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Blog 13 – I think I have a bunion forming, what can I do about it?

Have you recently (or not so recently) noticed a bump forming on the side of your foot where your big toe starts?  Does it now hurt to walk or is the bump red and painful to touch?  You could have the start of a bunion, a common (but sometimes painful) issue that effects over a quarter of the Australian population (over a third of the population if you are 65 or older).

What do bunions look and feel like?
First off, let’s be clear on what a bunion and what it looks & feels like so you can be sure if you have this common ailment. Symptoms of bunions tend to increase over time as the condition worsens, typical symptoms include:

  • Deformity of the big toe joint
  • Growth of a bony lump at the side of the big toe joint
  • Pain, redness and tissue swelling over the big toe joint, with thickening of overlying skin
  • Pain when walking (particularly during the “push off” phase)

People with advanced bunions can sometimes be so pronounced that the big toe overlaps or underlays the second toe.  Advanced cases like these can be very painful and debilitating, which is why it is very important to seek professional guidance now if you look to have the early stages of a bunion forming.  Treatments can be implemented in the early stages to slow down the progression of a bunion.

How did I get a bunion?
Some people are more susceptible to bunions than others due to the structure of the bones in their feet. This has been demonstrated consistently over time with some families having a problem with bunions, while other families don’t. In other words, your genetics play an important role in whether you will get a bunion… however that isn’t the only reason and there are things you can do (i.e. your behaviour and habits) to lessen the chances of getting a bunion.

Fun police warning: wearing shoes such as high heels and / or pointed toe shoes will increase your chances of getting a bunion, particularly if you wear them all day, every day.

Other factors that are known to increase the risk of bunions include:

  • Certain arthritic conditions and ligament disorders
  • Age (the incidence of bunions increases with age)
  • Being flat footed with feet that roll inwards
  • Past injury (trauma) to the foot

I am now sure I have a bunion forming, what can I do to slow and stop its growth?
The most important thing to do when treating a bunion is to reduce the pressure that has been placed on the bunion that created it in the first place.  There’s not much you can do about changing your genetics but certainly addressing the underlying reason you have the bunion (poorly fitted footwear, flexible flat foot) can have a positive impact in slowing down the growth of your bunion.  Wearing properly fitted and appropriate footwear is a must.

From there, a detailed biomechanical assessment of your foot and walking style would be conducted to understand whether a need for special orthotic devices is required, such as custom-made arch supports or shoe inserts.  These devices can help to relieve tension on the big toe and help prevent flat footedness. It will also be important to prescribe an exercise program to strengthen your foot muscles for correct form and function to further assist in bringing the toe joint back into alignment.

In severe cases, if a sufficient reduction in symptoms is not achieved by non-surgical treatment, then surgery may be recommended by your Podiatrist.

The most important thing you can do now to stop your bunions getting worse, and avoid the possibility of surgery, is to wear properly fitted shoes as much as possible.  You may not look as good when going to work, or hitting the town, but it will be worth it in the long run.  If you think you have a bunion forming and would like to get more detail on the treatment options discussed here, please give our Reception a call on (03) 9457 2336.  It is important to get expert advice as early as possible when treating bunions, so don’t hesitate to give us a call if you have any concerns.

Blog 12 – Looking after your feet in Stage 4 restrictions

Unless you are one of the relatively few permitted workers that can still go into work, the rest of Melbourne is essentially house bound until the Stage 4 COVD-19 restrictions are lifted. Literally millions of Melburnians are now spending the clear majority of their time indoors and around the house.

What does this mean for Melbourne’s feet?
Whether you are working from home, or just stuck at home, it is quite likely the average Melburnian is not wearing supportive footwear like they used to when they left the house pre-COVID (which feels like a life time ago now).

It’s safe to assume the number of people wearing slippers and Ugg boots, and the duration they are wearing them, would have sky rocketed over the past six months since COVID-19 reached our shores. If you own shares in a company that makes slippers, the lockdown is not all bad news, however the lockdown is not good news for your feet. Slippers are not designed to worn all day every day, and that kind of usage brings with it potential foot health problems you’ll need to watch out for.

