Uncategorized – Perform Podiatry

Choosing The Right Expert: Why A Podiatrist Is Your Best Bet For Foot And Ankle Pain

Foot and ankle pain can not only be debilitating, but also affects both our mobility and our overall quality of life. When faced with these issues, seeking the right professional expertise is crucial for accurate diagnosis, effective treatment – and getting back to feeling and moving well, as quickly as possible. In the realm of foot and ankle health, your podiatrist is your go-to foot and ankle expert. Here’s why.

Understanding The Role Of A Podiatrist

A podiatrist is a medical professional who specialises in the diagnosis, treatment, and prevention of conditions related to the feet, ankles and also the lower limbs. Their extensive training equips them to handle a broad spectrum of issues, ranging from common concerns like ingrown toenails to complex biomechanical problems influencing gait and posture including Achilles tendon pain, heel pain, shin splints, leg length differences and much more.

Why Choose A Podiatrist For Foot And Ankle Pain?

There’s a wide range of reasons that a podiatrist is the right health professional to see for your lower limb pain. These include:

They’re Experts In Foot Anatomy and Function

Podiatrists undergo extensive training focused specifically on the anatomy and function of the feet and ankles, as well as the lower limbs. Their in-depth knowledge allows for accurate diagnosis and targeted treatment plans tailored to address the unique challenges posed by this intricate area of the body.

Specialised Diagnostic Skills

Podiatrists possess specialised diagnostic skills honed through years of training and clinical experience. From identifying structural abnormalities to pinpointing the source of pain, their expertise ensures a thorough assessment of foot and ankle issues.

Comprehensive Treatment Options

Podiatrists offer a wide range of treatment options, including conservative measures, devices like braces, physical therapy, and minor surgical interventions when necessary. This comprehensive approach allows for the right, personalised care based on the nature and severity of a specific condition.

Management Of Chronic Conditions As Well As Acute Injuries

Chronic conditions such as arthritis, diabetes-related foot complications, and neuropathy require ongoing management. Podiatrists are well-equipped to provide continuous care, helping patients navigate the challenges associated with these persistent issues.

Biomechanical Expertise

Many cases of foot and ankle pain stem from biomechanical issues affecting gait and posture. Podiatrists specialise in assessing and addressing these concerns, utilising orthotics, exercises, and other interventions to restore proper biomechanical function.

Preventative Care

Beyond treating existing issues, podiatrists emphasise preventive care. Regular check-ups with a podiatrist can identify potential problems early on, allowing for proactive measures to prevent the development or progression of foot and ankle conditions.

Evidence-Based Practice

Podiatric medicine is grounded in evidence-based practice, with treatment approaches informed by the latest research and clinical guidelines. This commitment to evidence ensures that patients receive care based on proven methods and advancements in the field.

Podiatrists vs Physiotherapists

While physiotherapists play a crucial role in rehabilitation and overall musculoskeletal health, the specialised focus of podiatrists on the feet and ankles sets them apart in the context of foot and ankle pain.

Specifically, physiotherapists tend to have a broader focus on the entire musculoskeletal system, addressing issues related to muscles, joints, and movement patterns. Podiatrists, on the other hand, concentrate specifically on the lower extremities, making them more specialised in the intricacies of foot and ankle conditions. This enables podiatrists to provide more targeted interventions for foot and ankle pain, leveraging their focused skillset to address conditions ranging from toenail problems to complex biomechanical issues.

Podiatrists are also trained in both conservative and surgical interventions for foot and ankle conditions, where physiotherapists are not, being unable to perform procedures like permanent ingrown toenail correction surgery. This means that in cases where surgery is required, podiatrists can seamlessly transition from diagnosis to treatment.

Caring for Ageing Feet: How Your Podiatrist Helps

As we get older, certain tasks get that little bit harder – whether it’s getting your shoes on, opening a jar, or reaching your feet to trim your toenails. This is why skin and nail care is a very important part of what we do here as podiatrists. Taking care of ageing feet goes beyond maintaining comfort; it contributes to mobility, balance, and the enjoyment of an active lifestyle. Whether we’re reducing the thickness of your nails, removing corns, or managing cracked heels, we know that by relieving your pain and improving your comfort, we’re directly helping you to keep moving on your feet, so you can optimise your health.

Here’s a look at the ways that our team here at Perform Podiatry helps to manage and maintain the foot health of older adults.

