broadway foot clinic

FREQUENTLY ASKED QUESTIONS

General Podiatrist / Podiatry FAQ’s

Podiatrists can help to treat ankle sprains and injuries, and can assess and recommend the appropriate treatment with provision of pain relief as necessary. 

A podiatrist has specific education and training when it comes to dealing with broken ankles. Podiatrists can assess broken ankles and refer patients on for further assessment and investigations.

Ankle injuries should be monitored and a podiatrist will be able to examine and assess any swelling, along with referring patients on for appropriate treatment as required.

Stress fractures of the foot occur in the heel bone and mid foot. Ankle stress fractures can also occur. A podiatrist is the best specialist to see when it comes to foot and ankle stress fractures. 

Podiatrists are clinicians who are highly trained to diagnose and treat Achilles tendonitis. They are the specialist to see conditions affecting the feet and ankles. A consultation with a podiatrist is important to determine if the pain is due to a tendonitis or a more serious condition and if further investigation is required we can refer patients on to the appropriate team.

Podiatrists are trained to treat all kinds of tendonitis that affect the foot and ankle.  They will do a full biomechanical examination of the foot as well as use diagnostic tools such as X Ray and ultrasound to diagnose the injury.

Podiatrists study for three years and are registered with the Health Professions Council. Podiatrists work independently to diagnose and treat foot problems, and further degrees can be obtained in specialised areas such as diabetes, musculoskeletal, sports medicine and paediatrics.  If necessary, you can be referred to a podiatric surgeon who will create a specialised treatment plan.Podiatrists and Podiatric Surgeons are registered with the Health Care Professions Council (HCPC).

Podiatrists are specialists in medicine that diagnose, treat, and prevent foot, ankle, and lower legs injuries and conditions. They treat many injuries when it comes to the foot and ankle. These can include verruca treatment, orthotic prescription, gait analysis, nail surgery, removal of corns and callus. They can also refer patients on to other healthcare professionals if further treatment is required. 

Any foot pain or foot and ankle injuries can be assessed by a podiatrist. We can also see sport-related injuries, osteoarthritis, painful feet, heel pain, bunions, skin conditions, ingrown nails, swelling, and infections. If you are a diabetic you should not only be seen for pain and open wounds but also for annual foot check-ups. It is also worthwhile consulting a podiatrist if you are planning on undergoing a new type of exercise programme such as biking or running as they can advise you about appropriate exercises to reduce muscle fatigue, recommended footwear to prevent injury and talk to you about daily footcare routines to help maintain healthy feet.

On the first visit, you will complete a consent form and the podiatrist will take a full medical history, and you will be asked to describe your foot and ankle symptoms to help us diagnose and treatment will take place.

Many conditions affect feet and ankles, and podiatrists help treat many  conditions of the foot and ankle from skin disorders to structural deformities.

Some examples are:

  • Bunions
  • Hammertoes
  • Achilles tendonitis
  • Plantar fasciitis and heel spurs
  • Diabetes
  • Arthritis of the foot and ankle
  • Growing pains in children
  • Morton’s neuroma
  • Ingrown toenails.
  • Athlete’s foot.
  • Warts/verrucae
  • Toenail fungus
  • Identification of malignant conditions
  • Structural issues such as flatfoot
  • Foot and ankle fractures
  • Foot and ankle sprains
  • Achilles tendon ruptures
  • Gout

Yes, podiatrists can assist patients with toenail cutting.We offer this service for patients who have mobility issues, circulatory issues, and for patients who are unable to cut their toenails themselves or need general advice on nail cutting. This can prevent injury whilst cutting.

Booking an appointment is easy. You can call our clinic directly at 02089524405 or use our convenient online booking system .just click here to Booking an appointment

 

During your first visit, our experienced podiatrists will conduct a thorough examination, discuss your medical history, and address any specific concerns you may have. This comprehensive assessment helps us create a personalised treatment plan for you.

Appointment lengths can vary depending on the nature of your visit. Generally, a routine appointment lasts about 30-45 minutes, but more complex treatments or assessments may take longer.

