Why you’re not getting better and what you can do about it

Why you’re not getting better and what you can do about it

Blog, Fungal Nails, General Podiatry, Growing pains, Heel Pain, Ingrown Nails, Kids Feet, Shockwave

Why you’re not getting better

and what you can do about it - Its you not me

Why You're Not Getting Better and what you can do about it

Why You're Not Getting Better and what you can do about it

Have you ever wondered why you're not getting better after seeing a therapist, and what you can do about it?  Dr Brenden Brown, the Leading Podiatrist at A Step Ahead Foot and Ankle Care, Penrith, explains that it could be you, not the therapist.

It's Father's Day. I love my dad, and I'm sitting in the entertainment area of my childhood home after cooking my dad his Father's Day breakfast. My brothers are here with their children as well, and we are discussing my parents impending trip to Europe, but more concerning in the discussion is the Back Pain that has my Mum currently in a wheelchair.

Mum has been to see a therapist. She's been given exercises and a treatment plan that she needs to undertake. My dad says, "Oh well. I think from here it's all up to Peter." I look at him, and I ask, "Who is Peter." My dad replies, "Your Mum's therapist. It's up to him whether or not your Mum will get to Europe. Let's hope he can get her better in time."  Pardon?

My head twirled, my eyes roll, and I'm quite sure I probably became the colour of an orange. I reply with all the love I can muster,  "This has very little to do with Peter and a whole stack to do with Mum."

That's right; It's not Peter's responsibility to get my Mum better! Peter has developed a treatment plan, and the biggest participant in that plan is Mum. Peter can show her what to do, tell her when to do it, but in the end, who is the person that is responsible - MUM!

I have no idea who Peter is as I've never met the guy. Still, I know from experience that this is a common expectation of patients that somehow it is the practitioners' responsibility to get patients better. I've got to tell you that while Peter and I have our patients’ best interest in mind and as therapists work hard to help out our patients reach their goals. I think there is very little further from the truth than it's "up to us" to get patients better. Dad... Mum... listening?

If I were to make a list of the most common reason that I see for people not getting better, at least half would be the laid at the feet of the patient themselves. Yes, I know this is a bitter pill to swallow if you are a patient and reading this blog is not going to make me at all popular, but them's the breaks, so to speak.

So what is the on "The list":

  • Not following your treatment plan - broadly speaking
  • Not completing your exercise program as instructed
  • Not Completing exercises as often as required
  • Not wearing the footwear your practitioner suggests
  • Picking and choosing the best bits of your treatment plan
  • Holding your practitioner responsible for your success

Now, of course, other reasons can contribute to your lack of recovery and yes, at times they relate to therapy or perhaps the diagnosis. Yes, practitioners get it wrong but so do patients! As humans, we seem pretty programmed to point the finger at others than recognize that we may be a contributor to our problems.

If you find following your therapist's instructions difficult, let them know, SPEAK UP! Sometimes 13 different stretches in a day is too much. But equally, if they tell you that you need to do this to get better, you've two choices - 1. Get to it or 2. Get a second opinion. But that's it! Choosing not to follow the plan and then blame a therapist for your lack of progress is like not taking your medication the doctor prescribes and returning to them complaining that you're not getting any better.

Why you’re not getting better - Its not ME its YOU

To the therapist who is reading this: Stop being walked over! If your patient isn't following their plan and you know it or they are negotiating not completing vital parts of the program, fricken speak up! Tell them straight! You are in no way helping either of you by following that course. The patient doesn't improve, you look stupid and incapable, and that is a lose-lose for you all! That patient will see someone else and will bad mouth you to their friends, loved ones and the next therapist they see! I know because they see me!

Why You're Not Getting Better - Its not me its you

Why You're Not Getting Better - Its not me its you

Well, after my head stopped twirling like the cast of the Exorcist, I had to make sure my Mum had a clear understanding that Europe was not only physically thousands of kilometres away, but the same distance metaphorically. Unless she stuck to HER part of HER treatment plan, she was not going anywhere.

The result? My Mum is, as I write, jumping on and off buses in Europe enjoying her holiday!

ABOUT DR BRENDEN BROWN

Dr Brenden Brown, Podiatrist & Shendi Brown

Dr Brenden Brown, Podiatrist & Shendi Brown

Founder of A Step Ahead Foot + Ankle Care in Sydney, and former president of the Australasian Podiatry Council, Dr Brenden Brown (A.K.A Dr Foot) is a wealth of knowledge on how to take care of your feet, including how to find the best shoes.

