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. 

Why Do My Feet Feel Like They’re Burning At Night?

Getting spontaneous waves of burning feelings in your feet?  Burning feet are keeping you awake at night?  It can be quite alarming to feel unusual sensations moving through your feet, especially when you can’t pinpoint a specific cause or trigger. This is a concern for many of our patients, who aside from feeling burning through their feet may also feel some tingling, numbness, pins and needles, sensitivity to cold, and other altered or heightened sensations.  Feelings of burning in the feet can affect anyone, but are most common in those over 50 years. The symptoms tend to worsen at night and ease during the day – though some symptoms get worse when walking. So what could be causing your feet to feel like they’re on fire at night? Here’s a look into the top causes seen by our Auckland podiatrists.

Nerve Damage From Diabetes

Diabetes can cause damage to the nerves in our feet – a condition called peripheral neuropathy. As our nerves are responsible for what we feel, when our nerves become damaged, they can send pain and burning signals to our brain – even when we’re far from any potential source of heat. You can learn more about how diabetes can affect your feet, and how to protect them, here.

Alcohol

Prolonged or excessive alcohol use can lead to a condition called alcoholic neuropathy. Damage to the peripheral nerves usually occurs first, due to the long distance the nerves need to travel from the spinal cord to the feet. It isn’t just the alcohol itself that can affect the nerves – malnutrition can develop as alcohol can impair the absorption of essential nutrients. Like diabetic neuropathy, a burning sensation is just one of many altered sensations that those affected can experience.

Medical Conditions

Certain medical conditions or circumstances can also affect the nerves, even just temporarily, and result in burning sensations. These include hypothyroidism, a vitamin deficiency, kidney disease, nerve diseases like Charcot Marie Tooth, arthritis, inflammatory diseases, blood disorders, dermatitis and skin sensitivities, heavy metal poisoning, blood vessel damage (including due to smoking), and many more. It’s also not uncommon to experience burning in the feet a few weeks after bariatric surgery due to malabsorption of vitamin B after the surgery.

Infections Or Injuries

Infections and injuries can lead to burning in the feet because of the associated inflammation and swelling that they produce. When swelling in the feet or lower leg presses against and compresses a surrounding nerve, it can cause a wide range of changes in sensation in the area – including burning. The same can occur if there are changes in the space between the bones where nerves run through, like the tarsal tunnel in the ankle. Interestingly, an Athlete’s foot fungal infection can also cause itching, tingling and burning in the feet. 

Morton’s Neuroma

Having a Morton’s neuroma means that the lining around the nerve that runs down between the long bones of your feet has become irritated and swollen – and is another potential source of burning. A good way to test for a neuroma is to squeeze your feet from the sides (from the inside and outside of the foot, not from the top and bottom). If this produces notable pain, and perhaps some shooting sensations or any tingling, it could be a neuroma. Don’t worry – just book an appointment with our team.

Peripheral Arterial Disease

Also referred to as peripheral vascular disease, this can be a cause of impaired blood flow that may also cause burning sensations as well as other sensation changes, which may be exacerbated by walking.

Sometimes, Further Testing Is Needed

If you feel like you can’t relate to any of the causes above, you may need further testing. Here, your podiatrist will look at any injuries or problems that may be affecting your nerves and producing your symptoms. If the pain is severe and unmanageable, we may refer you to a neurologist.

How Do I Stop My Feet From Burning?

Stopping or preventing burning sensations in the feet is done by addressing the underlying cause of the nerve irritation or damage. If it’s a specific medical condition, getting it under control, like taking thyroid medication for hypothyroidism can help manage and prevent burning in the feet. Where there’s an infection or an injury that is causing the nerve to be compressed, managing the problem through the various podiatric treatments we have available will help ease the symptoms. In some cases, like where the nerve damage is significant and permanent like it may be in diabetes, the focus must stay on preventing the symptoms from getting worse.  At home, you can may find the following to be helpful:
  • Ensuring your shoes are comfortable, supportive and not too tight
  • Soaking your feet in cold (not freezing) water for 15 minutes may give some temporary relief
  • Avoid exposing your feet to hot temperatures
  • Taking non-steroidal anti-inflammatory medications if your feet are inflamed or swollen

Get Started With Auckland’s Leading Podiatry Team

If you’re experiencing unusual sensations in your feet – whether it’s burning or something else – and you’re unsure where to start, come in and see our experienced podiatry team here in Remuera, Auckland. We’ll help you identify the cause of the changes you’re experiencing, and can refer you for further testing if needed. If the cause is an injury or foot problem, we’ll help you manage it using our world-class treatments and services. Book your appointment online by clicking here or call us on 09 523 2333

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.

Get Your Feet Ski Ready: Pre-Ski Skin & Nail Care

With a great deal of uncertainty about where we can and can’t travel this winter, there’s one place that many families are excited about heading to – their snow trip! While there’s a lot of information out there on how to best prepare your body for the ski season to help minimise your risk of injury – today we’re sharing one secret weapon our patients are loving that’s helping them to not only move better on the slopes but look and feel great too: pre-ski medical pedicures.

How do medical pedicures help prepare feet for the slopes?

There are a few common pains that our patients experience from the slopes that medical pedicures can help improve or prevent altogether – and the difference can make or break your ski experience. These include:

Trimming and thinning toenails

Bruised, bleeding toenails are something that many skiers and snowboarders have experienced – and often it’s from something as simple as leaving their toenails that little bit too long so they spend the day pushing against the ends or tops of the boots if they’re thick. It seems simple – but given the number of changes nails undergo with age, they can become extremely tough to cut, difficult to reach, and seemingly impossible to thin. By safely and effectively trimming toenails, reducing their thickness and smoothing them during your medical pedicure, you can avoid this bleeding and bruising – and the pain that goes with it. 

