Tag Archives: heel pain

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.

EmailShare

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)

EmailShare

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.

EmailShare

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.

EmailShare

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

EmailShare

Plantar Fasciitis

Plantar fasciitis is the most common cause of plantar heel pain. Pain in the arch or heel often indicates inflammation of the long band of tissue under the foot that runs from the heel to the ball of the foot, known as the plantar fascia. Its characteristic features are pain and tenderness, predominately in either the mid arch region or at the inside heel, and less commonly the outside heel. It frequently causes pain upon rising from rest (especially first thing in the morning) and can progress to agony by the end of the day.

This condition is typically found in middle-aged men and women whose feet tend to over-pronate or roll in but can be experienced at all ages. It is commonly associated with the recreational athlete, overweight individuals or abnormal lower limb biomechanics. A sudden increase in frequency or intensity of activity can often spark these symptoms.

Although plantar fasciitis is the most common cause of this pain, a complete differential diagnosis of plantar heel pain is important via a comprehensive history and physical examination to guide an accurate diagnosis.

Symptoms

Symptoms of plantar fasciitis include

  • Pain on palpation of the inside of the heel and/or through the arch of the foot
  • Pain first thing in the morning or after rising from a period of rest
  • Pain at the beginning of exercise that gets better as you warm up
  • Pain with prolonged standing or walking
  • Sharp, stabbing pain at the bottom or front of the heel bone and can develop to a dull ache

General causes

Assessments are guided towards finding the cause of the injury. The plantar fascia contributes to maintaining the arch of the foot as well as transmitting weight as you walk and run, placing large amounts of tension and stress through this tissue. The most common cause of excess tension in the plantar fascia is abnormal lower limb mechanics.

With continual over-pronation, the plantar fascia is being overstretched causing inflammation, degeneration and pain at the attachment site of the heel and/or the bands of the tissue. In more chronic conditions, continuous pulling of the fascia at its attachment site can cause a bony heel spur which in itself is generally asymptomatic.

During long periods of rest, the plantar fascia shortens and the body begins the repairing process. When you stand again the tissue is rapidly lengthened and results in micro-tears in the tissue. This explains the tremendous pain with the first steps in the morning or after rising from rest.

Other causes include obesity, walking or standing on hard surfaces, unsupportive footwear, inactivity or sudden increases in frequency or intensity of activity.

Management 

Diagnosis of plantar fasciitis can usually be made through careful history taking and an examination of the area of pain to determine the extent and cause of the condition. If necessary, further investigation such as x-rays or diagnostic ultrasound may be ordered by your podiatrist to help evaluate the severity of the problem.

Conservative Treatment

Treatment of plantar fasciitis initially involves reducing symptoms and inflammation through icing, topical or oral anti-inflammatory medications, footwear advice and rest from precipitating activity. The podiatrist will conduct a full biomechanical analysis to determine the underlying causes of this condition and to determine the best course of action to reduce the heel pain. This may include stretching exercises, footwear modifications, plantar fascial night splints and customized soft full length orthotics.

Surgical Treatment

While in approximately 90% of cases conservative measures are successful in treating plantar fasciitis, some patients may require more invasive techniques to relieve pain. Surgical treatment is considered for those with persistent, severe symptoms despite all conservative intervention for at least 6 to 12 months.

Expected outcome

Treatment for this acute condition can take time, with most patients pain free within 3-4 months and over 90% within one year. Initial symptom improvement allows most people to return to activity within 1 month.

Despite common belief, heel pain attributable to plantar fasciitis IS curable ! The podiatrists at my FootDr podiatry centres cure this ailment every day.

Read more – The Truth About Heel Pain

We have proven results with a 98% success rate, contact us for an appointment today and Walk Pain Free.

EmailShare

Killer Heels

As a podiatrist, up to 40% of my day involves treating ladies of high heel wearing age, some of who have made a conscious decision to buck the trend and choose comfort over fashion, and many who haven’t.

The human foot was once described by Leonardo Da Vinci as “a masterpiece of engineering and a work of art”, and this is evidenced by our ability to walk, run, jump, and play. However, it doesn’t take much to upset the fine balance between precision function and disaster. High heels, by their nature shift the body’s anatomy into foreign territory, causing marked postural and alignment strain. If horses could talk they would tell you that walking on your toes (equine) has its drawbacks, and we’ve only got two feet to manage with!

By elevating the heel bone (calcaneus) there is an immediate change in the distribution of weight under the feet from the heel to the forefoot – the percentage of which is directly proportional to the height of the heel. With regular use, the calf muscles in the lower leg can permanently shorten, leaving you unable to comfortably wear flat shoes and further increasing pressure under the ball of the foot.

Habitual high heel wearers will invariably, at some point, suffer heel pain and disability because of this alteration in the way our body adapts to the ground and distributes weight.

Common complaints can include calluses, corns and blisters right through to permanent deformities including bunions, hammer toes and acquired flat feet. This list does not include increased incidences of fractures of the ankle and metatarsals (forefoot), arthritis, pinched nerves, tendonitis and other soft tissue injuries and inflammation.

Foot alignment or lack thereof, has the potential to affect the posture and position of all the joints in the lower limb and also the pelvis and the back. Many studies have found that increasing heel height increases anterior pelvic tilt and subsequent increased curvature of the lower spine (lumbar lordosis). Again, with repetitive use this can generate chronic lower back pain and increase intervertebral disc compression as well as deteriorate core stability strength.

Before you lose faith and trust in all things fashionable, here’s some tips on how to minimise risk while wearing your heels:

• Like most things in life, moderation is the key. Avoid wearing heels when walking to and from work (joggers are the safest bet), and kick off the pumps in the office and replace with flats.

• Pick shoes that suit the activity for the day – flats or shoes with only a slight heel pitch are best for standing and walking, whereas heels may be suitable during a seated meeting or dinner date.

• Keep the heel height sensible – really anything over 5cm is hazardous and should be for only special occasions.

• Stilettos (Italian for dagger) could not be named more aptly – really a dangerous shoe for ankle sprains and fractures. Try broader heels with more stability and tread on the ground.

• Stretch your calf muscles regularly to improve fl exibility and reduce the likelihood of muscle contraction.

• Seek immediate assistance from a podiatrist should you experience pain, swelling or a change in shape of any part of your foot. People suffering from diabetes, reduced circulation or with a history of foot problems should check with their podiatrist before changing footwear styles.

my FootDr podiatry centres

We Fix Feet

EmailShare