Common Conditions

 

General Foot Care

general-foot-careGeneral foot care in a podiatry practice is one of the most sought after treatments. General foot care covers a range of problems, ranging from nail cutting to removal of warts. It is typically ongoing and requires regular maintenance visits. General foot care may be required simply when you can’t bend over far enough to reach your feet to cut your toe nails, or due to a condition such as diabetes where it is inadvisable to cut your own toenails. On the other hand, many people just enjoy their getting their feet tended to by a qualified professional.

Nail cutting

Our podiatrists routinely provide general nail cutting for a variety of patients of varying ages, including:

  • Those with an inability to reach the feet to cut the nails
  • Those who require assistance due to thickened and/or ingrowing toenails
  • Individuals with diabetes, fragile skin or poor healing
  • Individuals who just enjoy a qualified and trained podiatrist tending to their feet

Fungal infections

Fungal infections of the foot can occur on the skin, known as Tinea Pedis or Athlete’s Foot, and the nails, known as onychomycosis. Fungal nails are typically thickened, brittle, crumbly, distorted in shape and discoloured. Athlete’s Foot causes scaling, flaking and itching on the soles of the feet and in the web spaces. Athlete’s Foot can often be mistaken for other skin conditions such as eczema and psoriasis, however your podiatrist will be able to distinguish between these. Both fungal nail infections and Athlete’s Foot are easily spread and thrive in warm, moist environments.

The mainstay of treatment for both conditions is the use of topical antifungal agents, as well as reduction of the fungal load. Your podiatrist will recommend the most suitable treatment for your fungal infection, as well as perform regular reduction of thickened, fungal nails.

Corns, callouses and cracked heels

Corns and callouses are areas of thick skin that result from excessive pressure or friction, usually over a boney prominence. Callouses are thickened areas of skin dispersed over an area, whereas corns tend to have a discrete core. They are both commonly signs of an underlying biomechanical issue. Cracked heels may develop when the callous on the heel splits. These can be painful and give way to infection. Our podiatrists are able to offer regular debridement of your corns and callouses, as well as address any underlying biomechanical issues that may be causing them. Treatment for this may be in the way of in-shoe padding, toe props or orthoses.

Plantar Warts

A plantar wart is caused by the human papillomavirus and occurs on the sole and/or toes of the feet. The virus is able to enter the skin through tiny cuts or abrasions in the outermost layer of skin. Treatment is often sought due to the appearance or pain caused by the wart. Plantar warts can often be mistaken for corns or callouses, however our experienced podiatrists will be able to distinguish between these.

A number of treatments are available for plantar warts at our clinic. These include the use of keratolytic agents such as silver nitrate, salicylic acid and monochloroacetic acid, and excision of the wart tissue under local anaesthesia. The best option for you will be determined by you and your podiatrist and will be based on the location, size and duration of the wart as well as your lifestyle.

Ingrown Toenails

ingrown-toenailIngrown toe nails are common conditions treated by our podiatrists in which the edge of the nail (usually the big toe nail) grows into the adjacent tissue. This may result in pain, swelling, redness and occasionally infection. There are a number of causes for ingrown toe nails, including:

  • Unsuitable footwear, in particular those with an overly narrow toe-box
  • Excess sweating
  • Improper nail cutting technique
  • Disorders of the nail such as fungal infections
  • Acute or chronic injury to the nail plate
  • Genetic predisposition

At your appointment, your podiatrist will assess your nail and discuss the best treatment options for you. This can include conservative treatments such as removal of the offending nail corner, with or without the use of an anaesthetic, packing of the nail, or conservative filing of the offending nail corner. A more permanent and highly effective treatment option is ingrown toe nail surgery, also known as a nail wedge resection. This involves the use of a local anaesthetic with the removal of the edge of the nail, followed by phenolisation of the nail matrix to prevent reoccurrence. This is performed in the clinic by our experienced podiatrists and requires half an hour to an hour, depending on severity. There is minimal discomfort after the procedure, and your podiatrist will provide you with appropriate after-care instructions.

Diabetic Feet

diabetic-feetCollectively, individuals with diabetes are at a greater risk of developing circulatory and nerve problems. Circulatory problems can result in a reduction of blood flow to the legs and feet, which may lead to fragile skin, poor healing, and ulcerations. Nerve damage can lead to a loss of sensation in the feet which reduces your ability to detect injury and pain.

Our podiatrists can provide you with regular foot checks, diabetic foot advice and general care. It is recommended that you visit your podiatrist at least every 6 to 12 months, and more often if general care is required, to minimise diabetic foot complications.

