Medically known as Onychocryptosis. This condition is when the nail starts to grow into the nail bed causing pain, swelling, redness, often accompanied by pus and infection. Most commonly caused by tight or constrictive footwear and may also be caused by ‘bathroom surgery’ when nails are trimmed incorrectly. Fungal nails may be a predisposing factor that causes the pressure from the thickened nail to press into the nail bed causing pain and discomfort. Toe deformities may also be a contributing factor. It often affects the big toes and rarely may also occur on the smaller toes.

This condition is medically known as Onychomycosis or ringworm of the finger or toenails, affecting toenails more than fingernails. Usually nails are thick, discoloured, flaky or brittle with a yellowish-brown appearance and can also lead to ingrown toenails if nails become too thick and exert pressure on the nail bed from various types of footwear. It affects people over the age of 50 and young athletes. Some predisposing factors include previous fungal infections of the skin that may have spread to the nails, underlying conditions such as diabetes, poor circulation and poor immune system, trauma to the nail and constant washing of the hands and feet.

Cracked heels are a common foot problem that is often referred to as heel fissures. It is commonly caused by changes in hydration, whereby the skin becomes dry and loses its elasticity, texture and strength and may be accompanied by callus around the edges of the heel. This condition can be worse in diabetic patients due to extreme dryness. Open back shoes or sandals may be a predisposing factor.  For most patients this is a cosmetic problem but when the fissures become deeper, they are painful to stand on, and the skin can bleed. Occasionally- in severe cases, this can become infected.

The medical term is known as Tinea Pedis. It is a fungal infection caused by sharing communal showers at gymnasiums, wet towels, wet footwear and excessive perspiration. It is contagious and affects the feet most of the time but can spread to other parts of the body. It typically presents between the fourth and fifth toes of the feet and can also affect the sole of the foot. Itching and scratching are the major symptoms causing a dry, scaly and flaky skin.

Thickening of the skin layers (hyperkeratosis) most commonly found on the side, top or in between toes. Calluses are flat thickened areas of skin layers whilst corns are more localised small areas of callus containing a deep centre or nucleus that presses into the underlying dermis to cause pain. The patient generally has a feeling of a ‘stone’ or ‘pit’ pressing into the skin. Corns can be painful especially when walking on them.

The above mentioned conditions are commonly caused by friction and incorrect pressure distribution. For example, incorrectly-fitted footwear, biomechanical abnormalities such as over-pronation and over-supination, abnormal anatomy of the feet such as hammer-toes, bunions and other toe deformities.

Also known as Verruca Pedis and is caused by the Human Pappiloma Virus (HPV) which invade the skin through small cuts and abrasions. They can occur anywhere on the body but can be very painful on the sole (plantar) of the feet. Pressure from standing and walking causes them to grow deeper into skin. Most commonly affects children and young adults. Incidence is higher in people who share communal bathing facilities, swimming pools, sport centres and gymnasiums. Dark, minute black spots are present and are sometimes accompanied by overlying callus. Pain is greater from lateral squeezing as compared to pain from weight bearing. It can also be a hindrance in some sporting activities that require running and jumping.

Ulcers are a break in the continuity of the skin that may fail to heal. Usually appears as a crater, which can be shallow, affecting the skin surface only or deeper affecting the bones, tendons or other structures. The main cause of ulcers is poor blood circulation and can even lead to gangrene and amputation especially in diabetics if left untreated. Other causes include trauma, infections, tumours, vascular diseases and some skin conditions. Arterial and venous ulcers are quite common, venous ulcers have a higher incidence.

Also known as LLD, can be anatomical or apparent.

Anatomical LLD is where the actual leg length difference is in the measurement of the bone itself. Either the femur or tibia is shortened due to various factors such as congenital, trauma or previous accidents, surgery and underlying neurological and bone disease.

Apparent LLD is the shortening due to uneven hip stability that is caused by muscle contracture around the hip joint. This leads to one hip being higher than the other giving an impression that one leg is longer.

