Hanan Kane – Page 5 – Perform Podiatry

Foot & Leg Cramps At Night

There’s no feeling quite like the sudden, painful and involuntary tightening in your feet and legs that we know as a cramp. During a foot or leg cramp, the affected muscle forcefully contracts, and you may notice your toes curling, your foot pointing down, or your muscle bulging in response. Cramps can last from a few seconds to many minutes, and no one is immune to them – not even us podiatrists!

What Causes Cramps?

It can be very difficult to pinpoint the exact cause of your cramp. Some cramps have an attributable cause, while others are idiopathic, meaning the origin is unknown. Some causes that may lead to foot and leg cramps include:

Muscle fatigue – exercising too hard or overexerting yourself during your day can place excess strain on the muscles in your feet and legs, causing them to cramp
Being pregnant – pregnancy places more pressure on your feet and legs with the added weight, increased blood volume, and potential swelling in the feet and legs
Dehydration – if your muscles don’t get enough water to function properly, you may be more susceptible to cramps and muscle spasms
Medical conditions – having liver disease, spinal nerve compression, alcoholism, kidney failure, hypothyroidism, or diabetes increases your risk of cramps
Certain medications – can also increase your risk of cramps, such as those used to help lower your cholesterol levels
Mineral depletion – calcium, potassium, sodium and magnesium are minerals that contribute to healthy muscle function. When you are low in any of them, you may experience muscle cramps
Foot or leg injuries or problems – having an injury may change the way you walk to stay more comfortable, and you may end up overusing other muscles, leading to muscle fatigue and cramping
Tight shoes – tight shoes can restrict your foot’s natural movement and lead to cramps

Treating Cramps

As uncomfortable as it may feel, stretching or moving the affected muscles is your best bet to help relieve your cramp. If you’re getting cramps in your calves, and you have a staircase, stand with the front half of your feet on a step and your heels off the edge. Gently lower your heels so that they are below the level of the step. Hold for a few seconds and lift the heels back up. If you don’t have a staircase, sit with your legs straight out in front, place a towel around the balls of your feet and hang onto the towel on both ends with your hands; gently pull your toes toward you while keeping your knee straight. A hot cloth, wheat bag, or cold cloth or ice pack can help relax the muscle, and thereby help alleviate the cramp.

Cramps At Night

Three out of four cramps happen in the nighttime, often when you’re in bed or asleep. No definitive research has revealed precisely why leg cramps have a higher prevalence at night, but it’s thought that it could be related to the position our feet and legs are in while we sleep – with our toes and feet extended, which shortens the calf muscles. Other suggestions include muscle fatigue from exercise during the day or standing for long periods.

Preventing Leg Cramps

Regular stretching during the day, especially before and after exercise, is a good start towards preventing leg cramps or reducing the rate at which they occur. You’ll also want to address any suspected causes of your cramps, which may include:

Avoiding dehydration to help your muscles to function at their best
Maintaining optimal mineral levels. This is usually managed through a balanced diet. Improve your calcium, potassium and magnesium intake naturally by drinking milk and orange juice and eating bananas, black beans and leafy greens. Sodium is simply table salt, so sprinkle a little bit on your meal if you are not having enough already
Not exercising too hard to prevent overexertion and muscle fatigue
Treating any existing foot problems
Wearing well-fitting, comfortable shoes

Worried About Your Feet Or Legs?

If you’re concerned about your foot or leg health, our experienced podiatry team is here to help. We’re located on the border of Remuera and Newmarket, at the One Health building. Book your appointment by calling us on 09 523 2333 or click here.

How To Stop Your Old Injuries From Flaring Up

We all know the feeling: we get excited about a new activity or sport, we head into it feeling confident and strong – and then we feel incredibly disappointed when an old pain, ache or injury flares back up – and sometimes feels worse than ever before. This is where prehab comes in – the rehab you do to help prevent old injuries that you’re concerned about from coming back, and it’s being used by sports teams, weekend warriors and leisure enthusiasts alike. As podiatrists that work extensively with managing foot and leg pains resulting from muscle, tendon and ligament injuries, and as those that believe that knowledge is power, today we’ve shared why your old injuries keep coming back and the ways in which you can best manage them before they start to bother you again.

Why do my old aches and pains keep coming back?

