Podiatry Review Winter (Q1) 2018

The Institute of Chiropodists and Podiatrists News

A step in the right direction

Published by The Institute of Chiropodists and Podiatrists 150 Lord Street Southport

Merseyside PR9 0NP Tel: 01704 546141 Email: secretary@iocp.org.uk Website: www.iocp.org.uk

Editor: Abid Ali, CFPodM, BSc, MInstChP

Academic Editor: Martin Harvey, PGCert, BSc, MInstChP, MCPodS

Academic Advisor: David M Holland, MSc(Dunelm), MFPM - RCPS(Glasg).

Academic Review Team

Ms B Wright, MSc BSc (Hons), PGCE PGDip, FInstChP

Mr S Miah, CFPodM, MInstChP

Mr A Ali, CFPodM, BSc, MInstChP

Media and Publicity Contact: Martin Harvey, PGCert, BSc, MInstChP, MCPodS

Email: media@iocp.org.uk

Medicines and Procedures Panel (MaPP)

Chair: Andrew Williams, MInstChP, CFPodM

Abid Ali, CFPodM, BSc, MInstChP

Somuz Miah, CFPodM, MInstChP

Martin Harvey, PGCert, BSc, MInstChP, MCPodS

IOCP Contacts

Executive Committee

President: Mrs L Pearson, FInstChP, BSc Pod Med

Chair Executive Committee: Mr M Harvey, PGCert, BSc, MInstChP, MCPodS

Chair Board of Education: Mr A Ali, CFPodM, BSc, MInstChP

Vice-Chair Board of Education: Ms B Wright, MSc BSc (Hons), PGCE PGDip, FInstChP

Honorary Treasurer: Mr S Miah, CFPodM, BSc (PodM), MInstChP Company Secretary: Miss A J Burnett-Hurst, HonFInstChP Standing Orders Committee: Mr M Hogarth, MInstChP & Mr M Franklin, MInstChP

Midland Area Council: Mr S Miah, CFPodM, BSc (PodM), MInstChP

North West Area Council: Mr D Topping, MInstChP

Irish Area Council: TBC

Scottish Area Council: Mrs H Jephcote, MInstChP

Southern Area Council: Ms B Wright, MSc BSc (Hons), PGCE PGDip, FInstChP

Yorkshire Area Council: Mrs M Ward, MInstChP

Branch Secretary Contacts

Branch Secretary Telephone Email

Birmingham & the Shires Kate Harrison 01789 262365 kathrynharrison87@gmail.com

Cheshire & North Wales Michelle Taylor 01704 540614 michelle.taylor35@hotmail.co.uk

Devon and Cornwall Mark Smith 01803 520788 mrkjoanne@aol.co.uk

Essex Beverley Wright 01702 460890 solespirits@hotmail.com

Hants & Dorset Robert Pike 07779 117009 bpike10@gmail.com

Leeds Caroline McCartney 07583 934468 hello@chiropodybycaroline.co.uk

Leicester & Northants Barbara Bletsoe 07790 350109 bbletsoe@hotmail.co.uk

London Sarah Bowen 07790 717833 footwoman@gmail.com

North West Alison Marsden 01772 623180 alison.marsden@hotmail.com

Northern Ireland Paula McDonnell 028 9062 7414 paulapod@hotmail.co.uk

Nottingham Valerie Dunsworth 0115 931 3492 adunsworth@btinternet.com

Republic of Ireland Breda Murphy 00353 868 525842 secretary.iocp@outlook.com

Sheffield Helen Rawse 07789 025022 hrawse@live.co.uk

South Wales & Monmouth Esther Danahar 01656 740772 estherdanahar@yahoo.co.uk

Sussex Valerie Probert-Broster 01273 890570 valerie.broster@btinternet.com

Teesside

Jon Ollivier 01287 349517 jon.ollivier@gmail.com

Western Rachael Littleton 07984 534264 rachaellittleton@hotmail.co.uk

West of Scotland

John Stott 0780 135 6585 jls@stottland.com

Wolverhampton Lynn Newland 07824 395487 lynnfeet@msn.com

Dear Reader Happy New Year!

With the Festive Season well and truly over, now’s the time to break old habits and make some new ones. I recently came across a self-help book published in the 1970s in which it states it takes 21 days to make or break a habit, so hang on in there with those New Year resolutions, and whatever your aspirations and goals are for your career, education or business this year, the IOCP and the College of Foot Health are here to support you.

I hope you enjoy this new-look issue of Podiatry Review which contains a good mix of articles, light reading and practical thoughts.

With the 2018 National Conference and AGM just around the corner we have been working hard to put on an event which is jam packed full of lectures that will appeal to everyone. Once again, the Conference is spread over 2 days. Building on our successes of last year, there will be a range of talks, lectures and practical skill sessions for you to take advantage of. There promises to be something for EVERYONE. We would be delighted if you could join us for a truly memorable event. As we bid farewell to this chapter in the history of the mighty Institute we are excited at starting the next one with a new direction for the IOCP. An exciting, and developmental year lies ahead for our organisation.

In moving the 2019 IOCP National Conference it is hoped it will make the event more easily accessible for our growing membership, non-members and traders alike to attend. More details coming soon. Our core foundations and principles continue to be strengthened as we seek direction into the next decade. The year 2020 is fast approaching and in order that we are fit for purpose in the future, for the continually developing world and our Podiatry profession, the IOCP has to continually evolve and as such we have been very busy behind the scenes. Our social media presence continues to grow, as does our internet profile with the new website and our marketing team are constantly developing new ideas.

2018 is an exciting year for the IOCP with the launch of the College of Foot Health Ltd (a subsidiary of the IOCP). FHPs can become Members of the College and enjoy the same benefits offered by the IOCP. In addition to the College we have the Faculty of Podiatric Medicine which will help support and further develop the profession, setting clinical standards, and championing extended scope practice. Please continue to support YOUR Institute by attending your local branch meetings and IOCP CPD courses, and help your Institute grow.

Finally, I would like to thank all those who have contributed to this journal, old and new, and to the suppliers and affiliates, staff and friends, and for your continued support.

Wishing you all the best for a very Happy, Healthy and Prosperous New Year!

Abid Ali

Guidelines for new and established authors

Content of your article should be Podiatry or foot health-related. Podiatry Review is mostly in easy-to-read format, and articles for submission should reflect this.

Please ensure that your name and title (ie - FHP, Podiatrist, or other) are included with your article. Please proof-read and spell-check your article before submission.

It would be helpful to the Editorial Committee if you could reference any books or Papers mentioned in your article. If you are not sure how to do this we are happy to assist.

Nail disorders & their significance

Nails have functional and aesthetic importance for patients. Toe nail disorders are common and often seen as minor ailments. If pain free, they can be long tolerated by sufferers slow to seek their identification and treatment. Ultimately many attend GP clinics or A&E nurses, with a variable response due to lack of expertise in dealing with the most distal parts of the body. Others seek podiatric help. The significance of nail lesions varies from minor concern to serious manifestation of sinister potential. They can testify to dietary or hormonal deficiency, herald generalised disease, and signal a possible fatal outcome. Almost always, nail disorders are diagnosed on the basis of clinical findings, but further general medical investigation and imaging methods such as ultrasound may be required for accurate assessment.1 Often a localised discomfort associated with one toe-nail, all the toenails and surrounding tissue can be affected.

Iain McIntosh

Nail conditions can be caused by malnutrition, localised and systemic infection, neoplasia and trauma. Some are more likely to affect the young, or the elderly. In elderly people carers can fail to appreciate that toe nail diseases can interfere with locomotion, disturb normal walking and result in patients going “off their feet” and becoming chair bound. Residents in care homes in particular are at risk of having toe nail disorders neglected by untrained, uncaring or over-worked staff2 .

The podiatrist, familiar with maladies of the feet, can often make a speedy diagnosis of toe nail afflictions and institute treatment, when a characteristic lesion is presented. Some conflicting conditions have common features however, making diagnostic decisions more difficult. Careful observation of the affected nails in regard to thickness, colour, texture, shape and surface can simplify identification. Taking a good clinical history is essential as well as close attention to proximal and general skin status. Some conditions resort to appropriate therapy, others will be untreatable and some will require referral to a physician or dermatologist.3

Nail Thickness

Nail growth density decreases with age, by up to one third from youth to old age. Over time, nails become thin and brittle with a lustreless grey surface and darker band, so-called “half-and-half nails” in which the proximal part of the nail is grey and the distal part brown. This half-andhalf appearance can often also occur in people with uraemia (a toxic condition resulting from kidney disease in which there is retention in the bloodstream of waste products normally excreted in the urine) and after chemotherapy discussed later as when there is defective keratinisation due to cell arrest in the nail.

Nails in a normal person have subtle longitudinal ridges, a feature becoming more accentuated with advancing years. In the individual older person, the nail can have a strikingly beaded appearance which is not pathological. A ridging disorder of all, or many, of finger and toenails can however occur, primarily in children or adolescents. It is an excessive ridging of the nail plate referred to as “rough nails” or trachyonychia. (Severe dystrophy caused by extensive involvement of the matrix) Also known as “Twenty nail dystrophy,” the nail plate flattens and the lunula is spotted, or obscured. The condition is sometimes seen in patients with lichen planus and psoriasis and

the aetiology is unknown. In chronic paronychia, often seen in women who are cooks, nurses or florists who have hands often immersed in water, the matrix of the nail can be involved causing characteristic transverse ridging of the nail plate.4 Beau’s lines, or horizontal ridges on the nails, have been related to malnutrition, heart attack, infections, and diabetes.5 Repetitive trauma to the nail bed can bring considerable permanent thickening of the nail if it has been lost and regrows.

Nail Status

Coloured nails

Marked colour changes in the nail can help identify the underlying condition.6

White nails (Leuchonychia - white nails or white spots on the nails) is a common discolouration of the nails. It may be traumatic in origin due to upset keratinisation when the nail has been formed, but it also can be congenital. Transverse white lines can also be caused by hypo-albuminaemia seen in patients with cirrhosis of the liver and also in patients having cancer systemic chemotherapy.

Black nails can be caused by the pigment from pseudomonas infection and after subungual haemorrhage following trauma. Some forms of systemic chemotherapy can result in black or

brown discolouration of nails, with the colour change caused by increased melanin formation in the matrix.

Red nails or red lunulae are rare, with the purplish-red colour caused by hyperaemia of the nail bed. It occurs in systemic lupus erythematosus and in alopecia areata (an autoimmune condition)

Blue nails, where there azure blue lunulae is a manifestation of argyria, with the change permanent and eventually deep in colour. Argyria or argyosis is a condition caused by excessive exposure to chemical compounds of the element silver, or to silver dust. The silver particles accumulate in the skin tissue.

