As the end of the year approaches, many of us find ourselves in a rush to use our health fund extras cover. But here's a thought: why wait until the last minute to take care of our health? The saying "use it to lose it" rings especially true when it comes to utilising our health benefits effectively.  The Importance of Preventive Care Too often, people wait until issues become serious before seeking medical attention or investing in preventive care. One area that frequently gets overlooked is orthotic services. An appointment to have your orthotics checked or replaced could significantly improve your comfort and quality of life, especially if you're experiencing foot pain or discomfort.  Don't Let Your Benefits Expire Did you know that many health funds have a rollover date? Some rollover at the end of the calendar year while others rollover at the end of the financial year in June. This means that if you don't use your benefits by a certain date, they simply disappear. As this date approaches, consider taking a proactive approach to your health. Instead of waiting until the last minute, schedule an appointment today to assess your orthotic needs.  How Orthotics Can Make a Difference Orthotics are designed to support proper foot alignment, alleviate pain, and enhance mobility. Whether you're an athlete, someone who stands for long periods, or just looking to improve your overall foot health, having your orthotics evaluated can lead to better outcomes. Take Action Now As the saying goes, the best time to plant a tree was 20 years ago; the second-best time is now. Don’t let your health funds roll over unused. Contact your healthcare provider today to find out if your orthotics are still serving you well, or if it’s time for an upgrade. In summary, take steps now to use your health funds wisely. Invest in yourself and your well-being. Schedule an appointment to have your orthotics checked, and make the most out of your benefits before it's too late. Call (07) 3385 0567 to schedule your assessment. Your body will thank you!

As the holiday season approaches, so does the excitement of Christmas parties filled with joy, laughter, and plenty of dancing. While choosing the perfect outfit is essential, one often overlooked aspect is footwear. After all, happy feet lead to a happy party! The key to enjoying your festivities is to prioritise comfort without sacrificing style. Let’s explore why it’s crucial to choose sensible footwear and highlight some options to ensure you keep dancing the night away. Happy Feet – Happy Party The festive season is all about creating joyful memories with friends and family. However, nothing ruins a good time faster than uncomfortable shoes. Whether you’re standing around the buffet table or busting a move on the dance floor, your feet deserve to be pampered. Opting for shoes that provide adequate support can make all the difference in your party experience. Be Mindful of Thin Strappy Sandals While thin strappy sandals may seem like an elegant choice, they often come with their downsides. Many of these sandals lack the necessary support, which can lead to blisters and discomfort after just a short period. If you’re drawn to this style, consider pairing them with a cushioned insole to enhance comfort. Alternatively, you might want to reserve those lovely sandals for occasions with less standing and moving around. Square Heels Are Better Than Stilettos When it comes to party footwear, square heels are a fabulous alternative to stilettos. While stilettos may offer a chic and sophisticated look, they can be challenging to walk in, especially on slippery surfaces. Square heels, on the other hand, provide a stable base, making them much more comfortable for extended periods of wear. You’ll not only look good but also feel secure as you navigate the dance floor. Stylish Yet Practical Options Here are a few suggestions that combine style and comfort, ensuring your feet remain happy throughout the festivities: Block Heels: These give you the height of stilettos while providing better balance and support. They come in various styles, making them suitable for any outfit. Ballet Flats: An elegant and comfortable choice, especially those with cushioned insoles. Plus, they can easily transition from day to night. Ankle Boots: Great for a chic winter look, ankle boots with a low block heel can keep your feet warm and stylish. Loafers: Opt for loafers with embellished details for a dressed-up look that’s still easy on the feet. Sneakers: If your style leans towards the casual, a pair of sparkly or chic sneakers can be both trendy and comfortable. In Conclusion This holiday season, remember that footwear plays a significant role in your overall enjoyment. By choosing sensible footwear, you can dance, mingle, and celebrate without the worry of sore feet. From stylish block heels to comfy ballet flats, there are plenty of options to keep your feet happy while looking fabulous.  So go ahead, embrace the festive spirit, and make wonderful memories with happy feet !

