How Fiona Beat Heel Pain

How Fiona Beat Heel Pain

How Fiona Beat Heel Pain

Meet Fiona

Is it really a heel spur's that causes the pain?

Fiona is a 43-year-old lady with two teenage daughters and a busy household. In the past six months she has returned to exercise by joining a gym, which she is …. or was really enjoying.

Lately she has been waking up in the morning, placing her heels on the ground, only to get what she describes as "excruciating pain". She feels the same pain if she sits for long periods and tries to stand: the pain, while not as bad as those first few steps in the morning, can make her hobble. This is now a BIG problem as she was really enjoying her return to fitness and wants to see what she can do to rid herself of the pain.

A visit to the GP

She visited her GP who spoke to her about a heel spur, he took x-rays and indeed there was a heel spur in the picture. He explained to her that generally very few surgeons will operate on heel spurs and there is little she can do but wait out the pain which on average would go away after about 18 months! He did give her some general stretches and said he could try an injection if she really wanted, but it was painful!

 

Off to the chemist

Fiona also went to the chemist to try to buy some heel pads to take pressure of the heel. She tried these for about a month. While they worked for a short while, the pain quickly returned.  She also tried some very cushioned shoes, again while this was comfortable at first within a short period of time this very expensive pair of sneakers gave little relief.

On attending an appointment at A step Ahead Foot and Ankle care Fiona was just about to give up. A friend referred her after they had suffered a similar pain and our podiatry team had made her pain free.

A diagnosis

Did you know that there is over a dozen different diagnosis for heel pain – YUP if you don’t get that part right you’re off to a rocky start! Our Podiatrist, after a thorough assessment, diagnosed Fiona with plantar fasciitis in this case. Plantar fasciitis is a soft tissue condition of the underside of the foot starting at the heel, where much of the pain is located, however the pain can radiate out towards the toes where the fascia again ends. The pain can begin quiet subtly at first and can last on and off for many patients for many years. Now that all sounds easy but guess what?

Shock wave is a new and highly effective treatment.

Treatment

Shock wave is a new and highly effective treatment.

We discussed a treatment plan with Fiona to rid her of her heel pain, this included looking at some new more appropriate runners, a series of STRENGTH exercise NOT stretching, and soft tissue treatment options. Our Podiatrist provided Fiona with options which included:

  • New Footwear- A super important component of stopping this pain FAST is getting really specific! Our Doctors never leave this to chance! Like Fiona they will look at your foot shape and type, and your walking pattern, then recommend a shoe exactly for you!
  • Deep connective tissue massage – This is a firm to hard massage which is in this condition under taken on the base of the foot around the heel and into your calf muscle as this is almost always also tight. These sessions can range from as short as one a week for 3 weeks but up to 12 – 18 weeks long, dependent on how long your pain has been present.
  • Shockwave Therapy (Extracorporeal Shockwave Therapy (ESWT)) – While Shockwave is a relatively new treatment which we have found very successful. Our Doctors have been suing this for over 7 years with great success! The basic principles behind shockwave therapy are the high-pressure acoustic shockwaves that travel through the skin to stimulate pain relief and tissue repair. We have found this treatment very successful and sees patients recover quicker. Most patients like Fiona recover within 6 to 9 weeks. This treatment is often recommended by sport physicians and orthopaedic surgeons. (Be warned - How long has your Practitioner been using this?)
  • Progressive Muscle Loading – Much to Fiona surprise our Doctors asked Fiona to STOP stretching! Despite what you may read on DR Google and friends the most modern research says stop stretching and start working on building your tendon strength!
  • Orthotic therapy – Orthoses are designed to hold your feet in a “corrected position”. Feet that are in poorly positioned or have poor foot posture have to over work which in turn causes muscles to over work and is most often the reason why people develop foot pain. While there are varying devices that do this there is no replacing custom made orthoses. These devices are made to match your foot exactly. - HARD RIGID orthotics can cause you MORE PAIN!! Soft pliable devices are the way to go!

A choice

In this instance Fiona opted for the quicker Shockwave therapy and orthotic therapy. Her podiatrist helped her select the correct foot wear to purchase from a footwear retailer. We then also provided her with an Isometric Strength exercises - NO NOT STRETCHES! that's right NOT stretching! Our team worked with Fiona to build up her strength readying the surrounding muscles for its work ahead at the same time as repairing the damaged tissue. On each occasion of shockwave reviewed these and provided supportive sports tapping to further support her foot.

