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How to manage achilles tendinopathy the best way?

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Shin Splints

Achilles tendinopathy is a common condition that affects the Achilles tendon, which connects your calf muscles to your heel bone. It can cause pain and stiffness in the affected area, making it difficult to walk or perform daily activities. Fortunately, physiotherapy can be an effective treatment option for Achilles tendinopathy.

What is Achilles Tendinopathy?

Achilles tendinopathy is a condition that results from overuse or repetitive stress to the Achilles tendon. This can cause the tendon to become inflamed, swollen, and painful. It can also lead to the development of microtears in the tendon, which can further exacerbate the condition.

Symptoms of Achilles Tendinopathy

The most common symptom of Achilles tendinopathy is pain in the Achilles tendon. This pain can range from mild to severe and may be felt in the heel, ankle, or calf. Other symptoms may include stiffness in the affected area, swelling, and a feeling of weakness in the leg.

Treatment for Achilles Tendinopathy

There are several treatment options available for Achilles tendinopathy, including physiotherapy. Your physiotherapist will work with you to develop an individualized treatment plan based on your specific needs and symptoms. Some of the most common physiotherapy treatments for Achilles tendinopathy include:

  1. Eccentric exercises: These exercises involve lowering the heel slowly while standing on the edge of a step. This can help to strengthen the Achilles tendon and reduce pain.
  2. Massage therapy: Massage therapy can help to increase blood flow to the affected area, which can promote healing and reduce inflammation.
  3. Stretching: Stretching exercises can help to improve flexibility in the calf muscles and reduce tension on the Achilles tendon.
  4. Rest and ice: Rest and ice can help to reduce pain and inflammation in the affected area.

In some cases, surgery may be required to treat severe cases of Achilles tendinopathy. Your physiotherapist will work closely with your healthcare provider to determine the best course of treatment for your individual needs.

Conclusion

Achilles tendinopathy can be a painful and debilitating condition, but with the right treatment, it can be effectively managed. Physiotherapy is an excellent treatment option for Achilles tendinopathy, and can help to improve your symptoms and overall quality of life.

If you are experiencing pain or stiffness in your Achilles tendon, don’t hesitate to seek our help with one of our qualified physiotherapists or call 9815 2555 .

What’s the best way to manage my plantar fasciitis?

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Plantar fasciitis is a common condition that affects the feet, causing pain and discomfort in the heel or arch of the foot. It is estimated that up to 10% of the population will experience plantar fasciitis at some point in their lives. Fortunately, physiotherapy is an effective treatment for plantar fasciitis.

Here are some evidence-based tips to help you get the most out of your physiotherapy sessions:

  1. Attend all of your scheduled appointments

A systematic review of the literature found that physiotherapy is effective in reducing pain and improving function in patients with plantar fasciitis. However, attending all of your scheduled physiotherapy appointments is crucial for your recovery. A study published in the Journal of Orthopaedic & Sports Physical Therapy found that patients who attended all of their scheduled physiotherapy appointments had better outcomes than those who missed appointments.

  1. Wear appropriate footwear

Wearing appropriate footwear is essential for people with plantar fasciitis. A randomized controlled trial found that wearing shoes with a cushioned heel and arch support reduced pain and improved function in patients with plantar fasciitis. Choose shoes that provide ample support and cushioning for your feet. Avoid wearing shoes with high heels or flat soles.

  1. Stretch regularly

Stretching is an important part of plantar fasciitis treatment. A randomized controlled trial found that stretching exercises reduced pain and improved function in patients with plantar fasciitis. Your physiotherapist can teach you stretching exercises to do at home that will help improve your flexibility and reduce your pain.

  1. Follow your physiotherapist’s instructions

Your physiotherapist will provide you with instructions on how to perform exercises and activities safely and effectively. A randomized controlled trial found that patients who received individualized physiotherapy treatment had better outcomes than those who received a standard treatment protocol. It is important to follow these instructions carefully to avoid causing further damage to your foot.

  1. Consider orthotics

Orthotics are special shoe inserts that can provide additional support and cushioning to your feet. A systematic review of the literature found that orthotics can reduce pain and improve function in patients with plantar fasciitis. Your physiotherapist can recommend the right type of orthotics for your specific needs.

