Sport Medcine – Perform Podiatry

How Can I Prevent And Treat Blisters On My Feet?

Blisters: they’re an enemy that most of us are far too familiar with – often accompanied by a fantastic new pair of shoes that we were initially very excited about. Instead, we’re left in pain and uncomfortable, searching for anything we can place over the blisters to cover them up and stop the stinging. Blisters develop when the skin on your feet rubs against shoes or other surfaces, leading to a buildup of fluid under the skin. Blisters can be caused by a variety of factors, including friction, pressure, or heat that damages the outer layer of skin. Specifically, ill-fitting shoes, repetitive rubbing movements, excessive moisture, and sunburn (less common for the feet, but still possible) are all culprits.

Preventing Blisters on Your Feet

Given the severe level of pain that these tiny but powerful bubbles can inflict on us, it’s always a good idea to take steps, where possible, to prevent them. This includes: Choosing The Right Footwear One of the best ways to prevent blisters on your feet is to wear comfortable, well-fitting shoes. Shoes that are too tight or too loose can cause friction and pressure on your feet, leading to blisters. Look for shoes with a wide toe box that allows your toes to move freely, and avoid shoes with high heels or pointed toes. Break in New Shoes New shoes can be stiff and tight, which can cause blisters on your feet. To prevent this, break in new shoes gradually by wearing them for short periods of time at first and gradually increasing the length of time you wear them. You can also try stretching the shoes before wearing them to help loosen them up. Wear Moisture-Wicking Socks Moisture can contribute to the formation of blisters on your feet. To prevent this, wear moisture-wicking socks that help to keep your feet dry. Avoid cotton socks, as they tend to trap moisture and can contribute to blister formation. Use Protective Padding If you have a spot on your foot that is prone to blisters, and you’re about to go for a long walk or hike, re recommend using protective padding to prevent friction and pressure. Moleskin or gel pads are good options for protecting your feet from blisters – and your podiatry clinic may have their own preferred recommendations, or even some available for purchase. Treating Blisters on Your Feet Once blisters have developed, there’s only one goal: to get them healed up as quickly as possible and to prevent further irritation that will worsen your symptoms and pain. Here are our tips for treating blisters at home: Leave Blisters Intact If you do develop a blister on your foot, it is important to leave it intact. The blister provides a protective layer over the damaged skin and helps to prevent infection. If the blister breaks, clean the area with soap and water, apply an antibiotic ointment, and cover it with a sterile bandage. Use Compresses To help relieve pain and reduce swelling, you can apply a cold compress to the blistered area. A bag of ice wrapped in a towel or a cold, wet washcloth can provide relief. You can also use a warm compress to help reduce pain and speed up healing. Use An Antibacterial Ointment If your blister has popped, apply an antibacterial ointment to help prevent infection. Cover the blister with a sterile bandage to keep it clean and protected. Rest Your Feet If you have a blister on your foot, it is important to rest your feet and avoid putting pressure on the affected area. This will help to prevent further irritation and allow the blister to heal. Absolutely avoid doing the activities that caused your blister to form in the first place.

Should You Drain A Blister?

Generally, we do not recommend popping blisters. This is because this ‘opens’ up the blister and makes it more vulnerable to further damage, as well as infections. However, in some cases, like when the blister is large or in an area like the back of your heel where you know it’s going to be exposed to pressure that is likely to take the top of the blister off anyway, it may be necessary to lance the blister. To do this, take a clean, disinfected needle and poke the blister from the side to drain the fluid. Once the fluid is removed, the pressure will subside. Then, soak your feet for 15 to 20 minutes in lukewarm water with Epsom salts. Using Betadine to help dry up the blister will speed up the healing process, keeping it safely covered and protected. You should notice your blister and the area around it getting better over the following days. If it’s not, contact your podiatrist immediately.

Need Advice On Blisters, Or Help Treating Or Preventing Them?

Then our team is here for you. We’re proud to be Auckland’s leading podiatry team, and understand the impact that painful blisters can have on your daily life and in helping you meet your health and fitness goals. Book your appointment by calling us on 09 523 2333 or book online here.

Is Your Recovery After Exercise Holding You Back This Summer?

Summer is here and many of our patients have launched into summer workouts, meeting their fitness goals – and just generally enjoying their time outdoors and getting out in nature. But while working out feels like the most important (and often most difficult) part of getting started, did you know that your recovery after exercise is just as important as the workout itself? Yep – your recovery technique is the reason why sometimes you feel sore after your workout, and other times, you don’t. It affects the post-workout inflammation, the lactic acid build-up in your body, and your injury risk. That’s why when you lie down after your workout, even if it’s from being rightly exhausted, you may be doing your body a massive disservice by not understanding the difference between the two types of recovery – and choosing the right option for you.

Passive vs. Active Recovery – What’s The Difference?

