Category: Podiatry

  • Plantar Fasciitis

    Plantar Fasciitis

    Plantar Fasciopathy, commonly known as Plantar Fasciitis or Policeman’s heel, plantar fasciosis, or plantar heel pain syndrome, is characterised by pain and structural changes at the insertion of the plantar fascia to the calcaneus, a bone that forms part of the heel. Plantar fasciitis most commonly affects individuals aged between 45 and 65 years (Riddle & Schappert, 2004), with 2–4 cases per 1,000 people per year experiencing some degree of plantar heel pain (Rasenberg et al., 2019).  

    Plantar fasciitis is often misunderstood, and for those suffering from it, the condition can at times be incredibly debilitating. However, with appropriate therapy and guidance, 90–95% of cases resolve within 12 months (Crawford et al., 2003). For cases where symptoms persist beyond a year, reasons can vary from misdiagnosis to the presence of bony changes or gastrocnemius involvement.  

    Cause  

    Plantar fasciitis is generally considered to result from degeneration/soft tissue damage of the plantar fascia, leading to repetitive microtears in the fibrous collagen structure on the underside of the foot. This structure provides support for the arch, enables foot function, and protects vital anatomical elements. Contrary to common misconceptions, plantar fasciitis leads to inflammation rather than being caused by it.  

    There are several reasons why individuals may develop plantar fasciitis, with the most common being previous lower limb injuries, overuse (particularly in runners and military personnel), and excessive loading (such as being overweight or engaging in frequent heavy lifting). Due to the complexity of the human body, increased Achilles Tendon tension can lead to stiffness when pointing or flexing the toes, subsequently placing greater pressure on the plantar fascia.  

    Risk Factors  

    Plantar fasciitis is more prevalent in individuals over the age of 45, with those classified as obese experiencing a 1.4 times higher risk of developing the condition. Although it may be expected that Plantar fasciitis would affect both feet equally, only 1 in 3 patients present with bilateral symptoms (Neufeld & Cerrato, 2008), meaning that it is 66.6% more likely to occur in just one foot.  

    Sports involving heavy foot strikes, such as running, Irish dance, and kickboxing, increase the risk of injury to the plantar fascia, subsequently increasing the likelihood of developing plantar fasciopathy. Occupations that require prolonged standing, such as hairdressing, security, and nightclub bouncing, also pose a risk—particularly for individuals who are overweight.  

    A podiatrist may assess various factors, including gastrocnemius muscle function, foot posture, big toe movement, ankle mobility, leg length, and footwear, as well as taking a detailed medical history. In some cases, diagnostic imaging, such as X-rays, ultrasounds, or MRIs, may be required depending on symptom severity and frequency.  

    Treatments  

    Once diagnosed with plantar fasciitis, several treatment options may be recommended:  

    • Ice therapy – Rolling a frozen bottle of water under the foot while seated can help manage pain and inflammation.  
    • Non-steroidal anti-inflammatory drugs (NSAIDs)– Medications such as ibuprofen may be suggested to help control inflammation.  
    • Physical therapy – Strength-building exercises can improve acute symptoms and prevent recurrence. It is advisable to consult a professional to receive tailored exercises, although regular appointments may not always be necessary. Those lacking access to in-person care may consider online services such as www.kindmoves.co.uk, which have gained popularity during COVID-19 and continue to provide structured support led by physiotherapists or personal trainers.  
    • Orthotics – Individuals who spend prolonged periods standing may benefit from orthotics aimed at improving foot posture, improving foot function and reducing pressure on the plantar fascia insertion.  

    Sometimes, professionals offer novel solutions such as dry cupping, shock wave therapy, low-level laser therapy, and various other treatments that lack reliable evidence of providing any clinically significant benefit. However, these treatments can be a lucrative source of revenue due to their low delivery cost and premium pricing, often justified by the scientific theatre accompanying them. 

    At Caledonia Foot Clinic, we will always perform a detailed assessment and provide the best advice and treatment, following up-to-date evidence based practice and if you ever want a second opinion we encourage you to do so and will provide you with our notes to ensure the best outcome, with us, be confident in your care. 

    Book an appointment at www.caledoniafootclinic.com

    Bibliography

    Riddle DL, Schappert SM. Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: a national study of medical doctors. Foot Ankle Int. 2004 May;25(5):303-10. doi: 10.1177/107110070402500505. PMID: 15134610.

    Neufeld SK, Cerrato R. Plantar fasciitis: evaluation and treatment. J Am Acad Orthop Surg. 2008 Jun;16(6):338-46. doi: 10.5435/00124635-200806000-00006. PMID: 18524985.

