OUR SERVICES
At Circle Podiatry we combine experience, professionalism, specialized technology and equipment to provide a wide range of effective services. We aim to fix your current foot and lower limb problems and to educate you on preventing further complications later in life. Our mission is to keep you on a strong footing so that you feel like you are walking on air doing the things you enjoy with your love
Podiatry and Chiropody explained
Podiatrist or Chiropodist –Who should I see?
You may be wondering just this- “what is the difference between a Chiropodist and a Podiatrist and who is the best for me to see”
First things First- There is no difference!
The general public impression appears to be that a chiropodist only deals with hard skin and nails whereas a podiatrist is able to address the gait and foot structure. That is not the case and here in the UK there is no difference between the two.
In fact members of the Society of Chiropodists and Podiatrists voted to drop the name Chiropodist and our professional body is now known as the College of Podiatry.
So, there is no difference, and you can choose to see any Chiropodist or Podiatrist (registered in the UK with the Health & Care Profession’s Council-HCPC), who should be able to provide a high level of care for your lower limbs.
Perhaps it should be noted that prior to 2005 there was no protection of our title and there were two main routes to be able to practice, either a 3-year degree (previously a diploma) or a 5-week correspondence course. When the protection of title came in those who had only done the correspondence course were required to meet certain standards to ensure the protection of the general public. A large number did not do this and so forfeited the right to call themselves a Podiatrist or Chiropodist (it is in fact illegal for them to do so or to suggest that they are able to provide Chiropody/Podiatry treatments.) Many of these then chose to call themselves Foot health practitioners and there are still courses today which allow a person to train as and call themselves foot health practitioners. These practitioners are not regulated by the HCPC The Hcpc is the body regulating the professions allied to medicine and as such helps protect you and ensure you are treated appropriately for example with properly sterilised instruments.
So, with that cleared up you now know that you should always see a
Podiatrist/Chiropodist.
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 send a photo via our Foot app and one of our team will advise you further.
Corns or Calluses
Description
A callus or corn is a build up of hard skin that forms at points of pressure or friction and often over bony 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 or friction. First the hard skin forms to protect the area 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 we can do
- 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 ABCDE characteristics below.
- Asymmetry – one side of the lesion doesn’t match the other.
- Borders - Borders look, uneven, or ragged.
- Colour - There may be more than one colour in an uneven distribution
- Diameter – The lesion is wider than the diameter of a pencil (greater than 6mm).
- Evolving –The lesion may be changing size, shape and colour or start bleeding or growing hairs
Skin cancers on the feet often go unnoticed meaning that when they are picked up they may have spread and be more difficult to cure. You can photograph any moles with a ruler beside them so you can compare to see if they are changing.
Ingrowing Toe nail
Description
An ingrown toenail is a usually 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. Healing is often complicated by infection which takes advantage of the moist environment. We often see people who have had several courses of antibiotics in a bid to solve the problem. However, 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. It usually occurs as a result of 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 we can do
First line treatment is always to assess. Sometimes all that is needed is to simply remove a piece of nail but if it becomes a recurrent problem you will be advised to have some nail surgery 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 destroyed to leave you with either no nail or a narrower one. If you suspect an ingrown nail is starting it is always advisable to get it assessed 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
An ulcer is a breakdown of the skin on an area of the foot. It can develop quickly and may be painful and difficult to heal. It often comes 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 and becoming starved of nutrients and oxygen. The local tissues then die off. Infection is a common complication.
Sometimes we might advise you to have imaging to determine whether the infection has penetrated to the bone. This can happen to anyone but is more likely and more serious 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 we can do
- Perform a physical examination.
- Offload the area with pads or insoles.
- Perform debridement and wound care.
- Laboratory tests.
- Footwear advice
- Referral to some specialists that include a diabetologist, endocrinologist, Hospital diabetic foot team, vascular surgeon, diabetes specialist nurse, radiologist, Orthotist and infectious disease specialist.
- Refer for imaging.
Verrucae/plantar warts
Description
Verruca or Plantar warts are viral infections affecting the epidermis. They invade the skin through small or invisible cuts and abrasions and 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 a 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 pool and gym changing facilities. If left untreated, warts can grow to an inch or more in circumference and can spread into clusters of several warts in extreme cases covering large areas of the
foot. 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 may facilitate 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 we can do
Remove the dead skin and advise on over the counter treatments 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 should be avoided by people with diabetes and those with cardiovascular or circulatory disorders.
