What shoes should I wear?

By Robson Brown

Shoes come in all kinds of shapes, sizes, colours and design. But which ones are the best? I will try to answer that today by explaining the different components of a shoe and how they affect the way we walk.

Shoe fastening: Velcro, laces, slip on?

Fastening is important because it secures your foot inside the shoe. Velcro or lace-up shoes are more likely to prevent your foot from slipping or ‘shearing’ when you walk. We want to prevent this movement because it can cause skin to become sore, causing blisters or painful callus to form on the sole of the foot. Usually, a slip-on type shoe (pumps, flip flops etc.) are not a very supportive type of footwear because they are without fastening. However, a slip- on trainer might be preferable for someone who is immobile, not doing a lot of walking, is struggling to reach their feet, or to do up laces/velcro straps. Ensure that the trainer supports the whole of the foot (e.g no open back).

Toe Boxes

A toe box is the tip of the shoe - where the toes generally lie. When picking your shoes, you should aim for a wide, high toe box. This means avoiding narrow, pointy shoes. The reason for this is that a shoe too slim can cause the toes to become squashed together, and the resulting pressure can cause skin sores or calluses, caused by the toes rubbing together when we walk. A tight, shallow toe box can also cause the metatarsal bones and nerves of the foot to become compressed, which can cause numbness, tingling or sharp pain in the forefoot. They can also cause painful deformities in the toes such as hammer, clawed toe or bunions.

Cushioned/cupped heels

Another thing to consider when buying a pair of shoes is the amount of cushioning in the

heel area. The heel is our first point of contact with the floor when we walk - taking the entire weight of the body through it with every step. Wearing a shoe with a solid, hard or raised heel increases the force acting on it, which can cause inflammation of the soft tissues, bruising, and in severe cases, hairline fractures. Wearing a high heel can also cause pain and issues in the back of the foot, ankle and lower leg, so should be avoided for everyday use. The ideal heel is one with a soft sole, but a firm enough backing to stabilise the heel (so that your heel doesn’t feel like it is rolling inwards or outwards) - this is called a cupped heel, one that the heel ‘sits’ in and has surrounding fabric to support it.

Ankle support

Ankle support is not always necessary, but can be a good addition to a shoe - especially if it is a shoe for a very high functioning activity, such as hiking. Ankle support does exactly that - supports the ankle, which can be useful when walking at awkward angles e.g - offroad, hills, rocky terrain and can help in avoiding injury to the ankle joint and its surrounding tendons.

Rocker soles

A rocker sole is exactly what it sounds like - a sole that ‘rocks’. By this we mean a shoe with a curved base, curing at the front of the shoe and at the heel, with the middle of the foot in contact with the floor. A rocker shoe can help your walking to be at its most efficient. A flatter shoe usually means making the muscles and joints of your foot work harder and be under increased force and pressure in order to propel us forward when we walk, which can cause things like osteoarthritis to develop in the joints, tendon strains and soft tissue inflammation.

Arch support - is it necessary?

Arch support is widely believed to be an essential component to a good shoe, but this is not always the case. The ‘arch’ of the foot can come in many different shapes and sizes - it is different for every individual. The arch of the foot is actually a moving structure made up of different bones and joints in the midfoot. This means that when we walk, our arch can become higher or lower, depending on which stage of the gait cycle we are in (gait = the movements of the lower limb during walking). That being said, an ‘aggressive’ arch support or insole can actually hinder the movement of the arch of the foot, causing our gait to change and lower limb issues to arise. Other conditions such as pes planus (flat foot) for example would not benefit from something like an arch support. However there are certain foot types/conditions that will benefit from an arch support, such as PTTD (posterior tibial tendon dysfunction).

If you are unsure about the correct kind of shoe, are experiencing foot/ ankle pain, or are finding it difficult to find a style that is comfortable, we recommend booking an MSK appointment with us. In this appointment we will assess your foot positioning, joint mobility,muscle strength and gait style to determine the best shoe type or insole you need to live your most comfortable life. We can also prescribe a custom made insole tailored to your foot type, should you require it.

Podiatry vs Chiropody - what's the difference?

The first port of call for foot and ankle care is often to your GP. However, typically you will be referred to a podiatrist. Podiatrists cover the branch of medicine that specialise in the diagnosis and treatment of foot problems and conditions related to the lower legs. Podiatrists are degree trained healthcare professionals who are experts in the study of the foot and ankle.

