Hanan Kane – Page 10 – Perform Podiatry

Help! I’ve Got Flat Feet

When we see patients for whatever problem or pain they’re having, one thing that they’re often quick to point out is having flat feet (for those that do). This happens because a lot of people associate having flat feet with having foot problems, regardless of their history of foot pain or if their flat-footedness has resulted in their problems or not. Because this is a common thought pattern among patients (well, at least in our experience here in Auckland), we thought we’d share a little more about flat feet and what they REALLY mean.

Flat feet: The basics

Having flat feet describes the biomechanical and structural position of the feet, which is characterised by rolling in at the ankles and showing little to no arch on the inside border of a foot. This is how the term ‘fallen arches’ was coined. This is medically referred to as pes planus, with the term for rolling in at the ankle joint when walking known as pronation. As the severity of pronation can range from mild to severe, podiatrists can measure the angle of your shin bone relative to your calcaneus, or use a Foot Posture Index (FPI), to help grade the level of pronation and best direct treatment where it is indicated. It should be noted that:

Flat feet are relatively common, and that having flat feet does not mean you are definitely going to have foot or leg issues or pains
Pronation is also a natural and necessary part of each step we take, helping our feet to absorb shock and adapt to the uneven surfaces

Flat feet are, however, linked with a greater incidence of foot problems because of the effect this position has on your bones, joints, muscles and ligaments. This happens because we over-pronate past the point that is necessary and healthy for our feet.

What causes flat feet and overpronation?

Typically, it comes down to the biomechanics of your feet and the way your bones, joints, muscles and ligaments are working together. Some people may have flat feet from birth and others may develop them over time and in association with other conditions. Causes may include:

Bone or joint irregularity
Muscle weakness
Tendonitis, such as in the posterior tibial tendon
Ligament laxity
Obesity
Pregnancy
Injury / Trauma
Arthritis
Diabetes

What are the symptoms of flat feet?

The symptoms of flat feet aren’t necessarily painful themselves, but the stress and pressure they put on the surrounding tendons and structures can cause pain as tendinopathies and other issues develop. These tend to be exacerbated by long periods of time on the feet and high-impact activities. When podiatrists evaluate the severity of flat feet, they often look for signs as opposed to symptoms. These include:

Shoes wearing out quickly on the inner side
Talonavicular bulging (a bulge on the inside of the foot)
Abducted forefoot (seeing your toes pushing out on the outside of the feet when looking at the heel)
The position of your heel bone and whether it’s rolling in or out
The shape of your arch
Talar head palpation (being able to feel the head of your talus bone at the ankle evenly when you’re standing)
The curvature below your malleoli (bony bumps on the sides of your ankle)
The position of your feet in a ‘neutral’ position (referred to as ‘subtalar joint neutral’) versus their position when standing relaxed

Do flat feet NEED treatment, and how are they treated?

If you’ve gone through 30 or 40 years with flat feet and have never developed any aches, pains or other symptoms, then no you don’t require treatment. Your body has adapted and adjusted to your foot position and has made everything else work accordingly. Which is great! When problems and pains do arise, treating flat feet is more to do with treating the problem the flat feet are creating or contributing to as opposed to treating flat-footedness itself. This does often involve changing and ‘correcting’ the alignment and position of the foot. We often use custom-prescribed orthotics to alter the alignment and positioning of the feet, as well as manage various conditions where overpronation is causing problems and pain. Having supportive footwear that stabilises the foot and ankle as opposed to letting it roll is also a key part of management. Strengthening weak muscles and stretching tight muscles can also help to support the better positioning and functioning of the foot. If you’re worried about the effect that your flat feet are having on the rest of your body, you should your feet and legs assessed by one of our expert podiatrists here at Perform Podiatry. We’ll be able to show you the impact of your flat feet on your feet and legs (and your daily activities and sports) and discuss with you the appropriate management options. To book in, give us a call on 09 523 2333 or book online.

Is your child’s foot pain from a tarsal coalition?

