Children’s bodies grow and change so much in the first years of life that it can be hard to know what is normal, and what is not – which is why we get many parents calling or asking about podiatry for kids.

From flat feet to pigeon toes, ingrown toenails and making sure shoes fit correctly, our Redlands podiatrists are trained professionals in matters relating to the feet, toes, and lower limbs for every member of the family.

While there are many reasons a parent might seek out podiatry help for their child, some of the more common concerns are listed below.

Lower Limb Development

The good news is that often what might seem abnormal compared to adult feet, is quite common in children.

Things like pigeon toe (in toeing), duck feet (feet that turn out), bowed legs, knock knees, flat feet, even walking only on their tip toes, can be normal in young children, and in most cases will resolve on their own by the time a child reaches school age.

However if you notice that your child has developed an unusual gait, for example limping or favouring one side; or that they seem to trip or fall a lot more than their peers, taking your child to a podiatrist for an assessment is a good idea.

Uneven shoe wear can also be a sign that there is a problem with your child’s biomechanics (ie the way that they are walking and moving), which could potentially cause extra strain on muscles, ligaments and joints, or even increase the risk of injury.

Pain, Injury and Infection

Carrying the full weight of our body is no easy feat for our feet, no matter what age we may be!

Your child may complain of pain from an easily identifiable cause such as a plantar wart or an ingrown toenail, both of which could benefit from a visit to your local podiatrist for treatment so your child is running around again in no time.

However sometimes it may seem that there is no apparent reason for your child to be experiencing leg or foot pain.

A condition known as “Sever’s disease” may cause heel pain in one or both feet, and is most commonly seen in children between the ages of about eight and fourteen, particularly those who lead an active life. While this is one of those conditions that children do grow out of, in the meantime your local podiatrist is able to help with managing symptoms and reducing pain.

What about Growing Pains?

Some children suffer from growing pains, and even though we don’t fully understand the cause, the pain is very real.

Growing pains tend to occur in the muscles of the legs and get worse later in the day, even interrupting your child’s sleep – only to disappear in the morning. If your child is affected, try gently massaging the affected area, some over the counter pain relief, or a wheatie or hot water bottle to help with symptoms and soothing your child.

If however you notice that your child is experiencing pain during the day, is limping, or otherwise unwell, or their leg is sore to touch, further investigation is warranted as it could be a sign of an underlying virus, infection, or other problem requiring treatment.

How to Look after your Child’s Feet

While the usual foot care tips apply, there are a couple of extra things to be aware of when it comes to looking after your child’s feet:

• There is no need for shoes (except for warmth) in babies that are not yet walking.
• Your child’s feet can grow up to 17 sizes in the first dozen years of their life, so make sure that they are not restricted by booties, socks, or shoes that are too tight or rigid.
• Such rapid growth can make it tempting to buy your children shoes with plenty of “growing room” – however don’t go overboard, as poorly fitting shoes can increase the risk of injury such as a sprained ankle or foot fractures.

If you are looking for a Redlands podiatrist with experience in podiatry for kids, at Trevor Lane Podiatry we are here to help. You can call us today on 3207 4736 or make a booking online 24/7.

It may seem strange to think of somebody going to a podiatry clinic, when they actually have a problem with their back.

After all, podiatry is the branch of medicine which diagnoses and treats issues related to the lower limbs – heels, toes, feet, ankles and knees.

And yet I see many patients complaining of leg or heel pain, for example, only to discover that their foot pain is caused by back problems, even though the back itself isn’t hurting!

Is Your Foot Pain Caused by Back Problems?

When I was in Cubs and Scouts years ago, we used to sing about how the knee bone’s connected to the thigh bone, the thigh bone’s connected to the hip bone, and so on.

We thought it was just a silly song, however in over twenty years of podiatry practice I have come to realise just how much truth it holds: the body is indeed a series of connective tissues, bones, nerves and systems, that all work in harmony with each other.

