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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.

Blog 3 Part 2:  How podiatrists can help you get rid of your heel pain

Welcome back – in our last blog we discussed the main causes of plantar fasciitis (which is just the technical name for an injury to the structure that runs along the bottom of your foot).  We also discussed that plantar fasciitis usually strikes first thing in the morning when you get out of bed, giving you heel pain that can feel like you have just stepped on a sharp pin, and what the main causes of the heel pain are.

In this next blog, we will discuss the various effective treatments that are available for plantar fasciitis and underline the importance of ensuring that your heel pain is accurately diagnosed so the right treatment plan can be put in place – a very important step in ensuring you get pain free fast.

As mentioned, while plantar fasciitis is a very common cause of heel pain, it must be accurately diagnosed to ensure the right treatment plan is put in place.  Not all heel pain is due to plantar fasciitis. In fact there are a number of other conditions that could cause pain around the heel region, which need different treatments.  This is where the skills of a qualified Podiatrist comes into the picture – we have the education and experience to accurately diagnose the cause of your heel pain and tailor a personal and effective treatment plan to get you back on your feet pain free.

Our podiatrists will firstly ask you a lot of questions about your heel pain and also find out a bit more about your activities, work and lifestyle.  We then ask the question, why you?  What is happening to you that is causing you to get heel pain and not the guy sitting in the desk opposite you at work?  This is where things get a bit more technical and when we start looking in to the way you walk and the way you foot moves.  We use the assistance of modern technology (good old video analysis) to watch you walk.  There are other assessments we do and are specific to your particular heel pain.

Depending on the diagnosis, a Podiatrist will prescribe you a treatment plan with one, or a combination, of the following treatment strategies (the good news is, when prescribed correctly, these treatments can work fast):

·        Plantar fasciitis stretching: starting with gentle stretches for the calf and bottom of the foot can often relieve the pressure on the plantar fascia and provide the start of heel pain relief.

·        Plantar fasciitis exercises: the source of your plantar fasciitis may be a lack of strength in key supporting muscles in the foot and lower limbs therefore it may be necessary to strengthen these muscles with specialised exercises to ensure your plantar fascia is able to function effectively and without pain.

·        Plantar fasciitis taping: an effective strategy for relieving heel pain in the immediate term that can supplement longer term strategies.

·        Custom made orthotics: shoe inserts designed for you to alter your foot function and take pressure off the plantar fascia. 

Now that you know what plantar fasciitis is, what causes and how to treat it, we trust you can now see that you really don’t have to put up with heel pain any longer.  Experience tells us that ignoring it will likely only make it worse, so if you have started to get a sharp pain in your heel after long periods of inactivity, you should take action and book in to see a podiatrist before any further damage is done.

Please feel free to give us a call during business hours on (03) 9457 2336 or book online now – we are here to help.

Blog 3 part 1:  Why are the first few steps in the morning painful?

We see a lot of people coming into our clinic around this time of year complaining about a sharp pain in their heel. This pain is usually worse first thing in the morning when they step out of bed or standing after long periods of sitting.  With so many people complaining about the same issue, it comes as no surprise there is a list of common reasons people get heel pain.

Do you answer yes to any of these questions?

  • Do you get pain at the base of your heel when you get out of bed in the morning?
  • Do you hobble around for the first few steps til it warms ups?
  • Do you get pain when you first put your foot on the ground after prolonged sitting?

If you answered yes to any one or more of these questions it’s possible that you may have plantar fasciitis – don’t worry this is just the technical name for some micro-tears to the strong fibrous band (which is called the Plantar Fascia) that runs along the bottom of your foot, from your heel to the ball of your foot.  Typically, this type of injury is most commonly found where the Plantar Fascia (the strong fibrous band with the fancy name) attaches to the heel.

Certain things may increase your risk of plantar fasciitis:

  • Suddenly increasing the amount of exercise you normally do
  • Wear poor fitting footwear (couldn’t resist those awesome boxing day sales!)
  • Increasing your body weight
  • Biomechanical issues that put the plantar fascia under strain

The reason you experience this sharp pain first thing in the morning (or after sitting down for a long period of time) is because the plantar fascia goes from a position of no pressure/stretch (like when you are lying down in bed) to bearing your whole body weight which forces the plantar fascia to stretch beyond what it has previously been accustomed to.  Our patients commonly refer to this type of pain like stepping on a pin/bruise – it is sharp, sudden and localised to the heel of the foot.

Right now you may be thinking, “this is all great information, but what can be done to get rid of my heel pain now?”  Glad you asked!  In our next blog we will be discussing the range of effective treatments we can prescribe to effectively treat plantar fasciitis.  With the right treatment plan, treating heel pain can be resolved much quicker than you think.  If you are suffering from heel pain, you should seek the advice of a trained professional.

