Flat Feet in Children

One of the most common reasons children are referred to a Podiatrist is due to flat feet.

Here I discuss the causes of flat feet and any treatments that can be provided.

Flat feet can be defined as a foot that has a low or absent arch when standing. The ankles also appear to be rolling inwards. This can occur in one or both feet.

What are the causes of Flat Feet?

Most children are born with flat feet, as their arch is yet to form. This should develop around the age of 3 to 4 years.

There are two types of flat foot, which are flexible and rigid.

Flexible Flat Feet

Nearly all children will have flexible flat feet. Generally flexible flat feet do not cause any problems and the arch will continue to develop as the child grows. No treatment is usually required unless there are specific symptoms for example:

• Pain, tenderness or cramping in feet, legs or knees
• Outward tilting of the heel
• Awkwardness or changes in walking
• Difficulty with shoes
• Voluntary withdrawal from activities.

Rigid Flat Feet

Rarely, a flat foot can be rigid, caused by the bones in the foot. These bones can be joined together or badly aligned which restricts movement and can cause pain. X-rays maybe required to diagnose this problem.

Assessing my Childs foot type

In order to determine which foot type your child has a simple test can be carried out. Ask your child to stand on their tiptoes. If an arch appears then the condition is probably flexible, and if an arch does not appear they may have rigid flat feet.

What treatment is required?

Unless there are any symptoms then treatment is usually not required for flexible flat feet.

Children with rigid flat feet will usually require a supportive insole which fits into their shoe to reduce foot pain, which can be provided from your Podiatrist.

The use of insoles will not change the shape of a childs foot in the long term, they are designed to help support the foot by holding it in a better position during growth.

What to do if you are worried

If you do have any concerns or require further advice then consult your Podiatrist.

For more info:

www.completepodiatry.co.uk

www.feetforlife.org

June is Feet For Life Month

Summer’s coming – time to let your feet shine

After months of being snuggled inside furry boots and cosseted in thick socks, it’s time to take a peek at your feet and give them a makeover for summer.

The College of Podiatry’s annual Feet for Life Month in June is the perfect time to give your tootsies some care for this season’s outing. Here’s our A-Z of looking after your feet:
Arch pain – flip-flops and flimsy sandals provide no/little arch support and constant wear can cause pain. Alternate your footwear so that this style of footwear isn't worn permanently.

Blisters – strike more often in hot weather. They’re caused by rubbing, especially between the toes if you’re wearing flip-flops with ‘thongs’. Prevent blisters by stretching out sandals. Wear them with socks and walk around indoors to loosen them up. Or use foot balm to protect your skin from chaffing. If you do get a blister, don’t pop it. Cover it in a plaster and if it bursts, apply some antiseptic.

Bunions - a condition where the big toe is angled excessively towards the second toe and a bony prominence develops on the side of the big toe. The condition is genetic and is not helped by wearing narrow shoes with pointed toes. Some treatments can ease the pain of bunions such as padding in the shoes, but only surgery can correct the defect. If you experience frequent pain, see a podiatrist.

Corns and calluses – occur as a result of pressure on the foot. Corns appear over a bony prominence such as a joint and a callus usually occurs on the sole of the foot. Do not cut corns yourself; especially if you are elderly or diabetic and do not use corn plasters or paints which can easily burn the healthy tissue around the corns. Commercially available cures should only be used following professional advice. Calluses can usually be kept at bay by using a pumice stone or non-metal foot file gently in the bath.

Diabetics - need to be especially careful in the summer. If a diabetic suffers from a condition called peripheral neuropathy, (numbness or tingling in their feet), cuts or injury to the skin are less likely to be felt e.g. by stepping on a thorn, piece of glass, splinter or other foreign body or from the shoes rubbing. Therefore, those living with diabetes must take extra care and do a daily foot check to make sure skin is intact and not broken. Try and avoid walking around barefoot. If you have a wound clean it and put a dressing on it and if it doesn’t appear to heal after 3-4 days get it checked.