Sesamoiditis is a common condition of the forefoot. Pain is in the ball of the foot specifically under the big toe joint. The sesamoids are small bones located under the big toe joint. These bones are in the tendons that run to the big toe on the under surface. Due to their location and function they are subjected to immense pressure and forces every time the big toe is used to push the foot forward. They can cause pain due to the surrounding tissue being inflamed, fractured or shattered. Symptoms Sesamoiditis is localized. Typically it may present with a mild ache increasing gradually to an intense throbbing. People participating in activities and sports that involve repetitive, excessive loading of the ball of the foot such as dancing and sprinting often suffer from this condition. People with higher arched feet tend to have more pressure on the balls of their feet also tend to be more prone to sesamoiditis. It may be an occupational hazard and common in professions where you are on your haunches, this adds direct pressure to the sesamoids. Treatment Conservative Treatment will vary according to the situation. It will involve a period of rest from any activities likely to aggravate the problem. Immobilization strapping, ice and oral anti-inflammatories may also be utilized to settle inflammation and pain. A soft full length functional orthotic is commonly used to float the sesamoids and deflect pressure away from the painful area. Orthotics are essential in treating an underlying causative foot condition, such as flat feet (pes planus), high arched feet (pes cavus), bunions or those with reduced plantar fatty padding. In the case of persistent severe sesamoiditis or stress fractures of the sesamoids, a moon boot (fitted by our podiatrists at Gait Way Podiatry) may be required for up to 6 weeks. Failing this an injection of steroids may be considered, depending in the condition. Surgery must be a last resort. Surgery In severe cases or following a true fracture of the sesamoids, surgery may be required to remove the damaged or fragmented sesamoid bone. Also in some cases, due to reduced blood supply there may be delayed or absent healing and a surgical review is warranted. Expected Outcome Most individuals will have immediate improvement is symptoms with conservative care, with total resolution achieved within months. It is essential to address the causative factors rather than the symptoms alone. Related Conditions Arch Pain Are Your Feet Ready For the Jetty to Jetty Fun Run? Bunions Claw Toes Foot Pain Investing in Tradespeople’s Health: Why It Matters Morton’s Neuroma Plantar Fasciitis PROLOTHERAPY Sesamoiditis

Neuroma pain is described as a burning pain in the forefoot. It can also be felt as an aching or shooting pain. Patients with this problem frequently say they feel as though they need to take off their shoes and rub their foot. This pain may occur in at any time. Commonly this involves the 3rd and 4th toes. Repeated trauma or compression of these nerves causes the nerves to swell and thicken causing a neuroma to develop. Symptoms Patients will often experience a clicking feeling “Mulder’s sign” in the forefoot followed by a sharp shooting pain or a sensation of numbness or pins and needles extending into ends of their toes. Tight, narrow fitting shoes may often exacerbate these feelings which become worse after long periods of standing or walking. Once the problem progresses, symptoms will become more frequent and often more intense. For athletes the pain occurs in the middle of a run or at the end of a long run. Management The cause of the problem is patient specific. An accurate diagnosis must be made by means of a thorough history. The podiatrist will also gather further information about the cause through a hands on assessment where they will try to reproduce your symptoms. A biomechanical and gait analysis will also be performed to assess whether poor foot alignment and function has contributed to your neuroma. Conservative Relief of symptoms can often start by having a good pair of well fitting shoes fitted to your feet, ensuring that the shoes don’t squeeze your foot together. Once footwear is addressed patients may require a small pre-metatarsal pad to be positioned onto the insole of the shoe to help lift and separate the bones in the forefoot to alleviate the pressure on the nerve. If the patients foot structure and mechanics is found to be a contributing cause, a custom made orthotic is usually the most convenient and effective way to manage the problem. The orthotic can be designed and created in our on-site laboratory at Gait Way Podiatry North Lakes. Sometimes an injection of local anaesthetic and steroid is recommended to assist in settling acute symptoms. Surgery If pain persists with conservative care, surgery may be an appropriate option. The common digitial nerve is cut and the neuroma removed. This will result is numbness along the inside of the toes affected. Expected Outcome About 70% of patients have success with conservative treatment. Related Conditions Arch Pain Are Your Feet Ready For the Jetty to Jetty Fun Run? Bunions Claw Toes Foot Pain Investing in Tradespeople’s Health: Why It Matters Morton’s Neuroma Plantar Fasciitis PROLOTHERAPY Sesamoiditis

