Each month Fitness Journal puts the spotlight on a health profession or treatment. This month Kate Caetano offers an insight into rehabilitation podiatry.
What is podiatry?
Rehabilitation podiatry is treatment focused; making sure your whole body is working efficiently. Finding what is preventing proper healing of an injury and identifying other factors are underlying the injury or pain recovery.
How does it work?
Rehabilitation podiatry works to give the body more support and insight into underlying factors that are preventing full recovery. We identify body imbalances in muscle tension, joint function and overall force loading during activity, work or leisure. If you’re not healing quickly; injuries are recurring; pain is not connected to injury or you just aren’t able to improve your speed or endurance, this is when we look more deeply and holistically.
Rehabilitation podiatry incorporates gait (walking/running) analysis, pressure pattern analysis and muscle versus joint loading testing with your individual body’s unique way of working within its range, from foot function up to ankles, knees, hips and spine.
If a joint or muscle is being overloaded, or loading is faulty or not being used when it should, this causes the structure to strain and breakdown while the body compensates and moves the problem around.
Rehabilitation podiatry can also provide more energy efficiency to reduce fatigue rate. Our main goals are to improve the function of the injured area and to decrease pain, but also make sure it doesn’t re-occur. This is done through strengthening and rehabilitation exercises, proceptive training, gait training, footwear modifications or orthotics.
Who can it help?
Anyone who is in pain, is prone to injury or wants to improve their running can be assessed. Usually injury affects the whole body, not just the area that hurts. Once we have found key factors influencing the painful area, we can work with other health professions to make sure the patient has a fast and long-lasting recovery.
Are there any restrictions on people who can have this treatment?
No – whether you currently have pain, are worried about injury or are just trying to improve your marathon and triathlon time, we help assess, coach and treat a wide range of lower limb issues. Also for parents unsure of their child’s development or walking, those with chronic conditions such as arthritis, or mobility issues that come with surgery. Prevention is always better than treatment. For a “warrant of fitness” for a sport, event or active job, we can check injury risks and sort them before they cause problems.
What conditions are most common?
Each activity, age and gender has common conditions that are also assessed and treated differently. Overall I see a lot of ball of foot pain that feels like a lump or shooting pain, or heel pain that is worst first thing out of bed. Ankle sprains that leave long term pain or instability. As well as knee pain that stops you tramping, going for long walks or playing sport because of the ache and jarring feeling.
Are there any side effects or restrictions?
If the treatment plans are too much too quickly for the patient, they can be a little sore. Let the podiatrist know if this happens and they can easily adjust the treatment plan. It can take a couple of sessions before they start to make a positive impact on your pain and injury, due to working against muscle memory and imbalance.
What are its origins?
Rehabilitation podiatry has branched off from its origins in chiropody which has been recorded as early as Ancient Egyptian times, with clear bas-carving depicting lower leg professional care found on tombs as old as 2400 BC.
How do you become qualified?
In New Zealand, AUT in Auckland is the only podiatry school, but there are many in Australia. The degree structure is three years in NZ and involves a Bachelors programme. AUT has a student clinic and practical application from day one. The course includes diabetes and wound care, dermatology, geriatrics to paediatrics, including anatomy, pathology, physiology, body movement analysis and radiology. A podiatrist can go on to do a Masters or PhD, or specialise in post graduate Diplomas in Rehabilitation and Sports.
Who regulates it?
A national podiatry board requires all NZ podiatrists to register, as well as be regulated by the Health and Disabilities Commission. To work as a podiatrist in this country you must have completed the degree with the appropriate qualifications and be approved in compliance recognised by the Board. Some podiatrists are ACC registered.
What are the most common misconceptions?
That podiatrists are focused only on feet. Our scope ranges from spine to feet, as we need to see how the whole body works in order to treat the patient. Especially in rehabilitation podiatry we tend to see how everything works from feet to head, and head to feet.
What are surprising facts about it?
Probably how often we find little misalignments or uneven walking/running can prevent injuries healing or make someone more prone to them. Once you find and adjust them, everything seems to fly from there.
What is the average cost per treatment?
The average cost is $75 or $45 with ACC. This differs with treatment options and clinic focuses.