It’s not a good idea to wear my trusty, super comfy slippers all day??
Firstly, consider the purpose of your common slipper or Ugg boot. They are designed to keep your feet nice and warm first thing in the morning, or late at night as you are winding down for bed. Slippers and Ugg boots have the following characteristics:

  • Zero support for your feet and arches
  • Are loose fitting and packed with faux-fur
  • Offer virtually no grip on their soles
  • Have even less cushioning for absorbing impact

They are built for comfort and warmth, and not much else. Consider what this means for someone’s feet when they are now wearing slippers up to 16 hours a day…

Wearing slippers and Ugg boots all day could cause foot health issues
With slippers and Ugg boots becoming the first choice in foot wear during the lockdown, people may start to experience the following issues:

  • Foot pain – constantly wearing slippers that offer no support can place increased pressure on the arches of your foot (this pain can also refer to your ankles, knees, hips and even lower back)
  • Tinea / fungal nail – Fungal infections thrives in the warm and sweaty conditions of constantly worn slippers, the perfect place for an infection to start and spread like wild fire
  • Bacterial infections – Bacteria, like fungi, love moist and warm environments.  Skin conditions like pitted keratolysis can cause pits to form in the skin and lead to smelly feet. So if your feet are a bit on the nose, check underneath your foot.
  • Slips and falls – slippers and Ugg boots are loose fitting and offer very little grip, especially if you are walking around on tiles, so slips, trips and falls are more likely (more so people over the age of 70)

Ok, I get it, don’t go overboard on wearing my slippers… so what do I wear on my feet instead?
It looks like Jerry Seinfeld may have been onto something with wearing a quality pair of sneakers around the house as they offer great support for your arches and fit snugly around the rest of the foot.

Also, we recommend you check out your current pair of slippers to see if the sole is worn down and / or the faux-fur cushioning on the inside is starting to smell. Slippers and Ugg boots weren’t designed to be worn up to 16 hours a day and it might be time to throw them out and get another pair that you wear sparingly around the house. Be sure to review your feet about once a week to check their appearance for any infections or changes in your skin.

If you have any questions about slippers and foot health, please feel free to give us a call on (03) 9457 2336 and ask to speak to one of our experienced Podiatrists.

Blog 11 – How to prevent blisters

Blisters are painful and can stop you in your tracks!  People of all ages and activities can get them.

Blisters are caused by excessive moisture and friction.  Usually this means your feet have become too sweaty or have come in contact with water.  Moist skin is much more vulnerable to the pressures of walking and running.

Moist skin, combined with activity and footwear that doesn’t fit well is a recipe for blistering!  A blister is when the top layers of the skin separate from the ones below and fill up with fluid.

Prevention is always better than cure. To prevent blisters consider the following:

 Socks

Thick socks are best – they absorb more moisture.  If there is room in your shoe try 2 pairs of socks; one thin and one thicker pair.

Moisture wicking socks help keep your feet dry by taking the moisture from the skin surface to the outside of the sock where it can evaporate through the mesh of your shoes.  Brands include Thorlos, WrightSock, Darntough and Lightfeet.  You can buy these at Rebel Sport, good footwear stores or online.

Antiperspirants

If you have unusually sweaty feet then a product such as No More Sweat can be used.  This product will temporarily constrict the sweat duct and can be purchased online or from your pharmacy.  Some people also find that wiping feet with alcohol wipes in the days leading up to a big walk/run can be helpful.

Footwear

Consider Gortex or waterproof footwear if you will be exposed to rain or other sources of water during your activity.  Some people do, however, find waterproof shoes a lot warmer and thus their feet can become sweatier.  It might be better in many cases to just change your socks if your feet become wet in your shoes.  Have your shoes fitted and choose the right shoe for the activity you are doing.

Callouses and Toenails

Callouses and corns can add to the pressure on skin and be hot spots for blisters; use a pumice Stone/Foot File to remove them at home.  If you have deep corns or thick callouses, it is advisable to have them reduced by your podiatrist before you head out for a big walk or away travelling.

Long or curved toenails can also be a source of toe blisters; keep them short (not too short!) and don’t cut down the edges of your nails as this can cause ingrown nails. Consult your podiatrist if you need assistance.

Preventative Taping

Hypoallergenic tapes such as Hypafix/Mefix/Fixomull are fantastic when layered on potential blister sites; any friction that occurs will be on the tape, not on your skin.

