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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)

19/01/2026

One tiny corner of a nail can cause major pain. Ingrown toenails are more than irritating if left untreated; they can become infected and severely impact your daily comfort.

An ingrown toenail happens when the edge of your nail grows into the surrounding skin, usually on the big toe. It might start as a slight tenderness but can quickly turn into redness, swelling, pus, and sharp pain when walking or even when lying in bed.

The most common cause? Improper nail cutting. Cutting toenails too short or rounding the corners encourages the nail to curve inwards. Tight shoes, trauma to the nail, and genetics also play a role.

At home, early-stage ingrown nails can be managed with warm saltwater soaks, clean cotton tucked under the nail edge, and wearing open or wide-toe shoes to reduce pressure. But avoid digging or cutting at the nail yourself this often makes things worse and risks infection.

If there’s severe pain, swelling, pus, or if you have diabetes, it’s essential to see a podiatrist. They can safely trim or remove part of the nail and give proper aftercare instructions. In recurring cases, a minor procedure can permanently stop that corner of the nail from regrowing.

And yes, prevention is possible. Always cut toenails straight across, not curved. Don’t cut them too short. And wear shoes that allow your toes to move freely without pressure.

Ingrown toenails might be small, but the pain they cause is anything but. Early care and proper nail habits can keep your feet healthy, your steps painless, and your toes infection-free. Don’t wait for it to get ugly; treat it right from the start.

19/01/2026

Flat feet aren’t always a problem, but when they are, they can affect everything from how you walk to how your knees and back feel.

Here’s what you need to know.

Flat feet, also called fallen arches, happen when the arches of the feet collapse or never fully form. For some, it’s genetic and lifelong. For others, it develops later due to injury, pregnancy, or conditions like arthritis.

Many people with flat feet don’t experience any symptoms at all. But when pain does show up, it’s usually in the arch, heel, or inner ankle, and can travel up into the knees or lower back. That’s because the arch acts as a shock absorber, and when it’s missing, the whole body feels the impact.

Signs to watch for include tired, aching feet after long periods of standing, shoes wearing out unevenly, and a feeling of instability when walking or running. Children may also complain of leg fatigue or struggle to keep up during physical activity.

The good news? Most cases don’t need surgery. Supportive shoes, arch-supporting insoles, and simple strengthening exercises can make a big difference. Avoid going barefoot on hard surfaces for long stretches, and be cautious with unsupportive shoes like flip-flops or ballet pumps.

If pain persists, or if you notice your foot shape changing suddenly, it’s time to see a podiatrist. They’ll assess your gait and foot mechanics and recommend a plan that fits your lifestyle.

Flat feet aren’t always a cause for concern, but if they’re causing pain or changing how you move, don’t ignore them. With the right support and care, you can stay active, pain-free, and steady on your feet.

19/01/2026

That bony bump on the side of your foot? It’s not just part of getting older; it’s likely a bunion. And ignoring it can lead to long-term foot problems.

Bunions don’t just pop up overnight. They develop slowly, starting as a small bump at the base of your big toe. Over time, that bump grows and pushes the toe inward, changing the shape of your foot and making it harder to wear certain shoes or walk without pain.

While tight or pointed shoes can make them worse, bunions are mostly caused by genetics and biomechanics. If your parents or grandparents had them, chances are higher that you will too. Women are also more prone to bunions, especially if they wear high heels or narrow shoes regularly.

The symptoms start with subtly aching feet, redness over the joint, or difficulty finding shoes that fit comfortably. But as the bunion progresses, it can cause joint stiffness, inflammation, and even lead to deformities in the other toes.

Treatment depends on how advanced the bunion is. In the early stages, switching to wide, supportive shoes, using bunion pads or orthotics, and doing toe-strengthening exercises can help reduce pain and slow progression. Ice and anti-inflammatories can ease swelling after a long day on your feet.

In more severe cases, a podiatrist might recommend surgery to realign the bones and relieve the pressure on the joint.

Bunions aren’t just a cosmetic issue they’re a s,ignal that your foot alignment needs support. Catching them early can mean avoiding surgery later. So if that bump is starting to bother you, don’t wait. There’s plenty you can do to protect your step.

05/01/2026

Nurses and other healthcare workers are on their feet for long shifts, often on hard flooring and in unsupportive footwear. As a result, they are particularly prone to plantar heel pain, including plantar fasciitis and fat pad syndrome.

A cross-sectional study from the UK found that up to 30% of nurses experience regular heel pain. Contributing factors include poor shock absorption, high BMI, and prolonged static standing.

