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MEET PODIATRIST & OWNER – PAUL GRAHAM

Paul has been a podiatrist in private practice since 1987 with a special interest in musculoskeletal conditions. He is a fellow of the Australasian Academy of Podiatric Sports Medicine and has recently become the first podiatrist admitted as a member of the Pain Society of Australia.

The focus of his practice has always been on comprehensive, evidence based examination and diagnosis of the underlying causes of presenting symptoms, to achieve the best possible outcome for each patient.

Paul is also a trainer of Clinical Plantar Pressure Analysis, teaching practitioners in many countries around the world how to use plantar pressure technology effectively in clinical practice.

If you wish for Paul Graham to speak at your next event please call 5223 1531 to arrange a time.

INGROWN NAIL SURGERY

Nail surgery is a common procedure performed by most podiatrists to effectively treat an ingrown toenail: a nail that has pierced (or is pressing against) the adjacent skin of the toe causing pain and inflammation and sometimes infection.

Conditions this service treats

Surgery may be required when an ingrown toenail repeatedly gets infected, is continually painful, when the patient is unable to wear shoes or the condition inhibits work, sporting or other activities.

Before surgery is recommended, your podiatrist will explore other, more conservative treatment options.

How does the treatment work?

A ‘Partial Nail Avulsion’ (known as a PNA or nail root and matrix resection) is a minor nail procedure performed under local anaesthetic. The offending portion of the nail is gently lifted and trimmed away, generally without the toe being cut or stitched. Both sides or the entire nail may be removed this way. A chemical may also be used, at this point, to assist in preventing nail regrowth.

Prior to ingrown nail surgery your podiatrist will conduct a complete assessment, taking a medical history, a list of any medications that have been prescribed for you, as well as considering any other clinical factors that will determine whether or not this surgery is suited to you. An assessment will generally also include an examination of blood supply to the foot.

What are the benefits of this treatment

Ingrown nail surgery aims to permanently treat ingrown toenails The procedure is performed in the podiatrists’ rooms and takes around one hour. You will be able to walk immediately afterwards, however, you will need to have someone take you home after the procedure.

As with any surgical procedure there is some risk of complication, however, this procedure is known to be very safe and effective.
The most common side-effects are post-operative infection, in the short term, and the possibility of regrowth of the nail over time. The risks of infection can be minimised through good post-operative care and your podiatrist will advise and assist with your after surgery care.

WARNING
THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.

EXPERIENCING PAIN IN YOUR ANKLES, KNEES OR HIPS? 

EXPERIENCING PAIN IN YOUR ANKLES, KNEES OR HIPS?

At Total Care Podiatry the podiatrist will ascertain what dysfunction is occurring in your feet, how this is interacting with the muscles in your back, pelvis and legs and will see what areas in your lifestyle may be placing you at risk of continuing the injury. We will also work together with other health professionals involved in your care to achieve a long term solution.

Your knees and hips are the largest joints in your body. They are responsible for supporting your weight as you stand and walk. If you are experiencing chronic pain in your hips, knees, or even in your lower back, shoulders and neck, there may be a connection between this pain and the way your feet function.

Walking is good for you, right? Absolutely. But beware of poor walking habits that can cause or exacerbate knee and hip problems. On the positive side, however, a safe and smart walking regime can help improve joint problems, not to mention how good it is for your overall health.

KNEE PAIN

Watch your feet. If you are prone to foot problems, such as hypermobile feet (when the joints in and around the feet move more than they should) or  fallen arches caused by over pronation, your gait may be compromised. And this change can cause unnecessary stress on the knees, resulting in painful injuries.

The knee is made to bend only in one direction—facing straight forward.  When the foot over-pronates, the leg rotates inward toward the opposite leg. This causes the knee to flex and extend while pointing inward and not in the normal direction, which puts stress on the knee.

