--------------------------------------------------------------------------------
Hi All
Just borrowed this from the arena
Society responds to an inaccurate description of Podiatry on BBC Radio 2
The Society has sent a letter voicing concerns over inaccuracies regarding the definition of Podiatry and treatment suggestions made by Physiotherapist Sammy Margo on the Jeremy Vine show on Monday 19th of November:
Dear Jeremy Vine Show
The Society of Chiropodists and Podiatrists, the largest body of Chiropodists and Podiatrists in the UK has this week received many complaints from members regarding the description of podiatry and subsequent treatment recommendations by physiotherapist Sammy Margo on your show dated Monday 19th of November.
The Society is concerned that there were a number of inaccuracies in the advice given on the show and disappointed that the podiatry profession of 14,000 podiatrists has been misrepresented by Sammy Margo’s description of it and we would like the opportunity to explain the full scope of practice of podiatry to your listeners. The Society of Chiropodists and Podiatrists is the main source of authority comment for most journalists’ foot health queries, particularly BBC radio programmes and national papers, and we would be grateful if you would contact us for future programmes.
Sammy Margo started off by stating that Chiropodists and Podiatrists treat separate conditions of the foot, this is not the case, in fact, there is no difference between the roles. The definition of podiatry listed below demonstrates the wide breadth of knowledge and skills required by chiropodists and podiatrists.
What is Podiatry?
Podiatry (also known as chiropody) is the diagnosis and treatment by podiatrists (also known as chiropodists) of diseases and other disorders of the feet. Podiatrists are highly skilled health professionals who have been trained to prevent, diagnose, treat and rehabilitate abnormal conditions of the feet and lower limbs. They also prevent and correct deformity, keep people mobile and active, relieve pain and treat infections.
A podiatrist will treat or advise on:
Ageing feet
Athlete's Foot
Biomechanics
Blisters
Bunion
Callus
Chilblains
Corns
Diabetes (Foot related)
Footwear
Fungal Infections
Gout
Heel pain
Insoles (Orthotics)
Ingrowing toenails
Osteoarthritis
Podopeadatrics (Children’s Feet)
Rheumatoid arthritis
Sports Medicine
Surgery
Sweaty feet
Toe deformities
Verrucae
Walking and Hiking
Working Feet
Please Note. Some of these areas are treated by specialist podiatrists only.
Chiropodists/Podiatrists deal solely with the foot and therefore the Society would like the opportunity to be represented on the show next time you have a segment regarding feet so we can work with our physiotherapist colleagues to give listeners the most accurate recommendations of treatment possible.
Of great concern is the inaccurate advice provided on the show, some of which are detailed below.
Lady with acute pain in her midfoot
This was the most serious - the caller and has a probable diagnosis of Tibialis Posterior dysfunction. Needed urgent and active management with possible treatments including non weight-bearing cast for six weeks. If not treated, may well lead to tendon rupture and need surgical correction. It was completely incorrect to simply advice lacing up her trainers laterally!
Plantar fasciitus aka heel pain
Incorrect – was not known as policemans heel; policeman’s heel is actually a bursitis of the whole heel pad and not inflammation at the point of origin of the fascia. Often referred to as heel spur syndrome.
Incorrect - that it causes all day pain. Not typical of the condition. Classically painful first thing in the morning only. Generally resolves but resolution can take several years.
Needs active management from podiatry in combination treatment, calf muscle stretches, taping, orthotics, steroid injections, footwear, Non steroidal anti-inflammatories. Podiatrists have supply and administration rights on a specific list of drugs including steroids and non-steroidal anti-inflammatories. Physios do not have these medicine rights and would have to refer the patient on. Ideally these patients would see both physiotherapy and podiatry for management, this is the best outcome for the patient.
Child with heel pain
Diagnosis; osteochondrosis dissecans (Severs). Often caused by underlying flatfoot. Children always need correct evaluation and diagnosis. If Severs then treatment includes orthotics and calf muscle stretches. Avoid soft, wet surfaces. Seek advice of podiatrist in the first instance.
Child in ballet
Over pronating. Ballet is great for children with flatfeet as due to the discipline itself they discourage “sickling” in. Generally advice is to get any over pronation assessed and evaluated by a podiatrist to see if they need footwear or orthotic advice and treatment. The physiotherapist’s advising intrinsic muscles is simply not going to work in isolation.
Cheap shoe discussion
“As long as they are supportive there is nothing wrong with cheap shoes”. Actually cheap can be very good as much as very expensive can be very damaging to feet. Again would have been better with a podiatrist talking about shoes and the need for avoiding too flat, too high and slip on shoes due to all the long term foot problems that affect many people later on in life.
Osteoarthrosis case
A very common problem, but essentially it depends on where it is i.e. big toe joint, mid foot ankle joint etc. Podiatrists’ work is very important in keeping feet comfortable and pain free. Footwear advice, cushioning insoles and regular general chiropody treatments.
Shin splints
Biomechanical factors are the causative factors. See a podiatrist, who should treat the underlying biomechanical foot faults and then see a physiotherapist for soft tissue work.
Hammer toes
The physiotherapist stated they are not usually not painful, this is incorrect – they are often painful! The buckled toe causes pain in the joints and is associated with corns and callus. Often well managed with general chiropody and may need straightening surgically, simple and effective; can be done under local anaesthetic.
Mortons metatarsalgia
States that the usual place to start is with physiotherapy, this is incorrect. Firstly, correct diagnosis is essential. There is a need to differentiate between capsulitis and neuritis, check for stress fractures. The condition is often associated with a structural foot fault. Treatment ;Footwear changes. Steroid infection and insoles. May need surgical excision.
Haglunds lump
Incorrect - it is not fatty tissue - it is osseous i.e the heel bone is irritated and thus enlarges, generally needs footwear advice, heel cups if needed and surgical excision less commonly.
The Society would very much appreciate a reply to the concerns listed in this letter so that we can go back to our members and assure them that profession that they work in is being accurately described by your show. We again would like to offer the use of one of our media savvy podiatry experts to provide your listeners with accurate information.
Yours faithfully
Joanna Brown
Chief Executive
The Society of Chiropodists and Podiatrists
