General Podiatry/Biomechanics clinic.

About this clinic.

Ratna’s clinic focuses on all aspects of podiatry, including painful nails, skin problems, verrucas and complex lower limb musculoskeletal injuries and gait analysis.

– Corns. (Read more…)
– Calluses. (Read more…)
– Verrucaes. (Read more…)
– Fungal nail infections. (Read more…)
– Fungal and bacterial skin infections. (Read more…)
– Ingrown toenails. (Read more…)
– Diabetic foot care. (Read more…)
– Nail surgery. (Read more…)
– Biomechanical assessment/gait analysis. (Read more…)

Corns.

Weight-bearing parts of your feet are prone to corns, due to the high pressure experienced in these areas. While some corns can be pain-free, others can be incredibly painful. Even if your corn isn’t causing you a practical issue, it’s a sign of a specific problem that needs to be diagnosed and treated.

Calluses.

Calluses not only look bad, but they can also be very painful. Similar to corns, they are most commonly caused by that specific area of your foot being exposed to an excessive amount of friction or weight bearing pressure.

Verrucaes.

Verrucae are caused by the Human papilloma virus and develop as warts on the bottoms of feet and occasionally on your hands. On visual inspection, verrucaes can appear similar to corns, however they are highly infectious and can spread through direct contact with an infected person or surfaces that an infected person may have walked on. Common places include swimming pools, hotels and changing rooms. Although harmless, verrucae can often be painful when present on a weight-bearing part of the foot.

Treatment options available:

Cryotherapy.

This involves the localised application of liquid nitrogen in the form of a spray to the verrucae. Cryotherapy works by destroying the verrucae tissue and instigating an immune response to fight off the virus. Cryotherapy is a safe and straightforward procedure causing minimum disruption to our patients, although it can take several treatments before the verruca is finally eradicated.

Acid-based treatment.

This involves the use of a strong acid-based paste applied to the verrucae tissue. Similar to cryotherapy, acid-based treatments are used to destroy the verrucae tissue and instigate an immune response. Acid-based treatments are generally less painful than cryotherapy, and therefore are typically their recommended treatment in children. Again, this treatment usually requires several sessions before the verruca is fully destroyed.

Verrucae dry needling.

Verruca dry needling is a minor surgical procedure performed under local anaesthetic. On successful anaesthesia, the verrucae tissue is punctured repeatedly using a sterile needle. Verrucae needling poses the benefit of typically requiring only one treatment, with a 70% success rate after one treatment.

Fungal nail infections (Onychomycosis).

Fungal nail infections are characterised by thickening of the nail plate and a yellowish-brown discolouration. While it is not painful in the early stages, as the nails thicken, they place too much pressure on the nail bed, becoming painful. Onychomycosis can also be contagious, and therefore early intervention is recommended before it spreads to other nails. An appointment for suspected fungal toenails will include trimming and thinning of the thickened fungal toenails, the option of a biopsy to confirm the presence of Onychomycosis and a tailored treatment plan to destroy the fungal infection and prevent recurrence.

Fungal and bacterial skin infections.

Infections such as Tinea pedis (Athlete’s foot) can damage the skin of the feet, becoming potentially itchy and painful. Your initial appointment will aim to diagnose the causal pathology and an appropriate treatment plan will be formulated.

Ingrown toenails.

Ingrown toenails are a common condition in which the corner or side of a toenail grows into the surrounding skin. This results in pain and inflammation to the surrounding skin and sometimes infection.

Conservative treatment for ingrown toenails involves your podiatrist removing the offending nail spike without the need for local anaesthetic. For chronic or severe cases, nail surgery can be performed to prevent recurrence.

Diabetic foot care.

People diagnosed with diabetes can develop foot complications such as impaired blood supply, causing issues with healing and a heightened infection risk, and damage to the nerve supply to the feet, known as neuropathy, resulting in a loss of sensation in the feet. This can result in damage that you may be unaware of, e.g., standing on a sharp object or a toenail digging in.

Small problems like this can become big problems in diabetes. People with diabetes are recommended to undertake regular foot assessments with a podiatrist to monitor for any loss of sensation and check the circulation and have hard skin and corns treated promptly to avoid high pressure areas that can ulcerate.

Nail surgery.

Nail surgery is a minor surgical procedure for ingrown or thickened toenails that haven’t responded to non-surgical treatment. The aim of the surgery is usually to prevent the area of nail that is removed from growing back. Surgery begins by performing a local anaesthesia block around the affected toe, to prevent pain during the surgery. A tourniquet (tight rubber band) is then applied around the toe which stays in place during the operation to prevent bleeding during the procedure. The offending section of nail, or the whole toenail is removed, and a chemical called Phenol is applied to the nail bed to prevent regrowth.

Biomechanical assessment/gait analysis.

A biomechanical assessment aims to diagnose the pain you are suffering, be it in your feet or further up the body. Common examples include soft tissue pathologies such as plantar fasciitis, Achilles tendinopathy and ankle ligament injuries, and osseous pathologies such as Osteoarthritis.

Such pathologies can be a result of injury, structural problems or the mechanics of particular foot types making you more prone to injury.

During your Biomechanical Assessment, your Podiatrist will ask about the pain you are suffering, and an in-depth medical history will be conducted. A static assessment will then be performed to specifically assess the onus area, before generally physically examining the joints, muscles and tendons of the lower body.

This will be followed by gait analysis (assessing the way you walk) to see how your body moves. This will involve the use of ‘Dartfish’ Motion Capture video technology, allowing your podiatrist to track specific movements and trajectories to highlight technique deficiencies.

In-shoe pressure analysis will then be conducted using special sensors inserted into your shoes. This will formulate specific data on key biomechanical functions, such as the degree of pronation and supination, force and pressures being exerted onto specific regions of the feet and foot strike patterns.

Once your Podiatrist has completed the assessment and identified the problem, a bespoke treatment plan will be formulated. This will be in the form of a report, detailing the causal factors for your symptoms and how this can be treated. Typically, this will contain an in-depth rehabilitation section, recommendations on footwear and potentially the provision of functional foot orthoses (foot insoles).

Click to access the login or register cheese