Blog, Heel Pain, Shockwave
Heel Pain, Uncategorized
Is wearing a Moon Boot going to help Heel Pain?
Should I wear a “Moon Boot” for heel pain?
The Answer?
NO, but why? Its best to settle on some understandings from the beginning. It is widely understood that it is “soft tissue and tendons that are what become sore in Heel Pain. The idea that Heel Spurs “cause” pain has been debunked and proven incorrect a number of times!
Over the last few years there has been an evolving understanding around how tendons and soft tissue works. Keep this in the front of your mind – “TENDONS HATE CHANGE”. Stopping all activity if you are currently active is a sure-fire way to ensure that when you return to your activity you will also see the return of your heel pain!
Boots can “Change” tendons – in a negative way!
As we said stopping all activity is not good for us. That same principal exists for those who are using an air cast or moon boots. Completely removing the function of the foot and calf will mean these muscles will most likely fatigue and lose condition. At best, you will need a delicate and dedicated rehab process to get you back to normal function.
This includes “tears” in fascia’s! We have found there is an ever-increasing body of evidence suggesting that many radiologically identified tears maybe completely normal and part of a normal aging process!
Patients often ask us at the clinic about “booting” or casting them after “a friends” practitioner did this with them their “friend”. All the evidence base suggests that this is often the wrong way forward. In good conscience, we can’t do this. It should be recognized this was once accepted practice, we know we did it!
However the evidence base suggests doing this will unload the soft tissue completely and can in itself start another chain of events and problems which you only have to overcome later! So NO BOOT!
If by chance you are reading this and you’ve been prescribed a boot. I’d respectfully ask your practitioner about what the current evidence base says about this method of treatment?
Should I change my activity?
You SHOULD make modification to activity; however, a complete stop will mean you either
A. Need to rebuild your activity over quite an extended time.
or
B. Your heel pain is likely to return!
For the moment STOP Jumping of and onto things. For example, on + off a truck, box jumps at exercise class, skipping or other high intensity impacting the heel and forefoot until we have you back to comfortable. We will then slowly load you back up to these activities. As a guide if it hurts STOP IT!
What do I do instead?
Our strong advice is to look for strong supportive cushioned footwear.
What does this mean? Look for the following in Sneaker style or work boot.
1.Always lace up!
2.Bend only at the toes
3.Shoes should NOT bend in the middle!
4.Should NOT twist or wring out
5.Firm heel counter (back of shoe that hugs the heel)
Wear your lace up shoes – From the moment you wake – till the moment you head to bed! No matter inside or outside! No thongs – NO bare feet! This is a far better way of providing the tendons and other soft tissue structures support without immobilizing the foot and creating more problems.
Need some help?
Our Doctors at A step ahead see between 8 – 12 heel pain patient each every day! Heel pain , sports injuries and musculoskeletal pain in feet + lower legs are our passion. We are often for many people the 2nd, 3rd or even 4th opinion for their heel pain. We are most often the last!
First steps to getting back to pain free?
Give our front desk team a call, they speak to dozens of people a day just like you with problematic heel pain. They will run through with you what you may have tried so far and get a better understanding of your pain. They will then help work out what type of appointment is best to make for you. From here they can reserve your appointment time.
We would LOVE to be able to help you on the way back to becoming Happy Healthy + active.
Our number is 96732987 or 47322007 we look forward to helping you
If you are looking for more information we have a prepared a dedicated page to helping both other practitioners and patients with information on HEEL PAIN. ” Heel Pain Doctor ” has loads of fact and helps busts some of the myths around heel pain.
Blog, Heel Pain, Kids Feet, Sports Care
He’s just not as fast as the other kids, and limps a little after games! I thought it would just go away but it seems to be getting worse
Sound familiar?
Ashley came to see us after a frustrating 4 weeks of Heel Pain for mum and daughter alike. Stretching and Rest had been prescribed by her physio, but to no effect! The GP said ice, but It just wasn’t getting better and Ash didn’t want to loose her spot in the team. Our telephone rang and on the end of the phone was an incredibly frustrated mum. Kristy our superstar behind the desk made some room in our appointment book and we got Ashley in to our clinic.
Winter is ball sport season and its also the season we see an increase in Kids heel pain!
Week one was a biomechanics and gait assessment (Walk run and standing assessment) by the team, (Yes we work as a team!!) gathering as much data (Info) about Ash’s foot, her walking and running style and her muscle profiles. We took a 3D laser scan of her feet and moved her out of her old slip on casual shoes, into some newly minted Asics Nimbus, giving her support and cushioning in every step.
Wow what a difference a week makes! We had a beaming Ashley walk into our clinic with a noticeable spring in her step!
