Arthritis treatment programs

Osteoarthritis can lead to not only a reduced ability to walk without pain, but the threat or reality of a decreased quality of life. It is crucially important to have a thorough assessment and diagnosis of the reasons for pain that relate to Osteoarthritis. The benefits of podiatric medical assessment include:

Assessment for pain reduction Very often this may require assessment for analgesia for pain relief. Although many people do not wish to take medicines for pain relief, careful assessment is necessary to assist in prevention of chronic pain. As pain becomes more chronic, it can lead to brain mapping of pain which can interrupt the resolution of discomfort, due to consistently repeated feedback mechanisms that reinforce the pain. Pain relief can include analgesia, non-steroidal anti-inflammatory medicines, or corticosteroid injections.

Biomechanical assessment: This is extremely important, as you can be born with and therefore genetically predisposed to bone shape that may be further preventing your feet, ankles, knees, hips and lower back and body parts involved in human locomotion, from performing efficiently. At Hip2Toe we perform complete biomechanical analysis and computer gait analysis using state of the art computer programs and equipment, to analyse and diagnose your postural problems and walking problems. These are services that require specialised levels of human biomechanical analysis and pathology of human mechanical and biomechanical function. Successful and appropriate analysis may help to or avoid surgical intervention of foot, ankle, knee and lower back conditions. It is vitally important in the avoidance of falls and ongoing weight gain due to inactivity, which can impact our health in detrimental ways.

3D laser scanned Orthotic assessment: Very often prescription foot orthotics can reduce the strain on the body and instability in the human anatomy, that often make Osteoarthritis symptoms even worse. We carry out 3D laser scanning of the feet to make sure there is absolutely perfect fit and analysis of the foot anatomy, and then a very careful selection of the world’s best supportive and cushioning materials for your orthotics. We are able to advise you regarding the best ways of wearing these orthotic devices, including specialist designed foot wear and sandals that are able to accommodate these devices.

Musculoskeletal assessment: This is very important, because it is often the musculoskeletal pain that is causing a great deal of the pain, and not always just the presence of Osteoarthritis. Very often Osteoarthritis is accompanied by musculoskeletal pain which presents as painful regions that often change their location, and can be difficult to describe the reasons for these changes. At Hip2Toe we are able to assess these pain patterns and presentations of pain, and carry out advanced musculoskeletal mobilization methods of foot, ankle, knee, hip and lower back regions. Often these mobilization methods cause little or absolutely no pain, with excellent outcomes in most cases. We can also carry out medical acupuncture where required, to assist in pain relief and reduction of spasm.

Vascular assessment: Very often vascular assessment is necessary to establish the possible involvement of reduced circulation in your pain presentation. Where there are absent pulses, we can carry out colour Doppler ultrasound studies in our surgery, and refer you for further investigation if we think it is required.

Assessment for massage of the lower limbs and back: Very often muscle and soft tissue pain can respond very well to special techniques of massage, designed to sooth and relieve muscle spasm and pain in the lower limb.

Assessment for strengthening exercises and stretching: Very often there are exercises and stretches that can help to strengthen muscles, help them function better and add support to tissues in the area affected by arthritis. They are carefully prescribed, and often are accompanied by exercise prescription when you leave our surgery, including walking and swimming programs, and sometimes sessions with a personal fitness trainer.

Electrotherapy: We have the latest low level laser therapy (LLLT) for treating Osteoarthritis and musculoskeletal pain. The LLLT is not painful to receive, and can reduce pain and inflammation, promote healing and reduce both acute and chronic pain. This form of treatment is supported by evidence based medicine, controlled trials and research from respected sources including Harvard and NASA. Ultrasound therapy is also available at Hip2Toe, and can be very helpful in treating osteoarthritic pain. Ultrasound therapy can also be very helpful in treating acute soft tissue injuries often associated with Osteoarthritis.

If your issues are related to Osteoarthritic pain, it is often best to come in for a one-hour initial assessment. This can be requested at the time of appointment request. It is also advised that you bring in any previous radiology reports (available from your original referring Doctor or Medical specialist), your current shoe wear and any orthotic devices you have, or that may require re-assessment. If new orthotics are required, our 3D laser scanned orthotics can be ready in 7 working days, or 3 working days if urgently required.

