Our Assessments and Treatments
A biomechanical assessment involves checking the mobility of your foot joints and determining if there is any restriction in flexibility. It also involves checking your forefoot and rearfoot alignment. A gait analysis involves assessing the way you walk. We also evaluate if any leg length inequality is present. This can often occur when a hip or knee joint has been replaced. A biomechanical assessment is warranted when a person is suffering with foot, ankle, knee or lower back pain.
A pediatric foot assessment is warranted when a child suffers with any foot, ankle, knee or lower back pain or if the child, is waking up at night with pain in the lower extremities. Also it may be warranted if the parents note that the child does not enjoy weightbearing activities and prefers sitting activites.
The Pressure Mat system provides a dynamic, weight-bearing biomechanical patient assessment. Metascan generates a Dynamic Gait and Pressure Analysis Report containing 2D and 3D color images of the patient’s footstep, data on kinetic pressure patterns during the stance phase of gait, and a conclusion describing any biomechanical abnormality detected as compared to normal gait values.
Why is this assessment superior and unique?
The human eye observes at a frequency of 7 images per second VS. The pressure mat scans the stance phase of gait at 150 images per second.
It captures Dynamic Function with 3 different types of Scans:
1. Dynamic Scan
Compares walking and running scan data of the same patient
Proprietary diagnostic software analyzes digital pressure mat and patient data. 2. Static Scan
Bilateral pressure distribution assessment and report
Useful in detecting leg length discrepancies 3. Postural Scan
Postural analysis to determine deviations in alignment, movement pattern and body symmetry
Visually observe postural movement over time (replay for analysis and patient education)
A diabetic foot assessment involves evaluation of the nerve endings in the feet, particularly to determine if any loss of sensation(neuropathy) is present. We assess for loss of fine prick, temperature and vibration sensation (sensory neuropathy). We are also evaluating muscle strength and reflexes (motor neuropathy) and loss of sweating, dry skin or flushing (autonomic neuropathy).
Compression stockings are a type of stocking that has a graduated change in compression up the leg. They are used in cases where the circulation going up the leg is compromised. A person may be suffering with spider veins, varicose veins or edema to be a candidate for this type of stocking. They are covered by insurance companies and require a prescription from a family doctor or nurse practitioner. When being measured, we take the circumference of the ankle, calf and thigh (if needed). The amount of compression need is discussed as well as material, length and colour.
When fitting a person with footwear multiple factors are taken into consideration -their health (diabetes, arthritis etc…), the length and width of their foot, and finally the presence of any toe deformities (bunions, hammer toes etc…). Footwear is then recommended for their medical necessity. Footwear is prescribed for function and comfort for difficult to fit feet.
Corns and Calluses are thick skin lesions commonly found on the bottom of the foot or on the toes. They are generally over an area of pressure.
Warts are skin lesions which are viruses and are communicable to other people.
Ingrown toenails are a condition where the skin on the side of the toe is being penetrated by the nail. It could be mild where the toe is red and inflamed. It can also be severe with bleeding, pus and infection.
Athlete’s foot is a fungal infection of the skin. It can occur on the bottom or top of the foot or even between the toes. It may present as red, inflamed and itchy skin.
Diabetics are at a greater risk to develop foot problems as compared to a non-diabetics. These problems include neuropathy, circulation issues, non healing wounds etc… Diabetic footcare includes a detailed diabetic foot assessment (both vascular as well as neurological assessment) as well as education based on your individual needs. A management plan is then created for you -possibly including skin and nailcare. It may be recommended based on your risk profile to have the diabetic assessment repeated annually.
We treat many types of foot pain. Most commonly seen conditions include heel pain (plantar fasciitis) and pain in the ball of the foot (metatarsalgia). Also some people present with pain in the toes such as from bunions or hammer toes or from past injuries such as ankle sprains and shin splints.
A bunion is a structural deformity of the bones. It can be from an abnormal bone growth over the joint (exostosis) or due to a deviation of the great toe from the metatarsal (hallux abducto valgus)
Flatfeet is a lowered medial arch on the inside of the foot when standing. This can be congenital from birth, or can be acquired over time due to overuse, injury etc…
High arches is where the medial arch is higher (more bridged) than average. It is commonly inherited from our parents, however some medical conditions can also cause high arches.
Knee and lower back pain can be caused from poor foot posture or mechanics. Many times flatfeet can result in lower leg pain, such as shin splints, as well as knee pain. High arches are commonly known to cause more heel, knee and lower back pain.
Custom foot orthotics are custom insoles that are created from a 3 dimensional mold of your foot. It is a prescription device that is used to help correct the posture of your feet, ankles, knees are lower back.
Ankle foot orthotics are a type of brace that is a combination of a custom foot orthotic and plastic uprights to help give ankle support. Some also contain a specialized hinge joint for dropfoot and other foot conditions.