Kids heel pain is most commonly an inflammation at the growth plate at the back of the heel, or underneath the foot at the insertion of the fascia. In Ashley’s case, it was the backs of her heels at the insertion point of the Achilles Tendon.
We started our course of soft tissue rehabilitation, which included a series of deep tissue massage, and some manual stretching and mobilisation of the foot and ankle joint.
Ashley’s muscles in the backs of her legs were incredibly tight, playing tons of sport and not warming up before and stretching after will do that to you! So we put in place a series of really simple and quick stretches and exercises for Ashley to do on the court before and after her games and trainings. It wasn’t easy to change her habits but after she saw improvement in her pain, she stuck to the plan. Mum and Dad even got in on the act! A fit happy healthy family!
Four further weeks of manual therapy, custom made orthotic intervention and a tailored return to sport program (plus some stern words about her shoes) and Ashley was back full time on the court. Why is this? An accurate diagnosis, more than one modality of treatment (Soft tissue rehabilitation) and a girl that really really wanted to get better!
Exercise induced heel pain in young athletes is an all too common thing, but 100% treatable! An assessment from your Penrith Sports Podiatrist will have your young star back on the footy field or netball court in no time.
We have been seeing kids like yours for many years! In fact we see children just like yours from all over Sydney, from the Eastern suburbs to North shore, from as far as western NSW to Wollongong. We would love to help keep families Happy Healthy and Active! If you would like our help getting there please call us on 96732987 or 47322007
A Step Ahead Foot + Ankle Care Team
Penrith , St Marys
and coming soon to a suburb near you.
Blog, Growing pains, Heel Pain, Kids Feet, Sports Care
How come my child’s heel pain isn’t getting better ….
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.
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
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!
Blog
DeFEET your HEEL PAIN!
1. If it HURTS, stop doing it! Pain is actually your body’s way of telling you that something is wrong – listen to it! Putting pressure on a (painful) damaged muscle/tissue/bone = further damage = no improvement = ongoing pain. It’s as simple as that.
2. Nothing will change unless YOU change it. You’ve been wearing the same shoes and trying the same stretches and whatever else google has advised you since your pain started and you’re still in pain. Consult a practitioner that specialises in heel pain – not all podiatrists and practitioners do! Look for a practice with a proven track record with heel pain – different practitioners do things very differently and get very different results!
3. STICK to the plan! “It’s only when people venture off the main path in the forest that they get lost and chased through the forest in the night.” As practitioners we don’t tell you things to try and make your life difficult and play ‘let’s test if anyone will actually do this’. We do this because we KNOW it works and see it working all day every day, for those who stick to it. If we could make it easier, we would! But taking shortcuts hasn’t produced good results for our patients, and you came to us to get you pain-free.
4. Understand what is happening! Make sure you completely understand: what your condition is, what causes it, what aggravates it, WHY you are having the treatment you are and what the treatment is actually doing to and for your feet. If you don’t see a purpose to doing something, you are a lot less likely to stick to it. Not being fully informed about your condition can create uncertainty about your treatment. Ask all the questions, ask them as many times as you need, and let your practitioner help you to understand. If you get a generic answer along the lines of “It’s plantar fasciitis and you need these very hard orthotics” – Our number will be at the bottom!
5. Finally, DON’T give up! Whether you’ve just started your journey to being pain-free or have tried multiple options from different practitioners with no success, very seriously, don’t give up! We are often people 3 or 4th opinion – some have been to physiotherapists, specialists, GP’s and other podiatrists – if they haven’t had success with you, sadly you’re not alone! I have the privilege of seeing the pain levels of my patients decreasing every week until the pain is gone. Every foot is different, the causes of heel pain are different, and when this is correctly analysed, diagnosed and treated, amazing things can happen. Our treatment is VERY different!
These are my top 5 because I see these so often! It’s actually fairly unusual to see anyone who isn’t struggling with at least one of these points. But rest assured – heel pain can be defeated, you don’t have to keep battling it and letting it limit your activity and you can be completely pain-free. We have patients who regularly travel from all across Sydney NSW and even interstate to see us! Its not unusual for us to be the last of a long line of other practitioners you may have seen. Come and join our ever-growing team of pain-free patients – we’d love to help you too!
Dr Nina to the right and Shendi on the left with our patient Kimberley who beat heel pain!
A Step Ahead Foot + Ankle care
Penrith, St Marys
and soon to come to a suburb near you!
Dr Brenden’s White paper report on the “6 Reasons You Won’t Beat Heal Pain” outlines what’s stopping you from beating this and tips on how to stop it in its tracks!