Common Foot Problems

Sunscreen Foot Cancer

London weather being predictably unpredictable can host a fabulous array of sunshine and tropical weather. As the heat, in one of the most overly populated cities in the world increases, layers can be left at home, umbrellas can be hidden under the stairs and sandals or flip flops can come out to play. Thats when cancer can strike! Or is it?

What is cancer?
Cancer is when the normal cells in your body change in an abnormal way which can be considered to be uncontrolled. When the amount of changed cells increase and feel like a lump, we can call this a tumour. Cancer, I feel is given a terrible stigma and for the right reasons too. When people are diagnosed most of the trauma is to the mind. Therefore it is essential that medical professionals explain clearly and with kind words just what this disease is. 

Why do people get skin cancer in foot?
Exposure to harmful rays from the sun is commonly true for most skin cancer however in the foot this is not entirely true. Other factors have been associated to skin cancer of the foot such as; chronic inflammation, viruses, chemical exposure, genetically inherited by the family gene pool and of course a significant exposure to unprotected harmful sun rays.

What types of cancer can be found on the foot?
There are three main types; basal carcinoma, squamous cell carcinoma and malignant melanoma. The first two tend to stay localised with low chances of spreading. Malignant melanomas are the potent skin cancers and requires early detection for survival. Malignant melanomas are notorious for being well disguised and can be commonly diagnosed as other pathologies.

Commonly, cancerous moles are associated to skin cancer. If you are concerned about your moles, here are a few things to look for...as easy as... ABCD.

A= asymmetry B= borders C= colour D= diameter.

Look out for uneven edges, spontaneous ulcers or sore, itchy skin that bleeds, lumps or bumps and unusual colour.

Why can DG Podiatrist help?
Podiatrists are specifically trained as lower limb specialists. The expert knowledge plays an essential role in detection as skin cancer of the foot is not like regular cancer in the body, as it appears in many forms. For this reason it is always advisable to find and book with DG if you have any areas of concern. After all, a cancer free world is a better world. 

Remember:
"Your skin doesn't stop at your ankles, use sunscreen down to your toes and enjoy the sun!"

Ingrown Toenail

Ingrown Toenail: "My toenail just doesn't take directions!"  "Ouch my toe!" Sound familiar? That pain in the top corner of your toe nail.

Ingrown toenails develop because of many reasons such as: ill fitting footwear, tight socks, injury, inherited and poorly cut toenails! Therefore, it is essential to learn to cut your toe nails properly. More often than not, toenails are cut awkwardly resulting in ingrown toenails. DG Podiatrist would be more than happy to show you the correct way for your feet.

Once ingrown, your toe can be very painful even in socks, shoes and even via on touch. Depending on how bad the condition is, the top corners of the toe can become red, sore, swollen and even exude pus.

Ingrown toenail treatment: The best treatment for ingrown toenail will be explained to you by DG Podiatrist on consultation. There is a conservative method in maintaining the nail and providing you with immediate pain relief. This method does not include surgery. DG will delicately loosen the nail spike which has ingrown into the skin with gentle precision. This is where the nail spike will be removed professionally. Routine treatment for your nails at intervals of six to eight weeks can achieve happy feet. 

Ingrown toenail surgery: Sometimes the ingrown toenail can be an on going problem. If you are prone to this condition, then ingrown toenail surgery is for you. This small procedure can provide you with permanent relief. No more painful toes! 

How is the ingrown toenail surgery done?

Primarily, the toe is numbed with the use of local anaesthetic. Once numbed you will not feel anything at all. The procedure consists of removing a thin section of the offending nail. Followed by a chemical called phenol that kills the area of your nail bed that stimulates nail growth. This part of the surgery is called Phenolisation. Your toe is then dressed and you ready to go.

You will be able to walk straight after the surgery but you are strongly recommended to wear loose fitting footwear or even flip flops. DG Podiatrist always offers her patients weekly checks up till full recovery, which is usually around 4-6weeks. Many clients have had miraculous results! This surgery really is a fantastic way to resolving these painful ingrown toenails.

So now that you know exactly how stubborn nails can be and what can be done about them, let DG Podiatrist take you that one step closer to having the best toenails.

* A wonderful comic strip, by talented http://theawkwardyeti.com/ingrown-nail/, to show you how a ingrown nail develops. 

Everything You Need To Know About Bunions

What are Bunions?

"Bunions", otherwise known as Hallux valgus, is when the big toe bends in a particular angle towards the second toe. This bending means the first metatarsal displaces medially towards the inline of the body and the proximal phalanx towards your second toe, therefore results in the bumpy bony appearance commonly seen on feet.  

What causes Bunions?

Rumour has it, it’s the shoes! But is it? There is truth that the long-term inappropriate shoes do contribute to the movement and displacement of the joint, but most often it is inherited along the family line. Other factors can include:

  • Foot injury.
  • Systemic conditions like diabetes, arthritis and flat feet.
  • Activities that place high pressure on that joint and loose joints.

