Services



At Circle Podiatry we combine experience, professionalism and specialized technology and equipment to provide a wide range of effective services and treatments. We aim to not only fix your current foot and lower limb problems but also to educate you on preventing further complications later in life. Our mission is to keep you on a strong footing so you can continue to do the things you enjoy with those you love and we leave you feeling like you’re walking on air.




General Podiatry




Chilling





Some people have a poor circulation either at the arterial level or poor perfusion into the capillaries. If the ambient temperature drops the tissues in the extremities may not get enough nutrients and oxygen and so begin to break down into an ulcer or necrose and go black. This is usually common in parts of the foot where there is most pressure such as the ends of the toes and under the ball of the foot which will first of all look cyanosed (blue). This should be seen by a Podiatrist as early as possible and usually is reversible provided it hasn’t been neglected too long.

If in doubt get them checked out. Even sending a photo through from the Foot app will allow one of our team to advise you further.

Corns or Calluses





Description/What is it?

A callus or corn is a build up of hard skin that forms at points of pressure and/or friction and often over boney prominences.

Calluses and corns can form either on the sole of the foot or on the top of the foot , in-between the toes and classically can arise in any area of high pressure/friction. First the hard skin forms to protect the area .Unfortunately it doesn’t know when to stop and continues to form .As the pressure builds the hard skin indents inwards ( a bit like an inverted cone) forming a corn when the pressure becomes particularly intensive.


Some likely causes:

Inherited foot structural issues.

Areas of high pressure over deformities.

Areas of high pressure from unsuitable footwear.

Areas of high pressure or friction caused by abnormal foot function.


What can we do for you?

Alter the way the foot is functioning by addressing poor foot function.

Perform a physical examination.

Remove any hard skin and the corns.

Protect the area of high pressure with padding to offload the area

Footwear advice.

Mole or Melanoma





Skin cancers such as melanomas are not common on the feet but the possibility of them occurring should be taken seriously. Any unusual bump or lump or pigmented area should be checked especially if it is growing , changing or has any of the characteristics below.

Asymmetry – one side of the lesion doesn’t match the other.

Borders - Borders look, uneven, or ragged.

Color - There may be more than one color in an uneven distribution.

Diameter – The lesion is wider than the diameter of a pencil (greater than 6 mm).

Skin cancers on the feet often go unnoticed on the feet meaning that when they are picked up they may have spread and be more difficult to cure..I t isn’t a bad idea to photograph any moles etc with a ruler beside them so you can compare to see if they are changing

Ingrowing Toe nail





Description/What is it?

An ingrown toe nail is a painful condition characterized by the nail digging into the surrounding skin, leading to inflammation and possible infection of the toe.


This is a serious condition for people with impaired circulation, diabetes or diseases causing immune suppression


Let us split ingrown nails into 2 broad groups.


Firstly those where a spike of nail is penetrating the flesh.

It can be an acute problem which comes usually due to trauma or poor nail cutting or picking at the nails where a spike of nail is left which then grows forwards aggravating the skin at the edge of the nail. If left it can often develop a mass of red jelly like tissue called hypergranulation tissue which bleeds very easily. Often healing is complicated by infection taking advantage of the moist environment. All too often we see people who have had several courses of antibiotics to try and solve the problem. However frequently that is not enough and the spike of nail needs to be removed. Usually this can be done without the need for local anaesthetic but sometimes it may be necessary and can be administered by a suitably qualified Podiatrist.


And secondly where the nail has curled over a period of time into the skin at the edges.

We call this involuted and is generally a chronic long term change in the nail profile that leads to it curling in at the edges. I t usually occurs secondary to pressure which could be due to poor fitting shoes or a poor foot structure leading to pressure in that area .Obviously it can be a combination of them both. Although this forms gradually and may cause discomfort just from the pressure it can also be harder to cut leading to an increased likelihood of a spike being left which then penetrates the flesh.


What can we do for you?

First line treatment is always to assess including taking a history. Sometimes all that is needed is for a piece of nail to simply be removed but if it becomes a recurrent problem you will probably be advised to have some nail surgey which can involve removal of either a part of the nail or the whole nail. This can either be done with the root of the nail left intact to grow again or with either the whole or part of the root being destroyed to leave you with either no nail or a narrower one.

If you suspect an ingrown nail is beginning it ias always advisable to get it seen to quickly as even 24 hours of walking around with it can make it worse and therefore the treatment more involved and costly.

Break down of tissue and ulcers





Description/What is it?

An ulcer is a breakdown of the skin on an area of the foot. An ulcer can develop quickly and may be painful and difficult to heal. They often come as a result of callus or corns being allowed to build up hard skin and resulting in extreme pressure squeezing the tissues in the affected area which become starved of nutrients and oxygen. The local tissues then die off. Infection is a common complication. Sometimes we may advise you that it is important to have an X-ray to determine whether the infection has penetrated to the bone. This can happen to anyone but is more likely in people with diabetes.


