Heel pain – A patient’s experience

Heel pain – A patient’s experience

How Fiona beat Heel pain!

woman kicking water at beach

Fiona is a 43 year old lady with two teenage daughters and a busy household. In the past six months she has returned to exercise by joining a gym, which she is …. or was really enjoying.

Lately she has been waking up in the morning, placing her heels on the ground, only to get what she describes as "excruciating pain". She feels the same pain if she sits for long periods and tries to stand: the pain, while not as bad as those first few step in the morning, can make her hobble. This is now a BIG problem as she was really enjoying her return to fitness and wants to see what she can do to rid herself of the pain.

Is it really a heel spur that causes the pain?

A visit to the GP

She visited her GP who spoke to her about a heel spur, he took x-rays and indeed there was a heel spur in the picture. He explained to her that generally very few surgeons will operate on heel spurs and there is little she can do but wait out the pain which on average would go away after about 18 months! He did give her some general stretches and said he could try an injection if she really wanted, but it was painful!

Fiona also went to the chemist to try to buy some heel pads to take pressure of the heel. She tried these for about a month. While they worked for a short while, the pain quickly returned.  She also tried some very cushioned shoes, again while this was comfortable at first within a short period of time this very expensive pair of sneakers gave little relief.

On attending an appointment at A step Ahead Foot and Ankle care Fiona was just about to give up. A friend referred her after they had suffered a similar pain and our podiatry team had made her pain free.

A diagnosis

Our Podiatrist, after a thorough assessment, diagnosed Fiona with plantar fasciitis. Plantar fasciitis is a soft tissue condition of the underside of the foot starting at the heel, where much of the pain is located, however the pain can radiate out towards the toes where the fascia again ends. The pain can begin quiet subtly at first and can last on and off for many patients for many years.

Shock wave is a new and highly effective treatment.

Shock wave is a new and highly effective treatment.

Treatment

We discussed a treatment plan with Fiona to rid her of her heel pain, this included looking at some new more appropriate runners, a series of stretches, and soft tissue treatment options. Our Podiatrist provided Fiona with options which included:

  • Deep connective tissue massage – This is a firm to hard massage which is in this condition under taken on the base of the foot around the heel and into your calf muscle as this is almost always also tight. These session can range from as short as one a week for 3 weeks but up to 12 – 18 weeks long, dependent on how long your pain has been present.
  • Shockwave Therapy (Extracorporeal Shockwave Therapy (ESWT)) – Shockwave is a relatively new treatment which we have found very successful.  The basic principles behind shockwave therapy are the high pressured acoustic shockwaves that travel through the skin to stimulate pain relief and tissue repair. We have found this treatment very successful and sees patients recover quicker. Most patients like Fiona recover within 6 to 9 weeks. This treatment is often recommended by sport physicians and orthopaedic surgeons. (Be warned - How long has your Practitioner been using this?)
  • Orthotic therapy – Orthoses are designed to hold your feet in a “corrected position”. Feet that are in poorly positioned or have poor foot posture have to over work which in turn causes muscles to over work and is most often the reason why people develop foot pain. While there are varying devices that do this there is no replacing custom made orthoses. These devices are made to match your foot exactly. - HARD RIGID orthotics can cause you MORE PAIN!! Soft pliable devices are the way to go!

A choice

In this instance Fiona opted for the quicker Shockwave therapy and orthotic therapy. Her podiatrist helped her select the correct foot wear to purchase from a footwear retailer. We then also provided her with an Isometric Strength exercises - NO NOT STRETCHES! that's right NOT stretching! Our team worked with Fiona to build up her strength readying the surrounding muscles for its work ahead at the same time as repairing the damaged tissue. On each occasion of shockwave reviewed these and provided supportive sports tapping to further support her foot.

A recovery

Fiona attended for shockwave over a period of five weeks and made good progress over that time with her pain dropping slowly over the first two weeks and then quickly once combined with her orthoses and more appropriate footwear.

At week five it was decided to push her appointments out to fortnightly and then when this was found successful out again another month. In total Fiona attended a total of seven times before her pain was relieved completely.

We introduced Fiona slowly back to attending the gym, with strict instruction on stretching and appropriate footwear for her foot type.  Fiona made a full recovery and with a month had returned to three gym sessions a week and a walk with friends for exercise on weekends.

Interested in more information? How about the common myths around heel pain?

Try our Dedicated Heel Pain Doctor site. HEEL PAIN DOCTOR.COM.AU

Or call our helpful team who are used to speaking to literally thousands of patients with heel pain! Our number is 02 9673 2987. We would love to help!

Heel Pain doctor Heelpaindoctor.com.au

Heel Pain doctor a dedicated site to the reduction of complex heel pain!

Book an Appointment Today

So are all orthotics the same?

So are all orthotics the same?

  • Needing a pair of orthotics?So are all orthotics the same? - 1
  • Heard mixed messages on how effective they are?
  • Aren’t they all the same anyway?

If you’ve ever even CONTEMPLATED getting orthotics – read this first!
Let me start by answering a question that goes through almost all of my patients minds at some point – nope, orthotics are definitely NOT all the same and when the right orthotic is properly designed for my patients foot using the right materials and design skills that come from years of experience (and very honestly, learning from previous mistakes that others are still making today), yes they ABSOLUTELY do alleviate foot, ankle and low-er limb pain.
In fact, orthotics couldn’t be more different – and in many ways, they should be! Let me explain while answering a few concerns I often hear:

  • Are my orthotics going to be like my pair from my previous podiatrist?
  • I know someone that has had orthotics before but they didn’t help him?
  • What do orthotics actually do?

