Some questions answered

1What is a Podiatrist?

A podiatrist is a registered healthcare professional (registered with the Health Professions Council of South Africa) specializing in the diagnosis and treatment of disorders of the foot and lower limb. As a specialist, a podiatrist plays an important role in treating lower limb pathologies, independently or as part of a multidisciplinary team with other medical professionals. Podiatrists are trained health professionals who deal only with the feet and the lower limbs. This includes areas such as paediatrics, diabetes, sports injuries, structural problems, the elderly and general foot care. It's easy to underestimate the role of our feet, but when we think about how long we spend on our feet all day, it's not hard to see why it's so important to look after this part of our body. It is estimated that our feet will carry us about 128,000 kilometers over a lifetime... now that's impressive! It's also important to remember that pain in other parts of the body can be related to the feet. For example, knee, hip and back pain may be relieved by treating the mechanics of your feet.

2Is foot pain normal?

If you are suffering from back, hip, knee, ankle or foot pain, it is important that you see a podiatrist before the problem worsens and becomes harder to treat. Many people can try and manage the problem themselves but lingering foot pain is a sign that the problem must be handled by a professional. Lower limb pain can develop from everyday injuries or sports injuries. Other causes of pain can be from too much activity, improper foot support and excessive weight. So if you have lower limb pain and you live in Pretoria, call The Pod Practice today for an immediate appointment.


1What is the bump on the side of my foot?

A bunion is a prominent bone on the side of the big toe joint caused by an imbalance of tendons and muscles in the foot. A big bump on the side of the foot is visible with the big toe leaning towards the lesser toes. If you have a bunion call The Pod Practice today for an appointment to discuss your treatment options.

2What is a bunion?

A bunion is a prominent bone on the side of the big toe joint caused by an imbalance of tendons and muscles in the foot. A big bump on the side of the foot is visible with the big toe leaning towards the lesser toes. Many people experience pain and inflammation from pressure over their bunions from footwear. The nerve that runs along the side of the foot can also become irritated from pressure from footwear. If pressure continues to occur, a fluid filled sac called a bursa can develop over the bone causing the redness, pain and swelling. Some people with bunions can be asymptomatic but with age the bunion can become painful and problematic. Splints, orthotics, cushioning and anti-inflammatories can help provide relief but surgical intervention can correct the bunion deformity. If you have a painful bunion call The Pod Practice today for an appointment to discuss your treatment options.

3Why does my bunion hurt?

Many people experience pain and inflammation from pressure over their bunions from footwear. The nerve that runs along the side of the foot can also become irritated from pressure from footwear. If pressure continues to occur, a fluid filled sac called a bursa can develop over the bone causing the redness, pain and swelling. Some people with bunions can be asymptomatic but with age the bunion can become painful and problematic. Splints, orthotics, cushioning and anti-inflammatories can help provide relief but surgical intervention can correct the bunion deformity. If you have a painful bunion call The Pod Practice today for an appointment to discuss your treatment options.

4How do I avoid bunion surgery?

As podiatrists, we are frequently asked about what other options there are to avoid bunion surgery and any other treatment to slow progression of a bunion and to relieve pain. At The Pod Practice, bunion surgery is a last option. If bunions run in your family it is important you visit your podiatrist early before the bunion worsens. A typical bunion is found to the side of the big toe or the smallest toe on the outside. A good time to visit your podiatrist is when these bumps are small and not painful. With early intervention the likelihood of surgery is greatly decreased. Bunions can be hereditary or caused by injury, arthritis or gout. During your visit your foot structure will be evaluated and X-rays taken if necessary. In most cases the foot will be unstable and have abnormal joint range of motion. In this case custom made inserts or orthotics will be required to stabilize the foot and prevent the bunion from worsening. Prevention is key to avoiding bunion surgery. What can you do to avoid bunion surgery?

  • Wear padding and cushioning around your feet
  • Stretch and strengthen your feet
  • See your podiatrist early
  • Avoid high heels
  • Avoid narrow or pointy shoes

  • Bunions are caused by an unstable foot so make sure you wear supportive, soft and non-slippery shoes that do not rub or press on the bump of the bunion. This will help slow the progression of the deformity. At The Pod Practice we can help you address your foot problems early and help prevent future problems. Call The Pod Practice for an appointment to take care of your bunion today. After all your feet must last you a lifetime!

    5When should I get my bunion fixed?

    Bunions are a very common biomechanical abnormality in most people due to improper foot function. Bunions can be hereditary and develop due to abnormal pulling of muscles as well as a deviation of the bones in the foot. If you have a bunion and you feel it is limiting your daily activities or is painful when wearing shoes, you should consider surgical intervention to fix the bunion. If you have a bunion and would like an assessment and referral to see a surgeon call The Pod Practice today for an appointment for an evaluation.

