Standing on your feet for long periods at work

Standing on your feet for long periods at work

Standing occupations and what happens to feet!

Standing on your feet for long periods at work

Busy looking people!

Most of us stand or walk everyday but amongst us there is a proportion of our population that do it more than others. We are talking to you Nurses, Builders, Hairdressers, Concreter’s, Teachers, process line factory workers and Check out operators and, and, and and! You guys know more than anyone what a toll standing for hours can do to your feet. Below is a very quick description of some of the more common problems you may have suffered and things we as foot specialists see day in day out and help to treat.

Plantar plate tears / injuries / dysfunction

Is this you? (What it can look like)

• Do you have pain in the ball of your foot? Is it worsened when you stand or possibly wear shoes?

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• Have you developed the feeling of a lump or a little pea under the ball of your foot?
• Is there dry hard skin (callus) developing under the ball of your foot?
• Have you noticed a small (or large) gap developing between your toes that resembles “V”? This is often the 2nd and 3rd toes, but it maybe any?
• How did it happen? Do you remember tripping falling and developing a pain in your forefoot (ball)? NO you DO NOT have to have had an accident!
• It may have developed slowly over time with no memory of a painful incident.

We see this many times a week and sadly we often see it misdiagnosed and therefore treated as the wrong problem. It can be misdiagnosed as a Mortons Neuroma or at times when people aren’t sure of things (and for many years) some practitioners diagnose Metatarsalgia .
Remember “Grandma’s feet? You know the ones where her big toe had formed a bunion and the next two toes popped up and crossed over each other? Yes those feet you wished you would never get, and swore you would never let it happen to you! Guess what without having it treated pronto –they soon may be yours!

Correct Diagnosis

A big part of this problem is misdiagnosis! You cant diagnose this if you don’t see a stack of it. As a clinic we will always send you for a Ultrasound BUT not just to anyone! Some radiologists commonly miss this and sadly are not familiar with the condition. Make sure when you are referred to get a diagnosis the radiologist knows and has diagnosed Plantar plate tears before!
Clinically your podiatrist should be able to see this quickly but it can be tricky and some Pods are more equipped for general nail care. Choose someone who sees this regularly! ASK!

Treatment

Strong supportive footwear is a key here! Shoes should be solid on the base not bend or twist. Cushioning this condition with fancy air bubbles WILL NOT fix this!

Orthotics (Custom made) – Well-made and designed orthotics will assist poor foot posture and correct alignment. They cannot come out of a packet and fix this, they need to be designed to help address this.

Soft tissue therapy – This condition is often slated straight to surgery STOOOOOOOOP! Unequivocally this condition has a good prognosis with conservative therapy trail first! We see this condition many times a day and get great success. Now we realise not all Pods do soft tissue like we do (Come on pods get to it!) but this is really necessary to go hand in hand with your Orthoses. Orthoses alone WILL NOT fix this. If your Pod wont do soft tissue then find a physio who will!

Surgery. Yes if this condition progresses to an unresolvable tear there is a need for us to refer you to an orthopaedic surgeon for surgery. SURGERY is A LAST resort! On most occasions surgery can be avoided with early quality intervention. As a note we worry about the amount of these we see that have unnecessarily sent to a surgeon. Many times way too early and before conservative care I has been trailed correctly these patients (you) are sent to surgery!

Heel pain

Is this you? (What it can look like)

• Pain on the first few step in the morning or pain on rising after sitting (Or Both)
• Pain Located in the heel area, under the heel where the slightly fatty area is, or pain in the Achilles running up the back of the lower leg.
• Pain may initially subside in first stages after first few steps
• Pain worsened by long period on your feet may become painful after walking or activity for reasonable periods of time.

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Correct Diagnosis

The first thing your friends will tell you is “It’s a Heel spur”. Sadly life is not that simple and where once medicos lumped this into one general diagnosis (Sadly some still do). We recognise that this set of symptoms may be one of many conditions. Plantar fasciitis, fatty pad syndrome, Achilles tendonitis, and even Abductor Hallucis tendonitis can contribute to this pain. Find a practitioner who knows the difference! Again not all practitioners see these things a lot.
At times simple clinical signs are enough, but diagnosis maybe needed via radiology such as diagnostic ultrasound. Xray will show you a spur (Yes I know) but the bony spur is NOT the problem.