Passive recovery essentially means being still and inactive after exercising. It’s when you finish your run, sit down to rehydrate, and don’t get up. This gives your body the rest it needs to let your muscles repair with minimal effort over the next day. Active recovery, on the other hand, uses continued movement to recover, with the key being that it is non-strenuous and gentle. The goal here is to keep the heart rate from dropping suddenly, and the blood and lymph flow going, while still giving your body the chance to recover.

Which Is Better – Active Or Passive Recovery?

Research shows different benefits for each. For active recovery, the benefits focus on the chemical processes occurring within the body. With the continued blood and lymph flow, metabolic waste is cleared from the body at a faster rate than with rest. Studies showed that when this recovery method was used by runners, they were able to run for three times longer during their next run than those who used passive recovery. When active recovery was used by cyclists, it was found that during their next ride, they maintained their power output, compared to the cyclists who used passive recovery whose power output decreased on their next ride. When examining swimmers, another study showed that active recovery dissipated 68% of the lactate that had accumulated in their blood, and would have otherwise settled in their tissues. When it comes to passive recovery, it is believed by some to help promote endurance through repetitively accelerating and decelerating their heart rates. It is thought that this type of training may decrease the window of time needed to recover between training sessions. The research on the superior effects of passive recovery is limited, though some professional cycling programmes have recently incorporated it into their programmes.

So, How Should You Be Recovering?

Here at Perform Podiatry, given that we work with a variety of sportsmen and women, as well as those just starting their exercise journey, we believe that there is a place for both forms of recovery when used appropriately. While using active recovery immediately following exercise can yield significant benefits, taking days off for passive recovery may also be a beneficial way to let your body rest and recover. The key is understanding the benefits of each, so you can make purposeful decisions about what you’re doing after completing your exercise and how you’re cooling down.

Ways To Recover At Home

Recovery is important – and you don’t need anything fancy or complex to help you do it. Here are three easy ways to additionally support your recovery at home:

Foam rolling: foam rolling your muscles can help to reduce stiffness, minimise post-workout muscle soreness, stimulate blood flow, improve your range of movement and reduce tissue tension – all of which can aid in recovery and performance.
Wear compression clothing: compression clothing creates a tightening force on the encompassed parts of the body and its muscles. This increased pressure can help improve blood flow and subsequently oxygenation to the area. This increased blood flow can also help move toxins out of the tissues, helping them to heal and rebuild quicker, while also helping to reduce inflammation and fatigue. The only limitation is the level of compression available in general, non-medical clothing.
Eating for recovery: during exercise, your muscles use their glycogen stores for energy which results in your muscles being partially depleted of glycogen after your workout. As your body tries to restore its glycogen stores, the food you eat can play an important role in getting it done faster. Quality carbohydrates (e.g. quinoa, fruit, oats, pasta and rice) and lean proteins (e.g. eggs, yoghurt, salmon, chicken and tuna) help to replenish your body’s muscle glycogen fuel stores, helping promoting muscle repair and preventing unnecessary breakdown of proteins. 20g – 40g of protein after a workout is recommended, alongside ensuring that you are rehydrating sufficiently.

And If Pain Is Holding You Back From Recovering Effectively?

If pain is holding you back from being able to exercise effectively in the first place – we’d love to help. Give our podiatry team a call. We’re based in Remuera, in the One Health medical building, close to Newmarket. Call us on 09 523 2333 or book online here.

What Can I Do To Improve My Bone Health?

Learning that you have fragile bones can be concerning, and for many, leave them with a lot of questions:

Why have I got fragile bones?
What does having fragile bones mean?
What are my risks?
What can I be doing to improve my bone health?

With many of the patients we see and treat being diagnosed with osteoporosis or osteopenia, today our team is sharing what it means to learn that you have “fragile bones”, and how you can best protect your bone health and overall health going forwards.

What Does It Mean To Have Fragile Bones Or Poor Bone Health?

If you have fragile bones, it means that the mineral density in your bones has decreased. Clinically this can either be classed as:

Osteoporosis: a condition that means “bones with holes”, diagnosed when your bone mineral density is significantly reduced. This makes them significantly weaker and more vulnerable to fractures.
Osteopenia: nicknamed as ‘pre-osteoporosis’, osteopenia means that your bone mineral density has decreased below normal values, but is not yet low enough for you to be formally diagnosed with osteoporosis. Osteopenia is a big warning sign that osteoporosis is not far off if your current daily activities and attention to bone health do not improve.

The symptoms of reductions in bone mineral density and either osteoporosis or osteopenia are often difficult to spot and recognise because they are “silent”, meaning that they occur within the bones without you knowing. For many people, they only learn that they have osteoporosis when bone density testing is performed, or if they have a fracture and the cause behind their fracture is investigated.

Am I At Risk For Poor Bone Health?

Looking at osteoporosis specifically, risk factors can be classed as either modifiable, meaning you can change them, or non-modifiable, meaning that you’re stuck with these risk factors.