    6Is it a bunion or a corn?

    A corn and a bunion are two very different problems. One is a skin problem and the other is a bone problem. A corn is simply hard skin that forms over a bony area for example a bony bump on the top of toes. A soft corn can form in between the toes. This is skin that hardens to protect a bony deformity such as a hammertoe or a bone spur. A bunion is a bump of actual bone that forms on either side or both sides of the forefoot. It's a bony deformity not a skin problem. The bunion forms when the 1st metatarsal bone protrudes outwards and causes the bunion or bony bump. The big toe may migrate towards the lesser toes as a result.

    Corns and Callus

    1What are corns and calluses?

    These hard skin lesions usually occur over bony areas on the foot. Corns and calluses form on the skin to protect the skin from becoming an open wound due to the pressure or friction against the bone. When the skin becomes too hard or thick then it may become painful. Reducing the hard skin and cushioning the area will provide only temporary relief, so sometimes the underlying bone problem must be addressed to get relief and stop the corns and calluses from forming. Plasters that contain harsh chemicals and acids should be avoided. They can burn the skin and are dangerous to those with diabetes and poor circulation. Orthotics and simple insoles can help these conditions. Orthotics help to redistribute weight over the foot and slow the progression of foot deformities. Deformities like bunions, hammer toes and protruding bones on the ball of the foot often have callused areas. Periodic reduction of the hard skin can bring relief as well as cushioning. These are simple interventions that can be done in the podiatrist's consulting room to relieve your corns and calluses and stop your pain. If you have corns or calluses call The Pod Practice today for fast and effective relief so you can return to your normal activities.

    Fungal infections

    1Is toenail fungus hereditary?

    There is no definitive evidence that toenail fungus is an inherited condition but there is ongoing research as to whether onychomycosis (toenail fungus) is linked to a gene in our DNA. Current research suggests that toenail fungus occurs most commonly because of a decreased immune response or from a weakened spot in the toenail. If your immune system is weak then you are unlikely to fight off normal bacteria or fungus that is on your skin. People with Diabetes, autoimmune conditions or old age are a few examples of conditions that weaken the immune system making them more susceptible to a fungal infection. Another reason you can develop toenail fungus is from trauma. Regardless of whether the trauma is due to a complete loss of the toenail or from repetitive micro trauma from tight fitting or too loose footwear, trauma will weaken a small area on the nail and allow a fungus to infect the skin under the toenail and cause a fungal infection. Also be careful of letting salons use tools to dig out ingrown toenails! If your nail starts to lift off the skin from repetitive use of instruments used for a pedicure, then it could allow for a fungus to creep underneath the skin and infect your nail. If you think you have a toenail fungal infection, don’t wait to seek treatment! Call The Pod Practice today. Don’t hide toenail fungus, treat it!

    2Can Athlete's foot cause toenail fungus?

    Athlete’s foot is a fungal skin infection that occurs on the bottom of the foot and in-between the toes in the web spaces. It can present as dry, scaling skin or burning, itchy blisters. The same fungus that causes fungal infections in toenails can cause an infection on the skin. Prolonged cases of athlete’s foot can cause fungal toenails. If you have athlete’s foot that is not resolving with the use of over the counter antifungal creams, then you need to call The Pod Practice for an appointment to discuss treatment options.

    3Can prolonged use of toenail polish cause toenail fungus?

    Leaving toenail polish on for long periods of time (weeks, months) can make it difficult to know if a fungus has infected the nail. In early stages of fungal infections, the nail may appear only discoloured (brown, white or yellow). If you are unable to observe what the nail looks like for weeks or months, a fungus can infect the nail without you knowing it and continue to grow. Once the fungus infects the nail, it will cause discoloration, thickening and loosening of the nail plate. If you are trying to treat a nail that has a fungal infection with topical treatments, the treatments are much more effective if you stop using toenail polish. Topical treatments cannot penetrate the nail plate properly to treat the infected skin underneath the toenail if you are wearing toenail polish. In most cases, an additional treatment such as an oral anti-fungal medication or laser toenail therapy needs to be added to using topical anti-fungal treatment for the most effective results. If you or someone you know has toenail fungus that needs treatment, call The Pod Practice for a consultation to learn more about how to treat your fungal infection.

    4Can fungus spread to other toes?

