The Stephen Kite Practice Journal

New Technology for Increased Treatment of Heel Pain and Sports Injuries

2012-01-27T18:34:00.001Z

"In the world of sports medicine an emerging concept is the use of Platelet Rich Plasma to treat chronic or acute musculoskeletal injuries by injecting one's own blood into a damaged joint, tendon, or ligament in order to speed up the body's normal healing process. I am happy to offer this new treatment for my patients, as it is an exciting new therapy for damaged joints, tendons and ligaments," said Dr. Kenneth Wilhelm .

More here

http://world.einnews.com/247pr/258933

Fish Pedicure Dangers for patients

2012-01-06T21:42:00.000Z

Can your beauty salon harm you?

a recent study claims that a simple fish pedicure that involves tiny toothless carp nibbling away at dead skin could spread deadly infection and disease. And that's just the tip of the proverbial iceberg. So, if you have intentions of stopping by the salon for a beauty treatment, read on.
http://timesofindia.indiatimes.com/life-style/beauty/Can-your-beauty-salon-harm-you/articleshow/11388075.cms

Posterior Tibial Dysfunction with leg length descrepancy

2011-11-23T20:59:00.002Z

This is a problem of the Posterior Tibial tendon. Whereby the tendon becomes overstretched by either injury or altered gait bad habits or leg length descrepency and causes the longitudinal arch to collapse and eventually the navicular bone moves out of place causing the patient a lot of heel and ankle pain.

As the foot remains severely flattened the problems of altered gait can cause many other problems such as knee, hip, back, and neck problem. Therefore it is most important to address this problem properly and quickly.

There are two options that of surgery to shorten the tendon and to realign the navicular or the other less drastic option to use prescription orthotics, prescribed by a Podiatrist. Orthotics are rather similar to a dental brace, as it had the same effect of pushing the bones back into the right position while supporting the foot and correcting alignment.

After six to nine months there should be a marked improvement, the arch should have started to build up and the navicular bone should have moved in to its proper position, and the posterior tibial tendon shortened. Thus alleviating the patient of severe pain.

As the foot has regained its arch height and where there has been a leg length discrepancy on the other foot where it has been been difference in shortness of up to 1/2 inch, the other foot under treatment has an had an increase in height.
If the patient has had leg length discrepancy before the treatment there is not much difference between to length of the two legs, due to arch collapse, but if after the foot under treatment regains its height the there is be an increase in LLD on the foot under treatment. Therefore, it is then necessary to put a heel raise into the orthotic to account for the new difference in the regained height of the treated foot .

by Steve Kite Podiatrist in Wimborne, Dorset

http://www.google.co.uk/search?q=posterior+tibial+dysfunction&hl=en&prmd=imvns&source=lnms&tbm=isch&ei=I17NTs_5H4yGhQfM6vyqDQ&sa=X&oi=mode_link&ct=mode&cd=2&ved=0CBYQ_AUoAQ&biw=537&bih=559#q=posterior+tibial+dysfunction&hl=en&sa=X&tbm=isch&prmd=imvns&bav=on.2,or.r_gc.r_pw.,cf.osb&fp=b9a3080b34287325&biw=1185&bih=603

http://scholar.google.co.uk/scholar?q=posterior+tibial+dysfunction&hl=en&as_sdt=0&as_vis=1&oi=scholart

Twitter & Facebook

2011-11-20T21:29:00.018Z

We are now using Twitter and Facebook,

Twitter

https://twitter.com/intent/follow?original_referer=http%3A%2F%2Fwww.stephenkitepractice.co.uk%2Fcontact.html&screen_name=stevekite1&source=followbutton&variant=1.1

http://www.facebook.com/profile.php?id=100003175665945&ref=tn_tnmn

World Diabetes Day Nov 14 2011

2011-11-15T00:12:00.015Z

World Diabetes Day is the leading global awareness campaign for this chronic disorder, held on 14 November each year. More than 346 million people have diabetes, and over 80% of deaths related to this disease occur in low- and middle-income countries, according to the World Health Organization (WHO).
In Europe, diabetes currently affects around 30 million people and this is only set to rise further, with 10 per cent of the continent's population expected to be suffering from the disease by 2025. Type 2 diabetes, in particular, is the fifth leading cause of death worldwide and contributes to the development of coronary heart disease, stroke, peripheral vascular disease and end-stage renal disease. Projections are grim: more than 900 million people are expected to be diagnosed with or at high risk of type 2 diabetes within the next two decades.

Are you at risk of Diabetes ?

According to Diabetes UK, most cases of diabetes are detected by accident, when the person visits their doctor with another medical condition.

But a late diagnosis of diabetes increases the risk of serious complications such as stroke, kidney failure, blindness, heart disease and amputation.

Middle aged men are twice as likely to have diabetes compared with women, but are less likely to visit their GP.

Most at risk

Being overweight or obese is a major risk factor. Around 80 per cent of people with type 2 diabetes are overweight. Other risk factors include:
•Having a large waist
•Being of Black or South Asian origin
•Having a family history of the condition
•Being over the age of 40, or over 25 if you’re Black or of South Asian descent

At risk waist measurements are 37 inches or more for men, except those of South Asian origin who are at risk at 35 inches or more, and 31.5 inches or more for all women.

Diabetes warning signs
•Increased thirst
•Having to pee all the time, especially at night
•Extreme tiredness
•Blurred vision
•Genital itching or regular episodes of thrush
•Wounds which are slow to heal

Diabetes risk assessment

As part of the NHS Health Check scheme for people aged between 40 and 74, GPs will assess whether you are at risk of developing, or may have type 2 diabetes.

Your BMI, blood pressure and family history will be taken into account. Depending on the results, they may order further tests to check your blood sugar levels.

If the assessment finds you are at an increased risk of developing diabetes, your GP will advise you on steps you should take to lower your risk of developing the disease.

References
yahoo.co.uk,(11/14/2011) healthy living,Diabetes: do you have it, but don't know it?

European Commission ( Cordis)news,(11/14/2011) World Diabetes DayWorld Diabetes Day: EU-funded researchers work to meet global challenge

Fish Pedicures in the news again

2011-10-18T22:03:00.001+01:00

The dangers of fish pedicures are back in the news again today.

Trendy fish pedicures could spread HIV and hepatitis C,” The Sun has today reported. Its front-page story said that officials have raised an “alert” over the treatment, popular in beauty spas, where tiny fish are used to nibble away areas of hard foot skin.

While The Sun has been carping on about warnings and alerts, the newspaper seems to have overestimated the scale of the risk, which health experts have described as being “extremely low”. Rather than being an alert, the news is based on a report by the Health Protection Agency that has set out good practice for so-called ‘fish spas’ that offer the service.

While the report did acknowledge that the risk of infections could not be completely ruled out, it is important to view this in context and not be reeled in by fishy headlines.

The Health Protection Agency report examined a number of issues relating to fish pedicures, including:

•potential ways infections might occur
•the risk of catching blood-borne viruses, including HIV and hepatitis
•the risk of bacterial infections
•the risk of catching parasites, such as fluke worms
•the risk of transmitting conditions, such as athlete’s foot and verrucas
•procedures that might reduce any health risks
The report is based on consultations with experts and professional bodies within the fields of public health, aquaculture, health and safety, and animal welfare.

What did the report find?
The report considered three main ways that a person might catch an infection:

•from a fish or a fish tank
•from tank water
•from another person via surfaces, such as floors
Within these areas they considered the different types of infections that might occur.

Blood-borne viruses

Viruses such as HIV and hepatitis are carried in the blood and, in theory, could be transmitted through tank water if someone with a cut or abrasion were to use a tank containing traces of blood from an infected person with cuts.

However, there is only anecdotal evidence that Garra rufa fish can draw blood, and the HPA says that any blood-borne viruses they come into contact with are unlikely to stay on the surface of their mouths and lead to infection. Any blood entering the tank is likely to be diluted by the volume of water used.

While transmission through this method cannot be completely ruled out, the HPA says the risk of catching a blood-borne virus in this way is extremely low. Further to this, the HPA is recommending that the fish spas check clients for cuts and abrasions both before and after their session.

Parasites

Fish-borne parasites, such as tapeworms and flukes that can be caught by humans if they eat undercooked fish. However, the HPA says that there is no evidence that these can be caught from a fish pedicure as this would require ingestion of the fish or the water.

Bacterial infections

The report looked at a number of specific harmful bacteria, including those that cause salmonella and legionnaires’ disease. Generally, these were deemed to be of low risk as they would not be ingested or would need broken skin to cause infection.

However, certain bacteria were identified as posing a greater risk of infection. For example, Staphylococcus aureus might infect people’s skin if they had eczema or psoriasis. Also, a type of bacteria called Mycobacterium marinum, which is associated with fish tanks and non-chlorinated swimming pools, could cause boils if transferred into broken skin.

Fungal infections such as verrucas and athlete’s foot

Fungi are known to survive on inanimate surfaces for prolonged periods and could, therefore, be passed on by infected clients walking around barefoot. However, the HPA points out that this route of transmission is not unique to fish spas.

So are fish pedicures safe?
The Health Protection Agency says that “on the basis of the evidence identified and the consensus view of experts, the risk of infection as a result of a fish pedicure is likely to be very low”. The agency does outline some groups who are not recommended to have fish pedicures due to increased risk of infection, such as people with diabetes or compromised immune systems.

The HPA also specifically addresses the possibility of transmitting blood-borne viruses such as HIV and hepatitis. The agency says that, in theory, transmission could occur if infected blood from one person got into an open wound on another person using the same tank, although, once again, the risk is “extremely low”. In part, the risk would be minimised due to factors such as the diluting action of the water and the fact that infected blood would be unlikely to stay on the fishes’ mouths.

However, the agency does say that the risk of infections cannot be completely excluded and, in order to reduce this risk even further, they have drawn up a list of recommendations for fish spas.

What recommendations does the HPA make?
The HPA has made extensive recommendations on how fish spas can further reduce the risk of infections. Below are some of the major ones.

Groups not recommended to have a fish pedicure

The agency also says fish pedicures are not recommended for people that may increase the risk of infection or pose an infection risk to other clients. This includes people who:

•have had their legs waxed or shaved in the previous 24 hours (they may have tiny cuts that increase infection risk)
•have any open cuts, wounds, abrasions or broken skin on the feet or lower legs
•have an infection on the feet (including athlete’s foot or a verruca)
•have psoriasis, eczema or dermatitis affecting the feet or lower legs
•are diabetic (which leads to increased risk of infection)
•have a blood-borne virus such as hepatitis B, hepatitis C or HIV
•have an immune deficiency due to illness or medication
•have bleeding disorders or take anticoagulant medication (for example, heparin or warfarin)
Safety procedures for fish spas

The HPA recommends that:

•Clients should be provided with medical information on any potential risk, including specific guidance on conditions that raise infection risk.
•Clients should have their feet examined both before and after treatment to make sure they are free from cuts and infections. Staff should log that these checks have been performed.
•Feet should be thoroughly washed and rinsed before a pedicure to minimise the number of micro-organisms transferred into the tank.
•If there is evidence that bleeding has occurred during a session the tank should be drained and cleaned thoroughly. The HPA has drawn up thorough guidelines on how to disinfect tanks in a fish-friendly way. After 48 hours in a holding tank the fish can be reused.
•Clients should be told to seek advice from their GP if they experience any adverse effects.

References
http://www.nhs.uk/news/2011/10October/Pages/hpa-risk-fish-pedicures.aspx

Podiatry expert

2011-07-23T22:31:00.010+01:00

The Forensic Analysis of Footwear Impression Evidence

Introduction

Many Police Forces worldwide are starting to use the services of Podiatrists to solve crimes involving Footprint Evidence or commonly known as Footware Impression Evidence. This is a complex science that can show detailed foot abnormalities from the tread pattern and pressure points to detailed abnormalities of gait patterns can be identified. The shoe imprint of the suspect can then be compared to the evidence of the print at the crime scene. The article below has more information on the subject.

The basis for footwear impression evidence is determining the source of a footwear impression recovered from a crime scene. The process of examining footwear impression evidence takes into account class and identifying characteristics. Class characteristics are those characteristics that result from the manufacturing process, such as physical size, design, and mold characteristics. In contrast, identifying characteristics do not result from the manufacturing process, but are accidental, unpredictable characteristics that result from wear. Identifying characteristics include objects that have become attached to the outsole—such as rocks, thumb tacks, or tape—or marks on the outsole caused by cuts, nicks, gouges, and scratches.
More on this article here.

http://www2.fbi.gov/hq/lab/fsc/backissu/july2009/review/2009_07_review02.htm

Tuberculosis of the foot

2011-07-12T14:28:00.000+01:00

I have recently been asked to comment of a case of Tuberculosis of the foot.
I had never come across this condition before. However, after researching the subject discovered some interesting facts. This condition is very rare and can be missed by health professionals, subsequently they can be held accountable for the outcome. Isolated involvement of bone in tuberculous infection is uncommon, and the variable clinical and radiological features may mimic pyogenic osteomyelitis, bone tumor or other inflammatory and neoplastic processes of the synovium. We have reported our experiences with the diagnosis of tuberculosis infection in the ankle and foot with the hope of providing sufficient information about these cases to lead to early diagnosis.
Tuberculosis of the foot and ankle is an uncommon presentation of skeletal tuberculosis. The uncommon site, lack of awareness, and ability to mimic other disorders clinically and on radiographs, leads to diagnostic and therapeutic delays. In the early stages and when the disease is limited to bone, medical treatment leads to excellent healing and limited residual disabilities. Joint involvement occurs because of spread from a periarticular bony focus, and in the midfoot, the disease may spread to involve all the interconnected joints, leading to a stiff foot and residual deformities. Of 74 cases reviewed, the calcaneus was involved most commonly, followed by infection of the midtarsal, Lisfranc joints, and ankle. The most common radiologic finding is that of osteoporosis, which may be intense: cancellous bone involvement may present as a cystic lesion with or without sequestrum. Computed tomography scans and magnetic resonance imaging are helpful examinations. Because the disease is paucibacillary, a positive acid fast bacilli culture is rare and the diagnosis usually is confirmed by obtaining granulomatous tissue on biopsy. The treatment basically is medical, with surgical intervention being reserved for patients with intractable disease or as a salvage procedure for patients with deformed hindfoot joints.

Footprints can play an important role in solving crimes

2011-06-20T20:52:00.005+01:00

Footprints are fairly common at crime scenes

Footwear marks are found at around 40% of crime scenes. In the United Kingdom, there has been a National Footwear Intelligence and Refererence Database established. They report that , Nike shoes are found most often at crimescenes there, with 60% of the shoeprints coming from this manufacturer. The most commonly encountered shoe was the Nike the Air Max 95. The bloody shoe prints at the crime scene of Nicol Simpson and Ron Goldman matched a size 12 Bruno Magli shoe, a relatively rare Italian-made model. O.J.Simpson wears size 12 shoes, which isn't that common a size. The prosecution linked O.J. Simpson to purchases of this type of shoe in order to link him to the murder scene.

More here :

http://www.science.marshall.edu/murraye/Footprint%20Lab.html

UK Forensic Science Service Footware evidence
http://www.forensic.gov.uk/html/services/expert-solutions/footwear/

http://www.usatoday.com/news/index/nns25.htm

http://law2.umkc.edu/faculty/projects/ftrials/simpson/evidence.html

http://www.wagnerandson.com/oj/heel.htm
http://www.wagnerandson.com/oj/fprint.htm
http://www.wagnerandson.com/oj/feet.htm

Neways Healthcare

2011-06-12T08:40:00.095+01:00

Wellness, Nutrition, Health Watch our Video here now !
http://www.newaystv.com/europe/

Neways who are a superb company offering an exellent choice of natural ingredients for everyday living.
There are many chemical substances contained within the food we eat, what we put on our skin, and contained in the enviroment that can have a detrimental effect on health and wellbeing.

These days food that is grown can be contaminated by all sorts of harmful substances and chemicals. Moreover, soil has become less fertile over hundreds of years of over use and over farming, producing less of the vital eliments and nutrients that were present in food years ago. The food that our grand parents ate had more vitamins retained in their food than their children.

About Neways

Neways produces safe and effective nutritional, personal care, and household products that are free of more than 3,000 questionable ingredients. Several hundred thousand Neways distributors share the products in 28 countries, with nearly half of the company’s annual revenues paid back to distributors as commissions.

In addition to providing exclusive products, Neways enhances people’s lives with a home-based business opportunity. Share the products in 28 countries, with nearly half of the company’s annual revenues paid back to distributors as commissions. The company pays back 50 % commission to their distributors.

Neways healthcare have identified mainstream products have contained the same potentially harmful ingredients as found in chemical formulations. In response, Neways have began manufacturing safety-conscious alternatives.
Here is a link to the Neways website offering products.
If you would like to buy any products or if you want to get involved further as a career with the Neways company via us please quote :-

Your Sponsors name is Mr Stephen Kite as recommended by us, and the ID number EU1014369 .
Then you are on your way to buying healthy products or becoming self employed and starting a successful business when you sign up on the links below.

When you have finished watching the presentation on the link below type into the search bar Nutrition have a look around or type in another product search of your choice i.e Skin, Make up, for example.

Then if you would like to go ahead and make an order or become a Neways distributor and get your own products at a greatly reduced cost fill out the order form . You must fill in the form the name of the sponsor as Mr Stephen Kite and our distributor number EU1014369 then you are on your way. If you have any questions please feel free to contact us on 0800 756 9812.

https://www.neways.com/gb-en-gb/Content1.aspx?PageId=109

https://www.neways.com/gb-en-gb/Login.aspx

Our Neways Now website will give you all the information you need in video format
http://skite.newaynow.com/

Fish Pedicure dangers

2011-05-26T23:03:00.005+01:00

Recently there has been a lot of publicity concerning so called Garra rufa, also known as “reddish log suckers,” who are native to Iran, Iraq, Syria and Turkey. There have been concerns in some parts of the USA concerning the use of the same fish to clean the skin of multiple patients may infact transmit infections and have banned the practice.

Arielle Fridson writes in the Bloomberg Business Week article July 30, 2010 the following statement :-

Using live fish to eat away dead skin in pedicures would be banned in New York State for health and humane reasons under a proposed bill.

The procedure, which developed in Turkey as a way to treat skin ailments including psoriasis, involves feet being dunked in a tank of water filled with one of two types of small, dark fish. The hungry creatures nibble off the dead skin while leaving healthy epidermis alone.