Modifiable risk factors for poor bone health

Physical inactivity
Calcium deficiency from your diet
Long-term glucocorticoid (steroid) use
Smoking
Being underweight with a low BMI
Hypogonadism
Inadequate vitamin D intake
High alcohol intake
Poor nutrition
Stress

Non-modifiable risk factors for osteoporosis

Your gender (particularly being female)
Entering menopause or having a hysterectomy
Age
Race
Genetic characteristics
Taking certain medications that are essential in treating other medical conditions including thyroid hormone supplements, certain diabetes medications, anti-coagulants, certain chemotherapy agents, proton pump inhibitors, certain immunosuppressants and more
The presence of other diseases including rheumatoid arthritis, cancer, kidney disease and more

How Can I Improve My Bone Health?

The first part of this conversation must be had with your GP, as medications are often involved in helping support your bone health and the bone-strengthening process. They may also recommend using hormone-replacement therapy like estrogen, and nutritional supplements like calcium and vitamin D. In the meantime, incorporating regular weight-bearing exercise is a good place to start in helping support your bone health at home as weight-bearing exercise is proven to be a treatment and prevention method for both postmenopausal and age-associated osteoporosis. Aim for at least 30 minutes per day, 5–7 days a week. When patients come to us with complaints about their bone health, they are often finding walking less comfortable than it used to be and may have concerns about their stability and balance. For these patients, we may use custom foot orthotics (insoles) to help optimise their comfort, support their foot function and stability, and help restore their confidence on their feet. We pair this with a footwear review to ensure the risk of falls (and hence osteoporotic fractures) is minimised. If foot pain or discomfort is being caused by nail or skin problems like corns, calluses, cracked heels or painful or thickened toenails, we also perform our skin and nail care for immediate relief. Book your appointment with our podiatrists by calling us on 09 523 2333 or book online here.

Returning To Exercise After A Break? Here’s How To Do It Safely

Whether it’s a planned holiday or an unexpected period of sickness for yourself or someone in your household, getting back to exercise or rejoining your friends at the gym is something that many people look forward to greatly, giving a good physical and mental boost. There’s just one problem we see – many people take a ‘pick up where we left off’ mentality to their exercise, under the impression that after all your regular gym-going and strength training, it should be that simple? Unfortunately, that’s not how it works. During a break from exercise, you actually lose strength, coordination and flexibility. While that can feel frustrating given the effort, time and dedication it takes to build up your fitness, the effects of your break can also make you more vulnerable to injury if you try to jump right back into your regular exercise routine and training schedule. Here’s a look into how you can return to exercise safely – by doing it gradually.

The Effects Of A Break From Exercise On Your Body

Periods of inactivity that last for longer than a week can begin to impact both your cardiovascular fitness and your strength

Cardiovascular fitness

When you have a break from exercise, the first place you’re likely to notice a change is your cardiovascular fitness. Cardiovascular exercise is the kind performed over a sustained duration, working the heart and lungs, such as a steady 5km jog. We wouldn’t count a 30-second sprint at your maximum speed in the same category. Regular cardiovascular exercise makes the heart and lungs more efficient at moving oxygen and blood around the body, delivering it to the muscles so that they can continue to produce energy, which builds up your endurance, so you can keep going for longer, and increase your speed in the process. According to studies, your cardiovascular fitness can begin to noticeably decline within just two weeks of inactivity. As a result, you may notice yourself getting more puffed than you’re used to when running up the stairs because your heart has to work harder to get enough blood to your muscles. The rate at which your cardio fitness is lost is influenced by your age and how fit you were when you started the break, with a slower loss in those who were already athletic or regular gym-goers.

Strength & muscle mass

When it comes to muscle strength, a person’s muscle mass decreases when there is no resistance, whether that’s a weight at the gym or a person’s own body weight, causing your muscles to become less efficient and able to exert less power. We call this detraining. This effect can start to be observed within two to three weeks of rest, with one study examining the effects of fourteen days of bed rest on middle-aged adults showing that rapid skeletal muscle loss in the feet and legs was induced. According to the Warriors head of athletic performance, for someone that is athletic, you can expect a decline in speed potential after 2-7 days, in muscular endurance after 10-21 days, in anaerobic endurance after 14-21 days, and in both maximum strength and aerobic endurance after 21-28 days. While this will be faster for the general non-athletic population, it is also influenced by the duration of consistent training, with those that have been regularly training for 12 months, for example, experiencing a lower rate of fitness lose when they take time off than those that have recently started their fitness journey. Gender may also play a role, with older women having been shown to lose muscle mass faster than other demographics.

What If You’re Very Fit?

