Lawrence Atrash, Podiatrist

Lawrence Atrash, Podiatrist General Foot care, Sports Injuries, Orthotics, Diabetic foot care and Assessment

28/04/2026

Constant foot fatigue isn’t just about a long day. If your feet always feel tired, heavy, or sore, there’s usually an underlying reason worth addressing.

Tired feet at the end of a busy day might seem normal. But when that heavy, aching feeling becomes a daily experience, it’s your body asking for help, not just rest.

One of the main causes is a lack of support. Shoes that don’t support your arches or cushion your steps force your feet to work harder with every movement. Over time, this leads to muscle fatigue and strain.

Poor circulation can also play a role. Sitting for long periods or standing in one place reduces blood flow, causing that heavy, sluggish feeling. You might even notice slight swelling or tightness in your shoes by the end of the day.

There’s also the impact of foot mechanics. If your feet roll inwards too much or don’t absorb shock properly, certain muscles are overworked. This imbalance can leave your feet feeling constantly exhausted.

So what helps? Start with your footwear, choose supportive, well-cushioned shoes suited to your daily activity. Take short movement breaks during the day to improve circulation. Elevate your feet when resting and stretch your calves and arches regularly.

If the fatigue doesn’t improve or starts affecting how you walk, a podiatrist can assess your foot function and recommend targeted support.

Tired feet aren’t something you have to live with. When your feet feel constantly worn out, it’s a sign that they need better support, movement, and care. Listen early; your comfort depends on it.

28/04/2026

Obesity places significant mechanical stress on the feet. Each step generates forces several times body weight, meaning excess mass dramatically increases load on foot structures.

Studies have shown that people living with obesity experience higher rates of foot pain, flatfoot deformity, plantar fasciitis, and joint degeneration. This discomfort can discourage walking and exercise, worsening weight gain.

In South Africa, obesity rates are increasing, particularly in urban populations. Many patients present with foot pain that limits their ability to stay active.

Podiatrists can help by addressing biomechanical strain through orthotic support, footwear recommendations, and low-impact activity advice. Encouraging gradual increases in walking and physical activity can help break the cycle of pain and inactivity.

Foot pain can both result from and contribute to obesity. Podiatrists in South Africa play a critical role in restoring mobility and supporting healthier lifestyles.

Source
Butterworth PA, et al. The association between obesity and foot pain.
Journal of Foot and Ankle Research.
https://f.mtr.cool/sssprsacgi

28/04/2026

Toe cramps can strike suddenly and painfully. That tight, curling sensation isn’t random; it’s your body reacting to strain, fatigue, or imbalance.

It starts without warning. Your toes curl, tighten, and refuse to relax. Whether it happens during exercise, at night, or while resting, toe cramps can be sharp, uncomfortable, and frustrating.

One of the most common causes is muscle fatigue. Long periods of standing, walking, or wearing unsupportive shoes force the small muscles in your feet to work overtime. Eventually, they cramp.

Dehydration is another key factor, especially in warmer climates. When your body lacks fluids, muscle function is affected, increasing the likelihood of cramping. The same goes for imbalances in minerals like magnesium and potassium.

Tight footwear can also play a role. Shoes that squeeze your toes restrict movement and blood flow, creating the perfect conditions for cramps to develop.

So what can you do? When a cramp hits, gently stretch your toes back towards your foot and massage the area to release the tension. Walking around slowly can also help reset the muscle.

For prevention, stay hydrated throughout the day, stretch your feet and calves regularly, and wear shoes with enough room for your toes to move freely. Simple exercises like toe spreads or picking up small objects with your toes can strengthen the muscles over time.

Toe cramps may be small, but they’re a sign your feet need attention. With the right habits and support, you can reduce the frequency and keep your feet relaxed, flexible, and ready for movement.

28/04/2026

Plantar fasciitis is one of the most common causes of heel pain in adults. It often develops when repetitive strain leads to microtears in the plantar fascia ligament.

Research shows that tight calf muscles significantly increase the risk of plantar fasciitis. Limited ankle dorsiflexion forces greater strain on the plantar fascia during walking and running.

Stretching programmes targeting the gastrocnemius and soleus muscles have been shown to reduce both the occurrence and severity of plantar fasciitis. These exercises are simple, inexpensive, and can be performed at home.

