What your Podiatrist WON’T tell you about heel pain.

What your Podiatrist WON’T tell you about heel pain.

Things your Podiatrist doesn't want you to know about Fasciitis

Heel Pain can stop you from getting back to exercise!

Pain on first step out of bed, pain in the ball of your heel, gets better after time on your feet only to get painful at the end of a day! Pain often doesn’t have a reason or incident. The horrible thing is this pain is often described to me months or even years after it first appeared and frequently after seeing a number of health care practitioners GP’s, Physios and including Podiatrists!

Many treatments Podiatrist’s and Physios prescribe DON’T WORK and sadly deep down they know this but in an effort to work with you, their patient, they persist not knowing what else to try. Sadly as a patient this doesn’t assist you, and leads only to frustration.

I see literally 8 to 10 people a day, with heel pain! I have been focusing on heel pain for over a decade, honing my skills to work through this complex problem. I see people from ALL over NSW and now have begun to see people travel to see me from interstate. I’d like to share with you some points I have learn't seeing literally thousands of patients.

So in an effort to help EVERYONE, I thought I would write a few of my Top Tips (maybe secretly frustrations). So you can get a better idea of why possibly you are NOT getting any better despite you seeking help.

Orthotics probably won’t work on their own.

This is probably the most common mistake in treatment I see on a day in day out. Orthotics are commonly used by Podiatrists and I use them also ALL the time! However they are not the only answer. I definitely see them having a role to play. We will prescribe so to provide a support or a “balance” to a foot, but you need more! The tissue is damaged and it’s VITAL that it is rehabilitated! Orthotics cant and won’t do this alone, you must rehabilitate the tissue,  using therapies such as deep connective tissue massage and shockwave and muscular stretching exercises!

Stretching won’t help 90% of people.

“I have been stretching for months and I am not getting any better” I see endless amounts of hard working people who have been given stretching exercises and sent on their way and told “Let me know how you go” by their well-meaning therapist.  I also see patients who present to me who have never had any treatment and I test their muscle tightness, only to find they have no tightness at all! Not all heel pain is from tight muscles and not all heel pain is Plantar fasciitis, so we need to break the mold and look elsewhere to help you, our patient.

Foot pain, footwear, heel pain

Great footwear is a key to treatment Yet lots of practitioner focus on this with their patients! Make sure you review your footwear!

You can’t wear any shoes you’d like and your love of Thongs/flip flop/ Jandals is harming you.

Sorry I am going to give you a hard time about shoes! Thongs, flip flops, yes even the special ones with arches etc  etc are all footwear that maybe adding to your pain. I know they make you feel good while you are wearing them. However over years of recommending more appropriate footwear and seeing significant changes in outcomes for the time it takes you to get better we keep you out of these. You can return when the foot is better and full recovered!

Hard rigid orthotics won’t only not fix it they may actually make things worse!  

I will start by acknowledging I am not a fan of rigid orthotics, I have never prescribed them and would not wear them myself. I know many many physios feel the same and are concerned about these actually irritating the structures of the base of your foot! I am sceptical at best around these rigid, hard, harbour bridge like devices in shoes.

Again I feel orthoses work however I believe the foot needs some of its natural motion and this is why our clinic has always used soft soft pliable orthotics that are custom made to your foot. These cup the heel and support the arch only where necessary and DON’T irritate the very area we are trying to fix! We make all our orthoses in our own onsite orthotic lab, we use the latest 3D technology and computer aided design, then milling them precisely to fit you foot, a mix of comfort and cushioning.

Heel pain - Is it your Orthotics causing you more pain?

You need more than a rub!

As I mentioned above most patients need soft tissue rehab HOWEVER I also see that without supporting the tissue around the foot and correcting some of the poor walking patterns that may have contributed to the problem slowly developing, patients often DO NOT get better! Have your walking pattern assessed and see improvements develop quickly

How to get better?

I think the key is to looking at treatment as NOT having one silver bullet that will fix everything. As you will see from my extended notes, just focusing on one element seems to be where people fall short. Looking at heel pain as if it is more than just the one condition, “Plantar fasciitis”, is also necessary to ensure that you get the right treatment. Heel pain can be and often is more than “Heel spurs” or “plantar fasciitis” and so to treat it you need to identify exactly what it is.

When you have established a good idea what’s going on, its time to look at treating all the contributors that made it sore in the first place. Structure, poor foot wear and then looking at treating the soft tissue.

Can you get better?

YES I hope you can see from this that there are very obviously MANY options available. As a practitioner one of the very nice parts of my day are seeing patients who have had this for months or years get better! Patients that don’t just get better they can now kick a ball with their kids, run with the kids in the park, keep up with the grand kids!

Can we help YOU?

Yes, if you would like our help back to a healthy happy lifestyle, we most definitely can and would LOVE to help! Unlike other podiatrists who focus on treating your Nan's toenails or dry hard skin on their feet, we focus on these more complex running and walking problems! We priorities patients just like you as we understand how important it is to get you back to pain free.  Please give our very friendly front desk team a call, not only are they helpful but after having helped literally hundreds of patients each year they are really good at leading you in the right direction back to pain free.

