Podologia Forti

15/09/2025

29/09/2023

Running/walking – The role of the Podiatrist

Podiatrists play an important role in the management of foot and ankle problems among runners and walkers. They can help prevent injuries, diagnose, and treat conditions, improve performance, and manage chronic conditions. Here are some ways podiatrists can help:

• Preventing injuries: Podiatrists can conduct gait analysis to identify any biomechanical abnormalities that may increase the risk of injury. They can also recommend appropriate footwear and orthotics to support the feet and prevent injuries.

• Diagnosing and treating injuries: Podiatrists can diagnose and develop treatment plans for common running and walking injuries such as plantar fasciitis, Achilles tendonitis, stress fractures, and shin splints.

• Improving performance: Podiatrists can provide advice on training techniques, stretching exercises, and footwear choices to help runners and walkers improve their performance and reduce the risk of injury.

• Managing chronic conditions: Podiatrists can also help people who have chronic foot and ankle conditions such as arthritis or diabetes, which can affect their ability to run or walk.

There is evidence to support the effectiveness of podiatry interventions in the management of foot- related problems among runners and walkers.

For example:
1. A study published in the Journal of the American Podiatric Medical Association found that runners who received custom-made orthotics experienced a significant reduction in pain and improved performance.

2. Another study published in the British Journal of Sports Medicine found that podiatrists were effective in preventing and treating lower limb injuries among athletes.

3. A review of multiple studies published in the Journal of Foot and Ankle Research found that podiatry interventions were effective in reducing pain and improving function in people with plantar fasciitis.

In conclusion, podiatrists are an essential part of the management team for runners and walkers, helping to prevent and treat injuries, improve performance, and manage chronic conditions. The evidence supports the effectiveness of podiatry interventions in this context.

Reference

Mundermann A, Nigg BM, Humble RN, Stefanyshyn DJ. Foot orthotics affect lower extremity kinematics and kinetics during running. J Am Podiatr Med Assoc. 2003 Jul-Aug;93(4):263-74. doi: 10.7547/87507315-93-4-263. PMID: 12892356.

Redmond AC, Crosbie J, Ouvrier RA. Development and validation of a novel rating system for scoring standing foot posture: the Foot Posture Index. Clin Biomech (Bristol, Avon). 2006 Jan;21(1):89-98. doi: 10.1016/j.clinbiomech.2005.08.002. Epub 2005 Oct 4. PMID: 16202793.

Baldassin V, Gomes CR, Beraldo PS. Effectiveness of prefabricated and customized foot orthoses made from low-cost foam for noncomplicated plantar fasciitis: a randomized controlled trial. Arch Phys Med Rehabil. 2009 Sep;90(9):1582-90. doi: 10.1016/j.apmr.2009.03.015. PMID: 19735749

29/09/2023

Hypermobility – Ankle sprains

Hypermobility is a condition where joints have an increased range of motion and can be associated with an increased risk of ankle sprains. Podiatrists play a critical role in the management of ankle sprains in individuals with hypermobility. Here are some ways podiatrists can help:

1. Diagnosis and Assessment: Podiatrists can diagnose hypermobility and assess the severity of the ankle sprain to develop an appropriate treatment plan.

2. Customized Orthotics: Podiatrists can provide customized orthotics to improve the stability of the foot and ankle, which can reduce the risk of ankle sprains and improve overall function.

3. Exercise Therapy: Podiatrists can recommend exercise therapy to strengthen the muscles surrounding the ankle joint, which can provide additional support and stability to the joint.

4. Bracing: Podiatrists can recommend appropriate bracing options to reduce the risk of ankle sprains, such as lace-up ankle braces or ankle stirrups.

There is evidence to support the effectiveness of podiatry interventions in the management of ankle sprains in individuals with hypermobility.

For example:

1. A randomized controlled trial published in the Journal of the American Podiatric Medical Association found that custom-made orthotics reduced the incidence of ankle sprains in basketball players with generalized joint hypermobility.

2. Another study published in the Journal of Athletic Training found that exercise therapy improved balance and stability in individuals with ankle sprains and hypermobility.

