CORONA VIRUS UPDATE

7 Day Lockdown commencing 11:59pm Sunday 19th September 2021

In this current Lockdown our permitted scope of practice has been further restricted to “Urgent Clinical Care”.

The Australian Podiatry Association has provided the following guidance:

Podiatrists must use telehealth for where possible and only treat face-to-face if providing urgent clinical care that cannot be delayed.
The definition of urgent clinical care for this purpose is:
Direct clinical care (and other clinical support activity necessary to support direct clinical care) that prevents a significant change or deterioration in functional independence necessitating escalation of care, OR is required as an adjunct to other urgent medical/surgical interventions. For example, urgent clinical care;
that avoids a potential hospital admission or emergency department presentation
that prevents/delays the need for further specialist medical or surgical intervention
that prevents an increase in care needs that would necessitate additional carer supports or change in accommodation needs
that limits secondary complications post-surgery
where deferral would lead to long term adverse consequences (ie. delays to child development)

In the Clinic

At Total Care Podiatry we are continually updating our response to the COVID-19 virus.

In line with the recommendations of the Victorian Health and Human Services we have implemented a COVID Safe Plan for Total Care Podiatry.

PLEASE GET TESTED if you have any cold/flu like symptoms, have had any contact with a person suspected of having or with COVID-19  or have attended any of the exposure sites listed by Victorian Health and Human Services. Call 5223 1531 to reschedule your appointment or call to arrange a Telehealth appointment. We’d love to see you when you’re well again!

For the most up to date alerts and information please check the Victorian Government COVID-19 pages:

COVIDSafe Settings

https://www.dhhs.vic.gov.au/coronavirus

When you arrive in the clinic please register using the QR code on the external doors or in the waiting area. If you are not able to use the QR code please advise the receptionist so your arrival can be recorded manually.

Under the Victorian COVIDSafe guidelines you are required to wear a face mask at all times in the clinic. When you arrive please make use of the hand sanitiser provided. You may also wash your hands in the patient bathroom. The chairs in the waiting room have the required space between them, however for two or members of the same family,  we have opened the running lab/multipurpose room as an additional family waiting area.

For the safety of our staff please stay behind the taped line on the floor in front of the reception desk. You will also see that we have installed perspex safety screens.

Hours

Our normal operating hours have now resumed Monday – Friday, including our fortnightly late clinic on alternate Tuesdays until 7:30pm.

Paediatric Clinic

The monthly paediatric clinic for Kids+ has now resumed, however we ask that only one parent/carer attends the clinic with only the child who is booked to be seen.   This will ensure we don’t have too many people in the clinic at the same time.

Same Day Orthotics

If your condition requires custom orthotics we are now able to offer a same day orthotic service as we have an in-house milling lab.  There is no extra charge for this service. The service includes:

  • Comprehensive Initial Musculoskeletal consultation
  • Plantar pressure and video gait analysis
  • 3D and 2D scanning of feet
  • Custom prescribed orthotics CADCam designed and milled

If you would like to use this offer please mention it when you call  on 5223 1531 to book.

TeleHealth

Total Care Podiatry now has two ‘TELEHEALTH’ options if you are unable to leave your home:

  1. Complimentary TeleHealth Advice. This service is about 10 minutes to answer general questions and provide you with advice. It is particularly good if you are a New Patient who needs some help to manage until you’re able to attend the clinic.
  2. TeleHealth Consultation. For existing patients who are unable to attend the clinic. Our podiatrists will be able to provide online:
  • a video conference for you to explain your concerns and receive clinical advice,  and, if required
  • an exercise and rehabilitation program of video demonstrations within the Physitrack App.

This will enable us to adjust your treatment plan from the comfort of your own home.

The billing for TeleHealth appointments will be the same as usual for NDIS and Veterans. For patients with a Chronic Diseases Management plan (for Medicare rebates) we are able to bulk bill with a new Item number provided by Medicare. For private patients the Fee is $30. Some health funds are providing a rebate for TeleHealth consultations. Check with your Health Fund.

If you’re not sure about whether TeleHealth is right for you please give us a call  on 5223 1531 to discuss your situation.

In times of Lockdown

During a Lockdown period Total Care Podiatry will still be open, however, our scope of service and our opening hours will be reduced.