Bunion conservative treatment/ Bunion surgery

Conservative treatments can include things like:

  • Pads and cushions.
  • Night splints.
  • Toe exercises.
  • Orthotics.
  • Pain relief medication.

Conservative treatments help manage the bunion and reduce pain. Surgery is usually left for chronic cases where conservative treatments are ineffective and the joint it self needs to be corrected. Post-surgery clients will be off their feet for 6 weeks.

The best shoes to wear when you have bunions are those with a very soft material - like soft leathers or suedes, the more they stretch, the better. It is also ideal to purchase shoes that are wide fitting and accommodate space for the bunion. If the bunion feels snug and tight, it’s best to try something wider. Try and wear a shoe that is supportive across the mid foot and arch. Laces or straps can also help with support! 

Diabetes UK - Putting Feet First

We understand how foot care can directly impact those who have diabetes, and that's why we strongly support the Putting Feet First campaign by Diabetes UK.

Up to 80 per cent of diabetes-related amputations in England each year are preventable. Diabetes UK is campaigning to Putting Feet First. Worldwide, diabetes-related complications result in the amputation of a lower limb every 30 seconds. It’s estimated that people living with diabetes are 30 times more likely to have an amputation compared to the general population.

Join Diabetes UK’s Putting Feet First campaign and together we can dramatically reduce the number of amputations suffered by people with diabetes. Know how to look after your feet and know what care to expect from the health service.

  • Attend your annual foot check. It’s as important as your retinal screening appointment.
  • Know your risk of developing foot problems and make sure that you are referred if necessary.
  • Make foot-care a part of your daily routine, just like managing your blood glucose and diet.
  • Be aware of any loss of sensation in your feet.
  • Ask someone to assess the feeling in your toes by doing the Touch the Toes test.
  • Avoid using corn-removing plasters or blades.
  • Keep useful numbers handy, and know who to contact at the first sign of problems with your feet.

Do you have diabetes? We offer a range of treatments that are tailored to help you maintain healthy feet. Call us today or email info@dgpodiatrist for more information.

Heel Pain

Your Heel is a fascinating part of your body. How so? The heel bone, also known as the calcaneus, has been considered, by many,  to be one of the strongest bones within the human body. It plays an essential role in walking, running, sports and even wearing high heels. Dance is another activity that has high impact. A classical indian form of dancing known as “khattak” and “bharata natyam” are known for their use of hitting their heel to the floor to the beat of the music.They do so effortlessly and truly amazing to watch. This is just one great example of how much force heels can handle.  The foot heel and foot arch has remarkable abilities to withstand substantial force from daily activities. When the foot touches the ground, the heel absorbs the impact whilst supporting your body weight. Since it works so hard to keep you up right, it’s understandable that sometimes over exertion can cause foot heel pain.

Types Of Heel Pain:

    •    Achilles Tendon Pain
    •    Heel Spur
    •    Heel Bursitis
    •    Heel Bony bumps
    •    Plantar Fasciitis (PF)
    •    Sever’s Disease
    •    Stress Fracture
    •    Chronic Heel Pad Inflammation
    •    Tarsal Tunnel Syndrome*

*All the common heels problems above can be found in more details in other blogs later to come this week.

Almost a third of people suffer from heel pain at some point in their life. Sore heels develop over a period of time. Commonly linked to wearing flat shoes and flip flops. Flat footwear stretches the connective tissue, known as the plantar fascia,  which inserts at the base of the heel and expands up the foot.  Here it splits into several sections to the top of the metatarsals. The metatarsals are bones that are positioned in the balls of your feet. Considering the calcaneus is the largest bone in the foot, it is easy to understand why it is most susceptible to damage. It does not necessarily require injury or a traumatic event but rather repetitive stress.

DG Podiatrist can assess and help you with treatment and preventative advice. One step at a time!

Foot Corns

Common foot problems like foot corns are usually seen on daily basis. Do you know what a foot corn is? Do you know how foot corns develop? Do you know how to remove them? You are not alone. Many do not know the science behind the existence of these common corns. Here's a secret, corns are localised areas of hard skin over bony prominences and pressure that occur with time. This may sound like a equation and it is! This is exactly what a foot corn is.

You may be thinking I have or have had hard skin before but it has never hurt like this so why now? Very good question. The sole of your feet, also known as the plantar aspect of the foot, is tougher than the upper skin. Corns can occur any where on the foot where pressure and friction remains constant. Footwear whch is small, tight and narrow are one of the common reasons behind why corns on feet occur in the first place. The best way to picture a corn is to visualise a witch's hat. The top end which is the spike is what penetrates into the skin, giving the illusion of walking on a stone.