Please ask reception for a paper invoice or an email invoice for any insurance company .

Please bring comfortable footwear that you wear regularly. Anything else your podiatrist will let you know.

We prioritise the safety of our patients and staff. We have implemented stringent cleaning protocols, ensure social distancing, and follow all recommended guidelines to create a safe and sanitised environment for all.

Yes, we provide a contact number for after-hours situations. Please refer to our "Contact" page for this information.

Yes, we have parking facilities available for our patients.

Diabetic Foot Care FAQ’s

All people with diabetes are at higher risk of complications of the feet so it is essential to have annual assessments with the podiatrist as a preventative measure. Seventy percent of all amputations of the foot are due to diabetic complications, so regular monitoring of the condition of the feet is extremely important. Having regular appointments will help to prevent problems affecting the feet so it is important to develop a good rapport with your podiatrist.

Yes, all diabetes, young and elderly, should see a podiatrist. Your doctor will let you know if you are at low or high risk for complications and will guide you and treat you appropriately so you can live a healthy life.

Regularly checking the feet is essential for diabetic patients to try to find problems in a timely manner. Patients are encouraged to check their feet daily and seek advice if anything concerning is found.

Some signs that your foot condition could be related to diabetes include:

 

  • Dry skin especially of the heels
  • Temperature changes to the skin
  • Poorly healing wounds
  • Swelling of the foot and ankle
  • Tingling and burning of the toes
  • Constant pain
  • Changes in the temperature of the skin

Pedicures are generally not recommended for diabetics simply because they are linked with specific risks such as infection. Blood sugar levels can then rise, and this can lead to impairment of the healing process. Sadly many patients fail to ask for help early enough and patients can be at much higher risk of problems such as ulceration and even extreme cases, amputation.

There are no regulations for beauty parlours to sterilise their instruments which is why diabetics need to be especially vigilant and ensure they are receiving the correct care.

If you have been assessed by a podiatrist as low risk then all patients can cut their own toenails, however higher risk patients may be at increased risk of problems such as injury, you may not be aware that you have cut yourself, and even small cuts can lead to infections and complications of delayed healing.

Stringent control of blood sugar will help to prevent diabetic complications from developing or worsening. Leg pain in diabetes can present as tingling, worsening aching pain and sensation can be impaired such that even lightly touching the skin can be extremely painful.

Custom Orthotics FAQ’s

Orthotics vary in price and depend on individual cases.

Custom made orthotics will vary in price depending on materials used. The more complex the deformity, the more individually tailored the orthotic will need to be, and prices can vary from £150 to £380.

Yes, custom orthotics are definitely are worth the cost, and in many patients go on to purchase a second pair. There is so much that goes into the creation of a custom made orthotic, from prescribing an orthotic in the first place to developing a bespoke prescription. A full physical examination and lower limb assessment is carried out by a podiatrist, and then a 3D scan of the foot is completed. There are also associated costs in creating and fitting the individual orthotic. Because this focuses on the patient’s individual requirements.

Most patients feel an immediate difference and improvement in their walking and decrease in pain, and also develop less corns and calluses far less.

Custom-made orthotics can last a very long time also, usually in excess of ten years, depending on the material used and the amount of wear.

Custom made orthotics are individualised inserts that are tailor-made for the person wearing them. This is very different from shop-bought inserts purchased at sports stores which are not individualised for each patient’s unique requirements. They have different purposes- one is medically prescribed and another is a generic type. They are not just a regular shoe insert you can buy online or at a sports store. They are customised and made specifically for your feet only. In order to make the orthotics, the podiatrist will evaluate your deformities and ask you about your symptoms. They will then try to reduce your deformities by placing you in the correct alignment. The orthotics are then created such that when they are inserted into your shoes your deformities and symptoms should be reduced and may even disappear entirely.

