Don’t get laser therapy until you’ve read this report (1 minute read time!)

Don’t get laser therapy until you’ve read this report (1 minute read time!)

Don't get laser therapy until you've read this report (1 minute read time!) - 1

Don’t get laser therapy until you’ve read this report (1 minute read time!)

Fungal nail infections are hard to beat! Facts are hard to find, and there are stacks of misinformation. Here is a quick run-down on some FACTS that may just help you beat this nasty!

Where do most fungal spores live

Almost anywhere! Infection will live in; Your shoes Your Socks Bathrooms Gym locker rooms Communal shower areas There is thoughts that Carpets may be able to carry the spores!

How do fungal spores travel?

Fungal infections are very contagious and very easy to contract because the spores travel so well and are not visible! They travel in socks and shoes. They are known to be in the bases of showers. There is conjecture that they may also be present in carpet!

Does cold water kill fungal spores?

Cold water has NO affect on Fungal Infections nothing. It will not kill the infection nor stop it from spreading.

Should I use Bacterial wash to kill my fungus?

There are now a number of bacterial washes and “disinfectant” washes for your clothes. They will have NO effect on a fungal infection present in socks, towels and their washing.

Do antibiotics kill fungus?

No! Antibiotic kill bacteria. Fungus is NOT a bacterial infection. Taking antibiotics will do nothing to your fungal nails! Sorry ZIP NOTHING NADDA

Is there an answer?

Medical Grade Hot laser is the current treatment of choice for fungal nail infections. Clearance rates for this therapy are as high as 80% plus. Compared to paints and ointments on the market which have a clearance rate of approximately 13% (yes that’s incredibly low). We have been using medical grade laser for 5 years now and our clearance rates match those seen in research.

Need more information? Want help?

We would love to be able to help. Our team have multiple patients a day contact our clinic with questions about this nasty infection. They will run through questions you may have, running through what you have tried. They can then advise on the best appointment type for you and costings. Then reserve an appointment time that’s best for you.

Our number is 96732987 we look forward to getting you on the way to clear healthy nails.

Would you like more information? Try our page on dedicated Fungal Nail site FUNGAL NAIL DOCTOR

Perhaps you’d like to know why your GP may have tested you and it returned a negative result ? Try our helpful post on False negatives! HERE !

Warming up and Stretching for Netball – NetballSmart

Warming up and Stretching for Netball – NetballSmart

Hi guys, back again to chat about rehab and even more importantly PREHAB, and we will stick to our netball theme in light of the Diamonds stunning World Cup Victory last weekend.

2015 World Netball Cup Allphones Arena Gold Medal Game Australia v NZ Caitlin Bassett celebrating the win with teammate Sharni Layton. Picture: David Callow

2015 World Netball Cup
Allphones Arena
Gold Medal Game

Preventing injuries is of massive importance as it link directly to enjoyment of sport, and optimum performance.  Lets face it, we all want to get around the court like Paige Hadley or shoot like Caitlin Basset right?  Sitting on the sidelines nursing an injury takes you away from the sport you love, and away from the eyes of coaches and selectors alike.

