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26/Apr/2017

Footerella TM is the fairy godmother for foot problems and their solutions. It is a combination of insoles in 3 stages for the lifting of the bones in your feet than increase arch height that decreases foot length and width. It has tapes to tighten the ligaments of your feet that act as the bindings between you bones that keep you foot in place. It also has an electro muscle stimulator pad that is wireless and engages the nerves that innervate the muscles and strengthen them. Strong muscles mean tight and toned feet.


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26/Apr/2017

Work shoes are particularly important for your feet. If they do not fit correctly they can lead to corns and bunions. We are now seeing more males than females with corns to the 5th toes from tight fitting footwear. Also, if there is foot collapse then orthotics (specialist insoles) can be placed inside the work shoes. Our patients in Dubai are health and image conscious. That is why Chief Podiatrist Michelle Champlin works with patients to keep them in their formal dress shoes using techniques invented for the high standards of Dubai. We even have an orthotic named after DIFC for men & women’s business shoes. You can see the various types of orthotics and insoles designed for DIFC. The most popular colour choice in DIFC for our male patients is purple and for women is beige pink as shown.


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26/Apr/2017

Heli-skiing, remote adventure skiing and Ski – Dubai have all become very popular in the desert! Due to ease of travel our patients can fly to other countries during ski season or pop in to Mall of the Emirates to go skiing. Calf cramp and forefoot numbness and knees together are common problems we see in skiing. Most of the actually biomechanical correction of the foot and lower limb is done outside the ski boot in work and sports shoes. The actual ski orthotic has to be minimal as the efforts from the orthotic are multiplied when skiing. Manipulation of the foot and lower leg can be done with high intensity orthotics placed in walking shoes and a much-refined version placed into the ski boots. Have at look at our ski orthotics.


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26/Apr/2017

In our previous blog, we shared some tips on choosing shoes that benefit your feet. Sometimes, due to medical reasons, retail shops don’t offer shoes that fit, so specialist footwear might be recommended. (In many cases though, orthotics may be able to fit inside regular retail sports, school or leisure shoes to correct a foot issue such as flat feet).

Stock Footwear 
Stock footwear is specialist footwear which is available in a variety of styles and fittings, for example extra deep and/or extra wide. The manufacturers of this footwear provide size charts of optimal ranges for length, joint width, joint circumference and instep circumference, which are the measurements that are required to enable the fitter to decide on the fitting of the footwear. Their choice may also be based on the style of the footwear in relation to function, for example the addition of rocker soles or extra padding. This footwear is generally supplied with 3 × 3 mm removable liners that can be replaced with orthotic devices. Often these liners are made from a shock-absorbing material.

Bespoke Footwear
This footwear is made on a last specifically created for the individual, and often requires a plaster cast to be taken so that the footwear technician can visualize the problems and capture the dimensions of the lower leg and foot. Many measurements of the foot are required and these are recorded on a draft with instructions for the technician. This is very much a craft skill and is being updated with scanning technology and the use of CADCAM in the manufacture of both the lasts and the bespoke footwear.

For foot and leg health care and treatment, as well as footwear advice and orthotics, contact Dubai Podiatry Centre, led by Chief Podiatrist Michelle Champlin, on +971 4 3435390.


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26/Apr/2017

Painless, problem-free free walking and running is achieved by the systematic and coordinated activity of the foot and lower limb muscles and bones working in harmony. The alignment and function of the bones of the foot play a vital role in turn, in aligning the joints of the ankle and lower leg, and they also influence the positioning and function of the knees, hips, back, arms and neck throughout the gait cycle. How the foot is held within shoes and the footwear design itself can have a significant effect on the biomechanics of the lower limb and upper body, whether this is sports shoes, flip flops or high heels.

Footwear and/or orthotics play a key role in modifying the position of the foot and limb and provide functional control through realigning and stabilizing the limb during when walking, standing or running.

Adaptations to the heel and sole of certain shoes may occasionally be advised by your Podiatrist, as it can enhance and complement orthotic therapy, reduce excessive and abnormal wear of the footwear, reduce painful symptoms and improve foot function and mobility.

Choosing Shoes
There are a vast range of footwear options in relation to style, purpose and function – a look around the malls of Dubai alone show an endless supply of shoes. However, the range can be confusing, and as Podiatrists, we are trained to advise on the suitability of footwear for different purposes and for each patient’s foot type. In addition to generic factors in footwear design and fit that make a good shoe, there are factors that are unique to each individual.

In particular, when a foot’s dimensions will not fit into retail footwear because of shape, posture or functioning, specialist therapeutic footwear may be required. This footwear may be off-the-shelf specialist footwear that is often described as ‘stock’ footwear. However, if the foot problem is greater than can be accommodated in ‘stock footwear’, or if the biomechanical needs are more complex, then the footwear may have to be ‘bespoke’ and made on a ‘last’ (a type of solid foot model) manufactured for the individual patient

Retail footwear: ‘What makes a good shoe?’
There are now many shoe designs that are appropriate for foot health and affordable. Many foot problems benefit from a change in footwear style or to a style with different features. Some footwear can also be modified to an extent. In fact there are features of retail footwear that make it ideal for the high-risk foot but that are also useful for maintaining good foot health in any individual. (read more about shoe related foot problems here). These features are:

  • stable, low heel (cushions heel strike and reduces risk of plantar fasciitisheel pain)
  • padded topline to reduce irritation to the retro-calcaneal (heel) area and the infra-malleolar areas (bony prominence around either side of your ankle)
  • no prominent internal seams (preventing irritation and blisters)
  • roomy, rounded toe box (avoiding corns due to a pointed, cramped toe box)
  • increased toe spring or rocker sole to reduce forefoot plantar pressures
  • lace-up or Velcro fastening to hold the shoe to the foot, adjustable for different foot types.

