The Beard Is Back At Indooroopilly

We’d like to welcome podiatrist Joshua Condon to my FootDr™ podiatry centres at Indooroopilly.

Joshua brings a wealth of experience with over four years in this local area as well as in London’s leading hospitals. Joshua is passionate about new and progressive treatment options to assist his patients recover from a broad range of foot and lower limb complaints. Particular interests lie in children’s feet, running and sports injuries, management of heel pain and provision of custom foot orthotics.

Joshua is available for consultations Monday through Saturday at 180 Clarence Road (Cnr Lambert Road) in the big blue house.

MFD-Ad---Quest-Newspaper-Aug-2014-92x262---Joshua-Condon

 

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Do You Have Smelly Feet – The shUVee UV Shoe Deodoriser Can Help

The shUVee™ UV Shoe Deodorizer uses UV light to clean the surface areas inside your shoes. No chemicals or other biological agents are needed.

shUVee UV Shoe Deodoriser

shUVee UV Shoe Deodoriser

The power of UV light, along with time is all that is needed to clean the inside of your shoes. Normally this damp and dark area is a breeding ground for bacteria and fungus that can attack the feet and cause foot odor.

The shUVee™ Ultraviolet Shoe Deodorizer – Stops Odor, Kills Germs, Works in One Hour!

 

Deodorize: UV light kills odor-causing germs in your shoes. Your nose will agree!
Refresh: Daily use keeps your shoes smelling fresh. Even shoes can use a mini-vacation.
Easy: Place your shoes on the wands, press one button and allow the advanced UV light to do its job. That’s it.
Green: No corrosive chemicals used – just the same UV light produced naturally by the Sun. Step into the light, pun intended.
Affordable: Only a single shUVee™ is needed for the whole family. Of course, you know who needs it.

Buy  a shUVee UV Shoe Deodoriser 

The shUVee UV Shoe Deodoriser is a great complement to our Fungal Nail treatment

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Skin Under The Microscope

Did you know that our skin is the largest organ in our body? Our skin plays an essential role in keeping us healthy by acting as a protective layer against pathogens as well as regulating our body temperature. Our skin also helps to hold us together and provides the sensation of touch through millions of pressure and pain receptors.

To the naked eye our skin looks smooth and uncomplicated, but when studied up close it has four separate outer layers (epidermis), plus deeper layers containing hair follicles, sweat and oil glands, tiny muscles, nerve endings and blood vessels. Take a look at this diagram!

Sebaceous Gland

Over the next few weeks we’ll be posting images of different skin lesion photographed using a podiatry skin microscope, with up to 200x magnification. The skin of your feet is a prime target for pathogens to attack and this revolutionary skin scope allows us to view and diagnose them like never before.

Verruca

Have a look at these images of a plantar wart (verruca plantaris), caused by localised infection of the human papilloma virus. See the way it invades the skin, pushing the normal skin striations apart established its own blood supply. The outer layers and scaly, nodular and irregular. They are often painful when on a weight bearing part of the foot.

Plantar warts are easily treated by a skilled podiatrist via local destruction of the wart tissue, normally using cryotherapy (freezing using liquid nitrogen) or chemical methods. Delaying treatment may cause pain or allow the virus to spread to other areas of the foot, or even to others that share a common shower or bathroom.

Verruca Under Microscope

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Jonathon Brown tears plantar fascia in his foot

Brisbane Lion’s fans on Saturday night were shocked to see their captain, Jonathon Brown limp from the field during the middle of the opening term with a suspected foot injury. The injury was confirmed today as a tear of his left plantar fascia, the strong ligament type structure that spans the arch of the foot. A true frank plantar fascia tear is not all that common, and is generally the result of violent force pushing the front of the foot upwards and overstretching the arch, or repetitive force on a weakened and degenerative plantar fascia.plantar-fasciitis-tear-foot-heel-paint-diagram

In Brownies case, the 31 one year old would have landed heavily from a contest to have sustained such an injury. ‘At 102kg, the forces going through his foot at the time of contacting the group could have been 3-4 times his body mass. A 400kg load though the plantar fascia of any athlete’s foot can certainly be sufficient to cause this type of acute injury’ says Mr Stewart, sports podiatrist.  The typical symptoms of a torn plantar fascia are a pop or snap in the foot at the time of injury, immediate sharp pain in under the sole and swelling and bruising. It can be difficult or impossible to take weight on the foot, and scans are required to assess the full extent of the injury.