Fish pedicures are illegal in at least 14 states, according to state Senator Jeff Klein of the Bronx and Westchester, who proposed the bill. The bans cite the concern that health conditions led by fungal infections may be transmitted by unsanitized fish in dirty water. Animal-rights groups are pushing for outlawing the procedure because it is inhumane to the fish.

“I do not recommend it to anyone who has any diabetes or any immuno-compromised condition such as AIDS or cancer, because of the risk of infection,” said Robin Ross, president of the New York State Podiatric Medical Association, in a telephone interview yesterday. “The fish are defecating and urinating in that water and you’re sticking your feet in it.”

New York’s Department of State isn’t aware that any of 26,345 licensed nail salons within the state offer the practice, said spokesman Joel Barkin in an e-mail. The practice is being done in the backrooms of New York City, Klein said when he first proposed the ban in October.

The bill has yet to be voted on, according to Gwen Rocco, a spokeswoman for the senator.

Chin Chin

While Garra rufa fish, also called doctor fish, were first used in the procedure, another type called chin chin have grown in popularity because they are less expensive.

John Ho, who claimed to be the first to bring the pedicures to the U.S., said there has never been a health incident with any of his customers. He runs three salons that offer the service in the Virginia cities of Alexandria, Woodbridge, and Crystal City.

“States ban fish pedicures because they don’t have much information,” Ho said in a telephone interview. His salons offer 15 minutes of immersion in the fish tank, in addition to a traditional pedicure, for $45. He said his lawyers are drawing up documents to franchise the business by the end of the year.

Pedicure and manicure customers, who are 96 percent female, spent $6.16 billion on nail services in 2007, according to Nails Magazine research.

People for the Ethical Treatment of Animals is pushing for the end of the procedure because it is cruel, said Kristin Dejournet, a Memphis-based worker for the Norfolk, Virginia- based animal-rights group. The animals can feel fear and pain, she said.

“Fish are still very misunderstood,” said Dejournet. “Changing the water would need to be done quickly in the interest of the customers, but in the interest of the fish, there’s just no way to do it without the fish thinking, Oh my God, what’s happening? Is my pond drying up?” she said. “It’s not natural.”

I have to agree with Arielle Fridson on this. The infection risk of patients having to put their feet into dirty water, repeatedly, even if after draining the water , the remains of dead skin that the fish have nibbled away could get caught in the filters , and contaminate the inside of the fish tank.
Is it the case that after every patient the pedicurist or practioner of this method of debriding callus is going to clean out the fish tank filters, inside the fish tank surrounds, and change the water after every patient? More importantly the risk to diabetic patients would be increased given the above. The BBC article link here http://www.bbc.co.uk/news/health-12595809

However, the risk maybe high and is a question of time surely that if measures are not taken to address this practise.

Secrets of Usain Bolt's success

2009-08-18T09:52:00.010+01:00

After Usain's tremendous success and world record at the 100 meters in Berlin, Germany the BBC tries to evaluate exactly how he does it?

http://news.bbc.co.uk/sport1/hi/athletics/8205753.stm

http://news.bbc.co.uk/1/hi/sci/tech/8206760.stm

What Causes exessive ankle motion at Sub Talar Neutral Positioning

2009-01-25T14:27:00.004Z

Upon treating many patients who display excessive pronation and Supination of the Ankle Joint, the question has been put to me why does the ankle have excess movement?
If you can imagine that the foot is like a lever and it is held together by many ligaments, tendons, and bones , that are tightly packed together until the toe off.
The tendons and ligaments play an important role in the gait cycle phase and help postion the foot into the ideal plane for proper walking.
However such problems as transverse, and sagital plane motion problems, deformities of the front of the foot, and Peroneal Tendon Abnormalitiies, together with the Kinetic Chain and the can all play a part in the ankle joint becoming unstable,Injuries and the tearing can occur.

Diabetic Blisters

2008-11-29T16:33:00.000Z

Blisters can be potentially very dangerous in patients who suffer with Diabetes. Normally treatment in a healthy patient would be to lance the blister and leave the flap of skin attached to offer protection to the soft tissue underneath also to apply Tinc Benzoin or other healing agents to speedily heel up the site together with a sterile dressing and follow up appointments. As a preventative measure avoid pressure blister points the use of orthotics/ Padding to help the patient of load pressure that may be causing the problem in the first place.

The problem with Diabetics is this. There is a danger that the blister when lanced in the normal way there may be a high risk of infection of the soft tissue under the blister site, that could ultimately worsen to an ulcer or in the worst case senario develope into gangrene.

Therefore it is with this in mind treating Diabetics with blisters then is most important to treat with care and not to lance the blister, but apply a sterile dressing with the approiate antibiotic and let the blister heal naturally. If there is evidence that the blister has been caused by pressure or shearing forces of the abnormal position of the toes it is adviseable however to apply proper padding to ofload such forces to the area.
Regular visits to the patients must be made to check the area is healing and that there is no danger of infection.

The blister is filled with a sac of fluid which if left contains anti - bacterial properties and this should prevent infection from occurring. Together with the ofloading at the pressure site this should be sufficient to prevent the blister from bursting the fluid and the blister should disperse into the blood stream and be taken back into the tissue.
Copyright 2008 Stephen J Kite Bsc Podiatric Medicine

Stephen Kite Practice Wimborne

2008-09-06T18:09:00.002+01:00

Stephen Kite Practice BSc

Wimborne

2008-09-05T23:27:00.026+01:00

Wimborne, Dorset and Images of Dorset – 1200+ photographs illustrating the landscape and rich visual diversity to be found across the county of Dorset, England. Covering every month of the year the pictures provide a pictorial guide to the county through all the seasons.
Images of Dorset website provide a great resource of information about the county.
We have the pleasure of visiting our patients in their homes all over the County and are overwelmed with the beautiful surroundings of the Dorset countryside. One of the advantages of having a Visiting Practice in this area. We cover Wiltshire , Dorset, Hampshire but like Dorset best!

Contact the Secretary on 01202 881088 or Freephone (0800)7569812

We also have a full range of footcare products much cheaper than buying in your local chemist / Stores etc... and can supply all your footcare product supplies to your door. You can order through our website contact page and clicking your orders to enquiries@stephenkitepractice.co.uk Click on the link Stephen Kite Practice BSc

The Stephen Kite Practice now have several opportunities and are looking for experienced Podiatrists to help with the ever increasing patient workloads.
If interested we can offer an excellent package and renummeration.
Please fax your CV to 44 1202 830406

Keeping an eye on ugly wounds

2008-08-31T17:06:00.004+01:00

SOMETIMES IT'S the little things that get you. Like a wound that doesn't heal up properly, which can lead to months of misery, and possibly even amputation of a limb. But often such dire outcomes could be avoided if wounds were better managed from the outset, according to experts.

http://www.irishtimes.com/newspaper/health/2008/0812/1218232759242.html

Sour grapes of the Aussies

2008-08-20T14:54:00.020+01:00

3rd in the medal table in the Olympics in Beijing only behind some powerful sporting countries like China and USA has certainly ruffled a few feathers with the Aussies. They sure seem envious of our great little countries success! As usual...
Anyway less of that as it isn't very sporting is it. lets not lower ouselves any further. Congratulations to all those Brits that won medals, especially the Golds! How many now is it 17 and more to come. lets make the London Olympics in 2012 the best ever results for us British and Team GB.
Take a look at this and have a laugh!

http://news.bbc.co.uk/1/hi/uk/7571901.stm

Podiatry Update Team G.B British Sport just keeps getting better.
The Paralympics in Beijing 2008 are proving just as good as their counterparts in the Olympics.
2nd in the medals table behind the mighty Chinese Nation, not bad for a small country with a big history!

New Technology Predicts Healing Potential of Diabetic Ulcers

2008-07-23T02:33:00.000+01:00

Bethesda, MD – Every 30 seconds, a lower-limb amputation is performed somewhere across the globe due to complications related to diabetes. But soon, just 15 seconds in a physician’s office may be all it takes to help prevent a devastating diabetic amputation.

New research technology, named Hyperspectral Transcutaneous Oxygen Monitoring (HTcOM), effectively measures real-time oxygen levels surrounding the foot ulcerations commonly seen in patients with type 1 and 2 diabetes. The measurements taken with HTcOM are calculated in approximately 15 seconds, and can then be used to determine the most successful treatment plan for that particular wound. Two poster abstracts summarizing results from the study will be presented at the American Podiatric Medical Association’s (APMA) 96th Annual Scientific Meeting in Honolulu, HI from July 24-27.

More here: http://www.takeforum.com/forum/viewtopic.php?t=520&mforum=pod1

How were wrecking our feet!

2008-04-29T13:15:00.004+01:00

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2008/04/01/nshoe101.xml

It took 4 million years of evolution to perfect the human foot. But we’re wrecking it with every step we take.Stiletto heels to cowboy boots.

The Emergence of Forefoot Pathology in Modern Humans?” in the podiatry journal The Foot. The study examined 180 modern humans from three different population groups (Sotho, Zulu, and European), comparing their feet to one another’s, as well as to the feet of 2,000-year-old skeletons. The researchers concluded that, prior to the invention of shoes, people had healthier feet.
More here: http://nymag.com/health/features/46213/index1.html

The world at your feet

2008-02-10T10:48:00.000Z

http://www.takeforum.com/pod1/viewtopic.php?p=591&mforum=pod1#591

Helping Patients Walk Again

2008-01-14T20:54:00.001Z

Physical Therapists are helping people with central nervous system disorders learn to walk again. A wireless computer-enabled device aids those suffering from a condition called foot drop, which happens when someone cannot raise the front part of the foot to accommodate a smooth gait. When an individual swings his or her legs forward, a sensor in the shoe signals a microprocessor, which sends an electrical pulse to the nerve that controls the foot, lifting it, and allowing the patient to walk smoothly.

More here:

http://www.sciencedaily.com/videos/2007/1010-helping_patients_walk_again.htm

Ingrowing nails

2007-11-27T14:00:00.001Z

An increasing number of patients are coming to me with ingrowing toe nails, most commonly of the great toe. It is usually the case that if you suspect you have an ingrown nail get it treated sooner rather than later.

What is it?
It is usually a curving inwards of a spike of the nail that grows inwards towards the side of the nail plate and can become very painful if not treated.

Causes
Heat of the foot bending the nail, hereditory factors, injury, altered walking patterns putting more pressure onto one part of the foot, fashionable shoes,
tight socks even.

What are the complications?
Complications that can occur are septic inflammation. This makes treating the ingrowing nail more difficult as control of the infection is of most importance in order therefore to make the taking out the offending spike of nail that has penetrated the skin.

If you suspect you have an ingrown nail it is most important that you seek medical advice be it either your G.P or your Podiatrist ( new name for Chiropodist ).
Please do not try to take out the ingrowing nail yourself, this may cause more damage.

Your Podiatrist can tell you what is the likely cause of the ingrowing nail and the correct course of action you need to follow.

Nail Surgery can usually be avoided , and that is only as a last resort the nail is recommended for removal.

Prevention of ingrown nails.
Check you feet regulary, seek attention immediately if you suspect ingrowing nail (before sepsis develops) ideally, if you have a foot slightly bigger in size than the other always make sure you take the bigger foot into consideration when buying shoes,when cutting the nails do not be tempted to cut a v into the nail to relieve the ingrowing nail, this doesn't usually work.

Footnote: We are able to give free footcare advise for patients who are worried about their feet, our phone lines are always open should you require advise.

We cover Salisbury, Downton, Ringwood, Ferndown,Verwood, Merley, Wimborne, Poole, Bournemouth areas, more information can be found on our website www.stephenkitepractice.co.uk

Hope this helps more information on ingrowing nails can be found here:

http://orthoinfo.aaos.org/topic.cfm?topic=A00154

Stephen J Kite

Podiatry Expert Witness

2007-10-24T23:19:00.002+01:00

Podiatry expert witness, what is it? It is a Podiatrist that gives legal testimony before a court.Usually expert are called upon by lawyers and are able also to provide them with a medico Lego report to help resolve matters in professional matters.

However this kind of work that Podiatrists are called to undertake is usually very demanding and has to be tried and tested over many years, so any report writing must be able to stand the test of time.

There are specialized organizations that are able to assist lawyers when choosing a Podiatrist expert witness, one of the leading firms that specialize in this work are known as the Round Table http://www.roundtablegroup.com/about/areasofexpertise/

We at The Stephen Kite Practice UK are pleased to be a part of their portfolio of Podiatry experts.

Other well established expert witness firms include Society of expert witnesses,also the society of chiropodists and podiatrists have a list of experts.
The Academy of Experts are also a good place to find a Podiatrist expert Witness.

This kind of work that podiatrists can undertake though can be rigorous and can involve having to present your finding in a court of law and having to be cross examined with questions from top barristers, so it isn't for the faint hearted .
There are courses however that can train the podiatrists in court room techniques and if you are planning to take up such work it would be well advised to go on one of these courses.

Stephen J Kite Podiatrist expert witness http://www.hgexperts.com/hg/ex_consultants.asp?action=page2&pcomp=45586

Robb's Lucky Break At Last

2007-10-20T21:41:00.000+01:00

Clydesdale Bank Premier League Spl Latest...

STEVEN ROBB can hardly believe that breaking his ankle at the age of 11 has cause him to endure three years of injury heartache as an adult.

But now the winger has finally solved his fitness woes he's eager to help Dundee United keep flying high in the SPL.

The 25-year-old has spent more time on the treatment table than he has on the pitch in recent times after being misdiagnosed with hamstring problems.

More here:

http://www.dailyrecord.co.uk/sport/football-news/2007/10/20/robb-s-lucky-break-at-last-86908-19981207/

BBC SPORT | Rugby Union | Rugby World Cup photos

2007-10-14T07:10:00.000+01:00

BBC SPORT | Rugby Union | Rugby World Cup photos

Australia down and out!

2007-10-06T15:42:00.000+01:00

England won again! Score 12 -10 Well done lads you didn't play your best though, Johnny Wilkinson missed quite a few penalties the score could have been better. He did however become the leading scorer in Rugby World Cup history, and with Andrew Sheridan it had Australia's front row on the back foot for the whole match.

I must also add that the wollabies did look a bit wobbly on their feet from the start.

Perhaps a few nerves of the thought of facing the might of the English team I suspect in France.

France will be playing New Zealand tonight.
Bring on the next Victims!!

Pictures here:http://news.bbc.co.uk/sport

http://www.rugbyworldcup.com/

Killer Crocs Stalk Hospital

2007-09-05T22:05:00.000+01:00

Beware Crocs can kill

More take a look at Podiatry 7 News http://www.takeforum.com/forum/viewtopic.php?t=463&mforum=pod1

Reliability of First Ray Position and Mobility

2007-08-23T18:32:00.000+01:00

Reliability of First Ray Position and Mobility Measurements in Experienced and Inexperienced ExaminersCrystal Shirk,* Michelle A Sandrey,† and Mia Erickson†
*Summersville Memorial Hospital, Summersville, WV;
†West Virginia University, Morgantown, WV

Abstract :
Context: Neither reliability nor validity data exist for the Root method of clinically assessing first ray position or mobility by experienced and inexperienced examiners.
Objective: To determine intrarater and interrater reliability for first ray position and mobility measurements in experienced and inexperienced examiners.

Design: Single-blind prospective reliability study.

Setting: Physical therapy clinic.

Patients or Other Participants: Four examiners, 2 experienced and 2 inexperienced, obtained first ray position and mobility measurements. Both feet of 36 subjects (14 males, 22 females) were measured.

Intervention(s): Each examiner evaluated first ray position and mobility for each of the subjects' feet on 2 separate occasions using the manual assessment techniques described by Root.

Main Outcome Measure(s): First ray position (normal, plantar flexed, dorsiflexed) and mobility (normal, hypermobile, hypomobile) decisions were made.

Results: We calculated kappa correlation coefficients for intrarater and interrater reliability. For position, intrarater and interrater reliability ranged from .03 to .27 for all examiners, experienced and inexperienced. For mobility, intrarater and interrater reliability ranged from .02 to .26 for experienced, inexperienced, and experienced/inexperienced. The percentage agreement (PO) values for all examiners were less than 58%. For individual values for position, intrarater and interrater reliability ranged from .00 to .26. For individual values for mobility, intrarater and interrater reliability ranged from .00 to .26. The PO values for all examiners were less than 50%.

Conclusions: Clinical experience was not associated with higher kappa coefficients or PO values when examiners assessed first ray position or mobility. Clinicians should acknowledge the poor reliability of first ray measurements, especially when making treatment decisions. Finally, a validity study to compare the Root techniques with a gold standard is warranted.

Refernce Source: Journal of Athletic Training 2006
Full article here: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1421489

Feet For Purpose

2007-08-21T15:01:00.001+01:00

ELDERLY people in the UK are being left housebound and disabled by a lack of footcare services, according to a national charity Age Concern.

It has recently published a report called Feet for Purpose, revealing that although one in three people over 65 are unable to cut their toe nails, basic podiatry services are being withdrawn by the NHS.

A lack of even the most simple footcare can lead to complications, resulting in falls, restrictions on mobility and social isolation.

http://www.ageconcern.org.uk/AgeConcern/Documents/feet.pdf

By Steve Kite

Can vitamins replace diabetic drugs?

2007-08-11T09:06:00.000+01:00

GRAND RAPIDS -- The pain in Rosemary Sousley's feet had gotten so bad she could barely walk into the next room.

Knowing it was caused by her diabetes and perhaps the chemotherapy she underwent for breast cancer a few years ago didn't help. Neither did the eight Tylenol she was taking every day.

So when her podiatrist, Dr. Michael David, invited her to join a study to determine if a formula of vitamins and minerals could reduce diabetes-related pain, the 68-year-old Middleville woman agreed.

Within two weeks, the pain in her feet had subsided enough she began cutting back on the Tylenol. Within a month, she was down to one Tylenol a day, and "now I'm at the point of taking two or three a week."

The pain is virtually gone, Sousley said. "It's a warm awareness," she said, "but it's not painful."

The group of Grand Rapids doctors who conceived and oversaw the study said the other participants had similar improvement in a nerve disorder common among diabetics called peripheral neuropathy, the death of nerves in the feet and hands, characterized by a burning pain and numbness.

At the beginning of the study last February, the 30 patients were asked to rate their pain on a scale of one to 10. After four weeks, on average, they reported a 30 percent reduction in pain.

After eight weeks, they said their pain was cut in half. After 12 weeks, their pain showed a 63 percent improvement.