    A fungal infection can present on the skin or the toenails, but they differ in appearance on examination. A fungal skin infection, or athlete’s foot, can present as dry scaling on the bottom of the foot and/or between the toes. It can also present as small blisters with burning, redness and itching as well. Toenail fungus causes thickening of the nail as well as a yellowish, brown or white discoloration with a build-up of debris underneath the nail. If an infection starts on the skin or in one of the toenails, it can spread to the other nails if it is not treated properly. Topical antifungal creams help treat skin infections, and nail fungal infections are best treated with a combination of topical or oral antifungals and laser therapy. If you have signs of either athletes’ foot or fungal nails, don’t wait to get treatment. Call The Pod Practice Today!

    Orthotic Support

    1What is an Orthotic?

    An orthotic is a custom arch support that allows your foot to function more normally. Podiatrists are the most highly trained professionals in the mechanics and function of the foot. So, your best source for an orthotic is your podiatrist. Arch supports are used to treat many foot, arch, heel, ankle, knee and back problems. Call The Pod Practice to see if you would benefit from a custom orthotic device!

    2Can an orthotic help my knee pain?

    Orthotics are custom made device you can place in your shoes. Orthotics are not just for foot pain relief, they can also help other lower limb problems such as shin splints, medial knee strain and lower back pain. Increasing stability in the foot helps guide the lower extremities into a more correct position alleviating stress to the lower back, shin and the knee. If you are experiencing any type of lower limb pain in the foot, ankle or knee, Call The Pod Practice so we can discuss your treatment options and determine whether orthotics will work for you!


    1What is hammertoe?

    A hammertoe is contracture of a toe at the joint. Hammertoes can cause pain at the ball of the foot or along the top of the contracted joint due to abnormal pressure. Hard skin can form on the top of the bumpy joint causing a corn or a callus. Conservative treatment usually involves padding to alleviate pressure from the area or getting extra depth shoes to accommodate the contracture. Surgical treatment involves either removing a piece of bone from the joint or a much simpler procedure of releasing the tendon to allow the toe to straighten. If you have painful hammertoes and would like to discuss treatment options, call The Pod Practice

    2How Do You Treat A Broken Toe?

    We have all had a time when we wake up in the middle of the night and catch our little toe on the leg of the bed or a chair and jump around in pain for about five minutes, but the question we all ask following the injury is how do I begin treating a broken toe? Most broken toes remain in good alignment so splinting it or buddy strapping it to the adjacent toe helps to stabilizes it. Depending on the amount of pain you are in you can either wear your regular shoes or you can wear a hard soled open-toed shoe dispensed by your podiatrist. Usually bone heals in approximately 6-8 weeks depending on how quickly you seek treatment for the injury. It is common to have occasional aching and throbbing as the broken toe heals. Call The Pod Practice if you think you broke your toe and need an expert’s opinion on what to do.

    3What is Runner's toe?

    Runner’s toe” is a common problem where the small blood vessels under the toenail burst and cause a dark, “bruise-like” discoloration to the toenail. It is caused by excessive pressure on the ends of the toes either from long distance running or from the shoe being too short. Sometimes part of the nail or the entire toenail can become discoloured. If the pressure becomes repetitive, the nail will become loose and possibly fall off. Changing shoe wear or adding padding to the toes can help resolve runner’s toe. However, if the nail becomes loose or painful, you should call The Pod Practice for a proper evaluation and care by a podiatrist.

    4Why do my toes feel numb?

    Numbness, burning or tingling are all symptoms of problems with the nerves. Common nerve problems in the foot include neuropathy, neuromas, and neuritis which can be detected by numb toes. Early treatment is key to resolving these problems more quickly. If you wait too long some of these problems may linger so if you experience these types of symptoms call The Pod Practice for an immediate appointment.

    5Why do I get painful hard skin in between my toes?

    Finding hard skin between your toes is a more common finding than one may expect. The typical reason you develop a corn between your toes is due to pressure from the close proximity of the toes. When the toes tend to curl or become hammer toes and start to rub up against the adjacent toe, the body forms hard skin to help protect the area from the pressure or the rubbing. They are sometimes known as “kissing corns” or soft corns. Conservative ways to eliminate the corn is to have it shaved down or apply a toe sleeve or spacer. Surgically the digital deformity can be corrected. If you have this problem, don’t wait for treatment. Contact The Pod Practice for treatment.

    6Do I have arthritis in my big toe?

