Podiatrist, Author at Foot And Ankle

Foot and Knee Problems? It Might be Custom Orthotics that You Need

Custom orthotics are shoe inserts specially designed for people experiencing severe foot problems. Their unique design is based on the result of the assessment of the patient’s gait, anatomy, and the type of pain being experienced.

Custom foot orthotics work by correcting the abnormal movement and position of foot and ankle joints. Furthermore, they help prevent foot problems from affecting the rest of the person’s body.

Most people with foot and ankle problems will benefit from custom orthotics.

So, what type of orthotics will work best for you?

And…

How do you know if you need custom orthotics?

custom orthotics

Image by Hans Braxmeier from Pixabay

Custom orthotics are effective for people suffering from the common health conditions such as:

People with diabetes often experience a loss of feeling in their feet due to poor circulation.
Arthritis can cause severe deformities in the foot and usually affects the joints.
Metatarsalgia is a painful foot ailment that affects our foot’s bones, joints and ball.
Plantar fasciitis is a painful inflammation that affects the sole. Many people who have this foot problem experience pain first thing in the morning.
Achilles tendinitis
Shin splints
Bunions and
Knee pain

The 3 Types of Orthotics

According to the Harvard Medical School website, there are currently 3 types of foot orthotics and they are the:

Shop front-generated
Over the counter (OTC) or Off-the-shelf and
Professional custom orthotics

Shop front-generated orthotics

These orthotic devices are ready to wear shoe inserts recommended to you based on a non-health practitioner’s recommendation.

Over the counter (OTC) orthotics

Also known as off-the-shelf shoe inserts, these are widely available and ready to wear orthotics recommended to you based on the size of your foot.

Take note that both Shop-front generated and OTC orthotics might need replacement more often as the materials used are prone to wear and tear. Also, because they are not custom made or prescribed by a podiatrist who has diagnosed a condition they cannot work as well as custom or prescription orthotics.

Professional custom orthotics

Acquiring a professional custom orthotic involves an appointment with a podiatrist or podiatric surgeon. who will perform a thorough assessment of your medical history.

Moreover, the assessment includes checking your activity levels, the location frequency and type of pain you may have and then a comprehensive examination of your foot and leg movement and function standing and walking.

After the diagnosis, the podiatrist will prescribe an orthotic specifically for you and your foot problem. Your prescription will involve selecting the correction of a number of different parts of the foot.

The most accurate way to record the exact shape, size and alignment of your foot is by using a laser scanner.

The 2 types of Custom Foot Orthotics

Custom orthotics are primarily the Functional and the Accommodative type.

Functional Orthotics correct the loading patterns of your foot and thus improve efficiency, help reduce pain and also reduce the risk of reinjury.

For heel pain, an orthotic can be designed to regulate the load on the plantar fascia.
For arthritis, an orthotic can be designed to minimise pressure within the joints.

Accommodative Orthotics prevent any form of pressure from causing bruises on the skin’s surface. This is quite helpful for diabetic patients.

Which type of orthotic is right for you?

Over the counter and kiosk orthotics

OTC shoe inserts and Shop-front orthotics can work well for people who:

are of average height, weight, foot type
suffer from general problems such as heel pain

Custom foot orthotics

People with specific needs or suffering from critical conditions such as diabetes and severe flat feet will need custom orthotics and since they will be under the care of podiatrists.

Some clinics that specialise in foot and ankle care usually include custom orthotics as part of a treatment plan.

In a treatment plan, the podiatrist prepares a written document that will describe how they and the patient will work together towards achieving a goal. In this case, the goal is to get the patient back on their feet to enjoy a pain-free, active lifestyle.

Should you wear orthotics all the time?

When and how long should you wear your orthotics will depend on your podiatrist’s advice. But in general, you are allowed to wear your custom shoe inserts whenever you wear your shoes for walking, running or when you leave your house.

custom orthotics

The Takeaway on Custom Orthotics

Even if you don’t experience foot pain, instabilities and imbalances of your feet’s muscles, tendons, ligaments and bones can contribute to other aches and pains of your knees, hips and back.

Remember, your feet carry your body’s weight and how your body feels can affect the way you stand, walk and run.

