Unlocking the Power of Podiatry: A Must-Have Training for Doctors & Physiotherapists

At some point, many of us have experienced chronic pain or discomfort in our feet and lower limbs. However, it’s often difficult to find the cause of this pain and determine the best course of action for relief. Fortunately, doctors & physiotherapists can now proactively alleviate lower limb problems through podiatry training.

 
Podiatry training provides a quick clinical diagnostic assessment that helps identify the root cause of foot and lower limb issues. This type of training is cost-effective and doesn’t require much investment, making it an attractive option for doctors & physiotherapists looking to expand their services.
 
With the right training, they can help their patients find relief from pain and discomfort while also learning a new approach to managing lower limb problems. This new approach can provide immediate feedback that helps patients understand the cause of their issues and how best to treat them. In addition, podiatry training can help doctors & physiotherapists become more efficient with their time, as they’ll be able to diagnose and treat issues in one appointment rather than having to refer patients to another specialist or wait for results from further tests.
 
By taking podiatry training courses, doctors & physiotherapists can also help boost their business’s revenue. The skills they gain can be used to offer new services that weren’t previously available, which can lead to an increase in patient visits and more money in the bank. Furthermore, the need to hire an orthotist is eliminated, which reduces overhead costs and allows practitioners to keep more of their income.
 
If you’re a physiotherapist looking for a way to take your practice to the next level, consider taking a podiatry training course. Not only will you be able to provide comprehensive solutions for your patients’ foot and lower limb issues, but you’ll also be able to increase your income potential with the added skill set. With podiatry training, you’ll be able to help your patients find relief from pain while giving your business a boost in revenue.

Welcome to the world of Podiatry training! It’s one of the most important skills you can have when it comes to taking care of your feet. Not only does it help to keep your feet healthy and strong, but it also provides you with a range of other benefits as well.

Here are 10 of the most important benefits of Podiatry training:

1. New Skill: Podiatry training is a great way to learn a new skill. Whether you are looking to become an expert in foot care or just want to be able to take care of your own feet, learning podiatry will give you the tools you need to do so.

2. Unique Specialty: Podiatry training provides a unique specialty that many people may not have heard of. As a result, it will give you an edge when it comes to foot care and can open up doors for you in the healthcare industry.

3. Fastest Diagnosis: Podiatry training enables you to quickly and accurately diagnose foot problems. This can help to ensure that your patients get the best treatment possible and can also help you to get your patients back on their feet faster.

4. Immediate Response: One of the biggest advantages of Podiatry training is the ability to provide immediate response in the case of any foot problems or injuries. This can help to save lives and reduce the amount of time it takes for a patient’s recovery.

5. Improve Patients Compliance: By having a better understanding of the foot, podiatrists can help their patients understand the importance of compliance with treatments and follow-up visits. This can help to improve overall patient satisfaction, as well as improve their health outcomes over time.

6. Chronic Problem Can Solve: Many chronic foot problems can be solved through Podiatry training. This includes issues such as plantar fasciitis, bunions, hammer toes, and more. Having an expert handle these cases can help ensure that your patients get the best possible results.

7. Root Cause Diagnosis: Podiatry training enables you to identify the root cause of foot issues quickly and accurately. This can help you determine what treatments will be most effective for your patients, making them more likely to adhere to them in the long term.

8. No Extra Space Required: With Podiatry training, there is no need for extra space or equipment. As long as you have a chair and table available, you can carry out consultations and treatments at your own convenience. 

9. No Need To Hire Technical Support: Podiatry training gives you all of the skills and knowledge that you need in order to provide quality foot care services without having to hire technical support staff or buy expensive equipment. 

10. Revenue Boost: Providing quality foot care services is an effective way to increase your revenue stream in any healthcare setting. By learning podiatry skills, you can make more money by offering specialized services that many other health professionals may not be able to provide. 

Podiatry training is an incredibly valuable skill that provides a range of benefits for both health professionals and their patients alike. If you are looking for a way to expand your career opportunities or just want to learn how to take better care of your own feet, investing in podiatry training could be just what you need!

