Sometimes practitioners get it wrong: Heel pain a treatment gone wrong

Sometimes practitioners get it wrong: Heel pain a treatment gone wrong

Blog, Growing pains, Heel Pain, Kids Feet, Sports Care

How come my child’s heel pain isn’t getting better ….

Sometimes practitioners get it wrong: Heel pain a treatment gone wrong - 1

Soccer, rugby league and Netball all culprits for creating heel pain in kids if mixed with poor foot posture and growth spurts

“He had heel pain last year and now it’s back. They have NO idea what it is. They did an x-ray and it’s not Severs. The physio massaged his calves and it helped for a few weeks but it’s not better. It’s almost been 6 months. We had to halve how much sport he does now and he hates it. As soon as he starts running or playing a game, it comes on. He describes a tight feeling when he walks too”

Very honestly, these were the exact words that came from a frustrated and concerned mum, paired with an equally frustrated 13 year old boy, just before lunchtime today. This family traveled across the city to see us, which is not uncommon but it must be frustrating.

The tragedy in these words is that they’re NOT uncommon. At least a few times a week I hear grumblings from frustrated parents – and they most definitely have a right to be frustrated! – because they’ve seen various practitioners without a real diagnosis and just when something has been suspected, imaging has gone and ruled it out and we’re back at square one. Or are we?

The matter of the fact is: People make mistakes. Practitioners make mistakes. Radiographers make mistakes. We’re human! It’s going to happen.

I feel like I could host a conference discussing the amount of times I’ve been handed an xray telling me that there is nothing wrong with my patient that currently sits in front of me in AGONIZING pain!

If it doesn’t sound right, you better believe that it’s not. Let me emphasis: pain does NOT happen for no reason, and no amount of negative radio-graphs is going to magically fix your very real pain.

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Kids stay happy and healthy and active – Kids should play sport PAIN FREE!

So then, WHY does this happen?

There can be a variety of reasons, and I’m going to give you the very real uncensored version that other practitioners may get annoyed at me for.

• Referrers can order the wrong TYPE of imagine study. If you’ve damaged a muscle, ligament, tendon or any soft tissue, your x-ray will show you are perfectly fine! Yep, go over there and sit your torn Achilles tendon down because you’re fine to go run that marathon. (Please DONT we are kidding)

• Radiographers are very HUMAN and can miss things. Some are likely to have seen more of a certain condition, or be more familiar with an area of the body, and so some may pick up or recognise things that others miss. And you can’t blame them – the body is composed of an extraordinary amount of bone and soft tissue and any expectation for every single person to be a scholarly expert on every single part is drastically unrealistic.

• Things CHANGE over time. Your imaging from a few months ago is a picture of what is happening in your foot a few months ago. Since that time, some tissues may have gotten better, some tissues may have gotten worse, and some ones may now be damaged that weren’t before!

Be assured:

  • There is NOTHING wrong with wanting a second opinion and getting a referral for another ultrasound or X-ray
  • There is NOTHING wrong with re-imaging if you feel that your injury has changed. And if you’re having pain but you’re being told there’s nothing wrong, you have EVERY right to be frustrated!
  • You SHOULD get a second opinion! or a third even if you are not getting the answers you need.
  • There is increasing evidence that we need to look past radiology reports and look at clinical symptoms 

So what do you do next?

Your child should not have to play sport in pain, we can happily tell you that we work with kids to get them back to happy healthy and active every day. Our team will work with your child to develop a detailed care plan, this of course after a thorough assessment of their run + walk patterns; including video analysis. we will examine foot wear and make recommendation and look at the damaged soft tissue and assess what is the best way to rehabilitate this back to health! They may require a soft pliable orthotic for inside their shoes to wear while playing (just like our patients that are international level athletes!)

One of the delightful things about treating kids is seeing them return smiling and back to playing the sport they love!

And for all those wondering.. Yes our little champion from this morning did have Severs 😉

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.