Warming up and Stretching for Netball - NetballSmart - 2

Quite often we see resources that don’t address the specific factors that will minimise the risk of injury to our netballers!  Our A Step Ahead NetballSmart blog aims to overcome this by giving you guys a simple to understand, point by point action plan for injury prevention.
Warming Up and Stretching
Preparing the body for participation in sports by warming up, will enhance the maximal performance and reduce the risk of injury!  Its a sentence i often find myself repeating over and over again to my young patients.  The Netball World Cup was a great example for us as a practice, with the public being able to see first hand the amount of time the best teams in the world spend on warming up before games.
Warming up improves blood flow to the heart, increases the muscle temperature and makes muscles more pliable.
Cold or less pliable or elastic muscle works harder to accommodate a given load and will be more resistant to sudden stretch.  Less pliable muscle tissue is also more susceptible to overuse injuries.
Below we have come up with a simple to understand table to break down the different stages of warming up.
Example for Netball
Aerobic Exercise
Increase Body Temperature
2-3 Light Jogging the width of the court
Increase Elasticity of Tissue
Increase Joint Range of Motion
Dynamic Stretches for Leg Muscles
(see examples below)
Sport Specific Exercises
Prepare the body for the type of activity expected
Short Sprinting
Changes of Direction
Passing and Shooting drills
Right, so now we have established our table, what does it all mean?  Well, basically, the first column (component) is the breakdown of a typical warm up routine you can use before your saturday games.  Once we have established we need to break our warm down into three different parts, and you want to skip the detail, we can look across the table to the examples.
First we start with a jog across the width of the court 2-3 times.  We can then move into some dynamic stretches for the major legs muscles you will use for the game.
A good start is to warm up the Calf muscles, which are the big muscles at the back of the lower leg and then upwards  to the Hamstring muscles.  If you don’t know much about Dynamic stretching, see our short description below!
Dynamic stretching WARMING UP PRE EXERCISE
Dynamic stretches differ from the norm in that they stretch the body through movement. Instead of putting your body into a stretched position and keeping it there as the muscles relax gradually, you move quickly into and out of a position that stretches your muscles. 
Dynamic Calf stretches:
Get yourself into a classic push up position.  Then, hike your hips towards the ceiling or sky creating a V position with your body.  Keep your back as straight as possible.  
Place one foot over the back of the other ankle, and slowly but actively push your heel into the ground.  Then, push your ankle upwards going up onto your toes.  
Perform three sets of 10 repetitions per stretch for improved calf movement and flexibility.
Warming up and Stretching for Netball - NetballSmart - 3
Dynamic hamstring swings:
A two-part dynamic stretch for the hip flexors, hip extensors, hip adductors, and hip abductors
This involves gentle swings of the leg forwards and backwards gradually getting higher and higher each time. Around 10 to 15 swings on each leg should be enough. 
Warming up and Stretching for Netball - NetballSmart - 4
We then want to move into some sort of sport specific movement, something that you will be doing regularly on the court.
We had the absolute privilege of watching the Diamonds take on Jamaica during pool play of the World cup thanks to Asics Australia.  It was really interesting to watch the girls going through there physical and sport specific warm ups.  These are generally done as a team, so your coach will want to have some input here.
I hope this blog has been informative, without being over the top with mumbo jumbo you don’t need.  That’s always the aim, to try and get the important information out there as efficiently as possible!
My next blog will be up shortly regarding cooling down and some specific things you can do!  Stay tuned for more editions of the A Step Ahead NetballSmart blog!
Aneesh Kesha
Part of the A Step Ahead Foot and Ankle care team
Warming up and Stretching for Netball - NetballSmart - 5
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!

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)

High heels – bad for feet?

The answer is YES. High heels are bad for your feet; avoid wearing them

Most ladies wear high heels because it is the modern way of dressing.  What they may not know is the fact that they risk developing foot complications.  If you go to the internet and research on the issue “High heels – bad for feet?” you will be offered conflicting information about the issue. Manufacturers of high heels tend to disprove the already established medical proof that high heels are not good for foot health.

Mr Brenden Brown, an experienced in podiatrist at A Step Ahead Foot and Ankle Care Clinic, explains that high heels are not only bad for feet, but also for the whole body. They strain even the back and the spinal cord.

It has been argued that they make women look more beautiful. This may seem true but your health as a woman is paramount – just keep in mind that High heels are bad for feet. High heels will destroy every part of your legs, ranging from hips, thighs, waist and legs and the foot will be impacted the most.

Some podiatrists have even proposed that shoes with high heels should come with a label “High heels – bad for feet”. This may still not put people off from wearing them because they make them feel good and look nice. High heels – bad for feet; think about your foot health first, not just how you look. Whoever loves you while you are dressed in high heels will still love you when you are dressed in flat shoes.

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