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Lets heal heel pain

heel pain

Heel pain can be very distressing and can stop you enjoying life or taking part in active pursuits. Here are some recommended at home tips from us and lets heal heel pain.

What can you do to help yourself

  1. Footwear review/change – wear footwear that is suited for the activity you are doing and be mindful to choose footwear that supports the length, breadth and form of the foot. Footwear that has inbuild support under the arch is good and with fastenings that can be adjusted such as laces. 
  2. Icing the heel 3 times a day can be beneficial as an analgesic. Although most heel conditions are not due to inflammatory causes so icing is used as a therapy to reduce swelling.
  3. Wearing an orthotic with a supportive heel cup and supportive heel cushion may be beneficial.
  4. Simple stretching programmes – calf muscles and the big toe complex.
  5. Taping the heel.
  6. Modify activity to reduce load onto heel or change to non weight bearing activities – cycling/swimming.
  7. Weight loss.

Not easing? Lets get professional help and lets heal heel pain.

What is a podiatrist?

A podiatrist is an expert in the lower limb, especially the foot and ankle. They are degree trained and can diagnose, treat and improve pain, form and function.

A podiatrist is to feet what a dentist is to teeth

What can a podiatrist do for heel pain

Podiatrists can clinically diagnose the structures involved with the heel pain, and if necessary facilitate further diagnostic tests.

They can build a treatment plan with patients which would typically involve taping, stretching and strengthening exercises, orthotics, shockwave therapy, steroid injection therapy, night splints.

Make Your Appointment Today

To book your appointment with Zest Podiatry & Physio book online, call us or contact us for further details.

Online Booking  Contact us

What is heel pain?

Are you or someone you know suffering with heel pain? Scared to take that first step in the morning or has it stopped you from enjoying walking and sports.

If you have heel pain you are in the company of many people who have foot pain, accounting for many visits to healthcare professionals – including podiatrists, physios and GPs. It is the most common foot disorder encountered by podiatrists (college of podiatry).

Who gets heel pain

Young children can get heel pain especially those who are active and sporty. Adults who enjoy running and high impact sports can get heel pain. Adults whose occupations require them to be on their feet for long periods are susceptible. As we age, the soft tissue within the heel can degenerate leading to heel pain.

What is the structure within the heel that can be injured

The heel consists of bone (calcaneus) and soft tissue structures that attach to the bone including tendons, fascia, ligament.

The foot is a key structure for walking and running and whilst it is very well designed to withstand such load, it can suffer from over -use, overload or degeneration. 

Causes of heel pain or injury

Degeneration of the soft tissue is the most common cause and in particular, Plantar heel Pain syndrome PHPS (commonly known as Plantar Fasciitis) especially amongst runners and those who stand for long periods at work.

Are you a runner?

PHPS is a degenerative condition rather than an inflammatory condition, and affects 10% of the population and 15% of all foot related complaints being seen by medical staff. 10% of all runners experience plantar pain and most common in those who run long distances.

Some of the common conditions include

  • PHPS
  • Baxter’s Nerve
  • Heel spur
  • Tarsal Tunnel Syndrome
  • Fat Pad Contusion
  • Distal Tear
  • Tibialis Posterior Dysfunction

How can we help

Treatment from a podiatrist will be tailor-made for each patient but likely to include advice, taping, stretching and strengthening exercises, orthotics, shockwave therapy, steroid injection therapy, night splints.

Make Your Appointment Today

To book your appointment with Zest Podiatry & Physio book online, call us or contact us for further details.

Online Booking  Contact us

Have you seen our new online runners section?

online runners section

At Zest Podiatry & Physio we hall have a keen interested in running. We have decided to make 2021 a focus in the clinic for runners. Launched in January 2021 our new online runners section will continue to grow through the year. As of January we have the following information.

Online runners section includes:

1. Are you thinking about running?

There are many reasons why you would choose running as your activity.

  • Running can be done anywhere.
  • it burns more calories than any other mainstream exercise.
  • It is free.
  • Go to section Thinking about running?

2. The health benefits from running in our online runners section.

Health benefits of running include reducing your risk of heart disease and stroke, boosting self-esteem and reducing your risk of Alzheimer’s disease. It can help you to live longer and healthier. There are huge benefits on the mind, body and lifestyle, find out more at Health Benefits.

3. Remaining motivated.

It is easy to have an initial boost of energy when taking up a new activity or during certain times of the year such as January. Below are a few ways to maintain your motivation, read How do I remain motivated?