A claw toe is a toe that is contracted at the middle and end joints in the toe. This position can lead to severe pressure and pain. Muscular imbalance around the toe can cause the toe’s joints to curl downwards. Claw toes may occur in any toe. There is often discomfort at the top part of the toe, which can rub against the shoe, and at the end of the toe that is pressed against the bottom of the shoe. Claw toes are classified based on the mobility of the toe joints. There are two types –  flexible  and  rigid . In a flexible claw toe, the joint has the ability to move. This type of claw toe can be straightened manually. A rigid claw toe does not have the ability to move. There is limited movement, if any, and it can be extremely painful. This sometimes causes foot movement to become restricted. This can lead to extra stress at the ball-of-the-foot, causing pain, and possibly the development of corns and calluses in that particular area as a result of friction and pressure. Cause Claw toes result from a muscle imbalance which causes the ligaments and tendons to become unnaturally tight. This results in the joints curling downwards. Arthritis can also lead to many different forefoot deformities, including claw toes. Callus can form at the bottom of the joint from thickening of the skin due to friction, while corns can develop of the top of the toes due to pressure and friction. Treatment and Prevention Off loading orthotics with padding can be made to fit most types of footwear.These devices will redistribute the pressure of certain areas on your foot in your shoes. Changing footwear is a very important step in the treatment of claw toes. When choosing a shoe, make sure the toe box (toe area) can accommodate the foot. The toe box must be high and broad. This will provide enough room in the forefoot area so that there is less friction against the toes. Other conservative treatments include using forefoot products designed to relieve claw toes, such as toe props, elevators and toe splints. These devices will help hold down the claw toe and provide relief to the forefoot. Gel toe shields and gel toe caps are also recommended to eliminate friction between the shoe and the toe, while providing comfort and lubrication. Related Conditions Arch Pain Are Your Feet Ready For the Jetty to Jetty Fun Run? Bunions Claw Toes Foot Pain Investing in Tradespeople’s Health: Why It Matters Morton’s Neuroma Plantar Fasciitis PROLOTHERAPY Sesamoiditis

Heel and arch pain is something we may likely experience at some point in time, however ongoing feel and arch pain is something that should be investigated further. In many cases, heel and arch pain is due to an issue called plantar fasciitis. Other issues it could be attributed to include Heel Spurs, Claw Toes, Morton’s Neuroma, Bunions, Sesamoiditis or Arthritis. It may also be from a biomechanical issue, for example flat feet, or high arched feet, could be the potential causes of pain. Ongoing pain in your heel or foot is not normal and should be looked at by a Podiatrist. Gait Way Podiatry can develop a tailored treatment plan to manage your foot and/or heel pain. Treatment options include: Shockwave treatment Strengthening Exercises specific to foot function Related Conditions Arch Pain Are Your Feet Ready For the Jetty to Jetty Fun Run? Bunions Claw Toes Foot Pain Investing in Tradespeople’s Health: Why It Matters Morton’s Neuroma Plantar Fasciitis PROLOTHERAPY Sesamoiditis

Hammer toes, Claw Toes and Retracted Toes. Hammer toes, claw toes and retracted toes are deformities that affect the little toes and not the big toe. The toes curl over or lift off the ground which creates pressure on the tops of the toes or increased pressure under the ball of the foot causing callus and corns to form. The lesser toe deformities are due to a variety of reasons including neurological deficiencies, muscle imbalances, arthritis or even injuries to particular tendons. The toes often require shoes with a deeper area in the toe box portion of the shoe. Tubes for the toes, little rubber props and even orthotics can help to reduce the stresses through the toes due to the deformity. Morton’s Neuroma A neuroma is thickening of the tissue around a nerve causing nerve related pain in the ball of the foot and into the toes. More often than not it affects the 3rd and 4th toes but the neuroma can be within any of the spaces between the toes. In addition to pain, numbness in the toes may occur or tingling between the toes, shooting pain into the toes or a ‘click’ might be felt under the forefoot. Treatment for a neuroma is aimed primarily at modifying the cause so wearing a wider fitting shoe with a lower heel is ideal. Addressing poor biomechanics with the use of orthotics is also essential as excessive pronation or supination can lead to a neuroma formation. Surgery is also an option but best utilised when conservative management has been unsuccessful. Sesamoiditis Under the big toe joint are 2 small bones that sit within a tendon. They are called sesamoids and, if pressure is increased under the area, can become irritated and create sesamoiditis. Football boots can be an instigator of sesamoiditis due to stud configuration causing direct pressure under the area, as does a particular foot type where the big toe joint sits lower than the other joints known as a plantar flexed 1st ray. When the sesamoids are inflamed, they require offloading. It there is a fracture this can be done with a post operative boot otherwise an orthotic with particular forefoot padding if often sufficient. For any forefoot pathology, a consultation with a podiatrist at Gait Way Podiatry is essential to discuss the appropriate treatment options for you. Related Conditions Arch Pain Are Your Feet Ready For the Jetty to Jetty Fun Run? Bunions Claw Toes Foot Pain Investing in Tradespeople’s Health: Why It Matters Morton’s Neuroma Plantar Fasciitis PROLOTHERAPY Sesamoiditis

