The Foot Clinic at Derma One

Derma One Medical Centre and Dr. Noor Janahi, Consultant Podiatrist, have combined their best efforts to bring to you the Foot Clinic. A specialized centre for the diagnosis and treatment of all foot and ankle problems

What is Podiatry?

Podiatry is a branch of medicine specialized in treating disorders and injuries of the foot and ankle while administering preventative health measures aiming at maintaining active ambulation within all ages including the senior citizens. The podiatry care that will be provided at Derma One will include diagnosing, treating and prescribing for any disease, injury, deformity, or problems of the foot and ankle using the very latest advancements in foot and ankle techniques. With an unrivalled focus on patient care, the processes of consultation, diagnosis, treatment and post-procedure care are all performed at the clinic by Dr. Noor Janahi and her exceptional staff.

Nail Conditions

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One of the most common nail disorders treated by Podiatrists are “Ingrown toe nails”. Ingrown toenail is usually caused by toe nails that grow inside the skin either as a result of trauma or poor nail cutting. Some people have naturally wide or curved nails that are more prone to developing ingrown toenail problems.

An ingrown toenail can often become infected with extra tissue growth around the toe nail as the body tries to fight the foreign body penetrating the skin. This is known as hyper-granulation tissue. Pus, discharge and redness results due to infection and antibiotics may be needed as treatment as well as removing the ingrown nail if it persists.

Ingrown toenail can be treated by a Podiatrist either conservatively or surgically depending on the severity of the problem. The most common procedure performed for ingrown toe nails involves the removal of wedges from the side of the nail. Phenol, a chemical, is then applied so that the nail is permanently narrowed. This operation leaves no scar and a normal looking nail.

Other Nail problems are those associated with infection or thickened nails. At Derme One Foot Clinic we have the latest technologies to reduce the thickness of the nails, and provide treatment for different types of infections associated with the nail or nail bed.

Heel Pain

10% of the adult population suffers from heel pain at some point in their life. Whilst there are many causes, examples of the most common conditions are shown below.

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Plantar fasciitis

Plantar fasciitis is caused by an overstretched ligament under the foot that causes inflammation and pain. This inflammation can lead to the development of heel spur (bony growth in the heel)

The treatment of this condition consists of a combined treatment plan which includes correcting the biomechanical structure of the foot causing the problem, a course of medication and rehabilitation. Most patients get better with conservative treatment using advanced orthoses and many other treatment strategies. Invasive treatments including techniques such as injections and shock wave therapy are sometimes required. Rarely, surgery is needed.

Stress fracture

Excessive activity on a specific bone in the foot can lead to the development of a stress fracture which can lead to a complete fracture if left untreated. Biomechanical analysis is done to check for areas of increased pressure on the foot and to reduce the impact on the bones. This can be treated with orthoses and specific running shoes and a planned rehabilitation programs.

Achilles tendonitis

Inflammation of the Achilles ligament (the ligament in the back of your foot) is very common. This can be treated conservatively with rehabilitation and orthotics. Or ultrasound guided injections.

Sever’s disease

Very common in children aged 10-14, Sever’s disease is inflammation of the growth plate of the heel.. The condition often occurs because of biomechanical and gait abnormalities and their treatment usually results in rapid resolution.

Diabetic Foot Disease

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How is the foot affected in Diabetes?

  • Diabetes damages the nerves (damage can occur to the foot without realising) – this is called peripheral neuropathy.
  • Diabetes also affect the the blood circulation. Poor circulation can affect the ability of the body to heal when damage occurs.
  • People with diabetes are more prone to infection – the body’s mechanism that normally fight infection respond slower and often have trouble getting to infections due to the poor circulation.
  • Diabetes can also affect the joints, making them stiffer which alters the shape of the foot

What can go wrong with the foot in Diabetes?

  • Foot ulcer are very common and usually detected at a late stage
  • Infections can spread and be harmful to patients
  • Amputations of parts of the foot may be needed to save the patient’s limb.
  • Charcot’s joints is another complication of diabetes in the foot, especially if peripheral neuropathy is present

Diabetic Foot Services at Derma One Foot Clinic will consist of:

  • Early detection and early prevention
  • Ulcer debridement
  • Advanced wound Care management
  • Patient Education
  • Custom Orthoses and Footwear
  • Management painful neuropathy (Foot Pain) caused by Diabetes

Forefoot Pain

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Forefoot pain (often referred to as metatarsalgia), can have many causes. The most important thing is to diagnosis it properly. We at Derma One use different techniques including orthotic therapy, mobilization, rehabilitation, and injection therapy for managing forefoot pain. Biomechanical analysis (pressure/force analysis) is one of the key investigations used at the Centre to determine the cause for metatarsalgia. This system is also required in ensuring that treatment has been effective in normalizing forefoot pressures.

Causes for metatarsalgia include:

  1. Morton’s neuroma: A condition where the nerve between the metatarsals becomes impinged and thickened. Non-surgical treatments are often used when the nerve has not enlarged too much. In cases where the nerve is large, injection therapy or surgery may be required.
  2. Plantar Plate / Flexor Tendon Inflammation: The most common cause for forefoot pain where the metatarsal heads have become over loaded due to forefoot instability and overload. Non-surgical treatment is generally effective unless the condition has become very chronic.
  3. Stress fractures: It is important to diagnose and manage a stress fracture quickly to avoid a “complete fracture” which can have far more serious consequences. The problem is generally caused by an overload due to the foot not functioning normally and a full biomechanical assessment is therefore important.
  4. Osteochondritis: Mostly related to injuries, Freiberg’s Infarction where the metatarsal head begins to fracture due to compromised blood circulation. This in turn is caused by a previous injury (commonly a stubbed toe).