Custom orthotics can treat any misalignment of your foot and ankle and thus help prevent ache and pain in other areas of your body.

Experiencing hip and back pain? Alignment problems in your feet could be the culprit. Set an appointment with Adelaide Foot and Ankle today so we can check for potential foot problems you might have overlooked.

Ingrown Toenails: Causes, Symptoms and Treatment

By Podiatrist - Ingrown toenails

Ingrown toenails or onychocryptosis is the redness and swelling of a person’s big toe. It occurs when the sides of the nail grow into the skin.

As the sides or corners of the nails continue to grow and curl downward, they pierce the soft tissues of the flesh around the nails. Thus, bringing pain and discomfort to our feet.

Two of the most common causes of ingrown are the incorrect trimming of toenails and wearing ill-fitting footwear.

You can treat ingrown toenails with home remedies as long as the condition is in the early stage. Otherwise, if there is already an infection or if you have diabetes or vascular disease (poor circulation) — you should contact your podiatrist as soon as possible.

Read on to know more about ingrown toenail causes, symptoms, treatment and overall foot care.

How to Know the Symptoms, Causes and Treatment of Ingrown Toenail

onychocryptosis or ingrown toenail

Image source: Wikipedia

Signs and Symptoms of Ingrown Toenails

The difference between ingrown toenails and other foot problems.

Foot fungus, such as Athlete’s Foot, can cause discolouration and malformation of the toenails. You may notice the presence of white spots on the nails or yellowish debris below your toenail. Sometimes, a toenail appears irregular in shape and chalky.
Psoriasis and Eczema are skin disorders that can disfigure your nails. Often, the nails begin to peel or split. Also, your toenail may start to ripple or become thicker.
Your toenails can turn black due to trauma, Melanoma or Skin Cancer.
Onychomycosis is a nail fungal infection that can cause abnormal toenail growth, which can become ingrown.

The early stage of ingrown toenail

The surrounding skin of the toenail becomes reddened, hardened, swollen and painful.
The swollen part may feel warm to the touch.
Pressure applied to the toe causes pain. Children limping can be a sign of ingrown toenails as they try to avoid putting pressure on the affected toes.

The later stage

Overgrowth of skin and tissue appear around the nail.
Yellow-coloured drainage starts to appear. This is not yet an infection but it’s our body’s response to the trauma or irritation as nails grow deeper and pierce the soft tissues under the skin.

The development of infection

The swelling and redness worsen.
The yellowish drainage now contains pus.
Although not common, fever may develop due to the infection.

Causes

Incorrect trimming

One of the most common causes of ingrown in toenails is cutting a nail too short and cutting the corners to curve in. This incorrect way of trimming encourages the edge of the nails to grow deeper into the skin.

proper toenail cutting to avoid ingrown toenails

Image source: Orthoinfo

The proper way of trimming the nails is to cut straight across and just enough not to expose the nail bed.

Foot Trauma

Frequent jamming or stubbing of the toes and accidental dropping of something on the toes can cause in the development of ingrown.

Ill-fitting footwear

Another common cause of ingrown toenails is wearing ill-fitting shoes. Repeated pressure brought about by activities such as soccer, running or ballet while wearing ill-fitting shoes can cause ingrown in the toes to develop.

Young adults and teens who participate in sports or ballet classes are prone to ingrown since they experience growth spurts and body changes at some point in their lives. They outgrow their shoes quickly without noticing it and so they keep on wearing ill-fitting footwear for a while.

Pedicure

There’s nothing wrong with having a pedicure. Just be cautious about how the nail technician trims your toenails. Keep in mind that incorrect trimming leads to the development of ingrown in the toenails.

Genetic Predisposition

The trait of developing toenail ingrown is passed on from parents and on to their children.

Photo by Min An from Pexels

Treatment

The early stages of onychocryptosis can be treated at home. And sometimes, you just need the nails to grow out. Anyway, here are…

Common Non-surgical Treatment or Home Remedies

Always wear comfortable socks and shoes

Remember, the leading cause of ingrown on the toes is wearing tight-fitting shoes and socks. Therefore, avoid shoes and socks that are too tight to prevent crowding the toes. Instead, wear shoes that fit but also leaves adequate space for your toes.

