Month: November 2015

Pedicure by Fish

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A Pedicure by Fish is an oddity. It consists of soaking the feet in a container of small fish who literally ‘eat’ the dead skin.

Fish pedicures, often referred to as ichthyotherapy, involve placing your feet in a shallow tub filled with warm water and small fish, typically Garra rufa (a.k.a. “doctor fish”). These fish gently nibble away dead skin, leaving the feet feeling smoother. Unlike regular pedicures that use scrubs, pumice stones, or razors, fish pedicures rely on the natural feeding behavior of the fish. Garra rufa lack teeth, so they don’t bite or tear the skin—they just slough off the topmost dead cells by suctioning and gently scraping.

The process is often described as ticklish at first but quickly becomes soothing and even meditative for many. A session usually lasts 15 to 30 minutes, and afterward, many users report that their feet feel soft and rejuvenated. The sensation is part exfoliation, part spa treatment. The appeal is both tactile and novel—there’s definitely a “weird but cool” vibe to it that attracts tourists and curious first-timers. Some spas pair the treatment with massages or traditional pedicures for a more complete pampering experience.

However, there are concerns around hygiene and safety. Since fish can’t be sterilized between customers and the water is reused, there’s a risk of spreading infections or diseases, especially in places with lax sanitation standards. People with open cuts, compromised immune systems, or foot conditions like athlete’s foot should avoid fish pedicures altogether. In fact, several regions—including parts of the U.S., Canada, and the EU—have banned the practice for these reasons. The fish themselves can also suffer if not properly cared for; overcrowding and poor tank maintenance are not uncommon in lower-quality spas.

Despite the controversy, fish pedicures still hold a niche place in the spa world. They’re more popular in tourist-heavy destinations in Asia and the Middle East, where the novelty draws in curious visitors. If you’re considering trying one, look for a well-reviewed, reputable spa that follows proper cleaning protocols and treats the fish humanely. It’s definitely not for everyone, but for those intrigued by unconventional spa treatments, fish pedicures offer a unique—albeit slightly squirmy—experience.

Most Useful Resources:
Fish Pedicure (PodiaPaedia)
The Pedicure by Fish! (Foot Health Friday)
Live fish used to give pedicure (Podiatry Arena)
Fish Pedicure (Foot Health Forum)
What is a fish pedicure? (PodiatryFAQ)
Is a fish pedicure safe? (PodiatryFAQ)

Duct Tape for Warts

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Duct tape has many practical uses and it has been advocated for the use of treating warts or verrucae by occluding the area. The clinical trials show that it does not work too well.

Duct tape, though originally designed for industrial and household repairs, has found a surprising range of medical uses—especially in improvised or emergency settings. One of its most well-documented medical applications is in the treatment of common warts. The “duct tape occlusion therapy” involves covering the wart with duct tape for several days, then removing it to exfoliate the top layer of skin, and repeating the process. Studies have had mixed results, but many anecdotal cases report successful removal, likely due to the combination of occlusion, irritation, and immune stimulation.

Another notable use of duct tape is in first aid and wound management, particularly in situations where medical supplies are limited. It can be used to secure bandages, create splints, or even fashion makeshift butterfly closures to bring wound edges together. When paired with sterile gauze or even clean cloth, duct tape can form a reasonably effective pressure dressing for bleeding control. Its water-resistant backing also provides a barrier against dirt and contaminants, although it’s far from ideal compared to medical-grade adhesives due to potential skin irritation.

Beyond minor injuries, duct tape can play a role in orthopedic or structural support, especially for stabilizing sprained ankles or immobilizing fingers in wilderness medicine scenarios. When combined with padding or soft cloth, it can reinforce a joint or secure a limb to a splint. However, caution is essential: direct application on skin for prolonged periods can cause blistering or allergic reactions, and its strong adhesive can tear fragile skin upon removal. While not a replacement for proper medical care, duct tape remains a clever, multipurpose tool in emergency kits and survival settings.