Podiatrists are the best answer for any foot problems. They treat everything foot-related from verrucas to plantar fasciitis. However, another old fashioned name for a foot doctor is a chiropodist. We often get asked what the difference is, but there are actually no technical differences between them when it comes down to how they work. Podiatry and Chiropody are exactly the same thing!

Why did it change to podiatry?

Whilst both terms have the same meaning, the US and UK led the way in the 1960s in the conversion to ‘podiatry’ for these reasons:

1. Confusion with chiropractors - In the 1950s and 60s, chiropractic medicine began to grow in popularity, and chiropodists were being confused with chiropractors. To ensure the confusion was evaded, it was decided they would embrace the term podiatry.

2. Clearer root - Chiropody is made up of two roots, ‘chiro’ and ‘pod’, meaning hands and foot in greek. The origins of podiatry come from ‘pod’ and ‘iatros’, meaning physician in greek. Changing the word chiropody to podiatry allowed better embracement of the modern reality when it became a recognised branch of modern medical care.

Can chiropodists provide proper foot care?

Many countries have stopped using the word chiropodist, but whether or not they can provide adequate foot care can vary case by case. Patients who are looking for a professional's help with both the prevention and treatment of foot conditions should be able to find a reputable and affordable podiatrist. You can ensure that your podiatrist is fully trained and qualified by checking the HCPC registry. Podiatrist and Chiropodist are protected titles and anyone using the title who does not appear on the register is committing a criminal offence.

Licensed podiatrists are educated in the following:

• Performing podiatric surgery related to the foot and ankles

• Performing microsurgeries and reconstructive surgeries

• Performing physical examinations and study medical histories

• Diagnose and treat conditions, such as ingrown toenails, flat feet, cracked heels and athletes’ foot

• Administer anaesthetics and sedation for foot-related conditions

• Construe x-rays

• Perform physical therapy

• Prescribe, order and fit prosthetics, casts, insoles and orthotics

• Diagnose and treat sports-related injuries

If you are unsure about someone referring to one self as a chiropodist, it is vital to ensure they have the proper knowledge, understanding and certification to perform the tasks of a podiatrist. Yet, for the most part, both chiropodists and podiatrists should both be able to perform the same treatment for your foot complaint.

Our top 10 tips for marathon training

If you’re reading this then congratulations! You’re either thinking about running a marathon or you’ll probably be about half way through your training for a spring marathon by about now. Running a marathon is a HUGE achievement, and at J&L Health we know just how much time and dedication goes into it. Our experts have put together their top 10 marathon training tips, to make your experience a more positive one!

1. Find the right trainers

First things first! If you haven’t already, go and get your feet properly measured and wear your new trainers around the house for a few days beforehand to make sure you’re happy with the fit. Its really important that you race in a pair that you have already trained in. If you’re happy with your first purchase then buy an identical pair and train in them both, alternating as you go. If something happens to one pair then the second pair can be worn without any issues. Remember that pronation and supination are normal movements within the gait cycle so there is no need to buy a specific trainer, purchase a neutral, stable cushioning pair (our personal favourite are HOKA’s). Bare in mind that a trainer’s lifespan is approximately 300-500miles after that it loses it function and shock absorption.

2.invest in your socks

Socks may not seem as important as trainers but investing in a few good pairs can prevent problems such as infections and blisters. The right pair are vital for good performance, comfort and support, because they have been designed specifically to increase ventilation, wick moisture and offer support in all the right places. Avoid cotton socks, try and opt for materials such as marino wool or bamboo instead. The devil is in the detail so make sure you check that the seams, thickness and sizing is just right for you too.

3. avoid blisters

Blisters are one of the most common injuries we see from marathon training. Whilst they are usually mild, they can be incredibly painful and actually prevent you from running. Wearing good fitting shoes and socks will lower your risk, but if you are getting them frequently you will need to speak to your podiatrist. Prevention depends on your skin type and what is causing them so its best to get tailored advice. If they are mild and infrequent we recommend hydrocolloid dressings such as Compeed. This will protect your blister and stop any infection getting in. If your blister is weeping a lot, you will need a more absorbent dry dressing such as Melolin, which you will need to change daily.

