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Reducing pressure on the foot can be done using other areas of pressure load from the foot and also using the lower limb to take pressure away from the foot also. The more surface area that can contact a support device such as an orthotic or leg cast, the less impact on the wounded and ulcered area.

For example, if there is an ulcer underneath the foot an orthotic will reduce the pressure in that area let’s say by 5%. This is very good for off-loading an area with a corn. It will stop it growing back from the high intensity of weight in this particular area. If the pressure is too severe in a particular place then there will be a wound or an ulcer. In this case we need to use more skin surface area to reduce the stress on the overloaded area even further. This is when we would implement a total contact cast from the knee to the foot to reduce the pressure on the foot greatly.

We can imagine it like holding a vase if you hold a vase from underneath all the pressure is solely on the bottom of the vase. If you hold the vase at the sides like a total contact cast does on the sides of the shin and calf muscles then the pressure is greatly reduced when you place the vase on the table. Similarly if you hold the lower leg at the sides and front, the pressure on the foot is much reduced. That’s why we use the total contact cast to reduce the stress on the foot. A corn can be reduced by using an orthotic as this will reduce the load by 5%. A wound has to be reduced by minimum 30% pressure using below the knee cast or an air cast.



It is very common in babies and young children to have curling of the fourth toe towards the third toe. This is due to the way that the baby has been positioned in the womb. Not all babies have this condition because the big toe is usually the longest, followed by the second, third, fourth and fifth getting progressively smaller in length.

However, genetically some people have longer second, third toes and sometimes also quite long fourth toes. When the fourth toe is straightened from its curling position it is always the same length as the third toe. Normally the fourth toes is much shorter than the third toe. This causes the fourth toe to be curled when positioned in the womb under the third toe from the nature of the fetal position of the baby in the amniotic sac.

These toes are a result of a triathlon event. The toes show some bruising and one shows swelling and nail bed inflammation. The pressure from the liquid building up under the nail and unable to escape can cause severe pain to the toe, specially if there is any extra pressure added such as pressure from footwear or bed sheets.

The toenail needs removed and pressure release and another new healthy nail will grow.

These little adidas children’s trainers are really helpful for parents. The insole that comes with this shoe has a helpful lined area. When the shoe is new the toes should touch the first line. This gives plenty of room for the foot to grow. It can be confusing trying to know what size to buy and how much room for growth to allow. This adidas children’s insole method is extremely helpful.

This orthotic was worn every day for 12 years. The base shell was still perfect but the leather top cover eventually gave up. After recovering and some refurbishment, the orthotic was restored to it’s former glory. Here is the before and after. There was no need to make a new orthotic. Just a simple refurbishment was all that was required.

Osgood Schlatters and Severs is a painful condition that affects growing children usually between the ages of 11 and 16. In the past it has been more common in boys than girls however now we see an even distribution between boys and girls mainly due to girls having more chance to play sport.

The pain that occurs at the front of the knee and the back of the heel happens when the growth plate is inflamed. In a growing child the growth plate is slightly detached as this is where the growth of the bone occurs in length and when the child is very active this already inflamed growth plate can become angered and become very painful immediately after sports. It can be as painful as a broken bone. Rest and cool compresses immediately after sport will always help. However the children that are sporty off and do not want to rest and asking them to have time away from sport is very difficult and emotionally traumatising for them if they’re not playing sport every day. So this painful condition is a series of events. Firstly the child is always very active and sporty secondly the child will be going through an intense growth fees for example if you look at the lines behind their knees you will see a few of these lines where there should only be one in an adult these growth lines were sure how much they have grown in recent months. And thirdly the Inability to rest I am for a few weeks to allow the inflammation to go down exacerbates the condition. There is usually a structural issue that makes the problem worse for example the feet leaning and can cause extra pressure on the calf muscle to attach with the Achilles tendon into the back of the heel bone. Children with high arches off and develop more pain in their knees due to the very strong pull of the anterior tibialis muscle into the toes which attaches to below the front of the knee and this is where the growth plate exists.

When there is damage to the plantar fascia band that inserts into the heel bone, the calcaneal nerve can become pressurised causing the pain to increase. If the plantar fascia continues to pull on the heel bone for more than 1 to 2 years, a heel spur or spike will begin to grow. This heel spur can press on the calcaneal nerve if the enlargement is great. This is a very rare case but it is a possibility to be checked with a 3-D CT scan or contrast MRI.

In Dubai is very common for men and women to suffer from heel cracks. The skin becomes dry and papery and there is a white powdery appearance to the skin. The skin loses its elasticity and begins to split.

A medical pedicure can remove a lot of the excess skin on the feet and then deep penetrating antifungal gel is placed on the feet. The main cause of heel fissures is a dry fungal infection which actually gets worse the more you moisturise your feet.

Shoes for flatfeet correction is a very old and traditional method of treating flat feet. With today’s technology most flatfeet can be corrected within 1 to 2 years and wearing normal shoes.

With modern day materials the foot arches can be raised and the ankle can become straight using materials less than 1 mm in thickness. This has been very helpful in the treatment of flatfeet which means that the patient can wear normal shoes instead of medical shoes.

The cast of the foot is taken to make a mould and then a customer medical prescribed orthotics is made to fit inside regular shoes that starts to correct the foot usually the patient may need between 3 to 6 pairs for correction over 1 to 2 years time.

When you have a verruca or a plantar wart on your foot refrain from picking and trying to remove it using your fingers. It also spreads very easily to other skin and areas. In the images shown, the original warts were on the feet and have spread to the fingers and around the fingernails from a manicure. The virus can also spread from using the same tools such as a cuticle cutter and then using them your wart to trim off the dead skin like so do to remove a corn. Picking and playing with the warts and verrucae out of habit will spread the virus to other fingers and toes and skin areas.

For example, if you have a wart on your finger and you bite your finger nails, you can spread the warts to your lips. Similarly, if you sleep on your side with your hand on your cheek you can spread it to your face.

Visit the Podiatrist for swift treatment to get rid of this virus.

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