So when a patient is experiencing foot pain, it could in fact be something called “referred pain”. That is, although they may not have pain there, it is actually a back problem which is causing the symptoms in their feet, knees or legs.

Conversely, lower back pain may actually be related to poor biomechanics of the feet. In such cases, a podiatrist may be able to address the back pain, by prescribing certain shoes or orthotics that improve your overall body balance.

The Connection Between Feet and Back

The lumbar region at the base of the spine consists of five vertebrae, which play a really important role in how we use our lower limbs.

So when a client presents at our podiatry clinic with pain in both feet, we not only check for conditions such as spurs, ligament or tendon damage – but we also need to consider the body as a whole.

It is extremely rare for a patient to have an identical injury in the same location on both feet at the same time. Instead, we usually find that there are lower back issues, or other pathologies such as:

• thyroid disease;
• osteoarthritis;
• limb length discrepancies;
• scoliois (curvature of the spine).

These conditions can put pressure on the nerves, which then refer that pain to whatever they innovate. The lumbar region, for example, refers pain to your legs and feet.

A Whole of Body Approach

This is why a good podiatrist needs to assess your whole body, and not just your lower limbs.

Whatever we do to your lower limbs impacts on your hips, your back, and right up to your neck. When we treat foot pain, we don’t want it to cause an increase in lower back pain or headaches instead!

So in addition to looking at your foot type, the surface you stand on, your shoes and how they are wearing – your podiatrist should also check things like:

• Your body’s symmetry: are your legs the same length? Are your hips and buttocks level? Are your shoulders level or dropped to one side?
• The condition of various muscles: are they tight, or weak?

Because of the way the various parts of our body are connected and impact on each other, there are times when as a podiatrist I may refer a patient to other allied health care professionals.

At our Redlands podiatry clinic, we have a great working relationship with some of the local physiotherapists, chiropractors, osteopaths and the like, to ensure the best of care for the whole of your body in these particular situations.

The Problem with Growing Older

No body is perfect and we all have alignment imperfections. However as we grow older, our body’s ability to deal with these alignment anomalies starts to falter, so symptoms start to appear.

Patients often ask me: Why now? When I was younger I never had this problem!

And that is exactly my point – the body is no longer coping with or compensating for a certain twist in the back, a short leg, a bow in the bone, etc.

So next time you visit our podiatry clinic, don’t be surprised if as well as considering your fallen arches, or sore achilles tendon, we also assess your whole body alignment.

At our Redlands podiatry clinic, we treat each patient as a whole person, rather than just a foot! Call today on 3207 4736 for an appointment, if you are experiencing foot or leg pain. 

If you’ve recently been diagnosed with diabetes, suddenly your calendar will fill with appointments for a whole team of health professionals such as a dietitian, optometrist, endocrinologist, and podiatrist, as well as your GP.

Some will help you to manage your condition, while others aim to prevent some of the complications which commonly arise. For example, as a diabetic, your risk of developing foot problems rises significantly due to two common features of the disease:

1. Reduced blood flow to the feet – which means any sores or other problems will take longer to heal; and
2. Reduced sensitivity of the nervous system – which means the diabetic individual may not even notice blisters, pain or sores developing on their feet and lower limbs in the first place.

How Often Should a Diabetic see a Podiatrist?

Due to this increased risk of foot problems, it is recommended that diabetics visit their podiatrist for a diabetic foot assessment regularly; the frequency depends on the type of diabetes.

• Type 1 diabetes – for those with type 1 diabetes, a diabetic foot assessment every six months is advised.
• Type 2 diabetes – the risk is slightly less for those with type 2 diabetes, so an annual checkup is usually recommended.

While podiatry services in Australia generally aren’t covered by Medicare, as an individual with a chronic health condition you may be able to access a rebate if you have a referral from your GP.

What’s Involved in a Diabetic Foot Assessment?

