Proactive Podiatry has formulated a list of reason, we think will be important to you when deciding “why choose us as your podiatrist?”

• Our podiatrist has over 5 years experience and is a member of Sports Medicine Australia and Australian Podiatry Association SA.
• Trained in dry needling (acupuncture) foot mobilisation therapy and prolotherapy.
• HICAPS machine for on the spot claiming with you private health insurance.
• Medibank Preferred Provider, with discount rates for members.
• Member of More for Feet Program offering HCF members a fully covered NO GAP initial consultation.
• Bulk billing available to those on a Chronic Disease Management Plan and Department of Veteran Affairs (DVA) clients.
• Ample on and off street parking facilities with ramps for easy access in and out of the building.
• Short waiting periods and reminder calls 24 hours before your appointment.
• Range of supportive footwear, arch support slides/thongs and sandals, that can be professionally fitted by the podiatrist.
• Early opening hours for before work appointments.
• Access to a range of health and medical providers in the one location (GP’s, clinical practice nurse, diabetes educators, psychologists, dentists, physiotherapists, dietician and visiting audiologist).
• Access to Health Scope pathology services.
• Home visits for eligible clients unable to attend the clinic.
• Large flat screen TV, water machine, magazines and a play area, with toys for the children in our waiting room.
• Close to shopping centre, supermarket, pharmacy, post office, bank and other amenities.

If this suits your needs and you are looking for a podiatrist who will care and cater to all your foot care needs then please call us on (08) 8265 2227 to make an appointment today or make an online enquiry and we will call you.

“The National Diabetes Services Scheme (NDSS), which began in 1987, is an initiative of the Australian Government administered by Diabetes Australia. The NDSS delivers diabetes-related products at subsidised prices and provides information and support services to people with diabetes. Registration is free and open to all Australians diagnosed with diabetes” (NDSS Website).

What Services are Available to You?

• Information about diabetes self-management.
• Ordering NDSS products and information on services available in your local area.
• Programs and activities for people with diabetes such as healthy eating programs and physical activity programs.
• Group support programs, such as peer support for people with type 1 diabetes or young people with diabetes.
• Fact sheets, brochures and other resources about diabetes.
• A variety of health professional resources.

How Do I Register for NDSS:

• Click on the link below to download the registration form and follow the instructions provided.

             NDSS Registration Form

• Call NDSS Infoline 1300 136 588.

What Services are Available for Health Professionals and Support Care Workers?

The NDSS provides training for workers who care for or support people with diabetes. This includes allied health professionals, Aboriginal health workers, bilingual community educators, teachers supporting children in school and pre-school, and disability or aged care workers.

The Myrtle Beach workers comp attorneys at Laird Hammons Laird will make sure that you get the full compensation you are entitled to and are treated fairly and with respect during the process.

Topics covered in the training sessions include:

• Medications for diabetes management.
• Insulin injections and initiation.
• Blood glucose monitoring.
• Diabetes complications screening.
• Prevention and treatment of diabetes complications.
• Healthy eating and dietetics.
• Physical activity, exercise and diabetes management, balancing food, insulin and activity.
• Chronic condition self-management skills.

Printable fact sheets are also available to NDSS members, with topics including basic information on how to self-manage your diabetes, healthy eating tips, advice for work and travel, and how to manage the stress when you need to change a tire with air compressors every time you go on vacation to a Twiddy: Outer Banks Rentals & OBX Vacation Rentals NC house by car, or when you don’t have access to the manhattan apartment cleaning services when you are in a rush.

Below is an example of one of the printable fact sheets covering sick days for people with diabetes and precautions to take.

For more information click on the link below to redirect you to the NDSS website http://www.ndss.com.au/

Proactive Podiatry advises you have your diabetes foot assessment undertaken by a podiatrist every 3 to 12 months, depending on your risk category, which our podiatrist will advise you on.

The new “Geko” blood booster, a battery powered, neuromuscular electro stimulation unit, with proposed mechanisms similar to the circulation booster has been designed to:

Note: Proactive Podiatry advises the Geko should not replace walking around the block but be use in conjunction to physical exercise or in those cases where weight bearing is not an option either temporarily or permanently.