Yellow nails. A yellow colour appears in nails when they stop growing. Patients with yellow nail syndrome need to cut the nails very infrequently. There is a yellowish green discolouration of the nail plate, which is thickened and the surface is smooth and carved in both axes. The cause is obscure, but the discolouration has been associated with pulmonary infections. As noted previously in “halfand-half nails” the proximal part of the nail is white and the distal part is brown. A yellow colouring with nail destruction can also occur with chronic fungal infection of the nails.7 Half-and-half nails” are also sometimes seen in patients with AIDS

Nail shape

Ingrowing toenails are common with deformity of the nail due to ill-fitting footwear and over trimming of the lateral edges of the nails. Coagulation tissue formed at the lateral nail border confirms the diagnosis.3 Pincer nails are also known as “trumpet nails” with transverse over curvature of the nails. This can be hereditary or due to trauma such as unremitting pleasure from ill-fitting footwear and can occur where the person has psoriasis. Clubbing of the nails is a well-recognised skin marker of associated systemic disease. It can accompany chronic lung problems, or heart disease with cor pulmonale and with carcinoma of the lung. Familial clubbing not associated with disease is also quite common and a history of familial clubbing should be elucidated to exclude this possibility.8 Spoon nails (koilonychias) occur where the nail plate is very brittle, thin and flattened with slightly elevated edges. They can be hereditary and sometimes

REFERENCES

1

2 McIntosh IB The vulnerable ageing foot Geriatric Medicine, 12-15, 2014

3 McIntosh IB Identification and management of nail and toe disorders Podiatry Review 72 (6), 14-16, 2015

4 Guidozzi F Foot problems in older women Climacteric.2017: Sept 1-4

5 McIntosh IB managing the diabetic foot Podiatry Review 72 (5), 17-21, 2015

6 Thomsen K Nails .A manual and atlas AO print Copenhagen Denmark

7 McIntosh IB Fungal infections of the feet Podiatry Review 71 (1), 8-10, 2014Podiatry Review 72 (6), 14-16, 2015

8 Medicine Ed Souhami R Moxham 1994 Churchill Livingstone

9 Gaziano R, Galluzzo New insight into the pathogenesis of nail psoriasis and overview of treatment strategies.Drug Des Devel Ther. 2017 Aug 30;11:2527-2535.

occurs in the big toenails of children below two years of age. It can also be acquired where there is malnutrition, and iron deficiency and with scleroderma. 8.

Pterygium inversum is usually seen in systemic scleroderma and with systemic lupus erythematosus. It is fixation of the distal part of the nail bed to the underside of the distal part of the nail plate. This can result in over curvature of the nail. Due to the tenderness which results, patients hesitate to cut the nails and wear them long. Lupus erythematosus vasculitis in the nail bed can also give rise to onycholysis. 8

Systemic and localised diseases can affect the nails. A characteristic feature of psoriasis of the nails is onycholysis with a yellowish brownish hue resembling that of an oil spot and caused by elevation of the nail plate by a psoriatic plaque in the nail bed. Pitting of the nail plate is seen with psoriasis and in alopecia areata and severe hand eczema.9 In 10% of patients with lichen planus the nails are involved. The nail plate is thinned, with longitudinal ridges becoming very fragile and sometime koilonychias may even develop. Lichen planus of the nails may ultimately lead to complete nail atrophy and it sometimes manifests itself as 20 nail dystrophy 8 Pityriasis rubra is a rare disabling skin disease which has an effect on the nails which is thickened and there is onycholysis with severe subungual hyperkeratosis and nail splintering.

Chemotherapy effects Multiple transverse white bands occur corresponding to a chemotherapeutic cycle. Inspection of the nail will reveal the number of cycles given. The white colouration is caused by defective keratinisation to cell arrest in the matrix. Chemotherapy may produce Beau’s lines. Pulse therapy with corticosteroids can also produce dark bands on the nail.6

Summary

Abnormal nail formation is often tolerated by sufferers who delay in seeking treatment. Nail disorders in elderly people in particular may be disregarded or their significance unappreciated by health professionals, especially in the care home environment. Careful observation of the nail and the surrounding tissues is paramount. Nail shape, thickness, colour, fragility and density are crucial considerations aiding accurate diagnosis. Clinical acumen, good history taking, acute observation of the toes and surrounding tissues can identify the condition and with accurate diagnosis, appropriate remedial action can be taken. This may mean conventional podiatric care, treatment of a localised infection, referral for systemic therapy or further investigation by dermatologist, or physician.

Award of Consultant Fellowship of the IOCP

The Institute of Chiropodists and Podiatrists

Award

Submissions are invited from members or academic fellows of the Institute pursuant to granting them additional recognition as a Consultant Fellow of the Faculty of Podiatric Medicine of the Institute of Chiropodists and Podiatrists (CFPodM). Consultant Fellowship is a clinical award for senior members of the profession, recognising and demonstrating their seniority and an advanced scope of clinical practice. The minimum attainments of individuals seeking the award must be as follows:

• They must be current registrants of the Health and Care Professions Council, in good standing, at the time of application without pending disciplinary action.

• They must be current full members or academic fellows of the Institute of Chiropodists and Podiatrists with current IOCP band 4 professional indemnity insurance.

• They must have a degree in Podiatry or Podiatric Medicine awarded by a UK university

• They must submit evidence of a pattern of continuing professional development throughout their career to date in subjects appropriate to podiatry.

• They must have Local Anaesthesia (POM-A) and Prescription Medicine (POM - S) annotations recorded on their HCPC registration entry. OR have POM-A and Supplementary Prescribing/ Independent Prescribing recorded on their HCPC annotations.

• They must have a minimum of 12 years of clinical practice as a podiatrist

• They must submit a curriculum vitae showing their journey through the profession to the date of application and this must demonstrate how they believe themselves to have a scope of practice that merits the title ‘advanced’

The award is via the agreement of the panel of Consultant Fellows of the IOCP who will ensure that all of the minimum standards have been met. Applicants will be required additionally to successfully undertake a telephone interview with a member of the panel, once all of the above bullet points have been met and the appropriate application paperwork submitted to the registered offices of the Institute. The award will then be formally issued upon payment of the nominal administration fee of £100.

PODARICK NAILS IT!

Podarick can you help me?

I have heard conflicting information regarding updates for Basic Life Support (BLS), Local Anaesthesia (LA) and Prescription Only Medicine (POMS). What are the requirements?

Podarick says:

The HCPC has recently made changes to the POMs annotations on the HCPC site. Therefore, practitioners using Local Anesthesia (LA), which is now annotated by the HCPC as POM-A and Prescription Only Medicines (POMs) now as POM-S, are required to update every three years. The Institute of Chiropodists and Podiatrists (IOCP) requires all its members with any POMs qualifications to have triennial updates. However, if practitioners do not use POMs then of course no updates are necessary.

The IOCP encourages continual professional development (CPD) of any kind; in order for registered and non-registered practitioners to meet the CPD requirements of the HCPC and/or the IOCP. CPD can be met at branch and national level or through other CPD events.

In the case of BLS many members do annual updates at their branch meetings. This supports the Health and Safety Executive (HSE) and regulatory body expectation of an Emergency First Aid at Work or First Aid in the Work Place certification that should be done every three years. Health professionals who have the intermediate (ILS) or advanced life support (ALS) must also update their qualifications annually.

Send your Nail Clippings to Podarick: c/o The Institute of Chiropodists & Podiatrists 150 Lord Street, Southport, PR9 0NP

The Institute of Chiropodists and Podiatrists

Certificate of Learning

The Institute of Chiropodists and Podiatrists would like to award members with a certificate of learning (for your CPD portfolio) in one of two ways:

(a) Reading an article in the current issue of the Podiatry Review and writing a reflective account of the article.

(b) Writing a case study. If you would like to submit a reflective account of between 750 and 1,000 words on a published article printed in the Podiatry Review, or a case study. These submissions will be considered for publication in the Podiatry Review.

Please

email pauline@iocp.org.uk

Could you win the £1000

Cosyfeet Podiatry Award?

Entries are now invited for the Cosyfeet Podiatry Award 2018. This £1000 award is open to any podiatrist or podiatry student who is planning voluntary work, a work placement or research, either in the UK or abroad.

The winner’s application should demonstrate that their selected project will develop their professional knowledge and skills while being of benefit to others. The £1000 award is designed to assist with the costs associated with the chosen project.

Former winners have undertaken a wide range of initiatives including those relating to the treatment of the diabetic foot, the podiatric needs of the homeless and preventative foot care in the elderly. Others have travelled to Africa, Asia, South America or Eastern Europe to help with conditions resulting from diseases such as Diabetes and Leprosy.

If you would like to apply for the award, visit www.cosyfeet.com/award for further information and to enter online before the closing date of April 20th, 2018.

The winner will be requested to submit a report and photographs of their experience, and to be included in Cosyfeet publicity relating to the award.

Ying Peng, a qualified Podiatrist and final year Honours Student at Queen Margaret University in Edinburgh, won the 2017 Cosyfeet Podiatry Award. She is using the £1000 award to help fund her ground-breaking podiatry work with dementia patients who display challenging behaviour.

Cosyfeet is the UK’s leading supplier of footwear, socks and hosiery for extra wide, swollen or problem feet. 11,000 health professionals recommend Cosyfeet products to their patients.

For more information email prof@cosyfeet.com or call 01458 449071.

Many dementia patients cannot communicate that they have foot pain, but may have an urgent need for podiatric treatment, and for specific footwear necessary for them to remain mobile,” says Ying. “My project involves treating such patients and suggesting measures that a podiatrist can take to minimise the risks attached to treating dementia patients with challenging behaviour.

People are reluctant to use public defibrillators to treat cardiac arrest

The study also suggests organisations don’t feel they should have one or feel unable to obtain one.

A study led the University of Warwick suggests that people are reluctant to use public access defibrillators to treat cardiac arrests.

The analysis of existing international studies, which has been published in the European Heart Journal, suggests that there are a number of factors that prevent members of the public from using them and potentially saving lives.

The researchers’ study suggests that many members of the public don’t know what an automated external defibrillator (AED) is, where to find one and how to use one. This is despite AEDs being suitable for use by untrained members of the public. Although studies suggest there is variation across the studies they analysed in the number of people willing to use an AED a lack of confidence and fear of harm are common themes.

