Category Archives: Uncategorized

Autumn itch? Winter scratching?

Why are my feet/legs itching with the change of weather?

There seems to have been little time elapsed between the hot sunny days of the summer and the leaves changing colour on the trees and changes in the weather means changes on what we see in clinic.

As Podiatrists, some of the conditions we see on the feet and lower legs are seasonal and related to exposure to too much or too little sunlight.

For example, too much sun leads to sunburn on the tops of exposed feet in a heat wave.

As we move through Autumn and into winter, when we are covering up and going back inside, there is one skin condition that becomes more common, and it is frequently (but not always) betrayed by itching and is commonly known as ‘the winter itch’.

It is a form of eczema.

Asteatotic Eczema

Eczema is commonplace, with numerous sub-types, and autumn and winter living can aggravate some of these. The ‘winter itch’ is known as Asteatotic eczema, also known as eczema craquele or xerotic eczema.

As the temperature outside falls, we cover-up and turn the heating on and up. As a result, skin dries out and can lead to the forming of discrete dry, scaly patches on the top of the foot and on the lower legs. It can also appear on the arms.

What does I look like?

The appearance varies from person to person.

When it begins, it can appear as a dry with a fine scale, with a criss-cross or crazy paving appearance and can easily be confused with an athlete’s foot or tinea infection.

When well-developed it can be similar to the dried mud cracking in the bottom of an empty pond in the heat of summer. As the eczema develops and enlarges, it is characterised by oval or circular lesions (nummular), an can appear redder, even with weeping and crusting.

Why has it developed?

Asteatotic eczema is more common in the elderly as the skin doesn’t produce enough natural moisturizing factors leading to it drying out, but can be found at any age. There are a number of aggravating factors including

  • Age
  • Illness
  • Hypothyroidism
  • Menopause
  • Side effects of medication
  • Zinc deficiency
  • Too much bathing/showering and drying

Should it be treated?

In short – yes. Definitely.

With this form of eczema, the skin isn’t able to serve one of it’s primary functions – as a barrier offering protection. If left untreated it can allow a gradual breakdown of the skin leading to larger areas being involved and the development of more serious conditions and sensitivity.

How do we treat it?

This is surprisingly simple but effective.

  • Reduce the frequency, length and temperature of baths/showers
  • Avoid standard soaps/detergents/shower gels as they will dry the skin
  • Thoroughly rinse any soap residue from the legs and feet before drying
  • Use soap substitutes such as E45 Wash Cream & QV Gentle Wash – but remember – it will make your shower/bath more slippery, so take care.
  • Dry by ‘dabbing’ not ‘rubbing’
  • Keep the skin at an even temperature
  • Cream, cream, cream – emollients are widely available with urea-based products being particularly useful. If in doubt, ask your GP or practice nurse

How can you be sure?

The first step is to confirm what is causing your symptoms. It is all too common to self diagnose through what you read on the internet. If you want to know for sure, then you need to seek the advice of an appropriate health care professional. Visit your local Podiatrist, GP, nurse practitioner or dermatologist.

If you would like more information or to make an appointment with one of our Podiatrists, call us on 01628 773588 or email info@maidenheadpodiatry.co.uk

Ten things you need to know if you are constantly on your feet

The ligaments, tendons, and muscles in our feet support and coordinate movement. So walking helps strengthen them and keeps them supple.

Ten things you need to know if you are on your feet most of the day.

1. Forget fashion

Unless your footwear at work is specified in your contract, or is part of your uniform, make sure you choose the most practical and appropriate shoe/boot for your profession.Don’t be a fashion victim, choose work specific footwear.

2. Before exercising or spending a long time on your feet

Consult your podiatrist if you start to develop any pain when walking, or consider a visit before embarking on a new walking program or taking on a new job where you know you are going to be on your feet for an extended period.

3. Current footwear

Properly fitting shoes is the key to keeping your feet healthy and comfortable. Whatever type of walking you do, wearing the right footwear is essential. When buying shoes especially walking shoes, try numerous brands, styles, and sizes. Walking shoes/boots do not come in different width fittings but widths vary with different manufacturers.

4. Your feet can expand as much as half a size during the day

Buy shoes in the afternoon or early evening when your feet are at their largest.

Feet can expand by as much as half a size as the day goes on.That is why shoes can feel as if they are getting tighter the longer you wear them.

This will help protect them as they expand during your long walks. Also, wearing the same type of socks when fitting shoes that you wear when you walk will help you choose the right shoe.

