Warm Feet Matter

If you know anyone who have the tendency to get cold feet during the cold winter weather, then the problem may lie in the shoes and even the socks. In addition to that, some medical conditions may be affecting the circulation and peripheral nerves, which may also lead to feelings of coldness. Whatever the reason may be, quality shoes, socks, and inserts can help tackle this common problem


During winter we tend to keep our feet in shoes more often to stay warm. Unintentionally, improper fitting shoes and tight socks increase the effects of common things that some of us already have (such as bunions and calluses).

Taking care of your feet by having the right shoes and general maintenance is important in the cooler weather. A combination of poor circulation and ill-fitted footwear can cause conditions such as Chilblains (photos above). Other underlying medical conditions in combination with cold weather can cause toes turning white and blue from the arteries (in areas like the toes) to get triggered by the cold, this is known as Raynaud’s syndrome.

How can a Podiatrist help?

Foot care is especially important for people with diabetes, people which feet tend to swell and for those who already have drier skin. This loss of moisture can lead to skin peeling and skin cracking. Those living with chronic paincan be more sensitive to stiffer joints, inflammation and neuropathy.

To manage feet in the colder months, a podiatrist can help you out with footwear advice and general foot care.

How do we treat heel pain?

Heel pain is the most common condition we see at Pioneer Podiatry, with at least 5 to 10 cases per day. In our clinic, we specialise in diagnosing and treating this condition and have a special focus on cases that have been chronic and difficult to fix. 

How do we treat heel pain?

There are several treatment options that can be used to resolve heel pain conditions and each one is carefully considered when treating each patient. What’s right for one person might not be right for another. A physical examination will be conducted in order to diagnose which heel pain condition you have and a biomechanical assessment will be carried out to help determine which treatment path to take.

The main treatment options are:

You may require one or a combination of the above treatments. Stretch techniques and footwear selection are also important. In addition to the treatments that we put in place for you, it is extremely important that we educate you and clear up the confusion surrounding things that you should and shouldn’t do. Commonly, patients are engaging in home remedies that a practitioner or a friend may have informed them of, or that they have learned about online. Some of these common remedies add stress to the heel and irritate the condition, even if they provide short-term relief, meaning the condition persists.


When should you see a Podiatrist for your ingrown toenail?

Ingrown nails may cause pain at the end of the toe or all along the edge. Pain is often worse in shoes. The edge that is in the skin may cause infection or inflammation. The toe may be red, swollen, or have pus or drainage.

How can it be prevented?

Because of nail shape and other factors, not all ingrown nails can be prevented. However, cutting nails too short may leave a rough edge or a corner that can pierce the skin as the nail grows outward. Cutting the toenails straight across allowing the sides of the nail to be smooth and just over the skin on the end of the toe can help prevent ingrowing toenails.

How is it treated?

At Pioneer Podiatry, our initial treatment goal is relieving pain and clearing infection or inflammation. If the toe is not infected, your podiatrist may be able to carefully trim the ingrown nail edge, without any discomfort. An infected toe usually requires removing the edge (a portion of the ingrown toenail) or, in some cases, the entire nail.

If your ingrown nail is reoccurring, we can perform a procedure called a partial nail avulsion with matrix phenolisation, which involves removing the whole edge of the offending nail and sterilising the nail bed for a permanent solution to your chronic ingrown nail. This procedure is painless as it is performed under local anaesthetic, and the recovery time is very fast. Most people can return to work the next day, as long as they are able to wear an open-toed shoe (eg sandals/ thongs) for a few days.

Sports injuries in teens and adults: Are they a problem? Can they be prevented?

Biomechanical podiatry in general terms involves the diagnosis and treatment of all lower limb and foot injuries, regardless of age, gender or activity.

A sports injury may be categorized as an acute injury or an overuse injury, depending on the cause of injury and the onset of symptoms.

When to seek treatment?

Most people have no idea whether or not they are running or functioning correctly, however, when an injury occurs they know they must do something about it. At Pioneer Podiatry, with the use of a computerised posture, balance and gait assessment we can quickly determine whether your foot and leg alignment and stability is sufficient for performing your particular activity.

What level of athletes can we help with?

To date, we have treated... 

If you fit anywhere in this group of athletes or have patients that fit anywhere in this group and have foot or leg pain limiting you in any way,
we are here to help you!

Injury Free Running

You’re ready to run if you’ve spent at least two weeks walking or doing some other form of exercise (like using a stationary bike or an elliptical trainer) on a regular basis—roughly 30 minutes per day, four or five days per week.

How to get started

Get the goods. You don’t need lots of fancy equipment to start running, but a new pair of shoes are non-negotiable. Worn-out shoes are a leading cause of injury, and often wear and tear aren’t obvious to the naked eye. We can help with this VERY IMPORTANT FIRST STEP

How fast or slow should you go?

