Issue 3/2014
FOOT CARE CURRENT
The magazine for the practice
Children‘s feet Standing on healthy feet from the start
fotolia | Denis Aglichev
About malpositions, deformities and care
Products CURRENT
Ware knowledge CURRENT
Marketing CURRENT
NEW: Sales display for the GEHWOL FUSSKRAFT Soft Feet trio
Suction or wet technology - it‘s a matter of personal preference
Planning campaigns for the foot care practice and using them in marketing
Table of Contents
Instrument offer “Fantastic, dynamic and precise“ Corner shears 492 “extra slender“.......... 3 Cuts and cuts and... Shear range from Gerlach................... 4 –5 Product offer Three for perfectly cared for feet and legs Sales display for GEHWOL FUSSKRAFT Soft Feet..........6– 7 Gift campaign 2014 Foot care gifts for your loved ones! Free choice from the GEHWOL FUSSKRAFT range............. 8– 9 Christmas campaign 2014 O Joy GEHWOL FUSSKRAFT Soft Feet Lotion and GERLASAN Hand Cream.......... 10–11 Technology offer Full performance - full flexibility and added comfort! GERLACH mobile foot care cabinet .. 12–13 Medicine CURRENT Between healthy development and pathology Dr. med. Klaus Halbhübner about children‘s feet........................ 14–15 Healthy feet are strong feet Guest contribution by Dr. med. Renate Wolansky on the subject of preventive consultations and clinical dianostics...16–17 Expert knowledge CURRENT Antibiotics from the past Hygiene update: Infectious microbes..... 18 Ware knowledge CURRENT More than a matter of appearance Tube material for cosmetica................... 19 Definitely undecided Suction or wet technology - it‘s a matter of personal preference.......... 20–21 “As if it had been made just for me“ Foot care chair Concept F3.............. 22–23 The spoiling trend Gerlach in Austria.................................. 24 Care consultation CURRENT ”Yes, you can do that” Foot hygiene for everyone a consultation outline ........................... 25 Practice CURRENT Prevent now, enjoy later Old age provisions for foot care professionals and podologists................ 26 “I want to complain“ Process optimisation in the practice, part 1: Complaints management........... 27 All-round certainty no chances of microbe entry Responsibility in the practice................. 28 Marketing CURRENT A look into the brain Dr. Kai-Markus Müller about neuromarketing in foot care practices.... 29 “Which shoes did Jesus wear?“ Campaign planning in the foot care practice................... 30–31
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Gift campaign 2014: Foot care gifts for your loved ones! Christmas is the festival of love and the time of gift giving. Gerlach‘s gift campaign combines both - gifts for your loved ones. The GEHWOL FUSSKRAFT has the right foot care product for every family member. Your customers can pleasantly surprise their friends, acquaintances and relatives with them. You can also expect valuable extras starting at an order value of 200 Euros.
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Preventive consultation and clinical diagnostics: Healthy feet are strong feet The feet are highly sensitive, but can handle a lot of stress and extreme weight. These properties are restricted by improper shoes, a lack of exercise and quite often by the wrong home foot care, Diabetics in particular have to pay attention to their feet. Foot specialists can encourage compliance with expert advice as part of clinical diagnostics, and provide specific tips on home foot care.
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Foot care chair Concept F3: “As if it had been made just for me“ It‘s often the little things which make a big difference. This also applies to the foot care chair in your practice. Foot care expert Hertha P. tells us which special details and features increase patient comfort and simultaneously make treatment easier for the foot specialist.
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A look into the brain - knowledge from neuromarketing for the foot care practice Brain scans, brain wave measurements and core spin images - these are some of Dr. Kai-Markus Müller‘s instruments. He is a diploma psychologist and neuroscientist, and looks inside other people‘s heads. In this way, the scientist finds out how the brain processes marketing messages and pricing signals, and what actions they trigger. In this interview with FUSSPFLEGE AKTUELL, he explains how to use this knowledge in everyday practice life.
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Imprint
Please order via the publisher
Publisher: FUSSPFLEGE AKTUELL is published on behalf of Eduard Gerlach GmbH, Bäckerstraße 4– 8, 32312 Lübbecke, Telephone: 05741 330-0, Fax: 05741 347300, E-Mail:
[email protected], Internet: www.gehwol.de Editing staff and publisher: Dorothea Küsters Life Science Communications GmbH, Leimenrode 29, 60322 Frankfurt am Main, Telephone: 069 61998-0, Fax: 069 61998-10, E-Mail:
[email protected], Internet: www.dkcommunications.de; Editorial management: Dorothea Küsters (responsable), Dirk Fischer; Redaktion: Stefan Dudzinski-Lange, Stefan Dietrich, Jana Zieseniß, Andrea Mühlbacher Graphic concept and implementation: PUNKTUM Werbeagentur GmbH, Bad Vilbel All rights reserved. Reprints, also in excerpts, are only permitted with the approval of the publisher and citing sources. Rights of translation and other uses reserved. We assume no liability for unsolicited manuscripts, discussion copies etc.. If FUSSPFLEGE AKTUELL cannot be published or supplied, this shall not result in legal claims against the publisher. Legal venue: Frankfurt am Main.
FUSSPFLEGE AKTUELL 3/2014
Instruments CURRENT
“Fantastic, dynamic and precise“
fotolia | carinthian
New: Corner shears 492 “extra slender“
The new corner shears 492 “extra slender“ from GERLACH TECHNIK excel for extremely precise work in the nail bed edge. Podologist Andreas Schmidt, specialising podology practice - Elblandkliniken Meißen, tested these feather-light shears.
Mr. Schmidt, what do you think of the new corner shears 492 “extra slender“? When I first picked it up, I was surprised at how light it was. The shears immediately felt right and familiar. The head and cutting surfaces are gracefully and cleanly made. I noticed that the shears barely drift to the back, which means that it is not necessary to correct the spring. A hook prevents the spring from releasing. The shears also look very dynamic with their long cutting surfaces. In which fields did you test the instrument? Ingrown nails, callus or inflammations in the confines of the nail bed edge - the long blades and the narrowness of the shears made it easy for me to reach these spots. You keep your visual field open. The shears lie flat and don‘t cover much. Deep corns in the nail bed edge or soft corns between the toes are also very easy to work on. I also found some other fields. For instance, if I enter the inflamed nail wall with the shears, I can remove the affected areas quickly and very precisely. This means much less pain for the patient. I‘m also very satisfied with the results in diabetics.
You can use the corner shears 492 to remove small spots without causing lesions or injuries. How do you evaluate the shears for daily work on feet? The shears are extremely well made. Corner shears should always be pointed, narrow and sharp-edged so that I can quickly help a patient who is in pain. When I look into the blades, the shears leave enough room to let removed skin material glide out to the rear. With this type of shears, it‘s tempting to use it for trimming thin nails. However, they are not suitable for that, and may become damaged, causing the tips to drift apart. For myself, the new shears are the ideal companion for the 490. The 490 is tighter and gives me a better idea of how close I am working to the affected site. On the other hand, the corner shears 492 are very dynamic and precise.
The new corner shears 492 from GERLACH TECHNIK permit extremely precise work, even in locations which are difficult to access.
Andreas Schmidt After training in podology in Dresden and a paedagogical diploma at the IHK, Andreas Schmidt became the specialised head and podologist at the podological focal practice and a specialised consultant at the Elblandkliniken Meißen/ Riesa. He is also a lecturer and provides education and continued training in podological themes and other specialist contributions both within the country and in foreign countries.
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In comparison to the corner shears 490, 1 the new 492 shears 2 have even more slender, longer cutting surfaces, penetrating more deeply into the nail bed edge. 3 .
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Instruments CURRENT
Shear range
Cuts and cuts and... The AESCULAP instruments from GERLACH TECHNIK traditionally excel with the very highest quality and stability. Work on the feet is precise and efficient with them. Proper and regular care means an even longer service life for the already very sturdy instruments. And if you do need a replacement, the instrument set which we offer here can be used to do essential work.
Nail shears HF 210
Stainless steel instruments are sterilisation resistant, with a long service life. There is also no risk of nickel allergies. Stainless steel also pays off in hygienic terms for pathogen-free use in your practice. Even if the instruments are cleaned, disinfected and sterilised several times a day, this does not result in the material surface peeling off or otherwise changing. Function may nonetheless become impaired. For instance, the instruments may suffer mild mechanical surface damage if they are dropped. However, this does not result in corrosion, since they are stainless steel. Aside from such “accidents“, instru-
ments are certainly subject to wear, especially if they are not regularly maintained Longer service life with care Permanent use and processing procedures in which several instruments touch each other eventually means greater friction. Worn spots can also happen in the long term. This can lead to a slip-stick effect. This occurs when the friction (stick) is greater than the gliding effect (slip). This may affect the instrument cutting surfaces, definitely impairing you when working with them. This is similar to a windshield wiper which unevenly glides over the windshield.
Skin shears HF 460
Skin shears HF 461
Skin shears HF 465
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Instruments CURRENT
Tamponade pusher DC 200 R
The effect does not occur when the areas which rub against each other are fully lubricated. Proper maintenance is therefore mandatory if you want to use the instrument as long as possible. We recommend special care products from GERLACH TECHNIK. For instance, the physiologically harmless and CFC-free Sterilite oil spray reduces friction, increases glide and protects against friction related corrosion. The oil film which is sprayed on remains permeable to water vapour, even in spots which are difficult to access. Sterilisation is not impaired. The silicone-free oil also causes no spots or crusts on the instruments. Lubra metallic oil has a practical dosing needle which can be used to apply the maintenance oil precisely.