Turf toe is a sprain of the ligament underneath the big toe joint, resulting from injury during sporting activities. The injury usually results when the big toe is forcibly bent up into hyperextension.

The condition can be caused from either jamming the toe, or repetitive injury from pushing off when running or jumping. When running or jumping, each subsequent step is started by raising the heel and moving body weight forward by “pushing off” the big toe.

Injury can result during this “pushing off” phase  if the big toe “gets stuck” and remains flat on the ground, causing bodyweight to go forward and so bending the toe up past its normal range of motion.

This injury is most commonly reported in football players who play on artificial turf, hence the term “turf toe.”  Artificial turf is a harder surface than grass and does not have much “give” when force is applied. Therefore the toe is more likely to get stuck or jammed.

However, turf toe still occurs in a wide range of sports such as soccer, basketball, wrestling, gymnastics and dance.

Causes of Turf Toe (Painful Big Toe):

• Sudden upward bending of the big toe causing a sprain or tear to the ligaments underneath (i.e If you are tackled or fall forward and the toe stays flat, causing hyperextension of the toe).
• Hyperextension, repeated over time causing eventual wearing and spraining of the ligament under the big toe.
• Non-supportive flexible soled shoes.
• Increased range of motion in the ankle joint.

Symptoms of Turf Toe (Painful Big Toe):

• Swelling and pain around the big toe joint.
• Limited joint range of motion of the big toe.
• Pain and tenderness when bending or pulling the toe upwards, typically lasting for two to three weeks.
• Sudden onset of signs and symptoms that intensify over a 24-hour period if direct trauma is the cause.
• Gradual onset of signs and symptoms that progress over time will be evident if repetitive trauma is the cause.
• Sometimes if the injury is great enough a “pop” can be felt. Usually the entire joint is involved, and toe movement is limited.

Diagnosis for Turf Toe (Painful Big Toe):

• To diagnose turf toe, the podiatrist will ask a series of questions about how the injury occurred, type of footwear worn, surface played on, sport played etc. to better understand the presenting condition.
• The podiatrist will then examine your foot, palpating for areas of tenderness and noting any swelling compared to the other foot.
• Range of motion of the joint will be examined.
• X-ray may be requested to rule out any other damage or fracture. Bone scan, CT scan, or MRI may be required in some circumstances.

Turf toe once diagnosed is then graded from 1 to 3 depending of severity.

• Grade 1. The ligament on the base of the big toe has been stretched causing pin-point tenderness and mild swelling.
• Grade 2. A partial tearing of the ligament with more diffused tenderness, moderate swelling, and bruising. Range of motion is limited and painful.
• Grade 3. The plantar ligament is completely torn causing severe tenderness, swelling, and bruising. It is difficult and painful to move the big toe.

Treatment for Turf Toe (Painful Big Toe):

Nonsurgical Treatment

Grade 1.

• Rest, ice, compression, and elevation (RICE) protocol is recommended initially for all gradings of turf toe.
• Taping or protective brace is worn to restrict bending motion.
• Non-steroidal anti-inflammatory medications to relieve pain and swelling.
• Stiffed soled sports shoe.
• Non-flexible rocker soled shoe is the most appropriate choice of footwear for casual wear while recovering.
• Orthotics, such as a thin graphite shoe insert, will restrict bending of the big toe joint and reduce stress on the plantar plate.
• Pain is usually tolerable and sports participation can be continued.

Grade 2.

• Immobilisation of the big toe, using crutches, moon boot or plaster cast may be prescribed for up to a week.
• Afterwards, these injuries are managed with a taping regime and the grade 1 treatments discussed above.
• In most cases, grade 2 injuries require 3 to 14 days of rest before returning to physical activity.

Grade 3.

• Immobilisation for a period of 6-8 weeks. Moon boot or plaster cast is used to keep the big toe in a partially pointed down position.
• As the injury heals, treatment will follow that of a grade 2 and then to grade 1 protocol.
• After the toe has been offloaded and healed, podiatry review may be required to re-establish joint range of motion, strength, and conditioning of the injured toe.

