For a large proportion of us, exercise is a crucial part of our lives and shapes who we are. Any niggle or injury that prevents us from being able to move and function day to day, can have a detrimental impact on our mental health, especially in COVID-19 circumstances where we are very restricted in where we can go and what we can do.

During the course of COVID-19, we have seen an influx in achilles tendon injuries as a result of tendon overload. This includes; working from home with no shoes on, less incidental movement throughout the day, sudden increases in walking and running and the change in surface from running on a treadmill to running outside.

The prolonged closure of gyms, rehabilitation centres and workplaces has meant that there is not as much exercise variety and people are substituting their normal routine for walking and running, as a way of getting out of the house. This has meant a loss of cross training in the form of swimming, gym workouts, pilates, yoga and fitness classes.

What is the achilles tendon and why is it so crucial?

The achilles tendon is a strong fibrous structure that connects the calf muscle to your calcaneus (heel bone). The function of the achilles tendon in walking and running involves plantarflexion of the foot which is crucial for the push off phase of gait when we are walking and running. The achilles tendon is vital in storing and releasing energy and has to withhold heavy loads of up to 6-7 times your body weight when running.

Why would I be experiencing pain?

Tendons are irritable structures that do not respond well to repetitive load with a lack of rest, inconsistency in training and sudden changes in training regime.
Achilles tendon pain can manifest in many different levels of pain and various stages from an early inflammatory stage to a prolonged chronic stage where the structure has calcified.

The most common precursor of tendon pain is when the load (walking, running or any given sport) exceeds the capacity and strength of the tissues, therefore resulting in an injury to this structure.

Other common causative factors of achilles tendon pain include:

  • An increase or change in your activity
  • Weak calves
  • Restriction in the ankle joint
  • Inefficient foot mechanics
  • Poor/under-supportive footwear

Why is my achilles tendon flaring up now during COVID?

  • Having a history of achilles tendon pain that hasn’t been managed properly in the first place can result in the recurrence of this injury.
  • An increase in activity or change in activity load, intensity and surface. This could be due to the closure of indoor facilities and rehabilitation centres.
  • Working from home, we are more sedentary than we usually would be in the workplace and there is less low intensity incidental activity.
  • Working from home in flat footwear such as slippers and in combination with working at a standing desk can increase pressure through the achilles tendon and heel.
  • Current walking and running footwear is providing inadequate support and are past their use by date.

What are some immediate changes I can make to help with my injury?

The treatment and management of achilles tendon pain is dependent on the stage of injury and the level of pain experienced. Below are some changes that can be made to target an irritable achilles tendon.

  • Reduce the INTENSITY and FREQUENCY of the aggravating load (walking or running every second day, decrease the pace of your walks and runs).
  • Allow 24-48hrs between runs to allow the tendon to recover and for tissue repair damage made.
  • Use a roller to roll out the calf muscles.
  • Use a ball (golf, spiky or lacrosse) to roll under the foot. Avoid the area of pain along the achilles tendon.
  • Update footwear. Runners typically only last between 600-800kms and compress at a quicker rate when worn for back to back days.
  • Get up from your home desk every 30 mins to move around, roll out your muscles and stretch.
  • Wear supportive shoes if working at a standing desk at home.

Management & prevention:

Gradual heavy loading (within tolerable pain range) is required to strengthen the tendon and prevent re-injury of the structure.
A weighted calf raise is a vital exercise for building strength in the lower leg and foot.
Implementing calf and plantar fascia rolling into your cool down and recovery routine post-exercise is a great way to alleviate tightness and symptoms.
Incorporating a second pair of runners to alternate between, can reduce repetitive strain through the muscles in your legs.

What we can do as podiatrists to help:

  • Injury screening and assessment of walking/running biomechanics.
  • Training load management + running/walking programs.
  • Taping and offloading.
  • Footwear education and assessment.
  • Orthotic therapy.
  • Prescription and guidance on strengthening exercises.
  • Shockwave therapy.

