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Can you see a Podiatrist during the COVID-19 pandemic?

The simple answer to this is YES! Podiatrists are grouped within medical and healthcare, and provide a wide variety of treatments to their patient groups. These include high risk wound care, musculoskeletal problems, painful ingrown toenails, and any other issue causing pain or discomfort in the foot and ankle.

We continue to see all patients currently under the COVID-19 guidelines and have strict social distancing and PPE protocols in place to protect everyone.

If you have any questions regarding our procedures, please do not hesitate to contact us to discuss this further.

 

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Fungal Infections

Good morning, everybody. Fungal infections and fungal nails. I know that most of you watching this probably have had, or currently have one, or will at some point in your life have a fungal infection in your feet. You might be horrified to hear this, but it is so normal. We see it every single day in the clinic.

So what’s a fungal infection? Basically, fungus are everywhere. They’re all over your house, they’re probably in your shoes, and living in your carpet, outside, everywhere. So some people tend to pick up fungus on their feet, some more than others. So there is a  slight genetic element, but also it’s the environment that is key with this. So fungus love a warm, sweaty environment. So if you live in socks and shoes, socks and trainers, sweat quite a bit or at the gym, or out running or out walking and get quite hot, sweaty feet quite a lot, then you may well be prone to getting a fungal infection in your feet. That’s not the only thing you know, gyms, changing rooms, swimming pools, public places, you know, there are lots of things flying around there. It’s very common to pick up a fungal infection.

So what are the signs? On the skin of the feet we usually see, so this skin might be slightly redder in colour, or it might be a bit more sensitive. Sometimes you feel a bit itchy and the skin can look like it’s peeling or a little bit flaky in some areas. Sometimes the only thing that you can see is sort of like a powdery effect in the lines, the striations of the skin on the bottom of your feet. It looks like a white powder almost. Even if you put a normal emollient on your feet, it won’t go away. That’s how you know if it’s a fungal infection or not. In the toenails, it’s different. It always jumps from skin to nail. So if you have it in the skin, you should really get on top of it and treat it. Otherwise it may jump into the toenails. In the toenails, they can be yellow, discoloured, sort of browney green, sometimes thickened, they might be crumbly, they might you know, get sort of deformed in shape they might start getting a little bit curlier eight edges and things like that because the fungus eats away at the nail and causes all these problems. Once it’s in the nail, it’s slightly more difficult to get rid of.

So what do you do? So in general, wash and dry your feet every day. Make sure you dry in between your toes. Change your socks daily, air your shoes out. Don’t be in your shoes all day every day sweating away. Okay. Use antifungal creams. So the usual Lamisil, Daktarin, Canesten – these are all antifungal foot creams that you can use if you see any signs of a fungal infection in your feet. When it comes to the toenails. If you’ve got what you think is a fungal nail infection, you can use something off the shelf called Curanail, or Loceryl – it’s the same thing. This requires you to paint it on one to two times a week. It’s like a clear lacquer, but you need to do it for a minimum of six months. There’s no point doing it if you don’t do that minimum time, okay. If you’re not getting anywhere with these treatments, you know what to do give us a ring 01372 464659 or email us at [email protected] All right, good luck.

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Callus and Corns

Today we’re talking about callus and corns, a very common treatment in podiatry, we see it day in day out. Multiple people have these problems. The reason being so what’s callus? For starters, callus is a diffuse area of hard skin, which we often find on the foot. And it’s caused by pressure. And it’s usually shearing forces, so like movement forces, you may twist when you walk or you have slight movement in your shoe, that sort of thing.

You might get a diffuse area of hard skin, which can as time goes on, that builds up and it gets thicker, it can become quite painful. And so common areas to get it are under these joints in the toe called the metatarsophalangeal joints. And you find possibly under the big toe is more common than the littler ones. And it builds up under there. It’s common under here as well around the heel, where we get a lot of pressure. Sometimes if it gets thick enough, it will crack and that can become quite painful.

So what we do to deal with that in clinic is we take it off with a blade, it’s called debridement. So we take away all that hard skin, which immediately gives you relief from that pain you’re experiencing. But we also look at why you’re getting it. So is it the footwear you’re wearing? Is it the mechanics of your feet? Do you need a little bit of cushioning, because you might have lost a little bit of fatty padding under the joints? What can we do basically to help prevent this build up over the long term.

The other thing I want to talk about today was corns, so that’s slightly different from callus. It is hard skin, but it is where you get an area of direct pressure. So for example, under this little toe, you might get a direct pressure if this joint sort of dropped slightly.