From talking to patients about tarsal coalition, we’ve come to realise that this is a term that is not very well known by the general public, unless you or a family member has been affected by heel pain from it. Despite this, tarsal coalition does affect a number of people seeking podiatric help for heel pain, and it’s estimated prevalence around the world seems to range from less than 1% up to 2%, which in the bigger picture definitely does have a clinical significance. This being said, we thought we’d illustrate the typical presentation of a patient with a tarsal coalition and their symptoms, so you know what to look out for in the future.

Tarsal coalition: The background

For your reference, a tarsal coalition describes an abnormal connection or fusion between two or more tarsal bones of the foot. These fusions may be bony, cartilaginous or with fibrous tissue. These tarsal bones are located from the heel bone and toward the middle of the foot. The bones and joints most often affected are the calcaneus and the navicular (calcaneonavicular joint) and the talus and the calcaneus (talocalcaneal joint). One or both feet can be affected. A tarsal coalition typically occurs in the womb, leading to improper bone formation, and so is present a birth. This being said, the symptoms don’t usually start until the ages of 8+ as this is the time that bones start to mature and harden. Not all tarsal coalitions will have painful symptoms.

A young patient presents

Tarsal coalition is typically diagnosed between the ages of 8 and 16 years old, and in our experience we see kids around 10-12 years old come in with their parents in the clinic. The level of activity that these kids partake in varies, though it’s often on the higher end. The pain experienced can present both as a dull ache or a sharp pain (or both) and is in the area of the affected joint, which will often be around the ankle. The pain can come and go over time, and is usually associated with physical activity. Often the pain has been left for some time (weeks ormonths) to resolve on its own, and we see the patient after it has failed to resolve for some time. Though this is our experience, we do highly recommend bringing kids in as soon as possible! The pain can stop kids from doing the things they love and participating in sports matches, as well as general daily activities as the symptoms progress. Pain can radiate to the knees and other joints, and the joints can feel stiffer, particularly around the ankle.

Our assessment

On our end, we conduct a comprehensive biomechanical assessment in which we:

Palpate around the heels and painful structures
Check the range of motion at all the joints of the foot, ankle, knee and hip
Conduct a gait (walking) assessment with shoes and without, on the ground and the treadmill
Conduct a foot posture assessment
Conduct a footwear assessment
Check muscle strength

The findings can vary significantly, but often we find a very flat foot profile with potential damage or weakening of the surrounding muscles or tissues, such as the posterior tibial tendon on the inside of the ankle. There tends to be a limitation in the range of motion across some joints, to varying degrees, depending on the stage of the coalition and how much fusion has occurred. A tarsal coalition is confirmed radiographically, and this is usually necessary to also rule out the possibility of a stress fracture or any arthritic changes in the bones and joints of the feet.

Treatment

The best course of action is decided by the podiatrist after the comprehensive assessment and evaluation of the feet and legs. We have tended to see patients in the earlier stages where the patients are relatively young and their pain is not severe. In these cases, an initial conservative approach is first indicated before considering the surgical route. Again, this is on a case-by-case basis. We can use things like custom-prescribed orthotics, footwear changes and activity modifications to improve stability, reduce pressure on the affected tarsal bones and limit their movement – as it is the pressure and movement on a bone that is not completely fused yet that tends to elicit the painful symptoms. These devices, especially the custom-designed orthotics, will help keep the foot in the best possible alignment while the bones continue to fuse (this process is irreversible). This will provide the most comfort and best long-term outcomes for the patient. Where appropriate and where the symptoms require, anti-inflammatories and physical therapies may also be used. We then monitor the patient regularly to ensure good alignment and that we are satisfied with the way the bones are fusing, so we can control and minimise any factors and changes that may impact the quality of life for our patient in the long-term. This is also where we may choose to involve an orthopaedic surgeon, though the need for this is again on a case-by-case basis.

The outcome

We are very pleased with the overall outcome of the patients we treat and their quality of life after the completion of the fusion. We work to minimise any resulting issues and restrictions and generally, they can function fairly normally apart from some restrictions in movement at the ankles/feet. We hope that this has given you a good insight into tarsal coalition and helping you identify the signs and symptoms if they arise. If you’re concerned or your kids are experiencing any problems or pains with their feet and legs, bring them in to see our kids foot experts here at Perform Podiatry. We’re located within the One Health Building on Remuera Road, close to Newmarket. You can give us a call on 09 523 2333 or book online.