  • Set yourself a goal, based on emotion
  • Make it a habit
  • Join a club
  • Keep a diary

4. Help, I’m a new runner.

What do you really need as a a runner, how to get started, and how to enjoy it.  I’m new to running, what do I need?

5. Tell me more about Run3D

Run3D helps you move better. It can reduce injuries, assist you to run faster and feel better with its 3D Gait analysis. Click here to see how it can help you Run3D.

6. Lastly in our online runners section is a first description of a local marathon

The first in our section on marathons is the Abingdon marathon, based in South Oxfordshire.  The course is mainly flat, great for first-time marathoners, and those chasing personal bests. As a business supporter of this marathon we felt it appropriate to start here.

Runners Section  Contact us Online Booking

online runners section study References:

Keep Exercising

keep exercising

As we get further into the start of 2020 we are often still thinking about turning over a new leaf or are just struggling to keep exercising. Should you wish to get healthier, shed a few pounds, need motivation or just want to improve your running we can certainly help you.

Our experienced msk team can advise you where you may potentially have weaknesses or asymmetries in your walking/running that could lead to potential injury. We are also able to use our Run3d gait analysis providing fantastic reports and guidance. Linking with our local sports shops (below), physiotherapists, and other health professionals we will put together a package for you. This package will get you to be where you want to be, whether limping or running your first sub- 20 minute 5K or just be able to get around the supermarket without in pain we can help you.

Running Events

We now starting the countdown towards some pretty major sporting and running events. One of the most participated in but also the most challenging of events is the London Marathon. Those running will be starting to increase their mileage over the next few months to be ready for the event on 26 April. As the mileage increases so does the impact upon your body so we will often advise runners who are starting to get some small levels of discomfort to get it checked out sooner rather than later. A small change to running style or footwear can make a big difference between something becoming mildly uncomfortable to becoming a full-blown injury that can put your place in your big race at doubt. A great local marathon is the Abingdon Marathon, which takes place in October.

Training Concerns

Should you be starting to get any little aches and pains beyond what you would normally expect them would certainly advise that you check out a few things. At Zest Podiatry we want to help you, to keep exercising.

Trainers

First of all check out your running shoes. Make sure they are giving you enough cushioning and support and are not looking worn out. If they are starting look a little bit worse for wear it may be a good time to start breaking in a new set. You’re unsure what sort of footwear you should be going for then we have a simple set of answers for you.

  • Comfort is key. You have to cover a lot of miles on your feet in trainers so something that is feeling a bit uncomfortable at mile two may be unbearably uncomfortable at mile 18 to make sure that you are happy with the shoes that you are running in.
  • Once you have got the shoe that you like and you are comfortable in would certainly recommend getting hold of 2 to 3 pairs if you are looking to wear them for your big event. The mileage that you are doing is to increase to over the next couple of months is certainly going to place incredible strain not only in your body, but also in your shoes. Last thing want to be doing in 2 to 3 weeks before your main event is having to look around for a new set of shoes because your other ones have become so worn they are not giving you the cushioning you need. We know how important it is to keep exercising when you are mid training.
  • The right shoe for the right job.With most events like the London Marathon being a road race we would certainly say look towards a set of good quality road running trainers for this. However should you be looking to complete your event on uneven surfaces you should certainly wear a slightly more structured supportive shoe like a trail shoe for this. This may mean that you have a set of trail shoes for your off-road runs as a road shoes that you’re looking to run in day-to-day but also for the main event.

Socks

  • If you buy shoes, buy socks. Good running socks at the singularly most undervalued bit of sporting equipment. We certainly recommend spending as much as you can on these.

Running Shops

Any good running shop can help you. We are fortunate to have great links and can recommend our friends in Oxford Up & Running, Fit to Run near Abingdon and Abingdon Sports in Abingdon town centre, all will be able to help you. They will be able to give you some good advice regarding footwear and socks to be used with the shoes.

If you have any doubts talk to the professionals like us at Zest Podiatry, we will help you keep exercising!

Start Exercising Today

walking

The festive period has long finished, the chocolates and shortbread biscuits are all eaten (well done!) and the plan of New Year resolutions is a distance past, fear not. Start exercising today, but not too much or too quickly as injuries can occur.

Start exercising slowly

When you are not used to exercising the challenges of a sudden increase in the level of activity can lead to injury which ultimately can dampen our aspirations, put them on hold but often knocks them dead in their tracks.

