Bookings are essential
No referral is necessary to see a podiatrist



To aid in diagnosis and to ensure appropriate, optimum treatment, please bring with you:

Referrals
EPC (medicare) clients - bring care plans/referral – essential
DVA clients – bring Veterans Affairs form – essential
GP referral letter if you have one
List of your current medications (dosage and frequency of medications
taken)
Shoes that are currently being worn (work, casual, sports shoes)
If booked for a biomechanical assessment then appropriate clothing (e.g
shorts)


Please advise if you are unable to attend or a fee may be charged.



At Nexus we use HICAPS for direct Health Fund Claims.  Many health funds cover podiatry, e.g. some funds will rebate $200 a year towards the cost of orthotics for each member of the family. Contact your Private Health Fund for details.



All accounts are to be settled at time of appointment.  We accept cash, visa, mastercard, EFTPOS & HICAPS.



The orthotic (Orthoses) describes different types of insoles sometimes referred to as shoe inserts or arch supports.  These are comfortable to use when supplied and fitted by qualified podiatrists.

Orthotics are available, both custom designed and off the shelf. Custom designed orthotics are especially designed for your feet and help correct abnormal foot and leg function. Off the shelf orthotics are available and may be useful in minor conditions.  These are pre-made and therefore not specific for your feet but some degree of modification to suit you can be undertaken by your Nexus Podiatrist.

Orthotics may be needed when abnormal biomechanical function occurs which leads to pain or long term injury to your feet.  These devices when professionally prescribed by a Podiatrist can greatly improve your lifestyle, by giving your feet the needed support and correct alignment.  Improvement in foot function is enhanced leading to alleviation of pain and the prevention of long term injury to your feet.   Why should you use a podiatrist for your orthotics?  Because podiatrists’ are the trained specialists in lower limb and foot biomechanics and are highly skilled in both the prescription and manufacture of custom made orthotics.

We are able to offer our patients a range of different options for Orthotics, depending on your needs.  These may be custom; general; sports; soft accommodative, which are suitable for those with diabetes or arthritis and dress Orthotics, which are designed to suit a range of dress and fashion footwear e.g loafers, flats or a moderately heeled shoe.



People who have diabetes need to have regular foot and lower limb assessments at least 12 monthly.  Diabetes can cause changes to nerve endings, resulting in numbness, with the person being unaware of injury to their feet.  The injury may be slow to heal due to the diabetes, leading to a high risk of infection and other complications.

You can help prevent such complications by attending Nexus Podiatry.  We have a special interest in prevention of complications in diabetes.  We provide full detailed assessment and treatment along with education /self help courses which address prevention of diabetes related complications.

There are some important areas to observe closely when you have been diagnosed with diabetes. The first and foremost is to keep your condition stable.  This involves careful monitoring of your diet, exercise, blood sugar levels and of course any diabetic medication which you are taking (insulin / diabetic tablets).

The next step is to have other potential risk areas assessed and attended to, such as eyes, kidneys and feet. Feet are one of the most important risk areas when you have diabetes; here at Nexus we carry out an extremely comprehensive assessment of your feet and lower limbs. Treatment we offer you is thorough, up to date with the latest research and incorporates other health professionals when needed. We aim to give you a clear picture of any risk areas you may have, with sound advice and treatment plan.

The areas covered in our comprehensive assessment and treatment follow: neurological, circulatory, biomechanical, dermatological, plantar pressure assessment, footwear assessment and education on self help for your condition.



Do your children’s feet hurt?  Do they complain of foot or leg pain?  Do they have instability issues or trip frequently?  Does your child walk differently to other children?

If you have any concerns regarding your children’s feet Nexus Podiatrists can undertake a foot posture and biomechanical assessment with view to the treatment most appropriate for your child.

 


Have your children’s feet measured (whilst the child is standing), every time you purchase new shoes.

Do not use shoes that are handed down from other children as these may exacerbate or cause new problems.


Good shoes feel comfortable at first fitting.
Shoes should not need a break-in period or slip off at the heel.
Shoes are best when made from natural fibers such as leather, as synthetics retain perspiration. A hot, wet, enclosed foot is an ideal environment for conditions such as tinea or even warts.
Shoes need to have good support such as laces or straps (important for school shoes).


Inappropriate footwear can cause ingrown toenails, calluses, ankle sprains, blisters and painful tendonopathy. If your child has a history of ankle sprains it would be a safe option to have a podiatrist to assess them and their shoes.