Footwear Assessment, Advice and Modifications

Your shoes become the ground you walk on, being responsible for supporting your comfort, stability and mobility. We work closely with older adults to ensure that their shoes are helping them through every step and not hindering them, and give personalised advice based on any foot conditions or ailments you have – from foot pain to bunions and more.

Generally speaking, you want to opt for shoes that provide ample support, cushioning, and a proper fit. Ill-fitting shoes can lead to discomfort, blisters, and even foot deformities. Look for shoes with a wide toe box and adjustable fasteners to accommodate potential foot swelling.

Keeping Toenails Trimmed

When your toenails are properly trimmed and maintained, it reduces your risk of ingrown toenails and related infections. Podiatrists can also reduce the thickness of your toenails, improving both your comfort and their appearance. If managing toenails at home, you want to trim them straight across and avoid cutting them too short to prevent discomfort.

Managing Corns And Calluses

Like with toenails, regular podiatry appointments help you stay on top of any corns and calluses that arise, meaning you get to walk comfortably and without pain. It is not recommended to attempt to manage these at home due to the risks in older feet.

Providing A ‘Second Eye’

While it’s one thing to advise older adults to regularly check their feet for signs of deterioration, redness, sores, blisters, cuts or anything else that’s sinister, it’s very different to be able to do it, especially with vision changes and greater difficulty reaching the feet. Your podiatrist acts as a ‘second eye’ at every skin and nail care appointment, catching potential issues early that may have been missed which can prevent them from escalating into more serious complications.

Addressing Dry Skin

Ageing skin tends to become drier, and this applies to the feet as well. Your podiatrist can help with dry skin as well as complications such as cracks in the heels, helping promote your comfort and reducing the risk of infection. If managing dry skin at home, applying a moisturiser, especially to the heels, can prevent cracking and discomfort. Avoid applying lotion between the toes, as it can create a moist environment conducive to fungal growth.

Monitoring Foot Sensation

Loss of sensation in the feet is another common issue among older adults, which can lead to unnoticed injuries. This is something that you can discuss with your podiatrist at your appointment, and something they can help you monitor and manage. At home, regularly check for numbness, tingling, or changes in sensation and consult a healthcare provider if such issues arise.

Preventing Falls

A person’s fall risk can be reduced by 36% when working with a podiatrist. With approximately one third of all falls being preventable in nature, many people are choosing to work proactively with their podiatrist in areas such as falls risk assessments, footwear checks, custom foot orthotics, balance assessments and more to help reduce their falls risk and improve their long-term health and comfort.

If your feet or legs are causing you pain or discomfort, or you’ve found that over the years you are no longer able to care for them in the best way, then our Perform Podiatry team here in Remuera, Auckland, are here to help. We’re proud to help thousands of people every year look after their foot health. We’d love for you to join us.

Book your appointment by calling us on 09 523 2333 or book online here.

Does Your Leg And Foot Posture At Your Desk Really Matter?

Whether you’re in the office or working remotely, a lot of our workforce spends a significant portion of their day sitting at a desk, often in front of a computer. While sitting may seem natural and harmless, poor posture has the potential to lead to various health issues, including discomfort, pain, and musculoskeletal problems that require professional care. Yes, the way you position your hips, legs, and feet when sitting on a chair can significantly impact your overall well-being. Here’s How.

The Consequences of Poor Posture

Your Hips

There are two main elements of poor posture when it comes to the hips. Sitting with a slouched hip posture, where the hips are rolled backwards, can lead to excessive pressure on the lumbar spine. This position places extra strain on the lower back muscles, potentially causing lower back pain and discomfort. Sitting with elevated hips, where your hips are higher than the knees due to an inadequate chair height can result in pressure on your hip flexors. Over time, this can lead to tightness and discomfort in these muscles.

Your Legs

Sitting with your legs crossed can restrict blood flow and lead to numbness and tingling in the legs. It may also place uneven pressure on the knees, potentially contributing to knee pain and long-term joint issues. Similarly, keeping your legs extended straight under the desk can hinder blood circulation, causing discomfort and potentially contributing to varicose veins over time.

Your Feet

Allowing your feet to dangle without proper support can result in lower back pain and poor circulation in the legs. This posture may also lead to the development of varicose veins. Tucking your feet under the chair can also create unnecessary pressure on the knees and lead to discomfort over time.

So How Should You Be Sitting?

