Conservative management services of musculoskeletal disease and injury of the foot and ankle is not supported as it should be in the NHS. The speciality of musculoskeletal podiatry is often very constrained by pressures on the service and budget. It is far better accessed privately and provided by clinicians who have specialist knowledge and demonstrable experience and further qualifications in the field.
Musculoskeletal Podiatry is...
the assessment, diagnosis and treatment of biomechanical conditions primarily affecting the lower limbs. Such conditions may lead to acute or longer-term problems.
The study of how biological materials behave under stress and strain. Podiatry practises the clinical application of this knowledge and understanding. Clinically podiatrists look at the movements of your foot and how it compensates for poor alignment and function as it contacts with the ground. foot dysfunction can also affect the rest of your lower limb and leads to aches and pains in your feet and other areas of your body – such as your knees, hips and back. Long-term biomechanical injuries occur when there is excessive movement and force placed upon joints and/or soft tissue structures, may also be referred to as overuse injuries.
The foot is unique in the body due to its position and function. The foot has to transfer forces greater than body weight to the ground to allow us to walk, and because of the number of steps we take each day any inefficiency in foot function is multiplied many times over. Sporting activities such as running and many sports involve forces much greater than this. The foot has to compensate for poor function or posture higher up the body, causing abnormal motions in the foot and ankle. These compensations can result in over strains and injuries. Equally foot dysfunction can cause other joints of the spine, pelvis, hip and knee to work in poor alignment creating pathologies within these other joints as well as in the foot
A detailed ‘biomechanical’ examination attempts to pick out these minor imbalances and seeks to correct them by mechanical means.
Musculoskeletal (MSK) Podiatrists should be the first health professional you should approach if you have activity related foot pain. They are trained to identify the cause and potential origins of lower limb dysfunction to resolve a multitude of conditions that can make being on your feet, or taking part in any sport uncomfortable. Conditions such as Plantar Fasciitis, Metatarsalgia, Arch pain, Tibialis Posterior Dysfunction and Achilles Tendinopathy are regularly managed by MSK Podiatrists.
Treatment can often involve the use of insoles to realign, cushion or offload structures. A foot orthosis works by increasing the efficiency with which the foot functions. This altered function can affect the whole lower limb, pelvis and back thus improving the body’s general posture and ability to function.
Treatment can involve manipulation, which involves short sharp joint thrusts, muscle and tissue stretches, and pressure and massage techniques. Manipulation can often produce a 'cracking' or 'popping' noise which is just the joint fluid expanding into the space released by treatment.
Stretching and strengthening exercises are often essential to correct or overcome dysfunction.
Making sure the right footwear is worn for the right occasion is often a key issue, one usually more of a problem for the ladies than the men!
What to expect
At your first appointment we will try and establish the pathology and mechanism of injury. We will examine your feet, legs, pelvis and spine alignment in stance and gait.
Please wear clothes that allow easy visualisation and access to the feet, legs and pelvis (avoid long skirts and dresses). Please bring or wear your regular footwear. It is helpful to bring with you a variety of shoes you wear for different activities, such as work shoes, walking shoes footwear used for sport e.g. running and in particular any footwear that causes symptoms.
Initial consultations last approximately 45 minutes and at the end of which we should have tailored a treatment plan, some of which we can start straight away. Most treatment plans will need between four and six visits, but some conditions may need long-term care.
After manipulation and stretches you can feel a little sore and stiff after treatment although this tends to last no more that 24-48 hours.
Insoles and other supports can also feel odd for a few days and can initially cause a few new symptoms. This is rarely more than for a few days.