Let me start in answering these with the first and most important point:

The way your orthotics look and how effective they are are dependent entirely on the skills and preferences of your podiatrist! Yes – your specific podiatrist alone dictates how they are made and using the resources, materials and skills they have available at any point in time. If your podiatrist wants to heat-mold a pre-made, soft, thin orthotic and add a colourful harder piece and call that a custom-made orthotic, then that’s what you get. If you get plaster-cast and the cast gets sent to Canada for a firm, plastic-like device to come back, then that’s the orthotic you get.

What does this mean? Simply and unfortunately put, you may receive a lower quality product (often associated with a cheaper price) that claims to do the same thing, but often fails to produce the same results (pain relief!) and tends to have a shorter shelf-life. Think of it as buying make-up (clearly, this is written from a female perspective). You’re after a lipstick. Sure, you can buy an $8 lipstick from pretty much anywhere, but we know it will never compare to buying a Mac lipstick, that you’ll love and keep using until the very very end.

So are all orthotics the same? - 2

So how do I know if my orthotics will be good? Don’t be afraid to ask! They should be more than happy to talk you through the process – I LOVE talking through our orthotic design and manufacture – from the extensive testing of the range of motion of your foot and ankle joints to muscle strength, foot posture index, video gait analysis and 3D laser scanning your foot! But that’s only the part you see – it all then collides when our principal podiatrist and founder, Brenden Brown, designs every single one of our patients orthotics (yes, over all of our clinics!) himself, using his 20 years of experience and the widest range of materials I’ve ever seen as a podiatrist. BUT THEN, our CAD/CAM milling machine actually mills out the base of your orthotic, all in our VERY OWN (and very exciting!) orthotic lab, and hand finished by our orthotic technicians! It’s safe to say that it’s a little more technical than sticking two bits of material together and naming it an orthotic, and FAR more effective.

Finally, think about what your orthotics do! Orthotics have a FUNCTIONAL purpose to alter the alignment of your foot, changing different pressures and strains over your muscles, bones, joints and exactly where you’re having your pain. They address the CAUSE of your lower limb problems to provide you with long-term relief, and when designed and created right, they do this VERY well.

Happy orthotic hunting!

Dr Nina Lansdowne

Podiatrist and Superstar Blog writer

So are all orthotics the same? - 3

Dr Nina , BB and a good looker who happens to be our patient!

Brenden our Podiatrist “back” in the media

Brenden our Podiatrist “back” in the media

If you havent come across us before you may not realise that Brenden our principal Podiatrist has for many years been considered one of the foremost experts on feet  and Podiatry in Australia. He has for years been called upon to make comment as an expert. From the today show to the Brenden our Podiatrist Sydney morning herald to Dolly magazine!
This month BB is in HCF’s Fit &well magazine, just in case you don’t get a copy or cant see and read the text here it is below.

“Best foot forward

“High heels tilt your pelvis forward, throw your centre of gravity out of alignment and force your back muscles to work harder to maintain stability,” says Brenden Brown, spokesperson for the Australian Podiatry Council.

If you have lower back pain women should choose a shoe with a wide, flat heel of no higher than 2.5 centimetres and men should avoid wearing loafers and things.  “Lower back pain can also be treated in some people by addressing poor foot posture with orthotic supports in shoes,” Brown says.”

Ingrown toenails – pain free treatment

Ingrown toenails – pain free treatment

Ingrown toe nails

Lisa had pain from an ingrown toenail for several months she felt she had tried everything including trying to remove the ingrown nail herself. A friend of hers told her just to cut a V into her toenail – which sadly didn’t work. She tried a shopping centre nail salon but they turned her away saying they could not help her. She also visited her GP who was some help and prescribed some antibiotics as by this time the nail had become a little pustulent. However while this cleared up the infection that had occurred it did not take away the pain for more than a day or so and she found that her problem returned a little while after her antibiotics ran out.

This ingrown toe nail requires treatment by a podiatrist

This ingrown toe nail requires treatment by a podiatrist

When Lisa visited our A Step Ahead foot and Ankle clinic her toe was red around the area where the nail meets the skin on the side of the toe. It became obvious that what had happened was that Lisa’s toe nail was quite ingrown and that the answer was to remove the offending piece of nail.  By this time Lisa was quite upset and was worried about how painful it was going to be to remove the nail.

Treatment

We offered Lisa the option of having a local anaesthetic injection but we assured her that our experience podiatrist see infected ingrowing nails several times daily. With this experience our practitioner are very good at removing these with little if any pain. In this instance Lisa opted to try without the anaesthetic injection. Within a couple of minutes the ingrown nail was removed from the infected area with little if any pain, yes as many people are Lisa was surprised at how painless and easy it was – this left Lisa wondering why she had waited so long?

We asked Lisa to keep a small bandage on the toe for another four days. Simply to keep the area dry and free of nasty bugs and bits getting into the area, as it was already red and inflamed  when she arrived. A check up in two weeks found Lisa to be pain free! She reported it took about 24 hours to calm down and has been completely pain free since and she can now go back to wearing her high heels ……….. hmmmmm