The podiatry profession has undergone considerable growth and change in recent years.
This page has been produced 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 the treatment of problems of the feet and lower limbs.
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A podiatrist is 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 in growing 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 Bachelor of Podiatry and be registered with state podiatry registration boards. (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 in, include:
- Sports Medicine
- Biomechanics
- Paediatrics
- Surgery
- Diabetes
- Athritis
- Gerontology
Basic foot care
In their undergraduate training 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.
Podiatrists are highly trained in the diagnosis and treatment of 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 is achieved through the ongoing monitoring of foot health, in particular of those with vascular problems such as 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 footcare 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 toe nails under local anaesthesia is a common podiatric procedure.
Treatment and prevention of corns, calluses and warts are also common podiatric procedures.
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 and 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 podiatrist's 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.
The child's 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 are trained to diagnose and treat children's foot problems by careful examination of the foot, and lower limb, where required.
Advice for the prevention or reduction of foot deformity that 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 children's feet such as osteochondroses, fasciitis and pes planus.
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 professions likely to develop long-term problems unless prevention is taken.
Podiatrists seek to address some of the issues responsible and can advise on occupational foot health safety.
This can sometimes involve the prescription of orthoses, or surgical advice.
Any sport that involves walking, running, standing or jumping places higher 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 are trained to examine and diagnose the foot and lower limb, have a good understanding and knowledge of the biomechanics of athletic movement, and can recommend appropriate footwear, training regiments and, if needed, orthotic devices to fit into the sports shoe.
Common sporting injuries treated by podiatrists include plantar fasciitis, Achilles tendonitis, stress fractures, ankle sprains and shin or knee pain.
Podiatric surgeons are first trained in podiatry and then undergo a further 10 year intensive training program. This includes a master's degree majoring in medicine and surgery of the lower limb, foot and ankle. The Australasian College of Podiatric Surgeons (ACPS) provides practical training that allows the training podiatric surgeon to qualify for Fellowship. This means that podiatric surgeons have 12 to 14 years of training and are highly experienced and knowledgeable in the diagnosis and treatment of disorders of the foot and ankle. In South Australia Podiatric Surgeons are licensed to prescribe a list of S4 drugs for the medical management of their surgical patients.
The vast majority of foot and ankle procedures can be safely and efficiently performed as day surgery. Podiatric surgeons manage patients on a same day basis whenever it is appropriate. Podiatric surgeons work within the health care system by using a "team approach" and working with anaesthetists, physicans and other surgeons.
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 limb.
Orthoses are custom-made shoe inserts made specifically to reduce foot pathology.
Tthe prescription and manufacture of orthoses is an important part of podiatric practice.
The podiatrist is trained in the manufacturing techniques for a diversity of shoe inserts.
Most inserts fall into two main categories - 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 stabilise the foot and to prevent it from moving into an unbalanced position while walking or running.
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.
To become a podiatrist a practitioner must complete a Bachelor of Podiatry (Applied Science).
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 formed post graduate qualifications in areas including sports medicine and surgery.
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.
It is usually not necessary to obtain a referral to see a podiatrist, however, when patients are claiming treatment under various programs including those run by Veterans Affairs, Workers Compensation, the Program for Aids for Disabled People (PADP) or the Enhanced Primary Care Plan, 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 centres and other publicly funded utilities. Refer to your Yellow Pages for a list of podiatrists in your area, or visit the website www.findapodiatrist.org
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