The research, Barriers and facilitators to public access defibrillation in out-of-hospital cardiac

arrest: a systematic review, was conducted by Warwick Medical School, the University of Warwick; the Institute of Digital Healthcare, WMG, the University of Warwick; Heart of England NHS Trust, Birmingham; London Ambulance Service NHS Trust and Imperial College Neurotrauma Centre, St Mary’s Hospital, London.

Gavin Perkins, Professor in Critical Care Medicine at Warwick Medical School said: “Public access defibrillation is very effective in certain cases of cardiac arrest outside of hospital.

“A study conducted in the US showed that the chance of survival was nearly double in the group that received CPR and were treated with a public access defibrillator compared to the group that received CPR alone. However, the number of cases when a public access defibrillator is used is very low – just 0.15-4.3% of cardiac arrests that occur outside of hospitals.”

Although only a minority of out of hospital cardiac arrests occur in locations where use of a defibrillator would help save a life AEDs are

Study suggests members of the public don’t know what they are, how to use them or where to find them.

Defibrillator Fund Update

Great news we’re already half way towards our target.

The defib will be securely situated on an external wall at our National Training Centre and Head Office. This will enable potential life-saving treatment to be administered in the local community, in addition to serving our own building, if and when necessary.

We will be strengthening our links with the local business community and members of the public.

Thank you for your continued support in this project.

Linda Pearson

…the number of cases when a public access defibrillator is used is very low – just 0.15-4.3% of cardiac arrests that occur outside of hospitals.

often poorly accessible or have limited availability; often their location is not known to even emergency services or those running training schemes. They also found that although members of the public saw the value of AED training most hadn’t undergone training.

Theo Arvanitis, Professor of e-Health Innovation and Head of Research at the Institute of Digital Healthcare, WMG, at the University of Warwick said: “Investment in more AEDs is great but it’s at least as important to maximise use of existing defibrillators.

“Many cardiac arrests that happen in public occur out of ‘normal business hours’ therefore if an AED is kept in a building there is a good chance the building won’t be accessible.

“We would also like to see the message put out that these devices can be used without training. However, our study

found that those with training were more likely to use an AED so training is important too.”

It was found that public-access AEDs were often acquired by donation or fundraising rather than private purchase, and donation was a predictor of AED acquisition among college athletic departments in one study.

The research team also examined the reasons for not obtaining an AED. They were: cost; concerns about liability; not being thought/considered necessary; lack of and/or attrition of responsible individuals; there was agood, local emergency service and there was a nearby hospital. One study reported that while 32% cited cost and 37% cited legal concerns as reasons not to obtain an AED, 55% thought affordability and 51% thought legal protection were good reasons to obtain an AED.

They also highlighted that maintenance of AEDs was variable. One study reported that all but one of 206 AEDs were ‘operable’ and ready for use, but many AEDs were not maintained or had no formal plans in place for maintenance or replacement.

The systematic review conducted by the research team consisted of an analysis of 68 English language articles. Many of these were observational, many collected data retrospectively or were surveys. Due to the nature of the articles surveyed the team recommend further research is needed before making policy proposals.

‘‘

Regards

NEW

Platelet Rich Plasma (PRP)

17th March 2018

Members £365 Non-members £385

This course is open to all HCPC registered chiropodists, podiatrists, physiotherapists, doctors, nurses, chiropractors and is approved and certified by The Institute of Chiropodists and Podiatrists.

Podiatrists with an LA certificate do not require further annotations to be trained in and use this useful technique.

This exciting one-day course covers the point-of-treatment collection, and preparation, of PRP and highlights its safe and effective use in intra-articular and peri-articular pathologies.

Led by Podiatrist Independent Prescriber Martin Harvey, who collaborated in research in 2007 and 2008 with USA based companies who were developing collection and preparation kits for the International market, the current course is supported by one of the UK’s principal manufacturers of collection and preparations kits.

NEW 28th April 2018

Botox in the Feet

Members £365 Non-members £385

The course is open to all LA qualified (POM-A) HCPC registered Chiropodists and Podiatrists from all organisations.

It is approved and certified by The Institute of Chiropodists and Podiatrists.

Before Botox gained popularity as a cosmetic agent it was initially developed as a medical treatment agent, and can be particularly effective when used by appropriately trained and qualified podiatrists in the treatment of various pathologies of the foot and associated structures, such as severe hyperhidrosis - and other conditions.

Further information will be provided to non-prescribers with POM-A listing only.

Tutors: Martin Harvey and Somuz Miah Venue: Sir Robert Peel Hospital, Tamworth.

Most Popular

Steroid Injection

14th April 2018

Members £355 Non-members £380

This course is open to all HCPC registered chiropodists, podiatrists with LA certificates, Nurse practitioners, Medical Doctors, Physiotherapists, Independent Prescribers and is approved and certified by The Institute of Chiropodists and Podiatrists.

This course is a mixture of detailed theory of the Pharmacology of steroidal agents, comprehensive guidance on the parts of the foot and lower limb that can be treated, direct observation of procedural skills and ongoing assessment.

NEW

Viscosupplements

Sponsored by the UK’s supplier of ‘Ostenil’ Viscosupplement injections 2nd June 2018

Members £365 Non-members £385

The course is open to all LA qualified (POM-A) HCPC registered Chiropodists and Podiatrists from all organisations.

It is approved and certified by The Institute of Chiropodists and Podiatrists and the course will allow delegates to add this modality to their level four professional indemnity insurance provided by the Institute.This insurance covers administration to the knee joint.

Viscosupplements are used for mild to moderate osteoarthritis in synovial joints. This course will cover injections to various synovial joints of the foot and ankle as well as the knee and explains the science behind the substances used, the range of products available from TRB Chemedica, indications for their use, safety considerations, the selection of suitable patients and techniques of use.

Tutors: Martin Harvey and Somuz Miah

Venue: Sir Robert Peel Hospital, Tamworth

Tutors: Martin Harvey and Somuz Miah

Venue: Sir Robert Peel Hospital, Tamworth

Tutors: Martin Harvey and Somuz Miah Venue: The Institute of Chiropodists and Podiatrists, Southport

We Need your Patients!

Course places are limited - for further details tel: 01704 546141 or email: julie@iocp.org.uk

NEW

Dermal Fillers in the Feet

3rd March 2018 - Full New date 16th June 2018

Members £365 Non-members £385

This course is open to all HCPC registered chiropodists, podiatrists, physiotherapists, doctors, nurses, chiropractors and is approved and certified by The Institute of Chiropodists and Podiatrists. An LA certificate is required.

Injectable dermal fillers based on hyaluronic acid, such as Restylane® have now been used – with an impressive safety record - for two decades for purely cosmetic purposes of reducing the appearances of wrinkles in the face.

The action of this (and other) fillers can be utilised for the medical purpose of insulating or offloading points of pressure in the foot or toes. This course, led by Podiatrist Independent Prescriber Martin Harvey who introduced the first such courses for podiatrists nearly ten years ago, will show the mechanism of these substances and their clinical applications in Podiatry.

The substances used are medical devices so can be accessed and utilised by Podiatrists with an LA certificate.

Tutors: Martin Harvey and Somuz Miah Venue: Sir Robert Peel Hospital, Tamworth

Most Popular

Podiatric Acupuncture

7th and 8th July 2018

Members £360 Non-members £385

This course is open to all HCPC registered chiropodists, podiatrists, physiotherapists, doctors, nurses, chiropractors and is approved and certified by The Institute of Chiropodists and Podiatrists. An LA certificate is not required.

Learn when and how to utilise this procedure safely. Common conditions treated include: • plantar fasciitis • achilles tendon injuries • shin ‘splints’ • calf cramping • arthritic joint pain as well as neuropathic pain, neuromas and ulcers

Tutors: David Lintonbon and Somuz Miah Venue: The Institute of Chiropodists and Podiatrists, Southport

As members will know, we now run a comprehensive variety of postgraduate training courses in advanced practice, as part of the exciting and ever-expanding range of activities of the Institute’s Faculty of Podiatric Medicine.

Unlike the majority of courses from other providers, these are not ‘talk and chalk’ theory sessions but where possible include real patients being treated with real therapies, as demonstration models. The problem is we keep curing ‘em and using up our supply of models.

If you would like to put forward any of your patients for treatments for the knee, ankle and foot which include:

• Prolotherapy injections for sprains, strains and tissue damage

• Steroid injections for joint problems

• Viscosupplement injections for mild to moderate arthritis

• Botox™ injections for excessive sweating of the feet

Then please contact Julie at Head Office on 01704 546141 or email julie@iocp.org.uk for more information.

Treatments are entirely free of charge in return for the patient allowing students (fully supervised HCPC registered podiatrists) to watch, or in some carefully guided cases, administer, these treatments. You, as their practitioner can accompany them for the duration of their treatment if they and you wish. The full price of some of these treatments can be well in excess of a couple of hundred pounds so it can make them accessible to people who may be unable, or unwilling, to pay themselves.

An Institute trainer will contact you initially to discuss the proposed patient and answer any questions you or they may have. Patients must be willing to travel, at their own expense, to a training venue at the time specified on the training day.

Training venues are either :

a) The IOCP National Training Centre in Southport, Merseyside

b) Sir Robert Peel Hospital, Tamworth, Staffordshire

As appropriate to a specific course.

(but we promise to give them back in a hopefully better condition)

Because you are worth it -

Ms. Beverley Wright F.INST.CHP, FHEA, MSC, PG.DIP, PGCE, BSC (HONS), MINSTCHP Vice-Chair of Education

Over the last few years I have been reading a collection of Brian Tracy books. I have always liked Tracy’s work, where I have listened to and read many of his, and various other self-development and business authors, and their renowned books and CDs. Each text and audio production contains a lot of thought provoking questions, which lead you to have a variety of ways of understanding some interesting life and business possibilities. Tracy, for example examines what it is that many self-made millionaires (wealthy people) have done to account in part for their success.

One of the things that the research confirms is that self-made millionaires will almost certainly invest in themselves. Apparently, there is a correlation between how much you invest in yourself and your own learning and development, and how it impacts on your net income. Tracy suggests we start with investing just 3% of our annual earnings. So, for example if your net income was £30,000 last year you should contemplate investing £900 on something that will enhance your skills, knowledge or abilities. In other words in our business as foot health professionals, this constitutes in the main as continual professional development (CPD). I cannot express this as eloquently as Tracy himself, but the take home message is simple: the more skills and knowledge you have - whether this be hands on practical skills, marketing or business skills, presentation skills, or any other skill relating to your specific work (in chiropody/ podiatry or foot health in general), including associated skills and therapies; then the greater your understanding and marketability of self and practice, the greater your income will be as a result.