Every patient with an existing appointment during the Lockdown period will be contacted to advise you that we  need to discuss your care needs before confirming your appointment. Under government legislation, we will be providing the permitted level of care to maintain your mobility and avoid the need for further treatment or an escalation of your podiatry care needs to ensure ongoing improvement and preventing conditions getting worse.

Updated 19th September 2021

BOOMERS NOT BACKING DOWN FROM FOOT & ANKLE PAIN

Boomers not backing down from Foot & Ankle Pain!

Foot problems in older people can have a hugely detrimental impact on a person’s independence and quality of life. There is a vast range of musculoskeletal, dermatological, vascular and neurological conditions that can cause pain in ageing feet. 

Remember, our feet have carried us for so many years and never really get a break! So, it is helpful to be aware of common foot conditions in older feet and how to best care for your feet, so that you can stay as mobile and independent as possible for longer. 

Some research conducted in aged care facilities has found that corns, bunions at the big toe joint & callouses were the main cause of concern for older people- you are not alone!

Toe Deformities

Secondarily, toe deformities developed over a lifetime can be a major cause of discomfort as they create pressure areas to the tips of the toes or joint prominences, which can further increase risk of corn development, ulceration for those with high risk feet; or the exacerbation of the toe deformity if footwear is not addressed properly.

There are three main types of toe deformities at the lesser digits, claw, mallet and hammer toes as seen below: 

Podiatric Surgery

At the big toe joint, Hallux Abducto Valgus (HAV) is the most common deformity of the big toe joint. Also known commonly as a bunion, it is a misalignment of the 1st metatarsal (long bone that adjoins to your big toe) and the big toe itself. Contrary to popular belief, a bunion is not a growth on the side of the foot. 

For all digital deformities, there are treatment options available! See your Podiatrist for an Initial assessment to determine if offloading devices, padding, splints or a combination treatment may be helpful in reducing the pressure experienced at your feet due to structural changes to the toes. First step-get a shoe that is wide fitting (if you have a bunion) or has a deep, roomy toe box (if you have any other toe deformities). 

Nail Changes

Nail growth can differ as we age. The nails can become brittle and thin, but more commonly the nails become thickened which can cause pain. Nails can also become thickened due to various toe deformities, trauma (whether an acute incident like dropping an object to the toe, or repeated trauma to the nail over time), fungal infection, genetic causes and commonly callous growth underneath a nail; all of these in addition to age. 

Did you know, your Podiatrist has a mechanical nail file that can buff down a thick nail to half its thickness and smooth out any ridges? See us for a general care appointment and we can address thickened nails. 

Skin Changes

With age, it is well known the skin becomes drier and more fragile as well as one layer of our skin thinning out, giving the appearance of atrophy to the soft tissues of the foot. These changes to skin integrity promote the risk of skin breakdown, pressure and soreness to the soles of the feet. 

Vascular Changes

Hot or cold feet at different times of the day? Your Podiatrist can undertake a Doppler assessment (Ultrasound) of the two main arteries that supply blood to the feet, to determine if you have any diminishment to your vascular supply that could be related to temperature symptoms or colour changes in your feet. It is important to notice changes to the feet like temperature, colour, nail growth, hair growth or varicosities as you get older as they may be an indication of reduced blood supply to the feet; which if you have, can impair or slow healing if you are to encounter an injury to the foot. At Total Care Podiatry, we believe in a holistic and multidisciplinary approach to healthcare, especially in the care of older patients and vascular conditions of the feet which are very important to be aware of. We will communicate with your GP regularly when we see you so your progress is understood. 

Musculoskeletal Changes

Osteoarthritis and Rheumatoid Arthritis are more prevalent in the ageing population, and these degenerative joint changes are a common cause of foot pain related to loss or inflammation to the cartilage lining the joints -the protective soft tissue allowing smooth uninterrupted joint movement. 

Muscle weakness as well as foot problems are factors that are largely involved in falls risk for our older population. With muscle weakness, an individual’s balance is affected which increases the risk of a fall. At Total Care Podiatry we appreciate that balance is a core component of one’s gait and enables greater mobility, so we run a Balance Clinic that is able to assess your risk of falls. 

This blog is merely a summary of common conditions encountered as our feet get older as we grow too! If you have any concerns at all about your foot or lower limb health even if different to those aforementioned, please book your initial appointment to see one of our friendly Podiatrists. We are here to help you prevent foot and ankle pain and want to help you stay active!

