Podiatrist - Career Advice - Community and Health

Forensic Podiatrist
Pedorthist

Podiatrists look after the health of people's feet by diagnosing, treating and preventing foot abnormalities, and by educating the public about good foot health.

Podiatrists diagnose and treat ailments of the feet and lower limbs. They help to relieve discomfort or Future Growth Very Strong increase mobility for their patients by diagnosing and preventing foot injuries and disorders, prescribing orthotics and offering advice on foot care. They also treat walking abnormalities in children and perform both minor and major surgery, either on warts and ingrown nails, or on misaligned toes. They also undertake administrative work, order medical supplies, and may also offer public advice on foot care through talks or conferences.

ANZSCO ID & description: 2526: Prevents, diagnoses and treats disorder of the feet. Registration or licensing is required. Child's foot examination

Alternative names: Chiropodist [old name], Podiatric Scientist,

Specialisations: Childrens Podiatrist, Diabetic Podiatrist, Podiatric Surgeon, Sports Podiatrist

Podiatrists may develop a special interest in dealing with particular client groups, such as children, the aged or sportspeople. They may also work in a particular area, such as occupational health, or with general medical conditions that result in foot and leg problems.

Knowledge, skills and attributes

A podiatrist needs:

a desire to help people
an interest in human biology
strong communication skills
organisational skills
patience and tact
hand-eye co-ordination and manual dexterity

Duties and Tasks

Podiatrists may perform the following tasks: Nails

examine patients' feet to diagnose any disorders or infections and decide on an appropriate treatment
give advice on foot health and the prevention of foot disorders
treat deformities such as flat feet and foot imbalance by using corrective devices such as orthoses
work with patients suffering from diabetes,
rheumatoid arthritis, peripheral vascular disorders
and other neuropathies
perform surgical procedures on the foot
treat abnormalities of bones, joints, skin and nails such as bunions, toe deformities, ingrown toenails, corns, warts and other infections
recommend footwear for specific foot conditions
prescribe orthotic devices for protection and correction of a wide range of foot and leg irregularities.
prescribing and fitting replaceable pads, palliative and functional supports and other devices for the protection and correction of foot abnormalities
advising patients about continued treatment and foot care
may provide rehabilitation services to the physically handicapped
may refer patients to or have patients referred from Medical Practitioners

Working conditions

Podiatrists work in private practices, health clinics, nursing homes and other medical facilities. They usually work regular hours but may be required to work long hours at times. They examine and handle peoples feet, and may come into contact with unhygenic body tissue.

Tools and technologies

Podiatrists make and fit insoles and other corrective devices that they fit to their client's shoes, feet and lower legs. They prescribe medications, skin creams and balms for their patients, and also use x-ray equipment to diagnose foot problems. They also use surgical instruments and dressings, sterilising equipment, and treatment tables, as well as orthotic materials, grinders and shaping equipment, and video gait-analysis equipment.

Education and training/entrance requirements

To become a podiatrist, you must first complete a bachelor degree in any discipline, and then complete a postgraduate degree in podiatry.

The Doctor of Podiatric Medicine three year graduate degree will provide you with the training to become an accredited podiatrist. To get into this course, you must first have successfully completed a bachelor degree in any discipline with a grade point average of at least 5.0 and achieved an average score of 50 in the Graduate Australian Medical Schools Admissions Test (GAMSAT).

To work as a podiatrist in Australia, you must obtain professional registration with the Podiatry Board of Australia, and hold a current Working with Children Check issued by the Working with Children Screening Unit of the Department of Community Services.

Employment Opportunities

Employment of podiatrists is projected to grow much faster than the average for all occupations. Continued growth in the demand for medical and surgical care of feet and ankles will stem from the ageing population. Podiatrists will also be needed to treat patients with foot and ankle conditions caused by chronic conditions, such as diabetes and obesity.

Did You Know?

A human foot and ankle is a very strong mechanical structure that contains 26 bones, 33 joints and more than 100 muscles, tendons and ligaments.

Xrays of feet

The 52 bones in your feet make up one quarter of all the bones in your body. When those bones are out of alignment, so is the rest of your body.

About 20-30% of the world's population have Morton's Toe, a foot condition in which the second toe is longer than the big toe.##About 20-30% of the world's population have Morton's Toe, a foot condition in which the second toe is longer than the big toe.

