Foot Care - Fall Prevention

Foundation Chiropody – Your Complete Foot Specialist

If you, your family or loved ones are at risk of falling and foot injuries, then read this article to know how to prevent serious foot problems.

Chiropody is a branch of medicine that focuses on medical and surgical treatment of the disorders of feet, and ankle. It concentrates in the treatment of corns, verruca and lower extremity. Chiropodist is a medical professional who specializes in the diagnosis and treatment of foot disorders.

Seniors or old people are mostly in danger of having injury problems in Ontario. As time goes by, foot injury has become more serious health issue. When you become older, you may still want to enjoy life, go out and be free. You don’t want to remain inside your home just to live longer and be more safely because your fear in tripping, stumbling and falling.

Foundation Chiropody in Mississauga can help you reduce the risk of falling. Our clinic offers the best ankle or foot orthotic practices together with the latest medical technology in taking care of the body’s foundation our patients deserve.

You may be at risk of falling if you have experienced the following conditions:

·         Losing stability or balance when standing

·         Trouble in walking

·         Instability of ankle

·         Shakiness of knee

·         Peripheral neuropathy

·         Ailments that causes the feeling of dizziness

·         Ankle osteoarthritis

·         Already had a history of falls

You can avail of our fall prevention brace called the Moore Balance Brace (MBB) from Langer Biomechanics. It is an ankle stabilizer created and designed to help develop balance and stability of elderly and those people who are at risk for trips and dangerous falls.

The Moore Balance Brace (MBB) provides patients the latest tool that supports balance for the elderly population and for those with falling conditions. The MBB is set bilaterally (both feet). It has a sleek design to be able to fit into most shoes. Its function provides steadiness and stability of the ankle and sensory input, generating a proprioceptive response.

What to expect?

The first thing you should do is to make an appointment with us. On your initial visit to Foundation Chiropody, we will need to get important information about you and your health history. This will also allow you to know your more about our services and our expert chiropodist.

If you’re a new patient, you may want to fill out our consent and registration forms before visiting us for you to save some time. You can do this by downloading our forms that is available in our website. However, if you already have a current list of medications, you can bring that instead of filling out the information again. It would also be helpful if you bring any orthotics or specialty footwear that you are currently using so we can check what type of treatment you need to undergo.

The feet are our body’s foundation. Protect it with the help of Mississauga foot specialists at Foundation Chiropody. Make an appointment and visit us to learn how our therapy, balance brace and foot orthotics could help you prevent risky falls.                

Connect with us by phone (905-916-3668) or email info@foundationchiropody.com to learn more about our Fall Prevention services. Visit Foundation Chiropody at 2155 Leanne Blvd. Suite 125 Mississauga, ON L5K 2K8. We are glad to help you with all your concerns.

Is one leg longer than the other?

Most people are slightly asymmetrical. In fact it is estimated that 90% of people have a leg length discrepancy (LLD). Studies haves shown that the right leg is usually longer than the left. The difference is often negligible and does not need to be treated. The body generally adjusts using several compensatory mechanisms to keep the pelvis level. Some of these compensations take place in the spine, pelvis, hips, knees and even the feet.

If the LLD is too much for your body type and activities, then you may have symptoms in the form of back, hip, knee or foot pain. Depending on the severity of your symptoms one can choose a) not to treat the problem, b) conservative treatment or c) surgical treatment.

Conservative treatment usually involves using ‘lifts’ in your shoes, either in your shoe, or on your shoe, or both. The amount to adjust must be carefully considered because the body has compensated over time. If someone has 2 centimetre difference and symptoms, then the adjustment should not be for the full 2 centimetres otherwise new problems may arise. A graduated approach should be taken and your foot specialist should consider the impact of your other treatments such as physiotherapy and chiropractic.

As a foot specialist I see patients suffering from heel or arch pain which is much worse on one foot. After initial assessment I often see a small leg length discrepancy for which the patient is compensating by pronating the foot on the side with the long leg (which shortens the long leg and levels the pelvis). This pronation is creating the downstream problem of plantar fasciitis. A mild heel lift sometimes reduces the pronation and eases the plantar fascia ligament. It is usually wise to provide leg stretching exercises in conjunction with any ‘lift’ or other orthotic therapy.

