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SPORTS PODIATRY/PODIATRIST QUESTIONS & ANSWERS

Why do my heels hurt and What is the difference between heel spurs and plantar fasciitis?

If you are an adult, the most likely cause of heel pain is plantar fasciitis. This condition is commonly called heel spurs by medical practitioners. Heel spurs a bony spur that develops at the base of the heel bone calcaneus and in does not cause an issue in the overwhelming majority of cases. Plantar fasciitis is a pathology that develops at the fascial insertion of the plantar fascia into the heel bone(calcaneus). The condition plantar fasciitis/heel spurs is usually caused by pressure related issues often associated to biomechanical abnormalities. Although this is the most common reason and most likely cause of heel pain, there are many reasons for pain which must first be excluded before treating the foot for plantar fasciitis. Your podiatrist at The Foot Clinic Point Cook will help to ensure that there is nothing more sinister going on with your feet. Podiatrists are qualified to diagnose Plantar fasciitis, this is often done by clinical signs and symptoms as well as further imaging such as ultrasound/ MRI if required.

It is important to find out whats causing your heel pain as other sources of pain will not respond to the same treatment regime. For a definitive diagnosis on the source of your heel pain feel free to make an appointment online (!!Click here!!) with one of our friendly Podiatrists.

What causes heel pain?

The most common cause of heal pain is plantar fasciitis(heel spurs).Plantar fasciitis is a common condition which can be brought on by multiple factors. Diagnosis and treatment is best undertaken by a Podiatrist. Pain in the heel is usually worst in the morning upon first step or after periods of rest. For more info and to make an appointment online!!Click here!!

What is Baxter nerve entrapment?

Baxter nerve entrapment is where the nerve on the inside of your heel/ankle becomes jammed and irritated. This condition is commonly seen at the same time as plantar fasciitis but can also appear in isolation.

What causes arch pain?

The arches are a complex structure with many muscles, bones, joints, ligaments, nerves and vessels. To find the exact cause of pain in the arches, a full clinical history, assessment and biomechanical will be required by your Podiatrist. Often the role of arch pain and more generally foot pain is either an injury or a biomechanical problem.

If there are
biomechanical problems with your foot, your Podiatrist can help in a range of ways ranging from a device to wear in the shoe, to a range of exercises to help strengthen the muscles in the arch, foot and legs.

Why do my arches hurt?

Arch pain can be due to soft tissue injuries, bony injuries, accessory bone pathologies and many more possible causes. Foot posture can play a significant role in the cause of arch pain.

What are foot orthotics?

Foot orthotics are devices that are worn in the shoes to correct flat or high arched foot postures. There are many different types of foot orthotics and many different places that prescribe and sell them. The three main types of foot orthotics are off the shelf orthotics, semi-custom orthotics and custom orthotics.

Off the shelf foot orthoses are the most common type of foot orthotic and can vary substantially depending on who and where they are prescribed. Most foot orthotics purchased from a retail store will in most cases not be sufficient for the treatment of foot related pathologies and will not last very long due to poor soft materials. If the right device is prescribed to the right person, off the shelf foot orthoses can be a great treatment option for many foot conditions.

Semi-custom foot orthoses are a device usually reserved for children as an alternative to a custom foot orthotic. These devices are called semi custom foot orthotics as the shell is not customised but the top cover is. This is where it gets its name semi-custom foot othotic as the device has custom parts as well as non custom parts.

Custom foot orthotics are devices made specifically for a person by taking a 3D casting of the patients foot. This can be achieved with plaster, 3D foot scanner, fiberglass socks, foam box and many other ways. Custom foot orthotics can be prescribed by a Podiatrist usually following a full biomechanical assessment. This involves checking range of motion, gait analysis and the acquisition of a full medical history. Custom foot orthotics are best prescribed by a trained professional so if you think that you require advice or treatment by a friendly Podiatrist feel free to contact us via (03) 8375 2062 or book online by !clicking here!

What are foot orthotics used for?

Foot orthotics are devices used to alter foot biomechanics to offload stressed structures in the foot. Orthotics can also be used to offload areas of pressure that lead to the development of corns. For more info!!Click here!!

How does a Podiatrist treat ankle sprains?