We are into Podiatry Training courses for the last decade, and our course is certified by LBG Medical UK. For More details kindly contact bellow.

India needs podiatry because of the country's high prevalence of diabetes and neglect of foot care.

SUCCESS STORY OF FLAT FEET WITH POSTERIOR TIBIAL TENDON DYSFUNCTION

CASE STUDY: FLAT FEET WITH POSTERIOR TIBIALTENDON DYSFUNCTION (PTTD)

41 year old female complaints pain & swelling at inner side of left ankle since a year. Pain was gradually increased. Initially it use to hurt on prolong standing & walking eventually pain got worst. Now not even able walk few steps also.

On Examination:

• Swelling was present around left navicular area
• Grade III tenderness at the navicular area

Biomechanical Assessment:
Static-

• Clawing of toes left side
• Medial Arch- Flat Bilaterlly (Flat Feet)
• Transvrse arch reduced
• Subtalar joint- Overpronation bilatrally more on lfert side
   
• Navicular drop- Present bilaterally
• Navicular drift- Present bilaterally
• Calcaneum (Posterior view)- Eversion bilaterally more on left side
• Knee- Valgus

Gait Assessment:

• Gait Pattern- Poor heel to pattern
• Heel Strike- Medial heel strike
• Stance Phase- Overpronation at the sub-talar joint bilaterally
• Limp on left side

Treatment & Advice:
Advice-

Bio-Advance

• Complete rest for one week with cold pack 4 time a day over affected area for 20 min. each time.

Orthotic correction to improve lower limb biomechnical alignment-

• Advised to wear sport shoes (Even indoor) with firm heel counter (Stable Shoes) few days as concidering her pain & sevirity of flat feet.
• Prescribed Bio-Advanced medium density orthotic insole in her shoes & also to reduce stress on Tibialis posterior muscle tendon.

1st Follow up after two week

• Demarkeble changes seen. More than 50% of pain was reduced.
• Added correction in orthotics to further enhance arch support.
• Advised to continue with cold pack. 

2 nd Follow up after one month

Strive

• This time 90% pain reduced.
• Now slight discomfirt only after long stand or walk.
• Adviced Strive orthotic footwear for short distance (Near by) & continue the sports shoes for out door.
• Exercises for strengthening tibialis posterior muscle.

3rd Follow up after 2 months
No pain & Adviced to continue with orthotics

Feedback of Patient's husband

Feedback

Runners: Are you on right track…?

“You know you are a runner when your running shoes are the most expensive shoes you have”

Above line is absolutely true for runner. But expensive shoes doesn't assure that it will be right shoes for your feet. Achieving your desired goal for marathon needs consistent efforts & dedication. Injuries are not new for runners.  These injuries are barrier for your training. Many times you assume that injury&/pain is happening due to excessive running for which your body is not habituated yet. But few injuries become long term like IT band syndrome, Achilies tendintis, Plantarfascitis(Heel Pain) etc. Right medical advice can help you on time to time recovery.

Sometimes person has to give up their passion of running which is very disturbing for runners.

This article is an attempt to give you new insight for your running injuries. Marathon running is a quest in which so many people help you to understand your body Physiotherapist, dietician, trainers and last but not the least Podiatrist are those expertise to  whom you approach after getting any injury. Mentioned above all expertise you are aware but may not be aware of Podiatrist. Podiatrist we can say are foot doctors. Dear runners your feet are most important in living your "pace passion".

"Podiatry is the field of medicine which deals with most important aspect of running i.e. shoes & orthotics."

Yes you are right I am talking about Podiatry science. 

Dear runners your feet are so much important to live your pace and passion

.

Podiatry is a branch of medicine devoted to the study of diagnosis and treatment of disorders of the foot, ankle and lower extremities.

Most of the runners experience pain in calf, shin, heel even knees apart from that blackening of toe nails are few common problems which can be treated with Podiatry.