Some likely causes:

Biomechanical issues leading to areas of high pressure.

Poorly controlled and undiagnosed diabetes mellitus.

Vascular insufficiency.

Lack of sensation.

Trauma.


What can we do for you?

Perform a physical examination.

Offload the area with pads or insoles.

Perform debridement and wound care.

Arrange laboratory tests.

Referral to a multi disciplinary team which may include a diabetologist, endocrinologist, Podiatrist, vascular surgeon, diabetes specialist nurse, radiologist, Orthotist and infectious disease specialist.

Advise X-ray evaluation.

Verrucae/plantar warts





Description/What is it?

Verrucae (plural for Verruca) are viral infections affecting the epidermis (outer layer of skin). They can also be called Plantar warts. They invade the skin through small or invisible cuts and abrasions.

They can appear anywhere on the skin. Children, especially teenagers, are often more susceptible to warts than adults, some people seem to be immune.

It is also possible for a variety of more serious lesions to appear on the foot, including melanomas.

It is therefore wise to consult a podiatrist when any suspicious growth or eruption is detected on the skin of the foot in order to ensure a correct diagnosis.

The Verruca is often contracted by walking barefoot on dirty surfaces where the virus is lurking. The causative virus thrives in warm, moist environments, making infection a common occurrence in communal bathing facilities/changing rooms

If left untreated, warts can grow to an inch or more in circumference and can spread into clusters of several warts, these are often called mosaic warts. Like any other infectious lesion, plantar warts are spread by touching, scratching, or even by contact with skin shed from another wart. The wart may also bleed which is another route for spreading.

They are often mistaken for corns or calluses – which are layers of dead skin that build up to protect an area which is being continuously irritated. The wart, however, is a viral infection.


What can we do for you?

Over-the-counter preparations contain acids or chemicals that destroy skin cells indiscriminately whether or not they are infected with the virus. Thus they can destroy surrounding healthy tissue. Self treatment with such medications especially should be avoided by people with diabetes and those with cardiovascular or circulatory disorders.

That said we will often advise self treatment initially in a healthy person with no complications.This should for best chances of success only be started after the dead skin on the surface of the verruca has been removed to allow the active chemical access to the actively infected cells below the surface.

After an advised duration if rthere is no improvement then often you will be advised to try in clinic treatments with stronger acids (for example most over the counter acids are 26% salicylic acid whereas we use 60-70 in clinic.

Other treatments include:


Cryosurgery where the verruca is frozen.

Cryosurgery involves the use of liquid n nitrogen, which is extremely cold and has an operating temperature of -196 C. It can either be applied using a probe or spray. The liquid rapidly freezes the water content causing ice crystals to form within the cells around the area of application. The rapid cooling effect along with the low temperature of liquid nitrogen allows accurate treatment to the affected area with less damage to the surrounding healthy tissue. Whilst cryotherapy is an effective form of treatment; it may be need to be repeated at periodic intervals to completely eradicate the verrucae


Needling.

This is a routine procedure which is carried out under local anaesthesia. It is commonly used to remove verrucae. The procedure has a 90% success rate. However, there is a small chance that re-growth may occur. There is also a possibility of infection if it is not looked after properly. You may experience slight pain after the procedure.

This is a routine procedure which is carried out under local anaesthesia. It is commonly used to remove verrucae. The procedure has a 90% success rate. However, there is a small chance that re-growth may occur. There is also a possibility of infection if it is not looked after properly. You may experience slight pain after the procedure.

The verrucae is then punctured using a sterile needle multiple times. This causes a bleed (haematoma) directly under the verrucae and surrounding viral tissue.

The area will then be dressed and monitored until it heals (approx 4-6 weeks).

It should be noted that verrucae are particularly stubborn and there is no definitive treatment that is guaranteed to work in all cases.Your podiatrist at your assessment will advise you of a treatment plan most suited to your verruca and your lifestyle.

Fungal Nail Infection





Description/What is it?

It is not just a cosmetic problem. It is an infection of the nail plate and nail bed underlying the surface of a nail.

Fungal nail infection, a condition called onychomycosis (ON-i-ko-my-KO-sis), is caused primarily by organisms called dermatophytes. It is extraordinarily common Once these tiny organisms find their way under a nail, they begin to multiply. Ironically, when the fungus finds its way under the nail, the nail itself provides a protective environment for the fungus to thrive. The toenails are most vulnerable to infection, since they spend much of their day surrounded by dark, warm, and often moist shoes and socks.

When fungal nail infection begins to take hold, it can cause the nail to change colour, often to a yellow/green or darker colour. Debris may collect under the nail, causing a foul smell. Your nail may thicken and become brittle and crumble.. Thick toenails, in particular, may cause discomfort in shoes and may even make standing and walking uncomfortable for some people.