Nail shears G 495
Corner shears G 491
Corner shears G 490
Corner shears HF 482
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Products CURRENT
Ware presentation: GEHWOL FUSSKRAFT Soft Feet in the new sales display
Three for perfectly cared for feet and legs Even now, the feel-good products from the GEHWOL FUSSKRAFT Soft Feet series are an absolute sales hit. Put together in the new trio display, they are a real attention-getter. This is due to unique advantages such as the modern scent. Or the attractive package design: The embossed folding carton points out ingredients such as milk, honey, bamboo and water lily, emphasising their select nature and expressing the high quality of the recipes. The systematic nature of the series is also helpful for consumers. Overall, lily almost magically alters the feet and legs, lending them freshness, a well cared for appearance, a tender skin sensation and optical elegance. Soft Feet cream with its extracts of milk and honey is reminiscent of the care rituals of graceful beauties, such as Cleopatra. With special hyaluron, urea and Vitamin E, milk and honey supply plenty of moisture, transforming hard foot soles into silky soft skin. Gently massage it in, and really relax with the cream while you inhale the mild, summery scent. The scrub with bamboo and sugar thoroughly prepares you for the rich, intensive care - best done in the shower. But the Soft Feet scrub does more than just scrub. Massaging jojoba spheres activate the circulation, while avocado oil, Vitamin E and honey extract spoil the gently, but thoroughly rejuvenated skin with the first portion of care.
fotolia | natanaelginting
New in the product range: the lotion Refreshing moisture care with a revitalising wake-up effect for tired legs - that‘s our lotion. It is even easier to spread than the cream. It is absorbed immediately and needs less time for massaging. Of course, the massage is the special highlight of foot care for many users - especially when it‘s about stressed feet. But other customers need a faster solution.This is especially true for leg care when you want to put on pants or stockings immediately afterwards. The Soft Feet lotion is immediately absorbed, and quickly lends the same well-groomed
sensation, thanks to hyaluron, avocado oil, phytosqualane and Vitamin E. They lend moisture and protect the skin against dryness and unpleasantly itchy scaling. The packaging describes another central attribute of the lotion. It shows a white water lily. Nymphea alba is its Latin name, reminding us that the water lily is truly a magical nymph which, according to mythology, died of unfulfilled love and returned to the world as a white water lily. It stands for graceful beauty. That‘s true for care as well. For water lily extract, or actually the tannins which it contains, has an astringent effect, refining the skin surface. It obtains additional shine from
the silk fiber protein fibroin, so that water lily and silk are combined to produce an aesthetically smooth skin appearance with a silky sheen. The refreshing lotion is just the right thing for heavy legs as well. This is due to the red algae palmaria palmata. Its extract activates the blood microcirculation, eliminating the unpleasant sensation of heaviness.
GEHWOL FUSSKRAFT Soft Feet on Facebook
om/softfeet
www.facebook.c
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Are you a fan of the GEHWOL FUSSKRAFT Soft Feet series? If yes, just like our fan page on Facebook. You‘ll find out news about the products, and can participate in campaigns and raffles. The fan page also shows you consumer favour. The page regularly presents experience reports from the GEHWOL tester club on the cream, scrub and lotion. Reviews answer important consumer questions on efficacy and tolerability, as well as user comfort. This gives you helpful arguments for your consultation. You can add your own opinion to support sales as well.
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Products CURRENT
GEHWOL FUSSKRAFT Soft Feet Cream M ildly scented cream experience R ich care, silky soft skin S pecifically for the feet W ith milk and honey
GEHWOL FUSSKRAFT Soft Feet Lotion I mmediately absorbed R efreshing care, silky skin F itness for tired legs W ith water lily and silk
GEHWOL FUSSKRAFT Soft Feet Scrub T horough scrub massage P reparatory care, gentle removal of dead skin cells F or the feet and legs W ith bamboo and jojoba
Sales from consultations For the first time, you can present all three GEHWOL FUSSKRAFT Soft Feet products to your customers at a glance. The high quality acrylic display offers space for 20 125 ml packages, immediately showing what the series is about: Feel-good care for the feet and legs! The image motif tells the right story, enticing observers into a wellness atmosphere where they can witness a scenery in which the user enjoys the tenderness and beauty of silky soft, well cared for skin. The presentation does not contradict what GEHWOL FUSSKRAFT Soft Feet promises - and what many customers secretly wish for: Fun foot care!
consultation which the customers request themselves; it gives encouragement for home foot care, also optimally completing your treatment.
Comparability is another advantage. Customers now have a choice. They can inform themselves about the three products and choose freely according to their needs. They usually need help. In this manner, the display generates a reason to communicate. When customers want to know more about the presented wares, they will ask about the benefits and the differences between the products. This active impulse opens the sale conversation without any effort on your part. Explain the care benefits of the series to your customers, as well as the differences. That‘s sales in the form of a
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Products CURRENT
What could I give my family for Christmas? Dad has lots of callus on his feet from all that jogging. Let‘s get rid of it! Grandma uses the GEHWOL FUSSKRAFT Hydrolipid Lotion and is satisfied. Dad has to try it too! Mom loves footbaths to keep her feet beautiful and soft. The herbal bath is the right thing for her. GEHWOL FUSSKRAFT Red can help with Grandma‘s cold feet - maybe Santa can bring it for her. And Grandpa with his diabetes has extremely dry foot skin. Instead of getting coal for always being mean, he will receive GEHWOL FUSSKRAFT Blue - for he still manages to be the best grandpa in the world!
Giftwrap: attractive and easy
fotolia | stocknroll
Your customers will please their loved ones with a surprise from the GEHWOL FUSSKRAFT product range. If the gift should also be attractively packaged, try the new gift bags which you can order additionally. With their shiny surface and solid material, these pouches have a high-quality appearance. The pouch is big enough for up to two 125 ml tubes.
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fotolia | INFINITY
Products CURRENT
Foot care gifts for your loved ones! Gift campaign 2014
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Products CURRENT
Christmas campaign 2014
O Joy Make your customers happy by surprising them with a small Christmas gift. A product from your exclusive product range is just perfect. How about the new GEHWOL FUSSKRAFT Soft Feet Lotion and the proven GERLASAN Hand Cream in the exclusive 40 ml gift tube? Due to Gerlach‘s Christmas campaign, you get the gifts without any stress at all, and you ensure your customers‘ loyalty in the coming year. Attention: The offer is only valid while supplies last.
fotolia | XXXXX
As a foot care pro, you know the benefits of the two Christmas campaign products: GEHWOL FUSSKRAFT Soft Feet lotion is not only new, but provides the perfect feelgood care for the legs and feet with its mild, modern scent and recipe - and it‘s available exclusively from you. It ensures a silky soft skin sensation, provides an aesthetic skin appearance and smoothes the skin. Its exclusive ingredients make it unique. GERLASAN Hand Cream is the right care product for coarse and brittle skin. The cream is an adequate solution for itchy hands as well, and not just in the cold season: It relieves inflammation, encourages wound healing, regenerates the cell structure and thereby strengthens the skin‘s natural protective barrier. Small gift - great joy Now your customers only need to find out about the care performance of the two products. Instead of immediately selling the product, you can give them an attractive sample such as the 40 ml gift tube from the Christmas campaign. Once your customers have grown to love the two products, they will surely buy more. This small attentive gesture also unconsciously triggers a very strong emotional process, which can ensure the loyalty of the recipients.The secret lies in the rule of reciprocity, as marketing experts call it.
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One hand washes the other! This rule relates to a behaviour pattern which is deeply anchored in human beings, explaining why a person returns the favour when they receive a gift. In our culture, it‘s natural to give something back for a received service or gift. Those who always take but never give are eventually sanctioned in our society. This psychological reaction pattern is therefore deeply anchored in human beings. If one is aware of this, one can make use of it in everyday business - e.g. by using the GEHWOL gift sizes. It‘s important to know that the rule of reciprocity works almost independently of the size of the gift. Even small gifts cause the recipient to give back with behaviour which is often of greater value. If the customer stays loyal to you next year and regularly buys products from you, the small Christmas gift pays for itself.
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Products CURRENT
fotolia | olly
The small, exclusive 40 ml gift tubes from Gerlach‘s Christmas campaign will surely surprise all your customers. This gives you a nice Christmas gift and helps you bind your customers, for: Small gifts preserve the friendship!
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Technology CURRENT
GERLACH mobile foot care cabinet
Full performance - full flexibi and added comfort! Home visits require the foot care pro‘s best efforts. This makes the heart piece of mobile work even more important: a well equipped foot care cabinet. Selection criteria should include: Weight, ergonomic handling, hygiene and the spatial concept. The GERLACH mobile foot care cabinet excels in these terms. And the cabinet also has the option of bringing along a unit with either spray or suction technology. Last but not least, this unique organisation means: less stress and more time for your customers! With the GERLACH mobile foot care cabinet, the foot care pro uses the measure of quality to which they are accustomed in their daily work at the practice. Good to know: The optimal adaptation of both units to the ergonomically designed, slender cabinet profile and the weight reduction are not at the expense of their performance. For the foot care suction unit TRITON AT MICRO and the foot care spray unit NEPTUN NT MICRO are nothing short of the proven standards in stationary use in terms of rotation speed, as well as suction or spray performance. An intelligent box concept in the case ensures that sterile and
used instruments are hygienically separated and stored with an easy overview. The airtight sealing boxes therefore ensure safe and microbe-free transportation of all required utensils, and their rapid exchange if required. The case itself has a joint-free, disinfectable inner liner for easy cleaning. The removable storage trays simplify the obligatory wiping disinfection in mobile everyday work. Those who have to move a lot of “luggage“ in mobile foot care and also otherwise strain their back by long sitting and a bent position should pay special attention to the correct selection of working equipment from ergonomic perspectives, states Swiss ergonomics expert Dr. Thomas Stüdeli:
fotolia | Deklofenak
Keep the spine straight when lifting and carrying. Relaxed back stabilisation can be trained with simple exercises.
