pain – Perform Podiatry

About to hit the slopes this winter? This is for you!

Winter is coming! Yep, after a long and hot summer, winter is now just around the corner and with it comes the opportunity to partake in all the best winter sports and activities. We’re not talking about Netball, but the much *chillier* winter sports – including skiing and snowboarding! These brilliant activities are enjoyed by many Aucklanders each year as we make the drive down to Mt. Ruapehu for the weekend or are even lucky enough to fly down to the South Island ski fields. With the fun and excitement, come the massive physical demands, especially on the legs and feet. That’s why we highly recommend having your feet and legs, as well as your ski or snowboarding boots assessed before starting the season so you can continue to feel your best throughout! Here are a few of the ways we can help you have a comfortable ski season:

We can check the size and fit of your boots

If you’re a skier or snowboarder, you’ll be very familiar with the effect that having a pressure point in the boot or ill-fitting boots will have on your feet, pain levels and comfort. When you bring your boots to us, we can check the fit of the boots in combination with any symptoms you’re having (if any), your foot posture, walking style (gait) and any signs of rubbing or a poor fit. We can then look for ways to improve the comfort in your boots, or if you’re after a new pair, let you know what you should be looking out for and feeling for when you’re buying them. Even if you’ve had your boots for years, as our feet can change over time with things like bunions developing or our arches flattening, this can make even your favourite and trusty pair of boots much less comfortable – so don’t be surprised if it feels different from one season to the next! We’re also one of the only podiatry practices in New Zealand with the expertise and facilities to make footwear modifications – though ski boots will need to be assessed on a case by case basis to assess their suitability for any modifications.

We make custom slimline orthotics that can fit comfortably inside your boots

We understand the extreme size constraints that come with ski and snowboard boots – we’ve felt them for many seasons ourselves! These boots struggle to fit regular orthotics without compromising the comfort and space available for your feet. We not only create slimline orthotics that do fit comfortably inside your boots but also make them specifically tailored for your feet to optimise the way you move and help you perform at your best when hitting the slopes. In order to create these custom orthotics, we…

Conduct a comprehensive biomechanical assessment of your feet and legs

This helps us to not only see exactly what’s going on with the movement and function of your feet and legs, but also see how this function is helping or impairing your performance and enjoyment on the slopes. During the assessment, we check your:

Muscle strength in the feet and legs
Muscle and tendon overuse
Available range of motion at your joints, especially any restrictions that are impacting the way your feet and legs move
Your foot posture
The way you walk (gait)
Structural abnormalities
Any areas of high pressure that are or may become problematic
Footwear

We use this to answer why are experiencing certain problems, as well as form a prescription for the right orthotics and other treatment modalities that will help solve your problem. Our team have had decades of experience in sports medicine, orthotic prescription and injury and pain management and prevention when it comes to a variety of sports. We’re proud to serve our local community and be recognised as leaders in the field of Podiatry in Auckland. We’d love to help you have the best winter season in 2018! If you have any questions or you’d like to book an appointment, you can give us a call on 09 523 2333 or book online.

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.

Why Do I Have Heel Pain, Again?

You’ve had heel pain before and were ecstatic when it finally went away. Weeks, or even months, of taking it easy, wearing the right shoes and orthotics, doing the right stretches and following the sound advice of your Podiatrist had paid off. You were able to hit the ground running, literally, without that gnawing pain, dull aches or any discomfort. Life was back to its happy, healthy self.

So what changed and why is the pain back?

Let us first assure you that pain doesn’t come back for no reason or without a cause. It’s also not a case of that it never healed in the first place. Your injury was indeed completely healed if you were able to resume life and daily activities without pain or symptoms. And it can be completely healed again.

However.

Just like how we can throw a ball through a window, repair the window, and throw a ball through it again, we can re-injure the same muscle, tendon, or ligament twice. But this time, there’s usually more to it. When you sustain an injury for the first time, there’s a good chance it could be an unfortunate wrong-time, wrong-place injury. You ran too fast for the ball, tripped over, and snap. Or you went for a 12-hour hike for the first time, something you’re likely never to do again, and your feet flared up from injury. In cases like these, and most accidents, as Podiatrists we look at managing your symptoms, relieving your pain, and helping you get better and heal as fast as possible. But when an injury re-occurs, that’s a red flag for us to further investigate whether there is something else, either intrinsic (to do with your bones, joints, muscles, tissues) or extrinsic (to do with your footwear, with a sport you play and factors outside of your body) that is causing or contributing to your injury.

Usually, there is a cause we can control

This is why it’s important for us to conduct a comprehensive biomechanical assessment. A biomechanical assessment looks at:

Your foot posture
Muscle strength
The range of motion through the joints of your feet
The way you walk (gait analysis)
Structural abnormalities
Footwear assessment
Various other tests depending on the findings

From this, we can deduce likely causes for your heel pain and tissue damage. If you have flat feet, wear footwear with relatively low support, occasionally run and get plantar fascial heel pain, it is likely that the repetitive strain on your fascia from running without support is causing damage and leading to pain. Or it could be that you’re getting the same pain at the back of your heel during soccer season again, when you’re training lots and wearing the same soccer boots that have a low-set heel. These boots will put greater strain on the insertion of your achilles tendon and paired with strenuous activity, can definitely overuse and damage your achilles tendon leading to heel pain.

Treating the cause, not just the symptoms

In these cases and so many more, it’s not just about treating your existing symptoms, but putting appropriate measures into place to stop the pain from coming back. This is one of our key focuses here at Perform Podiatry – preventing re-injury so it won’t keep bothering you in the future. We offer comprehensive biomechanical assessments from expert Podiatrists that specialise in Sports Medicine and Clinical Biomechanics. We’re proud to be trusted by hundreds of patients each month to help them feel great and perform at their best. We often use orthotics to control the movement of the feet and reduce the strain on otherwise overused and tired muscles. We also use strengthening techniques to get you back to your best. If your injuries keep coming back or you’re experiencing any issues with your feet or legs, give us a call on 09 523 2333 and one of our friendly team will be happy to answer any questions you may have!