If you are experiencing pain or discomfort, please call us today for an appointment on 5223 1531

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.

TENNIS INJURIES

Tennis Injuries

 

Lateral Ankle Sprains

Tennis is a multidirectional sport that comes with a great degree of lateral moment, specifically as the athlete’s eyes are on the ball and often not watching their foot placement. The running, jumping and landing involved (even when serving the ball) in tennis can result in landing incorrectly turning the ankle over. It is good to be mindful that clay courts are slippery but also soft, so the lateral aspect of the foot can dig into the ground upon landing, inverting the foot and significantly increase the risk of an ankle sprain. 

Tennis Toe ie Subungual Haematoma

Tennis toe is caused by repeated pressure or injury to the toenail causing pooling of blood under the nail. A Subungual Haematoma is common in tennis as the big toe especially is used to drag on the ground during a serve or play, as well as the “stop and start” nature of the game, causing the toe to glide towards and hit the end of the shoe. Often however this injury is primarily caused by shoes that are too short, or narrow at the toebox, so make sure you get fitted professionally into tennis shoes as well as keeping the toenail clipped short to avoid this issue. If your big toe goes “up at the end” and commonly hits the top of your shoe, come into the clinic for a Musculoskeletal assessment to look at options to reduce the hyperextension of the big toe joint. 

Sesamoiditis

The sesamoids are two small spherical bones underneath the base of your big toe, encased by the big toe’s flexor tendons that stabilized the big toe joint when flexed. Tennis players spend a lot of time on the toes to be ready to move quickly in response to game play quickly as well as landing on the toes a lot which places the joint in a flexed position under a lot of body weight. Repeated strain to the big toe joint in this position can cause the Sesamoid bones to be inflamed and in serious cases, fracture. 

Plantar Fasciitis or Plantar Heel Pain

Tennis is a sport played on hard surfaces in firm shoes. Although there are many Biomechanical factors that more commonly predispose someone to have Plantar Fasciitis, ie the inflammation of the long fascia band (a crucial tissue in the foot that is similar to muscle tissue) that connects at the heel, hard surfaces can contribute to symptoms if there is an existing heel pain caused by Plantar Fasciitis. It is important to see your Podiatrist to get these contributing factors addressed as this condition can become quite recalcitrant if left untreated. 

Peroneal Tendinopathy

The Peroneal musculature involves 3 muscle tendons running to the outside of foot, which when inflamed through Tendinopathy cause pain commonly to the lower lateral ankle but mostly to the lateral border of the foot. The Peroneal muscle group’s role is to evert or pronate the foot, and is often active as a reaction during an ankle sprain or excessive lateral load to take the foot out of the “rolled” or vulnerable position by rolling the foot in. In tennis, players have to rely on loading the lateral foot in change of direction, which can create overuse to the Peroneals and eventuate in injury over time. 

Achilles Tendinopathy 

A common overuse injury caused by microtrauma to the tendon described as pain, swelling and stiffness to the tendon either at its join at the back of the heel or towards the calf region. Achilles Tendinopathy is prevalent in tennis due to the major loads placed on the calf muscle in short bursts of movement (deceleration and acceleration) in game play and during hitting a forehand or a backhand by use of an open stance, which places a majority of the stress on the calf during the backswing. In serving, stress is also placed on the calf and achilles during a ball toss. It is important to rehabilitate this condition before continuing to play, as if the tendon is inflamed in some cases it can rupture or tear without intervention if repeated microtrauma is sufficient enough. 

Cramping

Muscle cramping, commonly in the calf or sole of the foot, occurs when there is a reduced blood supply to the area and in tennis is often due to an increased loss of bodily fluids due to sweating in exercise. 

Muscle cramps can be quite debilitating and frustrating, preventing a player from continuing in a match or reducing movement.

Preventing cramping 

Ensure cool clothes to reduce body temperature, drink electrolytes, ensure good training and strength and conditioning incorporated into training and prepare for long matches. 

Blisters

The main cause of blisters in tennis is a combination of friction and shear. In tennis due to the combination of both running and pivoting on the feet, the skin is pulled in different directions, and this is known as “shear” force. 

Preventing blisters

A tight fitting anatomical sock is best to reduce the likelihood of skin movement. Moisture wicking fibres are also helpful as the skin is more likely to break down into a blister when the foot is sweating. 