4. GET Stretching

Most people realise that you need to warm up and cool down your muscles to avoid injury, but sometimes we become complacent. Make sure your stretches are slow and sustained. Stretch and then stretch some more after a run – especially if your training involves hills. Inclines will strain your calf muscles and so stretching becomes even more important, as these muscles can take a while to repair. Don’t forget to add in those strengthening exercises too! As you increase your mileage, the length of time you spend on strengthening and stretching should increase too.

5. Address those aches and pains

Any small pain or discomfort in your feet can quickly worsen and turn into an injury that requires you to forgo participating in your marathon. Because of the repetitive movements of running, overuse injuries like achilles tendinitis and plantar fasciitis are common. If you experience any pain, stiffness, or discomfort during or after running, schedule an appointment with a podiatrist. The sooner you address your pain, the sooner you can get back to training. The best way to avoid injuries is to follow a good training programme- this should be regular, build up over a suitable period and, crucially, should also include rest days. Keep it in mind that rest days are as important for your marathon training as running days!

6. manage YOUR CALLUSES

The repeated friction from contact between your foot and your shoe during running causes the skin on your foot to die and harden into a protective surface. Calluses are usually caused by improper fit of shoes and socks, but can also be caused by your running gait. Preventing calluses at home should involve using a pumice stone regularly in the shower and applying an emollient before you go to bed (we recommend CCS foot care cream). You may also want to look into different lace thing techniques to avoid excess pressure on areas of your feet. There are some really good video tutorials online to show you how to do this, depending on where your calluses are. However, if you are struggling to keep on top of them yourself or if they are painful or dark in colour then its a good idea to schedule an appointment with a Podiatrist to have them treated regularly during your training.

7. PRACTICE GOOD FOOT HYGIENE

As bacteria and fungi thrive in warm, damp conditions, so practicing good foot hygiene daily is important to remove sweat and reduce the likelihood of odour and infections. Wash your feet using a non-perfumed shower gel and dry your feet thoroughly after, not forgetting between your toes. Your feet have a quarter of a million sweat glands, so good foot hygiene is vital! To keep your feet free of infection, make sure you leave your trainers to dry too, somewhere warm but ventilated is best. If you find that your skin is becoming itchy or red then book an appointment to see your podiatrist.

8. KEEP YOUR TOENAILS TRIMMED

It’s particularly important for runners and joggers to keep their toenails short. If a nail overhangs the toe, your trainers will exert undue pressure on it, sending shockwaves through the nail bed. That leads to swelling and bruising. This usually grows out on its own but in some cases this can lead to complication such as infection, ingrowing or thickened, painful toenails. Trim your nails regularly, cutting across and then filing off the edges. Avoid cutting too far down the sides which can lead to ingrowing toenails.

9.Don’t try anything new

You’ve taken months to plan for your marathon and the day is finally here! When you’re feeling those pre-race nerves its really tempting to observe what other people are doing or wearing in the lead up, but its really important to stick to what you know. That means no new shoes, socks, clothing, creams, even running style! If you want to experiment and try anything new make sure its done with plenty of time in advance so that your body can adjust and you can ensure its not making things worse!

10. and lastly…HAVE FUN!

You have done absolutely everything you can to get to this point. Hundred’s of hours of preparation and no doubt a whole lot of blood, sweat and tears. Remember to listen to your body, if something feels too much then slow down, take some time to stretch and try again. There will be a large medical team of volunteers, including many Podiatrists, waiting to patch you up at the end should you need it. Enjoy yourself, soak up the atmosphere and know that you are doing something incredible. Wishing you the very best of luck from all of the J&L team x

Podiatry Appointment Do's and Don'ts

Our aim at J&L Health is to make all of our patients feel confident and satisfied, when they leave an appointment. So if this if your first time with us or even your first time with a podiatrist, we’ve put together a helpful list of tips, so that you can really get the most out of your podiatry appointment.

DO bring with you any frequently worn footwear. This is particularly important if you are coming in for a biomechanical assessment. Looking at your gait pattern will assist your Podiatrist in diagnosing what is causing your pain.

DO take time to fill out your health assessment form before you arrive. It should take you around 5 minutes to complete and contains vital information about you that your Podiatrist needs to know. It may not all seem relevant but you would be surprised what can have an effect on your feet! If you are a current patient with us then please let your Podiatrist know of any changes to your health or medication so that we can update your records.

DO bring any other information that may help your Podiatrist. This may include referral letters, x-ray or scan images or results.

DO make list of any questions you have. Write them down and bring them with you, this is your appointment time and we want you to get the most out of it.