Sports Injuries Treatment programs

It is important to have the reason for your sports injury assessed and identified, to make sure that the short, medium and long term treatment programs allow you to return to performing at your maximum capability in a sustainable and comfortable way. We look after children and adults.

Our principal Podiatrist Dr. Jeremy Hawke (Podiatrist) has a wide background in sport, including Australian rules football, basketball, competitive swimming, Marathon running, golf and cycling. Jeremy was also a professional dancer prior to his Podiatry career, dancing professionally in Australia for Heidelberg ensemble and Adelaide Dance Company. Jeremy is involved in helping young athletes to become more focused in their training, and regularly is involved in lecturing on sports and physical activity. He is the author of “Lets learn about Power of activity”, available globally.

Sports podiatry involves treating injuries that involve overuse of the foot and limbs, including the impact on knees, hips and back. We are able to carry out a full assessment of your running style to establish if any correction to running style is required to carry out your chosen sport. We have experience in all major sports, for treating the injuries associated with these sports.

Whether your injury to your foot, ankle, knee, hip or back is acute or chronic, the benefits of our sports injury program include:

* The most sophisticated computer gait analysis and treadmill analysis available in sports medicine.

* Running analysis and fitness assessments for increasing distances.

* Endorsed to prescribe scheduled medicines including S4 medicines.

* Ultrasound guided corticosteroid injection therapy for Podiatric sports medicine conditions.

* 3D Laser scanned orthotics for correcting running style and lower limb function, for a physical sporting advantage in stabilization and stability. (Available in 7 working days or 3 days express).

* Gait analysis and biomechanical analysis. We are able to study your walking and running patterns to establish the level of stability and functional alignment you have, and correct it if required for your given sport.

* Access to Low level laser therapy(LLLT) for treatment of your injury.

* Access to therapeutic ultrasound treatment for your injury.

* Dry needling techniques for sports injury treatment. (Medical acupuncture)

* Advanced musculoskeletal bone mobilization for structural dysfunction involved in sports injury.

* Foot, ankle, knee, hip and back massage.

* Access to Medicare benefits for foot x rays and investigative ultrasounds, and referral for MRI when required.

* Over 22 years of Podiatric sports medicine experience.

* Professional members of Sports medicine Australia (SMA) and the Australian Academy of Podiatric sports medicine. (AAPSM)

* A full medical history and sports history take, with analysis of your current sport and training strategy.

* Full running analysis where applicable, with coaching in running technique correction where required, for helping to prevent further sports injury.

* Organization for referral to other sports medicine specialists when required.

* Foot wear recommendations and running shoe assessments.

Sports injuries treated in our sports injury treatment program include, but not limited to:

Plantar fasciitis, Achilles tendinitis, Achilles tendinopathy injuries, ankle injuries, Athletes foot, bone bruising, shin splints, hamstring pull or tears, ilio-tibial band syndrome, muscle spasm and overuse injuries to muscle, knee injuries, hip injuries, back injuries, stress fractures, ingrown nails, turf toe, synovial joint injuries, Morton’s neuromas, joint injuries, Tarsal tunnel syndrome, bursitis, foot injuries, growth plate injuries. Iliopsoas strains, Osgood Schlatters disease, Severs disease, nerve impingement, groin injuries and adductor injuries, piriformis syndrome, Patello-femoral pain syndrome, runners knee, quadriceps injuries, sciatica.

Initial assessments are up to one hour long. Please bring running shoes and shorts if possible. Please contact us now for an appointment, or email us out of hours to get you back into your sport as quickly as possible, or for full assessment of preventing further injuries and increasing your athletic performance.

