Are you struggling with back, foot or leg pain?
Podiatry can help improve agility and speed, as well as treating pain and discomfort and reducing injury risk.
Plantar Heel Pain
Plantar fasciitis is pain under the heel and sometimes under the arch. The pain is usually most severe post rest, especially with the first steps of the day. Risk factors include long periods of standing, an increase in exercise and obesity. It is usually associated with inward rolling of the foot (pronation). Heel spurs are frequently found on Xray but the correlation is unclear as they are also found in patients with no heel pain.
Katherine treats plantar fasciitis with orthotics, footwear (everyday and sports) advice, strassbourg sock therapy, Physiotherapy referral (to include hands on soft tissue massage and mobilisation) and stretching exercises. If this is not successful then referral for extracorporeal shockwave therapy and Surgical opinion is advised.
Heel pain is not always plantar fasciitis but a full assessment will reveal an accurate diagnosis.
Anterior ankle joint pain (front of ankle)
Pain at the front of the ankle can be ankle arthritis, a bony spur, or tendinopathy of the tendons responsible for lifting up the front of the foot. Podiatrists can treat this with heel raise orthotics which reduce pressure and muscle pull at the front of the ankle.
Sinus Tarsi symptoms (front of ankle and slightly to the outside)
Pain at this site is commonly linked to a flat foot and rolled inwards ankle. The tissues in the Sinus Tarsi become inflamed. This is resolved by using an orthotic to roll the foot onto its outside edge.
Achilles and posterior calf pain
Achilles Tendon pain can take months to resolve completely but we know the best way to treat it is usually with carefully administered strengthening exercises. If the Achilles is also attached to a very flat, leaning inwards, or very high arched foot then orthotics can help to straighten the tendon and reduce the necessary muscular pull during walking and running.
Tibialis Posterior Tendinopathy
The tendon responsible for holding up the long arch on the inside of the foot has to work too hard where the arch is flat or the ankle rolled in. Orthotics and strengthening exercises can relieve pain in the Tendon and help to prevent further damage.
Arch and Midfoot Pain
Midfoot joint pain (inner side of midfoot)
Osteoarthritic changes can occur in the medial midfoot joints at any age but more commonly in later life. This can be as a result of injury or foot posture and the pain is usually resolved with orthotic therapy and Physiotherapy. Referral to a specialist foot and ankle Orthopaedic surgeon is indicated when the pain is severe, present at rest or if orthotics and Physiotherapy aren't successful.
Cuboid syndrome (outer side of midfoot)
Pain on the outer edge of the middle of the foot can be related to the Cuboid bone and its surrounding structures. In the flexible foot; as the heel lifts the foot bends down in the middle and subluxes the Cuboid. Orthotics can stop this from happening, reduce pain and improve the propulsive power of the tendons in this area. In the very high arched foot, the Cuboid is too compressed and orthotics can improve shock attenuation and support the high arch.
Metatarsalgia, Neuromas, Plantar plate tears and stress fractures
Forefoot pain can be very debilitating at any age. There are multiple possible symptom diagnoses for the forefoot but with a common cause; usually the big toe joint isn't bending properly or taking enough weight and so the smaller Metatarsals have too much loading through them. All the above symptoms can be treated with orthotics in the first instance but occasionally referral onto the Orthopaedic team is necessary.