One issue with shoes, is that due to the differences in the ‘lasts’ used for different footwear brands and even differences in international sizing, there is lack of standardization. Thus, you may be different sizes in different shops. Be sure to try shoes on in every shop you try. See more tips in our shoe buying guide and guide for buying teenagers’ shoes).

For advice on foot and leg health, and the best shoes for your foot type or sport as well as assessment for orthotics, contact Dubai Podiatry Centre on +971 4 3435390.


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26/Apr/2017

Toenail issues commonly occur due to participation in various sports, such as tennis, running, basketball or netball. Problems are usually caused by repeated trauma to the nail plate, nail bed, or nail matrix.

The most commonly reported sports-related nail problem is sometimes referred to as ‘tennis toe’. This condition is marked by darkening of the toenail caused by subungual (‘under the nail’) haemorrhage. This subungual hematoma is caused by repeated banging of the athlete’s toes against the toebox of the shoe as a result of abrupt stops on the tennis court. Footballers experience similar issues – called ‘onychoptosis defluvium’ (nail shedding), ridging across the toenail and onycholysis (toenail lifting up) that often are frequently caused by the impact force of kicking.

More nail conditions, including onychocryptosis (ingrowing toenails) and subungual exostosis, have been reported among dancers. Nail changes also have been reported among basketball players, netball players and runners.

Runner’s toe refers to subungual hemorrhage with associated nail discoloration, onycholysis, and erythema of the smaller third, fourth, and fifth toes. The affected nail(s) may also eventually become ridged, lift up and eventually fall off.  Sometimes it is just the big toe that is affected, but frequently the second toe is – especially if it is longer than the big toe.

Diagnosis
Diagnosis of runner’s toenail will also mean ruling out other causes, such as onychomycosis (fungal nail) and subungual malignant melanoma. Unlike jogger’s toenail, onychomycosis typically is characterized by subungual hyperkeratosis – a build up of hard skin under the nail. Malignant melanoma causes nail plate discoloration and can also involve the nailfold. The Podiatrist will be able to differentiate between these upon examination and may recommend removal of the nail or biopsy of the area, both of which are easily and painlessly achievable.

Runners (and other sports players) may be advised to wear sports shoes that have an adequate toebox so that the longest toe and nail does not slam into the end of the shoe – both in distance and depth of the toebox. Shoes also should fit the midfoot properly, as choosing a shoe that is too big overall will also lead to the foot slipping around inside it.

Treatment
A training shoe that fits snugly but comfortably in the midfoot prevents the foot from being forced forward into the toebox, particularly during training on downhill courses (see our guide to sports shoes). Orthotics can also aid in this function, especially if the toes are positioned / moving in a way due to a biomechanical malalignment further back in the foot and/or ankle. Most runners already keep their nails short and maintain excellent foot hygiene, and this also lessens the risk.

If you notice any changes in your toenail condition, such as discolouration, ingrowing or lifting up, see the Podiatrists at Dubai Podiatry Centre led by Chief Podiatrist Michelle Champlin. Contact the clinic on +971 4 3435390.


26/Apr/2017

Today, 14 November, is World Diabetes Day. The UAE has one of the highest rates of diabetes in the world. Although much is being done to tackle this global epidemic, there are simple steps you can take to minimize your risk. Get yourself tested (it’s easy and fast). And if you are diagnosed with diabetes, there’s plenty you can do to lead a healthy life without complications, such as getting your eyes tested annually by your ophthalmologist, your feet by your Podiatrist and seeing your Diabetologist / GP regularly. Yaking any medication as prescribed as well as eating healthily and being active are vital too.

Here are the latest statistics (courtesy of the International Diabetes Federation):

  • Approximately 415 million adults have diabetes; by 2040 this will rise to 642 million
  • The proportion of people with type 2 diabetes is increasing in most countries
  • 75% of adults with diabetes live in low- and middle-income countries
  • The greatest number of people with diabetes are between 40 and 59 years of age
  • 1 in 2 (46%) people with diabetes are undiagnosed
  • Diabetes caused 5 million deaths in 2015; every six seconds a person dies from diabetes
  • Diabetes caused at least USD 673 billion dollars in health expenditure in 2015 –12% of total spending on adults
  • More than 542,000 children live with type 1 diabetes in 2015
  • More than 20.9 million live births were affected by diabetes during pregnancy in 2015 – 1 in 7 births 

If you are worried you might be diabetic, see your GP without delay. They will refer you for an eye and foot check (and you can also refer yourself here in the UAE). Contact the UK trained and qualified Podiatrists at Dubai Podiatry Centre on +971 4 3435390 today


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