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Footwear & Orthotics

Athletic footwear

The athletic shoe is commercially available in many styles, designs and colours. In fact there are over 400 different footwear models available to the consumer. How do you know what shoe is best suited to your feet, running style, or injury? Our team has vast experience in footwear prescription.

Dr Michael Kinchington PhD has developed the innovative footwear app Shoe Buddy The App provides current information on a range of running shoes and allows you to scan your foot, enabling Shoe Buddy to determine the correct shoe for you based upon your weight bearing foot shape.

The Centre obtains regular briefs from all the athletic footwear companies and liaises closely with specialty running shoe stores. Furthermore, podiatrists within the practice are involved in post graduate footwear related research.

Let our team to prescribe the shoe for you, provide a list of suitable models matched to foot type, and a shoe matched to your lower limb kinematics, injury history and body shape.

Footwear Tips for shoe selection & use

  • Purchase footwear at the end of the day, or following a strenuous workout to allow for foot-ankle swelling.
  • Purchase footwear from a reputable sport shoe provider.
  • Footwear models & designs change frequently, therefore consult a qualified podiatrist to determine the correct shoe style
  • The life of a shoe ranges from 300km to 900km dependent upon body weight, activity, injury and purpose of the shoe
  • Shoe specificity for your individual mechanics & comfort is possible by a simple analysis of foot type, injury, & gait. 

Orthotics

Scientific evidence shows that musculoskeletal conditions of the foot-ankle & lower limb can be assisted with the use of an orthotic. Stabilisation of foot mechanics and altering the angular alignment of the foot through orthotics, unloads the muscles, tendons & joints of the foot-ankle & lower limb. Improved overall postural body position may also be achieved when an orthotic is tailored for an individual. If the foot-ankle complex are not aligned correctly, the lower limb will compensate and create other imbalances within the entire musculoskeletal system.

Who needs orthotics?

Orthotics (arch supports) assist foot, leg and postural discomfort due to a walking or running imbalance. Joint and muscle imbalances such as flat feet, rigid high arch feet, knock knees, leg length differences, bunions and bowed legs are all implicated in many musculoskeletal foot-leg discomfort conditions.

What specific conditions may be helped?

  • Arch pain / Plantar fasciitis
  • Heel pain
  • Achilles Tendinopathy
  • Great toe joint pain
  • Metatarsalgia
  • Sesamoiditis
  • Flat Feet
  • Pronation
  • Runners & Jumpers Knee
  • Shin Splints
  • Groin pain

Which orthotic is correct for me?

There are many types of orthotics ranging from simple cushioned gel insoles, inserts which support the arch and customised orthotics. The library has relevant articles about orthotics which can be downloaded.

The Centre For Podiatric Medicine sources a range of orthotics from quality manufacturers and laboratories who use evidence based practices.

For Prescription Orthotics we have partnered with Biolab in Western Australia for over 20 years. Biolab is one of the eminent foot orthotic laboratories in the country designing orthoses via 3D CAD CAM and 3D Non Weight Bearing Foot Scanning. The turn-around time from visit to practice to dispensing your orthotics is 10-14 days; one of the fastest in the country. If needed this process can be done within 36 hours.

Pre-Fabricated  Medical Orthotics are used when customised devices are not required but the foot still needs supporting. We have partnered suppliers who manufacture high quality medical grade foot orthotics. The team at the Centre For Podiatric Medicine will determine what style of orthotic is most suited to your needs.

All Orthotic devices dispensed by the Centre For Podiatric Medicine are rebatable through private insurance and are accepted by Workers Compensation and The Department of Veteran Affairs.

 

General Nail Care

There are a number of skin conditions that cause discomfort and pain.

Recommendation: Our qualified Podiatrists who are APHRA accredited will assess the cause of your skin condition and outline a cost-effective solution and a comprehensive management plan. The practice works closely with Macquarie Street Dermatologists whom we regularly share ideas and patients to provide evidence based interventions.

  • Corns and Calluses can be painlessly debrided at your first visit giving immediate relief.
  • Plantar Warts are more involved. There are many dubious treatments that have “popped up” in the city that are not evidenced based.
  • Fungal conditions including tinea can be effectively managed with some diligence. We will outline the quickest possible resolution.
  • Cracked heels are painful and unsightly. We have a solution.

