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.

Thongs-  Flip flops -Jandals -double pluggers – “Slappies” – Zori and YOU!

Thongs- Flip flops -Jandals -double pluggers – “Slappies” – Zori and YOU!

Brenden Today Show


Our podiatrist Brenden Brown was recently on the Today show discussing thongs! If you missed this segment press on the photo above and you can watch the video!


Quick points

  • Thongs make your foot muscles work harder
  • To keep a thong on your foot you need to scrunch up your toes and pull them in tight. Often keeping the thong on your foot comes at the expense of other muscles as these seem to become sore form compensating.
  • If you have a foot that requires extra support “Thongs” are problematic as they have no support, creating muscle soreness
  • While we have always “known” or thought that we tend to trip and fall more easily in thongs there is a mounting body of evidence that this true.

The Humble thong

Australian’s have come to love the humble thong, it has almost become an institution in its own right. Characterising Australian life as much as Beer, our love of summer cricket and Barbeques.  Despite our love of the humble thong this easy to wear piece of footwear somewhere in our heads we have come to realise, perhaps even sub consciously, it may not be as good for us as we would LOVE it to be!

Interestingly, despite our love of the thong and its acceptance as almost iconic Australian footwear it does not originate in Australia but from much further a field.

This style of footwear has been worn by the people of many cultures throughout the world, originating as early as the ancient Egyptians in 4,000 B.C. The modern Thong  descends from the Japanese zōri, which became popular after World War II when soldiers returning to the United States brought them back.(*1) Its possibly here and our involvement in this conflict that brought the “thong” to Australia.

So why is it so bad?

Thongs are not the most evil thing in the world …….. That is day time television…. but there is mounting evidence that they maybe creating more harm than good. We see a lot of patients that come in on an almost daily basis in summer who have pain in their feet and legs which can be attributed to excessive wearing of thongs.

So what’s happening? The muscles in your feet are working very hard when you have a pair of thongs on. They do this for two main reasons 1. They are trying to keep the thong on your foot so they cramp up and claw onto the base of the thong. 2. Because in a thong your foot is not very stable. Your foot is moving about quite a bit, you may not that often your thong does not head in a straight direction rather slips from side to side on  our foot. Again here is where your foot is moving about trying to simply stay stable much like it maybe while simply walking in bare feet.


Can it cause me long term damage?

There is a court case in Australia that was recently overturned when someone slipped in a shopping centre. At first the person who slipped won a case against the shopping centre but this was overturned when it was found that it may well have been the instability of the thong the person was wearing at the time that caused the fall!

People not only get sore muscles in their feet and legs but there seems to be at the very least anecdotally a mounting body of evidence that wearing a thong may lead to falls trips and other accidents. We also know on many occasions apart from simple things like excessive callous development on the heels of chronic thong devotees there are many people who find themselves with lower back pain, shin pain or heel pain from the malaised thong!

How can I make it better?

OK so I always fear talking, writing or even uttering poorly about the Aussie thong. At the time of writing this article I had just been on the Today show here in Australia giving my expert opinion on thongs. On the Today show Facebook page they placed a post about me appearing on the show saying it may not be good for you. At last count there are 831 people commenting, mostly bemoaning that I would dare criticise the thong. To put this in perspective on the same day Dan Aykroyd Hollywood legend was on the show, his article has attracted 53 ……… Australia I hear you!

  • Wearing a thong is not a bad thing but it needs to be in moderation! Wearing a thong daily is not a good idea. Nor is wearing it on very long trips with loads of walking etc. So what makes thong wearing bearable?
  • Wear a thong in moderation an hour a day at most if you are wearing them daily, Try to cut it down to wearing them on maybe weekends and around a pool.
  • I have a rule that my patients can wear their thongs anywhere they are within 50 metres from a large body of water. This does NOT include back yard swimming pools.
  • Try wearing sandals if you can as an alternative – still open footwear without all the “hard work” for your foot muscles!
  • Moisturise your heels daily if your wear thongs for long periods it will soften those dry heels!
  • Alternate with good supportive sneakers – give your muscles a break.