Aim to:

Sit with your hips in a neutral position, where the natural curve of the lower spine is maintained. This minimises the stress on the lower back and helps prevent pain and discomfort.
Use a chair with lumbar support, as it can help maintain the natural curve of your lower back and provide additional comfort.
Ideally, keep your hips and knees at a 90-degree angle to one another when sitting. Adjust the chair height so that your feet are flat on the floor, promoting proper circulation and reducing stress on the knees.
Avoid crossing your legs, instead keep both feet flat on the ground or on a footrest to prevent pressure on the knees and ensure optimal blood flow.
Use a footrest, as it can help support your feet and maintain proper posture while reducing the risk of lower back pain.
Ensure that your feet are not tucked under the chair. Instead, keep them flat on the ground or on a footrest.

Experiencing Pain In Your Feet Or Legs?

If you’re experiencing pain in your feet or legs, whether that’s related to your lower limb posture or from something else – 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.

NZ Skiing and Snowboarding: Injury Prevention Tips From Your Podiatrist

Snow sports like skiing and snowboarding can be thrilling, even here in New Zealand. Whether you’re planning a trip down to Queenstown this season or making the most of the (potential) last season at our North Island ski fields, it’s important to spend at least a little time preparing your body to minimise the risk of injuries and enhance your performance on the slopes – especially if you’re planning to spend a week at the mountain.

Cardiovascular Work

Snow sports demand stamina and endurance, making cardiovascular fitness vital. Despite relying on gravity for downhill momentum, skiers often encounter flat areas that require skiing or pushing along. Snowboarders may need to remove their boards and walk on flat terrain, which can quickly become tiring due to the added weight of gear. Building cardiovascular fitness through regular aerobic exercise, such as running or cycling, can enhance endurance and help you navigate these challenges with ease. Try to add a few extra sessions weekly in the month leading up to your trip (or longer if you can!).

Strengthening Work

Both skiers and snowboarders rely on specific muscle groups while on the mountain. Skiers require strong core muscles to stabilise their spine, pelvis, hamstrings and quads for knee bending and leg extension, lower leg muscles for foot control and ski edging, and glutes for overall stability. Snowboarders, on the other hand, heavily engage the quads, hamstrings, and glutes while maintaining knee flexion, with the calves playing a crucial role in maintaining balance and controlling ankle movement. Additionally, upper body strength is essential for skiers who use ski poles and for snowboarders who need to manoeuvre and re-strap their boards. This means getting in a few extra weekly gym sessions in the month leading up to your ski trip to help your body prepare best.

Flexibility Work

Snow sports really put your joints to the test, making flexibility crucial for preventing injuries and helping you have a safe ski holiday for the whole family. We recommend incorporating a thorough stretching program before your ski holiday to enhance your joint strength and mobility. Prioritise consistency over session length, stretching frequently for shorter durations. Ensure you stretch through the full range of motion, feeling the stretch at the end points. On ski days, warm up your body and stretch your muscles properly to reduce the risk of injury, as cold muscles are more susceptible to strains.

Provide Extra Support To Vulnerable Areas

If you have any pre-existing injuries, niggles, or weak areas, it’s essential to provide them with additional support to prevent exacerbation on the slopes. Consider using strapping, compression gear, or knee guards if necessary. Seeking advice from a podiatrist can help you determine the best ways to protect vulnerable areas and prevent potential injuries. They can guide you on proper strapping techniques and injury prevention measures tailored to your specific needs.

Listen to Your Body

Listening to your body is crucial both before and during your snow sports adventure. Pain and discomfort should never be ignored, as they are often signs of an underlying issue. If you experience pain or niggles before your trip, it’s important to address them to avoid further complications. Likewise, if something feels off during your time on the slopes, pay attention to your body’s signals and take appropriate action. Ignoring warning signs can lead to more severe injuries and prolonged pain.

Frequently Asked Questions

Can foot pain affect my performance while skiing or snowboarding?

Yes, foot pain can significantly impact your performance and overall enjoyment of snow sports. Proper ski footwear, foot support, and addressing any underlying foot conditions are crucial for optimal performance.

Should I wear custom orthotics while skiing or snowboarding?

If you use custom orthotics in your daily life, you may consider using orthotics that are fitted especially for your ski or snowboard boots – but this may only apply in some cases and you should consult your podiatrist. While custom orthotics can provide additional support, improve alignment, and help alleviate foot pain, standard orthotics don’t tend to fit into already tight-fitting ski and snowboard boots, and the skiers we work with usually have custom ski orthotics made if they’re heading to the slopes regularly.

What type of socks should I wear for snow sports?