Ankle sprains should be assessed thoroughly by a Podiatrist to rule out soft tissue/ligamentous tears and fractures. Inversion ankle sprains are common and usually affect the ligaments on the outside of the ankle. It is important that imaging is referred for immediately to rule out a fracture or soft tissue injury. Depending on results our Podiatrists will fit cam walkers (moon boots) on the spot and base treatment plans off of imaging. Following a ankle sprain it is important to see a Podiatrist for rehabilitation to ensure that the ankle resumes its original function. Our Podiatrists will put in place a rehabilitation plan including stretching, strengthening and proprioception re-training.

How does a Podiatrist treat ankle pain?

Ankle pain will be assessed at the time of the initial appointment. This will involve diagnosing the cause of ankle pain (it may be tendinopathy, arthritis, osseous or inflammatory in nature) Depending on the results of a thorough biomechanical assessment, a treatment plan will be put in place by your Podiatrist. This may involve correcting foot posture to reduce excessive tissue stress and referral for imaging to identify the exact cause.

Can a Podiatrist treat foot and ankle fractures?

Foot and ankle fractures are treated by Podiatrists in a similar fashion to ankle sprains. Imaging will be referred for and a cam walker depending on the results of imaging. In the case of the need for a further surgical referral our Podiatrists will refer this back to your GP for a referral to be put in place to an orthopaedic surgeon or podiatric surgeon.

What causes ball of foot/forefoot/end of foot pain and How does a Podiatrist treat ball of foot/forefoot/end of foot pain?

One of the most common presenting concerns seen by our Podiatrists is pain in the forefoot. Some symptoms related to forefoot pain are described as burning, tingling, numbness, sharp pain and some patients report feeling as though they are walking on a pebble. Pain can be caused by morton's neuroma, sesamoiditis, osteoarthrtis, bunions, plantar plate tears, stress fractures and fractures. Treatments for forefoot pain can involve custom foot orthoses with a metatarsal dome or metatarsal bar, injection therapy, dry needling, strengthening and stretching exercises, cam walker and footwear modification.

What causes knee pain, Can a Podiatrist help with knee pain and how do Podiatrists treat knee pain?

Knee pain is often referred to as patellofemoral joint syndrome and occurs during periods of exercise. Pain is often located on the inside of the knee cap. Studies have found that people who display a flat or high arch foot type are more likely to develop this type of knee pain. Your Podiatrist will assess this by performing a full biomechanical assessment. If the foot posture is seen to be contributing to this pain then custom orthotics are often prescribed to correct biomechanical anomalies.

Can lower back pain be caused by my feet?

Lower back pain is both common and complex in it's causes. Chronic lower back pain can be due to sciatic nerve entrapment or compression. if there is excessive motion at the foot or ankle this can be seen to create excessive motion at the lower back pain. Your feet can have a definite impact on your lower back pain.

Can a Podiatrist help treat my back pain?

Lower back pain has been associated with foot posture. Generally if you have a foot posture that pronates (or rolls in) this causes excessive tibial external rotation and internal rotation of the femur this can lead to increased chance of developing back pain. A Podiatrist can also assess for a limb length discrepancy (one leg longer than the other). This can be corrected by the use of custom orthoses often with a heel lift to correct the difference in the length of legs.

What is pronation?

Pronation is a term used to describe your foot type/posture. Pronation is a multiplanar movement and is seen as the ankle rolling inwards and often involves arch collapse.

What is Supination?

Supination is also a descriptive term used to describe foot posture. It refers to a high arch foot posture.

Why do my feet roll in or Why do my feet roll out?

Your feet rolling in or rolling out is demonstrating your feet are on the scale of flat to high arched and the motion in the ankles and feet that are associated with this. There are many factors involved in foot posture, which there are more details in our blog here. Neither are inherently problematic but either could be contributing to your injury or pain. This is biomechanics and is where sports Podiatrists specialise, if you have pain and are wondering if your foot posture affects your foot pain please contact us at The Foot Clinic Point Cook.

Is it bad if my feet roll in when I walk?

Although your feet rolling in during activity is not bad in itself. If you have foot, leg or lower back pain then controlling motion in the foot and ankle can be a valid treatment option.

What is foot posture?

Foot posture is a term that describes the level of pronation or supination that is observed in the foot and ankle. The assessment is performed by a Podiatrist and the results are then interpreted in the context of your problem. If you would like a more in depth explanation of foot posture book an appointment or check out our blog.

