Hints & Tips

From injury prevention, demystifying modern footwear, running techniques & tips, how to improve mobility & restore function, to even help you overcome the Donald duck walk and get you engaging your core through barefoot activation! All that wisdom and more is shared on our Hints & Tips page!

Be sure to drop back to our Hints & Tips page as it will be updated on a regular basis.

The feet are a very complex part of the body, allowing you to perform essential daily activities as well as tackle inspiring physical achievements - so they should not be neglected! Our foot expert Hayley will work with you to address your goals, relieve pain, regain mobility and effectively treat your foot problems.

Do you have sore toes, bunions, or get heel pain when running? Are you wanting to learn more about footwear? Concerned about whether barefoot is good or bad? Interested in injury prevention and improving your performance? Reach out to our Townsville Podiatry team today!

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Psychological factors associated with foot and ankle pain

Foot and ankle pain is common in the community. Foot pain is estimated to have a prevalence between 13 and 36% and ankle pain has an approximate prevalence of 12%. Compared to other body regions, the foot/ankle is the third most common site of self-reported joint pain for adults aged over 55 years. The presence of foot and ankle pain is a risk factor for functional impairments such as: Locomotor disability Impaired balance Increased risk of falls Reduction or inability to do physical exercise Reduced health-related quality of life "Negative psychological constructs are greater in participants with foot and ankle pain compared to those without foot and ankle pain". Foot and ankle pain, however, is not only associated with increased risk of physical or functional impairments – but also negative emotional and cognitive factors were more common in people with foot/ankle pain compared to those without foot/ankle pain. Emotional factors such as depression, anxiety and general indicators of emotional distress are more common in people with persistent pain than in pain-free controls for a range of conditions (e.g., mixed, back, head, neck, fibromyalgia, arthritis). A significant association was also found between emotional distress with foot pain and foot function in some people with plantar heel pain. Foot and ankle pain is generally viewed through a biomedical lens rather than applying a biopsychosocial model. Health practitioners treating foot and ankle conditions should utilise a biopsychosocial model, which describes foot/ankle pain as a result of the interaction between biological, psychological and social factors. This model shifts the focus from the pathophysiological processes associated with pain and reinforces the influence of a person’s emotional state, cognitive processes, and subsequent behaviour on pain. [feature-block] Our experienced Podiatrists appreciate the psycho-social impact pain can have on your general wellbeing. Book Now [/feature-block] Psychological factors associated with foot and ankle pain: a mixed methods systematic review: Matthew Cotchett, Nicoletta Frescos, Glen A. Whittaker &  Daniel R. Bonanno 

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Heel Pain? There may be more involved than just the Plantar Fascia

Plantar Fasciitis is the most common cause of heel pain and also the most common condition presenting to our Townsville Podiatry clinic. With that being said, heel pain can be quite a complex condition that needs to be correctly diagnosed and treated specific to each person. Learn more about heel pain here. A more recent and appropriate term for heel pain is Plantar Heel Pain - pertaining to pain on the bottom of the heel. So this will often involve injury to the plantar fascia in either an inflammatory process (plantar fasciitis) or a degenerative process (plantar fasciosis). The plantar fat pad may become bruised, the plantar calcaneal bursae may be inflamed and irritated. A plantar spur may be contributing to symptoms. The calcaneus (heel bone) may have bone oedema. The posterior tibial nerve may be compressed (Tarsal tunnel syndrome) or a branch of the medial calcaneal nerve may be compressed (Baxter's neuropathy) both of which can refer pain into the heel. The plantar fascia may not even be involved. Often the longer the heel has been sore, more of the above issues come into play. Our experienced Podiatrists can refer for medical imaging (X-ray, Ultrasound or MRI) to assist with our diagnosis if required. Together with thorough questioning and a detailed assessment we can make an informed decision as to the most appropriate treatment plan for your heel pain. [feature-block] Take positive steps towards addressing your heel pain and get back to living a healthy, active lifestyle today!  Book Now [/feature-block]

