Core Podiatry has Changed
When at college in the mid-seventies there was a general understanding that we all were expected to provide a ‘full-treatment’ – FTx. First of all the FTx implied managing nails and hard skin, apply a cornucopia of padding, whichever fitted best to the needs of the patient and the properties of foam, felt, fleece or foam-o-felt. Appliances (not orthoses in the seventies) became the pinnacle of our prescribing and manufacturing skills. Biomechanics was not a term known to most British podiatrists. Local anaesthetics were in their infancy.
Cartilage Damage in Hallux Valgus
While the observation of cartilage damage often confounds clinicians on how patients manage such extensive cartilage damage this paper visits the real reason behind joint pain.
Tarsal Tunnel Pain
I want to introduce you to the condition called tarsal tunnel syndrome as a cause of heel pain but with the distinctive quality that the pain burns. The second feature that gives the condition away is that feeling of fullness, a sort of exploding sensation when exercising worsening with standing walking or running. Sometimes this type of problem pain is called referred. This means that the source of pain and location may not match. The pain may be in front of the foot but is related to the structures in the hind part of the foot.
More About Heel Problems
The most common types of heel pain problems arise from general overuse or repetitive heel pad strain but heel pain is complex and if left can resist treatment. In this article, there are four key subjects that you need to know about. The first relates to children while the other conditions are adult related. There are conditions such as rheumatoid arthritis, gout and ankylosing spondylitis that may affect the heel as well as rarer conditions and of course fractures. If the pain does not subside with self-help remedies recommended after several weeks, then seek professional medical help from a podiatrist or medical practitioner.
Biomechanics and the foot orthosis
In the USA, from the sixties, the earlier designs were based around a popular subject called ‘biomechanics’. This was a pseudo term but became a significant part of the podiatric medicine degree course in the USA. Much of this pseudo-science involved measurements with protractors (tractographs) and in build error ‘eyesight’ assessment which led to assumptions with a predilection for the concept of wedging. The foot orthosis (F.O.), as it was called, tried to separate itself from the older insole and appliance. A google search today will still confuse the terms.
First Use of Corticosteroids by UK Podiatrists
There has been no previous podiatric publication regarding the use of local corticosteroids in the UK; indeed, in the USA podiatric literature studies have often been conducted empirically by retrospective analysis. It was decided to look at the range of foot pathology routinely treated with local corticosteroids to establish the clinical effectiveness of two preparations. Local glucocorticoid action is a common method used to treat inflammatory pain and one that is well recognized in clinical practice the world over.
A career in Podiatric Medicine
Most podiatrists are only too happy to speak to school leavers and students about the profession of podiatry. Contact the practice and ask if you can attend a clinic
Emergency in a Podiatry Setting
Alison’s detailed description provides an accurate timeline with considered actions and thoughts before, during, and after. It covers what we see as an anaphylactic emergency – that slow progressive change then wham-bam! In publishing this scenario, I dug out a case from 1999 that, at the time, I did nothing – maybe I was too embarrassed to admit my event, doubtless because, at the time, the drugs I had access to office were not the norm for podiatrists. We should all follow Alison’s approach to many such events which offer objective reflection.
Which Bones are Most at Risk from Fracture?
When my wife broke a bone in her foot back in October 2021, no one was more surprised than me. During my career, I have been interested in two facts. How people walk on their feet for so long without knowing they have broken a bone. Secondly, the methods we use to make such an assessment can fail, or the diagnosis can be missed. I wanted to introduces broken bones into the discussion about foot health as part of my ongoing pain series. Officially we all know breaks as fractures. Fractures, by dictionary definition (Little Oxford dictionary, 2002), are cracks or breaks which serves my purpose well. A quick check on Wiki and the definition has not changed but our views have.
Complex Pain as a Syndrome
Everyone knows about pain – it hurts, but what if that pain does not subside, or pain medication fail. In this article, I will introduce you to a pain known as the ‘sympathetic pain syndrome’.
Pain arises because of insult or injury. A process known as inflammation kicks off, and clinicians recognise redness and swelling as part of the so-called cardinal signs.