We provide several different surgical options to our patients that are not responding to conservative measures. These include partial nail avulsions, total nail avulsions and surgical excision of skin lesions.
A corticosteroid injection can be administered for heel or Achilles tendon inflammation, pain or injury. It is generally a mixture of an anaesthetic and a steroid.
The CryoProbe is nitrous oxide gas in a convenient handheld device. The CryoProbe is used to freeze various unwanted lesions, including plantar warts and skin tags. Its combination of accuracy, ultra-cold freezing power and pressure provides a unique and more effective treatment than other systems on the market today.
Accuracy: the ability to pinpoint to just one millimetre allows treatment of the smallest lesions.
Freezing Power: the CryoProbe provides nitrous oxide at -127F - the next coldest to liquid nitrogen.
Pressure: delivery of the coolant allows deeper, faster penetration to the bottom of the lesion without pausing for ice build up, with little to no pain experienced by the patient.
Manual therapy is an osteopathic treatment used to restore foot function. This treatment is performed through joint mobilizations to determine the area requiring attention, followed by a high-velocity, low-amplitude thrust (manipulation).
Why manual therapy?
When there is displacement of the bones of the foot, the body tries to compensate for the mechanical impairment. Signs of mechanical impairment include joint tension, muscle strain, limited movement, and pain. The object of manual therapy treatments is to restore foot function and relieve symptoms through manual adjustment of the bones and muscles of the foot, without the need for surgery.
If the problem has become chronic, as in a professional athlete, joint infiltration and adhesions may also be broken up through manipulative procedure, freeing the foot for better mobility. Many cases of bursitis, usually a symptom of inadequate mechanical function, also heal spontaneously when foot position is corrected by manual adjustment which reduces the friction of limited-motion on foot tissues.
Simply, manually replacing bones in the proper position starts a free flow of fluid through lymphatic channels to allow healing. Once bones are properly set and the circulation is restored, swelling and pain often reduce dramatically. (Rue Tikker 2001)
LLLT improves tissue repair, reduces pain and inflammation wherever the beam is applied. Treatments take about 10 minutes and should be applied two to three times a week. Depending on the condition being treated, 6 to 8 treatments may be needed. LLLT has been used for many years on sports injuries, arthritic joints, neuropathic pain syndromes, foot and ankle pain.
What is LLLT?
Low Level Laser Therapy is the application of red and near infra-red light over injuries or lesions to improve wound and soft tissue healing, reduce inflammation and give relief for both acute and chronic pain. First developed in 1967, it is now commonly referred to as LLLT.
LLLT is used to: increase the speed, quality and tensile strength of tissue repair; alleviate inflammation and relieve pain (analgesia).
The red and near infrared light (600nm-1000nm) commonly used in LLLT can be produced by laser or high intensity LEDs. The intensity of LLLT lasers and LED’s is not high like a surgical laser. There is no heating effect.
The effects of LLLT are photochemical (like photosynthesis in plants). When the correct intensity and treatment times are used, red and near infrared light reduces oxidative stress and increases ATP. This improves cell metabolism and reduces inflammation. These effects can be enhanced with pulses, however when analgesia is required, there is a second mechanism which works best when a strong continuous beam is applied.
LLLT devices are typically delivering 10mW - 500mW (0.01->o.o1 Watts). The power density typically ranges from 0.005W/Cm2 - >5 W/Cm2.
LLLT is popularly used for soft tissue injuries, joint conditions, neuropathic pain, non-healing leg and pressure ulcers.
Just as orthodontic braces slowly and painlessly straighten your teeth for a dazzling smile, nail braces slowly and painlessly straighten and correct nail growth.
A nail brace is a custom made nail splint that attaches to either side of the nail and gently lifts the painful ingrown nail into correct alignment. This procedure is used as a non-painful and non-invasive alternative to the surgical removal of ingrown toenails or involuted toenails.
Patients feel instant relief when the nail brace is applied. Over time, with the nail brace in place, the shape of the nail is corrected.
What is Swift? Swift is a new technology, developed in the UK, which has been licensed for the general treatment of skin lesions in Podiatry and Chiropody. Swift microwave energy is delivered through a special probe applied to the skin to treat the affected tissue.
Does it hurt? Like many treatments for skin lesions, some minor discomfort may be experienced. Pain levels vary from person to person but most people undergoing Swift liken it to a pain similar to an injection or a scratch, lasting 2 - 3 seconds then quickly subsiding.
What can I do after treatment? In some cases the treatment area may feel sore but will not prevent you undertaking normal daily activities.
How many treatments will I need? This is dependent on how you respond to treatment. In some cases, you may need more than one treatment (these can be from 14 days to over a month apart depending on the response).
Find out more about Swift Microwave therapy at www.treatverruca.com
