The ancient Greek philosopher Socrates once claimed “When our feet hurt, we hurt all over”. The Kingston Foot and Ankle Clinic understands that and offers a state-of-the-art array of services to help promote a pain free recovery of your foot and ankle health. For convenient reference, we have included some of the more common symptoms and relief that we offer in he drop down main menu under the item “I am here because…”. If you do see your symptom or question here, please feel free to check our FAQ page or contact us. Our staff of friendly professionals will be happy to advise.
I Want to Try Laser Therapy
Laser therapy speeds the body’s natural repair response to reduce pain and inflammation and accelerate healing. It can be used for numerous conditions including but not limited to: plantar fasciitis, Achilles tendonitis, sprains and strains, circulatory issues and ulcers.
The Kingston Foot and Ankle Clinic uses MedX Phototherapy System that features Superluminous Diode (SLD) and Low Level Laser Therapy (LLLT). For more clinical information on how this laser works. Find out More
Laser therapy has been proven to increase local micro-circulation, accelerate tissue repair, reduce pain, decrease inflammation and/or edema, as well as enhance the immune response.
At our clinic, we have been using laser therapy to treat soft tissue inflammation and wound healing for many years with great success. Laser therapy appointments usually lasts about 30 minutes. There is no pain involved and you can simply sit back and relax or read a magazine. Your condition and the severity of it determines how many treatments you need and the frequency of the treatment sessions.
Our staff has had extensive training using the laser. Depending upon the specific condition and how long the area has been painful, the laser therapy can be micro-adjusted to deliver different amounts of either continuous or pulsing light. None of these options will be noticed by the patient, but such precision makes a big difference in how fast your condition resolves.
The Kingston Foot and Ankle Clinic specializes in offering laser therapy for conditions of the legs and feet. Our years of experience in dealing with so many such cases has provided us with excellent accurate data on how the tissues respond in these areas. NOTE: the Kingston Foot and Ankle Clinic specializes in lower limb treatment. Your initial appointment will involve assessing your condition to make certain that you are a good candidate for laser therapy. If so, we will then recommend a treatment regimen that works for most of our patients.
Conditions that we treat the most often include plantar fasciitis, Achilles tendonitis, arthritic joints, ulcerations, bakers’ cysts, Morton’s Neuroma, bunions, hammer toes, knee, hip and ankle pain.
Laser therapy can be covered under Extended Health Insurance coverage using your Podiatry/Chiropody visit coverage. If in doubt, please check with your insurance provider or contact our helpful office staff.
I want to learn about orthotics
A foot orthotic is a device that is worn under the foot, inside appropriate footwear, that alters the gait pattern or re-distributes weight in order to provide symptom relief of the target area. A pre-fabricated orthotic is one that is found commercially at drug stores and shoe stores that are already made and can be purchased in one size or simply the size of your foot. Many people can benefit from these appliances, as long as the patient is aware of their condition and which appliance to get. It is best to consult with your Chiropodist. A custom made foot orthotic is one that is made especially for you. Precise measurements are taken of your feet as appropriate for your condition. There are several ways you can take these measurements:
There are several ways that a patient’s feet can be cast in plaster of paris, the traditional method of gathering the information needed for the orthotic. The way the patient is cast, i.e. standing, neutral, semi-weight bearing, etc., depends on the patient and the condition being treated. Foot specialists rely to this day on plaster casting for the accuracy of information it captures which determines the success of the orthotic. The Kingston Foot and Ankle Clinic exclusively uses plaster casting techniques for all orthotic appliances.
Computerized Pressure | Gait Analysis
There are several computerized gait analysis programs on the market today that try to capture the patient during standing and/or walking. The measurements taken, however seem to differ somewhat depending on how many times the patient walks over the mat or the posture of the patient while standing, etc. Most foot specialists do not use computerized gait analysis as the only method in obtaining the measurements for their orthotics, but the software and equipment’s effectiveness will depend on the qualifications of the practitioner. If you are thinking about this method, make sure you are seeing a Chiropodist/Podiatrist to determine if weight-bearing measurements can work for you. It is our opinion that, in our experience, these orthotics are not aggressive enough to treat many of the conditions we see on a regular basis.