Footwear

It is essential that people with diabetes wear well fitted, protective footwear. The ideal shoe should cushion whilst also providing ankle, arch and heel support. It should allow an even distribution of pressure and weight to avoid pressure points that are likely to breakdown and ulcerate.
The podiatrists at Stephen Cardinal Podiatry Group are able to recommend appropriate footwear for your individual needs. We also carry the Dr Comfort diabetic footwear range and are fully trained in measuring and fitting these.

Skin

Corns and callouses are areas of thick skin that result from excessive pressure or friction, usually over a boney prominence. Callouses are thickened areas of skin dispersed over an area, whereas corns tend to have a discrete core. They are both commonly signs of an underlying biomechanical issue. Our podiatrists are able to offer regular debridement of your corns and callouses, as well as address any underlying biomechanical issues that may be causing them. Treatment for this may be in the way of in-shoe padding, toe props or orthotics.

If you have diabetes, there is a greater risk of these high pressure areas becoming ulcerated. It is therefore very important that you have any callouses and corns tended to by your podiatrist.

Ulcerations

Diabetic foot ulcers are one of the most significant complications of diabetes mellitus. The two major risk factors for the development of a diabetic ulcer are vascular insufficiency and peripheral neuropathy. These risk factors result in reduced healing and an inability to detect pain and injury, respectively. High pressure areas where callous formation occurs are also more prone to ulceration. Your podiatrist is able to assess your circulation and nerve supply to the feet, as well as remove callouses and corns. This can ultimately reduce, or eliminate, your risk of developing a diabetic foot ulcer.

Heel Pain

heel-painHeel pain is one of the most common presenting complaints at our clinic. It can range from mild to severe in its nature, and if left untreated can lead to serious complications. People often describe symptoms including morning pain, shooting pain, swelling and pain with activity. Heel pain can be caused by a number of conditions, including plantar fasciitis, Achilles tendinitis, heel spurs, fractures of the calcaneum, posterior tibial tendon dysfunction and nerve entrapments.

Plantar Fascitis

Plantar fasciitis is the most common cause of heel pain. Typically there will be pain upon standing after a period of rest, especially first thing in the morning, as well as at the end of the day. As the condition worsens, pain may be present all day long. The condition itself is the inflammation of the plantar fascia – the fibrous band that runs under the foot. Most cases of plantar fasciitis occur at the insertion of the plantar fascia into the heel bone, and is often caused by excessive pronation of the foot. Aggravating factors include inadequate footwear, a recent increase in activity and weight gain.

Plantar fasciitis can often be mistaken for other causes of heel pain, however our experienced and qualified podiatrists are able to perform a thorough assessment and make an accurate diagnosis. Treatment consists of stretching, padding and strapping, rest from aggravating activities, footwear modification and orthotics. We will be able to recommend the appropriate treatment for each individual case of plantar fasciitis. If required, our podiatrists are able to fit you with a customised orthotic which will correct the alignment of the foot and allow healing to occur.

Achilles Tendinitis

Achilles tendinitis is the inflammation of the Achilles tendon – the tendon that connects the calf muscles to the heel bone. It is caused by excessive strain on the Achilles tendon which creates micro tears. Precipitating factors include inadequate footwear, sudden increase in activity, weight gain, tight calf muscles and excessive pronation of the foot. The typical presentation of Achilles Tendinitis is pain and swelling at the back of the heel which is exacerbated by activity.

A multifaceted treatment approach is required for Achilles tendinitis and includes stretching and strengthening, heel raises, footwear modification, rest from aggravating activities and orthotics to correct any biomechanical causes.

Heel Spurs

Heel spurs often occur in conjunction with plantar fasciitis. Essentially, it is a bony formation at the insertion of the plantar fascia into the heel bone. It is caused by the same mechanism that leads to plantar fasciitis. Heel spurs can typically be quite painful during formation, however this pain often subsides. In most cases, it is the inflammation of the plantar fascia itself and not the heel spur that causes pain.

Treatment consists of the same approach taken for plantar fasciitis; stretching, padding and strapping, rest from aggravating activities, footwear modification and orthotics.

Kid’s Feet

kids-feetChildren’s feet are not just small adult’s feet. The bone structure is still forming and will change as much as the rest of their body will. Critical aspects of postural development occur from birth to approximately eight years of age, when the adult gait is typically formed. Advice should be sought when you first notice a problem with your child’s feet; treatment is often simpler the younger the child. If you think something is wrong with your child’s feet there may well be. Don’t wait for your child to grow out of their foot problem because many do not.

Some of the common foot problems found in children include:

  • Ingrown toenails
  • Plantar warts
  • In-toeing/out-toeing
  • Flat feet
  • Hypermobile joints
  • Growing pains
  • Sports injuries

If your child is experiencing any foot or leg pain, it is advisable to make an appointment with a podiatrist who will perform a thorough examination and determine the most appropriate course of action.