In one of Tracy’s books he relates to an amusing story of a man who followed this self-investment principle and wondered to himself what would happen to his income if he increased the amount he spent on his self-development each year, over and above 3%. This he did, year on year, investing up to 10% of his net income, so that in the end, he was earning so much that he had to start planning how to invest money in himself at the very start of his financial year in order to be able to spend it all!

My problem is and perhaps for some of you reading this, is restricting the amount I/ we want to spend on self-improvement, and why not! To that extent my Amazon book wish list sometimes looks like the catalogue for a small teaching library, to add to my already extensive library at home, which has now extended into the garage. Over the next 12 months I am booked onto a

few part-time evening courses and endeavour to do a couple of upcoming CPD courses with the Institute of Chiropodists and Podiatrist (IOCP), as well as attending branch meetings, conferences and seminars. In addition there is an MBA starting in January 2018 with my name on it. Not to mention the money I have already invested in new books, and no doubt there will be more to buy with the future courses I will be involved with. This alone with the upcoming HCPC renewal process for registration and random auditing in July 2018 will have allowed me to meet many of my own CPD goals and meet the targets the HCPC intends registrants to achieve with a commitment of doing some sort of CPD - at least every two months. Believe me when I tell you, having been audited in the last round of registration renewals in 2016, you do not want to leave anything by chance, or to the last minute in getting all of your CPD done and recorded.

So, here is a challenge for any readers out there who would like to take it up: is anyone willing to give this a try with me and invest in themselves for 2018? How much are you willing to invest in yourself? What books can you invest in that will add to your knowledge? What courses can you attend? What audio programmes can you listen to? What webinars can you view? What magazines can you subscribe to? What did you earn in the last 12 months? If you were to invest 3% of your annual net income on self-development, what would you spend it on?

I would love to hear from anyone who is up for this challenge and to let me know at the end of next year (2018) how it went. I do not need any actual figures, but the point is other than the knowledge you will have hopefully gained, did you also increase your annual net income, or at least gained the 3% income back that you initially invested in yourself?

If you were to invest 3% of your annual net income on self-development, what would you spend it on?

Award of Academic Fellowship

The Institute of Chiropodists and Podiatrists

Submissions are invited from members of the Institute pursuant to granting them additional recognition as a Fellow of the Faculty of Podiatric Medicine of the Institute of Chiropodists and Podiatrists (FPodM).

Award

Application is by way of completion of the appropriate paperwork and submission of a 3000 word (+/-2%) dissertation containing previously unpublished material on a relevant podiatric subject that meets the approval of the Review Board of the Faculty of Fellows. Such dissertation is to be constructed on sound academic principles and be adequately referenced in an accepted academic style.

For members who have not previously published, the Board is happy to give informal and friendly guidance to members wishing to develop this interesting new area of their professional career. A nominal fee of £75 is payable to cover the necessary administration by Head Office. Certificates of Fellowship will be awarded to successful Fellows and their names recorded on the Roll of Fellows maintained by the Faculty.

Accepted dissertations will be published in Podiatry Review and be added to The Fellows Library which will be an electronic knowledge bank available online to registered members. Such activity is also held to be Continuing Professional Development (CPD) by the IOCP and is suggested as being suitable to record in the event of HCPC audit.

Applications will be accepted from current members who are HCPC registered, annotations such as POMs or LA are not a condition of application as this is an academic award open to all HCPC registered full members of the Institute.

For further information and an application form please contact Head Office by emailing Pauline@iocp.org.uk.

National Leads Required

As part of the continuing expansion and development of your professional body, we are inviting interested members to take on various National Lead positions.

The concept of ‘Leads’ in healthcare organisations is well established, and such Leads become a focal point for incoming information concerning a specific element of professional activity, for example: diabetes, peripheral neuropathy, safeguarding, mental health, equality and diversity etc.

Leads should have an interest in or experience of, an area that they wish to become Lead for (or be willing to develop knowledge of it) and be willing to be named as the contact point for information that comes into the IOCP from Government, other professional bodies and organisations or the media.

It would then be the responsibility of the Lead to advise Head Office, the Executive Board, and our editorial team for the Review and website, of items of information that they consider worthy of dissemination to the wider membership or flag up to staff or Board members that they should consider further action in a specific area. For example, new guidelines on a subject may be published that the whole membership should be made aware of etc. As Leads gained further knowledge in their specialist area, it is hoped that they could be approached as a source of advice by staff and directors and indeed other professions or the wider media - when specialist knowledge was needed.

As the leading democratic podiatry organisation in the UK, run by members, for members, this is yet another example of how all members have the opportunity to involve themselves in the activities of our organisation and continue to develop it to even greater heights.

As with all voluntary positions held by members (including Executive Council members), there is no remuneration, but you will be making a real contribution to our continued professional growth and the growth of the wider profession. Such activities naturally also count as CPD.

If you are interested please contact Julie at Head Office by phone or email, currently we are seeking to recruit national leads in:

• Mental Health • Biomechanics • Safeguarding

• Podiatric Surgery

Equality issues

• LGBT issues

Regulated areas such as podiatric surgery and biomechanics require HCPC registered members, Associates are most welcome to apply for areas such as mental health, safeguarding, equality and LGBT issues.

ANNUAL BRANCH AWARD FOR ENDEAVOUR

The Institute of Chiropodists and Podiatrists

Award

This Award is to be made in recognition of the sterling efforts that are made by Branches for the furtherance of our Association, and the wider profession and, not least, for the membership of the Branches irrespective of the size of membership of the Branch. Where there has been consistency of achievement, or change for the better; increase in membership at Branch meetings; increased provision of Continuous Professional Development or any innovation, progressive implementation or improved business-like procedures that have been for the good of the Branch and, subsequently, have added to the professionalism of our Association, or several or all of the above, then do consider putting your Branch forward for the Award.

There is a wide criteria in submission to explain why your Branch should receive the Annual Branch Award for Endeavour and will not only be testament to individual efforts but to the collective efforts whereby promotion of the Branch shows a vital and dynamic professional body for your local membership.

Good luck with your submission!

General rules of the Annual Branch Award for Endeavour

1 The Annual Branch Award for Endeavour will be a shield engraved with the name of the recipient Branch to be presented at the Awards Ceremony and which will be held by the Branch until the following Awards Ceremony.

2 The award is open to all Branches of the IOCP, irrespective of the size of membership of the Branch.

3 Submissions for the Award should be in the form of a typed precis of achievement of not more than 200 words.

4 The submission must be signed, and evidenced, by two attending members of the Branch who are not Branch Officials and must be forwarded to: The IOCP, 150 Lord Street, Southport, PR9 0NP, marked “Branch Award”.

5 Submissions must be received by Head Office on or before the 31st January 2018.

6 The Executive Committee will confer and will decide on the recipient of the Award and the decision will be final.

7 Branches should be prepared to furnish Head Office, should the need arise, with a copy/copies of Branch Minutes if so requested.

History corner

History corner

“Practical Podiatry”

Since our founding as The Joint Council of Chiropodists of Great Britain and Ireland in 1938, when some 20 associations from all over the UK and Eire came together, through becoming the Institute of Chiropodists in 1955, then adding ‘and Podiatrists’ to our name in 1995, the Institute has always been present in the forefront of developments of our profession.

In the late 1960’s the first green shoots of podiatric surgery were springing up in the UK, with assistance from Podiatrists in the USA who had been developing invasive procedures in the foot from just after the second world war. Early UK podiatric surgery started exclusively in the private sector and the Institute was closely linked with the British College of Podiatry.

Two notable members of the Institute and British College of Podiatry in the 1970’s, and after, were Philip Basham, BA, FInstCh and Jean Truscott, BA, FInstCh. After several years of surgical work, they decided to share their knowledge of surgical procedures in a book, published in 1984; ‘Practical Podiatry’.

In celebration of the efforts of such pioneering members we are delighted to publish extracts from their seminal work - one of the earliest UK publications of such guidance.

In the 21st century the Institute has remained well represented in developments in Podiatry, notably supplementary and independent prescribing, working in liaison with the Department of Health to take these exciting developments forward and remains so to this day, being currently involved in future forthcoming medical developments.

Forms & payment can be completed online via our website or by filling in the form below and following the instructions.

Friday 11th May 2018

9.30 – 10.30

Workshop: ”Growing your business through effective messages” by Tony Gavin, OSGO

Lecture: ”Dementia Friends” by Linda Lawson, Alzheimer’s Society 11.00 – 12.00

Lecture: ”Red flags of the foot and lower extremity” by David Lintonbon, DO, PGCert(ClinEd) Workshop: ”Setting a price in private practice” by Jonathan Small 14.00 – 15.00

Lecture: ”Achilles Tendinopathy” by Daniel Lawrence, Rocktape Workshop: ”Lacuna Method for fungal nails” by Nicola O’Brian, Love your feet CPD courses 15.30 – 16.30

Lecture: ”Anatomy & examination of the spring ligament /tendon of muscle tibialis posterior” by Michael Ratcliffe, Cuxson Gerrard Lecture: ”Management of Plantar Hyperhidrosis” by Dr Richard Oliver, STD Pharmaceuticals

Booking

Saturday 12 May 2018

9.00 – 10.00

Workshop: “Verruca? Verrucae? Verrucee?.... Plantar warts” by Belinda Longhurst Workshop: “Flexitol – a range to add value and profit!” by Caroline McGowan, Flexitol Lecture: “Introduction to platelet rich plasma” by Martin Harvey 10.00 – 11.00

Workshop “Our role in fall prevention” by Olga Frankowski, Medifoot CPD School Workshop: “Emtrix - update on research including Nail Psoriasis” by Steve McGowan, Moberg Pharma Workshop: “The pelvic equilibrium theory - a new pardigm” by Clifton Bradeley, Sub-4 MD 11.30 – 12.30

Workshop: “Cosmetic podiatry - a beautiful way to diversify your practice” by Nicola O’Brian, Love your feet CPD courses

Lecture: “Clinical management and self management of Raynaud’s / Scleroderma in the foot” by Tracey Spray, SRUK Workshop: “Podiatrist in the Box!” by Catherine Brown, Bond Solon Training (NEW for 2018) 14.00 – 15.00

Workshop: “First aid” a 2 hours workshop by Martin Harvey Workshop: “Safeguarding children and adults” by Somuz Miah Workshop: “Medical cuppings for the lower limb” by Abid Ali 15.30 – 16.30

Lecture: “First principle & innovative business thinking to develop a mega practice” by Clifton Bradeley, Sub-4 MD) Lecture: “Naloxone saves lives” including an open Q&A on substance/alcohol/POM misuse by Dr Carola Sander-Hess

WIN A SHOFT!