Injury Prevention Tips

Warm Up

Warming up especially before competitive tennis is crucial to prepare the body for the more strenuous nature and demands of competitive play. Tennis is a game that although has times of rest between points, is no less difficult and can be very gruelling and harsh on the body in longer game times! 

Shoes

Injury prevention? This is where appropriate shoes come into play. For tennis, if you are training once a week or more or playing matches or competitively at all you should definitely be wearing a shoe that is appropriate for the sport-a tennis specific shoe. Tennis shoes are categorised often into hard court, clay shoes or grass shoes. 

Tennis shoes are structured to provide: 

  • Rigidity to the midfoot and heel of the shoe to reduce the likelihood of unwanted torsion (rotation) through the foot, thus enhancing stability of the ankle in comparison to a pair of runners.
  • Allowance for lateral movements (side to side movement)
  • Panelling in the upper material that is more rigid around heel and midfoot to secure the ankle in place better
  • A toe guard at the toe box to protect the mesh upper from getting damaged during a drag/slide or toe pressure from inside the shoe. 
  • A hard court shoe is heavier, giving the shoe’s outsole durability and cushioning for hours on the more unforgiving surface
  • A herringbone or Entecar sole allows for the best grip on your surface whilst allowing a slide/drag if needed on a clay/Entecar court. 

Surfaces

  • If you can play on Clay or Grass, this is ideal for prevention of stress related or joint injuries as the surface is much softer and easier on the joints and feet!
  • However, if you are prone to ankle sprains, for example, a hard tennis court is better in assisting you to grip your surface better compared to the more slippery nature of a clay or grass surface.
  • Before starting to compete or play matches, make sure you are familiar with the court surface you will be competing on. 

Blisters

  • Check your feet for bony protrusions
  • Shake your shoes out especially after play on clay to avoid debris causing pressure areas on the feet during play
  • Lace up your shoes just right
  • Wear in new shoes gradually-ie walk around in your new tennis shoes first, then train in them, before playing a match

If you play tennis and have any injury even if experiencing different symptoms to the above common conditions, please book in with one of our Podiatrists for a Musculoskeletal assessment where we will form a comprehensive treatment plan so you can get back to the court as soon as possible!

If you are experiencing pain or discomfort, please call us today for an appointment on 5223 1531

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.

SOCCER INJURIES

SOCCER INJURIES

Developmental/Youth

Calcaneal Apophysitis (Sever’s)
In young children aged 8-14 years old, commonly boys, the heel bone goes through a growth
phase which can include significant inflammation to its growth plate. When a child is more
active, particularly if wearing hard shoes such as football boots this condition may be further
aggravated because of the firmness of the heel counter on a boot.

Osgood Schlatter’s Disease
A childhood overuse injury also commonly coinciding with growth phases/growth spurts that causes a painful lump below the kneecap due to the pull of the quadriceps muscle at its insertion. This knee injury is common in sports like soccer.

Acute

Ankle Sprains
Soccer players are one of the most common athletes to experience ankle sprains (medial or
lateral) due to the multiple direction changes required in their play, including jumping and
landing (often in an uneven manner or in physical contact with other players), planting, pivoting, turning and stepping. The simple technique of kicking the ball involves external rotation of the foot (abduction) and lateral loading (inverting) of the foot. Any inversion of the foot places the foot at risk of an inverted/lateral ankle sprain ie “common ankle roll”. The lateral ankle sprain is the second most common Soccer injury. This can damage ligaments on the outside of the ankle and sideline a player for many weeks. Contrastingly any pivoting, contest or aspects of the game like jumping can result in a less common excessive eversion causing an everted ankle sprain (medial ankle sprain).
Contusions and bone bruises often result from high impact contact with other players such as in slide tackling, or having the toe box of your boot stepped on resulting in a very sore toe! It is helpful to be aware of the difference in pain levels between a contusion or bony bruise as opposed to a structural or soft tissue injury. In an acute impact, usually if an injury is more significant it is noticed straight away and is of a higher severity than the ache caused by a bruise that develops much later hours to days after an impact that is less painful in its initial incident.

Stress Fracture
Also seen as an overuse injury for athletes frequently training under high activity loads, common stress fractures for soccer player (ie partial breaks to bones) occur at the second and fifth metatarsals, tibia (medial malleolus), and fibula (lateral malleolus).