Follow him on social media:
 instagram.com/askdrfoot
 facebook.com/podiatristsydney
 twitter.com/AStepAheadFAC

Ten-things-to-know-before-choosing-a-podiatrist

Free Report “10 things to know before choosing a Podiatrist”

Choosing your Sydney foot doctor is an important decision and can mean the difference between getting mediocre results and living pain-free. Learn about the top 10 things you should know when choosing your podiatrist in St Marys or Penrith.

Shameless Plug or where to get real help!

Need help? Need another opinion? Just want to get this sorted? Great, we'd love to help you 😊 You can start by calling our wonderfully helpful team on 9673 2987. They are all parents and will be able to help answer questions and guide you in the right direction.

Another option is to use our call back service, pop your details in the very short form and we will call YOU back on a number and times that suits YOU best. 😊

I Just Want to be Fit For Summer

I Just Want to be Fit For Summer

Blog, Heel Pain, Shockwave, Sports Care

I Just Want to be Fit For Summer

Walk run and skip and dont stop for foot pain

Don't let foot pain stop you from reaching your goals!

The warm weather had started last September, we had a series of warm spring days and this is when Sarah appeared in my office. “I just want to get fit for summer” I am so sick of not getting there and I just need some answers. Sarah went on to explain that this was not her first attempt at getting fit, frustratingly she had tried the year before and throughout winter to get there. But despite eating the right thing her training or more accurately her foot pain always got in the way!

New Shoes might be the answer?

Sarah had been to a reputable sports footwear retailer and had grabbed a pair of runners that the store had recommended. While initially comfortable and her looking seriously cool in them ;-). After her attempts each night to walk or run she still found herself in pain. If not that night, over the following days she developed pain in her arch on the inside of her foot. It went from being a dull ache to at times being a sharp pain. It also felt like it ran up the inside of her leg a little. (ahhhh ok so that’s a bit different) If she stopped running or walking for a few weeks / days it got better but once she started again it was back!

A visit to the doctor

Kühlpack auf Fuß mit SchwellungFrustrated with this she saw her GP who suggested she try putting some ice on the area. Again, she went home determined to get better but with little result, YUP the ice made it immediately feel better, but straight after on the next walk it came back.

Ok let’s try the physio!

Still not deterred she headed to a local Physio. He said it was a heel pain may be fasciitis or a heel spur? He did a short massage, used a machine that created a type of heat and showed her some stretching. Ok so this was a bit better she thought, for several days and even a session of walking it felt bearable but ………. on trying to increase her activity again, there it was like that old uncle you can’t stand but see every now and then at family function, you don’t want to see them but bam!!! There they are!!

A solution!

Finally, after speaking to a friend, who had a similar problem, she came across our clinic. “My friend drove across the city to see you and you got her better.” She said. “You must be worth it because my friend had been everywhere and now raves about you” (feeling pretty chuffed right now)

Its NOT a heel spur!

That’s right nope and it wasn’t fasciitis! Yep these are super common MISdiagnoses for this type of pain!  If you don’t see this multiple times a day, and you are also trying to work on shoulder pain and fix dodgy knees its easy to get it mixed up!

Tibialis Posterior pain is NASTY

On watching Sarah’s walk on our Video Walk run analysis equipment it became pretty clear that her walk or “gait” and “biomechanics” in podiatry speak was lousy! We found that Sarah’s feet were rolling in too much and that put very simply her arches needed more support, to give her muscles a chance to work properly.

While the physios stretches and exercises were great, the lowering of her arch needed assistance for her to be able to do all the work they required. NO amount of super special exercises are going to get this muscle strong enough. Not if you actually want to get active!

So, what’s the plan?

I chatted to Sarah and developed a treatment plan that meant we could get her back to training and finally fit for summer! So what did we do?

  • We made a custom-made pair of orthoses for her after taking a 3D laser scan and a detail series of Biomechanical measurements – fancy talk for checking each joint in your foots movement – all the muscles strength and how all the joints and muscles work together! SOFT SOFT SOFT but more below.
  • Arranged a series of Deep connective tissue massages. While the orthoses will fix why the problem was occurring the soft tissue therapy will address the muscle, we need to help the muscle along it way to being healthy again and ready for activity.
  • Stretches which is pretty standard BUT really importantly strengthening exercise were also prescribed if you don’t get the muscle STRONG we are running in circles.
  • We addressed Sarah’s shoes. While her shoes were fantastic, and truthfully loads of patients aren’t as good as Sarahs. If you don’t get this right with patient’s treatment falters! The right shoe for the patients foot type helps, not only supporting the foot, but also working with the orthoses. The aim is to get Sarah back to exercise as soon as possible to reach her health goals.

