Frustration and foot pain
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!!
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?
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?
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.
Principle Podiatrist and founder for
The A Step Ahead foot and Ankle care team
- Needing a pair of orthotics?
- Heard mixed messages on how effective they are?
- Aren’t they all the same anyway?
If you’ve ever even CONTEMPLATED getting orthotics – read this first!
Let me start by answering a question that goes through almost all of my patients minds at some point – nope, orthotics are definitely NOT all the same and when the right orthotic is properly designed for my patients foot using the right materials and design skills that come from years of experience (and very honestly, learning from previous mistakes that others are still making today), yes they ABSOLUTELY do alleviate foot, ankle and low-er limb pain.
In fact, orthotics couldn’t be more different – and in many ways, they should be! Let me explain while answering a few concerns I often hear:
- Are my orthotics going to be like my pair from my previous podiatrist?
- I know someone that has had orthotics before but they didn’t help him?
- What do orthotics actually do?
Let me start in answering these with the first and most important point:
The way your orthotics look and how effective they are are dependent entirely on the skills and preferences of your podiatrist! Yes – your specific podiatrist alone dictates how they are made and using the resources, materials and skills they have available at any point in time. If your podiatrist wants to heat-mold a pre-made, soft, thin orthotic and add a colourful harder piece and call that a custom-made orthotic, then that’s what you get. If you get plaster-cast and the cast gets sent to Canada for a firm, plastic-like device to come back, then that’s the orthotic you get.
What does this mean? Simply and unfortunately put, you may receive a lower quality product (often associated with a cheaper price) that claims to do the same thing, but often fails to produce the same results (pain relief!) and tends to have a shorter shelf-life. Think of it as buying make-up (clearly, this is written from a female perspective). You’re after a lipstick. Sure, you can buy an $8 lipstick from pretty much anywhere, but we know it will never compare to buying a Mac lipstick, that you’ll love and keep using until the very very end.
So how do I know if my orthotics will be good? Don’t be afraid to ask! They should be more than happy to talk you through the process – I LOVE talking through our orthotic design and manufacture – from the extensive testing of the range of motion of your foot and ankle joints to muscle strength, foot posture index, video gait analysis and 3D laser scanning your foot! But that’s only the part you see – it all then collides when our principal podiatrist and founder, Brenden Brown, designs every single one of our patients orthotics (yes, over all of our clinics!) himself, using his 20 years of experience and the widest range of materials I’ve ever seen as a podiatrist. BUT THEN, our CAD/CAM milling machine actually mills out the base of your orthotic, all in our VERY OWN (and very exciting!) orthotic lab, and hand finished by our orthotic technicians! It’s safe to say that it’s a little more technical than sticking two bits of material together and naming it an orthotic, and FAR more effective.
Finally, think about what your orthotics do! Orthotics have a FUNCTIONAL purpose to alter the alignment of your foot, changing different pressures and strains over your muscles, bones, joints and exactly where you’re having your pain. They address the CAUSE of your lower limb problems to provide you with long-term relief, and when designed and created right, they do this VERY well.
Happy orthotic hunting!
Dr Nina Lansdowne
Podiatrist and Superstar Blog writer
His brother has very flat feet and wears orthotics, so I thought I’d get him checked too. He doesn’t get any pain though. I hope that’s okay that I’ve brought him in?
You wouldn’t believe the number of parents I see who are almost embarrassed to have made an appointment for their little one because they’re not sure if they should have.
After chatting to them about why they are uncertain, the most common thoughts floating through a parent’s minds tend to be:
• Is he too young to come in for an appointment? I’m not sure what a good age for this is.
• He doesn’t actually get any pain so I’m not sure if I need to have him looked at?
• I think I might be over-thinking this because it’s only a small thing I’ve noticed!
• This might just be a normal part of her growing, I’m just not sure what’s normal!
These are all very valid thoughts and concerns, and are completely NORMAL!
Unless you’ve undertaken a 4-year podiatry degree and then had at least a few years on top of that working particularly with kids, then there’s not a single person in this world that can expect you to know what is and isn’t normal and when to bring your little one in.
That’s PERFECTLY okay – we’ve taken care of that hard “qualification” stuff for you!