Soak your affected toes in warm water

Soaking your affected toes in warm water can help ease the pain and reduce the swelling. Do this 3 times a day with a duration of 20 minutes. You can add Castile soap and Epsom salt in the water for an extra relief.

Apply antiseptic ointments

After 20 minutes of soaking in warm water, apply an antiseptic ointment and then bandage the affected area. Podiatrist recommend antiseptic ointments such as Betadine or Savlon n

The following are common home remedies but they come with disadvantages.

Using dental floss or cotton under the edge of the nails

This is a home remedy suggested by the Mayo Clinic. However, other medical groups do not agree with this advice since it can only cause more pain and more bacteria to thrive into the infected area.

Over-the-counter pain relievers and oral antibiotics

Over-the-counter pain relievers may work but they come with side effects such as diarrhoea, upset stomach and abdominal pain. Likewise, there is no proof that oral antibiotics can improve the condition.

Surgical Treatment

Here are the reasons why your toes need medical treatment from a podiatric surgeon or podiatrist.

If home remedies didn’t work after a week and signs of infection begin to appear.
If you have heart or vascular disease, diabetes, suffer from repeated ingrown toenails and a long history of tobacco abuse.

What happens if infected ingrown toenails are left untreated?

A superficial infection called Paronychia can advance into a deeper infection called Cellulitis or tissue infection, which can proceed in a much deeper problem — Osteomyelitis or bone infection.

Seek medical help even if your ingrown toenails are in the early stages

Don’t wait for your foot condition to complicate into a serious infection. Make an appointment at Adelaide Foot and Ankle before it’s too late.

Orthotics and Shoe Inserts: What you need to know about these foot treatment devices

By Podiatrist - Bunions,Diabetes and poor circulation (vascular disease),Flat Feet,Foot and ankle pain and instability,Hammer toes,Heel spurs & plantar fasciitis,Orthotics

Orthotics are medical devices that patients wear inside their shoes. A podiatrist often prescribes foot orthotics or foot orthoses to patients who have problems with how they stand, walk and run.

Orthotic devices are also used to treat patients with foot pain caused by disorders such as arthritis, bursitis, plantar fasciitis and diabetes.

Most people have foot and leg issues and you could be one of them. One of the best remedies is the use of orthotics and shoe inserts.

Read on to know more about how foot and leg problems are treated with orthotic therapy.

What orthotics and shoe inserts are and how they are used to relieve pain of the foot, leg and back.

Orthotics definition

In simplest terms, orthotics are medical devices designed to treat foot, leg and back problems. The best way to make prescription orthotics is from a laser scan of the feet and either computer-aided design and milling or 3 D printing.

Generally, the main purpose of orthotic devices is to promote proper alignment of your foot and ankle when you’re standing, walking, or running. You will use them as shoe inserts and they are often referred to as orthotics inserts and orthotics insoles.

Differences between shoe inserts and prescription custom orthotics

Shoe inserts are over-the-counter medical devices that provide support and cushion for your foot. They are made from different kinds of materials such as foam, gel or plastic.

Shoe inserts are not sold as one-size-fits-all products so you can easily get a pair that would perfectly fit your shoes.

However, they are not prescription or custom-made so the design won’t match with your feet correctly. Shoe inserts may provide cushion and support but they don’t necessarily solve an individual’s foot problem.

Common Types of Shoe Inserts

orthotics fabrication

Foot cushions are a solution to those situations where you feel your shoes are rubbing against your toes or heel. You can use them as barriers between you and your shoe. Foot cushions come in various shapes and sizes.

Heel liners, also known as heel cups or heel pads, are extra cushions for your heels. This type of shoe inserts is especially helpful if you are experiencing heel pain due to the thinning of your heels’ natural fat pads; this condition often occurs in older people.

Insoles are for extra cushion and you can easily slip them into your shoes. They are usually made of foam, gel or plastic.

Arch supports often have that ”bumped up” appearance that keeps your foot in its natural arch position. They are designed to treat patients who have either high arches (pes cavus) or low arches (flat feet).