Removing corns

Corns are small, hard areas of callus that protrude into the foot and can feel like walking on small pebbles. They develop from areas of rubbing and friction in everyday life – often from shoes. They tend to appear on the heels, the ball of the foot, and around the toes.  When paired with tight ski or snowboarding boots, corns can become incredibly painful, and further rubbing against the corns can quickly make them worse. We’re able to remove corns entirely, leaving you without any pain or problems in your boots.

Reducing callus and cracked heels

Much like corns, callus develops in response to rubbing and pressure, but in larger areas on the surface of the skin. Callus can take up a lot of extra space in properly fitted boots, quickly making them uncomfortable. When callus builds up thickly and dries out, cracks can form, often in the heels. This can become very painful for snowboarders that spend half their time on their heels. If the cracks are deep, they can also crack the healthy skin beneath, causing bleeding.

Preventing itchy feet from Athlete’s foot

Ski boots create the perfect conditions for fungus to grow and thrive – they’re moist from the perspiration of your feet, enclosed and dark. These conditions can amp up your fungal infection and leave your feet feeling itchy and uncomfortable on the slopes. During your medical pedicure, we’ll provide you with information about your Athlete’s foot infection and team you with the right products to help manage it, so you can focus on your ski trip, not your itchy feet!

More than medical pedicures…

While medical pedicures are a favourite with our patients, there are more ways that we work with our patients to help them on the slopes, including: 
  • Checking the size and fit of your ski boots
  • Making custom slimline orthotics for your ski boots
  • Conducting comprehensive biomechanical assessments to improve your comfort and performance and minimise your pain on the slopes
Read how we help with all of these here.

Ready to have the best season yet?

If you’re planning to hit the slopes, we recommend booking your medical pedicure within three or so weeks before you leave. To make your appointment, call us on 09 523 2333 or book online here

5 Things That Are Causing Your Heel Pain

Heel pain sucks – and we hear this expressed with much pain and frustration daily from our patients. When your ability to walk is affected, it impacts your whole day and freedom to not just do the things you enjoy, but generally complete simple everyday tasks. Treating and relieving heel pain effectively starts with identifying the cause, then working to allow the injured structure to heel (and speeding up the process). Because there are many potential causes of heel pain, we thought we’d list the top 5 conditions/injuries that cause heel pain for our patients here at Perform Podiatry. Here we go:

Plantar Fasciitis

Plantar fasciitis is the biggie. We treat hundreds of patients each year with plantar fasciitis, which unfortunately develops in a lot of people when they’re on their feet, running around or have decided to get fit and exercise more. It describes damage to a fan-like fibrous band that attaches from the bottom of your heel to your toes, called the plantar fascia. It’s more common in those with flat feet. You’ll experience:
  • Pain at the bottom of the heel
  • Radiating aches up into the arch
  • Pain that is the worst with your first few steps in the morning, which then tends to ease
  • Pain when standing after resting

 Abductor Hallucis Tendinopathy

Abductor hallucis tendinopathy (AHT) is an injury to the abductor hallucis muscle, which runs from the bottom of your heel to the big toe. It follows a similar route to the plantar fascia (except that it doesn’t fan out), so is often misdiagnosed for plantar fasciitis. You’ll experience:
  • Aches or pain at the bottom or inside of your heel
  • Tenderness may radiate inside the arch
  • Pain that is the worst with your first few steps in the morning, which then tends to ease
  • Pain when standing after resting

Achilles Tendinopathy

Achilles tendinopathy is an injury to the Achilles tendon – a thick band that connects the calf muscles to the back of your heel bone. This tendon plays an important role in helping us walk. You’ll experience:
  • Pain, aches and tenderness at the back of the heel
  • Pain that can be worsened by physical activity, especially running
  • Tenderness that may radiate up the back of the leg
  • Stiffness at the back of the heel
  • Inflammation at the back of the heel

Sever’s Disease

Sever’s disease is a temporary condition that occurs when kids are growing quickly, especially between the ages of 8 and 15 years. It describes the irritation of a growth plate situated at the back of the heel. Growth plates are present in all growing bones and solidify once the bone has reached full maturity. When strain and forces from surrounding muscles and tissues pull on the area around the growth plate, damage to the growth plate occurs. Kids will experience:
  • Pain and tenderness at the back of the heel
  • Pain during and after physical activity
  • Both sharp pains and dull aches
  • Tightness in the muscles at the back of the legs
  • Potential swelling at the back of the heel

Heel Fractures

There are two types of fractures:
  • Stress fractures
  • Regular fractures
Regular fractures involve the break or crack of a bone. A stress fracture builds up from repetitive strain over time, resulting in tiny cracks through the bone, appearing like tree roots. Regardless of the cause, they both need good care to ensure proper healing. You’ll experience:
  • Sharp pain at the heel (regular fractures)
  • Dull, aching pain that can start very mildly (stress fracture)
  • Tenderness in the area of the heel
  • Difficulty putting the heel down and bearing weight (mild to severe)
Regardless of the diagnosis, the next step is to see your podiatrist so it can be thoroughly assessed and the best course of treatment can be started. The sooner you commence treatment, the sooner you’ll get back to feeling great on your feet again! If you’ve got heel pain and need it gone, you can give us a call on 09 523 2333 or book your appointment online here.