Fungal nail infection (also called onychomycosis) is responsible for approximately 50% of all nail disease and in western countries it appears to be on the rise* due to our ageing populations and lifestyle changes.
If you suspect you have a fungal nail infection there are many treatments available—although success rates vary greatly.
Treating fungal nail
“Typically fungal nail infection won’t go away without treatment; this can include over-the-counter topical antifungal creams and ointments, prescribed oral antifungal pills, laser treatment, or, in severe cases, surgical nail removal,” says Dr Brenden, principle podiatrist and owner at A Step Ahead Foot + Ankle Care.
“The biggest problem with topical antifungal agents is that they’re often ineffective, while oral terbinafine—despite being considered a ‘first-line’ treatment—requires strict adherence for 12 weeks.”
In recent years laser technology has emerged as an effective method of treating fungal nail infections. Performed by your local podiatrist, laser allows light to pass through the nail into the nail bed, effectively treating the infection at its source.
The heat from the laser kills both fungi and spores. Providing every nail is treated (which is what we recommend), the likelihood of success is high.
Preventing fungal nail from striking
“Fungal nail infection is much like a tummy bug; it can be passed on to others you come into contact with, particularly family members. As such, it really does pay to know how to protect against fungal infection,” says Dr Brenden (A.k.a Dr Foot)
The following steps can help keep your feet and nails fungus free:
Avoid public showers. If you must use a community shower—wear thongs
Boil your socks. Fungi thrive in warm, moist environment (Hello sports socks!) but they can’t survive extremely high temperatures. Boil your socks regularly, for at least 10 minutes, to kill off any hidden fungi spores.
Keep feet clean and dry. In between sweaty toes is the ideal habitat for infuriating fungi. Stop fungal infection for striking by keeping feet clean and dry. If you’re prone to sweaty feet, try an antifungal foot powder, spray the soles of your feet with antiperspirant and don’t forget to change your socks daily.
Don’t share nail clippers. Sharing is caring but not when it comes to fungal nail infection. Be vigilant at the nail salon; ensure the nail tools they use have been sterilised.
We treat several people a day for fungal nail infections. If we can help you please let us know! You can contact us through our helpful front desk team. They speak to multiple patients a day with this condition. They can run you through our process and costings and reserve an appointment time that suits you best. Our number is +61 2 9673 2987 we would LOVE to help.
Medical clinics + other podiatry clinics
If you are one of the many Podiatry / Medical clinics that follow my posts please read the details in my clinic websites, I am currently developing a course for practitioners interested in learning more effective and efficient ways of treating nail fungus. If you follow our posts we will announce this as it occurs or simply send us a message and our office will save your details. We look forward to helping you as well! Our number is 02 9673 2987. Hope to chat soon.
Children spend at least 30 hours a week stomping around in their school shoes. This means that choosing the right shoe is really important for the health and comfort of your child’s feet.
“Ill-fitting school shoes can lead to a multitude of foot problems in adulthood, such as ingrown toenails, corns, callus, bunions and hammer toes. There’s also evidence to suggest that poorly fitting shoes can cause back pain,” says podiatrist and founder of A Step Ahead Foot + Ankle Care, Dr Brenden.
No parent wants to put their child through undue foot pain or cause feet issues in later life. By understanding how to select the right shoes for children and following the guidance of a podiatrist, parents can help ensure they’re a step ahead when it comes to picking out the best back-to-school shoes.
With Dr Brenden’s top tips, choosing the right back-to-school shoes for your child should be as easy as…well…A,B,C!
Get the best fit. It can be tempting to buy a size bigger, given how fast children’s feet grow, but the key is to allow a maximum of one thumb width between the top of the longest toe and the end of the shoe.
Heel support. Squeeze the back of the shoe to make sure the heel counter is strong and stable. This way you know you’re getting good heel support. The heel of the shoe should also be no higher than 1.5 cms.
Fasten up. Check that the fastening mechanism (laces, Velcro or buckle) holds the heel firmly in the back of the shoe. Slip-on shoes are not recommended for school wear.
Sole survivor. The soles of shoes should be fairly straight, rather than curved, as this accommodates the straightness of the foot. Also, if you attempt to ‘wring out’ the shoe by holding one hand at the heel and the other in the middle, it should not twist.
Flexibility. A flexible shoe allows for the natural movement of the foot but make sure that the shoe flexes at the ball of the foot; the shoe should NEVER bend in the middle.