Am I Pronator/Supinator? is common question asked by patients who are runner.

This image is self explanatory about how to identify whether person is pronatory/supinator.

COMMON FOOT RELATED CONDITIONS WHERE PODIATRY CAN HELP:

• Pain in calf muscles: Typically described as tired aching legs. Because of faulty foot posture (Flat feet or high arch) can reduce efficiency of calf muscle.

• Toe nail blackening: Many runners use one size bigger shoes with misconceptions that foot swells after running. Due to this foot slide inside the shoes & can lead to blackening of toe nails. This way using tight or loose fitting shoes both can lead to blackening of toe nails.

• Achilles Tendinitis: Further calf muscles can get strained at its insertion which is back side of heel which is called as achilies tendinitis. To know more click here...

• Plantarfascitis: Pain below heel which aggravates after rest initially. Later it also aggravates after running certain distance. Pain is due to inflammation of plantar fascia which is ligament below the feet. To know more click here...

•  Ankle pain: While running you may land up in ligament injuries. High arch person (Supinator) is prone for straining of ligament/muscles on outer side of ankle. Overpronators can injure inner side of ankle. Sometimes patterns are variable depend on many factors like tibial varus/uneven terrain. To know more click here...

•  Shin Pain: Pain in inner/outer side of shin area known as shin splints. Including alignment issue, calf tightness and running surface also causing factor for the pain

•  IT Band syndrome: Runners are very prone to ITB (Ilio Tibial Band) injury deu to following factors.

1.  Narrowed stance in running and loss of double limb support
2.  Fatigue of the hip abductor group producing a “droopy pelvis”
3. Female runners are more susceptible to ITB problems due to slightly wider pelvis

Apart from above knee pain, back pain is also very common in runners and closely related to altered lower limb biomechanics.

ORTHOTICS Vs INSOLES:

Many people pick up off the shelf available insoles & feel that they are sorted with their flat feet/any foot correction. But it is absolutely wrong. Orthotics need to customize as per your particular foot alignment which is expertise task.

Podiatrist need to do through evaluation of lower limb biomechanics & then design orthotics accordingly.  As mentioned earlier it’s not only pronation/supination issue but alignment all proximal joints is important.

Before making orthotics it is important to be sure that your running shoes are appropriate. Following is basic guideline for shoes.

1. Basic shoes test:  There are few basic shoe tests are necessary, before going in arch pattern.

•  Flex Test—by pushing down on the shoe, the breakpoint, should be firm but not provide
  significant resistance.   
  
•  Torsion Test—by twisting the shoe in opposite directions, this will check the stability of the soling.  If the shoe twists over on itself, inadequate support.
• 
  
  
• Counter Test—by grasping the heel of the shoe, apply pressure to the heel counter with your finger.  If the counter collapses with little/no resistance, the shoe is not supporting the heel.
  

2. Shoe size: Shoes should appropriate to your foot size as well as width. If your foot is broad then you should buy Wide shoes & not a size bigger. 

After wearing shoes there should be thumb nail gap between shoe front & your longest toe.

With proper traning, right shoes and orthotics can drastically boost your performance. V-Care Clinic is working in the field of Podiatry since many years. We follow guideline provided by UK Podiatrist. To know more about your feet & posture visit us.

Our Address.

V-Care Clinic

305 Akruti Arcade, Opp. Wadia School, Azad Nagar Metro Station, J. P. Road, Andheri West, Mumbai 4400053

e-mail- doctor@vcarerehab.in

web- www.vcarerehab.in

contatc- 022-65585515

HOW PODIATRY: AN INNOVATIVE SOLUTION TO ANKLE, FOOT AND LOWER LIMB PROBLEMS

Podiatry must definitely be a new word for many people among us. But before we get into the details of Podiatry, let's answer the question that why is there a need to gain knowledge about foot or problem related to it ??? As we have commonly known that while constructing any structure it is essential for the basement to be strong and sturdy. Taking this fact into consideration, we infer that when it comes to the Human body, the Foot is that important base which is needed to perform the human functions of mobility and stability. There are 26 bones, 33 Joints, 107 Ligament & 19 Muscles which are intricately connected to each other to complete the anatomy of foot.  Hence, if the alignment of the base i.e. the foot is affected it will have repercussion that will affect our postural alignment. But unfortunately, most often, this amazing structure is neglected & not given the care & attention it needs.

