Christelle Ingratta Podiatrist

14/02/2026

10/02/2026

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Pregnancy brings profound physiological changes, many of which affect the lower limbs. Relaxin, a hormone that softens ligaments in preparation for childbirth, can lead to increased joint laxity and altered foot posture.

Studies have shown that arch height often decreases during pregnancy, contributing to overpronation, heel pain, and fatigue. Weight gain and fluid retention further compound the strain on foot structures, leading to swelling, numbness, and sometimes varicose veins.

In South Africa, podiatrists can support pregnant individuals through education, footwear advice, and customised insoles to reduce mechanical stress. Addressing discomfort early can prevent longer-term issues like chronic plantar fasciitis or tibialis posterior dysfunction.

Postpartum follow-up is equally important to reassess foot posture and address lingering pain or functional changes.

Pregnancy can significantly alter foot mechanics. South African podiatrists have a role in preventing and managing discomfort during this transformative period.

Source: Segal, N.A. et al. (2013). Pregnancy leads to lasting changes in foot structure. American Journal of Physical Medicine & Rehabilitation. https://f.mtr.cool/hyfpfulyjw

02/02/2026

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A bit of swelling after a long day isn’t unusual, but when your ankles puff up regularly, it could be a sign of something more serious.

Swollen ankles are a common complaint, especially after standing or sitting for long periods. It might seem harmless, but persistent or unexplained swelling shouldn’t be brushed off.

Mild swelling can happen after a hot day, a long flight, or hours on your feet. In these cases, it’s usually temporary and improves with rest, leg elevation, and gentle movement.

But if your ankles swell daily, or if the swelling comes with pain, redness, heat, or tight skin, it’s time to pay closer attention. It could be a sign of an underlying issue like poor circulation, venous insufficiency, or lymphatic problems. In some cases, swelling may signal kidney, heart, or liver concerns — especially if both ankles are affected, and there’s no clear cause.

Injury-related swelling, such as a twisted ankle or sprain, is usually accompanied by bruising and a sudden increase in pain. It needs proper support and, in some cases, X-rays to rule out fractures.

Simple ways to manage mild swelling include elevating your legs above heart level, staying hydrated, wearing compression socks, and avoiding tight shoes. But if swelling persists, spreads, or comes with other symptoms like fatigue or shortness of breath, seek medical advice.

Swollen ankles aren’t always serious, but they’re never something to ignore. Your body may be signalling that something isn’t right. Whether it’s your veins, joints, or something deeper, early care can prevent long-term problems and keep you confidently on your feet.

26/01/2026

Persistent foot pain doesn’t always start in the foot. Sometimes, it’s a symptom of something deeper — a sign that your body is dealing with more than just tired soles.

Foot pain is often blamed on long days, bad shoes, or ageing joints. But when the pain is persistent, unusual, or doesn’t improve with rest, it may be a sign of an underlying condition affecting more than just your feet.

Diabetes is a common culprit. High blood sugar damages nerves and reduces circulation, often showing up first as tingling, burning, or numbness in the feet. If left unchecked, this can lead to serious complications like ulcers or infections that heal slowly.

Arthritis, particularly rheumatoid arthritis, may cause stiffness, swelling, or aching in multiple foot joints, especially first thing in the morning. Inflammation can also change how the foot functions, leading to changes in walking patterns and balance.

Circulatory issues like peripheral artery disease (PAD) may cause cramping, pain during walking, or cold feet. In these cases, the problem lies in blood flow, not the foot itself.

Even lower back conditions, like a slipped disc or sciatica, can cause pain that radiates down the leg and into the foot, mimicking plantar fasciitis or heel pain.

If foot discomfort comes with other symptoms like numbness, skin changes, pain at rest, or pain in both feet, it’s time to go beyond home remedies and see a medical professional.

Conclusion:
Not all foot pain begins at ground level. When symptoms linger or spread, your feet may be alerting you to something bigger. Listening to those early warning signs can protect not only your mobility, but also your overall health.