So if you look in this line, and it just slightly drops down like that, you might be getting an extra bit of pressure under it when you walk. And what you’ll find is it’s like a circular bit of hard skin, it looks a little bit like glassy, that’s the way to describe it. It’s a little glassy bit of hard skin. But what it does is it goes into the skin like this in a point, okay. And so when you walking on it from that circular shape, it goes up into the foot like a point so when you walk it is very painful. Okay, corns are a lot more painful than callus in general, because it feels like you’re walking on a pebble or a stone almost all the time, once they build up. And common places to get them are under these joints here.

You might get one under the little toe joint, the big toe joint, the tops of the toes. And these are always caused because of footwear. Because you get direct pressure from footwear. If you don’t wear shoes at all you can get on the top, because there would be no pressure on the top. Okay, and we deal with those in a pretty similar way. We take them out and it’s called enucleation. We take out the corn and again, you get immediate relief and then we look at the reasons why you’re getting it. Is it footwear? Is it abnormal pressures in your foot? Is it the way that you’re walking? That sort of thing and try to address it that way as well as giving you the immediate relief of taking away the problem.

So they are fairly simple things but they can cause a lot of discomfort in our patients. And if you’ve got a problem like that, you can give us a call or 01372464659 or you can email us at [email protected]

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Achilles Tendinopathy

 

Today’s topic is Achilles tendinopathy. What is that I hear you cry? Well, it’s basically a pain in your heel, let me show you. So just here your Achilles runs from your heel bone up into the calf, okay. It’s a big thick tendon. Okay. And we’ve seen quite a lot of people who are getting quite a lot of irritation on it at the moment, the main reason being is a sudden increase in exercise. So all that lockdown walking, running, extra sport you’ve been doing, it’s beginning to have an effect on your Achilles. Basically it doesn’t like a sudden increase either, if you’re running, for example, a sudden increase in speed, or distance. So you need to do everything gradually, if you’re increasing exercise. If you suddenly go from here to here, it’s likely to cause a little bit of an issue with your Achilles.

So symptoms include pain, a little bit of inflammation, it might be hot, and it might not be painful when you’re actually doing the activity but maybe afterwards, it gets a bit sore. And then as time goes on, if it gets a bit worse, it might be painful all the time. It tends to hurt when you own your feet. Sometimes it can get a little bit bumpy, just along along the tendon, sometimes just down here, you can feel a little nodules. If you do a little squeeze test like this, that will be quite painful. If your Achilles has got a bit of tendinopathy on it. And you can also experience symptoms up further up here, where it inserts into the muscle as well as down here.

So what can you do about it? Well, number one thing to do is reduce that exercise that you’ve just increased. So just bring everything back down to a much lower level and take it easy, okay. Other things to be doing are footwear, look at that footwear that you’re wearing? Okay. So here we go. This is the sort of thing I want you to be wearing. If you’re running, training, I don’t know, in the gym, whatever, even walking, if it’s not muddy and disgusting. Don’t worry about the brand, but this is a good supportive running trainer. Okay, it’s nice and cushioned on the bottom, it’s supportive here on the inside of the foot, and it’s got nice firm heel cup. Okay, the other thing as the insole comes out, so if you need an insole, you can put your own in.

So that brings me to insoles. So here we go. Here’s an example. So the thing that the Achilles quite like is when you take the pressure off it, okay, so often on insole with a slight heel lift, like this one’s got here is a good treatment for Achilles tendinopathy. It just takes the strain out of it to allow it to settle down and heal. So insoles might be a good idea if you’re really struggling with a bit of tendinopathy there. Okay, other things include ice, anti-inflammatories, you know, you can either take them orally or use a gel, that sort of thing. And rest it, do that as well. But if all that fails, and you’re still having problems, you know what to do – get in contact with us. Okay, you can ring us on 01372464659 or you can email us at [email protected]

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What is Toenail Reconstruction?


 

Today’s topic is toenail reconstruction, and I have been in quite a lot of these lately and it’s quite an interesting aspect of our work here in the podiatry clinic as it’s a little bit different, it’s more cosmetic, rather than clinical if you like.

So what is toenail reconstruction? It is, it’s almost like a gel, which we cure under a UV light. So we build it up in multiple layers on people who have got deformed toenails or lost part of their toenails and they want to have a toenail in place to paint or for protection on the nail bed, and it’s specifically for toenails so it’s a little bit flexible. It’s not like acrylics that you use on fingernails at all.

