Children and Sports Podiatry

HEEL PAIN IN KIDS

Is your child experiencing heel pain after training?

Training season is on! Many active kids are busy training and playing Football, AFL and Netball to keep them healthy and fit. Kids that get heel pain are typically active and sporty. Heel pain, can be known as Sever’s Disease. The growth plate on the back of the heel gets sore when your child runs and jumps a lot during sport. The heel cord that attaches to the growth plate pulls and causes tension and inflammation on the back of the heel.

Kids often enjoy their sport so much, that they fail to tell parents that there heels hurt after they have been training. I think this is because they fear that they might get told that they have to rest. If you notice your child limping or running awkwardly, ask them if they are in pain.

Many active soccer players get heel pain between the ages of 9-13 years

So what can I do if my child has heel pain?

Seeking professional advice from a podiatrist who specializes in children is advised. At Inspire Podiatry we are the experts in managing kids’ heel pain. Initial treatment can include, checking the foot posture and mechanics of how the foot moves when your child runs. We check how aggregated the heel is by hopping on the spot. The foot is assessed to see if there is any inflammation in the surrounding tissues.  The growth plate and the Achillie’s Tendon is examined. It’s important to check and treat any inflammation in the area. We have the latest state of the art equipment such as electro-therapy which will help to heal the tissue on a cellular level. This is a painless treatment.

Kids can get heel pain because they are growing and can often get tight muscles in the leg and thigh. We take the time to check lower limb flexibility. Your child may be given exercises to do at home to improve their flexibility. Pain can be reduced by doing these prescribed exercises.

What treatments are there for my child with heel pain?

Sometimes children just need some sports specific shoe advice. Others may need a cushioned support like an orthotic innersole or insert. This treatment has the ability to reduce the load on the growth plate. At Inspire Podiatry we have 3D laser scanning technology to make this happen. This is the latest state of the art equipment used to scan the foot in the corrected alignment so a truly customized orthotic device can be made for the right fit. These are worn in your child’s shoe. This treatment can change muscle firing patterns during running and realign the foot.

Your child doesn’t have to stop their training if they get the right treatment for their heel pain. I believe in treating the pain first before having to reduce activity. It’s important to keep our kids active and happy so they can enjoy doing what they love. Sever’s pain does not last forever, it will cease by the time your child is around 15 years of age, when the growth plate forms part of the adult heel bone.

IS THE SHOE THE RIGHT FIT?

IS YOUR SHOE A GOOD FIT

A Podiatrist can check if your shoe is the correct fit and type that you need. I have given footwear advice and assessed well over 30 000 patients in my career.  That is a lot of pairs of shoes that have been assessed.

In the footwear world today there is so much choice. I feel it is a challenge for patients to get a shoe that is the correct fit. Given the average Australian spends 7 hours on their feet at day, its important to get a shoe that fits your foot correctly. This ensures comfort, and protects your feet from further deformity.  Podiatrists focus exclusively on footwear and are known experts in the industry.

Fit Tips:

Shoe fit tips from Inspire Podiatry

 

Heel & Ankle

The heel needs to sit comfortably into the back of the heel counter, with the correct depth, height and shape around the ankle bones to avoid irritations.

Width

Ensure that the foot sits into the widest part of the shoe, with no forefoot over hang or excess space.

Volume & Lacing

Making sure the volume of the shoe matches the fitting requirements, and relevant lacing techniques to improve the comfort and fit of the shoe can be used.

Depth

Check that the fit within the toe box matches the forefoot shape.

Length

The shoe length is determined by the forefoot shape and longest toe. The length is checked when the patient is standing up and their toes are down.

Flexibility

Forefoot flexibility in the midsole allowing the foot to flex in a natural position.

 

 

 

Inspire Podiatry works alongside Albany Creek Physiotherapy

Inspire Podiatry works closely with experienced physiotherapists Rob Thams and Scott Smith who are the founders of Albany Creek Physiotherapy. They have an established practice which has been open in Albany Creek for over 30 years.

