This Little Piggy went to… work.

A Day in the Life at Five Little Piggies Podiatry

You know the rhyme, but have you ever wondered what happens when the 'five little piggies' actually arrive at our door? From the first Giant Leap of a new patient to the final Doorstep visit of the afternoon, life at the clinic is a whirlwind of science, problem-solving, and a whole lot of heart. Here’s what a typical Tuesday looks like behind the scenes…

It's very important to start the day right.

To start, the gentle hum of the coffee machine is the first task I look forward to as I step into Five Little Piggies. It’s 8:30 AM, and the traffic outside is getting noisy. But inside our cosy clinic, a different kind of day is beginning – one dedicated to the intricate world of feet. As a podiatrist, my days are a fascinating blend of clinical expertise, patient care, and a genuine passion for keeping people on their feet, comfortably and confidently.

My morning ritual is sacred. A strong black coffee and a quick mental run-through of the day's appointments. Each patient is a unique puzzle, a new set of challenges and triumphs waiting to unfold. Today, the schedule looks particularly diverse, ranging from routine maintenance to complex diabetic foot care and even a bit of aesthetic magic.

Ready for the day's first patient

Before the first patient arrives, the clinic must be immaculate. This isn’t just about aesthetics; it’s about infection control, patient safety, and maintaining the highest standards of professional care. I meticulously clean and sterilise all the instruments, ensuring every drill bit, nipper, and file is pristine. The treatment chairs are wiped down, the floors mopped and fresh paper laid on the workstation. It’s a quiet, focused task, setting the tone for the precision required throughout the day. 

The first patient of the day, Sarah, arrives with a common, yet incredibly painful, complaint: an ingrown toenail. Her big toe is inflamed, red, and the nail edge has burrowed deep into the surrounding skin. "It's been bothering me for weeks," she confides, wincing as I gently examine it. This is a classic presentation, often caused by improper nail cutting or tight footwear. My goal is to alleviate her pain immediately and provide a long-term solution.

The spray drill in action!

I explain the procedure as I work, putting her at ease. Using sterile instruments, I carefully lift the offending nail edge and remove the spicule – the tiny shard of nail that's causing the irritation. Sarah lets out a sigh of relief almost instantly. I then apply an antiseptic dressing and advise her on proper nail cutting techniques, recommending wider shoes and showing her how to gently "pack" the nail groove to prevent recurrence. "Thank you so much," she says, already feeling a significant improvement. "I can actually walk without limping now!" Next up is Mark, a keen runner who’s developed a rather unusual problem: an embedded

Runners' feet often need extra care to keep them healthy and in good shape.

hair on his heel. It's become inflamed and formed a small, painful lump. "I thought it was a blister at first," he explains, "but it just keeps getting worse." Embedded hairs are not uncommon on the soles of the feet, especially with people who work in the hair styling industry. These occur when a small fragment of hair gets stuck to the skin on a weightbearing area and, after several thousand steps, starts to burrow into the skin.

This requires a delicate touch. I debride the area, carefully removing the inflamed tissue around the embedded hair. Once the hair is extracted, I thoroughly clean the site and apply an antiseptic dressing. The key here is to educate Mark on prevention and knowing how to spot the problem if it occurs again. "Make sure you wash and dry your feet thoroughly especially after being to the barbers for a hair cut," I advise, "and if you think another hair has embedded, cleanse the area daily with salt water and phone us for an appointment." He leaves with a lighter step and a better understanding of how to prevent future occurrences.

The middle of my day often involves a steady stream of routine nail care. These appointments, while seemingly simple, are crucial for many patients, especially the elderly or those with dexterity issues. I see Mrs. Henderson, a delightful lady in her late seventies, for her regular nail cuts and callus reduction. She tells me about her grandchildren as I expertly trim and file her nails, carefully removing any hard skin. For many, these appointments are not just about foot health; they're also a social connection, a chance to chat and feel cared for.

"My feet always feel so much lighter after you've worked your magic," she beams, slipping her comfortable feet back into her shoes. It's these small moments of appreciation that truly make the job rewarding.

However, not every case is straightforward. My next patient, Mr. Davies, is a gentleman with diabetes. He presents with a painful pressure sore under a corn on the ball of his foot. This immediately raises a red flag. Diabetes can significantly impair circulation and nerve function, making foot injuries extremely dangerous. What might be a minor issue for someone else can quickly escalate into a serious infection or even amputation for a diabetic patient.

I perform a thorough assessment, checking for signs of infection, assessing his blood flow with a Doppler - a non-invasive, handheld ultrasound device for detection of blood flow in arteries - and testing his sensation. The corn itself isn’t the primary concern; it’s the underlying sore and the potential for it to worsen. I gently debride the corn, apply some deflective padding to relieve pressure and cover the lesion with an antiseptic dressing. My immediate priority is to refer Mr. Davies to his GP for an urgent referral to the NHS diabetic multi-disciplinary team. This team, comprising podiatrists, doctors and nurses specialising in diabetes, vascular specialists, and orthotists, will provide comprehensive care and ensure he receives the specialised attention he needs. I explain the seriousness of the situation to Mr. Davies, emphasizing the importance of diligent foot care and regular check-ups. It’s a sombre moment, highlighting the critical role podiatrists play in preventative healthcare, especially for vulnerable patient groups.

Just before lunch, I have an appointment that showcases the aesthetic side of podiatry. Chloe is going on holiday next week and is incredibly self-conscious about a disfigured toenail, likely due to an old injury. "I hate wearing open-toed shoes," she confesses, "it just looks awful." This is where gel nail reconstruction comes in.

Before (L) and after (R) gel nail reconstruction of a damaged toenail (Image credit: LCN UK)

Using specialised podiatric gels, I carefully sculpt a new, natural-looking nail over her existing one. It's a delicate art, requiring precision and an eye for detail. As I build up the layers, curing each one under a UV lamp, Chloe watches with growing excitement. When I’m finished, she looks down at her perfectly shaped, healthy-looking toenail and is delighted with the transformation. She exclaims that she no longer feels anxious about her feet being seen on her sunny holiday!

I’ve been a Podiatrist for nearly 27 years now and have never grown tired of the challenges and rewards of the job. I am grateful every day that I get to see the benefits of my efforts, the comfort and peace of mind that my skills can give. The Podiatry profession is an evidence-based, peer-reviewed profession allied to medicine, that I am proud to be part of and advocate for. The importance of looking after the feet is not often a popular subject and their capacity for being troublemakers is woefully underestimated. 

Ready to get your piggies back in the race? Whether you're heading to market or just to the garden gate, we’re here to help you find your stride.

Until next time—keep those toes twinkling!  The Five Little Piggies Team