Podiatrists, otherwise known as chiropodists, work to diagnose and treat abnormal conditions of the feet and lower limbs. Their aim is to restore mobility, correct deformities and to relieve pain and discomfort arising from foot conditions, as well as treating infections. Our feet have the onerous task every day, of bearing our weight as we move. Each step we take imposes 2-3 times our body weight upon our feet. The foot and ankle has 33 joints, and 26 bones- it is inevitable that problems occur from time to time. A podiatrist would be able to give advice about how to care for your feet and the footwear which would suit you, taking into consideration the foot problems you may be suffering from.
Photo of podiatrist treating a patient
The types of problems treated by a podiatrist are diverse. They include such conditions as
- Injuries, including sports related injuries.
- Ingrown toenails.
- Calluses and corns.
- Athletes foot.
- Hard skin removal/ hard toenail care.
- Fungal infections.
- Cracked, smelly or dry feet.
- Flat feet.
In a consultation with a podiatrist, they would ask you about your medical history, any medication you are taking, and the problem that you are experiencing. They may wish to test the circulation in your ankles and feet, and the degree of feeling you have in them. Depending upon the problem, they may ask you to walk in order for them to determine whether that is having an impact on your feet. They will talk to you about the problem, and inform you of their diagnosis and the treatment plan that they propose. Your initial appointment will last 30-60 minutes. Podiatrists are able to prescribe ‘orthotics,’ which are specially made insoles used to correct some foot problems. Padding and arch supports are available to help relieve pain and give support where it may be lacking. They are able to administer local anaesthetics, and carry out surgical procedures (such as toe nail removal and soft tissue surgery).
NICE (National Institute for Health and Care Excellence) recommends foot care services for long-term conditions such as diabetes, peripheral arterial disease, cerebral palsy and rheumatoid arthritis. Diabetics run the risk of losing sensation in their feet, and a study supported podiatry intervention1. A person suffering from a ‘high risk’ problem means that their legs and feet are at an increased risk of injury. They may suffer from poor circulation, fragile skin and reduced sensation in the feet. Assessment and treatment from a podiatrist on an on-going basis, means that the risk of long term damage is reduced. Podiatry intervention in such situations reduces the amputation rates by 40%.
There are many conditions which podiatrists are able to treat. Bunions are more common in women than men, with 15% suffering from them. Women genetically have looser ligaments and often wear restrictive footwear. The most common cause is having a genetically defective foot structure. Bunions can also develop as we age, if we suffer from arthritis or from a sports injury. It is a deformity of the big toe, which angles in towards the second toe. A bony lump develops on the side of the foot. When this happens, the small bones of the toes move out of line with the longer bones which run through the foot to the ankle. If untreated, the tendons are unable to pull in a straight line, and the condition can worsen. Corns and calluses may also develop. Sometimes a ‘bursa’ may also develop, a fluid filled sac which is often painful. The podiatrist would discuss the type of footwear you need, orthotics, exercises and may use bunion pads to relieve the pain and discomfort. A referral for surgery may be needed if these measures do not help the problem.
Corns and calluses are areas of thickened skin, formed when an area is subject to excessive friction or pressure. Corns are smaller than calluses, and tend to form a small circle of thick skin either on the sole of the foot or the sides of the toes. A callus is a larger, less defined area of rough skin which may appear to have a yellow tinge. They will often develop in areas where weight bears down, such as on the ball of the foot. The podiatrist will assess the best treatment option, which will include footwear advice and possibly removing the thickened skin if necessary.
1.Photo of a corn 2. Photo of a callus
Plantar fasciitis is a common foot problem causing pain. The plantar fascia is a band of tissue which runs from the mid-foot to the heel. It serves to act as a shock absorber and to support the arch of our foot. If this tissue becomes inflamed, the result is plantar fasciitis. Several causes may contribute to the development of this condition. A tightness in the calf muscle may initiate it, ill-fitting shoes, over pronation (when an individual is walking and the foot rolls inwards too much), or from suffering injury. Treatment may include deep tissue massage, insole advice, exercises, splints and padding.
The remit of foot and ankle complaints a podiatrist is able to help is wide. Verrucae are warts, and are commonly suffered on the weight bearing areas of the feet. They are caused by the human papilloma virus, and can be spread by contact. They range in size, and form a flat rough area, sometimes with a black centre. Hammer toes occur due to a deformity causing a toe to bend or curl downwards. Gout can be experienced in a toe, most commonly the big toe. It is a painful condition arising from a build-up of uric acid crystals around the joint.
Podiatrists are also able to assess posture and gait when an individual is standing, running or walking. They would look for asymmetrical patterns which may be impacting the feet. The treatment options may include insoles and orthotics to change the way you walk and improve your posture. They may use exercises to strengthen and stretch, or to help mobilise joints by manipulation and massage.
A visit to the Podiatrist is not necessarily restricted to people experiencing problems. It is a useful exercise to ensure our foot health and care are good. The podiatrist would be able to find minor problems before they cause symptoms. Prevention is always preferable to cure, especially concerning our hard working feet!
- McGill, M. et al. ‘Which Diabetic Patients Should Receive Podiatry Care? An Objective Analysis’. Internal Medicine Journal 2005. Volume 35 issue 8 p451-456.