Blog Archives

Flat feet- Children’s feet | The Podiatrist and yourfeetnz

 

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Children with flat feet, also called pes planus, have a flattening of the arch during standing and walking.

Flat foot is normal in infants and young children. At this age, in the absence of any associated symptoms, treatment is highly debatable.

Flat foot usually naturally corrects itself as muscles strengthen and soft tissues stiffen. The height of the arch in the foot increases with age until about 9 years. The problem is when flat foot persists, spontaneously occurs in older children or later in life, or is associated with pain and disability.

Flat feet can be flexible or rigid, painful or painless and associated with a tightness of the calf muscles (Achilles tendon). The majority of flat feet are painless, but when pain is present it is usually during weight-bearing activities such as walking and running. The pain can be in the sole of the foot, the ankle, or non-specific pain all around the foot area.

 

What causes flat feet?

A complex and sophisticated interaction of bones, ligaments, muscles and nerves within and above the foot defines its anatomy and function. Anything that interrupts the integrity of these structures leading to a collapsed arch can cause symptomatic flat feet.

Examination of the foot begins with an examination of the entire child, because the flat foot may have an underlying cause.

Flat foot can also originate from unusual anatomy such as a tarsal coalition (bones joined together), ligament or muscle damage, restricted ankle movement, outward rotated lower legs, and knock knees (where the legs bow inwards at the knee). Obesity can result in collapse of the arches by the increased load on the foot. If knock knees also develop, the middle of the foot will tend to turn out (abduct). The foot will point outwards when walking, instead of straight ahead, which is inefficient and can cause early fatigue.

Footwear in early childhood has been thought to cause flat foot. It is likely that children who wear shoes, are not physically active and have flat feet will have decreased muscle activation in their feet and thus impaired foot function and weakness.

Some older children and adolescents develop flat feet in the absence of any disorder or associated factors.

 

Does flat foot need to be treated?

Flat feet require treatment only if clearly associated with pain or decreased function. Managing the underlying cause or disease is of highest priority; just treating the symptoms should be secondary.

If flat foot is observed in a child who is overweight and has knock knees, or in a child with excess joint flexibility and poor footwear, each of these factors could be contributing to the symptoms, and each should be addressed.

If a child’s quality of life is affected by how their feet look, feel or function, then the associated issues should be addressed.

For any foot problems, contact The Podiatrist.

http://www.thepodiatrist.co.nz

http://www.kidsnmotion.co.nz

5 quick and easy tips to healthy feet and legs | The Podiatrist and yourfeetnz

one pair has to last a lifetime

There are many causes of leg pain right from muscle cramps and inflammation of tendons to arthritis, varicose veins and nerve damage. Leg pain due to muscle strain following an injury or wearing tight shoes for a long time can be prevented by following few simple tips:

  1. Stretch the leg muscle: One of the most effective ways to prevent leg pain due to a sudden muscle twist or cramp is to stretch the muscle. This not only improves blood flow to the injured muscle but it also helps in reducing muscle tension thereby relieving muscle soreness.
  2. Take a warm shower: If you suffer from leg pain, then take a warm shower to relax the muscles. If taking a bath is not feasible, then placing a heating pad on the affected areas can also help. A heat pack works best if the pain is due to a previous injury as it not only relaxes blood vessels but also improves blood circulation, alleviating leg pain.
  3. Wear a proper fitting athletic shoe: Most people fail to choose the right fitting shoe, which is one of the common causes of leg and heel pain. To get the right fit, determine the shape of your foot using the ‘wet test’. For this, step out of the shower onto a surface that will show your footprint, like a brown paper bag. If you have a flat foot, you will see an impression of your whole foot on the paper. If you have a high arch, you will only see the ball and heel of your foot. When shopping, look for athletic shoes that match your particular foot pattern.
  4. Choose the right sports shoe: Not many people are aware that different types of shoes are specially designed to meet your sports requirement. Did you know running long distances in court-style sneakers can contribute to shin splints? It is important to choose the shoes according to your sport or fitness routine.
  5. Go slow if you are a beginner at the gym: One of the common mistakes that most people commit is to overexert on the first day of the gym, which not only exerts pressure on the knee but also causes muscle soreness and leg pain. The key to preventing leg pain and sticking to your workout routine is to build your fitness level slowly. You can start off with less strenuous workouts and then gradually increase the duration, intensity, and frequency of your exercise regimen.

