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Foot pain is common but not normal. Whether you have injured yourself playing sport or simply have painful feet, a biomechanics assessment is aimed to find the specific bony or soft tissue structure involved in causing pain in your feet or legs.
Your initial consult will involve a thorough history and assessment. A video gait analysis and
physical examination is normally needed to diagnose your problem. Common complaints we see are plantar fasciitis, Achilles tendonitis, flat feet, bunions, sprained ankles, tibialis posterior tendon dysfunction, shin splints, knee pain, Morton’s neuroma and Sever’s disease.
Treatment will often involve advice and education, physical therapy, strapping, dry needling,
custom orthotics, footwear recommendations and activity modification. Treatment is tailored to the
individual and their specific diagnosis.
VIDEO GAIT ANALYSIS
Gait analysis is performed on a treadmill with the use of specific video analysis software. This allows us to playback footage of your walking or running and closely assess exactly what is happening during the different phases of the gait cycle. In real-time some subtle joint movements, especially when running, can be missed with the naked eye.
By being able to replay the footage in slow-motion means we can educate the patient and highlight any abnormalities
SKIN AND NAILS
General Podiatry includes many common skin and nail complaints. Including painful corns, rough or callused/hard skin, cracked heels, plantar warts, fungal nail infections and fungal skin infection (Athlete’s Foot), excessively dry or sweaty skin, thickened or deformed toenails.
Just like you see a dentist for your teeth or an optometrist for your eyes, if you have any concerns with your skin or nails you should see a podiatrist.
As you get older it may become more difficult to trim your own toenails, or even if you are younger and just have ‘tricky’ nails, a podiatrist can easily assist. If any of this sounds familiar, book a ‘general treatments’ appointment.
INGROWN NAILS
They may occur due to poor nail trimming, such as leaving a spicule or ‘spike’, excessively curved nails, tight-fitting shoes, or trauma to the toe.
Antibiotics from your GP may be required if the toe is infected. In mild cases, conservative treatment includes removing the offending nail piece with a podiatry nail clipper. In more severe cases, nail surgery may be required.
NAIL SURGERY
In severe or recurrent cases, permanent nail surgery may be necessary. It is a minor procedure performed under local anaesthetic in the toe, that is performed in the clinic room.
The podiatrist will conduct a thorough assessment to determine the best treatment option and determine if you are suitable for nail surgery.
The surgery involves removing a small piece of nail lengthways down the side of the nail, including the root, where it is killed off using a chemical to prevent this from regrowing.
CHILDREN’S PODIATRY
‘Growing pains’ are quite common, but this term should not be used as a diagnosis, a thorough podiatry assessment can be great in determining the exact cause of these ‘growing pains’ and can help prevent this.
Common problems in children’s feet include in-toeing or out-toeing, knock knees or bow legs, Sever’s disease and Osgood-Schlatter disease, toe walking, awkward gait or tripping when running, uneven shoe wear, low-arched or flatter feet, or ingrown nails or warts.
Your child’s foot will appear ‘flatter’ when they first begin to walk, generally between nine and 18 months of age, due to more fatty padding and flexible and weaker foot muscles, a podiatrist can help put you at ease if you are concerned about your child and their feet.
FOOTWEAR
Your shoes are your base, so it is important to have the correct shoe and fit for your feet. When buying a good shoe it should have a strong heel counter, flex through the sole at the ball of your feet, have a thumbnail width at the end of your shoe from your longest toe, allow you to wiggle your toes freely and be able to be secured or fastened to the foot.
In the Northern Territory, we have our own unique challenges with footwear as it is always hot, and most people live in thongs or barefoot. This is not necessarily a bad thing but can lead to feet becoming tired and painful as they are generally in less supportive footwear than people living elsewhere.
In this case it is best to have an assessment and get advice on what other footwear options are available which may be more suitable. Generally, a pair of runners will last 500-800kms and not twelve months as some people believe; this can be problematic as you may require an upgrade sooner than you think without realising.
If you are wearing an orthotic in a shoe that is old and beginning to wear unevenly, you may be losing the effect of the orthotic.
DRY NEEDLING
Superficial dry needling uses fine acupuncture needles to treat ‘knots’, known as trigger points, in your muscles. These trigger points within tight muscle bands can be the cause of localised of referred pain. The aim of dry needling aiming to release this muscle tension to allow better function, improve range of motion and reduce pain. For podiatrists to perform dry needling they are required to complete additional training on top of their university degree. Despite using acupuncture needles, dry needling is different to acupuncture and uses a different concept.
Dry needling is generally not painful but can be uncomfortable as can cause a ‘twitch’ response. Commonly used in the calf, the needle is left in position for five to ten minutes. Afterwards, you may feel a dull ache in the muscle with this shortly relaxing and feeling looser.
Diabetes can affect your feet in several ways if the diabetes is poorly controlled, such as your blood flow and feeling. Poor circulation can lead to slow wound healing with less oxygen being delivered around the body and impaired protective sensation, or neuropathy, can lead to undetected injuries to the feet which can become much larger issues if not treated.
Diabetes can also affect the joints of the feet and change the health of your skin and nails. A diabetes assessment is recommended every six to twelve months to assess how much risk you are in developing these complications. We will be able to provide you with advice and education to help look after yourself between assessments.
Your GP will often refer patients who have diabetes under a Medicare Enhanced Primary Care (EPC) plan to see a podiatrist each year. If you have any questions regarding your diabetes, please get in touch and we can assist you.