Overuse 

Calf strain, pull or tear

In soccer there is great susceptibility to muscle strains particularly to the calf due to the often
explosive changes in direction, high running load and rapid acceleration and deceleration involved in the sport, as well as towards the end of a game (fatiguing conditions) placing a great load on the calf muscle. The calf muscle, aka Triceps Surae is made up of the two headed Gastocnemius (upper calf portion) Soleus (lower/mid calf portion) and Plantaris muscle. Soleus strains are often  lateral.

Gastrocnemius strains are often medial. The Gastrocnemius medial head is most prone to a tear.
Calf strains are graded 1-3, with a grade 3 tear the most painful resulting in inability to contract the calf and a much longer recovery time. This injury can best be prevented by an assessment of calf strength, function, ankle joint mobility and other examinations by your Podiatrist to determine if preventative treatment is necessary.

Achilles Tendonitis/Tendinopathy

Soccer requires a lot of plyometric force through the back of the calf, from the power required
for short bursts and sprint work, to jumping for a header. Sometimes, if you are in a very flat
soled boot with minimal heel height; all the motion above can place a strain on your achilles.
Over time, if training loads are not carefully managed, the Achilles tendon can experience wear
and tear and can become inflamed either at its mid portion or at its end where it inserts to the
bone. In the instance of an acute injury to the Achilles, this tendon can rupture if an incident of
high plyometric load is instigated in an unstable position. This injury often occurs with a “pop”
sound.

Knee Meniscus injury or tear
Repeated lateral or forceful movement involving the knee joint can place the knee at a high risk
of damage or tear to the meniscus, a spongy triangle shaped wedge of cartilage that acts as
your knee’s natural shock absorber. Although commonly an injury that occurs as a result of
degeneration from overuse (ie many years of soccer), an acute meniscus tear can occur as a
result of excessive twisting of the knee whilst in a flexed position (ie tackling or changing
direction).

Turf Toe
A strain of the ligaments surrounding the big toe can be caused by the frequent tackling, planting and stopping of the foot, toe-first into ground.

Medial Tibial Stress Syndrome (MTSS)/(Shin Splints)
Pain is felt in the lower ⅓ of the inside of the shin (ie not the front of the shin lower to the knee-this is a different issue). MTSS is a common injury related to running or plyometric activity overload ie overtraining, or a rapid change to training type or intensity. Many factors are involved in the cause of this condition, which you should discuss with your Podiatrist if you are concerned you have MTSS.

Subungual Haematoma (Ie bruise under toenail) 
If soccer boots are too small or a player is repeatedly jamming the top of the toes (commonly
big toe) into the end or top of their boot during contest, the nail bed underneath a toenail can
bleed due to the excessive pressure and cause pain.

Blisters
Poorly fitted soccer boots or playing on a wet field in winter can cause blisters to the feet. See
your Podiatrist at Total Care for blister prevention tips and the best type of socks to wear on
field!

One key aspect of any Soccer player’s training to protect the foot and lower limb from injury
should place focus on balance and proprioceptive work to ensure the best possible strength for
single leg weight-bearing.

Other tips include:
 Warming up thoroughly before training or play

 Ensure to always wear protective shin pads, try a thicker sock, and make sure boots are
comfortable and fit well

 Do a pre play field check for anything like uneven ground, debris, stones or puddles!

 Allow sufficient time off field and off training when you have had an injury, avoiding
rushing back into your original training load as this can enhance re-injury risk.

Feel free to book into the clinic with one of our Podiatrists for an injury risk assessment. If you
have had an injury in your sport, come and see us for your rehabilitation program so you can get back to the field as soon as possible!

If you are experiencing pain or discomfort, please call us today for an appointment on 5223 1531

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.

ANKLE PAIN ~ Check out our latest blog for more information!

ANKLE PAIN

Ankle pain is a common source of foot pain that can be as a result of an acute, one-off trauma injury to the ankle, repeated injury and overuse to the ankle joint and its surrounding anatomy, or also from degenerative changes to the ankle over time. However, there are other reasons as to why you may be suffering from ankle pain.

 

Ankle pain can also be in different regions of the ankle due to the number of bones that form the ankle joint.

