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
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, 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!!
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?
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 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
BB and Shendi Yes they have 3d glasses on at home. Because they can 😉
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.
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.
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!
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.
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!)
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.
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.
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
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
Growing Pains- More than just pain from growing – A case study
Sam is 10-years-old. He’s a great kid who loves being active, but there’s a problem and it’s getting worse. Sam plays football in winter and, in summer, he’s a cricket fanatic. Apart from these regular sports he’s running about at school and is, yes your average Aussie kid!
Sam’s mum and dad brought him into A Step Ahead Foot + Ankle Care because, despite being a very happy and active kid, Sam is waking up a couple of nights a week with pain in his lower legs. When he wakes he wants his mum to rub his legs because they ache and are sore. Sam’s mum Beth has used heat packs and paracetamol which does take the pain away after a while but, as Beth says, “They aren’t fixing the cause”.
A key factor is that fact Sam’s parents recognised that the pain sometimes came on in the night after Sam had quite active days, like sports days or family activities with lots of walking.
Visiting the GP, Physio and Dr Google
Sam’s parents took their son to a GP who sent them to see a Physiotherapist. While the physio was nice and showed Sam some stretching and did a couple of massages, these again helped at the time but didn’t stop the problem from coming back. After chatting to the GP their opinion was that this was “Just growing pains”—something Sam would have to get used to, and that he would simply “Grow out of it”. Frustrated with a fantastic but upset little boy, Sam’s parents felt they needed another opinion.
Sam’s mum Beth jumped onto Dr Google and found herself even more confused. Some parents were recommending vitamin supplements, others recommended oils and others suggested all kinds of home remedies. She then found herself on Facebook asking other parents for help. This is where a friend of Beth’s recommended our practitioners at A Step Ahead Foot and Ankle Care.
Finally some answers
When our practitioners assessed Sam it became pretty clear there was more than just some kind of phantom pain going on. We undertook a detailed walk and run assessment, along with some measurements and testing on Sam’s muscles. Nothing was invasive and everything we do is done in a fun, friendly and non-confronting environment. After a short while we established that Sam’s feet were rolling in a lot and his arches where a little flat. In essence Sam had pretty poor foot posture. What this meant is that the muscles in Sam’s lower legs were over working to try and give his poor foot posture support.
This meant that a big day on his feet, like a family outing, a busy day at school or doing sports caused his muscles to work even harder. This led to them getting sore, not necessarily at the time of the injury, mostly at night several hours after the muscles had rested.
Helping fight “growing pains”
To help Sam we gave him a custom-made pair of orthotic insoles. These are made from a soft material so are very comfortable to wear but provided support for the rolling of his ankle. We took a 3D scan of Sam’s foot and video recorded his walking patterns using our specialised assessment software. The orthotics are then designed using our computer-aided design software. Next step is to make the orthotics, which is done in our on-site Orthotic laboratory by our technicians and overseen by our podiatrist.
After fitting his new orthotics into a new pair of runners that we recommended, Sam headed on his way feeling comfortable to return in a couple of weeks. We prescribed some stretching to work with his orthoses and suggested that we may need to follow this up with a specialised massage to relax his muscles as his orthoses took over and began doing their job.
A couple of weeks later a very relieved set of parents and Sam returned to our clinic. In a little over two weeks the orthoses had started to do their thing. Sam had only had pain in his legs once since starting to wear his orthoses and this was after a very big day, his school athletics carnival! After only a couple of weeks we expected this to decrease so we asked them to return in another month at which time they reported Sam to be pain free!! Sam’s parents also reported that he was much more comfortable at sport as well. They were overjoyed; they had their happy, healthy little boy back!
Growing pains ARE TREATABLE in most cases. While many well-meaning health practitioners may say you have to wait and outgrow growing pains, there are alternatives. Our practitioners have had the pleasure of helping many kids with this same problem. It’s what we love to do! Helping kids become pain free, happy, healthy and active is a privilege. If you would like to help your little one to become pain free, please give our helpful reception team a call on +61 9673 2987 or 4732 2007. You can also see find us on our Facebook page https://www.facebook.com/podiatristsydney
Contact us at 9673 2987 with questions we want to truly understand what’s happening at present with your foot and leg pain if you are ready we will set up your initial appointment.
Learn more about your condition - Check out over 40 Educational videos our team has prepared on our Facebook page. From heel pain, and what’s the best shoes, to ball of foot pain; it’s all there.
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