Podiatry Definitions

Podiatry care services may be covered by GP Care Plans, Private Health Insurance rebates and DVA depending on patient circumstances.

Plantar Fasciitis

Plantar fasciitis is a common reason for people to see a podiatrist with painful feet and typically involves pain at the middle of the heel . It is an irritation and degeneration of the point that the plantar fascia joins onto the calcaneus (heel bone) and is generally seen as an overuse injury. People often experience increased pain after rest, especially in the mornings.
Treatment for plantar fasciitis is multifaceted and can include options such as exercises, strapping and sometimes orthotics. Some in-clinic treatment options we have at SSF clinic are low level laser therapy and extracorporeal shockwave therapy.

Heel Pain

Not all heel pain is caused by plantar fasciitis and it is important to identify other causes of chronic heel pain. Some other possible causes of heel pain include:

  • Fat pad syndrome
  • Baxter’s neuritis (irritation of the inferior calcaneal nerve)
  • Sever’s syndrome – in children aged 9-12 it is possible that their calcaneal growth plate is panful or symptomatic
  • Stress fracture – in athletes of all levels it is important that calcaneal stress fractures are not mis-diagnosed.

Flat Feet

Flat feet or pes planus in adults is a common reason to see a podiatrist. Lower arches can sometimes increase the risk of soft tissue injuries or increase foot fatigue.
A foot that is getting progressively flatter over time, especially when it is just one side, may be due to an undiagnosed injury such as tibialis posterior tendon dysfunction (PTTD). This tendon injury can be greatly assisted by podiatric interventions and earlier intervention may reduce the duration and severity of symptoms. Often an ultrasound referral can be used to confirm diagnosis before a treatment plan is commenced.

Flat Feet in Kids

Some children have feet that are flatter than other kids (pes planus) and it is important to remember that healthy feet come in all different shapes and sizes.  However flat or flexible feet that are painful or limiting function can often be improved through consultation with a podiatrist.

Signs that a child’s flat feet may be causing issues can include increased fatigue compared to peers, not meeting milestones or frequent lower limb pain.  Causes of flat feet can be due to benign hypermobility disorder or a specific connective tissue disorder such as Marfan’s or Ehler Danlos syndrome.  Pes planus is seen more commonly in children who experience growth pains and can also be due to a condition called tarsal coalition.

Foot arthritis

Foot arthritis can be a painful condition affecting any of the joints in the foot. Some arthritis may be osteoarthritis through chronic use or as the result of a previous trauma and other foot arthritis may be secondary to disease processes such as rheumatoid arthritis, psoriatic arthritis, scleroderma or gout.

Painful bunions

Bunions or hallux abducto valgus are a deviation or bowling of the big toe at the 1st MTP joint or knuckle. Bunions are not always painful but they can be and can sometimes limit footwear options. Treatment is often aimed at symptom management and can include recommendations such as footwear advice, taping techniques, inshoe padding and orthotics and low level laser therapy.

Sever’s and other growth related foot pain

Pediatric feet are fascinating and undergo massive amounts of change from birth to adulthood. As bones begin to ossify and form and growth plates begin to close these sites can become painful and sometimes need special attention. The growth plate in the heel is the most common osteochondrosis and is vulnerable to irritation around 9-12 years of age. This condition is called calcaneal apophysitis or Sever’s syndrome. In addition to this condition, there are multiple other growth plates or centres that can also affect growing feet.

Diabetic foot disease

Regular diabetic foot screening in accordance with the Evidence Based Australian Guidelines for diabetes- related foot disease is recommended for all diabetic patients. Our podiatrists will assess the level of sensation in your feet, the status of the blood flow to your feet, and examine the skin and nails for any concerns.
Low Level Laser Therapy is a treatment that can assist with reducing discomfort caused by Diabetic Peripheral Neuropathy. Read more about this here.

Corn and callouses

Corns and callouses are hard skin lesions caused by pressure and friction. They are most commonly found on the ball of the foot, the tops of the toes, around the toenails and on the heels. Soft corns can also develop between the toes as a result of sweating and inadequate drying. Our Podiatrists can treat your corns and callouses, and recommend solutions to reduce further development.

