A podiatrist is a specialist who specializes in treating pathologies of toenails and feet. Just 10 years ago, few people had heard of this profession, and finding a competent expert was difficult.
But you can’t argue with the statistics: more than 50% of people experience nail diseases, calluses, corns, and foot deformities. This percentage is growing every year, which means the answer to the question of whether a podiatrist is needed at all can only be affirmative. The profession is in demand, especially among older people.
Who is a podologist?
A manicurist, pedicurist with deeper knowledge, or a doctor like a gastroenterologist, cardiologist, or neurologist?
In fact, neither the first nor the second. Let’s be honest: in Russia, the profession of “podiatrist,” as in other CIS countries, is not included in the list of medical specialties, so legally a podiatrist is not a doctor.
In Europe, America, Canada and other foreign countries the situation is different. There, the profession of podiatrist is officially recognized. Podologists are seen in clinics and hospitals. They collaborate with orthopedists, traumatologists, surgeons, and dermatologists. Although, to become and work as a podiatrist, basic medical education is not required.
Compared to a pedicurist and manicurist, a podiatrist’s work is aimed at preserving the health of the feet, care, identifying pathologies in the early stages, and treatment. This requires knowledge of anatomy, biomechanics, and physiology of the foot, which he receives in specialized courses. And clients come to a pedicure or manicure specialist for external beauty: to apply makeup, nail extensions, apply gel polish, and get a design done.
A little history
As a separate branch of science, podology originated in Germany in the last century. It all started in 1923 with the production of equipment and special tools for pedicures and is associated with the names of Christian and Helmut Ruck. Modern materials and devices for podiatry of the Hellmut Ruck brand, founded back then, are characterized by the highest German quality, convenience, and reliability.
In 1929, Helmut Ruck opened the first foot care training school in history, after which graduates faced a serious exam. The development of podiatry proceeded at an active pace, more and more schools and even a college for training masters of orthopedic shoe technology appeared (1948, Hannover). Today this college has transformed into the School of Podology, which in 2003 was recognized as the largest in Germany. In addition to specialized subjects, medical disciplines are taught there.
Over the next decades, methods were improved, new tools, cosmetics and preparations for treating the foot appeared. Cooperation was carried out with clinics and enterprises producing podiatry products.
Germany remains the world leader in this field to this day. The profession of podiatrist is officially recognized here and is considered prestigious. At the state level, the “Law on Podology” has been adopted.
In Russia, podology as a separate field began to develop in the late 90s. The impetus for this was the appearance on the market of companies that offered equipment for hardware pedicure for podiatry, furniture, equipment, and tools. Representatives of these companies additionally trained their clients, namely pedicurists, in working with the products they sold. Later, after 2010, special courses for podologists began to appear, the program of which included not only basic care, but also had a medical bias.
What does a podiatrist do?
A podiatrist provides nail treatment and care. Deals with complications of injuries, dermatological, endocrine, orthopedic diseases that affect the foot.
At the reception, the podologist:
- Performs medical pedicures without applying decorative varnish.
- Consults on the care of nails and skin of the feet, recommends products for home use, taking into account the client’s skin type and problems.
- Treats nail fungus (onychomycosis), cleans the affected areas of the nail plate, selects medications, and, if necessary, refers to a mycologist.
- Helps with peeling or ingrown nails, installs corrective plates, staples, tamponade.
- Corrects distortions in the shape of the nail plate.
- Treats changes in the skin of the feet (calluses, corns, cracks, hyperkeratosis).
- Selects interdigital correctors, insoles, orthoses.
- Provides care for problematic feet with diabetic foot syndrome and in older men and women.
Due to the use of modern techniques, tools and materials, sessions with a podiatrist take place without pain or with minimal discomfort. When identifying diseases, he conducts a thorough examination, questioning, and finds out the cause so that there is no relapse in the future.
What to do with a deformed nail?