Clips to your seatbelt to provide it with optimal performance!

Please answer the following question

SHOFTTM is a small palm-sized product designed to help keep the slack out of the seat belt. After a 2 second install adding a SHOFT to the seat belt provides it with extra functionality by turning it into an ‘anti-slouch’ device. By keeping out the usual slack that creeps into our seatbelts, SHOFT helps to keep both driver and passengers in a better and potentially safer seated position.

Either email the answer to julie@iocp.org.uk or post your answers to The IOCP, 150 Lord Street, Southport, Merseyside. PR9 0NP to arrive no later than 25th February 2018, please include your name, address and contact number. A winner will be drawn at random from all correct answers. The winner will win a SHOFT, see page 28 of the July issue of Podiatry Review for further information about the product.

Prize Draw Rules

• Entry to the competition is restricted to one entry per person please.

• Multiple entries will be disqualified.

• Winners will be chosen at random from all valid entries.

• Winners will be contacted and names displayed on our website and available to SHOFT for advertising purposes.

• The Judge’s decision is final and no correspondence will be entered in to.

Diabetes Representative within the IOCP

Do you have an interest in Diabetes and are currently a member of the IOCP?

The Institute of Chiropodists and Podiatrists currently has a vacancy for a Diabetes Representative. This is a voluntary position within the organisation and would suit someone with an interest in diabetes.

The role involves liaising with Diabetes UK on a regular basis and informing the Board of Directors on all the latest news and updates in this regard. Such important updates and information can then be passed on to the membership.

It is important therefore that applicants are computer literate and have access to the internet/email as you will be required to liaise with Head Office via email in order that relevant diabetic news can be circulated.

This is a very important role within our organisation. It will assist members, readers of Podiatry Review and the public in keeping up-to-date with relevant diabetic news and infor mation which the Institute can publish.

If you are interested in this position please email your contact details to secretary@iocp.org.uk

Closing date for this position is Friday 6th January 2018

Q: How many seconds does it take to fit a SHOFT onto a seat belt tongue?

Could you identify the condition that affects 10 million people?

Raynaud’s phenomenon is a common but under-recognised condition.

It is a condition that affects up to 10 million people in the UK.

The symptoms of primary Raynaud’s are usually mild and manageable. Over-sensitivity of peripheral small blood vessels to temperature change or stress leads to characteristic attacks, with blood vessel constriction leading to loss of blood and oxygen from the extremities, followed by excessive blood vessel dilation on warming. This leads to the common colour changes seen in Raynaud’s from white, to blue/purple and then to red. Attacks can very be painful.

Secondary Raynaud’s phenomenon is usually associated with autoimmune conditions, which is when the body’s immune system attacks healthy tissue. It is more serious than primary Raynaud’s and can lead to ulceration and calcification. Almost all patients diagnosed with scleroderma have secondary Raynaud’s phenomenon. Treatment, other than to relieve symptoms, is relatively ineffective.

Identifying Raynaud’s

Primary

1

Cold fingers and toes 2 Colour changes in the skin in response to changes in temperature or stress 3 Colour changes in the affected area from white, to blue/purple then red 4 Numbness, tingling or pain in the affected area

5 Stinging or throbbing pain upon warming up or stress relief

Secondary

The 5 symptoms to identify primary Raynaud’s plus:

6 Ulcers, sores or breaks in the skin usually on the fingers or toes.

Chelsea with her husband & son

Treating Patients with Raynaud’s

If you are seeing a patient with primary Raynaud’s there aren’t any major changes that you need to change to your normal practice. These simple tips however, will ensure comfort and are aimed at avoiding a Raynaud’s attack:

1 Ensure your clinic is warm ahead of the appointment – it can feel around 5 degrees colder for someone with Raynaud’s

2 Warm up your hands before touching the patient’s feet – applying cold hands to warm feet can cause an instant Raynaud’s attack

3 Ensure creams are warm before application – this may mean warming the tube or a small amount in your hands before applying. Don’t let the feet become cold once applied. Use a warm towel or let the patient put socks on immediately after application.

4 Massage the feet – a massage will not only help to relieve stress but can also encourage blood flow to the affected area.

Self-Management advice for patients

The following advice is recommended for both primary and secondary Raynaud’s.

• Keep your whole body warm, especially your hands and feet. Wear gloves and warm footwear in cold weather. On colder days, if you are going out consider warming up your socks, shoes and / or gloves on the radiator for 10 minutes or so prior to putting them on

• If you smoke, stop. Quitting smoking will improve your circulation, which should help to improve symptoms.

• Exercise regularly, as this helps to improve your circulation and reduce stress levels. For most people, 150 minutes of physical activity a week (spread over 5 days) is recommended.

• Try to minimise your stress levels. Regular exercise, eating a healthy diet, and relaxation techniques, such as deep breathing or activities such as yoga, can help.

• Avoid stimulants such as coffee, tea and sugary drinks.

Chelsea was diagnosed with Raynaud’s five years ago, Nowadays when I have an attack my feet will go blue straight away. I used to get the white colouration and this used to be a really prominent feature but nowadays, as my condition has become more severe, they go straight to blue.

Referring a patient with Raynaud’s

If you identify primary Raynaud’s in a patient, we would encourage you to speak to them about the condition and advise them to make an appointment with their GP to receive a formal diagnosis.

If you are concerned that a patient is showing signs of secondary Raynaud’s, please speak to them about Raynaud’s and advice them to make an appointment with their GP. Advise them to ask their GP for an ANA blood test and a capillaroscopy.

During February, Raynaud’s Awareness Month, Scleroderma & Raynaud’s UK (SRUK) have launched the #KnowRaynauds campaign to increase awareness and understanding of the condition.

Sue Farrington, SRUK CE explains, “Research we have undertaken over the last year reveals that only 4% are able to identify the symptoms of Raynaud’s. SRUK is tackling this lack of understanding by getting everyone to #KnowRaynauds during February”.

Order your free Raynaud’s Information pack today. Simply email gettoknow@sruk.co.uk with your Name, Practice and Postal Address.

Skiing & the Lower Limb

Sports Injury Fix

Winter is coming has been a famous phrase this year and now it’s here it’s estimated that over 1 million of us Brits will go on a winter sports holiday with about 80% skiing, 16% snowboarding and 4% skating, climbing, sledding etc1.

Sadly, injuries are part and parcel of winter sports for a multitude of reasons such as crashes, overuse, lack of fitness, equipment failure or just bad luck. Injuries associated with winter sports affect the whole body but for the purposes of this article we’ll give an overview of the most common and focus on those affecting the lower limbs. We certainly won’t be mentioning the helmet vs non-helmet debate.

How frequent are injuries?

There are a number of studies of injury rates for skiers and snowboarders with results ranging from 1-6 injuries per thousand skiing days to 2-16 injuries per thousand snowboarding days2. For the more adventurous ice climbing only has estimated injury rates of 4 per thousand hours3

Over the last ten years sledding has increased in popularity with moonlight sledding being an increasing popular past-time and thus injury rates here have increased too. Indeed, one insurance company4 found their breakdown of claims related to winter sports injuries was as follows:

34% snowboarding 33% skiing 21% sledding 12% skating

Written by Malcolm Sloan, Sports Injury Fix

Sports Injury Fix helps you find the right treatment for your injury/sport. The free online resource even allows you to search by specialism in a particular sport. For more details please visit SportsInjuryFix.

So, what are the main injuries?

The knees are the number one injury and typically account for around 30%5 of all winter sports injuries. This is not just because of how much they are used in most winter sports but the number of ways they can be injured. Most people only have one winter holiday a year so it’s an intense amount of exercise on muscles and ligaments in a way they may not be used to. As such the strains and pains that come from overuse are common but also medial collateral ligament (MCL) or anterior cruciate ligament (ACL) injuries account for the majority6 of knee injuries.

The harder boots used in skiing protect the ankles, but give a higher chance of knee injuries. ACL damage tends to happen when trying to stop falling by squatting with arms out and the weight goes on the inside edge of the downhill ski causing a twisting motion. MCL injuries tend to happen during crashes when an edge is caught and it stresses the medial ligament. Dislocations and knee fractures also occur along with leg fractures although these are less common.

With no poles for balance and both feet connected to the board without an automatic release mechanism then for learners a bruised bottom is the most embarrassing injury when learning to snowboard but wrist injuries are the most commonly recorded accounting for over 20%7 of snowboarding injuries. The impact of landing often causes shoulder problems too. Knee injuries in snowboarders are less common than skiers, accounting for 16% of injuries8 and most knee injuries tend to happen not whilst

snowboarding but from getting on and off ski lifts when one foot is fastened to the board and the other is pushing. Twisting while falling over risks injury to the knees as does the impact from crashing, particularly at speed and on icy ground.

The softer boots used in snowboarding are easier to walk in and feel more flexible but offer less protection and as such lead to increased vulnerability to ankle sprains and fractures.

‘Snowboarders ankle’ refers to a fracture of the lateral process of the talus due to the fact it is 15 times9 more likely in snowboarders than the general population. The lateral process of the talus is above the heel bone on the outer side of the ankle.

In sledding then, lower leg injuries are very common with knee sprains accounting for 13% of injuries followed by ankle sprains (11.5%), and ankle/leg fractures (9%).10 It’s thought the increase in sledding injuries is down to the rise in its popularity and particularly that of ‘moonlit sledding’ and the potential effects of après ski.

It’s estimated that with the rise of winter time temporary ice rinks that at least 4%11 of the UK population ice skates which is one of the few winter sports that is done predominantly in the UK and not abroad. Skating injuries tend to be focused on the upper body from outstretched arms trying to break a fall. Ankle and knee injuries do still occur but account for just 7%12 each of total injury numbers and tend to occur from twisting to avoid falling leading to strains and tears.

And how do you treat these injuries?…

Knee ligament injuries - Treatment and management options

There are many treatment options dependant on the severity or type of injury, and which ligaments are affected. Low-moderate grade injuries may benefit from active physiotherapy or rehab techniques, utilising proprioception, strengthening taping etc. Low grade to moderate injuries may also benefit from one or more of the various injectable treatments available for knee ligament injuries. Here are some known examples listed, many of which require further in depth discussion to fully appreciate potential value, effectiveness and pathomechanics of how they actually work.

Corticosteroid injections

These are powerful synthetic antiinflammatory drugs, used to help reduce pain from inflammation. Whilst they may be useful for reducing inflammation and pain, there is no significant research to suggest they specifically help in healing injuries of tendons or ligaments.

