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Encouraging foot health in your children

8/8/2022

Want a hot tip for life?

It’s never too early to make good choices!

Learning good foot health hygiene habits early on can help save them from problems later on.

Here are a few to encourage:

• Your child’s shoes are theirs alone.
There can be dreadful surprises when you share shoes such as fungal toenails, warts and athlete’s foot. Teach your child to only wear their shoes, and never let someone else use theirs.

• Warm-up before high activity.
Warming up with stretches and light jogging before sports and running is a good way for everyone to help prevent overuse injuries.
Making warm-ups a habit will be valuable in the future (and any sports coaches your child may have will likely love their discipline).

• Wash well.
Daily foot hygiene is important!
A routine foot wash should include washing between the toes with warm water and soap.
It does not count to just run soapy water over the feet (yes, we are looking at you, adults).

• Be open about foot or ankle problems.
A common problem with children is that something may hurt, but they are scared to talk about it due to fear of missing out on activities or fear of enduring a treatment that feels even worse.

Always be open, honest, and empathetic with your children about potential treatments and problems, and they will be more open to talking with you about them.
Don’t be reluctant to ask us if you have any questions about your child’s foot or ankle care.

We will be happy to help!

How did I get flat feet as an adult?

8/3/2022

When you were growing up, you might have known of a child who had flat feet. You might have even had flat feet yourself but grew out of it.

But now you’re an adult and feeling foot pain, and you’ve been told you have flat feet.

What gives?
You didn’t have them earlier!

Adult-acquired flatfoot is different from childhood flatfoot.

The “acquired” part is the key.

While flatfoot in children is something they tend to be born with and often grow out of once their foot structure firms up with time, adult-acquired flatfoot is the result degradation or failure of a "solidified" structure.

This condition is often caused by the posterior tibial tendon in adults.

As you walk, this tendon supports the arch of your foot. Any sort of damage or vulnerability in the tendon can cause this support to be lost and the arch to collapse.

Athletes commonly damage their posterior tibial tendons, but excess weight (either from overweight or pregnancy) and rheumatoid arthritis can also be damaging factors.

Adult-acquired flatfoot can have a variety of causes, but one thing is certain;

If you experience foot or arch pain, talk to us right away!

To help you move more comfortably, we will find the root cause of your injury and recommend the best treatment options.
Click here to read more on how we can help you with your flat feet.

Custom orthotics for different circumstances

8/1/2022

Custom orthotics correct foot, ankle, lower leg, knee, and hip alignment deficiencies just as prescription eyeglasses correct vision deficiencies.

You may be thinking, what are orthotics, and what purpose do they serve?

Foot orthotics or orthoses are shoe inserts that 'support abnormal foot movement'. It is important to note that not all orthotics are made from the same materials or of the same quality.

Using orthotics, you can relieve pain and pressure by repositioning structures of the lower extremities, which will allow them to move more freely and prevent injuries.

A pair of orthotics helps rebalance pressure or to float a part of the foot that is taking too much pressure while walking.

Many people can benefit from custom orthotics. For example:

Persons who have arthritic conditions in their ankles or feet.
A child or adult with a foot deformity, such as flat feet, or a child who has an in-toeing or out-toeing gait disorder.
Athletes who have ‘imbalances’ that under normal conditions are not harmful and might not even be noticeable, but in high-stress athletic activity can cause muscle, ligament, tendon, and joint fatigue; reduce efficiency; and elevate vulnerability to injury.
Diabetics, with or trying to avert foot ulcers.

Custom orthotics fall into three broad categories:

Soft orthotic devices can improve balance, take pressure off uncomfortable or sore spots, and absorb shock.
They are constructed of soft, compressible materials for improved cushioning. People with arthritis, a lack of protective fatty tissue, or diabetes benefit most.

Rigid orthotics are made of firm materials such as carbon fibre, polypropylene plastic or EVA. They are designed to control foot function in two major foot joints just below the ankle joint to alleviate discomfort in the feet, ankles, knees, and lower back.

