Audio Interview: Running Barefoot - Are Your Feet Up to the Challenge? Associate Professor Anthony Blazevich
The Barefoot Running movement is rapidly growing in popularity, but is it possible for everyone to run barefoot?
Proponents of barefoot running argue that humans are meant to run without shoes, rather than in heavily padded sports shoes.
However, many podiatrists disagree, and say running barefoot can damage feet and legs.
Associate Professor Anthony Blazevich is a Sports Biomechanics at the School of Exercise, Biomedical and Health Sciences, Edith Cowan University.
He spoke on Day One of the 2011 Australasian College of Podiatric Surgeons Annual Scientific Symposium yesterday and gave an alternative view of viewing running injuries.
In this interview (2 min 32 sec) recorded after his presentation, Associate Professor Blazevic explains why he supports barefoot running and goes into detail about how to prepare your feet for running barefoot all the time.
Audio interview: Foot Pain Forum
Chronic and acute foot pain is one of the most difficult foot issues to treat.
The 2011 Australasian Podiatric Surgeons Scientific Symposium in Perth has been told the answer is a multi-modal approach.
Mr Frank Pigliardo, Podiatric Surgeon FACPS, Associate Professor Marek Haviat, Histopatholgoist, Dr Brenden Adler, Radiologist and physiotherapist presented at the Symposium, in the session entitled: Multimodal Approach to Diagnosis and Management of Plantar Heel Pain: It's not it's not just Plantar Fasciitis!
In this interview with all three speakers, they talk about the different roles they play in treating foot pain - and why a multi-modal approach is so important.
From left to right, Dr Brenden Adler, Radiologist and physiotherapist, Mr Frank Pigliardo, Podiatric Sureon FACPS, Associate Professor Marek Haviat, Histopathologist
Tips on avoiding litigation: Dr Robert Hermann
Dr Robert Hermann is a Podiatric Surgeon at the Australian Foot and Ankle Surgicentre with practices in Brisbane and Adelaide.
While his talk was largely aimed at surgeons, there was also some cross over advice for podiatrists.
Dr Hermann emphasised the importance of keeping proper documentation.
In his case, he scans existing patient records such as imaging and pathology reports, makes "scratch notes" during consultation and then synthesizes the final patient record during dictation (which is then transcribed) and he then checks the transcription for accuracy.
He takes photos and or video of patient symptoms using a digital camera.
Dr Hermann says he goes to great lengths to ensure that patients are comprehensively informed about possible complications of both medications and surgery and has created what he calls a ‘consent process’ which is much more than a patient signing a consent form.
His consent explanation starts on the first consult. He gives the patient a consent form including a list of possible complications on a PDF and all stages of the consent process are recorded into his notes.
The consent form is given to the patient 1-2 weeks before surgery and Dr Hermann encourages the patient to see him again with questions.
He has a consent check list, to ensure every step has been taken.He takes a digital recording when verbally explaining the consent during consultation with the patient's permission.
Dr Hermann strongly recommends that all digital records should be backed up and stored separately from the practice so that a record still exists if something happens to your practice (for example fire or flood).
Dr Hermann spoke about post-operative care and said it's essential to have verbal and written instructions and to supply written instructions along with the consent form.
He ensures the advice is repeated on the day of surgery, both pre and post the operation.
He checks next day for compliance. He offers after hours and alternative practitioner advice in the unlikely event that patient cannot reach him after surgery.
Dr Hermann also includes photos to show patients how to manage their postoperative care (for example, how high to elevate the foot post surgery).
He writes a discharge summary which includes an operative report that he gives to the patient on the day of surgery. This is in case the patient requires care in addition to normal postoperative care such provided by an Emergency department. The discharge summary is also sent to the GP or any other practitioner who may be providing other care for the patient that includes a comprehensive description of the surgery provided and medications prescribed
He then writes to the GP and any other practitioner involved in the patient's care, keeping them informed of the patient's progress. He said in the uncommon event when the patient's care needs to be transferred to another practitioner an appropriate clinical handover protocol should be followed and documented.
Dr Hermann concluded by recommending that podiatrists and podiatric surgeons have as much documentation as possible, that communication is clear and constant and that you have a back-up computer protocol.
Audio interview with Mr Ben Yates MSc, Consultant Podiatric Surgeon
In this audio interview (3min 49 seconds) Ben Yates talks about his experience as a Podiatric Surgeon within the NHS in the United Kingdom. He discusses what a recent audit showed about patient experiences and even discusses his training in Australia under Dr Mark Gilheaney.
Topic: Integration of a Podiatric Surgeon into an Orthopaedic Department within the NHS: An Audit of Outcomes
Mr Ben Yates is a Consultant Podiatric Surgeon in the Department of orthopaedics, Great Western Hospital, Swindon, UK. He has been in post since 2003. He graduated in Podiatry at University College London in 1989 passing with distinction and clinical prize. He gained his specialist surgical training in various hospitals in Northampton, London, and Melbourne, Australia. He undertook his masters degree in Manchester completing this in 1999. Ben was previously head of Podiatry at both La Trobe University in Melbourne Australia, and University College Northampton. He gained his surgical fellowship in 1997.
