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verrucae south west podiatry

Warts and Verrucae in Wimbledon

Warts and Verrucae

Verrucae are small viruses which are similar to warts but occur on the feet. They are the same as warts on any other part of the body but on the feet they are called Verrucae Pedis. Verrucae are very common which occur frequently in children and people with a lowered immune system.
They are usually pain free and in general podiatrists only recommend treatments when they become painful or an issue. They often look like small cauliflower lumps on the feet and can also contain small black dots in the middle which are capillaries. Verrucae’s can appear as single verrucae or can be multiple viruses covering large surface areas. Verrucae are caused by different strains of the human papilloma virus (HPV) and like any virus, it needs your immune system to see it and then respond to it, in order to resolve the verrucae.

What should I do if I think I have Verrucae?

If you have explored home treatments and read a little on the internet about Duct tape, Banana skins and Cider Vinegar and found that none of it worked but you are still concerned or the verrucae is still painful then you should contact south west podiatry.

How can our team help you?

It is important to diagnose your problem and be reviewed by a HcPC registered Podiatrist or Chiropodist. During your initial consultation your podiatrist will assess your feet and discuss your treatment options.

Treatment may consist of:

 

Call Now to book 020 7164 6607 

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Shockwave Therapy | ESWT | Wimbledon

Here we discuss indications for shockwave therapy or ESWT.

In this blog we cover the main indications for shockwave therpay which our podiatry team in Wimbledon use to promote healing and reduce pain in injured tissue. 

This blog explains how shockwave therapy works so if you are unfamiliar with shockwave in medicine, click here : What is ESWT or Shockwave therapy?

What can shockwave therapy be used to treat?

ESWT – Shockwave therapy

Click on the video below to see how ESWT / shockwave therapy is used for heel pain:

How many sessions do I need?

At an initial consultation your podiatrist will discuss if ESWT is recommended and the frequency of visits.  Generally, patients attend clinic at 1-2 week intervals for up to 6 sessions with a view to reviewing the outcome a few weeks after your final session.

Call Now to book 020 7164 6607

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Shockwave therapy for heel pain | Wimbledon

What is ESWT or Shockwave Therapy?

Extracorporeal Shockwave Therapy (ESWT) is the application of Shock Waves in medicine.

Shock Waves are movements of extremely high pressure caused by, for example, an explosion, an earthquake or a plane breaking the sound barrier.

It is clinically proven that pressure waves, when applied to injured tissues, stimulate metabolic reactions and promote the initial phases of healing.  Podiatrists use a large machine and a probe to administer shockwaves into injured tissue to promote healing.

Let me explain how shockwave therapy works.

When the clinician applies shockwave therapy or ESWT to injured tissue. Injuries are affected in three ways:

ESWT – Shockwave therpay

 

  • Reduction of pain by reducing nerve impulses.
  • Increase of blood circulation in surrounding tissue.
  • Beginning of the healing process through stem cells activation.

 

 

Everyone has C nerve fibres in their body and when C nerve fibres are activated, the fibres release a substance called substance P.  Substance P is responsible for causing pain and discomfort.  ESWT activates C nerve fibres, initially causing a widespread release of substance P which causes discomfort during application.  After a prolonged period of applying ESWT, C nerve fibres are disarmed and incapable of producing substance P.

A reduction in the production of substance P in tissue, leads to a reduction in pain.

This reduction of nerve fibre stimulation, together with increasing blood circulation and the activation of stem cells in the treated tissue, promotes recovery and can significantly reduce musculoskeletal pain.  ESWT can be used for heel pain on the bottom or back of the heel.  There is an abundance of high level evidence to support the use of shockwave therapy in combination with other management strategies such as orthotics and manual therapy.  Our premium ESWT machine is used in the vast majority of high level evidence and is widely recognised as the most effective device :  EMS 

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Nail surgery and ingrowing toe nails | Wimbledon | London

What are ingrowing toe nails?

There are many types of ingrowing toe nails which can appear as painful or infected nails.  Big toe nails are commonly affected with the smaller nails infrequently affected.  We know ingrowing toe nails are painful which may require courses of antibiotic therapy.  The nail can appear red, hot swollen or painful to the touch.

How can ingrowing toe nails be treated?