If symptoms are to persist, then book in online for a telehealth or face to face consult with one of our professionals.

What exactly is telehealth?

Telehealth is an online video-based consultation that connects you with our expert sports podiatrists. Telehealth allows our practitioners to diagnose, treat and manage your condition and injury from the comfort of your home. All of our sports podiatrists are uniquely trained to provide the service and will support you through the simple and easy to use platform.

Why telehealth?

Telehealth enables us to reach you in the comfort of your home and continue your care as an alternative to coming into the clinic.

Providing consistent and thorough care is important to achieve results and telehealth is a great option when you are…

  • unable to leave the house
  • way on a holiday or a business trip
  • too busy to come into the clinic due to work
  • living rurally or interstate
  • or, if you’d prefer the consultation to be carried out via video rather than face-to-face.

Research shows telehealth consultations have been shown to be the same, if not better, than in-person care.

Is telehealth a temporary or permanent service for Up and Running?

Telehealth is here to stay at Up and Running Podiatry and will provide us with more flexibility conducting appointments outside of the clinic. However, it will NOT replace all face-to-face appointments.

Just like with any new service, we will constantly be refining and developing telehealth in order to suit the needs of our patients. We will keep you updated with any new information or changes made.

How do I book a telehealth appointment and what do I need to do prior to the appointment?

It’s easy! All you need handy is an iphone or laptop with a camera and internet connection.

Follow this procedure:

  • Go online to our online bookings (https://bit.ly/3esCcQS) and secure a “Telehealth” appointment time with a practitioner of your choice.
  • Our practitioners will then share a link to your video call via email and to ensure the process runs smoothly.
  • Click the link to download the software in advance and join the meeting at the time of your appointment with video and audio connectivity.

We then deliver our expertise on your presenting problem, email you your individual management plan and compliment it with online learning resources and videos. Bring along your current runners, footwear or any accompanying programs or questions to the appointment!

What can you help with over telehealth?

Most musculoskeletal injuries can be treated and managed through a telehealth consult, without the need for hand-on care.

Common problems we provide solutions include:

  • Any active foot pain
  • Diagnosis and education of ankle and foot pain
  • Running injuries and education
  • Orthotic and footwear reviews
  • Lower limb strength and mobility exercises
  • Education on taping techniques and self-care

Following the telehealth consultation we will send you an individual management plan that summarises what was discussed. We will also include relevant exercise handouts and links/ online resources.

What are the costs involved for telehealth appointments?

For existing patients who have attended our clinics before, review telehealth consults are $60 and for initial/ new patients the cost is $80.

Payments can be made prior to the consultation by credit card over the phone or by direct bank transfers. Telehealth can also be bulk billed for patients with a VALID EPC referral from your GP.

For more information about the Medicare Benefits Scheme, visit: http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/News-2020-03-29-latest-news-March

If you would like to have more information about telehealth, please do not hesitate to contact us on 1300 185 335!

Preparing for a big race is all about establishing a routine and the final one percenters.

The Australian national championships are always the pinnacle of the Australian season – it is an opportunity to test yourself against some of the best athletes in the country.

Coming into this year’s championships I had come off the back of a good winter training block and had already won some races on the Australian domestic circuit. A few weeks out I knew the bulk of the work had been done and it was just about tweaking my training load to give myself the best shot. Nerves are a part of any big championship or race, a way I try to manage my nerves is through establishing a good pre-race routine. As the race was in Sydney, I made sure I planned my travel, nutrition, warm up and recovery to ensure I was able to stick with the same routines I have at home.

Training

1500m running can be one of the most tactical running events. It will either be a fast sprint from the gun or a tactical affair- a slow first few laps, winding up with a fast finish. The best runners can do both, my coach and I worked hard to put together a program that tried to cover all bases. Every track session would start with a tempo of either 10-15 minutes with a specific session to follow. To mimic a tactical race with a faster finish, one of my favourite sessions to do was;

  • 4 sets of 800m at 3km pace with 60 seconds rest followed by 400m at 800m pace.