Prolotherapy, Proliferating therapy

Glucose is currently the hyperosmolar agent of choice of many prolotherapy practitioners and research supports its efficacy as a cytokine expressant due to its interference with cellular osmolality (28) (29). A solution of 20% W/V glucose for injection combined with 1% W/V Lidocaine Hydrochloride (formerly Lignocaine) is advocated by many acknowledged experts including the Australian prolotherapy tutor, Dr Margaret Taylor.

Prolotherapy resulted in safe, significant, progressive improvement of knee pain, function and stiffness scores among most participants through a mean follow-up of 2.5 years and may be an appropriate therapy for patients with knee OA refractory to other conservative care. (Rabago et al., 2015).

Hyaluronic acids

Hyaluranon is a glycosaminoglycan (essentialy a protein) widely found in connective, epithelial and neural tissues. Also a natural component found in synovial fluid, said to help lubricate synovial joints and give temporary pain relief. Whilst the main bulk of research in this area is for osteoarthritis of the knee for example, (Aksari et al., 2016) This could be useful to help repair injured, non torn ligaments, the research is limited in this area.

Prp/autologous bloods

Platelet and white blood cells. Whole blood is centrifuged to separate red blood cells from the protein rich plasma, which provides a higher yield of growth factors, than whole blood.

This serum is usually injected at, or around the point of injury to help stimulate and promote faster healing and regeneration within the injured structures. (Yuan, Zhang and Wang, 2013) Completed a more detailed study into the use of Prp for tendon and ligament repair, more research has and is being conducted, purporting Faster recovery times and no adverse reactions. (Taylor et al., 2011)

Stem cells

Usually derived from the mesenchymal cells taken from bone marrow. These cells are harvested and processed to produce an injectable solution with regenerating properties. New cells are born from stem cells and are essential in healing and repair. Although not widely utilised just yet, this technology appears promising, the research and evidence is beginning to emerge worldwide and seems promising in the use of musculoskeletal conditions, amongst many other potential applications.

Surgery/operative treatments

For the most severe, or non responding to conservative treatment cases, surgical options, (Usually orthopaedic) may be required. This may involve allograft, or autograft from another tendon in the body, usually harvested from Achilles tendon, patella tendon or biceps femoris tendon, or even synthetic grafts.

There is no “ideal” graft to be used in anterior cruciate ligament reconstruction surgery and each of the four major graft choices has its advantages & disadvantages. Success or failure of the procedure depends heavily on surgical technique. Surgeons should be aware of the evidence behind the use of each graft and thus be able to make an informed decision of its appropriateness. (Shaerf, 2014).

REFERENCES

Aksari, A., Golami, T., Nagizadeh, M., Farjem, M., Kouhpayeh, S. and Shabafard, Z. (2016). Cite a Website - Cite This For Me. [online] Ostenil.trbchemedica.co.uk. Available at: http://ostenil.trbchemedica.co.uk/data/documents/Askari%20HA%20compared%20with%20 corticosteroid%20injections%20for%20knee%20OA%20(1).pdf [Accessed 4 Dec. 2017].

Rabago, D., Mundt, M., Zgierska, A. and Grettie, J. (2015). Hypertonic dextrose injection (prolotherapy) for knee osteoarthritis: Long term outcomes. Complementary Therapies in Medicine, 23(3), pp.388-395.

Shaerf, D. (2014). Anterior cruciate ligament reconstruction best practice: A review of graft choice. World Journal of Orthopedics, 5(1), p.23.

REFERENCES

1

Ice Climbing” Med Sport 13 (4): 210–218, 2009

4 www.globelink.co.uk/news/Globelink-Travel-Insurance-News/winter-sports-injuries-statistics 2014

5 www.ageas.co.uk/intermediaries/news/almost-heads-shoulders-knees-and-toes

6 Jordan et al. Anterior cruciate ligament injury/reinjury in alpine ski racing: a narrative review

Open Access J Sports Med. 2017; 8: 71–83

Paletta and Warren Knee injuries and Alpine skiing. Treatment and rehabilitation. Sports Med. 1994 Jun;17(6):411-23.

Taylor, D., Petrera, M., Hendry, M. and Theodoropoulos, J. (2011). A Systematic Review of the Use of Platelet-Rich Plasma in Sports Medicine as a New Treatment for Tendon and Ligament Injuries. Clinical Journal of Sport Medicine, 21(4), pp.344-352.

Yuan, T., Zhang, C. and Wang, J. (2013). Augmenting tendon and ligament repair with platelet-rich plasma (PRP). [online] Muscles Tendons and Ligaments Journal. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3838322/ [Accessed 4 Dec. 2017].

7 Kim et. al. Am J Sports Med. 2012 Apr;40(4):770-6.

8 Worldwide Insure research 2017 https://www.worldwideinsure.com/travel-blog/2017/01/ common-snowboarding-injuries-avoid/

9 Mussman and Poirer J Chiropr Med. 2010 Dec; 9(4): 174–178

1 Corra and Di Giorgi Sledding injuries: is safety in this winter pastime overlooked? A three-year survey in South-Tyrol J Trauma Manag Outcomes. 2007; 1: 5.

11 Barr et al. Int Orthop. 2010 Jun; 34(5): 743–746.

12 US National Electronic Injury Surveillance System data - www.product-injuries.healthgrove. com/l/88/Ice-Skating

Discovery Orthotics is a department of Kent Community Health NHS Foundation Trust and has the capacity to manufacture bespoke insoles for both NHS and private podiatry services to help patients with a range of foot, ankle and gait problems.

Department manager Rhys Toghill said; “This is a oneof-a-kind facility which can provide a full service from computer-aided design through to full production. We can manufacture all types of insole and podiatric orthotics that can transform the lives of patients across the UK.”

Current clients include several large NHS Trust as well as private podiatry practices from across the UK. The facility was until recently located in the Queen Victoria Hospital in Herne Bay but the new purpose-built lab will allow production to expand. For more information on Discovery Orthotics call the team on 0300 123 1540 (option 2) email kcht.podiatryorthotics@nhs.net

When I was asked to write a short article on Winter-related conditions I thought it would be easy. David Holland writes:

And it is.

Easy to write yet another humdrum article on chilblains and the importance of wearing warm socks for oldies (etc, etc, ad nauseam). I see no point in doing this however, since every newspaper and most websites will carry an article of this type over the Christmas period.

So this Winter-related conditions article is based on my observations as a podiatrist over many years of practice. I hope you find it interesting, and hope too that some of the information is helpful. Here goes…

If you have chilblainsdon’t, repeat don’t warm your hands and feet in front of the fire. Are you mad?

Let’s start with Ugg Boots

I have nothing against Ugg Boots. They look to be comfortable, well-made, and warm. But every Winter I watch people slopping around in fake Uggs – the ones where the back has collapsed so that the heel is weightbearing on the inner side of the boot rather than the heel seat. It looks horrible, can’t be comfortable, and has to produce a pinch callous in some people. Is that a Winter condition? I think it qualifies.

The problem is that the heel stiffener of the fake boot, also known as the quarter, is simply not up to the job of holding the heel and maintaining the shape of the boot. Advise your patients accordingly – fake Uggs bad, real Ugg Boots ok.

Digital corns

Surely that isn’t a Winter condition? Well yes, it can be. Thicker socks, or an extra pair of socks can either press the toes together, or curl them up making the interphalangeal joints more prominent. Same goes for ingrown nails, and callous caused by extra friction on a joint. In your regular patients look for reasons why the feet may be worse in the Winter. In new patients you can become something akin to a miracleworker if you cannot only treat the corn, but stop it returning by pointing out that the Winter hose may be just a little constrictive.

Ok, ok – chilblains

Let’s look at why folk develop chilblains, and how they can actually be pretty dangerous to one client group. What is a chilblain, why do some people get them and others not?

A chilblain is an area of tissue which has been damaged by cold. The mechanism by which a chilblain forms is relatively simple, but you first have to revisit simple anatomy and physiology to fully understand what happens.

Our bodies are so constructed that under adverse circumstances our autonomic nervous system will ensure that the brain and vital organs remain supplied with blood, no matter what.

The main adverse circumstance in which this phenomenon can be easily observed is in extremes of cold, where circulation to the extremities – hands, feet noses and ears - closes down, sometimes completely. It can also happen in systemic infection, but far more rarely.

When you go out in the cold and your hands turn bluethat’s the circulation in your hands closing down. Tight hose and shoes can also affect the peripheral circulation, driving blood away from superficial tissues, so advise your patients accordingly.

If you can warm up your extremities gently before any tissue damage occurs they will be fine. If you have poor circulation due to peripheral arterial disease you have a much greater risk of damaging the tissues. If you have any of the conditions

in which the muscular arterial wall (the Tunica Media) of your arteries or arterioles goes into spasm - the most common is Raynaud’s Disease, but there are other conditions in which this happens – you have a much greater risk of damaging the tissues.

Why do the tissues become damaged? Simple – they don’t have any oxygen because the blood can’t reach those tissues to facilitate this. The result is that common Winter lesion we call a chilblain.

Advise your patients as follows:

Wear warm, non-constrictive footwear and hose – this is actually really important.

Don’t, repeat don’t, warm your hands and feet in front of the fire. Are you mad? The tissue is already damaged and you think speed-warming in front of the fire is going to help?

Chilblain ointment is useful, but not on broken chilblains.

The danger in chilblains.

I mentioned earlier that there is one client group in which chilblains can pose a real danger, in extreme cases life-threatening. These are diabetic patients.

Before discussing how this works, let’s put a little meat on the bones by looking at the accepted statistics of ulceration and amputation in diabetics. (Ref 1).

Here’s the crunch…

Up to 70% of people with diabetic foot ulceration and amputation die within five years of having the amputation. Up to 50% of people with a diabetic foot ulcer die within five years of developing the ulcer.

Diabetes and peripheral vascular disease go hand-in-hand. So too, does diabetes and peripheral neuropathy, in which some or all of the normal protective sensation in the feet is absent. A chilblain can be a precursor to an ulcer in a diabetic patient.

Your diabetic patients should, without doubt, have regular foot checks, especially in the Winter months. I think the podiatrist is the right person to do this, although being a podiatrist myself I can legitimately be accused of being a tad biased.

And try as I might, I can’t think of anything else which is really and honestly relevant to Winter and foot health.

This is available as a free download from www.nice.org.uk/guidance/ng19

Reference: 1. NICE NG19 Diabetic foot problems: prevention and management.

Diabetic ulcers precede more than 80% of amputations in people with diabetes.

It is estimated that 10% of people with diabetes will have a diabetic ulcer at some time in their lives.

Membership details

If you have recently changed any of your personal details, such as those listed below, please would you advise Head Office, either by email, telephone or letter so the details we hold for you can be updated. Please ensure you include your IOCP membership number on all correspondence.