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“Physical strains in mobile foot care, particularly including strain on the musculoskeletal system, tend to be high. On the one hand, transporting your working equipment is an important factor; on the other hand, the combination of long drives and forced positions during foot care is associated with high risks. The following must also be considered: Foot care work demands flexibility and a customer orientation, and is therefore not always easily organised. At least for brief periods, foot care providers must be able to do their work even in non-physiological body positions. Nonetheless, it‘s important to plan and prepare your work as well as possible, and take time to find the optimal working position for yourself and your customer.“
All advantages at a glance L ow overall weight: only 5.4 kg (empty case: 2.9 kg) Compact dimensions H 455 x W 385 x D 163 mm High carrying comfort, stable and ergonomic transportationt Lots of stowage space: functional division with 3 storage compartments Hygienic and clear instrument storage with a box system Precisely integrated foot care suction technology or spray technology unitt Housing made from light, acrylic coated ABS plastic, suitable for disinfection
This is how the ergonomics expert sees the GERLACH mobile foot care unit:
ility
“Good aids and good organisation are important prerequisites for efficient, health-conscious work. The GERLACH mobile foot care unit lets you organise your most important work equipment, and transport it efficiently in a manner which is easy on your back. The following generally applies: From an ergonomic perspective, the optimal adjustment of a foot care cabinet to the entire work system is the goal in mobile foot care. Therefore, aspects such as weight, form, easy handling (especially cleaning), stowage space, the ability to organise and access, manoeuverability and handling during transport should be considered for a “human centered“ foot care cabinet design.“ Dr. Thomas Stüdeli, PhD, certified Europe ergonomist (Eur. Erg.) Human Factors Engineering, Mettmenstetten
My tips hen transporting weight, consider W this: Good packing is half the job. Leave what‘s not needed in the car, and figure out the best transport route during the first home visit with light luggage. And on the subject of “forced posi tions“: check your posture and avoid hectic work in each work step. In terms of organising your work and the work utensils: Think about the individual work steps when readying your materials for the job!
Unser Angebot
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Medicine CURRENT
Children's feet
Between healthy development and pathology Foot care pros are often confronted with fears of worried parents because the foot position of their child, its position or the movement process seems to deviate from “normal“. Very often, they don‘t consider that that which they think of as pathological might only be a developmental phase. Which foot deformities require treatment, and how can one encourage the healthy development of children‘s feet? A foot deformity refers to a significant deviation from the ideal physiological shape of the foot, involving malpositions of the foot bones. Foot deformities may occur individually or in combinations; they can also be either congenital or acquired during development. They are among the most complex and difficult to treat orthopaedic foot problems, and are common and varied in childhood. They also often result in the child being seen at a paediatric practice or in a paediatric orthopaedic consultation. During the well-child examinations (U2, U5, U6, U7), anomalies requiring treatment should absolutely be recognised and treated by the fourth year of life. Due to their dynamics, however, it‘s often very difficult to assess which foot deformities will improve spontaneously, and which ones will remain unchanged or worsen with further growth.
Did you know? 98 percent of newborns‘ feet are healthy. In adults, only 40 percent have healthy feet. At the time of starting school, twelve percent of children already have foot deformities.
Childhood foot development The human foot is not fully grown until the age of about 14 years. Foot growth ends about two years before a child stops growing taller. The newborn‘s foot skeleton is still largely cartilaginous. As the child begins to stand upright, the foot plate is placed under increasing pressure. The longitudinal and crosswise arches become more strongly defined, and gain height. At the beginning, the young child still has a thick fat cushion on the foot sole to protect the sensitive structures and relieve pressure on the foot soles. When inspecting infant feet, the flat sole should therefore not deceive you, for it has an important protective function.
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When the child has learned to walk, the foot and leg position as well as the gait pattern become of central interest. In the first two years of life, the child still places his or her entire foot on the ground while walking. Their walking pattern is therefore described as “waddling“. The gait only corresponds to the adult pattern approximately from the age of ten years. If the foot position or gait is abnormal, concerned parents often fear permanent damage. Doctors can usually tell them not to worry. For it is known on the basis of long term spontaneous progressions that postural defects are usually growth and development related, and therefore don‘t need therapy since they are only temporary stages. When there is a need to take action or provide treatment? A foot malposition, such as the physiological bent and sunken foot often observed in children until the age of six (“childhood flat foot“), is mostly due to not yet sufficiently developed foot musculature and lax connective tissues. A sunken arch and an angled heel are characteristic. This usually corrects itself spontaneously without therapy in the course of the physiological development of the foot, as well as motor maturation. There are no bony malpositions, and the joints are not contractile; that is, they have no functional or movement impairments. Therefore normally developing children‘s feet don‘t need insoles. The foot muscles have to exercise (see “Tips...“, page 15) and not be supported. If, however, foot function and movement processes are impaired, there are generally pathological foot changes. Diagnostics are based on a precise examination of the feet and the leg axes while walking, standing and lying down, as well as the age of the child. A doctor will also assess the foot position while on tiptoe, as well as the mobility of the foot joints. Records of the weight distribution pattern under the foot
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(podogram) also provide information about pathological foot positions. The following describes the most important foot malpositions: (Bent) inward heel foot (pes calcaneus valgus) The most common malposition in infant feet at birth is inward-turned heels, sometimes also with bending (see Fig. 1). It is marked by the impossibility of performing plantar flexion in the central position; that is, bending the foot in the direction of the foot sole. Dorsal extension in the upper talocalcanean joint may be so far advanced that the back of the foot touches the frontal edge of the tibia. The foot lifter muscles are shortened, and the heel is in the valgus position (tilted inward). This is often due to a lack of space in the uterus towards the end of pregnancy. The prognosis is good, and it usually spontaneously corrects itself. Tape or plaster bandages are therefore rarely needed.
Figure 1 Bent foot (pes valgus) Bent feet (see Fig. 2) shows a stronger valgus position of the heel at birth. The frontal foot is abducted (spread off) and pronated (bent to the inside). The range of motion in the foot joints is not restricted. Usually, redressing treatment for any wrapping is sufficient here in the form of stretching techniques and activating skin stimuli. Plaster treatments are an exception. Experience has shown that findings are normal after about a month. If the valgus position of the heel remains beyond the sixth week of life and is more than six degrees, physiotherapy treatment should be provided.
Medicine CURRENT
Tips for healthy foot development: alk barefoot as often as possible to W strengthen the foot muscles and maintain a correct toe position.
S elect variable ground for walking, running and playing if possible, such as lawn, sand and grown ground.
Figure 4 Figure 2 Sickle foot (pes adductus) Sickle foot (see Fig. 3) shows a sickle shaped medially oriented frontal foot bend with a flattened medial longitudinal arch and pronounced heel valgidity. It often appears bilaterally and shows unrestricted mobility in the talocalcanean joints. The therapy - first manual redression, then using a sickle foot splint or fixing plaster bandage in a corrected position depending on severity - should start in the newborn if possible. This can then be followed by corrective growth direction in a specialised splint and insoles with a raised inner edge.
Plattfuß (pes planus) The term “flat foot“ is a collective term for various foot deformities: In bent flat foot (talus verticalis, see Fig. 5), which is already present at birth, the heel is in the valgus position, with abduction and pronation of the frontal foot and no longitudinal foot arch. Therapy consists of treatment with a talus ring orthotic according to Baisse; if necessary, also surgery in the first year of life with subsequent orthotic treatment. On the other hand, flexible flat foot is often present in obese persons and persons with weak muscles, and still appears normal in the newborn. It consists of the absence of a medial opening in the weight bearing area as well as reduced dorsal extension
layfully practice agility, e.g. by climbP ing, daily foot exercises (grasping exercises, standing on tiptoe and walking on the heels). arious sports can positively influV ence the inner rotation position (e.g. inlining or skating) and the outer rotation position and parallel position of the leg and foot (e.g. skiing). ptimising body weight and muscular O activity by a motivating and unforced postural correction. ay attention to fitting shoes: Children‘s P feet are barely pain sensitive in response to pressure, and shoes which are up to five sizes too small can be worn without protest. Shoes, sleepers or socks which are too tight can also have severe consequences.
Figure 5 Figure 3 Club foot (Pes equinovarus, excavatus et adductus) Club foot is a classic case of a combined malposition (see Fig. 4), in which pointed, hollow and sickle foot are present. “Congenital“ club foot must be differentiated from the numerous forms of secondary club foot. It is marked by the back of the foot being tilted in an O position, with an inward-held,tilted frontal foot and a pointed foot position with a shortened Achilles tendon. It is corrected with six weeks of plaster treatment according to Ponseti immediately after birth. If the pointed foot remains, the Achilles tendon must be percutaneously cut in a minimally invasive procedure. The three-year follow-up treatment involves a specialised splint, which can prevent recurrence of the club foot.
