Why a Chiropodist

If you or loved ones are experiencing difficulty in balancing and walking, then you might be at risk of falling and foot injuries. Normally, the older or elderly are most highly in danger of having injury problems. Through the years, foot injury has become more serious health issue in anywhere in the world. As we grow older, our bones became weaker. Taking care of the feet is an important matter because it is the human’s body foundation.

Chiropodists focus on the assessment, examination and treatment of the abnormalities of the lower limb. They treat people with arthritis, diabetes, nail surgery and sports injuries. They treat people of all ages especially the older people who are at high risk of amputation, such as those suffering from arthritis or diabetes to stay mobile, active and independent. They provide professional advice on how to take care of the feet and prevent foot problems.

Foundation Chiropody in Mississauga is also here to help you reduce the risk of falling. We deliver the best ankle or foot orthotic practices in Ontario. We use the latest in medical technology in taking care of your body’s foundation and also, we have the most expert chiropodists in the city.

We help improve your foot health by delivering keen and careful assessments. Foundation Chiropody offers various patient-centered treatment plans for patients. Our team works collaboratively with client’s family doctors, other physicians, chiropractors, physiotherapists, diabetes educators and other health professionals in order to provide exceptional health care treatments.

Our family foot clinic welcomes and treats people of all ages, from children to seniors. It is important for us to communicate well with our patients to make sure they fully understand their condition and the right treatment plan for them. From sports injury to diabetic foot care, Foundation Chiropody is here to give a helping hand.

Foundation Chiropody offers special custom foot orthotics for patients to deliver the unique biomechanical and pathological needs of the feet and body. We have expert staff that will execute a biomechanical evaluation to patients. We use up to date and high technology facilities to ensure the right treatment of our clients.

There are many factors that indicate fall risk:

  • Bones get weaker as you age
  • Difficulty in balancing
  • Numbness weakness and pain in feet or neuropathy
  • Instability of ankle joint from ligamentous injury
  • Foot and ankle osteoarthritis

The following are some of the services our patients will encounter in our fall prevention program

  • We consider many factors why a particular patient is at risk of falling
  • We offer strengthening exercises, balance braces and also recommend physical therapy if needed

Contact the family foot clinic of Foundation Chiropody. Help reduce your risk of falls today. Call us at 905-916-3668.

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Knee Pain, Osteoarthritis and Prescription Custom Foot Orthotics (PCFOs)

We have all heard about the epidemic of diabetes but what about the epidemic of knee and hip surgery? Lately, during new patient intakes, I am seeing many elderly patients (50-80 years of age) with recent knee arthroscopy surgery or total knee replacement surgery (often in both knees). Evidence supports that most of these surgeries are very successful, no doubt due to our skilled orthopaedic surgeons.

 But why not try to avoid getting to the point where you need the surgery? In many cases, PCFOs (orthotics) can realign and optimize your lower limb, reduce wear and tear on your knees and hips. Most people are concerned about the cost of PCFOs. It seems to me that a few hundred dollars every 2-3 years is a small price to pay for saving your knee and hip joints years down the road. Of course, there are other factors for the development of arthritis so you should consult with a ‘regulated’ foot specialist (chiropodist/podiatrist) near you to see if orthotic therapy can help you [i]

 “The number of hip replacements in Canada increased 11% between 2006–2007 and 2010–2011. The number of knee replacements increased by 15% over the same period. [ii]

 “Osteoarthritis affects an estimated 10% to 12% of Canadian adults. The therapeutic goals of osteoarthritis treatment are to improve joint mobility and reduce pain. Stepwise treatment options include exercise, weight loss, physiotherapy, analgesics, anti-inflammatory drugs, intra-articular steroids and hyaluronic acids, arthroscopic surgery, and, in severe cases, total joint replacement with follow-up rehabilitation. These treatments are delivered by a range of health care professionals, including physiotherapists, occupational therapists, family physicians, internists, rheumatologists, and orthopedic surgeons. Total Knee Replacement is an end-of-line treatment for patients with severe pain and functional limitations. More women than men undergo knee replacement, and most patients are between 55 and 84 years old.[iii]

 Prevention may be in YOUR shoes…..