26/01/2026

How big is the "placebo effect" in running footwear?
Well, I have always suspected that a part of the effect we see with advanced footwear technology (AFT) is powered by suggestion.
So, if you had a gait analysis and biomechanical evaluation, and then had a shoe recommended based on this analysis, would you be able to tell the difference between the recommended shoe and another.
It seems the answer is yes.. you could!
A recent study took twenty-one women runners who completed a clinical gait analysis and four 5-min treadmill trials at a self-selected comfortable speed sequentially in their own shoes (OS), the first experimental shoes (randomised), their OS, and the second experimental shoes (randomised).
The shoes were presented as either a ‘basic’ shoe or, the ‘gait-matched’ shoe selected for them based on the clinical gait analysis conducted.
Runners rated gait-matched shoes significantly more favourably than basic shoes in every subjective measure, and similarly to their OS in all measures except for overall comfort and running pleasure. Gait-matched shoes were consistently rated over 10 mm higher than basic shoes on VAS, indicating a clinically meaningful difference.
The only problem is that there was a deception.
The "gait matched" shoes and the "basic" shoe were in fact identical except for colour!
No participant indicated that they believed the experimental shoes to be identical when assessed for blinding effectiveness.
Nearly a quarter of participants overall preferred the "gait-matched" shoes above their own, indicating that they were effectively persuaded by the recommendation derived from gait analysis and favourable product description.
What does it all mean? Well, it is not necessarily bad, it just means we have to be aware of the power of suggestion. Smart clinicians can leverage this to the benefit of their patient.
This study sounds a note of caution with respect putting all ones eggs in the basket of the "comfort filter", although, especially for non elites, I still believe this is important.
What the study does underline is the importance of increasing your knowledge about what shoe might suit which runner, because it is completely individual and you need to understand the nuances.
There were limitations.. and an all-female cohort of only 21 recreational runners.
All the same it is food for thought!
Fife et al 2025 (https://onlinelibrary.wiley.com/doi/10.1155/tsm2/1419641)
For another commentary, take a look at Tom Goom's The Running Physio https://mailchi.mp/running-physio/shoe-perception?e=cebe0eaa22

26/01/2026

A sharp sting between your toes? It might be a corn, and it’s not just caused by bad shoes. Here’s why these little lumps appear and how to get rid of them safely.

Corns between the toes — known as soft corns — are small, painful lumps of thickened skin that form where the toes rub against each other. Unlike the hard, dry corns found on top of the toes or soles, these are kept soft by the moisture between the toes, making them feel rubbery or sponge-like.

They usually form when shoes are too tight or have a narrow toe box, forcing the toes to press together unnaturally. But they can also appear when toes are misaligned, or if there’s a bony prominence that increases pressure in one spot.

At first, it might feel like a slight irritation, but over time, soft corns can become quite painful, even making walking uncomfortable. In some cases, they can break the skin and increase the risk of infection, especially in people with diabetes or poor circulation.

What helps? Start by switching to shoes with a wide, breathable toe box. Toe spacers or soft foam pads between the toes can reduce friction. Avoid over-the-counter corn plasters with acid, as they can damage the surrounding skin.

A podiatrist can safely remove the corn and identify any underlying biomechanical issues causing the problem. In some cases, custom orthotics or small toe props can prevent recurrence.

Don’t ignore that sharp pinch between your toes. With the right care and better-fitting shoes, soft corns can be treated quickly and comfortably, keeping every step pain-free.

22/12/2025

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.

13/12/2025

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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.

06/12/2025

Gout is a form of arthritis caused by the buildup of uric acid crystals in the joints, leading to sudden, intense pain, redness, and swelling, often in the big toe. The primary cause of gout is high levels of uric acid in the blood, which can result from certain foods, alcohol, or dehydration. To av...

Read more: https://www.afcdallas.com/component/k2/item/47-preventing-gout-flare-ups

06/12/2025

Peripheral neuropathy affects up to 50% of people with diabetes and is a leading risk factor for foot ulcers and amputations. Early identification is essential to prevent complications. Podiatrists are often the first professionals to detect subtle signs of nerve damage.

Screening methods include monofilament testing, vibration perception thresholds (using tuning forks or biothesiometers), and pinprick or temperature discrimination tests. These tools allow for accurate staging of neuropathy and risk categorisation.

In South Africa, podiatrists in both private and public sectors should conduct annual foot screenings for diabetic patients. Incorporating quick, cost-effective screening tools into practice enhances early detection and supports referral for endocrinology or neurology care when needed.

Education around symptom recognition—such as burning, tingling, or numbness-should be provided to all at-risk patients. Behavioural changes such as daily foot checks, protective footwear, and smoking cessation can all reduce progression.

Podiatrists are front-line defenders against the silent threat of neuropathy. Early identification in South Africa can save limbs and lives.

Source: Tesfaye, S., et al. (2011). Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care. https://f.mtr.cool/eharzcrkpk