The warm weather 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 the year before 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!
New Shoes might be the answer?
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 she looked 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. (ahhhh OK, so that’s a bit different) 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
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. YUP, the ice made it immediately feel better, but straight after, on the next walk, it came back.
OK, let’s try the physio!
Still not deterred she headed to a local Physio. He said it was a heel pain, maybe fasciitis or a heel spur. He did a short massage, used a machine that created a type of heat and showed her some stretching. OK, so this was a bit 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 a 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” (feeling pretty chuffed right now)
It's NOT a heel spur!
That’s right, nope, and it wasn’t fasciitis! Yep, these are super common MISdiagnoses for this type of pain! If you don’t see this multiple times a day, and you are also trying to work on shoulder pain and fix dodgy knees, it's easy to get it mixed up!
Tibialis Posterior pain is NASTY
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 physio stretches and exercises were great, the lowering of her arch needed assistance for her to be able to do all the work they required. NO amount of super special exercises are going to get this muscle strong enough. Not if you actually want to get active!
So, what’s the plan?
I chatted with Sarah and developed a treatment plan to 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 detailed series of Biomechanical measurements – fancy talk for checking each joint in your foot's movement – all the muscle's strength and how all the joints and muscles work together! SOFT SOFT SOFT, but more below.
- 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 its way to being healthy again and ready for activity.
- Stretches were also prescribed, which are pretty standard BUT really important strengthening exercises. We are running in circles if you don’t get the muscle STRONG.
- We addressed Sarah’s shoes. While her shoes were fantastic, and truthfully loads of patient's footwear aren’t as good as Sarah's. If you don’t get this right, the patient’s treatment falters! The right shoe for the patient's foot type 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.
SOFT Pliable Inserts – NOT rock-hard harbour bridges!
That’s right, SOFT devices. We never make hard, rigid devices! All our custom-made orthoses are made and designed exclusively by our clinic. In our onsite orthotic laboratory, it takes about three weeks for the computer-aided design process by me; they are then milled out using CNC milling and finished by hand. We have a super dedicated team, and these are flicked off to a lab somewhere overseas like other clinics often do. Our devices are produced by our awesome lab technician right at the practice!
While waiting for these, we began the treatment plan and her DCTM, strength and stretching.
So, what happened?
In four weeks of her review, Sarah reported her discomfort had dropped dramatically. She no longer had pain after every walk and had found that she could increase to running. We reviewed her stretching and asked Sarah to increase her km 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, where to from here?
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 (02) 9673 2987. 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. It's free! We are privileged 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.
Dr Brenden Brown
Podiatrist
Founder of A Step Ahead Foot + Ankle Care in Sydney, and former president of the Australasian Podiatry Council, Dr Brenden Brown (A.K.A Dr Foot) is a wealth of knowledge on how to take care of your feet, including how to find the best shoes.
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!