Orthotics and Footwear

orthotics-and-footwearThe podiatrists at Stephen Cardinal Podiatry Group are able to recommend appropriate footwear for your individual needs. We also carry a number of footwear brands including Dr Comfort diabetic footwear, Orthaheel and Vasyli. All our podiatrists and receptionists are trained in fitting and measuring these. In particular, it is essential that people with diabetes wear well fitted, protective footwear. The ideal shoe should cushion whilst also providing ankle, arch and heel support. It should allow an even distribution of pressure and weight to avoid pressure points that are likely to breakdown and ulcerate.

Our podiatrists are experienced and trained in providing you with the right orthotic to meet your needs, whether that be a customized rigid orthotic or a prefabricated orthotic requiring adjustments.

Foot Conditions

foot-conditionsAt Stephen Cardinal Podiatry we see an array of foot problems, ranging from a simple corn to a complicated bone fracture. Our podiatrists are competent in assessing and diagnosing all foot complaints. Some of the more common foot conditions we see include:

  • Corns: a hard, seed-like lesion which can create a great deal of pain, depending on the location. The only safe and effective treatment for a corn is debridement and enucleation by a qualified podiatrist.
  • Morton’s Neuroma: a burning/neuropathic pain localized to the ball of the foot, usually between the third and fourth toes. This pain often shoots into the toes, but not always. Treatment typically consists of a dome pad, icing, footwear modification and orthotics.
  • Bone Fracture: depending on the bone affected and the severity of the fracture, treatment is quite varied. A simple toe fracture may require no treatment, whereas a midfoot fracture may require a boot for up to 12 weeks. Our podiatrists are able to refer you for a bulk-billed x-ray and determine the necessary treatment.
  • Plantar Fasciitis/heel spurs: pain that is localised to the inner heel, occasionally extending into the arch. Pain is worst first thing in the morning and after rising from being seated. Treatment consists of padding, strapping, icing, massage, footwear modification and orthotics.
  • Achilles Tendinitis: pain that is localised to the back of the heel, often aggravated going up or down stairs. Pain is worst first thing in the morning and after rising from being seated. Treatment consists of strapping, heel raises, icing, massage, footwear modification and orthotics.
  • Extensor tendinitis: pain that is felt on the top of the foot. This can be caused by incorrect training, inappropriate footwear or tight muscles. Treatment consists of strapping, icing, footwear modification and orthotics.
  • Bunions: the large prominence on the inside of your foot near your big toe. There are a number of factors which contribute to a bunion formation, including tight and/or high heeled footwear, genetics and excessive foot pronation. Treatment consists of footwear modification, orthotics to correct excess pronation, manipulation therapy and dry needling.

Lower Limb Conditions

lower-limb-conditionsOur podiatrists are experienced and qualified in examining the entire lower limb, from the hips to the toes. Incorrect foot posture is a common cause for knee, hip and back pain, and we are able to assess your body as a whole to determine what might be causing your pain. Common lower limb conditions include:

  • Osteoarthritis: osteoarthritis is the degeneration of a joint caused by overuse. The overuse can be caused by general aging and wear and tear, sports or misalignment of the foot. Common locations of osteoarthritis in the lower limb include hips, knees, ankles and feet. Orthotics can often provide immense relief for arthritis pain, as well as slowing the progression.
  • Osgood-Schlatter disease: a painful condition affecting the knee. It is mostly found in adolescents between the ages of 9 and 16, and is caused by overuse of the knee particularly during a growth spurt. The condition is usually self-limiting, however our podiatrists can assist with stretches and exercises.
  • Shin splints: the common name for medial tibial stress syndrome. It is pain felt along the shin and can be experienced in one or both legs. It is an overuse injury that often arises after trying to exercise beyond your current fitness level. Other contributing factors include flat feet causing the muscles to overwork, poor footwear and high impact exercise such as running. Treatment consists of icing, rest, stretching, footwear modification and orthotics.
  • Deep vein thrombosis: a potentially serious health issue involving the formation of a blood clot in the deep veins of the legs. Factors that contribute to the develop of a DVT include long flights, surgery, immobility, heart disease, smoking, obesity, heart disease and family history. A DVT is symptomised by pain and swelling in the affected leg. A DVT becomes life threatening if the clot travels through the circulatory system and becomes a pulmonary embolism. Treatment consists of anticoagulatory drugs, hospitalisation and modification of risk factors.
  • Muscle tears and strains: can occur during strenuous exercise or during the course of everyday activity where a sudden movement occurs. Symptoms include pain, bruising and stiffness. They can range in severity from tearing a few muscle fibers to a complete tear of the muscle. Treatment depends on the severity of the strain, and includes rest, icing, compression and surgery.