 

The ankle joint is also known as the Talocrural Joint; formed by the connection between the Fibula (outside leg bone), Tibia (inside leg bone/shin bone), and Talus, a small bone that sits in the mortise shaped socket formed by the Fibula and Tibia. The end of the Tibia (your “inside ankle bone”) is called the Medial Malleolus, the end of the Fibula (your “outside ankle bone”) is called the Lateral Malleolus. The most common fracture to either of these bones is a lateral malleolus fracture.

 

 

General Ankle Joint pain

à Generalised, non localised pain to the whole ankle joint

 

Common Diagnoses

  • Osteoarthritis: Cartilage degeneration
  • Rheumatoid Arthritis : Inflammation to joint lining causing cartilage degeneration
  • An arthritic joint is frequently noticed by stiffness to the joint

 

Ankle pain

 

Lateral Ankle pain

à Pain on the outer side of your ankle

Commonly caused by an acute incident, but can be of gradual nature

 

Common Diagnoses

  • Ligament injuries (tear or rupture) : Anterior Talofibular (ATFL), Calcaneofibular (CFL), Posterior talofibular (PTFL)
  • High Ankle Sprain aka Syndesmosis Injury: Ligament injury to Distal Tibiofibular Ligament (ligament connecting your main leg bone/shin bone, to your outer leg bone)
  • Peroneal Tendinopathy/Tendinitis
  • Peroneal Subluxation/Dislocation
  • Fracture : Cuboid, 5th metatarsal “Jones” fracture or Lateral Malleolusankle lateral ligaments trauma pain location lateral inversion trauma inversion

 

Medial Ankle pain

à Pain on the inner side of your ankle

Usually due to overuse, ie “wear and tear”

 

Common Diagnoses

  • Tarsal Tunnel Syndrome or Medial Calcaneal Nerve Entrapment
  • Tibialis Posterior Tendinopathy
  • Ligament injury: Deltoid ligament
  • Flexor hallucis longus tendinopathy

Photo: Location of Tibialis Posterior Syndrome

Anterior Ankle Pain

–>Pain on the top of the foot at the front of your ankle joint

 

Common Diagnoses

  • Anterior Ankle Impingement

-Often due to Bone Spur formation

-Common in Soccer players or Dancers

-Often intense, sharp pain

  • Osteochondral lesion at Talar Dome
  • Tibialis Anterior Tendinopathy/Tendinitis
  • Extensor Retinaculum restriction/injury

Location of Pain in Anterior Ankle Impingement

 

The above information is informative only, see your Podiatrist for a detailed examination to determine what may be the cause of your ankle pain or injury, to diagnose correctly and form a comprehensive treatment plan to get you back and moving!

If you are experiencing pain or discomfort, please call us today for an appointment on 5223 1531

 

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.

*Sources

https://orthopaedia.com/page/Anatomy-of-the-Foot-Ankle

https://www.completepaincare.com/patient-education/conditions-treated/ankle-pain/

https://www.physiocheck.co.uk/condition/4/lateral-ankle-ligament-injury

https://www.physioroom.com/injuries/ankle_and_foot/tibialis_posterior_syndrome_full.php

MUSCULOSKELETAL CHANGES TO THE FEET IN MENOPAUSE

Musculoskeletal Changes to the feet in Menopause

The following are just some of the common difficulties in Menopause that may affect joint and soft tissue injury in women, due to a reduction in Oestrogen levels. 

Collagen reduction

When hormone levels drop during menopause, the production of collagen slows. Collagen is a blend of elastic tissue that’s a very important ingredient that enables the supporting structures of the feet to stay strong. When collagen is reduced our ligaments that connect our joints and engage muscle function, and our fascia, can become strained more easily and more prone to injury. An example of an injury that relates to this scenario is Plantar Fasciitis, pain at the heel that sometimes extends into the arch due to the elasticity of the fascia being reduced sometimes from lack of collagen. 

Increase in body weight

Unfortunately it has become well known that women in their 50s and 60s can be prone to an increase in body weight depending of course on many genetic and lifestyle factors. An increase in body mass increases the strain on joints and soft tissues of the foot which can eventuate to injury risk due to tissue stress and can also generally increase pressure to the foot. With a lifetime of wear and tear most feet will have some existing biomechanical factors that predispose these risks, and unfortunately weight gain is common and can exacerbate the above potential for injury. The key in treatment of a foot that is suffering under a recent weight gain is to redistribute and share pressure around the foot to ease strain on vulnerable areas and there are many ways this can be done. Feel free to talk to your Podiatrist about your concerns and we can get you back on your feet in no time! 

