The Foot Clinic Brampton - J. K. Takhar

Orthotics

In concept, customized biomechanical foot orthoses are no different from prescription glasses for the eyes.  Both custom foot orthotics and prescription eye glasses come in different styles, shapes and corrections. True biochemical devices are known to operate on the principle of enhancing biomechanical functions and not merely correcting and supporting the arch of the foot. Store bought devices (such as insoles and arch supports) are not true foot orthotics, like the custom orthotics obtained from Chiropodists.

In Ontario, Chiropodists / Podiatrists are the only regulated primary health care professionals that are able to prescribe, manufacture and dispense foot orthotics.

2 Types of Foot Orthotics

Accomodative Orthoses

Foot deformities which cannot be corrected are best protected and supported by the use of Orthotic devices known as Accommodative Orthoses.

Functional Orthoses

In instances where there is a biomechanical imbalance between the hind foot and the fore foot, this could lead to problems in the ankle, foot, legs, knees and even the hips. This is best controlled by the use of Orthoses known as Functional Orthoses.

How Orthotics are Custom-Fitted

The Chiropodist/podiatrist at our office will put you through a biomechanical examination of your feet and then conduct a 3 D volumetric impression. This is best done using one of two procedures, that of putting a plaster cast for impressions or alternatively using a 3 D laser scanner.

The detailed report so generated is then sent to a specialized laboratory and customized orthotic devices specific to your biomechanical or foot condition are manufactured for you.

Laser Therapy

The staff at the Brampton Foot Clinic has experienced excellent results using Low Level Laser Therapy (LLLT) with the THOR Laser.  The staff have been involved in extensive training with the laser directly from the creators of the laser in order to customize each treatment to the specific condition being treated.  The therapeutic effects of Laser Therapy have been tested in hundreds of clinical/laboratory studies and published in numerous leading medical journals.  There are many benefits in using Laser Therapy:

• Safe with no side effects
• Non-surgical treatment
• No patient sedation
• Immediate results
• Speeds healing process

In general, laser therapy can be used to increase blood circulation, accelerate tissue repair, decrease inflammation/edema, enhance the immune response and reduce pain.  In particular, our clinic has experienced success in treating numerous lower limb, foot and ankle conditions

We treat many foot related conditions; some of the more common complaints are briefly discussed below.

Achilles Tendonitis

• The Achilles tendon is the thickest and strongest tendon in the body. It is situated in the back of the leg and connects the calf muscles to the heel bone. Achilles tendonitis is an over use injury and the pain can usually be felt at the insertion of the tendon to the heel bone, or about 4cm above the heel bone.

Athletes Foot

• Common symptoms associated with Athletes foot include itching, redness cracking and peeling of the skin. It is very common between the 5th and 4th toes. The cracking of the skin may allow a bacterial infection to occur and so it is important to have it treated as soon as it is noticed. Treatment may vary according to the type and extent of the Athletes foot so it is important to consult with the chiropodist/podiatrist before choosing a therapy.

Bunions

• A bunion or Hallux Valgus is a progressive misalignment of the big toe. It is commonly described as a bump on the joint of the big toe which can become swollen, or tender. In severe cases the first toe may overlap the second. While inappropriate shoes may cause a bunion, it is more likely to be caused by faulty foot biomechanics.

Children's Feet

• Most parents are concerned enough to make sure that their children attend the dentist regularly for preventative treatment. Unfortunately this is not true of the health of their children’s feet. Many problems we encounter in adult feet, which cannot now be resolved, could have been successfully addressed had we seen that individual as a child. Many of the problems are genetic and so if a parent suffers from a particular complaint it is advisable to have your children assessed.

Chondromalacia Patella Syndrome

• Chondromalacia Patella is the wear and tear on the cartilage behind the knee cap, often known as “runner’s knee”. This condition may be as a result of a) Weak quadriceps muscle. b) Dysfunctional patellar below the knee. c) Faulty biomechanics of the foot/lower leg.

Corns and Callous

• Callous is a yellowish plaque of hard skin and a corn is a localised cone of the same hard skin which is pushed into the skin causing pain. Both are associated with intermittent pressure, or friction. Corns may also occur between the toes. If not treated the underlying tissues may breakdown leading to ulceration or infection.

Diabetic Foot

• Foot care is important for everyone, but for the diabetic patient, it is essential. Diabetes affects the nervous and circulatory systems. It slows down the natural healing process, and increases the risk of infection, so that minor injuries quickly become serious. The feet are often the first part of the body to be affected by this disease, but serious problems can be prevented by paying careful attention to your feet on a daily basis. Poor foot care can lead to serious problems, and even amputation.

