Month: November 2015

Chilblains

Posted on by Staff

Chilblains are a painful itchy reaction mostly n the toes to a too rapid change in temperature from cold to hot.

chilblains

They usually appear initially as painful, reddish itchy lesions that later become a darker or blueish color that may breakdown. If not protected they can become infected.

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The best treatment for chilblains is to prevent them from happening in the first place by keeping the feet warm and not letting them get cold. If they do get cold, then they need to be warmed up slowly and gradually. If a chilblain does develop, then a cream to stimulate the circulation can be used. It is important that they are protected and not allowed to develop into an infection.

This new video from PodChatLive is a really good discussion on chilblains:

Most Useful Resources:
Chilblains (Foot Health Forum)
Chilblains (Podiatry Arena)
Chilblains / perniosis (Podiatry Arena)
Chilblains (Pernio; perniosis) (ePodiatry)
Chilblains (PodiaPaedia)
Chilblains (Foot Health Friday)
Beetroot juice for chilblains? ….. say what? (Its a Foot)
Chilblains Season is Here (Croydon Total Footcare)

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Chi Running

Posted on by Staff

Chi running is a particular approach to the running technique that claims is more economical and has less injuries. The evidence says otherwise.

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Chi Running is a running technique developed by Danny Dreyer that blends elements of Tai Chi principles with modern endurance running. The core idea is to use posture, alignment, and mindful movement to make running more efficient and reduce the risk of injury. Instead of relying heavily on muscular effort, Chi Running emphasizes using gravity and momentum to propel the body forward. This approach shifts the focus from pushing with the legs to letting the body “fall” into motion, reducing strain on joints and muscles. It’s often described as running from your “center” or “core,” rather than just your legs.

A key aspect of Chi Running is body alignment. Practitioners maintain a tall, relaxed posture with a straight line from the crown of the head down through the hips and ankles. The body leans forward slightly from the ankles—not the waist—allowing gravity to assist in forward movement. The head stays level, the shoulders remain relaxed, and the arms swing lightly to maintain rhythm without excessive movement. By keeping the posture relaxed and symmetrical, Chi Running aims to minimize the energy wasted on unnecessary motion and muscle tension.

Foot placement is another major focus. Chi Running advocates for a midfoot strike rather than a heel strike, allowing the foot to land directly under the body’s center of mass. This reduces braking forces and helps maintain smoother forward momentum. Cadence—often around 170–180 steps per minute—is kept relatively quick, with shorter strides to reduce impact. The combination of midfoot landing, quick cadence, and forward lean is designed to keep the body moving efficiently and in sync with gravity, much like a controlled fall.

Beyond the mechanics, Chi Running incorporates mindfulness and breath awareness. Much like Tai Chi, it encourages runners to stay present, listen to their bodies, and make subtle adjustments to maintain flow. This mental aspect can help prevent overexertion and promote better running economy. Many runners who adopt Chi Running report lower injury rates, improved endurance, and a more meditative experience on the road or trail. While it may take time to retrain muscle memory, the technique offers a sustainable way to run longer and more comfortably by aligning movement with natural body mechanics.

Most Useful Resources:
Chi Running (Foot Health Forum)
Chi Running App (Podiatry App)
Forefoot Pain in Chi Running ? (Podiatry Experts)
Chi Running (Podiatry TV)
Chi Running (Clinical Biomechanics)
Chi Running (PodiaPaedia)
Chi Running (Podiatry Arena)
I did a Chi Running course! (Running Research)

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Corns on Toes

Posted on by Staff

Corns develop on the toes when the medium to long term pressure on an area. The skin thickens in response to that pressure, but becomes so thick that it becomes painful. The only way to permanently get rid of corns is to remove that cause.

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Corns on toes are areas of thickened skin that develop as a protective response to repeated friction or pressure, often from ill-fitting shoes or abnormal toe alignment. They usually form on the tops or sides of toes and can be either hard (dense and compact) or soft (moist and rubbery, often found between toes). While corns themselves are not dangerous, they can be quite uncomfortable and even painful, especially when pressure is applied while walking or standing. The body creates this extra layer of skin as a defense, but over time, it can actually increase discomfort if not addressed.

The primary causes of corns include wearing tight or narrow shoes, high heels that shift weight to the front of the foot, or shoes without enough cushioning. Toe deformities like hammertoes or bunions can also contribute by creating friction points. Activities that involve repetitive motion or prolonged standing can exacerbate the problem. In some cases, people with underlying conditions such as diabetes or poor circulation may be at higher risk, as they may not notice irritation until the corns are more advanced, increasing the risk of complications.

