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Preventing Falls

Preventing Falls

Falls can occur anywhere and anytime but as you grow older you are more risk of falling down during day to day activities and are likely to injure yourself. There are number of reasons for falls in elderly patient’s. As you grow older your vision becomes impaired, your muscles can become weaker and joints stiffer, which can all lead to the risk of falling. Falls can also be a sign of side effects from medications, balance problems and short term illnesses. 

If you have had a fall in the past six months you have a higher likelihood of falling again. Moreover, other factors that can increase the risk of falling include: poor footwear, hazards in your home, poor lighting, chronic diseases and sensory and balances issues.

However, there are number things that you can do to help prevent falls. Here are a few tips to reduce the risk of falling. 

  • Good diet that provides all the vitamins and minerals that you need. 
  • Drink enough water to keep you hydrated
  • Exercise to strengthen muscles and joints
  • Wearing good shoes that are supportive and well fitting. 
  • Avoid walking in socks. 
  • Wearing well-fitting clothing, especially pants. 
  • Decluttering your house to prevent trip hazards (e.g. loose mats, objects in your path). 
  • Using aids to walk/installing grab rails in the bathroom. 
  • Using ramps and other mobility aids if required. 
  • Have good lighting in your house, especially at night time. 

Contact us today for foot problems.

Cerebral Palsy and Toe Walking

Cerebral Palsy and Toe Walking

Photo credit: BabyCenter.com

You may notice that your child is walking on their toes or tip toeing around the house. However, there is usually no reason to worry as some children may just like to walk on their tip toes (while pretending to be a ballet dancer, for example), whereas others may just have tight calf muscles causing them to have a bouncy gait.

However, you should talk to your podiatrist if:

  • they always walk on their toes and have stiffness in their muscles
  • they uncoordinated
  • this is accompanied by delayed development in their motor skills
  • there is a waddling gait or a lot of stumbling

Cerebral Palsy

Cerebral palsy is a condition or group of disorders, present at birth (congenital) or acquired, which adversely effect the movement, muscle tone and balance of a child. Cerebral palsy occurs due to damage to the brain centre that control the movement of muscles. There are other factors that can cause cerebral palsy such as:

  • deprivation of oxygen at birth (asphyxia) or reduced oxygen levels in the womb or during birth
  • womb infections leading to abnormal inflammatory response, which can cause an
  • autoimmune attack on the developing baby’s nervous system

Other causes include:

  • placental pathology
  • inborn errors
  • genetic causes

Risk factors for cerebral palsy are premature delivery, coexisting at birth abnormalities, growth restrictions in the womb and excessive multiple pregnancies.

Types of cerebral palsy

Spastic hemiplegia – one arm and one leg are affected on the same side of the body.

Spastic diplegia – both legs or both arms are affected.

Monoplegia – only one leg or one arm is affected.

Quadriplegia – both legs and both arms are affected. Sometimes, the muscles of the trunk, mouth, tongue and windpipe are also affected making it difficult to eat and talk.

Triplegia – both arms and one leg or both legs and one arm are affected.



Orthotics can help prevent functional problems from getting worse and allows the passive correction of the deformity in a non-rigid spasticity; they also provide stability during gait and assist with function. Orthotics do not necessarily have to extend above the knee, but their main function should be to provide joint and foot alignment.

Ankle Foot Orthoses / Ritchie Braces

AFOs (ankle foot orthoses) or other products, such as Ritchie Braces can also be recommended if they have excessive calf muscle tightness. A solid AFOs ensures foot control and helps the ankle joint. Also, they increase side-to-side stability and help the foot with ground contact. Research has shown that these braces reduce the high impact forces early in children with spastic diplegia.

Physical Therapy

Physical therapy helps maintain balance, with postural exercises being the most effective. Furthermore, lower extremity exercises such as Theraband calf muscle exercises can also help increase the muscle strength. Presently, physical therapy options include: neuro-developmental therapy, sensory integration therapy, bracing, stretching and pressure point stimulation.

Intramuscular Injections

Newer treatment types include intramuscular injections for spasticity. Injections include local anaesthesia in order to block the nerve supply to the muscle and reduce spasticity. Botulinum (the same thing used for “botox” injections) can also be used for intramuscular injection to block and release the muscles. This helps to relieve spasticity.

What Next?

If you child has a problem with walking or if you just want your child checked to see if their function is within normal limits, see our podiatrists today for a thorough assessment and discussion of options.