Treatment

Strong supportive footwear is a key here yet again ! Shoes should be solid on the base not bend or twist. Cushioning this condition with fancy air bubbles WILL NOT fix this!

Orthotics (Custom made) – Well-made and designed orthotics will assist poor foot posture and correct alignment. They cannot come out of a packet and fix this; they need to be designed to help address this.

Soft tissue therapy – Deep connective tissue massage, will be useful in all the above conditions. Again be wary of people simply telling you that orthotics will get rid of this. They go hand in hand but are not the only answer.

Shockwave – As a clinic we have been using shockwave for about 3 and a half years. As we are “early adopters” of new therapies, this is not as common to other practitioners but the use of this therapy is very handy and growing in popularity. We find this takes half the time that Deep connective tissue does to relieve this in combination with the other therapies.

Stretching – there are some very specific stretches that can be used for this group on conditions and for a large group of individuals this will help. Don’t be discouraged if these don’t work. Look above there are more options and solutions.

Tibialis Posterior dysfunction.
(Super flat feet / Fallen arches)

Is this you? (What it can look like)

• Pain in and around the arch. May be worse after walking or standing
• Discovering you have a “Fallen arch”
• Noticing one arch is lower than the other.
• Pain fatigue during or after walking. Pain on standing on toes ,climbing ladders.Standing on your feet for long periods at work - 4

Correct Diagnosis

This should be fairly easy to diagnose. The lowering of one arch, as opposed to the other, in combination with pain located in the arch. Should lead to an easy diagnosis. Diagnostic Ultrasound maybe used and your Podiatrist (us) can refer you off for this.

Treatment

Strong supportive footwear is a key here yet again and now again ! Shoes should be solid on the base not bend or twist. Cushioning this condition with fancy air bubbles WILL NOT fix this! (Can you see a pattern)

Orthotics (Custom made) – Well-made and designed orthotics will assist poor foot posture and correct alignment. They cannot come out of a packet and fix this; they need to be designed to help address this. IN particular without orthoses this condition WILL NOT get better! Get them and GET THEM QUICKLY!

Soft tissue therapy – Deep connective tissue massage, will be useful in all the above conditions. Again be wary of people simply telling you that orthotics will get rid of this. They go hand in hand but are not the only answer.

Braces – In the initial stages having braces specifically designed to support the arch will support and make steady the arch. It works well at first but is really a short term solution. Look towards orthoses and soft tissue.

Surgery. Yes if this condition progresses to a tear there is a need for us to refer you to an orthopaedic surgeon for surgery. On most occasions surgery can be avoided with early quality intervention.

Bunions

Is this you? (What it can look like)

• Your big toe starts to point out towards the smaller toes and is no longer straight

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• Pain may develop around the big toe joint. Making it difficult to walk or stand
• Many people can have a bunion and not have any pain.
• The toe may begin to twist as well

Correct Diagnosis

On most occasion a qualified health practitioner should be able to diagnose this simply by looking at the clinical signs, however you may require a xray if you are considering surgical intervention.

Treatment

Strong supportive footwear. (Wow we just wont stop talking about this supportive footwear will we!!!) Shoes should be solid on the base not bend or twist. Cushioning this condition with fancy air bubbles WILL NOT fix this! (Can you see a pattern)

Orthotics (Custom made) – Well-made and designed orthotics will assist poor foot posture and correct alignment. This problem is often a result of a variance in the structure of your feet Yet again these cannot come out of a packet and fix this; they need to be designed to help address this.

Soft tissue therapy – Deep connective tissue massage, will be useful in all the above conditions. There is a problem with the balance of two muscle in your feet. This can also lead to another condition that may damage other muscles and soft tissue structure, the plantar plate rupture or dysfunction. Again be wary of people simply telling you that orthotics will get rid of this. They go hand in hand but are not the only answer.