A recovery

Fiona attended for shockwave over a period of five weeks and made good progress over that time with her pain dropping slowly over the first two weeks and then quickly once combined with her orthoses and more appropriate footwear.

At week five it was decided to push her appointments out to fortnightly and then when this was found successful out again another month. In total Fiona attended a total of seven times before her pain was relieved completely.

We introduced Fiona slowly back to attending the gym, with strict instruction on stretching and appropriate footwear for her foot type.  Fiona made a full recovery and with a month had returned to three gym sessions a week and a walk with friends for exercise on weekends.

 

How Can We Help?

If you’ve read this far you most likely have Heel Pain…. good guess right! If you have heel pain and you are serious about getting better it’s time to take action.

If you need more info you can book a  phone consult with one of our Heel Pain Experts. Our Foot Doctors will revise where you are and advise you on your next steps – Book a call back here!

Want to read more?

How about the common myths around heel pain?

DOWNLOAD Dr Brenden’s FREE report on beating heel pain!

Or call our helpful team who are used to speaking to literally thousands of patients with heel pain! Our number is 02 9673 2987. We would love to help!

 

Heel pain – A patient’s experience

Heel pain – A patient’s experience

How Fiona beat Heel pain!

woman kicking water at beach

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Fiona is a 43 year old lady with two teenage daughters and a busy household. In the past six months she has returned to exercise by joining a gym, which she is …. or was really enjoying.

Lately she has been waking up in the morning, placing her heels on the ground, only to get what she describes as "excruciating pain". She feels the same pain if she sits for long periods and tries to stand: the pain, while not as bad as those first few step in the morning, can make her hobble. This is now a BIG problem as she was really enjoying her return to fitness and wants to see what she can do to rid herself of the pain.

Is it really a heel spur that causes the pain?

A visit to the GP

She visited her GP who spoke to her about a heel spur, he took x-rays and indeed there was a heel spur in the picture. He explained to her that generally very few surgeons will operate on heel spurs and there is little she can do but wait out the pain which on average would go away after about 18 months! He did give her some general stretches and said he could try an injection if she really wanted, but it was painful!

Fiona also went to the chemist to try to buy some heel pads to take pressure of the heel. She tried these for about a month. While they worked for a short while, the pain quickly returned.  She also tried some very cushioned shoes, again while this was comfortable at first within a short period of time this very expensive pair of sneakers gave little relief.

On attending an appointment at A step Ahead Foot and Ankle care Fiona was just about to give up. A friend referred her after they had suffered a similar pain and our podiatry team had made her pain free.

A diagnosis

Our Podiatrist, after a thorough assessment, diagnosed Fiona with plantar fasciitis. Plantar fasciitis is a soft tissue condition of the underside of the foot starting at the heel, where much of the pain is located, however the pain can radiate out towards the toes where the fascia again ends. The pain can begin quiet subtly at first and can last on and off for many patients for many years.

Shock wave is a new and highly effective treatment.

Shock wave is a new and highly effective treatment.

Treatment

We discussed a treatment plan with Fiona to rid her of her heel pain, this included looking at some new more appropriate runners, a series of stretches, and soft tissue treatment options. Our Podiatrist provided Fiona with options which included:

  • Deep connective tissue massage – This is a firm to hard massage which is in this condition under taken on the base of the foot around the heel and into your calf muscle as this is almost always also tight. These session can range from as short as one a week for 3 weeks but up to 12 – 18 weeks long, dependent on how long your pain has been present.
  • Shockwave Therapy (Extracorporeal Shockwave Therapy (ESWT)) – Shockwave is a relatively new treatment which we have found very successful.  The basic principles behind shockwave therapy are the high pressured acoustic shockwaves that travel through the skin to stimulate pain relief and tissue repair. We have found this treatment very successful and sees patients recover quicker. Most patients like Fiona recover within 6 to 9 weeks. This treatment is often recommended by sport physicians and orthopaedic surgeons. (Be warned - How long has your Practitioner been using this?)
  • Orthotic therapy – Orthoses are designed to hold your feet in a “corrected position”. Feet that are in poorly positioned or have poor foot posture have to over work which in turn causes muscles to over work and is most often the reason why people develop foot pain. While there are varying devices that do this there is no replacing custom made orthoses. These devices are made to match your foot exactly. - HARD RIGID orthotics can cause you MORE PAIN!! Soft pliable devices are the way to go!

