SERVICES

Peripheral Neuropathy

Peripheral neuropathy is a condition marked by the degeneration of peripheral sensory nerves that result from a complication of a certain disease or injury. 

Peripheral Neuropathy implications are far-reaching, affecting balance, gait, and significantly increasing the propensity for falls. It also imposes functional limitations and gives rise to negative moods, ultimately undermining overall quality of life

Neuropathic pain can be described as tinging, burning, sharp, shooting and loss of feeling.  This creates a tremendous issue with painful walking, loss of balance and muscular tension. 

In this set of patients, practitioners, patients and caregivers should be mindful of the often-overlooked signs of autonomic neuropathy. Dry skin, which scales and fissures easily, thick distorted toenails, and diminished hair growth are common early findings.  Lack of perspiration can contribute to the tendency to form hotspots, calluses and potential abrasions and breaks in the skin. Making a skin care routine that nourishes the feet important to reduce chances of complications.

People with peripheral neuropathy are like the general population in so much as no two cases are the same. Extra care must be taken in examining this patient population, and determining their circulatory, neurological, psychological, dermatological status in addition to our normal biomechanical exam findings is critical in achieving consistent outcomes.

A thorough multi-system examination of the lower extremities may be the first opportunity to uncover the existence of peripheral neuropathy in any given patient. Once diagnosed, neuropathic patients should be counseled regarding how the disease may affect their feet and legs.

Balance and Proprioception Testing

How does neuropathy affect balance?

The sensory motor system is a complex system it is how we use our senses, like touch, sight, smell, hearing, and proprioception to generate co ordinated movements or motor outputs that maintain balance.

The neuropathic patient has sensory deficits that can lead to an impaired ability to feel the ground, resulting in unsteady walking and a higher risk of falls. Muscle weakness further complicates gait, causing difficulties in lifting the feet, leading to a shuffling walk or foot drop. The loss of proprioception, the sense of the relative position of body parts, exacerbates balance issues, making it challenging for individuals to maintain stability, especially in low-light conditions or on uneven surfaces. Consequently, peripheral neuropathy not only diminishes physical mobility but also significantly affects the quality of life. Proper assessment is key in helping manage symptoms and tailored programs like our clinic offers are key in improvement in balance and gait.

We go beyond a visual assessment alone and use the RSscan pressure plate to see how you move and assess your balance which allows us to tailor the therapy to match your needs.

By using the footscan v9 and clinical software it creates comprehensive reporting for static, dynamic, 3D visualizations, and force graphs.

The footscan v9 and software is scientifically proven and validated having actively participated in over 3,000 scientific studies, research papers, articles and books.

Gait Analysis

Your feet and ankles are complex load-bearing structures with many interconnected moving parts. Gait analysis is critical to determine underlying cause of most foot and lower extremity conditions. Many problems can be treated most effectively by addressing mechanical function. Biomechanical care may include orthotic devices, shoes, shoe modifications or changes, stretches, physical therapy, and other modalities.

Evaluating how you walk

Most foot problems occur because of improper function of the foot during gait. Analyzing how your feet and legs function when you walk can provide us crucial information when designing a proper treatment plan to help make your feet feel and function better.

Abnormal gait biomechanics can cause foot problems such as arch pain, heel pain, and bunions. Alterations in foot function can also lead to problems with your knees, hips and back.

Some items we look for when performing a gait analysis include:

• How hard do your feet hit the ground? If your feet hit the ground excessively hard the increased shock can damage tissue. If this is the case, additional cushioning under the heels or the ball of the foot may be needed.
• Are your feet functioning symmetrically? If one foot rolls in more than the other that puts abnormal strain on the pelvis and back which can lead to lower back pain among many other conditions.
• Does one leg appear to be longer than the other? Limb length discrepancies can lead to a number of lower extremity problems.
  Watching you walk – gait analysis

First, we simply watch you walk. Most significant gait abnormalities can be identified with simple visual analysis. We understand how feet should function. While watching you walk we are also paying close attention to the areas of the feet that are causing you discomfort.

G-Pulse

The G-Pulse machine is used to increase blood supply and oxygen to the body by using a pulsating Magnetic field therapy and magnetic bio stimulation and IR laser light beams. The G-Pulse has great success with peripheral neuropathy, connective tissue repair, acute and chronic inflammation.

How G-Pulse Works:

The number and duration of treatments will vary according to the indication. In the case of acute disease, the duration of the therapy is mostly shorter and less frequent.

Treatment may make symptoms worse after first 1-3 treatments because chronic conditions are brought to an acute stage, the “reactive phase”. This period is a sign that the body is reacting to the treatments as well as a sign that regeneration is beginning. After this period, the long-term healing effect begins, and there should be improvement, along with a decrease in pain.