In South Africa, where nurses form the backbone of public healthcare, podiatrists can offer critical interventions. These include footwear recommendations, stretching regimens, taping techniques, and orthotic devices tailored to their work demands.

Engaging with hospital wellness programmes or providing in-service training could extend podiatric care into occupational health spaces. Prevention, early treatment, and ergonomic support are key to maintaining workforce productivity.

Heel pain is a common yet overlooked issue among healthcare workers. South African podiatrists should advocate for better foot care in hospitals and clinics.

Source: Bowen, C.J., et al. (2009). Foot health and plantar heel pain in nurses: a cross-sectional survey. Journal of Advanced Nursing. https://f.mtr.cool/lutdhyltlo

05/01/2026

Constantly dealing with damp socks, smelly shoes or slippery soles? Excessive foot sweating isn’t just embarrassing; it can lead to serious skin and nail problems if not managed properly.

Sweaty feet, also known as plantar hyperhidrosis, affect more people than you might expect. While some sweat is normal (especially during hot South African summers), excessive moisture creates the perfect breeding ground for bacteria, fungi, and unpleasant odours.

The sweat itself isn’t the problem; it’s what happens when it stays trapped in socks and shoes. This warm, damp environment can lead to athlete’s foot, fungal nail infections, and skin breakdown. It can even make walking uncomfortable if the skin becomes too soft or slippery.

Start with breathable footwear. Choose shoes made from natural materials like leather or mesh that allow airflow. Rotate your shoes daily and let them dry out completely between wears. Avoid synthetic socks and instead go for cotton or moisture-wicking fabrics designed to keep your feet dry.

Foot powders or antiperspirant sprays can help reduce moisture. Apply them to clean, dry feet in the morning and reapply during the day if needed. For persistent sweating, speak to a podiatrist about clinical-strength solutions or referrals for advanced treatments.

Most importantly, wash and dry your feet thoroughly every day and don’t skip between the toes.

Sweaty feet might feel like a small problem, but the consequences can be big if left unchecked. With the right routine, breathable footwear, and daily care, you can stay dry, fresh, and confident on your feet, no matter the weather.

05/01/2026

Infrared thermography has shown promise as a non-invasive tool for detecting early inflammatory changes in the feet, especially in diabetic patients. By measuring surface temperature variations, it can identify areas of increased pressure and subclinical inflammation before ulceration occurs.

Research demonstrates that a temperature difference of more than 2°C between corresponding foot sites may predict ulcer development. This gives clinicians an early warning to modify footwear, adjust orthotics, or implement offloading strategies.

In South Africa, the high cost of thermal imaging equipment limits its widespread use. However, as technology becomes more affordable, its integration into high-risk foot clinics could revolutionise early detection.

For now, podiatrists can incorporate manual temperature checks and visual monitoring into regular diabetic assessments, using thermography when available as an adjunct tool.

Thermal imaging enhances proactive diabetic foot care. South African podiatrists should be aware of its value and advocate for broader adoption where feasible.

Source: Lavery, L.A. et al. (2007). Using temperature monitoring to predict foot ulceration in diabetic patients. Diabetes Care. https://f.mtr.cool/qaamudvoph

05/01/2026

That first step out of bed shouldn't feel like stepping on broken glass. If your heels scream in the morning, your feet are trying to tell you something important.

Waking up with sharp heel pain is more common than you think. Often described as a stabbing or pulling sensation under the heel, it usually eases up as you move around. But the relief is temporary, and the pain often returns after rest. Sound familiar?

The most likely culprit? Plantar fasciitis. This condition involves inflammation of the thick band of tissue (plantar fascia) that runs along the bottom of your foot. Overnight, the fascia tightens. When you take your first step in the morning, it suddenly stretches, triggering sharp pain near the heel.

Other possible causes include Achilles tendinitis, heel spurs, or even poor foot biomechanics, especially if you have flat feet or high arches.

The good news is that early treatment works. Start by doing gentle calf and plantar fascia stretches before getting out of bed. Avoid walking barefoot, even indoors and opt for supportive shoes or slippers with cushioning. Ice packs and over-the-counter anti-inflammatories may help reduce the pain.

But don’t ignore the problem for too long. Heel pain that lasts more than a week, gets worse, or affects your ability to walk should be assessed by a podiatrist. They can recommend tailored solutions from orthotics to physical therapy that address the root cause.

Morning heel pain isn’t just a rough start to your day; it’s a warning. With the right attention and early care, you can get back to pain-free mornings and active days. Don’t wait for it to get worse.

05/01/2026

Cerebral palsy often presents with neuromuscular abnormalities that significantly affect gait and foot posture. Equinus deformity, pes planus, and toe-walking are commonly observed and can result in functional limitations and increased risk of contractures.