What is a biomechanical assessment?

A biomechanical assessment is an assessment by a sports physician or sports Podiatrist that focuses on the way your foot and leg moves and how that impacts on your injury or pain. Biomechanical risk fators that are determined during your asessment will be factored into any treatment plan given by your sports Podiatrist.

How do I know what runners are good for my feet?

There are three main foot types that present in the human foot. These are pronated(rolling in), neutral(in the middle) and supinated(rolling out). Once you know your foot type the next step is choosing the correct shoe. Shoes have varying degrees of correction and technologies.
To keep it simple the shoes will be grouped into 4 categories.

Category 1: very Corrective - Can be used for excessively flat feet. Vary rarely recommended at The Foot Clinic Point Cook as an
orthotic in a neutral or corrective shoe is a better approach for treating this foot type.
Category 2: Corrective - Great at controlling the
pronated foot type and can be used in conjunction with an orthotic easily.
Category 3: Neutral - Great for a
neutral and supinated foot type and can be used in conjunction with an orthotic.
Category 4: Minimalist shoes - Not recommended for the general population. It can take months of training to build the body up to a shoe in this category. Patients should take caution when wearing this form of footwear.

There is no ideal foot type and each foot type has its own negatives and positives. To decide what shoe is suitable for a person's foot you first need to understand what you are trying to achieve with the shoe. A Podiatrist can help assess your foot type and point you in the right direction. They will also set out a treatment plan if necessary. For an appointment to undergo a full assessment you can book online by
clicking here or calling us on (03) 8375 2062.

What are sesamoids, What is sesamoiditis and How do Podiatrists treat sesamoid pain?

Sesamoids are round bony structures that sit under the big toe and aid in tendon movement. These bones can sometimes become irritated, painful and inflamed. This is known as sesamoiditis. Sesamoids can be treated with multiple conservative therapies such as dry needling, padding, taping, stretching and orthotics. If Sesamoids do not respond to conservative therapies, surgical intervention may be required.

Can Podiatrist refer for X-Rays and ultrasounds?

Podiatrists regularly refer for X-Rays, ultrasounds and MRI imaging. Based upon a patients presenting complaint, these diagnostic imaging techniques may be required to confirm and diagnose specific conditions.

Can Podiatrist refer for MRI?

Depending on presenting complaints a patient may be referred by their Podiatrist for MRI. MRI's are not usually the first type of imaging requested due to the added cost to the patient and most injuries/conditions can be identified using other, more cost effective imaging.

Are X-Rays and ultrasounds bulk billed when I'm referred by my Podiatrist?

Podiatrist's are able to refer for X-Rays, Ultrasounds and MRI's. X-Rays will be bulk billed at most locations with a Podiatry referral. Ultrasounds can require a gap payment the same as a GP referred the patient. Some places will bulk bill ultrasounds. MRI's will always incur a gap payment whether a Podiatrist or a GP refers the patient. MRI's can be bulk billed upon referral from some medical specialists. Podiatrists will use referrals for ultrasound/X-Rays/ MRI's depending on the presenting complaint.

What is Prolotherapy and what do Podiatrist use Prolotherapy for?

Prolotherapy is also known as injection therapy. This is where a needle is inserted into a target area at which point a solution may or may not be deposited. Different substances that are commonly injected are autologous blood injections, Glucose, Local aesthetic and cortisone. Dry needling is a technique where a solution is not injected and an acupuncture needle is used in a trigger point to encourage blood flow.

What is dry needling and what do Podiatrists use dry needling for?

Dry needling is where a needle very similar needle to acupuncture is inserted into a trigger point. This encourages blood flow to the area and is very good at releasing muscles. Research has found dry needling to be an effective therapy in the treatment of heel pain/ plantar fasciitis/ heels spurs. It can also be used in a lot of other tissues in the body.

What is cortisone used for in the foot?

Cortisone is a steroid and is injected for its long acting anti-inflammatory properties and is commonly used for plantar fasciitis or Baxter nerve entrapments. This powerful anti inflamatory treatment can be used in tissues throughout the body by a trained professional.

Can Podiatrist prescribe medications?

A Podiatrist can prescribe medications if they have undertaken further training in pharmacology and passed in depth testing.