Who
is a Podiatrist?
The podiatry profession has
undergone considerable growth and change in recent
years. The following information has been provided by the Australian Podiatry
Association to provide other health professionals with
an overview of these developments and to outline the
role of the podiatry profession in relation to the treatment of
problems of the feet and lower limbs.
A podiatrist is a health
professional who deals with the prevention, diagnosis,
treatment and rehabilitation of medical and surgical
conditions of the feet and lower limbs.
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The conditions podiatrists
treat include those resulting from bone and
joint disorders such as arthritis and
soft-tissue and muscular pathologies as well as
neurological and circulatory diseases.
Podiatrists are also able to diagnose and
treat any complications of the above which
affect the lower limb, including skin and nail
disorders, corns, calluses and ingrown
toenails. Foot
injuries and infections gained through sport or
other activities are also diagnosed and treated
by podiatrists.
To become a podiatrist a
practitioner must complete a Bachelor’s Degree and be
registered with the state podiatry registration board.
(Until 1977, Australian podiatrists were known as
chiropodists. The
official name change to podiatry reflected the upgrading
of education levels and an expansion in the scope of
practice by the profession.) |
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Some
areas in which podiatrists may develop a special
interest include:
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Sports medicine
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Biomechanics
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Paediatrics
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Surgery
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Diabetes
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Arthritis
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Gerontology
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The skills of a podiatrist
Podiatrists
diagnose and treat both common and more rare skin
and nail pathologies of the feet.
Podiatrists play an important role in
maintaining the mobility of many elderly and
disabled people, and others.
This achieved through the ongoing
monitoring of foot health, in particular of those
with circulation problems and diabetes.
Podiatrists are recognised as important
members of the health care team in preventing and
managing lower limb complications for those living
with diabetes.
A basic area of foot care undertaken by
podiatrists is the treatment of various acute and
chronic nail conditions, the treatment of which
depends on the pathology.
Podiatrists have specific instrumentation
for painless and effective treatment of these
conditions. For
example, the surgical correction of chronically
ingrown tow nails under local anaesthesia is a
common podiatric procedure. |
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Basic Foot Care
In
their undergraduate education podiatrists learn to
use a variety of modalities including physical
therapy and diagnostic modalities such as x-rays.
Some of the common conditions treated by
podiatrists, and the methods of treatment and
assessment, are outlined in the following pages.
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Treatment and prevention of
corns, calluses and warts are also common podiatric
procedures.
Systemic diseases
As systemic diseases such as
arthritis affect the joints in the foot, podiatrists
monitor feet for any degenerative changes.
The effects of these diseases and the medications
often used in their treatment can predispose sufferers
to circulatory pathology and/or peripheral neuropathies. This can result in nail an skin lesions, deformity of the
feet and the increased incidence of ulceration.
The multiplicity of possible
causes and complications demands a comprehensive method
of examination in order to establish a sound diagnosis
as a basis of treatment. The podiatrist’s role entails much more than merely
attaching a label to a condition.
It often includes the monitoring of circulation
and neurological examination, using methods such as
Doppler assessment and motor and sensory tests.
The manufacture of palliative and
functional orthoses also aids in the prevention and
treatment of pressure lesions or deformities, enabling
individuals to maintain a more normal, active lifestyle.
Children’s feet
The child’s foot is not just a
small-scale model of an adult foot.
Its shape is not finally determined until growth
ceases at the end of the second decade of life.
Podiatrists diagnose and treat children’s foot
problems by careful examination of the foot, and lower
limb, where required.
Advice for the prevention or
reduction of foot deformity which often develops later
in adult life may involve the provision of appropriate
information on footwear, treatment by splinting, advice
on exercises and/or orthotic control of the feet.
Podiatrists also treat common, chronic and acute
problems of children’s feet such as osteochondroses,
fasciitis and pes planus.
Occupational Podiatry
Some occupations are more prone
than others to foot problems which can arise as the
result of standing on hard surfaces for long periods.