Moreover, because fungal nail infection is an infection, it can spread to other nails, and possibly to other people. Something as ordinary as an emery board can carry the fungal organisms from an infected nail to an uninfected one. That's why it is so important to seek treatment as soon as you think you have an infection.

In the elderly or ill an important consideration is the likelihood of cross infection to the skin which initself isn’t dangerous but could easily create a break in the skin allowing far more dangerous bacterial infections to get in.


Some likely causes:

Fungal nail infection has little to do with personal cleanliness. Something as simple as banging a toe or finger, trimming your nails too closely, or wearing tight shoes is enough to weaken the nail and expose the underlying nail bed to infection. The fungus that causes the infection resides in many common places, even your garden. You can also contract the infection while getting a manicure or pedicure, from unsterilized instruments that have been used on others with the infection.

Some people have chronic disorders that make them more susceptible to fungal nail infection. People with diabetes, circulatory problems, and immunological deficiencies (such as AIDS/HIV infection) are at increased risk, as are the elderly. Moreover, fungal nail infection appears to be more prevalent in those with a history of athlete's foot (a fungal infection of the skin) and people whose feet perspire a lot. Additionally wearing of nail varnish for long periods of time can damage the surface of the nail plate allowing the fungus to get a hold.


What can we do for you?

Fungal nail infection will not go away by itself. Our Podiatrist can assess and prescribe effective treatments for fungal nail infections.

This will normally involve thinning down the thickened nail followed by the use of special solutions to kill the fungus.This can take a long time as you have to keep applying the chemical whilst the nail grows out which can take a year.




Athlete's foot





Description/What is it?

Athlete’s foot is a common fungal infection of the skin characterized by itching, scaling, redness, and the formation of small blisters.

In general the lesions start between the toes and can extend to the borders and bottom of the foot. The fungus has the potential to spread to the toenails, causing them to become thickened, discolored, and painful. In this case the infection is called onychomycosis .While this infection is common among athletes, keep in mind that it can affect athletes and non-athletes alike.


Some likely causes:

The feet are vulnerable because shoes commonly create the perfect , warm, dark and humid environment that encourages fungal growth.

Athlete’s foot can be picked up anywhere that the fungus comes into contact with the skin of the feet. Typically places such as changing rooms and hotel rooms where your feet are walking where someone with the fungus has already walked.


What can we do for you?

Perform a physical examination of your feet and advice you.

Prescribe topical anti-fungal medications.

Advise oral anti-fungal medications (only available by prescription).

Pregnancy and the foot





Ways that Pregnancy can affect your feet.

1) In the later stages of pregnancy, you may tend to turn out your feet for stability. This can put undue stress on the tendons, muscles, and ligaments of the feet.

2) When you are pregnant, the excessive weight gain increases the pressure through the feet.

3) During the 3rd Trimester the body releases a hormone called Relaxin which makes the pelvic ligaments elastic ready for the pelvis to be able to stretch at childbirth.Unfortunately this also affects other ligaments including those in the feet and so the alignment of the bones can change.Often we hear ladies say “all my foot problems started after I had my children”

4) As your baby grows larger, your centre of gravity changes from the lower back to the front of the body often causing more force and pressure in the forefoot causing problems there such as pain in the ball of the foot.

5) A pregnant woman’s foot can also swell or enlarge anywhere from one to two sizes, causing discomfort especially from pressure from the shoes.

6) Other common complications include swelling of the legs, varicose veins, leg fatigue, and cramps.


Here at Circle Podiatry we believe all expectant mums should be seen for a foot assessment so we can empower them to know how best to tackle these unwanted complications that can mar such an important and special time in your life and possibly beyond into the future.


We often intervene to provide orthotic insoles to help maintain the integral structure of the foot during that critical last trimester when the ligaments aren’t holding the foot bones together as well as they should be.

Footwear advice





We all like our own space and most of us would prefer not to live in a cramped house. Our feet are just the same, yet we force them to live in inappropriate houses. That’s right: your choice of footwear, both shoes and hosiery (socks, tights and stockings), are what you expect your feet to live in for the best part of the day. It’s a pity that many people buy them for style and fashion rather than comfort. Podiatrists will advise you to wear the most sensible shoes possible for your everyday life – then you’ll probably be able to get away with those fashion shoes once in a while. Poorly fitting footwear and unsuitable shoes contribute to the many foot complications.

For more info please see our blog.

Diabetic foot care





Description/What is it?

Diabetes is the No 1 reason for amputations of the lower limbs with on average 135 a week in the uk and one every 20 seconds happening worldwide. Up to 85% of these could be prevented.


Here at Circle podiatry we are so passionate about preventing you meeting this fate that we set up a non for profit community interest company called undefeeted which we would encourage you to interact with. There is a wealth of information in the book Undefeeted by diabetes which along with resources on the website www.undefeeted.org will give you all the knowledge you need to understand what can go wrong.


