Learn About Your Feet, Foot Problems, and Treatment Options
This section gives you an opportunity to educate yourself about various foot problems. Here you will learn about common foot ailments and tips on how to care for your feet.
Please do not use this section to self diagnose.
Patient Education Sections:
Chiropodists or podiatrists are licensed foot care specialists regulated by the Health Professions Act and governed by the College of Chiropodists of Ontario. Chiropodists or Podiatrists specialize in assessing, diagnosing and treating problems in the lower limbs. They are trained to provide foot care and give professional advice to patients of all ages. Chiropodists or podiatrists are the only health professionals who are trained exclusively to assess and treat foot problems. No referral is necessary to see a chiropodist.
Services provided by Chiropodists include (but are not limited to):
- Treatment of dermatological conditions such as corns, calluses, warts and fungal infections
- Assessing a persons walking or running pattern and correcting alignment by prescribing, manufacturing and fitting orthotics, braces and other aids and appliances
- Monitoring foot problems and deformities of high risk patients, such as diabetics, and advising them on proper footcare
- Performing minor surgical procedures using local anesthesia
We work closely with many other medical disciplines to provide you with the best care possible. These include general practitioners, such as your family doctor.
For more information on the chiropody profession, here are some helpful websites:
When to Call A Foot Specialist?
People call a chiropodist for help diagnosing and treating a wide array of foot and ankle problems. Please contact our office if you are experiencing:
Skin or nails changes such as:
- Blisters, cracking, or peeling of the skin on your foot or around your heels
- Spreading of an infection from one area of the foot to another, such as under the nail bed, to the nail itself, or to the surrounding skin
- Foot or ankle symptoms that do not improve after two weeks of treatment with a nonprescription product
- Odour coming from your feet
- Thickened skin in areas on the feet
Issues such as:
- Persistent pain in your feet or ankles
- Pain in your knees, low back, or hips
- Persistent pain that is not alleviated by ice or over-the-counter painkillers (such as Aspirin, ibuprofen or acetaminophen)
- Excessive wear on the outer sole of the shoes
- Shoes tend to wear out quickly
- Someone else in your family has similar issues with their feet
If you are Diabetic and have:
- Poor circulation or numbness in the feet
- Increased pain, swelling, redness, tenderness, or heat coming from an area on your foot
- Red streaks extending from a lesion on the foot
- Discharge or pus draining from an area on the foot
- Interest in diabetic footcare education
A daily foot care routine is easy to achieve. Giving your feet some regular care and attention will also help you to identify any problems early.
- Letting water run over your feet when you are taking a shower is not enough. Wash your feet with warm soapy water and a sponge. This will help remove dirt, sweat and bacteria. This will also prevent infections and odours from developing.
- After washing your feet, dry your feet well, ensuring that you dry between all of your toes. Bacteria as well as fungus thrive in warm and moist environments.
- Don't share towels, socks or shoes, as this is a means of spreading infection.
- Moisturize your feet daily to help keep the skin hydrated. Try to make moisturizing your feet part of your daily body care routine.
- Toenails need to be trimmed regularly. Always cut straight across and follow the natural shape of each nail. Don't cut your nails too short or down the sides of your nails as this can result in soreness, infections and ingrown toenails.
- If your toenails are hard, thick and difficult to cut, try soaking them in warm water to soften them. If you are still experiencing problems then seek the advice of a Chiropodist.
- Always use a fresh pair of socks or stockings. This will help keep your feet feeling fresh and prevent odours from developing. Try to alternate the shoes you wear every day, your feet sweat in the shoes and rotating footwear will allow them to dry out thoroughly.
All orthotics are not created equal.
Many different 'in-shoe' devices are referred to as orthotics. 'Orthotics' can be found on stands at consumer shows and infomercials on TV. Also, arch supports and insoles sold in drug, sports and shoe stores are increasingly referred to as 'orthotics'. Then, there are the orthotics that chiropodists and podiatrists prescribe for their patients.