There are ink pads and foam boxes that have been on the market for many years that provide a rough measurement for orthotic devices. We feel that there is too much of a margin of error if you are trying to get the patient’s foot in a specific position and decreases the effectiveness of the therapy. However, we have found for patients who require only a light prescription, this method has been proven to be successful.
Why Is Orthotic Therapy So Popular
Many people today are not willing to give up their profession or their sport simply because they have developed some back pain, or knee pain, etc. They want to find a solution and they are not satisfied with the traditional medication of anti-inflammatories or surgical options. Foot orthotic therapy works for a large section of the population.
A biomechanical exam from a Chiropodist/Podiatrist is required to determine if orthotic therapy can help you and to what degree.
Currently in Ontario, foot orthotics are not regulated. This means that when you choose a clinic to go to, you may not be seeing a Chiropodist/Podiatrist simply because they have orthotics in their advertising. There are many commercial labs that manufacture foot orthotics for chiropractors, family doctors, nurses, physiotherapists, and others with staff that have little or no medical training.
Only a Chiropodist\Podiatrist has the proper intensive training and continuing education in orthopaedic materials to offer the correction of biomechanical dysfunction through the use of orthotic therapy.
Some of these commercial labs, in order to keep orders high, offer one-day and weekend training seminars to get anyone interested in orthotics. Many health professionals can be seen advertising that they offer orthotic therapy on the side. Our clinic regularly sees patients that have obtained orthotics from less qualified commercial clinics only to be told that nothing could be done when the therapy was not working. Protect your investment: check the qualifications of the practitioners at the foot and ankle clinics- make sure that there is a registered Chiropodist/Podiatrist on staff!
How Does An Orthotic Work At Our Clinic
After the cast is taken of the foot in the desired position that is going to help the patient the most, the hardened plaster cast is then filled with liquid plaster and set to dry. After the cast is dry, the outer shell (the part that came off your feet) is removed to expose a positive impression of your foot in that position. The technician will then apply the prescription to the cast. This is done by adding or removing plaster and by measuring the different areas of the foot to achieve the desired shape.
For example, if the patient had a severe corn under his big toe joint, we will have to look at what is causing that corn. The metatarsal arch may need to be raised, the area itself will need deflection, the position at the ankle may need to be corrected, etc.
After the plaster work is done, the cast is set into a vacuum former. This machine will take the heated material that is going to be molded to the foot exactly.
The materials chosen for a patient are as important to the whole treatment as the casting technique. A soft comfortable orthotic, for example, may not be beneficial for a 300 lb man that has rolling ankles and knee pain – everyone must be treated individually!
When the material has cooled and the desired shape of the molded material is set, it is removed from the cast and taken out of the vacuum former. The “shell” which this material is now called is then ground on a machine to form it into the shape that will fit into the desired footwear.
After this is done, a top cover is then chosen to be applied to the shell. Again, the selection of materials used depends on the success of the orthotic. Once this is adhered, the final product is buffed and is ready for a fitting.
One benefit of a clinic that has it’s own orthotic lab, is that there is short turn-around times before you get your new appliances and that all repairs and adjustments can be done in house, rather than sending casts or orthotics out for adjustments. It can take weeks before they return to the clinic and then you are waiting for an appointment to get them again.
The staff at our clinic actually see and know the patients that they are making custom made appliances for, so all of the criteria that goes into the orthotic are gathered, such as activities of the patient, types of footwear worn for dress, sport, work and hobbies, weight, problems they are experiencing, etc.
Our Orthotic Lab
We take great pride in our orthotic appliances and choose our materials very carefully at the Kingston Foot and Ankle Clinic. New materials are introduced into the marketplace all the time and we test their effectiveness thoroughly before we add them to our list of over 40 different orthopaedic materials. We only use non-caustic glues which are healthier for everyone. We offer a full range of services for any type of orthotic from any lab.
