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!
Ingrown toe nails

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.

By this time, the nail had become a little pustulent, Lisa then also visited her GP who was some help and prescribed some antibiotics. 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 shortly after her antibiotics ran out.

When Lisa visited our clinic her toe was red around the area that 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.

We offered Lisa the option of having a local anaesthetic injection but we assured her that when you know what you are doing and have seen as many ingrown toenail as the podiatrists at A Step Ahead Foot + Ankle Care, you get very good at removing these with little or 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 – she’s 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


Ingrown toe nail for 5 years = 5 years of pain

My patient can’t believe it, well in fact she can’t feel it, which is what she is having trouble adjusting to. You see this lovely lady has had a painful ingrown toenail on her big toe for the last 5 years. Her doctor who thought he was doing the right thing continued to put her on multiple courses of antibiotics but to no relief. Antibiotic whilst obviously successful in treating the infection in the surrounding tissue does not remove the small piece of nail that has protruded sharply into the skin around the nail.

This nail had also been treated by another Podiatrist who recognising that the patient had this nail protruding into the skin removed the nail …….. well the nail that they could see! This is truly what is needed in many cases. A simple quick process of removing the offending piece of nail relatively painless and simple for most people.  However in this case, as with others that suffer from this condition over many months or even years a nail surgery was required.

The patient had spoken to their Podiatrist about this a few times and had mentioned it again at their last appointment with the Pod however the Pod was sure that with regular treatment it would be manageable. After many more months this lovely lady justifiably lost patience and faith in her Pod. She was looking for a solution to her ingrown toe nail pain and wanted it NOW !

Nail surgeries are not new for podiatrist and are something we do on a regular basis. It is done in our rooms and is a relatively simple procedure.  I often describe this as relatively pain free – it is wrong to say any surgical procedure is “pain free” but as procedures go our patients report very little if any pain.  I recommend this procedure for patients with involuted or very curved nails, Nails with areas that seem to catch the skin on the side of the nail. Again nails that have a long history of infection or growing in.

The message – really is a solution and that you don’t need to be in long term pain. 5 years is a long time in pain!

For all your Foot and Lower Limb Care needs, come and see us at:
A Step Ahead Foot & Ankle Care
24 Phillip Street, St Marys; or
Suite 4, 36 Woodriff Street, Penrith