    Big toe joint arthritis is also known as hallux limitus or hallux rigidus. This is a common painful foot condition that is frequently seen by Podiatrists. What is the difference between hallux rigidus and hallux limitus? Hallux limitus is when a patient feels pain and has limited range of motion in the big toe joint. The pain and limited range of motion is due to narrowing of the joint space and also development of arthritic bone around the joint. The combination of the two creates pain and swelling when walking or performing weight bearing activities.
    Hallux rigidus is the more serious condition of the two. The arthritis in the big toe joint becomes so severe, the toe will no longer move and remains in a fixed position. Problems arise when the stiff or fixed joint will rub against the shoe causing pain.
    How do you develop arthritis in the big toe? There are many causes of big toe joint arthritis. If the bones that make up the great toe joint are either too long or too short, it causes jamming of the joint and this will eventually lead to extra bone formation and a limitation in the motion of the joint. Trauma to the great toe, whether it is stubbing the toe, dropping an object on the toe, or even repetitive motion will result in arthritis of the joint. The trauma to the toe causes damage to the cartilage of the joint and results in subsequent swelling. This change in the cartilage can result in loss of mobility and pain when performing activities. Other causes can be related to metabolic diseases such as gout, rheumatoid arthritis, osteoarthritis, and infection.
    What are the conservative options to treat big toe joint arthritis? Initially if the symptoms are not severe then anti-inflammatory drugs can be prescribed to help decrease pain and swelling to the area. This is usually combined with a device that limits the great toe from moving. A custom orthotic can help to keep the great toe joint properly aligned to limit excessive abnormal motion of the joint. This will relieve pain from the big toe joint arthritis.
    The Podiatrist can make an orthotic to limit motion at the big toe joint and help to rest the joint. Corticosteroid injections to the great toe joint will also help to alleviate pain and swelling in the area associated with big toe joint arthritis. Padding to the joint will help to decrease pressure from the shoe when walking.
    How do I prevent hallux limitus/rigidus? Custom made orthotics is the number one way to prevent arthritis to the great toe. If the proper alignment of the foot can be maintained when walking then the abnormal pull of the muscles will decrease and therefore help to prevent the symptoms. If the medial arch is supported then the arches will not collapse. Avoiding trauma to the area is very helpful but can be hard to avoid. Also wearing proper shoe gear when performing physical activities will help to avoid unnecessary trauma to the great toe joint. Playing soccer bare foot or running bare foot is a recipe for disaster and is not advised if you have big toe joint arthritis.

    Ankle Problems

    1Why do my ankles swell?

    Swelling in the legs, ankles and feet, also called oedema, is most commonly due to high blood pressure, heart and lung disease, and problems with the veins in the legs. If left untreated, swelling in the lower limbs can cause pain and even open wounds. If you have persistent ankle swelling, contact The Pod Practice for immediate treatment.

    2Can ankle arthritis be treated without surgery?

    Ankle arthritis is a condition where the cartilage in the ankle joint becomes worn down and the bones are rubbing together causing pain. Pain occurs most commonly with activity or after you’ve been resting for a long period of time. The ankle joint may feel stiff initially and begin throbbing as the day progresses. Most people take anti-inflammatories for arthritic pain anywhere in the body including the foot, ankle, knee and hip. Other conservative treatment options include using an ankle brace for support, physiotherapy, a steroid injection in the joint to alleviate inflammation, and custom orthotics to stabilize the foot and ankle in a neutral position. Most people with ankle arthritis do not need surgery, and there are plenty of conservative treatment options available to alleviate arthritic ankle pain. If you are experiencing pain in the ankle joint and you believe it could be related to arthritis, call The Pod Practice for an appointment.

    3Can Gout affect my ankle joint?

    Gout is an arthritic disease that causes uric acid crystals to settle into a joint causing intense pain, redness and swelling. It most commonly affects the big toe joint; however, it can affect any joint in the body including the ankle. Gout in the ankle may not present as intensely as it does in the big toe joint, but it will cause the area to become red and painful. Usually a prescription anti-inflammatory or gout medication is needed to alleviate the gout flare-up and reduce pain. X-rays and uric acid levels should also be obtained. If you are concerned about whether you have gout in your ankle, then you should see your podiatrist for further evaluation. Call The Pod Practice for an appointment today.


    1Why do I have cold feet?

    Cold feet can be a sign of poor blood flow to the feet. People with circulation problems have difficulty getting blood to flow through the small blood vessels in the feet. If blood flow is limited in the blood vessels to the toes, then the toes can feel cold to touch; however, the skin will feel warmer the farther back you go on the foot, ankle, and leg. If you are experiencing similar symptoms, your circulation should be tested to determine what is causing cold sensation. Call The Pod Practice today so we can find out why your toes are cold and most importantly help treat them!

    2How do I know if there is good blood flow to my feet?