We therefore advise self treatment initially only in a healthy person with no complications. For best chances of success, it should 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 (Normally 4 weeks) if there is no improvement then often you will be advised to try other in clinic treatments with stronger acids.
Other Treatments we offer include:
Verrutop:
Verrutop is a Class II Medical Device for specialist application by Healthcare Professionals.
Verrutop is not intended for home use by members of the public as difficult to treat warts and verrucae need specialist attention to prepare the surface prior to treatment.
Verrutop is a new type of wart treatment. Unlike Cryotherapy or other chemical treatments, Verrutop is a combination of organic and inorganic acids, the acid base is not designed to either burn or stimulate an immune response but to create the production of nitrite on the wart or verruca which produces a desiccating effect, drying up the cells containing the verruca virus and reducing residual viral DNA. The verruca just dries up and falls off, leaving intact skin beneath.
Treatment is normally quick and painless.
Verrutop is supported by a large number of clinical papers and poster presentations at major conventions involving hundreds of patients with multiple warts. There are also a growing number of individual case reports and user feedback is extremely positive.
Cryosurgery where the verruca is frozen.
Cryosurgery involves the use of liquid 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 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. 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 will advise you of a treatment plan most suited to your verruca and your lifestyle.
What to expect at the appointment:
Similar to most wart treatments your Podiatrist will carefully remove some of the dead skin from the surface of the Verruca prior to application. This is done using a scalpel and the nature of verrucae is that often little blood vessels come to the surface, so it is not unusual for them to bleed a bit. This can usually be stopped and the treatment applied. On occasion it may bleed more profusely which would mean the treatment cannot be applied and you will need to come back for a short appointment on a later day (or possibly even later that day.)
A small amount of Verrutop solution is applied by a capillary tube at 1 to 2- weekly intervals and clinical studies show a clearance rate of around 40% with a single application and up to 90% after 6 applications. It is virtually pain-free but as there is some acidity it can sometimes give a stinging sensation for a short while. It can be used in children as young as 6 years of age. After treatment your podiatrist may decide to cover the area or offload it but this is not essential.
Fungal nails / Athletes foot
Fungal Nail Infection
Description
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. 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 are always surrounded by dark, warm, and often moist shoes and socks. When fungal nail infection attacks, 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. Since it 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 person an important consideration is the likelihood of cross infection to the skin which in itself 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 from unsterilized instruments that have been used on others when getting a manicure or pedicure.
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 nail varnish for long periods of time can damage the surface of the nail plate allowing the fungus to get a hold.
What we can do
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 year as you have to keep applying the chemical whilst the nail grows out.
Athlete's foot
Description
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, it can affect non-athletes as well.
Some likely causes
Athlete’s foot can be picked up anywhere 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 can pass on the fungus.
What we can do
- Perform a physical examination of your feet and advise you.
- Prescribe topical antifungal medications.
- Advise oral antifungal medications (only available by prescription).
Pregnancy and the foot
Ways Pregnancy can affect your feet
- 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.
- When you are pregnant, the excessive weight gain increases the pressure through the feet.
- 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”
- 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.
- A pregnant woman’s foot can also swell or enlarge anywhere from one to two sizes, causing discomfort especially from pressure from the shoes.
- 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.
We all prefer spacious houses but so do our feet, 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 and appropriate 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. Feet Facts
About Kids Foot Care
Maintaining and caring for a child’s feet will benefit their health, mobility and wellbeing throughout their entire lives.
Children’s feet have their own unique issues that can lead to 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.
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:
- Poor nail cutting
- Picking at the nails
- Tight socks/baby grows
- Tight shoes
- Poor foot function leading to abnormal forces and pressure.
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 require treatment but every child should be assessed to see if there are any indications for further assessment or for treatment to begin.
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.
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.
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).
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.
Heel pain
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.
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.
We offer any child under the age of 16 an initial free foot health check (this is subject to availability – max 2 per day).As children take up a particular sport and become more active at school, foot and lower limb problems associated with unaccustomed exercise can occur.