"It was amazing," said Dr. Mark Gostine, a Grand Rapids pain specialist. "Some people got rid of their pain completely."

The idea for the study grew out of a dinner conversation between Gostine and Dr. Larry Pawl, a Grand Rapids cancer specialist. Many of his patients on chemotherapy suffer neuropathy as a side effect of their treatments, Pawl said. He knew Gostine was a big believer in natural supplements, so he asked him if vitamins or other natural substances might help.
"It was more of an off-hand remark by Larry, which turned into a challenge for me," Gostine recalled. "I'm a big believer in nutrition. I always tell people, 'It's not what you eat; it's what you don't eat that's hurting you.' "

Gostine began on a year-long search through thousands of medical articles, looking for which micronutrients might work.

He and Pawl narrowed them to five (N-acetyl-cysteine, alpha-lipoic-acid, L-carnitine, vitamin C and selenium) and contracted with a pharmaceutical company to manufacture pills with that formula.

Pawl offered the supplements to his cancer patients and noticed it seemed especially helpful for those who also were diabetic.

Thus, they undertook the six-month study, hired a researcher and recruited patients through Foot & Ankle Specialists of West Michigan. They published their findings in the this month's issue of the Journal of Practical Pain Management.

Not only did the supplements help reduce pain, but also the numbness, which can lead to injuries and infections for diabetics.

Gostine conceded the study did not use a control group of patients receiving a placebo for comparison, but said he is convinced supplements work for most patients.

The apparent success of the Grand Rapids study attracted the attention of Celgene Corp., a multi-national pharmaceutical company, and Cleveland Clinic is considering a more-scientific study to see if the supplements can help reduce neuropathy for cancer patients.
Reference Source: Sunday, August 05, 2007
By Pat Shellenbarger
The Grand Rapids Press
Related reading on Diabetes go to http://www.takeforum.com/pod1/viewtopic.php?t=450&mforum=pod1

Cairo toe earliest fake body bit

2007-07-28T16:36:00.001+01:00

An artificial big toe found on the foot of an ancient Egyptian mummy could be the world's earliest functional fake body part, UK experts believe.
A Manchester University team hope to prove that the leather and wood "Cairo toe" not only looked the part but also helped its owner walk.

They will test a replica in volunteers whose right big toe is missing.

If true, the toe will predate the currently considered earliest practical prosthesis - a fake leg from 300BC.
The Roman Capua Leg, made of bronze, was held at the Royal College of Surgeons in London but was destroyed by Luftwaffe bombs during the Second World War.

Lead researcher Jacky Finch said: "The toe dates from between 1069 and 664BC, so if we can prove it was functional then we will have pushed back prosthetic medicine by as much as 700 years."

Colleagues at the University of Salford will also be testing a second, even older ancient Egyptian big toe which is currently on display at the British Museum.

This artefact, from between 1295 and 664BC, is made from cartonnage, a kind of papier-mâché made from linen, glue and plaster.

The British Museum toe may have been cosmetic

Like the Cairo toe, this too shows signs of wear, suggesting that it was worn by its owner in life and not simply attached to the foot during mummification for religious or ritualistic reasons.

However, unlike the Cairo toe, it does not bend, suggesting it may have been more cosmetic.

Jacky Finch said: "The Cairo toe is the most likely of the two to be functional as it is articulated and shows signs of wear.

"It is still attached to the foot of the mummy of a female between 50 and 60 years of age. The amputation site is also well healed."

The Cairo toe is on display at the Cairo Museum in Egypt.

Refernce Source: BBC News health 27/07/07

A question of Professional Fees

2007-07-01T16:29:00.001+01:00

Our headquarters are moving to a new area, although this won't affect our practice areas of service to all our old patients , and new ones etc...
I was just checking out the " competition " ! and came across an advert place in the local rag for Chiropody " female operator " charges £18.00.

I wondered how on earth such practitioners can charge such low prices considering all the new legislation one has to abide by nowadays. Continued training ,sterilzation,waste disposale,professional memberships, insurance.
I was recently reading an article on feet for life website whereby it was worked out after deductions and expenses a Chiropodist who charges £25.00 per patient actually end up with £7.50 profit!

Private fees can vary according to location and the practitioner's experience - £25 to £40 a session is the norm', but fees below £20.00 must be treated with caution. Thought of the day. "You get what you pay for".
and if it sounds too good to be true it usually is !

Forensic Podiatry

2007-06-16T16:26:00.000+01:00

Last weekend I attended a conference on Forensic podiatry with some eminent speakers on the subject. Professor Wesley Vernon who is widely regarded as the leading expert in the subject who specializes in Footware / insoles and Footprint collections and his colleagues Haydn Kelly specializing in cctc and Forensic gait analysis an and Owen Facey Shoe identification and footprint capture along with some other non podiatry experts who are leading experts in Forensic Medicine. Haydn Kelly On 12th July 2000 made legal history at the Old Bailey Law Courts, London. It was the first occasion that Biomechanics and Gait Analysis were admissable as evidence in criminal law.

According to the event organizers it was the first of its kind in the UK and to the present day the biggest conference of its kind in the world. There were about 60 delegates in total. Not all were Podiatrists some were Forensic experts wanting to familiarize themselves in this up and coming new science.

The conference was spread over 2 full days at Regents College in London, and PEM professional events management were the organizers of the event.

I can not speak more highly of the speakers, especially Professor Wesley Vernon, whose knowledge and expertise was first class. I found his way of teaching effortless, he had an excellent way of making the delegates feel right at ease and was very clear in his presentation and explanations.

It is often said in Podiatry Circles that "those who can't.... teach". Well, after listening to Wesley Vernon also his excellent colleagues I think in this case it definately does not apply!

Well done to all for this most excellent presentation.

Congradulations to all involved.

The Zimmers

2007-05-28T22:10:00.000+01:00

Watch the video here the single is out now !
http://www.youtube.com/watch?v=zqfFrCUrEbY&eurl=http%3A%2F%2Fwww%2Egoogle%2Ecom%2Fsearch%3Fsourceid%3Dnavclient%2Dff%26ie%3DUTF%2D8%26rlz%3D1B2GGFB%5FenGB210GB210%26q%3Dmy%2Bgeneration

To download the song and interviews with the stars
http://www.myspace.com/thezimmersband

Geriatric 1927 himself talking about the event.
http://www.youtube.com/watch?v=ztclyGYYwHU&mode=related&search=

Self-heal bandage helps diabetics

2007-05-28T18:10:00.000+01:00

Self-healing bandages, which use patients' own cells, could help treat diabetic ulcers, their makers say.

The bandage is being developed by CellTran, a company linked to the University of Sheffield.

Currently, diabetics have to attend clinics over months or even years to have their wounds dressed.

Trials of the bandage have shown it can help these difficult-to-treat wounds to heal in an average of eight weeks. It is already used to treat burns victims.

Foot ulceration ... is the most common reason for people with diabetes to be admitted to hospital in the UK
Natasha Ede, Diabetes UK
The bandage is created by taking a small tissue sample is taken from a patient and growing a culture from the cells in a laboratory.

The cells are then placed on a membrane made from a medical-grade polymer. The membrane is then treated with a special cell-friendly coating, enabling skin cells to attach and grow on this surface.

When cells are ready, the cell-membrane bandage is used to dress the patient's wound instead of a standard bandage.

Because the cells belong to the patient, they are not rejected by the body but can actually transfer to the wound and grow.

For particularly difficult wounds, the cells are applied every week.

'Serious complication'

Clinical trials of the bandage are now underway, and the technique is also being used on other types of ulcer.

The research has been funded by the Engineering and Physical Sciences Research Council.

Levels of diabetes in the UK are forecast to rise significantly in the years ahead. Chronic ulcers affect many diabetics, with sufferers often attending clinics for months or years to have their wounds dressed.

Natasha Ede, care advisor for Diabetes UK, said: "Foot ulceration is a serious complication of diabetes. It is the most common reason for people with diabetes to be admitted to hospital in the UK.

"Foot ulcers should be treated by a healthcare professional and normally a sterile dressing and antibiotics are used.

"Diabetes UK would welcome any safe effective method of treatment which would help people with diabetes make a swift recovery from painful foot ulcers."

Reference Source BBC News Health May 27 2007

osteoporosis

2007-05-06T20:03:00.001+01:00

Annual treatment for osteoporosis :

A once-a-year treatment significantly cuts the risk of broken bones caused by osteoporosis in post-menopausal women, international research has shown.
Compared with a dummy pill, an infusion of Aclasta cut the risk of broken hips by 41% and of spinal breaks by 70%.

The condition accounts for 60,000 hip and 120,000 spinal fractures a year in the UK, mostly among post-menopausal women - and numbers are rising.

The study features in the New England Journal of Medicine.

Full Story here: http://news.bbc.co.uk/1/hi/health/6615725.stm

National Osteoporosis Society have a lot of useful information.
www.stephenkitepractice.co.uk

Alan Ball Tribute

2007-05-03T14:34:00.000+01:00

Today saw the funeral and service at Winchester Cathedral of Alan Ball, Footballer and a member of the 1966 world cup final in which England beat Germany 4 - 2. Alan, who most people and commentators agree that he was deservedly Man of the Match for his constant chasing of the ball and his continued efforts in creating chances that gave England their greatest Football Sporting achievement. Ball won 72 England caps in his career.
Alan Ball 12/05/1945 - 2007

At his service his Son read a poem "If"

http://www.thefa.com/England/SeniorTeam/Archive/?pf=p&i=2291&searchname=Ball&ap=p

How to maintain 'happy feet'

2007-04-26T12:56:00.000+01:00

The human foot is a marvel of biomechanical engineering that most people take for granted until the system breaks down. The average person will walk the equivalent of twice around the world in a lifetime.

Podiatrists in the UCLA Medical Group offer the following tips for maintaining healthy feet:

+Inspect feet regularly and pay attention to changes in color, texture or appearance.

+Maintain good foot hygiene, including washing and drying between the toes.

+Hydrate the skin. Southern California weather and open shoes can cause rapid loss of moisture from the skin and may result in cracking or the formation of fissures. It is helpful to replace the moisture content by using lotions or creams on a regular basis.

+Buy shoes that fit properly. A person may not wear the same size in shoes made by different manufacturers. Purchase new shoes late in the day when feet tend to be at their largest. Always buy the shoes that feel the best.

+Don't ignore foot pain. Symptoms that increase or do not resolve within a reasonable period of time need evaluation by a podiatrist.

+Cut toenails straight across. Never cut into the corners- this could cause an ingrown toenail. Gently file away sharp corners or rough edges with an emery board.

+Exercise. Walking is a great way to keep weight under control and is an excellent conditioner for the feet. Wear appropriate athletic shoes when exercising.

+Alternate shoes each day. Since the feet have sweat glands, shoes will absorb moisture from feet. It's important to allow shoes to dry out completely.

+Avoid walking barefoot to help protect feet from injury and infection.

+Put sunblock on feet while wearing sandals during the day to avoid sunburn.

Reference Source: UCLA News.

Diabetes Advice for Patients

2007-04-19T19:41:00.004+01:00

Below is some useful advice for Diabetic Patients here in the UK and around the World.
More and more people are developing Diabetes, it is an epidemic due to our lifestyles and diet. The feet can play an important role in ageing successfully and regular exercise together with a healthy diet is a start in the right direction.
Regular check up at the Podiatrist is most important and many Diabetic Clinics in Bournemouth, Dorset have regular out patient departments whereby patients can receive the best of advice and the Diabetic Nurses there know that one of the most important things a diabetic patient should do is to have regular foot care from an HPC Registered Podiatrist

Below is some useful advice from our collegues. You can also visit www.stephenkitepractice.co.uk for free information regarding Diabetic Footcare.

http://www.aofas.org/files/public/DiabeticFootCareEnglishTranslation.pdf

Reynaud's disease an overview

2007-04-17T19:47:00.000+01:00

First of all let us look at the condition itself Reynauds.
What is it?
It is a constriction or narrowing of the blood vessels, whereby the blood supply to the extremities are impaired. It causes the skin to change colour and the patient often complains of a burning sensation, cold, numbness and no feeling in the affected area often the foot. The small arteries in the fingers and the toes spasm. The spasms restrict blood supply to these extremities, causing them to become pale, numb or tingly. The disorder is most common in women between the ages of 15 to 45 and is usually mild. Raynaud's syndrome can be classified as one of two types: primary, or idiopathic (of unknown cause) disease; and secondary, which is also called Raynaud's phenomenon.

Some patients that have Reynaurd's may go onto develop autoimmune rheumatic disease.
The exact cause of Raynaud's is unknown. One theory links blood disorders characterized by increased platelets or red blood cells that may increase the blood thickness.
Causes:
Can be hereditary, brought on by a nervous complaint, smoking, alcohol,allergic reaction to food or chemicals, Rhumatoid Arthritis or a bacterial infection sometimes from the stomach, stress, thyroid problems, or medication for migraine treatments or beta blockers ( beta blockers are sometimes used by heart patients in order to slow the heart rate, this however may cause circulation of the feet to be affected, also have to be considered ). Also anemia, B12 deficiency, and lupus and flat foot (over pronated foot type)and the biomechanical function of the foot and ankle have to be considered by the Podiatrist.

When diagnosing reynauds we have to rule out the effects of the muscles and attachments of the lower leg and foot impairing the circulation,(Tarsal Tunnel Syndrome)in particular, inspection must be, to look at the peroneus longus
and the nerve around the fibula, (the deep peroneal nerve)
this can become thicked and trap the nerve. Also we must take a look at the extensor of the great toe, (hallucis brevis), and the posterior tibial nerve and artery these too can become trapped leading to reduced blood flow.

Dangers of Reynauds:
With any vascular disease the dangers can be severe, although Reynaud's itself is not life threatening there is a danger of digital ulceration or gangrene.
Less serious conditions such as thinning skin and toe nail changes can also occur.

What can the Podiatrist do for the patient?
One of the first things a Podiatrist should do is to take a full and detailed vascular assessment discussing with the patient any history of foot sugery or changes,to check for the presence of glucose in the blood and an xray again to be carried out by a health professional who can offer this service to the patient, the xray itself is to determin soft tissue calcification or osteopenia.
An Ankle Brachial index test should also be perfomed to check the blood pressure of the foot. This will determin the severity of the disease and help in suggestions to the patient with regards as to type of treatments to be offered. Finally the Inspection of the patients footware, sometimes if the patients shoes or hoisery are too small this can restrict blood flow to the feet. If foot and ankle deformity have been identified then a rigid arch support may be manufactured to control over pronation and relieve the pressure of the posterior tibial nerve.

Treatments to be considered:
Exercises, eating more iron rich foods, dress to maintain body temperature, the use of polyester socks and not cotton, this will avoid the problem that cotton has with retaining moisture especially when the foot sweats,this can bring down the temperature of the foot, the use of a foot powder to dry the skin and thus not lowering foot temperature. eating hot food before going outside, ( this will raise body temperature ), don't smoke, drink plenty of fluids ( herbal teas ), tea and coffee and alcohol can contrict the blood vessels, the use of heat pads may be considered.
Afterthought:
It is most important that the patient relalizes the potential dangers of this type disease, the patient should be reassured and full after care should be provided . It is advised that the patient should have regular treatments for routine podiatry for callus removal and nail and skin changes. Usually it is the Podiatrist who is the first to witness serious development that may arise with this disease and can refer the patient upon serious, or life threatening changes to the appropriate specialist.

References Sources:
The Internet, Foot and Ankle Anatomy BM Logan , Common Disorders of the Foot Donald Neale

By Steve Kite Podiatrist Copyrighted 17/04/07

Deep Venous Thrombosis, Lower Extremity

2007-04-03T19:09:00.000+01:00

Deep vein thrombosis is most commonly known as the syndrome that inflicts travelers who stay in one spot for long periods of time. You may notice that your feet fall asleep, giving you that pins and needles sensation. But people who have very poor leg circulation may also develop deep vein thrombosis, when a blood clot inhibits the flow of blood and causes severe leg pain.

The blood clot due to deep vein thrombosis develops in a deep vein – thus the name, deep vein thrombosis.

Deep vein thrombosis can occur when a vein is damaged or if blood flow slows down or stops completely. If you’re obese and/or over age 40, you’re at particular risk for deep vein thrombosis.

Since poor circulation is the number one reason people develop deep vein thrombosis, it’s important to understand what can cause decreased circulation in your lower body. Aside from sitting still for long periods of time, like you do on long airplane flights, here are some risk factors for deep vein thrombosis:

Smoking tobacco can lead to poor leg circulation and deep vein thrombosis.
As we mentioned above, obesity is an important risk factor for poor leg circulation and deep vein thrombosis.
Not exercising enough or at all can lead to poor leg circulation and deep vein thrombosis.
Not eating right can contribute to poor leg circulation and deep vein thrombosis.
High blood pressure can cause poor leg circulation and deep vein thrombosis.
High cholesterol can lead to poor leg circulation and deep vein thrombosis.
If you have diabetes, you’re at particular risk for poor leg circulation and deep vein thrombosis.
Certain nerve and thyroid conditions can contribute to poor leg circulation and deep vein thrombosis.
Women who are pregnant should be aware that they’re at risk for developing poor leg circulation and deep vein thrombosis.

To make sure you don’t develop deep vein thrombosis, it’s important to address these risk factors. If you’re on a long airplane ride, make sure you get up and move around often, or at least do some leg stretches in your seat to avoid the development of deep vein thrombosis.

It’s also important to keep your feet and legs warm. The cold can cause decreased circulation and thus deep vein thrombosis.

Reference Source: Footsmart.com

On Your Nerves… The Basics of Foot-Related Nerve Injuries

2007-03-31T12:31:00.000+01:00

Sometimes patients may suffer from severe pain at the top of the foot. This is sometimes caused through nerve damage or results of paresthesia or change in gait or the foots biomechanics.

MORTON'S NEUROMA

A neuroma is the thickening of a nerve that usually occurs from chronic irritation caused by tight-fitting shoes or socks, repeated pressure on the ball of the foot, or abnormal foot biomechanics such as overpronation that can result in injury to the nerve or its surrounding structures.

The most common location for a neuroma on the foot is between the third and fourth metatarsals and toes. Known as a Morton's neuroma, this condition usually has symptoms that include a burning or tingling sensation in the ball of the foot that radiates out to the third and fourth toes. You may also experience a cramping of the toes or a sensation that your socks are bunching up underneath your feet. If you remove your shoes and massage the area, these sensations will decrease, but the pain and discomfort usually recur when you resume activity.