Footwear itself can, to some degree, determine the success of the orthotic appliance. The greatest orthotic in the world, may not be able to reach it’s full potential in an ill-fitting shoe or boot. Our staff can give advice regarding the many different types of footwear that would be suitable for each patient depending on their prescription. Today, many of the orthotic appliances are not as bulky and thick as they once were, and most have thinner shapes that can be accommodated in existing footwear. Today, we stock many materials that are rigid enough to provide the support over the long term, yet have some ‘bounce’ to avoid a ‘hard’ feeling when there is no give to the material. Of course the actual characteristics of any patient’s orthotic will depend upon the prescription. However, the orthotic is the most important part of the equation. If a patient requires a special top cover that will be thicker, i.e. to defect pressure from a corn or an arthritic joint, there are still many choices today to choose from in footwear that does not appear as ‘orthopaedic’ looking as was the case in the past.
Private Insurance Coverage
Private insurance companies are doing their part in trying to regulate orthotic therapy by requiring a prescription for orthotics that include a biomechanical assessment, materials used, and so on. A Chiropodist/Podiatrist has full prescription rights and is usually preferred by insurance companies. The Kingston Foot and Ankle Clinic will provide the patient all the necessary documentation that is required for your insurance coverage.
We are a provider for the following government programs:
- Veterans Affairs Canada
- Workman’s Compensation Board
- Department of National Defence
- Indian Affairs
How You Can Get Seen At Our Clinic?
The simplest way is to click on our Contact Us main menu item at the top of every page. Alternatively, the clinic telephone number appears at the bottom left of every page. There is no referral required. Usually we can provide appointments within 2 weeks of booking. Appointment times run from 30-45 minutes in length.
You will be provided all of the information that you require for insurance company reimbursement at the completion of your treatment. You will also have the option of sending a copy of the information of your condition/results to your family doctor, if desired.
Neuro Cryo Stimulation
Neuro Cryo Stimulation, also known as hyperbaric gaseous cryotherapy, is a drug-free, non-invasive treatment of pain, inflammation and musculo-skeletal trauma.
The treatment stimulates the nervous system by the use of CO2 at -78°C under high pressure which causes the skin temperature to fall from 32°C to 2°C within 30 seconds, creating a ‘thermal shock’ factor.
The treatment’s physiological effects on the body include:
Analgesic: Quickly provides relief for approximately 3 hours!
Vasomotor: It triggers a rapid cycle of constriction and dilation to drain the vascular system of substances that cause pain, inflammation and swelling. It re-balances the pressure of body fluids that cause swelling and pain.
Anti-Inflammatory: It controls the production and synthesis of the enzymes that are responsible for acute inflammation.
Muscle Relaxant: The above three effects combined with the vibration from sound waves help the muscle fibres to relax.
The efficacy of this efficient treatment is validated in many areas where there is pain including: Rheumatology/Osteoarthritis, Trauma/Sports Injuries/Bruising, Post-surgical, Vascular, Inflammation, Edema, Sciatica, Sprains, Plantar Fasciitis/Heel spurs/Morton’s Neuroma/Achilles Tendonitis.
I Have Heel Pain
Heel pain is a very common complaint with patients who attend the foot clinic. The most common condition that causes heel pain is Plantar Fasciitis.
Plantar Fasciitis is a very common ‘overuse’ injury that can strike at any time, at any age, men or women. The most common time for experiencing heel pain is first thing in the morning, after you get out of bed or after resting, and after you have been sitting for a while or driving. Once you resume walking for a while, the symptoms usually become less severe. However, if the condition persists, you will notice that pain in the heel will become worse as the day goes on or the longer you have been on your feet. It is also characterized by being intermittent or some days it actually feels like it is improving, only to be followed a few days later by becoming worse.