Kids Feet Health Tips
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 professional opinion.
Growth, possible weight gain and increased exercise can all contribute 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 to 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.
Gait Analysis
In our computerised video gait analysis session, we turn the spotlight on your unique walking and, if relevant, running patterns through video analysis. The foot is a unique, intricate and mechanically complex structure made up of 26 major bones and associated joints. The efficiency with which the foot functions when walking depends on the way in which those bones and joints move in relation to each other.
Gait analysis allows us to observe and assess any irregularities and inefficiencies that might not be evident otherwise. By closely examining your gait, we gain invaluable insights into the nuances of how you move.
This dynamic assessment is pivotal because it mirrors your movements in real life and in real-time, offering a clear window into the causes behind your current foot issues or potential problems that could arise in the future.
This critical step in your treatment plan is focused on uncovering exactly WHAT is happening as you walk or run. Understanding these dynamics is key to tailoring a treatment strategy that addresses your specific needs, ensuring we not only remedy existing conditions but also safeguard your foot health for years to come.
G-Walk
"The HOW"
While video gait analysis provides a comprehensive view of your walking and running patterns, our commitment to cutting-edge technology takes your assessment a step further. We possess the tools to uncover the unseen, to delve into what's happening "behind the scenes" of your movement
G-Walk Technology
A cornerstone of our technological suite is the G-Walk system, a groundbreaking "wearable laboratory" designed for the intricate analysis of movement.
This non-invasive, wearable device equips us with the ability to conduct detailed functional analyses of your gait in real-time.
The G-Walk system, utilizing a specialised wireless inertial sensor attached to the patient, allows us to perform clinical tests that reveal the symmetry of your pelvic movements across three dimensions. These insights are crucial because pelvic movement is deeply influenced by foot function, highlighting the interconnectedness of your body's biomechanics.
Moreover, G-Walk provides critical data on key walking and running parameters, such as the duration your feet are in contact with the ground and the propulsion speed. This information is vital for understanding the efficiency of your gait and for identifying areas for improvement. In some cases, based on our initial assessment, we might find that our pressure plate analysis offers additional or more suitable insights. Should this be the case, it will be seamlessly integrated into your personalised treatment plan. Our approach ensures you benefit from a comprehensive, technologically advanced assessment, setting the foundation for targeted, effective treatment.
Why do we choose G-Walk for your gait analysis?
It's simple: G-Walk represents the pinnacle of motion analysis technology, offering accurate, reliable data through an innovative approach to understanding your gait and functional movement. This system isn't just advanced; it's designed with your comfort and freedom in mind. The heart of the G-Walk technology is its lightweight, compact wireless inertial sensor. Fastened around the waist with a specially designed ergonomic belt, it ensures that you, the patient, can move naturally and unencumbered. This freedom to walk and run as you normally would is crucial, as it allows us to capture the most authentic representation of your movement patterns.
Flat Foot
Description
Flat foot is a structural deformity resulting in the lowering of the arch of the foot. This can be inherited or acquired.
A person with a flat foot that is painful is in need of treatment. If you have flat feet you 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 effect could be a time bomb of musculoskeletal problems waiting to explode.
Some likely causes:
- Heredity
- Arthritis
- Trauma
- Musculoskeletal disorders
What we can do
- Perform a physical examination and gait analysis.
- Advise imaging.
- Prescribe custom orthotics.
- Advise on exercises.
Foot and ankle injuries
Description
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
Many fractures have not received proper treatment because of the notion that “It can’t be broken, because I can move it” which is false.
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’ fractures 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. 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.
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 tight footwear 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
Generally 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 often after the operation the causative factors such as poor fitting shoes or poor foot function are not addressed.
Haglund's deformity
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.
Orthotics and Insoles
Description
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 cases 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.
Heel pain and Plantar fasciitis
Plantar fasciitis is an inflammation of the long band of connective tissue running from the heel to the ball of the foot.
What is Plantar Fasciitis?
The name of the condition refers most commonly to an inflammation of the plantar fascia.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 we can do
- Prescribe orthotics
- Perform a physical examination
- Perform taping and strapping
- Prescribe orthotics
- Administer injections
- Instruct in appropriate exercise
Foot Pressure Analysis
The Foot Pressure Analysis can often provide the extra hidden information that could otherwise be missed. 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 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 or dynamic 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 feedback on the pain and how you walk or run.