Five Types Of  Corns On Feet;

  1. Hard corns:-This type being the most common corn on feet. They can vary in size and are usually found on larger bony prominence areas of the foot. It is of the norm for hard skin to be present in the area. Hard corns can be uncomfortable to walk on but are very easy to remove. With DG podiatric removal you will achieve immediate relief. The treatments are virtually pain-free.

  2. Soft corns:- Second most common corn from the five. Typically found in between the toes in where the skin is soft from sweat or poor drying. Due to the soft nature of the skin the corn can appear rubbery and white. Soft corns can be painful and require treatment immediately. DG Podiatrist uses gentle techniques to remove the corn by also using astringents to dry the skin for a thorough removal and prevention.

  3. Seed corns:- Least painful of all five types of corns. Can be found singularly or in a cluster. Extremely easy to remove and absolutely pain-free.

  4. Fibrous corn: Fibrous meaning tough and fibre like in nature of the skin. Fibrous corns require patience and gentle approach for a good thorough removal. DG Podiatrist uses unique and gentle techniques to provide ultimate comfort. Many clients are seen by DG for this care due to the nibble handed treatment.

  5. Vascular corns: As the name would suggest these corns have a good supply of blood. Therefore making it vascular corns easy to bleed. with careful  precision bleeding can be avoided. DG provides this careful touch to reduce the corn for desired comfort.

How to remove corns on feet? DG Podiatrist strongly advises clients to refrain from using medication corn pads as they cause more harm than good. These medicated pads damage the surrounding tissue and don't remove the spike of the corn, which is better known by many people as the root of the corn. Now that you know the science and nature of each type of foot corn, you will understand how professional podiatric care is essential for a thorough removal.

DG Podiatrist believes in using unique and gentle techniques at all time. DG understands that all feet are different and require tailored care for the ultimate pain-free removal. If you have corns, be treated and feel revived. Lets keep all types of corn harvest under control and achieve happy feet.

Heel Pain: Heel Bursitis

Let’s break down the word bursitis; you may be realising there’s a trend for pathologies ending with “-it is” meaning inflammation of that specific word. So the site in question this time is called a Bursa. When it becomes inflamed, we call it bursitis. You may have heard in the past referred to as policeman’s heel.

Bursae are fluid filled sacs that can be found around most large joints. For this common heel pain, as you’ve rightly predicted it is located in the ankle very close to the Achilles tendon.  This Achilles tendon connects the calf muscles to the heel bone known as the calcaneus. But why is there a bursa there? The bursa acts a lubricant that enables muscles and tendons to easily slide on bone. A heel bursa can be thought of as a cushion.

Cushions are comfortable so why does a heel bursa become painful? A heel bursa can become irritated from increased overload of activity. Generally this activity is repetitive in nature such as walking, running and jumping. Once irritated the bursa becomes inflamed. Now we have a case of heel bursitis.

Heel Bursitis can be deep or superficial depending on location. If the bursae is located between the Achilles tendon and the calcaneus bone, it would be considered as deep. This type of bursitis is known as sub-tendinous calcanea bursa. The superficial bursa would be positioned between the skin and Achilles tendon and is otherwise called subcutaneous calcanea bursa.

The symptoms associated to heel bursitis are redness, warmth and tenderness. Tip-toe standing is known to elicit the pain further more than general walking, running and jumping. Heel pain can be uncomfortable and disrupt your daily activities.

DG Podiatrist feels it is essential to thoroughly assess the ankle and heel. Once the assessment is complete, you will be given a set on manageable treatment plan targets to utilise in order to resolve the condition. The treatment plans will be explained in great depth.

Bunions – Hallux Valgus

Possibly one of the greatest known foot pathologies of all time. But why is that? Let us take a closer look into exactly what a Bunion is, who gets it and what you can do about it?

What are Bunions?

"Bunions", otherwise known as Hallux valgus, is when the big toe bends in a particular angle towards the second toe. This bending, means the first metatarsal displaces medially towards the inline of the body and the proximal phalanx towards your second toe, therefore results in the bumpy bony appearance commonly seen on feet.

What causes Bunions?

Rumour has it- Its the shoes! But is it? There is truth that the long term inappropriate shoes do contribute to the movement and displacement of the joint but most often it is inherited along the family line. Other factors can include;

  • Foot injury.
  • Systemic conditions like diabetes, arthritis and flat feet.
  • Activities that place high pressure on that joint and loose joints.

Women tend to develop bunions more than men. 

What are the effects of Bunions?

  • The obvious includes deformity of the forefoot. Sometimes depending on the severity- the second toe can become deformed (hammer toe).
  • The joint of the metatarsal and the big toe it self plays an important role in the walking cycle. When there's an imbalance the pressure shifts to the right. Therefore some people experience a hard skin/callus build up which can become increasingly uncomfortable. Corns are also commonly associated the this pathology on the second toe.
  • Painful/ Non-painful bump that can be relieved with good footwear and painkillers.
  • Red and swollen bump.
  • Formation of a Bursae/Bursitis.
  • Limited range of movement in your toe.
  • Difficulty in finding shoes that fit comfortably.