The idea is to run in a relaxed manner with as little tension as possible. Hold your head high, centred between your shoulders, and your back straight. Imagine your body is hanging from a string that is attached to the top of your head.

Aim for a mid-foot strike. Landing in the middle of your foot is the safest way to land for most recreational runners. Avoid striking the ground with your heel or your forefoot first. Your foot should land below your hips – not out in front of you.

Our Podiatrists can plan simple and effective ways to begin exercising or running, which suits your individual needs including selecting great exercise shoes. 

What do you call a nurse with a sore foot? A nurse.

Who works harder than nurses? OK, no need to start a fight here, but do I have a point?! Walking around a LOT, standing for hours, hard concrete floors, lifting and manual handling. And not always in the best shoes... because they're usually the ugly shoes! One thing is for sure, at Pioneer Podiatry, we see a LOT of nurses.

Not surprisingly, there have been quite a few studies into the kind of injuries that nurses get. And guess what? Nurses have some of the highest rates of musculoskeletal injuries amongst all the medical and health professions. In some studies, up to 85% of nurses reported a musculoskeletal injury, with foot and ankle pain coming in close second behind lower back pain, and just in front of shoulder pain.

Another review of over 35 studies into lower limb injuries in nurses showed that foot and leg pain is a major cause of sick leave amongst nurses.

So how do we help nurses?

Firstly, footwear prescription is so important to get right. Just like writing the right script for the right antibiotic for the right bacterial infection is critical to getting a good clinical result, so is getting the right footwear script with the right design and technology elements to prevent or help to cure a musculoskeletal injury. Too much, or not enough, support or cushioning can make a small problem worse. Other things such as midsole density and heel pitch make a huge difference. And, perhaps the most important factor of all... style! If you need a more dressier footwear style, you don't want to have to be stuck with the ugly shoes. The honest truth is... you might buy them, but you're very unlikely to wear them.

We take all these factors into account when prescribing shoes; support, design function, and fashion. If you get one element wrong, it's not going to help. We are certified shoe nerds, and we pretty much know every shoes out there. If we can't direct you to where to get the shoe you need, we can source and fit it directly for you.

The second way we help nurses is by using one of the super skills of our profession... custom orthotics. An orthotic is something you put in a shoe to change the way the foot works, usually to reduce the tissue stress on an injured area, or to improve biomechanical function. A custom orthotic is an orthotic that is made from a 3 dimensional impression, mould, or optical scan of your foot. Custom orthotics are very effective at treating many injuries, and they are many nurses walking around Mackay with our orthotics in their shoes. It has enabled them to walk and work without the end of day pain they previously experienced. And that is good news, not just for those nurses, but also for the patients they treat! I mean, is it easier or harder to do your job with a sore foot? You know what I'm saying?

If you know a nurse with a sore foot, you should share this blog post. They will thank you for it!

Frequency and risk factors of musculoskeletal pain in nurses at a tertiary centre in Jeddah, Saudi Arabia: a cross sectional study
Suzan Mansour Attar
BMC Research Notes 2014, 7:61 doi:10.1186/1756-0500-7-61

Lower extremity musculoskeletal disorders in nurses: A narrative literature review.
Stolt M, Suhonen R, Virolainen P, Leino-Kilpi H.
Scand J Public Health. 2015 Sep 9. pii: 1403494815602989

Is the hippocratic oath still relevant today?

Ever since the dawn of medicine, we have been drawn towards a sense of presumed ideals and ethics necessary in the healing arts. When we seek the help of a doctor, most people are in a state of physical, mental, or emotional vulnerability, and we need to assume the best intentions of the person into whose hand we are putting our health, or perhaps even our life. For this reason, there is a long tradition of oaths used by physicians upon completing their training to explicitly outline these ideals, so no one is guessing what is expected of these venerable citizens.

And when I say long, I mean really long. The Hippocratic oath is perhaps the oldest, and most well known, and is attributed to the ancient Greek Physician Hippocrates of Kos from the 5th century BC. While it is a fascinating read, it is hardly something most modern physicians would honestly abide by, particularly considering the opening promise to "swear by Apollo the physician, by Aesculapius, Hygeia, and Panacea". However, even in these dark distant past times, there are thoroughly modern medical concepts such as to use treatments and procedures only "for the good of my patients according to my ability and my judgment and never do harm to anyone". There is even a promise to not undertake procedures that you are not experienced in, but to "leave this operation to be performed by specialists in this art".

Many medical oaths also make explicit the most powerful skill which a treating physician can possess. Surprisingly, this is not an elusive technical clinical skill, but rather the rare art of careful listening. It is the ability to truly probe into the root motivations and desires of our patients and to empathise with what they want to achieve. In teaching our new graduates, I tell them to look beyond to presenting complaint, and find out what this pain is preventing your patient from doing. Their real problem isn't heel pain or an ingrowing toenail, it's the fact that they can't play soccer with their teammates, or that they can't stand at work, and are afraid of losing their job. Or that they can't go walking each afternoon for exercise with their wife, they are gaining weight, and facing mounting criticism for this from their doctors. Once you find this deepest level of "why", you have to key to connecting your medical interventions in a relevant and engaging way.

