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Dr Sebastián Reyes Reyes Moguer
 In his surgery, as well as classic foot care – calluses and corns, in-growing toenails, papillomas, plantar verrucas, etc, he attends amongst others, orthopaedic problems, creating customised insoles himself, after a detailed study of the foot, taking three dimensional imprints and plaster casts, and manually creating each insole. Customised orthesis (silicone correctors).
He also practices micro-surgery on pathology of the foot, on bunions or “hallus valgus”, stenosing tenosynovitis, etc.
Always check the dangerous “diabetic foot” condition, avoiding the common dry gangrenes.
What is podology?
Podology is a healthcare profession that handles the complete and integral care of the foot and its relation to the rest of the body. It is practised by podiatrists who obtain their qualification after three years of university studies. It used to be a branch of nursing but due to the need to specialise it became an independent discipline and career.
What are the functions of the podiatrist and how is he/she different to the chiropodist?
The podiatrist handles the care and treatment of all illnesses and disorders that may affect the foot: skin alterations (calluses, corns...), nail alterations (in-growing toenails, deformed toenails), infections (funghi, papillomas...), deformities of the toes (hammer toe, claw foot, bunions...). And deformities of the foot in general (high arch, flat foot, vertical talus...).
While the term chiropodist is a term for the person who is dedicated to the removal of calluses. It does not exist as a professional qualification. The podiatrist goes far beyond that, as he/she tries to solve all problems that appear on the foot, not just calluses.
Does the podiatrist form part of the national health service?
No, it is an independent profession practiced in private centres: podology clinics or poly-clinics that have other healthcare specialties.
Who should visit the podiatrist?
Although it is the elderly who take special care of their feet, it is recommended to attend a consultation from an early age as problems may arise in children that can pass unnoticed and which need to be treated as soon as possible to avoid complications in adulthood.
PODOLOGY ADVICE:
What bears more relation to the skin?
There are a great number of diseases that can affect our feet: muscular diseases, circulatory, of the nervous system, etc. But especially diabetes due to the large number of people it affects and the serious foot problems it can cause.
Diabetics must pay special attention to the health of their feet and get regular check-ups with their podiatrist, as any problem affecting the skin of a diabetic’s foot (cuts, calluses) if not adequately treated may lead to subsequent complications such as ulcers and in more serious cases, amputations.
What are the most important steps for maintaining good foot health?
Maintain daily hygiene, with special attention to the drying of certain areas such as the gaps between the toes as excessive sweating can provoke the appearance of fungal infections.
Good moisturising is advisable, with creams, especially on the heels. When normal creams are not sufficient and cracks appear in the heels or an excess of hard skin, you must visit the podiatrist or dermatologist for advice on specific foot creams.
The nails must be cut straight across, trying not to cut the corners as they may stick into the skin and cause infections in the toes.
It is also necessary to attend the podiatrist in the event of any problem and not try to solve it at home by using dangerous products such as callicides, razor blades, patches, etc, as in many cases these can worsen the problem.
Is footwear important for the health of our feet?
It is not important, it is fundamental. We must bear in mind that the main purpose of footwear is to protect our feet from the floor; therefore it must be comfortable and adequate.
All feet are different, which is why we have to find the footwear that best adapts to the characteristics of our feet. Unfortunately, nowadays, footwear is chosen for aesthetic reasons and often is incompatible with good foot health. The footwear must be wide at the tip and not squash the toes or create calluses, hard skin or in the long term produce deformities on the toes (such as claw foot, bunions).
It is advisable that the heel not be excessively high or thin in order to avoid overloading the front part of the sole of the foot and, lastly, the footwear must be made from natural materials, such as leather, to avoid problems of excess perspiration and unpleasant smells.
PODOLOGY INFORMATION
DEFORMITIES OF THE FOOT
Flat foot: deformity characterised by the collapse of the plantar arch through the subluxation of the astragaloscaphoid and/or astragalocuneiform joint, accompanied by pronation of the rearfoot and supination of the forefoot.
Pes valgus (vertical talus): external deviation of the axis of the calcaneus on frontal plane with sole of the foot facing outwards.
Pes cavus (high arches): deformity characterised by an increase in the height of the plantar arch.
Pes cavus-valgus: a peculiar variety of flat foot in which the collapse of the plantar arch is due to a deviation of the rearfoot valgus without an alteration of the astragaloscaphoid or astragalocuneiform joints.
Pes equinus: deformity of the foot characterised by a plantar flexion of the ankle with collapse of the forefoot.
Clubfoot: congenital foot deformity. There are 3 varieties:
Equine-varus-supinatus (the most common), talipes valgus (the resolution is almost always spontaneous and vertical astragalus (which has the worst prognosis).
Synostosis: anomalous bone junction between two or more bones of the foot.
Halux valgus (bunions): deformity of the forefoot characterised by a varus deviation of the 1st metatarsal and varus of the 1st toe, with prominence of the head of the 1st MTT (bunion).
Hallux rigidus (arthritis of the big toe) arthritic degeneration of the first metatarsal-phalangeal joint with progressive reduction of flexing movement on extension of same.
Metatarsalgia: localised pain at plantar level of forefoot at the top of the metatarsals.
Talagia: localised pain at plantar level or behind the calcaneus, of inflammatory, neurological or mechanical origin due to overloading of the insertion of tendinous and aponeurotic structures of the rearfoot.
Hammerfoot: deformity in the flecion of the interphalangeal proximal or distal joint of a toe.
Paralytic foot: deformity of the foot as a result of the loss of movement due to neurological disorders which provoke paralysis of the muscular groups with insertion in the bones of the foot.
Diabetic foot: group of sequelae at cutaneous, vascular, neurological and osseous level that can be found in the feet of diabetic patients, as a consequence of the failure to control the metabolic profile.
Rheumatic foot: inflammatory or degenerative diseases of the foot which recognise a systemic pathogenesis of rheumatic nature.
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