DO wear clothes that you feel comfortable in. This is particularly important if you are coming for a biomechanical assessment, avoid any clothes that are too tight as your podiatrist may want to assess other areas such as hips and knees.

DON’T hesitate to bring along a family member or friend. It can be really helpful to have a second set of ears at your appointment if you are afraid you won’t remember everything.

DON’T hesitate to ask the podiatrist to go over any part of your diagnosis or treatment plan that you don’t fully understand. If the podiatrist has prescribed you with any medication or custom devices, please ensure you are clear on what you need to do. If you think of something after you have left, please don’t worry, feel free to drop us an email or give us a call.

DON’T worry about what your feet look like. We really have seen it all here and our aim is to make you feel as comfortable as possible. We do appreciate clean feet but please don’t feel the need to shave your legs and feet beforehand. Hair growth is a sign of health and good circulation. It helps to diagnose foot problems associated with hair loss.

DON’T get a pedicure beforehand. When done in non-sterile conditions, pedicures increase the risk of foot infections. They also usually come with a few coats of nail polish, which can hide infections and nail issues. Your podiatrist will also need the unvarnished version of your feet to diagnose issues like corns, calluses and bunions.

Looking after your feet in Pregnancy

Pregnancy is a very exciting time! There are regular scans, blood tests and appointments to monitor the health and growth of both mother and baby, but the feet and legs are often forgotten, despite being expected to bear the increases in weight, the balance and centre of gravity changes, and the effects of all the pregnancy hormones. Here’s a look into how pregnancy affects your feet and what you can do to stay comfortable and active throughout all three trimesters of your pregnancy.

Causes And Symptoms Of Foot And Leg Problems In Pregnancy

Many of the causes of foot pain and leg aches during pregnancy occur due to changes in hormone levels, particularly of the hormones relaxin and progesterone which lead to increased laxity in the ligaments - meaning the ligaments are much more flexible than normal. This added flexibility is essential to help support changes around the pelvis to accommodate the growing baby, as well as assist in the birthing process.

You’ll tend to see the biggest changes in the second trimester and into the third, particularly between weeks 12-34 of your pregnancy. While many of the changes you experience in pregnancy will naturally resolve after giving birth, it may take some time, and you may need added support for your feet in the first post-partum year or even longer.

Feet Can Grow In Pregnancy

Previously we mentioned a hormone called relaxin that is plentifully produced by your body in order to help loosen the ligaments and tissues around your pelvis in preparation for childbirth. Unfortunately, relaxin isn’t limited to the pelvic area but flows freely through the body to also act on your feet. When looser ligaments are combined with the increased weight from your rapidly-growing baby, you get more pressure on the looser joints of your feet and the feet can flatten, making them appear bigger and wider.

Most pregnant women find they go up between half a size to one whole shoe size, sometimes more. While some feet return to their normal position during the postpartum period, others maintain a permanent increase in shoe size - and unfortunately it’s impossible to predict which category you’ll fall into.

Swollen Feet And Ankles

During pregnancy, a woman holds anywhere up to twice her regular blood volume. This blood is circulated through your veins which places a great demand on them, especially when it comes to the veins working against gravity to return blood back up the legs to the heart. For approximately 80% of women, this leads to swelling of the feet and ankles. This is typically seen from 20 weeks gestation onwards. As swollen feet and ankles are also a sign of a serious medical condition called pre-eclampsia that puts both mother and baby at risk, if you notice swelling in your feet or ankles, you should always let your doctor or midwife know.

Unsteady Or Off Balance On Your Feet

During pregnancy, particularly during the third trimester when your baby and uterus are both at a considerable weight, your centre of gravity shifts forwards, meaning that your natural balance is very different than it used to be. Combine this with weaker ankle ligaments due to the effects of the relaxin hormone, and many women feel less steady and off balance on their feet.

Tired And Achy Legs

Our legs are managing a lot of changes during pregnancy that makes it common for them to regularly feel tired and achy, especially in the third trimester. These changes include managing greatly increased blood volume which can cause swelling, keeping steady and balanced when our natural centre of gravity has shifted forwards, counteracting the effects of relaxin which can reduce stability in our ankles, and generally managing a much heavier load and using muscles in ways they’re not used to.

