BLOG - REGULAR BLOG BY JANET McGROGGAN - PRINCIPAL PODIATRIST 

Week three of winter foot care.  
 
Now you have your shoes and are treating your nails it is time to look at hard skin. 
 
You really cannot beat a trip to a HCPC registered podiatrist to have all your hard skin removed to give you the best start to regular maintenance. You podiatrist will debride your hard skin (Callus) using a scalpel and sanding discs. Then it is over to you. 
It’s the second week of getting your feet ready for winter and this is the perfect time to prep your nails for next summer. 
 
A big toe nail can take up to a year to grow out and if you have ever dropped something on your toe or bruised a nail during running you will know this as you painstakingly watch the blacked old nail grow out. 
 
So as soon as it is sock time think nail care. 
 
For fungal nails this is the perfect time to try the Lacuna Method of treatment which I have blogged about before. If your fungal nails are beyond the Lacuna Method a course of Terbinafine from your GP should do the job. 
 
• If you have been wearing metallic nails throughout the summer you may find a whitish colour on the top layer of nail when you finally remove the varnish. 
• If you have been wearing reds or dark colours you may have a yellow or brown staining on the top layer of nail. 
• If you have had a cured gel nail polish applied over the summer you may find the nails weak and brittle when the polish is removed by your beautician. 
OK it’s time to get those feet ready for Winter, this is preparation time. Let’s do a week by week preparation. 
 
In a back to front way Foot Wear is first. 
 
This is a time of year I struggle to cope with regarding footwear. I want a shoe that understands that my feet have been footloose (erm) and fancy free in Fitflops or Birkenstocks all summer. They have been supported underneath but totally unrestricted on the top. 
 
I do not want a pair that look like school shoes which in my 40’s still haunts me. Nor do I want a pair that say…. This gal is 40 and has lost her mind. 
I am searching for a podiatrist to join my team. 
 
Successfully Aaron will be joining me to run a Saturday Clinic.  
 
But I still need a part time pod (moving to full time in the future).  
 
There is a dearth of podiatrists so have a look at this video to see what it's all about.  
 
It is simply one of the most rewarding careers ever and there is a shortage so jobs a plenty for GOOD ENTHUSIASTIC PODIATRISTS. 
I have seen an increase in the number of patient’s presenting with what I call Festival Feet.  
 
This would have been called Trench Foot (originating in 1812 with Napoleon’s Army) and more recently Immersion Feet. Immersion Feet has been seen in people who assist in disasters and foot soldiers who are deep in jungle environments. 
 
Festival Feet – yes, you’ve guessed it, occurs amongst the population who brave the wet and wild festival season. 
 
These adventurers unwittingly expose their feet to cold (below 15°C), wet and often unhygienic conditions for prolonged periods of time, although the condition can take less than a day to manifest. 
 
 
I just have to tell you about how 3D technology is coming to a podiatrist near you. 
 
Firstly, a disclaimer: I am not sponsored by Podfo and I use other orthotic suppliers also. 
 
Orthotics are insoles that are made for you. Bespoke devices are not new but even in the seventeen years I have been studying and practicing podiatry the production has evolved. The devices you will see in this video are 3D printed from a capture of the patient’s foot. All orthotics are prescribed meaning that the podiatrist adds corrective tweaks to support the feet and improve function. The capture plus the prescription create the finished device. 
This is a very important blog. 
 
I have been on my holidays and have come back raring to go (as we say in my native Northern Ireland).  
 
When I returned I was THRILLED to see my Private Practice Accreditation certificate had arrived.  
 
I didn’t even know that my application had been approved!  
 
Weeks and weeks of drawing up documents and policies and reading everything relating to best practice I could find had paid off. 
 
WHOOPIE!! 
A so-called soft corn is a plug of skin that occurs between the toes.  
 
The natural moisture that we get between our toes keeps the skin soft but they can be incredibly painful. 
 
This is because they are caused by pressure and movement, so two bony prominences (the equivalent of a knuckle in your hands) rub continuously and stimulate the skin to develop, flatten and become a plaque. The plaque may or may not have a hard centre. 
I know, I know... cutting your nail across is the only way to do it, right? 
 
Yeeaahish. 
 
If you are lucky enough to have none of the above and have a lovely flat nail like this one then please cut it straight across and it will stay lovely. 
 
Unfortunately, many of us do not have flat nails and have variations on the top images to a greater or lesser degree. Cutting these can be a minefield and really, it's worth seeing a podiatrist and having a lesson on nail cutting. The curly nails, called involuted nails, impact the skin and can cause hard skin and corns to develop along the nail borders. They can become painful. 
 
 
Image Alert *** 
 
I have recently seen a lot of heel pain in the clinic and at this time of the year there is one culprit which prevails in the cause of this. 
 
Picture the scene, you’ve been on your holibobs, spent a fortnight, all-inclusive sunning yourself around a clear blue pool only rising during to pad over to the pool side bar for a strawberry daiquiri. The nights are spent dancing, walking into the local town to try something new and when you look down at your feet, shock, horror you have been wearing a pair of FLIP FLOPS for two weeks!!! 
 
So what? You may say. In my opinion, you may as well stick a piece of cardboard onto your feet for a fortnight. 
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