A session which I would do to prepare myself to run fast would be;

  • 3x800m at race pace or quicker with 5 minutes rest in between.

Taper

Every race is different but during the season I try and train through races and taper for the important ones. As nationals is at the end of the season, my coach and I usually modify my training load a few weeks out to ensure I have more recovery days. The volume usually decreases slightly, and the intensity increases as I try to sharpen up. A typical week with a race on a Saturday would look like:

Monday: 45 minutes easy, strides + light gym session.

Tuesday: 15 min warm up, 10-minute tempo, 5-6x 400m at race pace, strides, 15-minute warm down.

Wednesday: 45 minutes easy.

Thursday: 10-minute warm up, 6-8x200m, 10-minute warm down.

Friday: Pre-race jog and strides.

Saturday AM: Shakeout.

Warm Up

A warm-up is a key component to any race distance, my typical pre-race warm-up always includes a fast 200m at least 20-30 minutes before the race starts. This is important as it primes my VO2 system and means I can pump oxygen around my body more efficiently during the race. The rest of my warm-up includes;

15-minute steady run

Drills and dynamic stretching

A few strides.

Fast 200m

Nutrition

Nutrition is important as it helps fuel my runs and ensures I recover well from sessions. Before races, I usually like to eat similar foods that I know agree with me. A typical pre-race dinner would be wholemeal tomato pasta with chicken and steamed vegetables. Food aside I usually try and drink a lot of water in the days leading up to the race which can be anywhere between 2-4l per day to make sure I am well hydrated. Something I value a lot as part of my pre-race routine is one and a half beetroot shots two and a half hours before the race and then a caffeine gel 15-20 minutes before. Often my races are in the evening and the caffeine really helps give me a boost.

Sleep

Sleep is when the body does most of its recovering which is important both in training and in competition. I always try and get at least 8 hours of sleep a night and sometimes more in the few weeks leading up to a race. During competition, I will try and have a nap every afternoon.

Recovery

The Nationals this year was a heat and a final. The heat was on a Thursday evening and the final was on Sunday. The night before my race I always have an ice bath, usually a contrast between hot and cold, this is something I will also do in between races to try and help my legs recover.

Preparing for a race of any kind is the difference between a good or bad performance, by considering all of the above you are giving yourself the best chance to feel race ready.

One of the key things that I try to instil into the runners that I coach, is to “finish strong.” They are two simple words that may not seem like much when written into a training plan, but they make an enormous difference to how you run.

To show you what I mean, take a second to think about the different feelings in these two scenarios…

1. Finishing your run by pushing home, feeling strong and overtaking people in the last couple of kilometres.
vs
2. Finishing by gradually slowing, being overtaken, feeling tired and floundering, breathlessly to the finish line.

Which would you rather experience?

The emotions and feelings of these two finishes are completely different, yet you may end up with exactly the same finish time in both scenarios. I know which one I would prefer…
I ask my runners to “finish strong” every so often in their training because it relies on them pacing themselves in the early part of the run or race. Whether you do that by feel, heart rate or pace doesn’t really matter, but the principle is to keep all of those under control and not empty the tank too early. Control the early stages of the run, in order to be able to push home at the end.
Sounds simple enough, right?

You would be shocked by the number of runners that I talk to who swear that they “just can’t do it,” as if to say that they are not in control of their legs, brain or heart. But there in lies the point. They genuinely don’t feel like they are in control or that there is actually a choice in the matter. It actually requires discipline, restraint, calmness under pressure, patience, trust in yourself and self control to pace yourself, which is probably why not many people do it!

This is the sort of thing that fascinates and frustrates me in equal measure as a coach, because most of the time, it’s not an ability thing, it’s an attitude thing. It’s not about average pace, stride length, heel striking or vertical ground oscillation, which so many people read so much into. It’s predominantly about attitude and if we can get the attitude right, the rest will come.