Foot And Leg Cramps

Foot and leg cramps are more common in pregnancy, particularly in the second and third trimesters. While it is medically unclear exactly why this is the case, it may be related to the increased weight the feet and legs now support, the pressure the uterus is placing onto the surrounding veins, changes in mineral levels in the body associated with a greater blood volume, or even from insufficient water intake.

Varicose Veins

Varicose veins occur when our veins become damaged and become more prominent beneath the skin. They are more prevalent in pregnancy because the veins are working with a much higher blood volume which they are not used to handling and supporting. As a result, the veins can become damaged and take on a more prominent, bulging or twisted appearance.

Back Pain

Back pain can occur during pregnancy because the weight of the growing uterus and baby accentuates the curvature of the spine, placing excess stress on the spinal joints. This causes tightening of the spinal muscles, while the overall increased weight means the back muscles have to work much harder than they are used to. This is why back pain is common in pregnancy.

Diagnosis

All of the causes and symptoms of foot problems in pregnancy that we have described are easily detected and diagnosed at an appointment with one of our podiatrists. Medical imaging is not required. If there are any abnormalities with any of your symptoms, we’ll refer you to the best practitioner to help promptly.

Treatment

If you’re struggling with foot pain or discomfort, we recommend seeing one of our podiatrists. We’ll conduct a comprehensive exam of your feet and legs, assess what’s going on and if any of the muscles, ligaments or joints have been injured, and then start you on a treatment plan designed to reduce your pain and improve your comfort on your feet throughout the rest of your pregnancy and through your post-partum period.  

What Happens If I Ignore My Pregnancy Foot Or Leg Pain?

As the weight of the baby and uterus continues to grow exponentially until birth, aches and pains during pregnancy are likely to worsen. Your podiatrist can help relieve your symptoms and help keep you comfortable throughout your pregnancy. 

WHAT CAN I DO TO AVOID PROBLEMS?

• Avoid being on your feet for long periods of time. This one may seem obvious, but it's often missed. Don't underestimate the power of a good rest. Rest with your feet elevated as much as possible, especially when you get to the later terms of pregnancy.

• Wear comfortable and supportive shoes and socks. Try to avoid anything tight-fitting with a strap or something that may pinch if your feet do swell.

• Drink plenty of water to help flush out the excess water content in your body.

• Exercise, but don't overdo it. Take regular, small-duration walks to help keep your blood flowing. 

Are your feet beach ready?

We all know how hard summer can be on our feet. The combination of sun, sweat and sandals can take it’s toll. So to help you, our Podiatrists have put together a list of our top-tips to get those feet looking beach ready!

1. KEEP YOUR FEET MOISTURISED

Cracked heels are a common sight in summer, but this doesn’t have to be the case. Make sure to keep the soles and tops of your feet well moisturised. The best time to apply cream is after a shower or before bed but, make sure to give it a good rub in to make sure it is all saturated into the skin. We recommend using a urea based cream, at least 2-3 times a week, but preferably every day! For very dry feet, apply an emollient, a pair of damp socks and then a pair of dry socks over the top, and leave overnight. Don’t forget! When you’re lounging in the sun, as well as slathering the sunscreen on your body, remember not to leave out your feet!

2. AVOID WALKING BAREFOOT

• Walking outside barefoot in the summer might sound idyllic, but this increases the risk of injury to your feet. This is especially true for those with conditions such as diabetes or neuropathy. Cuts, bites and stings are much more likely when barefoot, and if left unnoticed, could lead to infection. Being barefoot also increases the chances of you developing verrucae or fungal infections on both your skin and nails, particularly in damp areas.

3. KEEP THOSE TOOTSIES CLEAN!

• Its always important to keep your feet clean and dry no matter what the seasons. Ensure that after washing, you dry your feet thoroughly, especially between the toes to avoid conditions fungal infections, such as athletes foot. Spotting a fungal infection on your nails or skin is not always easy and if you suspect one, this should be assessed by a Podiatrist. Fungal infections usually present with white, discoloured areas on your nails and peeling or itching skin on the soles of your feet. These infections can spread easily if not treated quickly.

4. THE IMPORTANCE OF SUMMER FOOTWEAR

• Supportive footwear all year round is important however, summer is when we tend to wear shoes with the least amount of support. Shoes like flip-flops or slip-ons offer little support for the arches of your feet, which is often the cause of common problems such as hammer toes and plantar fasciitis. However, it is still important to allow our feet to breathe therefore, we suggest choosing footwear made of natural materials which still offer a good arch and heel support.

