Restoring physical freedom.
Why us?
Dr Angus Chard PhD leads our team. He is an internationally recognised, second-generation Sports Podiatrist and Honorary Associate of The University of Sydney. His extensive clinical experience and Doctorate distinguish him as a leader within the Podiatric profession and a Specialist in Lower-Limb Musculoskeletal Medicine with an emphasis in Paediatrics.
"We balance the latest evidence-based medical treatments and interventions with a wealth of clinical experience."
"We are about offering solutions to people suffering foot and leg pain. We pride ourselves on providing cost-effective treatments for the conservative management of acute and chronic foot and leg musculoskeletal conditions."
Our Team
Dr Angus Chard PhD
Is a second-generation Sports Podiatrist, awarded PhD by The University of Sydney (USYD) in Biomechanics, emphasis, Paediatric Pathomechanics in 2018
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Dr Michelle Cuthbert
Educated in Johannesburg and has accumulated over 20 years of clinical experience
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Dr Michael Gumatay
Perused podiatry after suffering chronic foot pain for most of his growing years.
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Genevieve O'Brien
Is responsible for the practice running smoothly and is passionate about ensuring patients have a world-class customer experience...
Read MoreOur Values
Team First
We are humble, function as a team
Credibility
We balance evidence with experience
World Class
We strive to exceed expectations
Above the Line
We do what we say we will doVideos & Blogs
Why do I have Bunions?
Painless Ingrown Toenail Treatment
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Foot and Leg Pain Centre
At the Hills Foot and Leg Pain Centre
Prescribing Better Custom Foot Orthoses: Morton's Neuroma![]()
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Thomas George Morton, MD, was a civil war surgeon that was one of the first to describe the most common nerve pathology that occurs within the forefoot, Morton’s neuroma (Morton TG: A peculiar and painful affection of the fourth metatarsophalangeal articulation. Am J Med Sci, 71:37-45, 1876). Patients with Morton’s neuroma classically describe their discomfort as being a burning, tingling, aching or cramping sensation in the area between the third and fourth metatarsal heads which often radiates toward the distal aspects of the third and fourth digits. Patients often report the pain of Morton’s neuroma as becoming worse when wearing tighter shoes or when walking for long distances. ![]()
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Clinical examination for Morton’s neuroma often reveals a “clicking mass” that is evident with manual side-to-side compression of the metatarsal heads (i.e. positive Mulder’s sign). Frequently tenderness is present between the plantar aspects of the third and fourth metatarsal heads and there may also be a specific loss of sharp/dull sensation between the plantar aspects of the third digit and fourth digits. Care must be taken during examination to also palpate the plantar plate area of the surrounding metatarsal heads to rule out plantar plate tears or other pathologies of the plantar forefoot.![]()
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Patients with Morton’s neuroma often have a history of wearing fashionable dress style shoes for many years. Shoes that are too narrow for the foot will generate significant external compression loading forces on the medial and lateral forefoot which will also be transmitted as a compression force to the intermetatarsal nerves (see my illustration below). Since the intermetatarsal nerves lie plantar to the deep transverse intermetatarsal ligament, the nerve can also be compressed between the ground and the intermetatarsal ligament, especially in shoes with higher heel height (Miller SJ, Nakra A: Morton’s Neuroma. In: Banks AS, Downey MS, Martin DE, Miller SJ (eds): McGlamry’s Comprehensive Textbook of Foot and Ankle Surgery, Vol. 1, 3rd ed, Lippincott Williams & Wilkins, 2001, pp. 231-252.) ![]()
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Therefore, it seems likely that any shoe that compresses the medial and lateral forefoot from side to side or any shoe that has a higher heel height may be responsible, over time, for the development of a Morton’s neuroma. Another theory of why the third intermetatarsal nerve is the most common site for neuroma is that there may be more frontal plane motion between the third and fourth metatarsal heads since the third intermetatarsal space is the junction between the medial and lateral columns of the foot.![]()
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The clinician should spend a considerable amount of time discussing with patients about the types of shoes that they wear for work and leisure in order make certain that their shoe choices are not causing excessive forefoot compression forces and an exacerbation of neuroma symptoms. Initial treatment involves a change to roomier shoes, icing the plantar forefoot twenty minutes once to twice a day, oral non-steroidal anti-inflammatory medicines, metatarsal pads and cortisone injections. My clinical experience has consistently been that even though many patients may improve with my initial treatment plan for neuroma, many patients may also require a custom foot orthosis (CFO) to avoid surgical treatment for the neuroma. Orthoses can be very helpful in treating Morton’s neuroma if they are designed with the specific goal of reducing the abnormal internal forces acting on the nerve within the third intermetatarsal space during weightbearing activities. ![]()
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First of all, the clinician needs to pay very close attention to the function of the foot during gait. If the patient exhibits late midstance pronation, instead of the more normal slight supination of the foot during late midstance, then this abnormal pronation motion will cause an abnormal dorsiflexion of the medial column relative to the lateral column when ground reaction force (GRF) is at its maximum on the forefoot. Late midstance pronation is common in patients with Morton’s neuroma and a well-fitted CFO with a standard rearfoot post, minimal medial expansion to increase arch congruity and possibly a slight (e.g. 2 mm) medial heel skive will help reduce late midstance pronation.![]()