People who suffer from osteoarthritis pain have worn cartilage on the inside (medial) area of their knee joint. Research is being done to determine how walking differently can help manage this pain. According to the Arthritis Foundation, studies are finding that pointing your toes slightly outwards (about 7°) when you walk will shift pressure to the outside (lateral) part of the knee, relieving the pain radiating from the inside of your knee joint.

RUNNER’S KNEE (which is not exclusive to runners!) is identified by a throbbing pain on your kneecap. The impact of your foot hitting the ground causes your kneecap to rub against the femur bone. If you have a misaligned kneecap or previous injury, your knees are more vulnerable. Other causes are weak thigh muscles, soft knee cartilage, or flat feet.

HIP PAIN

Pain from bursitis is felt on the outside of your hip, whereas arthritis is felt on the inner hip near your groin. Relief from each requires different walking treatments.

Repetitive stress (including excess walking or running) can cause the bursa that cushions your hip to become inflamed. Another cause of bursitis is exercising without proper warm-ups and cool downs, which are a vital part of any program. You need to follow a very slow walking regime when recovering from a bout of bursitis. This involves gradually increasing the frequency and length of your walks.

As with osteoarthritis in general, the cause of hip arthritis can be genetic. It can be a hereditary or a congenital problem with an improperly formed hip joint. Hip arthritis can also develop from an injury or trauma to the hip area, or stress from excess weight or activity.

The problems caused by over pronation, which were discussed for knee pain, are also true for the hip joint. When the foot pronates, the leg rotates inward and the hip can become unaligned. This condition puts stress on the hip and on the entire leg muscles.

HOW TO HELP YOUR ANKLES, KNEES AND HIPS

Any problem with the foot or ankle resulting in a compromised posture or gait can lead to knee and hip pain. Examples of common foot problems that can lead to poor posture and irregular walking patterns include:

  • Plantar fasciitis, which can lead to chronic heel pain and/or arch pain
  • Nerve pain or numbness in the foot (such as neuromas and tarsal tunnel syndrome)
  • Bunions and bunionettes (big-toe versus little-toe side, respectively)
  • Excessive foot  pronation (rolling in) or  supination (rolling out)

When you experience pain and you are diagnosed with a dysfunction in the foot or ankle, it may be possible to reduce the knee and hip pain by improving foot function, using proper footwear and orthotic insoles.

A Harvard medical school health publication advises that exercise is an important treatment for arthritis. It improves the strength and function of the afflicted area(s).

In many cases, a moderate walking plan is recommended to alleviate such pain. It is considered a low impact activity that strengthens the supporting muscles, relieving the pressure on the joint. Be sure to walk on a smooth, soft surface such as a track or treadmill. Your doctor or physical therapist can advise how much walking is best for you. An extra bonus is walking will help with weight loss, which takes some stress off your joints.

When you compensate for pain by limping or walking with an abnormal gait, other joints can suffer wear and tear. Your rheumatologist, orthopedic doctor or physical therapist can help determine if changing your walking gait could help reduce pain. Many PTs will video patients as they walk on a treadmill and then review their walking habits to determine what pain reduction improvements can be made. You can make a conscience effort to minimize limping by holding your body straight without swaying and maintaining and even stride.

THE RIGHT SHOE REGIME

Healthy shoes play a significant role in knee and hip pain management. Here are a few tips on the importance of wearing good shoes.

  • Never wear heels over two inches high. Heels increase the risk of knee joint degeneration.
  • However, not all flat shoes are good for your feet. Flats that do not provide any arch support can lead to knee, hip, and back pain.
  • Get the right fit. Tight shoes can cause limping from foot pain. Oversized shoes can also impair your gait. Either way, you’ll be putting unnecessary stress on your knees and hips.
  • Stability sneakers provide cushioning and help control over pronation. They also relieve the ball of the foot, which helps arthritic pain in the hip, knee, foot or ankle.
  • Replace your shoes as needed. When the supporting cushioning becomes worn, it is no longer helpful.
  • If knee or hip pain is due to your foot function, the proper footwear along with orthotic insoles can be a very effective way to relieve symptoms.
  • Invest in quality shoes that are specifically made for your condition. Total Care Podiatry provides the ability to browse shoe selections that meet your needs.