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 the results of which will become the fundamentals for your orthotic prescription, enabling us to provide you with tailor-made orthotics which aim to realign and improve the foot’s function.
Stress fractures and other internal foot pains
Stress fracture
Description
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 we can do
- 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
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 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 we can do
- 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
A hammer toe is a contraction deformity, resulting in bony prominences on the feet.
There are numerous different types of toe deformity but they all have one thing in common –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
- Its gradual
- You don’t notice gradual changes
- From your view or angle all may look ok. Get a photo at the side or below or end to have a true appreciation of any deformities.
They can be halted or at least the rate of deterioration can be 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 we can do
- 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
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 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 osteoarthritis.
- Hereditary
- 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 we can do
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.
Biomechanics and Gait Analysis
The term Biomechanics is often used interchangeably with musculoskeletal assessment. However we like to use the term Biomechanics as an umbrella term to cover Both Gait analysis and musculoskeletal assessment. Where Gait analysis shows us (and you) what is going wrong with the lower limb function and the musculoskeletal assessment shows us why. Together they allow us to prescribe both exercises and functional orthoses (insoles usually made from scans/impressions of your feet) which address the foot and lower limb function issues, caused by structural abnormalities. To learn more please see the information here on Gait analysis, Musculo skeletal assessment, G-Walk and pressure plate assessment.
About Diabetic Footcare
Description
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. 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 from 2 of the 3 aspects of being in the diabetic sweet spot-a, safe zone where you will be at 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. 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 having an amputation.
Good care of your feet and good control of your blood sugars together gives you the best chance of avoiding complications.
What we can do
- Gain knowledge by reading the book "Undefeeted by diabetes".
- Help to control your blood sugars better.
- Advise 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.
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 and 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 ones 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 with us today. We are proud of our team and the quality of service that we provide. We tailor our services to the needs of the clients and the setting, not the other way round. Each year 1000’s of families experiences and enjoy the comfort and benefits that we provide and the difference we make in their lives and the lives of their loved ones
Schools
“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: To teach the kids on how to look after their feet.
Gyms and sports clubs
High street
What people say about “Happy Feet”
Podiatry and Chiropody explained
Podiatrist or Chiropodist –Who should I see?
You may be wondering just this- “what is the difference between a Chiropodist and a Podiatrist and who is the best for me to see”
First things First- There is no difference!
The general public impression appears to be that a chiropodist only deals with hard skin and nails whereas a podiatrist is able to address the gait and foot structure. That is not the case and here in the UK there is no difference between the two.
In fact members of the Society of Chiropodists and Podiatrists voted to drop the name Chiropodist and our professional body is now known as the College of Podiatry.
So, there is no difference, and you can choose to see any Chiropodist or Podiatrist (registered in the UK with the Health & Care Profession’s Council-HCPC), who should be able to provide a high level of care for your lower limbs.
Perhaps it should be noted that prior to 2005 there was no protection of our title and there were two main routes to be able to practice, either a 3-year degree (previously a diploma) or a 5-week correspondence course. When the protection of title came in those who had only done the correspondence course were required to meet certain standards to ensure the protection of the general public. A large number did not do this and so forfeited the right to call themselves a Podiatrist or Chiropodist (it is in fact illegal for them to do so or to suggest that they are able to provide Chiropody/Podiatry treatments.) Many of these then chose to call themselves Foot health practitioners and there are still courses today which allow a person to train as and call themselves foot health practitioners. These practitioners are not regulated by the HCPC The Hcpc is the body regulating the professions allied to medicine and as such helps protect you and ensure you are treated appropriately for example with properly sterilised instruments.
So, with that cleared up you now know that you should always see a
Podiatrist/Chiropodist.
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 send a photo via our Foot app and one of our team will advise you further.
Corns or Calluses
Description
A callus or corn is a build up of hard skin that forms at points of pressure or friction and often over bony 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 or friction. First the hard skin forms to protect the area 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 we can do
- 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 ABCDE characteristics below.
- Asymmetry – one side of the lesion doesn’t match the other.