It is a challenge for most consumers to tell the difference between these different products and making an informed decision. You need to recognize a slick sales 'spin' and separate it from the facts. Here is some information to help you to differentiate these products.
There are 3 common types of Custom Made Foot Orthotics:
Custom devices, customized devices and off the shelf devices.
Custom Made Foot Orthotics are prescription medical devices designed to control the abnormal motions within the feet. Specifically they are designed to help control excessive pronation (collapsing in) and excessive supination (rolling out) and make standing, walking and running more efficient. Accommodative orthotics help to support the existing structure and redistribute the body weight, alleviating pain caused by corns, calluses and other bony prominences.
A thorough examination is performed, weightbearing and nonweightbearing, standing and walking. Measurements are taken. Then a three dimensional volumetric impression is taken, usually with plaster of paris, while you are lying down or sitting. A standing impression is not recommended as it does not capture a true representation of the feet. A detailed prescription is then filled. Your casts and prescription are sent to a professional lab with qualified technicians who manufacture the device.
Customized foot devices are newer on the market and more difficult to distinguish from a true custom foot orthotic. They are commonly a product of computerized pressure platform systems that capture and display pressure information and are created by adding components to a pre-manufactured insole.
These are, unfortunately, often marketed as a 'custom' device and sold at similar prices. A simple way to determine if the product you are receiving is truly custom is if a plaster cast or three dimensional scan is not taken of your feet. Computerized pressure platform systems are a great way to evaluate some aspects of foot function and weight distribution using a colourful graphic display. However, this technology does not capture a true, three-dimensional impression of your feet. Beware of the slick sales 'spin'.
Off-the-shelf devices are sold in retail drug, sports and shoe stores. Some chiropodists and podiatrists recommend them for minor foot problems. They cost under $50.00 and some of the better quality products provide good support and cushioning.
If you are having foot, ankle, knee or lower back issues; start by consulting your chiropodist or podiatrist. A detailed evaluation will help to determine which foot orthotics are best for you. This expertise cannot be found on TV, in the mall or consumer shows. Minor foot problems can often be treated with inexpensive, off-the-shelf devices and proper footwear selection. More pronounced and persistent problems usually require a more precise, custom orthotic solution.
Plantar fasciitis is a term commonly used to refer to heel and arch pain. More specifically, plantar fasciitis is an inflammation of the connective tissue, called the plantar fascia; which stretches from the base of the toes, across the arch of the foot, to its insertion into the heel bone. Overpronation is the most common cause. As the foot rolls inward excessively when walking, it flattens the foot, lengthens the arch, and puts added tension on the plantar fascia.
Over time, this causes inflammation. Also known as heel spur syndrome, the condition is often successfully treated with conservative measures, such as the use of anti-inflammatory medications, ice packs, stretching exercises, orthotic devices, corticosteroid injections and physical therapy.
Most children begin walking somewhere between 10 and 18 months. They learn by imitating adults or older siblings. They crawl, stand, walk with the aid of tables, etc and finally walk alone.
From birth until walking, shoes are not necessary; including booties. They can be restrictive to natural growth if they are too tight or small. They do not aid or encourage the child to walk. Footwear should be used for protection at this age. If the floor in your home is safe from sharp objects, it is alright to let your toddler walk naturally. When he or she leaves the house, shoes and socks should be worn.
Walking is a natural process. Don't compare your child to other children who may begin walking sooner and do not force your child to walk. Let nature take its course. In a toddler's normal gait (walking) cycle, the feet will appear flattened and turned to the outside, like a duck. With time you will notice the feet and legs rotate into a more straightened position. This will take time. You should notice less flattening of the arches and a straight walking cycle by the age of 6 to 7 years. If the arches remain flattened or legs rotated, an assessment by a chiropodist is recommended.
To help with flatfeet, special shoes or orthotics may be prescribed. To correct mild in-toeing or out-toeing, stretches or strengthening exercises may be prescribed. In a severe case, corrective shoes, splints, or night braces may be prescribed.