Treatment for a Morton's neuroma involves removing the pressure that is causing the nerve irritation and reducing the inflammation around the nerve. Often, if you switch to an athletic or dress shoe with a wider toe box, the symptoms decrease or even disappear. Using a toe separator between the affected toes may also take pressure off the nerve.

If this self-care treatment does not relieve the discomfort, injection therapy can often reduce the inflammation around the nerve. If abnormal foot biomechanics are contributing to the problem, orthotics, combined with a metatarsal pad or other modifications to spread the metatarsals from each other, take pressure off the nerve. In most cases, conservative care will alleviate the problem. However, in resistant cases, it may be necessary to surgically remove the inflamed nerve branch to provide relief. This treatment will usually result in complete resolution of the problem.

Reference Source

The Basics of Foot-Related Nerve Injuries

The Stephen Kite Practice

2007-03-25T10:36:00.000+01:00

The Stephen Kite Practice

Metatarsalgia problems through heel pain

2007-03-20T15:44:00.000Z

Metatarsalgia denotes a painful foot condition in the ball of the foot or metatarsal region. This is a common disorder that can affect the bones and joints at the ball-of-the-foot. With this common foot condition, one or more of the metatarsal heads become painful and/or inflamed, usually due to excessive pressure over a long period of time. Ball-of-foot pain is often caused from improperly fitting footwear, excessive pressure over a long period of time, insufficient cushioning, and the natural aging process. Because the pain is in the forefoot metatarsal area, recommend properly fitting shoes with maximum forefoot cushioning and flexibility.

A bunion is an inflamed swelling of the small sac on the first joint of the big or great toe. You can see it as a bump, but this bump is actually a protruding bone. With the continued movement of the big toe towards the smaller toes, it is common to find the big toe resting under or over the second toe. This causes a forefoot condition called overlapping toes. A bunionette involves the swelling of the small sac on the joint of the little or lesser toes. It is a smaller bump that forms due to the little toe moving inwards. Symptoms include swelling, inflammation, soreness, and discomfort while walking. This deformity can be caused by an abnormality in foot function or arthritis, but is most usually caused by wearing improperly fitting footwear it can also be brough on by an accident of the leg or foot. Shoes with a wide toe-box and metatarsal padding are recommended to alleviate the pain and discomfort in the forefoot. Any cushioning or pressure distributing insoles will also help. acement cushioning insoles are also recommended to alleviate this pain. Metatarsalgia and bunion of the big toe is sometimes brought on by the heel pain because the forefoot has overcompensated for the rear foot pain and there is impared heel strike because of that pain.
Patients with flat foot are more prone to plantar fascilitis.
Reference Source: New Balance.com

Chiropodists and Podiatrists and the HPC

2007-03-17T16:33:00.000Z

It is most important, when a patient seeks the advice on foothealth they are advised to seek the services of a Chiropodist or Podiatrist who are HPC Registered. The new regulations on footcare here in the UK were introduced to protect the public from practitioners whose standards, education, or qualifications fell below the minimum standards of practice and those practitioners now have to call themselves Foothealth Professionals. New practitioners have come into being who call themselves foothealth professionals and who are not Chiropodists or Podiatrists.
Although they are qualified to carry out minor footcare task they are not accountable to the HPC and their qualifications are in foothealth, not Chiropody or Podiatry.
When visiting a Footcare/Foothealth Professional one should always be aware of the above.

Its Official

2007-03-17T13:37:00.000Z

Yes our new official website is now up and running, we have aked our good friends at infoserve to produce and maintain it. To have a look at it please click here.

www.stephenkitepractice.co.uk

Extremity X Factor

2007-02-07T20:36:00.002Z

Just how good are your feet!
Now it is that time of year when you should be getting your feet trained up for auditions on the beaches this Summer.
Instead of a voice coach for your voice, have a Chiropodist and Podiatrist train up your feet.
We don't have any Simon Cowells here ! Mr Kite will put you right in a kind and friendly service.
we are looking for 1000's of feet. Dancers, Tap Dancers, Ballet, even Morris Dancers are welcome for our Extremity X Factor. Audition are now available !

The Stephen Kite Practice

2007-01-16T16:31:00.001Z

The Stephen Kite The Official Webpage
http://www.locallifedesign.co.uk/clients/linksites/stephenkite/index.asp Practice

www.stephenkitepractice.co.uk

The Stephen Kite Practice

2007-01-16T16:31:00.000Z

The Stephen Kite The Official Webpage
http://www.locallifedesign.co.uk/clients/linksites/stephenkite/index.asp Practice

www.stephenkitepractice.co.uk

The Stephen Kite Practice Private Visiting Practice areas of service

2007-01-13T13:54:00.000Z

The Stephen Kite Practice Private Visiting Practice areas of service

Chiropody & Podiatry Services

2007-01-13T08:31:00.001Z

Practice details : Practice Hours
Mon - Wed 9:00am - 5:00pm
Thursday Closed
Fri 9am - 12:00 mid day
Saturday 9:00 am - 12:00 mid day

Charges are £30.00 per visit.
Wilshire,Dorset,Hampshire coverage

All dressings and medications are included at the Practitioners discretion
Fees should be paid on completion of treatment and are not allowed to aquire
Full range of treatments are available.

38 Ensbury Avenue
Bournemouth
Dorset
BH10 4HG
tel: 01202 530356 / 881088
For more information about our services please take a look at our website
www.stephenkitepractice.co.uk

China's passion for foot-washing

2006-12-21T10:59:00.000Z

The Stephen Kite Practice & Podiatry Source Journal

China's passion for foot-washing
By Fuchsia Dunlop
BBC News, China

What is your antidote to a frantic day's Christmas shopping? In China, one of the de-stressing options available to rich and poor alike is to go for a foot wash.

The young man sits at my feet, gazing up at me occasionally with almond eyes.

"How is this?" he asks me. "Is it comfortable? Too heavy? Too light?"

He massages ointments into my feet, rubs them and strokes them, easing away every tension.

From time to time he explains what he is doing in terms of Chinese medicine.

"This is the stomach," he says, as he focuses on one spot on the sole of my foot. "This is the kidney."

And after an hour and a half of his gentle ministrations, I am so happy and relaxed that I can hardly move.

Leisure activity

So-called foot-washing is one of the most popular leisure activities in China.

They soaked our feet, and then they kneaded, pummelled and slapped them in such perfect unison it was almost comical

I was first introduced to it by a sassy female restaurateur on a rainy afternoon in Hunan Province.

She and her friends had planned to take me sightseeing, but there was a thunderstorm raging outside.

"Let's go and have our feet washed," she cried. I had always assumed that foot-washing was a euphemism for more sleazy services. But I am always ready for an adventure, and in such respectable company, who could refuse?

So the four of us piled into the car and drove off to a luxury hotel, where we hired a private foot-washing room.

Soon, as we lay back in our easy chairs, four young women came in with wooden pails of hot water, fragrant with herbs.

They soaked our feet, and then they kneaded, pummelled and slapped them in such perfect unison it was almost comical.

My host spent most of the time on her mobile phone, doing deals and gossiping with her friends. The rest of us sipped chrysanthemum tea and watched television. It carried on raining all afternoon, but none of us cared.

That blissful experience was, for me, the first of many foot-washes all over the country.

Pleasure emporium

I started to notice the proliferation of neon signs advertising xi yu, "wash feet", in every Chinese city. And I have tried out all kinds of places.

Some foot-washing centres, obviously, are also brothels, and it is not always clear where the boundary lies

Some are cramped basements carved up into cubicles, others have the air of private medical clinics.

And some are extraordinary emporia of pleasure, vast cinema-like spaces where you can have your feet massaged while watching the latest kung fu DVDs.

In the more salubrious establishments, an hour and a half of indulgence might set you back £5 or £10.

But in the cheaper places, it will not cost you more than £1 or £2, so you do not have to be rich to afford the occasional visit.

Some foot-washing centres, obviously, are also brothels, and it is not always clear where the boundary lies.

Once I spent a surreal evening at a massage parlour with a restaurant tycoon and a food-writer, both middle-aged men.

I felt uncomfortable as they unhooked their trousers and loosened their clothing. I felt out of place, as two pretty, flirtatious girls crawled all over them in a vigorous massage.

The apparent loucheness of the situation brought out all my English reserve. But they just carried on chatting and smoking as normal. I was as baffled by the end of the evening as I had been at the start.

My Chinese friends have mixed opinions about the whole business of foot-washing. Some love to indulge whenever they can. Others feel slightly embarrassed to confess to a footwashing habit.

A great friend of mine, a gastronomic journalist, was delighted when I told him I'd become a foot-washing addict.

"I never dared invite you before," he said. "I was afraid you might think it was part of the dixia shehui -the social underworld."

The foot-washers themselves are migrant workers from the countryside. The media tends to portray these people as a vast, faceless ocean of humanity. In fact, many are skilled, articulate, and working hard to better their lives.

In Chengdu, I met a masseur who had come with his wife from Yangzhou, more than 1,000 miles away in eastern China. They were enduring years of separation from their young son so they could earn enough to send him to school.

And in Shanghai I had my feet washed by a bright, funny 22-year-old from deepest Guangxi province. She was one of seven children, and her parents couldn't afford to give her more than a middle-school education. Now she was sharing a flat with three other girls, having fun, and spending her earnings on learning English, Japanese and computing.

"One day," she told me, "I'm going to to run my own company."

The young man with the almond eyes had travelled from his home village in Henan province to Kashgar, the old Silk Road town on the distant fringes of the Chinese empire. It seemed an unlikely destination - but he told me his main motivation was curiosity.

Like a Western teenaged backpacker, he wanted to see a bit of the world - the difference was that he was working his way. And as I lay back in that massage parlour in Kashgar, I was full of admiration for his spirit of adventure, his skills and his ambition.

I reflected on how it is now China, with her cheap and willing labour, that is massaging the feet of the West. But as I enjoy the easy luxury that my English pounds can buy, I wonder how long it might be before it is the other way round.

From Our Own Correspondent was broadcast on Saturday, 16 December, 2006 at 1130 GMT on BBC Radio 4. Please check the programme schedules for World Service transmission times.
Reference Source: BBC News 16-12-07

The Stephen Kite Practice & Podiatry Source Journal: The Stephen Kite Practice & Podiatry Source Journal

2006-10-27T04:22:00.000+01:00

The Stephen Kite Practice & Podiatry Source Journal: The Stephen Kite Practice & Podiatry Source Journal

Posted: Fri Oct 27, 2006 2:59 am Post subject: Rothbart BA 2006. Relationship of Functional Leg-Length Disc

--------------------------------------------------------------------------------

It is with the greatest of pleasure our friend and colleague of The Stephen Kite Practice Professor Brian Rothbart has published a very intersting article for publication in the prestigous Journal of the American Podiatric Medical Association. Nov, Dec 06

The objective of this study was to determine whether a correlation exists between abnormal pronation and functional leg-length discrepancies.
http://www.rothbartsfoot.info/FLLDModel.html

http://www.japmaonline.org/cgi/search?volume=&firstpage=&author1=Rothbart+B&author2=&titleabstract=&fulltext=&fmonth=Sep&fyear=1965&tmonth=Oct&tyear=2006&hits=10&sendit=Search&journalcode=jpodma&fdatedef=1+September+1965&tdatedef=1+September+2006

To Ski or not to Ski

2006-10-05T04:05:00.000+01:00

Some interesting information for patients & Podiatrists who like to Ski / Skate.

See thread on Podiatry 7

The Stephen Kite Practice & Podiatry Source Journal

2006-09-22T04:19:00.000+01:00

We here at The Stephen Kite Practice are acvtivly involved with the preservation of English heritage and the saving of our green and pleasant land.
We endevour to support all good causes around the county and are always willing to help others less fortunate.
We have recently set up a service whereby we can help the homeless and provide for them a basic Podiatry & Chiropodycare & advice service free of charge.

Here are some photographs of some churches around the county.

http://www.nashfordpublishing.co.uk/churches/index.html

The Stephen Kite Practice & Podiatry Source Journal

2006-09-15T04:03:00.000+01:00

The Stephen Kite Practice & Podiatry Source Journal

Continues:

In the last issue, I looked at the basic anatomical and biomechanical dysfunctions that often lead to overuse injuries in the joints, and specifically at the role of faulty foot mechanics (PP 205, November 2004). The current article goes on to consider a range of treatment regimes for chronic sports injuries, including orthotic therapy and prevention.

http://www.pponline.co.uk/encyc/orthotic-therapy.html

The Stephen Kite Practice & Podiatry Source Journal

2006-09-14T04:09:00.000+01:00

The Stephen Kite Practice & Podiatry Source Journal

Verrucae
For information about this painful condition take a look at Podiatry 7 News

The Stephen Kite Practice & Podiatry Source Journal

2006-09-12T06:05:00.000+01:00

The Stephen Kite Practice & Podiatry Source Journal
For latest discussions and News relating to Podiatry UK, Podiatry arenas in the UK look no further than Podiatry 7.
We haveall the latest research from Podiatry in the UK and are UK based.
7 reasons to choose Podiatry 7.
1: Very user friendly
2: UK Based
3: Well moderated by experts in Podiatry
4: Polite and respectful discussions
5: Non Podiatrists section for questions and answers
6: Latest Podiatry News and research
7: Unbias views

Podiatry 7 for all your Podiatry discussions

Forensic Podiatry

2006-08-30T10:04:00.001+01:00

Footwear, The Missed Evidence is a handbook designed to address the needs of the crime scene investigator in the areas of collection and recovery of footwear impression evidence. Written by an internationally recognized authority in forensic footwear evidence, this 5 ? by 8 ? book can be carried in the field or used in the laboratory as the primary reference on locating, collecting and recovering footwear evidence.

Use easy available tools and equipment to assist in locating footwear evidence. Apply the simple methods to locate this evidence.

COLLECT:

Use a variety of methods to collect footwear evidence, including photography made easy. Casting that is as easy as one, two, three instructions.

RECOVER:

Learn how to recover this evidence by following step-by-step instructions. Find out how simple footwear evidence really is.
What people are saying
First responders should read this book! This is the first step in the training and education of crime scene investigators and police officers!!!

Debra Wood, Crime Scene Specialist, Scottsdale Police Department

Very informative, useful, and helpful.

Lynette Faeser, Forensic Science Specialist, Anaheim Police Department

Outstanding workbook for crime scene investigators. Every cop should read this.

Dr. John DiMaggio, Forensic Podiatry, Tempe, Arizona
Contents Include
CHAPTER 1 -- The Beginning

Introduction
What is evidence

CHAPTER 2 -- History of Footwear Evidence

Can the gait help crime scene investigators?

CHAPTER 3 -- Anatomy of The Human Foot

CHAPTER 4 -- Understanding Basic Manufacturing Process

How are athletic shoes of today built?
Case Example
The outsole making process
Nomenclature of an athletic shoe

CHAPTER 5 -- Why Are Footwear Impressions Overlooked

CHAPTER 6 -- Protection Of The Crime Scene

CHAPTER 7 -- Crime Scene Searching

Searching the crime scene
Hypothetical crime scene
Four basic methods of recovery
Crime scene footwear evidence

CHAPTER 8 -- Recovery Through Photography

Crime scene photographs
Taking quality examination photographs
Photographing three dimensional impressions
Photographing two dimensional impressions
Photographing of footwear impressions in light colored substrates
Check list procedures
Highlighting the impressions

CHAPTER 9 -- Recovery Through Lifting

Using adhesive lifters
Using various powders and tapes
Blood enhancement and using other chemicals
Electrostatic dust lifters
Case Example
Impression media and collection chart

CHAPTER 10 -- Recovery Through Casting

Casting impressions
How the material is made
Why casting?
Preparing a cast
Procedures
Stones versus plaster of Paris
Casting in water
Casting in snow
Helpful hints
Batch numbers
Casting material comparison chart
Impression media and casting procedures

CHAPTER 11 -- Understanding The Comparison Process

Obtaining known shoes and making test impression exemplars
Test impressions

CHAPTER 12 -- Court Testimony

Definition of an expert
Qualifications and knowledge of the expert
Admissibility of footwear evidence

GLOSSARY OF TERMS

REFERENCES

APPENDIXES

Basic Equipment for Taking Quality Examination Photographs of Footwear Impression Evidence
Basic Equipment for Casting Footwear Impressions
Basic Equipment for Lifting Footwear Impressions
Chemical Formulas for Footwear Impression Enhancements
The Introduction, by Mr. Ernest D. Hamm.
"Footwear track evidence can be very instrumental to the successful conclusion of a criminal investigation. In Footwear, The Missed Evidence, Mr. Hilderbrand has put forth essential information to the crime scene investigator on the recognition, preservation and collection of this potentially very valuable and important evidence. The techniques and methods set forth in this work serves to improve the quality of this form of evidence, which can be so important to subsequent comparative examinations and conclusions. Footwear, The Missed Evidence, should be recommended reading to those technicians and investigators involved in crime scene processing, as well as footwear examiners. It serves to reinforce the understanding of this type of physical evidence, its association with a crime, and the attention that must be given for its successful recovery. The knowledge gained from Footwear, The Missed Evidence will insure that footwear evidence is not missed, but is properly collected and its information applied to the criminal justice process."

Podiatry Update 17/06/2011

Update to Forensic Podiatry news.
by John A. DiMaggio, DPM

Forensic Podiatry Part 1
THE TYPICAL LAYPERSON would have a difficult time explaining the difference between the job descriptions of footwear examiners and forensic podiatrists. Experts in both disciplines are able to deal with evidence left by feet or footwear at a crime scene, but in most cases a foot-wear examiner and a forensic podiatrist will bring with them their own area of expertise and specific realm of study. More on this article is here http://www.evidencemagazine.com/index.php?option=com_content&task=view&id=41&Itemid=49

Forensic Podiatry Part 2
http://www.evidencemagazine.com/index.php?option=com_content&task=view&id=27

An exellent book on Forensic Podiatry: Principles and Methods [Hardcover] by
John A. DiMaggio (Author), Wesley Vernon OBE (Author) has excellent content and first class insight that is required for the Forensic Podiatrist to enhance and add to their specialist knowledge on the subject.
Take a look inside
http://www.amazon.co.uk/Forensic-Podiatry-Principles-John-DiMaggio/dp/1617379751#reader_1617379751

2006-07-31T05:36:00.000+01:00

Bournemouth has a special atmosphere, its a haven for all those who like to vacation where the beaches are clean and friendly and plenty of attractions for people with young families.
No mosquitoes or flies here. Welcome to Bournmeouth and surrounding areas for an excellent holiday.
For more information about Bournemouth click on the links below:

http://www.imagesofdorset.org.uk/

http://www.comptonacres.co.uk/

http://www.bournemouth.co.uk/

Also why not treat yourself to Podiatry & Chirpody treatments at
The Stephen Kite Practice either before your holiday starts or ends so your holiday here will be a pain free for all that walking you'll be doing.

