South Hams Podiatry

Nick FarmerBSc(Hons) DPodM MChS FRSPH HPC reg Pod

 01548 559 191
  07850 784 725
   07376 382 630

Podiatric Conditions

Callus and corns may be caused by ill fitting footwear or gait abnormalities where pressure, friction or continuous direct impact on certain areas stimulates the body to produce excess skin over those affected areas to protect them.

The callus may be centred at some points and this produces a corn which is like an inverted diamond causing pain. Some corns may be soft and found between toes where joints rub together and these too can become extremely painful and in some cases infected.

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These nails are horrendously overgrown and also infected with a fungus . This is not an uncommon sight and often occurs as people become less able to cut their own nails either through disability or because the nails have become too hard and big to cut with scissors. They are able to be cut back and reshaped normally with one visit.

The first picture shows another nail that is infected with fungus or yeast. It can be seen that the infection is slowly spreading across the nail and may in time totally destroy the existing nail and possibly affect the neighbouring nails too (as in the second picture on the right).

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This is a fungal infection between the toes, commonly known as 'Athletes Foot'. It often occurs where toes are very close together either because of structural reasons or due to tight fitting shoes which over a period of time may lead to decreased space between the toes. If these spaces are not dried carefully after a shower or bath the moisture and warmth will encourage the infestation of fungus (think of mushrooms which like to grow in warm, dark and moist conditions!). The area between the toes may become itchy and sore and macerated (white appearance and damp) with the skin peeling off. In some cases they may bleed and cracks appear below the toe webbing and are this then becomes a prime area for bacterial infection. It can be treated with some topical gels and shoes sprayed regularly with an anti fungal powder spray.

Never put non fungal cream or talcum powder between your toes as this provides a substrate on which the fungus may live.

Sometimes the fungus may affect the entire sole and sides of the foot presenting in dry powdery looking skin with small or large red spots or pustules and often flaking skin.

Bunions or to give them their correct title Hallux Abducto Valgus can be painful, unsightly and a nuisance when it comes to buying shoes.

The term "hallux abducto-valgus" is the most commonly used medical term associated with a bunion anomaly, where "hallux" means the big toe, valgus" refers to the abnormal angulation of the big toe (i.e. it is often flat to the ground) and "abductus” refers to the abnormal drifting or inward leaning of the big toe towards the second toe.

Bunions are often genetic or are a result of ligaments, muscles and tendons being out of sync with each other. Often people who start to develop bunions have flat feet or excessive flexibility of ligaments, abnormal bone structure, and certain neurological conditions.

Some experts believe that poor-fitting footwear is a major causative factor of bunion formation, but others think that footwear only exacerbates the problem caused by the original genetic structure. No evidence exists to suggest that wearing 4 inch high heels cause bunions!

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People may be born with or develop certain gait abnormalities over a period of time. It is said that we will walk around 100 -150,000 miles in a lifetime and as each step that we take may place up to 3 times our own body weight onto a few bones, muscles, tendons, ligaments and cartilage is it any surprise that sometimes things can go wrong and we experience pain or discomfort?

A bio-mechanical or musculo skeletal examination involves looking at what is happening to not only the feet, but also to the rest of the body in relation to a persons gait, posture and footwear. Not all problems require insoles or orthotics to be prescribed and some conditions may be resolved by footwear advice and the provision of exercises.

If additional assessment is required patients can be referred for X Ray or scans including Ultrasound Diagnostic Scanning via their GP. Ultrasound diagnostic scanning is also available privately and normally at relatively short notice. Referrals to private physiotherapists and other practitioners is also available.

Verrucae are caused by the human papiloma virus (HPV). This virus is very contagious and can only be caught by direct contact. It thrives in warm, moist environments such as swimming pools, changing room floors and bathrooms. So if an infected bare foot walks across the poolside, it may release virus-infected cells onto the floor. If you then walk on the same floor, you can pick up the virus, especially if you have any small or invisible cuts and abrasions that make it even easier for the virus to penetrate. You could also catch the virus from an infected towel.

A verruca is a wart that is usually found on the soles of your feet, though they can also affect the toes and around the nails. At first a verruca looks like a small, dark, puncture mark but usually turns grey or brown. It may become rough and bumpy with a cauliflower-like appearance and may develop a black spot in the middle, which is caused by bleeding. A verruca can grow to half an inch in diameter and may spread into a cluster of small warts which can in some cases cover the huge areas of the foot.

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If treated when symptoms first become apparent then often the nail may be 're-trained' (along with the patient's nail cutting skills!). If not then sometimes the only solution is to remove either part or all of the nail to alleviate the problem.

Nail surgery is often thought of as a very painful procedure but apart form a few seconds when local anaesthetic injections are given the whole procedure is quick and painless. Normally patients are in and out of the surgery in under an hour. Healing normally takes between 6-8 weeks and generally people find that they are not too restricted in what they can do post surgery during the healing process.