After a full biomechanical examination is taken, measurements are taken, placing the patient in a neutral, non-weightbearing and weight-bearing position, and using Plaster of Paris, a mould of the foot is taken or a 3D scanner is used to take an image of the foot. Following the findings, a prescription is created to build the bespoke orthotic, and sent to the lab.

Yes, orthotics really do work. They are an integral part of the treatment and can help with foot alignment, lower back issues, posture and by altering forces we can achieve better foot function and reduce and forces that can lead to injury or pain. They also help offload pressure from the delicate bones of the feet, and from leg tendons and muscles and this helps reduce the risk of injuries in the future. Custom orthotics also greatly help to decrease pain experienced in the knees, hips and back also.

Surprisingly, orthotics are essential for a number of conditions and deformities of the foot, including, amongst other conditions:

  • Plantar fasciitis - is one condition in which the use of orthotics will reduce inflammation and support the arch of the foot.
  • Arthritis – Orthotics decrease the discomfort of arthritic pain and help to adjust poor positioning
  • Bunions and Hammertoes- These issues are caused by an individual’s foot type and are caused by the tendons becoming out of balance leading to movement of the bones and ultimately creating a deformity. Wearing orthotics will help lead to the correct positioning of the foot and orthotics will position the foot correctly, reducing the progression of the deformity.
  • Back pain – long periods of time spent with poor alignment of the foot can ultimately affect the posture and orthotics will help decrease the pain.
  • Diabetes – Many diabetic patients are affected by neuropathy, and have loss of sensation in the feet. Use of orthotics can assist in the reduction of pressure created on the foot and can even help in the prevention of ulcers and amputations.
  • Flat feet – Having flat feet can lead to a number of problems, including foot, ankle and even in some cases back pain. Correct foot positioning can be encouraged with the use of custom-made orthotics.
  • High arches Orthotics help support the tendons of the feet which can help in problems caused by the development of high arches
  • Injuries – Orthotics can help prevent excessive rolling inwards and outwards of the ankles by giving extra support to the feet.

You do not necessarily need bigger shoes for orthotics. Simply remove inserts from shoes and replace them with the new custom orthotics. Modern orthotics are far less bulky than they often were in the past and can fit neatly into a variety of shoe types.

The ideal orthotic will help to support the foot in the best way possible and correct any foot conditions or deformities and is very much dependent on the needs of the individual. It is therefore important that orthotics are tailored to people’s individual needs, therefore types will range from more rigid types to ones which are more accommodating. There are also a variety of types, with some being of full length as well as semi and shorter varieties, depending on the problem we are trying to correct. Podiatrists at the Broadway Foot Clinic are experienced in creating the correct mold of the feet and ultimately in designing the best bespoke orthotic for your specific needs.

Every insurance company is different, and some will partially cover custom orthotics whilst  others might not, therefore it is always recommended to ask individual insurance companies about their policies around this.

When new orthotics are first placed into a shoe and worn, they will most likely feel different to your usual insoles or orthotics, and so they may well feel uncomfortable initially,  as your feet become used to being held in a different position, and they might even hurt a little to begin with. This is why it is so important to allow time for your feet to ‘break into’ the new orthotics and slowly allow your feet to become accustomed to the new orthotics. This is therefore done slowly, and it is advised to wear them for only short periods initially, gradually increasing the amount of time spent wearing them until you are wearing them all the time.

This is because the orthotics are actively altering the manner in which the muscles and tendons of the feet are working and affect the alignment of the bones also, which will then ultimately affect the way you walk, and can lead to an overall improvement in your entire posture.

If, after periods of breaking them in they are still uncomfortable or feel painful, it is important to make a new appointment to review the orthotics to ensure any adjustments can be made.

Here at the Broadway Foot Clinic we have worked long and hard to find the best teams possible to develop your individual orthotic. We work closely with Kent-based suppliers  ‘Discovery Orthotics’, who provide orthotics for the NHS, and have many years of experience in developing comfortable and high quality custom-made orthotics for a variety of needs.

Wound Care FAQ’s

Wounds should be kept covered and closed in order to keep them moist. A covered wound is the best environment to promote healing, as better blood flow is encouraged and therefore inflammation decreases.

