I Just Want to be Fit For Summer

I Just Want to be Fit For Summer

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

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!

 

How to treat and prevent fungal nail infections

How to treat and prevent fungal nail infections

How to treat and prevent fungal nail infections - 1

How to treat and prevent fungal nail infections

Fungal nail infection (also called onychomycosis) is responsible for approximately 50% of all nail disease and in western countries it appears to be on the rise* due to our ageing populations and lifestyle changes.

If you suspect you have a fungal nail infection there are many treatments available—although success rates vary greatly.

Treating fungal nail

“Typically fungal nail infection won’t go away without treatment; this can include over-the-counter topical antifungal creams and ointments, prescribed oral antifungal pills, laser treatment, or, in severe cases, surgical nail removal,” says Dr Brenden, principle podiatrist and owner at A Step Ahead Foot + Ankle Care.

“The biggest problem with topical antifungal agents is that they’re often ineffective, while oral terbinafine—despite being considered a ‘first-line’ treatment—requires strict adherence for 12 weeks.”

In recent years laser technology has emerged as an effective method of treating fungal nail infections. Performed by your local podiatrist, laser allows light to pass through the nail into the nail bed, effectively treating the infection at its source.

The heat from the laser kills both fungi and spores. Providing every nail is treated (which is what we recommend), the likelihood of success is high.

Preventing fungal nail from striking

“Fungal nail infection is much like a tummy bug; it can be passed on to others you come into contact with, particularly family members. As such, it really does pay to know how to protect against fungal infection,” says Dr Brenden (A.k.a Dr Foot)

The following steps can help keep your feet and nails fungus free:

  • Avoid public showers. If you must use a community shower—wear thongs
  • Boil your socks. Fungi thrive in warm, moist environment (Hello sports socks!) but they can’t survive extremely high temperatures. Boil your socks regularly, for at least 10 minutes, to kill off any hidden fungi spores.
  • Keep feet clean and dry. In between sweaty toes is the ideal habitat for infuriating fungi. Stop fungal infection for striking by keeping feet clean and dry. If you’re prone to sweaty feet, try an antifungal foot powder, spray the soles of your feet with antiperspirant and don’t forget to change your socks daily.
  • Don’t share nail clippers. Sharing is caring but not when it comes to fungal nail infection. Be vigilant at the nail salon; ensure the nail tools they use have been sterilised.

Next steps…

We treat several people a day for fungal nail infections. If we can help you please let us know! You can contact us through our helpful front desk team. They speak to multiple patients a day with this condition. They can run you through our process and costings and reserve an appointment time that suits you best. Our number is +61 2 9673 2987 we would LOVE to help.

Medical clinics + other podiatry clinics

If you are one of the many Podiatry / Medical clinics that follow my posts please read the details in my clinic websites, I am currently developing a course for practitioners interested in learning more effective and efficient ways of treating nail fungus. If you follow our posts we will announce this as it occurs or simply send us a message and our office will save your details. We look forward to helping you as well! Our number is 02 9673 2987. Hope to chat soon.

Want to know more about fungal nail infection?

Check out fungalnaildoctor.com.au

See what Dr Brenden has to say on the topic of fungal nails and laser therapy via his Facebook Live session

Clue up on our top 5 tips for fungus-free feet

Discover how Tanya beat fungal nail infection

* Thomas J, et al. Toenail onychomycosis: an important global disease burden. J Clin Pharm Ther 2010;35(5):497-519.
Kids’ feet: Choosing the right back-to-school shoes

Kids’ feet: Choosing the right back-to-school shoes

 

Children spend at least 30 hours a week stomping around in their school shoes. This means that choosing the right shoe is really important for the health and comfort of your child’s feet.

“Ill-fitting school shoes can lead to a multitude of foot problems in adulthood, such as ingrown toenails, corns, callus, bunions and hammer toes. There’s also evidence to suggest that poorly fitting shoes can cause back pain,” says podiatrist and founder of A Step Ahead Foot + Ankle Care, Dr Brenden.

No parent wants to put their child through undue foot pain or cause feet issues in later life. By understanding how to select the right shoes for children and following the guidance of a podiatrist, parents can help ensure they’re a step ahead when it comes to picking out the best back-to-school shoes.

With Dr Brenden’s top tips, choosing the right back-to-school shoes for your child should be as easy as…well…A,B,C!

Kids’ feet: Choosing the right back-to-school shoes - 2

Get the best fit. It can be tempting to buy a size bigger, given how fast children’s feet grow, but the key is to allow a maximum of one thumb width between the top of the longest toe and the end of the shoe.

Heel support. Squeeze the back of the shoe to make sure the heel counter is strong and stable. This way you know you’re getting good heel support. The heel of the shoe should also be no higher than 1.5 cms.

Fasten up. Check that the fastening mechanism (laces, Velcro or buckle) holds the heel firmly in the back of the shoe. Slip-on shoes are not recommended for school wear.

Sole survivor. The soles of shoes should be fairly straight, rather than curved, as this accommodates the straightness of the foot. Also, if you attempt to ‘wring out’ the shoe by holding one hand at the heel and the other in the middle, it should not twist.

Flexibility. A flexible shoe allows for the natural movement of the foot but make sure that the shoe flexes at the ball of the foot; the shoe should NEVER bend in the middle.

A higher price tag doesn’t always mean a better shoe. Well-known brands, such as Clarks, do tend to outlast some of the cheaper brands but this is because they are well made using quality materials. Check to see that the shoe you’re considering buying is made from a high-quality, durable material.