In "A Modern Hippocratic Oath by Dr. Louis Lasagna" we have the wise assertion to "... remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems if I am to care adequately for the sick." Unless we truly understand the surrounding life context of our patients, we are never able to work alongside them in a partnership towards their goals.

And finally, though the modern oaths have removed the references to Apollo the Physician, there is still space to recognise these oaths as more than just a code of ethics for professional behaviour. Dr Lasagna states in his modern oath "...Above all, I must not play at God", indicating that there may be ethics and decisions above our pay grade as mere mortals. In recognising some of these self-evident truths, many ways choose to define this oath as a pledge to God himself. Whatever the personal persuasion may be in the end, to recognise the gravity and weight of such a responsibility as we have, and by articulating this and declaring it in front of those we seek to serve, is surely one of the most powerful ways to keep ourselves accountable to our highest ideals and ambitions.

Healing Heel Pain

Firstly, the longer you or your patient has had the symptoms, the longer it will take to heal.

heel pain to see podiatrist

Plantar heel pain is the culprit in most mechanical heel pain cases. It has a fairly predictable patient description- severe pain localised to the plantar heel, particularly when first weight bearing after a period of non-weight bearing (i.e. getting out of bed in the morning, after driving 30 minutes in the car etc). This pain will typically decrease after a number of minutes, and then returns gradually through the day, and worsens with more time spent on feet, or with higher intensity activities (e.g. running, exercise, jumping etc).

You are more likely to develop the condition if you're femaleoverweight or have a job that requires a lot of walking or standing on hard surfaces.

You're also at risk if you walk or run for exercise, especially if you have tight calf muscles that limit how far you can flex your ankles. People with very flat feet or very high arches also are more prone to plantar fasciitis.

When to see or refer to us:

  • Heel pain that continues when NOT walking or standing
  • Heel pain that lasts MORE than a few weeks, even trying rest, ice and other home treatments

Reach out -- we can help!

Lacing Techniques for Proper Shoe Fit

Certain lacing techniques for shoes can prevent injuries, alleviate pain and relieve foot problems. If you have specific foot problems, follow these lacing techniques to get a good fit with your shoe:

Narrow Feet

Use the eyelets farthest from the tongue of the shoes. This will bring up the side of the shoe.

Narrow Heel and Wide Forefoot

Use two laces. Thread through the top half of the eyelets and the other lace through the bottom half of the eyelets. The lace closest to the heel (top eyelets) should be tied more tightly than the other lace closest to the toes (bottom eyelets).

Wide Feet

Use the eyelets closest to the tongue of the shoe. This technique gives the foot more space.

Heel Problems

Use every eyelet, making sure that the area closest to the heel is tied tightly while less tension is used near the toes. When you have reached the next-to-last eyelet on each side, thread the lace through the top eyelet, making a small loop. Then, thread the opposite lace through each loop before tying it.

We are always here to help. whether be it in the correct shoe lacing techniques or in finding the correct footwear! Head over to our book online page to see our real time availabe schedules!

How to use others' perspective to help you see your vision and achieve your running goals

To achieve great things, we need to be surrounded by people who agree with our vision of the future. But not only do we need them to agree with our vision, we need them to share with us their own unique perspective of that vision, from their own unique position in their life, and in ours.

When talking about the literal use of the word perspective, as Podiatrists, we are experts in viewing human movement and considering its role in health and injury. So obviously, we literally view our patients from several perspectives to assess this. One of the most fun parts of our job is showing people how their own body moves, and showing them how problems with this movement can be a major part of what causes injury.

Just as a car with poor wheel alignment wears out tires, steering and suspension in a quarter of the kilometers, so too does a body with poor biomechanics wear out joints, ligaments, tendons and muscles at a rate that the body cannot endure.

The body is an amazing thing, and the foot itself is very remarkable. A quarter of the bones in the body are below the ankle, not to mention the hundred joints, ligaments, tendons and muscles that are there as well. The forces that act on the tissues in the foot are massive when you consider that your whole body weight is spread over these 5 small bones. And this movement is repeated 5 to 10 thousand times each day! It is easy to see why just a small amount of discrepancy in movement and tissue stress can add up and cause an injury, particularly when doing a very repetitive activity, like running.

Whether you're aiming at a 5k fun run, a 42k marathon, a 108k ultra marathon, our perspective at Pioneer Podiatry is that we are here to help you achieve that, without foot pain. We will find out what your vision is and share it, and give you our unique perspective.