All of the major private medical insurance companies recognise the centre. Patients with medical insurance would require an appointment with the centre's lead podiatric surgeon and consultant, Mr McCulloch. Mr McCulloch's provider recognition codes include: BUPA: 30013533, AXA PPP: RM04115, WPA: 2076278, Aviva: 600006547, Cigna: 113191, CS Healthcare: CH11409, Pru Health: 639836. Please call the centre for further information and guidance prior to calling your insurance company.
The London Podiatry Centre aims to achieve a careful balance between providing the highest level of medical care and affordability. All major private medical insurance companies recognise the centre. Costs do vary according to the practitioner and type of assessment. Please call the Centre for further information.
For self funding patients this is not necessary. For patients claiming on their medical insurance a doctor's referral letter is often required. Please call the centre to discuss this.
Patients generally attend for an initial consultation at which point a treatment plan is formulated. The appointment can be with Mr McCulloch (this is necessary if claiming through your private medical insurance) or one of his associates.
We would generally suggest that you first attend for a consultation which will allow us to determine what sort of further investigation is required. However, for patients who are travelling from far, it is possible to combine the consultation with other investigations such as gait analysis and investigations such as X-ray. Please call the centre to discuss this.
Many patients have surgery under local anaesthetic (whilst awake). This is generally the safest form of anaesthesia. General anaesthetic is also available.
These can be organised on the same day in most instances. The centre works closely with a number of excellent radiological facilities, but also offers a number of very sophisticated on-site scanning modalities, including high resolution musculo-skeletal ultrasound and laser scanning.
Most patients comment on how little pain they experience after their operation. There is no discomfort at all for many hours after surgery due to the use of long acting local anaesthetic. Most patients find the
Many patients are very concerned about the appearance of their feet and the centre specialises not only in resolving pain but also in surgery to achieve a normal looking foot. Patients often request surgery to improve the length and alignment of their toes and this is often carried out under local anaesthetic.
The centre has produced a booklet about podiatric surgery.
A simple way of understanding the concept of biomechanics is to consider this analogy. A perfectly aligned car is far less likely to develop faults than one which has mechanical defects such as an uneven axle, a single flat tyre or tracking issue. The human body is also more likely to become injured if there is some form of mechanical malalignment. This could be the result of any one of many imbalances such as a leg length difference, stiff great toe or twisted vertebra! The centre specialises in the diagnosis and treatment of mechanically induced injuries.
Many practitioners simply assess a patient statically but many conditions are caused by the way an individual walks and runs. It is therefore essential that a comprehensive assessment is performed to analyse the movements (kinematics) and forces (kinetics) that may be causing abnormal tissue stress and injury.
Gait analysis can be divided into: Kinetic analysis: This measures forces and pressures. We utilise a state of the art in shoe pressure system with 900 sensors in each shoe to measure kinetic function. Computerised video analysis: Here multiple digital cameras are positioned around the patient. This information is then processed through powerful computerised software to provide information on walking and running. Whilst the system provides useful information, it can only observe motion two dimensionally. Quantitative three dimensional gait analysis: This gold standard system is mainly used in medical research and detailed medical analysis. It is an extremely useful clinical tool that adds a huge amount of objective information to the assessment process.
This will be determined during your initial consultation. This somewhat depends on the nature and complexity of your problem.
Before initiating treatment, the assessment process is aimed at understanding the mechanical factors which may have caused an injury or interfered with the normal healing process. This is key to the development of an effective treatment plan. The centre uses many forms of treatment to resolve a condition, including: orthotic therapy, manipulation, exercise rehabilitation, strapping techniques, mobilisation techniques, injection therapy, surgery, minimally invasive surgery, cryosurgery.
A number of sports shoes are available which have specialised features to control abnormally functioning feet. Those individuals with flat feet are often best suited to a stability trainer and the Centre would be happy to make appropriate recommendations during a consultation. Some shoe manufacturers make all sorts of claims about their shoes and the Centre does see many patients with "shoe inflicted" injury. It is therefore important to get this essential piece of equipment right! The Centre regularly tests different shoes to determine which is the most effective for their patients.
Orthoses can be worn with sandals have insoles which have removable insoles which can then be replaced by our custom orthoses. A small section of Velcro will keep the orthoses in place. Suitable sandals can be purchased from the London Podiatry Centre. Please contact the Centre for more information.
This type of footwear is not ideal for feet as it offers very little support. Toes tend to "claw" as a result and the soft nature of the sole material often distorts very easily. Ladies who wear higher heels throughout the winter are more susceptible to injury if they then convert to a flat flip-flop for summer, because their calf muscles may not be able to tolerate the sudden increase in tension. This can lead to a variety of symptoms including plantar fasciitis (heel pain) and Achilles tendon injuries and back pain. The "fit-flop" pictured below offers certain advantages including a more substantial heel and this shoe is therefore recommended over conventional flip flops.
In the context of podiatric medicine, an orthotic can be described as any in-shoe device that alters foot function. The London Podiatry Centre prescribes foot orthoses after in depth biomechanical analysis. Whilst orthoses do change movement, they have their greatest effect by altering the stress exerted on tissues including ligaments, tendons, joints and bones. Orthoses are prescribed using advanced 3D laser scanning techniques and they are made by means of a computerised milling process. This ensures optimal accuracy and longevity.
Orthoses are designed with the assistance of advanced technology which includes the use of a three dimensional laser scanner. They are manufactured using a computerised milling process which replaces more old fashioned hands on technology. The orthoses are manufactured with the assistance of an expert CAD CAM engineer so offering a unique degree of adaptability in their manufacture. A key factor the sets the centre apart from others is the highly scientific way in which orthoses are prescribed. Rather than simply issuing an orthotic, assuming that it functions in a certain way, orthoses are routinely tested to ensure that they improve the patients' biomechanics. Key variables such as pressure distribution, force and timing are measured. Changes are made to the device in our onsite laboratory to ensure optimal function. Whilst there are literally hundreds of types of orthoses on the marked, the London Podiatry Centre offers three types of device according to the accuracy, longevity and cost. Type one is manufactured using our sophisticated 3D scanner which allows for the manufacture CAD CAM (computer assisted design and manufacture) devices which are extremely accurate, thin and long lasting. Type two is a semi-customised device which continues to use CAD CAM using a best fit approach where the device has been predesigned. Type three is a simpler type of device where a good quality pre made orthotic is adapted according to the patients specific circumstances.
All types of orthotic (types 1, 2 and 3) should last for 5 years although this can be much longer. Some London Podiatry Centre patients have had their orthoses for over 10 years. Soft covers and additions require more frequent replacement but should last at least one year although this may vary with usage.
Rarely, orthoses may prove uncomfortable and require adjustment. Patients tolerate different levels of control and some people with more sensitive feet may require greater cushioning or a more flexible type of orthotic. The Centre does not charge for adjustments or re-makes if orthoses are not comfortable, providing that the patient returns within a month of receiving them.
Soft orthoses made from various types of foam material often seem instinctively more comfortable and desirable to patients. However, these types of devices distort more rapidly and offer less control and reduced value for money. At The London Podiatry Centre, highly accurate orthoses are manufactured and designed with the aid of computerised technology. The shells are resilient offering some flexibility but the cushioning comes from soft "top covers", thus achieving the ideal balance between accuracy, longevity and comfort.