Biomechanics Assessment 

This appointment is for adults requiring an assessment of their lower limb biomechanics. This is usually when you have a specific pain, symptom or concern in an area of your foot/feet or lower limb (including back and hip) which may be caused by abnormal mechanics of the joints and muscles. 

Assessment 

The assessment will start with questions about your medical history and the symptoms you have been experiencing. This will be followed with an overall examination of your spine, hips, knees and feet; including a focus on the relevant joints, tendons, muscles, nerves and ligaments of your lower limb. The areas of focus will depend on your symptoms and the findings observed. 
 
Other clinical observations will include your foot posture when stood and how your body functions during walking (gait assessment). The complete assessment allows examination of many potential factors contributing to your symptoms in order to devise the appropriate treatment plan. 
Sometimes there is the need to request for further testing via your GP, which may include: blood tests, X-ray, Ultrasound scan, MRI scan or referral to other practitioners. If necessary, these requests can be made by the podiatrist as part of the assessment appointment. 
 
Aside from systemic (whole body) conditions, malalignment of bones/joints and/or imbalances within muscles/tendons during gait (the way we walk) can cause varied symptoms associated with many of the lower limb conditions/pathologies seen in the below table: 

Location 

Common conditions/pathologies 

Big toe joint 
Bunions, Osteoarthritis, Gout, Sesamoiditis, 
Lesser toes 
Clawed toes, Hammer toes, retracted toes 
Forefoot 
Metatarsalgia, inter-digital neuritis, Morton’s neuroma, Joplins neuroma, bursa, capsulitis, flexor plate tear/rupture, metatarsal fractures, Freiburgs infarction, bunionette 
Dorsum 
Osteoarthritis, extensor tendinopathy, Tarsal coalition, Tarsometatarsal arthritis, Lisfrancs injury 
Arch 
Plantar fasciopathy/plantar fasciitis, Plantar fibromatosis (Ledderhose disease), Tibialis Posterior dysfunction/tendinopathy, Flexor tendinopathy, Tarsal coalition, Tarsometatarsal arthritis, Lisfrancs injury 
Heel 
Plantar fasciopathy/plantar fasciitis, Achilles tendinopathy, Medial plantar calcaneal nerve entrapment, Haglunds Syndrome, Calcaneal Spur, Heel bursa. 
Ankle 
Tibialis Posterior dysfunction/tendinopathy, Ligament injury, Peroneal tendinopathy, Sinus Tarsi syndrome, Tarsal Tunnel syndrome, Extensor tendinopathy, Flexor tendinopathy, ankle impingement, Osteochondritis 
Lower Leg 
Shin Splints/Medial Tibial Stress Syndrome, Limb length discrepancy (one leg longer than other) 
Knees 
Patello-femoral syndrome, Patellar tendinopathy, knocked knees/knocked-kneed(genu valgum), bowed knees/bowed-kneed (Genu varum), anterior cruciate ligament, posterior cruciate ligament, meniscus injury, plica, co-lateral ligament injury, 
Upper leg Hip/lower back 
Limb length discrepancy (one leg longer than other) can cause lower back symptoms or hip symptoms, trochanteric bursitis (hip condition), 

Other complaints/presentations 

It may be you have other concerns but not necessarily in relation to symptoms: 
Gait abnormalities 
 
In-toe walking/in-toeing gait/Intoed gait/Pigeon toe 
Toe walking. 
Ankle collapsing/’rolling in’ 
Instability 
Ankle sprains 
Hypermobility 
 
Excessive range of movement in joints/ligamentous laxity (ligaments are slack). Many people describe hypermobility as ‘double jointed’, ‘very flexible’ and ‘bendy’. Many patients with hypermobility have excessive stresses through joints and soft tissue due to the nature of the excessive movement. 
Treatments 
 
Following the biomechanics assessment, the treatment plan will typically focus on initial footwear advice, strengthening/stretching exercises and insole therapy customised to your particular needs. Other treatments offered may include bespoke silicone toe devices (separators/splints/props), lacing techniques, taping and strapping. 
 
As a last resort it may be that you require a surgical referral, a referral can be arranged by the podiatrist to orthopaedics. 
Biomechanics assessment 
(60min appointment, but may depend on complaint): 
 
Assessment price: £80.00 
 
Bespoke insoles/orthoses: £45.00 - £65.00 

Podopaediatrics 

Podopaediatrics is an area of podiatry focussing on the treatment of children. 

Children matter too! 

Jordan specialises in podopaediatrics and has treated children within the NHS since 2008. Jordan provides treatment for all podiatry/chiropody pathologies and these can present in children as they do in adults. Treatments included (as required): removal of corns, removal of callus, treatment of verrucae, treatment of nail pathologies (thickened, fungal, ingrowing nails and loosened nails), simple nailcare, wound management, advice for the management of skin conditions and footwear advice. 
If your child is a new patient and you are seeking for treatment described above, a ‘New patient podiatry appointment’ is the initial appointment required. The appointment includes circulation checks, nerve sensation checks, basic foot structure and strength to evaluate your overall general foot health, footwear advice as well as the treatment for the podiatry/chiropody complaint. 
 