- Borders - Borders look, uneven, or ragged.
- Colour - There may be more than one colour in an uneven distribution
- Diameter – The lesion is wider than the diameter of a pencil (greater than 6mm).
- Evolving –The lesion may be changing size, shape and colour or start bleeding or growing hairs
Skin cancers on the feet often go unnoticed meaning that when they are picked up they may have spread and be more difficult to cure. You can photograph any moles with a ruler beside them so you can compare to see if they are changing.
Ingrowing Toe nail
Description
An ingrown toenail is a usually 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. Healing is often complicated by infection which takes advantage of the moist environment. We often see people who have had several courses of antibiotics in a bid to solve the problem. However, 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. It usually occurs as a result of 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 we can do
First line treatment is always to assess. Sometimes all that is needed is to simply remove a piece of nail but if it becomes a recurrent problem you will be advised to have some nail surgery 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 destroyed to leave you with either no nail or a narrower one. If you suspect an ingrown nail is starting it is always advisable to get it assessed 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
An ulcer is a breakdown of the skin on an area of the foot. It can develop quickly and may be painful and difficult to heal. It often comes 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 and becoming starved of nutrients and oxygen. The local tissues then die off. Infection is a common complication.
Sometimes we might advise you to have imaging to determine whether the infection has penetrated to the bone. This can happen to anyone but is more likely and more serious 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 we can do
- Perform a physical examination.
- Offload the area with pads or insoles.
- Perform debridement and wound care.
- Laboratory tests.
- Footwear advice
- Referral to some specialists that include a diabetologist, endocrinologist, Hospital diabetic foot team, vascular surgeon, diabetes specialist nurse, radiologist, Orthotist and infectious disease specialist.
- Refer for imaging.
Verrucae/plantar warts
Description
Verruca or Plantar warts are viral infections affecting the epidermis. They invade the skin through small or invisible cuts and abrasions and 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 a 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 pool and gym changing facilities. If left untreated, warts can grow to an inch or more in circumference and can spread into clusters of several warts in extreme cases covering large areas of the
foot. 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 may facilitate 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 we can do
Remove the dead skin and advise on over the counter treatments 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 should be avoided by people with diabetes and those with cardiovascular or circulatory disorders.
We therefore advise self treatment initially only in a healthy person with no complications. For best chances of success, it should 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 (Normally 4 weeks) if there is no improvement then often you will be advised to try other in clinic treatments with stronger acids.
Other Treatments we offer include:
Verrutop:
Verrutop is a Class II Medical Device for specialist application by Healthcare Professionals.
Verrutop is not intended for home use by members of the public as difficult to treat warts and verrucae need specialist attention to prepare the surface prior to treatment.
Verrutop is a new type of wart treatment. Unlike Cryotherapy or other chemical treatments, Verrutop is a combination of organic and inorganic acids, the acid base is not designed to either burn or stimulate an immune response but to create the production of nitrite on the wart or verruca which produces a desiccating effect, drying up the cells containing the verruca virus and reducing residual viral DNA. The verruca just dries up and falls off, leaving intact skin beneath.
Treatment is normally quick and painless.
Verrutop is supported by a large number of clinical papers and poster presentations at major conventions involving hundreds of patients with multiple warts. There are also a growing number of individual case reports and user feedback is extremely positive.
Cryosurgery where the verruca is frozen.
Cryosurgery involves the use of liquid 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 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. 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 will advise you of a treatment plan most suited to your verruca and your lifestyle.
What to expect at the appointment:
Similar to most wart treatments your Podiatrist will carefully remove some of the dead skin from the surface of the Verruca prior to application. This is done using a scalpel and the nature of verrucae is that often little blood vessels come to the surface, so it is not unusual for them to bleed a bit. This can usually be stopped and the treatment applied. On occasion it may bleed more profusely which would mean the treatment cannot be applied and you will need to come back for a short appointment on a later day (or possibly even later that day.)
A small amount of Verrutop solution is applied by a capillary tube at 1 to 2- weekly intervals and clinical studies show a clearance rate of around 40% with a single application and up to 90% after 6 applications. It is virtually pain-free but as there is some acidity it can sometimes give a stinging sensation for a short while. It can be used in children as young as 6 years of age. After treatment your podiatrist may decide to cover the area or offload it but this is not essential.