Associated symptoms may include:

– Lower back pain

– Limping if the LLD is greater than 2cm

– Hip arthritis due to uneven body weight distribution

– Spinal curvature or tilting of the spine (scolisios)

– Difficulty in walking or running

A very common ailment during middle age and later in life. Your feet are your foundation and play a key role in shock absorbtion on a daily basis. Problematic feet can cause problematic knees and hips. If you have flattened arches (flat feet) or excessive pronation, the legs rotate internally and the pelvis tilts forward resulting in excessive spinal curvature and tension on the lower back muscles. Other factors such as: age, occupation, footwear, leg length difference, poor posture and reduced fitness levels can be contributing factors.

Also known as ITBFS syndrome, a very common condition in athletes, such as runners and cyclists. The Ilio-Tibial band is a tough fibrous band that extends on the outside of the hip all the way down to the outside of the shinbone (Tibia). The main function of this band is to provide stability to the knee joint during ambulation. Friction of this band between the shin bone and thigh bone can be caused due to following factors: overuse of the muscles, weak and tight gluteal or quadriceps muscles, obesity, bowed- legged and excessive supination whereby the body is constantly on the outer edge of the foot causing the leg bone to rotate outwards. Pain is the main symptom on the outside of the knee.

Medically known as Patellofemoral syndrome (PFS), Runner’s knee and Jumper’s knee. Affect athletes majority of the time but may affect other patients as well. This condition refers to pain around the kneecap, behind the kneecap and pain after a period of inactivity.

The main cause is due to overuse of the knee joint, repeated bending of the knee joint can cause an irritation of the nerves in the knee. Other factors include: weak quadriceps muscles, previous injury, malalignment of bones and obesity. Excessive pronation and flat feet are also major contributing factors as these conditions causes the legs to rotate internally, thus putting strain on the patella ligament and quadriceps ligament.

Inflammation of the metatarsal heads, mostly caused by ill-fitting footwear eg. high heels and biomechanical anomalies such as excessive pronation and supination. Very common in ladies but also affects the elderly, as we age the fibro fatty pad thins out and provides less shock absorption to the metatarsal heads causing pain and inflammation.
The following symptoms may be associated with Metatsalgia:
– Pain in the ball of the foot when waking barefeet on hard surfaces
– May be accompanied by corns, callus and bunions
– Sharp, burning and aching pain
– Numbness and tenderness on the ball of the foot.

Medically known as Hallux Valgus (HV), malalignment or deviation of the big toe joint in relation to the other joints. The big toe bends towards the smaller toes causing an enlargement or a prominent bump on the side of the foot. Over time the bump gets larger and becomes painful causing the big toe to rest over or under the smaller toes. Heredity is the most common cause, however other factors such as ladies footwear, muscle imbalance, ligament laxity, flat feet and over pronated feet may also cause bunions. As all humans go through an ageing process, the bones and muscles eventually get weaker and bunions only worsen if treatment is ignored during its early stages.

Tailor’s bunion is a bump on the outer part of the smallest toe, this form due to the smaller toe bending inwards, towards the bigger toe joint.

Symptoms include:

– Pain, Inflammation and swelling on the side of the big toe

– Discomfort when walking

– Arthritis and stiffness can develop

The above medical term is used to describe the inflammation and swelling of the nerve between the bones in the forefoot, caused mostly by mechanical stresses such as high-heeled footwear, excessive pronation or supination and uneven pressure distribution on the forefoot. It affects the space between the 3rd and 4th metatarsal heads but may also affect other spaces.

Chronic Digital neuritis may lead to Morton’s Neuroma, which is a benign tumor (thickening of the tissue that surrounds the digital nerve)

Patients may experience the following symptoms associated with these conditions:

– Burning, numbness and tingling in the forefoot region

– Pain mostly when wearing footwear because tight and narrow shoes cause a compression of the bones, placing more pressure on the nerve

– Feels like a stone or marble in the shoe

A small bony projection formed on the back of the heel or at the bottom of the heel bone due to chronic inflammation of the Achilles tendon or the plantar fascial band. The patient may have no symptoms of pain or inflammation at all. Sometimes may be accompanied by the same signs and symptoms of plantar fasciitis

This most common type of heel pain is Plantar Fasciitis. The plantar fascial band is a muscle that connects the heel bone to the base of the toes and creates the arch of the foot. This muscle becomes inflammed due to various factors namely:

– Flat feet (pes planus) or high arched feet (pes cavus)

– Increase in activity or injury

– Weight gain

– Poor support in shoewear

– Lack of flexibility in calf muscles

– Standing for prolonged periods of time

Symptoms include:

– Pain is the worst when climbing out of bed in the morning as the muscle tightens up during sleep and pain is diminished, the muscle then becomes taut when climbing out of bed applying pressure to it causing acute pain.