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Another orthosis modification that is commonly used to treat Morton’s neuroma is a soft metatarsal pad that is sandwiched between the orthosis plate and a topcover. The goal of using a metatarsal pad on a CFO, or by itself in a dress shoe, is to attempt to place sufficient force between the third and fourth metatarsal shafts so that these metatarsals will “spread away” from the neuroma. Unfortunately, patients may have a difficult time with the metatarsal pad as many may feel that it is more of an uncomfortable bump in their arch rather than a valuable part of the orthosis designed to reduce the compression forces acting on their neuroma. ![]()
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After hundreds of trial-and-error applications of metatarsal pads on orthoses over the last third-century of treating these patients, I have found that placing the metatarsal pad so that its leading edge is 15 mm anterior to the distal orthosis edge is the position that is most comfortable for the majority of patients. However, I still write in the “special instructions” section of the orthosis order form for the lab to leave the anterior half of the orthosis topcover unglued so that I can more easily move the metatarsal pad to another location on the orthosis if the patient reports that the metatarsal pad “feels that it is in the wrong place” under their foot.![]()
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Lastly, it is important that when designing the CFO for a patient with a Morton’s neuroma that the patient understands that any foot orthosis will tend to make their shoe fit tighter which may also tend to increase the internal compression forces acting on their painful neuroma and prevent the orthosis from performing properly. Therefore, patients are informed that unless more roomy shoes can be worn that allow the orthosis to fit their shoes without increasing shoe tightness, that foot orthoses are unlikely to reduce their pain. For patients that do need to wear stylish dress shoes for their work, I often will make both a thin cobra style dress orthosis with metatarsal pad for their dress shoes and a thicker full length orthosis with metatarsal pad for their athletic shoes in order to allow them to benefit from the therapeutic effects of orthoses while at work and while participating in their leisure activities.![]()
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[Reprinted with permission from: Kirby KA: Foot and Lower Extremity Biomechanics IV: Precision Intricast Newsletters, 2009-2013. Precision Intricast, Inc., Payson, AZ, 2014. pp. 91-92.]![]()
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My five Precision Intricast Newsletter books may all be purchased from the Precision Intricast website at www.precisionintricast.com/shop.
Surf Life Saving Australia if your not part of it your missing out!
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Timeline photos12-year-old Nipper rescues woman while preparing for Youth State Championships 📣![]()
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On Friday 17th February, Ari Hamill, from the Surfers Paradise Surf Life Saving Club, was training with his club mates in preparation for Surf Life Saving Queensland Youth Championships when someone told him a woman was in trouble.![]()
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He responded quickly and with his board in hand, quickly paddled out to the woman offering her his board and helping her safely to shore. His five years involvement in nippers provided him with surf survival and rescue skills that gave him the confidence to save a life❤️💛![]()
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This was his first rescue and he makes us all so proud👏![]()
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Congratulations and well-done Ari😊![]()
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Visit our website to read the full story on Ari's rescue 👉http://bit.ly/3IM0rug![]()
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#redandyellow #thisislifesaving
EXCELLENT
39 reviews on
Robert Jennings
19/04/2022
This was my first treatment which was a wonderful experience. Such welcoming, friendly staff who took great care of me. Excellent service, excellent treatment. I felt so well looked after.
I definitely recommend this service.
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Robin Widoyo
07/03/2022
Dr Angus is very kind, attentive. The advice given is very well explained. Most importantly, it works! My feet feel so much better now. Thank you Dr Angus and the team.
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Kew Somerville
18/02/2022
I went with a foot issue that I was quite embarrassed about but was met with nothing but kindness, professionalism and understanding. From being greeted warmly on arrival then meeting with Michael who took the time to thoroughly examine the issue and proceed to explain the treatment needed, I could not be more grateful. I'm looking forward to my return and progress. Many thanks.
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Phillip Roberts
16/02/2022
I have visited specialists, had surgery, seen so many medical practitioners & podiatrists to get help with my very painful feet. I made a first visit to see Dr Angus Chard a week ago, and I was so pleased with the help he gave in just one visit. I was very happy with the way he listened to me and all the positive things he started & told me to help me. I will certainly be keeping a regular time with him as I feel that his treatment will help me. He is a very pleasant & knowledgeable person and his staff are very pleasant and helpful. I would have no hesitation in recommending him to anyone with nail or painful wart problems
Regards Di Roberts
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Ann Flegg
02/02/2022
A passionate, friendly & caring team of people who are excellent at their work. I don't think there is a better place for foot care.
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Bill Heinrich
12/01/2022
friendly and pleasant experience. Gentle handling of my extremely troublesome ingrown toenail. Excellent explanation of my situation, and clear advice for future treatment, including promise of oversight of any further needs.
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Karey Takchi
03/10/2021
Great people. My orthotics fixed my feet instantly
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REBECCA SAVAGE
23/09/2021
Friendly and experts!
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Calvin Brodie
23/07/2021
Cannot recommend Angus highly enough. Over the years he has assisted me with leg, ankle, and foot sporting injuries with genuine care and expert knowledge. If you’re not getting the results you need from your current provider, go and see Angus.
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