  1. Rest your feet

Rest is an important part of the recovery process for plantar fasciitis. A randomized controlled trial found that patients who rested their feet had better outcomes than those who did not. Your physiotherapist may recommend rest as part of your treatment plan, so be sure to follow their instructions.

  1. Stay active

While rest is important, it is also important to stay active during your recovery. A randomized controlled trial found that low-impact exercises, such as walking and cycling, can improve function and reduce pain in patients with plantar fasciitis. Your physiotherapist can recommend exercises that are appropriate for your specific needs.In conclusion, if you are suffering from plantar fasciitis, seeking the help of a physiotherapist is crucial for your recovery. By following the above evidence-based tips, you can get the most out of your physiotherapy sessions and start feeling better soon. If you would like an appointment to have your foot pain assessed, call us on 9815 2555 or book online here

The Importance of Doing Your Physiotherapy to get Optimal Recovery

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Physiotherapy exercises are a vital component of any rehabilitation program, and they are designed to help individuals recover from injuries or illnesses that have affected their mobility, strength, and overall quality of life. While it may be tempting to skip these exercises or only do them occasionally, there are several compelling reasons why you should prioritize them and make them a regular part of your daily routine.

Improve Range of Motion and Flexibility

Physiotherapy exercises can help you regain your range of motion and flexibility, which is crucial for maintaining good physical health. When you have an injury or illness that affects your ability to move, your muscles and joints can become stiff and rigid. Physiotherapy exercises can help to loosen these areas up and allow you to move more freely, which can help to reduce pain and discomfort.

Strengthen Muscles and Improve Stability

Many physiotherapy exercises are designed to strengthen your muscles and improve your overall stability. This can be particularly important if you have suffered an injury or illness that has left you weak or unsteady on your feet. By working on these areas through targeted exercises, you can improve your strength and balance, which can help to prevent further injuries and improve your overall quality of life.

Reduce Pain and Discomfort

Physiotherapy exercises can also help to reduce pain and discomfort in the body. This is achieved through a variety of techniques, including stretching, massage, and strengthening exercises. By targeting specific areas of the body that are causing pain or discomfort, you can help to alleviate these symptoms and improve your overall sense of well-being.

Speed up Recovery Time

When you have an injury or illness, the recovery process can be long and frustrating. However, by incorporating physiotherapy exercises into your daily routine, you can speed up your recovery time and get back to your normal activities more quickly. This is because physiotherapy exercises are designed to target the specific areas of the body that need attention, which can help to speed up the healing process.

Prevent Future Injuries

One of the most important benefits of physiotherapy exercises is their ability to prevent future injuries. By strengthening your muscles, improving your range of motion, and enhancing your stability, you can reduce your risk of getting injured again in the future. This can be particularly important for athletes and individuals who are prone to injury, as it can help to keep them healthy and active for longer.

In conclusion, there are many compelling reasons why you should make physiotherapy exercises a regular part of your daily routine. Whether you are recovering from an injury or illness or simply looking to improve your overall physical health, these exercises can help you to achieve your goals and live your best life. So, don’t skip your physiotherapy exercises – your body will thank you for it!

Why Rehabilitation is just like a Fairytale!

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The three bears find Goldie locks asleep in a bed.

Rehabilitation is a complex thing but just like the fairytale Goldilocks and the Three Bears, if you get it just right it can be quite simple.

Just like Goldilocks, finding a fair middle ground is best. I find that the people who go too hard with their exercises do the worst at rehab. All you are doing is stirring up the inflammation which just makes you like a bear with a sore head!

Doing nothing will mean you get sore and stiff. Weakness will soon follow and you will soon be as stable as a house of sticks! We all know how that one ends.

But how do you find the happy ground?

What is the holy grail of rehabilitation?

Unfortunately there is no magic bean to guide us here. Everyone is different. Each day presents different challenges and as time goes on our ability to push harder improves.

Accommodation is the process in which progressive overloading of the bodies structures causes them to strengthen in the patterns in which we move. It’s a vital part of rehabilitation but it needs to be done in conjunction with the natural rates of healing.

Soft tissues generally take about 6 weeks to heal.

Bones, 6- 12 weeks depending upon where they are in the body.