Standing and walking are integral part of our daily routine. However, people do not give heed to foot problems until it hampers their standing or walking routine severely. This is the fundamental reason foot problems are not easily treated and hence are ignored. However, ignorance is not always bliss. Since our feet & the ability to move is what demarcates the difference between INDEPENDENCE & DEPENDENCE.

Podiatrist is a doctor who specialized in treating conditions related to foot, ankle and lower limb. Consequently, the medical science of diagnosis and treatment of foot, ankle and lower limb related problems called Podiatry. Although still an alien term, Podiatry has been in practice since early 1900s in America, Australia & Europe.

FOOT SCREENING

Now that we are acquainted to & agree on the importance of foot. Let’s get an insight on some common signs which will help you to identify any foot related problem and screen yourself. So you can check for yourself for following signs.

Other Toes

Great Toe Deviation (Bunion)

Flat Feet

Corn & Callus

Heel

Shoe Wear Out

LOW BACK PAIN AND KNEE PAIN

 

The human musculoskeletal system can be considered facsimile to a chain link. If the position of any one end is changed or if anyone links, is broken, then it will damage the entire chain link.  Thus, altered foot alignment can result in knee pain & back pain. Therefore, there is an interconnectivity between the foot, knee and spine.

DIABETES

 

Diabetes is a multi system metabolic disorder which even has its implications on the normal functioning of foot. However, the treatment of foot complications related to diabetes is an entirely different domain (elaborated in previous article)

    It causes two major problems in feet

• Poor blood flow (PVD)
• Damaged nerves (Diabetic Neuropathy)

WHAT DO YOU DO NOW?

In case you have incurred any of the above enlisted problems, who do you approach for the same. The answer is a Podiatrist.

HOW DOES IT WORK?

Before starting the treatment it is essential to identify the root cause, which can only be known after a thorough assessment. This assessment involves the following-

•       Understanding the patient’s complaints & lifestyle.

•       Visual inspection of FEET- Skin Condition, Colour, Corn/Callus/Ulcer

•       Foot Alignment & Posture.

•       Gait Analysis.

•       Foot sensation.

•       Measure foot size- Length & width.

•       Inspection of the patient’s footwear.

THE INNOVATIVE SOLUTION

Once you understand the main reason of the problem, Podiatry line of treatment includes following-

1. Shoes: Appropriate shoes as per patients problem &  lifestyle demand, Doctor will guide you about sports shoe specifications, size & other details.
2. Prescribe corrective Orthotics:

The main solution is corrective Orthotics (also known as insoles). Use of such orthotics helps re-align the body in a corrected posture & thus provides a long-term solution without any side effects.

COMMON FOOT RELATED CONDITIONS WHERE PODIATRY CAN HELP:

Flat Feet Plantarfascitis/Calcaneal spur(Heel Pain) Calcaneal Apophyasitis High Arch Bunion Metatarsalgia Morton’s Neuroma Hammer toes

Ankle sprain Achilles Tendinitis Posterior Tibialis Tendon Dysfuncion Knee pain Back Pain, Leg length Discrapancy Accessory Navicular Bone Corn & Calluses Diabetic Neuropathy

Other Problems

KNEE PAIN

Knee Pain

As explained earlier, foot is the supporting structure/ base of the human body. Any change in the alignment of foot will reflect its effects on other proximal joints.

Knee Deformities

 Most commonly people suffering from flat feet are more prone to knock knees (Genu Valgus) deformity in the knee joint which affects outer compartment of knee joint whereas people with high arch are susceptible to bow legs (Genu Varus) deformity which affect the medial compartment of the knee joint.