Interestingly, the fitter you are, the faster a decline will occur compared to a less fit counterpart, until you reach a plateau, with fitness loss after this being more gradual. This is because the body is used to regular training at a higher level, making the changes to your fitness more noticeable. Those with a lower fitness baseline are more likely to experience a slow fitness decline in the first few weeks, however, after 4-8 weeks fitness is likely to drop away completely to a minimal level. This all means that even if you had a high fitness level, our gym closures are likely to still have had a significant impact – and you need to take it slow and return to exercise gradually, which means:

Build Up Slowly

While it is difficult to predict exactly how long it will take you to regain your previous fitness level, it’s likely that it won’t take you as long as it did in the first place, thanks to muscle memory. Your muscles have special cells that ‘remember’ previous movements, allowing you to build lost muscle and cardiovascular fitness faster than you initially may have. However, it is still important to build up gradually to protect against injury or excessive fatigue. For strength training, a good rule of thumb is to start at a comfortable level (try between 50%-70% of your original weight or intensity levels), and increase this by no more than 10% each week until you reach your goal. This 10% increase can come from different places, such as increasing your lifting weight by 10%, or increasing your repetitions by 10%. Aim to increase only one aspect of your exercise at a time, and to increase the number of repetitions before increasing weight. This principle can also be applied to cardiovascular fitness. You can increase the distance you travel, your speed, or the level of difficulty, for example by going up hills, or running with light ankle weights. We find increasing the volume before the intensity (speed or difficulty level) safer from an injury standpoint.

Retaining Your Fitness In The Future

If you want to better control fitness loss for periods of holidays or other circumstances in the future, the good news is that maintaining fitness requires significantly less work than building it. A recent study examined adolescent athletes that had been regularly training for over a year, and then as part of the study began performing significantly less exercise – though still performing lighter movement almost daily – as part of a ‘detraining’ protocol for three weeks. Interestingly, their muscle strength and sports performance were not affected. The general rule for maintenance is 2 strength sessions and 150 minutes plus of moderate physical activity each week. In practical terms: just try to maximise your movement over your days. Say yes to those evening walks, take the stairs, walk to the shops or take the bike, play a social sport – it all counts.

And If You Get Injured When Returning To The Gym?

Book in with our podiatry team here in Remuera. We have extensive experience in working with everyone from professional athletes to gym junkies and enthusiastic weekend warriors. We understand how important it is for you to get back to doing the things you love as quickly as possible. For any questions or to book an appointment, give us a call on 09 523 2333 or book online here.

How To Stop Your Old Injuries From Flaring Up

We all know the feeling: we get excited about a new activity or sport, we head into it feeling confident and strong – and then we feel incredibly disappointed when an old pain, ache or injury flares back up – and sometimes feels worse than ever before. This is where prehab comes in – the rehab you do to help prevent old injuries that you’re concerned about from coming back, and it’s being used by sports teams, weekend warriors and leisure enthusiasts alike. As podiatrists that work extensively with managing foot and leg pains resulting from muscle, tendon and ligament injuries, and as those that believe that knowledge is power, today we’ve shared why your old injuries keep coming back and the ways in which you can best manage them before they start to bother you again.

Why do my old aches and pains keep coming back?

First thing’s first. The most common reasons we see in our clinic for the same injuries continuing to rear their heads include:

1. Whatever is causing the injury hasn’t been fixed

If your unsupportive, worn-out shoes were the reason that your Achilles pain started, and after rehabilitating your Achilles tendon you got right back into those shoes, that will explain the return of the pain. For this example, it could be the low-set heel of the shoe paired with its inability to adequately support your foot that keeps straining the Achilles with every step. While your Achilles may have had a chance to heal and recover during your careful rehab period, once that finished and you got back into those shoes, the same forces kept being applied to your feet and legs that were happening when you sustained the original injury. Before you know it, your Achilles is damaged and sore again. The potential causes vary greatly, and we often see causes include an improper running technique or gait pattern, poor foot posture, muscle tightness, weakness or imbalances, and going too hard too fast when training – before the muscles are ready to handle the load. The solution is simple: address the cause. This is something we always aim to do here at Perform Podiatry as part of your treatment plan, as our focus is always on the long-term and keeping you healthy and happy for the years to come.

2. Your injury has created long-term effects that need addressing

Our bodies are truly amazing – but they’re not invincible. Sometimes, injuries can have lasting effects, especially when they’re not rehabilitated properly or fully. A common example we see is ankle sprains. When patients suffer an ankle sprain, or multiple sprains, and they ‘walk them off’ without proper care, they may be left in a weakened state. Given the role of these ligaments is to stabilise the ankle, if they’re not functioning at 100%, the ankle is left vulnerable to the cycle of future sprains – and further weakening. The solution is to work on reversing or accounting for the damage or long-term effects. For this example, this may be done by implementing an ankle strengthening program and wearing an ankle supporting brace until the strength has been regained. Strapping may also be used to temporarily support the ankle to prevent sprains. Your podiatrist will let you know when the impact has been sufficiently addressed and you no longer need to take additional precautions.

3. Your ‘time off’ has affected your feet or legs

There are good reasons why you’re often advised to keep moving and start a specific strength or exercise program shortly after an injury, surgery and the like. When we’re immobile, or we avoid using muscles a certain way because of pain, activating our body’s use-it-or-lose-it framework – meaning that if we stop using certain muscles for a prolonged time, they’ll weaken and become less flexible. Once enough healing has occurred for you to move without pain again, these areas are still weak – and so you’re more vulnerable to injury. The solution: exercise programs. While many people give us a shy smile when we ask how their rehab programs are going – there’s a good reason we give you these exercises – and will continue to do so. Stretching tight muscles and strengthening weak muscles is proven to enhance your recovery and overall performance. It’s not a ‘maybe’ or a ‘possibly’. We see a large difference in the rate of recovery for those that complete their exercise programs compared to those that don’t, and we’ll always create a tailored program for you that works with what you’re able to do and your life.