3. A systematic review published in the British Journal of Sports Medicine found that ankle bracing reduced the risk of ankle sprains in athletes with hypermobility.
In conclusion, podiatrists play a critical role in the management of ankle sprains in individuals with hypermobility, providing customized orthotics, exercise therapy, and appropriate bracing options to improve stability and reduce the risk of injury. The evidence supports the effectiveness of podiatry interventions in this context.

References:

DiLiberto FE, Shaffer SW. Custom-made orthotics reduce the incidence of ankle sprains in basketball players with generalized joint hypermobility: a randomized controlled trial. J Am Podiatr Med Assoc. 2013 Mar-Apr;103(2):113-25. doi: 10.7547/1030113. PMID: 23426283.

Hertel J, Gay MR, Denegar CR. Differences in postural control during single-leg stance among healthy individuals with different foot types. J Athl Train. 2002 Mar;37(1):129-32. PMID: 12937497.

Dizon JM, Reyes JJ. A systematic review on the effectiveness of external ankle supports in the prevention of inversion ankle sprains among elite and recreational players. J Sci Med Sport. 2010 May;13(3):309-17. doi: 10.1016/j.jsams.2009.03.004. Epub 2009 Jul 1. PMID: 19574094

08/10/2022

Happy International Podiatry Day to all Podiatrists from all over the world. Be proud of this unique and vital profession. Lets work together for a better future for this profession. Be part of FIP. Join us to harmonize Podiatry in Europe and beyond. Together we achieve more 🥰🦶

07/10/2022

Non-infective nail conditions

About 50% of nail conditions result from various causes, including nail injuries, psoriasis, lichen planus, and occasionally tumours (cancerous and noncancerous)

Lichen planus affects the nails in up to 10% of cases. Some people may have only mild symptoms such as discoloration of the nail beds, thinning of the nails, and formation of nail ridges. Other people may completely lose their nails

Nail psoriasis can manifest clinically as a wide variety of nail changes, like nail discoloration, subungual hyperkeratosis, pitting and onycholysis. Patients with psoriatic nails have impaired quality of life due to the appearance of nails, and significant morbidity and functional impairments may arise in large cases.

Onycholysis is partial separation of the nail plate from the nail bed or complete nail plate loss. It can result from an injury, overzealous nail cleaning, Psoriasis and thyrotoxicosis, Frequent exposure to water and cleaning agents

Nail neoplasms include benign and malignant tumours that have different signs and symptoms causing deformities and affecting nail growth. In general, malignant tumours deform the adjacent tissue while benign tumours preserve tissue architecture; however, it should not be considered a rule. Malignant tumours are the most important lesions of the nail apparatus for their impact on the prognosis. A biopsy is the only confirmatory diagnostic means.

Haneke E: Important malignant and new nail tumors. J Dtsch Dermatol Ges. 2017, 15:367-86. 10.1111/ddg.13223

Park JH, Lee DY, Kim N: Nail neoplasms. J Dermatol. 2017, 44:279-87. 10.1111/1346-8138.13702

Starace M, Alessandrini A, Dika E, Piraccini BM: Squamous cell carcinoma of the nail unit. Dermatol Pract Concept. 2018, 8:238-44. 10.5826/dpc.0803a17

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03/10/2022

Skin cancer of feet

Melanoma, the sternest skin cancer, grows on skin that gets too much sun. It can also commence in places where the sun hardly shines, such as your foot. Because most people never check their feet for signs of melanoma, this cancer often spreads before it’s noticed. Allowed to spread, melanoma can turn deadly. By inspecting your feet, you can find it early when it’s highly treatable.

People of all races and colors can get melanoma on their feet. In fact, about the same number of African Americans and Caucasians develop melanoma on a foot. For people of African or Asian ethnicity, the feet and hands are the most common places for melanoma to appear. Research has shown that a foot injury may increase your risk of developing melanoma. Sometimes, melanoma on the foot feels painful, bleeds, or itches, but not always. The bleeding tends to stop and start.

Desai A, Ugorji R, et al. “Acral melanoma foot lesions. Part 2: Clinical presentation, diagnosis, and management.” Clin Exp Dermatol. 2018;43(2):117-23. Merkel EA and Gerami P. “Malignant melanoma of sun-protected sites: a review of clinical, histological, and molecular features.” Lab Invest. 2017;97(6):630-5.