In South Africa, where many patients cannot access regular physiotherapy, podiatrists can teach stretching routines during consultations. This empowers patients to manage their symptoms independently.

Stretching is a powerful preventative tool for plantar fasciitis. South African podiatrists should incorporate stretching education into routine care.

Source

DiGiovanni BF, et al. Tissue-specific plantar fascia stretching exercise enhances outcomes in chronic heel pain.
Journal of Bone and Joint Surgery.
https://f.mtr.cool/ueoutlzqtg

28/04/2026

Insoles aren’t just for comfort. The right pair can change how your feet function, reduce pain, and improve the way you move every day.

Not all shoes are created equal, and sometimes, even a good shoe needs extra support. That’s where insoles come in. Small addition. Big impact.

Insoles sit inside your shoe and help redistribute pressure, support the arch, and improve alignment. For people with flat feet, high arches, or foot pain, this can make a noticeable difference within days.

There are two main types: over-the-counter insoles and custom orthotics. Store-bought options can provide general cushioning and mild support, which works well for everyday comfort. But they’re not tailored to your specific foot structure.

Custom orthotics, on the other hand, are designed based on your unique foot shape and walking pattern. These are especially helpful for conditions like plantar fasciitis, bunions, or chronic heel pain. They don’t just cushion, they correct how your foot functions.

But here’s where many go wrong. Not every insole suits every foot. Choosing the wrong type can actually increase discomfort. That’s why it’s important to understand your foot type or get assessed by a podiatrist before investing.

Also, insoles don’t last forever. Over time, they wear down and lose their support. Replacing them regularly is key.

Insoles are more than a comfort upgrade; they’re a support system for your entire body. The right pair can improve posture, reduce pain, and keep you moving better for longer. Sometimes, the smallest changes make the biggest difference.

31/03/2026

Investigating how improper footwear affects foot development in children.

Footwear plays an important role in supporting the developing foot during childhood. Shoes that are too tight, poorly structured, or lacking support can interfere with normal growth patterns and lead to discomfort.

Research indicates that many children wear incorrectly sized shoes. This can contribute to toe deformities, altered gait patterns, and pressure-related skin problems. Poor footwear may also reduce physical activity due to discomfort during play.

In South Africa, socioeconomic factors often influence footwear choices. Some children wear shoes that are too small because they must last for multiple school years, while others spend large amounts of time barefoot.

Podiatrists can contribute through school screening programmes and community education. Teaching parents how to measure children’s feet and select appropriate footwear can prevent long-term issues.

Proper footwear supports healthy foot development in children. South African podiatrists can promote early education to prevent deformities.

Source
Evans AM, Rome K. A review of footwear fit in children.
Journal of Foot and Ankle Research.
https://f.mtr.cool/vejquytxaq

31/03/2026

Foot problems rarely start suddenly. Small changes often appear first, and catching them early can prevent bigger, more painful issues later.

Your feet are constantly sending signals. The problem is, those signals are often ignored until pain becomes unavoidable. But most foot conditions start quietly, with subtle changes that are easy to miss if you’re not looking.

Start with the skin. Dry patches, cracks, redness, or peeling can point to pressure, fungal infections, or poor hydration. These may seem minor, but they can worsen quickly if left untreated.

Next, look at your nails. Discolouration, thickening, or changes in shape may indicate fungal infections or trauma from tight shoes. Nails that curve into the skin can become ingrown and painful over time.

Pay attention to how your feet feel. Tingling, burning, or numbness could signal nerve involvement, especially in people with diabetes. Persistent aches in the heel, arch, or ball of the foot often suggest strain or inflammation that needs attention.

Even your shoes can give clues. If they’re wearing down unevenly, it may reflect changes in your walking pattern or foot alignment.

Make it a habit to check your feet regularly, especially if you’re active, on your feet all day, or managing a chronic condition. Early detection makes treatment simpler and more effective.

Foot problems don’t appear overnight. They build slowly, often in silence. By paying attention to small changes, you can act early, avoid complications, and keep your feet healthy, comfortable, and ready for whatever lies ahead.

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.

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Sports Injury Clinic, Fourways
Johannesburg
2191

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

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