The Stephen Kite Practice based in Bournemouth can also arrange to visits your hotel if you so wish.

Happy holiday here in Bournemouth
Have a nice day!

The British Influence

2006-07-31T01:24:00.000+01:00

A brief history of Chiropody

In the UK . The profession of Chiropody has been established in the UK for approaching 100 years. Some countries like the USA have changed the word traditional Chiropody and have relaced it with Podiatrist in the last 50 years(1967 ) and the term chiropody there is now non existent there. The term "chiropodist" and the profession of chiropody is British in origin and the royal family helped initially to make the profession popular with regular visits to Chiropodists. It has been traditionally used to describe an individual who treats feet in various ways, and up until the 1950's and earlier, there were chiropodists in both the U.S. and Canada based on that British standard. Here in the UK now it is changing too; In 1993 the Society of Chiropodists added the name 'Podiatrists' to its title reflecting the use of this term throughout the English speaking world and with the objective of securing protection of this title for the State Registered profession.
Although it was the Egyptians who first treated foot conditions and in the bible there are references to treating feet there also, but it was a British man whose name was David Low who invented the word back in the 1700's. There is also written documentation in an Egyptian papyrus of 1500 B.C. outlining a treatment for corns. Hippocrates advocated a sensible approach to corns (thick, hard skin which usually forms on the knuckles of the toes). He recommended a simple operative technique and getting rid of the cause (probably tight sandals or boots). There are records of the King of France employing a personal podiatrist, as did Napoleon. In the United States of America, President Abraham Lincoln suffered greatly with his feet and chose a Chiropodist named Isachar Zacharie, who not only cared for the president’s feet, but also was sent by President Lincoln on confidential missions to confer with leaders of the Confederacy during the U.S. Civil War.
Some Common Mistakes
The word Chiro ( Cheir ) the is relative to the hand, wherby, Pody is the foot hence the word Chiropody. The pronunciation of the word is actually Cheiropody ( Chiropody )with the K being more strongly pronounced than the ch sound. The word Chiropody has been wrongly pronounced . I often say to patients who wrongly mis pronounce this word by comparing it to Christmas, you wouldn't say Shristmas , now would you!

The new word for Chiropody today is now Podiatry & Podiatrist less chance of this word being mis pronounced or spelt incorrectly.

Podiatrist comes from the Greek Word Greek podos, "foot," and iatros, "doctor.
By Steve Kite

Turf Toe Syndrome

2006-07-28T02:59:00.000+01:00

Turf Toe Syndrome

What is Turf Toe?

Turf toe can occur after a very vigorous upward bending of the big toe. It got it's name due to the fact that it occurs frequently in people who play games on artificial surfaces. The shoe grips hard on the surface and sticks causing bodyweight to go forward and so bending the toe up. It is also common in martial arts. You are more at risk if you have increased range of motion in the ankle and / or wear soft flexible shoes.

When the toe is bent upwards this causes damage to the ligaments which can become stretched. In addition the surfaces of the bones at the joint can become damaged. You should really have an X-ray to check if a bone has not been broken.
Symptoms of turf toe include:

Swelling and pain at the joint of the big toe and metatarsal bone in the foot.
Pain and tenderness on bending the toe or pulling (stretching) it upwards.
What can the athlete doto prevent turf toe?

Ice the injury immediately.
Apply a compression bandage.
See a sports injury professional for advice.
Rest, which might include crutches to take the weight off the toe.
Use a brace to protect the toe - or at the very least wear a shoe that has a firm sole that will not allow bending.
What can a Podiatrist/Sports Therapist do?

X-ray to check for a fracture.
Apply ultrasound or other electrotherapy treatment.
After 2 to 4 days the athlete may be able to weight bear again.
Tape the toe to prevent movement.
Advise on a rehabilitation programme.
Recovery of this injury can take three to four weeks depending on how bad the sprain is. If the athlete does not look after this injury then it may develop into Hallux Limitus! This is a decreased range of motion due to arthritis around the joint.
Reference Sports Injury Clinic

Foot Size Not a Constant

2006-07-28T02:47:00.000+01:00

The heat can make your feet swell and make problems with poor circulation even worse, but these aren't the only problems going around that might make your feet hurt. Dr. Kristin Titko is a podiatrist who says most of us think we wear the same shoe size for life. Guess what? That's not always the case. "Your foot size probably changes about a half a size every 5-8 years once we reach the age of 40 to 45."

Add heat and circulation problems, prior pregnancies, and more weight and it should be no surprise that many of use should be wearing a different shoe size than we used to. In fact, if you talk to foot experts, they'll tell you that about fifteen years ago, the average woman's foot size was about a 7. Now it's an 8 or 9 and the thought is that as our bodies are getting bigger, so do our feet. The bones simply shift down.

"To fix the problem, don't go by a shoe size, says Titko. Go by how the shoe fits and feels. "When shoes don't fit, if they are too small, we can get corns, calluses, sometimes toenails can get aggravated. We get heel pain (and) shin splits because we are not balancing on our feet correctly," says Titko.

Source: WKRC TV (Cincinnati, OH) [7/25/06]

Diabetics' Feet Need Special Care

2006-07-22T15:35:00.000+01:00

Check your feet every day for cuts, blisters or swelling.
Have your feet examined by a doctor at least once a year, more frequently if you have had past problems.
Call your doctor if you notice any changes in your feet, such as color, cuts, ingrown toenails, loss of feeling or pain.
Wash your feet every day, and dry them well -- especially between toes. Also apply a light lotion over the tops and bottoms of your feet.
Keep your toenails well trimmed.
Don't walk around barefoot -- always wear comfortable, properly-fitting shoes and socks.
Keep feet well protected from the cold, and be careful not to burn them in hot bath water.
Help circulation in your feet by not crossing your legs for long periods. Wiggle your toes and flex your ankles throughout the day.
Maintaining tight control of your blood sugar and regular examinations from your doctor will help keep foot problems at bay. If you continue to have trouble with your feet, see a podiatrist.

-- Diana Kohnle

Copyright © 2006 ScoutNews LLC. All rights reserved.

15 Ways To Keep Cool When it’s Hot

2006-07-19T12:21:00.000+01:00

As temperatures reach record highs in the UK (England) in july 2006 it is time to review some sound advice to keep safe in the sun.
Try some of these tips:

1: Alter your pattern of outdoor exercise to take advantage of cooler times (early morning or late evening). If you can’t change the time of your workout, scale it down by doing fewer minutes, walking instead or running, or decreasing your level of exertion.

2: Wear loose-fitting clothing, preferably of a light color.

3: Cotton clothing will keep you cooler than many synthetics.

4: Fill a spray bottle with water and keep it in the refrigerator for a quick refreshing spray to your face after being outdoors.

5: Fans can help circulate air and make you feel cooler even in an air-conditioned house.

6: Try storing lotions or cosmetic toners in the refrigerator to use on hot, overtired feet.

7: Keep plastic bottles of water in the freezer; grab one when you’re ready to go outside. As the ice melts, you’ll have a supply of cold water with you.

8: Take frequent baths or showers with cool or tepid water.

9: Combat dehydration by drinking plenty of water along with sports drinks or other sources of electrolytes.

10: Some people swear by small, portable, battery-powered fans. At an outdoor event I even saw a version that attaches to a water bottle that sprays a cooling mist.

11: Pour a bit of ice cold water into the hat, then quickly invert it and place on your head.

12: Avoid caffeine and alcohol as these will promote dehydration.

13: Instead of hot foods, try lighter summer fare including frequent small meals or snacks containing cold fruit or low fat dairy products. As an added benefit, you won’t have to cook next to a hot stove.

14: If you don’t have air-conditioning, arrange to spend at least parts of the day in a shopping mall, public library, movie theater, or other public space that is cool. Many cities have cooling centers that are open to the public on sweltering days.

15: Finally, use common sense. If the heat is intolerable, stay indoors when you can and avoid activities in direct sunlight or on hot asphalt surfaces. Pay special attention to the elderly, infants, and anyone with a chronic illness, as they may dehydrate easily and be more susceptible to heat-related illnesses. Don’t forget that pets also need protection from dehydration and heat-related illnesses too.

Reference Source: Medicinenet.com

Ankle Injuries

2006-07-15T20:19:00.000+01:00

The ankles support the entire weight of the body and are particularly susceptible to injury. Each year, an estimated 2 million patients are treated for ankle sprains and strains, and ankle fractures are one of the most common injuries treated by orthopedists.
For more information click here:

http://www.podiatrychannel.com/ankleinjuries/

Plan to get Welsh out of armchairs

2006-07-15T04:51:00.000+01:00

14/7/2006

Nature expert and TV presenter, Iolo Williams, today welcomed the Big Lottery Fund's announcement of five exciting new projects that aim to get the less active population of Wales out of their armchairs and into the local countryside.

Projects in Bridgend, Cardiff, Rhyl, Swansea and Pembroke Dock are celebrating after receiving a slice of the £6.5 million available under the Big Lottery Fund's Mentro Allan programme.

The programme aims to make the parks, paths, trails, waterways, coasts and countryside on their doorsteps in Wales more accessible to people who might otherwise never use them. Further projects all over Wales will be announced later in the year.

The projects announced today will make the less energetic population of Wales more active by urging them to increase the recreational use of their natural environment. Each local project focuses on specific hard to reach target groups in areas where physical activity participation is low and where there is a need to proactively remove barriers to enable people to enjoy activity in the outdoors.

As a presenter of well known TV programmes such as Iolo's Welsh Safari on the BBC and S4C's Crwydro, Iolo Williams enjoys nothing more than donning his trademark shorts and binoculars to prepare himself for tackling whatever the elements, rugged landscape and wildlife of Wales can throw at him.

Delighted to support initiatives such as Mentro Allan, Iolo said: "I'm proud to support such an exciting initiative that aims to get the population of Wales out of their armchairs and into the wilderness to explore.

"Boasting an abundance of beautiful beaches, lakes, rivers and mountains, some people are oblivious to the fact that there's so much to see and do right on their doorstep. Attracting millions of visitors every year, the Welsh landscape offers an embarrassment of riches for those who want to get out and about to enjoy the stunning scenery and lead healthier lifestyles."

The announcement also comes in the week that the Mentro Allan website (www.mentroallan.co.uk) is launched to the public.

Commenting on the importance of today's funding, Big Lottery Fund Board Member and Chair of the Mentro Allan committee, Taha Idris, said: "We wanted to make a significant investment in an area that would primarily bring significant health gain to a high risk section of the population. Mentro Allan will improve the health and fitness of people by increasing their participation in physical activity. It will also improve access to outdoor activities and the enjoyment of the local natural environment for people that currently do little or no exercise."

The first stage of the programme got underway last year when a new national partnership - led by the Sports Council for Wales - was launched at the National Eisteddfod to help develop a range of schemes across Wales and use the millions in the pot to develop projects that meet the programme's objectives.

Spelling out the benefits of the innovative new projects, Chair of the Sports Council for Wales, Philip Carling, said: "It is essential that people engage in at least 30 minutes of physical activity five times a week and the Welsh landscape provides the perfect backdrop to do so with its fantastic walks and cycle routes, breathtaking views and stunning scenery.

"The scheme demonstrates that people of all ages and abilities have the opportunity to develop a life-long positive approach to health and fitness by simply stepping out on to their doorsteps and exploring the natural environment around them."

The programme is also helping to drive forward the Welsh Assembly Government's 'Health Challenge Wales' initiative - a national focus to secure greater ownership, commitment and action for better health, as part of a co-ordinated and sustained effort to improve levels of health in Wales.

For further information about the Mentro Allan programme, please send your enquiry to info@mentroallan.co.uk or log on to www.mentroallan.co.uk.

THE 5 SUCCESSFUL PROJECTS UNDER STAGE 2 OF MENTRO ALLAN

Outward Bounds Cardiff Innovate Trust

The project will develop new opportunities for physical activity in local green spaces for people with disabilities in the Cardiff area, including accessible adventurous activities. A range of methods aimed at increasing levels of physical activity for the target group will be used. £450,000.

MAPD Pembrokeshire Coast National Park Authority

The project aims to encourage participation of young people (11-25) able & disabled, living in Pembroke Dock in physical activity with an emphasis on the environment and conservation. Activities to include sailing, kayaking, climbing, cycling, orienteering, gardening. £250,000

Mentro Allan Rhyl Denbighshire County Council Leisure Services

The project seeks to target groups at risk of disengagement such as youths, women & girls and those unemployed or not in education through the provision of partnerships with key agencies to deliver an extensive programme of outdoor adventure opportunities. These will include cycling, water sports, climbing, sailing and sand craft utilising the natural environment and local facilities. £300,000.

Venture Out Bridgend Bridgend County Borough Council ? Sport & Recreation

The project aims to increase physical activity levels amongst the hard to reach sedentary population in the over 50-age group by increasing recreational use of the rich and diverse natural environment in the area. Activities include walking, cycling, wildlife watching and environmental work. £450,000

Mentro Allan Swansea City & County of Swansea ? Culture & Tourism

The project aims to increase the amount of people taking part in physical activity within the outdoor environment of Swansea. The main groups to target are carers, people with mental & physical disabilities, older people & women. Activities will include walking, cycling, green gyms and outdoor adventure activities. £450,000

Source:
Web Link

Lucky Podiatrist from Canada !

2006-07-08T07:50:00.000+01:00

Canadian Podiatrist Appointed to Miss Universe Canada Position

Hartley Miltchin, DPM has been appointed the official podiatrist of Miss Universe Canada. He will provide services for the current Miss Universe and the current Miss Universe Canada.

Miltchin will be present at the Miss Universe Pageant taking place in Los Angeles, CA on July 23rd at the Shrine auditorium, and is an invited guest to Donald Trump's after party.
Hartley Miltchin
Accent on Feet was established in 1984 to provide comprehensive foot care utilizing the highest standards available. Our commitment to total patient care has allowed us to successfully treat thousands of people from all across Canada. Our clinic is consistently featured in magazines, newspapers, journals, TV and radio on a regular basis. Hartley Miltchin DPM is one of the most quoted podiatrists in Canada.

http://www.accentonfeet.com/aboutus.asp

2006-07-02T01:31:00.000+01:00

The July 06 edition of Podiatry Now is here.
Get it now from Podiatry Source

http://www.podiatrytoday.com/issue/V19I7

A Guide To Treating Ankle Sprains From Start To Finish
http://www.podiatrytoday.com/issue/V19I7

Increase Seen in Flip-Flop Injuries

2006-06-30T00:27:00.000+01:00

Podiatry Update ( Podiatry ) : (Flip Flops not good for your feet)

An Iowa podiatrist says flip-flops not only cause pain but also can lead to foot injuries. "Flip-flops are dangerous because they don't cover your feet, so when you trip, fall or bump into something, you're more likely to get cut" .

"People will miss a step and fall because there's no support, and they'll end up with ankle or foot fractures. It's also not uncommon for people to come in for toenail injuries after wearing flip-flops," she said.

Many flip-flop wearers suffer from lacerations as well as foot pain. "Flip-flops have no support for the heel or arch of your foot, so they can cause pain, tendonitis and swollen joints and muscles," adding that she sees an increase in arch and heal pain from mid-summer to early-fall because of the increase in flip-flop wearing.

Each summer she sees patients for injuries that occurred while wearing flip-flops, along with several patients who have pain directly related to flip-flop wearing. She recommends wearing sandals that have support and cover most of the foot. "The only time I would recommend wearing flip-flops is in a community shower to prevent fungal infections," she said. Flip-flop-related injuries and pain caused directly by the sandals have increased in the past 10 years that she's been in practice.

Source: Angela Meng, Iowa City Press-Citizen [6/28/06]

Nail Fungus Infections

2006-06-25T01:12:00.000+01:00

Fungal infection of toenails is a common foot health problem. A majority of victims don't seek treatment, maybe don't even recognize the existence of a problem. Studies estimate that it afflicts three to five percent of the population; however, doctors of podiatric medicine think that because so many cases go unreported, the incidence is much higher than that (they treat perhaps 2.5 million people annually, but that's less than a quarter of the cases estimated by the studies).
Probably one reason that so many people ignore the infection is that it can be present for years without ever causing pain. Its prevalence rises sharply among older adults (20 to 30 percent, the studies say, though podiatric physicians think it's much higher). Because the older adults may be experiencing much more serious medical problems, it is understandable that fungal nails can be passed over as very minor, though it is anything but that.
Whatever the case, the disease, characterized by a change in a toenail's color, is often considered nothing more than a mere blemish -- ugly and embarrassing. It is apparently assumed that since white markings or a darkening of the nail are minor occurrences, the change represents something minor as well, even when the blemish spreads. It may be that cosmetologists see this condition as often as doctors. Nail polish is an easy solution for many women, rendering the problem "out of sight, out of mind."
In many cases, however, that change in color is the start of an aggravating disease that ultimately could take months to control. Fungal infection of the nails is known to podiatrists and other physicians as onychomycosis. It is an infection underneath the surface of the nail, which can also penetrate the nail. If it is ignored, its spread could impair one's ability to work or even walk. That happens because it is frequently accompanied by thickening of the nails, which then cannot easily be trimmed and may cause pain while wearing shoes. This disease can frequently be accompanied by a secondary bacterial and/or yeast infection in or about the nail plate.
What is a Fungal Nail? http://www.drnelsonclinic.com/toenail_fungus.htm

The British Chiropody & Podiatry Association Convention 2006

2006-06-23T05:41:00.000+01:00

We are proud to announce The Annual Convention of The British Chiropody & Podiatry Association Friday 6th – Saturday 7th October at Warwick University.
It has many noteable speakers on the Chiropody & Podiatry profession in the UK and the latest news on the new regulations regarding Continued Professional Development from an HPC representative.

The British Chiropody & Podiatry Association provide a large proportion of privately practicing chiropodists and podiatrists in the UK. ...

Sloppy slippers to get the boot this month

2006-06-23T02:32:00.000+01:00

Older people in East Dorset, Purbeck and Christchurch will be encouraged to bin their sloppy slippers during Falls Awareness Week 26 - 30 June.

