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Monday 09:00 - 18:00 Wednesday 09:00 - 18:00 Friday 09:00 - 18:00

Lawrence Atrash, Podiatrist, Sports Injury Clinic, Fourways, Johannesburg (2026)

19/03/2026

Examining the relationship between plantar callus formation and ulcer development in diabetic patients.

Calluses form when repeated pressure or friction causes the skin to thicken as a protective response. While this may seem harmless, excessive callus formation is a major risk factor for diabetic foot ulcers.

Studies have shown that plantar calluses can increase localised pressure under the foot by up to 30%. In people with diabetes and peripheral neuropathy, this added pressure may lead to tissue breakdown without the patient noticing pain.

In South Africa, where diabetes prevalence continues to rise, identifying high-risk signs such as callus formation is critical. Many patients may ignore thickened skin until it progresses into a serious wound.

Podiatrists play a vital preventative role by safely debriding calluses, redistributing pressure through orthotics, and educating patients about daily foot inspections.

Calluses are more than cosmetic—they can signal dangerous pressure points in diabetic feet. Early intervention by podiatrists in South Africa can prevent ulceration and reduce amputation risk.

Source

Murray HJ, et al. The association between callus formation and ulceration in diabetic feet.
Diabetic Medicine.
https://f.mtr.cool/zeddqcnjmk

19/03/2026

Sore, aching feet at the end of the day aren’t just from “being busy.” There’s always a reason, and understanding it is the first step to real relief.

That dull, throbbing ache after a long day isn’t something you should simply accept. Your feet are supporting your full body weight for hours, and when something is off, they let you know.

One of the biggest culprits is prolonged standing or walking. Whether you're working retail, teaching, or constantly on the move, your feet don’t get enough time to recover. Muscles fatigue. Blood pools. Pressure builds.

Footwear plays a major role. Shoes without proper support force your feet to work harder. Flat soles, worn-out trainers, or tight shoes can all lead to strain in the arches, heels, and toes. Over time, this can trigger conditions like plantar fasciitis or tendon irritation.

There’s also the issue of poor biomechanics. If your feet roll inwards or outwards too much, certain areas take more pressure than they should. This imbalance can cause pain not only in the feet, but also in the knees and lower back.

So what helps? Start simple. Elevate your feet after work to reduce swelling. Stretch your calves and arches. Roll a ball under your foot to release tension. And most importantly, wear shoes that support your daily demands.

If the pain is constant or worsening, don’t ignore it. A podiatrist can assess your gait and provide targeted solutions.

End-of-day foot pain isn’t just fatigue; it’s feedback. Listen to it. With the right support and habits, you can finish your day as comfortably as you started it.

16/03/2026

Foot pain is one of the most common musculoskeletal complaints affecting mobility and daily functioning. Even mild discomfort in the feet can discourage people from walking, exercising, or participating in recreational activities.

Research shows that individuals with persistent foot pain are significantly more likely to reduce their physical activity levels. Over time, this inactivity contributes to weight gain, reduced cardiovascular fitness, and increased risk of chronic diseases such as diabetes and hypertension. In many cases, patients avoid movement simply to escape pain.

In the South African context, this relationship is particularly important. Walking is a primary form of physical activity for many communities, especially where access to gyms or organised sport is limited. When foot pain limits walking ability, it can have wider health consequences.

Podiatrists can intervene by diagnosing the underlying cause of pain and implementing treatments such as orthotics, footwear modifications, and targeted exercises. Education about a gradual return to activity is also essential.

Foot pain can quietly reduce physical activity and worsen overall health. South African podiatrists play a key role in restoring mobility and supporting active lifestyles.

Source:
Menz HB, et al. Foot pain and its association with physical activity in older adults.
Journal of Foot and Ankle Research.
https://f.mtr.cool/pdnhcezgcu

16/03/2026

Your feet change as you age. Skin, muscles, joints, and circulation all evolve over time, which means foot care needs to adapt to.

Ageing affects every part of the body, and the feet are no exception. Over the years, the natural cushioning under the heel and ball of the foot begins to thin. This makes the feet less able to absorb shock, which can lead to discomfort when walking or standing for long periods.

The skin also becomes drier and more fragile with age. This increases the risk of cracks, especially around the heels. At the same time, nails may become thicker or harder to trim, making proper nail care more challenging.

Joint stiffness is another common change. Conditions such as arthritis can affect the small joints of the feet and toes, leading to swelling, reduced mobility, and difficulty wearing certain shoes. Muscles and ligaments may also weaken, sometimes causing changes in foot shape or arch height.

Circulation may slow as well. Reduced blood flow can make feet feel colder and slow down healing if there are cuts or injuries. For older adults, even small foot problems can escalate quickly if ignored.

Regular foot care becomes especially important with age. Daily checks for cuts, swelling, or skin changes can catch problems early. Wearing supportive footwear, keeping the skin moisturised, and maintaining gentle exercise all help maintain foot health.