Elegant – the average shoe size for women in the UK has increased from a size 4 to a size 6 since the 1970’si so if you have large feet, do not be tempted to buy a smaller size. Instead, choose an elegant style in a neutral colour

Fungal infection - such as athletes foot can lead to intense itching, cracked, blistered or peeling areas of the skin. If left untreated it can spread to the toenails causing thickening and yellowing of the nail. Fungal infections are highly contagious so avoid handling and do not use the same towel for your feet as the rest of your body. You can buy over the counter remedies but nail infections do not often respond to topical treatments so you may need oral medication. See a podiatrist if your infection persists.

Gout – a form of arthritis that can result in waking up in the middle of the night with an acute throbbing pain in the big toe, which is swollen. Usually only one of the big toes is affected. The pain lasts for around three or four hours and will then subside and usually not return for a few months. It can be controlled by drugs, which your GP will be able to prescribe. The application of ice or cooling lotions will help during an acute phase.

Heels - cracked heels are painful and occur where the skin has become dry or has experienced excessive pressure. They can be caused by wearing open-backed shoes such as sandals and flip flops which rub around the edge of the heel. To prevent them, moisturise regularly and use a pumice stone or non-metal file in the bath or shower. If the problem worsens see a podiatrist as some severe cases can require strapping of the cracks in order to allow the feet to heal.

Ingrown toenails - these pierce the flesh of the toe and can be extremely painful and lead to further infection. They most commonly affect the big toenail but can affect other toes too. To reduce risk use nail cutters and cut nails straight across and don’t cut too low at the edge or down the side. If you have an ingrowing toenail, see a podiatrist who can remove the offending spike of nail and cover with an antiseptic dressing. If you have bleeding or discharge, you may require antibiotics.

June – is Feet for Life month and you can find more information on foot health, with free leaflets and tips at The College of Podiatry’s website www.feetforlife.org.

Knock-on effect – don’t wait for signs of pain before seeking foot help as foot problems can have a knock-on effect on your mobility and general wellbeing.

Loving care – to fresh tired, aching feet, massage gently with a foot roller, or better still, ask you partner to massage your feet.

Minor cuts - or abrasions should be covered with a clean dry dressing.
 Nail polish – nails need a break to breathe from time to time, so give your nails a break from nail polish about once a month for a few days to a week. This can help prevent discoloration—particularly if you like to use dark-colored nail polishes.

Odour – prevent excessive foot sweating and odour in the summer by wearing open sandals when you can, or change tights or socks at least once a day. Choose socks containing at least 70 per cent cotton or wool, although some man-made fibre socks are specifically designed to keep feet dry. Wash feet at least once a day and dry carefully between the toes. Wear alternate shoes daily to allow them to dry out. If odour persists try an antibacterial soap.

Paddling in the sea – then wear flip-flops or other lightweight shoes to avoid injury from sharp shells, sea creatures and broken glass.

Questions and queries - 90 per cent of women experience foot pain, but only 30 per cent have every sought professional helpwww.feetforlife.org. ii. Use the find a podiatrist search function at The College of Podiatry’s website

Rough, hard skin – do not cut this (it’s likely to grown back even harder). Use a pumice stone or file.

Sun cream – don’t stop at the ankle. Put sun cream on tops and soles of the feet. Lots of people neglect to apply a good SPF to their feet, but don't make this big mistake. Not only does the skin on your tootsies need protection, but nails are made of protein and are therefore as vulnerable as your skin.

Toe nails – a good time to give your toe nails a trim is after a bath when the toe nails are softer. Trim your toe nails regularly, using proper nail clippers. Cut straight across, not too short, and not down at the corners as this can lead to in-growing nails. File them, if that is easier.

UV light – the tops of bare feet (like the top of our heads and our shoulders) are at risk of the damaging effects of harmful UV sun rays, so remember to put lots of sun cream on the tops and soles of feet.