Tendons with their poorer blood supply take ages (up to 12 months).

Throw in age, activity, co morbidities and we get a really complex matrix beginning to form.

Then there’s pain!

Pain is amongst other things physical, chemical, social, psychological. It’s a bit like the seven dwarfs.

How we react and perceive these things will influence how we perceive and react to pain. This is why no two recoveries are the same.

Physios like to talk about good pain and bad pain.

Good pain is more like a stretching and working pain and its generally something tolerable and can be encouraged. It will settle fairly soon following workouts.

Bad pain is more searing and stabbing. It typically doesn’t settle so well and may last overnight and the next day. We like to avoid this pain.

So now you know the variables for recovery, how do you find the best option for you?

Firstly listen to your body. It will tell you how it’s feeling; you just need to learn how to listen to it. When starting with rehab, taste test first.

Start slowly.

See how you recover and if it pulls up well, then next time you exercise you can do a little more.

Be careful because it’s sometimes not sore until you’ve finished and by then its too late. Sooner or later you will learn how the area reacts and you will be able to predict how much to do with more certainty.

Rehab is not linear. Especially not in its micro form. Patients often don’t realise the progression they are making. It’s a bit like watching grass grow. You’ll find others will see your progression more than you. Comments like “you are moving much better” are common.

Working with your physiotherapist is really helpful to help you progress with your rehabilitation. See them more as your teacher or coach who will guide you through the weeks or months in order to get you back to all your normal activities. They will help to remind you that you are on track, when to push harder or when to back off. They are skilled to understand the time frames for recovery and when to commence working different structures following injury or an operation. They understand the “just right in between” balance you’ll need to find.

How To Identify If You Have A Sprained Foot?

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As winter sports start up again, we been seeing more and more Sprained Foot injuries. We thought we should shed some light on the injury so you can identify the symptoms and insure you are receiving the correct treatment.

So what does it mean if I’ve sprained my foot?

Great question, the term sprain is often misunderstood, let me shed some light on that for you.

Here goes, a sprained foot is when you damage or tear the connective tissue – such as ligaments, cartilage and joint capsules – of one or more joints in the foot.

During certain movements of the foot, activities such as landing after jumping on an uneven surface or with the foot in an awkward position or even rolling an ankle can cause stretching or compression forces that are placed on the joints within the foot.

If these forces are excessive in the sense of too much repetition, or of high impact, injury to the joints are more likely to occur. This injury is known as a sprained foot and may affect one or more joints.

How will I know if I’ve sprained my foot? What will it feel like?

Trust me- you’ll know!

It feels nasty.

Here’s some important info for you.

Patients with a sprained foot will often experience a sudden onset of pain during the activity they are par-taking in.

This pain can also carry over to the next morning, where they will often experience pain and stiffness.

Many patients who suffer from a sprained ankle will experience pain on the top, bottom or side of the affected joint. Occasionally this pain can be referred into the toes or ankle on the affected side of the foot.

These symptoms are often only noticed when matched with activities that place pressure on the affected joint. These can be things such as standing, walking, running, standing on tippy toes, etc.

It is also common for patients to experience bruising or swelling when the case is more severe. This can cause walking with a limp.

Patients suffering from a sprained foot can also feel pain when firm pressure, like touching, is applied to the affected area.

What should I do if I sprain my foot?

Take action quickly is my advice!

Your therapist will guide you in the next step and provide you stretches and exercises for you to do. It will begin with initial, basic exercises and eventually progress to more intermediate exercises.

These will be proscribed to you depending on the severity of the sprain, and how well you are progressing.

Returning to sport or other normal activity can usually occur within 2-6 weeks, in the case of a minor to moderate foot sprain.

This can be achieved by following an appropriate management and treatment plan.

For patients who suffer a more severe injury will usually require a longer period of rehabilitation to gain back optimum function.

If you are suffering with a sprained foot, or are unsure if you have sprained your foot, please contact us at the office and one of our experienced therapists will help you out. Our number is 03 9815 2555 or book online here

How to manage an Achilles Rupture Conservatively?

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What is an achilles rupture?

Achilles rupture is where the achilles tendon that joins the calf to your heel tears. Typically this means surgery; however conservative management is a viable option.