Let me quickly clear up a few of the burning questions:
1. There is NO such thing as too young. We see kids as early as 12 months old – from the moment that they start walking! You’re actually doing us a favour – firstly because the younger we start treating, the better (and faster!) the results tend to be, and secondly because if we have to wait before we start treating, we are able to see and track the progression and changes in your child’s feet. I often ask if the foot was like this a year ago and am often greeted with ‘I honestly don’t know’. The more pieces of the puzzle we have, the more specific we can get in our treatment plan.
2. Pain is NOT the only indicator that something’s wrong. Parental instincts are a powerful thing – if you notice that something is odd, or isn’t quite right, there may well be something going on that needs to be addressed. Don’t doubt yourself!
3. A small thing may indicate something bigger happening. You’re not over-thinking anything at all – everything has a cause, and sometimes something as seemingly small and resolvable as a little bit of in-toeing can actually be a result of a structural foot abnormality that needs correction before it gets worse or weakness in the core muscles that need strengthening to correct and aid normal development.
I think the BIGGEST thing that I want to emphasise here is that we LOVE that you bring your child in at an early age! We LOVE that you just want to get their feet checked to make sure everything is progressing normally. We LOVE that you want to be as proactive as us and prevent any problems from developing instead of having to fix a painful foot after the pain has already started. We will NEVER think it was a bad idea to bring your little one in.
Kids are at the centre of what we do – it’s WHY we come to work – and nothing makes us happier than seeing happy, healthy and active children running around our practice and tearing up our toy box (literally, we have a drawer filled with toys now).
A Step Ahead Foot + Ankle care
Penrith, St Marys and soon to come to a suburb near you!
A Step Ahead Foot and Ankle care have founded “My Kids Foot Doctor” a clinic specifically geared towards treating Kids feet. We see dozens of kids a day, unlike other practitioners who see your Grandma’s toe nails and the occasional kid we see these balls of fun all day every day.
Our clinics are set up with kids in mind we have big toy boxes, Ipads, TV’s coloring in and lucky dip boxes. Our practitioners are the kind that sit on the ground and chat to your child, who laugh, may wear silly glasses and love handing out chocolate WE LOVE SEEING KIDS!
What does this mean? It means we have built up an enormous amount of experience with kids because we get to see them ALL the time! If we can help you with your little one, if you have a nagging doubt or worry please call our helpful team on 96732987 we’d love to help!
“Ok so I went to the guys down the road.” Say Lee my Triathlon loving patient says to me. “It’s just really sore here under my second toe, they said it was a Neuroma but they have been trying to fix this for weeks, no months and it’s just not getting better” !
The pain that Lee was chatting about was not a surprise to me and nor what I noticed on her foot. She had developed a small V between her 2nd and 3rd toe, had pain under the ball of her foot and had developed a small amount of callous around the same area. Yup I’d seen this many times before!
If she wore tight shoes, high heels or bike shoes in her case she found the pain got worse. If she ran a lot while it may have got numb for a while at the end of the race it got sore! Over time she noticed the split or V sign getting worse.
On seeing this her GP suggested Metatarsalgia, which for years has been a reasonable diagnosis and what most would suggest this may be, However it’s NOT. The “other guys down the road” AKA another group of Podiatrist, had diagnosed a Morton’s Neuroma, again this is a common misdiagnosis. Often radiologists will under ultrasound call this a Neuroma because these two conditions can look strikingly similar. The scan or ultrasound the Radiologist undertakes is only as good as the information provided to them though your diagnosis in the clinic get it wrong and so will they!
After a bit of pushing and prodding, and watching Lee walk again on our Video walk / run analysis equipment I was now sure what we had BUT I wanted to get another set of eyes to have a look so off she was sent to see a particular radiologist we use all the time. He sees our patients very specifically because he is overly experienced in looking at FEET!
On the report there it was “A plantar plate disruption between the 2nd an 3rd Metatarsal heads.”
So we started Lee on a series of Deep connective tissue massages with our Podiatrist, renewed her orthotic insoles and arranged for her to get some new trainers on our advice.
6 weeks later and BOOM Lee was about to start running again! “I won’t be going elsewhere again” she said and this time I believe her!
Brenden (AKA BB)
A Step Ahead Foot + Ankle Care