5. COPING WITH SWEATY FEET

• Poor footwear mixed with sweaty feet can increase the risk of blisters on our feet. If you feel a blister developing, use padding such as moleskin or a dry dressing on the area and change your shoes. DON’T be tempted to pop the blister as this will lead to an infection.

• When your shoes get wet with water or sweat, make sure they’re completely dry before wearing them again. This will help to prevent bacteria and fungus from growing in your footwear, and on your feet!

• Wearing the right socks will reduce the amount your feet sweat. Acrylic or cotton socks work best to wick away perspiration that can lead to fungal infections of the skin and nails.

Brrrrr....Keeping your feet warm this winter

Winter is almost upon us, and whilst you might be dreaming of chunky knitwear, log fires and hot chocolate…lovely! But for many of us, it can be a very trying time for our feet. Conditions such as arthritis, chilblains and reduced circulation are particularly affected by the colder weather, so management of your cold feet is key to your health and comfort.

So if you struggle to keep your feet warm, here is our list of top-tips to keep those toes cosy, until you can dig out your favourite pair of sandals again!

1. STOCK UP ON QUALITY SOCKS

It may sound simple, however many of us are in the wrong socks during these winter months. Cotton socks (which are great in summer time) are unfortunately not helpful for retaining heat, resulting in icy toes. Synthetic fibres such as those used in tights or stockings, also provide no insulation for your skin.

We recommend purchasing socks that contain a high percentage of wool which assists in heat retention. Specifically, merino wool socks are fantastic. Bamboo socks are also thermo-regulating, which means they keep feet cool in the summer and warm in the winter. Their wicking properties keep feet dry, which helps to prevent irritation. They are also have anti-fungal properties.

Be careful! Socks that are too thick or tight may restrict blood flow when in enclosed footwear and make the problem worse.

Top-tip! Pop your socks on the radiator before putting them on to retain maximum warmth in your shoes.

2. THOSE BOOTS WERE MADE FOR WALKING!

A good pair of winter boots can accommodate a cosy sock, keep you dry, give you support and stop you slipping on icy, wet surfaces, all in one. They are versatile and should be a staple in your winter wardrobe. They come in all different shapes, sizes and colours, so there’s something for everyone.

Preferably your shoes should have a thick sole to keep your feet off the cold ground, as well as a fastening such as laces or velcro to offer you maximum support.

For those of you who enjoy running or walking, whatever the weather, we recommend you opt for shoes with GORE-TEX technology. GORE-TEX is a breathable and waterproof material, so will also stave off those dreaded fungal infections too.

Top-tip! Always shop for shoes in the afternoon when your feet are at their largest!

3. ADD LINERS TO YOUR SHOES

If your still suffering with cold feet and have a little extra room to move around, try adding liners to your shoes. Not only do they keep your feet further away from the floor, they also have insulating properties to keep the warmth inside your footwear for longer. We recommend sheepskin liners, which can be purchased in most large pharmacies or online. Alternatively, ask your Podiatrist about plastazote insoles.

4. KEEP MOVING!

Whilst its all too tempting to snuggle up on the sofa binge-watching your favourite programmes, particularly for those with poor circulation, its important to not stay in one position for too long. It can be as simple as wiggling your toes or performing some short exercises.

Top-top! Trace the alphabet with your feet a few times a day if you’re sat down for long periods, which will also improve your ankle mobility…win!

5. GOOD QUALITY SLIPPERS

Whilst you’re at home try to walk around barefoot as little as possible. Slippers with sheep skin liners are best at retaining heat and offering maximum comfort. Whilst they can be costly, they will last you several years and are more breathable than synthetic alternatives.

Whilst synthetic materials can still serve a purpose, you’ll need to ensure you wear a pair of natural fibre socks with them to prevent fungal infections and smelly feet.

As with all footwear, you should try to ensure your slippers have a supportive fastening as well as a thick, non-slip sole.

6. MOISTURISE YOUR FEET

We know we’re always nagging you about it, but no Podiatry blog would be complete without us telling you to cream your feet, and yep you’ve guessed it - we mean every day!

Applying cream to your feet daily is recommended as the skin gets really dehydrated and dry in the winter and consequently the skin will crack especially around the heel area, which is not only painful but can be a portal of entry for infection especially for higher risk groups who have poor circulation.