So who is it suitable for? Well, anybody really who has got a problem toenail. So you might have had nail surgery in the past, so you don’t have much toenail left, and you want to build it up slightly. You might have had a fungal infection and so you might have crumbled away slightly. It might be deformed or thickened through trauma. Basically, if your nails not looking as you want it to look for the summer or for any time really, we can build it back up to make it look like a normal nail. The one key thing that you do need is something for it to adhere to. So it won’t work very well on people who’ve only got just skin on the nail bed. If you’ve got any nail at all or any rough callused skin, something for it to adhere to, then it will work.

Okay, you can paint it, you can cut it, you can file it like any normal nail. But as your nail grows, it will grow up and out with it and it will come slightly loose. We say generally that it will last for six to eight weeks. We don’t advise soaking it in baths for a long time because it tends to, the water gets kind of trapped underneath and it tends to loosen it off slightly. Showers are better, and not too much trauma from sports or bad footwear. If you adhere to all that it should last a good six to eight weeks, maybe more, and then we just take off and replace it if you want another one. It also protects the nail underneath if it’s damaged while that grows out as well so it’s quite good for just keeping that in check and giving it a protective layer just on top of the damage nail like that.

So that’s it really it’s a harmless treatment, it doesn’t take long. It’s a half an hour appointment for one toenail or an hour for two. If you want to book in just ring us on 01372 464659 or you can email us at [email protected] and we will get you booked in. You can also look at the website www.surreyfootservice.co.uk and the blog that will go with this post for before and after pics so you can see examples.

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How to Manage Your Verruca

Verrucas – so they are everywhere apparently! We see lots and lots of a verrucas every day here in clinic, everyone’s always asking me, how can I get rid of my verrucas? They are a bit of a pain to be honest. And I’m sure, if you’ve had one, you will know this. The reason that they are a bit annoying is that they’re a virus. So it’s not just something like a corn on the foot where you can come in, we’ll take it out, and that’s it gone. Because it’s a virus, that’s a systemic thing going on in your body. All treatments are aimed at trying to get your body to recognize the virus and fight it. And once it does that, it picks up on it and fights the virus, they will go.

Okay, so they present as little thickened areas on the bottom of your feet. And they’re usually flat on the bottom of your feet, because we walk on them. So it’s sort of pushed up into the bottom of the foot in there, because you’re walking on it all day. They can be painful, they can get quite big and they can spread. So there’s lots of things you can do about this. One thing to note is they’re not harmful. So if they’re not bothering you, you can just leave them and the theory is that your body will pick up on the virus and fight it at some point. It may take weeks, months, maybe even years, but it should pick it up at some point, and they will go. If however you want to get rid of them sooner or they’re painful, then there are things you can do.

So you can try lots of over the counter treatments from the chemist. These tend to work better on younger kids because their immune systems are better at fighting the virus anyway. However, if you’ve tried it and it’s not worked, then you can come into clinic and we can offer you different options. So we mostly would offer two things. One is cryotherapy, two is needling. So when we see you, we would assess your verruca and discuss the options with you, and if you’re happy to have a treatment with us here, we could either go with cryotherapy, which is effectively freezing the verruca. And we usually do that minimum of three times at three sessions. It can be quite nippy, but it’s very fast, so it doesn’t take long and your foot might be a little bit tender for a day or two after but you don’t need any dressings, anything like that. So that’s one option. The second option is needling, and that is more of a one off treatment. We put some anaesthetic in the foot and we basically cut out as much of the verruca as possible and then we puncture it hundreds of times with a needle. It’s more aggressive than cryotherapy and the theory is that you’re physically getting it as much as you can and by puncturing it, you’re getting the virus into the bloodstream, so your body will pick it up and fight it. Both have got good evidence that they’re about 70% effective. You will not find a treatment for verrucas that’s any more effective than 70-75% because it relies on your body fighting the virus.

If you’re interested in coming in and to have a chat about treatments or you want to book in with us, it’s the usual number or 01372 464659 or email us at info at [email protected] All right bye for now.

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Ingrown Toenails Can Be Fixed!