We’d love the opportunity to get you back on your feet pain free – feel free to call during business hours on (03) 9457 2336 or book online now.

Blog 2: Footwear mini-series: Volume 2: Runner vs Cross trainer?

Runner vs. Cross trainer

One common issue I come across in our clinic is the confusion between whether someone should be wearing a runner or a cross trainer.  So let’s first look at the design of a runner and the design of a cross trainer.

Design of a runner

A runner is designed to do the following:

 

  • Protect the foot
  • Provide cushioning
  • Provide support
  • Provide structure

 

Runners are designed to provide all the above when the individual is moving in a straight line, such as walking, running or jogging.

Design of a cross trainer

A cross trainer does all the things a runner does but the difference is that cross trainers are best for activities where side to side movement is involved, for example in netball, basketball, tennis and gym classes etc.

The structure of a cross trainer is different to a runner:

 

  • The midsole is denser than a runner and decreases torsion in the midfoot.
  • Heel height is often less, therefore a cross trainer will allow you to ‘feel the ground’ and decrease your risk of ankle sprains.
  • The upper is usually made from a mixture of mesh and leather which further provides support for side to side movement.
  • The outsole offers great traction and protection against excessive wear.

 

In short, the cross trainer is an all-rounder.  However you wouldn’t wear a cross trainer if you were playing a game of soccer.

So does that mean I need a different pair of shoes for every sport?

When it comes to sports such as tennis, soccer, football, hockey and golf YES, it is best to use the shoe designed specifically for that sport.  Football/soccer/hockey and golf shoes all have cleats which make your performance a lot better and also reduce your risk of injury on those surfaces.  But if you play netball, basketball and indoor soccer, runner, the cross trainer is the right shoe for you.

Need more advice on which shoes will give you the support you need?  Call us today on (03) 9457 2336

Welcome to our 1st blog series: Footwear!

Welcome to our 1st blog series:  Footwear!

We are really excited to have just launched our new website at the end of April, with more information about common foot problems, of course our new blog, products that we sell in the clinic and more information about our footwear range. We will be updating our information on a monthly basis and also keeping our blog up to date on a weekly basis, so make sure you check back regularly or follow us on our Facebook page to be updated about any new blogs.

Our first 8 blogs will be all about footwear.  Each week in May & June we will be talking about a different footwear topics.  So to kick it off, let’s talk footy boots!

Kicking off our 1st blog: Football boots

I thought I’d kick off are first post by talking about football boots!  We see a lot of foot problems in both soccer and Aussie rules football players.  There are many reasons why these particular sports are so prone to foot problems, firstly because of the nature of the sport.  They are high impact, high intensity sports and a lot of running is involved.

Secondly, the choice of football boot greatly will affect how much support your foot is getting during a match.

Thirdly, the playing surface.  Particularly in the ground is hard or water logged, this can lead to injury.

In this post we will focus mainly on the choice of football shoe, given you can’t really do too much to improve the grounds or conditions of the sport!

Picking the right shoe for your position

  • Forwards: Consider a boot that has minimal weight for rapid movement and no laces or seems in your strike zone, preferably a grippy material.
  • Defence: You may need more protection over your foot to avoid being hurt. Rounded studs might be best.
  • Midfield: Light weight for endurance.
  • Goalkeepers: Quick footwork is key so a light weight boot is best!

Features to look out for in a good soccer/football shoe

  • Upper: Boots are usually made from either a synthetic material or from leather.  Synthetic materials tend to be a bit lighter than your leather shoe, but leather tends to be a bit more comfortable as it conforms to the foot better.
  • Studs: The type of stud will depends on how well your shoe will grip on to the ground:
    • Blade studs:  Grip better and promote speed. Great for increased traction.
    • Round studs:  Release a lot faster from the ground. Ideal for wet conditions.
    • Moulds:  Suited for natural or synthetic grass, but for drier conditions.
  • Midsole:  Some boots will not have a midsole which is a material that is placed between the outsole and the upper of the boot, providing extra cushioning. Unfortunately this can make a boot heavier as there is more material in the boot. This part of the shoe is preferable as it provides further support and usually is required to build the heel height.
  • Innersole:  This will provide some cushioning and preferably should be removable, particularly if you require orthotics down the track.
  • Heel counter/height:  The heel counter of a shoe should be stiff to stop your heel from moving around.  Your heel should be higher than the front of your foot, particularly if you suffer from Achilles issues or in children, severs.  It could also predispose you to lower limb injury.

Need more advice on which boots to buy?  Pain after or during soccer or football?  Call us today on (03) 9457 2336