• Name, Address, Marital Status

• Telephone Numbers (Land line and/or Mobile)

• Email address (Home and/or work)

• Business address details

• HCPC (registration OR de-registration)

• Insurance

• Changing your working status from ‘ACTIVE’ to ‘NON-ACTIVE’ or vice versa

Note to Branch Secretaries: should a member contact you directly to amend their personal details please advise Head Office.

IOCP Website - Find a practitioner

If you would like your details to appear on the IOCP’s website, www.iocp.org.uk ‘Find a Practitioner’ section and they don’t already, please email:secretary@iocp.org.uk Alternatively, please telephone: 01704 546141

Please include your contact details, membership number and the practice details.

APPEAL FOR PHOTOGRAPHS

Do you have any foot-related photographs that could be used on our website and/or within this journal?

If so, we would love to hear from you. Prior to submission of any photographs, you would be required to ensure that you have written consent from the client/patient that you can submit them for use by IOCP?

Data Protection Act

If you collect and maintain patient treatment records, medical history, medication lists etc. on any kind of electronic system you must be registered with the ICO (Information Commissioner’s Office).

For further information and how to register please visit the ICO website www.ico.org.uk/for-organisations/

WEBSITE

Are you ready for GDPR?

GDPR (General Data Protection Regulation) will apply in the UK from May 25th 2018 and is for those who have day-to-day responsibility for data protection. For further information please visit the ICO website www.ico.org.uk/ for-organisations/dataprotection-reform/overviewof-the-gdpr/.

You can also find more information on resources and support available to you.

Have you logged in to the members’ area of the website recently?

If not, why not pay a visit and find out more about the exclusive Members’ Benefits that are available to you.

Note to all members

Please remember to log on to the members’ area of the website to find out more about what’s happening in your Institute.

If you are having any problems logging in, please contact Head Office or email pauline@iocp.org.uk

PODIATRY REVIEW –

Opt out of postal copy

We are interested in hearing from any member who would like to opt out of receiving a hard copy of the Podiatry Review and prefer to access it via the members’ area of the website (with availability to download a pdf copy). To register your interest, please contact Head Office or email pauline@iocp.org.uk

IMPORTANT INFORMATION!

IOCP Membership and Insurance

The Board of Directors wish to remind ALL members that the annual subscription fees are due 1st January.

The insurance scheme is a benefit of IOCP membership. Therefore, those practitioners wishing to partake in the IOCP’s insurance scheme, via Arthur J Gallagher Insurance Brokers Ltd (AJG), IOCP membership fees must be paid in order for the insurance to be validated. Failure to do so will result in no insurance cover for the period up to IOCP fees being paid.

Both the IOCP and AJG offer members a direct debit facility in order to pay their annual subscription and insurance fees. For further details please contact:

IOCP annual subscription: IOCPTel: 01704 546141 or email: secretary@iocp.org.uk

Insurance: AJG – Tel: 01384 862637 or email: samantha_grigg@ajg.com

Western Branch Meeting

Sunday 15th October

Thirteen members turned out for our final branch meeting of 2017.

The day began with an insight into the world of muscles and rheumatology by Professor of Medicine Robert G. Cooper, this was followed by a short break where members and nursing staff took advantage of the charity cake sale, to raise much needed funds for “Sunflowers” a local cancer charity.

We reconvened where Podiatrist and Fellow Loreto Sime gave an extremely interesting and thought-provoking lecture about “Nighttime eating syndrome”.

This was followed by the branch meeting. A total of £54.00 was raised for the Sunflowers charity, for further information www.liverpoolsunflowers.com.

We look forward to our next meeting and AGM at 12.15pm on Sunday 14th January 2018, at Liverpool Women’s Hospital where John Roose will be on hand to service autoclaves.

Cheshire, North Wales Branch Meeting Sunday, 15th October 2017

Sunday meetings of our Branch are something the regular attendees enjoy and this meeting was no exception as we were joined by a member of the Dementia Friends team. Natalie Pierce-Jones attended our meeting to highlight the importance of trying to understand this devastating disease of the brain and to attempt to shine a more positive light on some of the problems surrounding living with it. With over 100 diagnosed variations of the illness specific treatment is difficult to offer and often appears to be unsuccessful. However, the importance of trying to comprehend the sufferer’s point of view was emphasised and we were encouraged to try and view the world from their perspective and then comprehend what they see and experience.

Natalie included light hearted games to impart various information bullet points regarding many aspects of the illness to good effect. We all felt that the talk was very informative and worthwhile as during our work we meet many patients suffering from this condition and their carers too. The ability to communicate at some level is paramount to ensure their safety

during treatment and being sympathetic and compassionate is of vital importance.

At the end we were all invited to become a Dementia Friend then given a universally recognized badge to wear to indicate to others that we have some ability associated with caring for people with this condition.

The talk was followed by the raffle and Branch Meeting, this always raises differing viewpoints and encourages debate amongst members.

It was also a sad opportunity to bid farewell to Miriam Moorcroft. Miriam has been a strong and pro-active member of the branch for 25 years and we would like to thank her for valued input over the years and wish her well in her well-earned retirement.

Phil Yeomans

Introducing the College of Foot Health Ltd

As a new year approaches we are delighted to announce the inception of the College of Foot Health Ltd. The College is wholly owned by the Institute of Chiropodists and Podiatrists and joins our other associated professional brands; the College of Podiatric Surgeons and the Faculty of Podiatric Medicine.

Membership of the College is open to all Foot Health Practitioners and is an automatic right of all current IOCP Associates. It is designed to clearly announce the professional status of Foot Health Practitioners.

More information to come soon.

Linda Pearson

How to be aware, to protect yourself and your business

CYBER

by Dr. Therza Legend

Chiropodists, Podiatrists and foot health practitioners must all be aware of cyber-crime, which is all too often being imposed on both our personal and business lives.

To illustrate this, on one rare morning off, I caught sight of a TV programme called ‘Rip off Britain’1 that discussed the issue of identity theft, a fast growing problem that affects more than 100,000 fraud crimes in Britain each year. The situation seems to increasingly target young people and suggests that four out of five fraudsters are taking advantage of under 21 year olds online. While it is thought that a third of identity theft victims are now aged under 40, it is equally worrying that two thirds of the population over 40 years old are more likely to be affected by crime relating to fraud.

So why is this important to health professionals? Well, there is the increasing likelihood of practitioners and their patients being affected by this type of crime, which could result in lost revenue and savings from their own and/or their patient’s bank accounts. 2, 3

Many of us have experienced or know of someone that has been involved in some form of cybercrime. Once the identity thieves get their hands on any personal details they can go on a spending spree, take out loans and mortgages, as well as buying items using the victim’s name to gradually empty their bank accounts, which sadly was depicted in the programme. 2, 3 In ‘Rip Off Britain’1 a case study showed a retired couple who had the majority of their savings removed from their bank account and the hackers in this instance took their identity. This lead to the couple having to fight for months to try and get their rights and control back of their bank account. The source of this fraud along with the help of the TV presenter Angela Rippon found that hackers were able to obtain information while using the computer and

could find access to bank cards or any bills or bank statements that were visible around the computer, while they were online shopping or paying bills. Personal and any other details were being viewed using the camera portal on their computer. 4

I had heard about hackers being able to view the computer user, and although I tend to use Skype for business myself I am careful not to leave things lying about when using the camera for ‘Skype’ or ‘Whats App’, etc., while talking to business colleagues, friends and relatives. I always cover the camera at all other times when not in use, with duct or packaging tape to obscure the possibility of having my personal information, or just as importantly, my patient’s information being viewed or stolen. I tend to have patient notes recorded and then transcribe them to the computer, so any patient details and their conditions could be visible to would be fraudsters through the camera.

Traditionally, identity thieves have focused on the elderly or middle aged people with healthy bank balances and a good credit score, so it is easy to borrow or steal their identity.1, 3 But over the past years fortunately there are more campaigns to stamp out cyber-crime such as TV advertisements from Banks5, 6, 7 warning of just how easy it is for fraudsters to hoodwink the public, which has allowed cyber-crime to double each year.1

Many younger people are more frequently targeted by identity fraud now and just like the older generation identity theft is the result of using online shopping websites or taking out mobile phone contracts.2, 4 Shopping online is an easy activity, which can be done in your own

Many younger people are more frequently targeted by identity fraud now and just like the older generation, identity theft is the result of using online shopping websites or taking out mobile phone contracts.

home or indeed anywhere, but it also comes with its own risks too. Unfortunately fraudsters can steal information from reputable sites by simply putting a non-existent suffix such as a ‘co.com’ to mislead the public into sharing their private information or paying for goods and services that do not exist such as holiday bookings, which have recently been in the news.6 Make sure that the sites you use are locked sites with the usual padlock icon on the site indicates that they are protected. Even using contactless cards have been found to cause issues with small amounts of money vacating people’s bank accounts unknowingly.

The main issue overall is most people who regularly use social media are prone to reveal valuable information such as birthdays, family information, any addresses for home, school or work place, etc.5 This makes anyone an easy targets for hackers and fraudsters alike to easily find enough details on social media sites. For example Facebook, where other personal information is revealed on them, such as bank cards or other personal details that appear ‘accidentally’ in photos posted online, which can allow fraudsters to put the pieces of a jigsaw together, even pointing to their next victim’s location.5

It is interesting that most of us will go to great lengths to secure and protect our own personal and business property from being stolen.3 While the usual protection measures of locking doors and shutters, CCTV, and property alarms help abate any burglary crimes. The use of a computer, tablet or phone seems insignificant in consideration of the risks involved in potentially losing the contents of banks accounts and livelihoods.3, 4

In business or not it is important to check bank statements regularly for any unusual transactions, as there could be small amounts of money being taken out of the bank rather than bank accounts being cleaned out and having nothing left. Fraud experts from Bank fraud departments and credit reference agencies3 say that modern scams now follow a well-known pattern, which is increasingly popular among thieves. Small amounts of money for example in the region of the price of a treatment, which are small enough to fall under the victim’s radar, but the thief probably made away with a brand new, expensive phone bought with your name and money. Often payments are made to a third-party linked for example to a phone contract provider, where the phone contract deal is likely to have included a free top of the range phone.

So be wary of signing any contract that involves small amounts of money that will be extracted from your bank account each month. The best way in these instances is to check if any of your personal information is being used elsewhere, is to get a free credit report from any free credit checking agency. It adds to your peace of mind even if you are not looking for a big purchase like a house or car to buy.4

It is important to realise that fraudsters can and will collect personal information, which is done in several different ways, such as card readers while making payments in shops or restaurants. Bank details are often stolen by simply using a cheque or making card payments over the phone.7 Identity thieves can use these details to purchase goods, arranging them to be sent to another address or intercepting them along the way to the purchaser.