(stretching in the direction of the back of the foot), shortened Achilles tendons, increased valgus of the back of the foot and hyperpronation of the frontal foot. Treatment options include redression, ring orthotic treatment or plaster. Insole treatment can be provided once walking commences. Contractile flat foot manifests itself at about eight to ten years of age. It often involves intergrown adjacent foot bones such as the talus (heel bone) and calcaneus. The heel is in a hypervalgus position, and mobility in the lower foot joint is nullified. Surgery (removal of the bone bridge with fat interposition) is a therapeutic option.
Dr. med. Klaus Halbhübner Dr. med. Klaus Halbhübner is a specialist in orthopaedics, trauma surgery and paediatric orthopaedics at the Orthopaedics Centre Rankestraße in Berlin. He has worked in paediatric orthopaedics since 30 years and is an expert in treating foot deformities.
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Expert knowledge CURRENT Preventive consultation and clinical diagnostics
Healthy feet are stro The feet are highly sensitive, but can handle a lot of stress and extreme weight. These properties are restricted by improper shoes, a lack of exercise and quite often by the wrong home foot care, Diabetics in particular have to pay attention to their feet. Foot specialists can encourage compliance with expert advice as part of clinical diagnostics, and provide specific tips on home foot care.
Inspect regularly Check the feet daily in the evenings with good light - and not just after long walks or after breaking in new shoes. Use a mirror to check the foot sole for pressure spots, foreign bodies, swelling, redness and injuries such as wounds and cracks. Diabetics with peripheral nerve damage (polyneuropathy) have impaired or absent pain sensation.
Carefully bathe the feet The feet must be kept clean daily. If the skin is intact, foot baths can be done using high quality products with a balanced recipe. The bath must not exceed 35 degrees Celsius (check the temperature with a special bath thermometer, since temperature sensation is impaired or absent in polyneuropathy), and should take three to five minutes. Foot baths should not be done in the presence of skin irritation or wounds.
Dry carefully After the footbath, dry the feet carefully with a soft towel. Use commercial cotton swabs or pads for the spaces between the toes. A hairdryer, red light lamp, warmin bottle, heating lamp or sun light are taboo to dry or warm the feet, due to the risk of burns. Non-constrictive cotton socks which don‘t cut in and exercise are good for cold feet.
Care with fats and moisture For daily care of dry skin due to absent sweat secretion as the consequence of an autonomous disorder in polyneuropathy (anhydrosis), you can use fatty creams with moisture binding active ingredients (such as added urea). This stabilises the skin barrier; skin cracks or rhagades with a risk of infection due to bacteria or fungi can be avoided.
Neither sharp nor pointed Do not use sharp instruments such as shears, planes, nippers, razor blades or coarse rasps for nail care and callus removal. Sandpaper or diamond files are suitable for trimming nails. Among other things, natural pumice stone or a callus softening sponge is suitable for removing callus. After filing, the toenails should end parallel to the tips of the toes, with slightly rounded nail edges.
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Expert knowledge CURRENT Information on foot exercises is available at www.gehwol.de/service/patienten_information
ong feet Basics of diabetic foot syndrome The development of diabetic foot syndrome is based on multifactorial events. A glucose metabolism disorder may, among other things, cause damage to peripheral nerves(polyneuropathy) with sensory (impaired temperature, pressure, pain and vibration sensation), motor (muscle atrophy) and autonomous disorders (not subject to will). Blood vessels are often damaged as well (peripheral arterial occlusion disease). In foot deformities, it is necessary to see a doctor, who will then prescribe diabetes adapted foot beds, shoe devices or custom shoes as needed. Using dynamic pedography, the orthopaedic shoemaker measures pressure peaks to immediately redistribute the pressure. The foot therapist is often the first point of contact for foot problems, particularly in diabetics. The prognosis of diabetic foot syndrome is good with preventive, proper and early treatment.
Dr. med. Renate Wolansky The established orthopaedist, sports physician and medical foot care provider teaches in the field of podology at several educational institutions. The expert has also published numerous books and writes for recognised expert organs. For the water colours, I would again like to offer my special thanks to painter, graphic designer and friend Heinrich Bemben from Neuss.
Not alone in everything Using callus dissolving products (keratolytics) softens the skin, with a subsequent risk of infection, and should not be done for this reason. The treatment of corns (clavi) is a job for a foot specialist. Corn plasters or salicylic acid containing ointments and creams should only be used after consulting with a doctor, pharmacist or podologist.
The right shoes Precisely fitting, actively breathing, air permeable leather shoes without squeezing inner seams and with a maximum heel height of four centimeters in women and three in men - that is, no high heels - are recommended. Walking barefoot indoors and outdoors or walking on socks is dangerous if there is peripheral nerve damage. At pools or saunas, bathing shoes reduce the risk of fungal infections. Immediately see a doctor in case of injuries or infection.
Try shoes on in the afternoon Stones, crumbs and other particles, squeezing inner seams or worn inner liners can cause injuries. Therefore inspect and feel the inside of your shoes daily! Try on new confection shoes with diabetes adapted foot beds in the afternoon, since the feet swell in the daytime. Cotton socks without squeezing inner seams or tight edge seams allow a wrinkle-free fit without skin irritation. Wash your socks with at least 60 degrees Celsius.
Solid material Daily foot exercises to activate the circulation, strengthen the short and long foot muscles, and prevent postural weakness on the feet is part of the daily schedule for affected persons. Specific individual foot exercises stabilise the muscles. Frontal foot and tiptoe exercises are not suitable in diabetic Charcot foot (disorder of the nerves, bones and joints) due to the frontal foot load with the risk of bone fractures.
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Expert knowledge CURRENT
Infectious microbes
Antibiotics from the past Hygiene update: Bacteria, viruses, fungi - there are many of them. Some microbes cause little harm, while others have the potential of triggering severe infections in humans. The World Health Organisation also warns that there are more and more resistances due to the broad use of antibiotics. Since some time, there is an uncertain development in healthcare: multiresistant pathogens. Antibiotics increasingly become ineffective for them. This year, the World Health Organisation (WHO) published an investigation summarising the risk of a post-antibiotic era. According to the “Antimicrobial resistance: global report on surveillance 2014“ report, for instance, 30 percent of the K. pneumoniae bacteria which are responsible for hospital infections are already resistant to standard antibiotics. Even the available reserve antibiotic (carbapeneme) only works within limits.
Both the routes of infection and the diseases which viruses, bacteria and other pathogens may trigger are highly varied.
Hygiene against resistance The WHO summarises that this development can only be met with improved hygiene awareness. We need more information and information for those who have to deal with pathogens in their work. This also affects foot care pros. Extremely careful compliance and regular implementation of required hygiene measures according to the hygiene plan is of ever greater significance, last but not least due to the clearly different resistance situation. Some microbes also have an extremely long survival period.
As early as 2011, the Robert Koch Institute categorised 127 pathogens and published them in its epidemiology bulletin 44/2011. Among them, 26 microbe strains had the highest, and 39 high priority. This means that fungi, bacteria and viruses tend to have a high incidence, poor therapy options or even high lethality. Aside from these criteria, chronic late consequences, prevention options as well as work and school absence times were also part of the evaluation. A selection of important pathogens shows the possible consequences of an infection from them:
Top priority pathogens “ Helicobacter pylori“ (gram negative, microaerophile staff bacterium): They trigger a series of gastric disorders such as type B gastritis, an estimated 75 percent of gastric ulcers, and practically all duodenal ulcers. antavirus (family of bunyaviridae, human pathogen): It causes severe H lung disease (pneumonia), acute kidney failure (nephrotic syndrome) or fever disorders. S taphylococcus aureus (including MRSA, spherical, gram positive bacterium): leads to skin inflammation (boils, carbuncles), muscle disorders (pyomyositis); in unfavourable cases, also to life threatening disorders such as lung inflammation, endocarditis, sepsis and toxic shock syndrome (TSS). It is particularly difficult to eliminate, since it is resistant to several important antibiotics. neumococci (type of Streptococcus pneumoniae, gram positive P bacteria): Pneumococci cause severe lung inflammation which may become dangerous in infants, toddlers, elderly persons and persons with chronic underlying illnesses. Meningitis, sinus and corneal infections are also due to them.
High priority
fotolia | ag visuell
otavirus (family Reoviridae, human pathogen): Frequent vomiting, R followed by high fever and diarrhoea ranging to an acute, life threatening diarrhoea disorder are triggered by this virus. lebsiella (usually Klebsiella pneumoniae, gram negative staff bacteria): K Triggers hospital infections, urinary tract infections, bacteraemia, lung diseases or rhinitis with atrophy of the nasal mucous membranes (ozaena). E pstein-Barr virus (family Herpesviridae, human pathogen): The enormously varied symptoms range from head, neck and back pain to pneumonia, multiple sclerosis or depression. E bolavirus (family Filoviridae): triggers infectious fever disorders accompanied by bleeding (haemorrhagic fever).
