Case Studies and Guides Comprehensive Insights into Foot and Lower Limb Health
At Well Heeled Podiatry, we believe in empowering our patients with the knowledge and resources they need to understand and manage their foot and lower limb health. Our collection of case studies and detailed guides provides real-life examples of how our expert treatments have transformed the lives of our patients, along with in-depth advice on managing a wide range of foot conditions. Whether you’re seeking solutions for chronic pain, recovering from an injury, or exploring preventative care, our resources offer valuable insights to support your health journey.
Managing Ingrown Toenails Joan's Journey to Pain-Free Feet
At Well Heeled Podiatry, we recently treated Joan, a patient struggling with a painful ingrown toenail on her right foot. The nail was highly curved (involuted) and digging into her skin, making daily activities and wearing certain shoes uncomfortable. Left untreated, this condition could have led to infection or required surgery.
Immediate Relief & Early Intervention
We carefully trimmed and filed Joan’s toenail, removing any sharp edges that were cutting into her skin. This instantly relieved some of her discomfort and prevented further irritation. Early intervention is crucial, as untreated ingrown toenails can lead to infections and more severe complications.
Footwear Adjustments
Upon assessing Joan’s footwear, we found her shoes were too narrow with a pointed toe box, placing additional pressure on her toenail. We advised her to switch to wider shoes with more toe space, which helped alleviate discomfort and prevented the condition from worsening.
Custom Nail Bracing for Prevention
Given Joan’s naturally curved nails, she was at high risk of recurring ingrown toenails. To prevent this, we recommended custom nail bracing, a non-invasive technique that helps straighten the nail over time. This significantly reduced her risk of future nail issues and allowed for natural, pain-free nail growth.
Avoiding Surgery
While Joan’s case was managed conservatively, if her condition had worsened, we would have considered partial nail avulsion—a minor surgical procedure to remove part of the toenail. Fortunately, her toenail responded well to our non-surgical approach, eliminating the need for surgery.
Key Takeaways:
- Don’t ignore ingrown toenails—early treatment prevents infections, severe pain, and the need for surgery.
- Proper footwear matters—narrow, tight shoes worsen the condition, while wider shoes relieve pressure.
- Custom nail bracing is an effective, non-surgical solution—ideal for those with highly curved nails.
- Surgery is a last resort—many cases can be resolved with early intervention and preventive care.
Joan’s case highlights the importance of seeking podiatry care at the first sign of an ingrown toenail. With the right treatment plan—timely intervention, proper footwear, and preventative bracing—patients can enjoy long-term foot health without invasive procedures.
Overcoming Chronic Toe Pain Julie’s Journey to Pain Relief
We recently worked with Julie, a hardworking professional who spends long hours on her feet. She had been struggling with chronic pain and stiffness in her right big toe, which worsened throughout the day and significantly impacted her mobility. She also experienced occasional hip pain, adding to her discomfort. Julie’s case highlights how a comprehensive and individualised treatment plan can lead to lasting relief.
Identifying the Root Cause
A thorough assessment and imaging confirmed that Julie had arthritic and degenerative changes in her right big toe joint. This led to a limited range of motion, making walking painful. Additionally, she had tight calf muscles and restricted plantar fascia, which were contributing to her discomfort.
Supportive Footwear for Immediate Relief
We recommended that Julie wear stiff forefoot sole shoes to offload pressure from her big toe joint. This helped reduce strain while walking and improved her overall mobility.
Foot mobilisation and soft tissue therapy
We implemented a six-week treatment program consisting of foot mobilisation and tool-assisted massage. These techniques helped restore joint movement and break apart stiffness, allowing better flexibility in the toe joint.
Addressing tight calves and plantar fascia
Julie’s tight calves and plantar fascia bands were worsening her symptoms. We introduced myotherapy, which used targeted massage and release techniques to improve flexibility and reduce strain on her foot and lower limbs.
Exercise program for strengthening and flexibility
Julie followed a tailored exercise program that included:
- Mobilisation exercises to improve big toe movement
- Spiky ball exercises to loosen tight muscles in the foot
- Calf stretches to improve overall flexibility
Custom foot orthotics for long-term support
To prevent the recurrence of pain, we designed custom foot orthotics tailored to:
- Realign foot posture and correct imbalances
- Redistribute plantar pressure to reduce stress on her toe joint
- Enhance toe function with a specialised cut-out, aiding propulsion and minimising joint strain
The Outcome: Lasting Pain Relief and Improved Mobility
After following her treatment plan, Julie experienced significant pain reduction and improved mobility. Her big toe stiffness eased, allowing her to move comfortably throughout the day. The correction of her foot posture also alleviated her hip discomfort, ensuring better overall movement. Julie’s case highlights the importance of a holistic approach to foot pain. By treating the root cause and combining multiple therapies, we helped her achieve lasting relief—allowing her to continue her active lifestyle, pain-free. Read more about this case study here.
Overcoming Sciatic Nerve Pain Wendy’s Journey to Pain Relief
At Well Heeled Podiatry, we had the opportunity to help Wendy, a patient who had suffered from sciatic nerve pain for 16 years. Despite seeking physiotherapy and using custom orthotics, she continued to experience discomfort that limited her mobility. Eventually, her pain worsened, and she sought our expertise to find a more effective, long-term solution.
Uncovering the Root Cause
Wendy had been told her foot pain was related to her sciatic nerve. However, after a thorough biomechanical assessment, we found localised pain under the third metatarsal of her right foot. We recommended an MRI, which revealed a tear in her plantar plate—an essential stabilising ligament under the foot. This was a major breakthrough, as it meant that her ongoing pain had a separate cause beyond sciatica.
Custom Orthotics and Adjusting Footwear
Wendy had been using a toe separator for temporary relief, but it was aggravating her plantar plate injury. We guided her through a gradual phase-out of the separator while introducing new custom orthotics specifically designed to offload pressure from the injured area. Additionally, we discovered a leg length discrepancy (0.8 cm), which was contributing to uneven weight distribution and worsening both her foot and sciatic pain.
Shockwave Therapy for Faster Healing
To accelerate Wendy’s recovery, we implemented shockwave therapy, a treatment that reduces inflammation and promotes tissue healing. Over five sessions, this therapy significantly improved her plantar plate injury. We also recommended supportive footwear with a stiffer forefoot sole, allowing her to walk more comfortably without straining the affected area.
An Unexpected Outcome: Sciatic Pain Relief
While our primary focus was treating Wendy’s foot pain, correcting her leg length discrepancy and foot biomechanics had a surprising benefit—her sciatic pain, which had persisted for 16 years, completely disappeared. By restoring balance and alignment in her lower body, we removed the underlying mechanical stress that had been affecting her lower back, hip, and sciatic nerve.
Key Takeaways:
- A holistic approach is essential—treating foot biomechanics can resolve pain beyond the feet, including long-standing sciatica.
- Custom orthotics should be specific to the injury—generic insoles may not provide targeted relief.
- Shockwave therapy is a powerful tool—it promotes healing in soft tissue injuries and can enhance recovery.
- Proper footwear matters—shoes with a stiffer sole reduce strain on the foot and support long-term healing.
- Leg length discrepancies impact the entire body—correcting even a small imbalance can significantly reduce pain and improve movement.
Wendy’s case highlights the importance of seeking a podiatrist who looks beyond surface symptoms. By addressing her unique biomechanical needs, we helped her achieve pain-free mobility, allowing her to walk long distances again—without sciatic or foot pain for the first time in years. Read more about this case study here.