Thursday, June 29, 2017

Podiatry: The ten plus one most frequently asked questions

Less than one third of the world's population will require foot care. This relates to all ages and all stages of the life cycle. Contrary to popular belief this means the majority of human beings enjoy pain free feet lifelong. Those people in need of foot care will range from mild discomfort and need of foot toiletry to severe 'at risk' limbs with imminent amputation. Please note, the information contained here is for information only and does not constitute direct health care advice. In the event of foot problems then consult a podiatrist or your own physician.

What letters of qualifications should I look for when I want to find a podiatrist?
Qualifications vary from country to country but in Australia and New Zealand as all Western Countries where podiatry is a closed profession, it is illegal not to be registered with the Australasian Health Practitioner Regulation Agency (Podiatry Board of Australia). Most registered podiatrists belong to a professional association, and many are members of the Australasian Podiatry Association with the post nominals, M A Pod A (WA). Some practitioners include their academic qualifications such as Diploma of Podiatry (Dip Pod), Bachelor (BSc) or Master of Science (MSc), or Docorate (PhD). In the latter case they will use the pre-nominal "Doctor".

More information:
Australasian PodiatryCouncil
American Association of Podiatric Medicine
The College of Podiatry

What is the difference between a podiatrist and a chiropodist?
Lay people are fascinated with names and want to know "What is the difference between a podiatrist and a chiropodist?" In Australia both terms are used within the state acts which govern registration. As a term chiropody is less popular now and since podiatry means to treat feet, ‘podiatrist’ is the preferred term. The majority of foot problems involve skin or nails i.e. corns and acute infections. Systemic diseases, musculo -skeletal and repetitive injury are the common precursors. Not everyone however suffers sore feet and approximately one third of the population at any age or any stage requires services of foot physicians.

Do corns have roots?
Corns and callus are Nature's way of protecting skin surfaces subjected to complex shearing stress. Increased cell reproduction arises when the normal skin cells are damaged by friction. Over a bony prominence this causes skin to appear deeper as if growing from a core or root. Successful pain relief comes from excess skin reduction with a sharp scalpel. This is almost impossible to do safely for yourself and needs an expert to do this on your behalf. Hard skin will return within 28 days as the damaged cells are replaced. All external cause of friction must be removed.

Are verrucae catching, and can I go swimming if I have one?
The short answer is conditions apply, because at certain stages of the life of the wart (caused by a virus) it may be more contagious than others. It is prudent to take precautions. Viral infections are picked up by physical contact and can live outside the body especially in wet conditions e.g. changing room floors. Protecting the sole with rubber socks reduces the risk of cross infection and allows those with verruca to swim safely without contaminating others.

What causes Athlete's Foot and how can I prevent it?
Athlete's foot is a generic term for fungal infections of the foot. Fungi and yeasts thrive outside the body in warm, moist conditions such as showers or changing room floors. These flora are highly contagious and present symptoms such as: irritated patches of skin between the toes, which crack and peel. These may appear soggy and smell unpleasant and hence, the reference to the foot of an athlete. Discoloured nails and or scaling and itching skin are common symptoms. Good foot hygiene improves skin texture and many Symptoms disappear. In the event of an identified fungi or yeast then prescribed medicines are usually very effective.

Tell me why my feet hurt after standing on them all day?
The amount of energy required to stand still is greater than walking and running. People compromised by a lack of circulation moving through the lower extremity coupled by gravity, drawing body fluids downwards causes the ankles to swell. By the end of the day the gathered fluid makes feet bigger. Symptoms vary but many people complain of burning sensation relieved only by removing shoes and bathing and resting their feet.

My feet tend to get very sweaty in summer, what can I do?
There are more sweat glands per inch of our feet than anywhere else in the body. Sweating is perfectly natural and with good foot hygiene then even the wettest foot will present fewer problems. Increased temperatures around the feet cause by exercise or environmental increases perspiration rates. Fluid buildup in the presence of certain bacteria of accounts for foul smells. Going barefoot or wearing open-toed shoes or sports thongs encourages sweat evaporation and regular bathing in salt water removes of sweat breakdown and smelly feet. Avoid covered footwear and regular use good antiperspirants also help.

How can I get rid of hard skin?
Man-made fibres dry out the surface of the skin and when general friction increases local temperatures skin cell production is increased. Old dry cells become dry and are slow to separate from the new cell beneath. How we walk dictates callus patterns and depending on the type of stress over the area determined its appearance e.g. cracked skin on the heels. Skin cells respond instantly to moisturising creams. Complicated hard skin types may respond better to prescribed medication. Using a pumice stone to gently remove the hard skin is often made easier after a warm foot bath (46C0) for no more than 10 minutes.

Why do women suffer more foot problems than men?
More women visit the podiatrists‘surgery but that does not preclude men from having as many foot problems as their gender counterpart. They just do not go to their podiatrist. Many misguidedly blame the apparent sex difference on inappropriate footwear but there is little scientific evidence to support this premise. Epidemiological studies have shown that over the age of eighty, more men are likely to need podiatric care.

Are shoes the source of most foot problems?
The simple answer is no and provided the shoe fits comfortably and is appropriate to the activity It is put to then foot and shoe should be completely compatible. Not everyone complies. In studies women are more likely to wear shoes smaller than the physical dimension of their feet and a neat fit does feel more comfortable. Differences in nerve proprioception between the genders are thought to be a significant reason why women prefer tighter fitting shoes.

What is a foot orthotic?
Allopathic medicine is based on the concept there is an ideal model of normality and deviation from the norm may be corrected by replacing the missing piece. Corrective foot orthoses consist of foot platforms with balanced wedges made from different materials to effect different functions.

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