SOFT pliable inserts – NOT rock-hard harbour bridges!

That’s right SOFT devices we never make hard rigid devices! All our custom-made orthoses are made and designed exclusively by our clinic, in our onsite orthotic laboratory it takes about 3 weeks for the process of computer aided design by our me, they are then milled out using CNC milling and finished by hand. We have a super dedicated team and these are flicked off to a lab somewhere overseas like other clinics often do. Our devices are produced by our awesome lab technician right at the practice!

While waiting for these we began the treatment plan and her DCTM, strength and stretching.

So, what happened?

In four weeks at her review Sarah reported her discomfort had dropped dramatically. She no longer had pain after every walk and had found that she was able to increase to running. We reviewed her stretching and asked Sarah to increase her Km’s of running per week. She was stoked! 8 weeks later on her final review Sarah was ecstatic “I can run” she said. “I haven’t been able to run pain free in years”!

So, where to from here?

woman runner running at tropical parkYou don’t have to put up with Foot pain! There are answers other than waiting for it to go away and pills! At A Step Ahead we see dozens of people like you with foot and lower limb pain all day and we love it! We love getting people better so they can kick their health goals whether its running 5 km or 50 km’s or if it’s professional sport or simply ridding yourself from foot pain so you can play in the park with the kids!

Why not call our friendly team and ask if we can help? Chances are we can! You can also check out more of our website for information on other common conditions we see regularly!

Call us on 9673 2987 or 4732 2007. We are located in St Marys and Penrith in Sydney and unlike Macquarie street you can park right out front and it doesn’t cost 65 dollars an hour its free! We are privilege to have patients travel from all over Sydney and NSW to see us: From the North shore and as far away as Port Macquarie and Wollongong.

We would really love to help you get on the track so please give us a call.

Dr Brenden Brown
Podiatrist

Shen glasses

BB and Shendi Yes they have 3d glasses on at home. Because they can 😉

How Fiona Beat Heel Pain

How Fiona Beat Heel Pain

Blog, Heel Pain, Shockwave, Sports Care

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!

 

DOWNLOAD YOUR FREE REPORT
Heel pain – A patient’s experience

Heel pain – A patient’s experience

Blog, Heel Pain, Shockwave, Sports Care

How Fiona beat Heel pain!

woman kicking water at beach

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

What your Podiatrist WON’T tell you about heel pain.

What your Podiatrist WON’T tell you about heel pain.

Blog, Heel Pain, Shockwave

Things your Podiatrist doesn't want you to know about Fasciitis

Heel Pain can stop you from getting back to exercise!

Pain on first step out of bed, pain in the ball of your heel, gets better after time on your feet only to get painful at the end of a day! Pain often doesn’t have a reason or incident. The horrible thing is this pain is often described to me months or even years after it first appeared and frequently after seeing a number of health care practitioners GP’s, Physios and including Podiatrists!

Many treatments Podiatrist’s and Physios prescribe DON’T WORK and sadly deep down they know this but in an effort to work with you, their patient, they persist not knowing what else to try. Sadly as a patient this doesn’t assist you, and leads only to frustration.

I see literally 8 to 10 people a day, with heel pain! I have been focusing on heel pain for over a decade, honing my skills to work through this complex problem. I see people from ALL over NSW and now have begun to see people travel to see me from interstate. I’d like to share with you some points I have learn't seeing literally thousands of patients.

So in an effort to help EVERYONE, I thought I would write a few of my Top Tips (maybe secretly frustrations). So you can get a better idea of why possibly you are NOT getting any better despite you seeking help.

Orthotics probably won’t work on their own.

This is probably the most common mistake in treatment I see on a day in day out. Orthotics are commonly used by Podiatrists and I use them also ALL the time! However they are not the only answer. I definitely see them having a role to play. We will prescribe so to provide a support or a “balance” to a foot, but you need more! The tissue is damaged and it’s VITAL that it is rehabilitated! Orthotics cant and won’t do this alone, you must rehabilitate the tissue,  using therapies such as deep connective tissue massage and shockwave and muscular stretching exercises!