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Is one leg longer than the other?

Most people are slightly asymmetrical. In fact it is estimated that 90% of people have a leg length discrepancy (LLD). Studies haves shown that the right leg is usually longer than the left. The difference is often negligible and does not need to be treated. The body generally adjusts using several compensatory mechanisms to keep the pelvis level. Some of these compensations take place in the spine, pelvis, hips, knees and even the feet.

 If the LLD is too much for your body type and activities, then you may have symptoms in the form of back, hip, knee or foot pain. Depending on the severity of your symptoms one can choose a) not to treat the problem, b) conservative treatment or c) surgical treatment.

 Conservative treatment usually involves using ‘lifts’ in your shoes, either in your shoe, or on your shoe, or both.  The amount to adjust must be carefully considered because the body has compensated over time. If someone has 2 centimetre difference and symptoms, then the adjustment should not be for the full 2 centimetres otherwise new problems may arise. A graduated approach should be taken and your foot specialist should consider the impact of your other treatments such as physiotherapy and chiropractic.

 As a foot specialist I see patients suffering from heel or arch pain which is much worse on one foot. After initial assessment I often see a small leg length discrepancy for which the patient is compensating by pronating the foot on the side with the long leg (which shortens the long leg and levels the pelvis). This pronation is creating the downstream problem of plantar fasciitis. A mild heel lift sometimes reduces the pronation and eases the plantar fascia ligament. It is usually wise to provide leg stretching exercises in conjunction with any ‘lift’ or other orthotic therapy.


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What’s that on your foot?

Seeing skin conditions or skin irritation on the toes, toenails or foot is a daily event for those practicing podiatric medicine.


The most common irritations are caused by pressure, immune reactions, fungus, viruses, bacteria or parasites. It is important to see a foot specialist if you have a skin problem so that we can determine what the irritation is caused by and therefore decide on the appropriate medication/treatment.


In our experience, most cases are caused by pressure and the skins reaction to pressure. The next most common cause is our own immune system. After that, fungal and viral infections seem to be the culprit.


The foot needs a balance of dryness and moisture. Too much moisture makes a good environment for infections and too dry could lead to cracking and fissuring.


Tip: if you have difficulty drying between your toes after a shower or a swim, spray a little isopropyl alcohol (IPA 50% or IPA 70%) on the tops of your toes – it runs down between the toes and keeps them dry.

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Things you should know before having an ingrown toenail procedure


If you have ingrown toenails and this has been causing pain, swelling and infection for some time, then you may have decided to have a partial or full nail removal. The most common procedure we perform is the PNA w/matricectomy (or partial nail avulsion with phenol or laser matricectomy). While this procedure is relatively minor there are some things you and your foot specialist should know;

If you are pregnant in your 1st trimester, have ischaemia (very poor arterial blood flow in your lower limbs), have been diagnosed with RSD/CPRS (a chronic pain syndrome), or have allergies to local anaesthetics, then you should consider postponing the procedure and trying alternative treatment.
In addition, if you have an infection at the site of injection, are under the age of 5, or have porphyria (a disorder which affects heme and the distribution of oxygen in the tissue), then you should also consider conservative (non-operative) treatment.

Your foot specialist should also tailor your procedure and recovery based on other considerations.

Your healing may be affected if you have diabetes, take steroids, have anaemia, leukaemia, autoimmune disorders, connective tissue disorders, kidney disease, liver disease or thalassaemia. The use of a toe tourniquet during the procedure may cause problems if you have Sickle cell anaemia, Raynaud’s or other connective tissue conditions. Healing could also be impaired if you are taking blood pressure medication such as ACE inhibitors, ARBs or have severe calcification of the blood vessels.

While there is little risk in using modern local anaesthetics for this procedure, your specialist should also be aware if you are taking beta blockers, anti convulsants, diuretics, MAOIs, procarbazine or benzodiazepines, or if you have kidney and liver disease. Also if you are under extreme anxiety, let your specialist know.