Skin conditions on your foot

Seeing skin conditions or skin irritation on the toes, toenails or foot is a daily event for those practicing podiatric medicine.

The most common irritations are caused by pressure, immune reactions, fungus, viruses, bacteria or parasites. It is important to see a foot specialist if you have a skin problem so that we can determine what the irritation is caused by and therefore decide on the appropriate medication/treatment.

In our experience, most cases are caused by pressure and the skins reaction to pressure. The next most common cause is our own immune system. After that, fungal and viral infections seem to be the culprit.

The foot needs a balance of dryness and moisture. Too much moisture makes a good environment for infections and too dry could lead to cracking and fissuring.

Tip: if you have difficulty drying between your toes after a shower or a swim, spray a little isopropyl alcohol (IPA 50% or IPA 70%) on the tops of your toes – it runs down between the toes and keeps them dry.

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Things you should know before having an ingrown toenail procedure

If you have ingrown toenails and this has been causing pain, swelling and infection for some time, then you may have decided to have a partial or full nail removal. The most common procedure we perform is the PNA w/matricectomy (or partial nail avulsion with phenol or laser matricectomy). While this procedure is relatively minor there are some things you and your foot specialist should know;

If you are pregnant in your 1st trimester, have ischaemia (very poor arterial blood flow in your lower limbs), have been diagnosed with RSD/CPRS (a chronic pain syndrome), or have allergies to local anaesthetics, then you should consider postponing the procedure and trying alternative treatment. In addition, if you have an infection at the site of injection, are under the age of 5, or have porphyria (a disorder which affects heme and the distribution of oxygen in the tissue), then you should also consider conservative (non-operative) treatment.

Your foot specialist should also tailor your procedure and recovery based on other considerations.

Your healing may be affected if you have diabetes, take steroids, have anaemia, leukaemia, autoimmune disorders, connective tissue disorders, kidney disease, liver disease or thalassaemia. The use of a toe tourniquet during the procedure may cause problems if you have Sickle cell anaemia, Raynaud’s or other connective tissue conditions. Healing could also be impaired if you are taking blood pressure medication such as ACE inhibitors, ARBs or have severe calcification of the blood vessels.

While there is little risk in using modern local anaesthetics for this procedure, your specialist should also be aware if you are taking beta blockers, anti convulsants, diuretics, MAOIs, procarbazine or benzodiazepines, or if you have kidney and liver disease. Also if you are under extreme anxiety, let your specialist know.

Conditions like MS and Parkinsons need to be taken into consideration also. Allergies to betadine, iodine, shell fish, chlorhexidine, latex, silver and bandages should also be discussed.

To assess the risk of infective endocarditis (or inflammation, of the inner tissue of the heart) your specialist should ask about your history of heart valve damage, prosthetic heart valves, and any history of rheumatic fever.

To assess the risk of post-op bleeding your specialist should also ask you about anticoagulant and antiplatelet medications, or haemophilia. Adjustments in your medication may be needed prior to the procedure. Also if you are having chemotherapy, treatment for AIDS/HIV or on medication for severe acne or psoriasis, your specialist should know. Other drug or tobacco use should also be candidly discussed.

All of this information should be collected in a medical history and consent for special procedure process. This will significantly increase your chances of a successful procedure. Evidence shows that following standard post-op regimes, this procedure is safe and effective in more than 95% of cases and results in resolution of your ingrown toenail problem.

Why do orthotics cost so much?

Why do Prescription Custom Foot Orthotics (PCFO’s) seem to cost so much ?

Chiropodists are often asked this question. Here are some things you should know about PCFOs; In Ontario, the business of selling PCFOs (which are medical devices) is NOT regulated. So anyone can sell them. Chiropodists ARE however regulated by the College of Chiropodists and the province under the Chiropody Act. As such, we are held to strict standards for prescribing and dispensing orthotics. Most insurance companies will only honour your claim if the PCFOs are prescribed and dispensed by regulated health professionals like your family doctor or chiropodist.