– Sharp, aching, stabbing type of pain is felt anywhere from the heel bone to the base of the toes.

– Pain usually disappears after the muscle is warmed up and appears after long periods of inactivity.

Often characterized by ankle pain, the tibialis posterior muscle originates in the back of the leg and its tendon runs down the leg and turns underneath the inner ankle bone to attach to the navicular bone on the inner part of the foot. The tendon assists in inverting and plantar-flexing the foot and also helps maintain the arch of the foot. If this tendon is overused, too much tension and force is placed on it, causing it to become inflamed or degenerated.

Weakening of this muscle causes the arch to drop and may cause a flat foot deformity. Other contributing factors may include: obesity, trauma, arthritis, surgery or previous steroid injections

Common symptoms include:

– Pain in the lower leg and ankle area

– Loss of the arch and the ankle rolling inwards

– Tenderness over midfoot during activity

Pain and inflammation at the back of the heel due to repetitive stress or overuse of the Achilles tendon. Most commonly found in the middle- aged athlete due to incorrect biomechanics or footwear. As people age, tendons become less flexible and are at a greater risk for injuries. Excessive pronation or supination are the most common causes of pain in the the back of the heel.

The word pronation refers to the motion of several joints in 3 different planes. As body weight is transferred on the feet during walking or running, one has the tendency to apply more weight on the inner border of the foot whereby the heel and ankle roll inwards and the arch flattens out slightly. Pronation is a normal motion in all humans and only becomes a concern when a person overpronates whereby the arch remains flattened, the heel and ankle continue to roll too far inward causing increased stresses to the muscles and ligaments of the foot. This condition is often confused with flat feet (pes planus).

Some of the causes of Pronation may include:

– Ligament laxity

– Nerve injury

– High impact sports

– Shoe-wear

– Leg length discrepancy

Pronation is often the contributing factor towards the following conditions:

• Bunions
• Heel pain
• Hammertoes
• Medial tibial stress syndrome (shin splints)
• Achilles tendonitis
• Ingrown toenails
• Neuromas
• Stress Fractures

Supination is a normal motion involving movement of several joints in 3 different planes. It is known as the tendency to transfer body weight onto the outer border of the foot during ambulation. In a supinated foot, pronation does take place but weight remains on the outer border of the foot. A supinated foot may be associated with bow leggedness, increased tendency to sprain ankles, a bump on the back of the heel (Haglund’s Deformity) and high arches.

Oversupination may also be a contributing factor to the following conditions:

– Calluses

– Heel pain or calcaneal spurs

– Peroneal tendonitis

– Tailors bunion (5th toe)

The medical text describes flat feet as Pes Planus. Usually presents as a person having a very low arch or no arch at all upon weight bearing, often confused with the term excessive pronation (rolling in of the feet). All humans pronate, some pronate excessively that may be caused by flat feet. Commonly known as collapsed arches.

Easily noticeable by the practitioner, normally there should be a gap (space) between the ground and the foot within the arch area. People with flat feet sometimes have no symptoms and the condition can go untreated. It is a common hereditary condition but may be due underlying neurological factors, pregnancy and obesity. Flat feet affect people that are involved in high impact activities, sports, sales and jobs that entail long periods of standing.

By excessively pronating, the leg bones are continuously in an internally rotated position, the heel bones are tilted outwards and most of the body weight is transferred on the arch area leading to various conditions such as:

– Metatasalgia (ball of the foot pain) accompanied by Corns and Callus

– Plantar fasciitis, Heel spurs and Heel pain

– Calve pain and Shin pain

– Pain and tenderness along the arch

– Knee and Back pain

Medically known as Pes Cavus. All humans have a natural arch along the inner side of the foot, some higher than others. This condition is the opposite to flat feet whereby the arch is higher than the average height, the heel is tilted inwards (not always) and the body weight is distributed on the outer side of the foot referred to as excessive supination.