One of my favourite sessions to test out this attitude with my runners is to ask them to ‘negative split’ their 5km parkrun on a Saturday morning. Parkrun is now a global running phenomenon which is meant to be a run not a race. You can run, walk, push a pram, take your dog or crawl it. Whatever you choose. That’s fine in theory but just ask a collection of parkrunners how they did on their Saturday morning parkrun and you will see that they take it just as seriously as professional runners take their Olympic Qualifying Race. I’ll save the why’s behind that for another time, but it’s safe to say that people want to go faster each week and there is a certain amount of pride and ego that comes out to play each Saturday morning run.

Put simply, with this type of session, I want my runners to go faster in the second half of their parkrun than the first half, finishing the run fast and strong. What is interesting is not the finish time, the average pace, or even whether they ran a PB, it is whether they actually can do the session that I have asked them to do. At parkrun, similar to in a big race, when ego, competition and excitement creep in, people go out too hard at the beginning, leaving them no energy to speed up when they are supposed to be finishing strong at the end. In this case, it’s ego and / or the runner’ pre-conceived idea of what parkrun is (a race, not a run) that fascinates me.

I don’t want people to think that I am immune to this phenomenon. Certainly not! I have written about getting over my own ego before and as a male in his mid-late 30’s, that is not an easy thing to do! I distinctly remember Melbourne Marathon in 2017 as an example where I didn’t take my own advice. I screwed up my pacing early on, knew I was in trouble, promptly carried on running too fast and paid for it later. Whether it was ego, pride, stupidity, forgetfulness or a giant brain fart, all I know is that my last 12km was a struggle of epic proportions. My momentum, cadence, pace and probably everything else dropped off at that point, never to be seen again! Not pleasant, but very much a situation of my own making.

The point is that there are different ways to go about our running and we all actually have a choice in the matter. We can choose to control the first part of your run or not. We can choose to go out too hard, or not. We can choose to keep repeating the same mistakes, or not. I hope that more of us choose to experiment with controlling more elements of our running and being less influenced by our ego. I suspect the result will be stronger finishes for us all.

Chris is Founder of GoRun Australia, which helps recreational runners get back into running, keep consistent and see progress in their running. You can sign up for more training advice, discounts and run group: www.gorun.com.au

The latest research confirms that shoe weight does affect running economy – essentially the lighter the shoe the faster you run.

But of course, things are never that simple……

Can Running Shoe Weight Impact Your Speed

In 2016, Hoogkamer and a team of leading biomechanical researchers in the US found that reducing the weight of your shoes by 100g has the potential to improve your performance by 1% (which might equate to a few seconds over 5k in a sprint triathlon).

Although, if the shoe was too light, it reduced running economy due to the lack of energy “store and release”. Meaning muscles have to work harder to absorb shock and push-off.

Triathlon and clinical experience tell me – training smart will always trump a lightweight shoe.

The risk/reward of a lightweight shoe (ie. 250g or lower) is relatively insignificant to injury minimisation, and simply being able to train more.

The trend we see clinically is – calf pain, Achilles pain and heel/arch pain which are often a result of training errors.

Essentially a combination of inappropriate footwear selection and an excessive ramp in running load (i.e. too much, too soon).

I think “paying your dues” is a very important concept, especially for those with an inconsistent running history. We know starting running for the first time, or returning from an extended break are correlated with injury, so be patient!

It takes years of smart training to build a pair of resilient feet and legs.

So How Do We Choose The Right Shoe?

running shoes for marathon

This is never cut and dry, but a mainstay of my footwear advice for runners includes the right balance of a “distance” and a “speed” shoe.

The distance shoe (approx 280-350g / 8- 12mm heel offset) being your main or high volume shoe, and lighter shoe (approx 230-280g / 6-10mm heel offset)  reserved for shorter runs and integrated slowly.

Without consideration to an individual’s injury profile and running history, my general advice for introducing a “speed” shoe would be gradually over a 4- 6 week period.

Starting with a flat easy run (ie.10 mins off the bike) in week one, building into 2 runs by week 2, and layering in some controlled speed work by week 3.

