Kids Heel Pain – still not getting better?

Kids Heel Pain – still not getting better?

He’s just not as fast as the other kids, and limps a little after games! I thought it would just go away but it seems to be getting worse

Sound familiar?

Ashley came to see us after a frustrating 4 weeks of Heel Pain for mum and daughter alike. Stretching and Rest had been prescribed by her physio, but to no effect! The GP said ice, but It just wasn’t getting better and Ash didn’t want to loose her spot in the team. Our telephone rang and on the end of the phone was an incredibly frustrated mum. Kristy our superstar behind the desk made some room in our appointment book and we got Ashley in to our clinic.

Winter is ball sport season and its also the season we see an increase in Kids heel pain! - 1

Winter is ball sport season and its also the season we see an increase in Kids heel pain!

Week one was a biomechanics and gait assessment (Walk run and standing assessment) by the team, (Yes we work as a team!!) gathering as much data (Info) about Ash’s foot, her walking and running style and her muscle profiles. We took a 3D laser scan of her feet and moved her out of her old slip on casual shoes, into some newly minted Asics Nimbus, giving her support and cushioning in every step.

Wow what a difference a week makes! We had a beaming Ashley walk into our clinic with a noticeable spring in her step!

Kids heel pain is most commonly an inflammation at the growth plate at the back of the heel, or underneath the foot at the insertion of the fascia. In Ashley’s case, it was the backs of her heels at the insertion point of the Achilles Tendon.

We started our course of soft tissue rehabilitation, which included a series of deep tissue massage, and some manual stretching and mobilisation of the foot and ankle joint.

Ashley’s muscles in the backs of her legs were incredibly tight, playing tons of sport and not warming up before and stretching after will do that to you! So we put in place a series of really simple and quick stretches and exercises for Ashley to do on the court before and after her games and trainings. It wasn’t easy to change her habits but after she saw improvement in her pain, she stuck to the plan. Mum and Dad even got in on the act! A fit happy healthy family!

Four further weeks of manual therapy, custom made orthotic intervention and a tailored return to sport program (plus some stern words about her shoes) and Ashley was back full time on the court. Why is this? An accurate diagnosis, more than one modality of treatment (Soft tissue rehabilitation) and a girl that really really wanted to get better!

Exercise induced heel pain in young athletes is an all too common thing, but 100% treatable! An assessment from your Penrith Sports Podiatrist will have your young star back on the footy field or netball court in no time.

We have been seeing kids like yours for many years! In fact we see children just like yours from all over Sydney, from the Eastern suburbs to North shore, from as far as western NSW to Wollongong. We would love to help keep families Happy Healthy and Active! If you would like our help getting there please call us on 96732987 or 47322007

A Step Ahead Foot + Ankle Care Team
Penrith , St Marys

and coming soon to a suburb near you.

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!
I just want to be fit for summer

I just want to be fit for summer

Frustration and foot pain

I just want to be fit for summer - 1

If you just want to be fit for summer, don’t let foot pain stop you from reaching your goals!

The warm weather last year 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 last year 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!

So what’s going on?

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. 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 and more

Frustrated 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, yes the ice made it immediately feel better but straight after on the next walk it came back. Still not deterred she headed to a local Physio. He did a short massage and showed her some stretching, this was 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”

So what wrong?

I just want to be fit for summer - 2

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.

So what’s the plan?

We 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.
• 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. A series of stretching and strengthening exercise were also prescribed ensuring everything was cared for.
• We addressed Sarah’s shoes. While her shoes were fantastic loads of patients aren’t as good and without addressing this many patients falter. The right shoe 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.
As 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 Principle Podiatrist Brenden Brown, they are then milled out using CNC milling and finished by hand. While waiting for these we began the treatment plan and her DCTM and stretching.

So what happened?

In four week 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 were to from here?

I just want to be fit for summer - 3

You 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 96732987 or 47322007. 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.

Brenden Brown

I just want to be fit for summer - 4

Principle Podiatrist and founder for
The A Step Ahead foot and Ankle care team

Have you had your orthoses check recently?

We recommend you check your orthotics every 8-12 months!  Your custom orthotics are made with your biomechanics in mind.  They cater for your many differences in length, width, foot pronation and injury.  Over time, these specially made devices start to wear out.  The plates that sit under your arch start to loose integrity after a period of time and that will impact the prescription of your orthotics.  Kids’ foot orthotics will more often than not need changing in relation to the growth of your child.  As the foot grows, the plates become less effective. Remember to get your orthotics checked by your podiatrist on a regular basis to avoid any potential injuries!

For all your Foot and Lower Limb Care needs, come and see us at:
A Step Ahead Foot & Ankle Care
24 Phillip Street, St Marys; or
Suite 4, 36 Woodriff Street, Penrith
www.astepahead.com.au

What are Ankle Sprains?

Ankle Sprains are the most common form of foot ankle injuries. A Step Ahead Foot and Ankle Care Clinic records increasing numbers of the patients who seek treatment for these injuries.

Mr Brenden Brown, the Clinic principal podiatrist, has also treated many people suffering from Ankle Sprains for the more than 15 years he has been practising podiatry. Ankle Sprains refer to the tearing or stretching of the ligaments of the foot. The ligaments are the fibrous bands which connect the adjacent bones in a joint.

Ankle sprains occur as a result of involuntary sliding or twisting of the feet when you step on slippery or unstable ground. It occurs when the foot is forced into a position in which it is not used.  The intensity of stretching of the ligaments may sometimes be intense to the extent of causing fracture or serious inflammation and pains.

Ankle Sprains are managed through RICE – meaning Rest, Ice, Compression and Elevation. REST: do not carry weight or walk long distances; ICE: apply ice packs to the ankles; COMPRESSION:  apply bandages over injured area, and; ELEVATION: lift the foot up so as to remove the oedema.  If you suffer from ankle sprains it is always good to visit a podiatry clinic or podiatrist for proper treatment.

For all your Foot and Lower Limb Care needs, come and see us at:
A Step Ahead Foot & Ankle Care
24 Phillip Street, St Marys; or
Suite 4, 36 Woodriff Street, Penrith
www.astepahead.com.au