Haglund’s Deformity: The Bump at the Back of Your Heel

If you’ve noticed a bump at the back of your heel, then you may have a bony enlargement called a Haglund’s Deformity. As we’ve been seeing quite a few patients with these ‘bumps’ who have recently started developing painful symptoms at the back of their heels, we thought we’d fill you in on what’s going on the what’s, how’s and why’s of this condition. As patients come that come in with heel pain often assume it’s related to their Achilles Tendon, this is a condition that is NOT directly associated with the achilles, though can produce achilles pain as a result.

So, what is a Haglund’s deformity?

As we mentioned earlier, a Haglund’s deformity describes a bony enlargement of the calcaneus (heel bone). You may hear it being referred to as a pump bump because of the firm backs of pump-style shoes that will often rub against it at the back of the heel.

What are the signs and symptoms?

Generally, you’ll notice a palpable lump at the back of your heel that has been irritated. This irritation can cause pain and tenderness in the area, along with redness and swelling. The swelling can there irritate the surrounding structures and lead to things like bursitis, or even pain at the achilles tendon.

What causes the painful symptoms?

While many people with an enlargement at the back of the heel can go through their lives without developing pain, symptoms can develop from irritation and rubbing of tissues against the bump, for which there may be various causes. Note: it isn’t actually the presence of the bump itself, but the resulting friction with other tissues. Causes of the irritation can include:

Injury to the heel
Footwear that is tight or has a firm heel counter
Tight calf muscles or achilles tendon
Structural foot abnormalities such as a high arched foot
Abnormal foot biomechanics such as rolling inward or outward excessively
Gait abnormalities, such as walking on the outside of the heels

What should you do if you suspect you have a Haglund’s deformity?

If you haven’t experienced any pain or symptoms and just have the bump present at the back of your heel, then you may not require any treatment as the presence of the bony enlargement alone does not mean that anything is ‘wrong’ or that you’re definitely going to develop painful symptoms. It can, however, make you more like to develop symptoms. In this case, it’s all about making small changes to minimise your risk of this occurring. This can include:

Avoiding tight footwear
Avoiding footwear that has a firm heel counter over the area of your ‘bump’
Regularly stretching the calves and achilles tendon to reduce the likelihood of rubbing
Managing abnormal gait and foot abnormalities through devices such as orthotics

Where painful symptoms have manifested, treatment looks to reduce the painful symptoms and then alleviate the tension from the back of the heel. Your podiatrist will create the best treatment plan for you based on your symptoms and presentation. This may include:

Resting and icing the heel
Using anti-inflammatories to reduce painful symptoms
Heel lifts to reduce the strain at the back of the heel
Avoiding footwear that is tight and rubs against the back of the heel
Using orthotics to reduce tension from the back of the heel
Physical therapy to stretch tight muscles such as the calves and the achilles tendon

It’s important to have your feet and legs assessed to gain an understanding all of the biomechanical and structural factors that are contributing to your painful symptoms and therefore create the most effective treatment plan for you. Our team here at Perform Podiatry are experts in sports medicine and the biomechanics of the feet and legs, and have the pleasure of helping thousands of Aucklanders each year. For more information or to make an appointment, give us a call on 09 523 2333 or book online.

Which sports are best for your child’s development?