The calf muscle is the one that allows us to push down through our toes and raise on our toes.

It’s really important in walking running and jumping.

A torn achilles makes general life very difficult.

It tends to occur in middle aged persons, hence its nickname “the old mans disease”. David Beckham, Kobe Bryant and Jarryd Roughead have all been victims.

Why choose conservative management for Achilles Rupture?

A few years ago, a patient who is quite holistic, approached a surgeon I work closely alongside wanting conservative management for her recently torn achilles.

Her brother was an Orthopaedic Specialist in Germany. He suggested that a non operative approach was the best way to manage an achilles rupture.

My experience was certainly based around rehabilitation post surgical reconstruction, as was the surgeons I work with. However she talked us around, and with her brothers protocol in hand we nursed her through the next few months back to full recovery. She was happy, and it set the ball rolling for us.

Whilst we didn’t then treat every patient from then on conservatively, when patients were not a great surgical candidate we went the conservative route.

These patients too did well. And so gradually we started to see more and more clients who were choosing the non operative route.

Now, if it were my achilles that was torn, I would manage it conservatively.

So whats the difference between conservative and operative Achilles Rupture Management?

Well obviously one requires an operation to sew the torn ends back together and the other leaves the job for mother nature.

This means that there is a whole list of complications that operations can cause that are not apparent with conservative management.

Firstly, feet are slow healers. As such one of the biggest issues with achilles repair is wound breakdown and infection.

This can cause massive delays in the rehabilitation process.

It also means you have to take it easy for the first few weeks. Think lots of foot elevation to ensure the wound heals.

Because there is also an incision and stitches, pain is also an issue.

And then there is also the risks of having an anaesthetic.

Conservative management lets mother nature do the job along with a structured rehabilitation program.

Whats the difference in the rehabilitation?

Rehabilitation for both of the procedures is similar.

A gentle progression of weight bearing, stretching and strengthening exercise commence in the first few weeks.

A boot is worn to protect the achilles through the first few months and this is gradually weaned as the strength and range returns.

I prefer the Vacoped as it has all the bells and whistles to progress patients through the next few months; its also handy to have a spare liner as they tend to get stinky!

How long does it take to recover an Achilles Rupture?

I tell patients with both procedures that it will take about 12 months to recover.

But by 4-6 months they shall be moving around gently without too much issue.

Heavier loads can commence as ability allows from this period, but it’s really 12 months before they don’t think about their injury any more.

What are the Outcomes?

Well some studies say there is no difference between the two for long term outcomes.

I am still learning the long term effects (its only positive), but I work on under promise and over deliver, so as such, I tell patients that there is a 10% change of re-rupture over surgical management.

There may also be a small weakness compared with the other side, but this would be generally unnoticeable in the population we are speaking with.

If you play competitive sports, then I tend to recommend surgical intervention.

Time of rehabilitation is roughly the same, but the conservative program is easier in the first few weeks as you are walking on the foot sooner, and you don’t need to spend the first two weeks with your foot elevated following surgery.

Either way however, you are going to get pretty good on crutches.

In light of all this, we are seeing more and more patient adopt the conservative route, with great outcomes to boot.

I have only had one fail, but he was an older man who stepped into a rabbit hole in the early stages of his recovery.

As such, I tend to suggest conservative to all my achilles ruptures.

Glenferrie Sports and Spinal Clinic is located in Hawthorn. Situated conveniently near public transport and with convenient parking it is central to Camberwell, Kew, Richmond, Toorak and Malvern.

For appointments call 03 9815 2555, or book online here

Massage – Get in touch with its many benefits.

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after-massage-mood

Massage: Get in touch with its many  benefits

Massage can be a powerful tool to help you take charge of your health and well-being.

As a healing tool, massage has been around for thousands of years in many cultures. Touching is a natural human reaction to pain and stress, and for conveying compassion and support.

Think of the last time you bumped your head or had a sore calf. What did you do? Rubbed it, right?

The same was true of our earliest ancestors. Healers throughout time and throughout the world have instinctually and independently developed a wide range of therapeutic techniques using touch. Many are still in use today, and with good reason.

We now have scientific proof of the benefits of massage – benefits ranging from treating chronic diseases and injuries to alleviating the growing tensions of our modern lifestyles.