Semi-rigid orthotics are often used to reduce soreness, fatigue, and perform more efficiently. They consist of a layer of soft material reinforced with more rigid material.
If your foot alignment is out of whack, it can have far-reaching ramifications.

A thorough podiatric exam at our office can help you straighten things out. Click here to find out more about our orthotics.

Think Twice Before Getting a Pedicure at a Nail Salon or Spa

6/20/2022

A pedicure - whether you give it as a gift or get it for yourself - can feel like receiving a taste of luxury. It always pays to be cautious before you go to the salon or spa so that your trip doesn't end up being a regret.

Not all places operate the same, and some can engage in practices that can cause you to contract a fungal nail infection or another nasty problem.

A pedicure carried out by a 'medical professional' is always best.
Barring that, however,
here are some tips on what to look for regarding best pedicure practices:

• Are their tools sanitized? Make sure that the salon/spa correctly sanitizes all their metal instruments and uses clean/ disinfected tools for each customer.
Liquid disinfectants (Barbicide or similar) provide the best sanitation. The use of UV light for sanitation is sometimes permissible, but we don't recommend going anywhere that only uses that.

• There's no need to be intimidated by bringing your own tools. Any non-metal tools are for one-customer use only. Always. If you have your own files and other equipment that you can sterilize at home, you should not feel awkward about bringing them in, asking that they be used. If not, the salon or spa may have a kit that will be used only on you.

• Make sure foot baths are clean. If a previous customer with an infection has used a foot bath and it’s not properly cleaned between customers, your risk of getting what they had rises significantly. Pipe less foot baths are best, and never opt for bubbles or jets.

Heel spurs - how problematic are they?

6/20/2022

Quite often, heel spurs are blamed for heel pain, and we think we know why.

When you have pain in your heel after getting up in the morning or just generally placing weight on your feet, it seems quite natural to think it’s probably due to a pointy, bony growth happening down there.

Although heel spurs can cause pain, they might not be the cause as often as many people think. In fact, a lot of us have heel spurs and don't know it!

Many heel spurs cause no pain whatsoever and go undiscovered until an X-ray or other imaging test reveals them — usually when another condition is being investigated!

Heel spurs do also tend to hang out with plantar fasciitis, the most frequent cause of heel pain.

Plantar fasciitis develops when the thick band of tissue that runs beneath each foot becomes overstretched or stressed, creating small tears and growing inflamed.
The same strains that can cause plantar fasciitis can also stimulate the calcium build-ups that form into heel spurs.

However, even if both issues are present, the heel spur might not be causing issues; it could completely be the plantar fasciitis.

If you have heel pain, don't assume that you have heel spurs.

Do be quick, however, to let us know about your problem.
If you suffer from heel spurs, plantar fasciitis, or something else entirely, we can get to the cause of the issue and find you the relief you deserve.

Corns And Callus | Shockwave Therapy | Plantar Warts | Ingrown Toenails | Nail Fungus | Orthotics

9/25/2021

I will be touching on issues relating to general foot health, discussing how you can protect your feet and keep them healthy, as well as keeping you informed on what to expect should in person treatment be required.

Treatment for corns, callus, and other dermatological conditions

Shockwave Therapy

At home, corns and callus treatment tips

Never try to cut out, shave away, or remove corns or calluses with a sharp object.

For the 'typical' corn or callus, removing the build-up of skin is an effective treatment. Follow these steps:

Soak the corn or callus in warm water. Do this for about five to 10 minutes or until the skin softens
File the corn or callus with a pumice stone. First, dip the pumice stone in warm water, and then use the stone to gently file the corn or callus
Do not remove too much skin. This could lead to bleeding and an infection
Apply moisturizing lotion or cream to the area daily
Use padding. To protect calluses from further irritation during activity
Wear shoes that properly fit. Wear shoes with increased width and height in the toe area
Keep your toenails trimmed. Toenails that are too long can force the toes to push up against your shoe, causing a corn to form over time

If you aren’t sure what is causing your corn or callus, if the hardened skin is very painful, or if you have diabetes, poor circulation, are prone to infections or have delicate skin contact us for treatment. - This form of treatment will involve in-office painless debriding (shaving away or removing) of the hard skin build-up.