Fatty pad displacement

Did you know? In our feet we have a natural fat layer that runs throughout the sole of the foot. This fat layer known as “fat pads” provides the feet with natural shock absorption. However, it is a common feature in Menopausal women that the fatty pads dissipate or are displaced slightly, so they no longer apply their cushioning effect to the balls of the foot or areas of the foot where there are bony prominences that need that impact absorption! Having cushioned shoes (wearing runners is great) or cushioned liners (the best are made of a special ingredient called Poron) helps to sooth this issue. Choosing soft surfaces also may help when you are active, and avoiding being barefoot around the house too much. 

But if you are having ball of the foot or heel pain, consult your Podiatrist for a comprehensive examination as fat pad reduction may well not be the predominant issue. 

Reduced bone density

Sometimes, unfortunately Oestrogen reduction can precede a higher risk of bone density problems such as Osteopoenia and Osteoporosis. Especially if you are active, it is important to be aware of this risk so that no acute bone stress reactions or fractures are encountered due to the loads of activity being too high for a reduced bone density to cope with. 

If you are experiencing pain or discomfort, please call us today for an appointment on 5223 1531

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.

 

Our next Complimentary Paediatric Clinic will be held on Wednesday the 28th of July 2021

Complimentary Paediatric Clinic 

Every month at Total Care Podiatry we run a complimentary morning clinic to support the little feet that run around our community. We run short appointments designed to be a screening check of any areas of concern you may have for your child’s feet. 

Commonly we check for: 

  • ‘Tired legs’
  • Being clumsy
  • Walking ‘pigeon-toed’
  • Curly toes
  • ‘Flat feet’

Following a short appointment, we can provide some advice for next steps forward. These may include a more in depth follow up appointment, footwear recommendations or activity changes.

Bookings are essential – please phone our friendly staff on 5223 1531 to secure your free paediatric appoint today

THE EFFECTS OF MENOPAUSE ON THE FEET

The Effects of Menopause on the Feet

As we know, predominantly the function of Menopause in women is to reduce oestrogen levels. Menopause and particularly the decline in Oestrogen hormone levels does promote a few effects on the feet that you may not know! It helps to have consolation that you are not alone if you are starting to see some uncomfortable changes to your feet, many women out there suffer a range of effects, of which the following are merely a summary of common foot changes. 

Decline in Oestrogen can cause:

General Changes to the feet

Reduction in ability for skin to retain moisture

When the feet lose their ability to retain moisture in the skin layers, skin obviously becomes drier. However, when skin becomes drier it is more likely for callouses to form. Callous, also known as Hyperkeratosis (as it sounds literally- hyper production of keratin cells) is a lesion of hardened dead skin cells pushed to the outer layer of skin, forming a thickening in areas of the foot prone to pressure due to an over production of keratin. This is a protective mechanism of the skin! So if you have callous, that may not be the root cause of pressure to that area of the foot. 

If you are concerned about your skin getting drier or pressure or callous areas and are looking for advice, we have our Free Family Foot Check clinic day this Friday July 9th, contact our clinic to make a booking!

Reduction in foot temperature at the extremities

Menopause is also commonly known to cause symptoms of cold feet! The key to keep your feet warm through a chilly coastal winter is to ensure a woolen sock or woolen blend for maximum insulation and get any concerns about circulation addressed. 

Water retention

Although not a prevalent and obvious feature of menopause, water retention due to hormonal changes can cause swelling of the feet. So don’t be too alarmed if this happens as it can simply be a Menopausal feature as opposed to a more serious issue with your vascular circulation. If the swelling is persistent or presents with pain however, consult your doctors and Podiatrist for further assessment. 

If you are experiencing pain or discomfort, please call us today for an appointment on 5223 1531

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.

CHILDHOOD OBESITY LINKED TO FOOT PAIN

Childhood Obesity linked to Foot Pain

Did you know? Our body weight, if not evenly distributed through our skeleton by the help of normal alignment, can result in changes in the way the foot reacts to the forces acting on the foot from the ground up. The higher the BMI (Body Mass Index) of an individual, the more difficult the role of the foot to evenly distribute pressure, hence some areas of the foot and lower limb can be exposed to greater amounts of pressure and thus be prone to injury or tissue stress.