Five free events across the area will give helpful advice on how older people can live safely and independently in their own homes. The highlight each day will be a free slipper exchange, where local older people can come and exchange their old 'sloppy' slippers. Professional staff will be on hand to collect the battered slippers and fit a new pair for free.

26 June - Parish Hall, Wareham Quay
27 June - Allendale Centre, Wimborne
28 June - Indoor Bowling Centre next to 2 Riversmeet Leisure Centre, Christchurch
29 June - Royal British Legion, Church Road, Ferndown
30 June - Queensmead Hall, Queens Road, Swanage

Each falls awareness event will run from 10am - 4 pm.

The week will be launched at 10am on 26 June in Wareham by Mrs Sally Weld DL. Mrs Weld said:

"Having been the Chairman of the East Dorset Community Health Council for six years I am well aware of the ongoing problems of the elderly and their carers. I am very keen that people should be able to stay in their own homes for as long as possible so I am absolutely delighted to be involved with Falls Awareness Week."

The week's events will coincide with Help the Aged's second National Falls Awareness Day on 27 June which aims to raise awareness of the risk of falling as we age, the conditions that increase the chances of a fall and the practical changes that can reduce the risk.

Andrew Archibald, Dorset County Council Head of Community Care - Older People's Strategy, explained the thinking behind the Dorset slipper exchanges:

"Injury caused by falling is a leading cause of death among older people over 75. According to Help the Aged about 30 per cent of older people living in the community will fall in a year. This rises to approximately 50 per cent for those aged 85 and over. Fear of falling among older people and those who care for them reduces quality of life and well-being even though not all falls have serious consequences. One of the main reasons that older people fall can be badly fitting slippers.

"We thought that one of the best ways to keep people from being admitted to hospital because of a fall would simply be to hold a slipper exchange. We've got government funding to encourage people to think about giving up their old, battered slippers and getting a new pair that will fit well and won't trip them up. During Falls Awareness Week we'd like as many local older people to come along as possible between 10am and 4pm when we'll gladly supply new slippers for old, and there will be lots of other advice on staying independent at home, too. Anyone in East Dorset, Purbeck or Christchurch needing help with transport to get to their local event should call the helpline on 0845 4500 418."

The Falls Awareness Events have been organised by:

Dorset County Council
Anchor Staying Put
Help the Aged
South and East Dorset PCT
Help and Care
St John Ambulance
Purbeck District Council
East Dorset District Council
Christchurch Borough Council.

Reference Source: Dorset County Council Website 12-06-06

How to cut the nails properly

2006-06-15T06:42:00.000+01:00

http://www.womenfitness.net/beauty/handfeet/ingrow_toenail.htm

Buy your new shoes in the afternoon

2006-06-11T01:36:00.000+01:00

Shopping for shoes is best done in the afternoon. Your feet tend to swell during the day, and it's best to buy shoes to fit them then.
An excellent site for foot health information:

http://www.foothealthfdn.org/

Victoria Beckham is reportedly suffering from bunions

2006-06-10T07:00:00.000+01:00

http://www.gm.tv/index.cfm?articleid=20992

http://gmtv.medicdirect.co.uk/

http://gmtv.medicdirect.co.uk/clinics/default.asp?step=2&id=215

UK / EU Weather Map for when your next Podiatry treatment is scheduled
http://www.gm.tv/index.cfm?articleID=2932&showWorldRegion=2&showCities=YES

2006-06-08T07:08:00.000+01:00

Click on the below link for a witty video spoof of the apple ipod.
But this one is called ipodiatry.
Enjoy!!
The link below will take you to Podiatry 7 News and their look for the title Walkie Talkie Man

http://www.takeforum.com/forum/viewforum.php?f=12&mforum=pod1

2006-06-06T00:46:00.000+01:00

Here is some useful information for patients on pain on the bottom of the heel of the foot. Patients are reminded that they should always seek the advice of a Chiropodist or Podiatrist as pain in the heel is very painful and can lead to postural back and knee problems.

Mr Kite will put you right !!

http://www.footcare4u.com/ailments/heel.html

Soccer helps men express their feelings -study

2006-06-05T02:38:00.000+01:00

LONDON - Soccer gives men a way to express their innermost thoughts and feelings, according to a pre World Cup survey.

Almost two-thirds of men (64%) believe that while watching or playing soccer, they are more willing to share their feelings with other men than when doing other activities.

Three quarters said they would not be embarrassed to hug their mates while watching a match.

"Football does have positive effects on people's psychological well-being," said Sandy Wolfson, Head of Psychology at Northumbria University.

"It gives people a ready-made topic of conversation where opinions on team selection, strategy, and players' skills are enjoyable topics for debate," he added.

The survey was carried out by the Mental Health Research Foundation, an independent organization devoted to helping people across the UK maintain good mental health. It was conducted online, with 500 male participants ranging from ages 18-70.

"It is encouraging that football makes it easier for men to talk about their feelings as traditionally, men are far less likely than women to share their innermost thoughts," said Andrew McCulloch, chairman of the foundation.

Along with hugging their friends, 70 percent of men admitted that a match can make them upset while 58 percent said that what happens over the course of a football match can make them aggressive.

However, the ability of football to bring out a man's emotions does have its limits -- three-quarters of men polled said they had never cried over the outcome of a match.

2006-06-04T14:08:00.000+01:00

An excellent Biomechanics site from England

http://www.inov-8.com/links.html

Chamomile

2006-05-30T06:49:00.000+01:00

The chamomiles (or camomiles) have long been used and cultivated by Europeans and Americans. There is hardly one western herbal published in the past 500 years that does not include this group of plants. Tyler (1993) notes that the Germans refer to it as alles zutraut (capable of anything), equating its reputation (though not uses) as a popular European herb with the status afforded ginseng in other cultures.

Nomenclature

The word chamomile is derived from the Greek chamos (ground) and melos (apple), referring to the plant's low growing habit and the fact that the fresh blooms are somewhat apple-scented (Smith, 1963).

According to Hill (1948), accurate identity of a plant under discussion as "chamomile" is hampered by the fact that the name has been applied to a dozen or more species in six genera of the aster family (Asteraceae or Compositae). However, of all these plants, only two species are generally utilized in the herb trade and in broad historical folk usage.

Unfortunately for the botanist and lay person alike, both of those species have, in the past 20 years, been referred to by as many as five different Latin species names, as well as a number of common names. Tucker (1986; Tucker et al., 1987, 1989) retains Chamomilla recutita (L.) Rauschert as the proper botanical name of the "common chamomile" of the European continent, better known as Hungarian or German chamomile, also known by the synonyms Matricaria chamomilla and M. recutita. Tucker and co-workers cite Kay et al. (1976) as the authority. However, Jeffery (1979) provides convincing evidence for relegating the genus name Chamomilla to synonymy with Matricaria. Conveniently, Matricaria recutita is the name cited in Hortus Third (Liberty Hyde Bailey Hortorium,- 1976). This book has been widely used as a source of botanical names by the American herb trade. The unfortunate part of this taxonomic shuffling is that the lay person, herb trader, or research scientist must source information on the plant under at least three different Latin names, depending upon the year of publication. Such a complex problem for a simple herb! Henceforth, we will deem the major source plant of the chamomile of commerce Matricaria recutital "German chamomile," at least until a taxonomist provides a more definitive interpretation of the nomenclature.

Let's turn to the "common chamomile" of England, better known as English or Roman chamomile. In many herb books published prior to 1976, this plant is called Anthemis nobilis L. However, in 1785, an Italian botanist, Carlo Allioni (1728-1804), placed this plant in the genus Chamaemelum, naming it Chamaemelum nobile (L.) All. Buried in obscurity for nearly 200 years, the name resurfaced in the mid-1970s and was adopted in volume 4 of Flora Europaea, as well as Hortus Third. It is again retained by Tucker (1986; Tucker etal., 1987,1989). Chamaemelum nobile is best known as Roman chamomile, the name by which we will refer to it here. The name Roman chamomile was first bestowed upon the plant by Joachim Camerarius in 1598, after observing it growing abundantly in the vicinity of Rome (Fluckiger and Hanbury, 1879).

History

German chamomile is a sweet-scented, smooth, branched annual growing to 2 1/2 ft. in height. It is native to Europe and Western Asia, and has become widely naturalized in the U.S. (L. H. Bailey Hortorium, 1976).

Roman chamomile is an aromatic, creeping perennial, growing to one foot in height. It hails from the United Kingdom (UK) and is widely grown in American herb gardens.

Historically, Roman and German chamomiles have been used interchangeably or confused. The German is preferred on the European continent, while the Roman chamomile has been more widely used in the U.K. In the U.S., German chamomile is by far the most widely consumed of the two species. Despite the fact that the two plants have often been lumped together as "chamomiles," their chemical components and essential oils are quite different, and each should be treated as a separate entity (Mann and Staba, 1986). In addition to genetic differences, quality and quantity of essential oil and other plant components, as in most medicinal plants, are dependent upon a wide range of variables such as environmental factors, cultivation practices, plant part, plant age, and postharvest handling. Articles relative to these subjects are cited by Mann and Staba, (1986) and Simon, Chadwick, and Craker (1984).

German chamomile has a long tradition as a folk or domestic remedy used for a wide variety of purposes including an external compress or fomentation for sciatica, gout, lumbago, inflammations, rheumatism, and skin ailments. A tea (infusion), decoction, or tincture has long been used for treating colic, convulsions, croup, diarrhea, fever, indigestion, insomnia, infantile convulsions, toothache, bleeding or swollen gums, a folk cancer remedy, and many other uses. Historically, Roman chamomile has been utilized for similar purposes. It is best known as a pleasant-tasting, or healthful beverage tea (Leung & Foster, 1996; Duke, 1985).

Safety

In the late 1970s and the 1980s several popular and scientific articles strongly warned against drinking chamomile tea, the warning based on an isolated report of anaphylactic reaction resulting from drinking chamomile tea (Casterline, 1980; Benner and Lee, 1973). One report (Hausen, 1979) tested 25 human subjects known or thought to be allergic to aster family members, and found that two of the patients (8 percent) were allergic to chamomile. Cross-reactions with other aster family members were also observed.

Mann and Staba (1986) suggest that a possible source of allergic reactions attributed to chamomile flowers may be other closely related, more allergenic plants, such as Anthemis cotula, dog fennel or mayweed, which is known to cause toxic or irritating reactions, and is sometimes offered as or may be an adulterant to chamomile. These authors suggest proper identification and purity of chamomiles as a preventative measure, but warn that those with known sensitivities to aster family members (including ragweed, asters, chrysanthemums, etc.) may best be advised to avoid German and Roman chamomiles and their products.

In the proposed European monograph on chamomile flowers produced by ESCOP (European Scientific Cooperative for Phytotherapy) there are several headings that address issues relative to potential side effects or adverse reactions. These include headings for contraindications, side effects, use during pregnancy and lactation, special warnings, interactions, duration of administration, and overdose. Under contraindications, we find "none known." Use during pregnancy and lactation? "No adverse effects reported." Special warnings? "None required." Interactions? "None reported." Duration of administration? "No restriction." Overdose? "No intoxication symptoms reported." The side effect heading in the ESCOP monograph reads, "Extremely rare contact allergy" (ESCOP, 1990). What is rare? Tyler (1993), while reiterating a word of caution for those who suffer from hypersensitivity to ragweeds and other aster family members, notes that normal persons should not be deterred from consuming the herb. He cites a survey of world literature (Hausen, Busker, and Carle, 1984) which found only about 50 reports of chamomile allergies reported between 1887 and 1982. Only five of these reports were attributed to the widely available German chamomile (Matricaria recutita). The vast majority involved the genus Anthemis, primarily Anthemis cotula, which is not in commerce. These reports, however, emphasized the need for proper identification of source plants used in herbal preparations. The Commission E, an expert panel of the German Institute for Drugs and Medical Devices, concurs that there is no known adverse reactions nor contraindications for the nonprescription drug use of German chamomile (Blumenthal, et al., 1996).

Contemporary Medicinal Use

Azulenes, a group of chemical components found in both species of chamomile, possess experimental antiallergenic activity (Farnsworth and Morgan, 1972; Mann and Staba, 1986). Both histamine release and inhibition of histamine discharge have been advanced as mechanisms for the potential antiallergenic action of azulenes. Mann and Staba (1986) suggest that, since azulenes seem to prevent allergenic seizure, inhibition of histamine is probably involved in the true mechanism of their action.

In modem Europe, chamomile products, including extracts, tinctures, tisanes (teas), and salves, are widely used as anti-inflammatory, antibacterial, antispasmodic, and sedative agents. Extracts are used to allay pain and irritation, clean wounds and ulcers, and aid prevention and therapy of irradiated skin injuries, as well as treat cystitis and dental afflictions (Mann and Staba, 1986). The plant is included in the pharmacopeias of 26 countries (Salamon, 1992).

The German Commission E approves German chamomile preparations for external use in cases of inflammations of skin and mucous membranes, bacterial skin diseases, diseases of mouth and gums, inflammation and irritation of the upper respiratory tract, and inflammations of the ano-genital area by using chamomile baths. Internally, chamomile is approved for gastrointestinal spasms and inflammatory diseases of the gastrointestinal tract. The flowers must have a minimum of four percent essential oil (Blumenthal, et al., 1996).

Extracts and a number of components of chamomile, including azulenes (chamazulene) and alpha-bisabolol, have been shown to have anti-inflammatory activity. Chamazulene, comprising 5 percent of the essential oil, is an artifactual component formed during heating of teas and extracts (Der Marderosian and Liberti, 1988). This activity has been demonstrated, not only by long empirical use, but by a number of different laboratory models as well. Studies also show that alpha-bisabolol has a protective effect against peptic ulcers, as well as antibacterial and antifungal activity. Alpha-bisabolol has also been shown to reduce fever and shorten the healing time of skin burns in laboratory animals (Der Marderosian and Liberti, 1988). These two compounds are considered primary active components in German chamomile. Many commercial German chamomile preparations are standardized to chamazulene and alpha-bisabolol content (Tyler, 1993; Mann and Staba, 1986).

Four basic chemical types of Matricaria recutita (A, B, C, and D) are now recognized according to qualitative and quantitative analysis of the essential oil. Consequently, in the major chamomile production countries (Argentina, Czech Republic, Germany, Hungary, Poland, and Slovakia), intensive plant improvement programs have been initiated to produce plants with high levels of defined chemical components (Salamon, 1992).

About 120 secondary metabolite chemical constituents have been identified in chamomile, including 28 terpenoids, 36 flavonoids, and 52 additional compounds, all with potential pharmacological activity (Salamon, 1992). Components in the essential oil of German chamomile contribute to its smooth muscle relaxing activity. Nonvolatile constituents, including flavones (apigenin, luteolin, patuletin, and quercetin) are also antispasmodic (Tyler, 1993). Chamomile teas absorb only about 10-15 percent of the essential oil available in the flowers, but, if used over a long period of time, have the potential for a cumulative therapeutic effect (Der Marderosian and Liberti, 1988; Farnsworth and Morgan, 1972).

Summary

Chamomiles have been used for centuries in teas as a mild, relaxing sleep aid, treatment for fevers, colds, stomach ailments, and as an anti-inflammatory, to name only a few therapeutic uses. Extensive scientific research over the past 20 years has confirmed many of the traditional uses for the plant and established pharmacological mechanisms for the plant's therapeutic activity, including antipeptic, antispasmodic, antipyretic, antibacterial, antifungal, and antiallergenic activity. In addition to medicinal use, chamomiles enjoy wide usage, especially in Europe, Latin America, and the U.S., as a refreshing beverage tea and as an ingredient in numerous cosmetic and external preparations. One source estimates that over one million cups of chamomile tea are ingested worldwide each day (McCaleb, 1990).

Reference Source: Herbal gram.org

Are Boots To Blame For England Football Injuries?

2006-05-03T04:17:00.000+01:00

Article Date: 02 May 2006 - 9:00am (PDT)

The current question among England football fans after star player, Wayne Rooney, broke the fourth metatarsal bone on his right foot, is whether the boots are to blame for the number of injuries experienced by English footballers.

If Rooney makes a swift recovery he may be able to play in some of the World Cup matches. Whether he will be fighting fit is doubtful.

Rooney was wearing Nike Total 90 Supremacy boots. He wore them for the first time on the day he had the injury. Nike denies its boots are linked to a higher risk of injury.

Tom Docherty, who used to manage Manchester United, Rooney's current team, said to the Manchester Evening news that his wife, a physiotherapist, thinks the boots are to blame.

Docherty said that when he was a professional football player in the 1950s it used to take six weeks to break a pair of boots in. Players used to have to put them in a bucket of water. He added that balls are much lighter now and the pitches are in much better condition. Docherty believes the modern boot does not support the foot properly.

Rooney broke a metatarsal in 2004. David Beckham, Gary Neville and Roy Keane have all suffered a broken metatarsal.

When football pitches were not so good in the 70s and 80s hernias were the most common injuries.

Some ex-footballers say modern boots are like slippers.

Tony Book, an ex-professional footballer, told the Manchester Evening News he believes the name of the injury has changed. He believes the old ‘broken toe' injury is now reported as ‘fractured/broken metatarsal'.

Others say it is the media attention, or the faster pace of modern football.

The most common comments made by England fans and commentators are:

1. The boots.
2. Players are not getting enough rest.

There Are 5 Metatarsal Bones (in the foot)

-- The First Metatarsal Bone
Os metatarsale I; metatarsal bone of the great toe
The thickest and shortest one.

