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Podiatry

Podiatrists are qualified to diagnose and treat a wide array of conditions related to the foot, ankle, and lower extremities. Some common conditions they address include:

1. Plantar Fasciitis: Inflammation of the plantar fascia, a ligament that connects the heel to the front of the foot, causing heel pain.

2. Bunions: Painful bony bumps that develop on the joint at the base of the big toe.

3. Ingrown Toenails: When the edge of a toenail grows into the surrounding skin, leading to pain and possible infection.

4. Diabetic Foot Care: Management of foot-related complications in individuals with diabetes, including ulcers and infections due to poor circulation and neuropathy.

5. Heel Spurs: Calcium deposits that form on the underside of the heel bone, often associated with plantar fasciitis.

6. Athlete’s Foot: A fungal infection that affects the skin on the feet, causing itching, redness, and cracking.

7. Flat Feet and High Arches: Structural foot issues that can lead to discomfort and affect walking and posture.

8. Arthritis: Inflammation of the joints in the feet, which can cause pain, swelling, and restricted movement.

9. Sports Injuries: Including sprains, strains, and fractures related to physical activities.

10. Corns and Calluses: Thickened skin layers that form on the feet due to friction or pressure.

11. Hammer Toes: A deformity where a toe is bent at the middle joint.

12. Fungal Nail Infections: Fungal growth under the nails, leading to discolouration, thickening, and crumbling.

13. Gait Abnormalities: Problems with walking patterns that can lead to discomfort and dysfunction in the feet and lower limbs.

14. Morton’s Neuroma: A painful condition involving the thickening of tissue around a nerve leading to the toes.

Podiatrists employ various treatments, such as physical therapy, custom-made orthotics, medications, and sometimes minor surgery, to manage and alleviate these conditions, aiming to improve foot health and functionality.

The answer can vary depending on the type of treatment and the individual’s condition and pain tolerance. Many podiatric treatments are non-invasive and focus on relieving pain and discomfort, such as custom orthotics for foot alignment, physical therapy, and medication for inflammation and pain.

For some conditions, particularly those requiring surgical intervention, there may be some discomfort during recovery. Podiatrists are skilled at minimising pain and discomfort for their patients, often using local anaesthetics for procedures that might cause pain and prescribing appropriate pain management strategies post-procedure.

If you have specific concerns about pain related to a podiatric condition or treatment, it’s best to discuss these directly with a podiatrist, who can provide information tailored to your situation.

The number of sessions you might need with a podiatrist depends on various factors, including the nature and severity of your condition, your body’s response to treatment, and whether you’re undergoing conservative management or surgical intervention. Here’s a general guide:

1. For Minor Conditions: Issues like mild ingrown toenails, minor fungal infections, or temporary pain might require only one to a few sessions.

2. Chronic Conditions: Chronic or more complex issues such as plantar fasciitis, bunions, or diabetic foot care often require ongoing management. This could mean regular visits over several months or even longer to monitor the condition and adjust treatments as necessary.

3. Post-Surgical Care: If surgery is involved, you’ll likely need several follow-up appointments to monitor healing, remove stitches, and begin rehabilitation.

4. Rehabilitation and Physical Therapy: Conditions requiring physical therapy might need multiple sessions spread over weeks or months, tailored to your progress and specific rehabilitation goals.

Each individual’s situation is unique, and a podiatrist will provide a more accurate estimate after assessing your condition. It’s important to discuss your treatment plan and expectations directly with your podiatrist to understand the anticipated course of treatment.

Seeing a podiatrist usually doesn’t require a referral since they are primary health practitioners, accredited by the Australian Health Practitioner Regulation Agency (AHPRA) due to their extensive training, including a rigorous 5-year university degree.