Ingrown Toenail Surgery

3D Printed Custom Orthotics

The team at North Bay Foot and Ankle Clinic are at the cutting edge of new technology and products that will give our patients the best results possible, so they can live an active and healthy lifestyle.

As part of our commitment to innovation, our clinic offers FitStation powered by HP, which combines 3D foot scanning with dynamic gait analysis to enable both orthotic recommendations and 3D printed custom orthotic. The team at North Bay Foot and Ankle Clinic will analyze your findings and prescribe a 3D printed custom orthotic just for you.

The lattice-design of the 3D printed custom orthotic is superior in every way because they are lightweight and comfortable while helping to correct the biomechanical problems that lead to pain and discomfort.

• A 3D printed custom orthotic allows your foot specialist to design a device that has more precision and comfort than ever before.
• For areas of your foot where more biomechanical control is needed, the 3D printer fills the lattice-spaces without making the orthotic thicker or heavier.
• Other segments of the foot may require more, or less, support and flexibility. 3D printing can achieve all of this through more or less filling of the lattice-framework without the bulkiness or other custom orthotic
• Our 3D printed orthotics are thin and lightweight, so they will fit in most of your footwear.
• By wearing your 3D printed custom orthotic as prescribed, you will be pain free faster!

About 3D Printing

3D printing, also called additive manufacturing, is known to be very precise, and therefore, more reliable than error prone manual manufacturing, which has dominated the custom orthotic industry since the 1950s. Unfortunately, 3-D printing custom orthotic had not been an option due to slow printing speeds and materials that lacked accuracy, durability and comfort.

HP Inc. broke through those barriers through the introduction of a revolutionary Multi Jet Fusion 3D printer, patented bio-compatible nylon printing powder and lattice-design that offers unprecedented comfort and control, while maintaining a thin profile that will fit in most shoes.

Pediatric Assessment

It’s not normal for kids to complain of foot pain!

Children’s feet have a unique development pattern and function. Unlike teeth and eyes, foot health in kids is often neglected. This can lead to problems not only in the feet, but in the legs and back.

Contact us for an appointment at the North Bay Foot and Ankle Clinic if you notice any of the following:

• Your child complains of pain in their feet, ankles, or legs
• Your child is constantly tripping and falling
• Uneven shoe wear
• Your child has a gait or foot position when walking that you think is unusual
• You notice any skin rashes, hard skin, lumps, or bumps on the feet
• When should you have your child’s feet and gait checked?

When your child begins to walk (12 months)

• Age 3 ( this is when children develop a more adult “heel-to-toe” gait)
• Age 5 (when starting school)
• When beginning organized sports
• What is included in a kids foot check-up?

We will check every aspect of your child’s foot health, walking pattern, and footwear. Please bring in your child’s footwear to make the most out of your appointment.

• Examination of joints and leg of lower extremities
• Compare growth and development to normal for your child’s age
• Evaluate gait and walking pattern
• Go through family history of foot problems such as, flat feet, high arches, bunions, and much more
• Check skin and nail condition
• Evaluation of muscle function
• Evaluate child’s footwear
• Chiropodist Stephanie Poupore not only specialized in Podopediatrics but is great with kids and looks forward to making sure that your child’s feet and ankles are developing normally to prevent future problems. Contact us at the North Bay Foot and Ankle Clinic today to make your child’s future a step in the right direction.

Sports Medicine

As with any sporting activity, it’s very important to be aware of the safety precautions needed to help avoid injury and reduce risk. With that being said, injuries of the foot and ankle are fairly common among those who actively participate in sports.

Some sports may be considered more dangerous in terms of foot and ankle injuries compared to others. These sports may include basketball, running, football, soccer, and dancing. Sports that require tightly worn shoes as well as have a particular focus on jumping typically run a higher risk of injury. Because the feet are considered the foundation of the body, help us stay balanced, and enable us to perform our everyday activities, professional help should be sought at the first instinct of something gone wrong.

Some common contributors that lead to foot and ankle injuries in the realm of sports include not stretching properly or failing to warm up, wearing the incorrect footwear needed for your particular sport, as well as not taping or providing your feet and ankle with the needed support. There are a number of foot conditions that can develop if certain safety measures are ignored. Some of the most common conditions related to sports injuries include Achilles tendinitis, plantar fasciitis, and stress fractures, to name a few.

Achilles tendinitis affects the largest tendon in the body, the Achilles tendon. This type of injury typically occurs because of overuse. The main function of the Achilles tendon is to transmit power from the calf muscles to the heel and the foot. When this tendon is harmed, it can be extremely painful and may lead to further complications including tears, ruptures, tendinitis, peritendinitis, tendinosis, tendinopathy, and bursitis.

