Helpful Podiatry Information in Brisbane

Foot Health and Ageing

As our feet age, they naturally develop more problems. But painful and uncomfortable feet are not a natural part of growing old, nor are they something you just have to “put up with”. Many foot problems can be treated successfully, and the pain of foot conditions relieved by a podiatrist.

The condition of our feet often provides an early indicator for conditions such as diabetes, arthritis, and circulatory disease. Look out for signs of dry skin, brittle nails, burning or tingling sensations, coldness, numbness or discolouration. If you notice any of these conditions occurring, you should seek the advice of your podiatrist. 

As we age, our feet tend to spread, and lose the fatty pads that cushion the bottom of the feet. If we are carrying extra weight, this can also affect the bone and ligament structure. There are more than 300 different foot conditions, some are inherited, but for older people, most stem from the impact of years of use. 

A lot can be done to relieve pain, improve comfort and keep you on your feet for life.

Taking good care of your feet has many benefits including increasing your comfort, limiting the possibility of additional medical problems, reducing your chance of hospitalisations due to infections, and keeping you active and mobile. Mobility can be a problem for older people, yet with basic foot care, and prompt attention to any problems as they arise, staying on your feet shouldn’t be a problem.

Podiatrists provide services designed to keep older people on their feet!

• Older people should have their feet measured for shoe size more frequently, rather than presuming that their shoe sizes remain constant.
• Properly fitted shoes are essential. The older you get, the more you need a shoe that holds your foot firmly in place and gives adequate support.
• A shoe with a firm sole and soft upper is best for daily activities
• Never cut corns or calluses with a razor or knife, and don't use over the counter corn products as they can do more harm than good unless recommended to you by your podiatrist.
• Trim or file your toenails so they are slightly curved just short of the end of your toe.
• Inspect your feet daily or have someone do this for you. If you notice any redness, cracks in the skin or sores, consult with your podiatrist.
• Have your feet examined by a podiatrist at least once a year.

Your podiatrist will be able to cut even heavily overgrown or thick nails painlessly, and advise on appropriate self-care options.

Foot Health and Arthritis

Arthritis in the feet can have far reaching effects. Your ligaments, tendons and muscles are forced to work harder to maintain stability. This can cause injury to those ligaments, tendons and muscles, including ankle sprains, torn ligaments and a greater likelihood of falls. Another concern is chronic pain, which not only limits movement, but also disturbs sleep and can lead to problems with overall well-being and depression. 

There are two main types of Arthritis.

Osteoarthritis is common in older people, and is a result of wear and tear over time, particularly in the weight bearing joints, such as the feet and knees. Osteoarthritis is a general breaking down of the joint and usually causes pain and discomfort around the joint. You may also find that the range of movement is less than it used to be, and your ability to walk could become affected. Your feet can sometimes change structure with Osteoarthritis, so a well-fitting shoe with adequate cushioning and support will help keep you walking. 

Rheumatoid Arthritis is an auto immune condition that causes the body to work against itself, breaking down joints, and causing pain, swelling, stiffness and deformity around the joint. Rheumatoid Arthritis usually presents earlier in life, getting progressively worse over time. Range of movement can be severely affected, toes can become deformed and hammered, making walking extremely uncomfortable. Rheumatoid arthritis can be accompanied by arch collapse and a widening of the forefoot as well as swollen joints. The constant change of foot shape with this condition will require frequent reviews of your footwear.

Podiatrists can provide treatments to alleviate and reduce the symptoms of arthritis!

• Your podiatrist will carefully assess the severity of the condition, and can recommend footwear to give problem joints more room, thereby reducing the risks of other injuries such as blisters, corns and calluses that can be caused by shoes that rub on swollen areas. 
• Orthotics can also be specially made to provide your feet with extra support and to give you more stability, making it easier to get around. 
• There are also exercises you can do to help keep the joint moving, which will help relieve the stiffness and pain you may be experiencing. 

These treatments combined, can greatly improve your quality of life and general comfort and mobility.

Foot Health and Children

Children’s feet differ from adults, as they are not yet fully formed. At 6 months of age, the foot is still mostly cartilage, in fact the last bone doesn’t begin forming until children are about 3 years old. By the time we turn 18, the bones have fully matured.

Baby’s feet only need protection in the cooler weather. Play suits with feet, socks, or even natural fibre shoes can be used to keep little feet warm, they should always be loose around your baby’s feet. Allowing your baby to kick freely, will help with muscle development in their legs and feet.

Children begin to walk anytime between 10 and 20 months of age. It is important to remember that each child is unique and will move through the different development stages at their own pace. There is no evidence that the use of Jolly Jumpers or baby walkers will encourage your baby to walk before they are ready, however these types of equipment may place additional pressure on feet that are not yet ready for taking weight. 

Sometimes children walk with their feet pointed inwards (in-toeing) or outwards (out-toeing). In most cases, these variations in walking are a normal part of growth and development and most children will grow out of these walking styles by the age of 2, however it can take until the age of 12! Children under the age of 3 sometimes walk on their tiptoes, and this is a typical development stage, however any child over the age of 3 who is still tiptoe walking should be assessed by a Podiatrist. 