For any foot problems, contact The Podiatrist.

http://www.thepodiatrist.co.nz

 

Shopping for School Shoes | The Podiatrist and yourfeetnz

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  1. To avoid in-store arguments, parents and children should discuss in advance the style and brand of shoes they want to look for.
  1. Remember that a good fit is more important than the size of the footwear. A good fit allows for a 1/2” of space between the end of the toes and the end of shoe. Shop at retailers who provide a fit specialist for extra assistance.
  1. Avoid hand-me-down shoes; improperly fitted shoes can support feet in unhealthy positions.

4. Avoid shopping online or estimating a child’s shoe size.

  1. Remember that not all shoes of the same size fit alike. While foot measurement is a starting point, how the shoes fit is more important.
  1. Match the shape of the shoe to the shape of the foot.
  1. Remember that while a low arch is normal in young children, in children older than age seven, the lower the arch the more important it is to have shoes with good support. Look for a firm heel counter and stiffness when trying to twist shoes lengthwise.
  2. If a child wears orthotics, select shoes with removable foot beds and try the shoes on with the orthotics in place.
  1. Remember that price is not necessarily commensurate with quality. If price is a consideration, last year’s models can offer all the features needed at a discounted price.
  1. Check the fit on your child’s shoes on a regular basis as children’s feet grow at irregular rates.

For more information, or if you have any questions, contact The Podiatrist

http://www.thepodiatrist.co.nz

Keep those feet happy | The Podiatrist and yourfeetnz

foot-care

The importance of our feet has been understood for centuries. Even the Greek philosopher Socrates is reputed to have said, “To him whose feet hurt, everything hurts.” So, what comprises foot care that promotes comfort at any age?

  • Wear shoes and socks that fit and are comfortable.
  • Be sure your toes are not cramped.
  • Change socks daily and if possible have two pairs of shoes in everyday use so that you can alternate the pairs daily.
  • Elastic laces are handy if your feet swell.

Shoes should be worn that cover, protect, provide stability for the foot and minimize the chance of falls.

Whatever your age – student or grandparent – foot care is important.

  • Remember to cut or file your nails straight across and never shorter than the end of your toe.
  • If you are older, and particularly if you are diabetic, it is helpful to get The Podiatrist to do your foot care.
  • It is best to wash feet daily and always test the water’s temperature beforehand. Pat, do not rub, your feet dry and remember to dry between and under the toes. If your feet are bothering you you’ll find that short soaks of even ten minutes are soothing.
  • Use a lanolin (ointment base) moisturizing cream for dry and cracked skin. If your feet perspire, dust lightly with talcum powder. Remember to remove excess cream of powder from between your toes to avoid skin problems. If you are diabetic it is wise to examine your feet daily.
  • Exercise each day if possible. Walking is always good but there are also special foot exercises that can be done like rolling your feet over a rolling pin several times daily or picking up a crumpled towel with your toes.

Despite reasonable care throughout life, however, the older foot is subject to problems. Heredity is a factor as are the stresses over the years and complications from systemic diseases. It has been estimated that at least 80 percent of people over 50 have at least one foot problem.

The most common are corns and calluses, ingrown toenails, bunions, hammertoes, strained arches, heel pain and arthritis including gout.

In many cases there can be improvements jus by switching shoes to the type with wider, box-type toes. Also. shoe size can actually change with added years.

Feet carry our body’s weight, help hold us erect, co-ordinate and maintain balance in walking. We need to give them tender, loving and skilled care.

The returns are high, including the joy of a walk.

Make an appointment with The Podiatrist today.

www.thepodiatrist.co.nz

 

Kids- their feet and shoes | The Podiatrist and yourfeetnz

childrens orthoses are not like adults

If you have active kids, making sure they’re wearing the right shoes for what they’re doing, and for their own unique physique, can be as important and wearing their retainers or washing their faces.