This knowledge along with an understanding of your own personal risk form 2 of the 3 aspects of being in the diabetic sweet spot-a safe zone where you will be at least risk of complications. The 3rd aspect is to act on what you learn both from the book and from your Podiatrist.

We have devised a thorough diabetic foot assessment which focuses on checking your risk of complications developing empowering you to be able to act which in turn could ultimately lead to you preventing having to have an amputation of part of the foot or leg.

These assessments focus on testing the circulation within the feet, nerve supply to the feet, significant areas of callus and deformities such as bunions or hammer toes.


Some likely causes:

Diabetes if it is poorly controlled provides the “perfect storm” of events that can lead to you ending up on the slippery slope to having an amputation.

Good care of your feet and good control of your blood sugars together give you the best chance of avoiding complications.


What can we do for you?

Gain knowledge by reading the book "Undefeeted by diabetes".

Help to control your blood sugars better.

Advice on good foot health care for you.

Specific advice for you following your SATNAV diabetic foot assessment which lets you know what risk factors pose as a threat to you personally.

Provide ongoing foot care for you.

Mentoring to help you live in the diabetic sweet spot.

Kids Foot Care





Children’s feet have their own unique issues that can lead to sometimes complex problems that continue into adulthood and may go unnoticed for years before eventually becoming a problem.



Here at Circle Podiatry we are on a mission to enable any child in the UK to receive a foot check twice before their 12th birthday. Our vision is that by 2035 all children will routinely be screened twice for any foot abnormalities including structural and functional issues.


Common complaints with children’s feet include:

Verrucae (plural for a verruca).
A verruca is a viral infection, a wart on the foot and can easily be caught by children particularly if their feet are in contact with the ground where someone else has been with one. Places such as sports changing rooms are classically blamed. More information can be found here.


Ingrowing nails.
This is where the nail plate digs into the flesh at the side of the nail often penetrating it and allowing subsequent infection to get in.

Common causes are:
1) Poor nail cutting
2) Picking at the nails
3) Tight socks/baby grows
4) Tight shoes
5) Poor foot function leading to abnormal forces and pressure
Link to ingrown nails in General Podiatry.


Flat feet.
Prior to 3-4 years of age it is quite normal for a child to have flat feet. An arch should form if they go onto tiptoes which if it doesn’t may indicate a need for some form of intervention be it insoles or exercises. Not all cases are in need of treatment but every child should be assessed to see if there are any indications for further assessment or for treatment to begin. Find out more here.


Abnormal foot structure.
It is estimated that in excess of 80 % of us are born with an inherited misalignment of our lower limb bones. This should be screened for during foot health check and investigated further and addressed if appropriate. Find out more here.


Leg length discrepancy.
One leg longer than the other is a common issue which can have far reaching complications either at the foot end or higher in the body such as the back and shoulders. Find out more here.


Knee pain.
There is a direct link between the way the foot and the knee function and either can cause the other problems. Knee pain should always be taken seriously especially if occurring in the area of the growth plate of the bones (an area of softer bone where new hard bone is laid down at the borders). Find out more here.


Growth pains.
These are usually muscular pains often felt at night where the inactive muscle is not stretched and tightens up. Bone grows quickly during a growth spurt and the muscles take longer to catch up so we end up with the muscles feeling tight and subsequent pain. Your podiatrist will advise if this is the case and it may be necessary to carry out a course of stretching exercises. Find out more here.


Heel pain.
Can be a number of causes and foreign bodies should not be ruled out.However at approximately age 10-12 the heel bone called the Calcaneus has a soft growth plate which is subjected to a lot of pull from the tendo Achilles. This can lead to trauma and micro fractures in the heel and often needs to be protected with the use of orthotics to prevent further damage that could otherwise lead to a need for the foot to be casted for up to 6 months. Find out more here.


Curling toes.
Sometimes this is an inherited peculiarity but often is caused by abnormal pressures either from shoes or hosiery or by an abnormal foot function. If the latter then this should be addressed with orthotics. Find out more here.


We offer any child under the age of 16 an initial free foot health check (this is subject to availability – max 2 per day).


Kids Feet Health Tips


As children take up a particular sport and become more active at school, foot and lower limb problems associated with unaccustomed exercise can occur.



If a child indulges in any form of activity, injuries can occur and they will be likely to have aches and pains from time to time. However if a pattern emerges or there is prolonged discomfort you should seek a professional opinion.



Growth, possible weight gain and increased exercise can all contrive to make an underlying previously hidden foot structural issue become more relevant and the cause of a wide range of painful foot and lower limb problems.



Children may regard foot problems as normal and may not complain. However any complaints should always be taken seriously and a diagnosis made as soon as possible.