Due to the rapid growth in length and width of young feet, frequent changes in the size of shoes and socks are necessary. Do a size check at least every 1 – 3 months up to the age of 3 and every 4 months up to the age of 5, then every 6 months until your child stops growing!

If your child has pain walking, or a foot that looks different to their other foot, a podiatrist can assist!

Problems with skin and nails on your child’s feet may occur from time to time. Some conditions such as ingrown toenails, athlete’s foot and warts, may require treatment from a podiatrist. Children also tend to be more susceptible to warts than adults. A plantar wart is often on the sole of the foot, it appears hard and flat, with a rough surface and well defined boundaries. If the wart is causing discomfort, a podiatrist can assist with treatment. 

Please see your podiatrist if you notice any of the following –

• Uneven shoe wear
• Skin rashes, hard skin lumps or bumps on your child’s feet
• Recurrent pain in the feet or legs, which increases with activity
• Your child walks on their tiptoes
• Your child’s walk does not look symmetrical 
• You have any other concerns about your child’s feet. 

FOOT HEALTH AND FOOTWEAR

Our feet support all of our body weight, so it’s important that our feet are well supported and protected. 

Shoes play a vital role in this. Feet come in many shapes and sizes, and undertake a range of different activities depending on your particular lifestyle. When your buy new shoes, it is important to:

• Make sure they fit properly
• They are supportive for the kind of activity you will be wearing them for
• They do not cause damage to your feet or hurt you in any way

The importance of a well fitted shoe!

Because your feet are rarely the same size, it is important that you fit your shoes to your larger foot. An experienced footwear sales person can help you with this. People who have misshapen feet from an injury or medical condition, such as arthritis or diabetes, may require shoes with extra width or depth. Some people may require a shoe that can accommodate orthotics (inserts). Occasionally, a custom made shoe will be the most suitable. 

Your Podiatrist can advise what shoe is suitable for your foot!

When buying new shoes, keep in mind the following:

• Materials – leather is generally preferred for shoe uppers, synthetic or rubber are best for the sole
• Security – shoes should be secured with laces, straps or buckles, if your feet have to work to hold your shoe in place, your foot muscles may end up strained.
• Shape – pointy shoes can make your toes “claw” and this may affect overall body posture. Clenched toes can also cause rubbing, leading to corns and callouses. Broad toe shoes allow the toes more room.
• Height – the heel of the shoe should be less than 2.5cms high, high heels increase pressure on the ball of the foot. 

 Surgical procedures are commonly performed by podiatrists to treat recurrent nail problems such as ingrown nails. An ingrown toenail is a nail that has pierced or is pressing against the adjacent skin of the toe causing pain and inflammation and sometimes infection. Surgery may be required when an ingrown toenail repeatedly gets infected, is continually painful, the sufferer is unable to wear shoes or the condition inhibits work, sporting or other activities.

Nail Surgery Performed by Podiatrists

One of the most common nail procedures is partial nail avulsion. The procedure is usually performed in podiatrists rooms and the patient is able to walk immediately afterwards.

What Does a Partial Nail Avulsion Involve?

• The procedure is generally performed under local anaesthetic via injection into the toe to numb the area. The anaesthetic will most often wear off in about 2 hours.
• Once numb, a tight elastic ring called a tourniquet is applied to the toe to control bleeding and the area is prepped to minimise the risk of infection. The portion of nail to be removed is then gently lifted and resected, generally without the toe being cut or stitched. Both sides and even the entire nail be removed this way.
• A chemical is then used to help prevent nail regrowth. Once the procedure is completed, the tourniquet is removed and a sterile surgical dressing is applied. The patient is able to walk immediately afterwards, however assistance getting home is greatly recommended.
• Re-dressing of the toe at home and a few consultations with your podiatrist may be required following the procedure. Pain relief medications may be required, you should discuss this with your podiatrist.

What Are The Potential Complications?

All nail procedures have been associated with a slight chance of recurrence. Infection whilst the wound is healing can be an issue. Your podiatrist can advise you and help manage these and other complications that may occur. All surgical procedures have some risk of complication; however the procedure is associated with a low rate of complications. Again, you should always raise any concerns you may have with your podiatrist.

FOOT HEALTH AND SPORTS AND EXERCISE

High impact sports such as basketball, soccer, running, football, cricket and really any sport that involves using your feet can lead to injuries that will require specialist treatment. It is easy to injure your feet while playing sport as the forces between your feet and the ground are amplified during high impact activity. Overuse syndromes are common occurrences in sport and include injuries sustained from repeated action such as long distance running, as opposed to acute injuries which occur in an instant such as a sprained ankle. Your individual biomechanics will have an effect on the likelihood of certain injuries. Prevalent sports injuries include shin splints, runner’s knee, Achilles tendonitis and stress fractures. Sports people may also complain of thickened nails that can sometimes become ingrown or get bruises under the nail from repetitive trauma

Treatment

Treatment for sports podiatric injuries involves a biomechanics assessment to look at your posture, strength, flexibility and movement, and an analysis of how the movement of your feet affects your lower limbs. Evaluation of sports shoes, stretches, strengthening exercises, application of various physical therapies and the fitting of orthotics are methods your podiatrist may use to address your particular injury. 