  • One in three children who plays a team sport is injured seriously enough to miss practice or games.
  • Children’s bones, muscles, tendons and ligaments are still growing, making them more susceptible to injury.

When it comes to issues of our kids’ we need to know to keep them safe, and help them understand how to do things right.

A few things we can do, and remind them to do, include:

  • Kids should have at least one or two days off from any particular sport each week to avoid overuse injuries.
  • If you experience a foot or ankle injury while playing sports, early attention is key to preventing further damage. Always ice the injury, never use heat.
  • Choose footwear specific to your activity. Sneakers made for tennis players will provide different support and traction than cleats made for football players.
  • If you participate in a certain sport at least two to three times a week, you should wear a sport-specific shoe.
  • Go to a store that specializes in athletic shoes, or The Podiatrist for suggestions.
  • Be sure to have their feet measured every time you purchase new shoes, as feet size and shape can change (especially in kids) as we age.

For all your foot problems, visit The Podiatrist

www.thepodiatrist.co.nz

Ankle injury – don’t let it take the ‘spring’ out of your step| The Podiatrist and yourfeetnz

ankle sprains

Anyone from a well-conditioned athlete to the most inactive person can experience an ankle injury. Ankle injuries usually involve a sudden, unexpected loss of balance that results in a sharp twist of the ankle.
A strain occurs when a muscle or tendon overstretches. A sprain, which is more serious, occurs when the strong connective tissue that connects one bone to another (ligaments) become overstretched. In some cases, a ligament tears and may pull a fragment of bone with it. When a piece of bone is pulled away, it’s known as an avulsion fracture.
Everyone’s bone architecture is a little different and the arrangement of bone and muscle leaves us prone to injury. Uneven leg length, excessive pronation (flat feet), cavus foot (high arches), knee and hip alignment (bow legged or knock-knee) all play a part in creating weak points where injury may occur.
Sports-related injuries are part of the game and as athletes are becoming stronger, faster and better conditioned, higher energy injuries are becoming more common. Foot and ankle injuries are frequently designated as a sprain, which often minimizes the severity of the injury.
A healthy foot is necessary for running and push-off. These seemingly simple sprains can be devastating to the running athlete, often requiring an extended period of time to recover.
An ankle sprain is very common in normal daily activities – sports or otherwise. Although painful, it usually doesn’t cause any long-term problems, if treated properly.
However, if untreated, it can produce longer lasting problems, such as decreased strength, balance, flexibility and increased risk of re-injury. For the first 24 to 48 hours your ankle will probably swell and might even show some bruising. Minimize this by using the RICE formula – Rest, Ice, Compression and Elevation. Depending on the severity of the injury you may require physical treatments to restore joint range of motion, strength and joint stability.
See The Podiatrist if you have any problems.
http://www.thepodiatrist.co.nz

Avoid These Training Mistakes To Prevent Injury | The Podiatrist and yourfeetnz

running injuries

Follow these guidelines to stop injuries before they happen.
Getting injured stinks. Not only does it prevent you from getting out the door and doing what you love every day, but staying healthy for an extended period of time is the single most important factor to improving your running.
Interview any runner, elite or recreational, about what led to their most recent breakthrough and I can guarantee you the answer can be traced back to staying injury-free. Sure, they might credit their new coach, a change in diet, or a variety of other factors. However, these changes all resulted in the same outcome: healthy, consistent training.
Since staying healthy is so important, what aspects of your training are most likely to result in injury? More importantly, how can you avoid these costly mistakes?
Trying To Make Up For Missed Or Failed Workouts
While it’s perfectly OK to rearrange and adjust a training schedule to ensure you accomplish the most important runs, simply cramming in missed workouts or attempting them again is the quickest route to injury.

