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Severs Disease

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What is Sever’s disease?

Sever’s disease is an acute injury to the growth plate at the back of the heel common in young athletes. It is most common between the ages of 10-12.

How does Sever’s disease occur?

The calf muscle has a common tendon (Achilles tendon) that inserts into the posterior aspect of the heel bone. The function of the Achilles tendon is to help transmit forces produced by the calf muscle to the heel bone. In children, there is a growth plate located where the Achilles tendon inserts into the heel bone. During periods of rapid growth the calf muscle and Achilles tendon becomes tighter causing excessive forces through the growth plate. Forcible and repeated contraction of the calf muscles (i.e. exercise) can injure the growth plate causing pain.

What are the symptoms of Sever’s disease?

Pain is experienced through the back of the heel where the Achilles tendon inserts into the heel bone and there is usually more pain during and after exercise. The back of the heel can be tender to touch and there may be some localised swelling.

What are the causes of Sever’s disease?

* Excessive tightness through the calf

* Weakness through the calf

* Poor foot biomechanics (excessive pronation)

* Over training

* Playing sport on hard surfaces

* Inadequate footwear

What are some treatment options your podiatrist can discuss with you?

* Rest

* Activity modification

* Icing

* Anti-inflammatory gel

* Foot taping

* Padding

* Heel raises (for short term relief)

* Soft tissue treatment (massage and stretching)

* Calf and Achilles strengthening

* Orthotic therapy

 

Wade, our Podiatrist, is available for consultations at Chevron Island Physio on Tuesdays. BOOK NOW

Illiotibial Band Friction Syndrome

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Definition
Pain and inflammation on the outside of the knee, where the iliotibial band (a muscle on the outside of the thigh) becomes tendinous, and results in a friction syndrome by rubbing against the femur (thigh bone) as it runs alongside the knee joint.

Symptoms:
Initially, a dull ache 1-2 kilometres into a run, with pain  remaining for the duration of the run. The pain disappears soon after stopping running. Pain is worse on running downhill, or on cambered surfaces. Pain may be present when walking up or down stairs.

Causes:
Anything that causes the leg to bend inwards, stretching the ITB against the femur.  For example over pronation (feet rotate too far inward on impact), tightness of the ITB muscle, lack of stretching of the ITB, incorrect or worn shoes, excessive hill running (especially downhills) and running on cambered surfaces.

Treatment of Illiotibial Band Friction Syndrome:

* Rest – activity should be limited to those which are unlikely to aggravate the injured site such as swimming and cycling.

*Ice – ice will help reduce inflammation in to the area and will also help to reduce pain involved with the injury.  Ice should be applied for 10 minutes 3 times per day for the first 72hrs or following
activity.

* Anti-inflammatory medication – will reduce the pain and inflammation associated with the injury and will speed up recovery. Anti-inflammatory medication can be purchased over the counter from your chemist (Neurofen).

* Strapping – helps to rest the injured site without limiting your activity.  Strapping is also used to temporarily correct any mechanical abnormality in foot function.  If strapping has reduced the
amount of heel pain then an orthotic can be uses as permanent measure.

* Stretching & Strengthening – stretching of the iliotibial band helps to relieve the tension on the iliotibial band, which will reduce the amount of discomfort.

* Orthotics –  used when there is a mechanical deformity in the bony structure of the foot (usually rolling in).  Orthotics balance the foot which allows it to function more efficiently.  This will in turn relieve the amount of force that travels through the iliotibial band.

* Physiotherapy – some cases of iliotibial band friction syndrome require physiotherapy treatment in order to fully recover.

* Surgery – is used when all of the above treatments have failed to relieve the pain.  This usually involves a cortisone injection into the ITB, or surgery to release the ITB may be indicated.

Recovery

Your recovery will depend your individual health.  If you are suffering with iliotibial band friction syndrome, it normally takes about 4 to 6 weeks for a healthy individual to recover.  This of
course depends on the duration the condition has been untreated for.
If you have any questions or require treatment we have highly qualified Podiatrists and Physiotherapists available for consultation.

 

Wade Ellis, Podiatrist

Diabetes and Your Feet

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What is diabetes?

Diabetes is characterized by uncontrolled raising and falling of blood sugar levels.  This is due to a lack of secretion or lack of sensitivity of the hormone that controls blood sugar levels (Insulin).