Corns and callous treatment programs

When you come into our Cairns podiatry surgery at Hip2Toe Podiatry, this is what you will probably ask. Well, firstly we will do a Hip2Toe Podiatry corn assessment with you, to establish why you have a corn. Basically, the corn formation is a response of the body to excessive pressure placed on the prominence of a bone. Whenever pressure or shearing forces are applied to skin tissue, chances are that the deep tissues down at the basal layer of the skin are going to start manufacturing tissue that is high in Keratin content. Yes, just like in the nails and hair. However, the body in its own clever way creates different shapes, often saucer shaped on the top, to decrease the excessive shearing forces and friction. Clever? Of course. But hang on, they hurt! Well, very often the lower structures of the corn are more sharply shaped, and are able to press down on nerves below the corn. Pain is an interesting phenomenon; low speed nerve fibres cause what is called a banking effect to take place along the sensory nerve on the way to the brain. What starts out as a little nagging pain can end up being excruciatingly painful. Try telling that to someone who has never had a corn. Ready to come and have us look at it? At Hip2Toe Podiatry at our Cairns podiatry surgery, we are able to painlessly remove these corns, and let you get back to enjoying pain free walking. But it does not stop there. We are able to do a Hip2Toe Podiatry shoe assessment at our Cairns podiatry surgery, and see if the corns are being caused by your foot wear. It is worth noting that before men and women wore shoes, we still got corns. How can that work? Well, the principles of biology and physics are involved here, and we just call it biomechanics. By doing a full Hip2Toe Podiatry biomechanical assessment at our cairns podiatry surgery, we can establish what biomechanical factors are leading to your corn formation. Then, if necessary, we can design and manufacture a pair of Hip2Toe Podiatry professional foot orthotics at our Cairns Podiatry surgery, to go in your shoes, and more than one pair for you if you have lots of different types of shoes. Corns respond very well to orthotic control, so if you have been putting up with them for a long time, come and see us!

Diabetes management programs

We live in a wonderful world, and with all the challenges that Diabetes management has, it is important to embrace Diabetes management and move with your foot care management with a positive attitude. Being optimistic about your long term foot management should be a part of your daily life. We used to think that we had to wait for years to get the benefits from changes to our health management. Wrong. Lowering your blood pressure has immediate effects on your survival rate. So does lowering cholesterol, so does exercise. And so do all the other recommendations we have made here. Convinced? I hope so. Primary health care and foot care in the presence of Diabetes is largely about prevention. And you are your own personal manager. Your general practitioner will manage your overall Diabetes care, but so much is really up to you. You must believe change is necessary, and then you must reap the rewards of your lifestyle changes, and applaud yourself for these changes. As we are part of our family and part of our community, we have responsibilities to the people we love too. Your own personal management needs to include looking for ways to keep with your good routines. If finance is an issue, be aware of the Management plans that can be set up by your Cairns General practitioners, to allow you access to 5 allied health visits per year. You may decide one of those will be with a podiatrist, one with a Diabetes educator and two with a Physiotherapist, or maybe all with one of the many allied health professionals that are available. But what if you have developed some complications already? In that case, you must quickly make sure you are in a management routine that lowers the risk of any further complications, and prevent the many dangers that you must avoid. This is done by our Hip2Toe Podiatry foot care for Diabetes ongoing education, at our Cairns Podiatry surgery. Ring us and we will arrange for you to come in for a full assessment of your foot management requirements, and we can arrange vascular, neurological, dermatological, biomechanical and muscle assessment and examination. We look forward to being lifetime partners in you and your family’s foot health.

Heel Pain treatment programs

There are not many pains in the foot that can be so excruciating when you first climb out of bed, as heel pain. It tends to be one of the most common and also most misunderstood of all foot pains. Very often there will be a report of sudden pain when first standing from bed in the morning, or perhaps after reading the paper under a lovely palm tree and then standing an hour or so later. If this is familiar to you, you may be suffering from a condition referred to as plantar fasciitis. What is it? Well, in basic terms, there is a soft tissue structure on the bottom of the feet that has 5 insertions at the front of the foot, and inserts in the plantar medial calcaneal area of the foot in the heel region. This soft tissue encases other structures such as muscles, ligaments, blood vessels and nerves and is part of the architecture of the bottom of the foot. But in certain people, there are biomechanical forces generated, that pull the heel insertion to the extent that there is micro-tearing of the heel insertion of the fascia. This often leads to extreme pain in a specified region of the heel. There are other structures such as the plantar medial calcaneal nerve and fat pad tissue, along with the possibility of corns and callous or bruising leading to pain, just to mention a few.

Ingrown toenail treatment programs

Ingrown toe nails can be very painful, and can lead to missed days at work and school due to not being able to walk comfortably. What causes ingrown toe nails?. Well, there are different reasons for ingrown nails taking place. Some of the common reasons include the nail shape and therefore its ability to irritate the nail sulcus down the side of the nail plate. Incorrect cutting of nails is a big cause of ingrown nails. As sometimes cutting the nail may leave a sharp edge that was missed during self care of the nail, that later digs into the skin. Another reason can be shoe wear. Sometimes the shoe will press on the nail and cause the nail to dig into surrounding soft tissue in the toe. Occasionally a bony prominence under the nail bed, or sub-ungual exostoses, will lead to a nail growing in an undesirable direction. At Hip2Toe at our Cairns Podiatry surgery, we are able to carry out a full Hip2Toe nail health examination and assessment, to establish the factors that are leading to your nail growing in.