However, for treatment under Medicare’s Enhanced Primary Care (EPC) program, now more commonly known as the Chronic Disease Management (CDM) program, a GP referral is necessary to claim the EPC rebate. This program enables individuals with chronic conditions, lasting or expected to last six months or more, to access Medicare rebates for allied health services like podiatry. Eligibility requires management by a GP under a GP Management Plan (GPMP) and Team Care Arrangements (TCAs).

The process under the EPC/CDM program involves:

• GP Management Plan: Your GP evaluates your condition and, if eligible, develops a tailored GP Management Plan.

• Team Care Arrangements: For those needing services from other healthcare providers, such as a podiatrist, the GP will set up Team Care Arrangements involving at least two other health professionals.

• Referral to a Podiatrist: With an EPC/CDM referral, you’re entitled to up to five allied health services per year. The referral will detail the number of covered sessions.

• Medicare Rebates: Visiting a podiatrist with an EPC/CDM referral makes you eligible for Medicare rebates, currently around $58 per session, for a specified number of sessions. A gap fee, the difference between the podiatrist’s fee and the Medicare rebate, may apply.

Since rebate availability and processes can change, it’s recommended to check the current requirements and procedures with your GP for podiatry services under the EPC/CDM program.

AHPRA ensures all registered health practitioners, including podiatrists, meet national standards for education, competence, care, and ethics, maintaining the quality and integrity of healthcare in Australia.

Yes, podiatry can play a significant role in preventing injuries, particularly those related to the feet, ankles, and lower limbs. Podiatrists are trained to assess, diagnose, and treat various foot and lower limb conditions, and they can provide valuable insights and interventions to prevent injuries. Here’s how podiatry can help in injury prevention:

1. Biomechanical Assessments: Podiatrists conduct detailed evaluations of foot mechanics and overall lower limb function. Identifying and correcting biomechanical imbalances can prevent injuries that might result from poor alignment, abnormal gait patterns, or improper foot function.

2. Custom Orthotics: For those with structural abnormalities or specific foot conditions, podiatrists can prescribe custom orthotics. These are specially designed insoles that fit into shoes to support, align, or improve the function of the feet and lower limbs, thereby reducing the risk of injuries.

3. Footwear Advice: Proper footwear is crucial in preventing foot and ankle injuries. Podiatrists can provide expert advice on selecting shoes that offer the right support, fit, and cushioning for your feet, tailored to your activities and needs.

4. Strengthening and Conditioning: Podiatrists may recommend specific exercises to strengthen the muscles around the feet and ankles, improving stability and reducing the risk of falls and injuries.

5. Sports Injury Prevention: For athletes or those engaged in regular physical activity, podiatrists can offer strategies to prevent sports-related injuries. This might include advice on appropriate footwear, warm-up and cool-down exercises, and techniques to improve balance and agility.

6. Management of Pre-existing Conditions: By effectively managing pre-existing foot conditions such as flat feet, high arches, or previous injuries, podiatrists can help prevent further complications or injuries.

7. Education: Podiatrists provide valuable education on foot care practices, helping individuals understand how to maintain healthy feet and avoid situations that could lead to injuries.

Through a combination of clinical expertise, customised treatment plans, and preventive advice, podiatry can significantly contribute to reducing the risk of injuries and maintaining optimal foot and lower limb health.

In Australia, the term “podiatry” is the standard and recognised term for the profession that deals with the diagnosis, treatment, rehabilitation, and prevention of medical and surgical conditions of the feet and lower limbs. The distinction between “chiropody” and “podiatry” largely reflects historical and regional differences, but in Australia, “podiatry” encompasses the full scope of foot and lower limb healthcare.

Australian podiatrists are highly trained healthcare professionals who complete a university degree in podiatry. Their training covers a wide range of areas including biomechanics, pharmacology, general medicine, and surgery. This enables Australian podiatrists to offer comprehensive foot care, ranging from treating common conditions like ingrown toenails and calluses to more complex procedures such as corrective surgery for foot deformities and management of sports injuries.

