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Monday 09:00 - 18:00 Wednesday 09:00 - 18:00 Friday 09:00 - 18:00

Lawrence Atrash, Podiatrist, Sports Injury Clinic, Fourways, Johannesburg (2025)

14/11/2025

Charcot neuroarthropathy is a severe and potentially limb-threatening complication of diabetes, characterised by progressive bone and joint disintegration in the foot. It is most commonly seen in patients with peripheral neuropathy, which masks the pain that would normally accompany such damage.

Early signs include swelling, warmth, and redness in the foot, often mistaken for infection. Left untreated, the foot can collapse structurally, leading to a ‘rocker-bottom’ deformity. Early diagnosis is critical, as timely immobilisation can halt the destructive process.

In South Africa, Charcot foot is underdiagnosed, partly due to limited awareness and access to imaging modalities like MRI, which is often needed for confirmation. Podiatrists should maintain a high index of suspicion in patients with known neuropathy and unilateral foot changes.

While surgical intervention may be necessary in advanced cases, early-stage management with total contact casting or removable walkers is the cornerstone. Education of patients and clinicians alike is key to improving outcomes.

Charcot foot requires swift diagnosis and management to prevent severe deformity. South African podiatrists can lead in early recognition and referral for limb-saving intervention.

Source: Rogers, L.C., et al. (2011). The Charcot foot in diabetes. Diabetes Care. https://f.mtr.cool/zuvmkdynmu

14/11/2025

A good pedicure can be relaxing and refreshing, but if done incorrectly, it can cause more harm than good. Here’s how to enjoy the benefits without the risks.

Pedicures aren’t just about pretty toes; they can help maintain healthy nails and soft skin. But there’s a fine line between safe pampering and inviting problems like infections, ingrown nails, or fungal issues.

Start with hygiene. Whether you're visiting a salon or doing it yourself, cleanliness is key. Tools should be sterilised between each use. If you're unsure about a salon's hygiene, trust your gut or bring your own tools.

Don’t cut the cuticles. They protect your nails from bacteria and fungi. Pushing them back gently is fine, but cutting them opens the door to infection.

Clip nails straight across. Curving them at the edges may look neater, but it increases the risk of ingrown toenails, especially if the shoes you wear are tight or pointed.

Avoid sharp scraping tools on calluses. Over-filing can lead to cracked skin or sensitivity. Use a pumice stone or foot file gently and regularly, rather than trying to remove everything in one go.

Be cautious with nail polish. While it's not harmful in itself, keeping nails constantly painted can hide infections or discolouration. Give your toenails a break between pedicures to let them breathe and monitor their health.

A pedicure should leave your feet looking and feeling better, not battling avoidable problems. With the right care and a few smart choices, you can enjoy healthy, well-groomed feet without risking your foot health.

08/10/2025

Today, we celebrate every podiatrist’s skill, dedication, and foot-saving power.
From preventing amputations to keeping athletes moving, we change lives every single day.

👣 Celebrate your craft.
💙 Honour your impact.
💪 Keep the world on its feet.

31/07/2025

Foot temperature monitoring has emerged as a promising method to predict the onset of diabetic foot ulcers (DFUs) before visible signs appear. The principle is based on detecting subtle changes in temperature that reflect localised inflammation, which often precedes tissue breakdown.

Research from the Netherlands and the USA shows that daily foot temperature checks using handheld thermometers or wearable sensors can significantly reduce ulcer incidence in high-risk diabetic patients. These tools can identify “hot spots” which signal the need for offloading or clinical intervention.

In South Africa, thermographic tools are not widely used in podiatric practice due to equipment cost and availability. However, awareness of these developments is important. Podiatrists can implement manual temperature checks as a cost-effective alternative and educate high-risk patients on home monitoring routines.

Adoption of foot temperature monitoring, even in basic forms, can greatly enhance early detection and prevention of ulcers, especially in patients with a history of previous ulceration or peripheral neuropathy.

While advanced thermographic devices may be out of reach for many South African practices, integrating basic foot temperature checks could become a powerful tool in diabetic ulcer prevention.

Source: Lavery, L.A., et al. (2007). Thermometry in the prevention of diabetic foot ulcers. Diabetes Care. https://f.mtr.cool/ephqstzlfx

31/07/2025

It’s itchy, it’s flaky, and it spreads like wildfire. Athlete’s foot isn’t just annoying, if ignored it can cause bigger problems.

Athlete’s foot isn’t only for athletes. It’s a contagious fungal infection that thrives in warm, damp places like gym showers, tight shoes, or sweaty socks. And while it might start as a small itch between the toes, it can quickly turn into cracked skin, blisters, and even bacterial infections.

What makes it tricky? It spreads easily, not just from person to person, but from foot to hand, or into the toenails. That’s why scratching can make things worse.

The first signs are usually peeling skin, itching, and redness. Some cases burn or sting, especially when the skin is broken. Left untreated, athlete’s foot can lead to thickened nails, fungal nail infections, or painful fissures that invite bacteria in.

The good news? Treatment is simple, if caught early. Over-the-counter antifungal creams or powders usually clear it up within a week or two. But consistency matters: keep using the treatment for a few days after symptoms disappear.

Prevention is just as important. Dry your feet well, change socks daily, and wear sandals in communal areas like pools or changing rooms. And never share shoes or towels, fungus loves a free ride.

