Flat Shoes

Flat Shoes

If you have worn heels for a long period of time, it can take a good while to get used to wearing flat shoes. Flat shoes can cause some foot types to be positioned in a way which can cause issues such as big toe joint problems, heel pain, knee pain, callus or in some cases, a combination of issues.

If you have a low arch profile and a flexible foot, flat shoes may be the worst type of shoe for you. A shoe with a maximum of a 2-inch heel is usually the best for this foot type.

Modern flat shoes usually focus on fashion rather than support and fastening. This means that in some cases the foot holds on to the shoe rather than the shoe holding on to the foot. This causes toes to flex and the tops of the toes can develop pressure points which is perfect for a corn to form.

Foot pain is not normal and usually to decrease your foot pain you should start with your footwear. You should identify a shoe that eases the pain and consider visiting a podiatrist as they can advise on the best footwear for your foot type.

Diabetes and your feet

Diabetes and your feet

Diabetes affects a growing number of the population and can have huge implications on the feet.

Many changes can happen to a diabetic such as:

  • Anhidrotic (dry skin)
  • Hard skin
  • Neuropathy (lack of sensation)
  • Changes to the shape of the foot (extensor substitution)

Anhidrotic skin is more like to crack or split than normal skin is which increases the risk of infection. To help reduce this risk, feet should be moisturised on a daily basis.

Hard skin is formed by pressure and usually before ulceration. Hard skin should be removed by a podiatrist on a regular basis. The patient should continue to moisturise daily.

Neuropathy is a huge risk for those with diabetes as they would not be unaware of standing on sharp objects and not dressing any cuts or breaks of the skin. Those who have a lack of sensation should ensure their feet are always protected with footwear. Feet should be inspected regularly for breaks in the skin and medical advice should be sought as soon as possible if any are found.

Changes to the shape of the foot can happen, with the retraction of the lesser toes. This causes areas of higher pressure at the base of the toes (plantar to the metatarsal phalangeal joints). Furthermore, the natural fatty pad under these joints moves forward as the toes retract. This increases the pressure under these joints. The extra pressure here enhances the risk of ulceration especially if the individual has neuropathy.

Complications in the diabetic foot can be reduced by wearing appropriate footwear, vigilance, the daily application of moisturiser and most importantly, visiting a podiatrist for debridement of hard skin.

Is foot pain normal?

Is foot pain normal?

Foot pain is not normal and if you start to experience any discomfort in your feet, you should get this checked out. We spend the most of our day on our feet and many people ignore foot pain as they believe it is normal when in fact, it is our body’s way of telling us that something is wrong.

At some point in their life, around 50% of the population will experience pain in their feet. We have 26 bones, 33 joints and over 100 tendons, muscles and ligaments in each foot and therefore have a good chance of injury at least once in our lives. Foot injuries can happen in a number of different ways such as, falling, dropping something on them, twisting the foot, sports injuries and in some cases, by doing absolutely nothing! Also, having an abnormal structure of the foot can lead to foot pain caused by tissue damage and stress. Foot pain can be made worse by improper footwear.

Most types of foot pain and/or injury can be treated and in turn, cured. If the pain is due to abnormal foot structure, it is important to correct the problem to ensure the pain is relived and does not reoccur. This does not always include reconstructive surgery. Being provided with an orthotic device usually leads to long lasting pain relief in most cases. As well as the foot structure, the physical injury should be treated. The treatment for foot injury usually involves the support of the injured part of the foot, resolving the inflammation of the injury with elevation, medicine and icing, and resting the foot. Visiting a podiatrist can speed up the recovery time as they can provide you with a treatment plan as they are experts in all aspects of the foot and can offer the best treatment and advice.

Shoe lacing and problem feet

Shoe lacing and problem feet

If you have problem feet, tying your laces in a different way that is suited to your foot condition can be a big help.

Wide Foot/High Instep

Some shoes have two sets of eyelets, if yours do it is recommended to use the eyelets closest to the tongue to lace your shoes.

Using the under and over technique will provide you with more room in your shoe and when you tighten the laces, the fit of the shoe will not be too tight.

Heel Slippage

It is very common for your heel staying put in the heel cup of your shoe. The best way to keep your heel slipping is to tie your laces in a “lace lock” at the top of the shoe. Every eyelet should be used when lacing the shoe to ensure the shoe is tight and the heel does not rub.

Although this technique can be difficult at first, you should thread the lace through the top eyelet when you reach the next eyelet on each side and make a small loop. After this, thread the opposite lace through each loop before you tie the lace. With practice, this becomes easier.

Narrow Heel/Wide Forefoot

Buying shoes for this foot type can be very difficult and frustrating. If the heel fits, the forefoot is too tight and if the forefoot fits, the heel slips.

Two sets of laces can help with this. Having two shorter laces and lacing the bottom 3 eyelets with one lace and the top eyelet with another lace is recommended. To ensure the heel is a good fit, use the “lace lock” technique described above on the last eyelets.

The eyelets closest to the heel should be tied tighter than the bottom eyelets.