Flat Feet / High Arches

High Arches

• Arches typically extend from the ball of the feet to the heel. When this arch is higher than normal (High Arch) it could be accompanies by the presence of hammer toes and are also more prone to pain and discomfort. The major challenge faced by patients with high arches is that of finding the perfect fit shoe which would fill in the gap of a high arch. On occasions the pain may even extend to the back which is uncomfortable but not crippling.

Flat Feet

• On the contrary those with Flat Feet have an abnormal structure wherein the metatarsal bones in the feet do not maintain their normal angle. Thus the arch is lost and the patient invariably experiences pain, fatigue, tiredness and even a sensation of cramping in the legs. Custom-made orthotics are often used to alleviate the pain associated with these conditions.

Fungal Nail

• Onychomycosis is an infection of the bed and plate underlying the nail plate and is caused by various types of fungi. The nail appears white, yellowish brown and may be crumbly. It starts at the farthest edge of the nail and works back towards the cuticle. Once a nail is infected it can quickly affect the rest of the nails and can also be transferred to other family members.

Hallux Rigidus

• Hallux Limitus/Rigidus is a when degenerative changes are taking place at the first metatarsal joint of the big toe. Unlike bunions there will be no big bump at the side of the foot, but there will be a reduction in the way the toe bends when walking. There will be a dull pain in and around the first joint that is increased with activity and in the early stages decreased with rest.

Hammer Toes

• Hammer toes, or claw toes are deformities that affect the second, third and fourth toe. These are very often associated with other foot deformities and are usually caused when the foot is imbalanced. They very often develop painful corns and/or calluses on the top or the end of the toe. If left untreated they will become stiff and fixed in the position.

Ingrown Toenails

• Ingrown toenails are one of the most common problems treated by a chiropodist/podiatrist. An ingrown toenail may start out as swollen and tender but quickly becomes sore, red and infected. There may be some drainage of pus, the skin may grow over the nail plate and is extremely vascular at this point causing it to bleed easily when bumped.

Morton's Neuroma

• Morton's Neuroma or Plantar Digital Neuroma is a spasmodic neurological pain in the forefoot. It causes sensations of numbness and tingling in the area affected, often relieved by taking off the shoes. It is usually felt on the bottom of the foot in the 2nd-3rd or 3rd-4th spaces.

Nail Surgery

• Nail surgery may be indicated for a number of reasons but is most often used to address long term problems with ingrown chronically infected toenails. Nail Surgery is performed in the office and involves the injection of a local anaesthetic, with a four to six week healing time. It is no more traumatic than having a tooth filled and the patient in most cases can return to work the next day.
• When necessary our office will provide the patient with oral antibiotic and/or oral anti-inflammatory medications.

Orthotic Therapy

• Orthotics is used for a wide range of biomechanical conditions. At our office we use a combination of 3D Anatomical Volume metric laser scanning systems along with 3D plaster casts in order to manufacture the only truly corrective custom foot orthotics and ankle foot braces which are eligible for Insurance coverage.

Plantar Fasciitis

• Plantar Fasciitis/heel spur is a common overuse injury. The classic symptoms are pain at the bottom and side of the heel usually present during the first few steps you take in the morning. It tends to ease until the next time you rest sit or drive and returns when you stand on your feet again. If left untreated this pain can become constant, even hurting at rest. For many this pain can become so severe that it interferes with their daily work and leisure activities.

Plantar Warts

• Plantar Warts are caused by a virus that enters through a break in the skin. They round hard lesions and, depending on where they are located they can be painful. They are often confused with corns but they characteristically have small black dots in them and are painful when squeezed. If left untreated they may spread to other parts of the body, or other family members.

Shin Splints

• Shin Splints is an over-use inflammatory condition causing a painful inflammation of the periosteum- the dense outer layer of the connective tissue lining the bones-which occurs either along the inside or the outside of the shin bone. Shin splints generally have two causes, excessive pronation or beginning an exercise program too vigorously or intensely.

Sports Medicine

• The name is suggestive considering that Sports Medicine is that branch of science which deals with prevention, treatment of injuries sustained due to exercising and sports. A science of fairly recent origin Sports Medicine came into vogue in the late twentieth century. Thus treating of muscle, ligament and bone injuries is now specialized and when undertaken under closed supervision of an expert foot specialist ensures a productive and safe physically active life for the exerciser and the athlete alike.