Choose moisture-wicking socks made from synthetic or wool materials to keep your feet dry and warm. Avoid cotton socks as they retain moisture and can lead to discomfort and blisters.

How can I prevent blisters while skiing or snowboarding?

To prevent blisters, wear well-fitted boots or shoes that provide ample room for your toes. Consider using blister pads or applying moleskin to areas prone to friction. Ensure your socks are clean and dry before putting them on. We also have a range of silicone toe props and other products available from the clinic for you to try.

How do I choose the right ski or snowboard boots?

Unfortunately, the only answer to this is to consult with a professional boot fitter who can assess your foot shape, size, and specific needs to help you find the right boots, as individual needs vary so greatly from person to person.

Best Footwear For Foot Pain

Dealing with foot pain is a challenging and uncomfortable experience for most. Whether you’re suffering from plantar fasciitis, arthritis, a foot or ankle injury, or any other foot condition, take it from the pros: wearing the right footwear can make a significant difference in alleviating your discomfort, reducing your recovery time, and promoting proper foot health to see you through a lifetime. But what should you look for in good shoes?

Sports Shoes With Good Support

Athletic shoes that are engineered for specific activities, such as running or walking, can provide excellent support, stability and offloading (via good cushioning) for those with foot pain. Look for shoes that have a supportive midsole, ample arch support, and a cushioned insole. These features help absorb shock, reduce strain on the feet, and promote a stable gait. Additionally, sports shoes often come in a variety of widths, ensuring a good fit for individuals with different foot shapes and sizes, including a spacious toe box.

Low-Heeled Shoes

When your foot pain is primarily present at the forefoot, it’s best to avoid high heels and opt for low-heeled shoes instead. Higher heels place excessive pressure on the forefoot and can exacerbate conditions like metatarsalgia and pains around the ball of the foot. Low-heeled shoes with a heel height of approximately 2cm provide better stability, reducing strain on the feet and promoting a more natural gait. Again, look for low-heeled shoes with cushioned insoles for shock absorption,good arch support, stability around the ankle, and a spacious toe box.

Sandals with Arch Support

During warmer months or casual occasions, if you need to wear sandals, we recommend selecting sandals with built-in arch support to help offer comfort and support for foot pain relief. Look for sandals with contoured footbeds that provide adequate arch support – or better yet, sandals with removable footbeds so you can slot your own custom foot orthotics in. Having adjustable straps helps to ensure a secure fit and allows for individual customisation. Avoid flat sandals with minimal cushioning, as they provide little to no support and can exacerbate foot pain.

Orthopaedic Shoes

While traditionally orthopaedic shoes had a bad wrap due to their ‘unfashionable’ or bulky appearance, today orthopaedic shoes have actually come a long way and there’s a much wider option range that many of our patients are loving. The benefits of orthopaedic shoes are their very specific designs that are made to provide support, stability and cushioning for a range of foot conditions. They often also come with additional arch support, extra padding, wider toe boxes and several other features that help them stand out from standard shoes when you’re experiencing notable pain or discomfort. The arch support helps distribute weight evenly, reducing pressure on specific areas of the foot. The added cushioning offers shock absorption, minimising impact on joints. Orthopaedic shoes also provide ample room for the toes, preventing constriction and allowing natural movement.

What About Custom Foot Orthotics?

Custom foot orthotics are specially designed shoe inserts that are moulded to match the unique contours of your feet. These inserts can provide targeted support and stability, relieving foot pain caused by most podiatric conditions – from flat feet or high arches to plantar fasciitis or shin splints. Custom orthotics help improve foot alignment, redistribute pressure, and reduce strain on specific areas of the foot. They can be used in various types of shoes, including athletic shoes, casual footwear, and even dress shoes.

Footwear To Avoid

Just like choosing good, supportive footwear, it is also crucial to be mindful of footwear choices that can worsen your foot pain and leave you feeling worse for longer. Avoid shoes with unsupportive soles, thin insoles, or minimal cushioning, as they offer little shock absorption and can exacerbate your discomfort. Additionally, narrow or pointy-toed shoes can compress the toes, worsening conditions like metatarsalgia, bunions or corns. Shoes that do not provide proper arch support can contribute to improper foot alignment and increase strain on certain areas.

Frequently Asked Questions

Can I wear my regular flats and office shoes if I’m experiencing foot pain?

It’s best to avoid unsupportive shoes if you’re experiencing foot pain, including your work shoes. If you must wear your work shoes at work, consider consulting with a podiatrist about whether orthotics could be a suitable option for your work shoes. Invest in footwear specifically designed to provide support, cushioning, and stability for your feet.