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Shoes for Planet Earth

Here at Foundation Podiatry we love to do our bit for the planet. So we are continually stepping up our collection of used sports shoes! Why not give your runners a second lease of life instead of just sending them to the tip? We often like to remind you of why we recommend replacing your footwear regularly, especially if you're a runner. But that doesn't mean you need to chuck out the old ones - even if they aren't giving you the optimal support any more, they might still have some life in them. Through the wonderful organisation Shoes for Planet Earth  we are affiliated with two local organisations who pass on pre-loved sports shoes to those in need. Both Townsville Flexible Learning Centre and Townsville Women's Shelter have been so appreciative of our past donations. We are collecting joggers all year round. So if you're in a position to treat yourself to a new pair of joggers just drop the old ones off to our clinic and we will make sure they go to a good home.  Some basic guidelines for your donations: SPORTS SHOES only please. NO HOLES AND GOOD SOLES. We want to donate shoes that will last. CLEAN! They can be hand scrubbed or washed on a short cold cycle in the washing machine. Best dried in the sun stuffed with newspaper – no tumble trying please as it destroys the shoe. TIED TOGETHER in matching pairs so they are easy to keep together. SHOE LACES & INNER SOLES – yes please. THANK YOU for helping us to change the world one pair of shoes at a time!

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Should I exercise with heel pain?

Maintaining a physically active lifestyle is important to our health and wellbeing.  Heel pain can often limit the amount of physical activity we are doing.  But is safe to keep exercising with heel pain? In most cases, heel pain is due to the chronic degeneration of the plantar fascia which reduces our ability to tolerate loads (ie. the plantar fascia is not strong enough to handle the daily loads (work/daily activities/exercise) currently being placed on it).  General exercise and specific strengthening exercises can improve the load tolerance of the plantar fascia. Initially you may need to reduce activities such as running, walking and jumping activities if they are causing increased pain until you have improved your load tolerance.  Then you can gradually introduce these activities as your tolerance improves.  This is referred to as gradual progression.  It may also be necessary to avoid explosive activities such as fast walking or fast running (speed intervals, fartlek intervals, sprint sessions), running/walking up inclines, and plyometric activities like jumping, skipping, box jumps etc as these types of activities can generate higher loads, which may overload the plantar fascia. Monitoring your activity with a step counter (pedometer) or exercise diary can be helpful to make sure you aren’t progressing too quickly. If running or walking is causing too much pain, consider substituting for alternative forms of exercise such as bike riding, swimming, or weight training. If you have heel pain and are not currently walking or running for exercise, then adding that extra load would not be recommended until your load tolerance increases.

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Heel Pain - How Stretching, Mobility and Strengthening can help you

I’m sure many of you are aware how frustrating and uncomfortable plantar heel pain can be. It is one of the most common foot conditions we see here at Foundation Podiatry. Did you know that the faster you seek treatment, the better your outcomes tend to be?!  Delaying treatment for heel pain can result in: Longer healing times Greater involvement of other structures Poor mental health effects One of the treatment strategies at Foundation Podiatry that we can implement in all stages of management is stretching, mobility and strengthening exercises. Exercises for heel pain may include: Ankle mobilisation Calf stretches Trigger ball or foam roller to get into any tight areas Strength based activities to help build resilience and load tolerance To make sure we are selecting the right exercises for you its important that a thorough initial assessment is undertaken. During this assessment we are looking for any muscle tightness, mobility issues or weaknesses that may be contributing to increased load through the plantar fascia. This allows us to individualise your treatment plan to give you the best possible chance of recovery! By Emma Phelps | Biomechanical Podiatrist