Most Useful Resources:
Duct Tape (PodiaPaedia)
Duct Tape for Warts? (Foot Health Friday)
Duct tape does not work for Warts or VP’s (Podiatry Arena)

The Diabetic Foot

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Care of the foot in those with diabetes is so important as so many of the complications of diabetes put the foot at risk for damage and can have serious long term complications.

What is a Diabetic Foot?
A diabetic foot refers to a range of foot problems that develop in people with diabetes, typically due to nerve damage (neuropathy) and poor blood circulation (peripheral arterial disease). These issues can cause a loss of feeling in the feet, which makes it easy for small cuts, blisters, or pressure sores to go unnoticed. Over time, if these minor injuries aren’t treated properly, they can turn into serious infections or ulcers. Because diabetes also slows down healing, even a small wound can become a big problem fast.

Why Does It Happen?
There are two major culprits: neuropathy and vascular disease. Neuropathy dulls pain and sensation, so someone might walk around with a sharp object in their shoe or a deep blister and not feel it at all. Meanwhile, poor circulation caused by narrowed arteries means less oxygen and nutrients are delivered to the tissues, making it harder for wounds to heal. Add in high blood sugar, which weakens the immune system and supports bacterial growth, and it creates the perfect storm for infection and tissue damage.

What Does It Look Like Clinically?
Diabetic foot problems can range from dry, cracked skin to deep ulcers, gangrene, or even deformities like Charcot foot. You might see signs like redness, swelling, foul-smelling discharge, or blackened tissue indicating necrosis. Ulcers often develop over pressure points like the heel or the ball of the foot and can extend deep, even down to the bone. In severe cases, when infections spread or blood flow is too poor, amputation may be the only option — which is why early detection and treatment are crucial.

How Can You Prevent or Manage It?
Prevention is everything. People with diabetes should check their feet daily, keep their blood sugar well-controlled, and wear proper footwear to avoid pressure injuries. Routine checkups with a healthcare provider or podiatrist can catch early signs of trouble. If an ulcer or injury does happen, prompt treatment — including cleaning, dressing changes, antibiotics if infected, and sometimes surgery — can prevent complications. For some, revascularization procedures might help improve blood flow. Ultimately, managing a diabetic foot is all about being proactive and not ignoring the small stuff.

Most Useful Resources:
Diabetic Foot (Foot Health Forum)
Diabetic Foot & Wound Management (Podiatry Arena)
Diabetic Foot (PodiaPaedia)
Why do diabetics have so many foot problems? (Podiatry Experts)
Diabetes foot care (ePodiatry)
Foot Disease in Diabetes (Diabetes Textbook)

Plantar Heel Fat Pad Atrophy

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The fat pad under the heel protects the foot by providing cushioning and shock absorption. A problem can arise if that fat pad atrophies and it can result in heel pain.

Heel fat pad atrophy is a condition where the thick, cushioning pad of fibroadipose tissue under your calcaneus thins, shifts, or loses its elasticity. That pad normally acts like a built-in gel insert: it absorbs impact every time your heel strikes the ground. When it wears down, bone and skin take the force instead, and walking turns into a painful, bone-on-floor experience.

What causes the fat pad to break down?
The heel pad is a honeycomb of sealed fat chambers held by fibrous septa. Age is the most common culprit. After 40, collagen and elastin in the septa degrade, and the chambers deflate or rupture, so the pad becomes thinner and less springy. But age is not the only driver.

Common contributing factors:

  • Repetitive loading: Runners, nurses, retail workers, and anyone on hard surfaces for hours daily stress the pad until the septa fail.
  • Steroid injections: Multiple corticosteroid injections for plantar fasciitis can accelerate fat pad degeneration as a side effect.
  • Trauma or surgery: A calcaneal fracture or heel surgery can disrupt the fat chambers permanently.
  • Systemic disease: Diabetes, rheumatoid arthritis, and peripheral neuropathy reduce tissue quality and blood flow to the pad.
  • High BMI: Extra weight increases peak pressure on a finite area of tissue with every step.
  • Genetics and foot structure: A high-arched foot or a foot that supinates places more load on the heel than a neutral foot.

