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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

CHILDREN’S INJURED FEET

Children’s Injured Feet

Problems causing injury to paediatric feet are often correlated with the maturity level of bone development and can be categorized based on the age of your child. 

The following may predispose a child to a gradually developed injury: 

  • Congenital anomalies
  • Variation in development
  • Bone maturation
  • Lower leg alignment 

… but otherwise, given the nature of children with high physical activity levels, acute injury to the foot can occur. 

What does pain/injury look like, sometimes if subtle in a child?

It is important to be aware of the difference in pain presentation between older and younger children. 

Toddlers and young children: a child may limp, tire easily or refuse to walk or weightbear due to pain or injury. 

Older children and adolescents: their ability to compensate or isolate the pain may be better so injuries may go along unnoticed for a longer period. 

Acute vs Developmental Injury

Acute injuries are more likely in children (the younger they are) to result in stress reactions or fractures to the bone and often at the growth plate, rather than ligamentous strain or injury due to the fact children are undergoing stages of bone maturation as they develop into early adolescence and have relatively stronger ligaments than adults. 

Growth Phases

If your child is noticeably fatiguing or lagging behind other children, it is important to get an understanding of what may be the cause, and a Podiatric initial assessment can be a great starting point, to rule out any biomechanical insufficiences or growth abnormalities that for any reason haven’t been picked up on.  

When children go through growth phases, muscles can become fatigued easily as they can tug at the ends of the bone as the bone lengthens and grows; resulting in discomfort and fatigue not unlike the traditionally known “growing pains”. 

Common Paediatric specific injuries to the foot include: 

Sever’s Disease (Apophysitis of insertion of Achilles tendon into Calcaneus/heel bone)Age: 7-14

-Commonly known as children’s heel pain-pain at the back of the heel towards the bottom, associated with children experiencing growth phases. 

Osgood Schlatter’s (Apophysitis of insertion of Patellar Ligament into Tibial tuberosity)

Age: Ages 10-14

-Painful lump growth just below the kneecap, associated with children experiencing growth phases but more common in children playing sports involving running and jumping. 

Juvenile Idiopathic Arthritis (JIA) 

Age: Anywhere from 6 months to 16 years of age

-Joint pain, stiffness and inflammation or region warmth most commonly affecting the Ankle Joint as well as other joints in the body. 

Osteochrondritis Dissecans (OCD)

Age: Children & Adolescents 

-Often affecting the ankle after an ankle sprain or injury where a reduction in blood supply to the bone region affected causes a small fracture. The fragment of bone may remain attached or become detached. 

Sesamoiditis or Sesamoid Pathology

-Pain under the ball of the big toe joint which can be due to inflammation of the two sesamoid bones (small pebble sized bones situated under the metatarsal head that allow the gliding effect of the tendon of the muscle that flexes the big toe downward). 

-A common sporting injury in young athletes who push off the ball of the foot such as in jumping sports, ballet or karate. 

A reminder, Total Care Podiatry has a monthly free Paediatric Screening clinic where your Podiatrist will run through a free assessment to check on developmental norms in your child. We ask that to book into this clinic, a small donation be made to Kids Plus foundation upon attending. Kids Plus offers programs that include early treatment and specific intervention strategies to improve children’s abilities across a range of developmental areas. 

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.

Some information from today’s blog obtained from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2323000/

ARE YOU READY FOR THE SURF COAST TREK?

Free Foot & Leg Assessment

Total Care Podiatry is offering Surf Coast trek participants a complimentary Foot and Leg Assessment.  This will take into account your individual requirements and help you work out a strategy to help your feet and legs stay the distance.

Call Total Care Podiatry on 5223 1531 to book in your Complimentary Foot & Leg Assessment.

Make sure you mention that you have registered for the Surf Coast Trek.

Preparing for a long distance walk

Getting your feet ready for a 40 km trek needs a lot of planning and preparation. You’re asking a lot of your poor feet pounding into the ground, and they’ll need some TLC to get you there.

Every individual’s body will respond differently so there’s no one solution that will suit everyone, especially in an endurance event lasting many hours like the Surfcoast Trek.

Just like your fitness, preparing your feet and legs has to start early, not the week before or the day before.

During the 40 km trek, your body will change in a number of ways to keep you going. The extent of the changes will very much rely on how you’ve trained your body prior to the event.

