Health Professionals

Information For Health Professionals

Biomechanical Gait Analysis

The best way of assessing your patient’s gait is with evidence-based, objective measurements of body weight transfer and trajectory through the foot which can be repeated and compared.

  • Plantar Pressure: Our 5 metre walkway, ensuring a natural gait, is accessible for all types of patients whether they are injured, postsurgical or have a congenital condition.
  • Video Gait Analysis: The high-speed, high definition cameras that record at 50 frames per second showing both frontal and sagittal viewpoints, augment the plantar pressure data.

Plantar pressure and high-speed video analysis is also incredibly helpful for comparison of gait parameters for very large number of conditions including:

  • Multiple sclerosis,
  • Parkinson’s disease,
  • post Stroke,
  • rheumatoid arthritis and a number of other conditions.

It also can be vital in the case of people who have diabetes who are at risk of ulceration. Careful and accurate mapping of high-pressure areas under the foot, provides not only an understanding of where to offload pressure, but also where not to unload the pressure that may cause additional tissue injuries.

  • Plantar Pressure treadmill: For patients who need to have their running gait analysed our specialised treadmill has the same high definition plantar pressure measuring equipment with its own sagittal and frontal high definition cameras. It is unique in the region and can provide sportspeople with immediate feedback and information that is difficult to obtain visually, or by video alone.

The Biomechanical Gail Analysis can be provided as a written report with an MP4 video file combining the video analysis and the Plantar Pressure mapping. We’re more than happy to discuss your individual requirements so that it fits in with the care of your patient.

One of the great benefits of Planter Pressure analysis is the objective assessment and then reassessment after your appropriate treatment. We can do comparisons to show changes and improvements that will help your patient understand the benefits of your treatment.

Our practice is well-known for having been involved with Planter Pressure and Video Gait analysis for almost 20 years and we provide training in this type of analysis for podiatrists around Australia.

In-shoe Plantar Pressure analysis

The wireless Tekscan in shoe pressure analysis system can offer your patients some incredible benefits. It enables analysis in the workplace, on the sports field or just in day-to-day activity. It shows how different shoes affect the hip, leg and foot function. For example; how the lower leg and foot functions on the sports field with cutting movements or with muscle fatigue at the end of the game.

It is often used to understand why an injury continually occurs; such as stress fractures through the foot and re-occurring ankle injuries. It’s also excellent for assessment where there is a number of components complicating the overall picture making the condition very difficult to understand and address successfully.

Orthotic therapy

We can provide your patients with fully custom orthotics from a number of materials to suit their needs. Our evidence-based assessments enable us to decide on the most appropriate material for each patient from orthotics made of latex for patients who have arthritic joints or nerve hypersensitivity all the way through to very high density EVA, (as firm as 6 mm polypropylene).

The full biomechanical assessment for your patient is designed to gain enough information for the most appropriate prescription to achieve the best outcome. As part of this a 2D and 3D scan is taken so that we can visualise any Key points on the bottom surface of the foot as well as take the absolute contour of the foot. From this the prescription is designed using a CAD program and the orthotics are milled using a CAM milling machine situated in Geelong. This allows for very quick delivery times as well as high levels of quality control and adjustment where necessary. Read More

PBM low level laser therapy

Low level laser therapy, also known as Photobiomodulation or PBM Therapy, is effective in the treatment of a wide range of acute and chronic conditions. Some of the most common conditions treated with PBM Therapy are:

  • Sprains and strains (acute & chronic)
  • Achilles Tendinopathy
  • Plantar Fasciitis pain
  • Ankle ligament sprains
  • Shin splints
  • Arthritic pain
  • Post operative pain
  • Tissue healing

PBM Therapy improves tissue repair and significantly reduces pain and inflammation on the treated area. It has proven more effective and safer than Nonsteroidal Anti-inflammatory Drugs (NSAIDs) which often have side effects.

Specialised Diabetic assessment

The comprehensive diabetes foot assessment at Total Care Podiatry examines 6 major areas that will indicate the risk level your patient may have:

  • Doppler ultrasound of the blood flow (circulation)
  • Peripheral neuropathy
  • Biomechanical function, muscle strength & flexibility and joint mobility
  • Toenail and dermatological status
  • Pressure under the feet
  • Footwear – suitability and fit

The tests and the equipment used at Total Care Podiatry have been shown in research to be the best possible, to provide valid and reliable results.

We will provide you with a report, explaining the results and the patient’s options if any areas need to be addressed.
A regular 6 or 12 monthly diabetes foot assessment provides results which can be used for comparison to monitor your patient’s foot health.

