Musculoskeletal Foot Related Lower Limb Problems

Compleet Feet Podiatry have experts in treating foot related lower limb problems. Podiatrists understand the anatomy and functionality of the foot more than other specialists. We identifying etiological causes/ reasons why a patient has a lower limb related anatomical pain or a problem. This is not normal routine Podiatry. Not many podiatrists have this specialist developed skill set. It is a specialist branch of Podiatry. We can accelerate healing outcomes after surgery or more importantly negate the need for surgical intervention.

An experienced MSK podiatrist has a choice of adjunctive technology equipment to help during the assessment process, but this is not a replacement for an experienced hands on approach.

Please note: It is important to arrive 10-15 before appointment to fill out pre-assessment forms. Bring current footwear.

MSK Biomechanical Blogs

FAQs

Frequently Asked Questions

Some answers to our most asked questions

MSK Biomechanical Assessment

A musculoskeletal (MSK) biomechanical assessment is a specialist podiatry appointment. It is designed to help identity and treat foot related lower limb pain. Compleet Feet are fortunate to have MSK trained podiatrists. This is a complex area of foot care which is quite specific to podiatrists to treat and understand above other health professionals. Not all podiatrists can undertake an MSK biomechanical assessment.

Podiatrist will examine both legs and lower back in relation to lower limb function and alignment. The neck and positioning of shoulders is also examined, as is uneven arm swing. We encompass the whole body in our assessments. A treatment plan will be instigated on the day of your appointment to start achieving a satisfactory resolution or improvement of the presenting issues. Protocol requires that later you have a follow-up review. This is normally 3-6 weeks after initial consultation.

Musculoskeletal Foot Problems Can Cause Pain Upstairs!

Example 1: A stiff neck could be as a direct result of having stiff big toes, thus leaning forward to get forward momentum during gait or from a limb length shortening, and a head tilt.

Example 2: A flat foot, collapsing arch can lead to joint degenerative problems and lower back pain. Abnormal wear and tear resulting in a joint replacement procedure.

Example 3: A stiff functioning big toe can result in heel pain – plantar fasciitis, tendo-achilles tendinopathy.

“Your feet are your foundations, and if you don’t have good footings you will get subsidence upstairs”

Positioning of feet has a direct effect on function of joints, muscles, ligaments and tendons. The body can accommodate and compensate for small structural anomalies, but over time unwanted pathologies can occur. Abnormal wear and tear can develop. Individuals can become prone to injuries. Simply by altering the position of the foot can make a significant difference. Wearing of a specialised insole termed orthotic may be recommended as a preventive or curative measure.

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Compleet Feet can accelerate post surgery and treatment outcomes. Often continuing pain hinders healing and the return of normal or improved function. It is hard to work through pain to do required exercises e.g. post joint replacement. When the prescribed pain ‘killers’ cease to be effective or cause unwanted gastric issues, a cycle of recalcitrant pain can develop which halts progress. Stiffness, loss of optimal function can result.

Our clinic has a range of high-tech equipment to include pain lasers, shockwave therapy to help. We also have many simple solutions which can make a massive difference.

PLEASE NOTE: We will commonly issue specialised orthotic insoles, or make insert modifications before we proceed to other adjunctive therapies. Correctly prescribed functional support is often the remedy in a lot of cases.

Time is of the essence. Don’t wait or put too much reliance on physiotherapy, when podiatry can offer a more focused approach. Standard ultrasound has been proven to have limited effectiveness and recommended exercises do not suit all. Alignment is more important.

We work in a more focused way than physiotherapists who often work to a standard script of ultrasound and exercises.

What is an MSK Biomechanical Assessment?

A detailed assessment to include history, examination and diagnosis. Foot function, joint movement, and lower limb posture/alignment are assessed. An understanding of Pathomechanics; the loading stresses placed on tissue structures and outcomes.

Your gait pattern will be observed for any anomalies. It can often be quite easy with an experienced podiatrist to quickly identify a potential issue.

Once functional abnormalities are identified, a treatment plan is implemented.

An experienced MSK podiatrist is observing your gait from the moment you walk into the clinic.

How does the issues of insoles/orthoses help?

Improving the alignment of the foot/ feet. Support and control movement in the foot. Facilitate the correct functioning of the foot. Re-distribute weight-bearing pressures through the foot. Deflect pressure/ off-load painful areas. Control/ stop unwanted positional and functional stresses up the kinetic chain into leg.

We have a large range of in-house orthotics to choose from. Prices vary.

Orthotic Issue and Modification

We have small workshops whereby we can modify and adjust orthotic insoles or footwear on the day of appointment. We like to ensure that your MSK treatment is started on the day of your consultation. Our role is to correct, support and improve foot function, thus do expect (if required) to be issued orthotic insoles, which help to achieve this outcome. These have an additional cost.

In more complex cases patient’s may require laboratory prescription manufactured orthotics.

What do I need to bring along to my appointment?

New patients are asked to bring along a pair of shorts or clothing that can be adjusted so knees can be seen during gait analysis. We also ask patients to bring along a selection of current footwear and old shoes which may be broken down. If patients have orthotic insoles these need to be brought to appointment too.

What foot conditions do you treat?