As part of a diabetic foot assessment, your podiatrist will check:

• The blood flow to your feet by recording the pulse rate in two places – on the top of your foot (the dorsalis pedis), and the inside of the ankle (tibialis posterior). Should there be any concerns about reduced blood flow, your GP will be notified and you will need ultrasounds and further investigations.
• Your podiatrist will also check the sensitivity of the nerve endings in your feet. While you have your eyes closed, you will be asked to identify different sensations, such as sharp, blunt, hot, or cold. While most people take these sensations for granted, the nerves can be damaged by diabetes.

You can see why it’s really important for diabetics to take extra care of their feet: The decreased nerve sensitivity means that as a diabetic, you may not feel and therefore notice any sores or other problems; and the reduced blood flow means that the body’s healing ability is impaired.

As a result, if left unnoticed and/or untreated, sores, ingrown toenails and other problems may lead to infection.

Infection can cause serious health complications, such as ulcers and even the possibility of amputation of toes or feet.

Is There a Diabetes Podiatrist Near Me?

At our Redlands podiatry clinic, we offer personal diabetic foot care to help you manage the risk of complications, by providing you with education and support around:

• Foot hygiene and cleanliness;
• Daily foot examination, to check for visual signs of broken skin, punctures, cuts and wounds, because you may not feel or notice them otherwise;
• Cutting toenails correctly, to reduce the risk of cuts and infection;
• Footwear. This is crucial for diabetics, as poorly fitting shoes can lead to blisters, corns, calluses and worse. At our Redlands podiatry clinic we can provide guidance on the type of shoe and features to look for; we even offer a professional shoe fitting service and stock a range of quality footwear.

Regular appointments with your local podiatrist, in conjunction with the care of your GP, dietitian and other allied health professionals, will ensure that any potential problems associated with your condition can be detected as early as possible – when they are far easier to treat.

If you have ever wondered, “Is there a diabetes podiatrist near me?” – then call our Redlands podiatry clinic today on 3207 4736 to organise a diabetic foot assessment. 

Sports podiatry focuses on the diagnosis, treatment, management and prevention of injuries to the feet and lower limbs, sustained during sports and other physical activities.

When you consider that a quarter of the bones in our entire body are located in our feet you can easily understand why they might be more susceptible to injury.

Add to this the fact that sport and other high impact activities can subject our feet to loads and forces of up to 10 to 15 times our body weight, it’s easy to see how serious damage can occur – from a sprained ankle, to black bruised toenails, hamstring strains, and painful foot fractures.

As a keen enthusiast of activities such as surfing, hiking, skiing, bike riding, touch football and indoor soccer myself, I have developed a particular interest in the field of sport podiatry.

Common Sports Injuries

At our clinic in the bayside suburbs of Brisbane, we see a lot of clients suffering from sports injuries. Here are five of the most common:

1. Sesamoiditis

How can something as small as your toes, cause so much pain?!

The sesamoids are two small bones beneath the joint of your big toe, within the tendons; sesamoiditis is the name given when there is an inflammation in these bones.

High intensity physical activities like jumping, lunges, or activities with a heavy push off or loading – like what you’d do at boot camp style training – can all lead to a flare up of sesamoiditis.

If you are experiencing a painful big toe following this sort of strenuous activity, it is important to visit a podiatry clinic for diagnosis and treatment. Serious long term damage can result if the bones have fractured, or blood flow has been disrupted.

2. Stress Fractures

Sports and exercise can also cause stress fractures – tiny hair like fractures in the bones – usually in the five long metatarsal bones of the foot. While you can’t see if the bone is fractured, you may notice symptoms like swelling on the top of your foot, and pain when walking.

Stress fractures are associated with repetitive activity, or a sudden increase in training level and intensity. Other factors may include ageing footwear, an unforgiving training surface (eg concrete, tar, grass, artificial turf). People suffering from reduced bone density – osteoporosis – are at a much greater risk of foot fractures.