Repeating A Failed Workout

Asking to run a workout again after a poor showing is one of the most frequent requests I receive as a coach. Honestly, I empathize with why runners are so eager to run a workout again. It doesn’t matter if it’s weather related, a mental block, or just not having a good day, having a bad workout is very frustrating.
However, you should never try the workout again the next day.
If you ran more than half the workout already, attempting to perform the workout again is going to add serious fatigue and almost assuredly will result in overtraining or an overuse injury. Proper recovery is essential to staying injury-free.
The best approach is to examine why you had a bad day and try to fix that problem before your next session. Did you not fuel well? Not get enough sleep? Make sure you address these more important factors to ensure more consistent workouts over the long-term.
Moreover, look for lessons in the negatives. Did you give up easily when it started to hurt? Was your pacing off? Learn from these lessons and make your next workout count.

Cramming To Fit Everything In During The Week

Another all-too-common mistake is trying to cram missed workouts in during the week. It’s common to see runners miss their long run on a Sunday and then try to make it up on Monday. This isn’t a bad thing≤ provided they also move back their next hard session and consider reducing or eliminating their next long run.
However, most runners I know simply move the long run to Monday and complete their upcoming week as scheduled.

Again, this is a one-way ticket to your local sports doctor. Cramming workouts together only leads to overtraining and a significant increase in injury risk. More importantly, missing one workout will not impact your fitness in any meaningful way.
If you miss an important workout, like a long run during marathon training, take the time to examine and rearrange your schedule appropriately. Don’t simply force the missed run back into your current schedule.
Running Too Fast
Every runner loves when they crush a workout. Nothing feels better than exceeding expectations and soaking up the confidence from knowing you ran well ahead of pace. However, the feeling will likely be fleeting as your structural system attempts to recover from the excess strain you subjected it to.

Remember that no singular workout is the key to success. The only “secret” to faster running is healthy, consistent training.
Not Enough Focus On Injury-Prevention Work
Research has shown us that structural weaknesses are a primary factory in most running injuries. For example, there is a strong relationship between a lack of hip strength and running knee injuries (runner’s knee, IT band syndrome, and patella tendonitis). As such, one of the easiest and most effective ways to stay injury-free is to include core and hip strengthening routines into your training schedule.
Unfortunately, most runners already have a difficult time fitting in all the kilometers, never mind finding time for strengthening exercises. So, they skimp on the strength and preventive training in favor of running more kilometers However, a much wiser decision is to include strength and preventive training, even if it’s at the expense of a few kilometers.
Impressive mileage totals won’t do you any good if you get hurt after three or four weeks. The miniscule metabolic benefit a few additional kilometers is nothing compared to month after month of healthy, consistent training.
The next time you’re faced with the decision of whether to run an extra two miles or getting in your injury-prevention work, think long-term and remember how much being injured stinks.

There are right and wrong ways to use ice for injuries | The Podiatrist and yourfeetnz