Custom orthotics are much different from shoe inserts since the former is prescription-based, high-quality medical devices. They are custom-made using a laser scan of your actual foot so they are designed to fit your feet perfectly.

As a result, Custom orthotics have a higher chance of correcting biomechanical foot problems like the misalignment of the foot and ankle.

Misalignment of the foot and ankle comes in many forms and they are:

Pronation
Overpronation
Supination and
Over supination

The 2 Types of Orthotic Devices:

Accommodative orthotics are made from soft materials to provide extra cushioning and support. They are designed to treat uncomfortable medical conditions such as painful calluses on the foot’s bottom and diabetic foot ulcers.

Functional orthotics are made from semi-rigid materials such as plastics and graphite. They are used for the treatment of foot pain caused by an abnormal motion of the foot that can result in injuries such as tendonitis and shin splints.

Uses of Orthotics

Here are some of the common medical conditions that your podiatrist may require the use of orthotics:

Plantar fasciitis is one of the many known causes of heel pain. Podiatrists will often recommend orthotic devices for foot and heel support.

Injuries. Patients who are experiencing trauma to their ankles and feet sometimes need additional support.

High arches. Arches that are too high can cause stress to muscles and often lead to conditions such as plantar fasciitis, ankle sprains, knee pain and shin splints.

Heel spurs are conditions where too much growth of bones on the bottom of the foot or at the back of the heel. Patients with heel spurs may need support from prescription foot orthoses.

Hammertoes are often the side effect of bunions on the big toes, which also causes pain on the second toe and deformations on the ball of the foot. Hammertoes require the use of orthotic devices for foot support and to prevent further worsening of the condition.

Flat feet can cause foot, ankle, heel and back pain. Patients with flat feet need support from orthotic devices to promote the correct positioning of the foot.

Diabetes. Patients with diabetes sometimes experience diabetic neuropathy. It is a condition where the patients lose the sensation in their foot. As a result, the foot experiences excessive stress and pressure, which often leads to foot ulcers.

Bursitis is a pain and discomfort caused by the inflammation of fluid-filled sacs on the heels and toes. This discomfort can be treated using orthotic devices that have heel and arch support.

Bunions are painful foot deformities or bumps at the base of the great toes. The use of wide toe box orthotics can help lessen the pressure on the great toe.

Back pain is often due to poor positioning of your feet like arches that roll inward. Similarly, the lack of cushioning on the foot may also cause back pain.

Arthritis. Poor foot positioning, osteoarthritis and rheumatoid arthritis cause discomfort in your feet that only orthotics can help by promoting proper alignment of the feet and ankle.

What is a podiatrist?

A podiatrist is a registered healthcare professional trained to diagnose and treat conditions of the foot and ankle. A very small number of podiatrists have done 6 years of additional training to become a podiatric surgeon and registered specialists. Podiatric surgeons have the expertise to correct foot and ankle problems in addition to providing medical management.

The services of a podiatrist will often include a complete assessment of the biomechanical problems of the lower limb and analysis of gait.

When to call a podiatrist?

Foot and ankle care is essential because your feet are ‘shock absorbers’ as you move or get around. Your feet have complex bone structures that are instrumental for your well-being and overall health, thus they need expert care.

Orthotic therapy is beneficial for athletes not only for treating sports injuries but to greatly enhance their performance.

Let us take good care of your foot and ankle!

Whether you have foot issues or want to enhance your overall performance in sports, we at Adelaide Foot and Ankle can help you in getting your feet back to being active again. Contact us now to make an appointment.

Topographical Anatomy of the Foot and Ankle Lateral Aspect and Nerves of the Foot and Ankle

By Podiatrist - Videos

As a podiatrist, it is very important to accurately identify the anatomy of the foot and ankle. As a podiatrist in Adelaide and a podiatric surgeon, Dr. Rob Hermann demonstrates a technique used to identify the lateral anatomy of the foot and ankle. The nerves of the foot and ankle are also identified.

Using these methods can greatly assist in identifying nerve entrapment, treatment with orthotics, the administration of steroid injections and surgical management of the foot and ankle.

This information is useful in a podiatry clinic and for any clinician who manages foot and ankle conditions.

Watch a related video.