Conditions like MS and Parkinsons need to be taken into consideration also. Allergies to betadine, iodine, shell fish, chlorhexidine, latex, silver and bandages should also be discussed.

To assess the risk of infective endocarditis (or inflammation, of the inner tissue of the heart) your specialist should ask about your history of heart valve damage, prosthetic heart valves, and any history of rheumatic fever.

To assess the risk of post-op bleeding your specialist should also ask you about anticoagulant and antiplatelet medications, or haemophilia. Adjustments in your medication may be needed prior to the procedure. Also if you are having chemotherapy, treatment for AIDS/HIV or on medication for severe acne or psoriasis, your specialist should know.  Other drug or tobacco use should also be candidly discussed.

All of this information should be collected in a medical history and consent for special procedure process. This will significantly increase your chances of a successful procedure. Evidence shows that following standard post-op regimes, this procedure is safe and effective in more than 95% of cases and results in resolution of your ingrown toenail problem.


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Why do orthotics seem to cost so much?

Chiropodists are often asked this question. Here are some things you should know about PCFOs;

In Ontario, the business of selling PCFOs (which are medical devices) is NOT regulated. So anyone can sell them. Chiropodists ARE however regulated by the College of Chiropodists and the province under the Chiropody Act. As such, we are held to strict standards for prescribing and dispensing orthotics. Most insurance companies will only honour your claim if the PCFOs are prescribed and dispensed by regulated health professionals like your family doctor or chiropodist.

The PCFO device itself is only a piece of high tech plastic – so why does it cost so much? These medical devices are designed to treat medical conditions, eliminate, mitigate and/or prevent symptoms from various pathologies and/or biomechanical abnormalities. The education and clinical experience required to assess/diagnose these pathologies or biomechanical abnormalities in a patient requires years of training and experience. In addition, the correct casting of your feet, the writing of a prescription which identifies the type of device and specific accommodations also requires expertise – as does the manufacture of these devices. The total cost should reflect a blend of product and medical service and expertise.



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What about Orthotics?

Orthotics (or orthoses), are medical devices inserted into footwear in order to correct abnormal or irregular foot function. Since these are medical devices, they should be prescribed by a qualified foot specialist (a chiropodist or podiatrist in Ontario).  Sometimes called arch supports, orthotics allow people to stand, walk, and run more efficiently and comfortably. While over-the-counter orthotic are available and may help people with mild symptoms, they normally cannot correct the wide range of symptoms that prescription custom foot orthoses (PCFO’s) can since they are not custom made to fit an individual’s unique foot structure.

Orthotic devices come in many shapes, sizes, and materials and fall into three main categories: those designed to change foot function, those that are essentially protective in nature, and those that combine functional control and protection.

Rigid Orthotics (Functional Orthotics)

Rigid orthotics are designed to control function and are used primarily for walking or dress shoes. They are often composed of a firm material, such as PPE, plastic or carbon fiber. Rigid orthotics are made from a mold after a chiropodist or podiatrist takes a plaster cast or a 3D laser image of your. Rigid orthotics control motion in the two major foot joints that lie directly below the ankle joint and may improve or eliminate strains, aches, and pains in the legs, thighs, and lower back.

Soft Orthotics (Accommodative Orthotics)

Soft orthotics are generally used to absorb shock, increase balance, and take pressure off uncomfortable or sore spots. They are usually effective for diabetic, arthritic, and deformed feet. Soft orthotics are typically made up of soft, cushioned materials so that they can be worn against the sole of the foot, extending from the heel past the ball of the foot, including the toes. Like rigid orthotics, soft orthotics are also made from a mold after a chiropodist or podiatrist takes a plaster cast or 3D laser image of your foot.

Semi-Rigid Orthotics

Semi-rigid orthotics provide the patient with both corrective and accommodative features. In addition they provide foot balance for walking or participating in sports. The typical semi-rigid orthotic is made up of layers of soft material, reinforced with more rigid materials.

There are also special orthotics for patients with severe foot and ankle problems and also special orthotics for children to treat conditions such as pediatric flatfoot, in-toeing or out-toeing disorders.

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