Dry, cracked heels can be unsightly, and they can be cause of pain and embarrassment. Cracked heels are caused by dryness or thickening of the skin (callus) which then cracks or breaks under pressure. If this becomes severe enough, then fissures may form. When the skin around the heels becomes thickened and dry, it loses the natural elasticity in the skin, and can split under pressure causing painful and even bleeding heels. This can be made worse in people who have large fatty pad on the sole of their feet, which under pressure requires more elasticity in the skin to expand without cracking. This pressure can be the result of prolonged standing, pregnancy or excess weight. Causes Walking around barefooted or in footwear such as thongs, sling backs or open backed sandals which dries out feet. Standing for long periods at work or home, especially on hard floors. Increased weight which causes increased pressure on the heels causing callus. With increased weight the heel is also required to expand more and hence can often crack more. Poor fitting shoes or sandals that don’t support the heels from expanding sideways under pressure. Unhygienic circumstances or conditions. Unhealthy, dry scaly skin that can be caused by climate, such as low humidity during dry summers or cold winters. Medical conditions can also lead to drying of the skin such as: Diabetes where autonomic neuropathy leads to less sweating and thus less moisture. Psoriasis & Eczema. Fungal infections of the foot, i.e. Athlete’s foot. Note: in the elderly, callused heels may be a sign of increased pressure and can be a precursor to a bed sore. These cases should be assessed by a podiatrist before commencing any at home treatments. Treatment The thickened skin needs to be reduced in severe cases prior to using moisturiser. The skin may be so dry that it is almost impossible for moisturiser to penetrate to the skin under the callus. In more severe cases you may need the help of a podiatrist. Podiatrist’s can remove the thick layer of the heel callus fairly simply. This may need to be done regularly, or if you are willing to put the work in you can use pumice stone or an emery board to give you a kick start in the right direction. Once the callus has been reduced, the regular use of a moituriser is recommended. Below are some general guidelines to consider when treating cracked heels: If cracks start to bleed apply an antiseptic to prevent infection and keep clean. Wear closed in shoes and good socks when you can. Drink plenty of water to keep you and your skin hydrated. Investigate the cause of the problem, so this can be addressed. There may be an underlying mechanical reason for the load on the heel. If very painful and bleeding, strapping the heel with a rigid sports tape which may be used to ‘hold’ the cracks together while they heal. Treatment may include gait correction that alters the stresses on the foot. This is achieved by wearing orthotics. Custom orthotics are manufactured at Gait Way podiatry in our on site laboratory. Related Conditions Are Your Feet Ready For the Jetty to Jetty Fun Run? Callus and Corns Cracked Heels Ingrown Toe Nails Investing in Tradespeople’s Health: Why It Matters Moisture Socks National Health Month for Tradies – Protect Your Feet! PODIATRY CARE FOR VETERANS Step Forward: Caring for Your Feet During National Diabetes Week 2024 Step Up Your Game: National Health Month for Tradies

Ingrown toenails or onychocryptosis, is a common occurrence across all age groups. Patients usually present with moderate pain in the affected toe. The condition can progress rapidly with or without infection and severe pain. Many patients tolerate chronic ingrown toenails. Podiatrists are well trained in the latest surgical techniques to treat ingrown nails and can offer great pain relief permanently. Possible causes of ingrown toenails include incorrect cutting, “picking at nails”, hyperhidrosis or sweaty feet, poorly fitting footwear, trauma (ill-fitting footwear), abnormal nail shape (i.e.  involuted nails), obesity, or excessive external pressure. Ingrown toenails can be hereditary. Treatment Ingrown toenails may be managed conservatively to a point. Cutting the nail correctly and trying to repair the growth pattern is always the first option. The use of antibiotics to reduce the infection is essential. Surgical intervention by either a partial or total nail avulsion with the use of phenol proves to be successful. A Partial Nail Avulsion (PNA) is a minor procedure that permanently removes a section of the nail plate.  