Tag Archives: Brisbane Podiatrist

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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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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Paediatric Lateral Foot Pain – Is It Iselin’s?

Children often complain of aches and pain that settle with little more than rest. However, if you child is suffering from acute pain, or general soreness that last more than 5 days it is wise to have this checked out by a Podiatrist.

Children complaining of pain on the outside of the foot may have a condition known as Iselin’s disease/syndrome. Below is a summary of this often misdiagnosed condition.

Generally children suffering from Iselin’s syndrome will report pain on the outer boarder of the foot, at the prominence known as the styloid process. Some redness and swelling over the area will be present. Barefoot activity, jumping sports and narrow fitting footwear can be aggravating factors. Individual biomechanical factors need to be assessed and treated, as splaying of the forefoot associated with flat feet, and walking on the outside of the feet with high arched/inverted feet are associated with Iselin’s disease.

It has been reported rarely, but is probably more common than appreciated. Clinically it can be confused with tendonitis, ankle sprains, fractures of the 5th metatarsal or even labeled as  growing pains. It appears to be more common in athletically active, older children and adolescents, and more common in males. Early recognition and treatment may prevent long-term complications such as non-union and subsequent pain.

Early treatment often consists of conservative measures – rest, ice, padding, footwear, orthotics, stretching, massage of peroneals, etc. Delayed intervention can lead to continued stress through the fusion of the secondary ossification centre and even non-union. Non-union is usually very painful, and may require surgical excision of the proximal epiphysis or open reduction internal fixation with an orthopaedic screw.

See my FootDr’s website.

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Queensland Bulls use Podiatry to Ensure Peak Performance

my FootDr - Podiatrist for the Queensland BullsThe Queensland Bulls cricket team is already well into their preseason training and are hot favourites to retain the Sheffield Shield in the 2012-13 summer. So too the Brisbane Heat, who despite just falling short of the making the Big Bash finals last year are expecting big things this coming December and January. The squad welcomes back Nathan Hauritz after 6 years playing in Sydney and Usman Khawaja, the exciting left-handed opening batsman has also made the move north inspired by the unique coaching style of Darren ‘Boof” Lehmann. The squad is also bolstered by a number of emerging junior players and a solid list of experienced campaigners including captain James Hopes and veteran wicketkeeper Chris Hartley.

The Bulls squad in preparation for the compacted season ahead undergo a number of medical and fitness assessments and tests. Just like the rest of us, peak foot health is critical for optimal performance and comfort while on the field. Serious and debilitating foot and leg conditions commonly experienced by cricketers include stress fractures, tendonitis, sprains and strains, spurs, joint impingement and contusions. Fast bowlers in particular, can also suffer less serious but equally uncomfortable blisters, calluses and corns, bruised and broken toenails, and even open heel fissures (deep cracks).

my FootDr podiatrists and directors Darren Stewart and Greg Dower have been involved with Queensland Cricket for the past season and were yesterday invited to assess the squad and provide necessary treatment. The assessment of each player involved a thorough history, assessment of their joint and muscle range of movement, postural review, detailed gait assessment both relaxed walking and also the specifics of their playing mechanics, high definition peak pressure mat readings, and a 3D foot profile scan of their feet.

Each player will be provided with highly customised foot orthoses to improve comfort, optimise shoe fit, equalise pressure and overall assist in alignment and efficiency of the feet and legs. Some players have leg length discrepancies, a common anatomical variation, and benefit from having a raise inserted in the sole of the shoe to balance the pelvis and assist in spinal alignment. Both Darren and Greg will be in regular contact with the team physiotherapist and Queensland Bulls legend Martin Love during the season, and attend recovery sessions to provide onsite treatment and advice to the team.

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Sore feet and legs after the Bridge to Brisbane?

my FootDr podiatry Bridge to Brisbane Team

my FootDr podiatry Bridge to Brisbane Team

Were you one of the 40 000 plus Queenslanders who braved the early morning chill to climb the Sir Leo Hielscher bridge and walk or run your way to the RNA showgrounds? This was the 4th time my 11 year old daughter and I have participated, and we love the exercise and carnival atmosphere of one of the Australia’s largest fun runs. We walk and jog the course, enjoy the scenery and make a mad dash for the line to try and improve on last year’s time!

Being a podiatrist, it’s an occupational hazard walking alongside such a large pack of people; I can’t help but to observe the variety or different walking and running styles, choice of footwear to participate in and how people cope with the gradual fatigue that can set in. I suppose in many ways this is a perfect cross section of our community, with elite runners up the front slogging it out for a podium finish, recreational runners just behind and then the weekend hackers (me included) making up the pack.

It amazes me that so many people may not be aware of how their foot and leg biomechanics affect their body’s overall function. So common amongst the participants was some characteristics, that after pointing out to my daughter a few cases of quite profound excessive pronation (the most common form of foot dysfunction, where the ankle leans inwards and the arch of the foot flattens when standing and walking) she started to point them out to me!

my FootDr podiatry Bridge to Brisbane

my FootDr podiatry Bridge to Brisbane

Every day in clinic I assist people recover from biomechanical related foot, leg and hip/back – sometime it can take months to return to normal activities following an overuse injury such as:

  • Plantar fasciitis (pain on the heel or arch)
  • Shin splints (pain typically on the inner shin, but this term encompasses all shin pain)
  • Achilles tendonitis (either at the back of the heel bone or just above)
  • Stress fractures (bone fatigue that leads to a partial break – commonly metatarsal of the forefoot)
  • Anterior knee pain (around or to the side of the knee cap)

Almost all of these conditions can be avoided with awareness of the biomechanical dysfunction and appropriate advice and treatment if necessary. Even being recommended the right type of shoe may be beneficial in some cases.