The good news is, stress fractures usually heal on their own, following periods of rest and reduced activity. However it is still wise to consult with a podiatrist with a special interest in and understanding of sports podiatry.

3. Turf Toe

This painful injury occurs when the forefoot catches on the ground (usually grass or artificial turf) while you are in a forward motion, causing the toe to bend upwards, outside of the normal range of movement. Ouch!

Your podiatrist may recommend wearing footwear with a stiffened toe box, toe strapping, and/or reduced activity, for a period of time.

4. Plantar Fasciitis

Foot pain which improves over the course of the day, is generally caused by plantar fasciitis. Patients often report that the first couple of steps out of bed in the morning are the most painful.

Although plantar fasciitis is common in runners, dancers and people who jump, it also affects people with reduced flexibility (eg those born with a reduced calf length).

While high heels are not the usual footwear associated with the field of sports podiatry, we sometimes see this condition in women with a high heel habit. It often develops in flight attendants for example, after years of wearing heels at work. This is because over time the calf muscles shorten to adapt to the heel height – and the calf becomes so tight that it is no longer possible to wear flat or low heels. This places additional strain on the arch of the foot, resulting in plantar fasciitis.

Your local podiatrist can prescribe treatment such as ice, heat packs, exercises, and specific footwear.

5. Black Bruised Big Toenail

If you have been shocked to find a black bruised big toenail when taking off your shoes after a day of hiking or a game of netball, this is a sign that either:

• The shoe doesn’t fit properly, and your toes are repeatedly knocking on the toe box.
• Or, your feet are moving forward in the shoe. Generally patients with this problem have a narrow foot, and a lacing technique called a heel lock helps to pull the foot back into the rear two thirds of the shoe.

Often seen in runners, hikers, snow skiers and tennis players, a black bruised toenail is caused by a bleed under the nail (called a hematoma). It can be quite painful, so it’s a good idea to visit a podiatry clinic, where they can relieve the pressure under the nail.

Eventually the damaged nail will come away, but it may take as long as 6 to 12 months to fully recover.

Sports Podiatry Brisbane

If you live in the Redlands or in the south-east of Brisbane, make an appointment at our Birkdale clinic on 3207 4736 for any concerns relating to sports podiatry. 

Using digital gait analysis we can pick up any potential problems with your biomechanics, advise on the most supportive footwear, as well as recommend strengthening exercises and other preventative strategies.

And if you do have the misfortune to sustain a sporting injury – whether you are a professional athlete, enthusiastic amateur or just enjoy kicking a footy around the backyard – we can assist you with techniques like Foot Mobilisation Therapy to get you back to what you love to do!

I often encounter clients that say things along the line of: “My sprained ankle still hurts after 3 months!” or; “Ever since I had that sprained ankle, my foot has never been quite the same”.

Usually, they are having difficulties with things like wearing high heels or climbing stairs, or perhaps while exercising eg squatting or trying to get a good calf stretch – all because the ankle feels like it is “stuck”.

A sprained ankle is one of the most common sporting injuries, particularly within certain sports such as touch football, netball and basketball. Watching my daughter play netball one weekend recently, I noticed several players experience this terrible traumatic event.

When we sprain or roll our ankle, our immediate reaction is to catch our breath from the pain.

Often it will seem to swell up before our very eyes, or the area will become quite bruised over the next few days, making it quite clear that we’ve sustained some sort of ligament or muscle damage.

But My Sprained Ankle wasn’t even that Bad!

For others, however, there may be no visible signs of injury and they may be able to walk normally pretty much straight away, not realising the damage that’s been done.

It’s only further down the track they gradually realise that their ankle just hasn’t been the same ever since –  3, 6, 12, or even 18 months afterwards!