The Plantar Fascia is a non-elastic band of fibrous tissue that is connected to your heel bone and runs through the bottom of your foot spreading into five bands and attaching to the metatarsal joints of the forefoot. The heel pain comes from pulling of the fascia from the heel bone, causing pulls and tears, inflammation and pain. You can also get some micro-tears along the fascia, which could result in arch pain and forefoot pain. The longer this goes on, the more pulling on the heel bone, the more new bone will be created at these sites. The result is a heel spur, which is common on x-ray, but not the actual cause of the heel pain.
Treatment for this condition is recommended as soon as possible, as it only worsens with time. At the Kingston Foot and Ankle Clinic, we will take plaster of paris casts of both feet in the non-weight bearing position. We then make custom made orthotic appliances to support the plantar fascia and eliminate the pull on the heel and the forefoot. These orthotics slip right into your footwear and allow the healing of the plantar fascia while you go on with your daily activities (much like an arm sling). Pain usually subsides within a few days, depending on the length of time the condition has been going on and the severity of the tear.
For persistent heel pain, we use laser therapy. The laser is used to break-up or disperse inflammation at the site of the tear to reduce pain and accelerate the healing process. This is a painless procedure where you sit comfortably in the chair and the pedorthist applies the light therapy and then the laser to the affected area. Treatments generally last from 20-30 minutes.
At home we recommend that you rest the feet as much as possible, and replace high-impact exercise with lower impact activities while you are still having heel pain. Extra weight gain can also aggravate the problem, so keep your body weight in check and put off lifting heavy objects as this puts more stress on the plantar fascia.
We also recommend that you switch to a more supportive shoe for most of the day, even in the house. Take out an old pair of running shoes for in the house so you have them by your bed. This will avoid stepping into the floor in the morning without support. You will need these with your orthotic appliances in them, and wearing them first thing out of bed will greatly improve your speed of recovery.
Hot and cold therapy is also very beneficial to reduce some pain, especially after you get home from work. You should put the feet in moderately warm water for 2-5 minutes followed immediately with 2-5 in (5-12 cm) of cold water (or use ice packs). You can do this several times a day to a maximum of 10 times per session. This process greatly reduces the inflammation and promotes healing.
There a few exercises that you can do to prevent re-injury but take caution while the heel pain still persists:
- Use a cold soft drink can sideways on the floor and roll your foot over, back and forth, massaging the muscles in the arch. 2 minutes at a time, several times per day, go gently if pain is still persistent.
- Towel curls can strengthen the plantar fascia by trying to pull the towel towards you, on the floor, with your toes. You can add a weight to the towel to make it more difficult. Make the towel come towards you like an accordion.
- Try curling your foot around a can or the shin of your other leg. Repeating this exercise strengthens the muscles in your foot as it tries to grab around another object.
- Stand with your feet together, then rotate your knees outward while you are attempting to stay on the floor using the muscles of your feet. Hold for about 10 seconds and then relax. Repeating this exercise will take some pain away in acute cases that are very painful, and is also beneficial in prevention.
Other conditions that can produce heel pain include a fracture of the heel bone, slivers or embedded objects, fissures or severe cracks in the skin, plantar warts and problems with the fatty padding.
It is important to attend the foot clinic to make sure you know what is making your heels sore. A proper diagnosis and treatment plan will ensure prompt complete recovery so you can get on with life!
I Am An Athlete… My Feet Hurt
Our job is to keep you in your sport and active over your entire lifetime. The more active you are, the healthier it is for your whole body.
However, sometimes our sports may cause some pain in our feet and elsewhere. The most important thing you can do, is listen to your body. Do give it some rest when it requires it. You need your body for a lifetime and no sport is enjoyable when your feet hurt!
Being an athlete of any kind usually puts more strain on your feet, be it great stress from time to time or small amounts on a more constant basis. You should already know the times that are the most stressful for your feet during your particular activity. For example, runners running up or down a hill, can put more stress on the toes.
Appropriate footwear is of course key when participating in any physically demanding sport. While most athletes recognize the importance of their sports footwear, we often see that same athlete in the clinic wearing non-sports shoes past their lifespan.