Failure to recognise and treat these overuse problems can lead to long-term problems for the child including an inability to reach their true sporting potential. Most problems are readily managed by your podiatrist, utilising a variety of methods.



The Podiatrist you see will perform annual foot health reviews/checks to prevent or correct deformity and maintain normal mobility and function.



If you are a parent or guardian and have any concerns -for whatever reason- you should always seek professional advice, as it is better for your fears to be unfounded, than to discover, often too late, that treatment was required.



At Circle Podiatry, we continuously strive to provide quality foot care for you and the ones you love.




What can you look out for?



Skin – Areas of redness, rashes, blisters on the back of the heel and on the tops of the small joints of the toes.


Nails – Inflammation around the nails should always be taken seriously.


Deformities – Toes should be straight in line with the foot and not drawn back or curled, particularly, the big toe should always be straight.


Posture – the feet should not appear excessively turned in or out, or the arch very flat, particularly, if the child complains of pain.


Some helpful tips to help look after you little one’s feet.



Check the size of their socks.


Inspect their shoes regularly for unusual wear.


Unusual wear may be the first indication that there is a problem with the foot posture or general posture and should always be investigated by a qualified and registered podiatrist.


Nursing Homes and Domicillary Care





We understand the importance of finding the right team of professionals in the provision of high quality Podiatric care to your clients; we also understand that you need them to have a high level of experience and expertise, and be reliable and dependable.


This understanding underpinned by a good track record of excellent customer service is what has made us one of the most successful and widely chosen Podiatry practices. In addition to being able to understand your needs, our team is experienced in providing a fast, efficient and reliable service, which can be relied on at extremely competitive rates.




Key Benefits and Guarantees


We are so confident that we will be able to see your clients on the pre-arranged date that if we are unable to do so for any reason we will provide the following treatments absolutely free!


Reliable care plans and arrangements


Tailored care plans according to individual needs


Free foot health checks for the staffing team at our modernised fully equipped practice


50% off initial foot health checks/assessments


Up to 75% off our normal domiciliary care prices on multiple bookings


Enjoy 14 days credit on payment terms


Why choose us?


You can rest assured that your loved one(s)/ patients are being cared for by one of the leading Podiatry teams


Accredited by The Society of Chiropodist & Podiatrists


All Podiatrists are HPC Registered


Podiatry care covered by insurance


Our testimonials and awards speak for themselves; assuring you of the high quality of customer service that we deliver and the satisfaction our service users experience.




Entrust the care of your clients to us today. We are proud of our team and the quality of care/service that we provide, we tailor our services to the needs of the clients and the setting, not the other way round.


Each year over 21000 appointments are offered to individuals and families who have the opportunity to experience and enjoy the benefits that we provide and the difference we make in their lives!


Educational and Careers Advice




Shools


“Happy Feet” education and awareness campaign for schools


Happy feet is an educational campaign which provides schools, nurseries and educational settings a unique opportunity to help raise awareness and educate children, their parents and teachers about the great importance of foot health particularly in children absolutely free of charge.


Key aim Teaching the kids - how to look after their feet.


Diabetes


Gyms and sports clubs


High street


What people say about “Happy Feet”



Biomechanics and Gait Analysis


Bunions and haglunds deformity
Bunions develop gradually and ultimately may require surgery to correct them.
LEARN MORE!

Flat Foot
Flat foot is a structural deformity resulting in the lowering of the arch of the foot. This is sometimes referred to as 'fallen arches'.
LEARN MORE!

Foot and Ankles
Foot and ankle emergencies happen every day. Broken bones, dislocations, sprains, contusions, infections, and other serious injuries can occur at any time.
LEARN MORE!

Gait Analysis
This involves studying and analysing how your joints and muscles behave when your body moves and identifying any abnormalities that may present.
LEARN MORE!

Musculo-skeletal Assessment
Your lower limb joints and muscles from the hip down to the little toes will be assessed during the Musculoskeletal Assessment.
LEARN MORE!

Orthotics
An orthotic is designed to improve the mechanics of the foot . The most common treatment for biomechanical problems is the use of special shoe inserts known as orthoses, or more commonly, orthotics.
LEARN MORE!

Plantar fasciitis
Plantar fasciitis is an inflammation of the long band of connective tissue running from the heel to the ball of the foot.
LEARN MORE!

Pressure Plate
Even with other assessments done, sometimes it is still difficult to picture how the alignments and misalignments of the joints have an impact on your feet and posture.
LEARN MORE!

Stress fractures and other internal foot pains
Stress fracture in an incomplete crack in the bone caused by overuse. A foot that is not structurally sound is prone to developing stress fractures.
LEARN MORE!

Hammer Toe
A hammer toe is a contraction deformity, resulting in bony prominences on the feet.
LEARN MORE!