Medicine Prescriptions

Podiatrists in Australia can be endorsed by the Podiatry Board of Australia, with an Endorsement to prescribe scheduled medicines. This is an advance standing, which has only been given to less than one percent of over 4,500 Podiatrists in Australia. Dr. Jeremy Hawke(Podiatrist) is one of the 56 Podiatrists in Australia with this endorsement. This can decrease the time and expense that is required to arrange for an appointment to see your General practitioner or sometimes Medical specialist. It requires the same level of training to prescribe the medicines used in our podiatric medicine treatments, as the training and examination required for General Practitioners and other medical specialists who are Australian prescribers. For understandable reasons of course. These prescriptions only medicines can be used for treating some of the following conditions, that present in podiatric medicine:

* Plantar fasciitis: Sometimes short courses of non-steroidal anti-inflammatory medicines can be helpful in making walking more comfortable earlier in the treatment program. Corticosteroid injections under ultrasound guidance may be prescribed, depending on the time the pain has been present and the level of pain experienced.

* Sinus tarsi syndrome: This is a condition that may cause serious levels of pain around the ankle region and may require different prescribed medicines for management, including corticosteroid medicine prescription for injection under ultrasound guidance.

* Tinea infections: These are infections caused by a dermatophyte between the toes, soles of the foot and skin folds. They may require prescribing of antifungal medicine, corticosteroid medicine, or antibiotic therapy if there is a secondary bacterial infection. Where secondary infection is present in any of these tissues, it must be identified quickly, as it can lead to regional intermetatarsal or web space infection, which can progress to cellulitis and potentially septicaemia. Septicaemia is an acute medical condition requiring urgent specialist medical attention, and can be life threatening.

* Achilles tendinopathies: Pain relief and in some instances non-steroidal anti-inflammatories may be required for prescription at various stages of treatment.

* Morton’s neuroma (Interdigital neuritis): This is a very painful condition that may require analgesia, non-steroidal anti-inflammatories or corticosteroid injections under ultrasound guidance to relieve potentially chronic pain development.

* Antibiotics: There are a large number of potential infections that can take place in the feet and lower limb, which must be assessed and treated in a timely fashion. This can include conditions such as an infected ingrown toenail, soft tissue infections of the foot including deeper infections of the soft tissue, cellulitis that has developed in the foot and lower limb, and infected hair follicles. Assessment of potential infections of the foot, ankle and lower limb are crucially important, to prevent further spreading of the infection or systemic involvement.

* Fungal nail infections: There are certain types of fungal nail infections that do not or cannot respond to certain topical anti-fungal, and may then need further prescription only oral anti-fungal treatment. Careful assessment and management of these.

* Osteoarthritis: Osteoarthritis often requires assessment for the prescribing of medicines suitable for managing the short, medium and long term concerns. These may include non-steroidal anti-inflammatories, corticosteroids for intra-articular injections, and analgesia where required.

* Rheumatoid Arthritis: There are different concerns in the management of Rheumatoid arthritis, and prescribing of certain medicines may be required.

* Gout: Gout can cause present in various forms in the foot and lower limbs, and may need management with prescription medicines.

* Dermatological conditions: Often certain dermatological conditions such as eczema, psoriasis and dermatitis may require prescribed medicines such as corticosteroid creams and ant-fungal creams, and other prescription medicines.

* Conditions of the knee, hip and lower back that are either directly related to foot function or human locomotion or walking, requiring prescribing of medicines relating to these conditions.

* Ongoing prescription of certain medicines for foot, ankle, knee, hip or lower back conditions that are receiving ongoing medical specialist management or GP management, which may save additional visits, time and expense to these medical team members. PBS benefits are not available yet for patients, but most prescription costs are between $8 and $10 for the prescribing cost. Our professional bodies are trying to diminish this potential discrimination of charging as soon as possible.

* Anaesthetics: These are often used to allow pain free treatments for certain conditions.

   Our Address:  Suite 2, 600 Bruce Hwy Woree (Calanna Health Centre) facing Sondrio St. opposite the park