Ageing feet need extra attention, not less activity. With proper care and regular monitoring, your feet can stay strong, comfortable, and reliable for many years. Healthy ageing starts from the ground up.

16/03/2026

Walking barefoot can feel natural and freeing. But depending on where and how often you do it, it may place unnecessary strain on your feet.

Many people believe walking barefoot is the healthiest option for their feet. It feels natural, relaxed, and comfortable. But modern environments are very different from the soft, natural surfaces our feet were designed for.

Most homes today have hard floors like tiles, concrete, or laminate. Walking barefoot on these surfaces removes the cushioning and support your feet need. Over time, this can increase strain on the plantar fascia, heels, and arches. For some people, it can trigger heel pain or worsen conditions like plantar fasciitis.

Barefoot walking can also increase your risk of cuts, splinters, and infections, particularly if you step on sharp objects or rough surfaces. This risk is even greater for people living with diabetes or reduced sensation in their feet.

That said, going barefoot occasionally on soft, natural surfaces like grass or sand can help strengthen the small muscles in the feet and improve balance. The key is moderation and choosing the right environment.

At home, supportive house shoes or cushioned slippers can protect your feet while still allowing natural movement. If you enjoy barefoot activities, introduce them gradually so your feet can adapt safely.

Barefoot walking isn’t always harmful, but it isn’t always helpful either. Your feet still need protection and support in modern environments. A balanced approach keeps them strong, comfortable, and ready for whatever the day demands.

16/03/2026

Childhood obesity can place significant stress on growing feet, leading to pain, structural deformities, and reduced physical activity. Conditions such as flatfoot, Sever’s disease, and overpronation are more common in overweight children.

The relationship between foot pain and reduced activity creates a vicious cycle that contributes to further weight gain. Early intervention is essential to restore comfort and encourage movement.

Podiatrists in South Africa can screen children for biomechanical issues, provide footwear guidance, and collaborate with dietitians and paediatricians on weight management plans. Education for parents and school staff is also vital in promoting healthy habits.

With South Africa’s rising childhood obesity rates, podiatrists have an opportunity to influence both foot health and broader wellness outcomes through early, compassionate intervention.

Obesity affects the feet from an early age. South African podiatrists can support prevention and management through child-focused care.

Source: Mickle, K.J., et al. (2011). Childhood obesity and foot pain: Relationship between increased body mass and foot structure in children. Obesity. https://f.mtr.cool/yljffriefl

16/03/2026

That sudden, painful foot cramp that jolts you awake at night is more than just bad luck. Your muscles are reacting to something, and understanding why can help prevent it.

Night-time foot cramps can strike without warning. One moment you’re asleep, the next your toes are curling painfully, and your arch feels like it’s locked in a vice. The pain can last seconds or minutes, but the discomfort often lingers.

These cramps usually happen because of muscle fatigue or tightness. Long hours standing, exercising without stretching, or wearing unsupportive shoes can overload the small muscles in the feet. Dehydration is another common trigger, especially in hot South African climates where fluid loss happens quickly.

Low levels of certain minerals, such as magnesium or potassium, may also contribute. Pregnant women and older adults tend to experience night cramps more frequently due to circulation changes and muscle strain.

When a cramp hits, gently stretch the foot by pulling the toes back towards the shin. Standing up and placing weight on the foot can also help release the spasm. Massaging the arch or applying warmth often eases the tightness.

Prevention starts during the day. Stretch your calves before bed, stay hydrated, and wear supportive shoes that reduce muscle strain. If cramps are frequent, severe, or affect both feet regularly, consult a healthcare professional to rule out circulation or nerve issues.

Night-time foot cramps may seem random, but they rarely are. Your feet are responding to strain, dehydration, or imbalance. With a few simple adjustments, you can reduce the frequency and finally enjoy uninterrupted sleep without that midnight jolt of pain.

16/03/2026

Foot odour isn’t just embarrassing. When it lingers despite washing, it may be a sign that something deeper is going on.

Everyone’s feet sweat. In fact, they have more sweat glands than most parts of the body. But sweat itself doesn’t smell. The odour comes from bacteria breaking down moisture trapped inside shoes and socks.

If foot odour keeps coming back even after regular washing, it could point to excessive sweating, fungal infection, or poor shoe hygiene. Warm, enclosed shoes create the perfect environment for microbes to thrive. And once they settle in, a quick rinse won’t solve the problem.

Start with the basics. Wash your feet daily using mild soap, and dry thoroughly — especially between the toes. Damp skin is a breeding ground for fungus. Change socks at least once a day, more if your feet sweat heavily. Choose breathable fabrics that wick moisture away from the skin.

Rotate your shoes. Wearing the same pair daily doesn’t give them time to dry properly. Leave them in a well-ventilated space and consider using antibacterial shoe sprays or inserts.

If odour is accompanied by itching, peeling skin, or nail changes, athlete’s foot or a fungal nail infection may be present. These need targeted antifungal treatment, not just deodorising products.