For persistent blistering, orthotics and/or in-shoe padding can be beneficial to redistribute pressure.

A personalised blister management plan can be made by your Podiatrist.  The experienced Podiatrists at Bellevue Podiatry will give you a comprehensive treatment, specific management techniques and education for your needs.  Please give us a call on (03) 9457 2336 to make an appointment.

Blog 10 – The Importance of Foot Strength

The Importance of Foot Strengthening to Reduce Falls

As we get older, something that is important to start considering is our increased risk of falling and injuring ourselves.  It is a frightening fact that the chance of falling becomes much higher as we age.  In fact, one third of people over sixty-five and half of people over the age of eighty-five will fall every year.

While that may be an alarming statistic, the good news is that you can significantly reduce the risk of falling through foot strengthening exercises and choosing the correct footwear.

The muscles in our feet are critical in saving ourselves from falling.  These muscles weaken over our lifetime, so they require a simple strengthening program tailored to your feet to keep them doing their job as best they can.  It takes just a three percent increase in toe strength to reduce your risk of falling by twenty percent.

At Bellevue Podiatry, we use a specifically designed platform called the ‘ToePro’ (find out more at www.mytoepro.com.au) to strengthen the foot muscles.  This platform places the foot in a position that the muscles would be used to in walking, which strengthens the muscles four times faster than doing exercises with the foot flat on the ground.  Our podiatrists are all trained to use the ToePro and will tailor a program specifically to your needs.  This strengthening can start to show results in a matter of weeks.

Another very important factor in avoiding falls in older people is footwear.  The wrong choice of shoes can drastically increase your chances of falling.  When choosing footwear to avoid falls, we know that a range of features in a shoe are crucial.  Here are some important things to remember:

  • The heel base should be wide; narrow or very tapering heels reduce stability.
  • The base of the shoe should have grip to it; try to avoid shoes with smooth, slippery soles.
  • The shoes should always have either laces or a strap.
  • The heel counter, the part of the shoe that wraps around the back of the heel, should be firm and not easily squashed with your thumb.
  • Avoid wearing slippers, socks, or bare feet at home all day as this increases your chance of falling by up to 50%. If you can, keep a pair of shoes (that incorporate the features listed above) to wear around the house.

Following this simple advice can help you stay active and enjoying life!  If you have any questions about what you have read here and would like to know more, please give us a call on (03) 9457 2336 to discuss further.

Blog 9 – What you need to know about Shockwave Therapy

What is Shockwave Therapy and should I consider it as a treatment option?

We make it a consistent habit at Bellevue Podiatry to review the latest research literature – this lead us to take a close look at Shockwave Therapy as an effective treatment option for Plantar Fasciitis and other chronic tendinopathies.

If you haven’t heard of Shockwave Therapy, and have tried other conventional treatments for your chronic heel pain or Achilles tendinopathy without success, please read on and let us explain what Shockwave Therapy is, how it works, and what injuries and aliments it has shown to be effectively treat.

What is Shockwave Therapy and how does it work?

As the name suggests, Shockwave Therapy uses a patented technology to generate acoustic shock waves of pressure that can be applied to various injuries and aliments to trigger the body’s natural healing processes.  A number of clinical studies have shown Shockwave Therapy can provide the following benefits:

  • New blood vessel formation: The application of acoustic shockwaves waves creates capillary micro-ruptures in the tendon and bone which in turns triggers the body’s natural healing processes.  These healing process create new blood vessels that improve blood supply and oxygenation of the treated area and support faster healing.
  • Reversal of chronic inflammation: Mast cells play a crucial role in the healing process, and clinical studies have shown Shockwave treatments trigger mast cell activation which in turn triggers the body’s healing and regenerative processes that lead to a reversal of inflammation.
  • Stimulation of collagen production: The production of a sufficient amount of collagen is a necessary pre-condition for the body’s repair processes to be effective – clinical studies have shown shockwave therapy accelerates procollagen production.
  • Breaking down calcium build-up: Calcium build-up is most often a result of micro-tears or other trauma to a tendon.  Shockwave therapy starts the decalcification of the calcium build-up and the granular particles of calcium are then removed by the lymphatic system.
  • Pain reduction: If you lower the concentration of pain neurotransmitters in the injured area you reduce the pain felt.  Clinical studies have shown that acoustic waves generated by Shockwave therapy lower the pain neurotransmitter concentration and trigger pain relief.