Persechino F, Longo C, et al. “Acral melanoma.” J Am Acad Dermatol. 2017;76(2) suppl 1: S34–6.
Shin TM, Etzhorn JR, et al. “Clinical factors associated with subclinical spread of in situ melanoma.” J Am Acad Dermatol. 2017;76(4):707-13.

Sondermann W, Zimmer L, et al. “Initial misdiagnosis of melanoma located on the foot is associated with poorer prognosis.” Medicine (Baltimore). 2016;95(29):e4332.

André J , Moulonguet I , Goettmann-Bonvallot S . In situ amelanotic melanoma of the nail unit mimicking lichen planus report of 3 cases . Arch Dermatol 2010 ; 146 : 418 – 21 . 6 Weedon D , Van Deurse M , Rosendahl C . “Occult” melanocytes in nail matrix melanoma . Am J Dermatopathol

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01/10/2022

Peripheral Neuropathy in Diabetics

Diabetes can affect several systems in the body, including the nervous system. The most common type of peripheral neuropathy affects the leg and foot. Diabetic Peripheral neuropathy results in the loss of sensation of the foot. Symptoms may include tingling, numbness, and in some cases, pain. This loss of protective sensation may result in the patient being unaware of an injury by ill-fitting shoes, objects that have fallen in their shoes, stepping on an object while walking barefooted, or a burn.
The loss of sensation may also result in the development of painless ulcers. These painless ulcers may become infected and may result in amputation
Proper treatment includes management of diabetes by your physician and daily inspection of the feet by the patient or a family member.
Your podiatrist can evaluate your sensation for signs of peripheral neuropathy and other signs of diabetic foot complications and provide advice on proper foot care. Annual visits to a podiatrist for a foot examination are recommended for all diabetic patients.

Hicks CW, Selvin E. Epidemiology of Peripheral Neuropathy and Lower Extremity Disease in Diabetes. Curr Diab Rep. 2019 Aug 27;19(10):86. doi: 10.1007/s11892-019-1212-8. PMID: 31456118; PMCID: PMC6755905.

Selvarajah D, Kar D, Khunti K, Davies MJ, Scott AR, Walker J, Tesfaye S. Diabetic peripheral neuropathy: advances in diagnosis and strategies for screening and early intervention. Lancet Diabetes Endocrinol. 2019 Dec;7(12):938-948. doi: 10.1016/S2213-8587(19)30081-6. Epub 2019 Oct 14. PMID: 31624024.

Morbach S, Lobmann R, Eckhard M, Müller E, Reike H, Risse A, Rümenapf G, Spraul M. Diabetic Foot Syndrome. Exp Clin Endocrinol Diabetes. 2021 Aug;129(S 01):S82-S90. doi: 10.1055/a-1284-6412. Epub 2020 Dec 22. PMID: 3335259

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30/09/2022

FOOT IN MOTION

Our activities of daily living inherently involve interacting with the physical environment: the complexity of our bipedal walking is commonly done in an apparent remarkable easiness. We definitely want to keep feet in the best possible shape, as if they hurt your mobility and enjoyment of life are affected.
Movements allow children to connect concepts to action and learn through trial and error; as people age, their joints can lose fluid and tissue and this can cause pain and stiffness: motion is like lotion for joints and for independence to care for their selves.

Many foot pathologies are of biomechanical, infective or inherited nature. The Podiatrist is the foot specialist who can diagnose, prevent and rehabilitate complications of the feet, relief pain and keep people of all ages mobile and active.

In an average lifetime we walk 1000,00 miles: it is what our bodies are designed to do, but there are some sensible precautions we can take to ensure that our feet continue to give good service.
Healthy feet, at any age, enable to continue being active as we want, with less pain as possible.
Damaging feet due to inherited conditions, badly fitting shoes and illness can cause serious arm to our bodies and daily life, preventing from completing our daily tasks.