The injury is not to be confused with plantar fasciitis, which is repetitive micro tearing and subsequent inflammation of the plantar fascia. People suffering this condition, often referred to as a heel spur, have a gradual onset of pain with no known insult or injury to the foot. This overuse condition can strike people of any age and also requires early treatment to prevent the condition becoming chronic.plantar-fasciitis-tear-photo-foot-heel-pain

The medical team at the Brisbane Lions have advised they will wait 1-2 week before making a decision on the chance of Brownie returning before the seasons end. The team at  my FootDr wish Brownie all the best for a rapid return to fitness.

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Oxfam Trailwalker - my FootDr

Oxfam Trailwalker

Oxfam Trailwalker - my FootDrWell it’s that time of the year again! Oxfam Trailwalker is for a wonderful cause and every year raises much needed funds and awareness. Unfortunately, it also goes hand in hand with some foot and lower limb injuries that could easily be avoided with a little preparation!

So here are 10 friendly suggestions from the team here at my FootDr podiatry to help you get through the hard yards relatively unscathed!

1.      Prepare

First and foremost, prepare your body for the challenge with some training. Covering a distance of 100 km in one hit with no training is a great way to get injured. Start preparing a few months out from the big day by going for regular walks (beginning with a smaller distance for novices) and progressing to a bigger team walk on the weekends (for instance 30 km) over varying terrain. The course incorporates a variety of surfaces and gradients so choosing walking trails that are similar will help you adapt when in the big event! Regular walks will also increase your fitness and get your body comfortable with walking/jogging long distances.

2.       Address any problems early!

If you have had any pre-existing injuries or worries with your walking/jogging style; seek advice on support/guarding against major injury. The team here at my FootDr podiatry centres conduct biomechanical assessments regularly and would only be too happy to advise you on best course of action!

3.       Wear in your footwear!

The shoes you choose to wear for the event should be supportive (adequate cushioning) and suited to your particular foot type.

The shoes should NOT be brand new. New footwear takes time to shape specifically to your foot; wearing them straight up for 100km WILL GIVE YOU BLISTERS.my  FootDr podiatry - blisters

It is best to wear the shoes for a couple of weeks prior to the event for some bigger walks to make them comfortable. Resting the shoes for 3 days prior to the event will also make sure that the rubber in the soles is at it’s full potential!

4.       Stretching

Regular stretching and massage can help keep the muscles pain and injury free. A tight loaded muscle is more likely to suffer injury when fatigued. Keeping flexible will help protect you from major injury; so stretching after warming up during regular exercise and after warming down will go a long way to conditioning yourself for the major walk. Through-out the course there are a number of health professionals including podiatrists and physiotherapists who can help you in the event of minor injury or pain.

5.       Stay hydrated!

In the days leading up to the walk drink plenty of fluids to prepare your body; starting a 100km walk/jog dehydrated will only lead you to fatigue quickly and predispose you to injury. Exercise causes the body to use up it’s water stores whether for fuel or perspiration. There are regular drink stations along the trail walk, do not hesitate to use them!

6.       Blistering!

my FootDr - BlistersThe dreaded blisters will inevitably make an appearance during Oxfam due to the constant friction war of skin vs shoe! There are a number of ways to reduce the friction including good socks, checking you footwear fits correctly and if you are aware of any specific points you are prone to blistering, a few well-placed bandaids or strips of strapping tape can also help to prevent the blisters.