Preventing injuries: Know if you’re at risk

If you’re at that crucial point where you’re about to start something new but you don’t want a previous injury to return and stop you in your tracks, it’s important to find out if you’re at risk, and how vulnerable you are to getting injured again. We can do this by performing a lower limb biomechanical assessment that checks the integrity, function, strength and health of the previous injury site, as well as your overall foot biomechanics, to give you an idea of your risks. From there, we design a personalised management plan to help keep you from sustaining the same aches and pains, helping to keep you strong, active and pain-free. We recommend that you:

Always follow your stretching and strengthening plan as each exercise will have specific benefits to help prevent your previous injury from coming back
Warm-up and cool down appropriately before exercise – when we warm up, we increase our heart rate, our body (and muscle) temperature, improve our flexibility, get our circulation going and boost our mental focus. Each of these elements helps our body to reduce the risk of injury
Don’t go too hard too fast if you have recently recovered from an injury
Wear the right shoes for your foot type and the type of activity you’re doing to help stabilise, support and control your feet and legs
Let your body recover – with the right hydration and nutrition – between training sessions and matches
Use braces or strapping as directed by your podiatrist
Don’t ignore niggles – no matter how small. If you start to feel a dull ache at your previous injury site, it may be a sign that damage is starting to recur and you need to act immediately to prevent it from turning into another injury
If any pain or swelling does begin, follow the RICER principles – rest, ice, compression, elevation and book in with your podiatrist

Need help with aches or pains?

We love helping Auckland families stay injury and pain-free. If you’re worried, we’re here to help. Book your appointment online here or call us on 09 523 2333

I Think My Toe Is Broken. What Should I Do?

Excruciating pain in one of your toes? Wondering whether you’ve broken it – and if you have – whether you should go to the hospital or a doctor or a podiatrist and what they’ll do? Broken toes are more common than many people realise – and unfortunately, so is suspecting a broken toe, not doing anything about it, and then putting up with the consequences afterwards. While New Zealand tends to have a strong she’ll be right mentality, broken toes are not something that should be shrugged off in the hopes that the problem will just go away and be good as new. Here’s the inside scoop about broken toes and what they really mean for you.

What does a broken toe feel like?

Broken toes feel painful, swollen and may have some purple bruising from the bleeding beneath the skin. You may get some numbness or tingling, have marked redness or streaking around the toe, and your toe may look crooked or out of place. Try standing with weight and pressure on your forefoot and toes at least a few hours after the pain begins. Can you do so comfortably or are you unable to bear weight without significant pain on the toe? If it’s the latter, it very well could be broken. If it’s the former, don’t rule out the break just yet – some are more subtle than others!

How can toes become broken?

The most common ways people tend to break their toes are from stubbing it, dropping something on it, and during contact sports – particularly falls and tackles.

Should I see someone for my broken toe? Who?

Yes, you should. Every toe bone break is different – some are more severe than others, and there are special considerations based on which toe you’ve broken and what kind of a break it is, as well as your physical health and medical conditions. It’s important that your feet are also checked for circulation and nerve damage, skin injuries and any resultant wounds, as well as any injuries to any bones, joints, ligaments and tendons around the area. Often, breaks don’t happen on their own, and you’ll need to address any related problems too if you’re going to recover effectively. Your podiatrist should be the first port of call due to their comprehensive knowledge of the feet. They’ll be able to assess your toe against other causes of toe pain to get a clearer diagnosis. They can also refer you for an x-ray to confirm the break.

Can I treat my broken toe at home myself?

You can get some temporary pain relief at home by using ice to help reduce the swelling, keeping your foot elevated, removing any weight and pressure from the foot, changing to open-toed footwear, and using non-steroidal anti-inflammatories like nurofen. But you still need to see your podiatrist as quickly as possible. When broken toes aren’t allowed to heal properly or in the right position, this can have damaging consequences for you further down the line, from a prematurely arthritic joint to crooked toes, painful high-pressure areas or altered gait. At its worst, you may end up needing surgery – which may have been preventable. This is why it’s always best to get help early.

How are broken toes treated?

If you have a straightforward break where the bone is still well aligned, then your treatment may involve anything from ‘buddy taping’ the toe to act as a splint and then offloading the area, to using a moon boot for full immobilisation. You may need to change your footwear while your toe heals to give it adequate space and avoid harmful pressure. Here at Perform Podiatry, we understand that an effective treatment plan is far more complex than saying don’t walk on this foot for the next four to six weeks. Every treatment plan is made following a comprehensive assessment, and importantly, getting to know you, your work and life situation, and discussing which treatment options will be best for you under your circumstances.