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fotolia | vmelinda
Ware knowledge CURRENT
Tube material for cosmetics
More than a matter of appearance The packaging of skin care products must fulfill various functions. The contents place the greatest demands on the packaging. Nearly all cosmetics contain rapidly, easily volatile oils or aromatic substances. The packaging has the task of preserving them in the substrate without quality losses. At the same time, the barrier properties of the container provide protection against environmental microbial influences. A tube is a typical form of packaging for semisolid preparations such as creams and lotions. Today, plastic or aluminium tubes or compounds of plastic and aluminium are in nearly sole use here. Aluminium has the advantage of one-way removal; that is, it does not pull the contents back into the tube during use, unlike a plastic tube. No oxygen enters the tube, and therefore no pathogens. Aluminium can also be squeezed. It‘s easier to empty the tube. Plastic: light and attractive On the other hand, younger users in particular often complain about the not very decorative appearance. Therefore, plastic tubes are increasingly used for cosmetics, last but not least due to their aesthetic appearance. They offer more design room for advertising accents. The shiny varnished tubes of the GEHWOL FUSSKRAFT Soft Feet series are a very good example. The main ingredients such as water lily, honey and bamboo are emotionally displayed in this series. Plastic tubes are usually made from thermoplastic polyethylene. High density polyethylene (HDPE) is usually used for cosmetic products. It is made from weakly branched polymer chains and is therefore very dense. The high density lends the material better barrier properties. Byt high density polyethylene can still not guarantee complete diffusion tightness. To further reduce gas permeability, plastic tubes for cosmetics are made from several layers of plastic. Two HDPE layers surround an inner core made from polyethylene vinyl alcohol (EVOH). This is a copolymer with optimal barrier attributes against UV light, oxygen and aromas. Nonetheless, even a multilayered plastic material does not provide 100% barrier protection. There is also the not insignificant
disadvantage that the tube automatically fills with air after taking out cream or lotion. This may be optically pleasing under some circumstances and make it easier to take out cream, but necessarily causes the contents to interact with oxygen. Depending on the recipe composition, this interaction may result in a shorter shelf life.
When choosing the right packaging, it‘s therefore a matter of weighing the advantages and disadvantages of the material at all times in relation to the product properties, and finally choose a variation which best fulfills the packaging purpose.
Plastic tubes are entirely unsuitable for light or oxygen sensitive products. For instance, this applies to products with essential oils. GEHWOL uses only select hand picked natural oils with a high purity level. Despite their quality, these plant active substances are also highly light and oxygen sensitive, and lose their natural scent if the outer barrier is not sufficient. Only aluminium has sufficiently high barrier and removal properties to optimally protect even such sensitive products. Aluminium: airtight and secure Aluminium is impermeable to microorganisms, light and air, so that the contents are preserved, and product shelf life is extended. Aluminium is also used for the storage of foods for this reason, particularly since the metal amounts to approximately eight percent of the earth‘s crust; it is therefore the most common metallic element, and most foods therefore naturally contain aluminium. With a normal diet, the aluminium intake for the European population is estimated at three to ten milligrams per day. Unlike diet, no aluminium is absorbed from cosmetics. A protective layer is applied to the inner side of the metal during manufacture, so that the contents do not come into contact with the aluminium. Other definite benefits of aluminium include its low weight and the fact that the material can be completely recycled without quality losses.
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Plastic tubes have several layers. The middle EVOH barrier reduces gas permeation and protects the contents against air and loss of aroma.
The conified tube sections of the aluminium tubes can be inserted into each other. This saves storage space and makes tube filling more economical.
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Ware knowledge CURRENT
Suction and wet technology
Definitely undecided Suction or spray? In theory, there are a lot of disputes about this. In practice, however, the matter is very pragmatically solved. The technology which works best for the foot pro is the one they will use. Both have specific advantages: Suction and wet technology. A brief overview shows the significant differences; users report why they use which technology for their daily work. Suction technology is very effective in removing large areas of skin. The rotary instrument set is tendentially laid out for this. Modern foot care units have particularly good suction performance. However this is physically limited by the front opening of the tube at the hand piece. Even with higher motor performance, only a defined air volume with removed skin fits through. Even though the suction performance of the modern devices is high, tiny residual amounts are not picked up in the immediate work area. However, there is no risk of the treating person inhaling very fine contaminated dust due to the obligatory mouth and nose protection mask.
revolutions. This is not just a comfort advan tage, but also a therapeutic aid, especially in persons with reduced pain sensitivity such as diabetics.
There is a risk of certain skin regions on the foot overheating when work takes place in one location for too long. Due to the fact that they cannot report pain due to impaired or absent pain sensation as a result of neuropathy, serious problems may occur particularly in diabetics. In order to avoid this, the user must be sensitive and sufficiently experienced.
Sabine Kühnemund, Podologist, Kassel “I like wet technology so much because I do a lot of work with diabetics. Their skin is more sensitive and easily injured. At the same time, they often don‘t sense pain. By permanent cooling, wet technology avoids skin heating and thereby potential injury. This also applies particularly at the high rotation speeds which I like for working in the nail bed edge.
More than comfort Followers of wet technology often point out its good suitability for fine or complicated work. Using the fine grinding bodies, the permanent cooling makes it possible to work longer in the same spot or with higher
Critics of wet technology state that the spray mist spreads around a lot and would result in greater room air contamination. However users report better binding of fine dust by the spray mist, which occurs more or less intensely depending on the spray intensity setting. The treating person is protected by wearing gloves and mouth protection (see page 28), which is also obligatory for suction technology.
Carmen Lantzsch, Podology, Langenlonsheim “I have used wet technology since 1995. I‘m sort of a pioneer. It has always been especially important to me that my customers and I don‘t inhale the contaminated dust which is formed e.g. when removing thickly callused nails on the feet. This must definitely be avoided from a hygienic perspective. Wet technology, however, does an excellent job of binding the dust. In my opinion, the process improves painless removal, for instance in the nail bed edge, or of callus. Customers often tell me that it is more pleasant and less painful for them. They feel much less. This is particularly important in diabetics, since their pain sensation is often severely impaired and they may not be able to tell me if injuries are imminent.“
Suction and wet technology don‘t need a tug of war. The foot care industry needs both technologies.
Suction hand piece Saturn AT MICRO
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Removal is more effective overall, since e.g. the callus is already softened. Many customers repeatedly confirm to me that wet technology is pleasant for them. Those who compare to suction technology favour the spray mist.“
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Ware knowledge CURRENT
Rainer Kehm, Podologist, Kassel “I usually start with wet technology and then continue with dry technology. Dry technology generally takes some experience to avoid working in one spot too long, avoiding overheating. There is a risk of injury particularly in neuropathy, since the affected person does not feel pain and therefore cannot respond. I also use suction technology when I have first worked on callus with the scalpel. The soaked skin is then easily removed. Cracks are easily ground out dry, so that no edges are left behind. It looks almost like a wave. Edges smudge here if I use wet technology. But wet technology is outstanding for fine work in the nail bed
edge or on the foot sole. I can use higher rotation speeds here. The moisture cools the treated area on the foot. But wet technology is not just more pleasant for my patients, but also for myself. The ground material is bound immediately, and the treated area is immediately flushed clean. I can always see what I‘m doing. However it is a little too cool for some customers when it‘s cold outside, e.g. in winter.“ Rosi Schön, Podologist, Fürstenfeldbruck “When I‘m grinding on the heel, for instance, I don‘t want it to be wet. The constant misting makes it harder for me to see well. A moist area looks good when working. But the results are not always satisfactory when I wipe it dry. Some customers also complain that their foot gets too cold with wet technology, which is unpleasant for them. I prefer it dry. The dust which is formed doesn‘t bother me. I also had my bronchi examined. They are completely ok. My customers are also very satisfied, when I work on their feet with dry technology. I have no problems with potential heat development. One can adjust to this with experience. One‘s own handwriting is decisive. I‘m generally cautious when working on the feet; nothing happens even with diabetics.“
Andrea Horn, medical foot care, Leverkusen “I can fundamentally use suction technology very well and use it for all daily work. I learned both technologies in school. I found wet technology pleasant for customers, but not for me as the treating person. I had the problem that the removed skin material sticks to the foot. Wet technology would probably make sense in very pain sensitive patients. Overall, however, I find suction technology simplest and cleanest. Especially the modern units have very good suction performance, so that only little fine dust is not immediately suctioned away from the area being treated. If a little fine dust enters the air in the immediate treatment work area, I am protected by wearing the mouth and nose mask.“
Spray hand piece SIRIUS NT Micro with lamp
fotolia | Kirsty Pargeter
Wolfgang Meinl, cosmetician and foot care pro, Hainburg “Both technologies have been important for me since more than 15 years. For instance, I use suction technology when removing callus, but wet technology for finer work in the nail bed edge. Wet technology has finer instruments for these detailed tasks. The small amount of spray mist does not bother me during work. One has to learn how much water is needed. I usually work at the second highest level. Everyone should find a good measure between water use (particle binding) and thrift. I only use few instruments in suction technology, usually 10x caps. I use them for the soles and heel or large areas of callus. When affected skin areas are smaller, I change to wet technology. Its greatest advantage is that I can work on one area longer without overheating. My customers, for whom I do about 1700 treatments per year, are very satisfied.“
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fotolia | weseetheworld
Ware knowledge CURRENT
Foot care unit Concept F3
“As if it had been made just for me“ It‘s often the little things which make things nicer or better quality. This also applies to the foot care chair in your practice. Foot care expert Hertha P. tells us which special details and features increase patient comfort and simultaneously make treatment easier for the foot specialist.