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Plantar Fasciitis REVIEWED

Feet play an important role in posture and gait. Foot pathologies are common amongst the adult population, in particular plantar heel pain. Foot pathologies contribute to a negative impact on quality of life. Plantar heel pain (or Plantar Fasciitis) is a common musculoskeletal foot injury and the most common condition presenting to our Townsville Podiatry clinic. Below is a summary of a recent review of the research on plantar heel pain. Learn more about Plantar Fasciitis or Heel Pain here. Review of research on Plantar Fasciitis or Heel Pain Plantar heel pain is most common between 40 and 60 years and may affect both athletic and non-athletic populations, but the incidence is higher among runners (affecting 17.4% of running population). The pathology is characterized by pain in the medial (inside) heel that is exacerbated by weight-bearing activity, as well as after periods of rest. Plantar Heel Pain is often chronic with typical symptoms lasting more than a year. Despite the name “Plantar Fasciitis” – the condition is considered a degenerative pathology rather than a primary inflammatory condition. Therefore, the more correct terms which should be used from now on are fasciosis or fasiopathy or plantar heel pain. Authors found that while Body Mass Index (BMI) was not associated with plantar fasciitis in the athletic population, there was evidence to support such an association in the non-athletic population. Muscle function and muscle size differences between those with and without plantar fasciitis was reviewed in seven studies - and the strength of muscle groups including hallux plantar flexion, lesser toe plantar flexion, ankle dorsiflexion, ankle inversion, and ankle eversion was lower in patients with plantar fasciitis. Studies found that patients with plantar fasciitis were more likely to have increased plantar fascia thickness, hypoechogenicity, and plantar calcaneal spurs. Patients with plantar fasciitis had 2.16 mm thicker plantar fascia than controls and tended to have absolute plantar fascia thickness values exceeding 4.0 mm. Review of Treatments for Plantar Heel Pain Corticosteroid Injections: Corticosteroid injections have been used for the treatment of plantar fasciitis as it can reduce inflammation, fibroblast proliferation and ground substance proteins, which have been thought to play roles in pathogenesis of plantar fasciitis. The review of the literature concluded that compared to placebo, corticosteroid injection was more effective in relieving pain at one month but not over longer intervals. Among 21 trials that reported adverse events, two ruptures of plantar fascia, three injection site infections, and 27 minor adverse events such as post-injection pain were reported. ESWT Extra-Corpeal Shockwave Therapy: The proposed mechanisms for the effect of ESWT include increasing nerve supply, blood supply and collagen synthesis in degenerative tissues. Shockwave reportedly have benefits in pain reduction at 12 weeks, unlike corticosteroid injections. ESWT showed greater reduction in VAS pain scores and success rate of improving heel pain by 60% over placebo when taking first steps and during daily activities. The most recent of studies compared ESWT with other therapies and found greater success rate, greater reduction in VAS pain scores, decreased return to work time, greater overall reduction in plantar fascia thickness up to 6 months post-treatment and less complications in those treated with ESWT compared to other interventions. The 39 studies concluded that while there may be common side effects such as pain during treatment and transient erythema (redness), complications during the first year of follow-up are highly unlikely and concluded that Shockwave Therapy is safe for treating plantar fasciitis. Low-Level Laser Therapy (LLLT): LLLT is a form of photobiomodulation therapy that involves the use of wavelengths ranging from 620 nm to the infrared (820–904 nm) over the surface of patient’s skin. The proposed mechanisms include anti-inflammatory effect as well as stimulation of cell proliferation, microcirculation, vascular neoformation, and collagen production [85]. Fewer studies have been conducted on the efficacy of LLLT in the treatment of Plantar Fasciitis, however the systematic reviews that have been done found that LLLT significantly improved pain and function and decreased plantar fascia thickness compared to other therapies, such as exercise.  In Summary Regarding treatment efficacy for management of plantar fasciitis, outcomes using corticosteroid, PRP, and ESWT may have the largest number of studies and most reviews concluded longer-term outcomes favoured non-corticosteroid interventions. Similar to tendinopathy, plantar fasciitis has been characterized by degeneration of collagen even though inflammation may play an important role in the early disease process. However, this does not mean that inflammation and degeneration represent a continuum of disease but reflect two distinct or often coexisting processes. Therefore, corticosteroids may offer benefits in short term particularly within 1 month following treatment. By Hayley Paterson | Biomechanical Podiatrist A Systematic Review of Systematic Reviews on the Epidemiology, Evaluation, and Treatment of Plantar FasciitisHye Chang Rhim 1,† , Jangwon Kwon 2,†, Jewel Park 3, Joanne Borg-Stein 4,5 and Adam S. Tenforde 4,5,*

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