    Similar to a doctor checking your wrist for a pulse, a podiatrist can check three main blood vessels that circulate blood to your feet. A weak pulse to your feet can be a sign of poor circulation. Other signs that can be indicative of poor blood flow are lack of hair growth, thin and shiny skin, brittle nails and dark skin discoloration. Symptoms you could be experiencing with poor blood flow include cramping in your legs after walking a certain distance or pain while lying in bed that is only relieved with hanging your legs to the side. If you are noticing any of these signs or symptoms, you should contact The Pod Practice for an assessment of your circulation to your lower limbs.

    3Why do I get leg cramps when I walk?

    Sometimes blood vessels in the legs cannot deliver enough oxygen to the muscles due to plaque build-up or narrowing of the walls of the blood vessels. This can cause cramping in the legs while walking, also known as claudication. You may find the need to rest in order to continue your walking. Leg cramps in the calf muscles can be a sign of peripheral vascular disease, also known as PAD and should be evaluated by a podiatrist. If you experience these types of problems call us for an appointment.

    4Why are my legs discoloured?

    Dark discoloration in the lower legs, ankles or feet can be due to swelling in the lower extremities, also known as edema. Sometimes swelling can be due to problems with the veins preventing blood from being pumped back up to the the body from the legs. This “blood pooling” in the lower extremities can cause dark discoloration in the skin resulting in temporary or permanent skin changes. This is often called venous insufficiency and can lead to leg ulcers. Treatment includes elevating the legs above the level of the heart and using compression stockings. Further testing can also be done to evaluate the veins. If you have darkly discoloured legs or swelling in your feet, call The Pod Practice today.


    1Why do people with diabetes need to see a podiatrist?

    If you have diabetes, regardless of whether you take oral medication or use insulin, it is important to have your feet checked by a podiatrist. People with diabetes can develop neuropathy which is burning, tingling, or numbness in the feet. If you have diabetes with neuropathy you can develop open sores on your feet and not even realize it. You may also have a weakened immune system if you have diabetes making you at increased risk of developing infections. Having a podiatrist check your feet for wounds, evaluate nerve sensation and assess circulation are all very important factors for prevention of infection. If you have diabetes and haven’t seen a podiatrist yet don’t hesitate to call The Pod Practice for a screening of your feet.

    2Is there a cure for diabetic neuropathy?

    Peripheral neuropathy is common in people with diabetes. Peripheral neuropathy presents as burning, tingling or numbness in the feet. Initially it starts in the toes and continues up the foot. Although there are medications to help control symptoms of diabetic neuropathy, no cure has been found yet. Studies have shown that people with well controlled blood sugar levels have less severity of symptoms for peripheral neuropathy but it could still reoccur if the person has unstable or high blood sugar levels. For more information on diabetic neuropathy please contact The Pod Practice for an appointment.

    Toenail Problems

    1What is an ingrown toenail?

    An ingrown toenail occurs when the side of the nail curves into the skin edge causing pain redness and swelling. As the problem progresses, an infection may start. If you live in Pretoria and think you have an ingrown toenail, contact The Pod Practice for an appointment, The podiatrist will provide you with basic and advanced treatment options including permanent correction of your ingrown toenail.

    2Can a Pedicure cause an ingrown toenail?

    Yes! Ingrown toenails can be caused by improper trimming of the nail. If the beauticians’ instruments are not sanitized properly they can cause an ingrown toenail to become infected. When the edge of the skin around the nail becomes traumatized or breaks during a pedicure a problem at the corner of the nail can start and the nail fold can become painful, red and swollen. You may also notice some drainage if the ingrown toenail is infected. If you have an ingrown toenail or an infected ingrown toenail, contact The Pod Practice immediately for treatment and pain relief!

    3Can an Ingrown toenail go away on its own?

    Ingrown toenails occur when the side of the nail becomes curved and invades the skin along the side of the nail. This can cause redness, pain and swelling on the side of the nail. Ingrown toenails do not usually go away without removing the offending part of the nail. However, in some cases, an ingrown toenail can go away on its own if you gently round the corner of the nail using some clean clippers and then by soaking your foot twice daily with warm salt water. Finally cover the nail with antibiotic cream and a Band-Aid and if it does not improve within a few days, see a podiatrist. Deeper cutting of ingrown nails at home can be dangerous and should be avoided. When attempting to remove an ingrown toenail on your own, a piece of nail can often be left deeply imbedded in the skin along the side of the nail. This often results in an infection and complicates the treatment and may require an oral antibiotic. The only way to stop the infection is by seeing a podiatrist for treatment. Antibiotics alone are rarely a solution. A piece of the nail must be removed and the infection drained for the antibiotics to work. When you have had an ingrown toenail multiple times, there are permanent solutions to fix them. Once you do this you will no longer ask, “will an ingrown toenail go away on its own”?
    Instead of taking a risk and digging them out have a matrixectomy. This procedure is done in the rooms to kill the nail root. There is no cutting with a blade and no stitches. This has a 95% success rate. If you have an ingrown nail causing pain or discomfort, call The Pod Practice for an appointment to discuss removing your ingrown toenail and preventing it from growing back again.

