Biomechanics is the science of movement of a living body, including how muscles, bones, tendons, and ligaments work together to produce movement.

A podiatry biomechanical assessment involves an examination of the lower limbs, looking at their structure, alignment, and function. The assessment looks for any irregularity which may contribute to pain in your feet and lower limbs, or for abnormality which may contribute to callus or corn formation.

The foot is a complex structure of 26 different bones, 214 ligaments and 38 muscles, bearing our body weight as we walk every day.

The examination is not focused simply upon the foot but includes the pelvis, hips and knees, assessing the relationship between them. It is important to examine the lower limbs because they are closely connected and pain in one area can be due to a weakness or structural problem in another area. A biomechanical assessment forms part of a comprehensive assessment to understand pain or dysfunction in the lower limbs.

What happens during a biomechanical assessment?

During your appointment the Podiatrist will ask you detailed questions about your concern or problem and how this is affecting you. A full medical history will be taken at the start of the assessment. This will entail multiple questions being asked regarding your general health and well-being, any medications you may be taking, any previous medical or surgical interventions and also social questions such as exercise levels, alcohol consumption and smoking. This information is essential to help form a correct diagnosis and safe treatment plan. If you omit this information, there may be a delay in diagnosis or appropriate treatment.  The Podiatrist will then perform a full visual examination. The Podiatrist may need to examine your feet, legs, thighs and on some occasions your back. To aid this examination it is useful to bring a pair of shorts or active wear. Please do not wear skirts or tight clothing which will impair proper visualisation.

How long does a biomechanical assessment take?

It takes between 30 minutes to one hour to complete all the tests necessary, discuss the results and advise on the recommended treatment.

What sort of treatment will I need after a biomechanical assessment?

There are many different types of recommended treatments following a biomechanical assessment, depending upon your results. All advice and treatment will be bespoke depending on the problem and general health of the patient. For example, there is a strong link between obesity and foot and leg pain. If you are over-weight, your podiatrist is likely to suggest weight-loss as part of your treatment and may refer you to the local dietetics team for nutritional and dietary advice.

 For people who have good structural foot mechanics, the podiatrist may advise on suitable footwear in order to reduce the risk of foot problems. Simple changes such as wearing structured supportive shoes such as sports trainers can be very effective and ensuring the correct fit of footwear can be crucial for normal foot function.

For many biomechanical problems, there is frequently a combination of tight and or weak muscles contributing to pain. Almost always, a structured exercise programme involving stretching and strengthening exercises will be provided. It is crucial that if you are provided with exercises, that you fully engage with them to stand the best chance of resolving your pain.

If the podiatrist believes that your mechanics could be contributing to your injury or pain, insoles / orthotics can be prescribed. These are similar to spectacles for your eyes, in that the prescription and style for these will depend on what the treatment goals are. These may be off the shelf or custom made depending on the individual requirements of the patient.

If a biomechanical assessment indicates that surgery may be necessary to resolve pain or correct deformity, our podiatrists work closely with the Podiatric and Orthopaedic Surgery teams and can refer into these teams for an opinion. By working alongside surgeons, we ensure conservative approaches are used, where appropriate, but can offer surgical treatment when required.

Domiciliary care is defined as the range of services put in place to support an individual in their own home. All treatments that are provided under routine podiatry care can be offered under domiciliary care.

Generally, patients will be eligible for domiciliary treatment in the following situations:

  • Where the patient is totally bedridden.
  • Where medical conditions or mental health problems confine the patient to the home.
  • Where medical conditions result in poor mobility and an increased risk of falling.
  • Where the patient would require a two-person ambulance for hospital appointments.

The following patients will also be considered for domiciliary treatment.

  • Patients who are unable to get out without assistance and who don’t have any help.
  • Patients who are housebound as they are designated full-time carers and are unable to get out.
  • Where, in the opinion of the Podiatrist, it may be more practical to see the patient at home (as with the severely frail who are housebound).
  • Where the patient’s medical conditions create a risk if they attend clinic.

The following patients will not be considered for domiciliary treatment.

  • Patients who can independently leave the house.
  • Patients who can perform shopping, leisure or social engagements by themselves or with a chaperone.
  • Patients who have a family/friend/carers who can take them out of the house.
  • Patients who can attend clinics using modes of transport.

Nail surgery is the removal of all or part of the toenail. An injection of local anaesthetic into the affected toe is used so that you will feel no pain during the procedure. After the removal of the nail, a chemical may be applied to the exposed nail bed to prevent regrowth by destroying the nail cells. (However, it is possible that some nail regrowth may occur). Healing takes between four to eight weeks.

Routine podiatry looks to resolve many problems you may have with your feet or lower limb.

It can be carried out at any of our community clinics and covers a broad range of services based on your medical need, which do not require the input of one of our specialist teams.

These services can include:

  • Reduction of corns and callus
  • Pathological toe nail treatment
  • Diabetic foot care
  • Clinical assessment of the circulation in the foot and leg
  • Wound care
  • Basic biomechanics
  • Foot health education
  • Sign posting to other organisations to ensure you get the right care at the right time

What happens during a routine podiatry assessment?

The clinician will review all necessary aspects of your foot health. To aid with this, it is always good to have an up to date medication list with you, and any information about your medical, surgical and social history which you think may be helpful. Our experienced clinicians will then make a diagnosis based on the presentation that day regarding any problem you may have and may even carry out any necessary treatment there and then.

Routine podiatry may only require one visit, or the clinician may discuss and agree a care plan with you which could involve multiple appointments at the most appropriate clinic location. This care plan may also involve one on one appointments or group sessions to ensure you are provided with the most up to date clinical care possible.

Routine podiatry does not involve social or cosmetic nail care; however, we will always do our best to provide every patient with the right information on how to effectively self-care or point you in the direction of someone who can help.

All treatment is carried out by qualified podiatry registered with the Health and Care Professions Council (HCPC).

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