    Rasenberg, N., Bierma-Zeinstra, S.M.A., Bindels, P.J., van der Lei, J., & van Middelkoop, M. (2019) Incidence, prevalence, and management of plantar heel pain: a retrospective cohort study in Dutch primary care. British Journal of General Practice, 69(688), e801-e808. Available at: https://bjgp.org/content/69/688/e801 [Accessed 16 May 2025].

    Crawford F, Thomson C. Interventions for treating plantar heel pain. Cochrane Database Syst Rev. 2003;(3):CD000416. doi: 10.1002/14651858.CD000416. Update in: Cochrane Database Syst Rev. 2010 Jan 20;(1):CD000416. doi: 10.1002/14651858.CD000416.pub2. PMID: 12917892.

  • What is the difference between a Podiatrist and a FHP?

    What is the difference between a Podiatrist and a FHP?

    Choosing a Podiatrist or Foot Health Practitioner

    When it comes to ensuring the health and well-being of your feet, seeking professional care is of paramount importance. In the United Kingdom, individuals often find themselves choosing between podiatrists and foot health practitioners. While both professionals play significant roles in foot care, podiatrists bring a unique set of qualifications, skills, and expertise that make them the preferred choice for comprehensive foot health management. This blog will explore some of the differences between the two professions.

    Qualifications and Education

    One of the primary distinctions between podiatrists and foot health practitioners lies in their qualifications and educational background. Podiatrists undergo rigorous academic and practical training, ensuring that they are equipped to address a wide range of foot-related issues. In the UK, podiatrists must complete a degree in podiatry, which typically spans three years and includes extensive coursework and clinical experience. This degree is accredited by the Health and Care Professions Council (HCPC), the regulatory body that oversees podiatry practice in the country.

    Foot health practitioners, on the other hand, are not required to complete a university degree. Their training is often shorter and less comprehensive, for example the initial training is a 2 week course, focusing primarily on routine foot care such as nail trimming and callus removal. While foot health practitioners are capable of addressing basic foot care needs, their limited training may not prepare them to handle complex conditions or advanced treatments, or if a problem arises during treatment such as excess bleeding.

    Scope of Practice

    The scope of practice for podiatrists is significantly broader than that of foot health practitioners. Podiatrists are healthcare professionals qualified to diagnose, treat, and prevent a wide range of foot and lower limb conditions. Their expertise encompasses routine foot care, biomechanics, musculoskeletal disorders, skin conditions, and even surgical procedures. Whether it is addressing; difficult nails, hard skin, sports injuries, managing diabetes-related foot complications, or performing minor surgeries, podiatrists offer a comprehensive approach to foot care.

    Foot health practitioners, by contrast, focus primarily on routine maintenance and care. While their services are valuable for basic foot hygiene, they do not have the authority or expertise to diagnose and treat complex medical conditions. For instance, if you are experiencing chronic foot pain or suspect an underlying health issue, a foot health practitioner may not have the skills or resources to provide a thorough assessment or treatment plan.

    Regulation and Accountability

    Podiatrists in the UK are regulated by the HCPC, ensuring that they adhere to strict professional standards and ethical guidelines. This regulatory framework provides patients with confidence in the quality and safety of care provided by podiatrists. To practice as a podiatrist, professionals must register with the HCPC and undergo regular continuing education to maintain their license.

    Foot health practitioners, however, are not regulated by the HCPC. While some practitioners may choose to register with voluntary organisations, there is no mandatory regulatory body overseeing their practice. This lack of regulation can lead to inconsistencies in the quality of care provided by foot health practitioners.

    Advanced Treatments and Interventions

    Another key advantage of consulting a podiatrist is access to advanced treatments and interventions. Podiatrists are trained to perform a range of specialised procedures, including custom orthotics, wound care, and minor surgeries. For individuals with conditions such as plantar fasciitis, bunions, or ingrown toenails, a podiatrist can provide targeted treatments that address the root cause of the issue.

    In contrast, foot health practitioners typically offer more limited services. While they can assist with routine foot care, they are not qualified to perform advanced procedures or manage complex conditions. This limitation can be a significant drawback for patients seeking comprehensive care.

    Diabetic Foot Care

    Diabetes is a condition that requires meticulous foot care due to the increased risk of complications such as ulcers, infections, and neuropathy. Podiatrists play a crucial role in managing diabetic foot health, offering preventative care, early detection of issues, and specialised treatment plans. Their expertise in this area can help prevent severe complications and improve overall quality of life for diabetic patients.

    Foot health practitioners may provide basic care for diabetic patients, but their training does not encompass the specialised knowledge required to address complex diabetic foot issues. For individuals with diabetes, consulting a podiatrist is essential for ensuring optimal foot health.

    Biomechanical Assessments

    Podiatrists are skilled in conducting biomechanical assessments to evaluate the alignment and function of the feet and lower limbs. These assessments are invaluable for identifying issues related to gait, posture, and movement, which can contribute to conditions such as back pain or joint problems. Based on their findings, podiatrists can recommend targeted interventions, such as custom orthotics or exercises, to improve biomechanics and alleviate discomfort.