Creams with a 10-25% Urea content are great for really dry skin as they are better at softening as well as hydrating the skin. CCS is our favourite, whilst offering good value for money, in our opinion it out performs other brands. Ask your Podiatrist about the CCS Foot cream range when you are next in clinic.

We hope these tips help keep your toes toasty this winter, for individual or further foot health advice please contact the clinic on 01483 425 437 or book an appointment online.

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Covid-19 FAQ's

We have put together a list of frequently asked Covid-19 related questions, please get in touch with us for further information.

Are you open?

As an essential medical service, podiatry clinics have never been asking to close however, we have been restricted on the types of patients we are able to treat. Currently, we are open to all patients who are unsuitable for a video consultation or self-care advice. If you have a foot health concern, please do get in contact with us.

What happens when I get there?

When you arrive for your appointment, please wait in the car for as long as you are able to. We kindly ask that you do not enter the pharmacy until your appointment time, if necessary the Podiatrist will come and collect you from outside. Once you have entered the treatment room, the Podiatrist will close the door for you and provide you with hand sanitiser to cleanse your hands.

Do I need to wear a mask?

Before you enter the building, we kindly ask that you cover your face and nose, this could be with a surgical or homemade mask or a scarf. The Podiatrist has the right to refuse treatment if you do not wear a face covering.

Can I wash my hands?

You will be provided with hand sanitiser on arrival however, should you prefer to wash your hands instead, you are welcome to use the facilities provided.

What are you doing to keep me safe?

At J&L Health, we have always upheld the strictest infection control measures and adhered with PPE guidelines, however due to the current circumstances, it has been necessary to increase these further. We are committed to protecting the welfare of our patients and staff at all times, our policies are reviewed regularly following advice from the Government and regulatory body (HCPC) and our professional body (The College of Podiatry).

Our Podiatrists will at a minimum, wear PPE including; a surgical mask, face shield, apron and gloves. It may sometimes be necessary for Podiatrists to wear a surgical gown and/or a nurse cap also. We have introduced an additional 15 minutes to every appointment to allow for a deep clean of the treatment room between each patient. The Podiatrist will not remove their face shield or mask until you have left the room, so this time also allows for donning and doffing of PPE.

An addition to this, we have introduced advanced payments for patients. You will be asked to pay for your treatment before your appointment via email or text to reduce the risk of cross contamination. We understand this may not be possible for all of our patients, in this case our receptionist will be happy to discuss your options with you.

Can I bring a chaperone with me?

We kindly ask that where possible you attend your appointment alone. However, children under the age of 16 and vulnerable adults will be permitted to bring one chaperone with them to their appointment. This may include a friend, relative or carer. The chaperone will also be asked to wear a face covering and sanitise their hands on arrival as per our policy.

Am I allowed to visit the clinic?

Throughout these last few months when we have all been asked to stay at home, medical services such as Podiatry have been exempt from these measures. Whilst previously, we have been limited on the type of patients we have been able to see, if necessary you are allowed to leave your home for medical treatment. Please refer to our previous answers, for information on everything we are doing to keep you safe. For those patients who have received a shielding letter and are classed as extremely clinically vulnerable, we may be able to offer you a home visit. If you would like to discuss this further, please phone us on 01483 425 437.

How do I book an appointment?

We are currently open for all patients who are unsuitable for a video consultation or self care advice. If you feel in need of treatment you will be able to book your appointment in the usual way via our website or over the phone. At the time of booking, our receptionist will need to ask you some questions. This can take around 20 minutes and will include questions about your Covid-19 status, general health and foot complaint. This ensures that we are prioritising appointments for those at high risk of developing an infection, wound or losing a limb. This also allows us to ensure that anyone entering the clinic is free of symptoms, to protect the welfare of our patients and staff. If you book online, one of our receptionists will get in contact with you to complete the triage questionnaire before your appointment.

Where can I get up to date information about the clinic?

We realise that things are not quite normal at the moment and as a result our guidelines are changing regularly. The best way to keep up to date with information about the clinic is to check our website, facebook or instagram page. You can also sign up to our mailing list via our website.

I want to help Godalming Podiatry Clinic!

We have been overwhelmed with the support shown to us over the last few months. As a new small business it really means the world to us and we would like to extend our heartfelt thanks to all of those who passed on their well wishes. If you have a foot health concern please do get in touch, we are passionate about Podiatry and would love to help you! If you don’t need us at the moment then thats great! If you would still like to support us, we would be really grateful if you could follow us on social media, tell your friends and family about us or leave a google review here.