Treatment for corns typically focuses on removing the source of friction and softening or carefully reducing the thickened skin. This can involve changing to properly fitting footwear, using protective pads or toe separators, and soaking the feet in warm water to soften the skin before gently filing with a pumice stone. Over-the-counter medicated corn pads containing salicylic acid can help dissolve the thickened skin, but they should be used with caution—especially for those with diabetes or sensitive skin. In persistent or painful cases, a podiatrist can safely trim the corn and advise on preventing recurrence.

Most Useful Resources:
Corns on Toes (Foot Health Forum)
Painful corn on toe (Foot Health Forum)
Corn on toe(Foot Health Forum)
Foot Corns & Callus (hyperkeratosis) (ePodiatry)
Corns on the Toes (Dr the Foot)
What causes corns on the toes? (Foot Health Friday)

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Congenital Vertical Talus

Posted on by Staff

Congenital Vertical Talus is a severe cause of flat foot (or overpronation) in kids. The talus is almost vertically, pointing plantarly so that the navicular bone is articulating with the top of the head of the talus. Surgery is usually the only satisfactory treatment.

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Congenital Vertical Talus (CVT), sometimes referred to as “rocker-bottom foot,” is a rare but serious foot deformity present at birth. It is characterized by a rigid flatfoot where the talus bone is abnormally positioned in a vertical orientation instead of its normal horizontal alignment. This abnormality causes the midfoot and forefoot to dislocate dorsally (upward) over the talus, resulting in the distinctive convex shape of the sole. Unlike more common flexible flatfoot in children, CVT is a rigid deformity that does not improve with growth, making early recognition essential for effective treatment.

Causes and Associations
The exact cause of congenital vertical talus is not fully understood, but it is generally thought to arise from disruptions in fetal musculoskeletal development. CVT can occur in isolation or be associated with neuromuscular and genetic conditions such as arthrogryposis, spina bifida, or other syndromic disorders. In some cases, it appears as an isolated idiopathic deformity without underlying systemic disease. The condition affects both feet in about half of the cases and is slightly more common in males than females. Its rarity often contributes to delayed diagnosis unless clinicians are specifically familiar with the condition.

Clinical Presentation and Diagnosis
At birth, CVT is typically recognized by the distinct “rocker-bottom” appearance of the foot, with a rigid upward bend in the midfoot and a prominent heel. Unlike flexible flatfoot, manipulation does not restore the arch. Radiographic imaging confirms the diagnosis, showing the talus bone in a vertical position and misalignment of other midfoot structures. X-rays taken in both plantarflexion and dorsiflexion are especially helpful in distinguishing CVT from other similar deformities, such as calcaneovalgus foot or oblique talus. Early diagnosis is critical, as untreated CVT can lead to severe disability, impaired walking, and chronic pain.

Treatment and Prognosis
Treatment typically involves early, structured intervention. Historically, surgery was the mainstay, but current best practices favor staged correction through serial casting (often similar to the Ponseti method used for clubfoot), followed by limited surgical procedures such as tendon lengthening or soft-tissue releases to correct residual deformities. In some cases, subtalar or talonavicular joint stabilization may be necessary. With timely intervention, most children achieve good functional outcomes, including near-normal walking and foot appearance. However, delayed or inadequate treatment can result in permanent disability, making early recognition and multidisciplinary care essential for long-term mobility and quality of life.

Most Useful Resources:
Congenital Vertical Talus (Foot Health Forum)
Congenital Vertical Talus (Podiatry Arena)
Congenital Vertical Talus (PodiaPaedia)
C is for Congenital Vertical Talus (Podiatry ABC)

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Chinese Foot Binding

Posted on by Staff

Chinese foot binding was an ancient barbaric practice in rural China where the feet of young girls were tightly bound to try and prevent then growing. The practice resulted in severe deformity and painful feet. Special shoes were worn.

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Chinese foot binding was an ancient cultural practice that lasted for nearly a thousand years, beginning during the Tang Dynasty and becoming widespread by the Song Dynasty. It involved tightly wrapping the feet of young girls, usually between the ages of four and nine, to prevent them from growing naturally. The goal was to create what was known as the “lotus foot,” ideally about three inches long, which was considered a symbol of beauty, elegance, and high social status. The process was extremely painful and often led to lifelong physical disabilities, but for centuries, it was deeply ingrained in Chinese ideals of femininity and attractiveness.

