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Many different disorders of different body systems can affect the foot. For example, rheumatological disorders result in pain in the joint in the foot. Problems with the vascular system can have manifestations in the foot. So do dermatological disorders affect the foot, as it has skin just like every other part of the body. However, what is unique about the foot is that we walk on it creating a lot of forces and pressures that the rest of the body is not subjected to. We also place the foot into a tight-fitting shoe that is a dark and moist environment. Both of these issues mean that skin disorders affecting the foot are somewhat different to skin disorders in the rest of the body. For this reason an emerging field of podiatrist who specialise in disorders of the skin is emerging.
In one episode of the podiatry talk show, PodChative one of these experts, Ivan Bristow, was interviewed. Dr Ivan Bristow, PhD is a podiatrist in the United Kingdom. For most of his career, Ivan has developed a special interest in dermatological conditions that affect the feet. He initially spent over 11 years working full time within the National Health Service as a podiatrist. While working in Oxford, a chance meeting with a Dermatologist, allowed Ivan to establish the UK’s first dedicated foot clinic within in a dermatology department. He ran that department for almost ten years. He now has over 100 published papers on the subject of foot dermatology, including four text books. In the episode of PodChatLive they talked the use of and role of Dermatoscopes, Woods lights and the new 5-minute fungus test. They also talked about the best emollients and anti-fungals for the feet and of course take little trips down memory lane to when Ivan taught one of the PodChatLive hosts at University around 18 years ago.
The concept of foot orthotic dosing is been getting some more attention in recent years. It is based on the analogy of drugs dose. Each person who is on a different drug or medication for a medical condition should theoretically be on am individual dose or amount of that drug. The same should be the case for foot orthotics. A different “dose” of foot orthotic should be used. Too often foot orthotics are all given the same dose of foot orthotic, especially in clinical studies or research. An episode of the regular podiatry livestream, PodChatLive addressed this issue. The hosts of the show chatted with Simon Spooner to try to highlight some of the limitations of foot orthoses research based on the concept. They talked about the way clinicians should be viewing all conclusions from research made in the context of those limitations. They discussed about what “perfect” foot orthoses research may look like, the things we may want to ‘measure’ and the apparent discourse between the lab and the clinic. Most importantly they discussed what ‘dosing’ is, and how it may help us answer questions which are currently unanswered.
Dr Simon Spooner qualified as a Podiatrist in 1991 graduating from the University of Brighton, and in addition to his BSc in Podiatry, he was awarded the Paul Shenton prize for his research into callus. He then went on to complete his PhD in Podiatry from the University of Leicester in 1997, where he studied the causes and treatment of inherited foot problems. Simon is now the Director of Podiatry at Peninsula Podiatry. His practice specialties include sports medicine, foot orthotics, and paediatric and adult foot and gait abnormalities. In addition to his own clinical practice, Simon has published a number of research articles on podiatric care and has delivered papers at both national and international conferences, and provided postgraduate training for a number of NHS Trusts.