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The scope of practice of podiatrists is broad. Below you will find a list of the commonest foot conditions which can be diagnosed and treated by Podiatrists.
|Achilles tendonitis||Foot in the Elderly||Peripheral Vascular Disease|
|Athlete's foot||Fungal nails||Plantar fasciitis|
|Bunions||Growing feet||Plantar warts|
|Corns/calluses||Heel spurs||Posterior Tibial Tendinitis|
|Cracked heels||High arches||Sesamoiditis|
|Dry feet||In growing toenails||Shin splints|
|Flat feet||Knock knees/bow legs||Sweaty feet|
|Foot Arthritis||Malodourous feet|
|Foot in Diabetes||Metatarsal pain||Wound Healing and Tissue Viability|
|Foot in Pregnancy||Morton's Neuroma|
|Foot in Sports||Peripheral Neuropathy||
Podiatry and Chronic Illness
The scope of practice of podiatrists may involve conditions which do not primarily affect the feet but affect the whole body (systemic conditions) which in turn might have direct effects on the feet.
Chronic systemic conditions such as diabetes, neuropathy, osteoarthritis and rheumatoid arthritis affect the feet and lower limbs besides there effect on the general body health.
For example, patients suffering from high sugar levels (diabetes) this can result in an increased risk of wounds causing ulceration and amputations. Prevention of these problems can be provided by a multi-disciplinary team approach including the podiatrist, endocrinologists/ diabetologists, diabetes education, G.P’s and dieticians.
Regular foot checks are essential to test foot mobility, sensitivity, increased risk of ulceration (through identifiable pressure areas/ foot deformities) and injury, in addition to foot care education and treatment of ulcers, infections and related problems when they are present.
Podiatrists may specialise in the field of diabetes, rheumatology and vascular podiatry amongst others. A number of Podiatrists currently occupy posts in these fields while a healthy amount of other Podiatrists are currently embarking on postgraduate training and specialisations in these areas locally and abroad.
Correct foot development is essential for children. Although children will pass through different phases of development causing variations in foot, lower limb structures and consequently walking pattern, having a foot check up by a Podiatrist early on can help spot problems and provide fast and practical solutions.
Podiatrists may specialise in the field of Podopaediatrics, such a podiatrist is referred to as a Podopaediatric specialist.
It is recommended that parents should consult a podiatrist when there child has:
Podiatry and aged care
Podogeriatrics is the specialisation of foot care for the elderly. In fact, Podiatrists play a key role in the management of foot problems in the elderly. Injuries or pain can significantly impact the lifestyle and general health of elderly patients so specialised treatment is important.
General foot care for the elderly include treatment of hard toenails that develop as we age, treatment and prevention of ingrown toenails, fungal infections and removal (debridement) of corns and calluses when present.
Reaching the feet and self-maintenance becomes more difficult with age and therefore regular check-ups by a state registered podiatrist are important.
A number of podiatrists work in gerontology settings around Malta including government elderly residences such as Saint Vincent De Paul Residence (SVDP), other public and private homes across the island.
On the other hand, if you or your relatives are elderly and have a foot problem or trouble walking, it is recommended they see a podiatrist.
Podiatry and Sports Medicine
Sports medicine and podiatry is an area of considerable importance, although this field of Podiatry is not yet developed in Malta in contrast to foreign counterparts.
In fact, athletes are more prone to foot injuries such as Achilles tendonitis, stress fractures, nail problems, shin splints, sprains, plantar fasciitis and knee pain. All these conditions can be treated by Podiatrists and above all Podiatrists can help to prevent the occurrence or recurrence of such injuries through biomechanical assessment, advice on orthotics/ insoles and sensible footwear.
It is important for patients who play sports on a regular basis or else practice their sports professionally to consult a Podiatrist at least once a year to have their foot, lower limb and footwear examined. Meanwhile if an athlete has just suffered from an injury he/she should consult a Podiatrist as soon as possible who along with the multi-disciplinary team will aim to treat his problem in the shortest period but with the highest therapeutic benefit through a holistic approach.
Biomechanics and Orthoses
Podiatrists study biomechanics of the feet and lower limb so they can provide anatomical assessment of patients to detect abnormalities such as flat feet, high or fallen arches and ankle, hip and knee abnormalities. Abnormalities can be corrected through prescription foot orthotics (shoe inserts) or specific exercises to strengthen certain muscles or groups of muscles.
On the other hand, customised shoe insoles may be prescribed and fabricated by a podiatrist to offload pressure areas, particularly in rheumatoid or diabetic patients, and to correct certain biomechanical problems.
It is important that a podiatric assessment is made before one uses an orthotic or customised insole, otherwise problems may be exacerbated.
All Podiatrists state registered in Malta are qualified to provide non-invasive nail surgery for nail problems such as ingrown toe nails under local anaesthesia. Nail surgery is usually advised when other methods and treatments rendered no success. Most nail surgeries are carried out within a few minutes and the patient may leave the clinic at that time. Sometimes an antibiotic prescription may be required before or after the surgery to prevent any infection.
Unfortunately, although surgery for other foot problems such as bunions and hammer toes is carried out by Podiatric surgeons abroad such as in the United Kingdom, current legislation in Malta does not allow such practice. Attempts by UK Podiatric surgeons to start practicing in Malta, and expand the profession locally have remained futile. Despite this, a local Maltese Podiatrist is currently following his training in the UK in Podiatric surgery in order to become the first Maltese Podiatric surgeon.