Check to make sure the shoe still has support in the counters (the part around the ankle), support in the sole (has it worn out in areas, cracks?), is the inside coming apart, is the fit still comfortable, are they more than 6 months old? Give the footwear a good inspection and if you are coming to the foot clinic, bring the shoes that you have been wearing, they will usually tell us quite a story.
Another thing we will check for is soft tissue lesions such as blisters, callus, corns, fissures, fungal infections and plantar’s warts. All of these conditions are easily treated but can be cause for considerable discomfort in any sport. Blisters and callus may tell us that the footwear does not have the right fit or the style may be wrong for the width of the foot. If you notice any of these things, have them treated right away. Dismissing these problems as “minor” or “trivial” will invariably soon interfere with your enjoyment of regular daily activities.
Activities that do not require footwear, such as martial arts, gymnastics and swimming, may call for some special taping or bracing during activity for a time until the foot condition resolves. Some patients are able to do their activity only with a special footwear designed for them – don’t give up on your sport, there may be something that can help you.
One of the most common conditions we see in sports is rearfoot inflammation: Plantar Fasciitis and Achilles Tendonitis. Like all soft tissue injuries, there are several ways to treat them. Initially while at home, remember RICE: Rest, Ice, Compression, Elevation — listen to your body. We use orthotic therapy, laser therapy, padding, strapping and taping and footwear modifications where needed to get you back on your feet as soon as possible.
Athletes come in every size and age, whether you are a marathon runner or just walk for exercise, we want to keep you on your feet. Don’t put off treatment any longer.
I have thick | discoloured nails
Thickened and/or discolored toenails are a very common site in any foot clinic. Toenails can become thickened as we age, with injury, with some skin conditions such as psoriasis, and with fungal infections. It is best to find out what is making your nails thickened or discolored, there is help.
Often people attend the foot clinic for their nails, not because they are painful, but because they don’t look the best. They can become discolored with yellow and browns and become difficult to cut. They sometimes do not feel comfortable in footwear if the nails thicken too much and their feet do not look great with sandals. Often any kind of nail cutting at home is impossible.
At the Kingston Foot and Ankle Clinic, we assess the toenails to find out the cause for the thickening or discoloration. In the case of thickened nails, we initially reduce the thickness of the nails in a pain-free way that immediately makes them look and feel better. Sometimes we will offer home care instructions, such as recommending a solution or a cream, for keeping the nails thinner. Sometimes we recommend using special nail nippers at home that are made to manage your type of problem.
We advise that you not spend a lot of money on off-the-shelf products before you know exactly what is causing the condition and how best to meet your individual needs. Unfortunately, there is plenty of dubious information on the internet and the sometimes deceptive advertising of large pharmaceutical companies can easily mislead or confuse.
If the nails are thickened and discolored due to a fungal infection, we recommend treating the fungus in order to restore the nails back to their normal state. There are many topical and oral medications as well as natural options available to treat the cause. The type of fungus found, the specific way in which it affects the nails, along with the patient’s individual medical history will determine which options would be best for you. In most cases, we recommend starting with medication along with regular treatments of debridement (thinning the nails) along with some treatments to use at home.
Important Update: The Kingston Foot and Ankle Clinic now offers state of the art laser therapy for the treatment of fungal nail conditions. We have more details here: Laser Therapy for Nails with a Fungal Infection.
We recommend that women do not wear nail polish when they have a known fungal infection. This practice will allow the fungus to spread more rapidly among the nails. Do be careful when seeking pedicures. Ensure that the service provider only uses STERILIZED instruments. Feel free to ask them how they sterilize their instruments. They must use an autoclave! Fungus is extremely contagious, and it is takes a long time to clear up in toenails. Some toenail treatments take over 2 years to completely be free of fungus.
Most thickened toenails require some type of regular treatments by a qualified professional Chiropodist for truly effective foot care management. Some patients need to come once a month for a period of time and some can come every 3 months depending on the condition. Our staff is highly trained in state-of-the-art techniques to ensure that we properly identify your specific condition, provide effective treatment and help you to avoid future problems. Contact us today and find out how you can take control.
