at the front or back (or shaped into the insole itself), bits cut out,
    bumpy bits added or softer bits added in particular places. They are more expensive
    than shop bought insoles, ranging from £120-£320. This is not because the
    finished product is expensive, but because the professional prescribing the
    orthotic has an in-depth knowledge of lower limb mechanics and knows exactly
    where the additions should be added. To look at them, they may not look like
    much, but the subtle differences in thickness of only a few millimetres can
    make a huge difference. People who have endured pain for years suddenly find
    they are symptom-free.



    As previously mentioned, it takes a few months for orthotics
    to work. Whilst they will change lower limb mechanics, if worn regularly,
    alleviate symptoms and reduce the incidence of injury – they are not a cure.
    You cannot ‘cure’ bad foot mechanics. Just as you would lose tone and fitness
    if you were to stop running for a few weeks, your bad foot mechanics would
    return if you were to stop wearing your orthotics for a period of time.



    If you wear orthotics that have additions added in the wrong
    place, this can cause longer term detrimental effects that may not be obvious
    to start with. It is therefore important to seek advice, not only from an HCPC
    registered podiatrist, but a podiatrist who specialises in MSK conditions.



    When it comes to the material of the orthotic, there are various
    options. Many orthotics are made out of harder plastics which, although are
    very efficient and tolerated in walking shoes, tend not to be tolerated as well
    in sports shoes. That said, since walking and running gaits (cycles) are quite
    different, it may be that one may have orthotics in their work or walking shoes
    but they are not required in their sports shoes.



    My preferred choice of material is EVA – ethyl vinyl
    acetate. It is softer, compresses with the heat from your foot yet offers the
    required support for two to five years. Many top athletes in the U.K. wear
    orthotics made from this material in their sports shoes, since they are
    tolerated well.



    When looking at treatment options, don’t just rely on one
    professional. Many people call the physio in the first instance, but MSK
    podiatry also has its place. Other people rely solely (excuse the pun!) on
    their orthotics to do the job, but a combined approach, including treatment
    from other health professionals often helps to achieve the best results. It’s
    best to seek advice from a registered professional who works within a
    multidisciplinary clinic and is open to bouncing ideas off of different team
    members.



    For example, since I know that orthotics take a while to
    work, I call upon my physio colleagues to help rehabilitate patients in the
    meantime. My physio colleagues, on the other hand, often seek advice with
    regard to specific lower limb problems of which they have no experience in
    dealing with. They also refer patients they have treated for symptomatic relief
    since they understand that the orthotics I prescribe have longer term
    benefits. No health professional knows
    everything – a team approach is always best!



    What can you do to
    help yourself?

    ·
    See an MSK podiatrist for an in-depth mechanical
    assessment of your lower limbs. A lot of running shops offer similar
    assessments. Whilst they can be beneficial, staff in these shops lack the
    professional expertise and in-depth knowledge that an MSK podiatrist has

    ·
    Find a brand of shoe that works for you and stick
    with it. If you’ve been running for a while, have worn the same brand and style
    of shoe and have avoided injury, my advice would be to stick with that
    particular shoe. If you do suddenly encounter and injury, it will likely be due
    to one of the reasons mentioned previously. Go and seek professional help –
    don’t ignore a niggle since it could lead to something worse. Taking two or
    three days off of training is surely better that being out of action for two to
    three weeks

    ·
    Don’t try to go from zero to hero overnight.
    Setting yourself unrealistic goals could hinder your progress longer term since
    you’re more likely to injure yourself. Increase the distance gradually and
    incorporate different physical activities such as weight training and yoga into
    your weekly routine



    Finally… ask questions and be
    realistic. Understanding a bit about how your feet work and what you can do
    will enable you to have happy healthy runs and achieve that PB you’ve been
    dreaming of!

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  • 20/06/2017 - Margaret Grace 0 Comments
    Shoes

    In Western countries, shoes are a necessary part of one’s

    outfit. What with there being so many different styles and types of shoes, a
    bit of advice as to what’s right or wrong for a particular foot type, won’t go
    amiss.



    Victoria Beckham’s decision to hang up her heels and don a
    pair of flats has fuelled the misconception that ‘flat shoes are better than
    high heels’. Apparently, Victoria attributes the wearing of her high heels to
    causing bunions. This is not necessarily the case and flat shoes are not always
    better, as explained below.



    Since there’s so much to say about shoes, the information
    below, has been categorised to make it easier to follow.



    ·
    High heels v flat shoes: Whilst wearing a pair
    of stiletto shoes every day is not good for your feet, neither is the wearing
    of ballerina shoes or flip flops. High heeled shoes obviously put added stress
    onto the ball of the foot. This irritates the joints, muscles and nerves
    inside. Long term use can cause pain to develop in this area.