Are there specific brands known for foot-friendly shoes?

Several brands specialise in creating footwear for foot pain relief, such as Dr Comfort, Brooks, New Balance, Birkenstock, and Vionic. However, it’s essential to find shoes that suit your individual needs and foot condition. Your podiatrist can provide you with advice on particular styles that may work best for you.

Can I use orthotics in any type of shoe?

Custom orthotics can be used in a wide range of shoe types, as long as they have removable insoles. However, it’s advisable to choose shoes with ample space to accommodate the orthotics comfortably. Never try to cram orthotics in if your shoes aren’t designed to accommodate orthotics.

How often should I replace my shoes when I have foot pain?

When you’re experiencing foot pain, you don’t necessarily need to replace your shoes more often than normal, but you do need to make sure you’re following the guidelines for replacing your shoes. For shoes that you wear on a daily basis or get decent mileage on, this means replacing them every 800-1000kms, or every six months. If they have significant signs of wear or break down they may need to be changed sooner.

Can I wear high heels occasionally if I have foot pain?

As health professionals, we recommend avoiding high heels, even on an occasional basis, as they can significantly strain the feet and worsen your existing foot pain. If you must wear them, do so for as little time as possible – which may look like wearing good comfortable shoes in the car and stepping out in your heels for as little time as possible.

What’s The Alternative To Orthotics?

Had a previous experience with orthotics where they weren’t that comfortable, didn’t fit your shoes well, or didn’t do what they were meant to? If you’ve been recommended foot orthotics but are hesitant to try them out for whatever reason, you may be wondering if there are any alternative treatments available. The answer to this question is that there are alternative treatment pathways for foot pain and injury (and other issues) that don’t involve orthotics, but they may not produce the same results. Something that is definitely not an alternative to orthotics is the generic footbeds or insoles found at pharmacies or supermarkets, which in the eyes of podiatrists do close to nothing aside from add cushioning 95% of the time.

Why Can’t Anything Else Act In The Same Way As An Orthotic?

Simply put, when you position your foot over a custom foot orthotic, it starts sitting and functioning differently than it had seconds earlier – much like when you put in a hearing aid or put on a new pair of prescription glasses. And there are almost no treatment routes that can deliver the same results in the same instant timeframe – without you having to do months of rehab, exercises, undergo specialised treatments, or in the most extreme case, have surgery with its weeks or months of downtime and recovery (and no ‘guaranteed’ results, if we’re being honest).

What About Footbeds And Insoles?

Foot orthotics are highly specialised medical devices that are prescribed by a qualified podiatrist after a comprehensive assessment of your feet, legs, clinical testing, diagnosis, and consideration of various lifestyle factors. They’re customised for each individual’s unique foot structure, much like prescription glasses are tailored to individuals eyesight requirements. On the other hand, footbeds or insoles – which are most commonly viewed as the orthotic ‘alternative’ – are generic shoe liners that assume a lot about your feet and don’t have the skill, experience, modifications and technology to provide long-term changes to your foot health and injury risk. At best, they may offer temporary comfort (much like how sticking any foot cushion in your shoe might), but they don’t address the root cause of your foot problem. Hence, their minuscule price tag for a very ‘disposable’ item.

Legitimate Alternatives To Orthotics

With all this said, alternative treatments to orthotics do exist in terms of fixing your foot pain or problems without involving orthotics in your treatment, and it’s important to know that you have options. Here at Perform Podiatry, we offer a range of treatments for certain conditions and injuries – you can explore our range here. We take the time to explain each treatment and its expected outcomes to help you make an informed decision. We may need to take more aggressive approaches to certain treatments – like temporary offloading for a few weeks with a moon boot or walker (in severe cases), but will always work with you to ensure you’re happy with your course of treatment and if that means you don’t want to try orthotics in the instances that they’re clinically indicated, then we’ll always honour and respect that, and make a treatment plan accordingly.

Are Your Orthotics Different?

Compared to footbeds, insoles and even other prescription orthotics from other clinics? Honestly – yes. The thing with orthotics is that part of their performance and efficacy is dependent upon the experience, precision and knowledge of both the practitioner prescribing them and how they’re manufactured. And with our orthotics, we’re incredibly proud to have leading orthotist and former lecturer in orthotic prescription and creation, Martin Kane, create these by hand for us – meaning you get extreme care and skill with every pair. You can learn more about our orthotics here, or click here to book an appointment with one of our Auckland podiatrists at our clinic on Remuera Road.