Surgical Treatment

Is required if symptoms of pain and dysfunction persist effecting sporting abilities. Surgery is generally suggested for grade 3 injuries or any of the following injuries:

• A severe tear of the plantar ligament of the big toe.
• Fracture of the sesamoid bones.
• Instability (unusual up and down motion) of the big toe joint.
• Damage to the cartilage, or bony spurring of the joint.

The surgical procedure will vary according to the injury. The aim of surgery is to repair the soft tissues and restore the big toe joint motion, so that normal function can be preserved.

Prevention of Turf Toe (Painful Big Toe):

• Shoes with better support and a stiffer sole to help keep the big toe joint from excessive bending and force with pushing off.
• Custom made foot orthoses that your podiatrist can prescribe for you to offload pressure to this area and correct any abnormalities in gait that can lead to further injury

Proactive Podiatry is trained and skilled with treating pathologies occurring below the knee and can help heal and prevent the painful big toe.

A melanoma is a malignant tumour (cancer) arising from the pigment producing cell of the skin, know as the melanocyte.

Melanomas are a life threatening, but potentially treatable form of skin cancer on the feet, if diagnosed or detected at an early stage.

However, skin cancer on the feet, particularly within the nail and plantar sole can be difficult to recognise. Consequently, this can lead to a delay in diagnosis and a poor outcome, when compared to other body sites. This problem is increased when there is a lack of pigmentation in suspected lesions, known to occur on the feet.

The diagnosis of a skin cancer on the feet can only be certain though a tissue biopsy, histological examination and specialist interpretation. This is why it is very important to get any suspicious lesions on your lower limbs and legs checked by a health practitioner.

Furthermore the number of cases of malignant melanoma worldwide is increasing faster than any other form of cancer amongst Caucasians. The current statistics are 1:120 for men and 1:95 for women.

Melanoma is a rare occurrence before puberty, but shows a gradual increase in incidence from the age of fifteen, peaking at around the age of fifty. Around 80% of lesions occur between the ages of 20-74 years. 30% of these skin cancers occur on the lower limb, 3-15% of these will occur on the foot or ankle region.

If you are concerned about a unusual lesion on your foot or lower limb do not delay. If the melanoma is < 1 mm thick there is a 95% survival rate at 5 years. Lesions > 4 mm thick hold a 50% chance of survival at five years.

There are Four Types of Melanomas (Skin Cancer on the Foot):

 Acral Lentiginous Melanoma (ALM)

Running as a layer of malignant melanocytes within the superficial layer of the skin. This type of melanoma is found equally across all skin types and is frequently observed in darker skin, representing about half of the melanomas occurring on the hands and feet.

Clinically appears as a ill defined mole or patch of light brown or grey discolouration of the skin and can often be missed.

Nodular Melanoma (NM)

Clinically appears as a nodular lesion, often seen in older patients.

Superficial Spreading Melanoma (SSM)

Is the most common of the four types because of its rapid growth phrase (lateral spread), before becoming invasive. It may arise as a new lesion or in a pre-existing mole. This type has been most frequently reported arising on the top of the foot.

Letingo Melanoma (LM)

Is a type of melanoma, found almost exclusively on the face and neck of older adults as a result of sun damage.

Risk Factors for Skin Cancer on the Feet:

• Intense sunlight and UV radiation exposure.
• High number of moles.
• History of 3 or more severe sunburns.
• Immunosuppressant (including organ transplant recipients).
• Blue or green eye colour.
• Freckles and/or the inability to tan.
• Red hair colour.
• Pre-existing moles on the soles of the feet.
• History of penetrating injury.
• Exposure to agricultural chemicals.
• Any mole or solitary vascular lesion whether new or pre-existing which is growing or changing shape or colour should be referred for a specialist opinion.