I Have Plantar Warts
Plantar Warts (Verruca) a found most commonly on the bottom or ‘plantar’ area of the feet. Warts are caused by a virus that is common and grows in warm moist environments such as change rooms and pool areas. There are several different types of warts that affect the feet and they all present in a variety of ways. They could appear alone, in several areas of the foot, or grouped in clusters. They could also form a solid mass that becomes very thickened and will take up a large area of the foot.
Most of the time, what you see on the surface of the skin is only a small fraction of the actual size of the wart. Much like an iceberg, the largest part is found below the surface. Warts can be very painful or you may never even know you have one. We worry more when people are not aware they have warts and could be spreading the virus without even knowing it. It is important to inspect your feet on a regular basis for any lesion that looks suspicious, and attend the foot clinic to see what the best course of action is for you.
We recommend covering any warts, even those undergoing treatment, with a water-proof bandage during barefoot activities in order to prevent spreading the virus. Check other family members to make sure that they have not picked up some warts from sharing a shower at home. All infected individuals in the home should be treated at the same time.
There are some drugstore remedies available that seem to have limited effectiveness on plantar warts. If the wart is new and very small, you may want to try an over-the-counter remedy to see if that eliminate the wart. If it continues after several weeks, or if you see more, or if other members of your family get them, then it is time to come to the foot clinic. Here at the Kingston Foot and Ankle Clinic we have several types of topical treatment specific to your type of plantar wart. Often as little as 2 or 3 treatments are needed, depending on how long it has been there.
If you have been treated at the clinic, you will experience a blister formation under the skin, under the wart, that attacks the part that is hard to see. These can be quite painful for a few days and it is best to try and avoid being on your feet for long periods. Wear comfortable footwear and you can tape or add felt pads for cushioning during this period.
You will be advised that there is no risk of infection at that point, although sometimes it looks purple or yellow around the warts and can appear red with inflammation. It will also be advised to avoid puncturing the blister as this can let bacteria into the site. After a few days, the blister will subside and be more comfortable. If in doubt, please feel free to call the clinic.
I Have Foot And Ankle Pain
There are many conditions that can cause foot and/or ankle pain. The most important advice that we can offer, is to have the condition/pain assessed. If you have had other health professionals previously assess your symptoms, or perhaps have even had treatments but with no success, do not give up! You should still research and find all possible solutions to your pain.
Our expectation, is that, even if we can not completely eliminate the pain, we hope to give you tools so that you can manage the pain and become healthy and active again.
We see a considerable foot and ankle pain in patients who are older, but the condition is due to sports injuries while they were much younger. We tell all our younger patients to get the proper treatments after injuries and the proper prevention before (such as proper footwear and/or orthotics and bracing) to not let these injuries linger. Trying to prevent chronic injuries and re-injury is of course, the most important and effective way to help prevent chronic pain as we age.
Conditions such as arthritis, diabetes, surgical modifications, etc. can all require some special treatments from your Chiropodist/Podiatrist. There may be callus and corn formation resulting in considerable foot pain that may often be traced to altered walking patterns. These formations can be easily removed and provide immediate relief. Orthotic appliances and/or footwear modifications can also be used to prevent recurrence of soft tissue ailments.
Laser therapy has been proven to be quite helpful as well for a large variety of foot and ankle pain. Whether it be from old injuries or arthritis, soft tissue injury such as sprains, plantar fasciitis, Achilles tendonitis, baker’s cysts, Morton’s Neuroma, metatarsalgia; all of these conditions either can be eliminated or the healing accelerated. Laser therapy can be used alone or in combination with other therapies such as orthotic appliances and footwear modifications.
There are many taping applications that can also be helpful in short term for chronic foot and ankle pain. The Kingston Foot and Ankle Clinic has also successfully used a variety of taping techniques in order to alleviate some types of foot or ankle pain. Many of those techniques can be used by the patient at home to help stabilize a muscle group or reduce the range of motion a weakened or injured joint.