Don’t forget to practice your race specific setup (race shoe, elastic laces and sockless…) at least 2-3 weeks out from your first race of the season, including some race pace efforts.

Perfecting your skills in transition alone will have a far greater impact on your overall race time compared to the weight of your shoe.

Triathlon racing is a complex and variable sport, there are many opportunities to save time, the weight of your footwear, in reality, will have very little impact on your overall race time.

Training consistency is hands-down the single most important factor for faster racing. A measured approach to footwear selection is one controllable factor to maximise training consistency.

Getting back into running? Check out our 5 tips to minimising the risk of injury.

Does one or several of your nails look a little different than they did once upon a time? Have they turned a yellowish / brownish colour and appear crumbly when cut?

If the answer is yes, then you may be suffering from a nail infection.

What are Fungal and Nail infections?

nail infection

Nail infections are caused by the overgrowth of fungi under, in or on top of nails.

This usually occurs when a fungus called a dermatophyte becomes pathogenic and causes a discolouration of one or several of your toenails.

What should you look for?

When nails are infected, they can become thicker yet brittle and retain an unpleasant smell.

If infected nails are left untreated, they may become inflamed, separated from the nail bed and cause a level of discomfort.

How to avoid nail infections

Maintaining good foot hygiene is essential in the prevention of nail infections. Washing your feet regularly and avoid going barefoot in public centres such as pools or gym showers.

In addition, never share nail clippers or files with other people.

Keeping your nails short will prevent germ-prone substances getting trapped under the nail and wearing footwear that breathes properly will reduce the moistened environment infections thrive in.    

How to treat nail infections and when to see a podiatrist

If you believe you have a nail infection, never wear the same socks two days in a row. In addition, air your shoes out regularly and vary your footwear as much as possible.

Treatment of nail infections range from an anti-fungal application directly on the nails, through to prescription of an oral medication.

The first step is seeing your podiatrist clinic Melbourne, who will assist in a diagnosis and prepare the nails to help fight the infection.

If you have an issue with your nails and need some expert advice give us a call on 1300 185 335 or visit us at one of our Up&Running Podiatry clinics to arrange an appointment.

Has your child increased their activity recently and are complaining of a few aches and pains in their heel? If the answer is yes, they may be experiencing a common bone condition in kids called “Sever’s Disease”.

What is Sever’s Disease?

Sever’s Disease, also known as calcaneal apophysitis is a painful injury resulting from inflammation at the growth plate within children’s heels. Sever’s generally affects kids around the age of 8-14 years and is most common with those who are overly active.

What causes Sever’s Disease?

Growth spurts in kids can make their bones grow faster than the muscles and tendons attached to them. In the case of Sever’s, tension in the Achilles tendon pulls on the back of the heel causing inflammation and pain. Whilst a sharp increase in activity can trigger the pain, high levels of activity can aggravate the symptoms further.

Sever’s Disease

Sever’s Disease Symptoms – What should you look for?

Your child will complain of pain at one or both heels when partaking in sports. The pain is likely to increase during activity, ache afterwards and improve when rested. Occasionally you may see your child limping or walking differently when they are playing.

Sever’s Disease Treatment – What can you do to help?

If your child is complaining of a sore heel; icing, elevating and resting the foot is the first port of call. Reducing the frequency of their activity through the week or substituting some of their running based activity with more of a low-impact one, such as swimming, is a wise option. Footwear may also be a consideration; are their shoes appropriate for the activity partaken?

When should you see a podiatrist clinic Melbourne?

If rest, changing activity and addressing footwear haven’t shown a great improvement in symptoms, it is worth getting in touch with your podiatrist. Up and Running Podiatry are experts at diagnosing and treating heel pain in kids. Our treatments may include stretching and strengthening exercises, footwear advice and orthotics.

If your child is suffering from heel pain and needs some help, head over directly to our Online Bookings or check our Up & Running Podiatry Clinics to make an appointment with one of our team today.