You can contact us on 96732987 or 47322007 we look forward to helping you.

Brenden Brown

Principal Podiatrist

A Step Ahead Foot + Ankle care

BB with one of his patients

BB to the right, with out the yellow skirt

Top 6 reason your heel pain isn’t getting better – UPDATED!

Top 6 reason your heel pain isn’t getting better – UPDATED!

Top 6 reason your heel pain isn't getting better - UPDATED - 1

Top 6 reason your heel pain isn’t getting better – UPDATED

You CAN beat Heel Pain

Heel pain can be debilitating! The pain often stops people in their tracks first thing in the morning! Walk a few steps and it may be relieved. Others as the day progresses, the pain becomes worse. Finding help can be frustrating and confusing as you can often see multiple practitioners and receive multiple answers with little relief.

We first wrote this article in 2014. 3 years later, after helping literally 1000’s more patients with heel pain. After HOURS more of research and implementing significant changes in the way medicine has begun to understand Heel Pain, it became time to updated this very popular article!

With the experience of literally helping 1000’s of heel pain patients,  between 10 and 20 a day! We have put together the following list of the Top 6 reasons we have noted patients have not got better.

We hope this helps you on the way to beating your heel pain.

1.You decide to go it alone and NOT get professional advice.

Of all the people we see, a large proportion of them have never had any care or professional advice. Quotes like “I just thought it would go away” or “A friend told me what they did to get rid of the pain and I just tried that”. Most times it doesn’t!  You will increase your chance of beating heel pain, significantly by getting a professional opinion. Professional advice and treatment costs money. Yes some people find this expensive however others find it invaluable. It depends on how much you really want to get rid of your very sore heels?

2.You wear thongs (flip flops) because your feet are sore

Wearing thongs, Croc type shoes or even bare feet for many people make their feet feel better initially but all our experience tells us you are doing more damage.  The pain you feel days later not necessarily at the time. You are welcome to argue this point as much as you like, while you continue to hobble…………

3.You get advice and then choose which bits you use.

Great work on getting advice now it’s time to take it ……yes ALL of it. When a care plan is developed for you, if you choose only the bits you like to hear and the easy bits, you will end up failing to get better. Your Podiatrist should work with you as a patient to establish the best way to relieve you of your pain.  They should speak to you about what shoes are best for you. What treatment will get you better quickest, including strength exercises, therapy to relax the soft tissue and possibly orthotics.  Now choosing NOT to do some of the suggested treatment universally ends up with patients not getting better. Our Podiatrists do all that and more, does yours?

Top 6 reasons your heel pain isn't getting better - UPDATED - 2

4.You bought hard rigid orthotics from a Podiatrist.

Our experience tells us that rigid hard orthoses on most occasions irritate the heel and the arch region adding to your discomfort. We have over the years collected many pairs of rigid orthotic from patients who give them to us in frustration after finding they have hindered rather than help.  Secondly if this is the only therapy you were given, with the exception of a couple of possible stretches then we would suggest to you that there is more to getting rid of your pain than this – ask the question “So how is this rehabilitating my damaged soft tissue?”

5.You stop ALL activity.

As our understanding has changed over the years we now appreciate the following – “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!

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.


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.

6.You choose a practitioner who does not understand heel pain.

So your GP says they will fix your heel pain? Your Physio who is treating your shoulder says the same and the Podiatrist you see, who works one day a week at your local GP clinic and cuts your toe nails, says they will fix it no problem. Who do you choose?

Your heel pain is not simple its complex and for you it’s really sore!  Choose someone who see’s and treats heel pain regularly. Choose someone who is passionate about making sure that they help you on the way to getting you better. All the people above are probably very good at what they do, but they most likely won’t end up helping you beat your pain!

Did you know there are about 10 different condition’s that could be causing your pain?  When our practitioners are asked by GP’s Physio’s + Podiatrists on Heel pain it is often a surprised to the how complex this condition is! Our Doctors all sports podiatrists see this condition multiple times a day. When you see something that often you are more familiar with it + know how to get on top of it. Ask the person you see how many Heel pain patients they help a day.

Top 6 reasons your heel pain isn't getting better - UPDATED - 3

How can we help

At A Step Ahead foot + Ankle care we see approximately 8 to 12 heel pain patients a day. We have patients that travel literally hundreds of kilometres to seek our help – Which is really lovely!  Our clinics are set up quite specifically to treat patients with heel pain. We have invested hundreds of thousands of dollars into equipment and the latest technology to help us, help you- beat heel pain.

Our Principal Podiatrist Brenden Brown is recognized as an expert in Podiatry. A past President of the Australasian Podiatry council he is considered a Medical Expert in the area of Foot health, appearing regularly on television shows like the Today Show and Magazines like Men’s Health. He has appeared for some time as the Medical expert for lower limb conditions on ABC radio’s “the Waiting Room”

It would be a pleasure to help you beat your heel pain.

We are located in Penrith and St Marys in Sydney’s Western suburbs.

You can contact us on 47322007 or 96732987 we hope you will.

Top 6 reasons your heel pain isn't getting better - UPDATED - 2