My foot care pro surprised me last week: “Ms. Müller, you redid the practice“, I said. “Yes, we needed that after all these years. Go ahead and have a seat,“ she responded. And so I did. “Wait, I‘ll tilt the chair forward a bit so you can sit down more easily“ (feature 1). Getting in really is much easier than with the previous chair, also in terms of height (feature 2). I‘m not as young as I used to be, and have a few pounds too many. Sitting was normally quite difficult for me. When Ms. Müller placed my legs on the rests, I noticed that the rests had been swung out before (Feature 3). II felt very comfortable in the chair right away. Only the arm rests were a bit tight. “No problem. I‘ll pull them out a bit. How is that?“ my foot care pro asked me. Wow, I thought, comfortable (feature 4). Overall, sitting or rather, lying was also very pleasant. It felt as if the chair had completely adapted to me (feature 5). I did not have to get up for the obligatory foot bath before the treatment. Ms. Müller simply swung away the leg rests and pushed in the foot bath tub (Feature 3). I was then moved into the treatment position. I noticed that the sounds were quiet (feature 6/7). No comparison to before. “It‘s even better“, Ms. Müller says proudly. “The new chair has electronic fixing brakes. I can make the chair bombproof with just a little kick.“ I immediately had a feeling of satisfied safety (feature 8). This was confirmed during the treatment. The chair
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only moved when Ms. Müller wanted to get into a different position to work on the callus on my feet, and released the electronic fixing brakes for this purpose. Then it was entirely fixed again. Completely satisfied “Well, Ms. Müller, the new chair is great. I like the ‘Mint‘ too, and it totally fits here“, I praised her. “Yes, it was not an easy choice. The cover of high quality artificial leather, which is very easy to clean and disinfect, is available in 40 colours“ (feature 9/10). I enjoyed her enthusiasm. “Until next time then!“ “Thank you, I hope you get home well“, she said.
Feature 1
The base setting of the seat surface inclines three degrees forward in the entry position. This allows even patients with motor impairments to sit down without losing their balance.
Feature 2
The entry height is a low 52 centimeters, also making it easier to sit down. This, in turn, is a good start to a relaxed comfort experience.
Feature 3
Multiple pull-out and swing-out leg rests simplify getting in and out. And, for instance, prepared foot baths can be done without changing the client‘s position. The leg rests are unlocked and locked by gently tightening the quick tensioning locks.
Feature 4
The arm rests can be pulled out on both sides (optional feature). This widens the area from 57 to 67 centimeters. The patient is therefore no longer restricted on the seat surface by excessively close arm rests.
Feature 5 Further information: In order to exclude safety risks, regularly check all functions. Tips on this can be found in the user manual or as a download at bit.ly/concept-f3-wartung.
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In the CONCEPT series, the body of the seat and back surfaces and arm rests is shaped with pressure and heat. The laminated formed wood receives its ergonomic optimum (fit form) by the injected foam surrounding it. This also results in high long term stability.
Ware knowledge CURRENT
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Comfort and treatment features using the example of the Concept F3
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10 4
9 2
7
3
6 8
Feature 6
A powerful low voltage drive manoeuvers the seat of the F3 vertically and continuously on a telescoping lift cylinder to the desired position. Three high performance electrical motors lift a load of up to 220 kilograms by remote foot operation without difficulty.
Feature 7
The proven linear height adjustment adjusts the height with a telescoping lift cylinder - saving space, since the stable standing foot can be smaller compared to the height adjustable arm of other treatment chairs.
Feature 8
The electronically controlled fixing brake of the CONCEPT F3 allows flexible rotation and fixing. When the braking button is operated on the remote foot controls, the fixing brake pad, which originates from the automobile industry, applies pressure directly to the seat lift column. The drive shuts off as soon as maximum power takeup is reached. This ensures that it it always braked with the same force, which makes braking performance independent of manufacturing tolerances and wear.
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Feature 9
The choice of covers from a total of 40 custom colours makes it possible to coordinate the colours in the practice. A harmonic colour world positively influences your customers, and they feel good.
Feature 10
The foam surrounded arm rests, seat and back rests are covered with a sturdy artificial leather. The high quality material can be treated with the common cleaners and disinfectants (pay attention to tested products - VAH list) without losing appearance or quality.
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Ware knowledge CURRENT
Gerlach in Austria
The spoiling trend In the neighbouring Austria, SynPharma has already been working together closely with Eduard Gerlach GmbH since more than 30 years. The market is steadily growing in the alpine republic, and professional foot care is increasingly gaining significance, particularly in terms of customers‘ need for wellness and being spoiled.
Foot care is an apprenticeship profession in Austria. The high-level education puts 80 percent of the focus on the practice. There are nearly 3500 foot care pros in Austria who work as individual entrepreneurs or in small foot care institutes, spa and wellness facilities as well as hotelry.
here“, explains Reinhard Satzinger, branch manager of SynPharma GmbH in Hallwang at Salzburg. “While 40 percent of the female gender look after their feet, men definitely need to catch up at only 16 percent.“ Aside from daily classic foot care, treatment of various foot problems and the diabetic foot practice are the focal points of the trade. Soft Feet for Wellness The feel-good or spoiling factor also plays an increasingly greater role in Austria. “Users not only have foot care for callus or cracks, but also just want to do something nice for themselves and their feet. The products of the Soft Feet series perfectly meet these needs, so that end consumers can escape from hectic everyday life with the use of these products, and just relax“, Satzinger continued.
In the summer, when one shows “more foot“ or goes hiking more often, Austrians look after their feet slightly more than in winter. About 30 percent of the population do so in the summer months, while it is about 20 percent in the cold season. “Women are much more active than men
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“We are also experiencing greater demand in the pressure protection field. Many users notice that perfectly constructed pressure relief materials can provide rapid help.“ In general, feedback on GEHWOL products is very good, particularly in terms of the price to performance ratio and quality. “Customers are enthusiastic about the efficacy. Expectations of the products are fulfilled, and they keep what they promise.“
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Service from the inside and outside SynPharma has now been working together very closely with the GEHWOL brand and the foot care branch since 31 years. “The company became Austria‘s market leader over the years“, Satzinger enthuses. SynPharma is deeply rooted in the Austrian foot care sector as a complete provider. A team of field workers professionally advises the foot care pros. The office in Salzburg flanks this with a showrom where foot care devices, cabinets, instruments and products can be viewed. But SynPharma does even more: “We continuously try to expand our customer services. We expand continued education and further training offers for the trade or come into town with the GEHWOL roadshow. Using marketing and PR, we also increase the familiarity of the brand, which benefits the individual foot specialist“, Satzinger explains.
Care consultation CURRENT
The consultation: “Yes, you can do that“
Foot hygiene - for everyone! Families are on the go a lot today: whether at work, at school, in kindergarten or in sports. But what about foot hygiene? You can score with many a family manager with your valuable tips - and help beat foot sweat and fungi. first for hours at school and work, then maybe still go shopping and run around town. Customer: Yes, and the feet are thick and swollen in the evening! Foot care pro: Therefore you should all have a refreshing home footbath every so often. I can also tell you that walking barefoot whenever possible helps, so that the sweat can evaporate. Barefoot in sandals is also a good alternative to closed shoes. Customer: Is there a deodorant for the feet? My family would probably love it (laughs)! Foot care pro: For example, I can recommend GEHWOL FUSSKRAFT Herbal Lotion here. With its natural medicinal plants of rosemary, mountain pine and lavender as well as cooling menthol, it refreshes, deodorises and lastingly removes foot odour. The lotion also protects against foot and nail fungus infections and prevents inflammations. Customer: And which care cream is right for daily use? I want to set a foot care example, but I often lack the time and motivation! Foot care pro: A cream should bind moisture and strengthen the skin barrier. For example, I can recommend GEHWOL FUSSKRAFT GREEN as base care here. It‘s a light, mildly fatting emulsion. It keeps the feet hygienically fresh, enlivens and deodorises them. And with shea butter and
jojoba oil, it‘s also especially good for dry, brittle skin. Aloe vera in the cream binds plenty of skin moisture. Customer: I can see that I‘ll have to discuss your numerous good tips with my family. My husband and children really do play a lot of sports. Foot care pro: When your children are in sports, also make sure that they check their feet from time to time. Particularly around the toenails, which should always be trimmed straight, small injuries may quickly become entries for fungal infections. During sports, we often also spend time in pools, change rooms and shared showers. There, the moist and warm environment supports the growth of fungal pathogens. Therefore the rule is: always wear water shoes! Customer: I understand. How would I notice such a fungal infection? Foot care pro: Symptoms of foot fungus consist of itching, especially between the toes, but also burning and scaly, wetting skin. A nail fungus may show itself with discoloured, brittle or thickened nails. You should see a doctor if in doubt so that a possible infection can get early treatment. Customer: I hope we remain unscathed... and now, let‘s relax!
fotolia | Chlorophylle
Foot care pro: Hi, Ms. Schneider! Nice that it worked out with your appointment today. Customer: Hello there! Yes, I just dropped off my oldest for football training. You should smell his shoes afterwards! Foot care pro: (laughs) Better not, I can only imagine! The shoes should definitely be well ventilated after sports - that is, don‘t leave them in the sports bag. Those who tend to have sweaty feet should also wear cotton socks and change them every day. Customer: My son does shower daily, but he won‘t look after his feet at all. After all, they dry on their own! Foot care pro: I can tell you from experience: The spaces between the toes are often forgotten when washing. It‘s also important to dry them thoroughly. Otherwise, skin fungi have it easy. Customer: What else can I do to prevent those terrible sweaty feet? Foot care pro: Pay attention, especially in sports footwear, to actively breathing shoes. Avoid synthetics. It‘s always best to wear one‘s shoes alternately. Then there‘s enough time for the insoles and lining to dry out. Customer: Yes, unfortunately my children always want to wear the same comfy, wellworn shoes. Foot care pro: I know, we always prefer to spend the entire day in our favourite shoes:
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Old age provisions for foot care pros and podologists
Prevent now, enjoy later
fotolia | Patrizia Tilly
Practice CURRENT
The stressful everyday practice life of foot care pros and podologists leaves little time for planning one‘s future. But the subject of old age provisions is just as important as day to day business. What if you, as a self-employed person, cannot or do not want to continue generating income when you are of pensioning age? The earlier you think about it, the more calmly you can address the subject, and enjoy life at the pensioning age. Old age provisions are mainly about saving capital and increasing it with a positive return which is as high as possible. The capital which is saved and built in this way is to ensure the current or future desired standard of living at the pensioning age, even when no further earnings are coming from independent work. Saving and increasing capital Those who start to accumulate capital early can do a lot even with small monthly contributions. When a young independent invests 50 Euros a month for 45 years with a return of 5 percent, he will save nearly 100,000 Euros. If only 30 days remain for saving, he will reach nearly 41,000 Euros before pensioning age. On the other hand, someone who is pensioned in 10 years will only save less than 8000 Euros. This example shows that 50 Euros a month are surely not enough as an investment. After all, the saved capital has to last for 20 and more years after pensioning - and 100,000 Euros are definitely not enough for that. The return of 5 percent can also not be obtained all the time today, when interests are lower, without risks. Things are made more difficult by returns being reduced, e.g. due to inflation or high management costs. Old age provisions are a strongly individual matter for which there is no blanket rule for success.