Can I use the toilet at Godalming Podiatry Clinic?

Unfortunately, the toilet inside Godalming Pharmacy is for staff use only. The closest public toilets available are situated in Crown Court Car Park, however these are currently closed due to current Covid-19 guidelines.

What happens if I am unhappy about something?

At J&L Health, we always welcome any feedback from our patients. It is always best to speak to your Podiatrist during your appointment if you are unhappy about anything. Our receptionists will also be more than happy to assist you with your query, so please get in contact with us via email or phone and we will aim to respond within 24 hours.

We also love to hear any positive comments! All of our team are extremely passionate about providing an outstanding service to our patients, so if you have been happy with your experience please do let us know too!

If I need to cancel will I get a refund?

We understand that sometimes it is necessary for you to cancel your appointment. We politely request that you give us 24 hours notice if you need to reschedule or cancel your appointment. As per our cancellation policy, failure to provide us with 24 hours notice, will result in you being charged in full for your appointment.

Why are your prices higher than other private health professionals?

Due to the recent steep increase in costs of PPE and the additional infection control measures we have put in place, we have made the difficult decision to add a temporary £20 surcharge to all of our appointments until further notice. The safety of our patients and staff is paramount, however, it has meant that the number of patients we are able to see has significantly decreased. Many podiatry clinics have unfortunately not been in a position to reopen due to the current circumstances, however, we are passionate about continuing our vital services to our patients and have remained open throughout these difficult times for our most vulnerable patients. We have ensured that this temporary surcharge has been kept to an absolute minimum, without compromising our high-standards of care. We are reviewing this situation regularly and thank you for your understanding.

Due to the nature of Podiatry and the surgical aspect of our treatments our guidelines have always been stricter than that of other healthcare professionals such as physiotherapists and osteopaths for example. The risk to our staff remains high due to our treatments often producing large amounts of aerosols including dust and water droplets. As HCPC registered Podiatrists we must adhere to strict guidelines issued by the National Institute for Health and Care Excellence, such as sterilising our surgical instruments, you can find out more by visiting their website, alternatively your Podiatrist will be happy to discuss any queries you may have.

Diabetes and the foot

How can diabetes affect your foot health? And more importantly, how do you prevent problems developing?

“Worldwide, a person loses a limb due to diabetes-related complications every 30 seconds.”

— American Diabetes Association

Diabetes UK is a national charity who research all things-Diabetes. Their website has useful information on looking after your feet with diabetes.

Having diabetes means you’re at much greater risk of developing foot problems.

This is because raised blood glucose, also known as blood sugar, can damage the sensation in your feet. 

It can also affect your circulation, which can mean blood can't flow around your body properly, especially to your feet. Without a good blood supply, you may have problems with cuts and sores healing. You may also get cramps and pain in your legs or feet. These are just some of the signs of a serious foot problem.

Diabetes UK recommends 10 simple steps to prevent foot problems:

1. Get help to quit smoking

2. Manage your blood sugars, cholesterol and blood pressure

3. Check your feet every day

4. Eat a healthy, balanced diet and stay active

5. Watch out cutting your nails

6. Make sure your footwear fits

7. Use moisturising cream every day

8. Don’t use blades or corn plasters

9. Get expert advice

10. Keep useful numbers handy

If you don’t get these problems treated, they could lead to foot ulcers, infections and, at worst, amputations. Most foot problems can be prevented with good, regular foot care. So you need to know how to look after your feet at home. And make sure you get a quality foot check from a healthcare professional (Podiatrist) at least once a year.

At Godalming Podiatry Clinic we offer a “Diabetes Foot Assessment” appointment encompasses all treatment elements from our premium gold package as well as a full neuro-vascular, dermatological and musculoskeletal assessment of your feet and ankles. Your bespoke diabetes foot health report will be offered to you and your GP to help maintain the best possible health in your feet. Check out our treatment page for more information or book online here.

Monofilament test used to assess peripheral sensation in the feet - part of the Diabetic Foot Assessment appointment at Godalming Podiatry Clinic

References:

https://www.diabetes.org.uk/guide-to-diabetes/complications/feet

https://www.diabetes.org.uk/guide-to-diabetes/complications/feet/taking-care-of-your-feet