Foot ulcers can be cured if caught early and help must be sought as soon as any sores are noticed.

  • Controlling the amount of blood in a wound. Known as hemostasis.
  • Cleaning and debriding the wound.
  • Preventing pain with analgesic medications and preventing infection with antibiotics.
  • Skin Closure through suturing if the wound is small. Skin substitute grafts or autogenous graft ( skin taken from another part of the patient’s body) if the ulcer is larger.
  • Dressing the Wound and follow-up for evaluation.

Venous stasis ulcers – Are seen in patients who have leg swelling, varicose veins and a history of superficial or deep vein blood clots. These ulcers are usually found below the knee and on the inner aspect of the ankle.

Neurotrophic (diabetic) – These types of ulcers are mostly seen in patients with diabetes, although they can occur and affect anyone who has a decrease in sensation of the feet. They are usually seen on pressure points of the feet.

Arterial (ischemic ulcers) – These ulcers are seen in patients who have poor circulation and have other underlying conditions such as, diabetes, thin skin, renal issues or simply had trauma that initiated the process and poor blood flow did not allow healing of the wound. They can be located anywhere but mostly seen in areas where there is decreased blood flow such as the heels and the toes.

It is best to keep wounds moist and covered to prevent infections and allow faster healing. Hydrogen peroxide will only dry the wound and is not recommended as it could lead to further complications.

A patient is at high risk for an ulcer if they have or do the following:

 

  • Neuropathy
  • Poor circulation
  • A foot deformity (e.g., bunion, hammer toe, flat feet with a prominent medial column)
  • Wear inappropriate shoes
  • Poor and uncontrolled blood sugar
  • History of foot ulcers
  • Smoking
  • Consuming large quantities of alcohol
  • High cholesterol

  • Patients who have diabetes also have problems with their immune system. They do not have enough immune fighting cells to heal the wound and therefore the wound heals slower.
  • If the diabetes is uncontrolled it will lead to poor circulation. With a slow down of blood flow, the body has a difficult time delivering nutrients to the wound. The wounds are again slow to heal.
  • If a diabetic has a blood sugar that is higher than normal it will prevent oxygen from being delivered to the wound and it will not allow proper healing.
  • High levels of blood sugar also increase the risk of infections to the wound. Bacteria loves sugar and thrives on it and with the immune system being down, infections grow causing a slowing down in healing and even possible complications such as amputations.

  • Hemostasis – This phase happens when the blood in the wound clots.
  • Inflammatory phase – This phase begins at the time of injury and lasts up to four days.
  • Proliferative phase – This phase begins about three days after injury and overlaps with the inflammatory phase.
  • Remodeling phase – This phase can continue for six months to one year after injury.

Wound specialists are physicians who have been trained in the treatment of wounds. Podiatric doctors are trained to treat all types of wounds involving the lower extremity, acute and chronic.

Wound care specialists utilise wound care treatments that other doctors are not trained to perform. Seeing a wound care specialist gives you the best chance at healing. They use different forms of treatment to accomplish a successful healing. These include but are not limited to debridement, bioengineered skins, surgical incision and drainage, skin grafts, unna boots, total contact casts.

Wounds, if but treated properly can lead to amputations. It’s is extremely important to find the best wound care specialist. Sara had been treating wounds for over 25 years. Your physical health and quality of life depend on the special podiatrist  you choose to treat your wounds.

Bunion FAQ’s

Bunions cannot be cured without surgery, however symptoms can be reduced and they can be managed well through various means, and progression of the bunion can even be halted.

