RA or Rheumatoid Arthritis is a type of inflammatory arthritis where the immune system attacks the tissues of the joint lining. This can cause painful inflammation during “flairs” and stiffness.
It is common for many people with RA to develop these symptoms in the joints of the foot and ankle. It can be painful and swollen in the joints of the toes, ankle and even ligaments of the feet. Nodules, or lumps can occur on the heel, ball of the foot or the achilles tendon.
If left untreated deformities of the toes and feet can occur such as hammertoes or claw toes. Cartilage between joints can break down and cause changes in the shape of the foot, toes and ankles. It can be a cycle of pain and stiffness and visible changes.
In addition to managing your inflammatory levels with the help of a rheumatologist and possibly other health care practitioners such as a Naturopathic Doctor, a Chiropodist can help you protect your feet. Working closely with a Chiropodist allows them to help manage pressure, and prevent joint breakdown and deformity.
Custom Orthotics and guidance on proper footwear help support the joints of the foot and ankle. Orthotics will also help support joints above that can also be affected by Rheumatoid Arthritis, such as knees and hips. Custom orthotics help manage joint pressure as well as joint alignment.
Most private benefits cover visits / assessments with Chiropodists (foot specialists) as well as Custom Orthotics.
Contact us to book your consultation / assessment with one of our North Oakville / Halton Chiropodists.
As Physiotherapists, RMT’s, Chiropodists and Yoga Therapists we see many people who have osteoarthritis. We may or may not be treating them for issues directly related to the arthritis.
What is Osteoarthritis?
There are many different types of arthritis. Some affect the joints, some affect the tendons, muscles and ligaments. Some affects specific areas, and some affect the whole body.
The most common type of arthritis is Osteoarthritis or “OA”. This is a type of arthritis that affects a persons synovial joints. In OA, the cartilage that covers the ends of the bones may have changes or be worn away. Joint changes in OA can (but not necessarily) cause pain, stiffness, inflammation and trouble with movement.
OA refers to the classic “wear and tear” of the joints. It is commonly seen in the knees, hips, low back, neck, the joints of the fingers and the big toes. The pain generally stays locally in the joint that it is affected by.
Risk Factors of Osteoarthritis Include:
Age
Female Gender
Obesity
Anatomical Factors
Muscle weakness
Previous joint injury (eg. sports or occupation related etc)
Primary versus Secondary OA
Primary OA refers to normal “wear and tear” of the joints. It generally starts showing in people between 55 and 60 years of age. Everyone is different in how they experience symptoms and IF they have pain and limitations. The above risk factors also play a role in this.
Secondary OA refers to a specific injury or trigger that may accelerate cartilage breakdown. Injury, obesity, a history of certain diseases like diabetes, marfan syndrome and other connective tissue disorders,
Signs and Symptoms of OA:
People with osteoarthritis may come into our Oakville clinic looking for treatment from one of our Physio’s, RMT’s or Chiropodists due to one or a combination of the following issues.
There may be a precipitating event that flairs up symptoms of OA like a fall or injury. A person may complain of local pain. The intensity of the pain may be variable. A joint with OA may have stiffness or a decreased range of motion. This can be from a combination of the joint as well as the soft tissue structures around it, over time.
A person with OA may hear clicking or cracking with movement of a joint that may or may not decrease as they move more. The noises may or may not be associated with pain. There may also be mild swelling around a joint with osteoarthritis.
Imaging and Arthritis:
In addition to the signs above some family doctors like to send people for X-rays to confirm their suspicions. X-rays show the joint surfaces and the space between the joints. This will show the thickness and smoothness of the cartilage.
X-rays can sometimes be a red herring.This means that sometimes there may be pain in an area and the imaging shows no joint changes or someone may not have any pain but X-rays show more significant arthritis.
Management of Osteoarthritis:
If you have OA and or the above symptoms, a physiotherapist is a key member of your health care team.
The treatment and education they will provide you should be focussed on your specific limitations, your lifestyle and your goals.
If a joint replacement like a total knee replacement (THR) or total hip replacement (THR) is in your future, we (physiotherapists) can BOTH help get you ready and help you with your recovery. Hopefully you will access physiotherapy early enough that we will help you delay or even prevent needing these surgeries!