The term “chiropody” is less commonly used in Australia and is considered somewhat outdated. It may still be recognised by some people but is not the preferred term within the professional community. The evolution of the profession to “podiatry” in Australia reflects the expanded scope of practice and the advanced clinical skills that podiatrists bring to patient care, including their ability to perform surgical procedures and their role in managing systemic diseases that can affect foot health, such as diabetes.

In summary, in Australia, the term “podiatry” is used to describe the profession that provides specialised care for the feet and lower limbs, with a focus on preventing, diagnosing, and treating conditions associated with this part of the body.

Deciding whether to see a podiatrist or a physiotherapist for a foot problem depends on the specific nature and symptoms of your issue. Here’s a guideline to help you choose the most appropriate professional:

Podiatrist:

• Specialisation: Podiatrists specialise in diagnosing and treating conditions specifically related to the foot, ankle, and lower limb. Their training is focused exclusively on the feet and lower limbs.

• Conditions Treated: They treat a wide range of foot problems, including but not limited to bunions, heel pain, ingrown toenails, fungal infections, diabetic foot care, and structural issues like flat feet or high arches.

• Treatments Offered: Podiatrists can provide specialised treatments such as custom orthotics, nail surgery, and in some cases, minor foot surgery. They also offer advice on proper foot care and footwear.

Physiotherapist:

• Specialisation: Physiotherapists focus on movement and function throughout the body. They help patients recover from injuries, reduce pain and stiffness, and increase mobility.

• Conditions Treated: A physiotherapist can treat a range of musculoskeletal problems, including those affecting the feet, but their scope is not limited to just foot and ankle conditions. They also address issues related to muscles, joints, and soft tissues throughout the body.

• Treatments Offered: Physiotherapy treatments might include exercises, manual therapy, and advice on movement and posture. For foot-related problems, they may focus on strengthening and rehabilitation exercises to improve function and reduce pain.

Decision Guide:

• For specific foot and ankle problems, structural issues, or skin and nail concerns related to the feet, a podiatrist is likely the most suitable to consult.

• For issues related to overall movement, muscle strength, or if the foot problem is part of a larger musculoskeletal issue, a physiotherapist might be more appropriate.

In some cases, both podiatrists and physiotherapists can play complementary roles in the management and treatment of foot problems, especially where rehabilitation and specific foot care are both essential. 

Yes, you can see a podiatrist if you’re pregnant. In fact, it can be particularly beneficial to consult a podiatrist during pregnancy due to the various foot-related issues that can arise during this time. Pregnancy can lead to a range of changes in the body that affect the feet and lower limbs, including:

1. Swelling (Oedema): Increased fluid retention during pregnancy can lead to swelling in the feet and ankles, which can be uncomfortable and may affect your mobility.

2. Arch and Heel Pain: The added weight and pressure from pregnancy can lead to foot pain, particularly in the arch and heel, which is often a result of plantar fasciitis or flattening of the feet.

3. Changes in Foot Size: Some women experience a permanent change in their foot size during pregnancy, with feet becoming wider or longer, necessitating a change in footwear.

4. Varicose Veins: Increased blood volume and pressure on the veins in the legs from the growing uterus can lead to varicose veins, which can be painful and cause discomfort in the legs and feet.

A podiatrist can provide valuable care and advice for managing these and other foot-related issues during pregnancy. Treatments and recommendations might include:

• Supportive Footwear: Advice on suitable footwear to accommodate changes in foot size and provide necessary support to alleviate discomfort.

• Orthotics: Custom or over-the-counter orthotic devices can provide additional support and relieve pressure on the feet and lower limbs.

• Exercise and Stretching: Guidance on safe exercises and stretches to help maintain foot health, improve circulation, and reduce swelling.

• Management of Foot Pain: Treatments for specific conditions such as plantar fasciitis or arch pain, which might include taping, soft tissue therapies, or gentle mobilisation techniques.