LIMB LENGTH DISCREPANCY (LLD) & BACK PAIN

The human body is an epitome of balance. If there is any deviation from this balanced state the system go into malfunction. The same holds true while considering the length of lower limb. If there is any difference in the length of the two limbs, it alters the position of the pelvis. This in turn affect the spine resulting in Scoliosis i.e. tilting of the spine on one side.

In severe cases along with the spine the ribs also undergo rotation causing a rib hump. Once the vertebral bodies start rotating the spinous processes deviate more & can even compromise the respiratory capacity in sever case.

Treatment:-
If the reason for the scoliosis is LLD then it is advisable to detect the exact length of discrepancy. This can be corrected by adding the exact amount of compensation in the footwear to prevent further deterioration of the spine. Another important aspect is physical therapy intervention to maintain the flexibility & strength.

ACCESSORY NAVICULAR BONE

Accessory Navicular Bone

Accessory Navicular bone is a congenital condition in which an extra bone or cartilage which is present next to the Navicular bone on the inner side of  foot just above the arch region. In most of the cases it is undiagnosed as it does not give rise to any symptoms.

Accessory Navicular Bone

However a few percentage of people with accessory navicular develop a painful condition called as Accessory Navicular Syndrome.

Causes:-

• Recurrent trauma to the ankle or foot such as ankle sprain.
• Improper size & pattern of footwear which causes friction against the extra bone.
• reduction in arch.
• Injury to Tibialis posterior tendon.

Symptoms:-

• Redness & swelling over the inner side of the foot in the arch area.
• Pain on palpating the area of extra bone.
• Pain while walking & standing activities.

CALCANEAL APOPHYSITIS

An apophysis is a growth plate which is present at the end portion of the bone when there is no accompanying bone, Calcaneal apophysitis is an inflammatory condition which affects the growth plate present in the heel bone (Calcaneum). It usually occurs in kids falling in the age group of 8-14 years as till the age of 14 years the growth plate continues to grow. Repeated stress or trauma to this sensitive area results in inflammation & damage to the growth plate.

Causes:-

It is most commonly seen in kids participating in sports which result in high impact over the heel area which ultimately damage the still underdeveloped growth plate. Furthermore kids who have other alignment issues such as flat feet or high arch are more susceptible to this damage.

Symptoms:-

• Pain in the heel area.
• Excessive pain on squeezing the sides of heel.
• Pain on standing or walking which become worse as the time increases.
• Limping
• Inability to perform activities such as running, jumping & skipping.

TIBIALIS POSTERIOR TENDINOPATHY

Tibialis Posterior Tendinitis/ Tendinopathy is also know as Posterior Tibial Tendon Dysfunction (PTTD). The tendon of Tibialis posterior muscles is one of the most important supporting structures for the arch of the foot. This muscle originates from fibula & inserts over the medial cuneiform & navicular bone.

When the function of this tendon is impaired, it alters the walking pattern & is unable to provide adequate support to the arch. If left untreated overtime this muscle loses it's integrity & the arch collapses. This is termed as 'Adult acquired flat feet.

If the person continues to walk in this pattern it leads to outward deviation of toes & rolling inwards (Pronation). Therefor early treatment is advisable.

Treatment

• Reduction of inflammation over the tendon.
• Use of ankle brace while walking during the initial period to support the tendon & allow it to heal.
• Physical Therapy exercises to reduce pain & strengthen the muscle to prevent further complications.
• Use of corrective orthotics to prevent the arch from collapsing completely.

ACHILLES TENDINITIS

A Tendon is a connective tissue present at the end of the muscle & connect muscle to the bone. The Achilles tendon connects the calf muscle to the heel bone.
Inflammation of this tendon is termed as Achilles Tendinitis. It is characteristically an overuse injury. It results due to a sudden or gradual increase in repetitive activity which involves function of Achilles. But since the tendon is not exercised to bear the exerted stress, its fiber go into micro trauma. This micro trauma continues to accumulate overtime & results in injury to the tendon as the the body does not get the adequate time & rest required for healing.