At Total Care Podiatry the podiatrist will ascertain what dysfunction is occurring in your feet, how this is interacting with the muscles in your back, pelvis and legs and will see what areas in your lifestyle may be placing you at risk of continuing the injury. We will also work together with other health professionals involved in your care to achieve a long term solution.

WARNING
THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.

MEET RACHEL VALE – TOTAL CARE PODIATRY’S NEWEST TEAM MEMBER

We’re excited to welcome Rachel Vale to our team at Total Care Podiatry.

Rachel has had a lifelong passion for podiatry with interest in biomechanics, general foot care and nail surgeries. She enjoys working in paediatrics and strives to create tailored treatment plans for her patients.

Growing up in Geelong, Rachel has always had an interest in sports, particularly volleyball and basketball. Her interest in sports has helped her treat both acute and chronic musculoskeletal conditions. Outside of work she enjoys spending time with family, going to the gym and watching movies.

To make your next appointment with Rachel please contact our friendly reception team on 5223 1531

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.

TELEHEALTH – WHO IS IT FOR?

TeleHealth

Total Care Podiatry now has two ‘TELEHEALTH’ options if you are unable to leave your home:

  1. As a community service at this time we have made available three Complimentary TeleHealth Advice sessions per week. This service is about 10 minutes to answer general questions and provide you with advice. It is particularly good if you are a New Patient who needs some help to manage until you’re able to attend the clinic.
  2. TeleHealth Consultation. For existing patients who are unable to attend the clinic. Using secure  software our podiatrists will be able to provide online:
  • a video conference for you to explain your concerns and receive clinical advice,  and, if required
  • an exercise and rehabilitation program of video demonstrations within the Physitrack App.

This will enable us to adjust your treatment plan from the comfort of your own home.

The billing for these will be the same as usual for NDIS and Veterans. For patients with a Chronic Diseases Management plan (for Medicare rebates) we are able to bulk bill with a new Item number provided by Medicare. For private patients the Fee is $30. Some health funds are providing a rebate for TeleHealth consultations. Check with your Health Fund.

If you’re not sure about whether TeleHealth is right for you please give us a call  on 5223 1531 to discuss your situation.

If you have any questions,  concerns or special requirements please give us a call on 5223 1531 and we’ll do our best to help you.

Call 5223 1531 to book

TeleHealth at Total Care Podiatry

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.

WALKING SHOES

Around 400 BC the Greek Physician said “Walking is man’s best medicine”

If your daily exercise now involves walking you should be comfortable! Here are some of our common tips and tricks to find a perfect pair of walking shoes:

1)    Buy your shoes at the end of the day when your feet are more likely to be swollen.

2)    Look at your old shoes for hints on the type of foot you have – if you are a pronator/supinator/neutral. This can help with finding your next pair.

3)    Most people benefit from a small heel pitch – we recommend you see a podiatrist, but try a shoe with a 10mm heel pitch and see how you feel.

4)    For a durable shoe you will need a durable upper – that is the part that covers your foot. Soft leather is a good option. The upper should also be flexible and bend easily where your toes bend – the shoe should not bend where your arch is.

5)    It’s best to go and try the shoes on before buying or ensure the online shop offers returns if they are not right. The shoes should be comfortable, and you should be able to press your thumb between your longest toe and the end of the shoe.

If you have any pain or discomfort give us a call on 5223 1531

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.

FUSS ABOUT SOCKS

Socks provide an interface between our feet and the shoes we choose to wear. Generally, closed in footwear is designed to wear a sock with, so choosing appropriate ones can make a great difference to how the shoe feels!

Understand the pros and cons of different materials, so that when you are looking at the sock ingredients, you know what you’re in for!