The practice had strong social and economic implications. Bound feet became a marker of refinement and were associated with marriageability, especially in elite circles. Families would bind their daughters’ feet to increase their chances of marrying into wealth or status, as small feet were seen as a sign of discipline, obedience, and desirability. At the same time, it reinforced gender inequality by limiting women’s mobility, effectively confining them to domestic spaces and making them more dependent on male relatives. Over time, the cultural association between beauty and bound feet became so entrenched that even women from poorer families adopted the practice, despite the hardship it brought.

However, foot binding also sparked criticism and reform, especially in the late 19th and early 20th centuries as China sought to modernize. Intellectuals, reformers, and missionaries began condemning the practice as barbaric and detrimental to the nation’s strength, since it physically weakened half the population. Anti-foot-binding societies were established, and the movement gained momentum alongside broader calls for women’s education and emancipation. By the early 20th century, the practice was officially banned, though it persisted in some rural areas for a few decades. Today, foot binding is remembered as a stark example of the extreme lengths to which cultural beauty standards can go, as well as a reminder of how societal pressures can profoundly shape and restrict women’s lives.

Most Useful Resources:
Chinese Foot Binding (Foot Health Forum)
Chinese Foot Binding (Podiatry Arena)
Chinese Foot Binding (Podiatry TV)
Women Make me Angry! (Angry Pod Doc)
WTF? Chinese Foot Binding! (Sunday Soapbox)
Cortical reorganisation and chinese foot binding (Podiatry Arena)
Chinese Foot Binding (PodiaPaedia)

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Children Shoes

Posted on by Staff

The child foot is still growing, it is easy to mold, therefore the correct footwear to allow the growing foot to develop naturally is essential.

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When fitting children’s shoes, the first thing to check is length and toe space. Children’s feet grow rapidly, so it’s important to have about a thumb’s width (roughly 1 cm) of space between the longest toe and the end of the shoe. This ensures that toes aren’t cramped and there’s enough room for natural movement and growth. Always measure both feet, since one is often slightly larger, and fit the shoes to the bigger foot.

The second step is width and overall shape. A child’s foot should sit snugly without being squeezed. If shoes are too narrow, they can cause rubbing and discomfort, while shoes that are too wide may lead to slipping and poor walking posture. Many children’s shoe brands offer different width fittings, so pay attention to whether the child’s feet are narrow, standard, or wide. Look at how the shoe hugs the midfoot and heel — it should feel secure without pressure points.

Next, consider heel and arch support. A good children’s shoe will hold the heel firmly in place, preventing excessive side-to-side movement. This helps with stability and reduces the risk of trips or ankle twists. The sole should be flexible enough to bend with the child’s natural walking motion, but still provide enough cushioning and support for everyday activities. Lightweight, breathable materials also matter — they keep feet comfortable and reduce sweat buildup.

Finally, do a practical fit test. Ask the child to walk, run, and even jump in the shoes to see how they feel in motion. Observe whether the shoes slip off the heel or cause them to adjust their step. Check for any red marks on the skin after a few minutes of wear, as these can signal tight spots. Since children outgrow shoes quickly, it’s a good idea to recheck their size every 2–3 months to ensure a proper fit and prevent foot health issues later on.

Most Useful Resources:
Children’s Shoes (Foot Health Forum)
Childrens shoes (Podiatry Arena)
Toning Shoes for Children (Toning Shoes Today)
Children’s Footwear (Child’s Shoes) (ePodiatry)
Children’s Footwear (Podiatry TV)
Footwear for Kids (Foot Health Friday)
Childrens Toning Shoes (Kids Shooz)
Childrens Shooz (Childrens Shooz)
Bunions and the Fitting of Children’s Shoes (Bunion Surgery)
The APMA are taking some heat for this advice on childrens shoes and its hard to defend (Its a Foot Captain)

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Overpronation

Posted on by Staff

‘Overpronation’ is generally accepted as being the foot rolling inwards at the ankle or rearfoot joints. There is a lot of controversy about the use of the term; just how much of a risk factor for injury it is; if it should be treated or not; and what the best treatment for it should be.

overpronation

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Overpronation in runners refers to an excessive inward rolling of the foot after it strikes the ground during running. While some degree of pronation is natural and helps absorb shock, overpronation places extra stress on the foot and leg. When the foot rolls too far inward, it disrupts proper alignment and alters how forces are distributed across the lower body. This can affect not only the feet but also the ankles, knees, hips, and even the lower back, making it a common biomechanical issue among runners.