What injuries and aliments does Shockwave Therapy work on?

Shockwave Therapy is used to treat injuries and aliments all over the body – from calcifications in the shoulder, to tennis elbows, to hip pain and more.  However, for obvious reasons, at Bellevue Podiatry we are interested in what foot & ankle injuries Shockwave Therapy has been shown to effectively treat through clinical studies.  We discovered the growing body of evidence shows Shockwave Therapy can be an effective treatment option for:

  • Heel Spurs / Plantar Fasciitis: Calcium deposits on the underside of the heel bone (heel spur) is closely associated with scarring or inflammation of the plantar fascia (plantar fasciitis).  Shockwave therapy treats both of the problems simultaneously.  In one clinical study, acoustic waves were responsible for faster recovery and return to daily routine with long-lasting effects in up to 88% of the patients.
  • Chronic Achilles Tendinopathies: Cumulated micro-traumas from repetitive overloading can result in chronic tendinopathy.  Both inflammation of the tendon and damage on the cellular level are successfully treated with Shockwave.  In one clinical study, it was reported over 75% of patients were “very satisfied” with the results of Shockwave Therapy on their Achilles Tendinopathies.

Should I look further into Shockwave Therapy as a treatment for my heel pain or Achilles tendinopathy?

As we mentioned at the start of this blog, Shockwave Therapy can be an effective treatment option where other conventional treatments have been tried unsuccessfully.  If you are at a stage where surgery has been recommended, we would recommend you investigate Shockwave Therapy first before considering surgery as a last resort – it could save you a trip to the operating theatre.

It is important to keep in mind that Shockwave Therapy is used primarily for chronic heel pain or Achilles Tendinopathies, so you would need to consult with an experienced Podiatrist and seek their professional advice on when Shockwave Therapy would be appropriate for you to consider.  You wouldn’t typically try Shockwave Therapy without first confirming if other conventional treatment options weren’t effective.

If you think you may be a suitable candidate for Shockwave Therapy after reading this blog (or if you have any further questions about it), please give our Reception a call on (03) 9457 2336 and we will get your details so one of our experienced Podiatrists can call you back and answer your questions and provide more details.

We use the market leader in Shockwave machines at Bellevue Podiatry – Swiss Dolorcast.  Please check out their webpage to understand more about the science behind Shockwave therapy.

 

Referenced research:

  • Wang, C. J., Wang, F. S., Yang, K, D., Biological mechanism of musculoskeletal shockwaves. ISMST Newsletter, 2006, 1 (I), 5-11
  • Am J Sports Med November, Radial Extracorporeal Shockwave Therapy Is Safe and Effective in the Treatment of Chronic Recalcitrant Plantar Fasciitis, 2008 vol. 36 no. 11 2100-2109
  • 16th International Congress of the International Society for Medical Shockwave Treatment, Extracorporeal Radial Shockwave Therapy for the Treatment of Achilles Tendinopathies, 2013

Blog 8: Back to school – what shoes to buy?

As we prepare ourselves for the school year ahead, typically one of the activities on the list is to buy new shoes for our ever-growing children.  As our kids get older and morph into “independent” teenagers, we not only need to make sure we are buying the right shoes for their feet, but we also need to consider the right shoes for their image in the schoolyard – something they will have a lot to say about.  It’s a great outcome when we can buy shoes that support our children’s growing feet, while also buying them shoes that are happy to wear in front of their friends.

As buying school shoes is usually a joint decision with our children, keep these key points in mind when you take them shopping for this year’s school shoe:

  1. Buy the right size: When buying shoes it is tempting to buy a size too big for them so they can grow into them (and you’re not back at the shoe store in a couple weeks).  We don’t recommend this as buying shoes that are too big can lead to a range of issues such as clawing of toes, knee pain and blisters due to excessive movement of the foot inside the shoe.
  2. Buy shoes that provide good support: This is where you and your child may differ in opinion, but it is very important that any shoes you consider buying have a sturdy sole and stiff heel.  Make sure you try and bend any shoes they want you to buy them to make sure there is adequate strength and support in the arch.  If the shoe bends like a thong, that’s a definite no – regardless of how “cool” your child thinks they are.  You should always insist that your child wears shoes with laces or buckle, and that the shoes are deep enough for their feet and not too tight.  We also recommend you remove the inner sole from the shoe and place it on the ground, then get your child to place their foot on it – if their toes go over the end, the shoe is too small.
  3. If buying shoes for sport, do your research: If you are buying shoes for your child’s sport, make sure you do your research on the particular type of sport they are playing and buy shoes to match.  Your child could damage their feet if you buy them running shoes that they wear playing tennis.  Running shoes are not designed to twist and turn around a tennis court, so be sure to talk to your child about the importance of matching the right shoe to the right sport.  They may absolutely love the latest Nike basketball shoes but they won’t be able to run around the track in them due to the high ankle support.
  4. One for the teenage daughters – avoid high heels: This is one for the older teenagers that may be starting part time jobs during their final years at school that allows them to dress casually.  Teenagers’ feet are still developing as they approach their 20s, so regularly wearing high heels can do significant damage to your daughters developing feet.  Squashing the toes into a narrow toe box, while focusing the body weight on the ball of the foot can lead to flattened arches, bunions and a range of other foot aliments you want your daughter to avoid.
  5. Encourage your teenager to look after their shoes: Once you have made a purchase you can both agree on, it is important to encourage your child to look after their shoes and practice good foot hygiene (e.g. don’t leave sweaty socks inside their school shoes as it will increase the chances of tinea).  We also recommend, particularly with sports shoes, that children make sure they clean them after use if required.  Leaving mud caked on footy boots will significantly shorten their life and make them less flexible and supportive for your children’s developing feet.

So, with a little expectation setting up front (and a good helping of patience), you should be able to agree on a pair of school shoes with your children that provide good support for their feet, and they will wear proudly in front of their peers.  All the best!

Blog 7: What You Need To Know About Shin Splints

Shin splints – what are they and how can I get rid of them?

If you’re a runner, or exercise regularly, you likely know how shin splints feel, but you may not know why they occur, or more importantly, what you can do to get rid of them.  In this blog we talk about what shin splints are and what can be done to treat them so you can keep exercising pain free.

What are shin splints?

When you increase your training work load too quickly, or run a lot on hard surfaces, or just don’t give yourself enough time to recover between workouts you can damage the muscle that attaches to your shin and experience anything from a mild discomfort to serious pain that impacts on your ability to walk – damaging this muscle is known as shin splints.

What causes shin splints?

As we mentioned, over-training or running on hard surfaces could trigger shin splints, but the same type of exercise may not cause shin splints in someone else, how come?

Well, when understanding shin splints, you need to not only take into account the external factors such as training frequency, or footwear, but also the person’s biomechanical movements.

There are many different biomechanical movements involved in running or exercising that may not be properly balanced and be contributing to your shin splints (e.g. you have poor core stability or decreased flexibility in one or both of your ankles).  This is why it is important to see a trained health professional when dealing with shin splints – unless you accurately diagnose all the factors contributing to your shin splints, there is a very good chance they will come back if you just rest until the pain goes away (which is what most people do, and not surprisingly, is why most people struggle to get rid of shin splints).

How do I know if I have shin splints?

It’s pretty straightforward, if you exercise regularly and find you have a dull ache starting to flare up down the front of your shins, or up the back of your lower leg starting from your ankle and moving up to your calf, you may have shin splints.  These areas can also be painful to touch or when applying moderate pressure and you should take action to resolve your situation before it gets worse and impacts your daily movement such as walking or getting out of bed.

What treatment is available for shin splints?

The important thing to keep front of your mind when resolving your shin splints is to accurately diagnose the root cause and then put an effective treatment plan in place that ensures they don’t come back – this is not as easy or obvious as it sounds.

First off however, it is important to rest and ice your shin splints.  This initial treatment phase is crucial as it stops your shin splints from getting worse and gives your body the much needed opportunity to heal.  The tried and true soft tissue treatment of rest, ice and protection is how you should first start your shin splint treatment, but this alone won’t stop your shin splints coming back.

It is important during this healing process that you stretch, lengthen and mobilise the muscles running down your shin that were injured.  This will help strengthen them and better position you to safely face the next challenging workout without injury.  Your Podiatrist can advise you of the types of exercises, and their frequency, to optimally strengthen the specific shin muscles that you have injured.