Athletic Injury Risk screening

In all sports, and at all levels, there is always the risk of injury. At Total Care Podiatry we provide on-site athletic injury risk screenings. These include soccer clubs, the Geelong Football Umpires League, dance studios, gymnastics and tennis clubs.

Our injury risk screening sessions are designed for athletes, with a range of assessments including:
Static dynamic testing:

  • Lunge
  • single leg squat
  • Y test
  • Sport specific testing

Non-weight bearing:

  • Skeletal structure alignment
  • Joint range & quality of motion
  • Muscle flexibility and strength

Athlete’s taking part in our more comprehensive Elite Injury Risk screening are also assessed walking over a calibrated pressure plate and, if necessary, video gait analysis is undertaken.

The pressure plate screening enables us to assess forces and transfer of weight when walking, including asymmetries of weight distribution in the legs and feet. We also use the pressure plate to assess proprioception and balance ability.

The Athlete’s risk is then placed into one of three categories based on the functional characteristics observed. This provides an understanding of the individual injury risk as well as any necessary follow-up action to be taken.

Occupational and Foot & Leg health screening

We have provided on site foot and leg health screenings for the staff of several Geelong organisations with excellent results and positive feedback from staff and management.

Overuse injuries and footwear that doesn’t always fit well, can cause people to work less efficiently, especially those who are standing and walking for much of the time.

These are usually held as part of our community service for foot health week which is in October each year.

The Foot & Leg health screening takes approximately 20 minutes and includes:

Static dynamic testing:

  • Lunge
  • single leg squat
  • Y test
  • Plantar pressure using a calibrated force platform

Non-weight bearing:

  • Skeletal structure alignment
  • Joint range & quality of motion
  • Muscle flexibility and strength

Each participant is given a list of positive steps and options to improve their foot and leg health.

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Paul Graham

Paul Graham has been using plantar pressure analysis as part of his clinical practice since first purchasing an Fscan Mat and in-shoe system in 1998. It was a steep learning curve to understand the information behind the pretty colours and what it means. This form of analysis was in its infancy in Australia, and  the only way of gaining an appreciable understanding of what the data represented and how could be used in clinical practice was gained through regular email and phone contact with a number of American podiatrists who had been using the Fscan system for many years.

The most well-known of these practitioners is Dr Howard Dannenberg and through this relationship Paul grew to understand the relationship of sagittal plane movement and the importance of how the foot has a significant effect on the rest of the body. In fact Paul’s foundational knowledge of recording, data management and analysis came through Howard’s leadership and the plantar pressure case studies that were shared. This knowledge base was further augmented when Dr Bruce Williams DPM, a protégé of Howard’s training, visited Australia in 2004 and stayed with Paul in Geelong, working and training him in his clinic. In 2005, Paul was invited to Latrobe University to present on his clinical use of plantar pressure in the prescription of the orthotic correction design.

Up until this stage, Paul was combining evidence-based examination and video gait assessment with plantar pressure analysis and, through this orthotic manufacture. The issue was that each part of the assessment used different equipment. In 2006 Paul moved to the Milletrex system, (forerunner of the Freestep software and Sensormedica hardware) and as this combined all aspects of the diagnostic and manufacturing process, he moved to this system. Again a learning curve was required to become familiar with the different parts of the system, however planter pressure is planter pressure and as such, once you understand the recording and data management side, analysis can be done.

In late 2010, the Freestep software program was presented and the engineers in Italy were keen to make it the best on the market. Through the years there have been regular updates making the program more user-friendly and the data presentation more valuable and easy to understand. In fact at present Paul is working with Scott Sorenson and the Italian software developers to enhance this further so that areas of dysfunction and asymmetry are easily noted and measured,. This will be valuable for both the initial assessment and also to easily chart improvement at review appointments. This continued refinement and development, makes Freestep a very valuable clinical tool.

Plantar pressure analysis can only grow in significance as it shows objective data that the eye cannot see. This is now even more important with the discovery that vertical force,( that we describe as pressure), is what causes the overloading that results in tissue damage, rather than any angular anomaly such as an inverted heel or lowering of the medial longitudinal arch. Using Freestep enables Paul to chart improvement effectively and efficiently each visit by simply having a person walk over the mat or treadmill and comparing it to the previous visit; all within five minutes. This is then a record of the patient’s progress, valuable, not only to the treating clinician, but also to any third party who is paying for the treatment.

Video gait assessment is very, very helpful in understanding the biomechanics of the body in motion and should be used in conjunction with planter pressure analysis; however Paul’s clinical use of plantar pressure analysis has led him to the conclusion that it is superior in consistency, ease and speed.

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