The Impact of Ill-Fitting Shoes in Children

By Podiatrist - Children's Foot Problems

According to a study, 65% of children wear ill-fitting shoes. Unknowingly, your kid could be one of them. Indeed, there are potentially serious effects of ill-fitting shoes in children; not only to their feet but also to their physiological and mental growth.

Several factors such as age, gender, body mass index (BMI) and physical activity influence a child’s foot development. Merely wearing the wrong type of shoes or shoe size may likely cause short term as well as long term health risks for your kids.

impact of ill-fitting shoes in children

As a word of wisdom says, good shoes take you to good places. True enough, a good pair of shoes will not only get kids to wonderful places but protect children’s feet from getting injuries against different ground textures and temperatures.

If you are unsure whether or not your child is wearing shoes that fit properly, here is a guide you can follow the next time you’re buying shoes for your little one.

How to Get the Right Shoe Type Size for Children

For infants

Until an infant learns to walk, all they need are soft, warm booties or socks.
Introducing your baby early to tight crib shoes may only hinder their feet to stretch, breathe and feel different kinds of surfaces vital for sensory development.

ill-fitting shoes in children

For toddlers

When indoors, it is ideal for toddlers to go barefoot to strengthen the muscles around their ankles and develop arches. Just make sure the ground is always free from hazardous objects that a child may accidentally step upon.
Young children toddling outdoors may wear lightweight child shoes that have flexible and soft soles to encourage natural foot movement.

For children 4 years old and above

choosing well fitting shoes in children

Opt to shop for shoes at the end of the day

Various morning activities make your child’s feet expand by afternoon. This enables you to choose a shoe size that will fit the feet in its largest possible state.

Choose natural shoe materials

Leather, suede and canvas are examples of breathable shoe materials. When these are combined with mesh, it permits air circulation allowing your child’s foot to stay cool and dry.

Carefully assess the overall shoe fit

While your child is trying the shoes on, check the length, width, height and room for the toes, if everything fits comfortably.

A good shoe fit should be snug in the midfoot and heel part.

On the other hand, the toes must have plenty of room. Children should be able to wiggle their toes. Hence, it is important to consider a wide toe box in choosing the right type of kids’ shoes.
As a general rule, always ensure a half-inch clearance between the front end of the shoe and the outermost tip of your child’s toes.

Check your child’s foot length every 3-6 months

Every kid grows their feet at their own rate. So it is best to regularly measure the length of your child’s growing feet and frequently inspect for any sign your child might already have a snug or tight shoes like skin irritation.

7 Adverse Effects of Ill-fitting Shoes in Children

1. Minor Foot Ailments

Wearing shoes too tight for long periods of time may give your child foot problems such as reddened skin, blisters, cuts and sore spots.

2. Ingrown Toenails

Footwear that puts too much pressure on the corners of the toes makes the toenails grow into the soft flesh. This, in turn, may result in pain, swelling and infection.

3. Foot Deformities

If a child wears ill-fitting shoes and frequently rubs feet against neither breathable nor bendable footwear materials, it may progressively cause hammertoes, calluses, corns and bunions.

ill-fitting shoes in kids

4. Falls

Poorly-fitting shoes that are either too loose, too snug and without secure closure may affect children to trip often and fall down.

5. Arthritis

Prolonged use of ill-fitting shoes that don’t provide proper support may increase the risk of developing arthritis or joint pain in hips, knees, ankles and feet later in life.

6. Nerve Damage

Ill-fitting shoes may stress the foot repetitively and put extra pressure on the nerves resulting in nerve damage. Signs of nerve damage involve sensations such as numbness, tingling, muscle weakness and unusual pain.

7. Anxiety

Suffering from foot malformation, discomfort, pain and frequent fall in wearing ill-fitting shoes may cause an individual to become anxious. This may lead to poor self-esteem and affects your child’s quality of life.

ill fitting shoes effects

The Takeaway about Ill-Fitting Shoes in Children

The side effects of ill-fitting shoes in children may have short to long term physical as well as mental implications. As a parent, it is your responsibility to properly choose the type and size of footwear fit for your child. You can do that by making use of the tips mentioned above and avoid your own child from developing foot problems and underlying health risks.

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