    4Why does my toenail turn black when I run?

    If you are a runner or participate in other sports you can get toenail discolouration or a blackened nail. This can be caused by improper shoe fit. If you are concerned about the discoloration, possible tests should be considered. If you have other questions about the colour of your nail you should consult the Podiatrists at The Pod Practice.

    5Why is my toenail discoloured?

    Discoloration of the toenail is very common and can be caused by more than a common fungal infection. The colour and overall texture can help your podiatrist discover the underlying cause of the nail colour. Some diseases that may cause nail discoloration include certain medications, chemotherapy, systemic diseases and skin cancers. In some cases, discoloration can occur if you naturally have dark or pigmented skin. If you are a runner or participate in other sports you can get toenail discolouration. If you are concerned about the discoloration, possible tests should be considered. If you have other questions about the colour of your nail you should consult the Podiatrists at The Pod Practice.

    6Why has a red lump of skin formed over my ingrown toenail?

    After an ingrown toenail has been present for a long period of time, the skin becomes inflamed with the presence of redness and swelling. Because of the swelling, the skin will rub on shoes or on the other toe creating more pressure and more irritation and inflammation of the skin. This chronic irritation will cause a small bump to develop beside the ingrown nail. Sometimes it can feel hard or become very fragile and bleed easily. If you suffer from these symptoms, call and make an appointment with the Podiatrists at The Pod Practice to get permanent relief from painful ingrown toenails.

    Arch Problems and Flat Feet

    1What are fallen arches?

    Fallen arches” may indicate flattened feet. Flat feet can be caused by a muscle or tendon imbalance in the foot. Fallen arches can be hereditary or they can develop slowly over time. Some people with flat feet may experience no pain; others may experience severe pain and need to seek treatment. A person with flat feet can have pain in his or her arch or instep, along the ball of the foot, or even experience knee pain. Custom made insoles or orthotics can help provide stability for flat feet; however, if you have a flat foot, you should consult your podiatrist before attempting use of any over the counter or custom insoles. Call The Pod Practice today to see if you may benefit from fallen arch treatment using the latest in orthotic therapy!

    2Why Do I have Pain in The arches of my feet?

    Painful arches are a common foot problem, but it can be caused by several different things. It usually presents as a throbbing or stabbing pain to the bottom of the arch and hurts most with walking or exercise. It can present in only one or both of the arches. Having a flat foot or “fallen arches” is a very common finding in people that have arch pain. But people with the complete opposite problem, that have a very high arch, can have arch pain as well. Most of the time, the source of arch pain comes from certain tendons and muscles in the foot that are not working properly. These tendons that help support the arch eventually become fatigued and cause pain as a response that they are not able to perform the work they are supposed to do. Without treatment, these fatigued tendons can actually tear or allow the arch to fully collapse. Custom made orthotics can keep the arch stabilized allowing the tendons that support the arch to work in the correct position. If you have arch pain, flat feet or high arches, you should Call The Pod Practice for an appointment! We customize orthotics to fit your foot type and help your arch pain go away for good!

    3Is it normal for my child to have flat feet?

    Many parents get concerned about their kids having flat feet and whether or not it’s normal. Most children have flat feet when they are young, from birth to age 6 or 7 usually. As they get older they develop a normal gait and their arch will also develop with it. In-toeing is also normal in kids that are between the ages of 4-6 as they start to develop a normal gait pattern. Therefore, initially some kids may walk “knock knee” and have a flatter arch. However, some children will complain of pain in their arch or along the sides of their leg which is absolutely not normal. When children have pain associated with their flat foot condition or in-toeing gait, then you should seek medical advice. Custom made orthotics are a great conservative treatment that can be made for kids with flat feet that complain about pain in their arches. Contact The Pod Practice if your child has painful flat feet.

    Foot Pain

    1Why do my feet swell?

    Foot swelling may be caused by many different conditions. High blood pressure and faulty veins in the legs can cause swelling. In the foot, swelling may be caused by an injury, fracture, infection or gout. If your swelling does not resolve within a few days you should see a podiatrist. This is especially true if you have diabetes or poor circulation. Call The Pod Practice for a consultation.