This can be achieved in a variety of ways:

 

    • Through the wearing of shoes with a designated arch to support your feet.
    • Wearing shoes which help to protect the bunion area and provide adequate cushioning.
    • Wearing custom-made orthotics. These are made to try to align your feet back into the correct position. Our trained podiatrists at The Foot Clinic Broadway can assess your feet and create a prescription for custom-made orthotics for your shoes so that your problems can be addressed straight away whilst also preventing longer-term problems from developing,

Sadly sometimes bunions do grow back due to a variety of reasons:

 

  • One of the reasons bunions can return is the poor choice of procedure in the first place. It is essential that the bunion procedure chosen is correct for every particular patient to ensure that problems do not develop in the long-term.
  • Our podiatrists at The Broadway Foot Clinic are able to assess patients’ bunions and if necessary, they can refer patients to orthopaedic surgeons and podiatric surgeons for surgical opinion or for surgeon  surgical procedure.
  • Bunions sometimes return simply due to the individual structure of the foot and also as a result of the abnormal joint movements that can be experienced from the ankle and below.

Bunions develop for many reasons, some of which are listed below:

 

  •  Overpronation of the foot and the resultant lowering of the arch can lead to the pulling of the tendon which can result in instability of the toe joint.
  • In hypermobility the big toe joint can move much more than usual and this can result in problems.
  • Foot injuries can result in bunions developing.
  • foot injuries.
  • arthritis-related conditions can sometimes result in the development of a bunion, for example rheumatoid arthritis.

Bunion surgery is not always necessary in the treatment of bunions, however if a patient is experiencing constant pain and they are unable to perform their usual daily activities, then surgery to the area might need to be considered.

Bunion surgery is generally extremely successful with many patients finding their pain is quite significantly reduced following the treatment. Ultimately the alignment of the toes can be improved and this can help improve a patient’s walking. Bunion surgery should not be considered simply for cosmetic reasons as it is is very important surgery.

Bunions can not be shrunk naturally. There are things that one can do to help reduce pain and

swelling though. Such as wear wider shoes, avoid flip flops, ice the area of pain, home exercises, NSAIDS for inflammation, and bunion cushions.

A Bunions cannot be reduced without surgical treatment, however there are ways in which they can be managed that can reduce pain and swelling, for example:

  • icing painful areas
  • wearing wider shoes
  • avoiding flip flops as these do not provide adequate support for the foot and can even speed up the growth of bunions
  • exercises can be given that can be completed at home that can help develop foot muscles that can become weaker and worsen bunion pain if not exercised adequately.

Initially bunions might not hurt and they tend to cause minimum discomfort in the initial phases. Bunions tend to be progressive and over time, the large joint begins to move out of alignment, and with the growth of the bone the pain can begin to become constant and in some cases severe.

Many people confuse the pain caused by gout and bunion pain. Gout pain is made worse with movement and acute gout can be extremely painful. Bunions can be identified by a podiatrist very easily and a characteristic lump can typically be seen on the outside of the foot, with redness and swelling usually noticed around the joint. Gout tends to occur in conjunction with the build-up of levels of uric acid in the blood, so it can usually be confirmed with a blood test along with the symptoms experienced.

If you do not treat a bunion, it can worsen and lead to a number of problems affecting the foot and legs and they can then even lead to back pain. Calluses can form with the constant rubbing of the bunion against shoes and there is often a change to toe alignment with the second toe appearing to sit on top of the big toe, and if left to progress it can cause the other bones of the foot to move, worsening ball of foot pain and causing further callus formation. because alignment is affected, a person’s balance can be altered and this can put people at higher risk of falls. Bunions can be affected by osteoarthritis which can lead to pain and damage to the joint.

To prevent this often painful cascade of events that occurs with bunions, advice about bunions should be sought as soon as possible.

With advancing age, the fine ligaments and tendons of the feet can weaken and break down, leading to more misalignment and also movement of the bones. This can lead to pain whilst walking and problems with balance and mobility.

Misc Treatment FAQ’s

Walking barefoot for prolonged periods can lead to  foot pain as the delicate pad of fat under the foot can become degraded and thinner every time the feet are exposed to bare ground. If shoes which support the arch are not worn, the feet can start to become affected and a number of foot injuries can start to develop, for example tendinitis, plantar fasciitis and metatarsalgia, or pain beneath the ball of the foot whenever one walks without foot support. It is therefore recommended that adequate footwear is always worn.

