We often get asked “What is the difference between a Podiatrist, Chiropodist and a Foot Health Practitioner (FHP)?”
Up until 1990 all foot health practitioners were called Chiropodists. Then a Podiatry degree was brought in and Chiropodists could study additional qualifications to bring them to the same level as newly qualified Podiatrists. There is no difference between a Chiropodist (performing chiropody) and Podiatrist (performing podiatry) in the UK and both are protected titles by law and are trained to a degree level and registered with the Health and Care Professions Council (HCPC). Both treat, diagnose & prevent the conditions of the lower limbs (foot, ankle and lower leg) including lower limb surgery, biomechanical assessments, specialist areas (vascular, acute diabetic support, paediatrics) and are able to prescribe medication.
Foot Health practitioners (FHP) are diploma trained by the College of Foot Care Practitioners and often members of the Association of Foot Health Professionals (MAFPH). Foot Health Practitioners (FHP) are insured and qualified practitioners and can carry out all essential maintenance treatments including calluses, corns, general foot care, diabetic foot care, nail cutting, ingrown toenails, cracked dry heels, fungal infections, verrucas and athletes foot. Foot Health Practitioners (FHP) can refer onwards to other Allied Health Professionals such as podiatrists and chiropodists or to your local GPs.
At bodytonic clinic we provide Foot Health Practitioner (FHP) services and are currently looking for a Podiatrist to join the team. We currently refer all non Foot Health Practitioner (FHP) needs to local Podiatrists (privately or via your local GP) and all specialist biomechanical needs to a top central London clinic.
Why should I have my foot health checked? 5 Reasons
Foot health checks help to to diagnose conditions and treat them at the initial phase reducing the risk of complications and help to stop the spread of any infections.
Feet carry the full weight of our bodies so they play an important part in our daily activities. Our feet and lower limbs are often overlooked when it comes to health care. We use them as often as we use our eyes so why not get them checked regularly.
Having problem free feet makes walking and running more comfortable. Your foot health could be stopping you from wearing certain shoes or playing certain sports. Overall good foot health can help to make you more mobile.
Foot health checks help those with diabetes treat and control any possible damage caused by poor circulation and damage to the nerves of the lower limb. It’s also important to maintain foot health care as people with diabetes are prone to infections and ulcers.
Foot health care can help you feel less self-conscious especially on holiday or in the summer when we prefer to go barefoot or wear open toed shoes. Treatment of conditions such as athletes foot and cracked heels is easy with the assistance of a Foot Health Practitioner (FHP).
What to expect at your first visit
Please be aware that all nail polish and/or nail varnish will need to be removed before any foot health appointment.
On your first visit our Foot Health Practitioner (FHP) will take you through a full case history and to discuss your needs and goals which you want to achieve. A full general and neurovascular assessment will be performed checking circulation and sensory reaction on the lower limbs. This will help to determine the condition which needs to be treated.
Once the assessment has been carried out and the condition has been identified treatment will then be provided. After treatment has been given, and where time allows, the foot health practitioner will also provide a gentle foot massage using moisturising and hydrating foot care creams. This will help to improve circulation, muscle tension and overall improved foot mobility. In addition, the patient will be informed on the next steps to take and how to prevent future problems.
Foot Health Practitioners (FHP) can refer the patient to the GP and / or Podiatrist for further assessment if there is clinical indication to do so. All case history notes and assessment details are securely documented and accessed at future appointments.
Here there are 3 key points to check: circulatory, sensory and shape. Capillary refill tests, muscle strength test and a pulses assessment will be carried as a complement to give a broader idea of the condition of the lower limbs. A neurovascualr assessment is always carried out during a diabetic foot assessment.
Calluses are thickened and hard areas of skin which are generally not painful. Treatment is often needed when they become painful or when they cause problems and issues with wearing shoes. An assessment will determine why the callus has appeared in the first place to help avoid problems in the future. Treatment will be provided to help remove or reduce the callus as well as provide advice and information.