One of the main causes of overpronation is structural or biomechanical imbalances. Flat feet, low arches, and ligament laxity often predispose runners to roll their feet inward. Other contributing factors include weak stabilizing muscles in the hips and legs, improper running technique, or wearing shoes without sufficient support. Over time, these factors can combine to exaggerate the inward collapse of the foot, leading to poor shock absorption and inefficient running mechanics.

The symptoms and risks of overpronation are varied. Runners often experience pain in the arch or heel, shin splints, plantar fasciitis, Achilles tendonitis, and knee discomfort due to the misalignment of the leg. Overpronation may also contribute to overuse injuries, since the body compensates for poor foot mechanics with increased stress on surrounding joints and muscles. Recognizing these symptoms early can help runners avoid more serious chronic injuries that could interrupt training.

Management and prevention strategies typically involve strengthening exercises, supportive footwear, and sometimes orthotics. Strengthening the intrinsic foot muscles, calves, and hip stabilizers can improve foot control and alignment. Choosing stability or motion-control running shoes with proper arch support can reduce excessive pronation. For runners with more severe cases, custom orthotics may be prescribed to correct biomechanics. Additionally, focusing on proper running form and gradually increasing training load can reduce the likelihood of injury from overpronation. This balanced approach allows runners to maintain performance while protecting long-term joint health.

Most Useful Resources:
Overpronation (Foot Health Forum)
Overpronation in Runners (Podiatry Update)
Overpronation (Podiatry Online TV)
How do you treat overpronation? (Podiatry Experts)
My Advice if you Overpronate (Running Injury Advice)
Overpronation (Dr the Foot Without the Dr)
‘Overpronation’ (Podiatry CPD)
Pronation Mythology (Its a foot, Captain)
The nonsensical understanding of ‘overpronation’ (Run Research Junkie)
Is Overpronation a Problem? (Clinical Boot Camp)
“Biomechanics Corner”: Overpronation (Podiatry Arena)
Overpronation (Foot Info)
Overpronation (Podiatry Daily)

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Chevron Osteotomy

Posted on by Staff

A Chevron osteotomy is used for the correction of a mild to moderate hallux valgus deformity. The osteotomy reduces the angle between the first and second metatarsal.

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The chevron osteotomy is a commonly performed surgical procedure used to correct mild to moderate hallux valgus deformities, more widely known as bunions. The surgery involves making a V-shaped (chevron-like) cut in the distal portion of the first metatarsal bone, usually near the metatarsal head. By shifting the metatarsal head laterally, the surgeon can realign the joint, reduce the angle between the first and second metatarsals, and improve the overall biomechanics of the big toe. The procedure is generally less invasive compared to more proximal osteotomies and is especially effective when the deformity is not severe.

One of the main advantages of the chevron osteotomy is its relative simplicity and reliable correction in properly selected patients. It allows for good restoration of the metatarsophalangeal (MTP) joint alignment, pain relief, and improved cosmetic appearance. Fixation is often achieved with small screws or pins, and the recovery process typically includes protected weight-bearing in a surgical shoe or boot. Complications are relatively rare but can include recurrence of deformity, stiffness, or, less commonly, avascular necrosis of the metatarsal head if the blood supply is disrupted.

In terms of outcomes, most patients experience significant reduction in pain and improved function, making the chevron osteotomy a preferred technique for younger, active individuals with mild-to-moderate bunions. However, it is less suitable for severe deformities or in cases with significant arthritis of the MTP joint. In such scenarios, more proximal osteotomies, Lapidus procedures, or even joint fusion may be considered. Careful patient selection and precise surgical technique are key factors in achieving optimal results with this method.

Most Useful Resources:
Chevron Osteotomy (Foot Health Forum)
Chevron Osteotomys (Podiatry Arena)
Chevron Osteotomy (PodiaPaedia)
Charcot Foot (Podiatry FAQ)

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Charcot Foot

Posted on by Staff

Charcots foot is a problem that occurs in those with diabetes and nerve damage. The loss of sensation mens that fractures and dislocation to joints are more common as damage is not detected.