Podiatrists and medical staff will be on-hand at the check points to help relieve any discomfort, but being proactive will help reduce the pain!

7.       Toenails!

Yes Toenails! Cutting your toenails 3 days prior to the event will ensure that they are not too long that they will cause injury but also not too short that they will cause discomfort!

8.      Health Professionals are there to Help

If at some point during the walk you feel you have injured yourself and are in worlds of pain, CONSULT A HEALTH PROFESSIONAL at the nearest check point. Everyone who participates in Oxfam is a hero in their own right, but major injury is not part of the legacy. Seek medical assistance even if you are unsure, it is better to be safe than sorry!

9.      Assess the damage

The finishing point! You will be very tender towards the end of the walk/jog, not only have your muscles and joints in your legs taken a bashing but so have your feet. After finishing the big race, it’s a good idea to assess for any damage and have it seen to- whether it is blood blisters, skin irritation, lost toenails or major callus build up the last thing you want is infected feet!

10.  Recuperation

The following day- you will be sore. It is important to rest and recuperate; basic first aid Rest, Ice, Compression, Elevation is a good treatment for the residual soreness; especially for the feet and legs! So put them up, throw on some ice and rest easy knowing what a great job you’ve done!

If you have any queries regarding footwear advice, biomechanical assessment or injury prevention don’t hesitate to come in and see one of our helpful, friendly podiatrists.

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Mid-Season Junior Football Injuries

Now that we are well and truly into the winter sport season our young sporting stars may be complaining of some aches and pains. Due to the nature of football codes it is not uncommon for our kids to suffer from foot, ankle and leg injuries at this time of the season.

These injuries may range from a bump or a bruise, sprained ankle or something a bit more serious like a fracture. Participating in sport should be an enjoyable experience and therefore attending to pain and injury is essential to ensure our children continue to enjoy their sport.

Inversion Ankle Sprain

The most common injury suffered across all the football codes would have to be an inversion ankle sprain.  An inversion ankle sprain occurs when the ankle rolls and is twisted inwards overstretching and damaging the ligaments on the outside of the ankle. The severity of the injury can vary greatly. In minor sprains this can consist of damage to a few ligament fibres resulting in a small amount of pain and swelling around the ankle. In the most severe cases, rupture of the ankle ligaments and damage to the bone can occur. Severe injuries involving rupture or minor fracture usually result in severe pain, swelling, bruising and often an inability to put weight on the foot.

Initial treatment should follow the regime of rest, ice, compression and elevation (RICE).  Depending on the severity of the injury, crutches, ankle braces or cast walkers may be required to offload and support the ankle.  Poorly treated ankle sprains will often result in a recurrence of the injury and consequently a weakness and instability placing the player at an increased risk of further injury therefore a visit to your local podiatrist is recommended to ensure a proper treatment plan is initiated.

Severs Disorder

As a podiatrist heel pain is one of the most frequent problems to walk or hobble through the door.  Active children aged between 8 and 13 are particularly susceptible to heel pain or as we call it Severs disorder. This problem is caused by inflammation around the growth plate on the back of the calcaneus or heel bone where the Achilles tendon attaches. As the child grows the calf muscles and the Achilles tendon will often tighten up resulting in increased pulling on the back of the heel and growth plate resulting in inflammation and pain. This problem responds particularly well to treatment which usually involves stretches for the calf muscles, ice on the area and innersoles or orthotics to help elevate and stabilise the heel to reduce tension around the growth plate.

Shin Splints And Arch Pain

Shin pain (shin splints) and arch pain also top the list as the more common complaints we see in active kids.  These two problems can often come on gradually, starting as a mild ache during sport progressing to become a constant problem, impairing the child’s ability to participate in sport. Some kids will be more prone to these problems and this type of pain can often indicate that their feet and legs are not coping with the extra stress and strain that their sport places on them. Kids who have really flexible flat feet or feet that over pronate (roll in) are most at risk of these problems.  This is because the muscles that run up the inside and front of the shin bone and the along the underside of the arch work extra hard to keep the feet and legs stable and prevent them from rolling in and flattening out too much.