The ‘ABCDE ‘ Rule in Diagnosing Suspected Skin Lesions:

• Asymmetry, one half of the lesion is not identical to the other.
• Border, a lesion with an irregular, ragged or indistinct border.
• Colour, lesion has more than one colour present within it.
• Diameter, the lesion has a diameter of greater than 6 mm.
• Evolution, any change in the lesion in terms of size, shape or colour.

The “CUBED” Rule for Diagnosing Suspected Skin Lesion on THE FEET:

• Coloured, lesions where any part is not skin colour.
• Uncertain diagnosis, any lesion that does not have a definite diagnosis.
• Bleeding, lesions on the foot or under the nail, which bleed or ooze fluid.
• Enlargement, or deterioration of a lesion or ulcer despite therapy.
• Delay, in healing of any lesion beyond 2 months.

Differential Diagnosis for Skin Cancer on the Feet:

• Foot Ulcers
• Warts
• Ingrown toenail
• Tinea Pedis/ Onychomycosis (fungal nail infection)
• Foreign body
• Bruising
• Corns/ callus
• Ganglion

As many of the above benign conditions are very common, identifying a rare occurrence of skin cancer of the feet amongst them can be challenging. However when individual skin lesions do not respond to a treatment in a normal, timely manner the original diagnosis should be re-considered.

Requesting a histological assessment of any lesion that does not resolve in 2 months, but which oozes or bleeds or has no clear diagnosis is advisable.

Melanomas Found in Toenails:

Pigmentation and melanomas can also be found within the nail bed so must also be monitored or checked by a health professional.

It must be noted that typically in a dark skinned person, benign nail pigmentation becomes increasingly common with age and is typically found in varying degrees of intensity on several digits.

Harmless pigmentation in the nails may also be caused by certain drugs, trauma, fungal infection and inflammatory diseases, such as lichen planus or psoriasis.

Pigment that does not change is not necessarily benign, however lesions that increases in size or change are more likely to represent malignancy and should be checked promptly. One exception to this in children where the pigment arises in the nail and can change quite dramatically  as the child matures.

The “ABCDEF” Rule for Melanomas in the Toenails:

• Age, in the 5th to 7th decade of life.
• Band, longitudinal brown or black streak that measures 3 mm or more.
• Change, in the nail or lack of change in a nail despite treatment.
• Digit, most commonly the big toe.
• Extension, of the pigment onto the adjacent skin or nail fold.
• Family, history of melanoma or vascular nodule.

Podiatrist are often the first on the scene to see or alert their patients on lesions that need further investigation on the soles of the feet, as they are inspecting the area.

At Proactive Podiatry we routinely check if there are any unusual lesions on the feet, including in-between the toes if you are unable to reach or inspect for yourself.

National Diabetes Week is a time to check your risk and speak to your GP about screening test available for early diagnosis!

Diabetes is under diagnosed, with 50% of people unaware of their condition. This means that they can not take preventative measures against some of the most shocking and realistic facts associated with diabetes:

• Every 20 seconds a diabetic related amputation in undertaken.
• Diabetes kills more people annually than breast cancer and AIDS combined.
• Every 7 seconds someone dies from diabetes related conditions.
  

Podiatry Relevance:

Diabetes mellitus is a condition in which the pancreas no longer produces enough insulin, or the cells stop responding to the insulin that is produced. This results in increased levels of glucose in the blood that cannot be absorbed into the cells of the body.

The two types of diabetes are referred to as Type 1 (insulin dependent) and Type 2 (non-insulin dependent), although people with Type 2 diabetes may eventually need to go on insulin therapy.

Long Term Lower Limb Complications of Diabetes:

• Loss of protective sensation.
• Decreased blood supply to the feet.
• Increased risk of infection.
• Diabetic foot ulcers, amputations and gangrene.

Therefore if you are diabetic it is very important that you get your feet assessed by a podiatrist every 3 to 12 months, depending on your risk category, which the podiatrist will advise you on.

Neurovascular Diabetes Foot Assessment Includes:

Neurological Testing:

The podiatrist will assess you protective sensation and balance using a 10g monofilament and vibration tuning fork. Sensation in your feet  is important as it is responsible for:

• Pain.
• Pressure.
• Temperature.
• Blood flow/ sweating regulation.
• Muscle strength/control.
• Balance.