   



Many people suffer from an ingrown toenail. If this condition is treated quickly and effectively, discomfit can be prevented. If chronic or recurring, such as with people who have poor foot posture/poor footwear, or as a result of sporting activities, pain or infection may result. Your Nexus podiatrist can perform a simple procedure which removes the offending part of the nail permanently. This will prevent the troublesome area of nail from growing back while leaving the nail with an aesthetically pleasing shape. Local anaesthetic is used; no cutting of the skin is involved, the procedure taking around 40 minutes. Recovery time is very short, in most cases minimal discomfit is experienced and normal daily activities can be resumed the next day with care.  

In most cases, only a portion of the nail is removed, sometimes however it may be necessary to remove the entire nail. The podiatrist will identify the problem, explain the reason why surgery is necessary and which procedure would be the best option of treatment. The aim of having the surgery is to prevent the re-growth of a problematic nail.

Your Nexus podiatrist will discuss the procedure and all the possible risks involved with you well before surgery, so you can make an informed decision. A patient educational handout outlining the surgery, local anaesthetic, healing and possible risks is given to you well before the scheduled date for surgery. This handout and discussion with your Nexus podiatrist will also cover what you need to do both before and after surgery and our follow up service.



Cycling is Nexus sports specialty. Full dynamic podiatry and cycling biomechanical assessment is offered. A setup of your own bicycle is available to enhance your basic cycling technique. Specialised custom made cycling orthotics are also available.

Cycling technique is assessed during biomechanical assessment, including areas such as: pedal cycle, power phase and recovery phase. Discussion on the ideal morphology of a cyclist is included in the feedback of your personal assessment. Cycling shoes and cleat position inspection & any necessary adjustment will be advised.

Conditions such as the following can be treated at Nexus Podiatry: patellofemoral dysfunction, iliotibial band/greater trochanter bursitis, hamstring strain/tendonitis, calf cramping and achilles tendonitis.

Advice on safe cycling techniques and injury prevention is also offered.


 


The Cycle Correct at Nexus; biomechanical analysis and bike set up, is designed by Olympic Australian Cycling Team Physiotherapist Trish Wisbey-Roth. These assessments are based on the latest cycling research and are constantly being updated. Assessments are completed by Nexus podiatrist Anthony who is specifically trained in the area of cycling biomechanical analysis. Anthony is an accredited coach with Cycling Australia (NSW) and a competitive cyclist on both the road and velodrome. 

  1. Basic Analysis
  2. Performance Analysis
  3. Cleat Adjustment
  4. Computerised Fore-foot pressure measurement
  5. Assessment for orthotics if required
  6. Cycling Injury Assessment and Management
  7. Bike Analysis Review Session

A good bike fit is essential for ensuring a comfortable and injury free cycling experience; this will also help you obtain optimal power and efficiency. What constitutes a good fit is a very individual point. Factors include: the event type, riding style, strength, flexibility and injury history.

The bike analysis/fit services offered below are targeted at largely injury free riders with no significant past history of cycling related injuries. Any rider that has significant past/present injury problems should turn their attention to the Cycling Injury Assessment & Management section



This caters for the commuter or recreational rider. A basic physical and biomechanical screen is performed, to identify any issues that may need to be accommodated in the bike fit. Then body measurements are taken to guide the fitting process. All bike fit assessments are conducted in a systematic and thorough manner, which only concludes when both cyclist and Anthony are satisfied. Allow 1 hour for this assessment. An outline of the basic analysis fit is as follows:

  1. Basic physical and biomechanical screen
  2. Visual dynamic analysis of cyclist riding (on own bicycle on a trainer)
  3. Correct position set up on the bike
  4. Position measurement sheet for future reference
  5. Cost - $70 (Health fund rebate may apply).



This is for the serious racer or rider suffering from minor discomfort or pain on the bike. The performance fit offers a higher degree of precision through the use of video analysis. The use of video analysis facilitates the detection of more subtle biomechanical issues that may be difficult to detect with the naked eye. It also allows accurate quantitative measures to be taken with the motion analysis software. For example, the efficiency and symmetry of force application, throughout the full 360° pedal stroke, can be analyzed. This data can be incorporated to fine tune the position, in view of obtaining the most efficient pedal stroke. The physical and biomechanical screen is more comprehensive, to enable detection of any issues that may result in injury in the future. Allow 2.5 hrs for this analysis. An outline of the performance analysis is as follows:

  1. Comprehensive physical and biomechanical screen
  2. Correct position set up on the bike, aided by video analysis with simultaneous dual-camera capture
  3. Cleat adjustments if required
  4. Assessment for orthotics if required
  5. Computerised Fore-foot pressure measurement
  6. Position measurement sheet for future reference
  7. Cost - $220 (Health fund rebate may apply).
  8. DVD of computerised cycle performance analysis Cost $35


Fine tuning of position is sometimes required a number of weeks later to accommodate changes in strength and flexibility or minor changes in equipment. Allow 45 minus.

