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BOOMERS NOT BACKING DOWN FROM FOOT & ANKLE PAIN

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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

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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.

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

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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

Anterior Ankle Impingement

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

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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

CHILDHOOD OBESITY LINKED TO FOOT PAIN

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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

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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.

CHILDREN’S INJURED FEET

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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/

WHEN TO FIX KIDS FEET?

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When to fix kids’ feet?

 

Worried about your child’s feet? It is important to know what is a normal presentation for a child in their age group, as opposed to what actually may be considered a “red flag” in their development. When asking the question of whether to “fix my child’s feet” it is crucially important to make an informed decision with the professional advice and assessment of health professionals. Our Podiatrists will thoroughly assess your child and determine what treatment, if any, is suitable at that time of the child’s development and will reassure you what is normal! Depending on your child’s age and the presenting condition, there are treatment windows within a child’s normal physical development within which to correct any structural abnormalities.

Did you know? Recent evidence based research on thousands of children aged 3-15 years shows the most common foot posture or foot type is a ‘flat’ or pronated foot.* From this it can be concluded that a flat foot without any other abnormal characteristics is not abnormal. So, not all “flat feet” need to be fixed as such. Foot pronation in itself is often a compensatory response to other biomechanical and structural adaptations or elements of the lower limb and rest of the body. Hence overpronation of the foot may not be a causative element but an end result, and there may be other elements of the lower limb that are better addressed first before treatment of the flatfoot is considered. 

Did you know? At birth, only some bones of the foot are formed. By only age 5, the last major bone of the foot is formed, the Navicular, which structurally forms the “arch” of the foot. 

Total Care Podiatry believes in the value of assessing children at an early age or at any age in their development to rule out any abnormalities or red flags in musculoskeletal development in particular and to reassure parents what is normal. Total Care runs a Paediatric screening clinic once monthly to offer a free assessment. We ask that to book into this clinic, a small donation be made to Kids Plus foundation. Kids Plus “offers programs that include early treatment and specific intervention strategies to improve children’s abilities across a range of developmental areas.” 

On Friday July 9th 2021, we have a Complimentary Family Foot Check clinic scheduled. If you have any concerns about a family member’s foot health, especially your child of any age; please book in for your free assessment! PH: 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.

 

SURFCOAST TREK RECOVERY

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There are many things to consider after the trek – these are some tips we would recommend: 

  1. Take a recovery pair of socks and shoes. Clean and dry your feet and put these on after the event to prevent blisters. Keep warm. 
  2. Go for brunch! Treat yourself. You will be tired, and your body will be hungry for a high protein and carb meal. It is important to refuel!
  3. A light stretch and walk in the afternoon for optimal muscle recovery 
  4. Avoid deep tissue massage in the first week – be gentle and start with light muscle recovery. If you have any pain that is disproportional to what you consider to be normal recovering muscle pain, seek advice from the appropriate healthcare professional be it your GP, physiotherapist, or podiatrist ? 

If you have any queries before the trek, come in for your free 15 minute foot check! 

PH: 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.

FOOTWEAR FEATURES IN RUNNING SHOES FOR COMMON FOOT CONDITIONS AND PATHOLOGIES

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Footwear Features in running shoes for common foot conditions and pathologies

It is crucially important that we have a shoe that supports our feet in the right way and suits our personal needs and activity requirements. and no, by support this does not just mean arch support!

Our personal needs are not limited to our foot type and gait but include our injury history (both specific to the foot and upper body), our preferences based on previous shoe experiences, and the use of orthotics or other mechanical aids such as AFOs or Heel Lifts.

If you are doing a lot of activity for your occupation or lifestyle that involves walking or weightbearing, a pair of running shoes is a key shoe to have in your rotation due to its technologically advanced foam composition in the sole to provide a cushioning system to absorb the impact of your body weight as well as it’s stability features. Some of the features explained below for running shoes can also be replicated in other suitable, more formal footwear.

REARFOOT AND MIDFOOT PAIN

Such as…

ACHILLES PAIN

  • Commonly, avoid flat, thin soled shoes. A flatter soled shoe will stretch the achilles to its maximum and apply significant tension to the calf muscle, which if already inflamed will aggravate under this environment significantly.
  • So, ensure a high heel height (that is, the heel height, aka HHD or heel pitch is higher in reference to the thickness of the shoe sole at the forefoot). This does not mean wear high heeled shoes, but it does mean go for a pair of runners with at least a 12mm heel height differential. (Standard HHD is 10mm).

