Practice / Service DescriptionChiropody is the branch of medicine involving the assessment, treatment and prevention of foot and lower limb diseases or disorders by therapeutic, surgical, orthotic and palliative means.
Custom Foot OrthoticsAbnormal movement of the lower limb can place undue load and forces on muscles, tendons and ligaments which can lead to overuse, strain and injury. Custom foot orthotics (inserts) are a medical device made from carbon fiber or thermoplastic which are moulded to a cast of your foot and placed inside your footwear. They are commonly prescribed following a thorough Biomechanical assessment and gait analysis as part of your treatment plan to assist in addressing the abnormal movement and so reducing any harmful loads/forces, thus restoring you back to the activities you enjoy.
Other Relevant InfoWhile there are many providers (dispensers) of Orthotics in Ontario it's important to know that only a Physician, Podiatrist or Chiropodist can prescribe them as detailed by your insurance provider, following a thorough Biomechanical Assessment and Gait (the way you walk) Analysis.
FAQsWho needs orthotics?
Symptoms from abnormal lower limb biomechanics can include;
- Localized Foot Pain
- Bunions, Hammer toes
- Heel/Arch Pain
- Hip/ Knee pain
- Lower Back and even Neck Pain
Will it take time to get used to the new orthotics? And is it painful?
Typically it can take up to 7 days to be fully adjusted to your new orthotics, and while this adjustment can cause slight achiness there should NOT be any sharp pain experienced. Your Chiropodist will fit the orthotics correctly and provide instructions on increasing usage slowly.
Do I have to buy new bigger shoes to fit my orthotics?
Assuming your shoes are appropriately sized to your feet, (your Chiropodist will evaluate this at the time of your assessment so please bring a selection of footwear) usually orthotics can simply slip into the most slender of footwear. You and your Chiropodist will discuss the types of footwear and the options regarding size, shape and material the orthotics are made from to best fit your footwear.
How often should I use my orthotics and how long do orthotics last?
Orthotics work when they are being worn and don’t when they are not! With this in mind for maximum effect in your rehabilitation, you should aim to wear them approximately 70-80% of the time spent on your feet. Orthotics typically last anywhere between 1-3 years depending on usage.
Nail SurgeryNail surgery is performed by your Chiropodist under local anaesthetic where a small portion, 8-10% (Partial Nail Avultion, PNA) or all (Total Nail Avultion, TNA) of the nail is removed (including the root) so that the nail permanently becomes slightly narrower in the case of PNA or removed completely in the case of TNA. A chemical cauterizes the nail and prevents it regrowing. This is over 95% successful.
Nail surgery may be suggested if you are suffering from painful, and sometime infected ingrown toenails, have thickened unsightly and deformed nails (Onychogryphosis/Onychauxis) or Fungal nails..
What is an ingrown nail?
An ingrowing toenail is one that pierces the flesh of the toe. It can feel as if you have a splinter, be extremely painful and inflamed or infected. In more severe cases, it can cause pus and bleeding. Ingrowing toenails most commonly affect the big toenail, but can affect the other toes too.
What causes an ingrown nail?
There are a multitude of factors that cause or contribute to an ingrown toenail. These include;
- genetic factors
- nail shape making you prone to ingrown nails
- posture and the way you stand, gait (the way you walk)
- foot deformity such as bunions and hammer toes
- tight footwear, hosiery or socks
- excessive sweating
- brittle nails
- poor self cutting
- fungal infections
Surgery FAQs1. Does the surgery hurt?
While every effort is made to make the procedure as comfortable as possible, slight discomfort may be experienced whilst the toe is being frozen. There is no pain experienced during the procedure. Afterwards, as the anaesthetic begins to wear off, an aching, throbbing sensation may be experienced at which point a painkiller may make you more comfortable.
2. Will my ingrown nail grow back?
Nail surgery is a highly successful procedure with a failure rate between 2-5%.
3. How long will recovery take?
It's best to look at this in two ways;
1. recovery from procedure discomfort
2. healing of the wound
From a pain standpoint, we are all subjective, however recovery from the discomfort of the procedure will be within 2-5 days. At which point you will be free to resume almost all activities. Healing of the wound assuming there are no complications such as infection or outside disturbances takes a little longer, typically around 2-3 weeks.
4. Will my nail look unusual?
Your nail plate will be narrower than previously, however, once healing is complete and the site has matured, this will become virtually indistinguishable from surrounding toes. Indeed many patients have reported not recalling which toe has been done 6-12 months after surgery.
Wart NeedlingWarts are a virus. As the name suggests, wart needling (performed under local anaesthetic) aims to pierce the wart multiple times to ‘introduce’ the virus to your immune system, triggering an immune response that ultimately clears the wart. Think of it as a similar mechanism to the flu shot. A localized inflammatory response is the aim to maximise the treatment. Therefore, any anti-inflammatory medication or painkillers such as Advil, Tylenol, or Aspirin are to be avoided.
1. Does it hurt?
While every effort is made to make the procedure as comfortable as possible, slight discomfort may be experienced whilst the wart is being frozen. There is no pain experienced during the procedure. Afterwards as the anaesthetic begins to wear off, an aching sensation may be experienced.
2. What is the success rate of Wart Needling?
Individual results vary and success cannot be guaranteed particularly in long standing warts, however total resolution of wart needling has been shown to be approximately between 50-70% successful.
3. Will I be able to walk afterwards?
Yes. The procedure is performed under short acting local anaesthetic and has little effect on your ability to walk.
General Foot CareAs the name suggests, general routine foot care can be viewed as a regular service for your feet. This will primarily be based around routine treatments such as nail cutting and clearing, which may involve use of a nail drill in the case of thickened or fungal nails, callus (hard skin) debriding using a surgical scalpel, corn enucleation, and wound management. Your Chiropodist will also be able to perform checks on the skin, vascular structures and mechanics of your feet as well as inspect your footwear.
Wart Needling FAQs1. Do you use sterile equipment?
Your safety, infection control and sterilization are very important to us a SHAPE. We are delighted to be using Susol presterilized single-use instruments which are discarded and recycled following your treatment.
2. What is a callus? Does callus (hard skin) removal hurt?
The skin is a protection mechanism comprised of the dermis and epidermis. A callus is thickening of the skin formed on the outermost layer (epidermis) and is a result of higher than normal mechanical stresses, friction and pressure being placed on the skin be it from ill-fitting footwear, certain activities such as running, or occasional abnormal bony prominences in the feet. The epidermis contains no nerve ending and so callus removal using a sharp surgical scalpel can be performed without any pain whatsoever. A light scratching may be experienced.
3. Is treatment covered by OHIP?
Unfortunately Chiropody services are not covered by OHIP. However, most extended healthcare plans usually provide a level of coverage up to 100% depending on your individual plan.