Please understand that while I am no fan of the Aussie (Japanese /Egyptian) Thong I am myself someone who wears them. I follow the rules above and as a result I rarely get foot pain. Thongs have a place in our wardrobe but it should be kept for beach wear and light recreation, where not a lot of walking is involved.  There is a whole world of people including some of my academic colleagues who would almost go to any length to protect the humble Thong from attack on its image as iconic Australian footwear. However anecdotally no matter what double blind trial computer topography or emotional tirade you throw at me as a day to day practitioner I see an endless amount of punters with sore and damaged feet which are the direct result of a excessive Thong wearing.  And please let’s not even start me on what a fashion faux pas (Fopar)  they are !







* (from Wikipedia)

Fallen arches (Posterior Tibialis tendon dysfunction)

Fallen arches (Posterior Tibialis tendon dysfunction)

Mary decided to visit us at A Step Ahead Foot + Ankle Care because after starting walking in an effort to lose weight and get fit again, she was getting quite a lot of pain in her right foot. Mary explained that she’d been walking for about 3 weeks, 3 to 4 times a week for about an hour at a time.

Mary is a 49 year old mum of three children she leads a busy life; she works full-time, still runs the family home, volunteers at her husband’s footy club and is trying to get fit!

Mary noticed that she started to get a little bit of pain after each of her walks but put it down to just ‘getting used to walking’. After another week she noticed the pain became more intense and noticed it started very quickly after she began to walk. The week following she noticed the pain began to increase over time it went from hurting when on her walks to eventually hurting when she was not walking at all and all through the day. Mary swears she also has noticed that the arch of her right foot was falling.

After taking a detailed history we began to palpate (push and prod in non-doctor talk) around Mary’s ankle to find the area under the inside of her ankle bone (Her medial malleolus in doctor talk) was very swollen and painful to touch. Using our specialised digital video walk and run analysis equipment we discover that Mary had quite rolled in (over pronated) feet and she was correct, her right foot was more rolled in than her left. We sent Mary off to a radiologist with a referral for an ultrasound to confirm our suspicion that Mary was suffering Posterior Tibialis tendon Dysfunction. She returned that afternoon with exactly that!

Custom made orthoses from a 3d model of your foot

Custom made orthoses from a 3d model of your foot

Having confirmed our diagnosis, we began looking after Mary with the best quality care available. Firstly before leaving we strapped Mary’s foot to take pressure off the overused tendon, we ordered her a specialised brace for the short term again an immediate relief in pain and after a discussion we also prescribed a pair of custom made orthoses. These will stop the overuse of the tendon by reducing the excessive pronation.

Mary’s results have shown that unlike some people who wait too long, Mary came in quickly and has avoided the need for surgery, which can be necessary if this is left too long and not caught quickly. Her orthotics were manufactured in A Step Ahead’s own orthoses laboratory using our custom made milling system and hand finished by our technicians. After a fitting and wearing her orthoses for several weeks we also began a series soft tissue therapy sessions with our team to help rehabilitate the damaged muscle.

New 3d scanners create perfect models of your foot

New 3d scanners create perfect models of your foot

The good news – Mary’s ankle and foot is now back to normal and she has started back to walking slowly! After we designed a ‘return to exercise’ program for her to follow, she has reduced the chance of re-injuring her foot. Rehab took quite some time but was made easier by Mary’s compliance and her willingness to work hard at getting better.

Its always rewarding for our team to meet people like this who are striving to get back to health!

The relationship between Feet and your posture

There is direct connection between your feet and posture. Most people are not aware that how you walk, sit or even sleep has an impact on your feet.

It is recommended that you visit a podiatry centre like A Step Ahead Foot and Ankle Care Clinic for a professional check-up of the health of your feet and advice on how to keep your feet healthy.  With over 15 years in feet and posture matters, Mr Brenden Brown, the clinic’s principal podiatrist will give you the right attention and treatment.

The reason why feet and posture are directly related is that your feet bear the impact and all the weight of your body. A body posture in which the centre of gravity is not optimum will exert unnecessary pressure on the feet.

In thinking about feet and posture, take the example of a building. When the foundation shakes, the whole building becomes weak or collapses. This is the same with your body; if your feet are not maintained, or are not ‘stable’, your whole body will be affected.

Most damage to feet occurs because of walking or standing for long periods of time. Practice good feet and posture and you will live healthier, stronger and for longer.

 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