Fungal nail with “false negative” results?

Fungal nail with “false negative” results?

So you think you have a fungal nail? A sequence of a toe nail suffering from fungus infection.

Does any of this sound familiar?

  • Yellow and discoloured?
  • It has a line running through it or often down the nail.
  • It’s maybe becoming crumbly and brittle?
  • It may be a little smelly

You think it’s a fungal infection and all the pictures you’ve seen of fungal on the net tell you it’s a fungal infection, but your Doctors testing keeps saying you’re wrong. But maybe you’re NOT!

I hear time and time again over many many years this very same story. So why does it happen? Over the many years these are my summations as to why we are getting what we refer to as “False Negative” results.Fungal maginifying glass

  • Mistake 1. You need to treat it like mould in your kitchen! So your Doctor trims your nail and pops the offending nasty bit in a little see-through plastic jar with a yellow lid. Seems like it all ok, however that same little yellow container later that day is often placed in the back of a Pathology collectors car and it sits there possibly in the sun as they run around collecting all sorts of nasties from other Dr’s clinics. Sadly like mould fungus is killed off by UV sunlight – So here we have mistake one!
  • Mistake 2. This has been going on for months and you have tried everything! You tried creams and paints of all descriptions! However while it may seem to go away a little it comes back time and time again. Now if you have used those paints and creams then this may have an effect on the result the test results small amounts may kill any fresh fungal spores and are most likely to kill surface fungus however not the entrenched fungus. So all that cream may not be killing the real fungal problem but is killing the chance of a positive test result.
  • Mistake 3. When you head to your GP they often don’t cut very much of the nail and so the amount of nail sent with fungus on the surface or ingrained in the nail is not significant and possibly they miss the area entirely!

fungal bugs ASAWith 20 years of experience I have seen literally thousands of fungal infections and with those thousands of frustrated patients who had tried all the marketed pharmacy ointments paints and creams. I am really happy to say that we have finally found an answer in Laser treatment of fungal nails.

Laser treatment of fungal nails is now a safe and highly effective treatment of fungal nails. As a practitioner I personally went over to research treatment options for this condition and was impressed with laser so brought this technology back to Australia. Since bringing this back almost 3 years ago now we have had excellent results and haven’t looked back. Part of this success though has outstripped others in the field as we have introduced in combination with laser a 4 point system that assist in killing the fungus in all the places it lives.

If fungal nails are a concern for you please contact our team A Step Ahead Foot and Ankle care and chat to the team about Laser and our system for making sure you are truly successful in removing all traces of fungus in your nails.

Please call us on 96732987 or 47322007 we would love to help get you back on the right track!

BB's looking super clever in Bright red Red Foo frames! No BB doesnt wear glasses!

BB's looking super clever in Bright red Red Foo frames! No BB doesnt wear glasses!

Brenden Brown

Principle Podiatrist
A Step Ahead Foot + Ankle care
Penrith, St Marys and soon to come to a suburb near you!

Brenden our Podiatrist “back” in the media

Brenden our Podiatrist “back” in the media

If you havent come across us before you may not realise that Brenden our principal Podiatrist has for many years been considered one of the foremost experts on feet  and Podiatry in Australia. He has for years been called upon to make comment as an expert. From the today show to the Brenden our Podiatrist "back" in the media - 1Sydney morning herald to Dolly magazine!
This month BB is in HCF’s Fit &well magazine, just in case you don’t get a copy or cant see and read the text here it is below.

“Best foot forward

“High heels tilt your pelvis forward, throw your centre of gravity out of alignment and force your back muscles to work harder to maintain stability,” says Brenden Brown, spokesperson for the Australian Podiatry Council.

If you have lower back pain women should choose a shoe with a wide, flat heel of no higher than 2.5 centimetres and men should avoid wearing loafers and things.  “Lower back pain can also be treated in some people by addressing poor foot posture with orthotic supports in shoes,” Brown says.”

A new treatment for Heel pain.

A new treatment for Heel pain.

Heel pain treatment cuts down recovery time

Heel pain treatment cuts down recovery time

Shock wave therapy is a relatively new treatment option used for musculoskeletal conditions. This treatment was initially seen in hospitals for “breaking down” kidney stones that were too large to pass. A Step Ahead Foot and Ankle care has found it particularly helpful for HEEL PAIN.

Now the technology has been modified so that the high pressured acoustic shockwaves travel through the skin to stimulate blood flow to the injured area which speeds up our own healing processes within our body for tissue repair.

A Step Ahead Foot and Ankle care were one of the first clinics in Sydney to try this effective new technology and have found it to be highly successful.