Getting involved in sports from an early age has a myriad of benefits. It gets kids active, builds on their teamwork skills, forms new friendships and is great for their strength building and coordination – among the various other mental, physical, social and emotional benefits. We think that the Novak Djokovic Foundation words the benefits very well:

Kids’ character and moral principles are formed through fair play
Sports experiences help to build positive self- esteem in children
Sports bring people together from all over the world, regardless of their nationality, religion, culture, or skin colour
Teamwork and benefits of social interaction among children are best seen in sports
Playing sports enables them to create friendships they otherwise might not have formed
They view competitions on and off the field as opportunities to learn from their success and failure
They learn to respect authority, rules, team colleagues and opponents
Sport is an important learning environment for children
Participating in sports can be a helpful way of reducing stress and increasing feelings of physical and mental well-being

While any and all sports will help to harness these important skills and experiences, we at Perform Podiatry thought we’d shed some light on a question we occasionally get asked by parents around which sports are best for certain areas and stages of development. We thought we’d break it down by age category and the activities and functions that are typically learnt and built on within the age range.

Preschool Age

At this age, kids are still getting their feet planted firmly on the ground and are developing a good grasp on their coordination, balance and general motor function. At this age, it’s important to focus more on mastering the basics and less on ‘joining a team’ or looking at competing, if it’s just for the sake of it anyway. Swimming, dancing, running, side to side movements, catching, throwing and activities that look at improving balance and coordination, both at the feet/legs and the hands/arms, are encouraged. We remember playing bullrush and other games at preschool that while were played with others, thinking back on them now, really focused on developing each person individually as opposed to focusing on the team dynamics that become more important in the next age range. Spending time throwing and catching with your kids at this age can provide just as much (if not more) value, growth and development, so make the most of this time together.

Primary School Age

This is the time that kids can really enjoy and benefit from team sports and organised activities. They’re at school and building important social skills and a good understanding of how a team operates together. Mentally, they’re getting stronger and have a greater focus and drive. Physically, they’re also getting stronger and can run further for longer, throw better, and the like. They will have developed good coordination and at this age will pick up almost any sport with great ease, working on the skills particular to that sport, if they enjoy it that is. You can’t go too far wrong with the sports offered at primary school, some of our favourites include netball, tennis, cricket (and generally all bat/ball sports), soccer, handball, basketball, touch rugby, running and the like. It’s also a great time to start getting involved in activities like gymnastics, swimming and martial arts where you have a greater focus on yourself as part of the team and start honing new skills.

Intermediate School Age

There is a lot that happens during this time and age that has an effect on kids in sport. Kids start to get quite good, confident and skilled in the sports they’ve been playing or participating in for the years leading up to this. Part of this is their improved memory and understanding of techniques and strategies involved in sport, as well as their improved physical strength, speed, size and general ability. With this age comes growth spurts and unfortunately, for some kids, that also means growing pains. This means more time and care needs to be taken on warming up, cooling down and general conditioning of muscles. This is the age that kids also start getting involved in contact sports such as tackle rugby, that may have previously not been suitable due to inadequate strength in bones and muscles and hence a higher risk of injury. This does need to be considered on a case-by-case basis, as every child grows and matures at varying times. Alongside all of the previously mentioned sports, kids can start more technical sports like hockey and volleyball, if they haven’t already tried it sooner.

High School Age

At this age, the world is their oyster! They have good, refined motor skills that have built up over the last eight years. Kids (though they’re not so much ‘kids’ anymore) can pick up sports relatively quickly, especially if they’ve had experience playing similar sports. We remember starting sports like fencing and underwater hockey at high-school, both of which utilised the technical skills from various other sports and activities. Growing pains and growth-related injuries can still occur so be mindful and make sure your kids get the right treatment and adequate rest/recovery if they develop pain or injury. If you have any questions about this, are worried about your child’s development, or they’re experiencing pain or injury, give our team a call on 09 523 2333 or book online! We’re the kid’s foot experts in Auckland, located at the One Health Building on Remuera Road, close to Newmarket.

Toes Separating like a ‘V’? It’s a Sign of a Plantar Plate Tear

Have you noticed that two of your toes have come out of line? Perhaps where they used to line up normally alongside one another, they’re now moving apart from one another like a ‘V’. This is actually something we refer to as the ‘V Sign’, and more often than not, it’s linked to a plantar plate injury at the ball of your foot. Because plantar plate injuries can not only cause a fair bit of tenderness but also interfere with the alignment of the toes which can worsen over time, our team at Perform Podiatry thought we’d get you familiar with the ins and outs of plantar plate tears, so you know what to look out for!

