The questions most frequently asked of the podiatrist.
Should I always keep wearing my soles?
There is no general response. In congenital flat feet, one can only support the feet, not correct them. These people will always continue to wear soles. Other feet, both in adults and children, can be corrected and these people will be able to walk again without soles after a number of years.
Can I wear my soles in all types of shoes?
Soles of course take up extra place in the shoes. There are more and more shoes for sale with a loose insole. In its place, our sole may be worn. This does take up any extra space. In shoes which have no insole, it depends on how wide your feet are and how high the instep is. In people with a narrow foot and a somewhat lower instep, this will be easier than for someone with wide feet and high instep.
How long is the waiting period?
The waiting period is currently 2 weeks.
I am an emergency. What now?
Pain in your foot is very annoying. You are actually very inconvenienced straight away. Unfortunately, there are too few podiatrists, so there is a waiting period at every podiatrist. We have an agreement with the GPs that when someone must be seen quickly, the GP contacts us..
Are the costs reimbursed by the health care insurance?
For this question, please refer to the reimbursement section.
Are you a member of a professional association?
The podiatrists in our practice are all individual members of the Dutch Association of Podiatrists. Only someone who has successfully completed the podiatry course can join. Every podiatrist of this practice also registered in the Quality Register Paramedics.
I have been referred to a podologist, can I also come to you?
That depends on the complaints for which you have been referred, and also on the personal preference of the referrer. You should discuss this with your referrer, since they might have a good reason to specifically refer you to a podologist or a a podiatrist.
What is the difference between a podologist and a podiatrist?
Podology, just like podiatry, deals with feet. The big difference is that podiatry is wider than podology. Podology is part of the so-called alternative occupations while podiatry is part of the paramedical occupations, and there is a big difference in training. Podiatry entails a four-year full-time day program and podology is a much shorter, part-time training. Podology is mainly concerned with “making soles”, while podiatry also deals with nail and toe problems, taping, and wound treatment in diabetics. Make sure you are clear on who you have been referred to, all too often the terms are used interchangeably.
How often should I come for a follow-up?
Generally children come for a follow-up once every six months and adults once a year.
If I want to come back, will it take that long before I can come again?
If you have already been to see us before, you can usually come sooner. For the initial consultation/examination we reserve more time than for follow-up appointments. We keep “spaces” in the agenda for urgent cases and check-ups.
How long do the soles last?
An average of two to three years. This depends very much on the number of miles that someone walks or plays sports with them, but also on the degree of perspiration and the maintenance they get.
Do you get ‘lazy’ muscles from the soles?
In the case of real “orthopaedic soles” this is true; sometimes there is no choice and you can only support the foot. If the foot can be corrected to any degree, we will always choose a corrective sole. This means that the muscles themselves do the work.
When is it necessary to check the soles/when do I need new ones or when are they worn out?
You will be told when the soles are to be checked; often this is once a year. When no more checks are needed, it is important to come back when you have complaints or these return; this often indicates that the soles need to be modified or renewed. If the top layer of the sole wears out this will be easy to spot; often the sole can still be provided with a new cover layer.
With which complaints can you consult us?
- front foot complaints
- heel pain
- fatigue complaints in feet/legs
- overload or strain complaints
- foot problems in children
- ankle complaints
- misalignments of the nails/toes
- sports injuries
- recurrent callus formation/corns under the foot or on/between the toes wounds/complaints in patients with diabetes or rheumatism
- knee, hip, back problems which are caused by foot malposition/gait
Foot care tips for diabetics
- Wash your feet daily with lukewarm water. Dry them carefully with a soft towel (or a tea towel if there is insufficient space) and, in particular, between and under the toes. When the skin is too dry, use a good lubricating foot cream, but not between the toes.
- Inspect your feet every day to detect “strange” spots, for example cracks, wounds, fissures, blisters, discoloration of the skin (blue, redness), or changes to the toenails. Consider using a mirror to look underneath the foot and between the toes. When someone can’t see their feet themselves because of poor eyesight, ask family or friends to do it. It is important.
- Inspect the shoe before you put it on by feeling with your hand if there is something in it (e.g. pebbles).
- Never walk barefoot, not even at home. Rather wear flip-flops or slippers.
- Avoid tight socks and tights with seams, these can damage the skin and impede blood circulation.