As part of your circulation assessment, the pulses in your feet will be checked (two in each foot). If necessary, further assessment using Doppler equipment will be carried out to listen to the pulses. This is only usually required if the podiatrist is unable to feel the pulses or if other signs or symptoms suggest it is needed. 
 
As part of your nerve assessment, you will be assessed using a 10g monofilament. This is a fine piece of flexible plastic which is used for touching different locations of your feet to see if your sensation is normal and not impaired in any way. You may have additional tests to check your nerve sensation, if required. 
New patient podiatry appointment fee: £48.00 

Biomechanics Assessment for Children 

The assessment will start with questions about your child’s medical history, birth, development milestones and the symptoms that they have been experiencing. 
This will be followed with an overall examination of the spine, hips, knees and feet; including a focus on the relevant joints, tendons, muscles, nerves and ligaments of the lower limb. The areas of focus will depend on symptoms and the findings observed. 
 
Other clinical observations will include foot posture when stood and how your child’s body functions during walking (gait assessment). 
 
The complete assessment allows examination of many potential factors contributing to the symptoms in order to devise the appropriate treatment plan. 
 
Sometimes there is the need to request for further testing via your GP, which may include: blood tests, X-ray, Ultrasound scan, MRI scan or referral to other practitioners, this can be made by the podiatrist if necessary as part of the assessment appointment. 
 
Aside from systemic (whole body) conditions, malalignment of bones/joints and/or imbalances within muscles/tendons during gait (the way we walk) can cause varied symptoms associated with many lower limb conditions/pathologies. 
 
Children may present with musculoskeletal injuries of the lower limb and sometimes child specific pathologies related to development. The below table highlights the most common child pathologies we treat: 

Location 

Common conditions/pathologies 

Big toe joint 
Bunions 
Lesser toes 
Clawed toes, Hammer toes, retracted toes, curly toes 
Forefoot 
Metatarsalgia, fractures, bunionette, accessory bone, Sesamoiditis 
Dorsum 
Tarsal coalition, Tarsometatarsal arthritis, Lisfrancs injury 
Arch 
Flat feet, accessory bone, Plantar fasciopathy/plantar fasciitis, Tibialis Posterior dysfunction/tendinopathy, Flexor tendinopathy, Tarsal coalition, Lisfrancs injury, Kohlers disease 
Heel 
Calcaneal apophysitis/Sever’s disease, Plantar fasciopathy/plantar fasciitis, Achilles tendinopathy, Medial plantar calcaneal nerve entrapment, Haglunds Syndrome, 
Ankle 
Tibialis Posterior dysfunction/tendinopathy, Ligament injury, Peroneal tendinopathy, Sinus Tarsi syndrome, Tarsal Tunnel syndrome, Extensor tendinopathy, Flexor tendinopathy, ankle impingement, Osteochondritis, coalition 
Lower Leg 
Shin Splints/Medial Tibial Stress Syndrome, Limb length discrepancy (one leg longer than other) 
Knees 
Patellofemoral syndrome, Patellar tendinopathy, Osgood Schlatters disease, Sinding-Larsen-Johansson Syndrome, septic arthritis, knocked knees/knocked-kneed(genu valgum), bowed knees/bowed-kneed (Genu varum). 
Upper leg Hip/lower back 
Limb length discrepancy (one leg longer than other) can cause lower back symptoms or hip symptoms, SUFE (slipped upper femoral epiphysis) Legg-Calve-Perthes disease, septic arthritis, transient synovitis, developmental dysplasia (late presentation) 

Other complaints/presentations 

It may be you have other concerns about your child, but not necessarily in relation to symptoms: 
Gait abnormalities 
 
In-toe walking/in-toeing gait/Intoed gait/Pigeon toe 
Toe walking. 
Ankle collapsing/’rolling in’ 
Instability 
Ankle sprains 
Hypermobility 
 
Excessive range of movement in joints/ligamentous laxity (ligaments are slack). Many people describe hypermobility as ‘double jointed’, ‘very flexible’ and ‘bendy’. Many patients with hypermobility have excessive stresses through joints and soft tissue due to the nature of the excessive movement. 
Treatments 
 
Following the biomechanics assessment, the treatment plan will typically focus on initial footwear advice, strengthening/stretching exercises and insole therapy customised to your child’s particular needs. Other treatments offered may include bespoke silicone toe devices (separators/splints/props), lacing techniques, taping and strapping. 
 
As a last resort it may be that a surgical referral is needed, a referral can be arranged by the podiatrist to orthopaedics. 
Biomechanics assessment 
(60min appointment, but may depend on complaint): 
 
Assessment price: £80.00 
 
Bespoke insoles/orthoses: £45.00 - £65.00 
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