The Basics: What is Your Plantar Plate?

The plantar plate ligament is a thick band which runs across all of the toe joints at the ball of the foot, attaching to and connecting all five toes. The plantar plate works to protect the ends of the metatarsals (long bones of the foot), helps to absorb impact from heavy loads, stabilises the ball of the foot and keeps the joints (and toes) from separating, among other functions.

What Causes a Plantar Plate Tear?

Plantar plate tears or injuries occur when this ligament is damaged, usually from too much pressure on the ball of the foot. It usually occurs at the second metatarsal because it’s often the longest, and so takes on the most force when the toes bend during walking. Other causes and contributing factors may include:

Flat (rolled in) feet
Bunions and hammertoes
Short first metatarsal bone (and hence longer second metatarsal bone)
Repetitive high-impact activity such as running
Climbing stairs and similar actions that put pressure on the ball of the foot

What Does it Feel Like?

Generally, those with an injury to the plantar plate experience pain and tenderness at the ball of the foot in the affected regions. There may be some swelling and the feeling that you’re walking directly on the bone. Because the plantar plate ligament is damaged, it won’t be able to maintain the usual alignment at the ball of the foot, and the toes may drift apart, creating that ‘V’ sign. In our clinical experience, we’ve seen many patients who have previously sustained plantar plate injuries that didn’t even realise there was a serious problem. We notice the ‘V’ sign and then discover that some time ago, the patient did experience some tenderness at the ball of their foot but ignored it, thinking they had just over-exercised or had a long day on their feet and it would go away on its own. While the painful symptoms did settle, the alignment and positioning of their toes were never treated or corrected, leaving their toes in the ‘V’ position, and affecting the alignment of the rest of the toes around them.

What Should You Do?

Our approach to treatment at Perform Podiatry not only focuses on settling your painful symptoms, but also to correct the alignment of the toes and to reduce the risk of re-injury in the future. That’s why we conduct a thorough biomechanical assessment to address the causes of the injury in the first place and treat those too. Often we use strapping to help control the position of the toes, padding to alleviate pressure away from the affected toes, and orthotics to help control the position of the foot with every step to alleviate pressure and address any abnormal foot biomechanics that may have caused the problem in the first place. During your recovery, we’ll talk about your shoes to make sure they’re helping and not hindering your recovery, and we’ll look at what else is going on with your feet, such as bunions, that may be part of the problem. The good news is that with proper care, plantar plate injuries are very treatable and you can be out of pain and have your toes back in line relatively simply, following the treatment plan and recommendations from our team. If you notice a ‘V’ sign from a previous injury, we may even be able to help with that too, before the alignment of your toes worsens. Our podiatrists are experts in the biomechanical function and alignment of the feet and legs, and love seeing our patients back at their best and doing the things they love! To book an appointment, give us a call on 09 523 2333 or book online!

Why Are My Kids Walking with Knees Knocking?

We love seeing kids here at Perform Podiatry. Partly because it’s hard to be away from our own and they brighten up our day, but largely because of the massive difference that we know we can make to their lives and development. Kids should be able to run, play, explore, learn and have fun without being limited by pain or held back by foot or leg dysfunction. Thankfully, issues that arise in kids are usually much easier to manage than in adults. Today we thought we’d share on a condition that we’ve had a few questions about lately from concerned parents – knock knees!

What are knock knees?

Knock knees, medically referred to as genu valgum, is the position of the knees where they are turned inwards toward one another, meaning they ‘knock’ or brush against one another as you walk. It’s often seen in children between the ages of 3 and 5, and helps them maintain balance as they develop their walking.

What causes knock knees?

Before you panic – don’t worry. Knock knees are usually a normal variation of growth and development, and this position is just how some children find their footing. However. They also may be an indicator of an underlying condition such as rickets or osteomalacia. In these cases, knock knees may not develop until the child is six years old, or persist after the age of 8. Generally speaking, contributing factors to the development of knock knees can include:

Obesity
Loose ligaments at the knees that place excess pressure on the knee joints
Infection or injury to the knee or shin bone (tibia)
Conditions that affect bone development
Calcium or Vitamin D deficiency

If you’re worried, it’s always a good idea to get your child checked. This way we can inform you if your child has a normal or abnormal variation of knock knees, as well as track their progress over time to ensure that the lower limbs are developing appropriately.