Here’s what will happen for most of us at the 20 to 30 km mark:

  • Muscles in our core and legs will tire and as a result our walking pattern will change, placing more pressure on our joints.
  • Feet may swell causing changes in how the foot fits into the shoe, causing pressure areas, and
  • The heels may start slipping up and down in the shoe as the calf muscles tighten, increasing the risk of blister formation.

Footwear

For endurance walking the shoes you wear will have a significant bearing on whether or not you enjoy the trek. The runners you use around the house or for activities such as walking around the block will probably not be appropriate.

  • Footwear should fit your foot comfortably, not too tight or loose.
  • The upper should be made of a material that will easily breathe and allow the perspiration that your feet generate evaporates into the environment rather than build-up heat in your foot.
  • The sole should not be too stiff or controlling and provide good cushioning.
  • The toe box, (the area of the shoe where your toes are), should be deep and rounded to accommodate any swelling.
  • No part of your foot should slip in the shoes, at any time.
  • It is best if the lace area is as long as possible so you can alter the fit around the heel from the midfoot and the forefoot. You may have to adjust the lacing a number of times during the walk, to make sure your foot is supported and any pressure areas lessened.
    For more information regarding lacing techniques look here: How to Lace a Hiking Boot

Blisters

Blisters are caused by friction, where the surface of the skin is held in one place and the tissues underneath the surface are stretched to the point of tearing. It is influenced by 3 things:

1. The nature of your skin

Our skin often has different qualities depending on age, sun exposure, gender, shoes we wear etc. Some people have firm strong and resilient skin. Others have tender, thin and easily affected skin. The latter type of skin can be toughened to cope and protected for the walk using a number of different taping techniques. Skin temperature also needs to be maintained so that the skin does not become overly sweaty and moist which increases the risk of blisters.

Socks that are designed to ‘wick moisture away’; that is take the moisture away from the skin out through the sock to the other side of the sock, is the best way of managing this.

2. How your foot works

Your foot has two main functions, it has to adapt the body above to the ground beneath, and then has to be stable enough for the body to move over a solid foundation. If these functions are not working properly areas of high pressure develop which can directly cause tissue injury. The most obvious is blisters but also stress fractures and indirectly, increased risk of ligament or tendon damage as muscles get tired; often seen in cases of rolled ankles. Research shows that cushioning insoles can address the direct high-pressure areas, but the reasons why the foot is not functioning properly, causing risk of injury, needs to be understood and then addressed appropriately.

3. The level of friction.

There are many ways people use to reduce friction. For most people the best strategy is wearing well fitted merino padded socks. These socks should have built in padding to assist with small pressure areas.  If you have bony feet, or a tendency for rubbing, wearing two pairs of socks can be the solution. If you often have blisters on or in between your toes, ‘toe socks’, worn under the padded merino socks, can be the answer.

A final note on blisters, if the top of the blister rubs off and you’re left with a red raw sore, a band-aid type of dressing is not a good option as it may cause more friction. Instead, compound dressings are good for this, as is some taping, so long as your skin is not sensitive to the adhesive.

We congratulate everyone who is taking on the Surf Coast trek for the challenge it provides as well as supporting a fantastic local charity which benefits our whole community. Total Care Podiatry is proud to support your effort with a Complimentary Foot & Leg Assessment.

WARNING: 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.

MARATHON RECOVERY

Recovery from any sporting event is critical to injury prevention and must be a component that should be planned into your training program. The main basic steps to follow in the first few days: 

On the day: 

  • Keep warm. Your body will cool down rapidly which is stressful to your cells, so have tracksuit pants and a jumper ready, and get your wet clothes off. 
  • Eat. Protein – bananas, energy bars, sporting drinks, fruit are all good options and will help with recovery. 
  • Ice bath. Later in the day when you get home an ice bath will help with muscular repair. 
  • Walk. A light walk in the evening before going to bed.

Day 1 – 3 of recovery: 

  • Warm bath followed by stretch.

  • Eat, and eat lots. Focus on carbs and protein to refuel.
  • Light massage – no deep tissue at this stage, it will be too much for muscle fibres.

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.

PROMPT EVALUATION AND TREATMENT WILL FACILITATE LONG LASTING BENEFITS

Prompt evaluation and treatment will facilitate long lasting benefits

‘Prevention is better than a cure’

When it comes to your health, the best outcomes are always achieved by being assessed early and undergoing appropriate treatment. This decreases the risk of the condition intensifying and allows the healing process to start.