So today we’re talking about ingrown toenails. We see an awful lot of these in our clinic. So what is an ingrown toenail? Basically, it’s when the edge of your nail starts digging into the skin slightly, and it starts causing you a little bit of pain, inflammation, and if it’s not treated, it can lead to infection. So these can be incredibly painful if they’re not treated and dealt with correctly. So what causes an ingrown toenail? There are many reasons but one of the main reasons we see is the way that you’re made up, so your genetics. Some people just have a curlier toenail than others basically and therefore the edges of the nail just dig in slightly more. This may or may not cause you a problem, but other things that can exacerbate this or cause an ingrown toenail are what you do in your daily life. So for example, if you’re very sporty, football, rugby, dance, all these things cause an awful lot of trauma and pressure to the toenails, so these can cause an ingrown toenail to flare up. The shoes you wear are also very important. So if you were very tight fitting shoes. Heels, things that will cause a lot of pressure on the forefoot, then these can lead to an ingrown toenail as well. Other things, one off things like if you drop something on your foot, or if you’ve got a fungal infection in your nail, and it causes it to change shape and got thicker, all these things can lead to extra pressure and therefore an ingrown toenail.

So what can you do about it? I’ve already mentioned that footwear is very important. So wearing looser shoes, for example, a trainer or a shoe with a strap or a lace, which is wider and deeper at the front will definitely take the pressure off the nails. Cutting the nails, try not to dig down the sides. A lot of people will try and do this, but they may leave a little spike of nail, which may cause further problems. So just follow the natural curve of the nail when you’re cutting them and keep them short and neat. The other thing is try and avoid pressure basically on the nails. So I mean, I know if you’re into sports and things like that, you can’t really but just think about what you’re doing in your daily life and any pressure avoidance on the toenails will help. If you have got that inflammation and pain present, what you can do is pop them in a basin of warm salty water. So that just helps settle down any inflammation and pain.

If you’re still struggling, and it’s not working and you think I’ve still got pain, inflammation, this is getting worse then you need to see a podiatrist. So come in, and we will assess you, and we will either recommend a conservative treatment, or there’s a small minor operation where we remove a sliver of the nail which is causing the problem permanently. And that is a permanent solution to the ingrown toenail, basically. So once you’ve had that procedure done, it’s gone. You don’t have to worry about it again. We’ve had plenty people in with problems like this, one example, a lovely patient called Robert came in with toes double the size of normal, highly infected and had multiple courses of antibiotics trying to sort it out with no results basically. And the reason being it was the nail that was digging it and so no matter how many courses of antibiotics he had, it wasn’t going to resolve that problem. So, we did the minor procedure on him, took out the sides of the nails which were causing the problem. Healed up within a few weeks, back at work, no pain, no infection, no problems. So if you’ve got an ingrown toenail, do not leave it please. Get in touch with us or your local podiatrist if it’s not working what you’re doing at home. All right.

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Why Am I Getting Heel Pain?

 

Heel pain is our topic today and we see this every single day in clinic. So what exactly is heel pain?

Heel pain is any pain which you get under or around your heel, and it’s comes and goes, or it’s constant. It’s not just a one off thing.

 

So what causes heel pain?

There are lots of different things that can cause heel pain:

  1. One of these is footwear. If your footwear is not supporting you, in the correct way, classic things like bally pumps, or just slip-on shoes, this can cause the plantar fascia under the foot to stretch slightly, and then it pulls at the heel. So this can cause a little bit of a heel pain.
  2. What you are doing in your daily life. How much are you walking? How much exercise are you doing? Have you suddenly increased your exercise or have you changed your exercise regime? All these things can initiate a chain, which can lead to heel pain.  Have you recently put on weight? Then you’re carrying extra load through the lower limb and the feet, and this can trigger something in the foot as well.
  3. The mechanics of your walking or running could be putting extra strain on your lower limb leading to heel pain. 

 

What can you do about it at home? 

  1. Stretching. Often we find people have got tight muscles, ligaments, tendons, when they experience foot and ankle pain. So a basic calf stretch is always useful. You can always stretch under your foot using a tennis ball or a frozen bottle of water, if you roll that over the arch under the arch and under the heel of your foot, it often settles down pain and inflammation associated with it. 
  2. Ice and/or anti-inflammatories to calm down any inflammation.
  3. Modify your exercise regime – if you have suddenly increased it, just pull it back slightly to take the strain off the structures around the heel.
  4. Footwear – make sure you’re wearing the correct footwear for the job. If you’re running, make sure you’ve got a running trainer with good support, or if it’s tennis, make sure it’s a tennis shoe. 

 

Then what?