What conditions is it suitable for?

Shock wave is commonly used for musculoskeletal conditions, some examples include:

  • Heel pain / plantar fasciitis.
  • Achilles tendonitis / tendonosis
  • Patella tendonopathy.
  • Shin pain / Shin splints.

The Podiatrist at A Step Ahead Foot and Ankle care will be able to tell you if your problem is suitable for this treatment.


What does it feel like?

Pressure is pushed on the injured area with the probe. The shockwave treatment will feel a little uncomfortable like short bursts of throbbing sensations through the probe. Almost 100% of our patients while first a little hesitant have found this to be much better than first thought.


How can A Step Ahead Help you?Shockwave_Unit_HI

A Step Ahead Foot + Ankle care have had many years of experience using this technology and have become a leader in this field. With years of experience with this technology combined with almost 20 years of clinical practice experience you are in good hands

Resolution of pain is most often achieved through a combination of treatments this may include:

  • Assessment of foot and leg mechanics
  • Activity modification
  • Footwear advice
  • Orthotic therapy
  • Stretching exercises
  • Taping

Please call our helpful reception staff to make an appointment and be sure to mention your interest in the exciting new technology. 9673 2987 or 43322007

How is a custom made orthotic created?

How is a custom made orthotic created?

Several years ago A Step Ahead Foot and Ankle care decided that to have more control of our patients outcomes we needed to make our own orthoses in house. Patients and often their referring doctors often don’t realise that many podiatrists in fact do not make their own custom made orthoses. While they can prepare a script they have trouble really making a device that is perfectly matched to the foot.

In our last article we described how orthoses should be prescribed. As you will see the process is fairly complex and requires a number of measurements using some specialised equipment and a great deal of clinical expertise. The junior podiatrists at A Step Ahead Foot and Ankle care who have already completed a university degree and 1000 clinical hours still are observed and work with one of our senior podiatrists for the first two years after graduation to make sure they have a strong knowledge base behind them when designing an orthoses for a patient.
Once a 3 dimensional scan and measurements are taken of both your feet, it’s time for our Podiatrist to design the orthotics. Designing each orthoses is done using Cad-Cam software and specific to each person, each person’s individual design takes approximately 15 minutes ensuring a complete match to your foot.

From here the design is sent to A Step Ahead Foot and Ankle care’s CNC mill for cutting on average this takes about 20minutes for each of the orthoses shell. As mentioned before, each orthotic is individual and subsequently there can be as little as 1 mm differences in measurements in the orthoses so ensuring we get the milling right is very important. 

After the mill has finished its very precise job, the orthoses edges need grinding so they fit comfortably into a shoe. At this time we will add covers to enhance the comfort of the device and small additions which will tweak the way you walk, such as metatarsal domes and rocker bars and possibly even more cushioning! We will also look at any further adjustments needed to change the postural position of your feet and legs. This can all add up and takes about an hour’s worth of time per pair to finish.

As you can see making a custom made orthoses can really take some time they are very complex devices with a real “handmade” component to each of them. Each device is designed to meet each patient’s specific health needs. So when people rightly ask “How come your orthotics cost …….” You can tell them because my orthoses are handmade just for me!

What are Ballet Dancer’s feet?

While they may entertain you on stage with wonderful dancing styles which you have never seen, and you may think that they are smart in everything they do, but you are wrong – ballet dancers have very ugly feet. They suffer from a condition called Ballet dancer’s feet. This is the reason they dance in shoes.

Because of the pressure, straining and twisting they cause on their feet while dancing, their toes are crooked, their nails are discoloured and shapeless, and the skin is rubbed to the extent of becoming raw.

They also suffer from bunions, calluses and corns. This is what is called Ballet dancer’s feet; it is the condition in which the feet suffer deformities and other injuries, on the skin surface, and internally in the ligaments and bones.

It is not only dancing which may cause Ballet dancer’s feet; wearing tight shoes, and walking long distances, sporting and many other activities which strain the feet may cause your feet to develop injuries similar to those of the Ballet dancer’s feet. 

If at any time you suffer you should visit A Step Ahead Foot and Ankle Care. Mr Brenden Brown, Principal Podiatrist and the other foot care specialists of the clinic will assist you in the care and treatment of Ballet dancer’s feet. The symptoms of the condition include inflammation, pain, irritation, scalds and hard scars on or below the feet.

For all your Foot and Lower Limb Care needs, come and see us at:
A Step Ahead Foot & Ankle Care
24 Phillip Street, St Marys; or
Suite 4, 36 Woodriff Street, Penrith