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DIABETES WEEK 12-18th of July 2020

DIABETES

Why are the feet affected?

  • Due to the small size of the blood vessels and distance away from the heart, the feet are most commonly among the 1st to be affected.

Main complications are:

  • Neuropathy (decreased sensation in the feet and symptoms such as burning or tingling)
  • Vascular disease (diabetes affects the bodys ability to maintain healthy blood vessel walls)
  • Infection (the body has a decreased ability to fight bacteria and disease)

Other complications:

  • Changes to foot structure creating areas of high load
  • Changes to the skin and sweating regulation
  • Decreased sensation and reduced balance

Where podiatry fits in:

  • We conduct an annual assessment (or more regular if required) which investigates and monitors changes in
    • Blood flow
    • Nerve sensitivity
    • Foot structure
    • Areas of high load
  • We can provide tailored treatment which may include
    • Nail care
    • Callus reduction
    • Orthotics
    • Footwear recommendations
    • Review of activities
    • Referrals to include a multi-disciplinary and whole body approach to care

 

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.

NAILS AND SKIN CARE AT TOTAL CARE PODIATRY

At Total Care Podiatry your podiatrist will begin by assessing and treating the area of most concern to you and will cut your nails and painlessly remove any callus or corns. The circulation and sensation in your feet will be assessed, as will any lumps and bumps and/or foot dysfunction that may cause pressure points. Excessive pressure areas under your feet and on your toes can lead to corns and calluses or pressure ulcers.

Conditions this service treats & how does it work

Treatments for nail and skin conditions may include:

  • Painless removal of corns and callus and thickened skin
  • Treatment and ongoing advice on preventing cracked heels
  • Ingrown Toenail surgery to remove nail spike or complete removal of nail if clinically indicated.
  • Fungal nail treatments
  • Removal and treatment of plantar warts
  • Custom made silicon toe wedges or splinting to straighten overlapped toes or protect and prevent rubbing of toes.

What are the benefits of this treatment

Corns, calluses and thickened skin are generally symptoms of other problems, so it is important for your podiatrist to examine your feet to work out what could be causing the pressure so they can provide a treatment plan which includes offloading these areas.

Your podiatrist will also provide you with advice on how you can care for your feet to prevent ongoing problems and on whether further treatment is recommended.

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.

BLISTERS…why do they occur and prevention

Blisters form due to repetitive friction and trauma to the skin.

They are most commonly caused by rubbing or friction from footwear applying pressure to the foot and overloading the soft tissue during activity.A blister forms as a clear fluid filled lesion within the outer layers of the skin.

What to do:
– If the blister is closed; keep the blister protected (with a dressing), do not ‘pop’ the blister and reduce activity/change footwear.
– If the blister opens, apply antiseptic (e.g. betadine) to the area and a dressing. Reduce activity and monitor the blister for signs of infection. If any signs of infection occur contact your doctor.

Prevention

  • Appropriate shoe fit and style
  • Double layered socks and/or moisture wicking socks
  • Tapes/dressings
  • Paddings
  • Lubricant

Long term treatment

  • Footwear change
  • Biomechanical assessment to investigate areas of high pressure
  • Sock choice
  • Activity modification
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.

SKIP A STEP & SAVE MONEY…do I need to see my GP or Podiatrist for a foot complaint?

Podiatry

A podiatrist is an Allied health professional in foot care. Podiatrists help people in the care of their lower limbs including the foot and ankle and may also be involved in supporting older people to reduce their risk of falling.

They can treat conditions such as toe fungus, ingrown toenails, corns, calluses, bunions, infections and foot injuries. Podiatrists can perform ingrown toenail surgery using a local anaesthetic.

Where do podiatrists practice?

Podiatrists mainly work in private practices but also work in a range of health settings including hospitals, aged care, sports clinics and research and policy organisations.

When should I see a podiatrist?

There are a wide range of reasons to see a podiatrist but some typical foot conditions include heel pain, bunions, ingrown toenails, tinea, plantar warts, corns and calluses.  Some typical examples of why someone might see a podiatrist are:

  • Patient with diabetes and peripheral vascular disease, or neuropathy
  • Clinical diagnosis or history of foot or lower limb deformity
  • Clinical diagnosis of falls
  • Arthritis
  • Soft tissue and muscular pathologies
  • Circulatory diseases.