Forget foot weights. You might be fooled into thinking that a heavy shoe is a sign of good quality. Yet a shoe that is particularly heavy is probably not going to be the most comfortable choice. A shoe should weigh no more than approximately 250 grams. That’s less than a can of soup!

Hand-me-down shoes are a no-no. Aside from the risk of fungal or bacterial infection, pre-worn shoes are likely to have molded to the shape of the previous owner’s feet. It’s also probable that the tread and heel counter have worn down, offering less support and poorer stability for your child’s feet.

Listen to your child. If your child complains of foot pain or discomfort or you notice they are walking differently, take a trip to your local podiatrist to have their feet checked.

“Parents commonly ask how long school shoes should last. Of course, this will depend on the quality of the shoe but on average they should last nine months to a year.

“However, if you notice your child has a growth spurt—check to see if their feet have outgrown their shoes. On average, children’s feet grow about half a shoe size every six months,” says Dr Brenden.

Happy shoe shopping!

Want to know more about taking care of kids’ feet? Visit: www.mykidsfootdoctor.com.au

Plus, check out Dr Brenden’s YouTube reviews of some of the latest (2018) school shoes on the market (Includes Ascent Eve Black, ASICS Gel Trigger, New Balance 625 KX, Target Billy Senior—to name just a few!)

Or watch Dr Brenden’s Facebook live video chat on the best school shoes of 2018.

 

 

5 tips for fungus-free feet this summer

5 tips for fungus-free feet this summer

5 tips for fungus-free feet this summer - 1

5 tips for fungus-free feet this summer

Despite the fact that fungal nail infections are notoriously tricky to get rid of, they’re thankfully quite easy to avoid—if you know how, of course!

Fungal infections are seriously easy to contract and super contagious, so it pays to have a few tips up your sleeve to beat a fungal skin or nail infection.

Top 5 tips for fungus-free feet

1.Boil your socks

We’re not kidding; regularly popping your socks in a pot of boiling water can help stop you from getting fungal nail and prevent friends and relatives from catching it (if you’ve already got it!).

Why? Fungus can’t survive extremely high temperatures. Boiling your socks for 10 minutes at 55-60 degrees will kill off any fungus that might be lurking in your socks. But remember, simply washing your socks on a regular (40-60 degree) wash cycle will do nada to nuke fungal spores.

2.Don’t share showers

Communal showers are a breeding ground for fungus. This is because fungal infections are extremely common and public showers are high-traffic areas; lots of feet means a much greater chance of catching a fungal infection! Think Gyms, swimming pools, beach side change rooms!

Super tip; If you must share a shower area, be sure to wear thongs to help minimise the risk of picking up fungal spores.

3.Be nail salon smart

A professional pedicure can be a relaxing way to prep your feet for summer—but not if you go home with more than you bargained for. Busy nail salons can be a breeding ground for fungus, so make sure you seek out a reputable nail bar. Ensure a new set of tools is opened just for you and the foot basins are lined with plastic protectors that are replaced at every use.

Super tip; If you want to be super vigilant, take your own nail file.

4.Shower outdoors

If you’re at the beach or swimming pool and there are outdoor and indoor showers—take the outdoor option.

Indoor showers are darker and might not have the drainage that the outdoor showers do, which means that water can collect. This creates a dark and wet environment—the perfect place for a fungal spore party!

Super tip; Outdoor showers on the other hand have the benefit of UV rays, which dries the shower area and reduces the likelihood of a fungal infection.

5.Keep feet dry

Fungal spores love dark, damp places—just like between the toes of sweaty feet. An easy step to stop fungal infections in their tracks is to make sure feet are washed and thoroughly dried on a daily basis. Sounds easy right? Yet if it were really that simple, fungal infections wouldn’t be so commonplace.

Super tip; Help protect your feet from fungus by using an antibacterial foot powder or spray in your shoes and on your feet, changing your socks daily and washing your feet after exercise.

5 tips for fungus-free feet this summer - 2

Facing up to fungus

Fungal spores are invisible to the human eye, so it’s important to be able to quickly recognise the signs of a fungal skin or nail infection. Symptoms include:

  • Dry skin or white patches around the toes that remain even after moisturising
  • Callused skin – people often think its just dry skin, look for the other signs
  • Small blister like patches on your skin.
  • Discolouration of the toenail (usually white, yellow or brown streaks)
  • Thickening of the nail
  • Crumbling nail

Let’s face it, sometimes fungal spores will get the better of us. The trick is to treat a fungal skin or nail infection at first sight.

You can start by trying a broad-spectrum antifungal cream or ointment containing the active ingredient terbinafine, which can help kill the infection. Yet despite being widely available, antifungal ointments, paints and creams have a very low success rate.

Our Podiatrist Dr Ryan explains that this is why A Step Ahead Foot + Ankle Care are fighting more and more cases of fungal nail with laser.

“Laser works by penetrating the nail, heating up the nail base and killing the fungal spores.

“To ensure the best results we always treat all ten toes so that every single spore is busted. We also use a mirco drill, which makes tiny holes in the toenail and enables the laser to successfully reach the nail bed. It can help with post-laser treatment too, as any creams applied will also make their way into the nail bed for better results.”

Added benefits of fighting fungus with laser include:

  • Laser can beat even the most stubborn fungal spores
  • 80% of patients only require a single treatment
  • Treatment can take less than an hour
  • There are minimal (if any) side effects
  • No referral is required

Want to know more? Check out fungalnaildoctor.com.au or contact A Step Ahead Foot + Ankle Care

5 tips for fungus-free feet this summer - 3