Once you have made your purchase – take care of them.

5. Once I have my shoes/boots, what next?

If you are going on a long walk, prepare well ahead. When you first have your shoes/boots wear them around the house. This will keep them clean in case you need to take them back; it also allows you to get used to them on even, consistent surfaces. You can try different socks in the comfort of our own home too.

Wear your shoes for a ‘trial walk’ and build up the distance gradually. Don’t try to complete the Three Peaks on your first trip!

6. What else can I do?

It’s also a good idea to examine your feet every day, and pay a visit to your local HCPCregistered podiatrist who will be able to give advice. There they will treat any corns, callus, or any foot issue you may have.

7. Before you set off:

  • Pack simple first aid supplies, such as plasters or antiseptic cream, for your walking trip in case of accidents
  • It’s also a good idea to put Vaseline between your toes to prevent chafing. This makes it an ideal lubricant
  • Applied as a lubricant at the start of an event, such as between the toes, it will still be working well at the end

8. Warm-up

Begin your walk at a slow pace, increasing the pace of your walking gradually. This gives the muscles, bones, tendons, and ligaments that support the structure and movement a chance to get used to the activity by degree.

If you do experience any discomfort or foot pain, then it could be an indication that something isn’t right. In many cases, early diagnosis prevents a small injury from becoming a larger one.

9. Socks, and choice of socks are important

Good socks not only add to the comfort of your feet in your shoes but will also helps keep them dry, drawing moisture away from the feet.

It isn’t a good idea to wear 100% cotton socks as they hold moisture against the skin, and can lead to painful blistering.

Wool and silk are often blended with synthetic materials. If you find wool too warm or too irritating, you could try acrylic blended socks. Socks made with new material such as CoolMax or DriMax are designed to draw sweat away from the skin, keeping feet dry. Double thickness socks are great, particularly with distance walking, if you are prone to blisters.

10. Insoles can help support your foot

Frequently, an appropriate insole or orthotic can give the extra support you nee for a long shift.

Orthoses are available in a range of prices and styles, from off the shelf/one size fits all, to a fully moulded and customised professional product that will last you years.

At Maidenhead Podiatry we offer a complete musculo-skeletal and bio-mechanical package including fitting and follow-up.

If you would like more information or make an appointment with one of our Podiatrists, give us a call on 01628 773588 or e-mail info@maidenheadpodiatry.co.uk

What is Diabetes?

At Maidenhead Podiatry we are frequently asked – what is diabetes?

Diabetes is a chronic, potentially debilitating disease.

It occurs as a result of problems with the production and supply of a hormone called insulin.

Insulin is a hormone produced in the pancreas by the islets of Langerhans which regulates the amount of glucose in the blood.

In type 1 diabetes the body either produces no or insufficient insulin and in type 2, or late onset diabetes, the body can’t use the insulin it produces effectively.

Type 1 diabetes is sometimes called insulin-dependant, immune-mediated or juvenile onset diabetes.

It is caused by an auto-immune reaction where the body’s defence system attacks the insulin producing cells.

The reason this happens isn’t understood but explains why the onset of diabetes often follows illness.

It can affect people of any age but usually occurs in children or young adults.

Type 1 diabetics need regular injections of insulin to control the level of glucose in their blood.

Type 2 diabetes is also known as non-insulin dependant or late onset diabetes.

Generally speaking type 2 diabetics do not usually require insulin injections but instead control their blood glucose through diet, medication and exercise.

Type 2 diabetes is most common in people over 45 years old who are also overweight however the prevalence of type 2 diabetes in adolescents and young adults is dramatically increasing.

Similar to older-onset type 2 diabetes, the major predisposing risk factors are obesity, family history, and sedentary lifestyle.

Onset of diabetes at a younger age (defined here as up to age 40 years) is associated with longer disease exposure and increased risk for chronic complications.

Young-onset type 2 diabetes also. affects more individuals of working age, accentuating the adverse societal effects of the disease

Furthermore, evidence is accumulating that young-onset type 2 diabetes has a more aggressive disease phenotype.

This can lead to premature development of complications, with adverse effects on quality of life and unfavourable effects on long-term outcomes, raising the possibility of a future public health catastrophe.

Some pregnant women develop a third type called gestational diabetes.

It develops in 2-5% of pregnancies but usually disappears post-partum.

Having gestational diabetes means an increased risk of type 2 diabetes in later life.

