Heel pain – A patient’s experience

Heel pain – A patient’s experience

How Fiona beat Heel pain!

woman kicking water at beach

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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

Does your child need to see a Podiatrist?

Does your child need to see a Podiatrist?

5 quick signs you need to see a Podiatrist (Foot Doctor)

When to see a Podiatrist

Kids feet are different to Adults feet! Its the building blocks to making sure our kids enjoy activity

Have you been through this?

Grandma's are great at spotting it. Your friends aren't bad. The Shoe shop lady is often a superstar at it! But lets face it you've got a lot on and the occasional "Mum" or "Dad I am"  ........ shhhhhhhh I have stuff to do! "Just a second but Mum ..... my feet are sore! Whaaaaaaaaaaaaat!

So you drag the kids down to the plaza and seek out the closest and “best” footwear retailer you know. (Same woman you remember saying vaguely about it last year.) But on the way or while you are there, some funny things happen! You mention it to your “grandma” and she asks about your little ones “Flat feet” and asks have you had them checked! "Remember I mentioned it to you?" Hmm then you head to the shoe shop and the lady who is fitting the shoes asks the same thing. “Have you thought about seeing a Podiatrist” - WOW that's twice now - Houston we have a problem!

Kids and flat feet, growing pains, tripping falling and all that normal stuff! 

It’s not the only time someone may say it but it happens and we hear about it when Parents bring their youngsters into us confused with quotes like “I am not really sure if I should even be here?” So after seeing literally 1000’s and 1000’s of kids over my 20 years of practice I thought maybe a quick check list may help parent on what are the reason you bring your kids to see me !

Here is my quick 6 checklist – these are the reasons I WOULD bring my child to see a Podiatrist!

1. Flat feet. I thought I’d throw this on the mix pretty early as it’s often a reason people are told they need to see a Pod. It can be confusing and often it seems like there is conflicting advice. Here is my rule – If your little one is ONLY flat footed and does NOT have any of the following, you may well be perfectly ok the way they are now! However if they have Flat feet and ANY of the following YOU NEED TO SEE OUR PODIATRISTS !

2. Tripping or falling. You may notice it or it may take someone to mention it to you. With little reason and sometimes without notice your little one trips! Sometimes it seems justified other times it seems like they tripped over a blade of grass! Somethings happening here and yes we may need to take a look.

3. Pain at night or Growing Pains. If your little one wakes at night with pain in their legs, ankles or feet its more than likely time to see one of our team. Now it can be confusing at times you will take them to see a GP and sadly very sadly they will say “Its growing pains” Grrrr 9/10 you can attribute this pain can be treated and you don’t have to wait for them to “grow out of it” If your little one has “Growing Pains” or anything else like that sounds or smells like this – Visit` our team!

4. Kids that don’t like walking or avoid activity. Some kids seem like they are always whinging, you are out shopping or with the family and out on a long walk or other family activity and your child wants to “Sit down” or “stop”. Often we simply think our kids are being Lazy. However for a good proportion of these kids it’s got to do with their poor foot posture making walking harder and yes they are actually in pain! Sometimes kids don’t even realise they are uncomfortable (Its ok, we realise it sounds strange) they just know they want to stop! We have fixed kids foot posture and seen a change that means these kids go from not wanting to walk to almost running!

5. Unusual wear on old footwear. Have you noticed that your kids shoes seem to lean to one side after a couple of months or even weeks? Have you noticed they wear out the toes and have simply blamed it on loads of Handball? This again is in our top 5 reasons for needing to see one of our team!

6. Sore feet or pain at any times. (Ok so this is a sneaky Reason 6!)  It seems simple but if your child has sore feet it means they need to see a Podiatrist. NO you don’t need a referral (Permission slip) from your GP simply call and we will help. YES It’s what we do, we LOVE seeing kids because delightfully they often respond really well and very quickly to our treatment – and who doesn’t like a big smile!

So if your kids have ANY of the above Grandma and the shoe shop lady are actually on the money! If not then guess what you can fairly confidentially not worry!

As we have said above, we LOVE seeing kids. We are very lucky in that we see literally hundreds every year! If you have any of these problems or any other foot or ankle complaints please let us know! We are located in 2 spots in Western Sydney both conveniently located minutes from the M4 and with parking right out the front.
Please call our helpful team on 96732987 and our team will answer any questions and help with making times to see our Podiatrists.

Dr Brenden Brown (BB) Podiatrist
For the team at
A Step Ahead Foot + Ankle care

BB with one of his patients, kids foot pain

BB with one of his Patients!

Kids Heel Pain – still not getting better?

Kids Heel Pain – still not getting better?

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! - 1

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.

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

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

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.

Sometimes practitioners get it wrong: Heel pain a treatment gone wrong - 2

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!