There are two main reasons why these individuals are experiencing pain and discomfort so long after they sprained their ankle:

1. Twisting, rolling, or spraining your ankle places incredible abnormal forces on the bones and joints in your foot and surrounding structures. With 26 bones and 43 joints in the foot, there is a lot of potential for something to go wrong!
2. Spraining your ankle can disrupt the neurological pathway connecting your foot to your brain. Normally, we don’t need to think about being able to walk; our brain automatically knows the position of our feet, and how to move them. However, an ankle sprain can interrupt these messages between the brain and foot.

As a result, the individual begins to realise that the ankle is still hurting months after the event.

In the immediate aftermath of rolling or spraining your ankle, applying ice will help to reduce swelling and bruising – if it is particularly painful, x-rays may be called for determine if there have been any foot fractures. For many people, a day or two of resting the ankle may well be all that is required to get them back to normal.

If Your Ankle Still Hurts After 3 Months

If pain or discomfort persists however, further treatment may be required. You may find yourself limping in high heels, struggling to sit on the ground with crossed legs, or or even experiencing secondary problems such as sore knees and lower back pain, ever since you injured your ankle.

Fortunately, there is a treatment option: Foot Mobilisation Therapy, a fairly recent development in the field of podiatry. It is a simple process incorporating gentle traction or stretch, while placing the joint through the normal range of movement.

The foot mobilisation technique allows the joint to simply realign itself. Sometimes, the patient may be lucky enough to hear a click or a pop when this happens, though not always. It’s not painful, and the pop or click does not indicate any form of damage – rather, that full range of movement in the joint has been restored.

Treatment for Persistent Ankle Problems

At Trevor Lane Podiatry we are proud to be the first (and currently only) podiatrist in the Redlands providing Foot Mobilisation Therapy.

Once the ankle joint has been gently persuaded back into place, the focus is on restoring the electrical pathways between brain and foot (and vice versa). Your podiatrist may apply kinetic tape, to remind your body how the foot is supposed to function; and you may be prescribed certain exercises to help you regain balance and muscular strength in the affected foot and leg – for example, stretches using a resistance band (or theraband).

Suffering with a sore ankle for several months following a sprain, isn’t something you should just “put up with”, or dismiss as part of “old age”.

If you are suffering any pain or difficulties with movement in the months following an ankle sprain, call for an appointment today on 3207 4736. Although this type of podiatry treatment is not covered by Medicare, at Trevor Lane Podiatry we strive to keep our fees affordable for all.

Participating in sports such as football or basketball, or activities such as gymnastics or dancing, are the main culprits when it comes to foot fractures.

That’s why there’s a whole branch of our profession, dedicated to sports podiatry!

However even if you’re not into sports, you could sustain a painful foot fracture:

• in a car accident;
• falling from a great height;
• or even after a simple stumble.

And some trivia for you – men tend to be more often affected by foot fractures, than women!

The Foot Care Professionals

Podiatrists are the foot care professionals, undertaking four years of training so that they can provide expert diagnosis, treatment and management of all concerns relating to the feet – toes, ankles, toenails, heels and lower limbs. In order to practice, they must also be registered, which entails keeping up to date on all the latest developments in the foot care field – including the treatment of foot fractures, sprained ankles and the like.

A correct diagnosis is crucial if you are to receive the right treatment – that’s why we recommend a trip to your local podiatry clinic if you have sustained an injury to your foot and are experiencing pain and/or swelling, and suspect a fracture or sprain. Most people think of going to a doctor or hospital Emergency Department, not realising that a podiatrist is the expert when it comes to all things feet.

Sadly, we often see patients at our podiatry clinic, who have already visited a GP or physiotherapist regarding a foot injury – but have not received the correct diagnosis. Often this is because they were never sent for an x-ray, which would have revealed that a foot fracture was present.

You do not require a referral to visit a podiatry clinic, and just like a GP, we can give you a referral for an x-ray to determine if there is a fracture present. Currently there are no out of pocket expenses for these x-rays, as they are covered by Medicare.