These Problems Are Treatable

The good news is that these problems are treatable and should not prevent our future footy stars from running around the park.

We recommend a check-up with a podiatrist when:

• Your child complains of recurrent pain in the feet and or legs.

• Your child is constantly tripping or falling.

• You notice any skin rashes, hard skin lumps or bumps on your child’s feet.

• Or if you have any other concerns about your child’s feet.

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Spotting a Plantar Plate Tear

Plantar plate tear

Plantar plate tear

One of the most common forefoot complaints that presents to my FootDr podiatry centres is a plantar plate tear.   This is seen most frequently in middle-aged women who present with constant plantar metatarsal pain and swelling extending towards the toes (mostly affecting the 2nd toe).  Often swelling and redness can also be noted across the dorsum of the forefoot along with symptoms exacerbated by extended periods of walking or running and the use of high heel shoes.  As the plantar plate tear progresses, clawing and splaying of the toes is seen.

Early diagnosis and management of a plantar plate tear can often be challenging due to the complex structure and anatomy of the foot.  If necessary, furthe

r investigations can be ordered such as plain x-ray or diagnostic ultrasound to appraise the severity of injury.  However, the early stages of a plantar plate tear are best managed when there is only acute plantar metatarsophalangeal joint synovitis and no instability or deformity (clawing and splayed toes).  Conservative treatments primarily include symptomatic relief through NSAIDs, strapping, off-loading padding, footwear and activity modification.  Subsequently treatment will then focus on the underlying cause of the problem ie pes planus, bunions, hammer toes, mechanical stress.  At myFoot Dr podiatry centres we will perform a thorough physical and biomechanical assessment to determine the best course of action to offload the forefoot and decrease mechanical stresses.  Often a customised, soft, CAD/CAM orthotic device and footwear modifications are recommended that can prevent the problem from progressing.

Occasionally in chronic cases, an orthopaedic appraisal and surgery is recommended.  Generally, most patients are able to return to activity in 1 month of treatment and pain free within 3-4 months.

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Heel Pain in Junior Footballers

Watching a young footy player hobbling off the field is never a good sight to see. One of the most common problems often responsible for this is a type of heel pain known as Severs Disease.

Severs Disease or calcaneal apophysistis affects physically active boys aged 12 to 14 years and girls aged 10 to 12 years, which corresponds with the early growth spurts of puberty.  Symptoms usually come on gradually and can include:

• Unilateral or Bilateral heel pain
• Heel pain during physical exercise, especially activities that require running or jumping
• Increased pain level after exercise
• A tender swelling or bulge on the heel that is painful on touch
• Limping
• Calf muscle stiffness first thing in the morning

So what causes the pain?

During puberty the calcaneus or heel bone consists of two areas of bone known as ossification centres. These two areas are separated by an area of cartilage known as the calcaneal apophysis or growth plate.  This growth plate does not fully fuse together until the foot has finished growing. The strongest tendon in the body the Achilles tendon attaches to the heel bone. It is through that as the body grows and the muscles become stronger the calf muscles that attach to the achilles tendon tighten up and cause more pulling strain around the growth plate on the heel bone. This often results in pain and sometimes inflammation which is known as Severs Disease.

The good news is that in the majority of cases Severs responds very well to treatment.

Treatment typically involves a stretching and or strengthening program to help stretch out the calf muscles and Achilles tendon.  Ice is also recommended to help alleviate pain and is best placed over the painful area immediately after sport. The use of orthotics with a heel raise under both heels is also commonly prescribed and usually results in quick resolution of pain.  In very active kids playing a couple of sports and training several times per week modifying their training load may also be required.