What is Shockwave therapy?

For fast pain relief and mobility restoration.
Together with being a non-surgical therapy with no need for painkillers makes it an ideal therapy to speed up recovery and treat various indications causing acute and chronic pain.

Shockwave therapy works by delivering impulses of high-energy percussions targeted to specific damaged tissues. This increases the blood flow within the affected area, stimulates cell regeneration and healing, and decreases local factors which can cause pain.

How does it work?

Treatment produces an inflammatory response.
The body responds by increasing metabolic activity around the site of pain. This stimulates and accelerates the healing process (promotes the remodelling of dysfunctional collagenous tissues, such as tendinopathies, trigger points, muscle strains, etc.).
Shockwaves break down scar tissue and/or calcification.
Transmission of pain is diminished through neurological mechanisms (inhibition of pain receptors).

Plantar warts/ Verrucae

Key symptoms to look out for:

A well-defined spot with hard, thick skin
Growths with a fleshy, rough surface
Growths with small black dots
Pain and tenderness localised to a specific spot
Raised surface showing a grey-yellow or brown colour
Pain to squeezing the sides of the wart

At Greg Robinson Podiatry Clinic treatment is determined by the wart appearance, size, and location. We offer various forms of plantar wart treatments ranging from the use of a topical acid, needle like puncture removal to surgical excision with electrocautery or Neov Laser 1064nm.

Treatment for ingrown and difficult toenails

Preventing ingrown toenails

Trim your toenails straight across
Keep toenails at a moderate length
Avoid rounding the corners or digging into the sides of the nail
Make sure your socks and shoes fit properly
Avoid trauma to the toe area

Custom-made Orthotics & Gait Analysis

How will custom foot orthotics benefit you?

Support your feet and legs
Improve foot and lower leg sports injuries
Improve weight distribution and posture
Optimise shoe fit, comfort and absorb shock
Alter abnormal foot functioning position
Correct many common foot ailments or prevent them from getting worse
Aid child’s foot growth in more neutral or anatomically aligned position
Eliminate low back pain from leg length inequalities.
Improve balance

Laser Fungal Nail Therapy

Tip on how to protect your nails from fungus

Disinfect inside your shoes
Wear socks that are breathable and keep moisture from collecting around your feet
Keep nail clippers to yourself
Protect your feet in public - gyms, locker rooms, and public pools
Wash your feet and dry them thoroughly before putting on your socks and shoes
Wear properly fitting shoes that allow your feet to breathe. If your feet become damp, change your socks
Protect your nails from trauma
Practice safe mani-pedis

For more information on ways to keep your feet healthy, contact us.
Greg Robinson Podiatrist © 2021 All rights reserved

8 Shoe Shopping Tips

9/25/2021

Greg knows that once summer hits, many patients want to make flip-flops their full-time shoe choice.
Your average flip-flops have zero arch or any other support whatsoever. Although this type of footwear is good to wear at the pool or beach to protect feet from being exposed to bacterial and fungal infections and hot flooring, wearing them for an extended period is likely to leave your feet hurting, as well as increase your risk for a foot injury or ankle sprain.

It is possible to find well-designed sandals and summer shoes that will provide the proper support.

Below are eight tips to take with you to the shoe store to ensure you purchase shoes that will not damage your feet.

1. Get your foot 'professionally' measured.
It’s estimated that 75-90% of people are wearing shoes that are the wrong size for their feet. Get both feet measured and have the shoe sale person check the shoes you try on to see that they fit properly.

2. Shop for shoes at the end of the day.
That is when your feet will be the most swollen, and any problems with fit will be more obvious.

3. Allow wiggle room for your toes.
There should be about a 12mm (thumb space) between your longest toe and the front of the shoe. Avoid narrow, pointy toe boxes that squeeze your toes together because this can encourage the development of conditions like bunions and hammertoes as well as ingrown toenails.

4. If you can bend a shoe in half from toe to heel, don’t buy them. - This is an obvious sign of lack of support.

5. Choose soft, high-quality materials, and be sure the shoes are well-made and properly finished. Rough stitching and unraveling edges will cause friction and irritation to the skin of your feet.