If all of the above doesn’t work, go and see your podiatrist and we will assess you. We will video you walking, running and doing whatever sport it is that’s causing the problem and slow it down, have a look at what is going on and suggest a treatment programme. We will often suggest a stretching and strengthening program. We may suggest modifying your exercise, so change up your exercise regime, don’t just run if that’s what’s causing a problem and maybe do some swimming or cross training as well. Footwear, footwear footwear! Always look at your footwear as well. If it’s not doing the job, it’s going to be causing you problems. And we may suggest a referral, you might need a referral to someone else, like a physio or an osteopath to do some manipulation work on you as well. We may also suggest an insole or orthotic to support your foot if it needs it, and often we find this does help when you’ve got heel pain. Maybe temporary, maybe more permanent.

 

We will work with you to ensure the best treatment for you and your body to fit in with your lifestyle. Our podiatrists are experts in this field and we are here to help! 

 

Contact us on 01372 464659 or [email protected] to make an appointment. 

 

 

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Foot Peel Fun!

Loads of you have asked me about foot peel masks and whether they are any good, so I thought I would have some foot peel fun of my own! In short, I tried them out and reported back via a series of videos, so here they are….graphic content warning as they contain peeling skin and if you are not into this, don’t watch it! 

 

 

 

 

 

If these foot peel fun masks worked for you – that is great news…it means that your feet don’t have heavy callus and you don’t need any additional help with the skin on your feet. If however you still have callus, hard skin or corns you need to see a podiatrist. Contact us to book an appointment or find your local podiatrist to get booked in. 

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Frankie Bridge talks Feet!

See Frankie Bridge talking here about her ingrown toenails on Loose Women which she had treated by us last month. She is fantastic about sharing her foot troubles with the world and advocates that there is no need to be embarrassed by them.  Great work!

 

 

 

Frankie has had painful toenails for many years but due to her work commitments she was never able to do anything about them permanently. In lockdown she decided to finally get them treated and has taken to Instagram and Loose Women to tell all about her experience. She openly discusses the problems she has with her feet and why we shouldn’t be embarrassed by them. 

 

Find out more about Ingrown Toenails. 

 

Contact us to book an appointment. 

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When that niggle turns into pain

It’s early in the year, it’s lockdown, and it seems everyone is out walking and running as, let’s face it, what else is there to do?! But, be careful, you could start to get some niggles, or worse if your overdo it…

We are seeing so many new clients in lockdown with niggles which have turned into something more. This can be down to walking around the house barefoot due to home working, and therefore not wearing a supportive shoe or trainer like you usually would when out and about at work. It is also due to a generic increase in walking and running as a form of exercise outside as this is one of the main things we can do at the moment to keep fit.

However, due to the lack of variety in our exercise, wrong shoes, lack of support, tightening of muscles etc. we are seeing quite a few clients coming in with Achilles and heel pain injuries.

Here are a few top tips to keep you flexible and injury free: 

  1. Stretch stretch stretch…we don’t do enough of this – calf stretches are a great way of keeping you moving and is a must after a long walk or run 
  2.  
  3. Use the correct footwear for the job – if you are running wear a good supportive running trainer, walking requires a good support walking shoe or boot 
  4.  
  5. Vary your exercise routine – don’t do the same thing every day! Although it is tempting to have a routine where you do the same walk or jog daily this will put undue stress on your muscles and joints with no time for them to recover. Try and mix it up with an online Pilates class or weights session – this will work different muscle groups and give your body a much better chance of recovery from the other types of exercise you are doing. 
  6.  

If all else fails and you are still getting pain, then get in touch.  We are here to help with foot and ankle pain and can create a tailored treatment plan to meet your specific needs. 

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Current Prices

Here is a quick update on our current prices for our most popular treatments. If you have any questions or wish to contact us please call us on 01372 417585 or email on [email protected]

 

New Patient £60 30 minutes
Routine Appointment £55 30 minutes
Advanced Analysis Package 

(for foot, ankle, heel, knee pain

includes 60 min assessment + 1 follow-up apt)

£195 60 minutes
Verruca Needling Package

(includes needling + 2 follow-up apts) 

From £350 60 minutes
Cryotherapy £75 per session 30 minutes
Toenail Reconstruction (Wildé Pediqué) From £80 Variable
Nail Surgery Package

(includes surgery, dressings + 3 follow-up apts)

From £499 90 minutes

 

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Christmas Opening Hours

We will be closed for Christmas from 23rd December – 1st January. We will be taking a well earned rest with our families and hope you will be too! We wish you all a Merry Christmas and a Happy New Year. If you have an emergency please contact [email protected] as the phone lines will not be manned over the festive period. 

 

Fiona, Cindy & Melissa x

 

 

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