It’s important to inform the podiatrist about your pregnancy so they can tailor their care and treatment recommendations to suit your specific needs during this time. Always consult with your obstetrician or healthcare provider before starting any new treatment or therapy during pregnancy.

A general practice podiatrist in a clinic setting typically carries out minor surgical procedures under local anaesthesia as part of standard podiatric care. These minor surgeries aim to address common foot issues that don’t necessitate complex surgical intervention:

• Nail Surgery: Procedures like partial or total nail avulsion are common for treating ingrown toenails, involving the removal of part or all of the toenail, and possibly the nail matrix, to prevent future occurrences.

• Removal of Soft Tissue Lesions: Minor surgical techniques are employed to remove surface-level issues such as warts (verrucae) or small soft tissue masses like fibromas.

• Corn and Callus Debridement: The careful scalpel removal of hard skin (calluses) and corns, while not traditional surgery, helps reduce thickened skin areas and alleviate pain.

• Biopsy of Skin Lesions: To diagnose the nature of a skin lesion, a podiatrist may perform a small biopsy, which involves removing a piece of skin for lab analysis.

• Foreign Body Removal: This involves the extraction of objects like splinters that are embedded in the foot.

These procedures typically provide immediate pain relief and address conditions that might lead to more serious issues if untreated.

For more complex conditions requiring advanced surgical intervention, a general practice podiatrist would refer the patient to a podiatric surgeon or an orthopaedic surgeon specialising in foot and ankle surgery. Examples of such complex surgeries include:

• Bunion Surgery: Correcting the misaligned bones of the big toe and foot that form bunions to relieve pain and improve function.

• Hammer Toe Surgery: Addressing toe deformities where the toe is bent at the middle joint, causing pain and shoe-wearing difficulties.

• Neuroma Surgery: Removing painful, swollen nerves in the foot, often between the third and fourth toes (Morton’s neuroma).

• Plantar Fasciitis Surgery: Considered when conservative treatments fail, this surgery involves releasing part of the plantar fascia ligament to relieve tension and pain.

• Flatfoot Reconstruction: Involves correcting severe flatfoot deformities with techniques like tendon transfers, osteotomies, and joint fusion.

• Ankle and Foot Arthroscopy: A minimally invasive procedure using a small camera and instruments to diagnose and treat foot and ankle joint problems.

• Soft Tissue Masses and Cysts Removal: Including the excision of ganglion cysts, fibromas, and lipomas.

• Arthritis-Related Surgeries: Such as arthrodesis (joint fusion) for arthritic pain relief, or osteotomies for joint realignment and pain reduction.

• Fracture Repair: Ensuring proper alignment and healing of broken bones in the foot and ankle.

The scope of practice, including surgical privileges for podiatrists, varies by state and territory, and not all podiatrists are qualified or choose to undertake surgery. Patients should verify their podiatrist’s qualifications and experience in podiatric surgery.

In Australia, podiatrists are regulated and registered professionals, governed by the Podiatry Board of Australia under the umbrella of the Australian Health Practitioner Regulation Agency (AHPRA). AHPRA ensures that all health practitioners, including podiatrists, adhere to consistent national standards for practice and conduct.

To become a practicing podiatrist in Australia, one must complete an accredited university podiatry program, typically culminating in a Bachelor’s degree in Podiatry. Graduates must then apply for registration with the Podiatry Board of Australia via AHPRA, meeting educational and registration standard requirements.

Continuing Professional Development (CPD) is mandatory for maintaining registration, ensuring podiatrists’ skills and knowledge remain current. This stringent registration process and adherence to professional standards guarantee that podiatrists deliver safe and effective care.

Furthermore, podiatry services are recognised for their therapeutic value by various government programs such as WorkCover, the Transport Accident Commission, Veterans Affairs, and Medicare, which offer rebates for eligible individuals, underlining the profession’s integral role in healthcare.