Achilles tendinitis is more common in athletes involved in sports which require running & jumping activities. Therefore any such athletes who undergoes less than appropriate conditioning are more prone to such injury.

Apart from them another population in whom such common are the 'weekend athletes' i.e. who play sports occasionally without proper training. Another important variant is the type of shoes used while indulging in high impact sports. Not many people are aware about this predicament & hence damage their body. Therefore it is vital to select shoes which suit your arch type.

Symptoms:

• Pain & swelling over the calf region or above the heel bone.
• Early morning stiffness on walking after rest.
• Difficulty on standing & walking for long duration.

Ankle Pain

Ankle pain is a wide term that includes many causes which predispose to the pain in the ankle joint, however some of the common causes of ankle pain may include fracture, tendon inflammation, arthritis, gout, ligament injuries and the list goes on….

But the most common and predominant cause of ankle pain, include injury to the ligaments that surround the ankle joint which could otherwise be called ankle sprain or ligament sprain.

What are ligaments??

Ligaments are band of tough elastic tissue around our joints. They connect bone, give our joints support, and limit their movement.

So, when there is an excessive movement to the joint, the ligaments gets stretched or eventually tears which leads to ligament sprain.

ANKLE SPRAIN

Similarly when excessive stretch is put to the ligaments of the ankle which could either be caused due to faulty alignment of the foot, walking patterns on different terrains or sudden ankle twist as in the case of sport injuries can cause ankle sprains.

There are medial (Inner side) ligaments (deltoid) and the lateral (outer side) ligaments that surround the ankle joint. The most common injury is at the lateral ligament is less common which is caused due to outward rotation of the foot (Eversion).

                There are 3 grades of sprains depending upon the severity of injury.

The most commonly affected ligament is the anterior talo-fibular ligament & gets affected due to injury resulting in inward rotation (inversion) of the ankle.

A less common type of ankle sprain occur due to outward rotation (eversion) of ankle & injuries the deltoid or medial ligament.
Foot arch is responsible for supination (High arch) & pronation (Flat Feet) throw ankle more outer

border or inner border of foot respectively. Chances of inversion ankle sprain in supinator which is more common & eversion ankle sprain in pronators are more.

Causes:

• Trauma or fall is the most common cause.
• Weak musculature.
• Increased laxity &/ reduce stability of ligaments.
• Walking in high heels or footwear with inappropriate platform.
• Walking or running on uneven surface.
• Faulty foot alignment.
• Impaired balance.

Symptoms:

• Pain & swelling over ankle.
• Inability to bear weight over affected limb.
• Stiffness in the joint.

Treatment:

The most basic approach is to follow the PRICE protocol. This abbreviation stand for the following:

P- Protection- which can be attained by use of brace while walking or standing activities. Selection of the brace should be according to the grade or level of ankle sprain. 

R- Rest- which is required for allowing healing. If the patient attempts to walk with the present injury then the chances of further damage are high.

I- Ice pack- This helps in reduction of inflammation & helps in draining out of the end product which helps in pain reduction.

C- Compression- which also can be achieved by the use of braces that provide adequate support.

E- Exercise- which is the most important aspect. 

•  Physiotherapy for the ankle sprain includes strengthening of the weakened muscles around the ankle joint. Muscles around the ankle joint plays a very important role in maintaining the integrity of the ankle joint).
  
• Balance Training

• Proprioceptive Training

Similarly as mentioned earlier, the type of the foot (Flat Feet / High Arch) also plays a very important role in stability. Depending on the type of Arch, shoe modifications with proper insoles and firm ankle grip is important to prevent re-occurrence of the Ankle Sprain.

Apart from the above if the cause of ankle sprain is faulty foot alignment then it is necessary to administer appropriate treatment for the cause or consult podiatrist.