HEEL PAIN

Our heel, also known as our calcaneus, is essentially our first point of contact with the ground in most cases hence rarely gets a break. Plantar heel pain is a common condition that is exacerbated by excessive pressure to the heel and hard surfaces. Common conditions such as Plantar Fasciitis may be assisted by the following tips:

 

  • Commonly, avoid flat, thin soled shoes. Try a higher heel height in your shoes to offload pressure from the heel and create distance between the ground/hard surface you are walking on.
  • Most importantly, go for a premium cushioned shoe! Despite advertising’s best efforts, comfort wear shoes such as Sketchers are made up of a foam that does not last a long time with our body weight’s load and will compress, losing its structural integrity and shock absorption capacities.
  • Premium cushioning is best met with a running shoe using an EVA or Polyurethane foam composition, which has much more elastic or “spring back” energy to absorb your impact and ease strain to the heel.

 

ARCH PAIN

To relieve pain on our arch, shoes cannot specifically relieve pain.

  • However, a shoe with a more rigid density foam reinforced to the inside arch of the shoe will support the arch, which may reduce the potential of the foot to excessively pronate (roll in), given that sometimes excessive pronation can place greater strain on our arch and be one of the contributing factors to arch pain.

Caution: If your arch pain is quite tender and inflamed, a shoe with a significant density to the arch in initial stages may aggravate symptoms.

ANKLE PAIN & INSTABILITY

Ankle joint recurrent instability issues can be due to a number of causes. If your joints are hypermobile this can extend your joint’s motion to a range further than it should ie a maximum inversion ankle sprain. If your ligaments are loose, worn from previous injury or stretched over time; they will allow greater movement hence not protecting the joint from entering a risky range of motion.

Essentially, our shoes need to reduce motion laterally to the ankle joint! The bad news is, there are very few shoes that automatically are able to do this.

 

Important features that can help combat excessive motion by providing stability are:

  • Rigid last-the platform or sole of the shoe should be rigid and only bend at the toes. This means no Sketchers, “Nike Free Runs” or other shoes that simply fold in half (give your shoes the test today!). A flexible shoe has too much give to it, and will collapse and compress laterally underneath your body’s natural movement pathway, especially if your muscles and ligaments are weak and quite prone to ankle sprains/rolls.

 

  • Wide last-a wider last or shoe that has a lateral rearfoot flare ie flared shape of the shoe sole at the rearfoot section of the midsole/shoe sole, will allow greater total surface area contact with the ground, enhancing your balance and proprioception (awareness of your foot’s contact with the ground) hence enabling you to react more easily and more quickly if you roll your ankle.

 

FOREFOOT PAIN

  • Cushioning or added thickness to the forefoot section of the shoe sole will take pressure off an inflamed forefoot.
  • Adding a gel full length insole to your shoe is a second way to add shock absorption to the area to ease pressure from the ground up

 

Such as….

 

MORTON’S NEUROMA

-Wide fitting shoe in the toebox is crucial. Also try a loose fitting material. No pointed toe shoes!

Compression to either side of the forefoot either by a tight shoe material or simply a shoe that is too narrow will squeeze the inflamed nerve and elevate symptoms.

BUNIONS

-A wide fitting shoe is important, but did you know, a wide last in a shoe is also helpful?

Put simply, the platform or sole of your shoe should ultimately be slightly wider than the extent of your bunion’s bony prominence, as should the mesh have some airspace surrounding the bunion.

A wide last can also be attained by going for a pair of runners with a flaring to the outsides of the forefoot section of the shoe midsole/sole.

*RESOURCE – The bunion institute

 

1ST METATARSOPHALANGEAL JOINT OSTEOARTHRITIS

-Big toe joint sore and not as mobile as it used to be? Consult your Podiatrist for an appointment to discuss this. You may have Osteoarthritis in your big toe joint (this is the joint at the “knuckle” of your big toe, not the joint that bends the tip of your toe).

-Try a shoe with a rocker bottom or a very rigid sole (aka a shoe with a sole that bends minimally at the crease of the forefoot where a shoe normally bends for your toes). Reducing excessive motion at a joint with already limited motion is likely to help relieve osteoarthritic joint pain. Brands include: Hoka, New Balance, Asics, Chung Shi

LOWER BACK PAIN

Posturally, lower back issues can be aggravated by a higher heel on a shoe.

  • A shoe with a relatively neutral heel height or low heel height may put less strain on the posterior chain of the body. Consult your upper body health professional for further advice on your specific lower back condition as our spinal column is one with a multitude of anatomy and lower back pain can mean many things! Some people find symptoms alternatively alleviated with a slight heel.

Still unsure? Book in an appointment with your Podiatrist to have a Footwear Assessment and we can help you narrow down the most suitable shoes for your feet. We also have a number of partnerships and connections with shoe stores and shoe brands local and afar, to which we can direct you to their friendly teams for a new pair under our advice!

Phone our friendly front desk team today to make an appointment PH: 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.