They will let you know if you have any neuropathy (nerve damage) and where this loss of sensation has occurred.

Vascular Assessment:

At Proactive Podiatry we will check your circulation and give you preventative education and treatment strategies to manage poor circulation, which is responsible for:

• Delayed healing.
• Cold feet, cyanosed (blue).
• Chilblains.
• Muscle cramping/pain when walking or at rest.
• Poor skin/nail conditions.
• Hairless.

The combination of numb, insensitive feet (neuropathy) and poor circulation means cuts or injuries may go unnoticed and progress to infected ulcers which may heal poorly.

The podiatrist at Proactive Podiatry will educate you in respect to monitoring for infection, giving you extensive education on diabetes and foot related risks. They will provide you with advice on daily diabetic foot care and preventative strategies for diabetic foot complications.

Related Topics

• Ingrown Toe Nails
• Supportive Diabetic Footwear
• Diabetes Foot Assessment
• Type 2 Diabetes
• Heel Fissures
• Chronic Disease Management Plan

WARNING: This information should be used as a guide only and does not replace professional podiatry advice. The content is provided by Proactive Podiatry for educational purposes only and does not in any way replace the need for a face to face consultation with a podiatrist in order to accurately diagnose and treat the condition. Treatment and outcomes will vary between patients depending on the nature of the presenting complaint and subsequent diagnosis of condition.

Aloe Vera “the green spiky plant” has been recognised for years for its healing properties and health benefits.

With Aloe Vera being a hardy plant that is relatively easy to grow it is a popular household pot plant.

Aloe Vera has at least six natural antiseptics, which are able to kill mould, bacteria, fungus, and viruses.

It was named the “plant of immortality,” by the Egyptians 6,000 years ago and is still being used today to treat many conditions including; burns, skin conditions, inflammation, hair problems and oral hygiene.

This powerful plant if taken orally has also been found to lower blood sugar levels and reduce cholesterol for a healthy heart. This health benefit has prompted the recent study of Aloe Vera’s effect on aiding wound healing for patients suffering from diabetes.

This study has shown positive result when tested on an animal model (rats). A combination of oral and topical application of Aloe Vera gel ethanolic extract, at a dose of 300 mg/kg body weight was administered daily to diabetic rats, for a period of 9 days.

This resulted in a significant reduction in fasting blood glucose, significant improvement in plasma insulin and significantly increased DNA and glycosaminoglycans (GAGs) to improve the ulcer wound healing rate.

To find out more and read the complete article, click on the article below.

An in vivo and in vitro investigation of the effect of aloe vera gel ethanolic extract using animal model with diabetic foot ulcer.

At Proactive Podiatry we have a fond interest in diabetes foot care and wellbeing. We keep up to date with the latest in diabetes research and treatment modalities to try to provide the most relevant information and care to our patients.

If you have had a success story with Aloe Vera, especially with the new health benefits mentioned we would love to hear about it!

Bright coloured sports tape on our athletes today, seems to be the craze since its first appeareance in the 2008 Olympics. This tape consisting of cotton fibers woven with polymer elastic strands was first developed in the 1970s by Japanese chiropractor Kenzo Kase and is known as kinesiology tape.

Traditional sports tape, which is designed to prevent further strain by immobilizing the injured muscle, can impede circulation and slow down the body’s natural healing process.

Kinesiology tape allows support to injured muscles and postural correction while still allowing full range of motion. It has been found to promote circulation to the injured area and increase lymphatic drainage. Overall kinesiology tape keeps muscles moving and improves circulation reducing pain and enhancing healing.

But how does a piece of brightly coloured tape do all this?

Well when the tape is applied correctly, it causes a  lifting of the skin surface to create a small space between the muscle, fascia and skin layers. This space allows for drainage and blood flow to move in and out of the area, reducing pressure and inflammation in the tissue.

The sticky side of the tape also uses a water-repellant, medical-grade acrylic adhesive that further supports the muscles and connective tissues. This tape is unlike conventional sports tape, as it can stay attached to the skin for three to four days, even through sweating and showering.

