A podiatrist (voetkundige, in Afrikaans) is a medical professional with a four year degree in Podiatric Medicine from the University of Johannesburg, the only facility in Africa to offer the qualification. According to Stedman’s Medical Dictionary for Health Professions and Nursing, podiatry is defined as the health care specialty concerned with the diagnosis or medical, surgical, mechanical, physical, and adjunct treatment of the diseases, injuries, and defects of the human foot. SYNONYM: chiropody, podiatric medicine. But what does that mean? A podiatrist is the medical professional that sorts out your foot pain.
Why is it necessary to contact a podiatrist when you have foot pain or a lesion on your foot? The answer is simple to explain by means of an example: plantar warts or corns look very similar, but need very different treatment. Another example is foot pain: a cortisone injection will sort out your pain for now, but if flat feet or pes planus is the cause of the pain, you most probably need orthotics or arch supports to fix your foot pain. Podiatrists are the medical professionals that work with the most foot disorders of all medical specialties.
Have you ever suffered from any of the following disorders: heel spurs, heel pain, plantar fasciitis, plantar warts, corns, callosities, cracked heels, athlete’s foot, ingrown toenails, flat feet, bruised heel syndrome, pigeon toes, or Sever’s disease? These are examples of the conditions that are commonly treated by a podiatrist. However, to give you a better idea of when to consult a podiatrist, some of the above mentioned will be described briefly. These are not intended for self-diagnoses, but merely an indication for when to consult a podiatrist.
Sever’s disease: a condition of children noted by pain at the back of the heel, and is associated with a rapid growth phase.
Pigeon toes: when a person walks with his toes turned inward, often seen in children, and may be corrected when addressed early.
Plantar fasciitis: inflammation (pain, tenderness, swelling, heat) underneath and in front of the heel and underneath the arch of the foot. It often feels like a cramp underneath your foot, followed by pain in the arch and heel that may last a few days, weeks or it may be intermittent, and present for many years.
Plantar warts: a wart that grows on the foot sole. Warts are caused by the human papillomavirus. Plantar warts do not have a root, but is pushed into the deep layers of the skin by pressure and appears to be flat, and superficial, instead of lumpy and irregular as seen on the hands or elbows.
Corns and callosities: patches of thick skin or areas of concentrated skin growth caused by friction or abnormal pressure, such as ill-fitting footwear.
Bruised heel syndrome: a condition associated with pain underneath the heel, caused by bruising of the fatty pad underneath the heel.
Heel spurs (hoender of haak spoor): an abnormal growth in front of the heel bone (calcaneus) that may be painful - or not - and is often associated with plantar fasciitis.
Claw toes: toes that retract and may look like an eagle’s claw. A pair of simple insoles or orthotics (custom made, preferably) can help, or even correct the condition if treated early.
Why consult a podiatrist when your child has pigeon toes, or when you suffer from foot pain? A podiatrist is trained to identify and correct biomechanical faults or abnormal foot function. Furthermore, podiatrists prescribe (and can manufacture) orthoses and innersoles. These are corrective devices that change the foot function and support the arch in patients with painful high arched feet or painful flat feet (and feet types in between). These devices are often referred to as inners, inserts, or arch supports. Ask your podiatrist if he or she prescribes custom made orthoses, as custom made orthoses are made according to your own unique pair of feet and specific condition. Custom made orthoses are more comfortable than ‘prefabricated devices’, and in many cases be more durable. If you wear these devices and they are not comfortable, please inform your practitioner, as they are adjustable and may take up to 5 adjustments before they fit well. However, the treatment outcome of a decent pair of prefabricated and custom made orthoses are statistically similar. When compared there is no significant difference in the efficacy of the two types of devices, unless the devices are poorly prescribed. And please note that only podiatrists, physiotherapists, and orthotists are permitted to dispense orthoses. A final word of advice: if it looks cheap, it will probably not fix your painful feet, and if it is promoted to magically correct posture – it doesn’t.
In conclusion, South African podiatrists fix feet without performing surgery. In some cases we will recommend surgery as an option, for example a ruptured ligament that needs surgical repair to avoid osteoarthritis later in life. The great news is that Rustenburg has its own local podiatrists, situated in multidisciplinary health centers. Please perform an online search to get hold of your local podiatrist – the foot doctor.
(References are available on request).