Children's footwear should be firm enough to support the foot, yet flexible near the toes for ease during walking and allow proper gait to take place. They can be with laces or velcro. It is important to check your child's shoe size often. Make sure there is space between the toes and the end of the shoe and that the shoes are roomy enough to allow the toes to move freely. Don't let your child wear hand-me-down shoes as this can be the cause of many foot problems.
Remember if your child is complaining of pain, is waking up in the night with pain or you notice that his/her activity level has decreased, it is time to see a chiropodist.
Athlete's foot does not as its name suggests affect only athletes. It is a fungal infection that develops just below the skin.
Athletes foot can be recognised by taking a scaling of the skin and sending the sample for lab analysis. Signs and symptoms include peeling, red, itchy, cracked skin often with small brown marks or dried blisters. Itching and burning may increase as the infection spreads.
Fungi thrive in damp, warm environments. Pool decks, public showers, and other communal areas are breeding grounds for athlete's foot and it is transmitted from one person to the other. People who suffer from sweaty feet are particularly prone. Many over-the-counter products are available to help with this condition including anti-fungal powders, creams and sprays, but many times a prescription antifungal is required.
Prevention of such conditions from developing is key; daily washing of the feet, drying the feet carefully, changing socks and shoes regularly to decrease moisture, avoiding walking barefoot, reducing perspiration by using talcum powder and wearing cotton socks which absorb moisture will aid in preventing this condition.
A fungal nail (known as onychomycosis) is an infection underneath the surface of the nail, possibly penetrating the nail. A group of fungi, called dermophytes, attack the nail and thrive on keratin, the nail's protein substance. Similar to Athlete's foot, a fungal infection of the nails can be easily transmitted from one person to the other, especially through shared use of nail clippers. Fungal nails can sometimes be difficult to diagnose as there can be similar nail presentation from other disease states. Here are some signs which can be used to aid in differentiating a fungal toenail:
1. Thickening: Your nail may become thickened, more shell-like
2. Brittleness: The end of your nail may crack easily and pieces of your nail may break off
3. Discolouration: Your nail may be yellow or greyish-yellow rather than a healthy pink colour
4. Deformity: Your nail is misshapen; the end can be pulled away from your skin
5. Lack of Growth: The affected nail grows much slower than your healthy nails
6. Discomfort, Minor pain: The nail is sensitive to pressure and may cause discomfort
7. Athlete's Foot: For many people, the nail problem is associated with athlete's foot, a fungal skin infection
Many Canadians suffer from diabetic-related foot problems that could be prevented with daily foot care and proper shoe selection.
Typically, people living with diabetes will eventually experience decreased circulation and sensation in the feet. Unfortunately, this means that a diabetic can easily be walking with a foreign object in their shoe and be unable to detect it. If a foreign body or improper fitting shoes irritates the foot it can lead to the development of a diabetic foot wound or ulcer.
A diabetic foot ulcer is a defect or break in the skin. The skin acts to protect the foot from invasion of bacteria. An ulcer can act as a portal through which harmful bacteria can enter and cause infection.
There are several daily steps that, as a diabetic, you can take to decrease the likelihood of suffering from foot ulceration including the following:
- Check your feet daily. Look for redness, swelling, bruises, blisters, cuts and nail problems. If you are unable to do this yourself, ask someone to help you, or use a mirror. If you notice a break in the skin, cover it with a mild antiseptic and a sterile dressing. If you find that a cut or abrasion is not healing, then contact a chiropodist immediately
- Wear appropriate footwear. Make sure to accommodate for the length and width of your foot
- Wash feet daily and dry well between the toes. Do not force the toes apart when drying.
- Apply a moisturizing cream to maintain hydration of the skin.
- Cut nails straight across and do not cut down into the sides of the toe. Use a nail file to smooth rough edges. If you are having difficulty cutting your nails, or you have decreased sensation or reduced blood flow to your feet, than consult your chiropodist for treatment
- Never soak your feet for long periods of time.