Having an evaluation promptly will allow for more choice in treatment options and prevents the body from beginning mechanisms to compensate. When pain occurs, the body will compensate to offload the affected area. Although this may help reduce pain in the short term, this places considerable load into other areas or on other systems within the body.  

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.

INTRODUCING OUR NEWEST TEAM MEMBER ~ PODIATRIST CLEMENTINE SCHEFFERS

Clementine Scheffers

Clementine is a graduate of La Trobe University with a Bachelor of Applied Science and Masters of Podiatric Practice.
She is passionate about acute and chronic injury rehabilitation and sports injury management, given her love and passion for sport growing up, as well as managing a chronic injury herself. Clementine has a wealth of knowledge in all things running shoes and will be your go to for shoe advice!
In her spare time, Clementine enjoys listening to her favourite artists and keeping up with the latest music releases, walking her Wheaten Terrier Riley, staying active and spending time with her cousins in Torquay.

ACHILLES TENDINOPATHY – Who does it affect? Read our latest blog to find out more!

Achilles Tendinopathy

Tendinitis (inflammation), Tendinosis (degenerative) or Rupture

The Achilles tendon attaches the muscles of the calf to the calcaneus (heel bone). This tendon undergoes a lot of stress due to the amount of tension and forces it withstands. Over time, if the amount of stress to this tendon is too great, it may lead to an injury to the area and pain to develop. Most commonly, there will be a single event or injury that will cause the pain to start. 

Symptoms

  • May have started from an event/injury
  • Pain on movement or palpation
  • Swelling of the ankle
  • Bruising in the area

When injured, treatment of the Achilles tendon involves progressively loading the tissue as it best reacts to load. Repeated stimulation allows the tendon to properly heal and return to its ideal state

Treatment is tailored to each patient and their unique presentation

Treatment may include:

  • Surgery (if a rupture occurs)
  • Moonboot
  • Heel lifts
  • Exercise program
  • Activity modifications
  • THOR Laser
  • Taping
  • Orthotics
  • Footwear Recommendations
  • Activity Modification

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.

TOENAIL BRUISING AND INJURY

Toenail bruising and injury

Bruising of the toenails is very common. It can occur because of an injury (i.e. dropping something on it) or from repetitive stress to the area. This is frequently occurring in ballet dancers and football players due to the nature of their activities.

When to see a podiatrist?

–          If it causes any pain

–          If the nail breaks, thickens, cracks or lifts from the nail bed

–          If the bruising is not going away

–          If the bruising has defined borders or occurs in a strip

Depending on the presentation and cause for the changes to the nail, the podiatrist may:

–          Cut and file the nail

–          Monitor it for changes

–          Offload the area with paddings and/or orthotics

–          Provide footwear recommendations

–          Activity modifications

 

 

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.

 

BALL OF FOOT SORE? You may have Morton’s Neuroma

Neuroma

Is a condition where pain is caused by compression of the nerves between two bones. Most commonly in the foot this is a Morton’s Neuroma which occurs between the third and forth metatarsophalangeal joints.

Most often, the tissues in and around the nerves at these locations become inflamed and swell between the bones. The changes to the nerves may have been caused by mechanical irritation to the nerve and/or compression by the surrounding soft tissues.

Symptoms

–          Burning or tingling pain down the toes

–          Pain which may radiate up the leg

–          Pain worse in high heels or shoe that are tight across the forefoot

Treatment

–          Footwear recommendations

–          Rest

–          THOR laser

–          Offloading with padding and/or orthotics

–          Activity modification

–          If severe, surgery may be considered

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.

CAR ACCIDENT AND THE LOWER LIMBS – What can podiatry do?

Car accident and the lower limbs

Trauma to the lower limbs will cause varying degrees of symptoms and/or disability depending on the location and severity of the injury. In some causes a nerve may be heavily injured which will result changes to sensation and muscle function. This is particularly evident in injuries to the outside knee. There are very vulnerable nerves in this location which innervate the muscles of the lower limb. This may lead to muscle inactivity and/or weakness.

What can podiatry do?

We look at the muscle strength and the impact any changes will have on lower limb function. Depending on individual circumstance, the presentation may require a foot or ankle orthotic, strengthening program or footwear recommendations and alterations.
Most often injuries like this involve a multi-disciplinary team approach with occupational therapists, physiotherapists and/or exercise physiologist. 

We strive to help achieve the best possible outcomes for the patient and focus on improving quality of life. 

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.