leg 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

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.

A slight difference in leg length – does it really matter?

A lot of us have heard that it’s not uncommon to have a slight difference in the size of our feet or even legs. We often advise patients to buy shoes to the size of the larger foot so that toes don’t get cramped and cause pain. But when it comes to having a slight difference in the length of the legs, does it make any difference or have any effect on the body? Let’s start with the basics about limb length discrepancies.

What effect does a leg length difference have on a person?

For some, having a small difference in leg length won’t cause any problems, and they may not even be aware of the problem. For others, it can cause painful symptoms, alter their gait pattern (the way they walk), contribute to the development of other complications and negatively impact their quality of life. The extent of the effect largely depends on the measurable difference between the two legs and how the body is functioning (or not functioning) to compensate for the difference.

What causes a difference in leg length?

Differences may be caused by:

Growth abnormalities
Bone injury that results in healing in a shortened position (like a break or a fracture)
Damage to the growth plate during childhood
Bone disease and infection
Neurological conditions
Inflammatory conditions affecting the joints (like arthritis)
Abnormal foot biomechanics
Tightness and contractures of tissues
Ligament laxity and weakness

You’ll notice that some of the above are talking only about muscles and tissues and not the bones – don’t worry, we haven’t made a mistake! This is because differences in leg lengths can have either a structural or a functional cause. Structural differences describe a difference in the bone length of the thigh bone or the shin bone. This can result in a tilt of the hips and affect various joints and bones throughout the feet and legs, as well as the spine. Functional differences describe an observed length difference when standing because of biomechanical issues involving the way the muscles, connective tissues and jones function together. These occur even if the bone length of the shin bone and thigh none are identical. This is often due to muscular contracture, particularly at the hips, as well as ligament laxity or tendon dysfunction that affects one foot more than the other.

What are the symptoms?

Symptoms can vary greatly depending on the extent of the difference and the resulting misalignment of the lower limbs. This position of the bones, joints, muscles and connective tissues will determine what structures are overloaded, stressed, stretched and limited in the way they move. Because of this, it is difficult to pinpoint precise symptoms, but may include:

Altered gait pattern such as limping
Shorter steps on the affected leg
Slower walking speed
Uneven loading and pressure distribution between the legs
Stress fractures
Muscular strain and tendinopathies
Hip pain
Knee pain
Back pain

What should you do?

The first step is to get your leg length difference professionally assessed by your Podiatrist. We measure both structural and functional differences and ensure to get to the root of the problem and can address any factors playing a role in the difference to get the best results for you both now and into the future. After determining the presence or absence of a difference and its extent, we’ll be able to formulate the best treatment plan for you, your age, your symptoms and the risk of future problems. This may include: Orthotics to help correct any functional abnormalities and help bring the limbs into alignment with one another Footwear modification, such as building up one shoe to bring the joints of the lower limbs into alignment Stretching and strengthening tight or weakened muscles to help improve biomechanical function If the case that the difference is severe and cannot be managed conservatively, surgical correction may be required – though this is much less common so don’t worry and just start with getting it checked out, so we all know what we’re dealing with. Either way, our expert team at Perform Podiatry will be right alongside you every step of the way! We specialise in clinical biomechanics and restoring great foot function and health. For more information or to book in, give our team a call on 09 523 2333 or visit us at the One Health building in Remuera, just up from Broadway, Newmarket.