    2Do I have a stress fracture?

    A stress fracture generally affects the long bones of the foot for example the larger toe bones near the midfoot but can also occur in any bone of the foot. A stress fracture should be treated immediately. If untreated a stress fracture can turn into a regular fracture. Signs and symptoms include redness, swelling, bruising and continued pain even after icing. An X-ray can be done to diagnose the problem or even an ultrasound can be done which may pick up an early stress fracture. Further imaging modalities like CT or MRI scans may be necessary. Stress fractures are generally not caused from a direct injury, they can occur during everyday activities like walking or running. If you have redness and swelling and you are not getting any relief you need to see a podiatrist. Call The Pod Practice to book your appointment.


    1Can women get gout?

    Gout is a type of arthritis that causes uric acid crystals to deposit in soft tissue around joints. The deposition of these crystals causes a joint to become red, hot, swollen and extremely painful. Although gout most commonly occurs in the big toe, it can affect any joint in the body. Gout most commonly occurs in men; however, women are not exempt from having gout. Post-menopausal women, specifically, have a higher risk of developing gout which is thought to be linked to the drop in natural oestrogen levels. Research has shown that oestrogen helps the kidneys get rid of uric acid as it develops in the body. When menopause occurs, oestrogen is not helping eliminate the excess uric acid, and it ends up getting deposited into tissue surrounding the joints, therefore, causing gout “attack.”

    Ball of the foot pain

    1Why is the ball of my foot hurting after increasing my mileage?

    This is a common question asked by runners who are training for any race. Many runners can run a certain amount of time before they begin to experience any significant pain in their feet. Because of the shortened heel strike and increased time spent on the ball of the foot during a typical running pattern, it is common to increase stress on the joints and soft tissue on the ball of the foot. This stress can cause inflammation to the tissue surrounding the joints which is called capsulitis. Depending on your foot type, pain is most commonly localized to the bottom of the big toe joint or the second toe joint. If runners continue to “push through” this pain during their run, not only can they develop capsulitis, but they can also develop arthritis which is permanent damage to the joint. That’s why it is so important to have the right shoes and orthotics to prepare for these types of races and prevent these injuries. Orthotics are on the “must have” list for runners. Orthotics allow your foot to function in the best position. They alleviate abnormal pressure points and stresses to the foot, and allow you to perform at your highest level of competition. If you are experiencing pain in the ball of your foot while training for long distance races, don’t wait to seek treatment. Call The Pod Practice now for a consultation on how to resolve your foot pain today!

    2Why do I have pain in the ball of my foot?

    It may have started as a minor ache and you now have significant pain when walking. You may also notice that there is burning in the foot when on or off your foot. There are many reasons why you may have ball of foot pain but they all stem from foot instability and abnormal function of your foot. You can have this instability with an arch that has fallen or a high arch. If you push on the bottom of your foot and feel a hard knot that is painful, this is likely due to a prominent bone called the metatarsal with surrounding soft tissue swelling. You may also have some decreased fat padding leading to increased pressure on the ball of the foot. Many doctors will call this metatarsalgia. With this increased pressure, you may develop thick skin or callouses. These can be painful but are the result of the bone which has become enlarged or prominent. Removal of callouses and pads can give temporary relief but your main treatment should be a custom arch support also known as an orthotic. All arch supports are not created equal. See a podiatrist for the best treatment and orthotic. In some cases surgery may be the answer and your podiatrist can help you make that decision. If you do have callouses and have diabetes, you should see a podiatrist and avoid removing these yourself or using medicated pads which can cause burns and infections. So, if you don’t seem to have this type of problem and you experience, burning on the ball of the foot and possibly burning in the toes, you may have an enlarged nerve or neuroma. In some cases, the nerve may be normal but a tendon or inflamed joint may be pressing the nerve. Your podiatrist can help make the diagnosis. Of course there may be other causes for ball of foot pain such as an enlarged bone known as the sesamoid, arthritis and pain of the big toe joint, stress fracture, or even gout. So how are you going to get relief? Your best bet is seeing your podiatrist for a consultation.

    Heel Problems

    1Why does my child have heel pain?

    If your child is experiencing heel pain after walking, playing sports or wearing certain shoes, he or she could have Sever’s disease. Sever’s disease is inflammation of the back of the heel at the growth plate, commonly caused by overuse. It can present as redness, swelling and pain in the back of the heel. Most patients with Sever’s disease are usually between the age of 10 and 14 years; however, it can occur in younger or older children. Rest, ice, and changing footwear usually help resolve the symptoms; however, you should always consult your podiatrist for adequate diagnosis and treatment. If your child has heel pain, don’t wait Call The Pod Practice.