Basic steps to this procedure are: The procedure is done using local anaesthetic, making it as pain free as possible. The ingrown section of nail is removed, and the nail matrix/root is destroyed using a chemical procedure. This prevents the section of nail from regrowing. No sutures (stitches) are required, and therefore in most cases minimal pain is experienced post-operatively. The patient will be required to return for a couple of dressing changes. Healing time is rapid, with full recovery usually within 1 – 2 weeks. Closed footwear should be avoided on the day of the surgery. There is usually no need to take time off work. Ingrown Toe Nail Surgery Ingrown toenail surgery is to be considered when the infection has been recurrent. Antibiotics are only for the purpose of clearing up the infected tissue that surrounds the nail. An antibiotic cannot remove an ingrown toenail. It is a physical injury to the tissue that surrounds the nail. The toe will only settle down when the nail spike causing the infection has been removed. There are varying degrees of ingrown toenails. The cause of the ingrown toenail must be established before it is surgically removed.  Factors to consider prior to surgical removal are: How often has the incidence occurred? Could it have been as a result of bad cutting? Is it hereditary? The decision to have a surgical removal of a nail will be dependent on the answers to the questions. The age of the patient is very important as it can be a traumatic experience for a child. Only when conservative treatment has failed is surgery to be considered and is considered a last resort. Related Conditions Are Your Feet Ready For the Jetty to Jetty Fun Run? Callus and Corns Cracked Heels Ingrown Toe Nails Investing in Tradespeople’s Health: Why It Matters Moisture Socks National Health Month for Tradies – Protect Your Feet! PODIATRY CARE FOR VETERANS Step Forward: Caring for Your Feet During National Diabetes Week 2024 Step Up Your Game: National Health Month for Tradies

Sever’s disease is a common cause of heel pain in adolescence. Developing, physically active  “kids” are often more prone to this condition. During puberty the calcaneus consists of two developing sites of bone, known as ossification centres. These two areas are separated by an area of cartilage, known as the calcaneal apophysis. The Achilles tendon attaches the triceps surae (calf muscles) to the calcaneus (heel bone). As a child grows the calcaneus grows faster than the surrounding soft tissue, which means the Achilles tendon can be pulled uncomfortably tight. This increase in strain causes inflammation and irritation of the calcaneal apophysis (growth plate) which is known as Sever’s Disease. The pain is exacerbated by physical activities, especially ones involving running or jumping. Sever’s disease most commonly affects boys aged 12 to 14 years and girls aged 10 to 12 years, which corresponds with the early growth spurts of puberty. Symptoms Unilateral or bilateral heel pain Heel pain during physical exercise, especially activities that require running or jumping or are high impact. Pain is often worse after exercise. A tender swelling or bulge on the heel that is painful on touch. Limping. Calf muscle stiffness first thing in the morning. Treatment May Include Strengthening exercises. Exercise and training modification. Orthotic therapy. Ice terapy. Footwear changes (no thongs should be worn). Extreme cases may need casting or specialized night splints which will be determined by the podiatrist. Related Conditions Children’s Foot & Leg Development Flat Feet in Children Hypermobility Ingrown Toenails on Babies & Children Intoeing (Pigeon Toes) Knock Knees School Shoes Severs Disease/Heel Pain Toe Walking Warts on Children’s Feet

Having Diabetes puts one at risk of potentially having foot problems. There are a collective number of reasons that attribute to these concerns. Numbness caused by nerve damage (diabetic neuropathy) this results in a decrease in sensation therefore damage to the foot can occur and not be detected. In addition, poor circulation to the legs and feet reduces the healing process when damage occurs. Wounds that do not heal ultimately become foot ulcers. Diabetic foot ulcers may become infected and can subsequently turn gangrenous because of poor circulation. Non-healing foot ulcers are the most likely cause of amputation in people with diabetes. Why a Podiatrist? Regular foot checks and routine foot care from a Podiatrist is vital in preventing symptoms from developing. Nail care, callous and corn management. Diabetic assessments are performed for neurological and vascular screening to monitor the effects of diabetes on your feet. What is Diabetes? Diabetes (mellitus) is a chronic disease that can affect people of any age. There are predisposing factors for the onset of diabetes such as genetic history, weight, regular exercise, diet and age. Insulin is a hormone that helps the body metabolise sugar in the diet. Depending on the type of diabetes (Type 1 or Type 2) the body either produces less or no insulin (Type 1), or the body tissues are resistant to the effects of insulin (Type 2). This results in elevated blood sugar levels which is the cause of Diabetes. Podiatrists use a simple and painless method to check nerve function in the clinic. Neuropathy results in a decrease in sensation in the feet therefore the body’s nerves in the feet do not function properly. It can be due to poor glucose control or compromised blood flow to the