Treatment would depend upon the cause of your ingrowing toe nail.  Treatment can range from conservative, appropriate nail cutting to surgical management.

When ingrowing toe nails are chronic and recurrent, nail surgery may be suggested for a long term solution to your problem.

If surgery is required, how will the toe nail be removed?

Nail surgery is a minor surgical procedure which is completed by our podiatry team in wimbledon, london.  The surgical procedure is completed under local anaesthesia and we can plan your procedure around work commitments, holidays and social engagements.

  1. After an assessment for suitability for this procedure, two local anaesthetic injections will be injected into the toe/toe’s.
  2. After 5 minutes the toe/toe’s will be numb and either a portion of the nail or the whole nail will be removed. This makes the procedure pain free.
  3. A chemical (phenol) will be applied to destroy the exposed nail bed so the part of the removed nail never grows back again (95% success).
  4. The toe is then dressed with a large bandage.
  5. After the procedure you are required to rest and take pain relief (if required).
  6. This procedure takes around one hour, you can walk normally afterwards but are required to bring flip flops and cannot drive for 24 hours. The wound takes between 6-10 weeks to heal.

How painful is it afterwards?

Most patients do not need pain relief medication following this procedure however some patients may experience mild symptoms. If the toe is painful it is advisable to take over the counter pain relief such as Paracetamol and nothing which contains anti-coagulant medication such as Asprin.

What are the risks ?

This procedure is considered a safe and effective way to treat in growing toe nails.  Like any surgical procedure there are minor risks involved which your podiatrist will discuss with you during the assessment and when gaining formal consent prior to booking this procedure.

To book, call now 020 7164 6607

Email info@swpodiatry.co.uk

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Infected ingrowing toe nail | Antibiotic resistance | Wimbledon

How can a Podiatrist help to reduce antibiotic resistance?

Ingrowing toe nails can become red, hot and swollen.  They are very tender to touch and commonly become infected by bacteria.  The toe may bleed, be malodorous and discharge yellow pus from the toe nail.  Inappropriate management of ingrowing toe nails may require a series of antibiotic prescriptions.  Having multiple antibiotic treatments increases the risk of bacterial resistance or antibiotic resistance.

Ingrowing toe nails are easily managed by foot specialists, conservatively and surgically without the need for multiple prescriptions of antibiotic therapy.   Early intervention and treatment is key to reducing antibiotic resistance in the treatment of ingrowing toe nails.

Public Heath England have published the following video regarding antibiotic resistance:

To slow resistance we need to cut the unnecessary use of antibiotics. Public Health England.

To reduce antibiotic resistance and review your conservative and surgical treatment options of ingrowing toe nails, click on the link below:

 www.swpodiatry.co.uk/common-conditions/ingrown-toenails/

 

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Wimbledon podiatrist | Interview | Brunilda Agalliu

An open interview with Wimbledon podiatrist Brunilda Agalliu.

Wimbledon and Earlsfield Podiatrist | South West Podiatry clinic | Relieving foot pain.

Brunilda Agalliu south west podiatry

What’s your name, age ( if that’s ok to ask!!) and how long have you been a Podiatrist?

·       Brunilda Agalliu

·       29 years old

·       I have been a Podiatrist since 2013 (5 years almost)

 

You have been qualified a while now, you hold a band 7 specialist podiatrist role within the NHS working within musculoskeletal medicine and high risk diabetes, but what made you become a podiatrist in the first instance?

·       From a very young age I always wanted to help people and was fascinated with medicine sciences.

 

That’s great so how long did you study for, was that full time or part time?

·       I studied a full time 3 year course at The University of Brighton. It was a challenging period as the course was very demanding and was taught in English which is not my maternal language. However, I thoroughly enjoyed participating in a wide range of learning activities both University based and during clinical placements.

 

What was the best thing you learnt at University ?

·       I grew up in Lamia, a small city in the midlands of Greece and moved to the UK in September 2009. I was accepted to study at the University of Brighton and enrolled into the course of BSc Physiotherapy. During my first year in Physiotherapy my interactions with other students sparked my interest into the field of Podiatry. I found Podiatric medicine fascinating as it combines a holistic treatment approach including surgical intervention and the use of many other technologically advanced methods for the diagnoses and treatment of foot pathologies. After completing my first year in physiotherapy I decided to dedicate 3 more years in studying BSc Podiatry. During this time, I equipped myself with numerous skills taught during the course. If I must choose one to highlight as the best, I must say it is the use of orthotic devices as they can have a life changing impact for the patients receiving the prescription.