Getting injured isn’t any fun!  Maybe you are experiencing the lows of injury now or have been there before. An injury can affect your life in many ways, perhaps running is your stress release, or helps you sleep or it could be a big part of your social life. No one likes getting injured but unfortunately, it happens.

We sat down with Podiatrist and 1500m runner Madeleine Murray to find out how she comes back from injury and is working hard to prevent being forced to slow down in the future.

Here are some of the questions we asked.

What would you say the most common causes of injury are?

Returning to running after the injury

Over the years the biggest factor for me has been my return to running after the injury.  In 2016 I was sidelined for most of the year due to a hip injury. I had just moved out to Australia and was excited by the opportunity to complete an Australian season. Unfortunately, I didn’t spend enough time doing the groundwork and conditioning myself for my return, I just jumped back into it.  As a result, I became injured again and spent most of 2017 jumping in and out of injury before realising I needed to slow down and build the basics again.

The best advice I could give to anyone with regards to injury prevention, would be to take it slow, no more than a 10% increase in training each week and spend a good amount of time building running specific strength with your physio or podiatrist Melbourne before getting back on the roads.

Training load and frequency

Training load and frequency would be another common cause. I am sure many of us are guilty of ramping up the mileage in the lead up to a race and then falling short through injury. At the end of 2015, I had completed a British track season and cross-country season and was eager to get stuck into an indoor running season! Sounds crazy saying it out loud. It is easy to get carried away when things are going well but it is super important to take time out and let your body recover.

Since getting back into running this time around I have made sure I have kept some cross-training days in place to ensure I am giving myself a chance to recover. I also make sure I have a balance of hard days and easy days otherwise you easily fall into a trap of overtraining and not make any valuable training gains.

Diet

Another super important consideration is diet, making sure you are fueling your body to balance any calories lost through exercise. I have found fueling my body in the right way can make or break performance and aid recovery.

How often do you replace your running shoes?

Research suggests you should replace your running shoes roughly every 500km. Whenever I tell people that they laugh and say; “no way I have run 500km in these shoes”.  You would be surprised, if you have one pair of running shoes that you wear to the gym, to walk in and to run in the km’s stack up pretty quick. It is time spent in the shoe that wears the cushioning down, I usually replace my shoes every 4-6 months.

I also alternate between a few pairs of running shoes, running is such a repetitive sport so I like to vary my shoes and surface as much as possible.

How important is a warm up to prevent injury?

Some of the highest numbers of recorded injuries are as a result of muscle tears and strains. Therefore, undertaking a specific warm up depending on the activity is important. Before every run I have a series of activation exercises I do, to engage my core and glutes and warm up my calf muscles.

When should you stretch, is it important?

To stretch or not to stretch… I include both static and dynamic stretching exercises into my training. A few common dynamic stretches I will include in a warm-up would be:

  • Leg Swings
  • Lunges
  • Single leg arabesques

Static stretching should always be done when the body is warm, each stretch is held for roughly 20-30 seconds and repeated twice. I make an effort to try and stretch all the main muscle groups after a hard run or training session.

injury prevention tips - static stretching

Remember what you do after a setback defines you, so hang in there!

If you are suffering from injury or need advice with a return to running program. Head over to our Online bookings or visit our Up & Running Clinics and make an appointment with one of our teams today.

Lightning never hits the same spot twice but what about your feet?

There is a lot of information out there that tells us about the “perfect” strike location of the foot when running. What does this actually mean? What are the benefits and the risks? Is there such a thing as the perfect running style?

There are 3 areas of the foot that we can impact the ground with.

HEEL STRIKE: This where the heel is the initial point of contact with the ground. Heel strike pattern can increase the chance of overstriding. Overstriding is the running term which relates to the position of the foot in relation to the bodies center of mass. It infers that the foot strikes the ground out ahead of the body, creating a “braking” force before continuing to propel the body over the foot.

MIDFOOT: This is when the ground is impacted with the whole foot. It generally means that our strike position is closer to our center of mass, it is described as being a more energy efficient striking pattern whereby the common cadence is estimated around 180 steps per minute.