Köhler’s Disease

Köhler’s Disease

Photo credit: Fixmyfeet.co.za

Köhler’s disease is a condition that impacts a bone on the inner arch of the foot. This bone is called the navicular. This relatively rare disorder of the foot typically affects males more than females and occurs between the ages of 2 and 10 years of age with a peak occurs during the ages of 3 to 7 years. It is not fully understood why this condition occurs. Some researchers suggest that it is caused by excessive strain on the navicular bone, while others believe that it is caused by injury/trauma to the area. As a result of this, the blood supply to the bone get compromised as the child is growing. This leads to loss of blood flow (ischaemia) to navicular resulting in progressive degeneration of the bone. If not treated promptly, the bone can become permanently deformed. The signs and symptoms of Köhler’s disease can differ, but they generally include:
  • Redness around the inside of the foot, near your arch
  • A swollen foot
  • Tenderness/pain along the inside of the arch
  • Pain worse if putting pressure on the affected foot
This is an uncommon condition that warrants proper diagnosis, care and management. Generally, it does resolve on its own. It is important not to aggravate the condition as it can lead to complications later on in life. If the condition is very severe (as determined by X-ray/CT scans) then a fibreglass cast or moon boot may be required in addition to other treatment options. See our Podiatrists here for more information regarding this condition.
7 Foot Health Tips for People with Diabetes

7 Foot Health Tips for People with Diabetes

Diabetes can affect different parts of your body, including your feet and legs. Diabetes can adversely affect your feet and legs in three main ways: reduced blood flow to your feet, loss of sensation in your feet and increased risk of infection.

Here are 7 tips that will assist with managing your diabetic foot health.

  • Check your feet each day, especially every night before you go to bed, for any wounds, cracks, a foreign body or blisters. Diabetes can affect your nervous system and the loss of sensation means that sometimes you may not notice if you have a sore on your foot that may require treatment.
  • Don’t go barefoot, always keep your feet protected in shoes. Not having protection on your feet means you are more prone to infection, burning your feet in the sun, stepping on something sharp and not feeling it.
  • Wear shoes and socks with diabetes friendly features, such as shoes with a wider toe box, firm heel counter and good lacing mechanism to support your feet, and socks without seams that are made from a breathable cotton material to prevent infections.
  • Maintain good foot hygiene. Change your socks every day, clean your feet each day and dry well, especially in between your toes. You might use a tea-tree spray to help prevent fungal and bacterial infections. Also, make sure to moisturise your feet daily to prevent dry and cracked skin (but don’t apply it in between your toes).
  • See your Podiatrist regularly for foot care, advice and diabetes-related nerve and blood flow testing.
  • Keep active and do some low impact exercises that won’t put too much stress on your body, such as water walking/water resistive exercises, cycling, Pilates and yoga. Of course, if you feel up to more vigorous exercise, then go for it (but check with your doctor first, if you haven’t done much exercise in a while).
  • If corns and calluses develop on your feet, don’t try and remove them yourself, see your Podiatrist for professional help to avoid any unwanted problems.
Tarsal Tunnel Syndrome

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome is an unusual condition, where the main nerve in the foot becomes inflamed and entrapped between the structures in the foot. The tibial nerve supplies the skin and the muscles in the bottom of the foot and thus when it becomes entrapped it can cause pain in various locations on the foot. The pain (tingling, numbness or shooting pain) often radiates/moves up or down the leg and bottom of the heel and foot.

Tarsal tunnel syndrome can occur due to numerous factors including but not limited to: flat feet or fallen arches, ankle sprain/ankle swelling, arthritis, diabetes, swollen tendons, ganglion cyst, bone spurs and varicose veins. Diagnosis of this condition, requires thorough clinical testing of all structures of your foot by a Podiatrist. Imaging, including x-rays and ultrasounds do not show nerve entrapment, thus thorough clinical testing is even more important.

Some conservative or non-surgical treatment includes:
1.    Injection therapy with local anesthesia for pain relief and also for diagnosis
2.    Cortisone injection can also be beneficial if there is an inflammatory component associated with the entrapment.
3.    Oral anti-inflammatory medications
4.    Orthotic devices to assist with your foot shape and biomechanics to reduce/prevent the entrapment of the nerve between the different structures in your foot.
5.    Lignocaine patches
6.    Supportive footwear
7.    Taping
8.    Mobilization/manipulation

When is surgery required? Surgery is required if the pain is severe and all other conservative treatment options have failed. A Podiatric surgeon will we able to determine if surgery is necessary and what procedure would be most appropriate for your condition.