Definition of Podiatry
Podiatry is the study, diagnosis and treatment of disorders of the foot and lower limbs. These disorders include complex structural and biomechanical problems, sports injuries, ingrown toenails, acute conditions such as diabetic foot ulcers, and many others. Podiatrists can treat people of all ages.
Podiatrists’ Qualifications
Podiatrists in Singapore should have a podiatry degree from a recognised university. In Singapore, most podiatrists are mainly qualified from Australia or the United Kingdom. Singapore currently does not offer a podiatry programme in its universities.
General Information
Podiatrists offer a wide range of services that can cure or improve many foot conditions. Following a diagnosis, a podiatrist will design a treatment plan based on the best available evidence, and is individualised to suit each patient’s needs.
Treatments can come in various forms. Some conditions can be resolved quickly, while some require a series of consultations and follow-ups. Almost every treatment plan is a shared-care plan between a podiatrist and a patient to prevent the condition from returning or worsening. This includes suitable stretching and strengthening exercises for patients who are suffering from musculoskeletal foot conditions (e.g. plantar fasciitis), wearing appropriate footwear, off-loading pressure sites and keeping good foot hygiene.
Some Types of Podiatry Services
Musculoskeletal and Gait Pathologies
For patients referred with a particular category of conditions i.e. biomechanical abnormalities (structural or, in children, developmental), sports or musculoskeletal conditions, a podiatrist can provide a detailed biomechanical examination and gait analysis to identify abnormalities in foot functions when a patient is standing, walking or undertaking non-weight-bearing activities. A podiatrist can also help manage any abnormal foot function that may be causing foot pain.
Orthoses
Orthoses, otherwise known as insoles or orthotics, are devices worn inside a shoe to help manage a patient’s foot condition. They are manufactured for patients with a range of musculoskeletal conditions. Some orthoses are generally designed for comfort and support, while others are specially designed and manufactured based on prescription to manage complex foot conditions. Such orthoses aim to correct structure and redistribute abnormal forces on the foot when it makes contact with the ground inside the shoe. Orthoses are made for patients who require functional control of their foot condition or accommodative support to maintain the foot in an optimum posture, and reduce or prevent foot pain.
Lower Limb Ulcer Management
Podiatrists can help in the management of foot ulcers and provision of wound care. People can develop foot ulcers because of various reasons, largely due to abnormal foot structure, a lack of blood supply and/or and the loss of sensation in the feet. Both feet are usually affected, and both conditions are common among people with long-standing diabetes. Podiatric equipment can assess lower limb vascular supply and neurological status. Podiatrists can also advise on the most appropriate wound dressings.
Routine Foot Care (Skin and Nail Care)
Podiatrists diagnose and provide treatment for symptomatic or persistent skin and nail conditions of the foot, such as corns, calluses, warts, ingrown toenails and fungal nail conditions. Podiatrists can also teach patients how to best manage or prevent these conditions in the future.
Nail Surgery
Sometimes, a toenail can penetrate the skin on one or both sides of the nail. This is usually caused by inappropriate cutting techniques or trauma to the toe. Once the ingrown toenail is embedded, the toe may become painful, swollen and infected. Sometimes, deformed and thickened nails may also cause toenail pain. In both cases, podiatrists can permanently remove either the offending section of the nail or the full nail with a minor nail surgery procedure performed under local anaesthesia. There is no hospitalisation required and recovery is usually quick and uneventful.
Patient Education
Most of the time, patients can participate in the treatment plan to maximise or optimise their treatment efficacy. Some conditions can be prevented if patients modify their lifestyle choices, for example, by undertaking appropriate physical activities and wearing correct footwear. Podiatrists advise and recommend appropriate footwear to patients after taking into consideration an individual’s foot type, activity level, occupation and presenting foot problem.