A choice

In this instance Fiona opted for the quicker Shockwave therapy and orthotic therapy. Her podiatrist helped her select the correct foot wear to purchase from a footwear retailer. We then also provided her with an Isometric Strength exercises - NO NOT STRETCHES! that's right NOT stretching! Our team worked with Fiona to build up her strength readying the surrounding muscles for its work ahead at the same time as repairing the damaged tissue. On each occasion of shockwave reviewed these and provided supportive sports tapping to further support her foot.

A recovery

Fiona attended for shockwave over a period of five weeks and made good progress over that time with her pain dropping slowly over the first two weeks and then quickly once combined with her orthoses and more appropriate footwear.

At week five it was decided to push her appointments out to fortnightly and then when this was found successful out again another month. In total Fiona attended a total of seven times before her pain was relieved completely.

We introduced Fiona slowly back to attending the gym, with strict instruction on stretching and appropriate footwear for her foot type.  Fiona made a full recovery and with a month had returned to three gym sessions a week and a walk with friends for exercise on weekends.

Interested in more information? How about the common myths around heel pain?

Try our Dedicated Heel Pain Doctor site. HEEL PAIN DOCTOR.COM.AU

Or call our helpful team who are used to speaking to literally thousands of patients with heel pain! Our number is 02 9673 2987. We would love to help!

Heel Pain doctor Heelpaindoctor.com.au

Heel Pain doctor a dedicated site to the reduction of complex heel pain!

Book an Appointment Today

Sometimes practitioners get it wrong: Heel pain a treatment gone wrong

Sometimes practitioners get it wrong: Heel pain a treatment gone wrong

How come my child’s heel pain isn’t getting better ….

Sometimes practitioners get it wrong: Heel pain a treatment gone wrong - 1

Soccer, rugby league and Netball all culprits for creating heel pain in kids if mixed with poor foot posture and growth spurts

“He had heel pain last year and now it’s back. They have NO idea what it is. They did an x-ray and it’s not Severs. The physio massaged his calves and it helped for a few weeks but it’s not better. It’s almost been 6 months. We had to halve how much sport he does now and he hates it. As soon as he starts running or playing a game, it comes on. He describes a tight feeling when he walks too”

Very honestly, these were the exact words that came from a frustrated and concerned mum, paired with an equally frustrated 13 year old boy, just before lunchtime today. This family traveled across the city to see us, which is not uncommon but it must be frustrating.

The tragedy in these words is that they’re NOT uncommon. At least a few times a week I hear grumblings from frustrated parents – and they most definitely have a right to be frustrated! – because they’ve seen various practitioners without a real diagnosis and just when something has been suspected, imaging has gone and ruled it out and we’re back at square one. Or are we?

The matter of the fact is: People make mistakes. Practitioners make mistakes. Radiographers make mistakes. We’re human! It’s going to happen.

I feel like I could host a conference discussing the amount of times I’ve been handed an xray telling me that there is nothing wrong with my patient that currently sits in front of me in AGONIZING pain!

If it doesn’t sound right, you better believe that it’s not. Let me emphasis: pain does NOT happen for no reason, and no amount of negative radio-graphs is going to magically fix your very real pain.

Sometimes practitioners get it wrong: Heel pain a treatment gone wrong - 2

Kids stay happy and healthy and active – Kids should play sport PAIN FREE!

So then, WHY does this happen?

There can be a variety of reasons, and I’m going to give you the very real uncensored version that other practitioners may get annoyed at me for.

• Referrers can order the wrong TYPE of imagine study. If you’ve damaged a muscle, ligament, tendon or any soft tissue, your x-ray will show you are perfectly fine! Yep, go over there and sit your torn Achilles tendon down because you’re fine to go run that marathon. (Please DONT we are kidding)

• Radiographers are very HUMAN and can miss things. Some are likely to have seen more of a certain condition, or be more familiar with an area of the body, and so some may pick up or recognise things that others miss. And you can’t blame them – the body is composed of an extraordinary amount of bone and soft tissue and any expectation for every single person to be a scholarly expert on every single part is drastically unrealistic.