If you are still having problems with you shoes fitting after re-lacing your shoes, you may need an orthotic which can be prescribed by your podiatrist.

How can I become a Podiatrist?

How can I become a Podiatrist?

You need to complete a recognised course of study in order to be accepted for the Health Professions Council registration.

Currently, 13 university up and down the country offer full time and, in some cases, part time bachelor’s degrees in podiatry. The part time degree usually takes four and a half years compared to the full-time course which can take three or four years to complete dependant on the university you are studying at.

All the courses require work experience in the form of placements in private practice or the NHS. The courses all cover the required areas of local anaesthesia and pharmacology and clinical experience.

In England and Wales, the NHS usually fund places in all the institutions. Places in Scotland are funded by the Scottish Higher Education Funding Council. Some students are eligible for a means-tested bursary which are paid each semester to help with the cost of their living expenses.

Applying

All applications to universities offering full-time courses are required to be submitted online on the UCAS website.

Applications for part-time courses should be made directly to the university. Each university may have different entry requirements so checking with the university directly is recommended. However, the below points generally apply at each university:

School/College Leavers

  • The tariff point score ranges up to 300
  • A minimum of 2 (preferable 3) A-Levels are required. One should be science based but PE can be considered by some universities
  • The general entry level is 4 Highers for those students who are sitting Scottish Highers. One of these must be biology. Chemistry is also preferred

Mature Students (over 21)

  • Academic achievement in a science subject must be demonstrated to A-level standard or equivalent. A science subject is preferred
  • Recent academic study is expected

Consideration Points

Applications should prepare to travel for interviews as some universities require all suitable candidates to be interviewed.

Clinical shadowing of an HCP registered practitioner may also be required from some universities.

Any criminal convictions will need to be disclosed as some convictions will prohibit future employment in the NHS.

In most cases, it is a requirement of the NHS for the applicant to complete an occupational health assessment before a place is offered. This is to protect both patient and practitioner.

Running & Foot Health

Running & Foot Health

Taking care of your feet as a runner is obviously very important as foot pain can make your sport very uncomfortable!

A visit to a podiatrist should be made if you experience recurring pain before, after or during a run as pain usually means something is not as it should be.

Your podiatrist can provide you with a biomechanical assessment which is a thorough assessment of the feet, leg and body during weight bearing and non-weight bearing. The assessment allows the podiatrist to advise on the best way to improve your running and performance. The information produced from the assessment becomes the rehabilitation programme. An orthotic prescription may be needed if the problem is mechanical.

The cause of many injuries and pain can be because of changes that you have made such as changing your shoes or changing the surface you run on. You should consider having your gait analysed before you make any changes as a podiatrist can offer advice to reduce the risk of an injury.

Things to consider:

Looking after your toenails

Toenails should always be trimmed straight across rather than curved at the corner because if nails are cut too short there is a risk that ingrown toenails can develop.

Many competitive and long-distance runners can experience a condition known as subungual haematoma which is bleeding underneath the toenail. The toenail becomes black and in some cases the toenail begins to detach itself from the nail bed. It is recommended to secure the toenail with tape to ensure it does not tear away from the nail bed completely if it catches on shoes or socks.

Taking care of blisters

Most runners will experience blisters at some point. A recommend prevention tip is to buy dual layer socks as the inner layer moves with the foot and the outer layer moves with the shoe which reduces friction on the skin surface. If the socks become damp, you should change to a fresh pair. Another recommendation is to tape the blister prone toes or heels prior to running.

Once you feel a blister progressing, you should act as quickly as possible, stop running/walking and look at your feet. It may be a good idea to put on a waterproof plaster or material padding.

If a blister does develop you should cut a hole in a piece of material such as felt or foam and form a ‘doughnut’ shape over the blistered area. This should then be taped in place or covered with a gel-type dressing.

To prevent infection and to kick start the healing process, and open blister should be treated with an anti-septic cream or protective soft gel dressing.

Usually, if excessive irritation is avoided a blister will disappear within three to seven days.

Footwear

In most cases, running shoes should be replaced every 350-450 miles and should fit your feet perfectly. Running shoes should be purchased well in advance to a big race so you can ensure that they do not rub or pinch.

Many running shops will have experienced staff who will be able to measure your feet and recommend the correct shoe for you. As there are many different running shoes, it is important to know your foot type to make sure you are wearing suitable footwear. A biomechanical assessment can determine this for you.

Orthotic insoles

Back pain, hip, knee and lower leg injuries can be assisted with the help of an orthotic prescribed by your podiatrist. Although there are many orthotics available to purchase online and instore, it is advisable to have orthotics prescribed by a podiatrist to ensure they fit as they should and are helping your pain rather than hindering.

Always seek advice from a podiatrist should you feel any abnormal or uncomfortable pain as you may have an injury.

Foot Fatigue

Foot Fatigue

Often our feet get neglected especially after a night out or event. Below are some tips on how to look after fatigued feet and ensure they are kept in a good condition.

Moisturise!