References:

Gait adaptability
Weerdesteyn V, Hollands KL, Hollands MA. Copyright © 2018 Elsevier B.V PubMed (nih.gov)
Gait Posture 2013 Mar;37(3):445-51. doi: 0.1016/j.gaitpost.2012.09.007. Epub 2012 Oct 26. Foot type biomechanics part 1: structure and function of the asymptomatic foot. Howard J Hillstrom 1, Jinsup Song, Andrew P Kraszewski, Jocelyn F Hafer, Rajshree Mootanah, Alyssa B Dufour, Betty Shingpui Chow, Jonathan T Deland 3rd

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26/09/2022

PES PLANOVALGUS (Flat Foot)

Pes planovalgus (i.e., flatfoot) is a common condition among young children and also is encountered in adults. In children, congenital pes planus typically resolves with age as the foot musculature strengthens. Flexible pes planus is defined as a normal arch during non-weight-bearing activity or tiptoeing, with a flattening arch on standing. In rigid pes planus, the arch remains stiff and collapsed with or without weight bearing. Patients with rigid pes planus should be referred for subspecialist treatment. Patients with flexible pes planus, in the absence of signs of rheumatologic, neuromuscular, genetic, or collagen conditions, should be treated conservatively. Asymptomatic children should be monitored and maintenance of a healthy weight should be encouraged. Surgical intervention for refractory symptomatic pediatric pes planus may be considered but there is little evidence to support it. Several etiologies of acquired pes planus in adults have been identified as posterior tibial tendon dysfunction. Clinical and x-ray evaluation can assist in staging the condition and guiding treatment decisions.

A Podiatrist can reduce the symptoms through conservative treatments; advise appropriate shoes and exercises, he can prescribe custom made orthotics and rest or advise surgery when recommended. The correct foot position will help avoiding the risk of further problems, especially in severe cases and for further deformity especially in children.
The flat foot may impact on quality of life: pain and stiffness may cause disability and limitation at any age. There are many conservative and simple ways to reduce pain and limitation. The Podiatrist will evalute your condition and advice or treat if needed.

References:

1. Foot and Ankle Conditions: Pes Planus
Charlie Michaudet 1, Katherine M Edenfield, Guy W Nicolette, Peter J Carek
Foot and Ankle Conditions: Pes Planus - PubMed (nih.gov), 2018 Feb

2. Flat Foot in a Random Population and its Impact on Quality of Life and Functionality
Salvador Pita-Fernandez 1, Cristina Gonzalez-Martin 2, Francisco Alonso-Tajes 2, Teresa Seoane-Pillado 1, Sonia Pertega-Diaz 1, Sergio Perez-Garcia 2, Rocio Seijo-Bestilleiro 1, Vanesa Balboa-Barreiro 1
Flat Foot in a Random Population and its Impact on Quality of Life and Functionality - PubMed (nih.gov)

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24/09/2022

Skin foot infections

An infected foot is often painful and can make it difficult to walk. Infections can be both fungal and bacterial infections. An infection can occur after an injury, having bacteria entering the wound, such as a cut or a skin crack, and cause an infection. Certain medical conditions, such as diabetes mellitus and ingrown toenails, can also increase your risk for foot infections. An untreated infection can lead to cellulitis, which is a potentially serious skin infection that can spread to your lymph nodes and bloodstream. One must look for discoloration and consistent oozing, which are signs that the infection needs immediate attention.

Fungal foot infections like Tinea pedis and onychomycosis are commonly found in 34% of the European population, mostly in Northern European regions. Studies showed that this high occurrence is due to longer winters, where occlusive footwear is worn for longer periods of the year, which promotes fungal growth
Turner R & Testa M. Measuring the impact of onychomycosis on patient quality of life. Qual Life Res 2000;9(1):39–53. PMID: 10981205
[5] Lubeck DP, Patrick DL, McNulty P et al. Quality of life of persons with onychomycosis. Qual Life Res 1993;2(5):341–348. PMID: 8136799
[6] Burzykowski G, Molenberghs D, Abeck E et al. High prevalence of foot diseases in Europe: results of the Achilles project. Mycoses 2003;46(11–12):496–505. doi: 10.1046/j.0933-7407.2003.00933.x
[7] Faergemann J & Baran R. Epidemiology, clinical presentation and diagnosis of onychomycosis. Br J Dermatol 2003;149(Suppl 65):1–4. PMID: 14510968 Havlickova B, Czaika VA & Friedrich M. Epidemiological trends in skin mycoses worldwide. Mycoses 2008;51(Suppl 4):2–15. doi: 10.1111/j.1439-0507.2008.01606.x

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