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Affordability, security and liquidity Nonetheless, there are some key points. Foot care pros and podologists are selfemployed and therefore not mandatorily insured by the statutory pension insurance. They can, however, voluntarily obtain statutory insurance. This makes sense, for instance, to secure any claims formed after a non-independent type of employment. There are numerous other models, as alternatives or in addition. Their choice is often influenced by the magical triangle of the asset situation, which consists of affordability, security and liquidity. According to this theory, an investment can only fulfill two out of the three criteria. Therefore, those who decide to choose security - namely preserving the assets - and affordability will have to choose a form of investment which is less liquid. This means that you cannot access your money even in emergencies. This includes, for instance, long term loans and savings plans. On the other hand, those who want to take on more risk can expect higher returns, and access their money at any time as well. Stocks are a good example of this. But the rapid availability of the money is deceiving. If the stock exchange rate happens to be poor, the investor risks losses. Life insurance policies can also be liquidated only with partly very high losses. So there are no perfect old age provision methods. Fundamen-
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tally, self-employed persons should look into the following options for themselves, each of which has individual advantages and disadvantages: I nsurance policies and savings plans without state support, such as life and pension insurance S tate supported insurance policies and savings plans such as the Rürup pension S elf-utilised or rented real estate I nvestment into product capital, such as loans or stocks Thoroughly check the alternatives, and/or have them checked. Which is the right model for which person also depends on tax circumstances in the savings phase and the pensioning age. Professional support is helpful for weighing the alternatives. But caution is indicated here. There are financial consultants who work on a commission basis. They are paid by the finance companies, which means that some advisors prefer certain options. On the other hand, there are consultants who work on a fee basis. In accordance with his expense, the consultant bills the expense to the customer - you, in other words. He is therefore only at your service, and external influences are reduced. This investment might pay off for you, though, so that you can enjoy your well-earned pension.
Practice CURRENT
Process optimisation in the practice, part 1: Complaints management
“I want to complain“ All everyday activities of a foot specialist correspond to processes. The progression of a process can often be optimised. FUSSPFLEGE AKTUELL describes starting points for optimisations in some parts of the foot care practice in its new series. We start with managing complaints. You have heard of this: If you ask ten people the same question, you will receive just as many different responses. Opinions of products and services differ similarly. Customers are generally only satisfied when the experienced purchasing process fulfills or even exceeds their expectations. If the expected satisfaction does not occur, this often leads to complaints. Those who are affected generally see the criticism as negative at first.
“That which is the same doesn‘t faze us, but it is contradiction which makes us productive.“ Johann Wolfgang von Goethe
In truth, however, every complaint is an opportunity, for it means that the customer is pointing out a non-optimal process - at least from their perspective. For instance, this can help reduce errors, improve service quality or avoid consequential costs. Actively managing a complaint can turn a dissatisfied customer back into a satisfied customer.
consultation concerning subsequent, qualitative home foot care or reduced wait times. At a glance In order to make lasting use of the information which your customer is giving you, it is generally recommended to document the incident. This has two advantages. On the one hand, you can re-read details of the complaint later for the current problemsolving situation if the case takes longer than expected to solve. On the other hand, the documentation is saved. If a same or similar complaint occurs later, you already have a suitable argumentation aid or solution. This saves time and can quickly satisfy customers.
What is ... Process organisation? This is how business economists define process organisation: In organisation theory, it defines the determination and definition of work processes with consideration of time, materials, space and persons. Put clearly, this means that anything which you do in your practice or mobile foot care has a process which can often be further optimised. This makes your work easier, more efficient or faster.
Utilising technology Electronic aids are suitable for such documentation. For instance, corresponding comments can be entered and evaluated in MS BusinessCLASS. In this simple manner, you establish effective complaint management in your practice. You can then easily check whether certain problems accumulate or whether only specific customer groups (such as stressed professionals) complain. The analysis of the collected, documented complaints then lets you orient your services to the needs of your customers.
The ear for the customer It‘s initially important for you to take the complaint seriously, listen to the customer and calm the situation down. Let your customer know that you understand their dissatisfaction/their problem and are seeking a solution. You can ask specific questions to obtain further information.
fotolia | Matthias Buehner
Some problems cannot be solved, such as treating inflamed rhagades and clavi or other medical cases e.g. of diabetics or haemophiliacs without a doctor‘s order and supervision, or without a sectoral medicinal practitioner‘s permit. In cases defined as medicine, you can therefore only show your customer that statutory regulations require a doctor‘s consultation before treatment. If he declines this, it it already recommended to document the complaint for legal reasons, which is best done with photos of the medicinal findings. In other cases, a solution can be found, such as a
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Responsibility in the practice
All-round certainty - no chances of microbe entry Foot care pros are exposed to a greater risk of infection in their work. Pathogens can be transmitted by touch or inhalation. It‘s only responsible to use all options to protect yourself. At the same time, however, this protects the patient against infections as well. Worn-off, contaminated skin material, the patient sneezing strongly, colonised surfaces - there are many sources of infection in foot care. Illness leads to work absence and can have serious health consequences. Patients are also at risk. Aside from the possibility of unpleasant illness, the foot care pro also runs the risk of someone who became ill at the practice will hold him/her responsible. Overall, there are many good reasons to use all options to protect against pathogen transmission. GERLACH TECHNIK has the materials for all-round protection. Hand protection Always wear protective gloves when working on the patient‘s feet, even if this slightly lessens your sense of fingertip touch. Even the smallest skin cracks can be entry points for worrysome microbes and therefore, infections.
Mouth and nose protection mask Eathogens most often enter the human body via inhaled air. As a foot care pro, you are at particular risk, since you work very close to colonised skin areas and contaminated removed material. A mouth and nose protection mask effectively prevents the entry of microbes via the air. Even though masks are of high quality today and are moisture resistant, you should change them regularly. Foot protection Especially patients with foot or nail fungus should receive foot protection. This prevents skin scales from spreading in the practice. This protection makes sense for the foot not currently being treated and for the patient to walk around.
Protective goggles Foot care devices with suction and wet technology from GERLACH TECHNIK are at a high technical level today. Nonetheless, even the tiniest particles may still fly around during grinding and polishing. Protective goggles help to make sure that nothing enters the eyes. Grip tweezers They can be used to pick up used pads, swabs, gloves or trimmed nails and dispose of them without risk. Cleaning and disinfection Not just instruments and surfaces are a mandatory part of hygiene in the foot care practice; it applies to the hands as well. GERLASAN SOFT med. washing gel is suitable preparation for disinfection. Sterillium has proven itself for hand disinfection before and after every treatment. In disinfectants, generally make sure that they are tested and listed, e.g. by the Association for Applied Hygiene [Verbund für Angewandte Hygiene (VAH)]. A wall dispenser or the touchless Eurospender Touchless simplifies the application of the disinfectant. Patients‘ feet also require preventive care. You can clean them effectively with a foot bath or the antimicrobial cleaning foam Stellisept med. foam for prevention. Hand care Self-protection includes regular care of your hands. Frequent washing and disinfecting can severely stress the skin. Therefore, care for your hands with a rich hand cream such as GERLASAN Hand Cream in the dosing dispenser. This renders the skin resistant and also strengthens the natural barrier against microbes.
From disinfectants to protective goggles, foot care pros can protect themselves and their patients.
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fotolia | Bernd Leitner
Practice CURRENT
Marketing CURRENT
Knowledge from neuromarketing for the foot care practice
A look into the brain Brain scans, brain wave measurements and core spin images - these are some of Dr. Kai-Markus Müller‘s instruments. He is a diploma psychologist and neuroscientist, and looks inside other people‘s heads. In this way, the scientist finds out how the brain processes marketing messages and pricing signals, and what actions they trigger. In this interview with FUSSPFLEGE AKTUELL, he explains how to use this knowledge in everyday practice life.