• Things CHANGE over time. Your imaging from a few months ago is a picture of what is happening in your foot a few months ago. Since that time, some tissues may have gotten better, some tissues may have gotten worse, and some ones may now be damaged that weren’t before!

Be assured:

  • There is NOTHING wrong with wanting a second opinion and getting a referral for another ultrasound or X-ray
  • There is NOTHING wrong with re-imaging if you feel that your injury has changed. And if you’re having pain but you’re being told there’s nothing wrong, you have EVERY right to be frustrated!
  • You SHOULD get a second opinion! or a third even if you are not getting the answers you need.
  • There is increasing evidence that we need to look past radiology reports and look at clinical symptoms 

So what do you do next?

Your child should not have to play sport in pain, we can happily tell you that we work with kids to get them back to happy healthy and active every day. Our team will work with your child to develop a detailed care plan, this of course after a thorough assessment of their run + walk patterns; including video analysis. we will examine foot wear and make recommendation and look at the damaged soft tissue and assess what is the best way to rehabilitate this back to health! They may require a soft pliable orthotic for inside their shoes to wear while playing (just like our patients that are international level athletes!)

One of the delightful things about treating kids is seeing them return smiling and back to playing the sport they love!

And for all those wondering.. Yes our little champion from this morning did have Severs 😉

A Step Ahead Foot + Ankle care
Penrith, St Marys and soon to come to a suburb near you!

A Step Ahead Foot and Ankle care have founded “My Kids Foot Doctor” a clinic specifically geared towards treating Kids feet. We see dozens of kids a day, unlike other practitioners who see your Grandma’s toe nails and the occasional kid we see these balls of fun all day every day.

About our clinics

Sometimes practitioners get it wrong: Heel pain a treatment gone wrong - 3

Our team see dozens of kids from across Sydney every day

Our clinics are set up with kids in mind we have big toy boxes, TV’s coloring in and lucky dip boxes. Our practitioners are the kind that sit on the ground and chat to your child, who laugh, may wear silly glasses and love handing out chocolate WE LOVE SEEING KIDS!
What does this mean? It means we have built up an enormous amount of experience with kids because we get to see them ALL the time! If we can help you with your little one, if you have a nagging doubt or worry please call our helpful team on 96732987 we’d love to help!
When should I bring my child to see a Podiatrist?

When should I bring my child to see a Podiatrist?

His brother has very flat feet and wears orthotics, so I thought I’d get him checked too. He doesn’t get any pain though. I hope that’s okay that I’ve brought him in?

You wouldn’t believe the number of parents I see who are almost embarrassed to have made an appointment for their little one because they’re not sure if they should have.

When should I bring my child to see a Podiatrist? - 1

Little people get pain as well. DON’T wait till your child is in pain to look after them

After chatting to them about why they are uncertain, the most common thoughts floating through a parent’s minds tend to be:

• Is he too young to come in for an appointment? I’m not sure what a good age for this is.
• He doesn’t actually get any pain so I’m not sure if I need to have him looked at?
• I think I might be over-thinking this because it’s only a small thing I’ve noticed!
• This might just be a normal part of her growing, I’m just not sure what’s normal!

These are all very valid thoughts and concerns, and are completely NORMAL!

Unless you’ve undertaken a 4-year podiatry degree and then had at least a few years on top of that working particularly with kids, then there’s not a single person in this world that can expect you to know what is and isn’t normal and when to bring your little one in.

That’s PERFECTLY okay – we’ve taken care of that hard “qualification” stuff for you!

Let me quickly clear up a few of the burning questions:

1. There is NO such thing as too young. We see kids as early as 12 months old – from the moment that they start walking! You’re actually doing us a favour – firstly because the younger we start treating, the better (and faster!) the results tend to be, and secondly because if we have to wait before we start treating, we are able to see and track the progression and changes in your child’s feet. I often ask if the foot was like this a year ago and am often greeted with ‘I honestly don’t know’. The more pieces of the puzzle we have, the more specific we can get in our treatment plan.