Having a massage does more than just relax your body and mind – there are specific physiological and psychological changes which occur, even more so when massage is utilised as a preventative, frequent therapy and not simply mere luxury.

Massage not only feels good, but it can cure what ails you.

You don’t need any special preparation for massage. Before a massage therapy session starts, your massage therapist will ask you about any symptoms, your medical history and what you’re hoping to get out of massage. Your massage therapist will explain the kind of massage and techniques he or she will use.

The Consequences of Stress

Experts estimate that 80 percent to 90 percent of disease is stress-related. Massage and bodywork is there to combat that frightening number by helping us remember what it means to relax. The physical changes massage brings to your body can have a positive effect in many areas of your life. Besides increasing relaxation and decreasing anxiety, massage lowers your blood pressure, increases circulation, improves recovery from injury, helps you to sleep better and can increase your concentration. It reduces fatigue and gives you more energy to handle stressful situations.

Massage is a perfect medicine for good health. It’s undoubtedly a wonderful thing when your therapist begins unwinding those stress-tightened muscles, and your day’s troubles begin to fade away. But the greatest thing is to know this “medicine” only gets better with frequency.

Why not pamper yourself, come and book in with one of our amazing Myotherapists at Glenferrie Sports and Spinal Clinic inside Hawthorn Aquatic and Leisure Centre.

Glenferrie Sports and Spinal Clinic is located in Hawthorn. Situated conveniently near public transport and with convenient parking it is central to Camberwell, Kew, Richmond, Toorak and Malvern.

For appointments call 03 9815 2555, or book online here

IS IT YOUR RUNNING SHOES?

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dean-runningshoes_pic

Along with the widely publicised health and fitness benefits, running is an integral component of many sports. 

A pair of running shoes “runners” is an essential wardrobe item of athletes.  As a piece of training equipment the running shoe’s primary purpose is to protect the foot during the running gait pattern. 

Though, how well does it protect the foot and does it actually prevent injuries?

History of running shoes

It is interesting to note that despite advancements in running shoes over the past 40years injury rates have stayed relatively consistent over this period.  If we look at a typical running shoe from 40 years ago there are striking differences in the design to today. 

They were generally unspecialised from other athletic shoes and consisted of canvas uppers with vulcanized rubber soles.  This style of shoe became known as “sneakers” in the US as they were quiet when walking.   Their design was simple and similar to shoes such as the “Converse All Star” or “Dunlop Volley” on our shelves today.

The “Jogging boom” of the 70’s and 80’s was influential in the development of the modern running shoe.

It was pioneered by coaches Arthur Lydiard in New Zealand and Bill Bowerman in the U.S in the 1960’s.  These men popularised the activity of running at a steady, gentle pace as a form of physical exercise for all.

It led to the international sports footwear industry growing into an estimated US$55 billion industry, with the largest sector being running shoes (Powell, 2014).

Marketing vs Form

Marketers began to realise that the most effective way to sell athletic footwear was to appeal to people’s emotions. 

Brand identification with stripes and ticks became one of the strongest factors in shoe selection in a market dominated by superpower brands.  However, by the late 1980’s the market demanded a more scientific approach to shoe selection. 

Running shoe companies began suggesting that injuries could be reduced by selecting running shoes on the basis of foot arch height.   

Three distinct running shoe categories arose:

  • Cushioned (designed for high arched feet),
  • Stability (normal or medium arched feet), and
  • Motion Control (low arches or flat feet). 

In the November edition of the Journal of Orthopaedic & Sports Physical Therapy, Knapik and colleagues concluded that the prescription of shoes with elevated cushioned heels and pronation control systems tailored to an individual’s foot type was not evidence based. 

This was supported by data from over 7,000 male and female military recruits that after foot examinations were randomised to either an experimental or a control group. 

Recruits in the experimental group were assigned motion-control, stability, or cushioned shoes to match their plantar shape, which represented a low, medium, or high foot arch.  While the control group received a stability shoe regardless of plantar shape. Injuries during basic training showed no differences between the groups.