Foot pressure and unbalanced forces are the main cause for forefoot pain. We at Derma One Foot Clinic use advanced systems to measure the individual loading time and magnitude on joints and bones of the foot.

Treatment focuses on achieving normal loading through footwear change, orthotic therapy and rehabilitation.

Bunions

A bunion is a deformity of the great toe joint where the first toe drifts towards the smaller toes. Usually, a “bony bump” forms on the inside of the foot as a consequence of the joint becoming more prominent. Often, the smaller neighboring toes drift out of position and this is often an indication of when surgery should be considered to avoid the development of a more extensive forefoot deformity.

When the bunion becomes symptomatic as a result of pressing on shoes, then wider shoes or surgical correction. When pain arises within the great toe joint, then specialized devices, various types of injection and footwear modification can be undertaken.

Hip Problems

Common conditions affecting the hip include different limb lengths, flat feet, arthritis, sciatica and iliotibial band syndrome. Conditions such as this are caused by biomechanical imbalances easily identified at the Centre using in-depth biomechanical assessment and gait analysis.

One common reason for hip related symptoms is the presence of a leg length discrepancy. Treatment includes specialist orthoses and footwear modification.

Corns and Calluses

Corns are areas of hard skin caused by prominent bony lumps and bumps, often in association with toe deformities. Corns and calluses can be reduced conservatively without surgery. In some cases however corns can be permanently removed with excellent cosmetic and symptomatic results.

Knee Pain

The knee is very sensitive to biomechanical mal-alignment. Normal knee function relies on an efficient functional relationship between biomechanics of the foot and pelvis. When either of these are out, the knee will begin to function abnormally and so become prone to injury. It is important that patients undergo a biomechanical assessment and gait analysis to correctly determine the factors which are causing the condition so that effective treatment can be initiated.

A myriad of different treatments are used to effectively treat the knee including the correction of kinetic and kinematic imbalances using functional orthoses, rehabilitation, and core stability programmes.

Shin Splint

Shin pain is very common amongst athletes of all standards. The first step in the management is to obtain a diagnosis, as there are many types of shin pain. The most common form of shin pain encountered is known as medial tibial stress syndrome whereby the inside of the shin becomes tender due to inflammation between the junction of the muscles and bone. This condition is generally treated very effectively by means of biomechanical correction/foot orthotics and focused treatment plan.

Warts

Verrucae or plantar warts are very common among children and adults. They can be painful affecting patient’s daily activities, and can spread from one person to another. Verruca treatment consists of planned programs using either chemicals or cryotherapy for destruction of the warts conservatively. Sometimes surgery is needed for large lesions. The exact type of the surgery depends on the nature, size and location of the verrucae.

Toe Deformities

Toe deformities such as claw toes, hammer or mallet toes are common toe deformities seen in Podiatry clinics. Other conditions include overlapping toes, webbed toes and curved toes. All of these deformities can be treated conservatively using such toe devices and reducing pain developed from corns and calluses and footwear modifications.

Children’s Feet

Taking care of your child’s feet is highly important for your child’s comfort. We at Derma One Foot Clinic offer complete foot assessments for growing pain, flat feet, knocked knees, sever’s disease, warts and ingrown toenails. Using advanced assessment methods and a holistic approach together with pressure platforms and video analysis we can help track your child’s foot and lower limb development over time to prevent any complications from developing in the future.

Sports Injuries

Sports injuries are common and usually managed by Podiatrists and Sports specialists. Shin splint for example is a very common pain that occurs amongst athletes of all standards. The first step in the management is to obtain a diagnosis, as there are many types of shin pain. The most common form of shin pain encountered is known as medial tibial stress syndrome whereby the inside of the shin becomes tender and inflamed. This condition is generally treated very effectively by means of biomechanical correction/foot orthotics and focused treatment plan. Other sports injury related problems are mainly associated with the joints and ligaments around the ankle. An accurate diagnosis of the injury will help athlete’s treat and prevent sports related injuries in the future.

We at Derma One Foot Clinic provide a comprehensive management program for foot and ankle care within athletes. This will include things like investigating your unique walking style and posture using video and 3D foot scanning technology. We can recognize foot and ankle problems as well as knee, hip and back alignment issues.

After the analysis, our clinicians may recommend a treatment plan that incorporates exercise, specialized injections into tissues and joints as well as bespoke prescription orthotics or sandals that would improve your alignment and gait during walking or running.

Gait Analysis

Gait analysis is the complete assessment of your lower limb while walking.

Orthotics

Orthotics are specialist Insoles or devices that provide a proper structural support to improve you foot’s function.

Orthotics manufacturing and prescription is a specialized approach requiring a comprehensive assessment by a qualified Podiatrist to be able to provide best support system for your feet. At Derma One Foot Clinic you can expect our specialized podiatrist to provide best options for your custom made orthotics according to your needs and requirements.