6. Look for a structured design that will hold your foot in place and provide support all around.

7. Be sure the insole has some padding and thickness to prevent foot pain on the ball and heel of your foot.

8. Don’t buy shoes online. – First, try on both shoes and walk around for a while in the store. – then you can buy online.

If the shoes don’t feel comfortable, don’t buy them.
A “breaking in” period is a myth!

You can always ask your podiatrist for suggestions about the best shoe designs for your feet.

For more information on ways to keep your feet healthy, contact us.

Don’t Neglect Your Feet

9/25/2021

Often, we ignore subtle, nagging pains and physical problems and “tough it out.” But these types of problems can often become chronic issues that require more serious treatment to heal.

Here are some common foot problems that we often have – and too often ignore:

Fungus - Athlete’s foot isn’t just an annoying itch – it’s an infection that won’t go away by itself. Worse, this fungus can be spread to your hands and other body areas. Over-the-counter products may just give temporary relief. Come see us to have the correct medication prescribed.

Fungal nail - Yellow, chalky, or brittle toenails aren’t normal! For a permanent solution to this problem, we’ll Laser fungal treatment, prescribe oral or topical medication.
In severe cases, debridement or removal of the infected part of the nail may be recommended.

Bunions - Because of bad shoe choices or even genetics, the base of your big toe may have shifted sideways, crowding out the other toes and creating a painful bump at the base of the big toe. Painful bunions don’t get better by themselves – come in for help.

Hammertoe - Over the years, your toe may get permanently bent in the middle joint from small, tight shoes or muscle imbalances. Switch to shoes with roomy toe boxes and keep those toes stretched and flexible.

Arthritis - Yes, arthritis can hit your feet too. Switch to a workout that’s easier on your lower limbs such as swimming. Invest in new, supportive shoes for walking and running.

Plantar warts - These nasty skin problems can really be painful. The virus is contagious and easily picked up at public pools and locker rooms. A podiatrist has the right methods to get rid of that wart permanently.

Flat feet - If you suffer from hip or back pain, the real culprit may be flat feet. Let us fit you with arch inserts (orthotics) if your flat feet are painful and make recommendations for the correct shoes for your unique foot type.

Heel pain - Inflammation of the plantar fascia, a thick band of tissue running along the bottom of your foot can cause stabbing pain with each step. Come in and let us treat your plantar fasciitis with physical therapy, custom-made orthotics, or extracorporeal shockwave therapy.

Achilles tendonitis/ tendinopathy – This is a painful condition that can results in pain at the back of the heel. Tenderness can be felt along the course of the tendon and in some cases, there may be the presence of a localized nodule (small sack of fluid) on the tendon. This pain may be felt during activity and often begins with mild pain after exercise or running that gradually worsens.

Metatarsalgia - Metatarsalgia refers to pain in the area between the arch and toes.

Ingrown toenails (onychocryptosis) - nails whose corners or sides dig painfully into the skin of the affected toe. With progression, infection, pain, and even difficulty walking or playing sports can occur.

Remember, the sooner you address a foot problem, the sooner it will be treated and the quicker you will be free of pain!

Keeping your Feet Healthy this Summer Season

9/25/2021

Nail polish, gel nails, and acrylic nails should be applied in moderation and ideally for the sake of your nail health, for ‘special' occasions only.

The nail product should be cleaned off frequently so the nails can ‘get air’ and exposure to natural light.
Between pedicures, or removing your nails polish, examine your nails for discolouration as this may be the start of a nail fungus, or nail dehydration.

Apply foot cream/ moisturizer/ lotion daily to your feet, so to avoid dry feet and cracked heels.

Avoid moisturizing between your toes as you don’t want moisture to accumulate there as this can lead to skin fungal or bacterial infections.

Dry between your toes well after bathing so as to avoid moisture accumulation, which can lead to skin fungal infection.
Nails must be cut straight. Avoid trimming the corners so as not to get ingrown nails.
The use of flip flops is only encouraged in communal areas i.e., gym change rooms/ gym swimming pools, so as to avoid skin and nail infections.