About our clinics

Sometimes practitioners get it wrong: Heel pain a treatment gone wrong - 3

Our team see dozens of kids from across Sydney every day

Our clinics are set up with kids in mind we have big toy boxes, 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!
Fungal nail with “false negative” results?

Fungal nail with “false negative” results?

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So you think you have a fungal nail? A sequence of a toe nail suffering from fungus infection.

Does any of this sound familiar?

  • Yellow and discoloured?
  • It has a line running through it or often down the nail.
  • It’s maybe becoming crumbly and brittle?
  • It may be a little smelly

You think it’s a fungal infection and all the pictures you’ve seen of fungal on the net tell you it’s a fungal infection, but your Doctors testing keeps saying you’re wrong. But maybe you’re NOT!

I hear time and time again over many many years this very same story. So why does it happen? Over the many years these are my summations as to why we are getting what we refer to as “False Negative” results.Fungal maginifying glass

  • Mistake 1. You need to treat it like mould in your kitchen! So your Doctor trims your nail and pops the offending nasty bit in a little see-through plastic jar with a yellow lid. Seems like it all ok, however that same little yellow container later that day is often placed in the back of a Pathology collectors car and it sits there possibly in the sun as they run around collecting all sorts of nasties from other Dr’s clinics. Sadly like mould fungus is killed off by UV sunlight – So here we have mistake one!
  • Mistake 2. This has been going on for months and you have tried everything! You tried creams and paints of all descriptions! However while it may seem to go away a little it comes back time and time again. Now if you have used those paints and creams then this may have an effect on the result the test results small amounts may kill any fresh fungal spores and are most likely to kill surface fungus however not the entrenched fungus. So all that cream may not be killing the real fungal problem but is killing the chance of a positive test result.
  • Mistake 3. When you head to your GP they often don’t cut very much of the nail and so the amount of nail sent with fungus on the surface or ingrained in the nail is not significant and possibly they miss the area entirely!

fungal bugs ASAWith 20 years of experience I have seen literally thousands of fungal infections and with those thousands of frustrated patients who had tried all the marketed pharmacy ointments paints and creams. I am really happy to say that we have finally found an answer in Laser treatment of fungal nails.

Laser treatment of fungal nails is now a safe and highly effective treatment of fungal nails. As a practitioner I personally went over to research treatment options for this condition and was impressed with laser so brought this technology back to Australia. Since bringing this back almost 3 years ago now we have had excellent results and haven’t looked back. Part of this success though has outstripped others in the field as we have introduced in combination with laser a 4 point system that assist in killing the fungus in all the places it lives.

If fungal nails are a concern for you please contact our team A Step Ahead Foot and Ankle care and chat to the team about Laser and our system for making sure you are truly successful in removing all traces of fungus in your nails.

Please call us on 96732987 or 47322007 we would love to help get you back on the right track!

BB's looking super clever in Bright red Red Foo frames! No BB doesnt wear glasses!

BB's looking super clever in Bright red Red Foo frames! No BB doesnt wear glasses!

Brenden Brown

Principle Podiatrist
A Step Ahead Foot + Ankle care
Penrith, St Marys and soon to come to a suburb near you!

I just want to be fit for summer

I just want to be fit for summer

Blog, Heel Pain, Shockwave, Sports Care

Frustration and foot pain

I just want to be fit for summer - 1

If you just want to be fit for summer, don’t let foot pain stop you from reaching your goals!

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!!

A solution!

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?

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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?

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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.

Brenden Brown

I just want to be fit for summer - 4

Principle Podiatrist and founder for
The A Step Ahead foot and Ankle care team

When should I bring my child to see a Podiatrist?

When should I bring my child to see a Podiatrist?

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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.

When should I bring my child to see a Podiatrist? - 1

Little people get pain as well. DON’T wait till your child is in pain to look after them

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.

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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).

Nina Lansdowne
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!