The average adult takes 4,000-6,000 steps a day.

Akshat Saxena holds the world record for having the most toes with 10 digits one each foot!

In a pair of feet, there are 250,000 sweat glands. These sweat glands produce approximately half a pint [1 cup or 250mls] of perspiration daily.

Shoe sizes were devised in England by King Edward II who declared in 1324 that the diameter of one barley corn- a third of an inch- would represent one full shoe size.
(Source: Foot Facts)

Forensic podiatry is a sub-discipline which uses the anatomy of the foot along with the dynamics of walking or running that are particular to each person like length of stride, depth of impression, turn and Future Growth Strong angle of foot, and form. The evidence can be foot impressions on the ground or in footwear, could be the impressions of the footwear, or a person's walk. There could be a bloody footprint left at a scene, for use in footprint profiling, or use in large disasters.

It used to be that the shoe had to be cut up to obtain the impression. In modern science a simple UV light shone on the insole of a shoe can show a footprint impression and a photo taken for comparisons. Despite this advance forensic investigators still take plaster casts of the impressions left behind using technology that has barely changed in decades.

As opposed to fingerprints forensic podiatry is a new science. It was only added and certified by the International Association for Identification (IAI) in 2008. Nevertheless, it has already spawned forensic podiatry classes and certifications at places like Temple University and has its own professional journal, Forensic Podiatry from Springer Press.

Forensic podiatry is the evaluation of evidence relating to the human foot—technically termed pedal evidence—for the purpose of connecting an individual to footwear or a footprint. This area of expertise usually requires someone who has a background in podiatric medicine—in other words, it is usually a person who has dedicated their study to the structure of the foot, ankle, knee, leg, and hip.

Knowledge, skills and attributes

Forensic podiatrists can establish identity of the individuals from the footprints in many ways. The analysis of bare footprints involves the identification based on the individualistic features like flat footedness, ridges, humps, creases, an extra toe, missing toe, corns, cuts, cracks, pits, deformities, and various features of the toe and heel region. All these individualistic features can link the criminal with the crime. In addition to these, parameters of body size like stature and body weight as well as sex can also be estimated by using anthropometric methods.

If a series of footprints are recovered from the crime scene, then parameters of the gait analysis such as stride/step length and general movement of the criminal can be traced. Apart from these, a newly established biometric parameter of the footprints i.e. footprint ridge density can also be evaluated for personal identification. Careful analysis of the footprint ridge density can give an idea about the sex of the criminal whose footprints are recovered at the scene which can further help to reduce the burden of the investigating officer as the investigations then may be directed toward either a male suspect or a female suspect accordingly.

Forensic podiatry measurements
Various landmarks and measurements on the human foot.
(Source: Science Direct)

Duties and Tasks

A forensic podiatrist may be called upon to work as a member of the forensic team in a variety of situations and for a number of different types of evidence, including the following:

The examination of footprints, either made by bare feet or sock-clad feet, most commonly visible prints made with blood
The examination of foot impressions in a substrate
The examination of footwear, particularly when there is a question of the predominant wearer or ownership of the questioned footwear
Footprint profiling
Mass-disaster applications

Did You Know?

In 1786 in Scotland the impressions of boots left at the scene of the murder of a little girl were matched to those of a man attending her funeral.

Podiatrists have been involved in cases since the 1970s. Just before Christmas 1989 James Styers and Roger Scott abducted and shot little Christopher Milke in Arizona. Some footprints were found at the scene in the desert and these matched shoes later found in a garbage bin.

Based on the podiatric evidence of the shoe size, impression, and deformations of the foot the suspects were placed at the scene. They and an accomplice were later given the death penalty.

In England in 2008 a man was arrested based on video of his bow-legged walk which was matched to someone already known to police.
(Source: Criminology & Justice)

The use of foot-related evidence in criminal investigations dates back to 1862 when Jessie McLachlan’s footprint placed her at the scene of a woman’s murder for which McLachlan was subsequently convicted. In modern times, forensic podiatrists have assisted law enforcement in investigations since the 1970s.
(Source: Police Chief Magazine)

Education and training/entrance requirements

Forensic podiatrists are doctors of podiatry who have been in business for a number of years in order to gain the right expertise. There are a number of medical schools that offer the specialization.