nerves. There are three kinds of nerves:  sensory, motor and autonomic , which will be explained below. Diabetic neuropathy is usually symmetrical and is progressive – it worsens with the duration of the disease. It is often not noticed as it progresses, and it is underestimated and underemphasized. It is one of the main causes of amputations. Sensory Nerves The nerves that respond to touch, temperature, pressure and pain send messages to the brain. When the sensation is altered the message to the brain will indicate that. Sensory neuropathy may result in paraesthesia where the brain interprets ordinary sensations like touch as painful. This is worse at night and at rest and is relieved by movement. Standard tests for sensation will be nearly normal. Sensory neuropathy can also cause anaesthesia where sensations are dulled or not felt at all. This is obviously not painful but position sense and balance are affected. Sensory neuropathy can make injury more likely as your normal protective responses don’t occur (The response reflex is lost). It can lead to an injury not being noticed and therefore not cared for (You could stub your toe, breaking the skin and not feel it, you will only be aware of it when you see the blood). It can stop your immune and repair systems from detecting an injury and coming to fight infection or repair skin properly. Motor Nerves Neuropathy at the motor nerves (These allow movement) can cause muscles to become inactive and waste away. This causes muscle imbalances and bony joint deformities. Claw toes are so common in the diabetic foot as a result of this. Your Gait pattern will change and areas of excessive pressure will be found under the feet. Calluses and corns are the result. Autonomic Nerves The autonomic nerves control the actions that you are not in control of. For example, the beating of the heart. In the feet, they control sweating, blood flow, repair and healing. Loss of sweating leaves feet dry and cracked. This results in cracks in the skin which may become infected. When blood flow becomes impaired to the foot, the required amount of oxygen is not available for tissue repair, this will result in infection. Peripheral Vascular Disease (PVD) Your podiatrist or doctor should assess the arteries in the foot at regular intervals using a Doppler ultrasound machine. Physical inspection of the foot is as important. A foot with poor blood flow will have little hair growth. The skin is frail shiny, pale in color and thin with a loss of fatty tissue below the skin. The pulses are weak. The foot will be pale when elevated and mottled red / purple when hanging down. Cholesterol plaques in arteries are more common in diabetics. This is as a result of fat and glucose being increased within the artery walls. The collagen within artery makes the walls stiffer. Arteries are then more likely to have the irregularities that first allow blood to clot within the vessel. Blood clots within vessels can come loose and cause the death of any tissue downstream of the blockage. Thickening of artery walls reduces blood flow to tissues, which results in a reduction of oxygen to the skin and flesh. This restriction limits antibiotic medicine and white blood cells from getting to the site of infection, therefore the delays in wound healing. This ultimately results in amputation. Structural Problems Common structural problems in the feet are bunions, retracted or clawed toes, prominent metatarsal heads (the knuckles on the bottom of the ball of the foot) and areas of increased pressure that lead to corns, callus or ulceration. Those with diabetes can suffer from glycosylation of collagen. This means that the abnormally high blood sugar causes the soft tissue, muscles and like joint capsules, to stiffen up and contract. This results in pressure areas which ultimately ulcerate. Diabetic Arthritis Charcot’s disease (Neuropathic arthropathy) is almost exclusively to diabetics. It occurs when the nerves that run into a joint lose the ability to report back to the brain and the brain is unable to sense when the joint is being used incorrectly. This can result in the joints, particularly one just below the ankle, being destroyed. There is a long build up to Charcot’s disease but the damage occurs very quickly. A joint can go from working fairly normally to being ruined in one day. With the loss of motor and sensory nerve functions minor traumas such as sprains and stress fractures go undetected therefore untreated, leading to ligament laxity (slackness), joint dislocation, bone erosion, cartilage damage, and deformity of the foot. The bones most often affected make up the midfoot. If you suffer from neuropathy in the feet, you must see your podiatrist and have foot function monitored. If no damage has occurred yet, a foot support called an orthotic can dramatically reduce a Charcot’s episode from occurring. If it is too far advanced, an orthotic can help to make the position in which the foot will be permanently positioned a more functional position. If the foot is already trapped in a compromised position, parts of the foot will be bearing a lot of pressure. A different type of orthotic can be used to make these pressures more normal. What Will the Podiatrist Assess? Foot Pulses – physically or by Doppler ultrasound. Skin – the texture, hair