Plantar fasciitis may occur when the band of tissues that support the arch of your foot experience too much stress. These tissues can become strained from frequently performing sporting activities, thus causing inflammation and pain at the bottom of the heel.

Stress fractures can arise due to a lack of conditioning, use of improper equipment or technique, and repetitive stress placed on the foot and ankle. A stress fracture is a small crack in the bone that can be very painful and cause a great deal of discomfort.

Other conditions associated with Sports Medicine are: Neruoma, Bunions, Pes Planus (Flat Feet, Low Arch), Pes Cavus (High Arch), Heel Pain, Metatarsalgia, and Bursitis. 

If you commonly participate in sporting activities and would like more information about how to keep your feet and ankles safe, as well as learn more about your treatment options if injured, we recommend you contact our office for professional guidance and care.

Compression Stockings

Compression stockings are specialized hosiery designed to help prevent the occurrence of, and guard against further progression of, venous disorders such as edema, Phlebitis and thrombosis. Compression therapy helps decrease venous pressure, prevents venous stasis and impairments of venous walls, and relieves heavy and aching legs.

Treatment is usually prescribed by a physician to relieve all manifestations of chronic venous disease and prevent venous troubles. Compression stockings are recommended under the following conditions.

• Edema
• Chronic venous insufficiency
• Varicose veins
• Deep vein thrombosis
• Lymphedema
• Phlebitis
• Pregnancy

Compression classes

Compression stockings are offered in different levels of compression. Over the counter support is available in 10-15 mmHg or 15-20 mmHg.

Higher pressure stockings require prescription and a trained fitter. Higher pressure stockings range from 20-30 mmHg to 50+ mmHg.

Kery Flex

Kery Flex is a painless procedure that restores the appearance of a toenail that has become damaged or lost. This can be used on a toenail that has 10% of nail to adhere the porous resin. Kery Flex is a resin material that is applied and hardened to the remaining nail bed, to have a normal looking nail. Porous resin allows the nail to look great while treating fungal infections if needed.

How Kery Flex Works:

Once determined Kery Flex is right for you, the damaged nail is trimmed and filed down. Next a bonding agent is applied and then the resin. This is hardened with an ultra violet light.

Diabetic Foot Care

For people with diabetes, having too much glucose (sugar) in their blood for a long time can cause some serious complications including foot problems. As a person with diabetes, you are more vulnerable to foot problems, as diabetes can damage your nerves and reduce blood flow to your feet. Our clinic provides a thorough diabetic assessment as well as ongoing routine checkups to maintain excellent foot health.

Diabetes foot care health tips

• Wash your feet daily with mild soap in lukewarm water
• Pat to dry, do not rub
• Apply cream once feet are dry

Examine your feet each day

• Examine the tops and bottoms of your feet for any sores or debris. If you cannot examine them yourself have someone examine them for you.
• Check for any cracks and dry skin.
• Look for cuts, scratches, blisters, or any other sores.
• Check for ingrown toenails, corns, and calluses.

Protect your feet with proper footwear and socks

• Never go bare foot. Always protect your feet by wearing shoes or hard-soled slippers or footwear.
• Look and feel inside your shoes before putting them on to make sure there are no foreign objects or rough areas.
• Avoid tight fitting socks.
• Wear natural-fiber socks such as wool or cotton.
• Change socks daily.
• Wear shoes or boots that will protect your feet from various weather conditions such as the cold and moisture.

Nail Conditions, Corns & Calluses

Toe Nail Conditions

• Onychocryptosis (Ingrown Nails)
• Onychauxic (Thick Nails)
• Fungal Nails
• Involuted (nails that curl into the skin.)

What Really Causes Thick and Ugly Toenails?  Nail Fungus vs. Nail Dystrophy

There are two primary causes of thick toenails. The first is nail fungus and the second is a condition called nail dystrophy. Nail dystrophy is a thickening of the nails caused by repeated micro-trauma to the nail, for example from the nail hitting the top of the shoe over many years. The most common causes of thick, yellowed and ugly nails include:

• Nail fungus
• Trauma to the nail
• Shoe pressure on the nail
• Poor circulation
• Some disease conditions (psoriatic arthritis is one illness that can cause nail changes)

Calluses

Calluses are the skins response to excessive pressure and for on areas of the skin that overtime take on too much pressure. Corns generally occur at pressure points, typically the bottoms of feet and the sides of toes; left untreated they can become quite painful.

How do we reduce calluses and corns?

Gentle debriding using a painless skilled sterile scalpel technique removes calluses and painful corns. Then a thorough pressure analysis or biomechanical assessment is done in order to determine the cause of the corn such that a treatment plan can be implemented to stop the pressured thickened skin from returning.