Employment Opportunities

Forensic scientist job opportunities are expected to increase by an average rate of growth. There is strong interest in forensic science careers and crime scene investigation jobs, partly as a result of popular television and movie depictions. This is a highly specialised occupation, and it is likely that interest will outstrip the supply of available roles. The Forensic Podiatrist has even a smaller amount of opportunity as even less crime scenes have shoes or feet involved.

Many forensic scientist and forensic podiatrist jobs are subject to government and law enforcement budgets.

ABC Conversations with Richard Fidler: Dr Paul Bennett - Forensic Podiatrist
[Audio file] - 24 mins
31 January 2013 - Repeat Tue 20 Sep 2016

Dr Paul Bennett has an eye for detail.

He is a forensic podiatrist with a particular talent for identifying patterns left behind in footprints.

His knowledge and expertise have assisted police in decoding evidence from crime scenes, including in the case of the murder of Daniel Morcombe

Paul is a senior lecturer at the Queensland University of Technology's School of Clinical Sciences.

2016 Update

Ultimately, Paul’s testimony, along with that of other expert witnesses, helped with the successful prosecution of Brett Peter Cowan in the Morcombe trial.

Paul has recently been awarded a fellowship to the faculty of podiatric medicine in the Royal College of Physicians and Surgeons (Glasgow)

He continues to assist the Queensland Police Service on a number of cases.

Pedorthists are certified health care professionals who are trained to fabricate, fit, adjust and modify devices on patients that prevent painful or even disabling conditions of the foot or ankle. The pedorthist will identify the specific cause or pain of the patient’s condition, perform x-rays or other examinations to inspect the issue, and use the information to design a device for the patient to wear that will help hold their foot and ankle into the proper positions to help heal it back to the natural working state over time. Pedorthists observe bone structure, ankle joints, nerves, circulation and even skin conditions to determine what needs to be done to the patient. Once they have assessed the problem, they will also design a treatment and physical therapy plan for the patient to help get their foot and ankle healing quickly and efficiently. Future Growth Strong

Pedorthists choose, create, and modify footwear to help people acquire or regain mobility. They are trained to assess patients, formulate and implement a treatment plan and follow-up with patients.

Pedorthics as a health profession began to take shape in the late 1950s and is defined as the design, manufacture, modification and fit of footwear, shoes and foot orthotics to alleviate problem caused by disease, overuse, congenital defects or injury.

Case Study

Apert Syndrome

Background

10 year old boy with Apert Syndrome, a genetic disorder characterised by skeletal abnormalities. A key feature of Apert syndrome is the premature closure of bones of the skull. This early fusion prevents the skull from growing normally and affects the shape of the head and face. In addition, a varied number of fingers and toes are fused together.

The young boy in this case had four digits of his feet are fused together. He presents with a normal sized rearfoot for his age and an extreme wide forefoot due to the positioning of his toes. The width of his forefoot makes it impossible to fit prefabricated footwear.

Treatment & Outcome

For his treatment, one of our Certified Pedorthists fitted him with custom-made footwear fitted with an accommodative orthoses with medial arch support. The footwear comfortably accommodated his wide forefoot, and the choice of style and colour was an important factor to make the footwear aesthetically appealing to the young boy.
(Source: Pedorthic Association of Australia)

ANZSCO ID: N/A [2024]

Knowledge, skills and attributes

Pedorthists are certified medical professionals who are trained to design, repair and modify devices on patients that prevent abnormalities or even disabling conditions of the lower limbs, feet or ankles. They may design a wide variety of footwear and devices depending on the patients’ needs. Some of these devices include ankle supports, lifts, inserts, walking shoes, hosiery, night splints, surgical boots, arch supports, and custom-made shoes.

Intensive knowledge is required to practice as a Pedorthist. This includes anatomy of the lower limb and foot, biomechanics, gait analysis, pathologies of the foot and ankle, design and production of foot orthotics, shoe construction and modifications.

The Pedorthist will use this knowledge to develop treatment options based upon the physician’s diagnosis and recommendations.

These will include therapeutic shoes, foot orthotics, foot inserts, custom shoes, ankle foot orthotics and prosthetics for some partial foot amputations.