In the July 2015 issue of the British Journal of Sport Medicine, Nigg and colleagues reported in the article “Running shoes and running injuries: mythbusting and a proposal for two new paradigms ‘the preferred movement path’ and ‘the comfort filter’, that a runner intuitively selects a comfortable product using their own comfort filter that allows them to remain in the preferred movement path.

This may automatically reduce the injury risk and may explain why there does not seem to be a secular trend in running injury rates.

Despite the evidence, footwear companies’ ranges continue to be based on these categories. Along with the recent rise of two additional categories “minimalist” and “maximalist”.  

Observationally in the clinic it is clear that some runners may respond better to a certain shoe design. 

However, in a profession based on evidence there are far more proven approaches to treating injuries, than the often heard term “I think I need a new pair of runners”.

Glenferrie Sports and Spinal Clinic is located in Hawthorn. Situated conveniently near public transport and with convenient parking it is central to Camberwell, Kew, Richmond, Toorak and Malvern.

For appointments call 03 9815 2555, or book online here

Spring time injuries can be a “pain in the SHIN!”

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BEN shin-splints

With the sun finally coming out it’s time to dust off the runners and get moving again. What better way to enjoy the Spring air than a walk or a run around one of our beautiful parks and gardens. The key to getting active again is to stay injury free and shin pain is a common injury we see this time of year as we wake up our muscles after a long cold Melbourne winter.

“SHIN SPLINTS” is the common name for the condition medically named medial tibial stress syndrome (MTSS). It can be described as pain anywhere along the shin bone from the knee to the ankle.

The most common cause of shin pain is inflammation of the sheath surrounding the bone (periosteum.) Traction forces on the periosteum from the muscles of the lower leg cause inflammation and a sharp aching pain along the shin results.

How are they caused?

  • Rolling in of the feet (Flat feet/Over pronation)
  • Rolling out of the feet (High arch/Over supination)
  • Inadequate footwear ‐ too old or unstable shoes
  • Too Much too soon ‐ Increasing training too quickly
  • Training on hard surfaces
  • Reduced flexibility at the ankle joint

What does it feel like?

  • A Sharp pain over the inside of the lower leg.
  • Pain at the start of exercise which often eases as the session continues
  • Aching pain often returns after activity and may be at its worse the next morning.
  • Sometimes some swelling. Tender to touch.

This condition can take a long time to heal if the correct help isn’t acquired. It is important to assess the biomechanics of your leg and foot to determine any factors that may predispose you to shin pain. Poor shock absorption or muscle function can result in shin splints. A biomechanical analysis of you walking and running will enable your podiatrist to assess foot function with respect to the lower limb. It will help diagnose the specific muscles becoming fatigued and failing to cope with the loads.

Podiatry is here to help by firstly reducing the pain so you can walk comfortably. Then with specific exercises, footwear advice and insoles we can realign the foot to improve the mechanics.

At Glenferrie Sports and Spinal Clinic our podiatrist Ben Holland will provide:

  • stretching and strengthening programs
  • biomechanical assessment of your running/walking gait
  • orthotic therapy if required
  • footwear advice

     

Call us now and book in with our friendly Podiatrist for a footwear and biomechanical assessment so you don’t end up on the injury list this spring missing out on the best time of year.

Ben Holland works Mondays at GSSC.

10 Plantar Fasciitis Solutions

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00_plantarfasciitis

Prior to working at Glenferrie Sport and Spinal Clinic I spent 12months researching and co-ordinating a clinical trial into plantar fasciitis (or plantar fasciopathy as it should be correctly termed).

Until a couple of years ago, I personally, as a distance runner also battled this heel pain that feels like you are stepping on a piece of glass in the mornings and for the first steps of a run.

Plantar fasciopathy is one of the most common musculoskeletal disorders of the foot. It affects a wide cross-section of the community from elite athletes to the elderly. It is estimated to affect one in 10 people at some point of their life. Furthermore, it can be painful enough to restrict sufferers’ activity, mobility and general well-being

How do I treat plantar fasciitis?

Firstly, it is most important to gain accurate diagnosis. There are a number of lower limb conditions that may mimic some of symptoms. Listed are 10 plantar fasciopathy treatment options. Your physiotherapist will be able to guide through the treatment process and identify which intervention is most appropriate for you.