Podiatrists encounter cases of Severs disease daily especially during the footy season and know how best to diagnose and treat the problem.  A my FootDr podiatrist will conduct a thorough assessment of the patient including a hands-on assessment of the painful area, video gait analysis of the way the patient is walking and running and an inspection of the patients shoes and footy boots. This will enable our podiatrist to accurately diagnose the problem and outline the best treatment approach for the individual.

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Barefoot Running

In the past decade somewhat of a “fad” has gained considerable support throughout the health and fitness industries. This is the belief that running barefoot is the be all and end all when it comes to running training. At one end of the spectrum there are barefoot enthusiasts who believe that running barefoot is better for you and running shod causes injuries. On the other hand there are sceptics who will tell you that barefoot running should be avoided at all costs. Unfortunately, as with most issues, these “extremists” gain the most media coverage and therefore it is easy to fall into the trap of believing that you are either a barefoot runner or not. Surely, however, there is a middle ground.

If we look back through the pages of history, humans have been running barefoot for millions of years. Even right up until the 1970’s our most elite athletes were running on nothing more than thin strips of rubber (1). Therefore it can be said that, evolutionarily speaking, we are well adapted to running barefoot. That being said though, as podiatrists, we regularly see patients who have suffered from various injuries by attempting barefoot running. This is not to say that those individuals who run shod are injury free either. What is known is that there is no scientific evidence linking running shoes to injury; conversely, nor that barefoot or minimally supported running prevent injuries or enhances running performance (2). This is obviously contradictory to much of what can be found by a quick Google search of barefoot running!

Running styles differ considerably between shod runners and experienced barefoot. Various studies have concluded that, when running barefoot, we tend to strike more with our forefoot which then allows the ankle joint to absorb the shock generated from impact. When running shod however, we strike with the heel first, relying on the shoes rubber sole and our knees to absorb the impact forces (2, 3). These differences in running styles tend to lead to variances in the injuries sustained by both camps. Often, barefoot runners experience forefoot injuries (eg. sesamoiditis, plantar plate injury, metatarsal stress fracture) and Achilles injuries (eg. Insertional tendinopathy, mid-portion tendinopathy). In comparison, shod runners often present with “shock type” injuries such as Medial Tibial Stress Syndrome. Interestingly, both groups can present with the all too common injury, Plantar Fasciitis.

There are both advantages and disadvantages of barefoot running. Jenkins and Cauthon (4) summarised them nicely as follows:

  • Advantages
    • Changes to runner’s gait – decreased stride length, increased stride frequency, decreased range of motion at the ankle, knee and hip and more plantarflexed ankle at contact
      • This is not necessarily an advantage in itself, however the modifications are partially responsible for further advantages
  • Reduction in impact forces
  • Increased economy of running – some studies suggest that there is a decrease in oxygen consumption when running barefoot due to a reduction in weight
  • Increased proprioceptive ability – theoretically this may reduce the risk of ankle injuries however no studies have confirmed this statement
  • Potential increase in musculature strength – especially that of the intrinsic muscles of the foot
  • Decreased cost – no need for regularly changing footwear
  • Disadvantages
    • Injury from running surface, debris and general hazards
    • Thermal injury
    • Availability of adequate surfaces – no studies have yet determined the optimal surface for barefoot running
    • Exposure to microorganisms/Infectious agents
    • Runners who require mechanical control for existing conditions – an orthotic device dispensed by your podiatrist obviously requires a shoe
    • Potential injury to those with systemic conditions – the best example is a diabetic with peripheral neuropathy. If this individual was to run barefoot, his/her risk for serious injury is greatly increased
    • Potential increased shock at impact – this is particularly the case for those new to barefoot running. If an athlete has run in shoes their whole life it is more than likely they have developed a heel-toe strike pattern. If they were to continue with the same pattern they are at real risk of suffering from a stress related injury

As can be seen, there are various advantages and disadvantages for barefoot running. This is not to say that there is no place for it in a training regime however I think it is clear that it should not be the only modality used. Instead, it is my belief that barefoot running be used as an adjunct; something to enhance what is already being done. I see barefoot running as an exciting addition to training protocols, not a crazy fad that should be ignored or shunned in a hope that it will disappear.