Arthritis
Arthritis is a disabling disease. It is characterised by inflammation of the cartilage and the lining of the body’s joints.There are lots of different types of arthritis.
LEARN MORE!

G-walk
Circle Podiatry invested recently in the G-WALK system largely because we do not believe in quick fixes that can store up trouble for the future. Rather, we want to reassure you as far as we can of your future well-being on your journey through life.
LEARN MORE!

Bunions and Haglunds deformity





Bunions

Bunions develop gradually and ultimately may require surgery to correct them.

A bunion is an enlargement of the joint at the base of the big toe caused by a misalignment of the joint. The big toe tends to move over towards the other toes and the first metatarsal bone tends to deviate away from the other metatarsals. It is often characterised by arthritic changes and usually gets progressively worse and more painful. They can often be aggravated by footwear either too tight or creasing in the wrong place and then the soft tissues can become affected causing superficial sores or deeper blisters called bursas.

These deformities as with others can all predispose a person to pressure points and wounds forming which can be especially troublesome and dangerous in someone with diabetes.

Bunions usually form as a result of one of the following or a combination of them:

Inherited foot structure issues

Biomechanical abnormalities

Neuromuscular disorders

Inflammatory joint disease (arthritis)

Trauma

Congenital deformities

Occlusive footwear

Genarally our first line of treatment is to prevent the problem becoming worse by giving advice ,padding to protect and orthotics to offload and change the function of the foot.Bunions deteriorate gradually and eventually may require surgery however surgery itself has risks and all too often after the operation the causative factors such as poor fitting shoes or poor foot function are not addressed.


Haglunds deformity

Simply put this appears as bumps on the back outside edge of the heel bone. They are a bony growth called an exostosis and form as a result of repetitive trauma from the heel counter of the shoe rubbing and putting pressure on this area. The bone responds by laying down more bone which then can become irritated by there being even more pressure from shoes –it’s a bit of a vicious cycle of events. Often caused by abnormal amounts of Pronation the process can usually be halted or at least reduced by having orthotics made to address the abnormal gait and foot function. See gait analysis.

Flat foot





Description/What is it?

Flat foot is a structural deformity resulting in the lowering of the arch of the foot. This can be inherited or acquired when it is sometimes referred to as 'fallen arches'.

A person with a flat foot that is painful is in need of treatment. If you have flat feet may develop ankle, knee or lower back pain.

However if you have no pain you should still get your feet checked out as the abnormal forces going through your foot and legs will be likely to alter your gait and posture and in affect could be a time bomb of musculoskeletal problems waiting to explode.


Some likely causes:

Heredity

Arthritis

Trauma

Musculoskeletal disorders


What can we do for you?

Perform a physical examination and gait analysis.

Advise imaging.

Prescribe custom orthotics.

Advise on exercises.

Foot and ankle injuries





Description/What is it?

Foot and ankle emergencies happen every day. Broken bones, dislocations, sprains, contusions, infections, and other serious injuries can occur at any time.

Early attention is vitally important. Whenever you sustain a foot or ankle injury, you should seek immediate treatment from a podiatrist.


Some likely causes:


Myths about Foot and ankle injuries.


“It can’t be broken, because I can move it.” False

This widespread idea has kept many fractures from receiving proper treatment. The truth is that often you can walk with certain kinds of fractures. Some common examples: breaks of the thinner of the two leg bones; small ‘chip’ fracture of either foot or ankle bones; and the frequently neglected fracture of a toe.


“If you break a toe, immediate care isn’t necessary.” False

A toe fracture needs prompt attention. If X-rays reveal it to be a simple displaced fracture, care from a podiatrist usually can produce rapid relief. However, X-rays might identify a displaced or angulated break. In such cases, prompt realignment of the fracture will help prevent improper or incomplete healing. Many patients develop post fracture deformity of a toe, which in turn results in formation of a painfully deformed toe with a most painful corn. A good general rule is: Seek prompt treatment for injury to foot bones.


“If you have a foot or ankle injury, soak it in hot water immediately.” False

Do not use heat or hot water if you suspect a fracture, sprain, or dislocation. Heat promotes blood flow, causing greater swelling. More swelling means greater pressure on the nerves, which causes more pain.


“Applying an elastic bandage to a severely sprained ankle is adequate treatment.” False

Ankle sprains often mean torn or severely overstretched ligaments, and you should receive immediate care to ensure a normal recovery.

Gait analysis





Description/What is it?

This involves studying and analysing how your joints and muscles behave when your body moves and identifying any abnormalities that may present.

At Circle Podiatry we carry out gait analysis to identify any abnormalities in the way you walk or run that may be contributing to your problem.

Your overall walking and if appropriate running gait will be assessed during the Gait Analysis. Since it is a dynamic assessment, the abnormalities and inefficiencies detected are also reflections of those happening during real life and in real time which often lead to the current issues you may be experiencing.