ice or injuries

Ice treatment is most commonly used for acute injuries. If you have a recent injury (within the last 48 hours) where swelling is a problem, you should be using ice treatment. Ice packs can help minimize swelling around the injury.
Ice packs are often used after injuries such as an ankle sprain have occurred. Applying an ice pack early and often for the first 48 hours will help minimize swelling. Decreasing swelling around an injury will help to control the pain.
Ice treatments may also be used for chronic conditions, such as overuse injuries in athletes. In this case, ice the injured area after activity to help control inflammation. Never ice a chronic injury before activity. An athlete who has chronic hip or knee pain that increases after running may want to ice the injured area after each run to reduce or prevent inflammation.
Ice is a vaso-constrictor (it causes the blood vessels to narrow) and it limits internal bleeding at the injury site. There is controversy as to whether continued application of ice results in a sudden vasodilatation of the blood vessels and if so, at what time this response begins and how often a cycle of constriction and dilation occurs.
To ice an injury, wrap ice in a thin towel and place it on the affected area for 10 minutes at a time. Allow the skin temperature to return to normal before icing a second or third time. You can ice an acute injury several times a day for up to three days.
Ice for no more than 20 minutes at a time, as too much ice can cause frostbite. More ice does not mean more relief.
Heat treatment
Heat treatments should be used for chronic conditions to help relax and loosen tissues, and to stimulate blood flow to the area. Use heat treatments for chronic conditions, such as overuse injuries, before participating in activities.
Do not use heat treatments after activity, and do not use heat after an acute injury. Heating tissues can be accomplished using a heating pad, or even a hot, wet towel. When using heat treatments, be very careful to use a moderate heat for a limited time to avoid burns. Never leave heating pads or towels on for extended periods of time, or while sleeping.
Moist heat is best, so you could try using a hot, wet towel. You can buy special athletic hot packs or heating pads if you use heat often. Never leave heating pads on for more than 20 minutes at a time or while sleeping.
More about ice
• Sometimes ice may not be ideal for certain injuries, but there are still times when it can help an athlete out.
• Drinking ice water can lower your core temperature enough during training or racing on hot days to boost endurance. And putting ice on highly vascular areas during a race can be very beneficial too.
• Cryotherapy in the form of ice baths isn’t recommended for recovery and icing an area of soreness has not been linked to reducing delayed onset muscle soreness (DOMS), but cold baths may be beneficial. Cold baths or showers can help speed recovery, but this does not mean to sit in a bucket of ice: the idea is not to try to numb your body. If you have an area of your body that is tight or sore, say your calves, then you may help the healing and recovery by standing in a cold bucket of water. Make it cold enough so the ice slowly melts in the water.
See The Podiatrist if you have any injuries.
http://www.thepodiatrist.co.nz

Pain in the ball of the foot- The Podiatrist | YourFeetNZ

forefoot pain

Pain at the ball of the foot, or the forefoot, is a common complaint in athletes. The forefoot is the part of the foot in front of the ankle consisting of groups of bones that include the metatarsals (five long bones in the forefoot) and phalanges (the bones that make up the toes). There are many medical issues that can arise in this region due to trauma, overuse, or other factors. Forefoot pain can range from mild pain causing a slight limp to severe pain that prevents walking. Common causes include: stress fracture, interdigital neuroma (also known as Morton neuroma), and sesamoiditis.
Stress fractures
A stress fracture is one of the more concerning potential causes of your discomfort. Metatarsal stress fractures result from repetitive stress to the forefoot, usually from running, jumping, dancing, and other repetitive weight-bearing activities. Patients with stress fractures of the metatarsal shaft describe a history of gradually worsening pain in the forefoot. Initially the pain is intermittent and occurs only with use. The patient may present with poorly defined forefoot pain or point tenderness over a metatarsal shaft. If the causative activity continues, the injury can progress, with swelling, severe pain even with normal activities, and frank fracture.
Diagnosis is made using history, physical exam, and potentially imaging studies. They usually respond well to cessation of the causative activity. Crutches and partial weight-bearing for several weeks may be helpful in patients who have pain with walking. A short-leg cast and non-weight-bearing may be used for short periods of time in patients with severe pain.
Interdigital neuroma
Interdigital neuromas are thought to be due to swelling and scar tissue formation on the small interdigital nerves. They most commonly involve the third webspace, but may also be seen in the second and fourth. Symptoms associated with a neuroma may include sharp or shooting pain, numbness, or pins and needle sensation. Many patients describe it as feeling like something is wadded up under the toes. It frequently can be temporarily relieved by removing the shoes and massaging the area.
Neuromas can be caused by trauma or chronic irritation. Chronic irritation can be in the form of wearing shoes that are not wide enough in the forefoot area causing compression of nerve. The irritation may also occur from abnormal mechanics of the foot causing excess motion of the metatarsal bones.
Diagnosis can be made by using elements of the history and physical exam, or by imaging studies such as ultrasound or MRI. Conservative treatment may include use of properly fit shoes (well cushioned with wide forefoot), metatarsal foot pads (to evenly distribute pressure to the metatarsal heads), and physical therapy (to address mechanics and strengthen the intrinsic muscles of the foot). If conservative treatment fails, injection therapy and surgery are also considerations.
Inflammation
Inflammation or injury of the sesamoid bones located on the plantar surface of the big toe joint can also cause pain in athletes. The sesamoids are pea-sized bones that function as pulleys for tendons (just as the patella does for the knee extensors) and assist with weightbearing. The athlete with sesamoiditis typically complains of pain at the area of the big toe joint with weightbearing that is exacerbated by walking, and even more so by running. Exquisite tenderness of the sesamoids is present, and is exacerbated by pushing off with the great toe. Imaging may be required to differentiate between sesamoiditis and a stress fracture. Both may require a short period of immobilization followed by prolonged rest from weightbearing activity. Athletes can use alternative, nonweightbearing forms of exercise to maintain fitness. Treatment with custom orthotics, soft pads cut to relieve pressure on the sesamoids, and in severe cases, glucocorticoid injections may be helpful. Consultation with a foot surgeon is reasonable in persistent cases.
These are just a few of the potential causes of your pain, however there are many other potential causes of forefoot pain. Discussion with The Podiatrist is advised. A specific diagnosis can then be made, after a full history and physical is performed. Appropriate treatment can also then be discussed.