 

So how did that influence you in your current specialist role now?

·       From the minute I took a scalpel on my hands and learnt how to use it, I felt that Podiatry was what I always wanted to learn and improve my skills within.  I was fortunate to find a job immediately after I graduated and had a mentor that had a big influence on my passion within the profession, which is musculoskeletal injuries, Biomechanics and human movement related problems. I stayed in this role for 3 years and cultivated my passion by employing cutting edge methods such as Video Gait Analysis, Pressure Plate studies and Biomechanical examinations.

    

You worked with a podiatric surgeon for a while, how did you find that?

·       It was amazing to work with someone that has over 28 years’ experience and been exposed to seeing so many different cases. Podiatry and podiatric surgery is an area that is still new in medicine but has such a big influence in peoples’ life and I am very grateful for the opportunity to work closely with a leading podiatric surgeon.   

 

I think you would be an awesome surgeon! But like Tom explained, it’s a lot of dedication and your interest is slightly different, specialising in orthotics, biomechanical examination’s right? 

·       Podiatric surgery did cross my mind in the early stages of my career but I changed my mind after a few years of working in the profession. As Tom has noted already, the MSc in Podiatric medicine requires a lot of time and dedication to complete the training. I’m certain that this dedication pays off in the end as surgery has a very important role to play in the management of foot pathologies and must be rewarding to practice. However, we should not disregard the need for non-invasive treatment options as often patients cannot or do not want to undergo surgery and seek for alternative treatment options. Personally, I find great satisfaction in practising biomechanics and also find that it suits my current priorities better as it allows me to maintain a good work-life balance.

 

What lead you to specialise in this field of podiatry?

·       I find that my specialisation is a less invasive treatment option that is impactful and effective. Especially when dealing with children and young adults the outcomes are outstanding as we are able to correct gait abnormalities seamlessly.

 

I bet you get this all the time, but I have heel pain ! what should I do ?

 

·       Heel pain! We see at least 1 in 5 people with heel pain.

·       Podiatrists are the people to see when you have heel pain.  If someone suffers from heel pain they should seek early intervention and immediate advice. A foot specialist can examine, diagnose and provide an effective treatment plan which may consist of strapping, stretches, loading programmes, orthotics, ESWT or injection therapy. Podiatrists carry out Gait analysis / Biomechanical examinations and at South West Podiatry, we are fortunate to have access to infra-red pressure analysis, a private gait lab and 3 D scanning. 

 

Ok so I clearly need to book in to see you but there is no way you are injecting my heel! Back to the interview, what was your first podiatry job and did you enjoy it?

·       My first Podiatry job was in a private clinic in London (3 years) and I truly enjoyed the variety of people I was seeing and treatments that I was able to offer to my patients.

 

What is the best part of being a foot specialist ?

·       That every day I meet someone I haven’t met before, I hear stories that are happy or sad and I can have some influence in people’s life or be influenced by them.

 

And the worst ? 

·       I agree with Tom about the unfortunate misconceptions regarding our profession. On the other hand, I am hopeful that this is slowly changing as our patients spread the word about the amazing results they have seen under our care. I think the worst part of the job is dealing with high risk patients that often seek our care too late and the pathology has progressed to the point where there is not much we can do to improve their condition.

 

And what are the worst feet you have seen?

·       The worst feet I have seen were not in Europe and did not suffer from 21st century problems. In 2012 I volunteered with a charity organisation and spend a month at the Lalgadh Leprosy Hospital in Nepal. Many of the patients I treated presented with severe wounds caused by the life threatening disease of Leprosy.

 

Jeeeeez, how did you manage those feet?  

·       That’s why we are unique at what we do and essential as a faculty within health allied professionals.  We are equipped with skills that allow us to calmly deal with circumstances that others find terrifying.

 

If you could change on thing about your job what would it be, and why ?

·       I do love my job. One thing I would love doing more is seeing toddlers and children as they truly brighten my day.

 

This question is for our current podiatry students or newly qualified podiatrists, just starting out, what’s the best advise you could give them?