Hairdressers, factory workers and nurses are
examples of those from professionals likely to develop
long-term problems unless preventative measures are
taken. Podiatrists
seek to address some of the issues responsible for foot
problems and can advise on occupational foot health and
safety. This
can sometimes involve the prescription of orthoses, or
surgical advice.
Biomechanics
| In
treating chronic foot pain, and evaluating
specific needs of patients, the podiatrist will
often assess the anatomy and function of the foot
and lower limbs during gait.
This assessment of the shape and motion of
the limb allows for an effective diagnosis of the
cause of injuries and/or the development of
deformities.
The analysis of the function
of human motion is called biomechanics.
Podiatrists perform clinical biomechanical
evaluation of the lower limb.
Specialised equipment, including mechanized
treadmills with video and computerized assessment
equipment, are often used by podiatrists to detect
pathomechanical anomalies to ensure appropriate
and effective treatment.
This treatment may include specific
exercises and the prescription of foot orthoses,
from precise measurements of an individual’s
biomechanics. |
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Sports medicine
Any
sport which involves walking, running, standing or
jumping places greater physical demands on our
body than normal day-to-day activities.
Injuries to the foot and lower limb make up
a large proportion of sporting injuries.
Podiatrists examine the foot and lower
limb, have a knowledge of the biomechanics of
athletic movement, diagnose foot conditions and
can recommend appropriate footwear, training
regimens, and, if needed, orthotic devices to fit
into the sports shoe.
Common sporting injuries include plantar
fasciitis, Achilles tendonitis, stress fractures,
ankle sprains and shin or knee pain. |
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Orthoses
Orthoses are custom-made shoe
inserts made specifically to reduce a foot pathology.
As already outlined, the prescription and
manufacture of orthoses is an important part of
podiatric practice.
The podiatrists is trained in the manufacturing
techniques for a diversity of shoe inserts.
Most inserts fall into two main categories –
functional orthoses or palliative orthoses.
| Functional
orthoses are prescribed after the biomechanical
assessment and casting of the feet. They are made by various techniques to align the structure of
the foot in its most functionally efficient
position. The orthotic, moulded from the cast, is designed to stabilize
the foot and to prevent it from moving into an
unbalanced position while walking or running. |
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Surgery
Podiatrists
are qualified to perform both nail and cutaneous
surgery, but some have undertaken further
education to perform additional foot surgery.
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These inserts involve several
steps in both the diagnostic and manufacturing phases,
and are usually made of a thermoplastic.
Palliative orthoses are designed
specifically to reduce pressure from painful or
ulcerated areas of the foot.
These are often softer and less complicated
devices made of foam or rubbers.
Palliative orthoses are often used for the
treatment of severely deformed feet with a limited range
of motion and mobility.
They are often an appropriate choice for elderly
people with significant soft-tissue atrophy and/or
circulatory disease.
How are Podiatrists educated?
As already outlined, to become a
podiatrist a practitioner must complete at Bachelor’s
Degree.
Podiatry qualifications are
specifically aimed at addressing the internal and
external medicine involved in the systemic diseases and
local pathology affecting the feet.
In Australia the profession also
has formal post graduate qualifications in area
including sports medicine and surgery.
Where do Podiatrists work?
Podiatrists work in a variety of
areas including private practice, community health
centres, hospitals, sports medicine clinics and nursing
homes. Podiatrists
also work as part of the health care team and often
consult with other health care practitioners when
managing foot or foot-related problems.
How to access a Podiatrist
It is usually not necessary to
obtain a referral to see a podiatrist.
However, for patients to receive podiatry
treatment under various programs including those run by
Veterans Affairs, Workers Compensation, or the Program
for Aids for Disabled People (PADP), a medical referral
is required.
Private health insurance funds
cover podiatry services under their ancillary tables.
Government-funded services are
available in some public hospitals, community health
centres and other publicly funded utilities.
The
Association’s office is located in Melbourne.
Please direct any queries to (03) 9286 1885, or apoda@podiatryvic.com.au.
More
details can also be found on the Australasian Podiatry
Council website: www.apodc.com.au. |