Studies show that abnormal muscle tone and poor motor control in children with CP contribute to altered foot biomechanics. This affects weight distribution, balance, and joint alignment. Over time, secondary deformities may develop, leading to pain and reduced mobility.

In South Africa, children with CP may face delayed access to multidisciplinary care, particularly in under-resourced areas. Podiatrists can contribute to early intervention by identifying abnormal gait patterns and prescribing orthotic devices or customised footwear to improve alignment and function.

Working alongside physiotherapists and orthopaedic specialists, podiatrists can help manage spasticity-related deformities and delay or avoid surgical correction.

Foot biomechanics play a major role in CP-related mobility issues. South African podiatrists should be integrated into early intervention teams to optimise outcomes for children with CP.

Source: Gage, J.R. et al. (2009). The treatment of gait problems in cerebral palsy. Clinics in Developmental Medicine. https://f.mtr.cool/ceysjldhpf

05/01/2026

Dry, split heels are more than a cosmetic issue. If left untreated, they can become painful and even infected. Here's what causes cracked heels and how to fix them at home.

Cracked heels are one of the most common foot problems in South Africa, especially in dry climates or when wearing open-back shoes. They often start as rough, dry skin, but can deepen into painful splits that catch on socks or even bleed.

The skin on the heel is thicker than elsewhere on the body. When it gets too dry or lacks support from proper footwear, it loses elasticity and begins to crack. Walking barefoot or wearing sandals all day makes it worse, as the skin is constantly exposed to dust and pressure without protection.

So, what can you do? Soak and moisturise. Start by soaking your feet in warm water for 10–15 minutes to soften the skin. Gently remove dead skin with a pumice stone, no blades or aggressive scrubbing.

Next, apply a thick, urea-based foot cream. These draw moisture into the skin and help repair the outer layer. For best results, moisturise before bed and wear socks overnight to lock in hydration.

If the cracks are deep, painful, or bleeding, see a podiatrist. Open cracks can become entry points for infection, especially in people with diabetes or circulation problems.

Cracked heels may seem harmless, but they’re your skin’s way of asking for care. With the right daily habits and footwear choices, you can restore soft, healthy heels and avoid unnecessary pain or complications down the road.

05/01/2026

Abnormal foot posture, such as excessive pronation or supination, can disrupt the alignment of the kinetic chain, leading to compensatory movements in the knees, hips, and lower back. Over time, these biomechanical imbalances may contribute to chronic back pain.

A 2018 study found that individuals with flat feet had a higher incidence of lower back pain compared to those with neutral foot posture. The relationship appears to be strongest when asymmetries are left uncorrected.

In South Africa, patients often present with back pain without being evaluated for foot dysfunction. Podiatrists have an opportunity to address underlying causes by assessing foot posture and gait, and by prescribing custom insoles or stability shoes.

Collaborative care with physiotherapists and chiropractors can yield optimal results, especially for patients with chronic musculoskeletal complaints.

Lower back pain may start from the ground up. Podiatrists in South Africa should routinely assess foot posture in patients with spinal symptoms.

Source: Tong, J.W.K., et al. (2018). Foot posture and lower back pain. Journal of Foot and Ankle Research. https://f.mtr.cool/vszkhllcug

05/01/2026

Shoes can make or break your feet, literally. From style over support to size slip-ups, here are the most common footwear mistakes that lead to pain and long-term problems.

Shoes are more than just a fashion choice; they shape how your feet function every day. And unfortunately, the wrong pair can do real damage. Many foot conditions seen in podiatry practices today stem from avoidable footwear mistakes.

Wearing the wrong size is a big one. Feet can change over time, especially after pregnancy, weight gain, or ageing. A size too small leads to cramped toes, corns, and bunions. Too big, and your foot slips around, causing blisters and poor alignment. Always measure both feet, yes, they can differ and choose the larger size.

Flat soles with no support, like flip-flops or certain fashion pumps, may feel convenient but offer little protection. Without proper arch support or shock absorption, your heels, knees, and back take the strain.

High heels place too much pressure on the front of the foot and throw your posture out of line. Over time, this can lead to shortened calf muscles, hammertoes, and joint pain.

Even trainers aren’t always safe. Running shoes that are too worn out or the wrong type for your activity level can increase your risk of injury. Replace them every 500–800km or when they start feeling flat.

Conclusion:
The best shoe for your foot is one that fits well, supports your arch, and suits your daily activity. It might not be the trendiest option — but your feet will reward you with fewer aches, better posture, and longer-lasting comfort. Choose wisely. Walk confidently.

Lawrence Atrash, Podiatrist

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