What Does It Mean If I Have A Knot In My Muscle?

We all know the feeling of having a knot somewhere in our muscles, whether that’s in our calves, legs or elsewhere in our body. It’s that tender spot that you push down on and feel instant pain that often radiates around. Most people will try to massage it, or have a spouse help, but what actually is a knot, should we really be pushing down on it, and how should knots be treated and importantly prevented? Here’s the low down on what that knot actually is from Auckland’s leading podiatry team.

What is a ‘knot’ in my muscle?

Firstly to clear the air: having a knot does not mean that your muscle fibres have become physically knotted up, like how you and I imagine a sailing knot to look like. A knot is the name for a stiff muscle band where the long fibres that make up your muscles have spasmed and contracted, leading to a palpable lump beneath the skin. You’ll also hear this being called a trigger point, and if we’re getting technical, it’s defined as “a discrete hype-irritable focal spot located in a taut band of muscle”. These trigger points generally feel achy, tense, swollen, and when pressed, the pain tends to radiate through the surrounding area. This small, hard knot can form anywhere where there is skeletal muscle, and the muscle fibres start adhering to one another. It is very common for us to find knots in calf muscles when assessing foot or leg pain or an injury. Knots or trigger points can be classed into two stages: active or latent. Active trigger points can continue to cause you pain throughout the day with movement, whereas latent trigger points will only hurt when you press on them. It is not uncommon for latent knots to progress to active ones, and bring with it a great deal of discomfort for you.

The effect of knots on your body

While knots aren’t pleasant on their own, depending on their location, they can also lead to other recurring problems. In podiatry, this means affecting the way that other muscles and joints function, due to the contracted (tight) state of other muscles. Further up the body, such as around the neck, knots can also lead to problems like tension headaches, which is why we never recommend ignoring them. Interestingly, statistics show that 97% of people with chronic pain have trigger points. Muscles with knots in them are also tight (due to their contracted nature) – and because of this reduced flexibility, it means that these muscles have a higher risk of tearing when placed under strain (overuse injuries) compared to a flexible muscle.

Why did I develop knots?

We think it’s pretty safe to estimate that everyone will experience trigger points in their lifetime, but some people are more prone to getting them than others. A lot of the evidence points to overusing the muscles being a major risk factor, with other known risk factors including:

Poor posture and ergonomics, especially when sitting at work
Stress, both mental and emotional
Muscle tension
Fatigue
Nutritional imbalances and dehydration
Other injuries and pains

We see many trigger points in those that are both active and perform repeated movements without the right stretching routines, warm-down routines and recovery techniques. We also see trigger points in those that have a more inactive lifestyle.

Trigger points signs and symptoms

The biggest sign of trigger points is feeling along your muscles to find a small round bump or nodule that will feel tender when you apply direct pressure on it. You may feel areas of muscle, such as along your calves, that feel tender even without a palpable knot. In this case, we often find that going deeper and tracing along the entire muscle length will reveal several knots.

Treating muscle knots (trigger points)

Trigger points often aren’t treated alone, but are related to a person’s pain, injury or other symptoms. In this case, as part of your assessment, we’ll complete muscle testing which may identify the presence of tight muscles and trigger points. Often, this is a contributing factor to a person’s pain, and we’ll use a treatment called ‘dry needling’ to release the trigger points. Dry needling uses very thin needles, very similar to the ones used for acupuncture, to get into the trigger points (knots) in the muscles and release the tension. By releasing the trigger points, movement can be restored and pain can be reduced. Dry needling is a fast, simple and effective procedure, and we find it is a fantastic support for our patients’ recovery and rehabilitation.

Dry needling: The process

Once it has been concerned that you have trigger points that are related to your pain or injury, your podiatrist will use very small needles that are lightly tapped into the skin, so it gets to the trigger point. As the needles are so thin, some people feel this while others do not. The needle is guided gently deeper to reach the trigger point, at which point the muscle may twitch. Slight readjustments may need to be made to reach the perfect spot. The needle is then withdrawn, and we start work on the next trigger point.

Tight muscles holding you back?

If tight muscles and trigger points are holding you back from sport, exercise or living life without pain, we can help. Book your appointment with our podiatry team by calling us on 09 523 2333 or book online here.

Foot & Leg Cramps At Night

There’s no feeling quite like the sudden, painful and involuntary tightening in your feet and legs that we know as a cramp. During a foot or leg cramp, the affected muscle forcefully contracts, and you may notice your toes curling, your foot pointing down, or your muscle bulging in response. Cramps can last from a few seconds to many minutes, and no one is immune to them – not even us podiatrists!