Braces – Often called night splints there is some research that suggests these can be really helpful. I (Brenden) am a little dubious! This relies on you being super diligent on putting the splint on night after night. I always argue that on a Friday night after a busy week and a catch up with the girls after work it’s not likely you’ll want to pop this on before heading to bed. This is where the success of these will fall down BUT if you are super diligent, give them a try.Standing on your feet for long periods at work - 6

Surgery. Yes if this condition progresses there is often a need or want for us to refer you to an orthopaedic surgeon for surgery. This surgery over years has increased in its success. See a orthopod who does this all the time. Why ? Because ensuring that the person does this and other foot surgeries often increases the chance of success. If they are also doing shoulders knees hips wrists etc etc they simply cant be as use to doing this surgery as someone who does this every day.

The HARD sell !
At A Step Ahead foot + Ankle care we see several patients a day with this condition. We have patients that travel literally hundreds of kilometers to seek our help –which is really lovely! Our clinics are set up quite specifically to treat patients with muscle injuries and mechanical problems with their feet. We have invested hundreds of thousands of dollars into equipment and the latest technology to help us, help you- beat your pain.
Our principal Podiatrist Brenden Brown is recognized as one of Australia’s leading experts in Podiatry (No really). A past President of the Australasian Podiatry council he is regularly asked for his opinion in the media, appearing regularly on television shows like the Today Show and Magazines like Men’s Health.
It would be a pleasure to help you beat your foot 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……. See that wasn’t so bad was it!

Copyright 2015.   We take our copyright quite seriously. If you reproduce this without seeking our permission we will be very upset. So upset we will contact our solicitor and instruct them to deal with you. Big hairy scary with a steely glare enormous shoulders and a square jaw she will take you to task! We will instruct her to take all necessary measures to recompense us for your infringement on our intellectual property and copyright!
If you would like to reproduce this and are happy to acknowledge our company and share a link to our website then we will most likely be happy to allow you to reproduce this, but hey why not ask!

Why we make our own orthotics and how they are better

Why we make our own orthotics and how they are better

Q) Why did we start our own Orthotic Company in 2010?Why we make our own orthotics and how they are better - 1
A) Sometimes you just know things can be better!

I have been making orthoses for patients for a long time now nearly 20 years.  I do it because time and time again I see these seemingly simple devices (they are actually not simple) make great changes to people’s lives. Put simply I have watched as orthoses made with love, passion and a good dash of knowledge and advanced technology, make people live better!

In the past I had all my devices made by third party companies – almost all Podiatrists do. They are made from a script which we fill out giving you a series of options. For many people it works it did for me for many years. However while it worked and worked well, I knew we could do better I knew I could help people MORE and get a better fit if I could have more control right from the start till right to the finish.

Why we make our own orthotics and how they are better - 2

Our Lab technicians working on orthotics for patients each pair is hand finished. Some of our Lab technichians have been making orthotics for more than 15 years – that’s experience!

Better design – I wanted to design orthotics that patients LOVED to wear! So after extensive investigation and visiting 2 other countries, I came across what I consider to be the best orthotic design package available in the world to date.  So we invested in a state of the art system with limitless design capabilities.

Perfect fit – It has to fit our patient’s feet PERFECTLY! Not only did the package come with a brilliant design package it came with a laser scanner that took a 3D scan the accuracy and likes of which I could not find elsewhere. It maps the foot accurately to within half a millimetre – Heck I have had a piece of dirty stuck to someone’s foot and these scanners have picked it up! We bought two world leading scanners – I have not found better

More flexibility-Our patients need us to work with them! With minimal restrictions! If a patient really needs a different cover or a particular fit for a particular shoe, I want to give it to them! I wanted to not be restricted to a series of boxes ticked on a prescription. We now deliver a true Bespoke – custom made orthotic.

Best quality– Our patients deserve the best!  I want to provide all the best materials for my patients! The highest quality, too the best standards- no compromise! I wanted to be the person deciding on the quality – I am super fussy and I like expensive stuff!  We now buy only what we consider will last the longest for our patients and what will deliver them the most comfort and performance!