How it feels and how it differs from plantar fasciitis
People with heel fat pad atrophy describe a deep, bruised ache directly under the heel bone. It hurts most with barefoot walking on tile, concrete, or wood, and gets worse the longer you are on your feet. Unlike plantar fasciitis, the pain is central in the heel, not along the arch, and it is usually absent or mild with the first steps in the morning. Pressing straight up on the center of the heel reproduces the pain. You might also notice that the heel looks thinner and you can feel the calcaneus more prominently.

A podiatrist or orthopedic specialist can confirm it on exam. Ultrasound or MRI will show reduced fat pad thickness, often under 10 mm when unloaded, compared to a healthy 15-20 mm. They will also rule out calcaneal stress fracture, bursitis, or nerve entrapment.

Management and treatment options
There is no way to regenerate the fat pad naturally once the septa are gone, so treatment focuses on protection and pressure redistribution. Because this involves symptom assessment and ongoing management, you should work with a podiatrist, orthopedist, or physical therapist to tailor a plan.

Key strategies:

  1. Cushioning: Gel or silicone heel cups, U-shaped pads, and shoes with a thick, shock-absorbing midsole reduce peak pressure. Avoid minimalist shoes and barefoot walking.
  2. Offloading: Custom orthotics can shift weight to the midfoot. Taping techniques provide temporary relief for activity.
  3. Activity modification: Limit time on hard surfaces, use anti-fatigue mats if you stand for work, and cross-train with cycling or swimming to maintain fitness.
  4. Weight management: Reducing body mass directly lowers ground reaction force on the heel.
  5. Advanced options: For severe cases, some specialists offer fat grafting, dermal filler injections, or allograft implants to replace volume. These are surgical or office-based procedures with mixed long-term data, so risks and benefits should be discussed with a qualified surgeon.

Prognosis and daily living
Heel fat pad atrophy is a chronic, mechanical problem. Most people get substantial relief by combining footwear changes, cushioning, and load management. It rarely “heals” on its own, but it can be managed well enough to walk and exercise with minimal pain. If pain persists despite conservative care, or if you have diabetes and notice skin breakdown, seek care promptly to prevent ulcers.

Strengthening the intrinsic foot muscles and calf stretching will not regrow the pad, but they improve shock absorption throughout the leg and reduce compensatory stress.

In short, heel fat pad atrophy is wear-and-tear of your natural heel cushion. Catch it early, pad it well, and adjust your loads. A medical professional can measure your pad, rule out other causes, and guide you toward orthotics or procedural options if needed.

Most Useful Resources:
Heel fat pad atrophy (Foot Health Forum)
heel pad atrophy HELP (Foot Health Forum)
Fat pad atrophy (PodiaPaedia)
Heel Fat Pad Atrophy (Foot Health Friday)
Heel Fat Pad Atrophy Cushioning Pad (FootStore)
Fat Pad Atrophy (Croydon Foot)

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The Determinants of Gait

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The Determinants of Gait are the biomechanical strategies that the body uses in order to maintain the center of gravity in the horizontal plane, as well as increase efficiency and to decrease the expenditure of energy when walking and running

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The Determinants of Gait are a set of six distinct movements that occur during the gait cycle to minimize the vertical and horizontal displacement of the body’s center of gravity. The primary purpose of these movements is to make walking more energy-efficient and smooth. Without these determinants, a person’s walk would be an inefficient “compass gait,” characterized by a significant up-and-down motion. The selected text from the Canvas document describes the general gait cycle, but doesn’t go into these specific, energy-saving movements.