REFERENCES:

1 www.bbc.co.uk/programmes/b00wck32

2 www.bbc.co.uk/programmes/b011f8m5

3 www.cyberaware.gov.uk/

4 www.experian.com/lp/identity-int-2

There are certain measures that chiropodists, podiatrists and foot health practitioners can use. The use of a good, strong password that is so obscure that makes it really difficult for information to be retrieved.3 All too often we are guilty of using pet names or some obvious word that are continuously used on every computer, website and home shopping site.

It is important to change your password at least once a year or when there has been a data breach of any kind. If there are any software updates for your electronic gadgets act on this immediately, because they will often improve the existing security that has previously been provided and downloaded.3

To make sure you have not been scammed or fallen under the influence of the identity fraudsters, as mentioned above, check your bank statement regularly and call the bank if you notice any unusual transactions however, big or small. There is no point waiting for the credit reference agencies or the bank’s fraud department to contact you and to tell you that you may have been a victim of cyber-crime.3, 4 This actually happened to me, when I was called by my bank regarding big item purchases made in the USA, a country I had not been to in years. Other areas to be aware of are public Wi-Fi places such as cafes6 or transport hubs that have cunning fraudsters hacking into these type of hubs, which they can mimic.

Watch out, especially over Christmas and the sales!

The fraudsters are about, watching what the unsuspecting public are doing on their computers and phones, and they can, and do, intercept any information the public are sending.

5 www.youtube.com/watch?v=w2tW50CD6Aw

6 www.youtube.com/watch?v=8D3FbDgW9yQ

7 www.youtube.com/watch?v=HLiy_nQLJP0

CLASSIFIED ADVERTS

SVTS Chiropody Drill repair and sales

We offer an excellent competitive and efficient repair service for all makes of Podiatry/chiropody Nail drills. Berchtold, Hadewe, Suda, Footman, Podiacare, Podo Tronic and Podo Pro EVO-30,40&50 drills.

We sell Berchtold S35/ S30, Hadewe, EVO 30,40.50 Dust Bags from £1.25 –£2 each. We also buy unwanted Drills.

Unit 239 Stratford Workshops, Burford Road, London E15 2SP Contact us on 0208 5190044 or www.chiropodydrillrepair.co.uk

For Sale due to retirement

• Footman Power Rise Patient’s Chair £200 ono buyer to collect.

• Newmed autoclave

• Swivel Kneeling chair

Books

• Clinical Biomechanics at lower extremity by Valmassy

• Clinical Gait Analysis by Kirtley For information & prices contact bobxy49@gmail.co.uk

Part time Podiatrist wanted Sutton, Surrey.

Our busy podiatrist is cutting back his hours and we require an additional part time podiatrist to work in our busy poly clinic.

Please email alison@thechilterncentre.co.uk

READING outer suburb and area nearby. Routine chiropody practice for sale.

Established 17 years. Ground floor, freehold premises, good condition, low overheads Turnover £57,000 from 4 days per week. Scope for expansion.

Sale comprises either

(a) Premises, goodwill and equipment - £70,000 ono or (b) Goodwill and equipment only, with option for buyer to rent the premises - £37,000 ono.

May suit newly qualified Practitioner. Current Practitioner relocating to Midlands. Please email: abdm@talktalk.net - happy to answer any questions.

For Sale - Established domiciliary practice, covering Plymouth, Exeter and South Hams.

Average yearly income of £28,000. Offers in the region of £10,000

Contact Gardner Chiropody Limited on :  07980814126 / 01752 881167

Application for the award of Academic Fellowship of the Institutes Faculty of Podiatric Medicine (designatory letters FPodM) is open to ALL HCPC registered IOCP members in good standing, who successfully submit a 3,000 word original dissertation of good academic standard dealing with a podiatric subject, to the satisfaction of the faculty of fellows. This will be published in the review and be recorded in the fellows library.

Consultant Fellowship (CFPodM) is granted in recognition of seniority in the profession, advanced scope of practice and an exemplary record of continuing professional development and services to the profession. IOCP full members or academic fellows in good standing with more than 12 years clinical work in the profession, a degree in podiatry or podiatric medicine, POM - A and POM - S annotation (or POM - A and a supplementary /independent prescriber annotation) are invited to apply by way of a CV and supporting evidence of the above minimum requirements. Applications are considered by the Consultant Fellows awards panel.

A nominal administration fee is payable for the above and full details can be obtained by application to our National Administration Centre

www.iocp.co.uk

Looking for a next step in your professional career? Consider applying for recognition as an academic or consultant fellow.

JANUARY 2018

Leeds Branch Meeting and AGM

9.30am for a 10.00am start Venue to be confirmed. Contact Caroline on 07583 934468 for further information.

Birmingham & The Shires Branch Meeting and AGM

7.30pm at Wallace House, Oat Street, Evesham. Worcestershire. WR11 4PS

For further information contact Kate on 01789 262365.

Teesside Branch Meeting and AGM

7.30pm at 46 Blackwell, Darlington. DL3 8QT

For further information contact Jon on 01287 349517

14 Cheshire, North Wales Branch Meeting and AGM

10am for a 10.15am start at Dene Hotel, Hoole Road, Chester.

If you want further information contact Michelle on 01704 540614

15

North West Branch Meeting and AGM

7.00pm at St Joseph’s Parish Centre, Harpers Lane, Chorley. For further information please contact Alison on 01772 623180

17

London Branch Meeting and AGM

19.30 at Ozzie Rizzo, 14 Hay Hill, Mayfair. W1J 8NR.

Contact: Sarah on 07790 717833 or email footwoman@gmail.com

21 Leicester & Northants Branch Meeting and AGM

10.00am at Kilsby Village Hall/ Lutterworth Cricket Club

Contact Barbara on 07790 350109 for further information

21

West of Scotland Branch Meeting and AGM

At Express by Holiday Inn, Sprigkerse Business Park, Stirling, FK7 7XH.

Contact John on 0780 135 6485 for further information

21

South Wales & Monmouth Branch Meeting and AGM

2pm – 4pm venue TBC

Contact Esther on 01656 740772 for further information

21

Essex Branch Meeting and AGM

2pm at the Southend University Trust Hospital Education Centre, Carlingford Drive, Southend-onSea, Essex. SS0 0RY- Reflexology presentation TBC

Contact: Beverley on 01702 460890 for further information

MARCH 2018

10

Leeds Branch Seminar Huddersfield University

TBC, please check with your Branch Secretary, Head Office or website for further information.

18 Essex Branch Meeting

2pm at the Southend University Trust Hospital Education Centre Carlingford Drive, Southend-onSea, Essex. SS0 0RY – HCPC Audit or Lymphedema presentation TBC

Contact Beverley on 01702 460890 for further information

14 London Branch Meeting 19.30 at Ozzie Rizzo

JUNE 2018 (cont)

20 London Branch Meeting

19.30 at Ozzie Rizzo, 14 Hay Hill, Mayfair. W1J 8NR.

Contact Sarah on 07790 717833 or email footwoman@gmail.com

JULY 2018

14 EC/Board of Education/ Board of Ethics Meetings

Held at Head Office, Southport

SEPTEMBER 2018

Essex Branch Meeting

First Aid Course (tentative date) TBC

28

EC/Board of Education/ Board of Ethics

Meetings

Held at Head Office, Southport

Nottingham Branch Meeting and AGM

At Feet & Co, 85 Melton Road, West Bridgford, Nottingham. NG2 6EN.

Contact Valerie on 0115 931 3492 for further information.

28 Devon and Cornwall Branch Meeting and AGM

11am at The Exeter Court Hotel, Kennford, Exeter EX6 7UX. Lecturer to be confirmed.

Contact Mark Smith on 01803 520788 or email mrkjoanne@aol.com for further information.

28

Sussex Branch Meeting and AGM

10am at The Somers Vintage Tea Rooms 64a High street, Lindfield. RH16 2HL

Contact Dylan on 07759 535388 for further information.

FEBRUARY 2018

2 Midland Area Council AGM Meeting

3 Leeds Branch Meeting

9.30am for a 10.00am start at St Mary’s Social Club, Melton Street, Batley, West Yorkshire, WF17 8PT.

Contact Caroline on 07583 934468 for further information.

14 Hay Hill, Mayfair. W1J 8NR. Contact: Sarah on 07790 717833 or email footwoman@gmail.com

APRIL 2018

8

Leeds Branch Meeting

9.30am for a 10.00am start at St Mary’s Social Club, Melton Street, Batley, West Yorkshire, WF17 8PT. Contact Caroline on 07583 934468 for further information.

25-26 Naidex, NEC Birmingham

MAY 2018

10/11 IOCP will be present at COPA, ExCel London

11/12 IOCP National Podiatry & Associated Healthcare Conference

Southport Theatre & Convention Centre

20 Essex Branch Meeting

2pm - Southend University Trust Hospital Education Centre Carlingford Drive, Southend-on-Sea, Essex. SS0 0RY  Lymphedema or an A&P System presentation TBC

Contact Beverley on 01702 460890 for further information

JUNE 2018

2 Leeds Branch Meeting

9.30am for a 10.00am start at St Mary’s Social Club, Melton Street, Batley, West Yorkshire, WF17 8PT.

Contact Caroline on 07583 934468 for further information.

Contact Beverley on 01702 460890 for further information

26 London Branch Meeting

19.30 at Ozzie Rizzo, 14 Hay Hill, Mayfair. W1J 8NR.

Contact: Sarah on 07790 717833 or email footwoman@gmail.com

NOVEMBER 2018

18

Essex Branch Meeting

2pm at the Southend University Trust Hospital Education Centre

Carlingford Drive, Southend-onSea, Essex. SS0 0RY  TBC

Contact Beverley on 01702 460890 for further information

28

London Branch Meeting

19.30 at Ozzie Rizzo, 14 Hay Hill, Mayfair. W1J 8NR.

Contact: Sarah on 07790 717833 or email footwoman@gmail.com

JANUARY 2019

16

London Branch Meeting

19.30 at Ozzie Rizzo, 14 Hay Hill, Mayfair. W1J 8NR.

Contact Sarah on 07790 717833 or email footwoman@gmail.com

20

Essex Branch Meeting and AGM

2pm - Southend University Trust Hospital Education Centre

Carlingford Drive, Southend-onSea, Essex. SS0 0RY

Contact Beverley on 01702 460890 for further information