What are the symptoms?

The inward bending of the knees is the biggest symptom. You’ll also notice a gap between the ankles when the knees are together. One knee may turn inwards more than the other and pain isn’t typically experience during young childhood years. Where knock knees continue beyond the childhood years, symptoms may include:

Knee pain
Limping or altered walking patterns
Stiffness in the knee joints
Increased risk of developing knee arthritis

What should you do?

Because knock knees can resolve by the age of 7, you may wish to wait and see, or you may wish to get your child checked by your podiatrist. Your podiatrist will be able to assess exactly what is happening with the knee position, as well as the hip and foot position as these will be affected to some extent as a result. If your child is experiencing any painful symptoms, interventions such as orthotics, bracing, stretching and strengthening may be used to relieve the symptoms – as kids shouldn’t be in pain from their knee position, and if this is the case, it’s likely causing other problems too. Where knock knees persist into adulthood, management needs to be aimed at the issues that this misalignment is creating as opposed to the knee position itself. In later years, it is also important to rule out the possibility of any underlying bone conditions. Your podiatrist will be able to create a tailored management plan based on the symptoms you’re experiencing and your history. If you’re concerned about your kid’s feet or legs, or just want that peace of mind that everything is developing normally, give our expert team a call on 09 523 2333 or book online!

A slight difference in leg length – does it really matter?

A lot of us have heard that it’s not uncommon to have a slight difference in the size of our feet or even legs. We often advise patients to buy shoes to the size of the larger foot so that toes don’t get cramped and cause pain. But when it comes to having a slight difference in the length of the legs, does it make any difference or have any effect on the body? Let’s start with the basics about limb length discrepancies.

What effect does a leg length difference have on a person?

For some, having a small difference in leg length won’t cause any problems, and they may not even be aware of the problem. For others, it can cause painful symptoms, alter their gait pattern (the way they walk), contribute to the development of other complications and negatively impact their quality of life. The extent of the effect largely depends on the measurable difference between the two legs and how the body is functioning (or not functioning) to compensate for the difference.

What causes a difference in leg length?

Differences may be caused by:

Growth abnormalities
Bone injury that results in healing in a shortened position (like a break or a fracture)
Damage to the growth plate during childhood
Bone disease and infection
Neurological conditions
Inflammatory conditions affecting the joints (like arthritis)
Abnormal foot biomechanics
Tightness and contractures of tissues
Ligament laxity and weakness

You’ll notice that some of the above are talking only about muscles and tissues and not the bones – don’t worry, we haven’t made a mistake! This is because differences in leg lengths can have either a structural or a functional cause. Structural differences describe a difference in the bone length of the thigh bone or the shin bone. This can result in a tilt of the hips and affect various joints and bones throughout the feet and legs, as well as the spine. Functional differences describe an observed length difference when standing because of biomechanical issues involving the way the muscles, connective tissues and jones function together. These occur even if the bone length of the shin bone and thigh none are identical. This is often due to muscular contracture, particularly at the hips, as well as ligament laxity or tendon dysfunction that affects one foot more than the other.

What are the symptoms?

Symptoms can vary greatly depending on the extent of the difference and the resulting misalignment of the lower limbs. This position of the bones, joints, muscles and connective tissues will determine what structures are overloaded, stressed, stretched and limited in the way they move. Because of this, it is difficult to pinpoint precise symptoms, but may include:

Altered gait pattern such as limping
Shorter steps on the affected leg
Slower walking speed
Uneven loading and pressure distribution between the legs
Stress fractures
Muscular strain and tendinopathies
Hip pain
Knee pain
Back pain

What should you do?

