The skills of a Podiatrist
Basic foot care
In their undergraduate training, Podiatrists learn to use a variety of modalities including physical therapy and diagnostic procedures such as X-rays.
Podiatrists are highly trained in the diagnosis and treatment of both common and rare skin and nail pathologies of the feet. Podiatrists play an important role in maintaining the mobility of many elderly and disabled people, and others. This is achieved through the ongoing monitoring of foot health, in particular of those with vascular problems such as diabetes. Podiatrists are recognised as important members of the health care team in preventing and managing lower limb complications for those living with diabetes.
A basic area of foot care undertaken by Podiatrists is the treatment of various acute and chronic nail conditions, the treatment of which depends on the pathology. Podiatrists have specific instrumentation for painless and effective treatment of these conditions. For example, the surgical correction of chronically ingrown toe nails under local anaesthesia is a common podiatric procedure.
Treatment and prevention of corns, calluses and warts are also common podiatric procedures.
Systemic Diseases
Systemic diseases such as arthritis affect the joints in the foot, therefore Podiatrists monitor feet for any degenerative changes. The effects of these diseases and the medications often used in their treatment can predispose sufferers to circulatory pathology and/or peripheral neuropathies. This can result in nail and skin lesions, deformity of the feet and the increased incidence of ulceration.
The multiplicity of possible causes and complications demands a comprehensive method of examination in order to establish a sound diagnosis as a basis of treatment. The Podiatrist’s role entails much more than merely attaching a label to a condition. It often includes the monitoring of circulation and neurological status, using methods such as Doppler assessment and motor and sensory tests.
The manufacture of palliative and functional orthoses also aids in the prevention and treatment of pressure lesions or deformities, enabling individuals to maintain a more normal, active lifestyle.
Children's Feet
The child’s foot is not just a small-scale model of an adult foot. It’s shape is not finally determined until growth ceases at the end of the second decade of life. Podiatrists are trained to diagnose and treat children’s foot problems by careful examination of the foot and lower limb, where required.
Advice for the prevention or reduction of foot deformity that often develops later in adult life may involve the provision of appropriate information on footwear, treatment by splinting, advice on exercises and/or orthotic control of the feet. Podiatrists also treat common, chronic and acute problems of children’s feet such as in-toeing, out-toeing osteochondrosis, fasciitis and pes planus.
Occupational Podiatry
Some occupations are more prone than others to foot problems which can arise as the result of standing on hard surfaces for long periods. Hairdressers, factory workers and nurses are examples of those from professions likely to develop long-term problems unless prevention is taken. Podiatrists seek to address some of the issues responsible and can advise on occupational foot health safety. This can sometimes involve the prescription of orthoses or surgical advice.
Sports Medicine
Any sport that involves walking, running, standing or jumping, places higher physical demands on our body than normal day-to-day activities. Injuries to the foot and lower limb make up a large proportion of sporting injuries. Podiatrists are trained to examine and diagnose the foot and lower limb, have a good understanding and knowledge of the biomechanics of athletic movement and can recommend appropriate footwear, training regiments and if needed, orthotic devices to fit into the sports shoe. Common sporting injuries treated by Podiatrists include plantar fasciitis, Achilles tendonitis, stress fractures, ankle sprains and shin or knee pain.
Surgery
Podiatrists are qualified to perform both nail and cutaneous surgery.
Biomechanics
In treating chronic foot pain and evaluating specific needs of patients, the Podiatrist will often assess the anatomy and function of the foot and lower limb.
Orthoses
Orthoses are custom-made shoe inserts made specifically to reduce foot pathology. As already outlined, the prescription and manufacture of orthoses is an important part of podiatric practice. The Podiatrist is trained in the manufacturing techniques for a diversity of shoe inserts. Most inserts fall into two main categories – functional orthoses or palliative orthoses.
- Functional orthoses are prescribed after the biomechanical assessment and casting of the feet. They are made by various techniques to align the structure of the foot in it’s most functionally efficient position. The orthotic, moulded from the cast, is designed to stabilise the foot and to prevent it from moving into an unbalanced position while walking or running.
- Palliative orthoses are designed specifically to reduce pressure from painful or ulcerated areas of the foot. Palliative orthoses are often used for the treatment of severely deformed feet with a limited range of motion and mobility. They are often an appropriate choice for elderly people with significant soft-tissue atrophy and/or circulatory disease.