Consultant Q&A with ankle surgeon Mr Nick Cullen
Mr Nick Cullen, consultant Orthopaedic Surgeon specialing in the Ankle and Foot, is interviewd by Laura Harman, Senior BOOST Physiotherapist. Laura asks Mr Cullen 4 topical questions in this Consultant Q&A Interview.
Mr Cullen is a Consultant Orthopaedic Surgeon in Ankle and Foot surgery at the Royal National Orthopaedic Hospital in Stanmore. Privately he practices at the Wellington Hospital in St Johns Wood NW8 and at Spire Bushey Hospital WD23. You can view Mr Cullen’s website here.
BOOST PHYSIO: When running how important is it to wear a good pair of trainers?
Mr Nick Cullen: In my opinion when running good training shoes are very important when, it is often a good idea for those who take up running to be assessed by their physiotherapist or local specialist running retailer in order to purchase the correct shoes for their foot-type. A slight flatter foot type may benefit from a shoe with more support.
It is important that trainers are changed on a regular basis, for those running moderate distances they should consider changing their shoes every six to twelve months. Those who run long distance need to change more frequently.
BOOST PHYSIO: What is your opinion on the use of orthotics (innersoles) for different foot and ankle problems?
Mr Nick Cullen: There are a wide variety of normal foot shapes, ranging from relatively flat feet to relatively high arched feet, for asymptomatic feet, within this normal range I don’t tend to prescribe orthotics routinely.
There are a wide variety of foot problems however that do respond to orthotics but it is important to be advised on the correct orthotic for the correct condition, for example somebody might have a painful flat foot which would require completely different insole than a person who might have a high arched foot. The wrong insole for the wrong foot type may worsen symptoms but the right insole for the correct condition can produce a dramatic improvement in pain and function.
BOOST PHYSIO: Is it really bad to have flat feet?
Mr Nick Cullen: There is a wide spectrum of normal foot shape ranging from very flat to very high arched. Many flat feet per se can be regarded as normal in fact many of the great athletes of our time have had feet “as flat as pancakes”!
However in those with troublesome flat feet, a good rule of thumb is, if the flat foot is painful or the deformity is becoming worse, consider getting input from a physiotherapist, podiatrist or orthopaedic surgeon.
BOOST PHYSIO: When working as one of the Orthopaedic Surgeons for Saracens Rugby Club, you must have seen some interesting injuries. Can you tell us about one?
Mr Nick Cullen: One of the most intriguing injuries I treated was one of the female rugby players who had sustained a subtle but debilitating injury to her mid foot during a fairly innocuous tackle. She remarkably managed to carry on until her boot was removed in the changing room and the foot swelled quite dramatically and she was unable to weight bear on the ball of her foot. Weight bearing x-rays and scans revealed a very subtle commonly missed and debilitating injury called a Lisfranc Injury where the connection of the inside and ball of the foot becomes detached from the rest of the foot. I treated her with a new form of fixation called a mini tight-rope, (which is not dissimilar to an anchor used by climbers), rather than traditional screws or plate, this greatly accelerated her recovery allowing her to return to training within 6 weeks and back to contact at four months, ½ the time it usually takes.
BOOST PHYSIO highly recommends Mr Cullen to those patients who need an expert in ankle and foot problems.
BOOST PHYSIO has 2 High Street physiotherapy clinics. One in Hendon NW4 which covers North West London and one in East Finchley N2, covering North London. All
BOOST PHYSIOs specialise in post-operative orthopaedic rehab. Each week we help patients recover following: bunion surgery (halux valgus correction), foot surgery, hammer toe surgery, key hole surgery to the ankle, achilles tendon repairs. We also deal with all manner of ankle injuries too.
Call us on 020 82017788 for an appointment.
BOOST PHYSIO Hendon: 16 Parson Street, Hendon, NW4 1QB.
BOOST PHYSIO East Finchley: 200 High Road, East Finchley, N2 9AY.