It is important that, if you wish to begin barefoot running, the transition is a gradual one. These days there are many “minimalist” type shoes on the market that offer the protection of a shoe with very little support and cushioning. A slow progression to complete barefoot is essential to ensure that the foot’s structures are able to adapt to the increased loads being experienced.

Readers should be excited at the prospect of further diversifying their training. There are literally hundreds if not thousands of pieces of literature available on the topic. The trick is to decipher what is hype and what fact. And of course, if you have further queries or concerns, consult your podiatrist who will be more than willing to provide their perspective on the matter.

1)      Lieberman, D. (2011) What can we learn about running from barefoot running: An evolutionary medical perspective. Exercise and Sports Sciences Reviews. Retrieved from www.acsm-essr.org

2)      Lohman, E et al (2011) A comparison of the spatiotemporal parameters, kinematics, and biomechanics between shod, unshod and minimally supported running as compared to walking. Physical Therapy in Sport. (12) 151-163

3)      Lieberman, D et al (2010) Foot strike patterns and collision forces in habitually barefoot vs shod runners. Nature. (463) 531-535

4)      Jenkins, D & Cauthon, D (2011) Barefoot running claims and controversies – A review of the literature. JAPMA. (101) 231-246

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Solestar Cycling Orthotics

my FootDr Podiatry Centres is proud to offer cyclists the hidden secret which many professional cyclists have in their shoes called the Solestar cycling orthotics; the leading cycling orthotic as used by the pro peloton. Solestar orthotics have become standard for the likes of Fabian Cancellara, Frank and Andy Schleck, Andre Greipel and the entire Trek Leopard and Radioshack Nissan professional teams.

Solestar orthotics are handmade in Germany to ensure each one meets their high standards and build quality. The carbon simply offers a perfect combination of stiffness and flexibility whilst remaining extremely light and thin. Solestar orthotics store energy while pushing and give it back while pulling in your pedal stroke. An independent scientific study done by the Cologne Sport University (DSHS) showed that there was an increase of 6.9 % of torque at the pedal in sprint performance by riders using Solestar orthotics compared to standard insoles.

How Solestar works:

Solestar is made from a special carbon material, which makes the insole extremely light and thin, so the foot moves close to the pedal.

The metatarsal support provided by Solestar prevents the foot from deforming and the internal rotation of the leg during the pressure phase in the pedaling cycle; this will reduce the torsion stress on the ankle and knees.

Solestar lowers the joint of the big toe while also providing raised edges for the forefoot. This results in an equal distribution of force over the whole of the metatarsal axis. This aims to optimise the foot/pedal interface allowing for enhanced power transfer and minimising overuse injuries and strain caused by an unstable foot posture.

Solestar features a heel clasp that holds the rear foot and enables direct contact with the shoe sole.

my FootDr podiatry centres are an authorized fitting specialist of Solestar cycling orthotics. Each fitter has been trained by German developer Oliver Elsenbach to ensure a perfect fit. Your feet will be accurately measured during your appointment where we will assess your shoe fitting and cleat position, so don’t forget to bring your cycling shoes and your bike to the appointment! Good fitting shoes, orthotic and cleat position will allow you to have maximum power transfer during the power phase of your pedal stroke and therefore improved performance and reduced your chance of injury.

90% of the riders we equip with the insoles today are already trouble-free when they come to us and only look for added power. Be proactive not reactive about your cycling and cycling related injuries.

Solestar Cycling Orthotics - my FootDr podiatry

If you demand top performance from yourself, you must not waste power.
The new SOLESTAR cycling insole made from carbon optimizes the transfer
of power, increases comfort and reduces overuse.

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