A higher price tag doesn’t always mean a better shoe. Well-known brands, such as Clarks, do tend to outlast some of the cheaper brands but this is because they are well made using quality materials. Check to see that the shoe you’re considering buying is made from a high-quality, durable material.
Forget foot weights. You might be fooled into thinking that a heavy shoe is a sign of good quality. Yet a shoe that is particularly heavy is probably not going to be the most comfortable choice. A shoe should weigh no more than approximately 250 grams. That’s less than a can of soup!
Hand-me-down shoes are a no-no. Aside from the risk of fungal or bacterial infection, pre-worn shoes are likely to have molded to the shape of the previous owner’s feet. It’s also probable that the tread and heel counter have worn down, offering less support and poorer stability for your child’s feet.
Listen to your child. If your child complains of foot pain or discomfort or you notice they are walking differently, take a trip to your local podiatrist to have their feet checked.
“Parents commonly ask how long school shoes should last. Of course, this will depend on the quality of the shoe but on average they should last nine months to a year.
“However, if you notice your child has a growth spurt—check to see if their feet have outgrown their shoes. On average, children’s feet grow about half a shoe size every six months,” says Dr Brenden.
Plus, check out Dr Brenden’s YouTube reviews of some of the latest (2018) school shoes on the market (Includes Ascent Eve Black, ASICS Gel Trigger, New Balance 625 KX, Target Billy Senior—to name just a few!)
Despite the fact that fungal nail infections are notoriously tricky to get rid of, they’re thankfully quite easy to avoid—if you know how, of course!
Fungal infections are seriously easy to contract and super contagious, so it pays to have a few tips up your sleeve to beat a fungal skin or nail infection.
Top 5 tips for fungus-free feet
1.Boil your socks
We’re not kidding; regularly popping your socks in a pot of boiling water can help stop you from getting fungal nail and prevent friends and relatives from catching it (if you’ve already got it!).
Why? Fungus can’t survive extremely high temperatures. Boiling your socks for 10 minutes at 55-60 degrees will kill off any fungus that might be lurking in your socks. But remember, simply washing your socks on a regular (40-60 degree) wash cycle will do nada to nuke fungal spores.
2.Don’t share showers
Communal showers are a breeding ground for fungus. This is because fungal infections are extremely common and public showers are high-traffic areas; lots of feet means a much greater chance of catching a fungal infection! Think Gyms, swimming pools, beach side change rooms!
Super tip; If you must share a shower area, be sure to wear thongs to help minimise the risk of picking up fungal spores.
3.Be nail salon smart
A professional pedicure can be a relaxing way to prep your feet for summer—but not if you go home with more than you bargained for. Busy nail salons can be a breeding ground for fungus, so make sure you seek out a reputable nail bar. Ensure a new set of tools is opened just for you and the foot basins are lined with plastic protectors that are replaced at every use.
Super tip; If you want to be super vigilant, take your own nail file.
If you’re at the beach or swimming pool and there are outdoor and indoor showers—take the outdoor option.
Indoor showers are darker and might not have the drainage that the outdoor showers do, which means that water can collect. This creates a dark and wet environment—the perfect place for a fungal spore party!
Super tip; Outdoor showers on the other hand have the benefit of UV rays, which dries the shower area and reduces the likelihood of a fungal infection.
5.Keep feet dry
Fungal spores love dark, damp places—just like between the toes of sweaty feet. An easy step to stop fungal infections in their tracks is to make sure feet are washed and thoroughly dried on a daily basis. Sounds easy right? Yet if it were really that simple, fungal infections wouldn’t be so commonplace.
Super tip; Help protect your feet from fungus by using an antibacterial foot powder or spray in your shoes and on your feet, changing your socks daily and washing your feet after exercise.
Facing up to fungus
Fungal spores are invisible to the human eye, so it’s important to be able to quickly recognise the signs of a fungal skin or nail infection. Symptoms include:
Dry skin or white patches around the toes that remain even after moisturising
Callused skin – people often think its just dry skin, look for the other signs
Small blister like patches on your skin.
Discolouration of the toenail (usually white, yellow or brown streaks)
Thickening of the nail
Let’s face it, sometimes fungal spores will get the better of us. The trick is to treat a fungal skin or nail infection at first sight.
You can start by trying a broad-spectrum antifungal cream or ointment containing the active ingredient terbinafine, which can help kill the infection. Yet despite being widely available, antifungal ointments, paints and creams have a very low success rate.