 

·       Observe your teachers and colleagues closely, study meticulously and practice with a patient-centred thinking. It is also crucial to question and re-evaluate and improve our practices so ensure that you have packed with you a fresh pair of eyes.

 

You work within the NHS and Private sector.  To give the newbie podiatrists an idea, how do you find both sectors and what’s the difference?

·       In the private sector you will be faced with less limitations in resources in comparison to working in the NHS. You have to be at the top of your game and have the ability to act independently whilst factoring in the needs and the budget of your customers. On the other hand the NHS will provide you with experience in a large cohesive team that on a daily basis is focused on treating a long list of patients.

 

Which sector do you prefer?

·       I think both are enjoyable environments and I enjoy different aspects in each of them. I would advise newly qualified podiatrist to spend some time in the NHS before venturing in the private sector.

 

Just one more question, same question as tom, so you have a foot fetish right 😊 ?

 

·       Certainly not. That’s like asking an ENT specialist if he has a nose fetish!

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Wimbledon Podiatry Interview | Tom Walton | Podiatrist

Wimbledon Podiatry team member Tom Walton is interviewed and reveals the differences between Podiatry within the Private and NHS sectors.

Tom is an important member of the South West Podiatry team in Wimbledon.  Tom speaks openly about his life as a Dad and trainee Podiatric surgeon whilst also reflecting on his university days as a young aspiring foot specialist.

Tom Watson south west podiatry

What’s your name, age and how long have you been a Podiatrist?

o   Tom Walton

o   32

o   10 years

You’re a foot specialist Tom, with vast experience and working in a specialist role within the NHS, but what made you get into Podiatry in the first instance?

o   I have always been interested in biology and human science so when deciding what to study at University I was drawn to Physiotherapy at first but once I had researched into the various health professions, Podiatry seemed to appeal to me more, due to the varying specialities and differing caseloads.

o   I like the fact that Podiatry as a profession are specialists of the foot and ankle. As well as independent practitioners at south west podiatry team we work in a multi disciplinary approach with chiropractors, physiotherapists, orthopaedics and podiatric surgery. It is certainly better to work together and try to understand how other professions work, but for the foot and ankle, Podiatrists are well placed to provide assessment, diagnosis and management plans to treat all lower  limb pathologies.

That’s great that you work in an MDT privately and within the NHS, so how long is the undergraduate degree?

o   It is a full time Batchelor of science with Honours ( BSc HONS Podiatry) degree for 3 years or you can do it part time which will take 5 years.  You spend quite a considerable amount of time as an undergraduate within the NHS or, if your a pro active student, shadowing practitioners.  

Where did you study?

o   University of Huddersfield for my undergraduate degree and University of Brighton for my Masters.

I believe you have done some extra training ?

o   I have yes, I have completed courses for soft tissue and intra-articular joint injections for a wide range of foot pathologies as well as obtaining IRMER certification order and interpret diagnostic scans such as X-Rays and MRI’s.

o   I am also in my second year of training to become a Podiatric Surgeon.

So how long does it take to become a foot surgeon?

o   In order to become a Podiatric Surgeon you need to complete the undergraduate BSc HONS in Podiatry.  After a minimum of three yeas studying then you need a minimum of 2 years post graduate experience before enrolling onto a Masters degree which takes a further three years. It is encouraged to work within a surgical unit as a clinical assistant.  Once you have completed the passport to surgical training you are then eligible for Surgical training which is a 3-4 year pathway. Once you have completed this you are a Fellow in Podiatric Surgery and you need to work with a consultant for another three years to get your certificate of completion Podiatric Surgery training.

o   So in short 12-13 years.

That’s long, you get less time for murder! It must be hard work studying, working full time and raising your daughter, how do you do it? 

o   I won’t lie, it does take a considerable amount of dedication and a passion to learn.  You need a tremendous amount of knowledge, skills and experience to become a Podiatric Surgeon. You need to be organised and give up a lot of time for it. Thankfully, I have a very understanding and supportive wife and business partner so that helps.

So that’s where you are heading but where did you start.  What was your first podiatry job and did you enjoy it?

o   First Job was in Kilburn north London part of Camden NHS trust. It was great to be free from university and start earning money but scary at the same time. I learnt a lot in my first year as a Podiatrist.