presence, and pressure marks corns & calluses, as well as temperature. Spaces between toes – Tinea (fungal infections) and skin splits. Nails – Ingrown, thickening, discoloration and fungal. Deformity – pressure areas. Footwear – Fitting and pressure. Neurological examination – monofilament assessment (for sensation) and vibration perception. Gait – altered walking patterns create an imbalance resulting in pressure areas. Range of motion – Are the joints in your feet restricted or at risk? Dry skin – leads to cracks and allows bacteria to enter through the skin resulting in infection. Appropriate Footwear Footwear can protect the foot against injury or cause the injury. Shoes should be comfortable straight away. Buy shoes later in the day when your feet are swollen and strained. Have shoes fitted. If sensation is affected, you may not be able to properly assess the fit. Stand when trying on shoes as feet are longer when standing. Expensive does not automatically mean good. Extra depth shoes are available at specialty shoe stores. They are higher in the toe box and heel allowing more room for your feet. Shoes will not stretch on a stitch line. Avoid stitch lines over any bony area, such as joints. Wear a good quality sock when going for long walks and long periods of standing. Do not buy off the shelf orthotics. Have the correct assessment done by your podiatrist. Wear new shoes in slowly. Examine your feet immediately after taking the shoes off for rubbed pressure areas. Feel inside shoes before putting them on. Items may have fallen into shoes (surprisingly common) or shoe nails or lining may be protruding or torn. Throw out socks with holes. Do not repair them. Throw out shoes with holes in the lining. Socks should not be too small or too big. Wrinkles cause blisters. Ill fitting footwear causes problems, too big are just as dangerous as too small. Shoes should allow your foot to move slightly in your shoes. Your toes must be allowed to move. There are various lacing technique to keep shoes snug on feet. Make sure the tongue of the shoe is in the correct position before tying the laces. Do not wear the same pair of shoes every day, alternate them. Thongs, if your foot is working to keep the thong in place, do not wear them. The “to Do” and “Not to Do” for Diabetics Always know your blood glucose levels. Inspect your feet daily. If you are vision impaired try to feel your feet. Wash your feet daily and dry well between toes. Wear appropriate footwear. Have corns and callus regularly removed by your Podiatrist. Wear orthotics correctly if prescribed for you. Look after dry skin with an appropriate moisturizer. Do not use greasy preparations they do not penetrate dry skin. Do not cut your own toe nails if you do not have to. If your nails are not perfectly normal seek advice from your podiatrist. If there are no concerns with your nails, cut the nails following curve of toe, do not cut down the side of the nail. Have a plan of action should a problem develop with your feet. Always inform your carer and your podiatrist, that you have diabetes. Keep blood fats under control through diet, drugs and maintaining healthy weight. Exercise regularly to prevent weight gain and assist in improving circulation. See a podiatrist at least once a year for assessment. Have an eye and kidney examination as they can indicate problems in feet and vice versa. Do Not Smoke. Drink alcohol to excess. Use any chemist preparation to treat corns and callus. They are chemicals that cause burns. Go barefoot. Cut skin on your feet, see your Podiatrist. Do You Have Neuropathy? Beware of temperature extremes. Don’t use hot packs or cold packs, don’t put feet close to radiators or fires, don’t get sunburned and be aware of what surfaces might be hot. Remember how hot the sand used to get when you were a child? Concrete paths, balcony rails etc are still just as hot and can cause a severe burn, even if you can’t feel it. Don’t test water temperature with feet or soak in a hot foot bath. Don’t soak in any foot bath. Do not go barefoot inside or out. Don’t use pumice stones. Be wary of ripping skin with strong sticking plaster. Do not wear thongs. Don’t use garters or socks so tight that there is a visible mark on removal. Inspect shoes before putting on every time. Finally, remember that looking after your feet mostly involves looking after yourself as a whole. Controlling your blood sugar, cholesterol, blood pressure and body weight will have the biggest effect on how you fare in the long term. Why Are Feet Important? People with diabetes are at risk of foot problems due to numbness caused by nerve damage (diabetic neuropathy). With diabetic neuropathy, damage to the foot can occur and not be detected. In addition poor circulation to the legs and feet slows the healing process when damage does occur. Wounds that don’t heal may form foot ulcers (skin sores). Diabetic foot ulcers often become infected and can subsequently turn gangrenous because of poor circulation. Non-healing foot ulcers are a frequent cause of amputation in people with diabetes. What Are the Risk Factors Which May Cause Foot Ulcers? Previous history of ulceration. Poor circulation. Neuropathy. Poor foot care. Foot deformities e.g. claw toes, hammer toes which cause pressure lesions. Unsuitable footwear e.g. shoes