About Podiatrists

Who is a Podiatrist?

The podiatry profession has undergone considerable growth and change in recent years.  The following information has been provided by the Australian Podiatry Association to provide other health professionals with an overview of these developments and to outline the role of the podiatry profession in relation to the treatment of problems of the feet and lower limbs. 

A podiatrist is a health professional who deals with the prevention, diagnosis, treatment and rehabilitation of medical and surgical conditions of the feet and lower limbs.

The conditions podiatrists treat include those resulting from bone and joint disorders such as arthritis and soft-tissue and muscular pathologies as well as neurological and circulatory diseases.  Podiatrists are also able to diagnose and treat any complications of the above which affect the lower limb, including skin and nail disorders, corns, calluses and ingrown toenails.  Foot injuries and infections gained through sport or other activities are also diagnosed and treated by podiatrists.

To become a podiatrist a practitioner must complete a Bachelorís Degree and be registered with the state podiatry registration board.  (Until 1977, Australian podiatrists were known as chiropodists.  The official name change to podiatry reflected the upgrading of education levels and an expansion in the scope of practice by the profession.)

Some areas in which podiatrists may develop a special interest include:
  • Sports medicine

  • Biomechanics

  • Paediatrics

  • Surgery

  • Diabetes

  • Arthritis

  • Gerontology

 The skills of a podiatrist 

Podiatrists diagnose and treat both common and more rare skin and nail pathologies of the feet.  Podiatrists play an important role in maintaining the mobility of many elderly and disabled people, and others.  This achieved through the ongoing monitoring of foot health, in particular of those with circulation problems and diabetes.  Podiatrists are recognised as important members of the health care team in preventing and managing lower limb complications for those living with diabetes.
A basic area of foot care undertaken by podiatrists is the treatment of various acute and chronic nail conditions, the treatment of which depends on the pathology.  Podiatrists have specific instrumentation for painless and effective treatment of these conditions.  For example, the surgical correction of chronically ingrown tow nails under local anaesthesia is a common podiatric procedure.

Basic Foot Care

In their undergraduate education podiatrists learn to use a variety of modalities including physical therapy and diagnostic modalities such as x-rays.  Some of the common conditions treated by podiatrists, and the methods of treatment and assessment, are outlined in the following pages.

 Treatment and prevention of corns, calluses and warts are also common podiatric procedures.

 Systemic diseases

As systemic diseases such as arthritis affect the joints in the foot, podiatrists monitor feet for any degenerative changes.  The effects of these diseases and the medications often used in their treatment can predispose sufferers to circulatory pathology and/or peripheral neuropathies.  This can result in nail an skin lesions, deformity of the feet and the increased incidence of ulceration.

The multiplicity of possible causes and complications demands a comprehensive method of examination in order to establish a sound diagnosis as a basis of treatment.  The podiatristís role entails much more than merely attaching a label to a condition.  It often includes the monitoring of circulation and neurological examination, using methods such as Doppler assessment and motor and sensory tests.

The manufacture of palliative and functional orthoses also aids in the prevention and treatment of pressure lesions or deformities, enabling individuals to maintain a more normal, active lifestyle.

Childrenís feet

The childís foot is not just a small-scale model of an adult foot.  Its shape is not finally determined until growth ceases at the end of the second decade of life.  Podiatrists diagnose and treat childrenís foot problems by careful examination of the foot, and lower limb, where required.

Advice for the prevention or reduction of foot deformity which often develops later in adult life may involve the provision of appropriate information on footwear, treatment by splinting, advice on exercises and/or orthotic control of the feet.  Podiatrists also treat common, chronic and acute problems of childrenís feet such as osteochondroses, fasciitis and pes planus.

Occupational Podiatry

Some occupations are more prone than others to foot problems which can arise as the result of standing on hard surfaces for long periods.  Hairdressers, factory workers and nurses are examples of those from professionals likely to develop long-term problems unless preventative measures are taken.  Podiatrists seek to address some of the issues responsible for foot problems and can advise on occupational foot health and safety.  This can sometimes involve the prescription of orthoses, or surgical advice.

Biomechanics

In treating chronic foot pain, and evaluating specific needs of patients, the podiatrist will often assess the anatomy and function of the foot and lower limbs during gait.  This assessment of the shape and motion of the limb allows for an effective diagnosis of the cause of injuries and/or the development of deformities. 

The analysis of the function of human motion is called biomechanics.  Podiatrists perform clinical biomechanical evaluation of the lower limb.  Specialised equipment, including mechanized treadmills with video and computerized assessment equipment, are often used by podiatrists to detect pathomechanical anomalies to ensure appropriate and effective treatment.  This treatment may include specific exercises and the prescription of foot orthoses, from precise measurements of an individualís biomechanics.

Sports medicine

Any sport which involves walking, running, standing or jumping places greater physical demands on our body than normal day-to-day activities.  Injuries to the foot and lower limb make up a large proportion of sporting injuries.  Podiatrists examine the foot and lower limb, have a knowledge of the biomechanics of athletic movement, diagnose foot conditions and can recommend appropriate footwear, training regimens, and, if needed, orthotic devices to fit into the sports shoe.  Common sporting injuries include plantar fasciitis, Achilles tendonitis, stress fractures, ankle sprains and shin or knee pain.

Orthoses

Orthoses are custom-made shoe inserts made specifically to reduce a foot pathology.  As already outlined, the prescription and manufacture of orthoses is an important part of podiatric practice.  The podiatrists is trained in the manufacturing techniques for a diversity of shoe inserts.  Most inserts fall into two main categories Ė functional orthoses or palliative orthoses. 

Functional orthoses are prescribed after the biomechanical assessment and casting of the feet.  They are made by various techniques to align the structure of the foot in its most functionally efficient position.  The orthotic, moulded from the cast, is designed to stabilize the foot and to prevent it from moving into an unbalanced position while walking or running.

Surgery

Podiatrists are qualified to perform both nail and cutaneous surgery, but some have undertaken further education to perform additional foot surgery.

These inserts involve several steps in both the diagnostic and manufacturing phases, and are usually made of a thermoplastic.

Palliative orthoses are designed specifically to reduce pressure from painful or ulcerated areas of the foot.  These are often softer and less complicated devices made of foam or rubbers.  Palliative orthoses are often used for the treatment of severely deformed feet with a limited range of motion and mobility.  They are often an appropriate choice for elderly people with significant soft-tissue atrophy and/or circulatory disease.

How are Podiatrists educated?

As already outlined, to become a podiatrist a practitioner must complete at Bachelorís Degree. 

Podiatry qualifications are specifically aimed at addressing the internal and external medicine involved in the systemic diseases and local pathology affecting the feet. 

In Australia the profession also has formal post graduate qualifications in area including sports medicine and surgery. 

Where do Podiatrists work?

Podiatrists work in a variety of areas including private practice, community health centres, hospitals, sports medicine clinics and nursing homes.  Podiatrists also work as part of the health care team and often consult with other health care practitioners when managing foot or foot-related problems. 

How to access a Podiatrist

It is usually not necessary to obtain a referral to see a podiatrist.  However, for patients to receive podiatry treatment under various programs including those run by Veterans Affairs, Workers Compensation, or the Program for Aids for Disabled People (PADP), a medical referral is required.

Private health insurance funds cover podiatry services under their ancillary tables.

Government-funded services are available in some public hospitals, community health centres and other publicly funded utilities.

The Associationís office is located in Melbourne.  
Please direct any queries to (03) 9286 1885, or apoda@podiatryvic.com.au.

More details can also be found on the Australasian Podiatry Council website: www.apodc.com.au.

 

 
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