BLOG - REGULAR BLOG BY JANET McGROGGAN - PRINCIPAL PODIATRIST 

People living with Charcot Marie Tooth (CMT) will know that it is a multifaceted disorder that damages the peripheral nerves, and this causes motor and sensory problems in the arms, hands, legs and feet.  
 
There are several variations of CMT and each individual will know their own disease intimately. 
Rheumatoid Arthritis RhA is an autoimmune condition that causes the immune system to attack the joints in the body. 
 
Up to 90% of people living with RhA will develop symptoms in their feet.  
 
These symptoms can present as pain or stiffness in the feet, warmth and swelling in the joint of the feet and aching after activity or standing for long periods. 
Parkinson’s mainly affects people over 50 years old although 2-10 in every 100 people living with Parkinson’s is under 50. 
 
It is a progressive disease meaning that it moves through a series of well documented stages. 
 
These stages comprise of motor and non-motor symptoms. Motor symptoms refer to movement such as losing balance when walking, symptoms usually progress slowly. 
The Coronavirus is by no means over but luckily for my sanity and your foot and leg problems we were allowed to reopen our clinic this month.  
 
We rely on advice from The College of Podiatry who support and insure us as well as advice from the government. 
 
Much as I would like to say that I am a deep mahogany brown from sunbathing in lockdown weather, it’s not in my nature to lounge around, guilty conscience, I guess. 
Recently I treated a new patient who had been diagnosed with Plantar Fasciitis by her G.P. weeks ago and had been hobbling round ever since in agony. 
 
A podiatrist who treats heel pain will never have a chat and hand you a pair of insoles. 
 
I take about an hour. In this time, I take a medical and family history. This is to understand if there are any underlying conditions that you already know of that may contribute to the problem, medications that you take that may interfere with treatment or anything that you may not have flagged up that may affect diagnose or treatment. 
It is impossible to treat heel pain until a diagnosis has been made.  
 
I have been there, the knife like pain in the heel first thing in the morning and the dull ache that makes your heart sink every step you take, accompanied by a sharp tug in the arch when I need to go on my tip toes. The sheer relentlessness of it makes you grab the nearest pain killer in anticipation of what is to come. 
Athletes foot is generally easily treated using over the counter remedies but the fact that the nail harbours the fungal infection and is very slow to grow makes clearing up a fungal nail a challenge.  
 
Our nails are made up of three layers and the infection can be localised to the lowest layer and the skin under the nail plate. Onychomycosis can cause thickened, unsightly and sometimes painful nails in a variety of colours ranging from white to yellow and even green as different fungi families appear as different colours. 
The Plantar Fascia [fa-she-a] is a band of fibrous connective tissue in your foot. It is not a ligament, tendon or muscle.  
 
The plantar fascia originates in the calcaneus (heel bone) on the plantar surface (sole) of your foot. It stretches forwards and separates into five slips each one attaching into the plantar surface of each of the five metatarsal heads which make up the ball of your foot. 
 
Adding ‘-itis’ to any anatomical word means ‘inflammation’ E.g. Tendonitis – Inflammation of a tendon. Therefore, plantar fasciitis [fa-she-i-tis] means an inflamed plantar fascia. 
 
The plantar fascia has the unenviable task of supporting our body through our feet. It holds the fore foot to the rearfoot and without it our feet could completely collapse. 
There are several first line treatments you can try but remember Plantar Fasciitis is a symptom of a disorder and if home remedies do not work you must see a podiatrist or G.P. 
 
The first thing to do is take a long hard look at your footwear and remember when doing this think support, support, support! 
 
AVOID - Thin soles, flexible soles, high heels, narrow footwear, slip-on shoes. Especially avoid flip-flops (the havaianas style) and ballet pumps. 
If you have tried supportive footwear and gentle stretching with no success, then it is time to see a podiatrist. 
 
Go to Find a Podiatrist - UK or the HCPC website to find a qualified and regulated podiatrist. 
 
A podiatrist will take a medical history and ask you what treatments you have tried. They may recommend that you undergo a biomechanical assessment. 
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