FOREFOOT: Tippy toe runners or those who strike the ground at the metatarsal heads. This brings the foot underneath the runners center of mass and is a common position that a sprinter running short distances may adopt. This can be reflective of barefoot running.

foot strike patterns in runners

There have been studies that look into the strike pattern of sub-elite marathon and half marathon runners. One particular study by Larson et al (2010), found that of 936 runners at the 10km mark, 88.9% struck the ground with their rearfoot, 3.4% with their midfoot, 1.8% with their forefoot and 5.9% had an asymmetric strike pattern.

Associations have been made between heel striking and a higher risk of injury due to an increase in peak impact pressure or spike in ground reaction force (K. A. Kirby, n.d). While this may be true, these runner should still be considered efficient. They are able to complete training for their event without injury that inhibits their ability to race, they’ve been able to put in the time and dedication to get them to the finish line and 88.9% of them struck the ground with the rearfoot.

Literature suggests that a midfoot striking pattern significantly reduces the risk of injury by reducing the energy needed by muscles and tendons to generate a continued forward momentum. It should be noted that for any runner who does not naturally strike the ground at their midfoot, a change in their running style may increase risk for injury due to the varied muscle activation, greater fatigue and varied force. Energy expenditure may also be higher when running with ‘unnatural’ gait at slower running speeds.

The reasons for changing your strike pattern should be carefully considered. The strike pattern that allows you to run, train and race injury free is the best strike pattern for YOU! It would be advisable to discuss with a health professional (Podiatrist Melbourne) or running coach if you are considering a change to assist in reducing the risk of injury while you adapt to the new style.

 

References

Larson, P., Higgins, E., Kaminski, J., Decker, T., Preble, J., Lyons, D., McIntyre, K., & Normile, A. (2010). Foot strike patterns of recreational and sub-elite runners in a long-distance road race. Journal of Sports Science. DOI: https://doi.org/10.1080/02640414.2011.610347

K. A. Kirby. (N.D). Running Footstrike: Rearfoot, Midfoot or Forefoot Striking, Which is Best?. Facebook via Kevin A. Kirby, DPM.

 

Plantar fasciitis is one of the most common injuries relating to the foot, it is said to occur because of chronic overload resulting from a combination of lifestyle factors or exercise. It can affect both the elderly and athletic population. Recent studies propose the condition resembles more of a tendinosis labelling it plantar fasciosis which implies degeneration within a tendon without inflammation.

Anatomy

The plantar fascia is a piece of fibrous tissue that originates from the heel and extends towards your five toes.

Function

The plantar fascia functions a bit like a pully during gait and is placed under tension when the big toe dorsiflexes. This then shortens the distance between the heel and the toes raising the height of the arch. Therefore, it is particularly common in runners and dancers as these activities require maximum dorsiflexion of the
big toe.

Symptoms

Symptoms are often associated with pain in the heel that can radiate along the arch of the foot. Pain is often worse first thing in the morning when you get out of bed or after a period of rest. As the injury progresses the symptoms are said to worsen resulting in increased difficulty weight bearing.

Other common conditions affecting the heel

Although plantar fasciitis is the most common type of heel pain, it is important not to overlook the
other frequently seen conditions.

  • Fat pad contusion (a bruised heel).
  • Medial calcaneal nerve impingement.
  • Lateral plantar nerve entrapment.
  • Tarsal tunnel syndrome.
  • Bursitis.

Treatment

A thorough assessment of your heel pain is important before deciding on a management plan.
Treatments often involve a combination of:

  • A period of rest from activity.
  • Calf and plantar fascia specific stretches.
  • At home foot mobilisation exercises.
  • Footwear advice
  • Progressive program targeting intrinsic foot
    muscle strength and activation.
  • Calf strengthening exercises.
  • Extracorporeal shockwave therapy.
  • Case-dependent; a combination of strapping and
    orthotic therapy.

If you are suffering with heel pain, it is important to seek advice and receive a diagnosis early as the prognosis is far better when caught early.

Book in for an appointment today!