Stretching won’t help 90% of people.

“I have been stretching for months and I am not getting any better” I see endless amounts of hard working people who have been given stretching exercises and sent on their way and told “Let me know how you go” by their well-meaning therapist.  I also see patients who present to me who have never had any treatment and I test their muscle tightness, only to find they have no tightness at all! Not all heel pain is from tight muscles and not all heel pain is Plantar fasciitis, so we need to break the mold and look elsewhere to help you, our patient.

Foot pain, footwear, heel pain

Great footwear is a key to treatment Yet lots of practitioner focus on this with their patients! Make sure you review your footwear!

You can’t wear any shoes you’d like and your love of Thongs/flip flop/ Jandals is harming you.

Sorry I am going to give you a hard time about shoes! Thongs, flip flops, yes even the special ones with arches etc  etc are all footwear that maybe adding to your pain. I know they make you feel good while you are wearing them. However over years of recommending more appropriate footwear and seeing significant changes in outcomes for the time it takes you to get better we keep you out of these. You can return when the foot is better and full recovered!

Hard rigid orthotics won’t only not fix it they may actually make things worse!  

I will start by acknowledging I am not a fan of rigid orthotics, I have never prescribed them and would not wear them myself. I know many many physios feel the same and are concerned about these actually irritating the structures of the base of your foot! I am sceptical at best around these rigid, hard, harbour bridge like devices in shoes.

Again I feel orthoses work however I believe the foot needs some of its natural motion and this is why our clinic has always used soft soft pliable orthotics that are custom made to your foot. These cup the heel and support the arch only where necessary and DON’T irritate the very area we are trying to fix! We make all our orthoses in our own onsite orthotic lab, we use the latest 3D technology and computer aided design, then milling them precisely to fit you foot, a mix of comfort and cushioning.

Heel pain - Is it your Orthotics causing you more pain?

You need more than a rub!

As I mentioned above most patients need soft tissue rehab HOWEVER I also see that without supporting the tissue around the foot and correcting some of the poor walking patterns that may have contributed to the problem slowly developing, patients often DO NOT get better! Have your walking pattern assessed and see improvements develop quickly

How to get better?

I think the key is to looking at treatment as NOT having one silver bullet that will fix everything. As you will see from my extended notes, just focusing on one element seems to be where people fall short. Looking at heel pain as if it is more than just the one condition, “Plantar fasciitis”, is also necessary to ensure that you get the right treatment. Heel pain can be and often is more than “Heel spurs” or “plantar fasciitis” and so to treat it you need to identify exactly what it is.

When you have established a good idea what’s going on, its time to look at treating all the contributors that made it sore in the first place. Structure, poor foot wear and then looking at treating the soft tissue.

Can you get better?

YES I hope you can see from this that there are very obviously MANY options available. As a practitioner one of the very nice parts of my day are seeing patients who have had this for months or years get better! Patients that don’t just get better they can now kick a ball with their kids, run with the kids in the park, keep up with the grand kids!

Can we help YOU?

Yes, if you would like our help back to a healthy happy lifestyle, we most definitely can and would LOVE to help! Unlike other podiatrists who focus on treating your Nan's toenails or dry hard skin on their feet, we focus on these more complex running and walking problems! We priorities patients just like you as we understand how important it is to get you back to pain free.  Please give our very friendly front desk team a call, not only are they helpful but after having helped literally hundreds of patients each year they are really good at leading you in the right direction back to pain free.

You can contact us on 96732987 or 47322007 we look forward to helping you.

Brenden Brown

Principal Podiatrist

A Step Ahead Foot + Ankle care

BB with one of his patients

BB to the right, with out the yellow skirt

Top 6 reason your heel pain isn’t getting better – UPDATED!

Top 6 reason your heel pain isn’t getting better – UPDATED!

Blog, Heel Pain, Shockwave

Top 6 reason your heel pain isn't getting better - UPDATED - 1

Top 6 reason your heel pain isn’t getting better – UPDATED

You CAN beat Heel Pain

Heel pain can be debilitating! The pain often stops people in their tracks first thing in the morning! Walk a few steps and it may be relieved. Others as the day progresses, the pain becomes worse. Finding help can be frustrating and confusing as you can often see multiple practitioners and receive multiple answers with little relief.

We first wrote this article in 2014. 3 years later, after helping literally 1000’s more patients with heel pain. After HOURS more of research and implementing significant changes in the way medicine has begun to understand Heel Pain, it became time to updated this very popular article!