Podiatric Nail Care

Ingrown Toe nails, fungal nails, thickened nails can be painful, difficult to cut and if not treated promptly can effect general health and well-being. The podiatry team who have Australian Podiatry Association membership manage all nail conditions.

Recommendation: On your first visit you will receive a diagnosis and treatment plan to effectively manage your nail condition.

  • Ingrown Toenails can be managed conservatively in 80% of cases. For chronic and infected in-grown toenails a nail surgery can be performed within the clinic.
  • Thickened Toenails can be returned to a normal appearance on your first visit using high speed painless nail drills. Yes, it is painless.
  • Fungal Nails are complicated and difficult to manage. Our team will outline the treatment options that are evidence based and help you through the experience. Beware of new fad (non evidence based) Laser therapies that are popping up all over the City. We work closely with Macquarie Street Dermatologists whom we regularly share ideas and patients to provide evidence based interventions.

 

Keryflex Medical Nail Treatment 

For those unslightly cosmetic nail conditions the practice is one of the established clinics that offers a solution using the Keyflex system.

Recommendation: Contact our rooms to book an appointment and in one-visit the nail appearance will improve.

 

What are Foot Orthotics

Foot Orthotics can assist with specific conditions involving foot pain, ankle pain, shin splints, plantar fasciitis, heel pain, achilles problems, knee pain, arthritis and bunions.

Foot orthoses are a specifically designed medical brace that is worn inside a shoe. The purpose is to alleviate foot and leg pain, improve postural imbalances, stabilise walking and running styles and improve footwear function. The practice uses 3D laser analysis and engages laboratories with exacting standards to customise your individual orthotic.

Recommendation: There are many different types of orthotics. Not all orthotics need to be customised or be costly. The practice also uses a range of pre-fabricated medical grade arch supports that are very effective. Contact the practice for a discussion on what orthotic will best suit your needs.

All Orthotics dispensed by the Centre For Podiatric Medicine are rebatable through private insurance and are accepted by Workers Compensation and The Department of Veteran Affairs.

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Heel Pain in Children

Heel pain in children are commonly known as Severs Disease. It is a growth plate condition causing foot pain and ankle pain. Growing pains are common in children especially those who are active. Children between the ages of 8 - 14 years. 

Recommendation: Treatment commonly includes shoe advice, de-loading the heel, strength and stretching programs. 

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Plantar Fasciitis - Heel Pain

Heel pain is generally termed Plantar Fasciitis or Plantar Fasciosis. This is a very generic term. Heel pain can be more complicated and needs a correct diagnosis before embarking upon treatment.

Recommendation: At the clinic, you will receive a diagnosis and management plan at your first consultation. 90% of cases resolve with time but with a treatment plan you will get better. The practice uses evidence based science to treat your heel pain. We regularly liaise with radiologists, foot orthopaedic surgeons, physiotherapists and sports physicians that we can "workshop" your case if it is an atypical case of heel pain.

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Runners Knee (Patello-Femoral Syndrome)

Runner’s knee is an overuse injury common with running, jumping and court sports. The basic mechanism of the injury is the mal-tracking of the knee cap upon the knee joint. Causes of Runners Knee include faulty foot mechanics (flat feet, hyper-pronated feet, unstable feet, muscle imbalances and incorrect footwear) are factors.

Recommendation: At your first visit you will receive a treatment plan aimed at stabilising your foot mechanics that may involve foot orthotics, shoe recommendations, exercises and where appropriate sending for imaging and referral to physiotherapy.

 

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Shin Splints (Medial Tibial stress syndrome);

Anterior shin pain

Shin Pain or Shin Splints (medial tibial stress syndrome) are an exercise-related pain. Shin splints occur along or just behind the inner (medial) edge of the shin (tibia). 

Shin pain is commonly associated with running and jumping sports such as basketball, tennis, running, football and squash. Unstable foot mechanics such as pronating feet, flat feet, per planus and rigid feet such as feet with arches that are too high and playing sports with the wrong shoes are factors in shin pain.

Recommendation: By optimising foot mechanics, correcting foot posture, getting the correct shoes and modifying sporting loads shin pain can be easily managed.

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Diabetes

Australia has one of the highest recorded prevalence of diabetes for a developed nation. Foot care for people with diabetes is important because diabetes affects the feet in two ways. Diabetes can reduce blood circulation and also damage the nerves to the feet.