Experienced podiatrists in Remuera, Auckland

If you have pain in your forefoot and you’re worried that you’ve broken a toe or sustained another injury, our experienced podiatry team is here to help. We’re located in the One Health building on Remuera Road, with x-ray services available within our building if needed. Book your appointment online here or call us on (09) 523 2333

The Top Four Pains In Runners – And How To Treat Them

We ask a lot of our bodies when we run. The force through our joints and our legs easily exceeds three times our body weight – so it’s not all too surprising that a large portion of our patients are either regular runners, or developed their symptoms when wanting to get into running. Today, we’re sharing the top four pains and problems we see and treat in runners, here in Auckland.

1. Shin Splints

Medically referred to as medial tibial stress syndrome, shin splints describe pain to the front and inside of the shins that often comes on during running and physical activity. The trick with shin splints in runners is that there are two other conditions that closely mirror the symptoms: a stress fracture to the shin bone (tibia), and compartment syndrome. Effectively treating shin splints means looking at the way the muscles that attach to the front of the shins are being used when running. Often, biomechanical factors and poor foot posture means these muscles are overused and strained – flat feet, or pronation, is often a contributing factor. We must check the runner’s shoes and how they are affecting their performance and the way the shins and the muscles are being used. It’s also important to check how a runner is warming up, recovering after running, and stretching. Tight muscles, joint limitations and improper muscle conditioning are also common culprits in the development of shin splints. To learn more about shin splints, click here.

2. Knee Pain

In any 12-month period, up to 70% of runners will sustain an injury from running – and 42% of these will be to the knee. There are two primary causes of knee pain we often see in runners – runner’s knee, medically referred to as patellofemoral pain syndrome, and iliotibial band syndrome. Runner’s knee is an overuse injury caused by the irregular movement (tracking) and rubbing of the patella over the femur, while the knee is bending and straightening. Instead of gliding smoothly through a groove at the thigh bone, the poor alignment of the knee means the patella can mistrack and instead rub against the bone itself. This causes irritation at the joint and damage to the underlying cartilage and bone. Iliotibial band syndrome is when the thick connective tissue called the iliotibial band (ITB) that runs down the outside of your thigh rubs against the outside of the knee joint, causing pain, swelling and damage to the tissue fibres. It’s common in runners as the rubbing tends to happen when you bend and straighten the knee repetitively – especially when you have a tight ITB. Treating knee pain in runners effectively must focus on not only relieving the pain and helping repair the existing damage, but also addressing the cause to help prevent it from happening again in the future. Often this involves using a combination of custom foot orthotics, ensuring adequate footwear use, a targeted strengthening and stretching program, and changes to the running technique based on findings from a video gait analysis.

3. Calf Pain

Your calves are very important when you run – working up to 25% harder than your quads when running. When you need to stop or quickly change direction, they’re the ones that help you do so safely without injury. They help to stabilise your knee and absorb a large amount of force when you run. Hence, runners with calf pain are a common occurrence. The most common cause we see for calf pain is overuse without the right preparation and conditioning, often combined with unaddressed tightness. Yep – we told you those super simple calf stretches could prevent injury! Treating calf pain involves addressing all the factors that are contributing to the overloading and strain, identified during the biomechanical assessment – which often includes a stretching program, strengthening, correcting any abnormal foot and leg biomechanics, and even looking at a little gait retraining to optimise performance and movement.

4. Heel Pain

When it comes to heel pain in runners, plantar fasciitis heel pain is a biggie. You’ll often hear of people referring to this pain as ‘heel spurs’ – though this is medically and physiologically incorrect. Plantar fasciitis heel pain is characterised by sharp, shooting and stabbing pain at the bottom and inside of the heel. It tends to be most painful when you stand after rest – especially after sleeping – before easing as you continue to walk. Treatment must be specific and effective in order to prevent the tissue damage from progressing to a more severe injury – like a tear in the plantar fascia tissue – or even a rupture. We have a proven treatment that we find to be very successful, which includes temporary strapping, the use of good running shoes if you’re not wearing some already, custom-prescribed foot orthotics that address all structural and biomechanical foot and leg issues, and a stretching and strengthening program.

So, what’s stopping you from running?

If you’ve got a pain or problem during or after running, whether we’ve mentioned it above or it’s something completely different or unusual, we’d love to help. Treating foot and leg pain is what we do! And we have the best technology, skills and experience to allow us to do it excellently. Book your appointment online by clicking here or call us on 09 523 2333

Our Patients: From Ballet Dancers To Soccer Stars

Recently, we shared all about the big range of problems that our podiatry team here at Perform Podiatry can help you with. From in-toeing to foot drop, to managing falls risk and instability on your feet, we’re trained to help you with it all – you can read all about it here. Today, we thought we’d share with you the different types of patients we see, that aren’t your typical ingrown toenails or corns that need removing. We’re proud to be a diverse clinic with a wide range of offerings in the fields of sports medicine and beyond – so he’s a little insight into how we really spend our days as podiatrists!