See The Podiatrist for all your foot problems.
http://www.thepodiatrist.co.nz

Choose the right shoes

 

 

 

 

 

Choosing the right running shoe is an important part of your overall running comfort. It can be the difference between enjoying your run and sustaining long term injury. But how do you choose a shoe?

Surely a running shoe is just a shoe? Not so. Here are a few pointers on what you should consider before you go out and spend money on running shoes.

It’s not for nothing that runners are incredibly loyal about their shoes.

Once you find something, stay with it. Look at what worked in the past.

Comfort is important

Comfort and cushioning are important features to consider when buying a shoe. This might sound obvious to you, but, if the shoe feels rigid, too flexible or narrow, too soft or hard, then rather don’t get it. Your first experience doesn’t guarantee later experience, but if it’s not good then, it’s unlikely that it’ll get better over time.

If you’re a first-time buyer, it’s obviously different. You’ll need to try the shoe on and remember that if it’s not perfectly comfortable when you lace it up, then it probably won’t be comfortable after an hour of running.

Flexibility of the shoe, and even its shape, make just any old cross trainers unsuitable. They also tend not to give much support to the arches.

Many of us are lured by the look of shoe, and by the gadgets and marketing. People want the ‘air’ or the ‘gel’ or any of the array of marketing claims, because they’ve either read about it, or a famous athlete uses the shoe, or they have friends who recommend it. But there are other factors you need to consider too, such as whether or not you tend to pronate.

Do you pronate?

This involves the rotation of the foot outwards during the landing period.

That means that those who pronate land on the outside of the foot (usually at the heel) and then roll in, over towards the big toe. When this happens too much or too fast, there is believed to be a risk of injury because of the weight that joints have to support.

Many people do find that a stability shoe helps them because it does change the movement of the foot. These are the shoes that have a built up inner portion, so that when the foot lands, it is “blocked” from rotating inwards.

If you do this excessively, then you might be better off in these shoes, whereas people who roll in normally are better off in cushioned shoes.

You must be careful not to choose a heavy shoe that restricts movement of the foot.

If you find you are in some pain in your feet after running, rather see The Podiatrist for expert opinion.

How long will your shoes last?

Generally with shoes, one talks about the mileage of the shoe, and not about the time the shoe lasts, for the obvious reason that some people will run once a week, whereas others run six times a week, and so over six months, the shoe is used completely differently!

Even for mileage, it can be difficult, because it depends so much on the runner. Mass is obviously a key factor – 100kg running 8km is going to wear a shoe differently compared to 65kg running 8km.

Mechanics also affect the shoe, because it wears a shoe in different places. Generally, shoes will last 600km as a minimum, more in some people.

The only way to really gauge is when the midsole starts to get so compacted that it loses all its softness. Or, it gets compacted one side, but not the other, so the shoe starts to “lean”. Or the black rubber outsole wears away.

The Podiatrist

www.thepodiatrist.co.nz

www.kidsnmotion.co.nz

www.scooters.net.nz