For those that would like to see what excessive foot pronation looks like check out the following link http://www.youtube.com/watch?v=aQ83QrPKKMU

If you’re feeling more than just muscle fatigue today, or suffer from one of the conditions above you should have your lower limb biomechanics investigated with video gait analysis. A podiatrist competent in assessing and managing sports injuries will then be able to provide you with the advice you need to ensure you run faster next year!

Darren Stewart – Podiatrist (my FootDr podiatry centres)

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my FootDr podiatry and the Steady Steps Program

Podiatrists Darren Stewart recently presented to a group of south side locals on the importance of good foot health and footwear as part of the Steady Steps Program. Margaret Coates, Physiotherapist and Tai Chi instructor runs the Steady Steps program to improve the awareness of people of that factors that influence balance and provide advice which can reduce the incidence of falls.

Falls prevention is a critical issue for our aging population, as one incident of a fall can lead to a loss of confidence and independence, or even a serious fracture or head trauma resulting in hospitalisation. General factors include reduced muscle strength, slowed reflexes, vision impairment, altered cognitive function as well as pain associated with arthritis and other medical conditions.

my FootDr podiatry centres - Steady Steps Program

Darren Stewart with Margaret Coates, drawing the winner the my FootDr podiatry prize from attendees of the seminar (prize includes a 1 hours comprehensive consultation and free New Balance shoes)

“The feet also play a huge role in balance and therefore falls prevention. Foot pain of any type has been identified as a key factor in falls – so that includes everything from a painful corn or callus, right through to tendonitis, heel spurs and bunions. Furthermore, inadequate, inappropriate or ill fitting footwear can greatly decrease an individual’s ability to balance. If you’re not sure if your shoes are right, or you have suffered for foot and leg pain lasting more than a week, get yourself off to a podiatrist ASAP” said Stewart.

For more information on the Steady Steps Program or foot related issues please contact any of the my FootDr podiatry centres.

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Heel Pain in Children

With football and netball season well underway, podiatry clinics around the country will see an influx in children suffering from heel pain. Whilst there are a number of possible causes for these symptoms, the majority of these children are suffering from a condition known as Severs Disease, or as I prefer to call it, Severs Syndrome. Typically this affects girls between the age of 7-12 and boys from 9-15, involved in regular physical activity.

Symptoms include pain at the back of the heel bone near to the insertion of the Achilles tendon which can be present constantly, during, or immediately after playing sport. The most common sports that aggravate these symptoms include soccer, AFL, basketball, netball, athletics and other sports that involve explosive movements like sprinting and jumping.

Severs Syndrome is described as a tractional apophysitis. Traction refers to pulling, and apophysitis relates to inflammation of a growth plate. In Severs Syndrome it is the Achilles tendon that applies the traction on the juvenile heel bone, and the growth plate is irritated by a sheering stress due to one of a number of biomechanical imbalances.

A clinical assessment by a knowledgeable podiatrist is often all that is required to diagnose this condition, although in rare cases where disproportionate pain or swelling is present it may necessitate an x-ray referral directly from your podiatrist. A typical consultation will involve a thorough history of the symptoms and aggravating activity, a review of footwear, physical assessment including joint range of motion and muscle testing, and video gait analysis.

Generally children suffering from Severs Syndrome fit into one of two physical categories;

Mesomorph – Solidly built with strong and inflexible muscles. In this case there is insufficient flexibility at the ankle joint.

Ectomorph – Supple flexible joints result in excessive collapse of the arch of the foot (pronation) when standing or running, which in turn results in a delay in the natural timing of heel lift.

With a skilful assessment of the cause and correct diagnosis, effective treatment in almost all cases is possible. The earlier a correct diagnosis is made and treatment initiated, the less likely the child will require rest from activity. my FootDr Podiatry Centres successfully treat 1000’s of children suffering from heel pain every year.

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My FootDr Sponsors Mining Event with Darren Lockyer

my FootDr Podiatry Centres, with One Key Resources, were proud to bring Rugby League immortal Darren Lockyer to Dysart in Central Queensland for a two day event, starting with a Gala dinner last night. The evening was a fantastic opportunity for mining industry colleagues and related businesses to touch base, and hear the career stories of the great Darren Lockyer and team mate and media personality Ben Ikin.

Today Locky and the my FootDr team will be visiting the local Dysart football club and engaging with the local community. Podiatry services are in great demand throughout the Bowen Basin, with active local communities and the huge expansion in coal mining projects. my Foot Dr podiatry centres is strategically located in both Mackay and extensively around south east Queensland to provide both onsite and offsite podiatry care. ‘With the increase in mining personnel, we are seeing a huge demand for custom orthotics, footwear and specifically safety boot advice, and general foot care in our Mackay podiatry centre. Many of these people are working long shifts, on hard and uneven surfaces, which dramatically increases the prevalence of sprains and strains, heel and leg pain as well as lower back pain”, said Chris Watson, Podiatrist for my FootDr at Mackay.

Just like the great Darren Lockyer, everybody needs a little help to perform at their best. ‘People suffering from little aches and niggles in their feet, legs or back should consult a podiatrist before the problem increases and leads to time off work and significant pain” said Watson.

Appointments with a qualified occupational podiatrist can be made at any one of our centres by calling 1800 FOOT DR, and businesses interested in proactively managing foot complication in the work place should contact Paul Wigzell, Business Development Manager on the same number.

my FootDr Mining Occupational Podiatry Darren Lockyer

From left: Grant Wechsel (One Key Director), Paul Wigzell (my FootDr), Darren Lockyer (Legend), Chris Watson (my FootDr Mackay), Ben Ikin

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