Impaired glucose tolerance means blood glucose levels above what is considered normal but not high enough to be diagnosed with diabetes.

Although there is a high risk of developing type 2 diabetes and so significant changes to lifestyle including diet and exercise are strongly encouraged.

Type 1 diabetes

Recognising type 1 diabetes is important and the onset of symptoms can often be rapid and include

  • abnormal thirst and dry mouth
  • frequent urination
  • extreme tiredness and lack of energy
  • constant hunger
  • sudden weight loss
  • slow healing wounds
  • recurrent infections
  • blurred vision

Type 2 diabetes

These symptoms can also occur in type 2 diabetes but are often less obvious as the onset is usually more gradual and therefore harder to detect.

When it is finally  diagnosed it may have developed several years earlier with complications already present.

With impaired insulin production and action, sugar remains in the blood causing hyperglycaemia or raised blood sugar and it is this that can cause short and long term issues which can compromise health and lifestyle.

In the longer term, living with diabetes can lead to complications and a diabetic should always be mindful and aware of changes in their health.

Changes to the feet can take place with loss of sensation called neuropathy and reduction in peripheral circulation which in turn can lead to compromised healing.

The Podiatrists at Maidenhead Podiatry regularly perform diabetic foot checks for patients including

  • Visual health check
  • Skin colour and condition
  • Nail health
  • Pulse testing using Doppler
  • Sensation testing using 10g filament
  • Fine sensation testing using 128Hz tuning fork
  • Hot/cold temperature distinction

Early diagnosis and changes made to lifestyle and environment can significantly lessen the impact type 1 diabetes and those same changes in an adult can dramatically reduce the risk of developing type 2 diabetes.

There are many misconceptions about diabetes.

  • Anyone and everyone is at risk
  • Diabetes hits all populations regardless of income or social status
  • Diabetes is becoming increasingly common
  • More than 240 million people have diabetes worldwide
  • 380 million will have developed it by 2025
  • In Asia, Middle East, Oceania and Caribbean up to 20% of people are diabetic
  • Diabetes affects all age groups
  • Diabetes affects women proportionately slightly more than men
  • Up to 80% of type 2 diabetes is preventable

Ask us for a free copy of Diabetes : understanding your test results.

If you would like more information about foot care at Maidenhead Podiatry or to make an appointment to see one of our podiatrists please call 01628 773588 and speak to one of our reception team.

Ten tips for walking and running during lockdown

Maidenhead Podiatry and Chiropractic Clinic is open for routine care during lockdown. To view our Covid-19 measures, click here.

Groundhog Day

This is a popular North American tradition celebrated in the United States and Canada on February 2.

It follows on from a Pennsylvania Dutch superstition that when a groundhog emerges from its burrow on this day and sees it’s shadow because of clear weather, it will return to it’s den and winter will persist for six more weeks.

But if it does not see its shadow because of cloudiness, spring will arrive early and it  emerges to welcome the new season.

While the tradition is enthusiastically marked and celebrated in modern times, studies have found no consistent link between a groundhog seeing its shadow and the subsequent arrival time of spring-like weather but everyone enjoys a good story.

Popular culture

After the Harold Ramis film Groundhog Day starring Bill Murray was released in 1993, the phrase has come to mean something that is endlessly repeated in almost the same way each time, with little variation.

Just like life during lockdown…

Murray’s character Phil Conners gets stuck in an endless time loop.

According to Wikipedia ‘the term Groundhog Day became part of the English lexicon as a means to describe a monotonous, unpleasant, and repetitive situation’.

A bit like our restricted living patterns at the moment.

Managing the loop

So many of us are taking advantage of the restrictions to walk and run more.

That is great for our health and fitness but can mean we are engaging in the same activities on a repetitive basis and at Maidenhead Podiatry and Chiropractic Clinic we are starting to see an increase in repeat stress injuries.