Our Podiatrist Dr Ryan explains that this is why A Step Ahead Foot + Ankle Care are fighting more and more cases of fungal nail with laser.
“Laser works by penetrating the nail, heating up the nail base and killing the fungal spores.
“To ensure the best results we always treat all ten toes so that every single spore is busted. We also use a mirco drill, which makes tiny holes in the toenail and enables the laser to successfully reach the nail bed. It can help with post-laser treatment too, as any creams applied will also make their way into the nail bed for better results.”
Added benefits of fighting fungus with laser include:
Laser can beat even the most stubborn fungal spores
5 quick signs you need to see a Podiatrist (Foot Doctor)
Kids feet are different to Adults feet! Its the building blocks to making sure our kids enjoy activity
Have you been through this?
Grandma's are great at spotting it. Your friends aren't bad. The Shoe shop lady is often a superstar at it! But lets face it you've got a lot on and the occasional "Mum" or "Dad I am" ........ shhhhhhhh I have stuff to do! "Just a second but Mum ..... my feet are sore! Whaaaaaaaaaaaaat!
So you drag the kids down to the plaza and seek out the closest and “best” footwear retailer you know. (Same woman you remember saying vaguely about it last year.) But on the way or while you are there, some funny things happen! You mention it to your “grandma” and she asks about your little ones “Flat feet” and asks have you had them checked! "Remember I mentioned it to you?" Hmm then you head to the shoe shop and the lady who is fitting the shoes asks the same thing. “Have you thought about seeing a Podiatrist” - WOW that's twice now - Houston we have a problem!
Kids and flat feet, growing pains, tripping falling and all that normal stuff!
It’s not the only time someone may say it but it happens and we hear about it when Parents bring their youngsters into us confused with quotes like “I am not really sure if I should even be here?” So after seeing literally 1000’s and 1000’s of kids over my 20 years of practice I thought maybe a quick check list may help parent on what are the reason you bring your kids to see me !
Here is my quick 6 checklist – these are the reasons I WOULD bring my child to see a Podiatrist!
1. Flat feet. I thought I’d throw this on the mix pretty early as it’s often a reason people are told they need to see a Pod. It can be confusing and often it seems like there is conflicting advice. Here is my rule – If your little one is ONLY flat footed and does NOT have any of the following, you may well be perfectly ok the way they are now! However if they have Flat feet and ANY of the following YOU NEED TO SEE OUR PODIATRISTS !
2. Tripping or falling. You may notice it or it may take someone to mention it to you. With little reason and sometimes without notice your little one trips! Sometimes it seems justified other times it seems like they tripped over a blade of grass! Somethings happening here and yes we may need to take a look.
3. Pain at night or Growing Pains. If your little one wakes at night with pain in their legs, ankles or feet its more than likely time to see one of our team. Now it can be confusing at times you will take them to see a GP and sadly very sadly they will say “Its growing pains” Grrrr 9/10 you can attribute this pain can be treated and you don’t have to wait for them to “grow out of it” If your little one has “Growing Pains” or anything else like that sounds or smells like this – Visit` our team!
4. Kids that don’t like walking or avoid activity. Some kids seem like they are always whinging, you are out shopping or with the family and out on a long walk or other family activity and your child wants to “Sit down” or “stop”. Often we simply think our kids are being Lazy. However for a good proportion of these kids it’s got to do with their poor foot posture making walking harder and yes they are actually in pain! Sometimes kids don’t even realise they are uncomfortable (Its ok, we realise it sounds strange) they just know they want to stop! We have fixed kids foot posture and seen a change that means these kids go from not wanting to walk to almost running!
5. Unusual wear on old footwear. Have you noticed that your kids shoes seem to lean to one side after a couple of months or even weeks? Have you noticed they wear out the toes and have simply blamed it on loads of Handball? This again is in our top 5 reasons for needing to see one of our team!
6. Sore feet or pain at any times. (Ok so this is a sneaky Reason 6!) It seems simple but if your child has sore feet it means they need to see a Podiatrist. NO you don’t need a referral (Permission slip) from your GP simply call and we will help. YES It’s what we do, we LOVE seeing kids because delightfully they often respond really well and very quickly to our treatment – and who doesn’t like a big smile!
So if your kids have ANY of the above Grandma and the shoe shop lady are actually on the money! If not then guess what you can fairly confidentially not worry!
