another recent patient testimonial left for Peter

This is another recently left patient review for Peter, received at The Chiropractic Clinic on Hough Green in Chester from a patient who had, I think, also seen Dr Donna Strachan through at our Wirral clinic in Pensby:

''Donna referred me to 'Pete the Feet', whose insoles did not look much, but my!  What an improvement.  My two big toes, both formerly rigid, now have some 45 degrees of movement.  Amazing! Thanks so much!''

A Recent Patient Testimonial

A Podiatry testimonial recently left for Peter at The Chiropractic Clinic in Chester:

''Peter has done an excellent job and I no longer suffer from shin splints''

Mrs C M

Ball of Foot Pain

Talkabout Publishing (Chester) Ltd. Brief:
Peter’s Monthly Foot and Ankle Column, pp,
Overleigh Roundabout Magazine [Jan 2010]


This month, we look at an affliction that affects most people at some point in their lives: Metatarsalgia (or Pain in the Ball of the Foot.)

Metatarsalgia is a general term that simply denotes a painful condition in the metatarsal region of the foot.

It’s always best to have your ball of foot pain diagnosed specifically by a medical or health professional, because the proper treatment can only really be established after accurate diagnosis. Here are a couple of causes of ball of foot pain:

Morton’s Neuroma

This is where a painful growth occurs in between any of the the ball of foot ‘metatarsal head’ bones. It usually occurs on the digital nerve in the inter-metatarsal space near the little toe causing pain in the foot and nearby toe/s. It occurs four-times more frequently in women than men, and tends to present most in people aged 40-50. Morton’s Neuroma sufferers usually find obvious relief by removing their shoes and manipulating the foot.

Your Podiatrist can provide Orthotic Insoles with features to widen intermetatarsal space areas, and to off-load the painful area. Referral for confirmation of size and location by ultrasound may be needed in stubborn cases.

Hallux valgus

This is the commonest of the foot deformities. It is recognised by the big toe bending towards the little toe (sometimes moving under the second toe) along with some degree of a bunion at the base of the joint. There is usually a stiffness of this first MTP joint too, along with pain when walking.

Adolescents with family history and older patients with arthritic changes can develop Hallux Valgus with or without an accompanying bunion.

As with Neuromas, Your Podiatrist can provide Orthotic Insoles to off-load any painful toe joint, with extra design features to mobilise a slightly stiff joint as a starting point… or immobilise and support a very painful toe joint at the other extreme. A good Podiatrist will also advise when surgical opinion may be indicated.

Other Conditions

After taking a good case history, along with physical examination, your Podiatrist may make other diagnoses concerning your ball of foot concern. These may include: Freiberg’s Disease, March fracture, Claw Toe, Sesamoiditis, or conditions secondary to any medical issues (like Peripheral Neuropathy in Diabetes).

Don’t conclude that you have to live with foot pain! Many useful treatments are available, and we are happy to provide advice.

If you would like an appointment with Peter, please contact 01244 682500 or 07880 702475

Happy walking!
Peter Colhoun, Podiatrist
PeterColhoun.com

Flat-Foot and Overpronation

Peter’s Monthly Foot and Ankle Column
Overleigh Roundabout Magazine Nov 2009
Talkabout Publishing (Chester) Ltd.
 
I am alarmed when I read running magazines today. They - and the corporate giant trainer retailers - speak of ‘Pronation’ as a disease that needs to be avoided at all costs.
In this month’s article, I will discuss what pronation is, why it is normal, and when EXCESS-pronation reaches an extreme level that it needs treatment.

So What is pronation?

Pronation a medical term affecting several joints in the body. In terms of our feet, it is basically a flattening of the long arch of the foot, coupled with an everted rolling inward of the heel (specifically the sub-talar joint) and a slight ‘out-splay’ of the whole foot. Pronation is ‘tri-planar’ in that it makes the foot move in the three planes of anatomical function.
The thing I want to stress it that a degree of pronation is normal and necessary during the gait cycle. It allows the foot to adapt to the ground and puts us into “Shock-absorbing” mode. Pronation is natural and not a biomechanical curse. Do not buy trainers or ‘off-the-shelf- insoles just because you think you should decelerate pronation. For one thing you may not need such deceleration… in fact, you may even be a ‘fixed supinator’ who needs to be thrown into pronation!
When it comes to pronation, you only have a problem if you are going too far, excessively pronating and noticing symptoms or pain.
You usually have excessive pronation if your feet leave a complete “flat foot wet print” when you look at a tiled floor surface after showering/swimming etc. The low arch in this foot type is usually associated with overpronation and this is when the foot strikes on the outside of the heel and then rolls inwards too far (NB: other foot types can overpronate). If this is allowed to continue it can cause many different types of injury. With over pronation, the arch flattens, collapses, and soft tissues stretch. This causes the joint surfaces to articulate at improper angles to each other. When this happens, joints that were stable can now become hypermobile.
At first, this may cause fatigue. Symptoms can then manifest in many different ways. The associated conditions can depend on the individual lifestyle of each patient. As the problem gets worse, strain on the muscles, tendons, and ligaments of the foot and lower leg can cause permanent problems and deformities. When standing, your heels lean inward, this is turn makes one or both of your knee caps turn inward. Permanent conditions such as a flat feet or bunions may occur. This may affect your pelvis and lower back. You can also quickly wear out the soles and heels of your shoes.
After your condition has been confirmed by a biomechanics podiatrist, management can take several forms. Some bespoke orthotics (insoles) made from a flexible carbon-fibre shell can support your subtalar joint, mid-foot joint and medial arch during gait. If the heel and ankle collapse is making your big toe joint stiffen (with or without bunions), an extra orthotic feature will start to promote movement at that joint too. Be careful about using off-the-shelf orthotics in shops until you have taken podiatric advice… you could make the condition worse.
Your podiatrist can also provide you will exercises to strengthen your medial arch and relieve pain in any lower limb (foot/leg/hip) joints. Onward referral for musculo-skeletal care or even surgery may sometimes be indicated.
Good footwear advice is also essential. Over-pronating walkers and runners should look for straight or semicurved shoe soles which have firm midsoles and medial arch control features and support. Avoid excessively cushioned, fully curve-lasted trainers which will promote instability stability and poor control during the pronatory phase of gait.
Would you like a podiatric assessment? You can speak to Peter on 07880 702475 or call the clinic on 01244 682500 to book an appointment.

Peter Colhoun BSc MChS SRCh HPC IRMER

Peter is the Resident Podiatrist at The Chiropractic Clinic. He is a Podiatry graduate of Queen Margaret University Edinburgh and is registered with the HPC and the Society of Podiatrists.

Peter's specialist areas of interest are Biomechanical assessments, x-ray (IR[ME]R) referral pathways and podo-paediatrics (Children's walking problems). Peter is also an Expert Witness and has written numerous published articles and has a wealth of experience in all forms of foot and ankle related problems.

Peter works from our Chester Clinic.