Shockwave Therapy, how can it help me?

Shockwave therapy, also known as Extracorporeal Shockwave Therapy (ESWT) is a multidisciplinary device used by podiatrists and other sports physicians with the main benefits being fast pain relief and restoration to function and mobility. It is used for resistant soft tissue injuries that do not respond to conservative treatments such as icing, heat, stretching, strengthening, massage, supportive footwear and orthotics.

Corns, what are they? Why do they occur? Johan explains...

As a podiatrists, corns are something we see and treat on a daily basis. We have fancy names for them; seed corns, heloma durum, heloma millare, heloma molle. They are all different types of corns, but essentially, they are all corns.

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They can be extremely painful and if you’ve ever had one, you’ll know that they can really affect your daily life, activity and even mobility. So what are they? Well, it’s pretty simple really and here’s what happens. Callus often develops on bony areas, areas with a lot of friction or excessive load or pressure. Sometimes the fatty padding or cushioning underneath the foot becomes thinner and this also leads to excessive forces leading to the formation of callus. This then, often in combination with poorly fitted shoes, can cause hard skin to build up. Then, within the callused areas of highest pressure and friction, keratin cells are compressed even further to form a core. This hardened core is what is known as a corn. It applies pressure to the tissue below the skin and this is what causes pain.

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We can treat them successfully by removing them with a scalpel or by drilling them out with a special burr. It is usually painless to remove them and the great thing about treatment is that relief is instant. Depending on where they are, we may do one of a variety of things in order to reduce the load to a specific area to prevent them from returning. For example, if they are in between your toes, we often make special custom moulded silicon devices to reduce friction and pressure. In other patients they could be situated on the sole of the foot where we may design special insoles to reduce pressure over certain areas. There are a whole host of tricks podiatrists have up their sleeves to combat combat corns.

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It’s best to see a professional. We’d love to help. If you or anyone you know suffer from painful corns, contact us to make an appointment or check out our website for online bookings.

Ingrown toenails, it hurts!

If you’ve ever had one of these, the kind of pain that comes with it requires no explanation…it can be really painful and quite debilitating! Putting on a shoe or even having your sheets touch your toe at night can be enough to drive you up the walls.

There are a number of factors that can cause ingrown toenails:

  • poorly fitting shoes

  • poor nail cutting technique

  • genetics (curled or rounded nail shape)

  • trauma from either a stub or dropping something on your toe

Once a nail becomes ingrown, it usually becomes quite swollen, red and may even ooze pus. The reason for this is that your body treats the nail as if it were a foreign object, and as such infection sets in. It is important to have it treated professionally as to treat the infection as well as to remove the cause, otherwise it may become an ongoing problem.

Podiatists are trained and very skilled to treat ingwown nails in a variety of ways, both conservatively and surgically if required. I pride myself in very effective and gentle treatment of ingrown nails. Over the past ten years, my experience cetainly has perfected the treatment of ingrown nails and I just love treating them because of the instant relief my patients experience. I pride myself on a very gentle and steady technique for even the most stubborn ingrown toenail. If an ingrown nail is an ongoing issue I perform a minor nail surgical procedure which is extremely successful and solves the problem permanently.

If you or anyone you know suffer from an ingrown toenail, feel free to message me via my website if you have any queries or book in online for a consultation. Treatment can usually be performed during the initial consultation, however if nail surgery is required, a follow up appointment will be made.

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What are custom orthotics? A biomechanical assessment explained...

So what can you expect during a biomechanical assessment? It is normally a 40-60 minute consult where your podiatrist assess your feet and lower limbs in detail as well as how they function during walking and running. They look at how the lower limbs interact with the rest of the body i.e. your knees, hips, back and neck. For this reason, podiatrists will assess the range of motion in all your joints as well as if there are any limitations caused by tight muscles, ligaments, bony malformation or degeneration. You can expect to be assessed lying down, standing, walking and even running if this is part of your daily activity. You may also be referred for imaging such as x-rays, diagnostic ultrasound or an MRI.

Custom orthotic therapy is a primary treatment used by podiatrists, but even more importantly, they are used as a preventative measure to control progression of foot deformities that are both hereditary and developmental. There are a myriad of biomechanical factors that may be exacerbating or causing foot problems and for this very reason, podiatrists spend years studying to learn how to perform thorough biomechanical assessments.

Based on all the findings and diagnosis, your podiatrist will implement a treatment plan that may incorporate a change in activity, a different footwear prescription, modifications to your existing shoes, stretching exercises, soft tissue work such as dry needling, therapeutic ultrasound, taping and if required a very detailed custom orthotic prescription. In order for an orthotic to be manufactured accurately, your podiatrist will either take a 3D scan of your feet or a plaster cast. These are sent to a laboratory along with the podiatrists prescription for manufacturing. In saying this, podiatrists may prescribe a simple over the counter insole for some conditions if not complicated by a biomechanical factor.

So what happens next? Once the orthotics is ready, your podiatrist will schedule an appointment with you for an orthotic fitting. You are normally requested to bring your shoes with to this appointment so the orthotics can be correctly fitted to your shoes. Orthotics will be assessed on your feet to check that the prescription is correct and you will be asked to walk in them so that the changes brought about by the orthotics can be assessed. There is usually a wearing-in period where you will be instructed to gradually wear orthotics fro longer periods until you can comfortably wear them all day. You will be booked for a review within two weeks and then again in two months. Referrals to other health practitioners such as physiotherapists, chiropractors and remedial massage therapists to help with muscle work are also done at this time.

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