As we have said above, we LOVE seeing kids. We are very lucky in that we see literally hundreds every year! If you have any of these problems or any other foot or ankle complaints please let us know! We are located in 2 spots in Western Sydney both conveniently located minutes from the M4 and with parking right out the front. Please call our helpful team on 96732987 and our team will answer any questions and help with making times to see our Podiatrists.
Dr Brenden Brown (BB) Podiatrist For the team at A Step Ahead Foot + Ankle care
NO, but why? Its best to settle on some understandings from the beginning. It is widely understood that it is “soft tissue and tendons that are what become sore in Heel Pain. The idea that Heel Spurs “cause” pain has been debunked and proven incorrect a number of times!
Over the last few years there has been an evolving understanding around how tendons and soft tissue works. Keep this in the front of your mind – “TENDONS HATE CHANGE”. Stopping all activity if you are currently active is a sure-fire way to ensure that when you return to your activity you will also see the return of your heel pain!
Boots can “Change” tendons – in a negative way!
As we said stopping all activity is not good for us. That same principal exists for those who are using an air cast or moon boots. Completely removing the function of the foot and calf will mean these muscles will most likely fatigue and lose condition. At best, you will need a delicate and dedicated rehab process to get you back to normal function.
This includes “tears” in fascia’s! We have found there is an ever-increasing body of evidence suggesting that many radiologically identified tears maybe completely normal and part of a normal aging process!
Patients often ask us at the clinic about “booting” or casting them after “a friends” practitioner did this with them their “friend”. All the evidence base suggests that this is often the wrong way forward. In good conscience, we can’t do this. It should be recognized this was once accepted practice, we know we did it!
However the evidence base suggests doing this will unload the soft tissue completely and can in itself start another chain of events and problems which you only have to overcome later! So NO BOOT!
If by chance you are reading this and you’ve been prescribed a boot. I’d respectfully ask your practitioner about what the current evidence base says about this method of treatment?
Should I change my activity?
You SHOULD make modification to activity; however, a complete stop will mean you either
A. Need to rebuild your activity over quite an extended time.
B. Your heel pain is likely to return!
For the moment STOP Jumping of and onto things. For example, on + off a truck, box jumps at exercise class, skipping or other high intensity impacting the heel and forefoot until we have you back to comfortable. We will then slowly load you back up to these activities. As a guide if it hurts STOP IT!
What do I do instead?
Our strong advice is to look for strong supportive cushioned footwear.
What does this mean? Look for the following in Sneaker style or work boot.
1.Always lace up!
2.Bend only at the toes
3.Shoes should NOT bend in the middle!
4.Should NOT twist or wring out
5.Firm heel counter (back of shoe that hugs the heel)
Wear your lace up shoes – From the moment you wake – till the moment you head to bed! No matter inside or outside! No thongs – NO bare feet! This is a far better way of providing the tendons and other soft tissue structures support without immobilizing the foot and creating more problems.
Need some help?
Our Doctors at A step ahead see between 8 – 12 heel pain patient each every day! Heel pain , sports injuries and musculoskeletal pain in feet + lower legs are our passion. We are often for many people the 2nd, 3rd or even 4th opinion for their heel pain. We are most often the last!
First steps to getting back to pain free?
Give our front desk team a call, they speak to dozens of people a day just like you with problematic heel pain. They will run through with you what you may have tried so far and get a better understanding of your pain. They will then help work out what type of appointment is best to make for you. From here they can reserve your appointment time.
We would LOVE to be able to help you on the way back to becoming Happy Healthy + active.
Our number is 96732987 or 47322007 we look forward to helping you
If you are looking for more information we have a prepared a dedicated page to helping both other practitioners and patients with information on HEEL PAIN. ” Heel Pain Doctor ” has loads of fact and helps busts some of the myths around heel pain.
Contact us at 9673 2987 with questions we want to truly understand what’s happening at present with your foot and leg pain if you are ready we will set up your initial appointment.
Learn more about your condition - Check out over 40 Educational videos our team has prepared on our Facebook page. From heel pain, and what’s the best shoes, to ball of foot pain; it’s all there.
Speak to A Foot Doctor - Reserve your free 10 minute review with one of our qualified Sports Podiatrists to review where you are up to and discuss what are your next best treatment options. (Availability limited due to demand)
Try our Heel Pain Treatment advisor. Answer 7 simple questions to get a quick, reliable report on what treatment options you should be considering!