Fungal nails / Athletes foot
Fungal Nail Infection
Description
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. 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 are always surrounded by dark, warm, and often moist shoes and socks. When fungal nail infection attacks, 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. Since it 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 person an important consideration is the likelihood of cross infection to the skin which in itself 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 from unsterilized instruments that have been used on others when getting a manicure or pedicure.
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 nail varnish for long periods of time can damage the surface of the nail plate allowing the fungus to get a hold.
What we can do
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 year as you have to keep applying the chemical whilst the nail grows out.
Athlete's foot
Description
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, it can affect non-athletes as well.
Some likely causes
Athlete’s foot can be picked up anywhere 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 can pass on the fungus.
What we can do
- Perform a physical examination of your feet and advise you.
- Prescribe topical antifungal medications.
- Advise oral antifungal medications (only available by prescription).
Pregnancy and the foot
Ways Pregnancy can affect your feet
- 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.
- When you are pregnant, the excessive weight gain increases the pressure through the feet.
- 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”
- 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.
- A pregnant woman’s foot can also swell or enlarge anywhere from one to two sizes, causing discomfort especially from pressure from the shoes.
- 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.
We all prefer spacious houses but so do our feet, 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 and appropriate 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. Feet Facts
About Kids Foot Care
Maintaining and caring for a child’s feet will benefit their health, mobility and wellbeing throughout their entire lives.
Children’s feet have their own unique issues that can lead to 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.
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:
- Poor nail cutting
- Picking at the nails
- Tight socks/baby grows
- Tight shoes
- Poor foot function leading to abnormal forces and pressure.
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 require treatment but every child should be assessed to see if there are any indications for further assessment or for treatment to begin.
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.
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.
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).
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.
Heel pain
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.
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.
We offer any child under the age of 16 an initial free foot health check (this is subject to availability – max 2 per day).As children take up a particular sport and become more active at school, foot and lower limb problems associated with unaccustomed exercise can occur.
Kids Feet Health Tips
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 professional opinion.
Growth, possible weight gain and increased exercise can all contribute 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 to 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.
Gait Analysis
In our computerised video gait analysis session, we turn the spotlight on your unique walking and, if relevant, running patterns through video analysis. The foot is a unique, intricate and mechanically complex structure made up of 26 major bones and associated joints. The efficiency with which the foot functions when walking depends on the way in which those bones and joints move in relation to each other.
Gait analysis allows us to observe and assess any irregularities and inefficiencies that might not be evident otherwise. By closely examining your gait, we gain invaluable insights into the nuances of how you move.
This dynamic assessment is pivotal because it mirrors your movements in real life and in real-time, offering a clear window into the causes behind your current foot issues or potential problems that could arise in the future.
This critical step in your treatment plan is focused on uncovering exactly WHAT is happening as you walk or run. Understanding these dynamics is key to tailoring a treatment strategy that addresses your specific needs, ensuring we not only remedy existing conditions but also safeguard your foot health for years to come.
G-Walk
"The HOW"
While video gait analysis provides a comprehensive view of your walking and running patterns, our commitment to cutting-edge technology takes your assessment a step further. We possess the tools to uncover the unseen, to delve into what's happening "behind the scenes" of your movement
G-Walk Technology
A cornerstone of our technological suite is the G-Walk system, a groundbreaking "wearable laboratory" designed for the intricate analysis of movement.
This non-invasive, wearable device equips us with the ability to conduct detailed functional analyses of your gait in real-time.
The G-Walk system, utilizing a specialised wireless inertial sensor attached to the patient, allows us to perform clinical tests that reveal the symmetry of your pelvic movements across three dimensions. These insights are crucial because pelvic movement is deeply influenced by foot function, highlighting the interconnectedness of your body's biomechanics.
Moreover, G-Walk provides critical data on key walking and running parameters, such as the duration your feet are in contact with the ground and the propulsion speed. This information is vital for understanding the efficiency of your gait and for identifying areas for improvement. In some cases, based on our initial assessment, we might find that our pressure plate analysis offers additional or more suitable insights. Should this be the case, it will be seamlessly integrated into your personalised treatment plan. Our approach ensures you benefit from a comprehensive, technologically advanced assessment, setting the foundation for targeted, effective treatment.