What is the best part of being a foot specialist ?

o   The best thing is helping people, even if its just simple toe nail cutting on a person who is unable to do so, or treating painful MSK conditions of the foot that leaves people debilitated. Relieving people of pain is a great feeling and very rewarding.

And the worst ?  seriously, apart from sweaty feet?

o   Its is rare to get sweaty and smelly feet I must say, unless I have built up an immunity to smelling feet? The worst part would be the general publics perception and other health care professionals opinions / knowledge of what we do as a profession.  People and health care professionals believe we are nail and corn cutters. We do so much more than that, we are the specialist of the foot and ankle dealing with dermatological conditions, MSK conditions along with serious high risk disorders of the feet that if untreated can cause quite considerable mobility issues.  Liam has a strong opinion on this subject, so I will let him explain a little more in his interview!

Ok – Come on tell me, what are the worst feet you have seen?

o   For me it would have to be diabetic feet, ones that have circulatory problems as well, because these can go bad very quickly and you can usually smell them before you see them.

If you could change on thing about your job what would it be, and why?

o   As said before the recognition of our specialism with the wider public and healthcare professionals. As well as dropping and getting rid of the “C” word (CHIROPODIST)

This question is for our current podiatry students or newly qualified podiatrists, just starting out, what’s the best advise you could give them?

o   This profession provides a lot of opportunities to be a clinician but also a business person which will give you lots of career fulfilment.  Be pro active in shadowing people, learn as much as you can and don’t be afraid to ask questions. 

You work within the NHS and Private sector.  To give the newbie podiatrists an idea, what is the difference?

o   The NHS is great organisation with good values and morals, However, it has been widely abused by us as users of the service and professionals working with in it. Along with poor management it is a struggling service so cut backs mean that as a clinician we are constantly held back by budgets and a lot of red tape meaning the patient looses out. Privately you can manage and work in smaller services which means you are able to give more time and resources to the patient. Using equipment such as force plates, 3D scanning and imaging to help diagnose and manage patients in a more efficient way than possible in some NHS trusts. At South West Podiatry we have same day access to X rays, MRI, Ultrasound examination’s and lets say a patient wants a specific type of orthotic device, we can go out there and meet their expectation. We work with orthotic companies from Canada, Australia, Ireland and the USA. 

Which do you prefer, NHS or Private ?

o   Hard to say I love my NHS position I deal with a lot of complex foot pathologies which challenge me. But the private sector really allows me to treat and manage patients in the best way I can.

Just one more question, so you have a foot fetish right?

o   Ha ha ha most definitely not!!!!!! The feet I have seen and treated would put you off your dinner for life.

 

Tom Walton MSc BSc HONS MChs HcPC 

020 7164 6607

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Flip flops cause foot pain, or do they? | Wimbledon Podiatry

Are flip flops truly bad for the feet? A Podiatrists interesting view and discussion about common myths.

Our foot specialist who works in Wimbledon Clinic shares an interesting review; talking about common myths which suggest flip flops cause foot pain are bad for the feet.

 

 

 

Liam McManus BSc (HONS) M.Ch.S

Hopefully you will forgive me for thinking too far ahead, but summer is just around the corner.  As I travelled home from a busy day in the Wimbledon clinic, the car dashboard said 5 degrees.  Yes its cold, but in a few months you will be thinking about flip flops, sandals and walking barefooted along the beaches of your chosen holiday destination.

For the majority of people, walking barefoot and wearing flat Havaianas are very comfortable.  The secret is I love my Havaianas and find them incredibly comfortable. I wear them in the summer, abroad and visiting my family in Gibraltar.  The myth is that flat flip flops and barefoot cause problems.  I can tell you that when you walk barefoot, this is somewhat improving strength, conditioning, balance and something called proprioception which is important in walking and movement.  So what’s the problem?

As a foot specialist, 95 % of people who attend clinic have an injury.  When you see 20+ people in a day and all have pain when wearing flip flops or walking barefoot, then its easy to have tunnel vision and suggest a blanket NO to flip flops or barefoot.

“95 % of people who attend clinic have an injury”

Even when feet hurt, it’s important to remember that a small amount of walking barefoot is good for you, even barefooted rehabilitation.  When people suffer from heel pain, plantar fasciitis and arch pain, then its a good idea to seek medical intervention through a podiatrist.  When foot pain occurs then it is not advisable to wear flat flip flops or sandals for the summer months, at home or abroad.

