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Extracorporeal Shock Wave Therapy

Woodlands Podiatry and Glengarry Podiatry is pleased to introduce a new treatment in the management of chronic soft tissue injuries of the foot and lower leg know as Extracorporeal Shock Wave Therapy. Chronic inflammatory conditions of the lower limb can reduce your mobility. ESWT can effectively be used to treat lower limb conditions including:  
  • Plantar Fasciitis/Heel Spur Pain Syndrome
  • Achilles Tendinopathies
  • Shin Splints
  • Patella Tendonitis/Jumpers Knee
  Extracorporeal Shock Wave Therapy, or ESWT, was originally developed and used in the treatment of kidney stones sending high energy sound wave into the body to break up the stones. New technology has been developed to deliver specific high energy shock waves through a specalised probe to specific target area of the body which can be used to treat heel pain or plantar fasciitis.   ESWT increases blood flow and improves healing by triggering and activating cellular events(1), and showing clinically significant improvements in 78.38% in Achilles tendon pathology(2) and 82% success when combined with other treatment modalities (3), and significantly improves plantar heel pain commonly know as heel spur syndrome or plantar fasciitis(4, 5, 6, and 7).   Patients presenting for ESWT generally require 3 treatment sessions spaced over 3-4 weeks, although patients may achieve pain relief after one treatment. ESWT is a safe and effective pain management technique, especially when used in conjunction with appropriate stretching and muscle strengthening. Please call Woodlands or Glengarry Podiatry for an appointment so that we can help you further.   1. Int J Surg. 2015 Nov 23. Cristina d’Agostino M, et al. 2. J Foot Ankle Surg 2011, 50(3):315-9. Saxena A et al. 3. American Journal of Sports Medicine 2009, Volume 37, No. 3, pp. 463-471 Rompe et al. 4. Clin Orthop Relat Res. 2013 June 28. Aqil et al. 5. Arch Phys Med Rehabil. July 2012. Chang KV et al. 6. Foot Ankle Int. 2010 May;31(5):391-7. Ibrahim et al. 7. Am J Sports Med. 2008 Nov;36(11):2100-9. Gerdesmeyer L et al.

Cracked Heels

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A common question I get asked as a podiatrist is “What is the best way to stop cracked heels?”  especially towards the end of summer, when cracked and sore heels present more frequently.

The picture on the top shows a more severe case of extended thong use in a dry arid Australian climate, which we frequently see and treat at both Woodlands Podiatry and Glengarry Podiatry.

The following are some recommendations that will help reduce the problem.

  1. Foot soaks for 5-10 minutes to soften the skin in warm water.
  2. Use a pumice stone or file to loosen dead layers of skin (Do not use blades or razors)
  3. Apply cream containing 15-25% urea due to it’s water retentive properties.
  4. Apply small quantities of cream after showering.
  5. Apply cream more frequently in arid climates or when using open footwear.

Try the above treatment 2-3 times per week for two weeks and if there is no improvement in two weeks please make an appointment.

If you are a diabetic, present with poor circulation or have poor healing, please consult with your Podiatrist before undertaking the above management.  Please do not feel embarrassed, we can effectively and safely remove hard skin making you feel and look your best.


Do Children Need Orthotics?

Four babies learning to walk
As a parent you want the best for your children and early medical intervention often produces the best outcomes but do children need orthotics?   Orthotics or shoe inserts are specifically designed to alter gait and re-align foot posture. Herein lays the problem, children frequently present with flat feet. Please note the above picture, which shows that all the children who are weight bearing, appear flat footed!   So do flat feet need early treatment or are they something children simply ‘grow out of’? Treatment should not be automatic but depends on a number of factors including age, severity and type of problem and whether the child presents with pain. Three broad categories are normally applied at both Woodlands and Glengarry Podiatry, leave alone, treat, or ‘wait and watch’, but if pain presents treatment is normally offered.   What should you take home as a parent?
  • Children do naturally have flat feet.
  • Children should not automatically require orthotics.
  • Treatment and management may include, “leave alone, treat, or wait and watch.”
  • Research does not prove or disprove the use of orthotics in the correction of flat feet.
  • Treatment may be footwear modifications, simple calf stretching or orthotics.
  Please be assured at Woodland Podiatry we have a policy to not over treat and offer the very best in terms of experience and expertise in Perth when it comes to the treatment of your child.   Please contact Woodlands Podiatry for an appointment to have your child properly assessed so that you may receive the best advice.

Bunions

Photo of a pair of feet with bunions

Hallux Valgus, more commonly known as “Bunions”, is a deformity of the big toe joint. The foot becomes wider and the big toe joint develops a bony prominence and becomes painful against footwear.

 

Who gets bunions?

There is a well spread rumour that they are caused by pointed shoes! However, barefooted Islanders develop bunions! Literature accepts genetics plays a large factor in their development, with women developing bunions more frequently but other factors include: Foot injury.

  • Systemic disorders.
  • Hypermobility Syndromes
  • Skeletal alignment and angulations.
  • Foot function.
  • Activities that place high pressure on that joint and associated Hypermobility Syndromes.

 

Please see McCluney JG, Tinley P. J Foot Ankle Surg. 2006 May-Jun; 45(3):161-7, where I proposed a long 1st metatarsal contributed to the development of Juvenile Hallux Valgus, or go to www.ncbi.nlm.nih.gov/pubmed and read the abstract.

 

As my research would suggest, I am particularly interested in discussing bunions and Hallux Valgus so please contact me at Woodlands Podiatry.


Treating Fungal Nails with Lasers

Photo of a pin point laser being used to treat fungal nails

Laser for the treatment of fungal nails is a hot and current topic at the moment and is currently being promoted as the most effective treatment of fungal infections of toenails.

 

A perfect treatment modality would be inexpensive, very effective, and very safe. Sadly, we have not achieved this perfect situation yet. Current treatment modalities include:

  • Topical antifungal agents.
  • Oral antifungal agents.
  • Toenail removal.
  • Light therapy or photodynamic therapy.

 

Due to the difficulty of treating fungal nails and the modern age we live in, the use of lasers has been thrust upon us but do they work?

 

A review of www.ncbi.nlm.nih.gov/pubmed on laser treatments for fungal nails showed scant research over the last 10 years with variable results.

 

Before seeking expensive laser treatment on fungal toe nails, please contact our podiatrists to obtain a clear diagnosis of why your nails have their appearance. We frequently have patients worried they have fungal toenails, to only be diagnosed with another cause, often just a result of nail varnish damage. Woodlands Podiatry is closely monitoring the research and effectiveness of laser treatment of fungal nails.