This important first part of the Biomechanical Assessment is essentially an assessment to detect WHAT is going on during your walking and/or running.

However, the Gait Analysis alone is not sufficient for orthotic prescription since the analysis cannot address all the underlying causes of the abnormalities and inefficiencies unlike the Musculoskeletal Assessment. If we identify that there are likely to be abnormalities with your foot structure then we will advise you to have our in depth Musculo-skeletal assessment with a view to intervening and changing the way your feet and lower limbs are functioning.

Biomechanics





Musculoskeletal Assessment

Your lower limb joints and muscles from the hip down to the little toes will be assessed during the Musculoskeletal Assessment. The joint ranges of motion, structure and alignments as well as muscle integrity and functions will be thoroughly examined.

This is the part of the Biomechanical Assessment where we can understand WHY you have the problems and what are the likely causes. The results will become the fundamentals for your orthotic prescription, enabling us to be able to provide you with tailor-made orthotics which will help realign and improve the foot’s function alternative treatment options.

Orthotics and Insoles





Description/What is it?

An orthotic is designed to improve the mechanics of the foot . Its purpose is to prevent abnormal motion of the foot while allowing for normal motion and function.

The most common treatment for biomechanical problems is the use of special shoe inserts known as orthoses, or more commonly, orthotics.

They assist the feet to function more efficiently. They do this by controlling joint movement, and by altering some joint angles to prevent excessive motion.

Many look like arch supports, but they are not intended to support the arch. Orthotics are angled individually to control the heel and forefoot, and prevent excessive motion. The natural arch in the foot will in most case become more apparent whilst the orthotics are worn.

There are many different types of orthotics. The type that is used depends on the activity in which the patient is involved, the shoes they want to wear, and the underlying foot problem.

Orthotics are made from impressions of the feet .

Orthotics fall into three broad categories: rigid, soft and semi-rigid. Rigid orthotics are designed to control function. Soft orthotics help absorb shock and take pressure off uncomfortable or sore spots. Semi-rigid orthotics provide dynamic balance of the foot while walking or participating in sports.

Plantar fasciitis and heel pain





What is Plantar Fasciitis?

The name of the condition refers most commonly to an inflammation of the plantar fascia. However, in fact, plantar fasciitis is a condition caused by degeneration of the plantar fascia which can happen with or without inflammation.

The plantar fascia is a strong band of connective tissue which is responsible for maintaining the arch profile of the foot. The typical presentation of plantar fasciitis is pain in the heel area which is often the most painful during the first few steps in the morning or after periods of rest, and ease off with walking / gentle exercise. More extreme cases can lead to extreme pain whilst walking.

Plantar fasciitis can be diagnosed in clinic by experienced podiatrists without any requirement for further examinations. However, sometimes imaging can also be used to confirm the diagnosis or rule out other differential diagnoses. Differential diagnoses of plantar fasciitis include fat pad atrophy, Achilles tendinitis, heel contusion, posterior tibial tendonitis, and Sever’s disease (in adolescents).

Treatment options for plantar fasciitis symptoms normally include RICE therapy (Rest, Ice, Compression, and Elevation), stretching exercises, change of footwear, strapping, NSAIDs (anti-inflammatory medications), low level laser therapy, and therapeutic ultrasound therapy. In some severe cases, steroid injection may be considered, and if all else fails occasionally surgery may be required although this is very rare.

The above treatment options mostly concentrate on treating the existing symptoms of plantar fasciitis. However, they might not be able to address the possible underlying cause of plantar fasciitis which is poor feet and lower limb mechanics. Functional insoles to improve the mechanics of the feet and lower limbs should also be considered as a long term treatment plan to assist improvements of the symptoms and prevent reoccurrence of the condition.


Some likely causes:

Stretching the long band of tissue that connects the heel and the ball of the foot.

Muscle imbalance.

Bone deformity.

Obesity.

Trauma.

Tightness of the muscles on the back of the leg.


What can we do for you?

Prescribe orthotics.

Perform a physical examination.

Perform taping and strapping.

Prescribe orthotics.

Administer injections.

Instruct in appropriate exercise.

Foot Pressure Analysis





Even with other assessments done, sometimes it is still difficult to picture how the alignments and misalignments of the joints have an impact on your feet and posture. The Foot Pressure Analysis can often provide the extra hidden information that could otherwise be missed.

The distribution of foot pressure can tell you HOW the feet react to the misalignments of the other regions of the body as a compensatory mechanism or how the existing foot posture/functions are related to the problems in those regions.

The Foot Pressure Analysis can be performed during static (i.e. standing) and/or dynamic (i.e. walking of running) activities. This part of the Biomechanical Assessment can provide another piece of the puzzle of what is going on in your feet during your gait. It can also be used as a valuable quantitative tool in measuring the effectiveness of your orthotics, aside from your qualitative feedbacks on the pain and how you walk or run.