-- The Second Metatarsal Bone
Os metatarsale II
The longest one
David Beckham's injury in 2002

-- The third metatarsal bone
Os metatarsale III

-- The fourth metatarsal bone
Os metatarsale IV
Wayne Rooney's current injury

-- The fifth metatarsal bone
Os metatarsale V
Wayne Rooney's injury in 2004

Click Here To See Illustrations - Wikipedia

Written by: Christian Nordqvist
Editor: Medical News Today

Happy 80th Birthday your Majesty

2006-04-21T03:26:00.000+01:00

It is with the greatest of pleasure and honour that we are able to celebrate the 80th Birthday of Queen Elizabeth 11, Queen of England today 21 - 04 - 06

"Did you know the Queen of England probably stands on her feet more than a police officer, soldier, or night club bouncer". Quote BBC news 21 -04- 06

See the BBC Documentary here:
http://news.bbc.co.uk/1/hi/uk/4875264.stm

Footnote and Update to this story:
http://news.bbc.co.uk/2/hi/uk_news/5055596.stm

Latest Pictures of the Queen at St Pauls Cathedral to mark her official birthday.
http://news.bbc.co.uk/2/hi/in_pictures/5085432.stm

UK Monarchy link is here
http://www.royal.gov.uk/output/Page1.asp

2006-04-17T14:38:00.000+01:00

Patient Charter

2006-04-16T15:01:00.000+01:00

http://hometown.aol.com/stevekite1/index.html

2006-04-16T14:59:00.000+01:00

The latest edition of the most widely read Podiatry Journal is here

http://www.podiatrytoday.com/

Did you Know? There are more than 300 types of foot ailments:

2006-04-10T02:10:00.000+01:00

There are more than 300 types of foot ailment, with some resulting from genetic factors. However, for the elderly, most such ailments are caused by habitual neglect or accumulated damage. With just a little effort, people can avoid much harm. But if you are in pain, be sure to get medical treatment without delay.

Arthritis and gout:

Arthritis commonly occurs in persons over 50. The major cause is damage to soft tissues between bones. Because the foot (including all the parts below the ankle) contains 33 joints, this part of the body is more prone to arthritis than are others.

The cause of gout is an excessive level of uric acid in the blood. Uric acid is one of the body's waste products, and forms crystalline deposits in joints. The symptoms of gout are similar to those of arthritis, with the joints becoming painful and swollen, and tending to feel stiff on getting up in the morning.

Modification of the shoes can usually ease symptoms, as pain is caused when the shoes press against bone spurs. If the pressure on the joints is better distributed, pain can be reduced. Modifying the sole of the shoes is one approach. The curvature of the sole below the front and middle of the foot can be altered to better brace the foot and minimize stress on the joints.

Flat feet and high arches:

Regular shoes are designed to fit normally arched feet. However, because the soles of flat feet are insufficiently arched, making it difficult to maintain a solid footing, it is best for people with flat feet to add an arch support when exercising, as this will reduce the chance of soreness. On the other hand, for people with the opposite of flat feet-overly arched soles-smaller areas of the foot must bear the same weight, entailing the use of softer shoe soles to more evenly distribute the pressure exerted on the foot. If one does not know what type of feet one has, this can be determined by wetting the feet , stepping onto a white sheet of paper and then examining the footprint made. Regardless of whether a person has flat feet or high arches, athletic shoes with a wide instep, that provide support for the foot, are more comfortable to wear than dress shoes.

Heel pain:

Heel fasciitis is the heel ailment most frequently seen at clinics. Fashion-conscious women who wear high heels should be especially cautious. The heel fascia is a fan-shaped structure located on the bottom of the foot. Just behind it is the inside of the heel bone, while just five bones lie in front. When walking or running, the foot must bear the body's weight, and as a result, this fan-shaped structure is stretched to provide some torque and flexibility, as well as to absorb shocks from impacts with the ground. Over time, stretching of the fascia may lead to inflammation.

The approach for treatment is to place a heel pad with good impact damping inside the shoe; walking little to reduce the burden on the affected foot; and selecting a foot pad with appropriate arch support, or soles that are softer or more pliant.

Bunions:

The big toe on a normal foot should point outward (away from the midline of the body) at an angle of ten to 15 degrees. If this angle is greater than 15 degrees, the condition is called a bunion. In addition to genetic factors, the condition may be caused by poor choice of shoes, with high heels and pointed-toed shoes being especially likely to cause trouble. The "witches' shoes" that have been popular in recent years are one of the major culprits in toe problems. One treatment is the use of toe separators. These can be purchased at any medical supplies store.

Diabetes:

Diabetes patients often suffer from hardening of blood vessels in the foot. Sensory nerves may be numbed so that even when both feet are placed in hot water, the patient may not sense that they are being scalded. If the skin is cut, burned, blistered, or suffers from insect bites, the foot may easily become inflamed or infected.

1. Please be sure to take special care in the following situations: When clipping the nails, do not use pointed scissors, cut the nails too short, cut into the non-extruded portion of the nail, or otherwise cause injury or bleeding. Do not use a razor blade to cut calluses or corns. Do not apply strong medications or alcohol to wounds. If you find that a wound is healing very slowly, quickly seek treatment from a doctor.

2. Examine both feet: Every day, use a mild, non-irritating soap to wash the feet (first use the inside of your wrist to check the temperature of the water). Pay special attention to whether there are calluses on the areas on the sole of the foot that are subject to pressure. Use pumice to rub away calluses. Ask family members to assist in examining whether there are ruptures between the toes. If there is evidence of fungal infection, or if the toes have blackened or turned gray, seek medical attention immediately.

3. Shoes and socks: Shoes should not have uneven areas, nor have seams. Overly tight shoes should not be worn, but rather, well-fitting shoes made of soft, breathable material should be chosen instead. Before wearing shoes, use the hands to examine whether there are any pebbles inside the shoe. It is best to choose socks made from cotton or wool. Each day, shoes and socks should be changed to prevent the occurrence of athlete's foot (tinea pedis). Avoid walking barefoot (even at home).

2006-04-01T16:16:00.000+01:00

Podiatry 7 News & The Stephen Kite Practices "Better Podiatry for you"!
http://www.takeforum.com/forum/pod1.html

What is Cyro Surgery?

2006-03-27T22:46:00.000+01:00

Cryosurgery is the specialized field of using extremely low temperatures to destroy pathological tissues. Cryosurgery is not a new concept in the elimination of pain. Hippocrates recognized the analgesic and anti inflammatory properties of ice on injuries in the year 430BC.

In the past few decades, cryo-technology has been used in the treatment of malignant tumors of the prostrate, liver and other organs. Moreover, cryosurgery is gaining acceptance in dermatology, plastic surgery, urology, pain management and podiatry.

The application of cryo-technology in podiatry has been increasing since it first became approved by the FDA in late 2003. Common foot conditions that can be treated with cryosurgery are plantar fasciitis, infracalcaneal bursitis, neuromas, neuritis, and plantar fibromas.

So how does cryosurgery work? Cryoanalgesia or cryoablation as it is also called, is a minimally invasive procedure that uses extremely cold temperatures to selectively destroy nerve endings. Nitrous oxide is forced under pressure between 600 and 800 psig between the inner and outer tubes of the cryoprobe. The gas is released through a small opening into the chamber at the tip of the probe. As the pressurized gas is released into the chamber it expands and results in a rapid drop in temperature. This is referred to as the Joule- Thompson effect and results in an ice ball forming at the uninsulated tip of the probe. The temperature can reach -70C and the size of the ice ball can range from 3.5mm to 10 mm depending on the amount of the tube that is uninsulated. This is a closed system therefore no gas escapes from the system.

So what is a typical cryosurgical procedure? When performing cryosurgery it is extremely important to identify the area or areas of greatest pain. This becomes the target point for the cryoprobe. The area is injected with local anesthesia. A 3mm percutaneous incision is made and a trocar is inserted to separate tissue. Afterwhich, the cryoprobe is inserted and depending on the foot pathology the area is treated with 2 cycles of 2-3 minutes with a defrost cycle of 30 seconds in between.

So what happens after surgery? Activity should be reduced for about three days. The bandage is changed the next day by the patient. The patient puts on bacitracin ointment and a new bandage. The incision heals in 3-4 days. A patient may take an oral anti-inflammatory for 3-4 days postoperatively if needed.

When is cryosurgery of the foot needed? Cryosurgery is used when previous treatments such as non steroidal anti inflammatory medications, orthotics, night splints, physical therapy and injection therapy have failed. Our patient a 56 year old male complained of heel pain on and off for 10 years. The patient had tried all of the above with lessening of symptoms but no resolution. The patient described his pain as 9 out of 10 with 0 being no pain and 10 being the worst amount of pain. We performed cryosurgery on his right heel. One week after surgery the patient had a pain level 4 out 10. On the patient’s next visit the patient reported pain of 1/10. Six weeks after the procedure the patient was completely asymptomatic.

Overall, cryosurgery is an effective procedure where conservative methods have failed. The procedure is minimally invasive with a very short postoperative course.
Refernce Source: Dr Ann Nylund 27-03-06

WHAT ARE THE BEST ORTHOTICS FOR PLANTAR FASCIITIS?

2006-03-19T08:11:00.000Z

Plantar fasciitis (heel spur syndrome) is a common foot problem in athletes and accounts for approximately 7 percent of the injuries to the lower extremity. With each running step, the athlete subjects the plantar fascia to tremendous cyclic loading. In some athletes, this produces a mechanical irritation to the plantar fascia, resulting in an inflammatory response and pain.
The irritation is the result of biomechanical deformities such as limb length discrepancy, gastrocsoleus equinus, and excessive foot or leg varus, producing midtarsal and subtalar hyperpronation. In turn, this pronation produces a stretch of the plantar fascia as well as unwanted pulling on the origin of the fascia (the medial calcaneal tubercle).
The classic history of plantar fasciitis is marked by the insidious onset of sharp pain at the fascial insertion of the plantar surface of the anteromedial calcaneus. With these patients, you'll note arch fatigue and generalized soreness on the sole of the foot. The patients will usually tell you that the pain is more severe when they get up in the morning and eases some after walking. You'll also commonly hear that pain decreases during the middle of a run, but returns at the end of the day.
Upon palpation, you'll typically detect heel tenderness anteromedially at the origin of the plantar fascia on the medial calcaneal tubercle. However, keep in mind that the patient may have pain along the entire length of the plantar fascia. If you note tenderness over the distal and midportion of the plantar fascia, your patient may have the less common distal fasciitis. If the entire heel is tender, it may be a stress fracture, calcaneal apophysitis (Sever's disease) in a child, or possibly a bone tumor.
Although plantar fasciitis treatment often includes nonsteroidal oral medication, local steroid injections, ice after the run, ultrasound and stretching exercises, your main focus should be on treating the biomechanical imbalance. Employing orthotic devices can play a key role in this endeavor.
WhenYou Should Use Heel Pads And Cushions
The first line of relief for treating plantar fasciitis, heel cushions provide extra shock absorption in the heel area. They help absorb the shock of heel strike in walking and running. Heel pads are generally constructed of polyvinyl chloride, silicone, leather, polyethylene foams like Plastizote, and thermoplastics.
Soft heel cups cushion and contain the fat pad. They are effective for a plantar calcaneal bursitis or plantar heel spur syndrome. When you're treating patients who have heel pain as a result of fat pad atrophy, employing hard plastic heel cups (M-F Athletic, Cranston, RI) can sometimes be effective in positioning the heel pad underneath the calcaneus, restoring the natural cushioning and compressibility.
You may also consider the Anti-Shox heel cradle (Apex, South Hackensack, N.J.), which is made from a firm, open cell polymer. Designed to cup the heel, this orthotic provides both shock absorption and support. Another option is the SofSpot Viscoheel (Bauerfeind, Germany). This silicone heel cushion has a built-in area of softer durometer that is especially designed to disperse weight around the plantar medial tubercle of the calcaneus.
Sometimes, using a heel lift is helpful in shifting pressure to the forefoot. Keep in mind that a heel lift in the shoe should be no thicker than one-quarter inch.
An Overview Of Custom And Prefabricated Foot Orthoses
There are a variety of orthotic devices that you can use inside the shoe to provide support, increase shock absorption or influence foot position. Orthoses include dynamic insoles, heel cushions, prefabricated commercial foot orthoses and custom foot orthoses. Using an orthosis can help you reduce arch strain associated with plantar fasciitis.
When it comes to dynamic insole orthoses, you can construct them from Spenco (Spenco Medical Corp., Waco, TX), which is a closed-cell neoprene impregnated with nitrogen bubbles.
Prefabricated foot orthoses are commercially available in a wide variety of styles. Employing pre-made orthoses is adequate for treating many athletes with plantar fasciitis. They are also significantly less expensive than custom-made orthoses.
You can fabricate a custom-made orthosis from a negative plaster impression of the patient's foot. The orthosis is composed of the shell, a layer of material next to the foot and the posting, the material that fills in the space between the shell and the shoe. You can add materials such as metatarsal pads to the device to customize it further.
Using a custom-made foot orthosis may be required when you're treating a more severe athletic foot injury. Custom foot orthoses can be made of leather or plastic. Leather gives the patient more comfort, allows easy orthotic adjustments and is able to absorb 30 percent of its weight before it feels wet. You'll find that using a whale pad design and deep heel seat leather orthosis is well suited for treating the painful heel caused by plantar fasciitis.
It's more important to use a custom device for the cavus foot type as opposed to the hyper-pronated foot, which will generally improve with a well-constructed prefabricated orthosis.
Can The UCBL Orthosis Make An Impact?
The University of California Biomechanics Laboratory (UCBL) orthosis was originally designed to maintain a flexible paralytic valgus foot deformity in the corrected position. However, since then, DPMs have used it extensively to treat flexible flatfoot, plantar fasciitis and calcaneal spurs.
The UCBL is casted in a semi-weight-bearing position. Employing this device allows you to elevate the arch by holding the foot in a position of forefoot adduction and hindfoot inversion. Patients should wear it with a large shoe, such as a running sneaker. While the UCBL is not suited for running, you can use it to treat more recalcitrant conditions until the athlete is capable of returning to sports activities.
What About The Posterior Night Splint?
A classic treatment for Achilles tendinitis, the posterior night splint has been widely used by DPMs to treat plantar fasciitis as well. In one study, physicians were able to resolve recalcitrant plantar fasciitis with a night splint in 11 of 14 patients.
The splint is an ankle-foot orthosis (AFO) positioned in about 5 degrees of dorsiflexion. Patient would only wear this at night. In stretching the Achilles tendon and plantar fascia, this device prevents contractures of the Achilles tendon and plantar fascia that occur as a result of the plantar-flexed posture of the foot during sleep.
You can fabricate the posterior splint from plaster or fiberglass, or simply obtain the commercial device, Universal Plantar Fasciitis Orthosis (Orthomerica Products, CA). Regardless of the splint you use to immobilize the foot and ankle, you must ensure that it offers a good fit and maintains the desired position once you've applied the device.
In fabricating the splint, the patient lies prone as you initially place a stockinette on the leg. Then you would proceed to mold five to six layers of six-inch plaster splints (or three to four layers of fiberglass) to the lower extremity from the toes up to behind the knee. You should allow an extra two inches when measuring with the dry splints because the splint shrinks after immersion.
Then you can add overlapping side splint stirrups. Doing so adds strength to the cast and prevents it from failing in plantar flexion. Using a circular Ace bandage allows you to hold the entire splint in place. You can also dip the Ace bandage in water to help with molding.*

References Source: By Mark A. Caselli, DPM and Ellen Sobel, DPM, PhD & Podiatry Today 19-03-06

Raynauds and Scleroderma

2006-03-16T03:42:00.000Z

Information for patients and Podiatrist who are concerned about Chilblains and the Associated problems that can occur with this condition here is a free e book for help:

http://www.raynauds.org.uk/potioncms/articlefiles/54-Podiatry.pdf

FOOT PUSH UP TEST

2006-03-16T01:32:00.001Z

Take this simple test to check how well your arches are performing their important functions.

1: In bare feet, stand facing a kitchen counter.
2: Place your palms on the counter with slight pressure.
3: Stand with your back straight, and lift one foot off the floor.
4: Slowly lift the heel of other foot, placing all of your weight onto the ball of your foot.

5: Slowly lower your heel back to the floor.

6: Do 10 foot push-ups.

Repeat steps 1 - 6 with the other foot.
And now the results...
Did you have problems doing just one push-up? If you cannot rise up onto the ball of your foot without putting lots of pressure on your hands, leaning over the counter or experiencing pain, your arch may have a mechanical problem. The arch tendon can stretch or rupture, leading to lowering of the arch. A Podiatrist should be consulted as soon as possible.
Were you able to do all 10 without a problem?If you can easily rise up onto the ball of your foot, but have difficulty performing all 10 repetitions, you may be suffering from arch fatigue. Exercises focusing on strengthening and stretching leg muscles will help this problem. The foot push-up described above can also be used as an exercise technique.
Did you have pain in your arch during the exercise? If you can easily rise up onto the ball of your foot but experience pain in your arch, your arch may be inflamed and may have been overworked. Consulting a Podiatrist for weak and overworked arches is recommended to manage the problem and keep your feet healthy and free of pain.
Reference Foot Physicians.com