The first step is to get your leg length difference professionally assessed by your Podiatrist. We measure both structural and functional differences and ensure to get to the root of the problem and can address any factors playing a role in the difference to get the best results for you both now and into the future. After determining the presence or absence of a difference and its extent, we’ll be able to formulate the best treatment plan for you, your age, your symptoms and the risk of future problems. This may include: Orthotics to help correct any functional abnormalities and help bring the limbs into alignment with one another Footwear modification, such as building up one shoe to bring the joints of the lower limbs into alignment Stretching and strengthening tight or weakened muscles to help improve biomechanical function If the case that the difference is severe and cannot be managed conservatively, surgical correction may be required – though this is much less common so don’t worry and just start with getting it checked out, so we all know what we’re dealing with. Either way, our expert team at Perform Podiatry will be right alongside you every step of the way! We specialise in clinical biomechanics and restoring great foot function and health. For more information or to book in, give our team a call on 09 523 2333 or visit us at the One Health building in Remuera, just up from Broadway, Newmarket.

Say goodbye to discoloured fungal toenails!

It’s been a fantastic, hot summer here in New Zealand, with lots of time wearing sandals, at the beach and feeling that soft, green grass beneath of our feet. For many of our patients recently, it’s also been the time that they’ve noticed a few unusual changes in the appearance of their toenails – usually yellow and white patches – and have come in to find out what it is and what they can do about it! For many of these patients, the verdict is the same…

It’s a fungal nail infection

A fungal nail infection, medically referred to as onychomycosis, is the infiltration of the nail by a fungus. The changes you may see in your nail occur as the fungus spreads and feeds on the keratin in your nail. In fact, approximately 50% of abnormal toenail appearance changes are caused by a fungus, and around 10% of all adults suffer from fungal nail infections. What does that mean?

Fungal nail infections are easily spread

Yep, fungal infections are definitely contagious and are easily spread within households and public places. This is because fungus spreads through spores that move through the air, as well as direct contact. Fungus also thrives in warm and moist environments, and doesn’t require sunlight to grow. This makes places like showers, public pools, changing rooms, gyms and nail salons the ideal breeding ground for fungus. Once you’ve picked up an infection, the environment inside closed in shoes also provide ideal conditions for the infection to grow and persist.

When you come in contact with the fungus and your immune system doesn’t clear the infection before it takes hold, the symptoms will begin. Certain conditions do make people more susceptible to infection. These include:

Poor circulation
Increased age
Male gender
A compromised immune system
Previous trauma/injury to the feet and nails
Family history of infection
Diabetes

What do fungal infections look like?

Nails can appear:

Brittle
Crumbling/flaky
Thickened
White/yellow/brown discolouration
Worm-eaten appearance

You may also develop whitish streaks or spots in the nail, and the nail may begin to come away from the nail bed. They may also cause an odour.

Make sure it really is a fungal nail infection and not something else

It’s important to note that there are other conditions that have a similar appearance to fungal nail infections, such as psoriasis of the nail and trauma. This is why before spending time and money treating the infection, you should get a confirmed diagnosis. We can do this in our clinic in just 5 minutes, easily and painlessly from a small sample of your nail. Once we have a confirmed diagnosis, we’ll talk through the best way to treat your infection based on your symptoms and presentation. We’ll also give you all of the information you need to stop the spread of infection to your friends and family, and minimise your risk of future re-infection as much as possible! For more information or to book an appointment, give our expert team a call on 09 523 2333

Arthritis: How we can improve your comfort and relive your pain

Arthritis – it can be painful, frustrating and limiting for many New Zealanders. In fact, almost 50% of those aged over 60 years, and almost all over 80 years old, are affected by osteoarthritis arthritis in New Zealand. Yep, that means that if you haven’t already, you and your family members have a high chance of developing arthritis as we age! Often, arthritis is perceived to have limited treatment options because of its degenerative and irreversible nature. The truth is that while you can’t reverse the damage from osteoarthritis, we definitely have tools to help ease your pain and improve your comfort! But first, let’s start with the basics.

What is osteoarthritis?