Stress fracture





Description/What is it?

Stress fracture in an incomplete crack in the bone caused by overuse. A foot that is not structurally sound is prone to developing stress fractures.

Even a normal foot can easily develop a stress fracture from repetitive use; symptoms may include pain, redness, and swelling.


Some likely causes:

Sudden increased activity level.

Overuse or strain of the foot.

Medical conditions such as osteoporosis and diabetes.

Medications such as steroids.


What can we do for you?

Prescribe medications when indicated.

Perform a physical examination.

Immobilize or cast the foot/leg.

Prescribe custom orthotics for long term control and prevention.

Prescribe imaging.




Neuroma




Description/What is it?

A neuroma is a painful condition often referred to as a pinched nerve, swollen nerve, or nerve tumor.

It is defined more specifically as a benign growth of nerve tissue, frequently found between the second and third or third and fourth or fourth and fifth intermetatarsal spaces. This may result in pain, burning, tingling, or numbness in the toes and in the ball of the foot.

It is usually exacerbated by tight shoes and/or the foot structure causing the foot to experience abnormal forces and pressure.


Some likely causes:

Heredity – poor foot structure leading to poor foot function.

Improper or ill-fitting shoes.

Trauma.

High heeled shoes.


What can we do for you?

Refer for X-ray evaluation to rule out other causes

Perform a physical examination.

Recommend padding and taping.

Prescribe custom orthotics.

Prescribe anti-inflammatory medication.

Administer cortisone injections.

Toe deformities





There are numerous different types of toe deformity but they all for the most part have one thing in common – that they form gradually and are associated with a gradual deterioration.


Here are some diagrams of various deformities .Please check if any of your toes are developing like these but remember

1) Its gradual

2) You don’t notice gradual changes

3) From your view /angle all may look ok. Get a partner to photo them from the side or below or end on to have a true appreciation of any deformities.





In many cases they can be halted or at least the rate of deterioration slowed down by a combination of changing footwear, having orthotics to change the way the foot is working and sometimes with exercises to stretch or strengthen muscles.


Some likely causes:

Heredity.

Improper or ill-fitting shoes.

Trauma.

High heeled shoes.


What can we do for you?

Refer for X-ray evaluation to rule out other causes

Perform a physical examination.

Recommend padding and taping.

Prescribe custom orthotics.

Prescribe anti-inflammatory medication.

Administer cortisone injections.

Arthritis





Description/What is it?

Arthritis is a disabling disease. It is characterised by inflammation of the cartilage and the lining of the body’s joints.There are lots of different types of arthritis.

Symptoms include swelling in one or more joints, recurring pain or tenderness in any joint, redness or heat in a joint, limitation in motion, early morning stiffness, and skin changes including rashes or growths. The three main types of arthritis are osteoarthritis, rheumatoid arthritis, and gouty arthritis. Each foot contains 33 joints and has to change from the 26 bones being loosely packed (providing shock absorption) to becoming a tightly packed rigid lever ( to propel you forwards) whilst experiencing the force of up to 4.5 times your body weight.Thus the feet often are more susceptible to arthritis than other parts of the body. Additionally their function can lead to abnormal forces being applied higher up the body meaning that your foot function can have a direct influence on how quickly your knees hips and back may develop osteo arthritis.


Heredity.

Age.

Excessive weight.

Abnormal forces due to poor foot function and/or posture.

Systemic disease.

Ill-fitting shoes.

Trauma.


Some likely causes:

Viral and bacterial infections.

Prescription and illegal drugs.

Although when you present with arthritis the damage is done we can often help to minimize your pain be it in your feet, knees, hips or back.

Your feet are the foundations of your body and they are the number one reason for arthritic damage occurring in other weight bearing joints.


What can we do for you?

Stabilizing those joints with the use of orthotics and muscle strengthening can really help reduce further wear and damage and reduce the associated pain meaning risky operations such as knee and hip replacements can often be postponed for many years.

G-Walk





Circle Podiatry invested recently in the G-WALK system largely because we do not believe in quick fixes that can store up trouble for the future. Rather, we want to reassure you as far as we can of your future well-being on your journey through life.

The system uses an inertial sensor connected to a computer via Bluetooth, allowing us to determine spatio-temporal parameters as well as pelvic rotations. The sensor is located around the waist of the patient and secured by an ergonomic belt, allowing free body movement: the patient will be free to walk anywhere. When testing is over, an automatically generated report will show us the calculation of test parameters. These indexes are the result of a 3-years-long study which has been validated by the most avant-garde clinical centres in the world.

In the past, the success of an intervention such as an orthotic insole was monitored solely by how the symptoms improved. Now, we can compare the gait before and after any intervention observing and addressing any hidden affects that the naked eye wouldn’t be able to perceive. This is really valuable to ensure we have the safest possible long term outcome of the intervention.