That is, consumers like variety? In any case, variety helps consumers make decisions and choose from among similar products and services. Contrary to the statement of “being unable to choose because there is too much to choose from“, broader offers sometimes make it easier for consumers to choose a product. Of course, there are limits to variety. However, providers can primarily use it to steer customer decisions. There are often numerous offers which are never purchased, but nonetheless remain in providers‘ portfolios. For humans tend towards the middle. They don‘t like to buy the cheapest, but not the most expensive either - they choose the middle. Do you mean that the super premium care with wax and hand polishing at the carwash or the most expensive dish on the menu are never selected? They are, in any case, only selected infrequently and if yes, then the car wash or restaurant makes good profits from them. For the most expensive care program or dish is overly expensive in relation to what it provides. For instance, if foot care pros offer three packages - Gold, Silver and Bronze - most consumers will choose Silver. But if customers tend to go for the Gold package instead, one could add a more valuable Platinum package to the portfolio. Now the Gold package appears less expensive to the consumer, and is chosen more frequently. Higher quality packages are particularly selected as gifts. No one wants to be seen as penny-pinching.
fotolia | Sergey Nivens
Dr. Müller, what does neuroscience in general do, and what do you specifically do? We deal with two major fields: In the first, we use various techniques to observe primarily unconscious brain processes triggered by marketing measures. In the second field, we deal with behavioural research. To do this, we combine knowledge from neuro-science and psychology, and transfer this to advertising and sales. This shows us, for instance, that the decision-making behaviour of consumers strongly depends on alternatives.
The price of the Gold package stays the same? Yes, but people often perceive prices relatively, and seldom absolutely. That is, we compare to alternatives. And an offer with a higher price makes everything with a lower price seem better. This increases the willingness to buy. Foot care pros can also work with similar packages to offer services which the customer might otherwise not even ask for. For instance, it makes a sense to price a foot care product into the overall treatment with a foot bath, pedicure and massage, and advertise it as an added benefit, according to the motto: “This package also includes home care.“ Packages have the major additional benefit that they make it difficult to compare. Prices of individual contents cannot be compared to the individual price during the purchasing decision.
So packages make it possible to use neuromarketing in your own foot care practice? Precisely. Packages are easy to try out in the practice. But customer contact is also easily optimised. We know that aside from the actual offer, the personal bond is also very important - especially for services as they are offered by foot care pros. As a customer, I need a lot of trust, and it‘s difficult for me to be disloyal to a person whom I trust. Small gifts support the bond: whether it‘s a product sample or a cup of coffee as a greeting, or tea or a small treat. The brain interprets this gesture as trust given in advance, and the customer must follow. He rewards the behaviour of the foot care pro with loyalty and his purchase, which will surely be a little larger.
Dr. Kai-Markus Müller is a neuro- and behavioural scientist (M.Sc.) as well as a diploma psychologist. In 2011, he founded the research agency “The Neuromarketing Labs“. “The Neuromarketing Labs“ uses the knowledge obtained with modern technology and innovative physiological methods for price, product and advertising research. Dr. Müller is also the author of the world‘s first book on the subject of “NeuroPricing®“. www.neuromarketing-labs.de
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Marketing Marketing CURRENT AKTUELL Campaign planning
“Which shoes did
existing customers and trust, bind n e h t g n You can ty, stre foot care practice. As a foot speincrease familiari s in the n g i a p of this form of marketing, bring in n am itive use s ew customers: C o p d n ific a cialist, yo efficient campaign designs with u can make spec n create a c u o Y . e.g. in the Christmas period ach. l natural di r e scounts from G
fotolia | by-studio
Whether consultation or sale - campaigns will bring you to your customers‘ minds again and again. You also actively use themes from your field of expertise. When you are planning a campaign, a checklist (see box) is helpful with remembering all significant elements. But clarify the basis before starting your concrete plans. First and foremost, you have to ask yourself: What do you want to achieve? After the campaign, you can easily verify whether your expectations were fulfilled. The second question is just as important:
“What kind of campaign should I do?“. The following two campaigns which can be realised with few means on an everyday basis provide some ideas. Christmas quiz Your customers participate in a quiz and can win small gifts by answering simple questions. A single DIN A6 format card is sufficient. It should be decorated with a Christmas motif to create the reference. The questions should also be related to our most important holiday. For instance, you can ask the following questions: Question: What kind of shoes did Jesus Christ wear, according to the story? Response: Moccassins Flip flops Sandals Question: When were foot problems mentioned in writing for the first time? Response: 1500 BC 20000 BC 1999 BC The questions should not be too difficult, and it should be possible to answer them by choosing the answers from the list. This lowers the participation threshold. The card also needs the participant‘s address and brief information about the winnings. This may, for instance, consist of an allround wellness package with foot care, foot massage and other wellness offers. You can also raffle various product sets. Gerlach‘s natural discounts and Christmas
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offers/samples are easily used for this purpose, minimising the financial expense. A door for the customer An interactive Advent calendar is another Christmas idea. In November, encourage your loyal customers to fill out a participation card. You can also connect this with a question about your practice, foot care or Christmas. Raffle 24 “doors“ or “bags“ among all participants, depending on what the Advent calendar looks like. A customer who has won is allowed to open one of the doors on the Advent calendar. The Advent calendar itself can be creatively designed according to your own ideas, and also contributes to the Christmas decorations in your practice. Note that the compartments need to have enough space for the prizes. Ideally, you link the raffle with products which you recommend for home foot care. Here, it also makes sense to use Gerlach‘s Christmas offers (natural discounts, samples) for filling the calendar.
fotolia | photosnic
Marketing Marketing CURRENT AKTUELL
fotolia | Printemps
d Jesus wear?“
Checklist for successful campaigns The better the preparation, the greater your chances of success. For easy implementation of campaigns in the foot care practice, use the tips below which are chronologically sorted according to the progress of a campaign:
Packages are simpler Offer packages have also proven themselves in practice. They have the advantage that you can offer added value to your customers and simultaneously increase your sales. So both sides get something. For instance, an attractive gift package for the customer could look like this: 1. a Christmas orange-cinnamon tea as a welcome, 2. all-round spoiling foot care, 3. a foot massage, 4. a care product for wellness care at home. The tea should not be part of the package price, but a gift from you to your customer. This supports the success of an offer package, since the customer instinctively wants to give something back. In packages, it‘s best to offer three variants (bronze, silver, gold or Wellness classic, Wellness premium or Wellness de luxe). People tend to choose the middle package. This should correspond to your preferred offer.
Formulate a clear objective. Determine the campaign theme. D efine how often you want to implement or repeat this campaign. D ay, week, month: How long will your campaign take? When making your plans, take school holidays, competing neighbourhood festivities or other circumstances such as health days (Day of the Foot) into account. W rite down a time schedule. Use it to specify the details of what will be done when. This helps to avoid problems and stress. P lan your manpower. A lot can be done on your own, but some things will need support. Therefore involve employees or helpers at an early time. T hink about what products you will need for the campaign, and order them early. A special placement for products in the campaign period usually makes sense. S elect the materials which you will use to draw attention to the campaign, such as posters, flyers, window decorations, shelf stoppers, ceiling hangers etc.
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D raw attention to the campaign outside the practice, e.g. with advertisements, PR articles, handbills or mailings. D epending on the scope of your campaign, think about whether a cooperation with other advertisers makes sense. Integrated events such as “face painting“ or a music band are also possibilities. C ustomers are glad for small giveaways (gift articles) such as product samples. This solidifies the campaign character. Reserve attractive prizes in a raffle. A lways keep an eye on costs. Document campaign expenses. In this way, you can always tell right away if costs become too high. You can use sponsors to try to refinance a share of the costs. Think about the benefits which a possible partner could obtain. L ink your success measurement to your goal. For instance, sales should increase noticeably if it‘s a sales campaign. In an image campaign, on the other hand, the willingness to recommend you should rise.
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An image and its history
Little Franz and his fertile feet Those who go to Franzensbad cannot get past him. It‘s little Franzl, also called Frantichek. But one thing at a time. Franzensbad is a spa town near the southern edge of the Kaiserswald which was founded as early as 1793 by Emperor Franz II in Czechnyan Bohemia. Numerous parks in the English style surround the city core, lending it the flair of a traditional cultural and garden city. However, the story of Franzensbad began long before its founding as a spa city. The central focus was always the water from the Schlada spring as well as the surrounding moor areas. German physician and mineralogist Georgius Agricola (1494–1555) already recognised the healing effects of the water, which is available to guests at the drinking fountain. Healing effects are ascribed to the drinking treatments in Franzensbad for cardiovascular disorders, but particularly for women‘s disorders and infertility. And this is where little Franz comes into play. He is a bronze figure: A small, naked boy sits on a sphere and presses a large fish against his body with bare hands. The fish is of symbolic power, since fish populate the depths of the oceans. Many cultures therefore see them as embodiments of living content from the depths of personalities, which are associated with fertility and the lifegiving forces of the inner “mother worlds“. Accordingly, Franzensbad legend states: Women who stay for a spa treatment and touch the big toe on little Franz‘s left foot then become pregnant and give birth to a son after nine months. A lovely legend! Even to the present day, one can see female spa guests strolling about, staying by the figure, then - following the legend - touch little Franzl‘s foot. There must have been many over the years who trusted the child-bringing attribute of the statue. One can see it by Franzl‘s feet which shine brightly in the sun - polished by the many touches.
The easily visible, shiny copper polish on the statue‘s feet is no accident. The legend states: Those who touch it here will soon look forward to a child.
u. We are there for yo FOLLOW US!
10. Oct.–11. Oct. FUSS 2014 Forum for Podology and Foot Care Kassel 25. Oct.–26. Oct. BEAUTY FORUM Munich
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15. Nov.–16. Nov. COSMETICA Berlin