 

Types of Diabetes

There are two major types of diabetes;

  1. Insulin dependant diabetes melitis (IDDM) also called type 1.
  2. Non-insulin dependant diabetes melitis (NIDDM) also called type 2.

There is no such thing as “mild diabetes” only “well controlled diabetes” which involves regular checkups, self monitoring, exercise and a well planned diet.

 

What Causes Diabetes?

The body uses sugar from foods for energy. For this energy to enter the body’s cells where it can be used requires a key.  Insulin is this key that allows sugars to move form the blood into the cells.

If insufficient or ineffective insulin is produced and the doors into the cells are not unlocked your blood sugar levels will rise (diabetes).  This irregular rise in blood sugar level can be controlled by either;

  1. Injecting insulin (IDDM)
  2. Diet & exercise / Tablets (NIDDM)

 

Why Are Blood Sugar Levels Important?

When blood sugar levels are too low (<3mmol/l) the function of the brain in inhibited, which can cause fainting. When blood sugar levels are high (>8mmol/l) the sugar is toxic to bodily organs such as nerves, eyes, kidneys and arteries.

 

Tests For Blood Sugar Levels

You can monitor your blood glucose levels at home with a blood glucose meter.

Your doctor can order a test called a HbA1c which gives an indication of your blood sugar levels for the previous 3 months.

 

What Does Diabetes Have To Do With My Feet?

When high blood sugar affects nerves and blood vessels they lose their ability to function.  This leaves the person with nerve and blood vessel damage at a higher risk of foot trauma (they can’t feel it) and with a reduced capacity to deal with the foot trauma(the blood vessels can’t get blood to the area).

The statistics speak for themselves.  Foot problems are 2 times morel likely in people with diabetes.  50% of all cases of gangrene are seen in people with diabetes.

How Can I Prevent foot Problems?

  1. Wash and dry feet daily.
  2. Use Moisturizer on dry skin 1-2 times daily.  Cream with 10% urea is usually the best.
  3. Trim your toe nails straight across.
  4. Inspect your feet daily for injury or change.  Use a mirror if you have trouble getting down.  Have a podiatrist treat your corns and callus.
  5. Check shoes every time you put them on for sharp edges or foreign bodies
  6. Wear footwear whenever you are out of bed.

If you need any help with managing your foot problems, wade our Podiatrist is available for appointments on 5504 7000.

 

Achilles Tendonitis/Tendonopathy

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Achillies Tendonitis is an inflammation of the Achilles tendon. The Achilles is the large tendon connecting the two major calf muscles, the gastrocnemius and the soleus, to the back of the heel bone. Under too much stress, the tendon tightens and is forced to work too hard. This causes it to become inflamed (that is tendinitis) or degenerative (tendonopathy), and, over time, can produce a covering of scar tissue, which is less flexible than the tendon. If the inflamed Achilles continues to be stressed, it can tear or rupture.

Symptoms
Symptoms can include a dull or sharp pain anywhere along the back of the tendon, but usually 5cm above the heel. Limited ankle flexibility, redness or heat over the painful area are also common as well as a nodule (a lumpy build-up of scar tissue) that can be felt on the tendon or a cracking sound (scar tissue rubbing against tendon) with ankle movement.

Causes
• Runners who over pronate (feet that rotate too far inward on impact) are susceptible to Achilles tendinitis. Over pronation places an increased amount of stress on the tendon.
• Tight or fatigued calf muscles, which transfer the burden of running to the Achilles can also contribute to Achilles tendonitis. This can be due to poor stretching, rapidly increasing distance, or over-training with excessive hill running or speed work.
• Inflexible running shoes, which, in some cases, may force the Achilles to twist, can also contribute.