Persistent foot odour isn’t something to hide; it’s something to address. With the right hygiene habits and proper treatment when needed, you can restore freshness, protect your skin, and step forward with confidence every day.

05/03/2026

Foot drop refers to difficulty lifting the front of the foot due to weakness or paralysis of the dorsiflexors, particularly the tibialis anterior. It may result from nerve injury, stroke, multiple sclerosis, or spinal pathology.

Clinically, it presents as a high-stepping gait to avoid toe drag. Patients may also report frequent tripping or altered balance. Podiatrists can play a central role in identifying the condition and guiding conservative management.

Treatment includes prescribing ankle-foot orthoses (AFOs), facilitating gait retraining with physiotherapy, and advising on home modifications to reduce fall risk. In some cases, functional electrical stimulation (FES) may be used to restore dorsiflexion during walking.

In South Africa, podiatrists in both public and private sectors can collaborate with neurologists and rehab teams to streamline care.

Foot drop has functional and safety implications. South African podiatrists can assist with diagnosis, bracing, and rehabilitation strategies.

Source: Sheffler, L.R. & Chae, J. (2007). Neuromuscular electrical stimulation in neurorehabilitation. Muscle & Nerve. https://f.mtr.cool/aaxliopxgt

05/03/2026

School shoes are worn for hours every single day. If they don’t fit properly, they can shape a child’s feet in all the wrong ways.

A child’s foot is not just a smaller version of an adult foot. It’s softer, more flexible, and still developing. That means the shoes worn to school every day play a major role in how those feet grow.

Shoes that are too tight can lead to blisters, ingrown toenails, and long-term toe deformities. Shoes that are too loose cause friction, instability, and poor walking patterns. And remember, children’s feet grow quickly. A pair that fit perfectly in January may be too small by June.

When choosing school shoes, look for a firm heel counter at the back. This provides stability and prevents the foot from rolling inwards. The sole should be flexible at the toes but not bend in the middle. If it folds in half easily, it offers very little support.

There should be about a thumb’s width of space between the longest toe and the front of the shoe. Always measure both feet and fit to the larger one. Let your child walk around the store to test comfort before buying.

Avoid handing down heavily worn shoes between siblings. Shoes mould to the original wearer’s foot shape and gait pattern, which may not suit another child.

School shoes are not just part of a uniform. They are daily support systems for growing bodies. The right pair protects developing feet, supports posture, and prevents avoidable problems later in life. Fit matters. Structure matters. Growing feet deserve the best start.

05/03/2026

Discussing the presentation of gout in the foot and non-pharmacological interventions.

Gout is a form of inflammatory arthritis caused by urate crystal deposition, often presenting as sudden, excruciating pain most commonly in the first metatarsophalangeal (MTP) joint. Swelling, redness, and warmth typically accompany the acute phase.

Podiatrists may encounter patients unaware that their symptoms are due to gout. Early recognition and referral for medical management (e.g., colchicine or allopurinol) is key to reducing joint damage.

Beyond medication, podiatrists can assist by advising on pressure-relieving footwear during flare-ups, taping or offloading techniques, and cold compress strategies. Education on diet, hydration, and weight management also supports long-term control.

In South Africa, where red meat and alcohol are dietary staples for many, culturally appropriate advice can help patients make sustainable changes.

Gout is painful but manageable. South African podiatrists play a key role in identifying symptoms and supporting lifestyle-based interventions.

Source: Roddy, E. et al. (2007). Management of gout: a review of nonpharmacological and pharmacological therapies. Therapeutics and Clinical Risk Management. https://f.mtr.cool/ppjyeffetx

14/02/2026

That small, rough bump on the sole of your foot might not be a callus. Plantar warts are common, contagious, and often mistaken for something harmless.

Plantar warts are caused by the human papillomavirus, which enters through tiny breaks in the skin. They usually appear on the soles of the feet, especially on weight-bearing areas like the heel or ball of the foot. Because of the pressure from walking, they grow inward instead of outward, which is why they can feel like you’re stepping on a small stone.

Unlike calluses, warts often have tiny black dots in the centre. These are small clotted blood vessels. The skin lines around them also look interrupted, rather than flowing naturally across the surface.

They spread easily in warm, damp environments. Think swimming pools, communal showers, gym floors. Walking barefoot in these areas increases your risk.

Some plantar warts disappear on their own, especially in children. But others persist for months and become painful. Over-the-counter treatments containing salicylic acid can help, but they require patience and consistent application. Avoid cutting or picking at the wart. This can spread the virus or cause infection.

If the wart is painful, spreading, or not responding to home treatment, a podiatrist can offer safer and more effective options such as cryotherapy or specialised topical treatments.

A small bump can cause big discomfort. If you suspect a plantar wart, act early. Proper care prevents spread, reduces pain, and gets you back to walking comfortably without that nagging pebble-in-the-shoe feeling.

Lawrence Atrash, Podiatrist

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Monday	09:00 - 18:00
Wednesday	09:00 - 18:00
Friday	09:00 - 18:00