No excesses – Our patients are paying good money, they deserve only the best. If a cover is wrong, if it isn’t comfortable, if it wears out, if it needs to be better – it is all up to us! It’s not someone else’s fault, a faceless guy at a lab. It all comes back to us! We guarantee what we make- we make the best and stand behind it! 12 months guarantee on the shell and top cover, if it’s not right we fix it and in that time you will never pay!

We started this company to make patients the happiest they can be!

A Step Ahead Foot and Ankle care are located in Sydney’s Western Suburbs. We would love to be able to help you with your foot or ankle pain.

A side note: We are glad to see other practices around us start to develop a love for making their own orthotics. We say that’s great if we can lead the way and others pick up on our technology and as an end result we get all get better results for our patients that’s an awesome thing! We have now been doing this for a long time if we can help you in any way please let us know – Happy to help others get it right!

Heel pain’s latest treatment techniques

Heel pain’s latest treatment techniques

Heel Pain

Heel pain, heel pain relief, heel pain clinic

Heel pain relief for chronic Heel pain patients are available at our heel pain clinic

A Step Ahead Foot + Ankle care has been helping people to recover from heel pain for over a decade now and we thoroughly enjoy it! Being able to help people get back to active lives achieving the things they hope to do is what we both do and love! 

Heel pain can be debilitating and hinders people to do daily activities including anything from regular shopping outings to exercise.

Most people suffer from a slightly varying combination of Symptoms including:

  • Pain on placing the heel on the ground after sleeping or raising from a chair.
  • Pain may relieve slightly, only to increase again later through the day
  • Pain is located towards the back of the heel in many cases, however may progress towards the front of the base of the foot.

On many occasions people are told by their well-meaning health practitioner they cannot treat this, or that it will get better by itself or to try stretching or soft padding in shoes. Frustrated most people have nowhere else to go and put up with this debilitating pain.

With over a decade of experience and a passion for making people feel better A Step Ahead have developed a highly successful regimen of treatment which is delivering excellent results for patients.

Using a combination of therapies including specific stretching techniques, Specialised soft tissue therapy, custom designed and 3D cad cam designed insoles and our new Shock wave therapy. A Step Ahead is delivering relief of long standing heel pain treated unsuccessful by other practitioners.

How is a custom made orthotic created?

How is a custom made orthotic created?

Several years ago A Step Ahead Foot and Ankle care decided that to have more control of our patients outcomes we needed to make our own orthoses in house. Patients and often their referring doctors often don’t realise that many podiatrists in fact do not make their own custom made orthoses. While they can prepare a script they have trouble really making a device that is perfectly matched to the foot.

In our last article we described how orthoses should be prescribed. As you will see the process is fairly complex and requires a number of measurements using some specialised equipment and a great deal of clinical expertise. The junior podiatrists at A Step Ahead Foot and Ankle care who have already completed a university degree and 1000 clinical hours still are observed and work with one of our senior podiatrists for the first two years after graduation to make sure they have a strong knowledge base behind them when designing an orthoses for a patient.
Once a 3 dimensional scan and measurements are taken of both your feet, it’s time for our Podiatrist to design the orthotics. Designing each orthoses is done using Cad-Cam software and specific to each person, each person’s individual design takes approximately 15 minutes ensuring a complete match to your foot.

From here the design is sent to A Step Ahead Foot and Ankle care’s CNC mill for cutting on average this takes about 20minutes for each of the orthoses shell. As mentioned before, each orthotic is individual and subsequently there can be as little as 1 mm differences in measurements in the orthoses so ensuring we get the milling right is very important. 

After the mill has finished its very precise job, the orthoses edges need grinding so they fit comfortably into a shoe. At this time we will add covers to enhance the comfort of the device and small additions which will tweak the way you walk, such as metatarsal domes and rocker bars and possibly even more cushioning! We will also look at any further adjustments needed to change the postural position of your feet and legs. This can all add up and takes about an hour’s worth of time per pair to finish.

As you can see making a custom made orthoses can really take some time they are very complex devices with a real “handmade” component to each of them. Each device is designed to meet each patient’s specific health needs. So when people rightly ask “How come your orthotics cost …….” You can tell them because my orthoses are handmade just for me!