Treatment
• Rest – One way to reduce the symptoms of Achilles tendonitis is to avoid or modify those activities which aggravate the condition.
• Ice – Ice will help reduce inflammation in to the area and will also help to reduce pain involved with the injury. Ice should be applied for 10 minutes 3 times per day, or following activity.
• Foot Strapping – helps correct any mechanical abnormalities in your feet that will affect your lower limb function. If strapping has reduced the amount of pain then an orthotic may be used as permanent measure.
• Orthotics – used when there is a mechanical deformity in the bony structure of the foot (usually causes rolling in). Orthotics balance the foot which allows the foot to function more efficiently. Misalignment of the foot will also cause the leg to be misaligned. This will cause the muscles that help to slow pronation (the calf group) to be overworked.
• Physiotherapy- due to the chronic nature of Achilles tendonitis and the relative lack of blood supply to the region, Physiotherapy treatment is usually necessary to help regain flexibility to the calf group and to help to reduce pain and swelling.
• Stretching Strengthening – A specific exercise program stressing calf muscle stretching and strengthening may be necessary to speed recovery.
• Night Splints – used to stretch the calf muscle groups while you sleep. These are used if conventional stretching is ineffective.
• Modify Activity – Swimming is generally the most well tolerated fitness activity. In choosing a fitness program, one should use pain and swelling as a guide.
• Surgery – Used when all of the above treatments have failed. This usually involves scraping scar tissue off the tendon and is a last resort.

Recovery
Your recovery will depend on your individual health. Achilies tendonitis normally takes about 6 to 8 weeks for a healthy individual to recover. This of course depends on the duration the condition has been untreated for.

For any more information please contact Wade, our friendly podiatrist at Chevron Island Physio. 5504 7000.

Heel Pain / Heel Spur / Plantar Fasciitis

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heel spur
Heel pain is one of the most common conditions treated by podiatrists. Pain is often a message from the body that something is in need of medical attention.

Who Gets Heel Pain
The greatest incidence of heel pain is seen in middle-aged men and women. It is also seen in those who take part in regular sporting activities, those who are significantly overweight and those on their feet continually.

The Cause of Heel Pain
While heel pain has many causes, it is usually the result of faulty biomechanics (abnormalities in the way we walk). This creates too much stress on the heel bone and the soft tissues attached to it.

The stress may also result from injury, a bruise while walking, running or jumping on hard surfaces, wearing poorly constructed or old shoes or being significantly overweight.

Systemic diseases such as arthritis and diabetes can also contribute to heel pain.

Common Complications That Cause Heel Pain
Both heel pain and heel spurs are associated with degeneration of the long band of tissue that connects the heel and the ball of the foot (the plantar fascia). The role of the plantar fascia is to limit the flattening out of the foot. With excessive pronation (rolling in) the foot flattens, which strains the plantar fascia and leads to degeneration. Inflammation of this area is called plantar fasciitis.

Heel spurs are a bony growth under the heel bone. About 10% of people with heel spurs have no pain associated. Heel spurs result from strain of the muscles in the foot in much the same was as the plantar fascia is strained.

Other causes of heel pain

Excessive rolling in of the feet
An inflamed bursa (bursitis) small sack of fluid at the back of the heel
A neuroma (nerve growth)
Other soft tissue growths
Enlarged back of the heel bone
Bruises or stress fractures of the heel bone.

Treatment of Heel Pain

Rest – activity should be limited to those which are unlikely to aggravate the injured site such as swimming and cycling.

Heat – Heat will help the regeneration of the damaged tissue and will also help to reduce pain involved with the injury. Heat should be applied for 10 minutes 3 times per day for the first 72hrs. Ice can also be applied following activity.

Strapping – helps to rest the injured site without limiting your activity. Strapping is also used to temporarily correct any mechanical abnormality in foot function. If strapping has reduced the amount of heel pain then an orthotic can be used as permanent measure.

Stretching & Strengthening – stretching of the calf muscle group helps to relieve the tension on the plantar fascia in walking and at rest by allowing the foot to function properly.

Orthotics – used when there is a mechanical deformity in the bony structure of the foot (usually rolling in). Orthotics balance the foot which allows it to function more efficiently which relieves the strain on the plantar fascia.

Physiotherapy – some cases of heel pain require physiotherapy treatment.

Night Splints – used to stretch the calf muscle groups while you sleep. These are used if conventional stretching is ineffective.

Cortisone Injection – usually used in long standing cases of heel pain that have responded poorly to the above treatments

Surgery – is used when all of the above treatments have failed to relieve pain in the heel. This usually involves removing the plantar fascia from the heel bone.

Recovery
Your recovery will depend on the cause of your heel pain and your individual health. If you are suffering with heel spur or plantar fasciitis, it normally takes about 6 to 8 week weeks for a healthy individual to recover. This of course depends on the duration the condition has been untreated for. In a small number of cases conservative treatment of plantar fasciitis is unsuccessful and cortisone injections followed by surgery may be necessary.

For any more information please contact our clinic On 5504 7000.

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