With the experience of literally helping 1000’s of heel pain patients,  between 10 and 20 a day! We have put together the following list of the Top 6 reasons we have noted patients have not got better.

We hope this helps you on the way to beating your heel pain.

1.You decide to go it alone and NOT get professional advice.

Of all the people we see, a large proportion of them have never had any care or professional advice. Quotes like “I just thought it would go away” or “A friend told me what they did to get rid of the pain and I just tried that”. Most times it doesn’t!  You will increase your chance of beating heel pain, significantly by getting a professional opinion. Professional advice and treatment costs money. Yes some people find this expensive however others find it invaluable. It depends on how much you really want to get rid of your very sore heels?

2.You wear thongs (flip flops) because your feet are sore

Wearing thongs, Croc type shoes or even bare feet for many people make their feet feel better initially but all our experience tells us you are doing more damage.  The pain you feel days later not necessarily at the time. You are welcome to argue this point as much as you like, while you continue to hobble…………

3.You get advice and then choose which bits you use.

Great work on getting advice now it’s time to take it ……yes ALL of it. When a care plan is developed for you, if you choose only the bits you like to hear and the easy bits, you will end up failing to get better. Your Podiatrist should work with you as a patient to establish the best way to relieve you of your pain.  They should speak to you about what shoes are best for you. What treatment will get you better quickest, including strength exercises, therapy to relax the soft tissue and possibly orthotics.  Now choosing NOT to do some of the suggested treatment universally ends up with patients not getting better. Our Podiatrists do all that and more, does yours?

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4.You bought hard rigid orthotics from a Podiatrist.

Our experience tells us that rigid hard orthoses on most occasions irritate the heel and the arch region adding to your discomfort. We have over the years collected many pairs of rigid orthotic from patients who give them to us in frustration after finding they have hindered rather than help.  Secondly if this is the only therapy you were given, with the exception of a couple of possible stretches then we would suggest to you that there is more to getting rid of your pain than this – ask the question “So how is this rehabilitating my damaged soft tissue?”

5.You stop ALL activity.

As our understanding has changed over the years we now appreciate the following – “TENDONS HATE CHANGE”. Stopping all activity if you are currently active is a sure-fire way to ensure that when you return to your activity you will also see the return of your heel pain!

You SHOULD make modification to activity, However a complete stop will mean you either

A. Need to rebuild your activity over quite an extended time.

or

B. Your heel pain is likely to return!

For the moment STOP Jumping of and onto things. For example, on + off a truck, box jumps at exercise class, skipping or other high intensity impacting the heel and forefoot until we have you back to comfortable. We will then slowly load you back up to these activities.

6.You choose a practitioner who does not understand heel pain.

So your GP says they will fix your heel pain? Your Physio who is treating your shoulder says the same and the Podiatrist you see, who works one day a week at your local GP clinic and cuts your toe nails, says they will fix it no problem. Who do you choose?

Your heel pain is not simple its complex and for you it’s really sore!  Choose someone who see’s and treats heel pain regularly. Choose someone who is passionate about making sure that they help you on the way to getting you better. All the people above are probably very good at what they do, but they most likely won’t end up helping you beat your pain!

Did you know there are about 10 different condition’s that could be causing your pain?  When our practitioners are asked by GP’s Physio’s + Podiatrists on Heel pain it is often a surprised to the how complex this condition is! Our Doctors all sports podiatrists see this condition multiple times a day. When you see something that often you are more familiar with it + know how to get on top of it. Ask the person you see how many Heel pain patients they help a day.

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How can we help

At A Step Ahead foot + Ankle care we see approximately 8 to 12 heel pain patients a day. We have patients that travel literally hundreds of kilometres to seek our help – Which is really lovely!  Our clinics are set up quite specifically to treat patients with heel pain. We have invested hundreds of thousands of dollars into equipment and the latest technology to help us, help you- beat heel pain.

Our Principal Podiatrist Brenden Brown is recognized as an expert in Podiatry. A past President of the Australasian Podiatry council he is considered a Medical Expert in the area of Foot health, appearing regularly on television shows like the Today Show and Magazines like Men’s Health. He has appeared for some time as the Medical expert for lower limb conditions on ABC radio’s “the Waiting Room”

It would be a pleasure to help you beat your heel pain.

We are located in Penrith and St Marys in Sydney’s Western suburbs.

You can contact us on 47322007 or 96732987 we hope you will.

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