FROSTBITE PRACTICAL SUGGESTIONS

2006-02-17T02:23:00.000Z

Frostbite means that skin and underlying tissue actually freeze. This condition rarely occurs in still air above -10°C but may do so at higher temperatures in high winds due to the wind chill effect). It cannot be emphasised strongly enough that frostbite need not happen even at extremes of altitude, temperature and fatigue: frequently a degree of carelessness is the chief cause.
Recognition
Below minus 10°C, any tissue that feels numb for more than a few minutes may become frostbitten. Although all climbers are well aware of having suffered from numb cold feet or hands for hours at a time with no ill effects, it is important to realise that while being frost-bitten the subject is senses no more than this familiar numbness. It is wise therefore to have some idea of the temperatures in unfamiliar terrain: many miniature portable thermometers are available, so clip one on your sack or outer jacket zipper tab. If you feel the numbness and the temperature is particularly low it's time to act - flexing the fingers and toes, stamping the feet, clapping your hands or placing them in the armpits or groin should all bring back some sensation. If not, assume some degree of frostbite (probably frostnip) and perform more specific re-warming with warm water as below.
In early (superficial) frostbite in the unthawed state, the skin is yellow-grey, painless, numb and leathery to the touch - pain (lots of it!) occurs as re-warming takes place. In deep frostbite, the tissue is hard, white and obviously frozen like a piece of chicken from a freezer, and medical advice must be sought as soon as possible.
Emergency treatment
For all but trivial frostbite (e.g. a cheek, a fingertip) evacuation to a place of safety is essential. If the feet are frostbitten the difficult decision has to be made about the patient moving on foot. There are no absolute rules but in general, it is better to move for six hours with frozen feet to a place of safety than to thaw the feet at a high camp. Walking on vulnerable inflamed unfrozen tissue can cause further injury.
Once safe, re-warming should begin immediately. Avoid smoking (nicotine contracts blood vessels), but alcohol may be helpful (it dilates blood vessels) - however only provided hypothermia does not co-exist. If possible, immerse the frostbitten area in a saucepan of hand hot water - 39-42°C is optimal. If you have no thermometer heat the water until it is "really quite hot" to the touch, about as hot as your elbow can stand: take great care not to scald the patient! Immerse for periods of 20 minutes, moving fingers and toes if possible, but do not knock or rub the frozen tissue.
Thawing may be extremely painful, but perseverance is the key! After thawing, wrap gently in clean bandages, separating fingers and toes. The victim must use thawed tissue as little as possible - this may require them being nursed, fed and helped at the lavatory by colleagues. If a hot water container is not available, warm the affected parts in a warm sleeping bag (or on the abdomen, groin or armpits) for several hours. Above 5500m, oxygen should be given if it is available.
Further progress of frostbite
A few hours after thawing the tissue swells and during the first two days giant blisters form. Try not to break them, these blisters will settle during the first week albeit to leave tissue hideously discoloured, and if gangrenous, shrunken and black. This carapace, or shell separates in several weeks. If the frostbite is superficial, pink new skin will appear beneath the carapace, if deep, the end of a toe or finger will gradually separate off - an unsightly but usually painless process.
By far the most important emergency treatment after re-warming is to keep the skin as clean as possible to avoid any infection.
Risks and implications of frostbite
The disability caused by frostbite often leads to increased risks in descending difficult ground and usually means abandoning a climb. Anything more than very trivial frostbite means the end of climbing for the patient for a few months at least. It is wise to warn newcomers to cold conditions of these implications - adequate clothing, spare gloves and dry socks should always be carried; boots should not be too tight and if using plastic boots, consider carrying spare inners.
Long term management
There are widely disparate views on the use of drugs in frostbite, a tacit admission that few are really effective. It is imperative to keep damaged tissue free of infection: antibiotics may be necessary, and tetanus toxoid prophylaxis is often recommended.
It is extremely difficult to predict the outcome in the first few weeks after frostbite, and remarkable recoveries occur. Surgery is usually best avoided for several weeks or even months, until it is clear that there is no other alternative.
Summary
Frostbite on a climb is a major emergency, yet with competent nursing care most cases can be looked after in the field, e.g. at a Himalayan base camp. Frostbite can frequently be avoided, but when it does occur, it increases the risks both to the sufferer and their colleagues. Rapid re-warming is recommended and strict adherence to hygiene, but surgery is usually best delayed for at least several weeks, or months.
The UIAA Mountain Medicine Centre is supported by:
Mount Everest FoundationFoundation of Sport and the ArtsBritish Mountaineering Council.
Reference: UIAA Mountain Medicine Centre

Dates for running events in the South west of England

2006-02-16T02:55:00.000Z

February 19 (Sun)CITY OF SALISBURY 10KSalisbury, WiltshireClosing date: February 16 RW members running: 144

February 26 (Sun)CARDIFF ST DAVIDS DAY 5KCardiffClosing date: February 24 RW members running: 116February 26 (Sun)TERMINATOR 10Pewsey, WiltshireClosing date: February 24 RW members running: 217RW says: A mainly off-road course with some tough climbs. The event's name speaks for itself
March 11 (Sat)DYNAMIC ADVENTURE RACING Ringwood, HampshireClosing date: March 4 RW members running: 4 RW says: An off-road experience in which you visit as many checkpoints as you can in the time limit to accumulate points, using footpaths, bridleways and tracks
March 12 (Sun)DUCHY MARATHONRedruth, CornwallClosing date: March 4 RW members running: 27RW says: Each runner gets a Cornish pastie and there's an option to drop out at the 20-mile point

March 12 (Sun)POOLE 5K - PROSTATE CANCER RACEPoole, DorsetClosing date: March 5 RW members running: 26

March 19 (Sun)NATIONWIDE BATH HALF-MARATHON Bath, Bath and NE
SomersetClosing date: March 5 RW says: First come, first served, for 500 exclusive places available for RW's website users!

March 26 (Sun)SHERBORNE CASTLES 10KSherborne, DorsetRW members running: 23RW says: Totally off-road run through Sherborne Castles Estate

More dates will be available from us in the summer:
We are available for Podiatric services in these areas.
Please contact us for details:
http://hometown.aol.com/stevekite1/myhomepage/business.html

FOOT INJURIES

2006-02-15T11:27:00.000Z

The body's foundation originates with the feet, which support the body weight in a myriad of positions and function over a multitude of surfaces and contours. Most athletic activity begins with and is dependent on the feet. As such, the feet continually bear the brunt of physical stresses and rapidly changing forces thrust on them from all directions.
Injuries involving an athlete's feet are often magnified in severity because the feet are weight bearing structures. A relatively minor injury of the foot can impair an athlete's performance as dramatically as a major injury to another body area. Proper and adequate care should be given all injuries and athletic related conditions of the feet, no matter how minor they appear.
FOOT CONDITIONS
Bunion (Hallux Valgus)
A bunion is an inflammation and thickening of the bursa of the metatarsophalangeal joint of the big toe, usually associated with abnormal enlargement of the joint and lateral displacement of the toe. The normal cause is chronic irritation and pressure from poorly fitted shoes or structural anomalies. A bunion-like enlargement of the metatarsophalangeal joint of the fifth tore is called a bunionette or tailor's bunion.

Hammertoe
A hammertoe is an extension deformity of the metatarsophalangeal joint and flexion deformity of the proximal interphalangeal joint of the lesser toes. Occasionally this condition involves flexion of the distal interphalangeal joint as well.
Corns
A hard corn is a localized hardening and thickening of the skin produced by friction and pressure. The most common location is over the dorsum of the toes, especially the dorsal aspect of the proximal interphalangeal joint of the fifth toe. A corn has a conical shaped core that extends into the dermis, and causes pain and irritation. A soft corn is a thickening of the epidermis between the toes caused by pressure between the prominent phalangeal condyles. This type of corn is kept softened by moisture and maceration, and often leads to painful inflammation beneath the corn.
Ingrown Toenails
An ingrown toenail occurs when the skin of the nail fold receives pressure from the nail edge, causing inflammation and pain. It can be caused by improperly trimming of the toenail or poor fitting shoes. Ingrown toenails occur most often in the big toe. In a competitive athlete this condition can be aggravating and even disabling
Contusions
Contusions about the foot resulting from various types of direct impacts are common occurrences in athletics. The skin over the dorsum (top) of the foot is thin and only loosely attached to the underlying structures. Further, subcutaneous placement and exposed nature of most structures near the dorsum of the foot make them susceptible to contusion injuries. Injuries in this area tend to be painful even if actual tissue damage is minor. However, all direct trauma to the dorsum of the foot should be evaluated for the presence of significant damage to underlying structures such as bones, tendons, or nerves.
Contusions to the plantar, or weight-bearing, surface of the foot can be particularly bothersome and handicapping. These injuries, common to the plantar aspect of the heel and ball of the foot, are normally caused by direct trauma such as repeated pounding on a hard surface, a faulty spike or cleat, stepping on an object, or even a wrinkle in the athlete's sock. The subcutaneous tissue between the bones of the foot and the thick plantar skin becomes bruised and inflamed. This injury, often called a stone bruise, or heel bruise, may become quite painful and disabling during weight bearing and athletic competition. Localized tenderness at the site of trauma may persist until weight bearing is relieved. Contusions of this type may develop into a chronic inflammatory process and reoccur throughout the athletic season.
STRESS FRACTURES
Stress fractures may involve any bone in the foot, but more commonly involve the second, third, or fourth metatarsal. These fractures, occasionally called march fractures, occur with repetitive trauma. Excessive foot pronation or a high and rigid arched foot may contribute to the incidence of stress fractures. Symptomatically, stress fractures often exhibit a gradual increase in forefoot pain that is aggravated by activity and relieved by rest. X-ray films may be negative initially. If symptoms persist, the foot should be reexamined by radiography in a few weeks. At that time callus formation may indicate the presence of a stress fracture.
Fractures involving the midfoot and hindfoot during athletic activity are not nearly as common as those in the forefoot. When fractures do occur in these areas of the foot, they are usually associated with severe torsion or compression forces and result in major foot injuries.
STRAINS
Strains involving the foot are common occurrences in athletics. These injuries may involve the intrinsic muscles, the tendons, and tendinous attachments of the extrinsic muscles, and the plantar aponeurosis (plantar fascia). Strains may occur to any of the intrinsic muscles of the foot as a result of excessive overuse or violent stresses applied to muscles during athletic activity. Symptomatically, these injuries usually cause cramping or fatigue of the involved muscles and are painful during resistive movements. Symptoms normally subside when activity is reduced or discontinued. Strains of the extrinsic tendons cause tenderness at the site of the injury and increased pain on active and resistive contractions of the muscle or muscles involved.
Plantar Fascittis
Is a common strain of the foot involving the plantar aponeurosis or fascia. These strong bands of fibrous connective tissue originate on the calcaneal tuberosities and inserts into the sides of the metatarsal heads and into the flexor digital tendon sheaths. This tough fascia surrounds the soft tissue structures of the sole of the foot and acts as one of the primary supports for the longitudinal arch. It is often described as a "tie rod" for the longitudinal arch because it serves to connect its end and prevent their spread. The plantar fascia is subjected to many stresses and forces during athletic activity, which may result in a strain injury that often becomes chronic. The pain associated with this type of an injury can be acute and handicapping. In many cases is most severe when the athlete first puts weight on the foot, for example, when getting out of bed in the morning or at the beginning of activity. The pain generally diminishes during activity, only to increase when activity stops or when the athlete is "cooling down." Point tenderness is usually located toward the calcaneal end of the aponeurosis and very often over the anterior medial tuberosity of the calcaneus. Occasionally the pain can be reproduced by having the athlete stand on the toes. Plantar fasciitis is often aggravated by excessive pronation of the foot, obesity, or an abnormally high arch (pes cavus).
SPRAINS
Injuries involving the ligaments or ligamentous capsules surrounding the various joints of the foot are common in athletic activity. Sprains frequently result from forced motion at the joint, especially torsion movements, which can stress any of the supporting ligaments and cause various degrees of damage. Although it must be remembered that the human body is a chain-linkage system, sprains will be discussed in three segments that correspond to divisions of the foot: (1) Fore-foot, (2) Mid-foot, and (3) Hind-foot, which also includes the ankle joint. An injury in any one of these segments can cause problems or affect the others.
Fore-foot
The forefoot is composed of the metatarsals and phalanges. This part of the foot is used in the pushing off of the foot and is subjected to stresses that may result in various types of sprains. The interphalangeal and metatarsophalangeal joints are most often injured by extreme dorsiflexion or plantar flexion forces.
Great Toe Sprain -- the metatarsophalangeal joint of the great toe is a common site for a sprain type of an injury, which is often referred to as a turf toe. A sprain of this joint can be debilitating n that the great toe is very important in weight bearing and must bear the brunt of every step. Symptomatically, sprains about the toes will be tender at the site of injury with an increase in pain on reproduction of the stress that caused the injury. In addition, there are normally varying amounts of swelling, stiffness, and soreness surrounding the articulations. Depending on the amount ligamentous damage, there may be varying amounts of instability associated with the injury. If instability is recognized, the athlete should be referred for medical assistance.
Transverse Arch Sprain -- the metatarsal bones are joined by a complex mechanism of ligaments. Occasionally the ligaments and supporting tissues of the metatarsal head will be injured. The mechanism is varied but usually is associated with prolonged activity on hard surfaces or with overuse. Physical findings normally include tenderness and swelling under the heads of the metatarsals and pain upon weight bearing. Sprains involving the tarsometatarsal joints sometimes occur as a result of a twisting mechanism or direct stress, such as the athlete stepping on someone or something. This type of forefoot sprain can be very disabling because of the increased tenderness and pain upon weight bearing. Return to full activity may take up to 4 weeks or longer with this type of injury.
Fractures -- are by the most common area for fractures in the foot. These fractures can result from a direct blow to the area or by indirect trauma produced when harmful forces are transmitted along the shaft of the bones. Symptomatically these fractures demonstrate point tenderness over the injured site and increased pain during longitudinal stress. Swelling, discoloration, crepitation, and deformity may also be present.
Mid-foot
The midfoot is composed of the navicular, cuboid, and three cuneiform bones. The mid-tarsal and tarsometatarsal joints are supported by a strong ligamentous system that is not injured often. Midfoot sprains can result from severe twisting mechanisms or forceful direct trauma that causes a subluxation of the involved tarsals or metatarsals. These sprains produce tenderness at the site of the injury, and often weight bearing is extremely painful. Tenderness may be elicited at the involved joint by gentle passive pronation and abduction of the forefoot. Midfoot sprains can prevent an athlete from normal activity for a considerable length of time. If recovery is slow, it is often beneficial to place the foot in a firm-soled shoe or firm orthotic to decrease the stress across the midfoot and promote healing.
Longitudinal Arch Sprains -- the ligaments that support the longitudinal arch are also subjected to many stresses during athletic activity and can become inflamed, stretched, or torn. The mechanism of injury and symptoms are very similar to plantar fasciitis that was previously discussed.
Hindfoot
The hindfoot is composed of the calcaneus and talus. These bones serve as attachments for the medial and lateral ligaments that support the ankle joint; therefore injuries to the hindfoot are included in the segment with injuries to the ankle.
Information obtained from Booher & Thibodeau, Athletic Injury Assessment, 3rd Ed., Chapter 17

THE FEET CAN MEASURE THE HEIGHT ( Forensics )

2006-02-13T14:36:00.000Z

The bones of the feet can tell a lot about a person. What do feet reveal about a person's height? Forensic anthropologists team up with law enforcers to help solve crimes.
Bones of the feet can reveal an interesting fact about an individual. Let's combine math with forensics to see how.
Create a spreadsheet.
List the individuals name, height, and foot length.
Have some adults remove their shoes and measure their height.
Measure the length of the adult's left foot from the wall to the tip of the big toe.
Examine the numbers. Do you see a pattern?
Divide the length of each person's left foot by his/her height. Multiply the quotient by 100. What do you get? You may also want to use the calculator on a computer for this activity.
The results of your calculations should be about 15, illustrating that the length of a person's foot is approximately 15 percent of his or her height.
Find out the approximate height of each of your classmates by measuring their foot and charting it on a spreadsheet. Use this proporation for your calculations: 15/100 = Length of Foot/x (person's height)
When a forensic scientist has the length of a foot, the forensic scientist will be able to approximate the height of the individual. This works best on a full grown individual for the ratio of body parts is slightly different in growing children.
Reference Cyberbee

The Stephen Kite Practice & Podiatry Source Journal

2006-02-12T16:47:00.000Z

The Stephen Kite Practice & Podiatry Source Journal

Sterile environments anything but routine:
"There is no such thing as a sterile operating room environment," said Dale Bratzler, MD, of the Oklahoma Foundation for Medical Quality, who helped write national guidelines for reducing infection after surgery. "We make things as clean as possible, but most hospital surfaces still contain bacteria."
This chilling quote comes from a November Boston Globe article about a series of infections at a New England hospital. One of the infections may have been responsible for a patient's death. And this hospital, it should be noted, has a national reputation for an aggressive approach to infection control, according to the article.
In the situation cited in the Globe, the surgeon unknowingly had a staphylococcal infection, which went into his nose. The bacteria then went through his surgical mask and into the patient's lower back through the incision.
According to the Centers for Disease Control and Prevention, 20% of operating room workers have a staph infection, but show no symptoms. It's worth remembering that most institutions don't even test for it because it is so common, and unless a patient's immune system is severely weakened, staph is usually not a threat.
Of course, many hospitals and surgeons don't stop there in terms of infection control. Statistics cited in the Globe article claim that almost 70% of surgeons said they give patients antibiotic treatment before an operation, which is up 15% from 2001. And while 70% isn't bad (although I do wonder about the accuracy of the figure), the flip side is that 30% of surgeons don't feel this particular precaution is necessary.
And of course, along with the ubiquitous "wash your hands" signs, all personnel are instructed to wear gloves and masks and the patient's incision site is often shaved and cleaned before the procedure.
And yet, despite all that, patients get sick and some die from iatrogenic infections.
And, while it's not an apples to apples comparison, if you replace "operating room" with any of a choice of terms for examination room-any place, in fact, where practitioners are treating patients with wounds-the importance of proper care against infection is clear.
And yet, how do you impress on every practitioner, every staff member, every patient, even, the importance of this level of precaution?
After a while, those "wash your hands" signs become like anything you see over and over again. The importance stops registering and it becomes routine. But practicing that routine at the level necessary every single time falls to the rush to get to the next patient, the next procedure, the next location.
And the same logic applies with the prophylactic antibiotics. There are probably some situations where they aren't strictly necessary. Pharmaceuticals can be expensive, especially for small facilities. And sometimes the problem is not even the facility or medical staff. Patients might be given the drugs and then forget to take them before an outpatient procedure, for example. I know when I had my wisdom teeth out a few months back, the oral surgeon's office called me the day before the procedure to remind (I won't say nag) me about taking the antibiotics. But that takes staff time and leadership.
And maybe a real awareness, also, of the fiscal liability inherent in infection control. A patient gets sick while you are treating him, and even after he recovers, do you think he's coming back to your practice? How likely is he to consider some sort of action to recover damages? I don't know. But the threat of this kind of legal action should scare everyone to the sink for another round of scrubbing. Reference:Anthony R Edwards ( Biomechanics Journal) February 2006.

The Stephen Kite Practice & Podiatry Source Journal

2006-02-12T16:25:00.000Z

The Stephen Kite Practice & Podiatry Source Journal
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The Stephen Kite Practice & Podiatry Source Journal

2006-02-12T02:18:00.000Z

The Stephen Kite Practice & Podiatry Source Journal

Foot care is quite essential, even for those holidaying and relaxing at beaches and resorts in Southern Europe for the winter. If taking the occasional walk on the beach or a leisurely swim in the ocean is the extent of your vacation activity, be sure to listen to your feet. The following footcare tips are by Steve Kite will help you to live enjoy yourself safely when travelling in Southern Europe.
Always wear shoes or sandals while walking on sand, in order to prevent foot injuries from hot sand and objects that may be hidden beneath the sand. Make sure your sandals are well secured too, especially around the ankle.
Be sure to apply sunscreen to feet while basking in the sun; the skin on the feet is very sensitive and needs to be protected against the sun's harmful rays and you should wear a sunscreen no less that 30 Spf.
When buying sandals, be sure to look for ones that are comfortable and have plenty of arch support to prevent foot problems such as tired, achy feet and corns, calluses and blisters. . Fungus infections, which are responsible for Athlete's Foot, thrive in warm, moist environments including pool decks.

Have a nice vacation.
By Steve Kite