 

The six classic determinants of gait are:

  • Pelvic Rotation: The pelvis rotates forward on the side of the swinging leg. This action lengthens the stride and reduces the peak of the body’s center of gravity, smoothing out the vertical path.
  • Pelvic Tilt (or Pelvic Obliquity): During the swing phase, the pelvis on the non-weight-bearing side drops slightly. This also helps to lower the body’s center of gravity, preventing an excessive rise as the body moves over the stance leg.
  • Knee Flexion in Stance Phase: As the foot makes contact with the ground, the knee flexes slightly. This acts as a shock absorber and prevents the body’s center of gravity from rising too high during the middle of the stance phase.
  • Foot and Ankle Mechanisms: This refers to the coordinated movements of the ankle and foot. The plantarflexion of the foot at heel strike and the subsequent dorsiflexion work to smooth the path of the body’s center of gravity.
  • Knee and Ankle Interaction: The way the knee and ankle move together also contributes to maintaining a smooth center of gravity. The knee begins to flex after heel strike and extends later in the stance phase, while the ankle’s rotation also changes the effective length of the leg, keeping the body’s center of gravity from oscillating too much.
  • Lateral Pelvic Displacement: The body shifts from side to side over the stance leg to keep the center of gravity over the base of support. This reduces the lateral, or side-to-side, displacement of the center of gravity.

Together, these six determinants work to create the smooth, undulating path of the body’s center of gravity, which is essential for an efficient and effortless walk.

Most Useful Resources:
Determinants of gait (Foot Health Forum)
Determinants of gait discredited? (Podiatry Arena)
The Determinants of gait (Podiatry Arena)
Determinants of Gait (PodiaPaedia)
Determinants of Gait (Podiatry TV)
The Six Determinants of Gait (Podiatry Ninja)

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Cuboid Syndrome

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Cuboid syndrome is a reasonably common problem affecting the function of the cuboid bone and the joints around it. It is a common cause of lateral foot pain. Manipulation of the cuboid bone is a common treatment.

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Cuboid Syndrome is a foot condition that occurs when the cuboid bone—one of the small bones on the outer side of the midfoot—becomes partially dislocated or its alignment is disrupted. This bone plays a key role in supporting the foot’s arch and enabling smooth movement during walking or running. When the cuboid bone is out of place or the ligaments surrounding it are strained, it can cause pain, swelling, and stiffness along the outside of the foot. The condition is sometimes called “subluxation of the cuboid” and is relatively common in athletes, especially runners, dancers, and those who frequently engage in sports with sudden side-to-side movements.

The most common cause of Cuboid Syndrome is overuse or repetitive strain, though it can also result from an ankle sprain or sudden twisting injury. In many cases, the peroneus longus tendon—which runs along the outer side of the lower leg and attaches to the foot—can exert excessive force on the cuboid bone, pulling it out of alignment. Risk factors include poorly fitting footwear, training on uneven surfaces, inadequate warm-up, and having flat feet or very high arches. Because the pain may be mistaken for other injuries, such as a stress fracture or peroneal tendonitis, diagnosis can sometimes be tricky without proper examination.

Symptoms of Cuboid Syndrome typically include sharp or aching pain on the lateral (outer) side of the foot, tenderness when pressing on the cuboid bone, difficulty bearing weight, and pain that worsens with push-off during walking or running. In some cases, there may be visible swelling or bruising. The discomfort often makes the foot feel unstable, and athletes might find themselves limping or avoiding activities that require sudden changes in direction. While rest can sometimes reduce symptoms, the pain often persists until the bone’s alignment is corrected.

Treatment usually starts with a manual realignment technique known as the “cuboid whip” or “cuboid squeeze,” performed by a trained healthcare professional such as a sports physiotherapist or podiatrist. This may be followed by supportive taping, orthotic inserts to stabilize the foot, and targeted stretching or strengthening exercises for the surrounding muscles and tendons. Rest, ice, and anti-inflammatory measures can help manage pain in the short term. For prevention, it’s important to wear properly fitting shoes, gradually increase activity intensity, and maintain flexibility and strength in the foot and ankle. With prompt treatment, most people recover quickly, but ignoring the condition can lead to chronic pain or recurrent injuries.