The Pedorthist is skilled in the evaluation and treatment of many conditions from congential defects and sports injuries to the debilitating effects of diabetes. A major focus of pedorthics is within the field of diabetes, where studies have overwhelmingly proven the effectiveness of preventive foot care to preclude the worsening of damage to the diabetic foot and prevent amputations. Sports pedorthics is another fast growing arena.

Assessment
(Source: Sole Science)

Duties and Tasks

Examine a doctor’s prescription and discuss with a patient, before designing and manufacturing therapeutic footwear or foot orthoses to treat the problem.
Accurately and efficiently design footwear items which may include foot orthoses, shoes, boots, slippers, sandals, socks, hosiery, night splints, bandages, braces, partial-foot prostheses, or other devices.
Use computerised techniques to design and create three-dimensional models for specialised footwear instead of the traditional methods of model creation.
Instruct patients on the proper use of customized foot orthoses, answering questions patients might have and referring certain queries to others on the medical staff.
Conduct follow-up visits to monitor the patient’s progress and correct usage; and to gauge how well suited the footwear is for treating the problem.

Imaging
(Source: Academy of Pedorthic Science)

Working conditions

Pedorthists have the flexibility to work either full time or part time depending on their preference, and can design their orthotics on-site or make use of an offsite laboratory. This trait of the job allows a career that suits individual needs and can be adapted easily to different lifestyles.

Most pedorthists work in a hospital setting or private clinic. They deal mostly with elderly patients or athletes who are suffering foot injuries and need temporary braces or shoe alterations to allow them to continue playing. Some patients may come in with serious damage done to their foot or ankle, and the pedorthist will need to work with the podiatrist right away to get them treatment as quickly as possible.

Most pedorthists are not working directly in a hospital or emergency room type of setting, but often do have to visit with the podiatrist and patient to determine what type of footwear or material is needed to help heal their foot back to working condition. This may involve some lifting of patients or assisting them in and out of wheelchairs, and dealing with some patients who are suffering extreme pain.

Pedorthists work in settings indoors such as specialty shoe stores, orthotic and prosthetic patient care facilities, and rehabilitation facilities. Pedorthists find a variety of opportunities in the sports industry, where the right designs for athletic shoes can relieve impact on feet at running speeds or reduce wear and tear for the wearer.

While one is not working directly in a hospital or emergency room type of setting, visits with the podiatrist and patient to determine what type of footwear or material is needed to address the medical problem is not uncommon.

Education and training/entrance requirements

Pedorthic Association of Australia is responsible for accrediting pedorthic tertiary programs in Australia. On completion of an accredited Bachelor of Pedorthics program, ony can apply to be a PAA Certified Pedorthist Custom Maker. The Bachelor of Pedorthics is only available [2024]at the Southern Cross University, Gold Coast, Qld.

Certification within Australia is available at two levels to cover the types of provision of service and advice and is as follows:

Certified Pedorthic Retailer (CRetPed Au): for individuals who provide advice and prefabricated footwear for patients.
Certified Pedorthist Custom Maker (CPedCM Au): for individuals who provide a full service to the client including advice on the possibilities of prefabricated, modified, and custom-made pedorthic footwear.

Employment Opportunities

Jobs in pedorthics are increasing rapidly as foot related injuries or conditions are more frequent with an active life. Patients who are involved in sports or athletics often take the help of a pedorthist to ensure that damage of foot nerves or ligaments is avoided. The growing population and aging youth will also require more pedorthic care as they become older.

Employee outlook is also on the rise as more positions are opening up with experienced professionals reaching the age of retirement and therefore the opportunities are many. It is also quite possible to join the profession as an intern that works under an experienced pedorthist, who is looking for the right candidate to eventually replace him or her post-retirement.

Most pedorthists receive their hands-on training while working as an intern for a certified pedorthist, and are ready to work for a private clinic or physician once they receive their certification. Many internships will turn into full-time positions.

Day in the life

As a pedorthist, expect your day to day life to be exciting and rewarding. This is especially true regarding your role aiding patients with relieving their pain. A struggle in this position is convincing people to trust in orthotics. You will spend time educating and creating awareness among patients on how orthotics helps the healing process and reduces discomfort.

Just like family doctors, pedorthists collaborate with other medical professionals in order to find the best treatment options for a patient. Pedorthists also have the benefit of choosing if they want to establish an independent practice, or work with others at a healthcare centre or clinic.