Archive for September, 2017

The answers to common questions about Podiatry

1. Do I need to see my GP before seeing a Podiatrist?

If your concern is regarding your feet/ankles, a Podiatrist should always be your first port of call as Podiatrists are specialists in foot and ankle conditions.

They will be able to offer an expert assessment and a recommended treatment plan to help you with your condition. In most cases, the Podiatrist can fully manage your condition independently. However, sometimes the Podiatrist may refer you to another health professional such as your GP or Physiotherapist if they feel their input is required in addition to helping you.


2. I just need my nails trimming – can you help?

Yes of course. One of the many treatments offered by Podiatrists is routine nail care to ensure your nails are healthy and safe.

Many elderly people and people with reduced mobility are unable to trim their own toenails which can cause them to become overly long. This can lead to ingrowing of the nail and pressure wounds on the toes. In addition to this, if a person cannot trim their own nails they may not be able to inspect their feet properly, meaning that an abnormality may go unnoticed

A Podiatrist is the most appropriate professional to see for nail care as they can provide expert and safe treatment but also assess general foot health which ensures things aren’t missed.


3. What moisturiser should I use on my feet?

At the Hatt Clinic we recommend Ureka cream, which is carefully formulated to care for and hydrate dry skin.

Ureka cream contains urea which is an important component of the body’s natural moisturising factor (NMF) and is well known for keeping the skin revitalised and supple. Regular application of Ureka cream helps keep your skin smooth and supple. In addition to this, it also has anti-bacterial and antiseptic qualities. Ureka cream comes is 25% and 10% urea strengths. We recommend the 10% strength cream for general dry skin conditions and 25% for more severe cases of dry skin. You can purchase this cream at the clinic when you come in for your appointment. Alternatively, give us a call and we can put one aside for you.



If you have any other questions that you would like answered, get in contact with us on 01380 730473 or book in for an appointment to see one of our Podiatrists.

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What is a Podiatrist and why do I need one?

A Podiatrist and a Chiropodist mean the same thing and these two terms are used interchangeably. There are many preconceptions about what a Podiatrist is and what a Podiatrist does.


Many people believe a Podiatrist just cuts toenails and removes hard skin; however, a Podiatrist is a foot and ankle specialist, trained to assess, diagnose and manage any type of foot and ankle abnormality or problem.


Upon qualifying many Podiatrists choose to sub-specialise in a particular field of Podiatry such as dermatology, diabetic foot care, biomechanics, any many more.


Most people visit a Podiatrist when they have pain or discomfort with their feet or if they notice any abnormal physical changes such as a bunion.


When you visit a Podiatrist they will carry out a thorough assessment of your feet which allows them to diagnose your condition. They will then give you specialist advice and in many cases, formulate a treatment plan for you.


If you are suffering with foot/ankle pain or notice anything unusual your first port of call should be a Podiatrist. You should not delay seeking professional advice as early detection means treatment can be started sooner rather than later and this often means a better prognosis (treatment success/cure).


The most reasons people come to see a Podiatrist are:   

  • Corns and callus (hard skin)
  • In-growing toenails and general nail care
  • Fungal toenails
  • Verrucae
  • Athletes foot

You don’t have to be suffering with foot pain to make an appointment with a podiatrist. A benefit of seeing a Podiatrist can be for foot health education and prevention of problems. A Podiatrist can provide lots of useful information even before you have a complaint with your feet about how to stop the development of foot problems that are preventable.

Alongside this the Podiatrist can educate you on the self-care of your feet; self-care is beneficial when you are equipped with the correct knowledge of how to carry this out safely and effectively.


So, if you would like to book an appointment to see the Podiatrist, give us a call on 01380 730473 or Book Online

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An Introduction to Fascia and Myofascial Release

The words ‘myofascial release’ may sound alien to some but there is no doubt that over the last few years it’s become more and more popular and lots of our patients are asking for it.  So, what is it? Before we answer this, we need to explore the soft tissue known as fascia.

What is fascia?

Fascia is a 3D web like matrix that intertwines, surrounds, protects and supports every other structure in the body. The fascia extends from the inner aspects of the skull down to the soles of the feet. While anatomy books list around six hundred muscles, one way of visualising the fascia is to think of it as one muscle poured into six hundred pockets of the fascial webbing.