  1. Cost - $50 (health fund rebate may apply).
   



Cycling injuries can occur due to variety of causes. These include; incorrect positioning, overtraining, biomechanical faults, poor technique and trauma. To effectively manage a cycling injury, a thorough examination investigating each of these factors is required to determine the relative contribution of each. This is to enable the most appropriate course of action to be taken, for example; modifying training regimes, adjusting position on the bike, orthotics (such as Lance Armstrong wears) or referral to other health practitioners.

Conditions such as the following can be treated: patellofemoral dysfunction, iliotibial band/greater trochanter bursitis, hamstring strain/tendonitis, calf cramping, achilles tendonitis and fore-foot varus/valgus.

Taking the time to thoroughly assess the problem from all angles can speed the recovery process by implementing the most effective management strategy early. This could also save money in the long term by reducing the need for extended periods of treatment. This assessment is most appropriate for chronic or complex cycling injuries, particularly those that have failed to respond to other interventions.  Allow 3-3.5 hours this assessment details are as follows:

  1. Review of training and injury history
  2. Physical assessment relevant to the injury
  3. Biomechanical screen
  4. Correct position set up on the bike, aided by video analysis with simultaneous dual-camera capture
  5. Cleat adjustment if required
  6. Assessment for orthotics if required
  7. Computerised Fore-foot pressure measurement
  8. Position measurement sheet for future reference
  9. Short-term training advice
  10. Written reports to coach and /or other treating health professional
  11. Therapeutic exercise prescriptions if appropriate
  12. Recommendations regarding appropriate management, including referral to other health professionals as needed (e.g. sports physician, masseuse & osteopath).
  13. Cost - $290 (health fund rebate may apply).
  14. DVD of computerised cycle performance analysis Cost $35
Note for referring health professionals – Cycle Correct at Nexus Podiatry has a strict policy of non-solicitation of patients when referrals are received from other health professionals. Clients are encouraged to return to their original treating practitioner. Where multi-discipline treatment approaches are offered to benefit the patient, Anthony will liase with the original practitioner to discuss integrating treatments, for an overall best outcome of treatment.



Many people suffer from knee pain.  Sports participants and members of the general population with knee arthritis, commonly present with this complaint.

Immediate treatment after any knee injury is to apply an ice pack for 20 minutes with the knee straight.  Leave the ice pack off for 20 minutes and then repeat the 20 minute ice pack application.  This regime’ can be done 2-3 times during the day.  The aim is to reduce initial swelling and inflammation.

Ongoing treatment should be sought from an appropriate health professional, such as; a podiatrist, physiotherapist or medical doctor.  Investigation of the cause is important to ensure an appropriate treatment plan and to help prevent recurrence of the injury.

Podiatric treatment may include; foot and leg biomechanical examination, strapping, orthotic therapy, muscle strengthening program or stretching exercises.  The aim of the treatment is to further reduce any inflammation which may cause ongoing pain or swelling and correct the cause.

Some people suffering from pain, due to osteoarthritis of the knee, may be helped with the use orthotic therapy.  At Nexus Podiatry, a thorough biomechanical examination will be undertaken to determine whether specific orthotic therapy will be beneficial.

Referral to other health professionals will be given if necessary.



Shin pain is extremely common in people who participate in sport.  Those beginning an exercise program or increasing their current level of exercise may experience shin pain.  It can arise from several causes and thus needs to be correctly diagnosed.

Abnormal biomechanics, for example, may play a role in many types of injuries which result in shin pain.  The added stress on the muscular and skeletal systems, which occurs with abnormal biomechanics, needs to be properly addressed.  It is therefore important to diagnose and correct any abnormalities that are present, to help prevent any acute or chronic conditions occurring.  These can present as acute pain, or may in the long term, if not corrected, present as degenerative changes.



Acute ankle injuries are very common.  Without proper treatment an ankle injury may result in ongoing instability of the ankle joint.  As a consequence of this instability there is an increased risk of further injury and associated ongoing symptoms.

Immediate treatment of an ankle injury involves the application of an ice pack which is left on the ankle for the duration of 20 minutes,  removed for 20 minutes and then reapplied for a final 20 minutes.  This regime’ may be repeated several times during the day, the aim is to prevent increased swelling which will cause pain, restriction of movement and thus delay healing and rehabilitation.

The ankle should be seen by an appropriate health professional to obtain correct assessment, treatment and rehabilitation.  This is very important in order to prevent ongoing problems from an ankle which has not been adequately managed.

Nexus clinicians are trained to assess and manage ankle injuries.

Injury to other areas, such as bone, can sometimes occur as a result of what appears to be a simple ankle injury.  Specialist referral will be considered should any complications be found that indicate the need for orthopaedic intervention.  



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