What services do podiatrists provide?

Podiatrists provide a wide range of services from the treatment of calluses to the treatment of bone and joint disorders. For conditions such as recurring sprains and chronic pain, podiatrists may prescribe foot orthoses.

The podiatrist’s scope of practice includes areas such as paediatrics, diabetes, sports injuries, structural problems, treatment of the elderly as well as general foot care.

Podiatrists with additional qualifications and registration may also perform foot surgery.

How are podiatrists qualified?

In order to practice in Australia, a podiatrist must complete the following:

  • A Bachelor of Podiatry
  • Australian Health Practitioner Regulation Agency (AHPRA)
  • Continuing professional development.

Skip a step and make a direct booking with one of our qualified podiatrists today on 5223 1531 

TOP TIPS FOR FEET FOR TRAIL RUNNING

There are a few things to consider if you enjoy trail running.

Skin integrity
This may include blisters, callous, corns and dry skin.
To help prevent these from developing, wear appropriate socks.  The best material is predominantly polyester, as this transfers or wicks moisturise away from the skin. This keeps the skin strong and dry, less likely to cause blisters. You can also wear two pairs of socks(to reduce friction); one very thin, without any creases but stretches around the foot and the second pair worn on top, a bit more cushioned. Wearing two pairs creates a barrier, meaning that if there is any friction, it more likely to occur inbetween the two socks rather than directly to the skin.
You may require specific padding to redistribute pressure points in the feet.

Skin and nail preparation
Cut your nails (not too short and not the day before your run)
Moisturise your feet daily to prevent skin irritation from stress. Apply everywhere except inbetween the toes as we want to keep these areas dry. Use a quality urea-based cream.
Address callous and cracked skin if you are not able to manage this.

Footwear
Make sure that you have a well-fitted pair of trail shoes (a cushioned runner with appropriate grip)
Make sure you have a little room in the shoe, if the feet begin to swell. Ability to adjust lace-technique if signs of swelling and pressure from shoes occur is also important.

If you have any lower leg or foot injuries, your risk of injury may be heightened due to the possible uneven trail surfaces.  You may require taping or further advice from your Podiatrist.

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.

FEET AND ANKLE INJURY FREE -WHILST SMASHING OUT HIIT SESSIONS

Due to the nature of HIIT (high intensity interval training), certain stresses may be placed on the feet and ankles, especially if this is a new form of exercise for you.

It is important to build the strength in your legs prior to engaging in HIIT training, as movements are often rapid and repetitious. It can place excessive pressure on your joints if your HIIT workouts are too frequent, and you do ‘too much too soon’, like many other activities. There are specific modifications that your trainer may be able to suggest if you have any concerns. Correct technique is crucial, so it is necessary for you and your trainer to be on top of this, to avoid injury.
Should you develop an injury, seek medical advice as soon as possible.

Be sure to wear appropriate footwear. When buying athletic footwear for your HIIT workout, stick with a ‘neutral’ shoe, unless it has been otherwise suggested by your health professional.
The shoe should have a firm heel counter (doesn’t fold right down if you try to push it with your fingers). The shoe should have a moderate amount of cushioning (without it being too heavy), for good shock attenuation to reduce the amount of force on the feet and legs. The softer the outer sole however, the faster it will compress, which we want to avoid.

If you do not feel as you are being adequately ‘supported’ or have enough cushioning, try altering your footwear. If this doesn’t change anything, there may be other things that your Podiatrist can manage or educate you with.

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 THE FRONT DESK TEAM @ TOTAL CARE PODIATRY

At Total Care Podiatry our front desk team guides your first steps into the care we strive to give all our patients.

Our office manager Emily Meek and her team of Suzy Purtill and Kate Wombwell many years experience of service in private health practice. Their care and attention to detail is focused on our patients’ needs.

Our Practice Manager, Rae-Ellen Graham has worked for over 30 years in administration management and is also our shoe fitter and orthotic technician.

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.