Laser Treatment for Fungal Nails
This has been getting a lot of publicity all over the media and especially, on YouTube. Lots or providers widely touting it and its benefits. Fungal nails or onychomycosis is notoriously difficult to treat, so any new treatment that comes along needs to be considered. The problem with any treatment for fungal nails is that it can take 6 or more months to know if it works and the re-infection rate is so high. This means that even if a treatment is fantastic, there is no guarantee that you will not get the fungal nail problem again! Because of this good evidence is needed on the laser treatment of fungal nails compared to the other standard treatments. The laser treatment is not cheap and we just do not know how effective it is compared to other methods.
There is plenty of debate and advice, but no good scientific evidence as to it effectiveness.
Hallux Rigidus
Hallux rigidus is a problem of no or very limited motion at the big toe joint in the foot. It is almost always associated with osteoarthrtis of the joint and is usually painful. It also alters the gait and can result in compensations and symptoms in a number of other locations due to the way it alters the gait. The big toe joint is an important pivot for walking, so to loose that pivot due to hallux rigidus is significant. The only way to restore the pivot is with a rocker on the outside of the shoe or a surgical replacement of the joint. There are a number of things that can be done to help the symptoms and self exercises to mobilize the joint is always useful:
There is more on hallux rigidus at Podiatry Arena and you can ask a question about it at the Foot Health Forum.
The Foot Detox
I can’t believe that people are so gullible that they fall for this. A detox to remove toxins from the body via the foot. Its physiologically impossible. Its ludicrous.
The foot detox is a scam (see this) and does not work and will never work. See these videos for more.
Forensic Podiatry
Forensic podiatry is an interesting and fascinating discipline. It uses the expertise and skills that from podiatry in criminal investigations.
Some of these skills include footwear investigations, wear patterns in shoes and insoles and gait analysis. See these links here for more.
Cracked Heels
This is a problem that we see often and should not have to see as it can easily be managed by the individual if they are prepared to put in the effort to manage it. The cracks develop in the callus and dry skin around the heel. These fissure never heel and will tear on the good skin underneath which can become very painful. As long as the dry skin is kept moist and the thick skin is kept down, this is not going to be a problem.
Self care is the key to this condition. There is a good resource here on cracked heels. It really comes down to either putting the effort in to maintain it or coming and seeing a Podiatrists every few months. I give people the option. There is no miracle cure. Get the products you need and get going. Cracked heels is manageable.
The Foot Posture Index
Most of the students that come to me during their training have no heard of this, but are more familiar with the rather esoteric ways of measuring ankle in the foot. They often loose site of what the purpose of it all is and make it much more complicated that it really is. The loose site of the big picture and focus on the minute numbers. I teach them about the Foot Posture Index, so they can better focus on what the foot is rather than attach something mystical to all the numbers that they seem to put too much faith in.
Foot Reading
This is nutty. The whole purpose of “foot reading” is to determine people personality characteristics by looking at their feet. I have look at a lot of feet and I can not tell their personality form them!
Its can even be dangerous. There was a case highlighted here in which a Foot Reader was asking advice on a foot reading forum about how to interpret a black mark in the nail that sounded suspiciously like a malignant melanoma! Foot reading may be fine for entertainment and that is all! Others think that it could be an April Fools joke.
Fish Pedicure
The media love doing stories on this! The fish pedicure uses a small fish to eat the callus and dry skin on the foot. A number of spas around the world are offering this approach and it is becoming more popular. As to how effective it is, I do not know. I have not tried it, but do see a lot of testimonials on websites for it and they love it.
There are concerns about the infection risks from the water and the fish, which may or may not be valid. Health regulatory authorities are looking closely at this issue and some local agencies have banned the practice for that reason. As log as precautions are taken for a fish pedicure (eg no breaks in the skin), this should not be a problem or an issue for concern.
Forefoot Varus
Forefoot varus is an uncommon biomechanical dysfunction of the foot that causes the foot to pronate. It is due to a bony deviation that causes the foot to pronate or flatted to get to the ground. The only way to manage this type of flat foot is with foot orthotics. No amount of exercises or muscles strengthening will change anything, as the foot as to flatten to get to the floor.
Determining if forefoot varus is actually present or not is crucial, as there are potential problems if it is diagnosed as being present when its not (see this). The idea being is that if you use a forefoot varus post when there is no forefoot varus, then this will jam up the first pay to end range of motion and potentially be painful (more on this). Most cases of forefoot varus get confused with the soft tissue version of forefoot supinatis (link). There is a good collection resources here on this issue and its importance.
Foot Pain
If you have foot pain, then the internet is a treasure trove of information as well as misinformation! A recent study on the quality of foot care information on the web did raise some concerns with it:
The overall quality of Internet information for common foot and ankle diagnoses is variable, raising concerns about what information is currently available to patients.
There is no substitution for good quality advice from a licensed health professional versus an anonymous blogger!
Some source of infromation are better than other. I have found two sites that professionals answer questions on foot problems to be particularly helpful: Foot Health Forum and Podiatry Experts. Like any online advice, take the information with caution.