6. Avoid going barefoot. Moist environments are signs of infection.
7. Be careful when walking barefoot on the beach, mostly if you are diabetic.
Sharp objects can be hidden in the sand. And the sand may be deceptively hot.

Use beach shoes/ sandals/ flip flops.

8. Your feet, your toes need sunscreen as well. Skin cancers are more common on the skin which is exposed to the sun.

When sunbathing, don’t forget to apply sunscreen on the soles of your feet too!

9. Wear breathable footwear so to avoid excessive foot sweating. It is advisable to wear cotton socks with your closed shoes.

Wearing shoes with no socks is a breeding ground for fungal and bacteria to accumulate, as feet naturally perspire, and the moisture will accumulate in the material of your shoes.

10. In summer, feet tend to swell due to the rise in temperature. Rest your feet daily, cold showers may help to decrease the swelling.

For more information on ways to keep your feet healthy, contact us.
Greg Robinson Podiatrist © 2021 All rights reserved

Introducing shockwave therapy to my podiatry practice

5/9/2020

I have purchased the EMS-Dolorclast extracorporeal shockwave therapy machine for my practice.

I am incorporating this treatment modality to further grow and diversify my practice as this will offer a solution for the rehabilitation of resistant musculoskeletal conditions.

I think this will be a great tool for inter-referrals between practices to structure a rehabilitation program for our patients.

Shockwave therapy is a multidisciplinary device. Its main assets are fast pain relief and mobility restoration.
Together with being a non-surgical therapy with no need for painkillers makes it an ideal therapy to speed up recovery and cure various indications causing acute and chronic pain.
Shockwave therapy works by delivering impulses of high-energy percussion's targeted to specific damaged tissues. This increases the blood flow within the affected area, stimulates cell regeneration and healing, and decreases local factors which can cause pain.

Indications, (listed below as limited to the podiatry scope of practice) include but are not limited to the following:

Plantar fasciitis
Heel spurs
Patellar tendinitis (jumper’s knee)
Tendinitis
Chronic Inflammation
Bursitis
Shin splints
Morton' s Neuroma
Stress Fractures
Osteoarthritis

Insertion Tendinopathy i.e. calf muscle, hamstring
Myofascial Pain Syndromes
Impingement Syndrome
Tendon calcifications
Patellofemoral Syndrome
Tibialis anterior Syndrome
Lower back muscle spasm
Trigger point release

Click the following link to more info on my website http://www.fixmyfeet.co.za/shockwave-therapy.html

How many treatments will a patient need?

The number of treatments varies depending on the indication and tissue response.
Normally three to five treatments are necessary at weekly intervals; there is a small possibility that 2 or more
additional treatments may be necessary if your condition is very chronic.
The effect of the treatment is cumulative, so patients will typically need more than one treatment.

How often will patients need the treatment?

Treatments are done 3–10 days apart, depending on the patient’s tolerance and their tissue response.

Will patients feel pain after the treatment?

Patients may experience some soreness in the treated area. This soreness has been reported as tolerable and not limiting.

How quickly will I see results?

Many patients experience an improvement in symptoms almost immediately following treatment. This effect is usually (but not always) temporary and is associated with the analgesic effect resulting from hyper-stimulation of the tissue.

It takes several days for injuries to begin to heal, and many patients see an improvement before the end of the second week. Depending on the diagnosis, the healing process may take several weeks or even months to be completed, but pain relief often precedes complete healing.

Patients will benefit from undertaking the activity recommendations and rehabilitation advice & exercises during and after completion of the course of Shockwave therapy.

Are there any side effects from treatment?

Possible side effects include: (These side effects generally abate after 5-10 days).
• Swelling, reddening, haematomas
• Petechiae, bruising
• Pain
• Skin lesions (especially after previous cortisone therapy)
These side effects generally abate after 5 to 10 days. Pain can increase temporarily. Bruising and or swelling are also possible.

What evidence is there to support the use of shockwave therapy? Click the link to read more.

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