What Causes Cramps?

It can be very difficult to pinpoint the exact cause of your cramp. Some cramps have an attributable cause, while others are idiopathic, meaning the origin is unknown. Some causes that may lead to foot and leg cramps include:

Muscle fatigue – exercising too hard or overexerting yourself during your day can place excess strain on the muscles in your feet and legs, causing them to cramp
Being pregnant – pregnancy places more pressure on your feet and legs with the added weight, increased blood volume, and potential swelling in the feet and legs
Dehydration – if your muscles don’t get enough water to function properly, you may be more susceptible to cramps and muscle spasms
Medical conditions – having liver disease, spinal nerve compression, alcoholism, kidney failure, hypothyroidism, or diabetes increases your risk of cramps
Certain medications – can also increase your risk of cramps, such as those used to help lower your cholesterol levels
Mineral depletion – calcium, potassium, sodium and magnesium are minerals that contribute to healthy muscle function. When you are low in any of them, you may experience muscle cramps
Foot or leg injuries or problems – having an injury may change the way you walk to stay more comfortable, and you may end up overusing other muscles, leading to muscle fatigue and cramping
Tight shoes – tight shoes can restrict your foot’s natural movement and lead to cramps

Treating Cramps

As uncomfortable as it may feel, stretching or moving the affected muscles is your best bet to help relieve your cramp. If you’re getting cramps in your calves, and you have a staircase, stand with the front half of your feet on a step and your heels off the edge. Gently lower your heels so that they are below the level of the step. Hold for a few seconds and lift the heels back up. If you don’t have a staircase, sit with your legs straight out in front, place a towel around the balls of your feet and hang onto the towel on both ends with your hands; gently pull your toes toward you while keeping your knee straight. A hot cloth, wheat bag, or cold cloth or ice pack can help relax the muscle, and thereby help alleviate the cramp.

Cramps At Night

Three out of four cramps happen in the nighttime, often when you’re in bed or asleep. No definitive research has revealed precisely why leg cramps have a higher prevalence at night, but it’s thought that it could be related to the position our feet and legs are in while we sleep – with our toes and feet extended, which shortens the calf muscles. Other suggestions include muscle fatigue from exercise during the day or standing for long periods.

Preventing Leg Cramps

Regular stretching during the day, especially before and after exercise, is a good start towards preventing leg cramps or reducing the rate at which they occur. You’ll also want to address any suspected causes of your cramps, which may include:

Avoiding dehydration to help your muscles to function at their best
Maintaining optimal mineral levels. This is usually managed through a balanced diet. Improve your calcium, potassium and magnesium intake naturally by drinking milk and orange juice and eating bananas, black beans and leafy greens. Sodium is simply table salt, so sprinkle a little bit on your meal if you are not having enough already
Not exercising too hard to prevent overexertion and muscle fatigue
Treating any existing foot problems
Wearing well-fitting, comfortable shoes

Worried About Your Feet Or Legs?

If you’re concerned about your foot or leg health, our experienced podiatry team is here to help. We’re located on the border of Remuera and Newmarket, at the One Health building. Book your appointment by calling us on 09 523 2333 or click here.

Caring For Your Ingrown Toenails After Nail Surgery

If you’ve recently had an ingrown toenail surgery and are wondering how to optimise your recovery, here are some quick tips that we let our patients know about after their procedures.

Immediately after your procedure

Take the rest of your day off from work, school and any physical activity commitments. You want to kickstart the healing process and reduce the risk of continued bleeding
Keep your foot elevated as much as possible for the rest of the day
Use paracetamol if you need to manage pain, as opposed to ibuprofen, which can thin the blood
Don’t get your foot wet, shower with your foot completely waterproof, or wait until the next day to shower
Keep your foot clean, and don’t remove your dressing
Don’t drive on the day after your procedure
Don’t wear closed-in footwear on the day of your procedure

Within the first week of your procedure

Return within 2-3 days for your dressing change
After your redressing with us, redress your toe every 1-2 days, or anytime that your toe gets wet
Don’t remove or play with your dressing before your first dressing change
Don’t get your toe or dressing wet, if you do, let us know and we may get you in earlier to redress your toe
Avoid wearing tight shoes and socks that push on your toe
Avoid any activity that causes toe pain
Take time to elevate your foot where possible
Avoid any physical activities that involve kicking and direct impact to the toe