A side note for the muscle strengthening phase is that your Podiatrist will need to also consider your biomechanical movement – some shin splints are caused by poor biomechanical movement and may require the assistance of orthotics or a specific exercise plan that corrects your biomechanical imbalances.

Finally, you need to get back in the game… but rushing back too soon, even after you have rested, iced and strengthened your shin muscles, can still lead to injury if you don’t treat this final stage of rehabilitation with caution and respect for your body.  You should discuss with your Podiatrist what training goals you have, and your timelines to reach them, so the two of you can work together to develop a “return to fitness” plan that meets your needs without risking further injury.

Left untreated, shin splints can become a serious issue that not only stops you from training, but can also cause you serious pain when walking.  Don’t risk it, if you think you have shin splints, you should do something about it before it gets worse and ends up taking you longer to repair and rehabilitate.

Blog 6 – Ingrown toenail causes and how to fix them

Ingrown toenails are easily one of the most common, and potentially painful and debilitating, foot health issues we see at Bellevue Podiatry. Ingrown toenails typically effect the big toe, and occur when the nail grows around the side of the toe, and can cause pain, inflammation and even serious infection if left untreated.  There are a number of causes for ingrown toe nails, which is why they are such a common issue. You can get an ingrown toenail from:

  • Not cutting your toenails properly and one side ends up growing in the side of your toe
  • Stubbing or injuring your toe may cause the nail to grow abnormally into the side of your toe
  • Wearing shoes long-term that are too small can force your nails to grow into the side of your toe
  • Picking or tearing the corners of your toenail (you’re just asking for an ingrown toenail if you do this)
  • Playing lots of sport (i.e. sweaty feet) can make your skin softer and more susceptible to ingrown toenails
  • People can get ingrown toenails because their toenails are curved and grow that way (tough break)

If you catch an ingrown toenail in its early stages, you may be able to self-treat your situation at home and not need to see a Podiatrist. If you think you may be in the early stages of an ingrown toenail, you can try soaking your feet in warm water a few times a day for about 15 minutes. This will soften the nail and allow you to place a small piece of cotton wool under the nail – this will hopefully provide a successful barrier between the nail and your skin to stop it growing inwards. You need to repeat this process for a few weeks (replacing the cotton wool each time you soak your feet). If you find your ingrown toenail is getting worse, don’t risk it any further, book in to see a Podiatrist as soon as possible.

If you do need to see a Podiatrist there are a number of options available that will effectively resolve your situation. For those of you who dread needles and scalpels, we have a pain-free solution that has recently landed at Bellevue Podiatry for you, read on:

  • If your situation isn’t too far progressed, the Podiatrist should be able to non-surgically trim and cut away the troublesome piece of nail without too much hassle.
  • In more progressed cases, you may require a local anesthetic to remove the offending piece of nail – the procedure is very safe, you walk in and walk out and get back to normal life.
  • As we said earlier, if you dread the thought of a needle and scalpel, Bellevue Podiatry offers the BS Brace – a painless and effective way to get rid of your ingrown toenails, click the link to learn more.

Ultimately though, prevention is better than cure, so our advice at Bellevue Podiatry is to do what you can to stop yourself getting an ingrown toenail in the first place. If you follow these tips, you will reduce your chances of getting an ingrown toenail:

  • Always ensure you cut your nails correctly, straight across the curve of your nail, no ragged edges
  • Make sure you wear properly fitted shoes that aren’t too tight, especially around your toes
  • Keep your feet clean and dry as much as possible, if you play lots of sport, give them time to “breath” afterwards

Blog 5 – Chilblain season is here!

Chilblains
It’s that time of year again when the temperature in the morning leaves our feet cold and seeking the warmth of a nice hot shower, electric blanket, hot water bottle or heater… but have you ever had itchy red lumps on your toes in the winter time that drive you up the wall?

For some of you this image of itchy red lumps on your feet brings back memories of our childhood as it is more common in our younger years when we would run around without shoes or socks on in the freezing cold.  This issue also arises in elderly people and can have more serious effects like ulceration and blistering of the chilblains (a photo of someone suffering from Chilblains is shown below).