Why do we choose G-Walk for your gait analysis?
It's simple: G-Walk represents the pinnacle of motion analysis technology, offering accurate, reliable data through an innovative approach to understanding your gait and functional movement. This system isn't just advanced; it's designed with your comfort and freedom in mind. The heart of the G-Walk technology is its lightweight, compact wireless inertial sensor. Fastened around the waist with a specially designed ergonomic belt, it ensures that you, the patient, can move naturally and unencumbered. This freedom to walk and run as you normally would is crucial, as it allows us to capture the most authentic representation of your movement patterns.
Flat Foot
Description
Flat foot is a structural deformity resulting in the lowering of the arch of the foot. This can be inherited or acquired.
A person with a flat foot that is painful is in need of treatment. If you have flat feet you 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 effect could be a time bomb of musculoskeletal problems waiting to explode.
Some likely causes:
- Heredity
- Arthritis
- Trauma
- Musculoskeletal disorders
What we can do
- Perform a physical examination and gait analysis.
- Advise imaging.
- Prescribe custom orthotics.
- Advise on exercises.
Foot and ankle injuries
Description
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
Many fractures have not received proper treatment because of the notion that “It can’t be broken, because I can move it” which is false.
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’ fractures 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. 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.
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 tight footwear 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
Generally 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 often after the operation the causative factors such as poor fitting shoes or poor foot function are not addressed.
Haglund's deformity
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.
Orthotics and Insoles
Description
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 cases 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.
Heel pain and Plantar fasciitis
Plantar fasciitis is an inflammation of the long band of connective tissue running from the heel to the ball of the foot.
What is Plantar Fasciitis?
The name of the condition refers most commonly to an inflammation of the plantar fascia.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 we can do
- Prescribe orthotics
- Perform a physical examination
- Perform taping and strapping
- Prescribe orthotics
- Administer injections
- Instruct in appropriate exercise
Foot Pressure Analysis
The Foot Pressure Analysis can often provide the extra hidden information that could otherwise be missed. 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 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 or dynamic 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 feedback on the pain and how you walk or run.
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 the results of which will become the fundamentals for your orthotic prescription, enabling us to provide you with tailor-made orthotics which aim to realign and improve the foot’s function.
Stress fractures and other internal foot pains
Stress fracture
Description
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 we can do
- 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
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 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 we can do
- 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
A hammer toe is a contraction deformity, resulting in bony prominences on the feet.
There are numerous different types of toe deformity but they all have one thing in common –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
- Its gradual
- You don’t notice gradual changes
- From your view or angle all may look ok. Get a photo at the side or below or end to have a true appreciation of any deformities.
They can be halted or at least the rate of deterioration can be 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 we can do
- 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
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 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 osteoarthritis.
- Hereditary
- 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 we can do
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.
Biomechanics and Gait Analysis
The term Biomechanics is often used interchangeably with musculoskeletal assessment. However we like to use the term Biomechanics as an umbrella term to cover Both Gait analysis and musculoskeletal assessment. Where Gait analysis shows us (and you) what is going wrong with the lower limb function and the musculoskeletal assessment shows us why. Together they allow us to prescribe both exercises and functional orthoses (insoles usually made from scans/impressions of your feet) which address the foot and lower limb function issues, caused by structural abnormalities. To learn more please see the information here on Gait analysis, Musculo skeletal assessment, G-Walk and pressure plate assessment.
About Diabetic Footcare
Description
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. 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 from 2 of the 3 aspects of being in the diabetic sweet spot-a, safe zone where you will be at 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. 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 having an amputation.
Good care of your feet and good control of your blood sugars together gives you the best chance of avoiding complications.
What we can do
- Gain knowledge by reading the book "Undefeeted by diabetes".
- Help to control your blood sugars better.
- Advise 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.
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 and 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 ones 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 with us today. We are proud of our team and the quality of service that we provide. We tailor our services to the needs of the clients and the setting, not the other way round. Each year 1000’s of families experiences and enjoy the comfort and benefits that we provide and the difference we make in their lives and the lives of their loved ones
Schools
“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: To teach the kids on how to look after their feet.