All forefoot conditions:

Degenerative joint conditions e.g. hammer toes, bunions, bursitis, capsulities
Nerve involvements e.g. Morton’s neuroma
Stress fractures
Muscle weaknesses
Painful corns, callosities resulting from poor function or alignment

Mid- foot conditions:

Plantar fasciitis/ arch pain, ‘dropped arches’, tendon ganglions
Degenerative joint conditions
Subluxed cuboids
Styloid process pain/ stress (base of 5th metatarsal)

Ankle and Rearfoot Conditions:

Weak/ unstable ankles
Post-ankle sprain/ injury pain
Degenerative arthritis
Posterior Tibial Tendon dysfunction issues
Positional/ alignment issues
Tendo-achilles problems
Severs Disease
Heel pain
Posterior heel ‘bumps’/ Haglands Deformity

What Lower Limb Conditions do you treat?

Shin splints
Calf strains
Knee pain/ injuries
Hip pain
Hamstring issues
Hip pain
Lower back pain
Post surgery rehabilitation

Do you treat Sport/ Dancing Injuries?

Yes, we treat all sporting activity and dance related presenting problems.

Do you treat Sport/ Dancing Injuries?

Yes, we treat all sporting activity and dance related presenting problems.

Post Surgery Rehabilitation

Our clinic has a range rehabilitation and pain relief treatments:

Laser pain relief therapy – lasers can switch-off pain receptors
Extracorporeal shock wave therapy – NICE recommended
Mobilisation/ manipulation
Functional footwear
Orthotics and shoe/ insole adjustments

Ostenil® Injections for Painful Joints

Ostenil® is a treatment for the symptoms of osteoarthritis, for painful joints with degenerative changes. It has been used for the knee for many years, and more recently in smaller synovial joints of the foot like the ankle and big toe. Despite supporting scientific evidence, it is not commonly used within the NHS but has been used privately, within sports medicine and podiatry with great effect.

Ostenil® is an injectable solution of naturally occurring hyaluronic acid. It helps to replenish and restore production and concentration of synovial fluid. By effectively lubricating the joint, freedom of movement is improved and pain levels reduced. Injections of Ostenil can negate need for surgery. It is reciommended to have 3 injections at weekly intervals for optimal results.

A thorough consultation is required. It is not suitable for chronic joint pathologies and inflammatory arthritic conditions e.g. RA.

Do you treat children?

Yes, we treat children.

Podiatech Sidas Orthotics

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Compleet Feet can utilise the Podiatech Sidas system to manufacture semi-bespoke orthotic insoles. This is a reputable brand favoured by many podiatrists who specialise in in-clinic orthotic manufacture. Podiatrists can produce high quality cost effective orthotics. These are more comfortable than pre-fabricated insoles and cheaper than prescription laboratory ones. It is not suitable for everyone.

Benefits of Podiatech Sidas Orthotics:

Affordability
Fit like a glove to the anatomical contours of the foot
Can be manufactured and fitted on the day without having to wait 3-6 weeks for manufacture.
Can be easily modified in clinic
Shaped to fit footwear

Sidas Orthotic Manufacturing and MSK Assessment Appointments

All costs reflect appointment time, experience of podiatrist, materials and resources used.

Why are MSK Biomechanical Assessments Expensive?

An MSK biomechanical assessment is an advanced podiatry appointment requiring considerable expertise to identify and treat an issue. It takes considerable training and practice in this area of podiatry to be able to effectively treat patients. The cost charged reflects that expertise and experience. It also reflects time allocated for appointment and any resources, technology, materials used in clinic. Compleet Feet’s prices are set in accordance with other UK Podiatry Clinics.

MSK Biomechanical Assessment Costs

MSK Biomechanical Assessment Only

An involved appointment to assess and diagnose biomechanical problem(s). In-depth evaluation of presenting issues to understand and diagnose what it is a patient exactly requires. Gait analysis, joint and soft tissue function examination, exercises, footwear advice etc. Podiatrist will decide if orthotic insoles are required or not. Either simple footwear/ insert modifications or issue of pre-fabricated off-shelf orthotics. Pre-fabricated orthotics vary from £40-£150

45 – 60 minutes £120 Senior MSK Podiatrist

45 – 60 minutes £150 Consultant MSK Podiatrist

As part of our professional protocol a review is recommended after an assessment to ascertain progress and continue with treatment plan. Orthotics may need to be adjusted or swapped for a different format. Additional treatment may be required, or a referral.

30 minutes £60-65

Custom Orthotic Package

Laboratory prescribed and manufactured custom orthotic insoles. Comes as a package price of £500. Consists of 3-4 appointments with Katrina Waller, Consultant Podiatrist. Includes MSK assessment, taking foot impressions, fitting and review.

Custom orthotics are for patients with more complex requirements, and those individuals requiring long lasting, functional insoles.

Foot Mobilisation and Manipulation

We combine foot mobilisation and manipulation techniques taken from physiotherapy and osteopathy to help restore movement and function in the foot and ankle. We have a thorough understanding of foot anatomy and function to resolve niggling aches and pains which don’t respond to other treatments. Maybe a joint articulation is stuck or out of alignment which will have a knock- on effect to gait. After a treatment, your foot (feet) will feel more relaxed, with increased movement around the joints and reduced pain.

What problems benefit from Foot Mobilisation?

Aching feet
Stiff joints
Flat feet
High arched feet
Bunions
Knee pain
Problems adjusting to orthotics