Symptoms involves trying to understand your patient’s foot issue and patent history taking skills this might involve discussing:

• Investigating the location on the foot the pain occurs

• Describing the severity of pain with the visual analogy scale (VAS) or a patient reported outcome measure (PROM)

• Was the pain sudden from an acute injury or trauma or has the pain developed gradually over time

• How long has the pain existed in their foot, has it been there for 2 weeks, 2 months or 2 years?

• When does the foot pain occur, at rest, on activity, after activity during resting

• Describing the type of pain they are experiencing, ache, dull, throbbing or sharp, shock, pins and needles, tingling

• Pain management medication can help reduce symptoms/inflammation, which can aid recovery

• Community pharmacy can provide guidance on specific medication or other methods of pain relief

Padding 

• Some people also find benefit from wearing bunion pads, bunion protectors and toe separators etc. these devices can be made from various materials (fleecy web/semi compressed felt etc) and can help to reduce pressure and friction from footwear rubbing on the bunion. these devices/padding can also be bought from local pharmacy or online.

Corns, callous reduction and nail pathologies

• If required within clinic foot-care advice with regards to ongoing management of painful callous, corns, inflamed skin, nail pathologies

Insoles or functional foot orthoses are inserts that are put inside your shoes to influence and improve the function of your foot. they are designed to reduce or absorb pressure or alter how hard and long the muscles in your legs and feet work. these device are to provide relief to areas of tissue stress that affect the part of the foot, the service user is having trouble with.

The insole will form one part of a prescribed care plan to help your condition improve, along with home exercises, footwear advice and possible lifestyle changes. Insoles can have an effect on your whole body and consequently must be treated with respect when first using them.

Based on nhs scotland board’s realistic medicine strategy it’s important to listen and try and understand our patient’s problems and preferences.

Sharing decision making between healthcare professionals and your patients can be key to successful outcomes.

These three areas are a combined area that we require to help assist our service users in their rehabilitation of their foot issue, with these demonstrated to the service user and techniques, these are included on our website and our patient information leaflets for our service users. As a result of ageing, muscle and connective tissue decays resulting in a decrease in flexibility and strength, limiting the individual’s functioning capacity.

Strength Training
The nervous system includes the brain, spinal cord and nerves to control the motor function of the muscles. Neural adaptions, strength training helps develop motor pathways that enhance brain-body coordination, these adaptions describe how the brain recruits muscle to contract to produce a particular movement.

Stretching/Flexibility
What happens to the body when performing stretching, this might include increasing joint range of motion but also is known to:

• Change the water content in the fascia separating the muscles

• Induce stem cells in the tendon to aid stem cell differentiation to produce protein like collagen

• Reduce sensitivity to pain

• Down regulate the reflex loop

• Increase the sacromere length of the muscle fibres

Strapping
Using strapping with the use of applying tape includes the aim of limiting unwanted movement at a joint or offloading specific anatomical structures where a weakness has been identified but also allows our service users to improve their mechanics and alter muscle imbalances during movement.