foot pain – Perform Podiatry

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

Why Do My Feet Hurt In The Morning?

If you’ve been waking up with sore feet, heels or arches in the morning, this is for you. There’s a very specific kind of heel pain with the following three symptoms that you may relate to:

Pain at the bottom of the heel that radiates into the arch
Pain when standing up first thing in the morning, which tends to ease or go away as you take those first steps in the morning and stay walking
Pain in the heel or arch when you stand up after having a rest or sitting down during the day

The name of this heel pain is plantar fasciitis, and it’s the #1 most common cause of heel pain that we see here in Auckland. Today, our podiatrists have shared all about this heel pain, why it happens, and how you can get rid of it today.

Morning foot pain: Plantar fasciitis

We know – terms like plantar fasciitis can sound confusing, but this one isn’t. Simply put, you have a connective tissue at the bottom of your foot called a fascia. Because of its location, it’s called the plantar fascia, meaning the fascia at the sole of the foot. As there is some damage or inflammation to the tissue, it is called plantar fasciitis. What the plantar fascia actually is, is a thick band that runs from the bottom of your heel (where you’ll be feeling your pain) and spans out like a fan to connect into your toes. It supports your arch and works every time you take a step.

Why am I getting foot pain in the morning?

When this tissue is overloaded or strained, damage and pain occur. Specifically, the plantar fascia gets very small tears through its fibres. If the strain is high, it may even partially or completely tear. The reason behind the overloading and subsequent damage can vary greatly, and for our patients here in Auckland, tends to include:

Taking on more physical activity or training – like a fitness challenge or doing a very big day of physical activity like a hike
Foot biomechanics – the way the feet and legs function overloads the fascia when combined with other factors like a long day on the feet or poor footwear choices
Unsupportive footwear, especially ones that have a flat, firm base – this is often pronounced when you move from regularly wearing supportive shoes to wearing less supportive shoes
Hard surfaces – which affect many tradies at work
Specific activities that overuse the fascia like climbing stairs
Injury to the heel – like jumping down from a high surface, which injuries the fascia

I have been getting pain in the morning for a while. Will it last forever?

Absolutely not. Don’t worry – you will only continue to get pain while there is still damage to the fascia. Once we can help repair and heal the fascia, reducing the daily strain on it, the pain will also go and you can have your pain-free mornings back.

Will my morning foot pain go away on its own?

Not easily. The foot is a tricky area – unlike other parts of the body where you can immobilise it and just not use it for little while, you activate the fascia with every step you take, which may result in more damage occurring – or at least prevent it from getting better as it keeps getting irritated day after day. This is why plantar fasciitis should be professionally treated with the help of a podiatry team that have a strong focus on musculoskeletal injuries – like we do here.

How is plantar fasciitis heel pain treated?

Your treatment starts with a comprehensive assessment that looks at characteristics of your feet and legs, your gait, your injury and symptoms, evaluates the cause of the problem, and considers your lifestyle and goals. Here at Perform Podiatry, we don’t want you wasting time (and money) trying methods that aren’t effective. We focus on getting you the best clinical outcomes as fast as possible using evidence-based medicine, with superior long-term results. We start by alleviating your current painful symptoms and creating the right conditions for your fascia to heal. Next, we look at ways we can prevent your plantar fasciitis from returning in the future. Every treatment plan is different, but may include:

Custom foot orthotics – to support the arch and reduce tension off the plantar fascia so it can heal instead of continuing being strained with every step
Footwear check – to ensure your footwear isn’t contributing to your ongoing pain and inadvertently delaying your recovery
Strapping or bracing as needed
Strengthening weak muscles that may have contributed to the development of your heel pain
Stretching tight muscles – not only to help stretch the fascia to reduce pain (where appropriate) but to also stretch other muscle groups that may have contributed to your heel pain, which often happens with tight calf muscles
Dry needling – to release or activate trigger points to relieve pain or improve range of motion. This is usually done in the calf region

There are other causes of foot pain too

While plantar fasciitis is our #1 cause of morning foot pain, other conditions can create similar symptoms. This is why having a diagnosis is important – in our assessments we rule out other causes of heel pain like Abductor hallucis tendinopathy, fat pad syndrome and calcaneal stress fractures, to name a few. Once your diagnosis is confirmed, we will proceed with your care.

Proud to be trusted by thousands of people with foot pain every year

Our podiatry team here in Remuera is proud to be trusted by thousands with their foot and leg pain every year. If you’re waking up with foot pain, or it’s going all day, we’re here to help. Book your appointment online with us here or call us on 09 523 2333.

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.

Here’s Why Being Pregnant Made Your Feet Bigger

It’s not a myth. Pregnancy really can and does make women go up in shoe size, and unfortunately, for some women, their feet stay bigger too. This phenomenon can be confusing, after all, why can your foot size increase when you’re pregnant but not when you put on weight? Today, we’re sharing exactly why.

A hormone called ‘Relaxin’

When you’re pregnant, your body is flooded with a number of different hormones. One of these is called relaxin, and it’s responsible for helping to soften and loosen your ligaments and tissues. This is essential as your body is constantly growing and expanding to accommodate your growing baby. Without softer ligaments, this process could be very painful.

Aside from helping the ligaments and tissues in your abdominal area expand, it also affects your feet, as well as the rest of your body. You have a lot of ligaments in your feet that are responsible for keeping bones stable, held in position, and supported. As these loosen, your foot may ‘relax’ and flatten – especially with the increased weight and pressure they’re under. This can result in both an increased width and length of the foot, as well as a generally ‘flatter’ foot.

This is why your feet generally do not increase in size with weight gain (unless there are other factors involved), but do in pregnancy.

Can I prevent my feet from changing size?

Unfortunately, there’s not a lot you can do to prevent hormones from flooding your body and having this effect. What you can do is keep your feet supported throughout your pregnancy. This includes:

Wearing comfortable, stable and supportive footwear
Using custom orthotics to support and promote the natural shape and contours of your feet

By keeping your arch supported, you can help limit the stretching of the ligaments on the feet. Having your feet supported with shoe and orthotics can also help prevent overuse injuries from muscles and tendons of the feet and legs having to work harder to keep you moving with a flatter foot position.

Your shoes will also help restore some stability that may be lost with looser ligaments. A good example is ankle sprains – with the ligaments supporting your ankle not being as ‘firm’ as they originally were, you may have a higher risk of ankle sprains. Wearing good, supportive shoes that cup the ankle can help prevent this.

Wear the right size shoes

If your feet have gone up in size and width, make sure you get shoes that fit your new size and don’t try to squeeze into your previous pairs. Trust us, as parents ourselves, the last thing you want with a new baby is foot pain. Invest in new comfortable shoes to limit any rubbing against the sides of your feet, and pressing up against the front of your toes.

Returning back to your original foot size

While some people will return back to their original foot size, others won’t. It’s hard to predict – and even harder to control. Our best advice is to keep your feet supported and protected throughout your pregnancy.

Need help staying comfortable on your feet?

Our experienced podiatry team would love to help. We’re parents too – so we totally get it. You can book your appointment online by clicking here or call us on (09) 523 2333