    Foot health practitioners do not typically perform biomechanical assessments, as their training does not cover this aspect of care. For patients seeking a comprehensive evaluation of their foot and lower limb function, podiatrists are the clear choice.

    Collaboration with Other Healthcare Professionals

    Podiatrists often work in collaboration with other healthcare professionals, including general practitioners, orthopedists, and physiotherapists. This interdisciplinary approach ensures that patients receive holistic care tailored to their individual needs. Whether it is coordinating treatment for a sports injury or managing a systemic condition with foot implications, podiatrists bring a valuable perspective to the healthcare team.

    Foot health practitioners are less likely to engage in such collaborations, as their role is primarily focused on routine foot care. The lack of integration with other healthcare professionals can limit the scope and effectiveness of the care provided by foot health practitioners.

    Safety and Infection Control

    In healthcare, safety and infection control are paramount. Podiatrists are trained to adhere to strict protocols for hygiene and infection prevention, ensuring that patients receive care in a safe environment. Whether it is performing procedures or managing wounds, podiatrists prioritise patient safety and minimise the risk of complications.

    While foot health practitioners may follow hygiene standards, their training does not emphasise the same level of expertise in infection control. For individuals with compromised immune systems or complex medical conditions, consulting a podiatrist offers greater assurance of safe and effective care.

    Patient-Centred Approach

    Podiatrists adopt a patient-centred approach to care, taking into account the individual’s medical history, lifestyle, and goals. They develop personalised treatment plans that address the root cause of issues and promote long-term foot health. This comprehensive approach ensures that patients receive tailored care that meets their specific needs.

    Foot health practitioners, while attentive to patient concerns, may not have the same capacity to provide personalised and holistic care. Their focus on routine foot maintenance can limit their ability to address underlying conditions or develop detailed treatment plans.

    Cost vs. Value

    While the cost of consulting a podiatrist may be higher than that of a foot health practitioner, the value of their expertise and comprehensive care far outweighs the expense.  Podiatrists offer advanced treatments, preventative care, and holistic management that contribute to long-term foot health and overall well-being. For individuals seeking quality care and lasting solutions, the investment in consulting a podiatrist is well worth it.

  • Introducing

    Introducing

    Introducing: Caledonia Foot Clinic. A brand new venture from lead podiatrist Adam Wai-Man Lau, seeking to revitalise rural healthcare in the Scottish Highlands. Having graduated from Plymouth University in 2019 with a degree in Podiatric Medicine, Adam spent much of his career in high risk care. He worked in the NHS as part of a multidisciplinary team treating complex cases. 

    “It was this experience treating the worst cases where I developed an interest in autoimmune disease, which inspired my passion for preventative care. The reality is that once these patients got to my clinic it was often too late, leaving us with very few options in terms of treatment.” – Adam Wai-Man Lau

    Having moved to Inverness he grew concerned with the current system and continuous centralisation of healthcare forcing rural communities to travel ever further to access the necessary healthcare to ensure prevention of serious complications stemming from chronic conditions such as; diabetes, scleroderma, rheumatoid arthritis among others. 

    Caledonia Foot Clinic seeks to improve healthcare outcomes across the Highlands, through our novel approach. We utilise community hubs to deliver rotating clinics supported by modern technology. We monitor a variety of health metrics for our patients, providing education and tailored treatments to keep the Highlands moving. Our goal with each treatment plan is to improve healthcare outcomes for our community and take pressure off an overworked NHS. We have received funding from Business Gateway to begin trialing our novel solutions with the goal that should we see success we can grow and provide other services and professions to underserved communities.

    “I believe that with compassion, dedication and understanding we can improve our relationship with healthcare and help heal communities across the Scottish Highlands.” – Adam Wai-Man Lau

  • Foot Pain

    Foot Pain

    Living with foot pain can be a challenging and frustrating experience, affecting every aspect of daily life. Whether it’s caused by an injury, chronic condition, or an underlying health issue, foot pain can limit mobility, decrease productivity, and significantly impact overall well-being. Fortunately, podiatrists, also known as foot and ankle specialists, can provide valuable assistance in managing and alleviating foot pain. In this essay, we will explore the day-to-day experiences of individuals suffering from foot pain and the various ways in which a podiatrist can help.

    The Day-to-Day Experience of Foot Pain

    Morning Struggles

    For many individuals, the day begins with a struggle to get out of bed. Foot pain can make even the simplest tasks, such as standing up or walking to the bathroom, feel like monumental challenges. Plantar fasciitis, a common condition characterized by sharp pain in the heel, often causes the most discomfort during the first few steps after waking up. This pain can gradually lessen as the day progresses, but the initial discomfort sets a negative tone for the day.