Osteoarthritis describes the wearing down of the cartilage that covers the ends of our bones at the joints. Cartilage typically functions to help absorb shock, acting as a rubbery cushion, as well as creating a slippery surface for bones to move smoothly and efficiently past one another. As the cartilage is worn down, bones start to rub against one another. This causes pain and limits our ability to easily (and painlessly) move our joints and perform our everyday tasks.

What causes arthritis?

The term ‘wear and tear’ that is often associated with osteoarthritis refers to the loads that we put on the joints during our lifetime that cause them to wear down. This being said, any repetitive activity or action that overloads and stresses the joints can contribute to the development and progression of osteoarthritis. For example, this may be from our work, or may be as a result of increased weight (or both). Other contributing factors can include previous injury to our joints or bones, or infections. While osteoarthritis isn’t typically hereditary, it can run in families.

What are the symptoms?

The symptoms of osteoarthritis progress and worsen over time, meaning you’ll likely start off with a twinge or mild discomfort in a joint. While not all changes to the joints are symptomatic, symptoms that present can include:

Painful at the joints which may be exacerbated by use
Swelling and redness
Limited movement at joints
Creaking in the joints
Changes to the bone/joint shape (including irregular bony growth at the joints)
Weakened muscles surrounding the joints

How is it treated and what can you start doing today to ease the pain?

While the damage from osteoarthritis can’t be reversed or treated completely, they can be managed so you can feel more comfortable, have less pain, and generally move better. Our team specialise in custom-designed orthotics that will take pressure away from the painful joints and alter the way your foot and joints function. By changing your foot biomechanics and redistributing pressure, painful symptoms can be relieved or lessened, meaning that walking and performing daily activities can become a lot more comfortable. It also means that with the progression of your symptoms can be slowed by reducing the stress on the joints of your feet. We’ll also assess your footwear, talk about low-impact exercises to give you back strength and mobility to your joints, and discuss your regular activities and how they’re impacting on your symptoms and progression of arthritis. For more information or to book an appointment, give us a call on 09 523 2333, and we’ll be happy to help!

Occupational Podiatry – Helping You at Work

We spend a third of our life at work, with many of us on our feet all day, so it makes sense that the workplace can be a great source of foot pain. Pain at work not only impairs your (and your employees’, if you’re a business owner) performance, but also your mental well-being too. This is why we offer a range of occupational Podiatry services, to keep your team happy, healthy and at the top of their game. Whether it’s an injury sustained at work, or a pre-existing condition that is impacting your ability to carry out your work, our expert team here at Perform Podiatry have you covered.

We help you prevent injuries at your workplace

Identifying problems before they arise means your team stay healthy and happy. It keeps your business on-track with less sick days and appointments to attend, is cost-effective, and generally creates and happier and safer workplace. Our registered Podiatrists can talk you through your workplace, your injury risks, examine previous injury incidence, and work with you to mitigate injury.

We help your team manage existing injuries

From July 2016 to July 2017, there were 841 new claims of injury at work that affected the feet and legs in Auckland alone. That’s not including all of the existing claims that affected individuals are still managing. We can help you effectively manage your existing injuries so you can get out of pain and get back to feeling like yourself and doing the things you enjoy as quickly as possible. You can have a Podiatrist assess, diagnose, treat and manage the injuries incurred at your workplace. The management plan will be specific to their role, creating as few disruptions as possible to the daily workings of your company or business. For your interest, in 2016 there was a total of 233,000 claims for workplace injuries in New Zealand. Damaging your feet, and having an event like a fall, also risks damaging other parts of the body too.

We’re ACC registered

We’re ACC registered Podiatrists and have an additional contract with ACC for orthotic cover. That means when you need it, you’ll have the best level of cover for the treatments that’ll help you the most. We take the hassle out of filling in ACC paperwork – you’ve got enough on your plate with your injury! From lumps and bumps on your feet, muscle strains, sprains or any cause of pain in the feet, legs and knees, our team will ensure you get the best care. We’ll refer you for any diagnostic testing where necessary, as well as connect you with other trusted health professionals where your injury requires another health professional to assist in the management. Give us a call on 09-523-2333 to talk about your own foot care needs, or those of your workplace.