Verrucae – is a type of wart that looks like a small, dark puncture mark in the early stages but later turns grey or brown. It’s contagious through direct contact. You can buy over-the-counter remedies from your pharmacy; ask for products with salicylic acid. If at any stage
your verruca becomes painful and the surrounding skin goes red, stop treating immediately and see a podiatrist.  Warts – you are more likely to contract if you already suffer from germ-festering conditions like athlete's foot or hyperhidrosis, can be passed on through direct or indirect contact. A wart that develops on the foot is called a verrucae.

X – take Xtra care when wearing high heels because the unstable position can result in ankle sprains and prolonged wear may cause the calf muscle to become shortened over time. The body compensates for this tightness in the calf-muscle by lowering the arch of the foot, or affecting the knee, hip or back. So keep high heels for special occasions. Save backless high-heeled shoes for evening glamour. Backless shoes force your toes to claw as you walk, straining the muscles if worn over a long period.

Yellowing nails - the most common causes are fungal nail infections, nail psoriasis (see a podiatrist) or the frequent application of nail varnish.

Zzzz – if you are pregnant, your feet will be taking extra weight and strain so rest them by raising your feet and legs up whenever you can and do daily leg and calf stretches

More information on foot health, with free leaflets and tips can be found on The College of Podiatry’s website www.feetforlife.org.

May is Keep Walking Month

May is Keep on walking month and to help support this worthy campaign here is afew tips on the benefits of walking and how to take care of your feet from the Society of Chiropodists and Podiatrists.

Benefits of walking

Walking is good for you and if done at a brisk pace for regular exercise it helps condition your body and improve overall cardiovascular health in the same way running and jogging do. But compared with running, walking carries a significantly lower risk of injury, it reduces stress and gives you time to clear your head and aids better sleep. It’s the nearest thing to ‘perfect’ exercise in terms of a safe, all-round workout and it doesn’t cost a penny or need any special equipment.

• If you walk an extra 20 minutes a day, you’ll burn off more than 3kg of body fat a year
• A single step uses up to 200 muscles. So you’re not only doing a little cardio, but toning your muscles too and walking is easy on your joints
• Walking can halve your risk of coronary heart disease and help prevent some cancers and cuts cholesterol
• Walking may slow cognitive decline in adults, especially those with existing conditions such as Alzheimer’s
• Walking can help to prevent the onset of type 2 diabetes
• Walking requires little equipment can be done almost anywhere and is entirely free.
• Can help improve circulation in your feet by stimulating the development of tiny new blood vessels.

What walking does to your feet?In an average lifetime, we walk about 100,000 miles, which is tough on our feet. Yet our bodies were designed for moving not standing still, so walking is good exercise. Walking helps the muscles and ligaments in our feet to work more efficiently, and helps keep them supple and flexible.

So even if you have to sit around a lot in your job or at home, try to get up and walk briskly for at least 30 minutes every day. Feet are adaptable and can withstand a lot of pressure before they rebel. If you walk a lot, it’s important to wear the right footwear which won’t damage your feet.

Foot Problems associated with walking

• Blisters
• Heel pain - Plantar fasciitis
• Morton’s neuroma

How a podiatrist can help you keep walking

Consult your podiatrist if you start to develop pain when walking, or consider a visit before embarking on your new walking programme.

The main role of the podiatrist is to help you maintain normal mobility and function in the feet and lower limbs. Podiatrists provide the basis for the ideal walking style and posture and identify any  conditions that may require further referral and management. They also relieve pain, treat infections and skin, nail, soft tissue and connective tissue problems. This is achieved in conjunction with other members of a multi-disciplinary health care team. Podiatrists can also give expert advice on footwear, so it is a good idea to take your walking  shoes with you when you go to  see your podiatrist.


