The Role of Podiatry in sport

Podiatry is an independent medical speciality for the assessment and treatment of the foot, ankle, lower limb and associated structures. As Podiatrist we assess and treat a wide range of disorders. The profession is continuing to grow and evolve, particularly with the advent of advanced and extended scope practise. There are several Universities in the UK offering 3 to 4-year degrees in podiatric medicine, we are members of the Health care professions council as are other allied healthprofessionals i.e. Physiotherapist’s. Most will also qualify in prescription only medicines, minoroperations and procedures and Local analgesia certification, and can go on to specialise in a wide range of medical disciplines, with increasing skills in diagnostics and widening range of treatments both medical and non-medical.

Currently in the field of sports most Podiatrist are either providing footcare for painful foot corns/calluses and minor lesions, whilst others concentrated on biomechanics and orthotic prescription to help with foot/ankle, knee hip or back related mechanical pain. Others have specialised in minor or elective foot/ankle surgery treating a variety of orthopaedic or musculoskeletal type complaints affecting the foot and ankle.

Biomechanics involves careful assessment of lower limb and postural mechanics in movement (your gait) the way you walk and move, and excessive forces through soft tissue and bony structures. Such clinicians will often work closely with other practitioners, for example Physiotherapist’s, sportstherapists, chiropractors, orthopaedics and sports medicine doctors. The sports podiatrist is a rare bread and valuable asset to most sports and their medical teams.

There is a new generation of, advanced practitioners in musculoskeletal medicine, if you are lucky enough to find one. We are a small group approximately 13,115 (Hcpc-uk.org, 2018) Podiatrists nationally (ref). Of those most will work in the NHS in various medial disciplines, diabetes, rheumatology, neurology, msk and orthopaedics, not many NHS employees will be sports specialists, because of the way the NHS is funded. Most will be dealing with chronic long-term injury or disease.

Private practise is where you will find most of our sports specialist colleagues. These will generally utilise various types of computer aided software and gait or postural analysis systems.

From this careful assessment they may suggest a specific exercise/rehab regime, perhaps a change in running or gait style, and possibly work towards prescription orthotics to help influence or alter lower limb / foot function, either to help prevent injury, treat injury or improve performance.

There is a wealth of research in this domain, as always, some positive and some maybe negative viewpoints on the way podiatrists assess and treat their patients.

Most excitingly, the sports podiatrist is evolving to offer more, extending scope of practise. The traditional boundaries and professional roles, are blurring, for over a decade now practitioners have been able to train assess and treat outside of their traditional roles, gaining new diagnostic and treatment skills as extended scope practitioners, now more commonly known as advanced practitioners.

Examples include; diagnostic imaging, injection therapies, soft tissue and joint mobilisation and manipulation, acupuncture, cryosurgery, electrosurgery, platelet rich plasma, advanced local anaesthesia, dermal fillers and botox, minor ops and procedures and more.

Many of these advanced practise courses for Podiatrists, are to be found via one of the more forward-thinking professional bodies, in my opinion, The Institute of Chiropodist’s and Podiatrists (IOCP).

Mr Abid Ali CFPodM, MFPM RCPS (Glasg)
Consultant Podiatrist and Advanced practitioner (MSK) Biomechanix clinic & NHS Warwickshire

References:

Hcpc-uk.org. (2018). HCPC - Health and Care Professions Council - Professions. [online] Available at: https://www.hcpc-uk.org/aboutregistration/professions/index.asp?id=3 [Accessed 2 Sep. 2018].