2. Pain is NOT the only indicator that something’s wrong. Parental instincts are a powerful thing – if you notice that something is odd, or isn’t quite right, there may well be something going on that needs to be addressed. Don’t doubt yourself!

3. A small thing may indicate something bigger happening. You’re not over-thinking anything at all – everything has a cause, and sometimes something as seemingly small and resolvable as a little bit of in-toeing can actually be a result of a structural foot abnormality that needs correction before it gets worse or weakness in the core muscles that need strengthening to correct and aid normal development.

I think the BIGGEST thing that I want to emphasise here is that we LOVE that you bring your child in at an early age! We LOVE that you just want to get their feet checked to make sure everything is progressing normally. We LOVE that you want to be as proactive as us and prevent any problems from developing instead of having to fix a painful foot after the pain has already started. We will NEVER think it was a bad idea to bring your little one in.

When should I bring my child to see a Podiatrist? - 2

Kids are at the centre of what we do – it’s WHY we come to work – and nothing makes us happier than seeing happy, healthy and active children running around our practice and tearing up our toy box (literally, we have a drawer filled with toys now).

Nina Lansdowne
A Step Ahead Foot + Ankle care
Penrith, St Marys and soon to come to a suburb near you!

A Step Ahead Foot and Ankle care have founded “My Kids Foot Doctor” a clinic specifically geared towards treating Kids feet. We see dozens of kids a day, unlike other practitioners who see your Grandma’s toe nails and the occasional kid we see these balls of fun all day every day.
Our clinics are set up with kids in mind we have big toy boxes, Ipads, TV’s coloring in and lucky dip boxes. Our practitioners are the kind that sit on the ground and chat to your child, who laugh, may wear silly glasses and love handing out chocolate WE LOVE SEEING KIDS!
What does this mean? It means we have built up an enormous amount of experience with kids because we get to see them ALL the time! If we can help you with your little one, if you have a nagging doubt or worry please call our helpful team on 96732987 we’d love to help!
Why is your shockwave therapy not stopping your heel pain?

Why is your shockwave therapy not stopping your heel pain?

Heel pain can stop you in your tracks from the moment you get out of bed your heel can be unbearable. Our patients describe not being able to put their heel to the floor, hobbling to the shower or toilet only to get a slight relief but then for their pain to come back later in the day! It stops you functioning and stops you from all the activities you love!

When you have this pain you search and cling to answers. Many patients are sadly told by their GP there is nothing they can do. They may be given hard insoles or orthotics by well-meaning practitioners or lately they are prescribed Shockwave!!!

Shockwave is the latest treatment for this debilitating condition. Shockwaves cause micro trauma to the diseased tendon tissue. This results in inflammation, which allows the body to send healing cells and increase the blood flow to the injured site.

While we make the application of this technology sound very simple, in the wrong hands and if you don’t have experience applying this in practice, this therapy can at best not work, and at other times in the worst case scenario, make your condition worse. Anyone can hold a Dentist drill but would you let anyone do your filling for you?

Our team of therapist at A Step Ahead Foot + Ankle care have been using this technology for a number of years we see approximately 8 to 12 patients a day using this technology. Our staff unlike others who have adopted this therapy lately, have a great deal of experience and are continuously looking at ways which will increase the effectiveness of the therapy.

Why is your shockwave therapy not stopping your heel pain? - 1

Along with the experience our practitioners have comes the knowledge that in almost all cases shockwave therapy by itself will not fix you ………yes you heard correctly!

When patients visit us for heel pain and other muscular problems yes we do often use Shock wave, however it is only part of a treatment plan. We also give you advice on the right foot wear, stretching, possible taping and analysis your walk and run to assess if you need soft comfortable orthoses.  Shock wave may also not be right for you our Podiatrist may decide you are better suited to other soft tissue therapies we use.

So while Shock wave can be an excellent tool in the fight against chronic heel pain. Without experience and used in the wrong way, or used in isolation the success rate of this therapy drops dramatically.

At A Step Ahead Foot and Ankle care we have been successfully treating people for heel pain for at least 15 years. If you are suffering from Heel pain we would really like to help you. We are situated in Penrith and St Marys in Western Sydney.  You can contact us on 96732987 or 47322007.