Recovering from Foot Fractures

Once your podiatrist has arrived at a diagnosis, they can prescribe the best treatment and rehabilitation options – so you will be running around again in no time!

If you suspect that you may have a foot fracture, or just want some advice on another aspect of foot care, call us today on 3207 4736.Save

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In our last blog post, we discussed the painful condition known as onychocryptosis – or ingrown toenail.

If recurring ingrown toenail is a problem for you, your podiatrist may recommend a procedure called a partial nail avulsion or PNA.

Most people wince at the thought of surgery for an ingrown toenail, because for many years treatment involved cutting into the groove at the side of the nail (the sulcus), scraping the nail bed and being stitched afterwards. However in the majority of cases this is no longer warranted.

These days, your family podiatrist may suggest a partial nail avulsion, where phenol is used to cauterise the nail. This is a less invasive treatment, using a local rather than a general anaesthetic which means:

• that PNA is a lot more affordable as it doesn’t require an anaesthesiologist;
• recovery is less painful and more rapid;
• and it can be performed at your local podiatry clinic.

Behind the Scenes at a Partial Nail Avulsion

Before the procedure: You will be carefully assessed to ensure suitability for PNA. For example, it is not usually recommended for diabetics, people with kidney or liver problems, or if you are taking blood thinners. Your podiatrist will explain the procedure to you, encourage you to ask questions, and provide you with pamphlets to read at home.

The room is well prepped and instruments are sterilised.

During the Procedure: Two podiatrists are required by law – one maintains a sterile field and performs the procedure; the other is non sterile (to reduce any chance of cross infection), and is there to monitor your comfort levels and step you through the process. The whole procedure usually takes less than an hour.

You will be given instructions on aftercare, and the nail should be dry and you should be feeling comfortable by the time you leave the clinic.

Because a local anaesthetic has been administered, we ask that a family member, relative or friend take you home. We also supply data about the amount of anaesthetic used, just in case you are involved in an incident (eg car accident) and need further anaesthetic in the next 24 hours.

Recovery and Aftercare

We recommend you keep the nail dry for two days, and keep your foot elevated. Usually paracetamol is all that is required for pain relief, as there has been no cutting or stitching.

A follow up consultation 2 days post procedure is part of the initial fee, and allows your podiatrist to check for infection or any other problems. At this appointment you will be given dressings, antiseptic and further instructions on follow up care. Of course if there are any problems, please call us immediately, at no extra charge.

As with any medical procedure there are potential risks, the main one being infection. There is a very slight chance of regrowth; for the small number of clients who do not respond well to phenolisation (ie the nail regrows), your podiatrist will refer you to the appropriate practitioner for an excision procedure .

It might sound scary, but a partial nail avulsion should cause minimal disruption to your life, and provide an effective permanent solution (1).

Call us today to discuss treatment options if you are having problems with an ingrown toenail – phone 3207 4736.

Source:

1. 1. https://ebm.bmj.com/content/5/1/26 – viewed 22.08.19

If you are suffering the pain and discomfort of an ingrown toenail, I highly recommend visiting your local podiatry clinic for help.

I’ve found most people turn to the internet, their local chemist or GP, simply because they don’t realise a podiatrist can help!

Causes of Ingrown Toenails

Known medically as onychocryptosis, some people are unfortunately born with a tendency to suffer from ingrown toenails; it can also be common in children. They may naturally have toenails with high curves, or fan shaped nails (narrow at the base and get wider as they grow out), both of which are more likely to lead to problems.