Ingrown toenails

Ingrown toenails are a common complaint and can be extremely uncomfortable. They can be acute (short term) or chronic (long term) and sometimes involve an infection.
Treatment of ingrown toenails can involve cutting the nail to remove the nail’s ingrown portion and reshaping the nail to allow better regrowth. If required, a local anaesthetic can be used to make this process more comfortable.
In certain situations, permanent removal of a portion of the toenail and prevention of regrowth is required to achieve a good long term outcome, however this will only be considered after consultation with your podiatrist. Please note that any surgical or invasive procedure carries risk. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

Growing pains

Ingrown toenails are a common complaint and can be extremely uncomfortable. They can be acute (short term) or chronic (long term) and sometimes involve an infection.
Treatment of ingrown toenails can involve cutting the nail to remove the nail’s ingrown portion and reshaping the nail to allow better regrowth. If required, a local anaesthetic can be used to make this process more comfortable.
In certain situations, permanent removal of a portion of the toenail and prevention of regrowth is required to achieve a good long term outcome, however this will only be considered after consultation with your podiatrist. Please note that any surgical or invasive procedure carries risk. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

Acute sports injuries

Injuries are a ubiquitous part of playing sport and early diagnosis and treatment can make our return to sport as short as possible. The most common onfield lower limb injury is an ankle sprain and this injury can vary greatly in severity. Other common injuries can include turf toe, midfoot sprain and small avulsion fracture.
Ensuring that a rehabilitation program includes appropriate and progressive strength and proprioception training can reduce re-injury risk once we get back on the feld.

Other lower limb tendon injuries

There are multiple tendons that cross from muscles in the lower leg and finish in the foot as well as muscles that start and finish in the foot. Each of these muscle-tendon units can suffer from a chronic overuse pathology. While Achilles tendons are the most common lower limb tendinopathy other affected tendons include the peroneal tendons, tibialis anterior, tbs posterior, abductor hallucis and flexor hallucis longus. Treatment of these less common tendon injuries starts with correct diagnosis and uses correct levels of de-loading combined with appropriate rehabilitation and strength training. Orthotics can sometimes be used to reduce ongoing overuse of the injured structure.

Forefoot pain

The forefoot is a complicated part of the foot with some very small joints that are subject to big forces in walking, running and other activities. Forefoot pain can be caused by changes to the bones, joints, ligaments, tendons or nerves. Forefoot pain is often worse with activity and is sometimes more noticeable when standing on tippy toes. Some more common forefoot injuries include metatarsal stress fracture, plantar plate damage, metatarsal-phalangeal joint capsulitis and sesamoid irritation.

Morton’s neuroma

A Morton’s neuroma is a compression neuropathy of one of the nerves that run from our midfoot into our toes. Sometimes a neuroma will cause burning pain, worse with extended footwear use and can sometimes cause sensation changes with patients often reporting ‘pins and needles’ in one or two toes. The nerve and its sheath are often visibility thickened on sonography and a clinical test called a Mulder’s click test can also be used in the diagnostic process.

Achilles

The Achilles tendon is a powerful structure that connects our calf muscle to our heel bone and allows us to push off through our feet. During running and walking the Achilles acts as a spring which stores elastic energy and makes us more efficient.
The achilles is a common site of degenerative tendon change, especially in older athletes but can also be the site of acute injuries such as partial thickness and full thickness tears.

High arches

High arches or pes cavus feet are feet that have exaggerated height at the midfoot when in a weightbearign situation. These feet are often stiffer across the small joints of the midfoot and ankle joint. A pes cavus foot can often be accompanied by lesser toe deformities and lateral ankle joint instability. Stiff pes cavus feet may not be as effective at absorbing impact forces and will have higher peak plantar pressures due to the reduced contact patch. In many cases footwear and orthotics can be used help increase contact area and improve stability.
While some high arches are hereditary, arches that are progressively getting higher may be due to a neuromuscular condition.

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