    2Why Does my heel Hurt in the Morning?

    A common time to experience heel pain is in the morning when you get out of bed. You may have difficulty taking your first steps and then the pain may slowly ease. When the heel problem becomes more severe, it may take much more walking and time for your heel pain to ease. Most heel pain comes from a band on the bottom of the foot known as the plantar fascia. This band supports your foot and arch. While sleeping or sitting, the band contracts and cools down. So when you step out of bed the contracted fascia band pulls hard against your heel bone. As you stretch out the band and your foot warms, the pain starts to decrease. The actual pain is from swelling of the fascia band where it attaches to the heel. There are also surrounding nerves that produce the pain. Common treatments include icing, stretches, anti-inflammatories and arch supports or orthotics. Advanced treatments may include shock wave therapy. If you live in Pretoria and have heel pain, contact The Pod Practice for an appointment.

    3Does Stretching help plantar fasciitis?

    Plantar fasciitis is inflammation of the plantar fascia, which is a band of strong fibrous tissue on the bottom of the foot that enhances arch support. When the plantar fascia becomes tight after a period of rest, it can cause intense sharp pain to the bottom of the heel. Stretching the plantar fascia can elongate the tightened, contracted band of tissue and alleviate heel pain. Doing a heel stretch on a daily basis, such as a heel drop on a step or a towel stretch, can lengthen the plantar fascia and prevent heel pain from occurring in the morning when getting out of bed. If stretching doesn’t alleviate your heel pain, you should call The Pod Practice to discuss treatment options.

    4What is the bump on the back of my heel?

    Having a large bump on the back of your heel is typically indicative of having a tight Achilles Tendon. The body will react by forming a large spur or “pump bump” at the insertion of the tendon. The spur tends to be tender due to the overall tightness of the Achilles tendon and due to bursa formation or inflammation of the neurovascular structures found in the same area. Conservatively this can be treated with heel lifts, NSAIDS or rest. It can also be surgically removed. If you experience these types of symptoms call us for an appointment and treatment.

    5Do Heel Spurs Cause Pain?

    Heel spurs are small protrusions from the heel bone. Heel spurs form where the plantar fascia attaches to the heel bone. The heel spur itself indicates that there has been long-term stress on the heel. However, the heel spur does not cause actual pain. The pain is the result of inflamed and swollen soft tissues around the fascia band spur and nerves in the area. If you suffer from this condition, don’t delay treatment. Call The Pod Practice for an appointment and put an end to your heel pain.

    6How do I get long term heel pain relief?

    The key to treating any foot or ankle problem, including heel pain, is to identify the source of the problem. In most cases, heel pain results from an unstable foot and arch. This instability leads to over stretching of bones, joints, muscles, tendons and ligaments. This leads to the breakdown of these structures over time which creates a vicious cycle of further instability. Whether you are active or not, the key to solving your heel problem is a customized orthotic. If you don’t address the cause then treatments may be short-lived and less effective. If you suffer from heel pain or other foot and ankle pain, call The Pod Practice.


    1What is a neuroma?

    A foot neuroma or Morton’s Neuroma actually occurs when the nerve that runs between the toes gets irritated causing inflammation and enlargement of the nerve. Typically the patient can experience numbness in the affected toes, burning or sharp shooting pain. Treatment options include footwear with a wider toe box, orthotics and cortisone injections. For neuroma pain that doesn’t resolve with conservative treatment, cryosurgery or surgical excisions are options that can be discussed with your podiatrist. If you have symptoms of a neuroma and would like further treatment options and correction, call The Pod Practice today.

    Sports Injuries

    1Why do I get shin splints when I run?

    Shin splints develop from over-use, which is why they occur in runners or power-walkers. The muscle and tendon become inflamed particularly in the area where the muscle converges with the tendon. Shin splints can develop anywhere that a muscle is being over-used. The front, outside and inside aspect of the lower leg is the most common areas that shin splints occur. The most common factors that can lead to shin splints include biomechanical imbalance (one example is over-pronators), beginning a new work-out, resuming a work-out after a period of inactivity, change in surfaces or change in shoe gear. If you are experiencing pain from shin splints (burning, aching along the lower leg after work-outs), then try slowly increasing your activity level instead of performing too much too soon for beginner work-outs. Also ice, topical analgesics and anti-inflammatories can help reduce pain as well. If pain is not resolving with these treatments at home, then call The Pod Practice so a podiatrist can evaluate what’s causing the shin splints and how to prevent them from returning.