Shoes

Shoes must have sufficient room at the toe, we recommend a minimum of 2cm and not compress the sides of the feet in a way that causes friction and potentially lead to sores or corns. Identify the primary activity that will be performed in the shoes and select accordingly - different kinds of exercise require different kinds of shoes. Traditional running shoes are designed to absorb forces, which can be between 3 and 4 times your body weight. Lightweight mesh materials can ensure that the upper parts of the shoe are breathable and doesn't stretch or distort with exercise. Some runners are now choosing 'low profile' or 'barefoot' running shoes, however these do not offer the same support or cushioning as a traditional sports shoe. If you are choosing this type of running shoe, you may need to adjust your running technique to avoid injury. Shoes for general athletic or aerobic activities can have features that help control biomechanical problems. Your podiatrist can help advise you about the correct shoe for your preferred sporting activity and foot type. In general you should aim for sturdy heel support, good arch and appropriate cushioning.

Athletic shoes should be immediately comfortable and not require breaking in. An average athletic shoe should last 1000kms, although this will be influenced by your body weight and the surface you run on. You'll need to replace your shoe when it becomes distorted from constant wear or the mid sole has become compressed and is not able to absorb the forces of impact.

Your Feet - Indicators of health

Because they are so far away from our heart, our feet are often the first part of the body to show something is wrong with the way blood is circulating.

The condition of our toenails can signal the presence of the beginning of several diseases. For example, toenails that are thin, upward curving and with raised ridges on the surface can indicate iron deficiencies or anaemia (a shortage of iron carried by the blood). Increased nail thickness or bumps on the nail can be manifestations of psoriasis, which is an inherited skin condition.

Your podiatrist will check the condition of your toenails and can discuss the health implications of their appearance or provide a range of treatments for some toenail problems.

Our Toenails

The major parts of the toenail are: The nail itself or nail plate. The matrix, which is where the nails grows from. The lunula, the white moon-shaped area at the base of the nail. The nail bed, the soft tissue on which the nail lies and the sulcus, the grove at the side of your nails in which the nail sits.

Toenails grow constantly. Healthy nails are pink,free of dirt and impairment and grow along the grooves normally. It takes up to 12 months to replace the toenail of your big toe

Who Gets Nail Problems?

Toenails of all people and ages can undergo a range of changes, some of which are relatively common. They can become thick, brittle, curved, discoloured, infected, bumpy and grooved. In some cases, the nail falls off and a new one grows. As we grow older, we are more likely to develop nail problems.

What Causes Nail Problems?

Toenail problems may be caused by warts, tumours under the nail, trauma, infection or poor circulation. Major toenail problems can be caused by incorrectly fitting shoes, which press too tightly on the toenails. Injury, such as bruising under the nail and infection, can cause permanent nail deformity.

Common Conditions and Treatment

Ingrown Toenails: A very common nail problem. They may be caused by improperly trimmed toenails, very curved edges of nails, shoe pressure or repeated trauma to the feet from various activities. The tendency to get ingrown toenails may also be inherited. Pain in the groove (Sulcus) of the toenail can also be due to corn or calluses under the nail edge.

Most cases will require conservative treatment, while others may need minor surgical correction that can be conducted in your podiatrists rooms using a local anaesthetic.

Thickened Nails: A common condition where a single thickened nail is usually a result of injury to the nail bed, such as dropping something heavy on your toes, or a fungal infection. They can be easily and painlessly thinned down by your podiatrist.

Fungal Infections: One of the most troublesome nail conditions to treat. They are often characterised by thickening, discolouration and separation of the nail from the nail bed. In some cases, the nail crumbles. These infections tend to stay in the nail if they are not treated, and can spread to the nail bed.

There are a range of anti fungal medications available for treatment. Your podiatrist can assist with trimming and out of shape nails.

Other Infections: These can cause inflammation of the matrix and tissue adjacent to the nail. In people with lowered immunity, this may lead to serious complications, including more widespread infections spreading up the leg. Your podiatrist can assist in detecting such infections early and develop a suitable treatment plan.

Trauma: This can lead to permanent nail deformity. Such issues can be cared for by regular non painful podiatric treatment, involving filing and possibly the use of a special drill.

Older People

Older people with poor circulation are prone to fragile, brittle or thickened nails.

Many older people do not have strength, flexibility or eyesight to trim their nails, especially if their nails have become deformed. They should seek podiatric care for these services and receive advice regarding safe options for self care.

Warning Signs

Any sudden changes in colour or shape of the nail, signs of infection, development of a freckle under the nail or pain should be discussed with your podiatrist. Your podiatrist can diagnose the problem and then offer appropriate treatment.

Taking Care of Your Nails

• Trim toenails straight across to a length just below the end of the toe
• Use a strong pair of nail clippers
• After clipping, smooth nails with a file or emery board using downward strokes
• Wear only properly fitting shoes, not short or narrow ones
• Wash feet regularly, especially between toes, and dry thoroughly
• Wear socks or stockings that are not too restrictive; unless they are prescribed.