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What is the difference between a chiropodist and a podiatrist? Firstly as the practise podiatrist I would like to answer my most commonly asked question from allied health colleagues and patients alike, ‘What is the difference between a chiropodist and a podiatrist?’ As an Australian the word Chiropodist was also a foreign concept to me on arriving into this country, strictly it’s a British term that has been around for many years. Even though technically Chiropody and Podiatry is the same thing a Podiatrist is seen as a university graduated specialist of the lower leg, ankle and foot but mainly deals in the special interest of podiatric biomechanics and sports injuries. A Chiropodist on the other hand deals mainly with general foot care like nail cutting and hard skin debridment. However many Podiatrists prefer to call themselves Chiropodists because of the public familiarity with the term. Quiet confusing I know! To understand Podiatry it is first essential to have an understanding of what Biomechanics are and how having abnormal biomechanics can lead to injury. It is also important to recognize that the biomechanics of walking and running are different and therefore should be approached differently. Biomechanics were first written about by an Italian scientist Giovanni Borelli in 1608-1679 even though the Greeks had been studying the science as early as 384-322BC.(1) Biomechanics today have developed into a modern science of physics, anatomy and physiology all used to describe the movements of the body. Biomechanics are defined as ‘The application of mechanical laws to living structures specifically to the locomotor system of the human body’(2) Podiatric Biomechanics may be defined as the branch of biomechanics that specifically deals with the interaction of the foot with the lower limb.(3)While Gait biomechanics are the specifically movements of the body that occur when walking. Dr Inman(3) in 1945 made a most important podiatric finding when he discovered that during weight bearing the rotational movement of the foot causes rotational movement of the whole lower extremity. This went a long way to providing answers to the complexity of lower extremity biomechanics and how abnormal foot function can cause lower limb injury. There are two major rotational movements that occur within the foot.
When the foot ‘pronates’ its major function is to ‘unlock’ the structures in the foot so that the foot can adapt to its terrain. When the foot ‘supinates’ the foot will roll out and the structures will ‘lock’ to act as rigid lever for propulsion. Normal lower limb function is reliant on normal foot function as the two are completely biomechanically integrated. Certain structural deformities of the foot and leg may cause excessive pronation or supination of the foot on the ground. This abnormal motion leads to small pathological internal stresses within the musculoskeletal system with every step and if repeated enough overuse injuries can occur. Unlike macrotraumatic incidents where an athlete may completely tear a ligament in one large stress, microtrauma injuries occur over a long period of repetitive stress to a ligament, bone joint or muscle. Foot orthoses are a type of prescribed arch support that improve abnormal foot function and can also reduce the forces on the foot that occur during high impact activities. When walking the forces on the foot are about 1.25 – 1.5 times your body weight and when running are around 2.5-3 times body weight. It’s important to realise that orthotic therapy is not a cure for foot deformities but improves the function of the foot during activity by correcting its alignment to prevent micro trauma stress occurring on the body’s musculoskeletal system. Just as a pair of prescription glasses won’t cure your sight problems, they will enable you to see when you need to. The facilities at PHYSIO 4 ALL enable me to assess your biomechanics with state of the art video gait analysis technology so I can diagnose and demonstrate to you why your injury may be occurring and what the best treatment option is for you. The treadmill will also enable me to identify what your biomechanics may me doing when you’re running verses when you’re walking as they change dramatically as your speed increases. I hope this information has been helpful to you and may answer some of your questions about what Podiatry is and why it may help you and your injury. Keep checking our website as I will be occasionally writing some helpful hints on how you can help yourself with foot care. Juliet Physio for all |