1. The post-surgery recoverer

We have fantastic relationships with our local surgeons – and we’re privileged to help so many of their patients optimise their recovery. Whether it’s an unexpected surgery like having pins put in following an injury, a knee replacement, a bunion surgery – or something else, we work efficiently to improve the comfort and mobility of these patients, as well as their confidence on their feet. For these patients, we use a combination of custom foot orthotics, pads, boots or splints, supportive footwear and physical therapy (stretching and strengthening) to help them recover faster while staying as active and mobile as is safe to do so. Contrary to what some may think, staying active is shown to help promote faster recovery and better healing outcomes – compared to staying immobile.

2. The iron man

The iron man, or woman, is the one that is always challenging themselves to go further, push harder, beat personal bests, and enter all the events Auckland has to offer! While these people may need help with pains and injuries that can hold them back along the way, they’re also looking to give themselves a competitive edge by improving their walking and running performance, while reducing their risk of injury before it starts. For these patients, we start with a comprehensive biomechanical assessment to understand exactly what’s going on with their feet and legs – from the way their muscle strength or flexibility is affecting the way their feet move, to a comprehensive gait assessment to see how we can optimise the way they run.

3. The professional ballet dancer

The professional ballet dancer is one that spends a massive amount of time on their feet and toes – subjecting them to significant force and strain that can leave painful problems. They can see that their toes are changing – whether they’re curling or getting more bumps, and at the same time, also have to manage recurrent blisters, corns, callus and other foot pains to keep doing what they love. For these patients, there are multiple goals. The first is to manage their recurring problems – like the corns and blisters – and put the right measures in place to help prevent them from recurring in the future. Next, we must understand the unique demands that their sport and career place on their feet and legs – and create a plan to best support them so they can keep doing what they love as best and comfortably as possible.

4. The aspiring sports star

This young legend loves his favourite sport – whether that’s soccer or something else. They always give it 100%, while loving the fun they have during training and games with their team. While performance is important, being able to play every week without being limited by the pains and injuries – like growing pains – that other players in their team are facing is equally as important, if not more so. For these patients, it’s about conducting a comprehensive foot, leg, gait & risk assessment to get a complete picture of what’s happening in their feet and legs. Then we create a plan for managing any current problems and discrepancies that are likely to cause pain in the future. We also ensure we consider how to help them generally feel their best doing the sports they love.

5. The soccer mum

The soccer mum is the one that does it all. She runs around after the kids, gets them to all their games and appointments, and still has her own goals – one of which is looking after her health and well-being. Staying pain-free and moving on her feet is critical – if pain develops, she doesn’t have a choice but to push through. We work with these mums to help them recover from any pains or aches as quickly and effectively as possible. Aside from relieving the immediate symptoms that may be slowing her down, we always look to see how we can support her and help reduce the likelihood of the same pains – or new problems – from recurring in the future.

Are you putting up with pain or discomfort in your feet and legs?

If you’ve been putting off getting help for your foot or leg pain in the hopes that it’ll get better on its own – only to realise that it’s still holding you back – our experienced podiatry team are here to help. Unlike other podiatry clinics, sports medicine and injury recovery are two of our specialities, and we’re even equipped with our own orthotics manufacturing lab! Book your appointment by calling 09 523 2333 or book online.

Are Men Or Women More Likely To Injure Their Feet & Legs?

We have the privilege of treating foot and leg injuries day in and day out. It’s very easy to pick up on patterns – like the shoes you wear into the clinic giving us the first hint of what your pain or injury may be, or your walking style giving away some biomechanical problems that have likely contributed to your problem developing without you even realising. Today, our podiatry team thought we’d use our experience – paired with the clinical evidence – to share the answer to an interesting question we get asked from time to time: who is more likely to injure their feet or legs, men or women?

Men: The Considerations

While we hate stereotypes, we do see more men having a tendency to go hard and fast into exercise, pushing their bodies past the point that they can safely handle too quickly, and developing problems including:

Achilles tendinopathy
Knee pain
Plantar fasciitis heel pain
Shin splints
Hamstring injuries
Metatarsalgia

Examining the research and statistics, looking at hospitalisations for sports injuries across the ditch showed that men were twice as likely to be hospitalised for a sports injury compared to women, though with a positive declining trend, down from 3.5 times almost a decade ago. The participation rate is a big factor here, however, with participation in high-impact sports like rugby union being significantly higher in men compared to women – though the female participation rate is growing! When it comes to work-related injuries, in 2018 the highest incidence of work-related injury claims were in the agriculture, forestry and fishing industries, which affected notably more men than women. This is in line with previous years, where 71% of all work-related injury claims were for men – twice as high as women – and men represented three-quarters of all serious injury claims to ACC. Again, this figure is expected to be significantly influenced by the proportionally higher participation of men vs women in these industries.