CFPM has a diabetic foot health strategy which is based upon scientifically proven methods promoted by the Australian Podiatry Council and Diabetes Australia. It is recommended that people with diabetes (especially insulin dependent diabetics) organise a regular appointment with one of our Podiatrists to care for a comprehensive assessment of your needs and to outline a management plan.

Recommendation: A few simple steps can help prevent foot problems. A checklist of simple strategies to care for feet include:

  • Check feet daily for any signs of skin abrasions, blisters, corns or changes in colour
  • Wash feet daily and dry well between the toes
  • Keep toenails trimmed. Cut toenails straight across and file rough edges
  • Avoid foot trauma by wearing well-fitting, protective shoes
  • Do not treat corns or callus using home remedies or using commercially available corn pads. Rather have your feet treated by a podiatrist
  • Avoid wearing tight shoes. Have enough toe room within the shoe to prevent over-crowding of the toes

Regular Podiatry appointments have been proven to improve quality of life and prevent diabetic foot related complications.


 

Ingrown Toe nails

Ingrown toe nails are a common, painful condition that occur when skin on one or both sides of a nail grows over the edges of the nail, or when the nail itself grows into the skin. This condition is usually very painful and can be associated with infection. Some ingrown toenails are chronic, with repeated episodes of pain and infection. Irritation, redness, an uncomfortable sensation of warmth, as well as swelling can result from an ingrown toenail.

Ingrown toenails develop for many reasons. In some cases the condition is congenital, such as toenails that simply are too large.

The most common cause is cutting your toenails incorrectly, causing them to re-grow into the skin. Tight hosiery or shoes with narrow toe boxes only make matters worse. If the skin is red, painful or swollen on the sides of the nail, an infection may be present. This occurs because the ingrown nail is often in a warm, moist and bacteria-rich environment. When the nail penetrates the skin, it provides a convenient entry for germs that can cause infection. Untreated, the nail can go under the skin, causing a more severe infection. In either case, the infection needs to be cured with sterile instruments and antibiotics.

Recommendation: In many cases, short term relief using the following simple regimen:

  1. Soak the feet in warm salt water
  2. Dry them with a clean towel
  3. Apply a mild antiseptic solution to the area (eg. Betadine)
  4. Bandage the toe

Recommendation: Our Podiatry team have experts in the clinic who can perform a minor in-office surgical procedure to cure in-grown toenail problems. This procedure generally takes about 60 minutes, is pain free with local anaesthesia with wound resolution within 4 weeks. Contact our rooms to make an initial appointment to discuss your nail condition and options that are available.

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Warts

Plantar Warts are one of several soft tissue conditions of the foot that can be quite painful.

Recommendation: The team at CFPM have a variety of management strategies to best treat verrucae (plantar warts). Options range from chemicals and acids to removal by liquid nitrogen.

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Cracked Heels

Dry skin is the primary culprit behind cracked heels. While the dry skin itself is not dangerous, if untreated it can result in painful heels. If Diabetic complications are probable if not treated early.

Recommendation: Dry, cracked heels are best treated with therapeutic ointments and creams and abiding wearing open-heeled shoes such as sandals and sling-backs.

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ACHILLES TENDINOPATHY

Achilles tendinopathy is an overuse condition. The Achilles tendon does not have good blood supply and the injury can be chronic if not treated early.

Recommendation: Tendinopathy responds well to strength programs and stabilising foot mechanics such as using correct shoes, orthotics and reducing excessive loads. 

The practice uses a variety of management regimes and has a close network of physiotherapists, sports physicians, radiologists that we liaise with regularly to ensure best evidence based regimes are implemented.

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MORTONS NEUROMA

Pain and numbness at the ball of the foot can be many conditions. Morton's neuroma (also known as Morton's metatarsalgia, Morton's neuralgia, plantar neuroma and intermetatarsal neuroma) is one of the more common entities. The condition is a benign neuroma of an intermetatarsal plantar nerve, most commonly of the second and third intermetatarsal spaces (between 2nd-3rd and 3rd-4th metatarsal heads). This problem is characterised by pain and/or numbness, sometimes relieved by removing footwear.

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GROIN PAIN

Groin pain is a complicated topic that requires a multi-faceted approach. Dr Michael Kinchington (PhD) has an interest in lower extremity biomechanics as a cause of groin pain and rehabilitation of groin injury by gait stabilisation. He has teamed with Dr John Garvey a world leader in Groin Injury. For further information contact the Groin Pain Clinic, www.groinpainclinic.com.au

 

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