Physiotherapists will help you with specific ways to add strength and mobility in an area. This will help with activities of daily living and pain. Fall prevention activities are very important in people with OA as there is a 30% increased falls risk in people with OA. Some of this may have to do with pain medications frequently prescribed. Physiotherapists can help both with a persons pain and pain management as well as longer term pain management strategies.
Massage Therapists can also help with pain and mobility in stiff joints.
Chiropodists can help with the joint alignment from the bottom up through the use of custom orthotics. This can help with both hip, knee and low back OA.
How WE can help!
Having Osteoarthritis does not mean you are destined for years of pain and problems. There is a lot that can be done conservatively to take action.
Our team at North Oakville’s Palermo Physio and Wellness centre is here to help not only with your aches and pains but also with prevention.
Our Registered Massage Therapists can work on joints and muscles that are stiff and uncomfortable. Many people book in for massage when they have pain and find value in booking massages at regular intervals.
Our Chiropodists provide thorough biomechanics assessments and gait analysis. They can give advise on footwear and measure and fit you for the best custom orthotics for you and your lifestyle and needs.
Our Physiotherapists will work with you to help you get stronger, move better and to work towards your goals. You deserve to have an amazing quality of life and we are here to help!
There are so many terms and word to sort through when it comes to our bodies. Skeletal muscles are contractile. They contract and shorten to produce movement. They contract to hold and joint in place. They lengthen under force as well eccentrically (picture lowering down stairs).
Ligaments connect bone to bone and help secure your different joints.
Cartilage covered the joint surfaces between joints. It provide shock absorption and helps with smooth movement.
Your tendons are an extension of the skeletal muscles that connect muscles to bone. They act with a pulley and lever system to help produce movement.
Forces in and on your body don’t take place in a vacuum. These structures as well as the bones help move you, stop you and absorb forces.
Your achilles tendon is the strongest and largest tendon in the body. It is vulnerable to injury due to its limited blood supply, age related changes and specific activities.
Injury to the Achilles Tendon:
Tendonitis
Tendonitis is the acute inflammation of the tendon. In this case the achilles tendon connecting he calf muscles to the heel bone becomes irritated and inflamed. This is often associated with overuse. This is often from doing more or too much too quickly for our bodies to adapt. For many people there is a sudden increase in exercise activity or intensity.
Achilles tendonitis can cause local pain and stiffness. The first steps after sitting or laying down may cause pain in the achilles area. Walking down stairs can also sometimes be painful or stiff feeling in the area of the achilles tendon.
Achilles tendonitis can be common in athletes like runners, soccer, basketball, and volleyball athletes with running and jumping repetitively. Sudden increases in volume as well as a persons body structure can play a role. It can be helpful to have the area looked at by a Physiotherapist and / or Chiropodist to provide specific treatment.
This type of treatment may include things to address the inflammation and pain in the short term. It will also likely include long term suggestions of strengthening, footwear modifications and possibly custom orthotics.
Tendinopathy
Achilles tendinopathy is a longer term overuse injury of the achilles and excessive chronic stress. Due to the chronic nature of this issue, there may be a range of changes to the tendon. These changes are more likely to happen when there are repeated bouts of tendonitis that are not treated, managed or prevented.
Higher risk factors are obesity, high blood pressure, sudden load changes to the achilles tendon, Type II diabetes, prolonged steroid use, inappropriate footwear, and a family history.
Rupture or tearing of the achilles tendon is the most common rupture in the lower body. It its most common in those aged 30 to 50. Patients often describe this injury as feeling like someone has kicked them. They may hear a “pop” or “snap” sound.
Achilles tendon ruptures, like many injuries are multifactorial.
Achilles tendon ruptures are most common in people who are active “on occasion”. This could mean mild activity during the week and some weekends playing a couple games of floor hockey or soccer. There is a small percentage of people (~10%) that report having tendinosis prior to the rupture.
Ruptures tend to happen around 2-4cm from where the tendon attaches to the heel bone.
Achilles tendon ruptures may happen from sudden and forced plantar flexion (pointing), direct force on the area or longstanding tendinosis.
Foot and ankle position as well as systemic factors can predispose someone to achilles tendon issues. It is important to treat and have best control of all factors for best healing of the area. Some system issues predisposing a person to achilles issues are diabetes, renal failure, rheumatoid arthritis, lupus, gout, thyroid issues etc.
If you have been having heel or achilles pain that is ongoing, progressing or off and on, one of our North Oakville Physiotherapists or Chiropodists would be happy to assess you. They will take your health history, watch how you stand, move and walk and assess the area.
