Podiatrist Christian Ellul tells Stephanie Fsadni he has noted an increase in awareness on foot education, particularly among diabetics, but that it is still scarce among the rest of the Maltese.

Athletes, ballet dancers and those whose occupation poses increased demands on their feet are as likely to suffer from foot problems as individuals with systemic disease such as diabetes or arthritic conditions, but may not likewise take enough care.

Podiatrist Christian Ellul has noted an increase in awareness on foot education, particularly among diabetics, but says that it is still scarce among the rest of the Maltese population.

“Everyone is aware of the importance of routine dental check-ups, but how many actually undergo foot check-ups,” Mr Ellul asks.

“Yet complications related to the foot and lower limbs can be severe enough to lead to permanent disability.”

Problems may start from a very young age. Whereas parents are often concerned about developmental variations such as delayed walking or knock knees – which in the majority of instances, Mr Ellul says, are perfectly normal – children are more likely to suffer from fungal infections, ingrown toenails and in-toeing.

People who experience foot and ankle pain should seek a podiatrist immediately and never assume that time will make the pain go away

The most common problems among adults include heel pain, ingrowing toenails and foot infections, while elderly problems are often related to the ageing process and several decades of constant demands on the feet that lead to foot arthritis, callosities and corns, thickened and infected toenails, neurovascular problems, mobility problems and falls.

Sportspeople need to be extra cautious to prevent debilitating problems.

“The demands athletes put on their feet are high, and as a result, they need to be kept in optimal condition. Research shows that abnormal foot posture and function, for example, flat feet – often asymptomatic – increase risks of injuries and morbidity,” points out Mr Ellul, who is the president of the Association of Podiatrists of Malta.

A podiatrist – who carries out the same practice as a podologist but the term is the internationally recognised one for the profession and is the term regulated by local law – can help identify and address such functional problems before an injury actually occurs.

Frequency of visits to a podiatrist depends on the condition/s one is suffering from. However, Mr Ellul recommends that diabetics should at least have an annual review, irrespective of whether they are suffering from foot pain or not. This also applies to athletes, people suffering from arthritis, individuals whose occupation/lifestyle necessitates huge demands on their feet and people with biomechanical problems, such as flat feet.

Others who experience foot and ankle pain should seek a podiatrist immediately and “never assume that time will make the pain go away”.

Individuals, particularly sportspeople, should also check their feet regularly themselves, as foot and lower limb problems have easily identifiable signs and symptoms. This practice may be the key to preventing injuries.

“One should visually note any abnormal colouration in one’s peripheries, skin breakdown and loss of hair, and should regularly check the soles for any abnormalities.”

“On the other hand, one should not turn a blind eye to painful symptoms but act immediately. For example, frequent cramps while walking might be related to poor circulation that is particularly more common in diabetics and smokers,” explains Mr Ellul.

Wearing appropriately fitting shoes on a day-to-day basis also goes a long way in preventing ailments. But finding a balance between fashionable and sensible footwear is always a challenge, both for the individual and the educating practitioner.

“In most cases, fashionable footwear is the ‘bad footwear’, while appropriate, sensible footwear is unfashionable. In fact, flip-flops, high heels and stilettos are usually the biggest cause of foot problems, while sensible footwear, such as sandals and running/walking shoes, are the single most effective solution to many foot, knee and lower back pains.”

For more information on podiatry and foot health, visit www.podiatry.org.mt.

Foot awareness campaign

The Association of Podiatrists of Malta will be reaching out to the public with a foot awareness campaign this month, setting up two informative stands on November 10 and 30 at the University and The Point, Sliema. It will also distribute informative leaflets to all health centres, pharmacies and private clinics on how podiatrists can help patients with foot problems. The campaign will reach a climax with the first conference on podiatric sports medicine, which will be held on November 22 and 23. Health professionals with an interest or specialisation in sports and professional coaches are encouraged to attend.