Tips to help you exercise

Activity

  • Should you start exercising and get a niggle or an injury as you increase your distance then it would be a good idea to get this checked out. We suggest that you speak to the professionals relating to the area of the body where you are having a problem. It is in your lower limb particularly your foot ankle or shin that it would be advantageous to come and see the team at Zest Podiatry for an MSK assessment. A quick check over can put your mind at ease or give you the information you need to manage or cure your discomfort. 
  • Start out slow. If you’re looking to start running easiest thing to do is to try a few brisk walks for 30 minutes or so each day for gradually increasing into a jog. Ramblers have a great website if you want to walk with others. If this is the first time you have taken up running would certainly advise you to do a little work on your core strength and stability which is very important when you are starting activity. Something like yoga, Pilates, or tai chi, can be a good start.

Footwear & hosiery

  • Pick the right shoes for the right job. You are looking to start running decide which surfaces you’re going to run on. The majority of training shoes are designed for road running however should you live in the countryside be wanting to go across uneven surfaces something like a trail shoe may be more advantageous in giving you more grip and support. You can also use trail shoes on the road so there is any doubt and always choose for the most rugged surface you plan to run on.
  • Ignore all the hype surrounding footwear. Shoes are important, don’t get me wrong, but sometimes we can get over focused upon brands, styles, and how much support the foot is likely to need. Don’t be taken into all of the gimmicks that are surrounding structures, motion control, anti-pronation, barefoot running style shoes. The bottom line is go to someone who knows what they’re doing and can give you impartial advice based on evidence. A good quality running shoe does not have to cost the earth and if you’re going to pick on one thing make it comfort, pick the shoe that feels the best.
  • Never underestimate the power of a good pair of socks. Socks that we choose to run in are almost as important as the shoes. Poor quality socks can cause rubs and blisters and prevent you getting out and about. Would certainly recommend that you buy 3 to 4 pairs of decent running socks although this will be potentially quite expensive as they can been nearly £10 a pair they will be the best £10 you’ve ever spent if you progress further in your running.

If you find that you are just not progressing as you would like to perhaps it would be a good idea to get some professional advice and some high quality gait analysis (run3D) and see how you can improve.. It is our job to keep you on your feet. So why wait till it hurts.

Run3D Post

gait lab

As a wise man once said there is gait analysis then there is Gait Analysis. Run3D is the latter.

Most running shops will offer a look at you running on the treadmill to help you choose you running shoes. But if you have a persistent injury or niggle that is not settling, or you would just like to improve your performance Run3D is for you.

Our MSK team at Zest can help with both runners and walkers to look at your control of your lower limbs and help you be your best or get you back out there doing what you love.

Run3D works by placing a series of markers on your legs and feet in very much the same way CGI characters in films are created in the studio. These markers allow us to plot your legs and joints in time and space using special cameras giving us a model of your walking or running. From this we can see where things are working well, or indeed not so well, and help you put things right.

Following the Run3D assessment we will create a custom report for you giving you all the information you need as well as an exercise plan or recommendations on how to improve your movement. From this we can work with you possibly providing orthoses, if indicated, to get you back to being your best.

Read our article .. It’s all about MSK

Sever’s disease/Calcaneal apophysitis

Calcaneal apophysitis

This condition is also known after doctor who first identified it in 1912 It was called Sever’s disease which does sound rather scary. It is the most common cause of heel pain in children. Podiatrists regularly treat these common injuries when they affect a foot or ankle, at Zest we would recommend our MSK lead.

Symptoms of calcaneal apophysitis

In all growing children there are areas on the bone that are made up of special cells from which the bone will grow. These are called your growth plates or apophysis. The growth plate on the back of the heel bone (calcaneus) is situated where the Achilles tendon connects to it. Bones in children tend to grow quite quickly in comparison to other structures particularly tendons.

As parents can testify when their child goes through a growth spurt can be very quickly over a few weeks. These growth spurts are most prevalent between the ages of 9 and 11 which is the most common time to get calcaneal apophysitis and at the start of a new sporting season.

The shin bone (tibia) starts to grow but unfortunately the Achilles tendon, which does not have as good blood supply as the bone, cannot grow or stretch at the same rate. This means that the Achilles tendon becomes tighter and as they move it pulls with more and more force on the growth plate at the back of the heel bone causing the growth plate to become irritated.

Treatment

If left calcaneal apophysitis will eventually get better by itself within 2 to 4 weeks. But it can become very painful and last longer in which case your podiatrist can help. If the child is not in too much pain they can continue with their activities and use ice regularly on the area to relieve pain. In some cases, a heel raise, or orthosis will help and often stretches are used to help settle the condition more quickly.