Strength Training

01_strengthtraining

Strength training is the new frontier in plantar fasciopathy treatment and has developed a long way from short foot exercises. This treatment approach evolved in response to the pathology being identified as more closely resembling a tendinopathy.   Promising results from high tensile loads being applied across the tendon on degenerative tendon disorders such as achilles and patella tendinopathies have since flowed through to plantar fasciopathy treatment interventions.

Soft Tissue massage / Myofascial Release

02_massage

Trigger points are knotty, involuntary contractions of muscle bundles. They prevent the host muscle from relaxing and recovering. The foot is an intricate web of ligaments, muscles and tendons that can be a hub for trigger points to develop. Rolling the arch of the foot with a tennis ball, progressing up to a golf ball or spikey ball is often a great way to relax the intrinsic foot muscles and tension on the plantar fascia. Some more stubborn cases may respond to modalities such as dry needling or Extracorporeal Shockwave Therapy (ESWT).

Night Splints

Overnight the plantar fascia shortens in the sleeping position. Upon awakening the first few steps can be excruciating pain as the plantar is re-stretched and tugs on the heel. Night splints or a ‘Strassburg’ sock prevent the position of plantarflexion. So it prevents the plantar fascia contracting overnight and offering great relief of the most painful initial steps in the morning.

Biomechanical Analysis

04_biomechanicalanalysis

Muscular weaknesses and imbalance in the kinetic chain are often the root cause of heel pain. A thorough biomechanical analysis of your movement patterns will reveal areas of compromised movement or muscular activation. As a result of these inhibitions other structures of the body such of the plantar fascia maybe subject to amplified stresses to compensate increasing their likelihood of injury.

Stretching

Historically this was the treatment of choice for plantar fasciitis. The windlass mechanism is a term used to describe how the plantar fascia acts like a pulley. When the great toe extends (dorsi-flex) it shortens the foot and raises the arch. Decreased ability to dorsiflexion of the great toe and tight calf muscles can contribute to dysfunction. This is due to the increased tension on the plantar fascia exacerbating the condition.

Taping

06_taping

There are several variations of taping that may help reduce the symptoms of heel pain. These may work by controlling pronation of the foot or de-loading the arch. Your physiotherapist will be able to detect which technique is most suited to you. It is important to realise that although taping can be an effective management strategy it is not cure the underlying pathology.

Orthotics / Footwear Prescription

07_orthotics

People displaying either a lower or higher-arched foot tend to be more prone to plantar fasciopathy. People with lower arches may have conditions resulting from too much motion (over-pronation) increasing stretch on the plantar fascia. Whereas patients with higher arch foots tend to be more rigid and result in the foot’s inability to dissipate force. Appropriate footwear and orthotics prescription may be an effective way to alleviate plantar fasciitis symptoms. In the long-term the patient must still work on rehabilitating their foot so that they are not reliant on footwear or devices to manage their condition. Our Podiatrist can assist you with the fitting of Orthotics.

Cortisone Injections

08_cortisone

Cortisone injections are medical procedures that maybe prescribed to reduce inflammation around the fascia. Patients often report good pain relief within a couple of days with the maximum effect gained at around 10-14 days. However, this can pose some risks as cortisone is a catabolic steroid meaning that it breaks down tissue. Therefore, patients may have thinning of skin and soft tissue around the injection site, or tendon weakening or rupture. Also despite often effectively relieving the symptoms of plantar fasciopathy, reoccurrence can be high. The effect of the cortisone usually wears off within a few weeks.

ABI / PRP Injections

Autologous Blood Injection (ABI)and Platelet Rich Plasma (PRP) injections are medical procedures where a patient’s blood is drawn and then injected into an injury site to promote healing. They work by re-stimulating the healing process by supplying nutrient rich growth factors within blood platelets to the site of injury. The procedure is usually performed under ultrasound control by a radiologist . They will spin the blood before re-injection to increase the platelet concentration. ABI or PRP is without the re-rupturing/damaging risks of cortisone. However, much of the evidence is still inconclusive and the process can be quite lengthy. Often two to four rounds of injections are required, spaced out over months.

Invasive options should be a last resort. Surgery that usually consists of a release of the plantar aponeurosis (plantar fasciotomy) is rare. Most patients will make a full recovery within time with a good compliance to well-structured physiotherapy.