Mr Yates performs all aspects of foot surgery with a special interest in foot surgery in diabetes.
He performs approximately 1100 procedures per year. He has published numerous journal articles and book chapters relating to lower limb sports medicine and foot surgery.
He has lectured at both national and international conferences. He is the editor of the textbook “Assessment of the Lower Limb 3rd edition” published by Elsevier, 2009.
He is the regional dean elect for Podiatric Surgery (midlands) and the external examiner for the MSc in Podiatric Surgery at Huddersfield University. Ben was recently the Chair of the UK National Podiatric Surgeons Conference.
He is on the Editorial Board of a number of research journaonsultant Podiatric Surgeon
Mr Ben Yates is a Consultant Podiatric Surgeon in the Department of orthopaedics, Great Western Hospital, Swindon, UK.
He has been in post since 2003. He graduated in Podiatry at University College London in 1989 passing with distinction and clinical prize.
He gained his specialist surgical training in various hospitals in Northampton, London, and Melbourne, Australia.
He undertook his masters degree in Manchester completing this in 1999. Ben was previously head of Podiatry at both La Trobe University in Melbourne Australia, and University College Northampton.
He gained his surgical fellowship in 1997.
Audio interview - how to treat the curse of the weekend warrior - achilles tendon injury.
In this interview, Orthopaedic Surgeon, Professor Richard Carey Smith talks about this increasingly common injury...and what he'd do if he had it himself.
Professor Carey Smith spoke on the first day of the 2011 Australasian Podiatric Surgeons Annual Scientific Symposium.
Audio interview: Professor Richard Carey Smith interviews physiotherapist James Debenham
In this interview (5 minutes, 4 seconds) Orthopaedic Surgeon, Professor Richard Carey Smith interviews physiotherapist James Debenham.
Professor Carey Smith saw Mr Debenham's presentation this afternoon and wanted to speak to him about motor control strategies in the Aetiology of Achilles Tendinopathy.
Audio Interview, Dr Mark Gilheaney, Podiatric Surgeon
We spoke to Dr Gilheaney after his presentation: Present and Beyond - Future Directions of Podiatric Surgery in Australia (Dr Mark Gilheaney, Podiatric Surgeon FACPS)
Osteochondral Lesions of the Talus: Open and Arthroscopic Management
Dr Simon Smith, Podiatric Surgeon FACPS
Dr Mark Gilheany, Podiatric Surgeon FACPS
Dr Gilheany and Dr Smith talked about the osteochondral talar dome lesions and open v arthroscopic management.
They said preceding trauma was reported in 86% of cases. They also spoke about diagnosis options. They said x-ray has low sensitivity and also spoke about the benefits of CT and MRI.
They said the injury is commonly associated with lateral ankle instability.
Dr Gilheany and Dr Smith said synovitis and synovial hypotrophy is commonly associated with the pathology.
Management options:
Non-Operative - NWB cast immobilised, braces, NSAIDS, camwalker.
Operative - they said the options of open v arthroscopic depend on your training, your comfort levels, procedure requirement and access.
They said the size of the defect matters when deciding on arthroscopy v open surgery. The minimal incision approach is shifting to the mainstream.
Imaging: The Devil in the Detail - Dr Stephen Melsom, Radiologist, Perth Radiological Clinic
He said shock wave treatment (ESWT) if good for Plantar Fasciitis that doesn't respond well to other treatments.
Dr Melsom said a CT scan is good because it's widely available, there's a Medicare rebate if referred by a medical practitioner, it's quick and tolerated by most patients. It's also good because it has a relatively low radiation dose. Great at looking for bones, it avoids overlapping bones - to find fractures, locating arthritis etc.
However, in WA podiatrists are not legally allowed to refer for CT - has to be a medical practitioner. It has more radiation than an X-ray and it is signficantly more expensive than an X-ray.
He then discussed Magnetic Resonance Imaging Machines (MRI) and said it's excellent at seeing abnormalities in most types of tissues. However, he says one of the problems is there's no Medicare rebate in Western Australia if a patient is referred by a GP or a podiatrist. He says claustrophobic patients can find the scan very traumatic. He says the magnetic field can damage metal implants, such as pacemakers, bionic ears and some heart vales.
Dr Melsom discussed nuclear medicine and says it's good for pickingup problems in the bone before they'd be visible on a CT scan.
However, podiatrists can not legally refer in Western Australia , needs a medical practitioner referral, it's expensive, it involves radiation and it doesn't give good bone detail.
Dr Melsom says if the a podiatric surgeon or a podiatrist finds a bone/joint abnormality it makes sense to x ray it first. If it's a soft tissue problem - use ultrasound...and if in doubt, call a radiologist!
He says if the first scan doesn't show anything wrong, but you're still sure there is, keep going and using other methods until you find it!
About Me
acps2011Updates by the Australasian Podiatry Council's Communication Director, Kylie Johnson from the 2011 Australasian College of Podiatric Surgeons Annual Symposium at the Burswood Convention Centre, Perth
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