This thorough and individualized assessment will provide them an idea of factors leading to your achilles pain / dysfunction and allow them to give you individualized advice and treatment. Most insurance benefits cover physiotherapy and/or chiropodist assessments and treatments. At our Oakville clinic we are able to provide direct billing to most insurance companies.
Contact us to book your in person physio or Chiropody appointment at our North Oakville Clinic or virtual physiotherapy appointment.
it is easy to remember to care for your feet in the summer months because we see them more, but is just as important to look after your feet in the winter!
Here are some Chiropodist tips from our North Oakville foot clinic on how to care for your feet in the winter.
Keep your feet warm
Proper footwear and socks are vital in the cold weather.
Your shoes and boots should be covered all around and have a thick sole. The treads of your sole should be deep and ridged to help with grip and prevent slipping on snow and ice. There are also grippers that fit over your soles should you need to leave the home in more slippery conditions.
Wear warm socks that still breath. Wool socks are excellent for temperature regulation and wishing sweat away to prevent dampness.
People who have circulation issues, diabetes and other sensory issues are more likely to have issues in the winter months. If you have been having problems it is important to seek a solution and work with your Chiropodist to maintain your foot health.
Protect your feet from the elements
Wearing proper winter boots in cold and wet / slushy conditions is impotent to stay warm and for the health of your feet. Running shoes in slushy weather can be not only cold, but dangerous.
Your boots should also provide good ankle support. For more time on your feet, try to stay away from trendy soft walled “boots” that cause your ankles to collapse inwards.
Our Oakville Chiropodists can help you choose footwear that is best for you and your feet.
Inspect your feet regularly
After a shower or bath, before and after bed, are all great times to look at your feet. Look around your toenails, between your toes, and on the bottoms of your feet. Use a mirror or a cell phone if you can get to some of these places!
Look for redness, cuts, calluses or anything out of the ordinary. If you aren’t sure bring it to the attention of your doctor or book in with your Chiropodist / foot specialist.
Keep your feet and toenails clean and kept
It can be easy in the winter months to neglect your feet. Try and maintain a basic schedule for yourself. The regular foot look over will be helpful with this.
Cold weather can dry out your feet and cause cracks. Also, when your feet are in moist and dark places (like boots), fungus may grow and thrive. This can cause athletes foot and toenail fungus. Wearing proper socks and doing regular maintenance / foot care can help prevent this.
It is much easier and healthier to care for your feet regularly and have routine foot care visits with your chiropodist, than play catch up and treat ongoing or advanced issues.
Our Oakville Chiropodists are here to help with your foot health. We treat patients from all over Oakville, Halton, Burlington and Milton in our North Oakville foot clinic.
The New Year or beginning of the month is a great time to check on your shoes!
How do you know when it is time to switch out your old pair of shoes for a new pair?
Follow along and our Oakville Chiropodist will give you some tips!
How long have you had the shoe?
Your shoes should last you between 500 to 800kms of use. Depending on your training or exercise that is roughly 6 months to one year.
Look at the bottom
Turn your shoe over and look at the bottom are the treads evenly worn?
Are there any holes?
Are there any treads left?
The bottom on the shoe is a key indicator of when it is time to change your shoes up. Wearing a shoe that has worn unevenly or is very worn in general can lead to wear and tear type pain and injuries. There may be less cushioning for the feet and joints above. There may be less grip and your walking or running pattern changes unconsciously to adapt. Wear you put weight through your foot and joints may change if your shoe is worn unevenly.
It is always better to transition to new shoes before it is a problem.
A Chiropodist can discuss with you what shoes are best for you, your foot, how you walk/run and for the activities you use them for.
Bring your old shoes with you your foot clinic appointment. The Chiropodist / foot specialist will gain so much information from looking at you wearing the shoes, and looking at the bottoms of the shoes. They will be able to give you recommendations on shoes that will be ideal for you.
You do not need to be in pain to access foot clinic services. Prevention is so important. When many people are looking to begin new activities or transitioning with gym closures investing in a great pair of shoes is a great thing to do.
Most private benefits cover foot care appointments with a Chiropodist.
A Chiropodist is a regulated health care professional that provides medical foot care.
There are regulated by the College of Chiropodists. This means that they have rules and regulations to follow that are designed to protect the public. The most recent that you will notice are covid-19 related. They dictate what PPE (personal protective equipment) your Chiropodist needs to wear and the screening process of their patients.