Ten tips for lockdown walking and running

  1. Take care and take your time. One of the big issues at the moment is the weather. So many people are out and about taking their permitted exercise that there is mud everywhere and it is all too easy to slip and fall.
  2. Wear appropriate foot wear. Wellies are a tempting idea when walking in a morass of mud but they aren’t a good choice for any distance as they are not a firm fit on the foot.
  3. Whatever you wear on your feet, make sure they fit well to avoid rubbing and blisters.
  4. Use socks to improve fit and protect the soft skin of your feet from rubbing and blisters.
  5. If you are wearing lace-up shoes or boots, take the time to lace them properly so that they are firm on the foot. Firm but not tight. This prevents excessive movement of the foot inside the shoe/boot reducing the risk of blisters.
  6. Remember a well fitted and fastened shoe protects the foot especially going downhill where the toes can be forced forward cramping them into the toe-box.
  7. Wrap your feet up to prevent them getting cold. We are seeing lots of chilblains at the moment. They are not only caused by the cold but by rapid changes in temperature so don’t toast cold feet in front of a fire when you get home.
  8. Briefly give your feet a visual check after each walk/run looking for blisters, redness or areas of soreness.
  9. If in doubt about any aspects of foot care, consult a professional.Get in touch with your local Podiatrist for information and advice.
  10. Clean your footwear at the end of each walk/run while the mud is still soft and easiest to remove.

Enjoy your exercise

All these measures should allow you to enjoy your exercise without foot problems.

If you find that isn’t the case and you need professional advice then give us a call.

Maidenhead Podiatry and chiropractic Clinic offers a range of foot care services and is open during lockdown. Whether you have corns or callous, thickened nails or pain when walking – give us a call on 01628 773588.

If you would like more information or to make an appointment with one of our Podiatrists or Chiropractors give us a call on 01628 773588 or email info@maidenheadpodiatry.co.uk.

What does walking do to your feet?

What happens to your feet when walking?

The ligaments, tendons, and muscles in our feet support and coordinate movement. So walking helps strengthen them and keeps them supple.

Get up and walk!

Even if your job involves sitting in an office or at home, try to get up regularly and take a brisk walk for at least 30 minutes every day. Feet are adaptable and will withstand a lot of pressure before they complain. If you enjoy walking, it’s important to wear the right footwear which doesn’t damage your feet.

Walking at a brisk pace for regular exercise helps condition your body and improves overall cardiovascular health. This works in a similar way running and jogging but compared with this high-impact exercise, walking carries a significantly lower risk of injury.

Before exercising

Consult your podiatrist if you start to develop any pain when walking, or consider a visit before embarking on a new walking program.

Current footwear

Properly fitting shoes is the key to keeping your feet healthy and comfortable. Whatever type of walking you do, wearing the right footwear is essential. When buying shoes especially walking shoes, try numerous brands, styles, and sizes. Walking shoes/boots do not come in different width fittings but widths vary with different manufacturers.

Your feet can expand as much as half a size during the day, so buy shoes in the afternoon or early evening when your feet are at their largest. This will help protect them as they expand during your long walks. Also, wearing the same type of socks when fitting shoes that you wear when you walk will help you choose the right shoe.

Once you have made your purchase – take care of them.

Once I have my shoes/boots, what next?

If you are going on a long walk, prepare well ahead. When you first have your shoes/boots wear them around the house. This will keep them clean in case you need to take them back; it also allows you to get used to them on even, consistent surfaces. You can try different socks in the comfort of our own home too.

Wear your shoes for a ‘trial walk’ and build up the distance gradually. Don’t try to complete the Three Peaks on your first trip!

What else can I do?

It’s also a good idea to pay a visit to your local HCPCregistered podiatrist who will be able to give advice. There they will treat any corns, callus, or any foot issue you may have.

Before you set off:

  • Pack simple first aid supplies, such as plasters or antiseptic cream, for your walking trip in case of accidents
  • It’s also a good idea to put Vaseline between your toes to prevent chafing. This makes it an ideal lubricant
  • Applied as a lubricant at the start of an event, such as between the toes, it will still be working well at the end

Warm-up

Begin your walk at a slow pace, increasing the pace of your walking gradually. This gives the muscles, bones, tendons, and ligaments that support the structure and movement a chance to get used to the activity by degree.

If you do experience any discomfort or foot pain, then it could be an indication that something isn’t right. In many cases, early diagnosis prevents a small injury from becoming a larger one.

Six points to remember

  1. When you buy shoes, wear socks that you will wear when walking
  2. Try on and walk in several pairs of shoes/boots
  3. Don’t just put on but lace both shoes of each pair and take the time to walk around to assess comfort
  4. To keep your feet comfortable and free of fatigue and injury, good foot care is essential
  5. Consult a podiatrist if you experience any sort of foot pain
  6. Go through a warm-up and stretching routine before and after you walk

If you would like more information or make an appointment with one of our Podiatrists, give us a call on 01628 773588 or e-mail info@maidenheadpodiatry.co.uk