Very noticeable upon weight bearing whereby the arch just appears higher than usual.

The foot develops a tripod position where the body weight is distributed on the 1st and 5th metatarsal heads and on the centre of the heel bone sometimes accompanied by clawing of the toes. It may be hereditary, a normal variant or some underlying neurological condition that commonly causes it.

The symptoms in a person with high arched feet may vary depending on the severity and activity level of the person with it. There may be no pain or symptoms at all, however others may experience the following:

– Corns and callus under the bases of the 1st and 5th metatarsals

– Ankle sprains are more common

– Pain in the arch area due uneven pressure distribution

– Heel Pain and Calcaneal spurs

– Incorrect shoe fitting due to claw toes and high arches.

Medically known as Medial Tibial Stress Syndrome (MTSS), referring to pain and inflammation in the shin or frontal lower leg area (Anterior Shin Splints). It may also occur at the back of the leg known as Posterior Shin Splints. The main cause is overloading of the muscles and tendons of the lower leg by a sudden increase in activity. Other factors may include: excessive pronation or supination, obesity, inadequate footwear and weak ankles.

 Symptoms may include the following:

– Pain in the lower inside portion of the leg

– Numbness in the feet due to the swelling of muscles, affecting the nerves

– Pain at the start of activity and eases during activity

– Pain during running and high impact sports or sports that are performed hard surfaces

– Pain may be sharp or throbbing

– Tenderness around area involved

Our lab has amongst the World’s best technology in manufacturing orthotic and insoles and is South Africa’s first CAD/CAM lab in the Podiatric industry. CAD- Computer assisted design and CAM – Computer assisted manufacturing. Commonly referred to as arch supports. All our devices are computerised and custom made for each patient with 100% accuracy. Not only do we make orthotics and insoles for our practice but also supply other Podiatrists, Chiropractors, Physiotherapists and Biokineticists. We also supply pharmacies nationally and export ready-made devices to neighbouring countries.

Our process is as follows:

Step 1: 3D Foot scan , foam box impression or a cast of patient is taken.

Also known as “ringworm of the nail” and “tinea ungium.” This is the most common disease of the nails and constitutes about a half of all nail abnormalities. It may affect fingernails and toenails but toenails are more commonly affected.

How do we get it?

Our feet are spent most of the day in closed shoes and it creates a moist environment for a group of fungi dermatophytes to multiply and invade the nail bed. It may also be contagious and picked up in public places such as communal showers at gyms, hotel showers, nail polishes and pedicures at beauty salons. Other predisposing factors include previous fungal infections of the skin that may have spread to the nails, underlying conditions such as diabetes, poor circulation, lowered immune system, trauma to the nail and constant washing of the hands and feet.

What does it look like?

The most common sign of a fungal nail infection is the nail becoming thickened and discoloured: white, black, yellow or green. As the infection progresses the nail can become brittle, with pieces breaking off or coming away from the toe or finger completely. If left untreated, the skin can become inflamed and painful underneath and around the nail and can result in ingrowing toenails. There is usually no pain or other bodily symptoms, unless the disease is severe. Patients with nail fungus may experience significant psychosocial problems due to the appearance of the nail, particularly when fingers – which are always visible – rather than toenails are affected.

How does the laser treatment work?

The Fungus is heat and light sensitive. The light from the laser passes through the nail plate and the surrounding tissue including the nail bed and is absorbed by the pigment in the fungi which is darker than the surrounding cells causing the fungal cells to heat. The slight rise in temperature and repetitive light exposure kills the fungi and its spores. As your nail continues to grow the infected area grows out with it, leaving a new clean nail. Visual improvement is not immediate and will require at least 6-9 months for your old nail to grow out. A single treatment lasts only a few minutes and the patient experiences NO pain. Depending on the severity of the nail fungus a patient will require more than one treatment.