Load Management

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Load management is often the key determinant in a patient’s successful rehabilitation from plantar fasciopathy. This covers activity modification, gait retraining and minimising weight gain to avoid placing undesirable stress on the plantar aponeurosis during its recovery. Contrary to popular belief heel spurs do not cause plantar fasciitis and usually are the result of long-term suffering.
Treatment modalities should respect the biomechanical function of plantar fascia to stabilise the arch with the intrinsic foot musculature. This provides dynamic sensory and motor control to the foot.

If you have symptoms of Plantar Fasciitis, our Physiotherapy team is only too happy to discuss and help you manage your problem.

Glenferrie Sports and Spinal Clinic is located in Hawthorn. Situated conveniently near public transport and with convenient parking it is central to Camberwell, Kew, Richmond, Toorak and Malvern.

For appointments call 03 9815 2555, or book online here

Ankle Braces vs taping: What to do after an ankle sprain.

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Do you sprain your ankles?

If you’re anything like us then you’re no stranger to the odd ankle twinge. Or maybe you’ve even been unlucky enough to have a serious ankle injury – ouch!
The thing is, ankle sprains and instability are just so common.
Whether you’re walking along the street and happen to stumble on the curb. Or perhaps you’re playing sport or just going for a casual walk or run for fitness. Whatever you’re doing, you’re always faced with potential ankle rolling injuries.

In fact, the more you do it, the easier it becomes to do it again.

Anyway, case in point is that ankle sprains are bad news.

They cause pain and swelling, you miss out on doing what you love, and then even worse…is the chance of the darn thing recurring!

What are your options when you sprain an ankle?

Today I’m going to share two options to prevent recurrence in ankle sprains. This is helpful especially for those people that are returning to sport and need to be prepared for rapid direction change and impact.

Ultimately the role of taping and bracing is very similar. That is to ensure a safe return to sport, provide support where the affected structures are not able to do their job. This also aids in the healing process and to give you confidence to return to your pre – injury condition – yay!
In cases where you are not recovering from an ankle injury, ankle supports can still be sought to reduce the likelihood of an injury occurring in the first place.

High impact sports with lots of directional changes are good examples of where ankles supports can play an important prevention role.

But in most cases, the aim of using an ankle support is to return to a functional and confident level. You want to get to where taping or bracing is no longer required.
Here’s  a couple of things for you to consider when deciding between using ankle taping versus an ankle brace device. Then it’s really up to personal preference.

Ankle Braces:

Ankle braces were cultivated from the concept of ankle taping but with a significant advantage for some.

They are self-applied, reusable, and adjustable. Because you only purchase the product once, they are also more cost-effective (depending on how long you will need to use it of course).
However, athletes often find using ankle braces uncomfortable and unstable when wearing inside shoes in comparison to ankle taping.

New types of braces are constantly being developed so the comfort and stability is always improving. However ankle taping still leads the race in this department.

Ankle taping:

Ankle taping is a great way to get the support needed to return to your desire activity as well as facilitate the healing process.

Taping is a preferred choice for many people because it’s so light weight. It can provide more support than braces in many cases.

There are however some draw backs.

If you’re going to need to tape your ankle for an ongoing period then it is more expensive. Plus it’s very difficult to self-apply in comparison to an ankle brace. If done poorly, taping can cause cuts or blisters to the foot.

You also need to be aware of skin irritation or allergies to taping, especially with prolonged use.

Ultimately, the decision of whether to use ankle taping or bracing after having a sprained an ankle depends mostly on what suits you best after taking into consideration the above points. We are all individuals and have different goals and you need to choose what works best for you.

If you are unsure at all, please reach out and one of our team can help point you in the right direction to get back to doing what you love!

Glenferrie Sports and Spinal Clinic is located in Hawthorn. Situated conveniently near public transport and with convenient parking it is central to Camberwell, Kew, Richmond, Toorak and Malvern.

For appointments call 03 9815 2555, or book online here

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You now have access to all the videos in the Little League and Junior League folders. These feature J band Exercises, Stretching Exercises, as well as Myofascial Rolling Exercises that will assist with recovery. For access to our other videos, please contact us directly on admin@staging.performanceplushealthcare.com.au

 

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