The first one to two weeks

Return for your one week check with us, where we’ll be able to check the status of your healing and debride if needed
At this stage, different people may be at different healing stages, so it’s important to listen to the advice of your podiatrist
Continue to redress your toe as instructed. We’ll let you know when you can switch the kind of dressing you use to one that is less rigorous
Be cautious during physical activity until your toe has healed sufficiently
Continue to avoid any activities that cause you pain
Wear open-toed shoes as much as possible to encourage healing
Let your podiatrist know if you are experiencing significant pain, or are worried about infection

After two weeks

At this stage, your toe should have healed sufficiently to not be bleeding or leaking any white or yellow fluid. This means that you should be able to continue with a simple dressing to cover the toe, as opposed to heavier absorbent dressings. Many people will now be able to return to regular physical activities and wearing regular shoes. We do not anticipate that you will be experiencing significant pain. If you do, continue to use paracetamol as directed. Depending on your health and other medical conditions, it can take anywhere from 2-8 weeks for complete healing. If you’re worried about your progress, give us a call.

How Can Orthotics Relieve Pain From My Foot?

Orthotics are one of the most common treatment methods we use with foot pain and injury, due to the fantastic results we can achieve with them. If you’re not very familiar with orthotics, you may wonder how orthotics can help with so many problems – and how they work.

Today, we’re talking about a very important feature of orthotics – their ability to offload pressure. While orthotics have a myriad of other features that help them achieve their desired function (i.e. to help you recover from your injury and get pain-free), we’re going to start bringing you into the world of orthotics right here.

What you must know about orthotics

Before we start, we must emphasise this about our orthotics. The orthotics that we prescribe for you are custom-made for your feet, your pain, your injury, and the individual characteristics of your feet. These are not the one-size-fits-all silicon inserts you grab from the pharmacy in the hopes that you’ll feel more comfortable. Your orthotics are designed and made for you, using decades of knowledge and experience.

This is why an item that is under the broad term of ‘orthotic’ can achieve so many effects for many different people – every pair is different. Much like prescription glasses, they can help with many problems. Also, like prescription glasses, there’s a big difference between the ones you pick up at the supermarket, and the ones you get from your optometrist.

Off-loading – what does it mean?

When we talk about ‘offloading pressure’, we mean removing the pressure that is being applied to an area of your foot that is causing you pain. For example, say that your big toe joint at the ball of your foot is swollen and painful. Anytime your foot hits the ground, that joint has pressure applied to it as you push against the ground and you feel pain. In fact, because the joint is swollen, it is probably taking on even more pressure than it was previously.

Off-loading would mean redistributing the pressure away from this big toe joint, and instead, spreading it evenly between the lesser joints of the ball of the foot. These non-painful joints then take on a little more pressure each, and the big toe joint is either partially or completely offloaded, letting it heal – while you experience significantly less pain with every step.

How does an orthotic off-load pressure?

The real answer is – any way we design and prescribe it to! There are many offloading features that we can incorporate into an orthotic. Taking the example above, we can do a cut-out specifically beneath the big toe joint and the area of pain and swelling. This removes the pressure directly beneath it, using a cushioning top layer on the orthotic to redistribute that pressure over the lesser four toe joints, while helping them absorb some of that impact. This way, these joints will be the ones ‘pushing off’ the ground, instead of the big toe joint, letting it heal.

Taking a different condition as another example, let’s say that you have a neuroma. A neuroma presents as a painful, palpable, pebble-like mass that can develop between your metatarsals (the long bones of your feet). It’s actually the inflammation of the lining of one of your nerves. When you walk, and your metatarsal bones squeeze on the neuroma, you feel pain. We can place a dome-like addition into your orthotic, that sits just behind the position of the neuroma. This will raise the bones on either side of the neuroma, effectively increasing the space between the bones (so they don’t squeeze the neuroma), while removing excess pressure from it while you walk.

How do I know what orthotic will help me best?

Well, truthfully – you don’t. There’s no one-size-fits-all, especially when you must consider how adding a certain feature to your orthotic will affect the other bones and joints in your feet, especially when you have other medical conditions and problems. But that’s where we come in! We perform a comprehensive assessment and get to know you and your history extensively before we prescribe your orthotics.

Then, we’ll design, create and fit your orthotics, monitoring you to ensure you are getting the results that we both want. If you need help with foot pain from an experienced podiatry team, book your appointment online here or call us on (09) 523 2333.