What is a chilblain?
Chilblains are a reaction to severe cold weather when our capillaries shrink to keep the warmth of our blood close to our bodies and not close to the skin where heat is lost.  When we rewarm the feet too quickly this can lead to leakage of fluid and blood into the toes leading to chilblains.  The fluid and blood in the tissue can cause redness and cause irritation and itching.

Who is at risk?
Generally this condition is seen a lot in children as well as the elderly but can be seen in everyone.  There are particular population groups that need to be more careful including:

  • People who smoke (this can lead to constriction of arteries as well as peripheral arterial disease)
  • People with connective tissue disorders (for example lupus)
  • People who suffer from Raynauds syndrome
  • People with a family history of chilblains

I’m not sure if its a chilblain, what do they usually feel like?
Chilblains usually cause discomfort and pain and an extreme need to scratch the area.  They usually appear as red / purple lumps and in extreme cases they can blister and scab over.  They usually last for a week or longer and subside with appropriate treatment or warmer weather.  They are usually present on the extremities (toes, fingers, nose, ears) and over bony areas (knuckles).

Yep, sounds like me!  How do I stop myself from getting them?
It is important to keep your feet warm at all times and try not to go from cold to hot quickly.  If your toes are cold it is important to warm your toes up slowly, not jumping in a hot shower or putting your feet in front of the heater.  Slip on a pair of slippers or socks and slowly warm them up.  Avoid walking around barefoot and where socks and slippers/shoes all the time, particularly on cold mornings.  When you do get in the shower make sure the temperature is not too hot to start with and slowly increase the temperature.  Make sure you have some slippers near by for when you get out of the shower (dry in between those toes first!)

I have a chilblain, what should I do?
It’s important that you make sure it is a chilblain before commencing treatment.  Our podiatrists are able to diagnose chilblains with a few clinical tests and asking questions about your lifestyle.  We can then provide you with a treatment and prevention plan to make sure you don’t get them again, and more importantly they don’t get worse and blister.

Blog 4 – Why can fungal nail infection be so difficult to cure?

Podiatrists around the world can agree that effectively treating fungal nail infection is not always an easy task.  Most over the counter treatments have a low success rate, especially for serious cases of fungal toenail infection, and the probability of the nail fungus returning is quite high.

When treated directly, most nail fungus can be successfully cured with an over the counter fungicide, similar to what you would use to treat a case of athlete’s foot.  Most people would agree that treating athlete’s foot isn’t difficult, so why does nail fungus, a similar fungus to athlete’s foot, create so many issues for successful treatment?

The difficulty in effective treatment is due to the nail itself and where the nail fungus infection is located – being able to get under the protective nail to treat the fungus is no easy task.  Our toe nails are there to act as a structural support for our toes and provide more grip.  They are designed to be strong and durable, but this unfortunately means our toe nails provide a safe and protected environment for the nail fungus infection to thrive.

And adding insult to injury, our toe nails are made out of keratin, which is exactly what the nail fungus loves to feed on!  It’s no wonder it’s not always easy to effectively treat.  It is estimated up to 12% of the population are effected by toe nail fungus.

With so many people being affected by this issue, coupled with how difficult it can be to treat, a number of treatment options have been developed to treat toe nail fungus infection with varying levels of success depending on the severity of the infection.  Read on to learn more about them:

  • Topical nail paints usually require daily application until the nail grows out – It can be difficult to reach the toe nail fungus infection in serious cases with topical paints.
  • Oral anti-fungal medication are not suitable for everyone and should be discussed with your local doctor as it can have harmful effects if not used in the right circumstances.
  • Clearanail a state-of-the-art micro-drill that creates almost-invisible holes in the nail plate to allow an anti-fungal agent to reach the fungus under the nail and kill it.  We have had great success in our clinic using this effective and painless method to kill toenail fungus.
  • Laser therapy is typically recommended for serious cases of toenail fungus infection and usually requires multiple sessions as part of the treatment plan.  Laser therapy can add up to be an expensive exercise.
  • Surgical removal of the affected toenail under a local anesthetic and then treating any fungus left behind is considered in extreme cases.  Before undertaking this procedure you should seek a second opinion from your local health practitioner.

As you can see there are a number of potential remedies for toenail fungus infections out there, so it is important that you speak to an experienced Podiatrist about which treatment will work best for your situation – and the sooner the better.  The longer you leave a toe nail fungus infection, the more difficult it will be to get rid of.