- Cut nails straight, never cut the corners which may cause ingrown nails. If the nails are painful or too hard to cut, you can visit a pedicure (with diabetes-registration) or ask your podiatrist for advice.
- Never remove calluses, warts and corns. Also, do not use corn plasters which are for sale at the drug store/pharmacy. These can burn the skin (by the action of chemicals) and damage it.
- Never take a foot bath for longer than 5 minutes, otherwise the skin becomes to soft and particularly vulnerable to wounds and infections. In a foot bath, do not use soda or biotex but just ordinary salt. Always rinse with clean water. If you have small wounds, d not have a foot bath.
- Always test the water temperature with your elbow or a thermometer. Because of an affection of the nerves, you might not feel if the water is too hot, which puts you at risk of burning yourself.
- Do not walk on hot surfaces such as a sandy beach or the cement/tiles around a swimming pool, for instance.
- Moving improves blood circulation and may reduce any excess weight. The podiatrist can inform you what are good shoes for walking.
- Regular screenings are important. The podiatrist, as well as the doctor’s assistant/nurse practitioner, and possibly the diabetes nurse, can test your feet for feeling (sensitivity) and blood flow.
- Make sure your feet are measured well every time you go and buy new shoes. Improperly fitting shoes can be disastrous for someone with DM. Buy shoes later in the day, at the end of the day feet are “bigger” than in the morning. Pay particular attention to stitching and seams at the level of the toes and any lumps on the feet. Shoes should immediately fit well and “breaking in” should not be necessary.
- Do not consume too much alcohol. Alcohol can increase neuropathy (nerve damage), which may be already compromised by the DM. This makes small wounds more difficult to feel.
- Stop smoking! Smoking can affect the circulatory system, which already is a complication for people with DM.
General foot care tips
- Was uw voeten regelmatig met een milde (alkalivrije) zeep. Een dergelijke zeep “zonder zeep” zorgt ervoor dat de natuurlijke beschermlaag van de huid niet wordt aangetast.
- Spoel na het wassen alle zeepresten goed weg en droog uw voeten af. In het bijzonder tussen de tenen.
- Wrijf de voeten regelmatig met babyolie of een huidvriendelijke crème in ter voorkoming van een uitdrogende huid, kloofjes of andere beschadigingen van de huid.
- Knip de teennagels altijd recht af, dit voorkomt het ingroeien van de nagels.
- Als uw nagels bij het knippen snel splijten of afbrokkelen, knip dan met kleine knipjes of gebruik een vijl.
- Knip, peuter of snijd nooit zelf aan eelt of likdoorns, de kans op verwonding is groot door gebruik van verkeerd gereedschap. Wel kunt u overmatig eelt verwijderen met een puimsteentje of voetvijl.
- Neem nooit langer dan 5 minuten een voetenbad, anders wordt de huid te week en extra kwetsbaar voor wondjes of infecties. Gebruik bij een voetenbad geen soda of biotex, maar gewoon keukenzout. Spoel altijd na met schoon water.
- Wanneer u wondjes op de voet heeft, mag u geen voetenbad nemen. De genezing wordt namelijk belemmerd door het week worden van de huid rondom de wond.
- Always buy shoes in the afternoon, because in the course of the day your feet may get thicker.
- Always try on both shoes in the store. It is normal for one foot to be longer than the other. Always buy shoes with the longest foot in mind.
- Always try on the shoe while standing. When the foot is standing, it is a little longer than when sitting because of the weight on it.
- Walk around the shop for a while on the shoes. Take the time to buy your shoes. When in doubt, don’t buy them. When walking, the foot will even be a little longer than when standing.
- When trying on the shoes (and wearing them), fasten them the right way. In a lace-up shoe, pull on and tie the laces up well.
- Shoes do not expand. In other words, a shoe does not get bigger. If a shoe is too small, it will remain so. However, the upper leather when used becomes more flexible, so that it adapts to the shape of your feet.
- Make sure you get the correct length and width size. A size 40 of one brand is definitely not a size 40 of a different brand. So, pay attention not only to the shoe size but especially to the fit.
- A good stiffener, i.e. a good solid heel enclosure, is important. The stronger the stiffener, the less chance of spraining the ankles. It should not be possible to push in the heel enclosure with the thumb.
- The toes need to be able to move freely in a shoe. Pay attention to sufficient space both in width and in height around the toes. Toes and nails will quickly pinch, which may lead to pain complaints.