The most important thing is to keep the child is comfortable as possible while this condition resolves. We often recommend daily use of trainers or walking shoes until the pain settles. Recurrence of calcaneal apophysitis is not uncommon with each growth spurt but should this occur your podiatrist will tell you how to deal with it. This same sort of condition occurs in other areas of the foot such as at the base of the fifth metatarsal where it is known as Iselin’s disease.

Lateral ankle sprain Post

lateral ankle sprain

Lateral ankle sprain is one of the most re-occurring injuries in sports. Often the first instance of injury is as a child with a twisted ankle that causes damage to the ligaments around the outside of the ankle. This means that the outside of the ankle has reduced ability and as you start increase your activities this instability becomes more pronounced.

The most common ligaments damaged in the ankle is known as the Anterior Talo-Fibular Ligament or ATFL for short. Its job is to prevent the foot sliding forward too much at the ankle during activity. Ultrasound is used as part of the clinical diagnosis in all of our MSK treatments.

Sprains of the ankle are often characterised into three grades with grade 1 being a stretching of the fibres of the ligament. Grade 2 being rupture of some of the ligament and grade 3 being total rupture of the ligament. The reason why it is the most re-occurring injury in sport is that is often not treated correctly at the time of injury. Unfortunately, once damaged the ligament rarely repairs.

Once you have recovered from the initial injury can often rear its head again through repeated minor strains or increase in pain around the outer part of the ankle on different activities. Sometimes this can occur during a change in activity or even something as simple as walking over an uneven surface.

Treatment of lateral ankle sprain

Treatment of lateral ankle sprain often involves using a strapping or ankle brace to prevent further injury but also initiating a rehabilitation/strengthening or exercise plan to help get the muscles around the ankle to do the job the ligament would have done.

Orthoses or insoles can always be used to help reduce the chance of re-injury. In severe cases, where the ligament is badly damaged but intact, we may need to use an ankle brace and/or orthoses long-term, in these cases injection therapy can also be used to help make the area pain-free to allow appropriate rehabilitation.

Achilles Tendinitis Post

achilles tendonitis

The Achilles tendon is the tendon that connects the calf muscles to the back of the heel bone. It is a key tendon in providing movement and power on walking. On occasions it can become irritated or thickened as a result of trauma or overuse, causing Achilles Tendinitis. Often changes in heel height of shoes, from high to low, can also create this irritation. During this irritation the Achilles tendon becomes thickened, stiff and painful, particularly on movement after sitting.

It is important to keep the tissues of the tendon moving so rest id not usually recommended unless in high levels of pain. Your podiatrist will be able to examine the area to determine if there is any tearing of the tendon a period of rest or possibly surgery may be required. This can be done using ultrasound imaging that is available in the clinic

Achilles Tendinitis treatment

Once the integrity of the tendon has been determined the podiatrist can then start you on your treatment plan.

This will usually involve stretches and strengthening of the tendon and the calf muscles themselves. In order to help you with this your podiatrist may recommend that we use orthoses to help distribute the stress and strain through the tendon evenly or occasionally strapping to allow you to continue to be active.

In cases of extreme inflammation may be indicated to perform injection therapy. This usually involves a period of immobilisation cast boot.

Given that the Achilles tendon does not have a great blood supply compared to muscles it can take some time to fully recover from injury.

Interdigital neuroma

ball of the foot

Interdigital neuroma

More commonly called Morton’s neuroma people often describe a feeling of like having a stone in their shoe or that their sock is wrinkled up under the foot. They can get pain and numbness with tingling or burning sensation occurring in the toes or cross the ball of the foot. Shooting pains can occur in extreme cases. The pain is more noticeable on walking or in wearing particularly tight or closed in shoes.

An interdigital neuroma is an irritation of the nerve that runs to the toes in between the long metatarsal bones of the foot. For instance whilst walking or where footwear issues are particularly tight the nerve can get pinched. After that the nerve becomes enlarged due to this repeated compressed by the bones of the foot. The condition can occur gradually over time getting worse and worse and causing more pain and discomfort.

Treatment

Your podiatrist will be able to examine the area and using some diagnostic tests therefore being able to tell you whether a neuroma is suspected. The specialist podiatrist here at Zest will often use a diagnostic ultrasound scan to identify the site and size of the enlarged nerve.

Treatment options include

  • footwear changes into wide deep shoes with a lace or strap
  • insoles to help widen the space in between the bones of the foot
  • ultrasound guided corticosteroid injection to help reduce the size of the nerve

The guided injection is by far the most successful treatment for this. In addition and in extreme cases the neuroma may have to be removed by surgical team.

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