that are too tight may rub or cut your feet. How Can You Look After Your Feet Yourself? Wash your feet daily in luke warm water (not hot) with mild soap. Dry them well, especially between the toes. Check your feet daily for cuts, sores, blisters, redness, calluses, or other problems. You may need a mirror to look at the bottoms of your feet. If your skin is dry, rub lotion on your feet after you wash them. Do not put lotion between your toes. Cut your toenails when needed. Cut them to the shape of the toe and not too short. File the edges with an emery board. File corns and calluses gently with an emery board or pumice stone. If you are unable to reach your feet your podiatrist is happy to help. Always wear closed in shoes or slippers to protect your feet from injuries. Wear shoes that fit well and always wear socks or stockings to avoid blisters. Before putting your shoes on, feel the insides for things like gravel or torn linings. These things could rub against your feet and cause blisters or sores. When You Need to See a Podiatrist? 6-12 monthly podiatry reviews are required for patients with no neuropathy. 6 month podiatry reviews are required for patients who have neuropathy but no foot deformities. 2-3 month podiatry reviews are required for patients with both neuropathy and foot deformities. 1-2 month podiatry reviews are required for patients with neuropathy, foot deformities and a history of ulceration. Support and Assistance For general information on understanding diabetes ‘click here’ Newly Diagnosed Type 1 Membership to Diabetes Australia can be helpful for support and information. Click here for their website. Click here for The Queensland based diabetes association website. Support for adults by other adults with type 1 diabetes can be found on the “reality check” website . Newly Diagnosed Type 2 Membership to Diabetes Australia can be helpful for support and information. The Queensland based diabetes association website .

In recent years, shockwave therapy has emerged as a revolutionary treatment in various fields of medicine, particularly in podiatry. This non-invasive technique utilizes acoustic waves to stimulate the body’s natural healing processes, making it an effective option for patients suffering from a variety of foot and ankle conditions. Let's explore how shockwave therapy can benefit individuals seeking treatment for podiatric issues. What is Shockwave Therapy? Shockwave therapy involves the delivery of low and high-energy acoustic waves to the targeted area of injury using a handheld probe. The waves penetrate deep into the tissue, promoting biological responses that aid in healing. This can lead to reduced pain and increased mobility, offering a promising alternative to more invasive treatments. Benefits of Shockwave Therapy in Podiatry 1. Pain Reduction One of the most significant advantages of shockwave therapy is its ability to alleviate pain. By activating the body’s self-healing mechanisms, shockwave therapy can reduce inflammation and promote pain relief for conditions such as plantar fasciitis, Achilles tendinopathy, and other chronic foot and ankle pain syndromes. 2. Enhanced Circulation The acoustic waves generated during the treatment increase metabolic activity in the affected area. This leads to improved blood circulation and the formation of new blood vessels. Enhanced blood flow not only helps in delivering essential nutrients and oxygen to the injured tissue but also aids in the removal of metabolic waste, speeding up recovery. 3. Promotion of Tissue Regeneration Shockwave therapy stimulates the body’s natural healing processes, encouraging the formation of new collagen fibers. This regeneration of tissue can significantly improve the healing of tendons, ligaments, and other structures around the foot and ankle, making it particularly beneficial for sports injuries. 4. Non-invasive and Convenient Many patients seek non-invasive treatments to avoid surgery and lengthy recovery times. Shockwave therapy offers a relatively quick procedure that does not require anesthesia or downtime, allowing patients to return to their daily activities shortly after treatment. 5. Effective for Recurring Conditions For individuals experiencing chronic conditions that haven’t responded well to traditional treatments, shockwave therapy can offer a new avenue for relief. Many practitioners have noted significant improvements in symptoms after a series of sessions, even for previously difficult-to-treat conditions. 6. Minimal Side Effects Compared to more invasive procedures or medications, shockwave therapy has minimal side effects. Patients may experience mild discomfort during the treatment or slight soreness afterwards, but these effects are usually short-lived. Conclusion Shockwave therapy is proving to be a valuable tool in the field of podiatry, offering a safe and effective treatment option for a range of foot and ankle conditions. From reducing pain and enhancing circulation to promoting tissue regeneration, the benefits are clear. If you’re dealing with persistent foot or ankle issues, it may be worth discussing with your podiatrist whether shockwave therapy could be right for you. With ongoing advances in this field, patients can look forward to more innovative treatments that support their journey to recovery.