In the growing foot, the above scenario exacerbates. Growth in children’s feet involves fragility of the tissues as they develop. For example, the heel bone of a 14 year old child who is of a BMI within a normal range is still developing and already potentially under stress. When we look at a child of the same age who is obese, this heel bone under a greater amount of body weight will be unable to cope with the normal stresses of growth and development and be more likely to injure, sometimes even a heel stress fracture can occur. 

If a child with obesity is exposed to a foot problem or pain, this will render them less active which can impair physical fitness that is even more important in a child suffering from problems with their weight in their development. 

Mythbusting- are flat feet the problem?

High validity evidence from recent research has found no significant relationship between a flatter foot type and foot pain  in obese children however they did find a high prevalence between children with obesity and having a “flat foot”. From this we can infer that in overweight or obese children although foot problems or pain may not be due to a flat foot, the presence of a flat foot may suggest other biomechanical faults that could be the root cause of the presenting pain. 

This is because we know the foot pronates most often to compensate for other asymmetries or faults in the body which are sometimes in the upper chain. 

So, what effect does Obesity in a child have specifically on the feet?

However, research has found that obesity in children does specifically impact on the foot’s arch by creating disproportionate loading and increased loading particularly affecting the medial longitudinal arch and midfoot. This can mean that regardless of the arch being flatter or not in an overweight child, regardless, the arch will be strained more.  Plantar Fascial heel & arch pain is a common foot condition for children although less common than in adults. 

One contributing factor to excessive strain on the plantar fascia can be a flatter foot type as the arch band of the plantar fascia stretches more in movement. 

Think your child has a foot problem? See our friendly Podiatrists for our monthly free Paediatric foot check and screening held on a Wednesday each month. Contact our helpful Reception team for details, you can also get a referral from your Paediatric nurse. PH: 52231531

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.
Link to research: doi: 10.1371/journal.pone.0149924
Link to research: doi: 10.1111/cob.12091

FIVE SIGNS YOUR CHILD MAY HAVE A FOOT PROBLEM

Five Signs your Child may have a Foot Problem

 

In-toeing or tripping

Usually, sometimes thought of as the internal rotation of the foot but formally known as Metatarsus Adductus, Metatarsus Adductus is usually picked from birth at the very latest into the first year of growth but if left undetected may be a cause of in-toeing along with other things like an Internal Genicular (Knee) Position, Internal Tibial Torsion or Femoral torsion from the hip. It is best to get these things checked from the age of birth to the age of 6 to ensure nothing that needs to be treated is left untreated. 

 

Limping, pain, or withdrawing from or lagging behind in activities

If your child complains of foot or lower leg pain that lasts longer than an initial trip or fall or a few days, you should get your child assessed. 

 

Growing pains

For some children, growing pains may be more abnormal and associated with a Hypermobility joint syndrome which is best understood early to prevent excessive strain, pain or injury as well as some abnormal foot structures that can be associated with more profound growing pains. 

 

Your child is lagging in developmental milestones or has awkward gait

Although these may be not associated directly with foot problems, children require a stable foundation from the feet to allow basic motor skills as early as birth to first steps. If your child has some abnormality in their foot structure or alignment as discussed above, some of these motor skill milestones may be delayed; if not due to other red flags such as potential neuromuscular conditions. It is great to see your Paediatric nurse or Podiatrist if you have concerns.  

 

Tip toe walking

It is normal in the first few years of growth for a child to walk on their tip toes as they become accustomed to the confidence of walking. However, beyond the age of 3 if this continues it can suggest the potential for tightness and pain through the calf muscles if not treated, issues with growth phases, or also the potential for a developmental or intellectual condition diagnosis.  

Think your child has a foot problem? See our friendly Podiatrists for our monthly free Paediatric foot check and screening held on a Wednesday each month. Contact our helpful Reception team for details, you can also get a referral from your Paediatric nurse. PH: 52231531

 

THIS INFORMATION IS FOR EDUCATIONAL PURPOSES ONLY AND IS NOT INTENDED TO REPLACE PROFESSIONAL PODIATRIC ADVICE. TREATMENT WILL VARY BETWEEN INDIVIDUALS DEPENDING UPON YOUR DIAGNOSIS AND PRESENTING COMPLAINT. AN ACCURATE DIAGNOSIS CAN ONLY BE MADE FOLLOWING PERSONAL CONSULTATION WITH A PODIATRIST.