The different stages, of bunions/hallux valgus, can be mild to severe. 

Bunion treatment/ Bunion surgery

Conservative treatments can include things like;

  • Pads and cushions
  • Night splints
  • Toe exercises
  • Orthotics
  • ain relief medication

Bunion surgery is something worth considering if you are suffering poorly with the condition. There are many ways to correct the deformity and DG Podiatrist knows just the consultant podiatric surgeon, with over 25 years of experience, to perform it safely. Aftercare is crucial and requires commitment for full recovery. 

If you feel you have this, and would like to know the best options for yourself book with DG Podiatrist for happy feet.

Signs That Kids Have Foot Problems

Kids are the key to the future and every step can be a pleasurable thing. Sadly foot and ankle problems in children can occur and with subtle symptoms which allow them to go unnoticed. This makes it ten times more important to protect and nurture their young growing feet with regular check ups.

Signs for parents to watch for, by the American College of Foot and Ankle Surgeons highlights, the following five things;

1) The child does not want to show their feet.

Regular inspection by the parent/guardian and child can result in foot confidence. Sometimes when a child feels pain or notices something unusual in appearance their first instinct is to hide it, as most believe it will just go away. Several things to look for are callus or hard skin, redness, swelling in the corner of toenails and skin discolouration.

2) The child complains about pain.

Foot pain in children is never normal and should be queried. If after minor injury the pain lasts longer than a few days, this is a good indication to take the child for a thorough examination to DG Podiatrist.

3) The child is unable to keep up with their peers.

Kids are full of energy, that love to run around with their peers, to play games and enjoy sports. So when they start to complain about tired feet and leg muscles, this can be the result of dis-functioning feet. Fatigue is common in with flat feet. Your child may require insoles/orthotic to help correct the imbalance.  DG Podiatrist can go through assessments to determine the needs of individual children to provide them with necessary insole/orthotics.

4) The child often falls or trips.

Kids jump, run, dive and fall- agreed this is a common thing. But when the clumsiness because an reoccurring incident this should be examined. This can be a sign for things like balance problems, in-toeing and neuromuscular meaning nerves and muscle conditions.

5) The child may choose not to take part in activities they usually enjoy.

Most common foot problem is heel pain brought about by a condition called Sever's Disease. Sports that cause repetitive stress will induce this condition.

To help your children maintain ultimate foot health and prevent problems from developing get them check out. Review their footwear with DG Podiatrist to ensure they have the best for their feet. Kids need our guidance to grow into stars they want to be.

Heel Pain: Tarsal Tunnel Syndrome

Tarsal Tunnel Syndrome is a common heel pain typically found in active adults but can occur in children too. The tarsal tunnel is a space found near the ankle bone. Before we continue it is helpful to take a close look at the anatomy of the ankle and just how this pathology affects the heel.

Just over the tarsal tunnel space is a thick ligament, flexor reticulum, that covers and protects the other important structures within the ankle such as arteries, veins, tendons and nerve. The main nerve that sits there is called the posterior tibial nerve. Nerves protect the foot by sending your brain messages on touch and pressure. When the pressure exceeds the safety limit this is when you experience pain. When the tarsal tunnel narrows, this compresses the posterior tibial nerve, this elicits pain.

So if the nerve gets compressed why doesn't the whole foot ache? Here is when the foot gets even more fascinating. Each part of your foot is stimulated by an alternative nerve.  Looking at the diagram below it is easy to see just how much of the nerves affect the foot. The posterior tibial nerve sits in the pink section of the calcanea nerve. This is why you only experience pain in the heel. 

The common causes for tarsal tunnel syndrome are:

  • Systemic problems like forms of arthritis and diabetes.
  • Enlarged structures that can cause compression like cysts, ganglions, vericose veins and bone spurs.
  • Trauma to the heel which causes inflammation.
  • Flat feet.

Symptoms of Tarsal Tunnel Syndrome:

  • Pain that can be described as shooting pain in the heel. 
  • Numbness in the heel.
  • Tingling, burning pain localised in the heel. 
  • Worse in the night.
  • Aggravated by prolonged weight bearing (standing)
  • Inclination walking.
  • The pain can radiate into the calf.

DG Podiatrist aims to assess the ankle and will use techniques to determine the diagnosis. Once detected can advise you on the necessary steps to help eliminate the pain. Ice therapy is strongly advised in the meanwhile to help reduce inflammation in the area. Twenty minutes of elevated ice on the ankle will prove helpful. Remove the ice and leave for forty minutes prior to reapplication of ice.