    Ballerina’s and flip flops can be too flat
    for some people. Some individuals have a foot type that will cause them to
    experience lower back pain if they are standing for long periods in a flat shoe
    or bare feet. If you have experienced this, opt for a shoe with a small, broad
    heel. Shoes like ballerina’s or flip flops are too flimsy. They offer no
    support, therefore causing the little muscles in the foot to work really hard
    to try and keep the shoe on.

    ·
    High heels or pointed shoes cause bunions – This
    is a myth. Clinical research has shown that there tends to be a familial tendency
    to developing bunions. In my previous role as an airline podiatrist, I came
    across cabin crew who had worn high heels on a regular basis, yet had no
    deformities. Other crew, however, who had flown for just a short period, had
    large bunions. Tribal people in Africa, Australia and other continents who
    don’t wear shoes at all, also often have large bunions. Obviously if you are
    susceptible to developing bunions (and you’ll know if you are by looking at
    your family’s feet!), wearing high heels or pointed shoes regularly, will not
    help.

    ·
    Sports shoes – Sports shoe technology is so
    advanced. It really does pay to wear the right shoe for the right activity.
    Just as you wouldn’t wear a pair of jeans to work out in the gym, you wouldn’t
    wear a pair of golf shoes to run 5 miles. Gone are the days when ‘a pair of
    trainers is just a pair of trainers’. You now get shoes specifically for running,
    squash, cleats for RPM, shoes for football, tennis and I even recall one
    teenage patient telling me that she had special shoes for netball! Sports shoes
    for specific sports have enhancements that maximise certain movements whilst
    you are doing your chosen activity and help to reduce the incidence of injury.

    ·
    Seasonal footwear – As the summer approaches,
    you may be thinking about holidays and looking out your sandals. Flip flops are
    not a proper shoe – they are fine for kicking around the house or by the pool
    but don’t wear them if you’re going out for a walk. If you’re going to be more
    active, opt for a pair of sandals that offer support across the top of the foot
    and around the back of the heel.

    During the colder months, make sure you
    keep your feet warm and dry. Heat is lost through the extremities so ensure
    that your shoes are leather or are proper walking shoes from an outdoor
    retailer. Wearing two pairs of thin socks is a great way to keep your toes cosy!
    Again, if you’re walking any distance, make sure your shoes are supportive,
    having laces, straps, zips or buckles to keep your foot secure within the shoe.
    If you do have laces, use them! Often I see people slipping their feet in and
    out of a lace up shoe. Doing this causes the shoe to stretch. It then becomes
    too loose and offers no support whatsoever.

    ·
    New shoes – Try them on. Don’t order shoes on
    line unless they are an exact replica of a pair you already have and are happy
    with. When you do try them on, make sure you can wiggle your toes. Walk around
    the shop with them on. If your heel is moving up and down the back of the shoe
    or if you are scrunching up your toes, this means that they are too big. If you
    are in between sizes, you can add a very thin insole. This will help them to
    fit properly.

    Remember that all leather stretches, so before
    you opt for a smaller size or a pair of insoles, try breaking them in. Wear
    them for short periods to start with, gradually increasing the wearing time.
    Wearing leather shoes in the rain also helps them to stretch! If you are
    purchasing a pair of slip-on or court shoes, it’s even more important to
    remember that your shoes will stretch. You really don’t want to be wearing a
    pair of slip-ons that are too big since your feet will have to work hard to
    keep them on. With this in mind, a new pair of leather slip-ons or court shoes
    must be a little bit snug to start with.

    ·
    Both feet different sizes – Most people have one
    foot slightly bigger than the other. If the size varies by more than ½ a UK
    shoe size, I would recommend you consider getting bespoke shoes. Any difference
    less than ½ a shoe size can be dealt with fairly easy. Ensure that the shoes
    you like fit the largest foot. (You don’t want to be cramming your foot into a
    shoe that’s too small). This will now mean that the other shoe is too big for
    the smaller foot. Rectify this by placing a thin, simple insole into this show
    only. Doing so will make this shoe ¼ size smaller and will therefore be more
    secure.

    ·
    Shoe odour – With around 250,000 sweat glands in
    the feet, it’s no surprise that shoes can get a bit smelly! You can purchase
    shoe fresheners, but a really simple, effective trick, is to put a little
    bicarbonate of soda into a plastic bottle top and to then position this inside
    your shoes overnight. If you are prone to sweaty feet, wear natural fabrics or
    sports socks as opposed to synthetic fabrics (nylon stocks, for example, are
    not good for your feet). Also change your socks regularly. If your skin is
    itchy, you may have athlete’s foot – go and see an HCPC registered podiatrist.

    And finally... dress for the occasion and aim to be
    comfortable. Even I have been known to wear high heels or flip flops. I don’t
    wear them every day, nor would I go out for a walk in either of them. If the
    occasion arises, I will wear what I want knowing that I’m now going to cause
    any long term damage. I suppose it’s like a healthy diet – if you eat the good
    stuff 80-90% of the time, you can enjoy the occasional treat.

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