I have a solution for you if you have discomfort in your feet and you live in flip flops in the summer.  Fit Flops and Vionic footwear are  very comfortable and actually look good.  They can be worn when you are not wearing orthotics or instead of walking barefooted in your house to give your feet a degree of cushioning.  Vionic flip flops have a built in orthopaedic orthotic which can help ease symptoms of heel pain and arch pain.

What’s the key message ?

“Flip Flops don’t cause pain for the majority of people, but if you suffer from foot pain, its worth seeking medical intervention by a Podiatrist and shelving the flat sandals and flip flops”

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Three things that a Podiatrist won’t tell you | Wimbledon | Podiatry | foot pain

Three things that a Podiatrist won’t tell you, but you can be assured they are thinking it !

You / Patient :

I get a Pedicure every 4 weeks, I am not too sure about the cleanliness but the nails look great! Can you check them please??

Podiatrist :

You have a long standing fungal infection and having that darn nail polish on the nails has housed the fungus and its now all over the skin and nails.  She’s not going to like me telling her this but as soon as the clippings come back positive for fungal infection, we are going to consider a tablet and NO nail polish for a year.

You / Patient :

I play a lot of sports and my heels hurt, I have really cracked heels.  They have always been like this and I have never done anything about it, can you help?

Podiatrist :

OH NO ! Why have you never done anything about these heels, prevention is cure! I am going to ask him to cream these feet twice daily and book an appointment in 6 weeks to check up on him.  I hope he does it because this specific cream will really help but I doubt he’s going to stick to the regime.  When he comes back in 6 weeks, I am going to go mad if cracks haven’t gone ! MAD !

 

You / Patient :

I have been back to my GP about 3 or 4 times for an ingrowing toe nail and have been prescribed a few courses of antibiotics but it’s still sore ?

Podiatrist : 

We are the profession that specialise in any foot and ankle problem, including ingrowing nails. You could have seen us 1 years ago and I can see you this week and resolve your pain. You may even be able to get a referral to see a podiatrist via the NHS.  A podiatrist can cut the nail appropriately or perform a minor surgical procedure for a long term solution to your pain, see this link for further advice: http://www.swpodiatry.co.uk/common-conditions/ingrown-toenails/

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10 Tips for Children’s feet | Prevent foot pain | Earlsfield | Wimbledon

10 Tips for children’s feet to prevent foot pain.

Brunilda is our resident foot specialist in Earlsfield and Wimbledon.  She’s a mum  first then Podiatrist second ! In 2015 she gave birth to her identical twin boys who absorb most of her time and energy.  Together they enjoy family trips and activities, cooking and keeping active.  Its safe to say, she knows how to manage children’s feet! 

Here are Brunilda’s 10 Tips for children’s feet in preventing foot pain. 

  1. From the moment your child starts to walk, their feet must be measured for length and width.
  2. Buy correct sized socks.
  3. Clarks is a great shoe shop for children’s shoes, but not all the range is suitable! Once your child has had their feet measured, buy lace up shoes or shoes with a buckle and ensure they have a slight heel and a supportive heel counter for maximum foot support.
  4. Sweaty feet are normal, make sure you wash your child’s feet daily.
  5. Alternate shoes every day.  It takes 48 hours for sweat to dry from your child’s shoes!
  6. Cut your child’s nails straight across to avoid ingrowing toe nails. 
  7. Inspect your child’s nails and feet for signs of inflammation, infection or itching. 
  8. AVOID PLIMSOLLS AT ALL COSTS!!! These shoes are a Podiatrists worst nightmare!
  9. Growing pains are not always growing pains, especially in young sporty children, particularly aged 10-15. 
  10. Check your child’s wear pattern on their shoes.  Normal wear pattern is on the outside border of the heel.  Excessive wear pattern or an abnormal wear pattern may be due to walking or running problems which your Podiatrist can diagnose, assess and manage. 

 

If you are concerned about your child’s feet, whether this is an in-growing toe nail, verrucae, walking problems or flat feet, you can call us between 9AM-6 PM Monday to Friday and 9AM-4 PM on Saturdays to book in with Brulinda.

020 7164 6607

 

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