When we have our feet hidden away in boots, socks, slippers (especially in the colder months) we are basically dehydrating them by not giving them time to breathe. Feet should be moisturised each morning and night with a foot cream that has urea in it. It is recommended to do this after a bath or shower, so the moisture is locked in leaving the skin on your feet rehydrated and soft.

Corns & Calluses should be treated by a podiatrist!

Pressure and friction cause corns and callus and can feel like you have something such as a stone in your shoe which of course, can be very uncomfortable. You should not try to treat corns and callus yourself; they should be treated by a podiatrist. As well as treating, a podiatrist can provide information and advice to diminish friction and pressure to reduce the risk of developing corns and callus by recommending more suitable footwear and orthotic insoles.

Trim toenails!

Toenails should always be trimmed and not cut too short as very short toenails can develop into an ingrown toenail. They should also not be cut rounded at the corners but cut straight across. If you are unable to cut your own toenails or struggle to do so, you can visit a podiatrist who can do this for you.

Relax those feet!

You should try and relax and pamper your feet at least once a week if you can. Soaking your feet in a bowl of warm salty water for 20 minutes is a good place to start. To remove any dead skin cells, use a foot file or a pumice stone with gentle circular pressure. Feet should be dried thoroughly especially the toes and in between. Foot moisturiser should then be massaged into the feet.

Podiatrists do offer routine appointments which can vary from nail trimming to managing ingrown toenails so for any problems you may have with taking care of your feet, you should make an appointment.

Cosmetic Foot Surgery

Cosmetic Foot Surgery

Overseas, there has been an increase in cosmetic surgery of the feet by people who are wanting to make their feet look more aesthetically pleasing in and out of shoes. Hopefully, this trend does not make its way to the UK.

Bone retracting, injectable fillers and shortening of the toes are just a few of the many procedures that are on offer. As with all surgeries, these operations carry a risk to the individual going under the knife such as, delayed healing times, the risk of infection and other unexpected fallout. Putting our feet (and bodies) through such huge risks just for our appearance is incomprehensible for most people.

We ask a lot of our feet every day and they are very complex. Function should be the main consideration for our feet as many consequences can occur when mobility is reduced. Many health problems can follow if an individual can no longer be as mobile as they once were such as, depression and weight gain.

Of course, surgery is needed on the feet for numerous health reasons and there are many foot and ankle surgeons who operate appropriately and not for cosmetic reasons.

Wedding Shoe Tips

Wedding Shoe Tips

Wedding season is around the corner which usually means new shoes! We all like to make sure our feet look fabulous, but we should also make sure they feel fabulous. There are many things to consider when choosing footwear for an event:

Is there enough room in my shoe?

This is very important to consider as squeezing our feet into shoes that look good can cause pain and damage to our feet. Painful blisters and corns can appear when our toes are squashed into a shoe with insufficient room.

How far will you need to walk?

If you know that there will be minimal walking required, then your shoe choice can be made based on appearance. However, if you are expecting to be walking quite a lot, you should consider also taking a more comfortable type of shoe that can be changed when walking or if your feet do start to hurt. There are shoes designed especially for this, that roll up into a bag, so you can carry them around in your bag in case you do need to change.

Will I be dancing?

Whenever you are active you should choose footwear that holds and supports your feet. A shoe that has a fastening will reduce the chances of a fall so this should be considered. If you are wearing heels and are not confident in them, a lower heel may be wise.

Party shoes should be worn for as a small amount of time as possible to ensure your feet enjoy the party as much as yourself! Feet should be kept moisturised with a cream with urea content. If you notice any changes to your feet or are experiencing foot pain, visit a podiatrist.

Foot Health and Pregnancy

Foot Health and Pregnancy

Feet can often become very uncomfortable during pregnancy and after the birth due to the major changes that a woman’s body goes through. Common foot problems can include cramps, itchiness, swelling and aching.

Pregnant women have an increase in the ovarian hormone relaxin which can cause muscles and ligaments to soften and stretch. This can make the feet more likely to ankle and ligament strains.

Footwear is very important throughout pregnancy to ensure pain or discomfort is at a minimum. As feet can swell throughout the duration of the day, it is recommended to shop in the afternoon if possible. You should ensure that the shoes fit well before you purchase and leave the shop.

Square or round toe shoes are recommended for comfort and support. Heels with approximately 1.2 inches (3cm) should be considered to help with this as should wide fitting shoes with substantial support as this can assist with escaping any long-term damage. High heels worn throughout pregnancy are not recommended by Podiatrist’s and should only be worn infrequently. Shoe’s with straps can be helpful to ensure the shoe stays in place but fiddly straps should be avoided especially in the later stages of pregnancy. As calves often swell throughout pregnancy, there should be room in the calf area when wearing boots.

Before starting any exercise programs, you should consult your GP or midwife. Keeping active can be very helpful with reducing the risk of swelling and cramps.

An appointment with a podiatrist can be very beneficial when experiencing foot pain whilst pregnant. If required, your podiatrist can provide you with orthotics to ensure your feet feel comfortable.