How does fascia respond to injury?

Fascia shortens, solidifies, and thickens in response to injury. Over time, fascial restrictions can spread like a pull in a sweater, resulting in loss of flexibility and spontaneity of movement. This can set the body up for more injury, pain, and movement limitations.

How can it be released?

With Massage! Massage releases restrictions in muscles/fascia tissue. This can be achieved in various ways with either a gentle pressure or traction being applied to the tissues. It is a relatively slow technique where the practitioner has to wait for the tissues to respond to the pressure applied before a change can be achieved.

 What are the benefits of myofascial release?                                                                                                                                                                                                                                         

·     General increase in health
·     Relaxation and sense of well being
·     Elimination of general pain and discomfort
·     Re-established and improved joint range of movement and muscle function
·     Restored balance and correct posture
·     Injury recovery

Myofascial release is a powerful technique that can achieve amazing results.  At Hatt’s, our Massage therapists can incorporate myofascial release into your treatment. So if you’d like to experience the benefits of myofascial release then give us a call on 01380 730473 or book online.

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What is Strength & Conditioning?

Strength and Conditioning, or S&C as it’s more commonly known, is the selection and development of dynamic exercises used to improve physical performance. Whilst it originally benefited athletes, S&C is now widely used in both the sporting world and more generally.


S&C is used to develop every area of your body and improve the way you move, with the intention of enhancing your sporting or physical performance.


Research demonstrates that correct and appropriate training can improve physical performance. It also shows that incorrect and inappropriate training can be very detrimental to the way your body moves and performs, whether that’s in your daily life, such as walking the dog, or at your hobby or sport.


The skill and experience of an S&C coach will enable them to design and guide you through a bespoke training programme to help you achieve your specific physical goals.


Here at Hatts, you will begin your journey with a Quick Start programme where we will understand and set your physical or performance goals, develop your bespoke programme and get you started on your training. This will initially be achieved through three 1:1 sessions where you’ll get all the support and guidance you need to really understand your training programme.


In addition, our expert S&C coaches will teach you the correct exercise techniques, so that you can get the most out of your training. Following your Quick Start, you can continue with 1:1 sessions or join a small group S&C class where you’ll continue progressing towards your goals with a high level of individual attention.


To get started with your own Strength and Conditioning Programme and fast track to great results, give us a call on 01380 730473 to book onto a Quick Start Programme.

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Achilles Tendinopathy

What is Achilles Tendinopathy?

Achilles Tendinopathy is a common condition that presents itself typically as a sharp pain in the heel of the foot. The Achilles tendon is a large tendon located at the back of the heel which connects your calf muscles to your heel pain. When this tendon is injured, it is referred to as Tendinopathy. It occurs most commonly in middle-aged adults and in athletes.


What are the symptoms of Achilles Tendinopathy?

The most common symptom is a sharp pain at the back of the heel, but can also present itself as burning pain or a constant dull ache. It is usually worse when you get out of bed and put weight on your feet first thing in the morning, or if you walk or run after a period of inactivity. During an acute injury, there is often noticeable swelling around the tendon which may also be inflamed, which is characterised by redness and heat. It is often painful when gently squeezing the tendon compared with the non-affected side.


What causes it?

There is no single cause but instead a likely combination of risk factors. These can be described as 2 main factors; intrinsic and extrinsic:                                                                                        

Intrinsic factors include: 

  • Feet with very high arches or very low arches
  • Feet that roll inwards while walking
  • Tight Achilles tendons or calf muscles
  • Being overweight

Extrinsic factors include:

  • Standing on your feet for a large part of the day – such as is the case for Teachers and Factory Workers
  • Wearing footwear that does not support the foot correctly


How we can help with treatment:                                                                                                                                                                                                                                                             

Achilles Tendinopathy is definitely a treatable condition, with many different options available depending upon individual circumstances. A Gait Analysis appointment our Biomechanics Podiatrist will determine the causes of your Achilles Tendinopathy and recommend a treatment plan that is bespoke to you. This could include:

Orthotics: custom orthotics or insoles can be an excellent treatment option for Achilles Tendinopathy. Orthotics are suitable for people of all ages and because they are bespoke to your foot, offer the exact support required to aid your foot’s normal function and relieve the cause of your Achilles Tendinopathy.