As a result of injuries, previous diseases or congenital characteristics of the body, the structure of the nail plate may change. Deformation causes pain and chronic discomfort. To treat a deformed nail, one session of medical pedicure is usually sufficient.
Symptoms:
- formation of depressions, bulges or cracks at the base on the nail plate;
- change in nail color;
- curvature of the nail;
- a sharp increase or decrease in the thickness of the nail plate.
The podologist will conduct an examination, make a diagnosis and eliminate the cause using a therapeutic or hardware method. In advanced situations, the doctor writes a referral to a surgeon.
When to contact a podiatrist?
A consultation with a podologist will not hurt anyone, including even a child. He will teach parents how to properly care for and cut their baby’s nails. This is important, since correct foot care habits instilled from childhood are the key to the absence of problems in the future.
Teenagers will learn about hygiene rules, how to choose shoes, and what coatings are safe to use to decorate the nail plate on their feet.
For adults, a podiatrist does therapeutic and preventive pedicures and works with existing complaints. Everyone over 40 years old needs his consultation at least once a year. Especially for people who are overweight, women who wear shoes with narrow toes, high heels every day, as well as those whose professions involve intense stress on the lower extremities.
Older people need to visit a podiatrist regularly. The risks of diseases of the nails and skin of the feet increase with age, and it is better to identify them in the early stages. For example, nail fungus occurs in half of people over 60 years of age.
Reasons to contact a podiatrist include:
- core calluses, corns, cracks;
- increased blood glucose levels;
- excessive sweating of the feet;
- plantar warts;
- nail fungus;
- ingrown nail;
- frequent cramps in the foot area;
- pain, feeling of heat, cold, itching, burning in the feet;
- swelling of the legs;
- delamination, curvature, change in color of the nail plate;
- uneven wearing of shoes;
- foot deformity (bump on the big toe or little toe, flat feet, clubfoot, hammertoes, etc.).
Diabetic foot: features of the syndrome
Diabetes mellitus is a serious disease that affects the quality of life. Diabetes also affects the foot; pathological changes occur in the tissues.
With diabetes, it is dangerous to have any wounds; they can become infected, and loss of sensitivity leads to the development of serious diseases. Symptoms of foot syndrome include thickening or thinning of the skin and the appearance of cracks. If you have diabetes, careful attention to the condition of your feet is required.
If an ingrown toenail appears, you should immediately contact a podiatrist, as even a small wound can cause major health problems. It is necessary to remember the increased risk of developing gangrene and not to self-medicate. Patients with diabetes should be monitored by an endocrinologist and regularly visit a podiatrist to receive quality care.
How to choose a specialist?
To find a good podologist in Moscow or another city, you will have to analyze a lot of information. The difficulty is that in Russia there is not yet a legislative framework regulating podological practice and standards defining this profession. Therefore, there is a risk of getting to an inexperienced specialist with insufficient qualifications.
Each podiatrist bears responsibility for the quality of personal education and skills. It is important that he is competent, interested in professional development, and strives to help the client, and not to earn money for an appointment.
When choosing a podologist:
- look where he works, whether this place inspires confidence;
- read reviews about the work of a podiatrist from real people;
- inquire about education, diplomas, certificates;
- evaluate working conditions, cleanliness, equipment, sterility;
- check your readiness to answer questions and explain actions.
People are sometimes scared by how much podiatrist services cost, so they refuse to go to an appointment, hoping that everything will go away on its own. They begin treatment themselves using folk remedies or look for cheaper options. Procedures from a professional podologist cannot be cheap, because he uses expensive instruments, drugs, devices, and invests in education and advanced training.
Following low prices, there is a chance to get to novice specialists who want to get practice and gain experience.
Who will replace the podiatrist?
If there is no podiatrist in your city, a doctor from the clinic or a manicure-pedicure specialist will help with some foot problems.
Who to choose depends on the type of violation:
- calluses – pedicurist;
- onychomycosis – dermatologist, mycologist;
- ingrown toenail – surgeon;
- flat feet and other types of foot deformities - orthopedist, traumatologist;
- diabetic foot – endocrinologist, surgeon, neurologist.