Most Useful Resources:
Cuboid syndrome (Foot Health Forum)
Mobilisation for cuboid syndrome (Podiatry Arena)
Cuboid syndrome (Podiatry Arena)
Cuboid Syndrome (PodiaPaedia)
Manipulation for Cuboid Syndrome (Podiatry Update)
Woke up with pain on the outer side of my foot, what could it be? (Podiatry Experts)
Could it be plantar fasciitis? (Podiatry Experts)
Cuboid Syndrome (Podiatry TV)

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Cluffy Wedge

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The Cluffy wedge is a pad that is places under the great toe to hold it in a slightly dorsiflexed position. It is designed to treat functional hallux limitus and problems with the windlass mechanism.

The Cluffy Wedge is a trademarked pad designed to sit under the hallux (your big toe), aiming to hold it in a gently dorsiflexed position—that is, lifted upward just enough to get things moving right. Originally developed by Dr. James Clough, DPM, this wedge was first trademarked in 2003 under Cluffy LLC in Polson, Montana, and has also been marketed under the name P4 Wedge.

Functionally, the Cluffy Wedge is all about managing a condition called functional hallux limitus—where your big toe has a normal range of motion when off the ground but gets stuck when you’re weight-bearing. By dorsiflexing the hallux, the wedge preloads the toe so the windlass mechanism (which tightens the plantar fascia during walking) kicks in earlier and more naturally . The theory is sound: first metatarsal loading improves, less strain is placed on the other metatarsals, and the foot’s biomechanics get realigned—at least hypothetically.

On the practical side, you can use the Cluffy Wedge on its own inside shoes, under insoles, or as an extension in custom orthotics. While some podiatric labs initially offered it, most now craft their own versions to achieve the same effect—often by adding padding under the hallux in custom orthotic designs. However, it’s important to note that peer-reviewed clinical trials are lacking, so much of what we have are anecdotal reports, small-scale studies, or theses—not yet full clinical validation.

In short, the Cluffy Wedge stands out as a simple yet biomechanically savvy tool for specific foot dysfunctions, especially functional hallux limitus. While its theoretical benefits—like balancing forefoot pressure and reactivating the windlass mechanism—are appealing, we remain a bit short on robust clinical research. Still, for patients and practitioners looking for non-invasive ways to support hallux mechanics, it’s worth considering, especially if integrated thoughtfully into custom orthotic planning.

Most Useful Resources:
Cluffy Wedge (Foot Health Forum)
Cluffy Wedge (Podiatry Arena)
Cluffy Wedge (Clinical Biomechanics Bootcamp)
Cluffy Wedge (PodiaPaedia)
The Cluffy Wedge (Podiatry Update)
Cluffy Wedge (Podiatry Experts)

Cycling and Foot Orthotics

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Foot orthotics for cycling play an important role in getting the correct interface between the foot, shoe and pedal. It helps with performance, management of injury and prevention of injury.

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Foot pain when cycling can come from a few main culprits: poor bike fit, improper footwear, and overuse injuries. If the cleats are positioned incorrectly—either too far forward, too far back, or angled wrong—they can put excessive pressure on nerves or joints in the foot. Similarly, shoes that are too tight can compress the foot, while shoes that are too loose can allow it to slide and cause friction, leading to hot spots or blisters. Even the type of socks you wear matters—thin, moisture-wicking ones help reduce heat and pressure build-up, while thick or bunching socks can worsen it.

Another common cause is overuse and repetitive stress. Long rides, especially at high intensity, can lead to nerve compression in the ball of the foot, often called “hot foot” (metatarsalgia). This usually feels like burning, tingling, or numbness that gets worse the longer you ride. Riding in very stiff shoes without adequate arch support can also transfer too much vibration from the pedals to your feet, irritating tissues over time. Climbs, high gears, and prolonged standing on the pedals tend to make this worse because they put more load on the forefoot.

To address foot pain, cyclists often start with equipment adjustments. This can include moving cleats slightly back to reduce forefoot pressure, experimenting with insoles that match your arch type, or loosening shoe straps slightly to improve blood flow. Bike fit also plays a role—saddle height and fore-aft position can influence how your weight is distributed through the pedals. Off the bike, stretching and strengthening foot and calf muscles can help prevent recurrence. If pain persists despite these changes, it’s worth seeing a sports physiotherapist or podiatrist to rule out underlying issues such as nerve entrapment, stress fractures, or chronic inflammation.

