18 October 2022
Visit our eLearning platform this month where our Spotlight is on foot and ankle. We speak to Dr Heidi Siddle, Associate Professor at the University of Leeds and Consultant Podiatrist at Leeds Teaching Hospitals NHS Trust, about her career in podiatry.
Why did you choose podiatry?
I fell into it! Podiatry wasn’t my first choice of degree and once I’d completed it, I still wasn’t sure whether I wanted to pursue it as a career. I went off to work for a car leasing company for a while, then I realised I did want to give podiatry a go. I did a couple of roles in community settings in Sheffield and Wakefield, but I discovered I really wanted to work in the acute sector.
How did you get into rheumatology?
From the community, I took a role at Leeds Teaching Hospitals NHS Trust to help develop a podiatry service in rheumatology. Rheumatology wasn’t covered much in my podiatry training; we’d only had one lecture in our third year.
I soon realised this was an area that was different from the podiatry I’d known where I could use a spectrum of my skills. From musculoskeletal assessment and assessment of people's biomechanics, right through to high-risk acute wound care in connective tissue disease patients, it was fascinating. In 2002, I got a new senior post in rheumatology podiatry, working with the rheumatology team full-time, and it’s evolved over the years.
How did you first get into research?
I spent a couple of years supporting Professor Jim Woodburn, Professor Anthony Redmond and, Professor Philip Helliwell with recruitment to foot studies in Leeds. I spent half my time working in research, and the other half maintaining my clinical role.
Although I undertook a Master’s degree during this time, I wasn’t convinced about doing any further academic work. When I went back into my full-time clinical role, I realised I had a lot of questions that I wanted to answer myself. In 2007 I embarked on a PhD and have continued in a joint clinical and academic role ever since.
What was your PhD in?
I specifically worked with people with rheumatoid arthritis to better understand how people develop the well-known ‘walking on pebbles’ sensation. I used MRI and ultrasound to look at structures around the MTP joints to identify sites of inflammation and bone and soft tissue changes.
What kind of patients benefit most from podiatry input?
Podiatry is most effective for patients that report that they feel much better when their systemic disease has improved with medication, but symptoms persist in their feet. If someone is having a general flare, you may have to wait until that settles down, but we can offer some general advice about footwear, exercises, and foot care.
Typically, our role is about trying to work out whether the problem is caused by mechanical changes or inflammation, or both; it can be difficult to differentiate but podiatrists have the skills to do that.
What training would you recommend for new podiatrists looking to establish themselves in rheumatology?
Podiatrists who come out of training now have a much better understanding of rheumatology conditions than we did twenty years ago. But courses such as BSR’s foot and ankle course, and those from EULAR, can give you a much deeper understanding of the disease processes and the changes that occur in the feet.
To learn more about treating feet and ankles, please visit our eLearning Spotlight which includes the chance to hear more from Heidi in a webinar (along with Professor Philip Helliwell), a podcast, links to journal articles, and an eLearning case to test your knowledge.