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Charcot foot, also known as Charcot neuroarthropathy, is a serious complication of diabetes that primarily affects people with peripheral neuropathy. Because neuropathy reduces the sensation of pain, patients may continue to walk on an injured or fractured foot without realizing the extent of the damage. Over time, repeated microtrauma combined with poor bone healing leads to progressive weakening and deformity of the bones and joints in the foot. This condition often presents with swelling, redness, warmth, and sometimes pain, but these symptoms can be easily mistaken for infection, making diagnosis challenging.

The development of Charcot foot is linked to both neuropathy and impaired circulation, which are common in long-standing diabetes. Neuropathy diminishes protective sensation, while autonomic dysfunction causes increased blood flow that weakens bone structure. As a result, even minor injuries can trigger a destructive cycle of bone resorption and collapse. The midfoot is most commonly affected, leading to a characteristic “rocker-bottom” deformity where the arch collapses, increasing the risk of pressure ulcers and infections. If untreated, these complications can ultimately lead to amputation.

Diagnosis of Charcot foot relies on a combination of clinical suspicion, imaging, and exclusion of infection. X-rays may initially appear normal but can later reveal bone fragmentation, dislocations, and deformity. Advanced imaging techniques like MRI or bone scans may help detect early changes before structural collapse occurs. Since the condition mimics cellulitis or osteomyelitis, misdiagnosis is common, which can delay treatment and worsen outcomes. Therefore, recognizing the early warning signs—especially in diabetic patients with neuropathy—is essential for timely intervention.

Treatment focuses on immobilization and offloading to prevent further damage. Total contact casting or specialized orthotic boots are commonly used to stabilize the foot and allow healing. In severe or recurrent cases, surgical intervention may be necessary to correct deformities and restore stability. Long-term management includes custom footwear, ongoing monitoring, and strict diabetes control to minimize recurrence. With early recognition and proper care, the destructive progression of Charcot foot can be slowed or prevented, significantly reducing the risk of disability and amputation.

Most Useful Resources:
Charcot Foot (Foot Health Forum)
Charcot Foot (Podiatry Arena)
Charcot foot outcomes (Podiatry Arena)
Charcot’s Foot (PodiaPaedia)
Charcot Foot (ePodiatry)
Charcots Foot (Podiatry TV)

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The Circulation Booster

Posted on by Staff

The Circulation Booster is a controversial product that has been slammed by advertising standards authorities for the unsubstantiated claims that they made. Little or no evidence support there use, except for testimonials.

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The Circulation Booster device is a medical-grade therapy tool designed to stimulate blood flow in the legs and feet. It typically works by sending gentle electrical impulses through foot pads, which activate the muscles in the calves and lower legs. This stimulation mimics the natural muscle pump action that helps push blood back toward the heart, improving circulation in people who may suffer from poor blood flow due to age, medical conditions, or limited mobility. The device is often marketed to relieve symptoms like swelling, cold feet, and discomfort associated with circulation problems.

One of the main benefits of the Circulation Booster is its ability to reduce swelling and ease pain caused by poor circulation. Conditions such as diabetes, peripheral arterial disease, or venous insufficiency can limit effective blood flow, leading to discomfort or even complications. By improving circulation, the device may help reduce the risk of blood pooling in the lower limbs, while also providing a soothing effect similar to a massage. Some models also include TENS (Transcutaneous Electrical Nerve Stimulation) features, which can help manage nerve pain in addition to stimulating circulation.

In practical terms, the Circulation Booster is simple to use—most units only require the user to sit down, place their feet on the foot pads, and select the desired intensity level. Sessions typically last around 20–30 minutes, and many users describe the experience as relaxing. While it’s not a cure for underlying medical conditions, it can be a supportive therapy for people looking to manage symptoms and improve comfort in their daily life. However, individuals with pacemakers, certain heart conditions, or who are pregnant are usually advised to consult a doctor before use.

Most Useful Resources:
Circulation Booster (Foot Health Forum)
Circulation boosters, good or bad? (Podiatry Arena)
Circulation Booster (PodiaPaedia)
Does the Circulation Booster Work at Improving Circulation? (Podiatry Update)
Does the Circulation Booster really boost circulation to the foot? (Podiatry Experts)
Does the Circulation Booster Work? (Croydon Foot)
The Circulation Booster (Dr The Foot)
Cricket Legend believes REVITIVE Circulation Booster has helped him feel better! (Medical Releases)

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