Podiatrist

What is a Podiatrist?

Podiatrists, are specialists in treating problems in the feet and lower limbs. A primary aim of podiatry is to improve the mobility, independence, and quality of life for their patients. Podiatrists provide preventative care, diagnosis, and treatment of a range of problems affecting the feet and lower limb. The types of conditions podiatrists treat include those resulting from bone and joint disorders such as arthritis, soft-tissue and muscular pathologies, skin and nail disorders (corns, calluses, ulcers, infections and ingrown toenails) as well as problems related to neurological and circulatory disease.

How are podiatrists trained?

Podiatrists by law, must have completed a program of study that has been approved by the Podiatry Board of Australia (National Board), in order to practice as a podiatrist in Australia. The approved programs of study are generally offered through Universities and are at the minimum level of a bachelor degree. It typically takes students 4 years to complete an approved program of study in podiatry as extensive hours of supervised clinical practice are incorporated into the program. Podiatrists are required by law to be registered under the National Podiatry Board of Australia, overseen by the Australian Health Practitioner Regulation Agency (AHPRA). Continuing professional development and recency of practice must be demonstrated annually.

What services do podiatrists offer?

Podiatrists can work in a number of different clinical settings, including hospital and community health settings but the majority of podiatrists will work in private practice. You can self- refer to make an appointment with a podiatrist in the private setting but would need a referral from your GP if you wanted to see a podiatrist under a Medicare Plan.

When you go to see a podiatrist for the first time, they will undertake a detailed history about the problems you are having with your feet / lower limbs and ask about any medical conditions you may have, as this may be linked to your foot problems. In order to provide you with a diagnosis, the podiatrist may undertake a series of assessments, including assessing how well your joints are aligned or move, assess your gait (walking) pattern, assess your vascular or neurological status. In some cases, the podiatrist may want to arrange some additional tests to help assist in the diagnosis and this may include a referral for diagnostic imaging (x-ray or ultrasound scan) or referral onto another health professional. Once a diagnosis has been made, the podiatrist will be able to discuss with you the varying options for treatment.
The scope of practice of podiatry and types of treatments offered is wide and can include;

Advice on footwear / adaptions to footwear
Prescription of stretching or strengthening exercises
Use of strapping or padding
Prescription foot orthoses (in-shoe devices)
The treatment of skin disorders including the removal of callus, corns, management of foot ulceration or management of infections of the foot
The treatment of nail disorders including the surgical and non-surgical treatment of ingrowing toenails and fungal nail infections
Minor surgical procedures or injections

When should I see a podiatrist?

The joints in the feet and ankles can commonly be affected by different types of arthritis including osteoarthritis, inflammatory arthritis and connective tissue disorders. Involvement of the small joints in the foot causing pain and swelling, or inflammation at the back or under the heel, can often be one of the early signs of an inflammatory arthritis and this can make walking or standing for long periods very difficult. Podiatrists should be able to help you manage your foot pain using a number of different treatment strategies (listed above) which can be specifically tailored to your needs.
You may need to take special care of your feet if you have arthritis, either because of the condition itself or because of the medication you take which sometimes can increase your susceptibility to infections.
Examples of some conditions that may benefit from podiatry include

Inflammation of the joints (synovitis), tendons (tendinitis), or bursa (bursitis)
Pain at the back (Achilles tendinopathy) or under the heel (plantar heel pain/ plantar fasciitis)
Recurrent ankle sprains
Neuroma
Stress fractures
Foot deformity – Hallux valugus (bunions), lesser toe deformities (hammer toes), low or high arches, changes in heel alignment
Skin problems (callus, corns, fungal infections, plantar warts, ulceration)
Nail problems (thickened, curved or ingrowing nails, fungal nail infections)

How may I find a podiatrist who has a specialist interest in rheumatology conditions?

Podiatrists are generally experienced in assessing and managing foot problems that typically occur with the ‘common’ types of arthritis. There are currently not any recognised formal post-graduate training pathways available to podiatrists in Australia to undertake additional specific training in rheumatology. If your type of arthritis is ‘uncommon’, it is recommended that you enquire about the specific experience the podiatrist has with that condition, and whether there is a co-ordinated team approach with other the other health professionals that you see.