Also know as Heloma Durum, corns are common foot conditions which occur from consistent pressure on areas of the foot, for example when you wear no socks with shoes. You can have a hard corn (often on the top, bottom or side of the foot), soft corn (often between the toes) or seeded corns (often on the heel or ball of the foot). Symptoms include:
– Pain – Tenderness – Hard Corns (hard patches of skin) – Soft Corns (thin skin with a smooth centre) – Seed Corns (circle of dead skin)
Treatment will help to enucleated the corn (remove the nucleus – which is the painful part), cover and protect if it is soar and take action to prevent future corns. Advice regarding footwear is often given as this is the most common cause.
One of the most common foot problems are ingrown toenails especially amongst those who love their sport. The most common area to get them are on the side of the big toe and often appears swollen, red and if not treated can become infected. Ingrown toenails appear due to tight footwear, excessive flexible tissue around the nail but mostly due to incorrect cutting of the nail. Treatment is based around cutting the nail that is causing pain and irritation whilst making sure there is no infection. Advice will be provided regarding proper nail cutting so that the future growth of the nail does not cause any problems to the patient.
Verrucae are fairly common and harmless warts that grow on the foot. However if left untreated and spread and look unsightly often leaving the patient self-conscious. Home remedies can be purchased however for quick removal or to treat persistent verruca you are best to visit a foot health practitioner. Verrucae are caused by the human papilloma virus (HPV) passed through human contact often in moist, damp environments. Treatment will help to prepare the verruca to expose the lower layers. A strong acid is then applied, such as salicylic acid or silver nitrate, to the verruca to destroy the infected skin.
Diabetic foot care
Those with diabetes can often develop foot complications often resulting in neuropathy (loss of sensation) & ischeamia (reduced circulation). This can lead to risk of developing infections and decreased ability to clear infections. The main role of diabetic foot care is to educate patients, including the importance of routine preventative foot health care and correct footwear.
Like ingrown toenails fungal toe nail infections are common foot problems and often persist without causing pain or discomfort. Infections can cause the nail to become thickened, yellow / brown in colour and if untreated infections can spread to other nails, the surrounding skin and sometime the fingernails. Treatment often involves the application of a topical oil or preparation. The thicker nail is often debrided to help the topical medication penetrate properly.
Cracked dry heels are often referred to as “heel fissures” where the skin is hard and rough and often feels like sand paper. Normally the skin should feel soft and smooth. Cracked heels can cause serious implication so its important to seek assistance as soon as possible. Certain factors and conditions can make the skin more vulnerable to cracked heels:
– Diabetes due to poor circulation, nerve damage and dry skin caused by excess blood sugar – Obesity due to pressure exerted on the heels from the increase in weight gain – Eczema, psoriasis and other dry skin conditions – Fungal infections such as athlete’s foot which can make the skin flaky – Prolonged standing or walking on hard surfaces – Low zinc and omega-3 fatty acids levels which are crucial in skin health
Whilst applying moisturiser and using a pumice stone at home can help, to stop the problem getting out of hand it is best to seek treatment with a foot health practitioner. Treatment would involve filing the area of dry skin to expose the heels then applying special creams for cracked heels. Advice will also be given to help mitigate any future problems.
Athlete’s foot or “Tinea Pedis” is a common fungal infection which occurs between the toes, however you don’t have to be an athlete to get this condition. Athlete’s foot often looks like cracked, peeling or blistered areas of the skin (usually between the 4th and 5th toes) which is red, scaling and can feel itchy and sometimes feel like its burning. If left untreated it can spread to the soles of the foot, lead to painful fissures and further foot health complications.
Several fungal species can cause athlete’s foot and can be spread by walking barefoot in communal areas such as pools, showers and bathrooms especially where the skin can be moist or waterlogged. Once contracted wearing tight and cramped shoes can create a warm and dark environment for the fungus to breed.
Firstly always unsure that your feet are completely dry following a bath or shower. Regularly changing footwear helps as well as fully ventilating your shoes after using them. Treatment consists of filing the areas of concern and if possible looking for cuts or blisters that may be infected. Application of anti fungal ointment and creams will be used to control the fungus and advice on correct footwear wear and personal hygiene will be given where appropriate.
You don’t need to have any of the above conditions to visit a foot health practitioner. For many reason some people can not reach their feet and therefore they will need help and assistance with their foot care and health. Treatment involves filing and cutting toe nails, removal of dead skin, prevention and treatment of any of the above conditions on their feet. Advice regarding foot care and foot exercises and a gentle massage with a specific foot care moisturiser.