Most people are aware that podiatrists are for feet—but what they actually do in a practical sense is often up for debate. There’s no casting for a broken bone; no suturing for a cut. Just a range of complicated problems with even more complicated answers—or so it seems.
Understanding what we’re led to believe happens versus what actually occurs allows for a tempered expectation of what a podiatrist can realistically do—and why certain foot ailments take longer than expected to get better.
The Most Painful Heel Pain
Heel pain is one of the most common reasons why people visit the podiatrist, and more often than not, it’s plantar fasciitis—in layman’s terms, just inflammation of the thick band of tissue that’s overstretched along the bottom of the foot. And the worst? The first steps out of bed feel like you’re walking on glass.
But your podiatrist isn’t going to send you home with ice and hope it heals. They want to understand what’s causing it. Is it your shoes? Your gait? Did you randomly start walking tons or just up and run without training?
More often than not, treatment is a combination of things. Stretching your calves and the inflamed band. Wearing supportive shoes that fit as opposed to squished ones. Even inserts that alleviate pressure from the exact point of pain. They may tape your foot in a certain way for support as you heal, as well.
If this doesn’t help, there’s more to explore. Shockwave therapy may seem like something out of a sci-fi movie, but it’s sound waves to help heal your tissue; cortisone shots can help alleviate inflammation (or at least get rid of it faster). The beauty is that podiatrists adjust their course of action along the way to see what’s actually helpful.
For Ingrown Toenails
Ingrown toenails seem like a no-brainer but they’re tricky issues if not treated properly. The nail grows into the side of the toe, creating inflammation, redness and sometimes infection.
For small cases, podiatrists Perth generally dig out the offending piece that’s causing inflammation and show you how to properly cut your nails so this doesn’t happen again—but spoiler alert—it doesn’t mean just cutting them shorter. There’s a right way to cut them.
When you have recurrent ingrowns or it’s especially bad, however, they’ll recommend cutting part of the nail out. They numb your toe, cut out the offending piece and often apply something to the nail bed so that piece won’t grow back. It sounds worse than it is—the procedure is quick and recovery isn’t bad.
They want permanent solutions instead of painful toes every few months.
For Bunions—Without Surgery
Those bumps on the sides of your big toes? Bunions. Unfortunately, there’s no way to get rid of them without surgery—but not everyone needs surgery and there are options for managing without going under the knife.
They want to make sure they don’t hurt as much as they can—and don’t get worse over time. More accommodating shoes go a long way as much as padding and taping to relieve pressure; special inserts accommodate peculiarities when walking with bunions.
For swelling and discomfort, anti-inflammatories are recommended and cortisone shots sometimes relieve inflammation more quickly than an over-the-counter option. Certain exercises keep the joint lubricated and strong; surgery is only recommended when all else fails—and your quality of life with a bunion is above average—but they’ll provide non-surgical options first for those who aren’t candidates or those who don’t want corrective surgery.
For Calluses and Corns
Calluses and corns develop when tissue rubs up against something consistently or too much pressure is applied to a specific area repeatedly—resulting in thickened skin as protection. They’re not big deals but can be painful, particularly those with diabetes or poor circulation where they can create significant issues with infection.
Podiatrists take specialized tools that scrape them down more than any pumice stone can at home—especially corns that grow deeper and wider, but are painful and better removed by professionals.
But similar to ingrown toenails, removing them does not solve the problem; it makes them feel better, sure—but podiatrists want to figure out what’s causing them—are your shoes too tight? Is there something about your gait that’s pushing more force onto that area? Or is there a toe deformity causing friction?
Once they get to the bottom of things—new shoes, padding, inserts, whatever—they won’t magically reappear overnight.
For Fungal Toenails
Toenail fungus is obnoxious—and it’s essentially something that gets underneath your toenail bed enough to change its appearance, make it thicker and crumble when it’s not supposed to like toenails do.
Over-the-counter options rarely work since they cannot penetrate through the toenail bed effectively enough; much better options exist when podiatrists can prescribe antifungals of increased power for topical applications; pills exist to work through your system but not everyone is able to take them without bloodwork monitoring.
Lasers are becoming increasingly popular as they shine light through the fungus without impacting the other skin/nail area—and after multiple sessions tend to work well; in severe cases removal is required—but only if one’s toenail is ruined beyond repair; this is typically reserved as a last resort unless nothing else has worked prior enough.
For Flat Feet
Flat feet may bother some people while others are fine; when flat feet become painful or restrict you from doing daily activities, there’s help.
Podiatrists start by looking at how you walk, observing your feet while sitting and standing, seeing where problems arise—even some flat feet require no intervention at all.
But most who do need help require custom inserts—not just arch supports from a box—they’re made specifically for your feet and your gait; they support your feet where necessary instead of applying pressure to a debilitating sore spot.
Accompanying this adjustment are strengthening exercises for both legs and feet along with proper shoes. While children may require more intense treatment due to developing bones, most adults are fine with inserts/supportive shoes.
For Sports Injuries
Increased activity leads to increased foot problems—from microfractures to tendonitis; stress on ligaments—from overuse or incorrect motion over time. Podiatrists see these complaints on a daily basis.
They need to assess what’s going on—sometimes it’s x-rays or MRIs; accurate diagnosis makes a difference since different assessments render different treatments.
Most importantly, they’ll stress rest—to what degree? Should we be off it completely? Should we just back off from the activity—or should we change sports entirely? They provide adjustments through exercises, tape or braces; for runners especially they’ll assess how one runs and potentially prescribe inserts based on feedback they provided so they don’t reinjure themselves again.
Why This Is Important
Some people expect immediate results by going to the podiatrist—a promise that whatever issue plagues their foot will be healed in one visit. This is sometimes true—if you want your nail cut; callus taken off—you feel relief upon walking out the door.
But many issues develop over time based on gait or movements; fixing them properly takes longer than expected.
Getting used to inserts take time; bodies need time to heal; changing how one moves takes consistency over time. Good podiatrists know what’s expected of you—and what timeline has been established—and good news about proper placement is that intended functionality—not just appearance or short-term relief—is reinstated—which holds more ground for the long haul even if it took longer than anticipated in the first place.