However there are a number of other possible causes:

• Ill Fitting Footwear – An ingrown toenail may develop if the shoe is not long enough. When we are walking or running, our foot naturally expands  to fit the shoe. The secret to getting the best fit for new shoes, is to use the measuring device (known as a Brannock) to ascertain the length of your feet – and then add a complete size. This allows for foot expansion so the toenails are not constantly hitting the toe box, which can cause bruising and damage such as an ingrown toenail.
• Trauma – A blow or kick to the foot, for example when playing football or practising martial arts, can damage the toenail area. Or if you’ve ever dropped something on your toenail, you will know it goes black and blue and may even fall off eventually. When the new toenail grows in, it is usually more curved so the edges become sore and ingrown.
• Infection – Fungal nail infections can be nasty, causing the nail to thicken, change shape and look unsightly. Even once the fungus has been treated and eliminated, the sufferer will often find that their nail/s are more likely to become ingrown.
• Growing Older and certain Health Conditions – Blood flow to the extremeties (like our toes) tends to decrease as we age, or as a result of certain health conditions such as diabetes. This can change the shape of our nails and thus increase the chance of problems.
• Medications – Young people taking a certain medication for acne, may experience a side effect of ingrown toenails.

See your Podiatrist about Ingrown Toenail

When you see a podiatrist about your ingrown toenail, the first step will be to identify how it developed. Was it a one-off event, such as a kick, bump, or other trauma – or is it an ongoing problem?

Initial treatment aims to reduce the pain and inflammation, and prevent infection.

While this is usually all that is needed, in some cases the ingrown toenail has contributed to a permanent deformity of the nail bed, and requires further treatment.

The good news is that in most cases there is no need to see a specialist for surgery. Instead, we offer a partial nail avulsion (PNA) – a minor procedure which can be performed under a local anaesthetic, right here in our podiatry clinic. On the rare occasion when specialist treatment is required, we can refer you on to the appropriate medical professional.

Got a tender toenail? Call our Redlands podiatry clinic on (07) 3207 4736 or make a booking online today.

Heel pain would have to be one of the most common problems that clients present with at our Redlands podiatry clinic.

Heel pain affects all age groups and genders; it can involve either the bottom, sides, or back of the heel; and the pain can intensify at certain times of the day. Some people find it is worst when they first get out of bed, while others are affected at night, or after walking or running.

It can be puzzling because in a lot of cases, heel pain doesn’t follow an injury such as a sprain. Instead, it usually starts out as a mild irritation, becoming more severe – even disabling – over time.

Persistent heel pain usually won’t go away on its own; it may even be a sign of a rare yet serious condition known as osteomyelitis, so if heel pain has been troubling you for some time, please visit your local podiatry clinic.

What Causes Heel Pain?

Heel pain may be a symptom of a vast number of conditions, and may develop as a result of any of the following:

• Physical Trauma – in the wake of an injury such as a sprained ankle, where ligament, tendon, bone, or nerve damage has been sustained (this is where foot mobilisation therapy may be of benefit).
• Arthritis – usually associated with ageing, and a lifetime of wear and tear on the body – although genetic factors and old injuries may also be contributing factors.
• Sever’s Disease – this is a growth-related condition, most commonly seen in very active children under the age of 12.
• Autoimmune Disorders – eg rheumatoid arthritis.
• Plantar Fasciitis – inflammation of the ligament which runs lengthways along the arch of your foot.
• Heel Bursitis – a bursa is a fluid-filled sac which naturally occurs in the body, usually sitting between two structures as a cushion – for example, to prevent tendons from rubbing on bone. It can become inflamed as a result of injury or repetitive movement.
• Achilles Tendonitis – a chronic long term irritation, caused by abnormal loads placed on the foot and heel. Achilles tendonitis usually develops as a result of wearing incorrect footwear, or by suddenly getting back into exercise and doing too much too soon.
• Nerve Damage – such as tarsal tunnel syndrome. You might have heard of carpal tunnel syndrome in the wrist; the tarsal tunnel is located in the ankle region. It can arise as a result of abnormal foot mechanics, or perhaps due to systemic factors like rheumatoids.
• Back problems – Pain in the heel may actually be “referred pain” – that is, stemming from a problem elsewhere in your body, eg your lower back, and then referred to your foot.
• Heel Spurs – a bone-like growth which develops between the heel bone and the arch of your foot.
• Gout – Contrary to popular opinion, gout doesn’t just affect the big toes – it can also cause heel pain. When there is too much uric acid in the bloodstream, it can crystallise and form deposits in the joints.