- Do not use heating pads or hot water bottles
- Change socks or stockings daily. Avoid socks that have thick seams or that are constrictive.
- Never walk barefoot.
A bunion is an enlargement of the joint at the base of the big toe, the metatarsophalangeal joint (MPJ). It forms when this joint moves out of place forcing the toe to bend towards the others causing a painful prominent bony lump on the side of the foot.
Symptoms of bunions include a large bony bump which is red, swollen and painful. In advanced cases, sometimes the second toe will overlap the first toe and a corn may develop over the second toe. Bunions form after years of abnormal pressure on the MPJ caused by our walking pattern, inherited foot type or use of improperly fitting shoes.
If treatment is begun early to relieve the pressure on the bunion, the progression of the joint deformity can be stopped. Use of pads and shields around the bone, wide toebox footwear and avoiding use of high-heeled footwear can be some conservative treatment options. Surgical options include removal of the bony enlargement to restore normal bone alignment and relieve pain.
Ingrown toenails (known to chiropodists as onychocryptosis) is a common condition where the nail grows into the side of the toe causing swelling, pain and redness. Often the big toe is affected.
The most common causes of ingrown toenails are shoes that don't fit correctly and improper toenail cutting (cutting nails too short or cutting down into the sides of the toes). Some other causes include: toenails which are naturally too wide, trauma (stubbing the toe), frequent running and poor foot mechanics. Active children are particularly susceptible to this condition.
Soaking the feet in a warm, salt water bath and applying a mild antiseptic with a bandage can treat milder cases. If the toe is infected it should be treated by a chiropodist who will remove the offending nail and treat the infection. If the ingrown toenail is a recurring problem than it may require a more permanent solution where, under a local anaesthesia, a portion of the nail is removed and a chemical solution is applied to prevent that part of the nail from growing back.
Metatarsalgia is pain in the ball of the foot, the area between the arch and the toes. Pain is centred over one or more of the metatarsal bones, most commonly the second bone. Symptoms include pain and swelling; sometimes a callus may be found under the affected joint.
Metatarsalgia can be caused by walking on hard surfaces, wearing rigid soled work boots and high heels. It can also be caused by abnormal weight distribution caused by the person's walking pattern. If this is the case, the person needs to be evaluated by a chiropodist and any underlying problem needs to be addressed and corrected.
- Purchase new shoes later in the day when your feet are tired and may be swollen. Make sure that you walk around the store and ensure that nothing hurts or feels tight.
- Buy your shoes in the correct size. That means length and width. Have a chiropodist measure your feet.
- When trying on shoes, wear the type of socks you will be using most of the time.
- Natural fibre socks (such as cotton or wool) are good for your skin as they absorb perspiration.
- Laces or velcro straps prevent the foot from sliding in the shoe and secure the foot. They also allow adjustment for normal swelling as the day progresses.
- A strong heel counter is important to cup and support the heel and help stabilize the foot.
- Soles should be made of flexible, cushioned, non-slip material to absorb shock and provide good traction.
- Low heels (under 1.5") are recommended. A broad base is crucial for stability, and to distribute your weight as evenly as possible over the entire foot.
- Round or square toebox footwear will allow room for the natural shape of the foot.
- Allow enough depth in the toebox for the toes to fit comfortably without rubbing.
- Uppers (the top part of the shoe) should be made of natural breathable or vented materials to prevent a build-up of moisture within the shoe.
- Replace worn out shoes as soon as possible. Check the inside of the shoes for rough seams. Often the shoes look good on the outside but when you run your hand along the inside you can feel rough stitches which can cause blisters, corns and callouses.
- Select the correct shoe for the activity that you are engaged in (i.e. running shoes for running).
- Alternate shoes - don't wear the same pair of shoes everyday. Give time for the midsole to bounce back and dry completely.
- Avoid walking barefoot. Your feet will be more prone to injury and infection.
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