A study of 42 patients with shoulder pain, published in 2008 in the Journal of Orthopaedic & Sports Physical Therapy, “found that range of motion improved immediately after application of kinesiology tape, compared with a sham taping using no tension.” However the study found no significant difference in pain or overall disability scores. It should be mentioned that a significant limitation of this study is that the kinesiology taping technique was not customised to each patient’s injury.

A variety of different techniques and dimensions of kinesiology tape can be used and customised to the athletes or patients injury.

For example:

• For overused/injured muscles, requiring pain relief and healing, the tape is applied with no tension, starting from the tendons that hold the muscle to the bone and extending toward the origin of the muscle.

• For chronically weakened/ injured muscles, requiring support and full range of motion,  the tape is applied with light tension, starting from the origin of the muscle and extending toward the tendons that hold the muscle to the bone.

So next time you have a soft tissue injury or postural problem speak to us at Proactive Podiatry about Kinesiology taping and reap the therapeutic effects.

We have all probably undertaken a heated debate or discussion with friends, colleagues and family on whether barefoot running and minimalist shoes are really good for us or not.

This blog is definitely not about to get into that debate. However an interesting story and example has presented, that regardless what we all think about barefoot running we need to consider what part of advertising and marketing we take on board and choose to believe. In fact this goes for all marketing campaigns out there.

We need to critically analyze marketing claims to see how much of it is backed up by evidence.

Recently Vibram FiveFinger shoes have had to settle a class-action lawsuit brought about by customers who questioned their marketing claims that barefoot running shoes could improve health.

With claims that your barefoot running shoes were scientifically proven to “make your feet stronger” and healthier”.

The shoe manufacturer has had to pay out as much as $3.75 million to anyone who purchased a pair of their finger-shoes since March 2009.

Vibram shoes will also have to scale down its marketing health claims it’s made for years about the benefits of running in its minimalist shoes, which are meant to mimic barefoot running.

People who are pro barefoot running believes that by doing so it can increase muscle strength and balance in the lower limbs and feet, while promoting a more natural running style. Those on the other side of the fence argue that the risks of barefoot running include a lack of protection, which may lead to injuries such as puncture wounds, and increased stress on the lower extremities.

The reality is that regardless what side you are on there just isn’t much research on injury rates in traditional versus barefoot running shoes, which Vibram have learnt the hard way.

Please click on the link below to read further:

Science, American legal system confirm barefoot shoes are…

Proactive Podiatry would love to hear your opinions on barefoot running… so please tell us your thoughts!

A new technology allowing the production of antifungal socks, has emerged in the US with the Cupron PRO Therapy System for people with fungal skin infections, diabetes and sensitive skin.

These new antifungal socks use copper infused fiber technology to act as an antifungal agent and to help improve skin condition.

As stated on the website “They are the first and only socks to ever earn an EPA Public Health Claim for killing 99.9% of the fungus that causes Athlete’s Foot. Additionally, in an independent clinical skin trial, the Cupron PRO Therapy System was shown to increase skin elasticity, a major indicator of skin health, by up to 30% after only 30 days of normal wear”.

Cupron’s copper-infused antifungal socks are documented in a scientific study in the medical journal, Archives of Dermatology, which is published by the American Medical Association.

This study documents the socks technology in protecting the feet and preventing foot complications, such as tinea in the Chilean miners, who were trapped in the collapsed mine for 69 days in 2010.

These socks are great for people who are in steel capped or safety boots all day that do not allow the feet to breathe, impacting on the condition of their skin and risk of fungal infections. The antifungal socks use the copper infused fiber technology to help protect the skin from fungus as well as wicking sweat and maintaining a optimum environment for the skins surface.

The soft breathable material and loose top make it safe and suitable for people with diabetes to wear.

To find out more information visit the Cupron website.

At Proactive Podiatry we treat and manage fungal infections of the skin and nails and advise you on prevention guidelines to minimise your chance of re-infection and spreading of the condition.