Along with custom orthotics, ingrown toenail procedures, diabetic foot care, and treating fungal toenails, a Chiropodists provide routine foot and toenail care. This care can be provided to people of all ages.
Hygiene
Your Chiropodist (foot specialist) will clean the room after and before each patient. They will only use their specialized tools on your feet after they have been disinfected and then sterilized in our autoclave. They do not use foot soaks or foot baths with jets as these cannot be cleaned to their standards.
Healthy Feet are Happy Feet
Medical Training
Chiropdists have a medical eye. They are able to diagnoses foot and ankle issues that have to do with the toenails, skin, joints and soft tissues.
The Chiropodist is up to date on the best practices for foot and toenail issues. They specialize in assessing and treating a very small area of the body.
Prevention in your health care and early recognition of any issues are always the best ways to prevent complications. For example, warts are easier to treat earlier. This is also true of thickened toenails, or fungal issues.
A Part of your Team.
Having seen our North Oakville Chiropodists for routine foot care which includes foot checks helps establish a rapore with you and your health. If your health changes or your foot health status changes, your Chiropodist is already aware of you and your preferences. They have a rapore with you.
Our Chiropodists treat the whole family.
Private Insurance
Routine foot care and foot checks are usually covered under your private benefits under “podiatric foot care”.
Private insurance benefits recognize foot care as vital for your health. It knows that early recognition of more serious issues is what Chiropodists are excellent at. This is especially true of people with diabetes as well as neuropathy or numbness on the feet.
Our North Oakville Chiropodists often treat multiple members in a family. You do not have to struggle with fighting to clip your childs toenails. You do not have to struggle with self treatment for warts, athletes foot or fungal toenails.
Your Chiropodist will be able to diagnose your foot and toenail issues and provide treatment options that are effective for you.
To book with one of our North Oakville Chiropodists please contact us. We are here to help!
During and after pregnancy many women notice changes in their feet.
No, this is not your imagination. Pregnancy has been shown to be associated with permanent foot changes. The arch drops, and there is a loss in rigidity. There is a also an increase in foot length. In a nutshell your feet get bigger.
This has been shown to increase the likelihood of musculoskeletal issues in post-partum people.
The bases that we have been standing and walking on for years have all of a sudden changed. Our North Oakville Physiotherapists and Chiropodists (foot specialists) see may of these people experiencing arch pain, pain at the ball of the foot, and heel pain. We also see women complain of knee pain that wasn’t there before and hip pain. If there were these issues prior, they may even be worse.
There is nothing that can be done to prevent these changes. BUT, we can offer these structures support. During pregnancy, our bodies produce relaxin this is to help accommodate changes and shifts in the pelvis to prepare for birth. The body continues to produce this hormone for those who continue with breastfeeding.
Wearing supportive footwear even in the house will help support the arch and prevent the ligaments from stretching. Adding arch strengthening exercises to allow the muscles to provide support to the ligaments is helpful. Strengthening the hip and large leg muscles may also be helpful for control from above and shock absorption.
Don’t make the mistake of squishing your larger feet into your old shoes. This can make us grip out toes and walk differently. It may increase the progression of things like bunions and hammer toes as well. There is also an increased possibility of bruised and ingrown toenails with wearing shoes that are too small.
Custom orthotics can also be helpful to help support the changing foot structure.
Our North Oakville Chiropodists and Physiotherapists are happy to help with any questions or issues involving pain and discomfort. Contact us to book.
With a change is season, which seems to get more and more abrupt, our Oakville foot specialists tend to see a change in foot issues.
Moving from winter to summer we tend to free out feet! Taking winter boots off, putting running shoes, and sandals on. We may even spend more time outside and on our feet.
When there is an abrupt change, our bodies may not have time to accommodate as well. Our North Oakville Chiropodists see more people with things like:
Foot Pain– This pain can be located in the arch, the heel and even the ball of the foot. It is dependent on activity, what shoes you have been wearing, the structure of your feet etc.
Achilles pain – The achilles tendon is the largest tendon in the body. It connects our strong calf muscles to our heel bone. A sudden change in activity or foot wear can irritate this tendon and boy can we feel it with or after walking, running and often getting up from sleep or sitting for a long period of time.