Most Useful Resources:
Cycling (PodiaPaedia)
Cycling (Podiatry TV)
Cycling Threads (Podiatry Arena)
Cycling (Foot Health Forum)
Cycling Orthotics (Podiatry Arena)
Foot Orthotics and Cycling (Podiatry Update)
Foot problems in cyclists (Foot Health Friday)
Set up of the cycle for injury prevention (Physio Ninja)

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Chung Shi Toning Shoes

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Chung Shi are a brand of toning shoes

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Chung Shi Toning Shoes are a specialized type of footwear designed to promote natural movement and improve lower-body muscle engagement while walking. They feature a unique curved sole construction that encourages a rolling motion with each step, activating muscles in the feet, calves, thighs, and glutes more than traditional flat-soled shoes. This design aims to simulate walking barefoot on soft, uneven ground, helping to improve balance and posture while also providing a gentle workout during daily activities. Many models also include high-quality cushioning and ergonomic shaping to enhance comfort and reduce joint strain.

One of the key benefits of Chung Shi Toning Shoes is their potential to assist with both fitness and rehabilitation. For people looking to incorporate more muscle engagement into their routine without high-impact exercise, these shoes can help burn additional calories and strengthen stabilizing muscles simply through regular walking. They are also used in certain physiotherapy settings, as the sole’s design can encourage proper gait patterns, reduce tension in the lower back, and alleviate some common foot-related discomforts. The shoes are often recommended for those seeking a blend of mobility support and muscle conditioning in everyday footwear.

In addition to their functional benefits, Chung Shi Toning Shoes are made with quality materials and are often available in multiple styles suitable for casual wear, work, or light exercise. Many designs prioritize breathability, durability, and foot alignment, ensuring that users experience both performance and comfort over extended periods. While they may require a short adjustment period for new wearers due to their distinctive sole shape, most users adapt quickly and find the benefits well worth the transition. As a result, they’ve become popular among health-conscious individuals, active walkers, and those seeking supportive footwear with added wellness advantages.

Most Useful Resources:
Chung Shi (PodiaPaedia)
Chung Shi (Toning Shoes Market)
Chung-shi footwear (Podiatry Arena)
Chung Shi (Foot Health Forum)

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Croydon Total Footcare

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Croydon Total Foot care is a podiatry clinic in Croydon, Melbourne, Australia

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Croydon Total Foot Care is a podiatry clinic located in Croydon, a suburb in Melbourne, Australia, dedicated to providing comprehensive foot and lower limb care. The clinic offers services for a wide range of conditions, including heel pain, ingrown toenails, sports injuries, fungal infections, and diabetic foot complications. Their approach combines modern diagnostic techniques with tailored treatment plans, ensuring that each patient receives care specific to their needs. By focusing on both prevention and treatment, the clinic aims to help individuals maintain mobility, reduce discomfort, and improve overall foot health.

Beyond addressing existing issues, Croydon Total Foot Care places a strong emphasis on patient education, guiding clients on proper footwear choices, foot hygiene, and injury prevention strategies. This proactive approach helps minimize recurring problems and supports long-term wellbeing. The clinic serves patients of all ages, from children with developmental concerns to older adults managing chronic foot conditions. With a team of experienced podiatrists and access to advanced equipment, Croydon Total Foot Care has established itself as a trusted provider in the local community, offering both in-clinic treatments and advice for at-home care.

Most Useful Resources:
Croydon Total Foot Care (Podiatrists Online)
Croydon Total Foot Care (Podiatry Online)
Croydon Total Foot Care (Yelp)
Croydon Total Foot Care (Facebook)
Croydon Total Foot Care (Start Local)
Croydon Total Foot Care (True Local)
Croydon Total Foot Care (dLook)
Croydon Total Foot Care (BrownBook)

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