- The heel height should be such that the calf is relaxed. Usually it is no more than 3 cm high. The wider the heel of the shoe, the more stable the shoe is to stand on.
- A well-fitting shoe has its inflection point under the inflection point of the forefoot.
- The sole of a shoe should be as flexible as to permit good plantar flexion. When holding the shoe in your hand, you should be able to bend the sole at the forefoot.
- A flexible sole, preferably of rubber, provides more shock absorption and more grip.
- Make sure you get a good fastening on the instep that does not pinch or irritate, preferably with laces.
- Preferably do not get shoes with low-cut insteps. This shoe provides very little support around the foot, making it slip at the heel. To prevent this you tend to choose a smaller size which will make the toes pinch.
- Please make sure that there is no stitching or seams and trims, both on and in the shoe, that runs over sore spots on your foot. Stitching, seams and decorations are not flexible and are therefore not more pliable. Always use your hand to feel inside the shoe, to feel whether the finish is sufficiently smooth, and that ensure that there is no stitching on any pressure spots.
- Preferably buy leather shoes. Leather ensures good ventilation and is easy shaped and durable.
- When it is hard for you to reach the shoes, or you have impaired hand function (e.g. with rheumatism), there are elastic laces which you can set to the correct length and tension so that you create a kind of loafers.
- Please make sure that when using podiatric soles, you can remove bulges or inlays from your shoes, so that the soles lay flat in your shoes. This also saves space when you place the podiatric soles in the shoes.
- There are also sandals that are suitable for wearing podiatric soles. The existing inlay can be removed.
General terms and conditions 3D Foot Centre Netherlands
- To ensure a smooth administrative and financial handling of your treatment, you will find our general terms and conditions here. When you are being treated by one of our specialists, this creates a so-called ‘contract’. Of course, from this treatment agreement the obligation arises to reimburse your therapist for services rendered. The following terms and conditions unconditionally apply to all treatment agreements between patient and practitioner, unless otherwise explicitly agreed upon in writing. At a follow-up appointment, relating to a previous agreement, such provisions shall also apply. To all orders/agreements Dutch law is applicable.
- Billing is done directly to you directly after the treatment or when you pick up the therapeutic implements. You can pay the bills by debit card or, in exceptional cases in cash in our practice.
- We reserve the right, without further notice, to instigate collection measures when you are in default of payment. We will employ the services of the bailiff van Lith in Eindhoven. The incurred (collection) costs are for your account. If we have any receivables to be recovered under services provided which exceed the competence of the Court of first instance, the district bank in Eindhoven shall have exclusive jurisdiction. If there is a delay in payment, we shall be entitled to suspend the treatment until the arrears, including the interest rate and the costs, are met.
- The costs of treatment of a patient under the age of 16 are payable by the legal representative. Patients of 16 or 17 years old are due the cost of treatment themselves, unless the legal representative has confirmed in writing that they will meet the costs.
- You must see to any declaration of our invoice to your own health insurer. You are solely responsible for the claim to reimbursement from your health insurer. We can not guarantee that there will be any reimbursement. In practice, most insurers provide a full or partial reimbursement. For patients with diabetes mellitus other terms may apply. We advise you to consult the policy conditions.
- Agreements made (orally or by telephone) can be cancelled up to 24 hours in advance. We reserve the right to charge for appointments that are missed without timely notice or that are cancelled within 24 hours of the appointment. When you miss your follow-up appointment, any replacement appointment will be charged.
- You are required to reimburse all costs incurred by us. Oral permission after the examination in which you agree to the manufacture of podiatric soles, orthoses or nail brackets is binding. After the examination the manufacture will start immediately.
- Our specialists are committed perform to their best abilities. To ensure the quality and service, all our podiatrists are members of the Dutch Association of podiatrists (NvvP) and are registered with the quality register paramedics. Soles, orthoses and nail brackets are therapeutic devices, therefore it is never possible to guarantee the effect of these tools. Adjustments of soles/orthoses within 2 months after delivery (or until the first follow-up appointment) fall within the service and are therefore not charged. Insufficient results of the treatment in no event entitle you to a refund or exemption from payment.
- You may submit comments by e-mail to firstname.lastname@example.org
- We are not liable for loss of or damage to your belongings or for any other damage suffered by you.