Ingrown toenails – winter shoes and boots tend to be more spacious in the toe box. Summer shoes may be more narrow or ill fitting. This can lead to irritating or painful ingrown toenails.
Bruised toenails – a sudden increase in running and walking mileage can create impact with our toes in the ends of our shoes. It is not uncommon to have bruised toenails in this case. With a sudden change in colour or blackened toenail it is best to have it checked by a Chiropodist or health care professional.
Like most things, foot issues are not a one size fits all approach. The reason for your arch pain may be different than your friends arch pain. If your issue sn’t resolving or worsening it is best to have a thorough assessment by a Chiropodist (foot specialist). They will be able to tailor advise and a treatment approach to you specifically.
If you have having foot problems we are here to help at our North Oakville clinic. We service clients from Oakville, Milton, Burlington and Mississauga. Please contact us to book in, or for more information.
Our Oakville Chiropodists treat foot and ankle issues. This includes toenail and skin related issues. One thing people think most about with regards to Chiropody is custom orthotics, but they treat so much more in a foot clinic!
Any painful point, or skin issue on the foot, our Chiropodists are here for you. They are educated for years in the science and physiology of the body, and specifically the feet.
A Chiropodist uses tools that are are sterilized and cleaned in a special place called an autoclave. This is the same type of unit a Dentist uses for sterilize the tools they use in our mouth!
Some people call this type of treatment from a Chiropodist a medical pedicure. This is because while they treat your area of concern, they also give your feet a full “check-up”.
What is a Corn?
A corn is an area of thickened skin on the foot. It is a round area. Corns are formed from repeated pressure / rubbing of the toes on each other or on the inside of the shoe.
Corns most commonly appear between, or on top of the toes, but they can also be on the bottom on the foot and the ball of the foot. If nothing changes with regards to the footwear or areas of pressure that have caused the corn, it is likely they will come back.
Your Chiropodist will advise you on daily foot care and footwear to protect against corns coming back. If you have corns on the bottom of the feet or even the tops of the toes, custom orthotics may be the way to go. This is because custom orthotics help relief areas of pressure and correct fallen areas of the foot and hammer toes.
Corns, in a way, are the body’s way of preventing blisters. They may not be painful initially, but may cause tenderness and sensitivity over time. If you have an area of redness and you have neuropathy (decreased sensation) it is important to have it checked for infection by a Chiropodist.
Treatment of Corns by a Chiropodist:
As with all people who seek care for foot issues, the Chiropodist will perform a thorough assessment. This is based on your feet, walking style, health issues, footwear etc.
Based on what they find in your personalized assessment, they Chiropodist will formulate a treatment for you. This will likely include removal of the corn and also advise to help prevent recurrence.
Advice on proper footwear
Custom orthotics
Modification of footwear
Toe spacers or additional padding
If you have corns or calluses, our North Oakville Chiropodists are here to help. Podiatric foot care is covered under most private insurance benefits. We service patients from Oakville, Burlington, Milton and the surrounding Halton area.
Chiropodist’s, or foot specialists, focus on the feet and ankles. They assess and treat the skin or the feet, joints of the feet and ankles, and even the toenails of the feet.
Issues with the toenails are more common than you think. We are often able to self treat “small” issues related to our feet but there are many things that if you see a Chiropodist early in the game, it makes for less problems.
What are some toenail issues a Chiropodist treats?
I can’t reach my toenails / feet
I can’t see my feet / toenails
My hands have difficulty using tools to cut my toenails
I can’t feel my feet
Ingrown toenails
Thick toenails
Cracked toenails
Black toenails
Bruised toenails
Toenail issues can happen at all ages. Even infants can have ingrown toenails!
Our North Oakville Chiropodists certainly see patterns. Certain toenail issues are more prevalent in people of different ages and with other health issues.
It is important to see a Chiropodist or foot specialist for your foot and toenail care because of their medical training and eye. They also use special tools that have been cleaned and sterilized properly. They are able to prescribe medications if they are needed such as topical creams. They will also provide education to make sure you are doing the right things at home.
Chiropodist Nasim
Chiropodist Arien
Contact us at our North Oakville Foot Clinic to book in with one of our awesome Chiropodists. We service patients from Halton, Oakville, Mississauga, Milton, and Burlington. Chiropody, or podiatry foot care, is covered under most private benefit plans. Unfortunately, while we are able to direct bill for massage, physio and acupuncture, we are unable to provide direct billing services for foot care at this time.