Less common but more serious causes of heel pain include ligament tears; nerve entrapment; circulatory problems; soft tissue matter such as lipomas and fibromas; an underactive thyroid; bone cysts; stress factors; and osteomyelitis (infection of the bone).

Treating Heel Pain

The first step in treating heal pain is to establish a possible cause. As a podiatrist, I will consider variables such as:

• the age of the individual;
• their preferred footwear, and if it is fit for purpose;
• the surface or terrain upon which the pain is experienced;
• the time of day when pain is at its worst;
• lower limb alignment;
• and the individual’s general health.

In the majority of cases, symptoms may be relieved with the application of ice, heat, calf stretching, rest, and wearing the appropriate footwear.

However to paraphrase the TV ads: “Should heel pain persist, please see your ‘foot doctor'” – your local podiatrist.

How can you tell if your legs are different lengths? And why does it matter?

Although most of the population naturally have a difference in the length of their limbs (1), it is usually slight, and not likely to require any treatment. It is only if you notice symptoms such as a head tilt, shoulder dip, limping, or a variation in shoe sizes, these may be worth investigating with your local podiatrist.

But what most people don’t realise, is that injury and/or surgery can also cause limb length discrepancy.

Limb Length Discrepancy Symptoms

Should limb length discrepancy develop following these circumstances, it may result in pain in the:

• lower back;
• buttocks;
• running down the back of the leg;
• in, or on the outside of the knee;
• ankle;
• foot.

There may even be an increased risk of stress fractures (2).

These problems arise because the differing leg lengths increase pressure on the nerves in the lower back, which innervate the foot.

The Impact of Injury or Surgery

While surgical interventions such as hip or knee replacements, ligament or tendon repair, may fix one problem, these procedures – and aids such as crutches and moon boots – can affect the length of your limbs.

The simple ankle sprain is also a common culprit. We often see clients many months afterwards, reporting that although the sprained ankle is now healed, it still doesn’t feel quite right. The incredible forces placed on the site during the injury have caused joints to pop out of alignment. As a result the individual begins walking differently to compensate, without even realising it – upsetting the body’s natural balance.

It can take a full 6 to 12 months for the body to recover from surgery or injury. In the meantime however, our body has compensated and while we may have completed the rehabilitation process, all of a sudden something else is getting sore. The lower back, the ball of the foot, or the outside of the knee are suddenly causing pain! But why?!

All of these problems may affect your limb length, and ultimately, your body’s balance.

Treatment for Limb Length Discrepancy

Following injury or surgery, the connection between the foot and brain – and vice versa – can be lost.

In order to improve your body’s balance and reconnect that neurological pathway, at Trevor Lane Podiatry we may use treatments such as:

• Foot Mobilisation Therapy (the only local podiatrist qualified in this modality);
• special shoes or orthotics;
• kinetic tape.

However we can only assess what else was interrupted during that healing process, by physical examination, digital gait analysis or other diagnostic imaging, once you’ve recovered from the initial bruising, swelling, stitches, crutches, boots etc.

Sometimes there are other factors which may be at play, meaning that podiatry treatment may not be suitable. At these times your local podiatrist may refer you to another allied health care practitioner such as a chiropractor, osteopath, or physiotherapist. While your podiatrist plays a key role in a complex overall picture, the aim is to work in conjunction with other health services to ensure the best possible result for you as the client.

If you have recovered from a physical trauma, but now experience pain in your feet, lower limbs, or lower back, you can click to book an appointment online or call Trevor Lane Podiatry on 3207 4736.

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1232860/
2. http://www.podiatryinstitute.com/pdfs/Update_2011/2011_35.pdf