Shockwave Therapy: This is an excellent treatment option for chronic or resistant cases and helps increase your healing capacity. This treatment works best alongside other treatments listed here:

  • Physiotherapy: This is a crucial part of the treatment plan if you suffer from Achilles Tendinopathy. Physiotherapists may provide manual therapy, therapeutic ultrasound, acupuncture, and an individually prescribed exercise programme to help build strength in weak muscles that could be causing your Achilles Tendinopathy.
  • Massage: If your Achilles Tendinopathy is caused due to tight calf muscles, our massage therapists can help to ease the tension in your muscles, thereby addressing the cause.

You can find more about our Gait Analysis service along with what to expect at your first appointment here

If you’re suffering from Achilles Tendinopathy, we can help. Book your Gait Analysis appointment online or by calling us on 01380 730473. Appointments are available at any of our clinics in Devizes, Marlborough, or Frome.

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Morton’s Neuroma

A Morton’s Neuroma is a swelling of one of the nerves in the ball of the foot. Typically you will know you have a neuroma if you start to experience pain the ball of your foot. People describe the pain as shooting, numbness, burning or stabbing. It is intermittent, meaning that it comes and goes. Generally the pain gets worse with time. At first, the area may become a little bit numb for a few minutes in a pair of tight shoes, but this could develop over weeks or months to the point where you have an intense stabbing pain in the foot every time you stand or walk for more than a few minutes.


There are a number of theories on what causes a neuroma. However, the cause is not well understood and there is very little evidence to suggest a consistent cause. What we do know is:

  • The swelling is thought to be from trauma of the nerve i.e. pressure from surrounding bones
  • The swelling is benign, not cancerous
  • It is more common in women
  • It is made worse by certain shoes or activities




A diagnosis of a neuroma can often be achieved by a podiatrist by taking a thorough history of symptoms and a range of clinical examination tests. A podiatrist can also differentiate your condition from a range of other common and more rare causes of pain in the ball of the foot. Achieving a correct diagnosis is very important in formulating the correct treatment plan for you.

Most neuromas affect the area behind and between the third and fourth toes. However, they can also affect the second and third toes and more rarely the fourth and fifth toes. Diagnostic imaging tests are sometimes required if the diagnosis is not clear enough from a clinical examination alone. The most common imaging test is an ultrasound which can help aid the diagnosis if required. It is important to mention that sometimes the neuroma cannot be detected with an ultrasound machine and therefore an alternative test may be considered such as an MRI.



There are many treatments available for neuromas. Here at Hatts, we can support you with the following:

1. Injection therapy – Sometimes an injection of steroid and local anaesthetic into the neuroma and around it, can relieve the pain and stop the neuroma from developing.

2. Orthotics – These can be of benefit when alleviating pressure from the nerve. To assess whether this is a viable option, a podiatrist will perform a biomechanical assessment and gait analysis to help determine whether an orthotic may be a suitable treatment for you.

3. Footwear choice  This is the simplest. If your neuroma only hurts when you dance in your favourite 4inch heel Jimmy Choos, then take them off to dance. This is a ‘no brainer’ and can stop your neuroma from getting worse.


After having seen one of our podiatrists, if necessary we can also refer you on for:

1. Surgery When the pain warrants it, you can have the neuroma removed by a small operation. This is often done under local anaesthetic as an outpatient setting.

2. Cryosurgery  This is a new treatment and is used as an alternative to the traditional surgical method of excision. This procedure is less invasive and involves putting a small needle through the skin and into the neuroma which is frozen whilst it is in the foot. This is done under local anaesthetic. The success rate of this procedure seems to be equivalent to surgical excision and is thus, gaining increased popularity. There is only a small amount of clinical research compared with the excision option, therefore it is currently unknown whether there is a better option at present.


If you think you may have a neuroma or you have pain in your feet, please seek help from one of our podiatrists before it gets worse by calling 01380 730473.

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