Foot pain that affects the top of the foot is relatively common, and there are a number of causes:

  • Overuse when exercising- this can happen whilst wearing shoes that are too tight, during sports such as running, football, and especially in sports involving kicking or jumping actions.
  • Injury such as dropping a heavy object onto the floor leading to spraining of tendons or broken bones
  • Ganglion cysts, which is where a lump can develop beneath the surface of the skin
  • Diabetes
  • Gout
  • Arthritis

Patients who have diabetes can develop foot pain along with damage to the nerves, also known as neuropathy. Patients can develop a range of problems if diabetes remains uncontrolled, such as numbness, tingling and burning, and aching pains  which can be sharp in nature. Some diabetic patients have open wounds which can be painful and healing can sometimes be slow and they can also take longer to drain.

Diabetes can sometimes lead to the development of Charcot arthropathy, which can occur when nerves no longer function as they should. It can then lead to alterations in the fine bone structure of the feet. Patients can then sometimes encounter some signs indicative of inflammation, such as severe pain, redness, swelling and warmth around the area.

Symptoms of Sever’s disease include:

  • The development of heel pain during activities
  • Heel pain when cupping the heel with one hand
  • Pain and swelling exacerbated by some activities, such as playing sports, jumping and running
  • Tip-toe walking in children

Although a sore might not be causing acute pain, it could well cause long-term damage if help is not sought soon enough. It is especially important to obtain help as quickly as possible if one is diabetic, as diabetes can lead to nerve damage, and this is why people can lose sensation and in some cases not feel pain. Normally the presence of pain can alert us to the fact that there might be a problem, however if you cannot feel pain, you might not be able to act quickly and seek help simply because you cannot feel the pain arising from the problem.

Conditions which might not initially be thought to be serious, such as smaller wounds e.g. blisters, dry skin cracks, or even splinters, can lead to ulcer formation and become infected. In extreme cases, people might then go on to require amputation of the foot. Any wound to the foot should be assessed as quickly as possible so that timely treatment can be given.

Podiatrists can assess children with clubfoot and refer them on to the relevant teams if necessary, following a through assessment.

It is important to observe your child as much as possible. Things to look out for are:

 

  • Not being able to keep up with their friends
  • Not participating in the activities they love
  • They trip and fall excessively
  • They complain of pain

All diabetic patients need and should see a podiatrist. The podiatrist will help you maintain healthy feet and is there to treat and prevent complications. During your exam, your doctor will let you know if you are at high or low risk for complications. A diabetic with loss of circulation and a neurologic deficit will be seen more often to prevent complications such as infections, ulcers, and amputations.

Wearing high heels for prolonged periods can shorten the Achilles tendon, as the heel becomes pushed upwards, towards the direction of the calf muscles. If the Achilles tendon has become shortened, the plantar fascia become stressed and it is this that can lead to arch and heel pain, a condition commonly known as plantar fasciitis. Another problem that can lead to this development is the unequal distribution of weight when one is wearing heels.

Ingrown toenails must be thoroughly assessed by a podiatrist in order to find out the type of ingrown toenail and this will affect which treatment is given.

There are three different types of treatment:

 

  • Lifting the nail- this is usually used to treat a mildly ingrown nail (ie redness and pain without the presence of pus)
  • Partial removal of the nail - this is used for a more severe ingrown nail (with redness, pain as well as pus)
  • Removing the nail and tissue

One way to distinguish a sprained foot from a broken foot, is the presence of pain. Bruising, swelling and the presence of pain can occur when there is a sprain to the foot, but a break is much more severe. In the case of displacement of the bones and bad breaks, there can be associated deformities.

Although flat feet can be inherited, it can take a number of years to develop flat feet. Many situations exacerbate the development of flat feet, putting extra pressure on fine tendons and ligaments, bones and muscles. These can include repeated injury, pregnancy, and obesity. Neurological or muscular disease can also make the condition more likely to develop, such as cerebral palsy, spina bifida or muscular dystrophy.