The PCFO device itself is only a piece of high tech plastic – so why does it cost so much? These medical devices are designed to treat medical conditions, eliminate, mitigate and/or prevent symptoms from various pathologies and/or biomechanical abnormalities. The education and clinical experience required to assess/diagnose these pathologies or biomechanical abnormalities in a patient requires years of training and experience. In addition, the correct casting of your feet, the writing of a prescription which identifies the type of device and specific accommodations also requires expertise – as does the manufacture of these devices. The total cost should reflect a blend of product and medical service and expertise.

Got any questions – feel free to give us a call at 905-916-3668 or go to http://www.foundationchiropody.com

How much topical corticosteroid to prescribe?

For one foot, for 1 application, use 2 FTUs (fingertip units - a fingertip unit is defined as the amount of semi-solid expressed from a tube with a 5mm diameter nozzle, applied from the distal skin-crease to the tip of the index finger of an adult ), which is 1 gram (this should cover an area the size of the palm of your hand with the fingers held together). You will need 15 grams to treat one adult male BID x 1 week.

Special foot care is required for people with diabetes

According to the Canadian Diabetes Association, researchers predict that about 2.5 million people will have diabetes in Canada by the year 2016. Damage to the nervous system (neuropathy) affects over 50% percent of people with diabetes and can lead to the loss of sensation in your feet. Just try for a minute to imagine what it would be like to have no feeling in your feet. Foot problems can be a big risk for diabetics. Diabetics must constantly monitor their feet or face severe consequences, including a possible amputation.

In a diabetic patient a cut as small as a blister can cause a lot of damage. Diabetes decreases blood flow which makes injuries slow to heal and predisposes one to infection.

Persons with diabetes should inspect their feet every day. Look for small puncture wounds from slivers of glass, wood hair and other objects, bruises, redness, warmth, blisters, ulcers, scratches, cuts and nail problems. Get someone to help you, or use a mirror if you cannot see your own feet.

Below is some good advice for taking care of your feet especially if you are diabetic:

1.      Examine your feet daily and also after any trauma, no matter how minor, to your feet.

2.      Use a water-based moisturizer every day (but not between your toes) to prevent dry skin and cracking.

3.      Wear cotton or wool socks (or diabetic socks – white is the best colour). Avoid elastic socks and hosiery because they may impair circulation.

4.      Move or remove any items you are likely to trip over or bump your feet on. Keep clutter on the floor picked up. Light the pathways used at night - indoors and outdoors.

5.      Always cut your nails with a safety clipper, never a scissors. Cut them straight across and leave plenty of room out from the nail bed or quick. If you have difficulty with your vision or using your hands, let your chiropodist do it for you or train a family member how to do it safely.

6.      Wear sturdy, comfortable shoes whenever feasible to protect your feet. To be sure your shoes fit properly, see your chiropodist for fitting recommendations or shop at shoe stores specializing in fitting people with diabetes. If you have flat feet, bunions, or hammertoes, you may need prescription shoes or shoe inserts.

7.      Regular exercise will improve bone and joint health in your feet and legs, improve circulation to your legs, and will also help to stabilize your blood sugar levels. Consult your physician prior to beginning any exercise program.

8.      If you smoke any form of tobacco, seriously consider quitting. Smoking accelerates damage to blood vessels, especially small blood vessels leading to poor circulation, which is a major risk factor for foot infections and ultimately amputations.

9.      Following a reasonable diet, taking your medications, checking your blood sugar regularly, exercising regularly, and maintaining good communication with your physician are essential in keeping your diabetes under control.

10.  See your chiropodist or podiatrist on a regular basis

Additional Information

Prevention of diabetic foot problems involves a combination of factors.

1.      Good diabetes control

2.      Regular leg and foot self-examinations

3.      Knowledge on how to recognize problems

4.      Choosing proper footwear

5.      Regular exercise, if able

6.      Avoiding injury by keeping footpaths clear

7.      Visit your chiropodist on a regular basis