Women: The Considerations

When it comes to women and foot & leg pain, there are two important considerations that can influence their injury risk when compared with men. The first is the tendency to wear high-heeled, narrow or pointed footwear. Wearing high heels shifts the body weight from being distributed more evenly between the entire foot and forwards onto the ball of the foot, while decreasing the stability of the foot and ankle. This makes women more vulnerable to forefoot injuries like capsulitis, bursitis, metatarsalgia, bunions and other forefoot injuries, as well as ankle sprains and general foot pain. Wearing narrow and pointed footwear, for any gender, increases the risk of rubbing and friction leading to corns, calluses and blisters, while the cramped foot posture can encourage changes to the toes like claw toes, hammertoes, bunions and more.

Anatomical differences

Anatomical differences have also been shown in studies to make women more susceptible to injury than men when performing the same activities. The three primary factors include structural changes, hormonal changes and body composition. Structural changes include having smaller dimensions of bones and a wider-set pelvis that changes the angle of the hip bones relative to the knees and other bones. Hormonal changes include a higher concentration of hormones like estrogen, which has been shown to affect the function and performance of bone, muscles, tendons and ligaments. Hormonal variations throughout life, like during menopause, pregnancy and puberty, can also result in changes, like how the hormone relaxin causes greater ligament laxity during pregnancy. Finally, changes in body composition include the predisposition to have a lower bone mineral density, generally less muscle mass and a higher body fat percentage may affect a person’s injury risk.

So, what does this all mean?

While men and women may have some differences in their injury risk, the truth is that regardless of gender, there are plenty of other factors that influence our injury risk, including our foot biomechanics and posture, exercise habits and participation in sports, training techniques, injury history – and many more. Here at Perform Podiatry, we understand these risks and always assess your problems and injury risk on a case-by-case basis – taking all of these factors and much more into consideration to develop comprehensive treatment plans designed to help you reach your goals. Book your appointment with our experienced podiatry team by calling us on (09) 523 2333 or online here.

Stretching For Recovery – Is What You’re Being Told TRUE or FALSE?

Here at Perform Podiatry, we treat a lot of foot and leg pain. It’s our speciality! And while orthotics are a very important component of the treatment plan, there are other components too – namely stretching and strengthening, as well as having the right footwear during your recovery. Because we’ve recently seen a few patients who had either been given advice by a professional or read online some pretty crazy advice about stretching when you have foot or leg pain, we thought we’d set the record straight with some statements we’ve heard. We’ve put together some true/false statements that may turn what you think about stretching upside down, or just completely confirm everything that you already know. Here we go… FALSE: You should start stretching from the moment you sustain an injury. TRUTH: You should start stretching and strengthening once your initial painful symptoms settle, some healing/repair has occurred and you’re on the path to recovery. The reality is that if you’ve got a damaged, swollen and painful tissue that has recently sustained an injury and you go and try to stretch it straight away, it’s going to be very painful and may potentially further damage the vulnerable tissue. That’s why you wait until the initial symptoms have settled and you’ve begun the treatment plan. FALSE: You should spend as much time stretching as you can, doing over 100 repetitions a day as the goal. TRUTH: You should ease into stretching and strengthening, starting off slow and mild and gradually increasing to 10-15 minutes a day. We recently had a patient tell us that she was instructed to do 100+ single limb raises (which means going up to the toes on one foot while having the other off the ground) for her painful plantar fasciitis and to say we were shocked is an understatement. Stretching and strengthening following an injury must be a gradual process, to gently begin lengthening and strengthening the tissues and returning their function while being very careful not to cause further damage or overdo it. It’s just like running a marathon – you don’t begin by jumping into a 42km run – you start with a slow couple of km’s and work your way up. FALSE: You should keep doing stretches, even if they’re painful. TRUTH: You should feel a tightness when you’re stretching, but never pain. If you feel pain, stop immediately. Pain is our body’s way of letting us know that something is wrong. LISTEN to your body. It’s completely normal to feel a ‘tightness’ when you begin stretching a muscle or tendon that isn’t used to being stretched, but if you feel pain instead, it means you’re pulling on a damaged site and potentially causing more harm than good. When the damaged tissue has recovered enough to withstand some stress and stretching, then begin again. FALSE: Stretching and strengthening alone will fix your foot injury. TRUTH: Stretching and strengthening will assist your recovery from your foot injury AND can reduce the risk of future re-injury. Any treatment must address the various causes of the injury. If the wait you walk combined with your footwear and an increase in physical activity has resulted in an injury, then stretching and strengthening alone won’t help you fix the problem. That’s because when you start getting active again in the same shoes and with the same gait, you’ll strain the same muscles again and the pain will return. However! If the way you walk has also resulted in some tight calf muscles that contributed to the development of your problem, then stretching them will definitely help, especially with reducing the risk of the injury happening again in the future. Regardless of the cause of your foot or leg pain, our team have years of biomechanical experience to get the best outcomes for you – and keep the pain gone! We never just look at your symptoms but get to the root of the problem to make sure you recover well and the problem doesn’t return. For more information or to book an appointment, you can give us a call on 09 523 2333 or book online here.