Athlete’s foot might seem minor, but it can grow into a bigger problem fast. Treat it early, keep your feet dry, and don’t ignore the itch. Healthy feet don’t take risks with fungus.

31/07/2025

Chronic foot pain not only limits physical activity but also significantly impacts a person’s mental health and quality of life. Patients with ongoing pain often report increased levels of depression, anxiety, and social withdrawal. These psychosocial effects are often underdiagnosed in clinical settings focused solely on biomechanical or dermatological conditions.

Recent studies underscore the need for a holistic approach to foot care, integrating psychological support into the management of chronic foot pain. Tools like the Foot Health Status Questionnaire (FHSQ) can help assess the broader impact on daily functioning and emotional well-being.

In South Africa, where public health resources are stretched, these psychosocial aspects are often overlooked. Podiatrists, however, are well-placed to identify red flags during consultations and refer patients to counsellors or psychologists when needed. Recognising the link between chronic pain and mental health enables more effective, patient-centred care.

Collaborative care models, especially in multidisciplinary settings, can ensure that the emotional burden of chronic foot conditions is addressed alongside physical symptoms.

Chronic foot pain affects more than mobility—it impacts mental well-being. South African podiatrists can enhance care by acknowledging and addressing the emotional dimensions of persistent foot conditions.

Source: Psychological Factors Associated with Pain and Function in Adults with Chronic Foot Conditions – Journal of Foot and Ankle Research. https://f.mtr.cool/fvbmgqdtdf

31/07/2025

Flat feet, high arches, or something in between...knowing your foot type is the first step to preventing pain and choosing the right shoes.

Look down. Your foot shape holds more clues about your health than you might think. Whether you have flat feet, normal arches, or high arches, the structure of your foot affects how you walk, what shoes you should wear, and even how your knees and hips function.

Flat feet (low arches) tend to roll inwards, a movement called overpronation. This can lead to arch pain, heel discomfort, and tired legs. People with flat feet often do best in shoes with good arch support and firm midsoles.

High arches are the opposite. The foot doesn’t absorb shock as well, which can cause pain in the ball of the foot or heel. These feet often need shoes with extra cushioning and stability to protect the joints.

Most people fall into the middle, neutral arches but even they benefit from regular checks, especially if they spend a lot of time on their feet, play sports, or experience unexplained foot pain.

Not sure where you fall? Try the “wet foot test.” Step onto a piece of cardboard with a damp foot and observe the imprint. A full footprint suggests a low arch, while a narrow or disconnected one hints at a high arch.

Your foot type is more than a label, it’s a guide. Understanding it helps you make smarter choices in footwear, prevent injuries, and support your body from the ground up.

31/07/2025

Hallux valgus, commonly referred to as a bunion, is a progressive deformity that affects the alignment of the big toe. In cases where conservative treatments fail, surgery becomes necessary. Recent innovations include minimally invasive techniques that reduce soft tissue trauma and improve recovery times.

Procedures such as the minimally invasive Chevron or scarf osteotomy have gained popularity in the UK and Australia. These approaches offer reduced scarring, shorter hospital stays, and quicker return to function when compared to traditional open procedures.

In South Africa, such procedures may not yet be widely available due to training limitations or equipment costs. However, podiatrists can play a crucial role in pre-operative evaluation and post-operative care, ensuring that patients are referred appropriately and rehabilitated correctly.

Keeping abreast of international surgical advancements allows South African podiatrists to advocate for improved services and guide patients in understanding their options, even when surgical care is referred externally.

While surgical scope remains outside podiatry in South Africa, podiatrists are central to managing bunion cases pre- and post-operatively. Awareness of modern surgical techniques supports better patient education and outcomes.

Source: Minimally Invasive Surgery for Hallux Valgus: A Review – Journal of Foot and Ankle Surgery. https://f.mtr.cool/zmsoygdiwf

31/07/2025

Foot pain without a clear cause? These are the tools podiatrists use to find out what’s going on under the surface.

Sometimes, foot problems go deeper than what you can see. That’s where diagnostic tools come in, helping your podiatrist uncover what’s really causing your pain, weakness, or instability.

1. The first step is often a biomechanical assessment. You’ll be asked to walk, stand, or perform specific movements while your gait, posture, and foot alignment are observed. This helps identify pressure points or abnormalities in how you move.

2. X-rays are used to check for bone problems such as fractures, arthritis, or misalignments like bunions. They’re quick, painless, and commonly used in diagnosing chronic foot pain or sudden injuries.

3. Ultrasound scans can show soft tissue damage such as torn ligaments, tendonitis, or bursitis. While podiatrists in South Africa may not currently perform these scans themselves, they often work closely with radiology centres for access.

4. Vascular assessments check blood flow using a Doppler device, essential in patients with diabetes or poor circulation. It’s non-invasive and gives crucial insight into how well blood reaches the feet.

5. Lastly, monofilament tests and tuning forks help detect nerve issues. These are often part of a diabetic foot screening to identify early signs of neuropathy.

Podiatrists don’t guess, they test. These tools help uncover what’s happening beneath the skin so you can get the right treatment, faster and more accurately.

Lawrence Atrash, Podiatrist

14/11/2025

14/11/2025

08/10/2025

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Monday	09:00 - 18:00
Wednesday	09:00 - 18:00
Friday	09:00 - 18:00