For more information visit:
http://www.scpod.org/foot-health/keep-on-walking/

Ingrowing Toe Nails

One of the most common reasons I see patients in my Podiatry clinic is for treatment of Ingrowing toe nails. But what are they? and what can be done about them?

 

Ingrowing toe nails occur when the side of the toenail begins to grow into the skin of the toe. The big toe is most commonly affected, but it is possible to occur in the other toes aswell.  This may then cause pain and discomfort, particularly when pressure is applied to the toe, which will limit and have an effect on daily activities for example, walking.

                                               

What are the Symptoms of Ingrowing nails?

 

 

You may feel anything from mild discomfort to extreme pain. Symptoms will vary between all individuals and may include:

• Slight discomfort when pressure is applied to the nail
• Pain on touch, particularly when the foot is in a shoe, or when under the bed sheets at night.
• The toe maybe red, shiny and swollen.
• There may be overgrowth of skin around the nail.
• Infection may be present- you may see pus or discharge coming from the nail.
• Bleeding may occur

 

It is also important to identify if you do have an ingrowing toe nail. It could also just be a curved nail (or involuted nail). These nails can be just as painful but the nail has not pierced the skin. It maybe that debris (dry skin) or a corn has formed down the side of the nail. This can be easily treated by a Podiatrist  who can clear down the side of the nail and relive your symptoms.

 

 

Causes of Ingrowing Toenails:

There are many reasons why ingrowing toe nails occur and they are not necessarily due to poor nail cutting technique.

• Injury to the toe- For example, Stubbing your  toe.
• Tight fitting hosiery or shoes- This causes excessive pressure on the toes.
• Gait- The way you walk can affect your toes. If your foot rolls inward too much (pronates) this can cause excessive pressure on your toes, leading to deformity of nail shape.
• Foot deformities- Bunions and hammer toes can also cause ingrowing nails.
• Sweaty Feet- Moisture in the skin can make the skin weaker and therefore easily penetrated by nail.
• Brittle Nails- As the nails break off the spikes remaining can easily pierce the skin.
• Fungal Nail infection
• Poor nail cutting technique- Cutting the nails too short or digging down the sides of the nail can lead to the nail piercing the skin.

Self Care

If you think you may have an ingrowing nail here are some tips of how you can self care at home:

·         Salt foot baths may help relieve some discomfort.

·         Wear comfortable fitting shoes.

 

·         Correct nail cutting technique:

            - Cut the nails straight across (it is best to use nail nippers than nail

              clippers as the edge is smaller and not as curved)

            - Don't cut the nails too short.

            - Keep the corner edge visible so it is above the skin and therefore

              not able to dig in the skin.

 

 

·         Good foot hygiene

                        - Keeping feet clean

                        - Change socks regularly

                       

When to seek professional help by a Podiatrist:

 

·         If left untreated an ingrowing nail may become infected, so if unsure it is best to get a Podiatrists opinion.

·         Patients with  poor or weakened immune system, or diabetes should also get checked out as you are more susceptible to infection.

Treatment from a Podiatrist can vary, an ingrowing toe nail does not necessarily mean you will need nail surgery so it is best to seek advice if needed. Podiatrists can:

·       Remove the nail spike or piece of nail digging into the skin.

·       Debride or remove any corns/hard skin lying underneath the nail to clear the nail edge

·       If the nail is too painful to touch the piece of nail can be removed using a local anaesthetic  so that you will not feel any pain as the nail spike is removed.

·       If infection is present antibiotics maybe prescribed. The infection will not fully go until the nail spike has been removed.

·       If the ingrowing nail is persistent and frequently returns it may then be a good idea to undergo nail surgery. This involves removal of either the side or all your nail under local anaesthetic. A chemical called Phenol is used and placed on the nail bed to stop the nail permanently  growing back. It is worth discussing  these options in more detail with your Podiatrist.

 

Disclaimer- This blog is for information only and should not replace Medical attention if needed.