But when contacting them, you should not count on comprehensive treatment, clarification of the cause of violations, or measures to prevent relapse. Doctors will help relieve the acute condition, remove pain, inflammation, but no more. In the absence of a podiatrist, it is most difficult for people with several problems at once, since in this case it is not clear where to turn first.
For example, nail fungus or ingrown toenail due to diabetes.
It is easy to understand how the approach of a doctor and a podologist differs, using the example of treating an ingrown toenail. The surgeon will simply remove the nail or a significant part of it, which will result in an unpleasant rehabilitation with an unknown result.
After all, after such treatment, the likelihood of relapse will be high. Unlike a surgeon, a podiatrist will install a bracket or a correction plate on the nail, which will correct the direction of growth and relieve pressure on the sore spot. The procedure will be painless, and the nail plate will be preserved as much as possible. The podiatrist will also find out the cause of ingrown toenails, advise on how to change nail care, and choose shoes so that the situation does not recur in the future.
Features of an appointment with a podiatrist, diagnostic methods he uses
For a consultation with a podologist to be successful, the patient must prepare for it:
- Remember and write down all the details regarding the disturbing symptoms - when the problem arose, what it is expressed in, with what frequency and under what conditions warning signs occur, what methods help alleviate the condition. Remember or find out if blood relatives have similar problems.
- Prepare medical documentation, if the patient has one - medical card, insurance, results of previous studies.
- Carry out hygienic procedures, after which there is no need to apply any cosmetics or medications to the affected area.
- Wear comfortable clothes (not tights, but socks) and comfortable shoes in order to bare your feet painlessly and quickly.
An appointment with a podiatrist begins in the same way as with any other specialist - with anamnesis collection. For this purpose, the doctor will ask standard questions regarding the patient’s lifestyle, professional activities, symptoms of the disease, as well as questions about the presence or absence of any acute or chronic diseases.
After collecting anamnesis, the doctor may ask the patient to take off his shoes, socks and make some movements with his feet and toes. If flat feet are suspected, the podiatrist will perform a plantogram. During the procedure, the patient stands with the bare soles of his feet on a surface coated with dye, and then on a clean sheet. The doctor will evaluate the ratio of the width and length of the foot and determine the degree of flatfoot, if any.
Next, the doctor will invite the patient to sit in a special chair, which is designed for the convenience of the patient and the doctor, and will conduct a visual and palpation examination of the feet.
Depending on the clinical picture, the doctor may prescribe additional laboratory and hardware tests:
- Examination of the skin using a Wood's lamp.
- General clinical blood test for the presence of markers of inflammation in the body.
- General clinical urine analysis, which allows you to detect the release of fungal mycelium in mycoses of the feet.
- A blood sugar test may indicate the development of diabetes.
- A blood test for cholesterol levels helps in identifying blockages in the blood vessels of the lower extremities.
- X-ray of the foot or feet in two angles (projections) - helps to calculate the angle of inclination of the arch of the foot, the size and shape of bone tissue, and diagnose pathological growth or deformation of bone tissue.
- CT or computed tomography, including using a 3D tomograph, makes it possible to obtain a clear three-dimensional image of the tissues of the foot. Helps assess the structure and condition of bone tissue, tendons, and joints.
- Ultrasound – allows you to diagnose the presence of blood clots in the vessels of the lower extremities.
- Taking a smear or scraping of the skin and nails for laboratory diagnosis of mycotic lesions of the tissues of the feet.
Then there can be three scenarios:
- The patient is sent for further examination and treatment to another specialist (dermatologist, mycologist, surgeon).
- Having made a preliminary diagnosis, the patient is sent home until the test results are received, without which it is impossible to prescribe treatment. Therapy is prescribed at a follow-up appointment with a podologist, or based on the results of the research, the doctor will refer the patient to another specialist.
- Treatment occurs immediately after diagnosis - this mainly concerns diseases of the skin and nail plates.
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