One of the benefits of working inside Albany Creek Physiotherapy is that it’s a team approach to health care. There is open communication and sharing of clinical knowledge amongst health professionals. This helps us to create the best patient outcomes and get you healed faster. Did you know all professional staff meet on a fortnightly basis to workshop the latest research in sports medicine?  The facility has a working clinical rehabilitation area and hallway for gait and running analysis. As well as Physiotherapy and Podiatry other services available are:

  • Psychology
  • Paediatric Physiotherapy
  • Massage Therapists
  • Sports Physicians
  • Women’s Health Physiotherapists
  • Pilates Physiotherapy instructors

    Its a team approach to health care at Inspire Podiatry

As a sports podiatrist I honestly believe that patient results are best achieved when there is a multidisciplinary approach. For patient care it’s important to identify when there is a need to cross refer to another allied health practitioner. This way you are getting the best clinical expertise in treating a particular concern or sports injury.

 

 

Heel Pain & Heel Spurs from Albany Creek Podiatrist

Symptoms?

Do you wake up and limp on your feet and struggle to walk after rest?  The chances are you may be suffering from plantar heel pain or heel spurs or what podiatrists call plantar fasciitis. It’s heel pain on the bottom of the heel that throbs. The heel pain can sometimes sear and cause sharp pains in your heel.

How Common is Heel Pain?

Heel pain is something we see on a daily basis at Inspire Podiatry at Albany Creek.   Heel pain can affect up to 6% of the population. It is a repetitive injury so it can account for 8% of all running injuries (Taunton, 2002). Because if you are carrying a few extra kilograms or standing on your feet a lot at work you can be more prone to developing heel pain.

Imaging?

I rarely send a patient for images unless there are other underlying conditions suspected. An X-ray may show a heel spur but this does not treat your foot pain. Believe it or not the presence or absence of a heel spur is not helpful in the diagnosis of plantar heel pain as, 19% of people without plantar fasciitis have heel spurs (DiMarcangelo MT, 1997).

Treatment for Heel Pain with Shoe Inserts

Most importantly, treatment for heel pain is best achieved when it is detected early. If you have a low arch height, this can directly increase the amount of strain that is placed on the plantar fascia. The plantar fascial ligament is a long fibrous band of connective tissue that originates from the bottom of the heel and runs along the arch of the foot towards the big toe.  This is why shoe inserts or shoe orthotics can directly support the arch because they reduce the strain placed on the plantar fascia. Strapping techniques for heel pain can reduce the strain by 48%.  At Inspire Podiatry we often use foot taping on patients at their initial consultation to give them immediate relief with their walking and to restore a normal walking pattern without the limp.

Treatment for Heel Pain with Strength Training

The latest evidence in the research is to treat heel pain like similar to an angry tendon.  We can show you in your treatment session how to perform high-load strength training to improve your heel pain.

Treatment for Heel Pain with Mobilisation & Dry Needling

Our feet are designed to absorb half the weight of the body on initial heel strike on our heels. Limping and abnormal walking because of pain, can cause an increased stiffness in our ankle. This is why it is really important that we restore the range of movement in the ankle and foot joints to reduce the stiffness, so our feet can absorb shock. Some people can stretch and stretch and still be stiff. At Inspire Podiatry we use mobilisation techniques which are gentle movements that manipulate the joints to improve their congruency (contact points). This inturn assists to release the fascial tissue to improve the range of movement in the feet. We can also use dry needling techniques (a form of acupuncture) to reduce the tight knotting in the calf muscles which can improve ankle range of movement and indirectly reduce the strain on the plantar fascia.

Is Cortisone Good for Heel Pain?

At our Albany Creek podiatry clinic I often see patients who have had heel pain for months. Research has shown the use of non-steroidal anti-inflammatory drugs or ice are not very helpful. This is because there isn’t a lot of inflammation in the tissue. Degenerative changes in the fascia are noted rather than inflammatory. Sometimes patients ask “should I have a cortisone injection in my heel”? Cortisone should not be the first line of treatment offered for heel pain. Research has found cortisone does not improve the long term outcomes (Crawford.F 2003). An injection of cortisone may cause plantar fascial rupture (Aceredo JI, 1998). Cortisone can assist to reduce pain but pain often reoccurs after 4 weeks (McMillan, 2012).  I like to treat the underlying cause of the problem which is often the foot mechanics and alignment of their arch height.