  • Merino wool: breathable, can be worn all year round! Soft, cushioned and itch free, moisture wicking. Popular for sports people and hikers.
  • Acrylic: cheaper than wool, dries reasonably fast, not as good at wicking away moisture.
  • Cotton: traps moisture! Not good if you are prone to sweating as you will find yourself blister prone wearing cotton socks.
  • Nylon: often combined with other fabrics to increase sock durability. Also dries very quickly.
  • Stretch fabrics such as elastin, nylon or spandex: allows stretch so socks fit well and snug your foot! Make sure they only comprise of about 2-5% of the fabric.

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.

I’M INJURED – WHAT SHOULD I DO?

Injury can really impact you physically and mentally. It is important to take care of yourself when injured and allow your body to heal – be patient and be kind to yourself. If you have a lower leg injury that you cannot bear any weight on, we recommend you visit your local ED or GP as soon as possible.

If you can wait to see your podiatrist,the following points  are very helpful for you to consider and bring to your appointment:

1)    When did the pain start? Were you injured or has this happened over time?

2)    What kind of pain is it i.e. sharp, dull, ache, pins and needles, numbness?

3)    How intense does the pain get? (1-10 /10 scale, 10 being the worst pain)

4)    Where is the pain? Does the location move or are you getting any referred pain?

5)    What aggravates the pain? i.e. increase in walking, first thing in the morning, going up on tip toes?

6)    What is the pain preventing you from doing?

7)    What makes the pain better? i.e. ice, heat, rest

8)    What is your overall goal?

If you can have a think about these questions before seeing your healthcare professional, it can really help us in the consultation. If you need to wait a few days before an appointment, we recommend you keep a pain diary for those three days so we can really knuckle down to why you are in pain and get started on treatment!

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.

PAEDIATRIC CLINIC

For a gold coin donation to Kids Plus, Total Care Podiatry provides a specific Paediatric Clinic that focuses on our little one’s feet and legs: from 6 months – 6 years old.

We have been seeing little people for over 30 years now at Total Care Podiatry and we’ve noticed lately that more and more people are looking for advice regarding their children’s feet and how they crawl or walk. In response, this monthly children’s clinic is designed to answer these questions in a one on one assessment of each child in a child friendly environment.

Children’s feet are designed to change!

There are a lot of changes in the legs and feet during the first 6 years and most of these are perfectly normal. Sometimes, however, there are concerns which will need treatment. The key is understanding what’s normal development and what’s not.

If you are worried your child walks or crawls differently to your friend’s children and are concerned about whether everything looks okay, this 15 minute one on one assessment is very helpful

Every child’s development is different, so if there are any concerns it’s best to check at this young age when simple exercises are often all that are required to address potential long term problems.

Bookings are essential on 5223 1531.

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.

WHAT ARE BUNIONS?

A bunion is a bony malalignment of the first and/or fifth toes. Bunions that form around the base of the fifth toe are commonly called a Tailor’s bunion. If it occurs at the base of the first toe it is called a Hallux Abducto Valgus deformity. This is where the first toe is angulated away from the midline of the body toward the other smaller toes. Bunions are not just found in older people’s feet; sometimes they begin to develop in people who are quite young!

What are the most common problems with bunions?

Symptoms associated with bunions vary from person to person.  They commonly include pain, swelling and redness. Not all bunions become painful, but certain arthritic conditions can cause severe pain.

How do these problems arise?

  1. Abnormal foot mechanics.
  2. Impaired nerve stimulation of the muscles.
  3. Inflammatory disease.
  4. Surgical removal of the big toe joint cartilage.
  5. Hereditary deformities.

How can they be treated?

  1. Strengthening.
  2. Stretching.
  3. Footwear therapy.
  4. Joint mobilization in some situations.
  5. In shoe foot orthotics.
  6. Surgery is used only when other treatment fails.

When should they be checked by a podiatrist?

Bunions are able to be treated, especially if we begin in the early stages, so you should come and see one of our Podiatrists if you are concerned that a bunion may be developing. It’s still a good idea, however, to seek treatment if you already have a bunion which is causing you pain or you have difficulty fitting into footwear.

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.