    Commuting Woes

    Getting ready for the day and commuting to work can be particularly difficult for those with foot pain. Choosing the right footwear becomes a priority, as wearing uncomfortable shoes can exacerbate the pain. Many people with foot pain opt for cushioned and supportive shoes, which may not always match their desired style or professional dress code. The pain can make it challenging to walk long distances, climb stairs, or stand for extended periods, turning the daily commute into a painful ordeal.

    Workplace Challenges

    Once at work, foot pain can continue to pose significant challenges. Standing for long hours, especially in professions that require constant movement, such as teaching, retail, or healthcare, can be excruciating. Even sitting for prolonged periods can lead to discomfort, as certain foot conditions, like bunions or arthritis, can cause pain when pressure is applied to the affected areas. The constant need to shift positions or take breaks to alleviate pain can hinder productivity and focus.

    Limiting Physical Activity

    Foot pain can severely limit one’s ability to engage in physical activities and exercise. Activities such as running, hiking, or even walking for leisure can become daunting tasks. The fear of worsening the pain or causing further injury often leads individuals to avoid physical activities altogether, which can have detrimental effects on their physical health and mental well-being. The lack of exercise can contribute to weight gain, muscle weakness, and a decrease in overall fitness levels.

    Social and Emotional Impact

    Beyond the physical limitations, foot pain can also take a toll on one’s social and emotional well-being. The constant discomfort can lead to feelings of frustration, helplessness, and irritability. Social activities that involve standing or walking, such as shopping, attending events, or going out with friends, may be avoided due to the fear of exacerbating the pain. This can result in social isolation and a decrease in overall quality of life.

    How a Podiatrist Can Help

    Accurate Diagnosis

    One of the most crucial steps in managing foot pain is obtaining an accurate diagnosis. Podiatrists are highly trained specialists who can identify the underlying causes of foot pain through a thorough examination and diagnostic tests. Whether it’s a structural issue, an injury, or a chronic condition, a podiatrist can pinpoint the exact source of the pain and develop a tailored treatment plan.

    Customized Treatment Plans

    Once the cause of the foot pain is identified, a podiatrist can create a customized treatment plan to address the specific needs of the individual. This may include a combination of conservative treatments, such as physical therapy, orthotic devices, and medications, as well as more advanced interventions, such as injections or surgery. The goal is to alleviate pain, improve mobility, and enhance the overall quality of life.

    Pain Management

    Pain management is a critical aspect of treating foot pain. Podiatrists employ various techniques to help manage pain, including the use of anti-inflammatory medications, corticosteroid injections, and physical therapy. They may also recommend specific exercises and stretches to strengthen the muscles and improve flexibility, which can help reduce pain and prevent future injuries.

    Orthotic Devices

    Orthotic devices, such as custom-made shoe inserts or braces, can provide significant relief for individuals with foot pain. These devices are designed to support the feet, correct any structural abnormalities, and distribute pressure evenly across the foot. Podiatrists can create customized orthotics based on the individual’s unique foot structure and condition, offering targeted support and reducing pain.

    Surgical Interventions

    In some cases, conservative treatments may not be sufficient to alleviate foot pain, and surgical intervention may be necessary. Podiatrists are skilled in performing a wide range of surgical procedures to address various foot and ankle issues. This may include correcting deformities, repairing damaged tissues, or removing painful growths. While surgery is often considered a last resort, it can provide long-term relief and improved functionality for those with severe foot pain.

    Preventative Care

    Prevention is a key aspect of podiatric care. Podiatrists educate patients on proper foot care techniques and lifestyle modifications to prevent future foot problems. This may include guidance on choosing appropriate footwear, maintaining a healthy weight, and practicing good hygiene. By taking proactive steps, individuals can reduce the risk of developing foot pain and other related conditions.

    Holistic Approach

    Podiatrists take a holistic approach to treating foot pain, considering not only the physical aspects but also the emotional and social impact. They provide compassionate care, offer support, and address any concerns or fears the patient may have. This holistic approach helps individuals feel more empowered and confident in managing their foot pain and improving their overall well-being.

    Regular Follow-ups

    Effective management of foot pain often requires ongoing care and regular follow-up appointments. Podiatrists monitor the progress of their patients, adjust treatment plans as needed, and provide continuous support. This ensures that the patient receives the best possible care and that any new or recurring issues are promptly addressed.

    Conclusion

    Living with foot pain can be a daily struggle, affecting every aspect of an individual’s life. However, with the expertise and support of a podiatrist, managing and alleviating foot pain becomes more attainable. Through accurate diagnosis, customized treatment plans, pain management techniques, and preventive care, podiatrists play a crucial role in improving the quality of life for those suffering from foot pain. By seeking the help of a podiatrist, individuals can take proactive steps towards a pain-free and more fulfilling life.