First thing’s first. The most common reasons we see in our clinic for the same injuries continuing to rear their heads include:

1. Whatever is causing the injury hasn’t been fixed

If your unsupportive, worn-out shoes were the reason that your Achilles pain started, and after rehabilitating your Achilles tendon you got right back into those shoes, that will explain the return of the pain. For this example, it could be the low-set heel of the shoe paired with its inability to adequately support your foot that keeps straining the Achilles with every step. While your Achilles may have had a chance to heal and recover during your careful rehab period, once that finished and you got back into those shoes, the same forces kept being applied to your feet and legs that were happening when you sustained the original injury. Before you know it, your Achilles is damaged and sore again. The potential causes vary greatly, and we often see causes include an improper running technique or gait pattern, poor foot posture, muscle tightness, weakness or imbalances, and going too hard too fast when training – before the muscles are ready to handle the load. The solution is simple: address the cause. This is something we always aim to do here at Perform Podiatry as part of your treatment plan, as our focus is always on the long-term and keeping you healthy and happy for the years to come.

2. Your injury has created long-term effects that need addressing

Our bodies are truly amazing – but they’re not invincible. Sometimes, injuries can have lasting effects, especially when they’re not rehabilitated properly or fully. A common example we see is ankle sprains. When patients suffer an ankle sprain, or multiple sprains, and they ‘walk them off’ without proper care, they may be left in a weakened state. Given the role of these ligaments is to stabilise the ankle, if they’re not functioning at 100%, the ankle is left vulnerable to the cycle of future sprains – and further weakening. The solution is to work on reversing or accounting for the damage or long-term effects. For this example, this may be done by implementing an ankle strengthening program and wearing an ankle supporting brace until the strength has been regained. Strapping may also be used to temporarily support the ankle to prevent sprains. Your podiatrist will let you know when the impact has been sufficiently addressed and you no longer need to take additional precautions.

3. Your ‘time off’ has affected your feet or legs

There are good reasons why you’re often advised to keep moving and start a specific strength or exercise program shortly after an injury, surgery and the like. When we’re immobile, or we avoid using muscles a certain way because of pain, activating our body’s use-it-or-lose-it framework – meaning that if we stop using certain muscles for a prolonged time, they’ll weaken and become less flexible. Once enough healing has occurred for you to move without pain again, these areas are still weak – and so you’re more vulnerable to injury. The solution: exercise programs. While many people give us a shy smile when we ask how their rehab programs are going – there’s a good reason we give you these exercises – and will continue to do so. Stretching tight muscles and strengthening weak muscles is proven to enhance your recovery and overall performance. It’s not a ‘maybe’ or a ‘possibly’. We see a large difference in the rate of recovery for those that complete their exercise programs compared to those that don’t, and we’ll always create a tailored program for you that works with what you’re able to do and your life.

Preventing injuries: Know if you’re at risk

If you’re at that crucial point where you’re about to start something new but you don’t want a previous injury to return and stop you in your tracks, it’s important to find out if you’re at risk, and how vulnerable you are to getting injured again. We can do this by performing a lower limb biomechanical assessment that checks the integrity, function, strength and health of the previous injury site, as well as your overall foot biomechanics, to give you an idea of your risks. From there, we design a personalised management plan to help keep you from sustaining the same aches and pains, helping to keep you strong, active and pain-free. We recommend that you:

Always follow your stretching and strengthening plan as each exercise will have specific benefits to help prevent your previous injury from coming back
Warm-up and cool down appropriately before exercise – when we warm up, we increase our heart rate, our body (and muscle) temperature, improve our flexibility, get our circulation going and boost our mental focus. Each of these elements helps our body to reduce the risk of injury
Don’t go too hard too fast if you have recently recovered from an injury
Wear the right shoes for your foot type and the type of activity you’re doing to help stabilise, support and control your feet and legs
Let your body recover – with the right hydration and nutrition – between training sessions and matches
Use braces or strapping as directed by your podiatrist
Don’t ignore niggles – no matter how small. If you start to feel a dull ache at your previous injury site, it may be a sign that damage is starting to recur and you need to act immediately to prevent it from turning into another injury
If any pain or swelling does begin, follow the RICER principles – rest, ice, compression, elevation and book in with your podiatrist

Need help with aches or pains?

We love helping Auckland families stay injury and pain-free. If you’re worried, we’re here to help. Book your appointment online here or call us on 09 523 2333

Are Heel Pain & Back Pain Related?

The heels and our back seem miles apart, so could there be a relationship between the two? According to studies, there is, with up to 75% of people with ongoing heel pain being shown to have unmanaged low back pain or low back dysfunction. As podiatrists, this tells us that if our heel pain isn’t resolving, we should also look at the nerve pathway between the lower back, down the leg and to the feet. To help you better understand the connection between the two and what it means, today we’re talking about the back problems that can lead to heel pain at the bottom of your foot. If you have any questions, feel free to send them to us via our Facebook page – we are highly experienced in heel pain and love helping Remuera & Auckland residents get rid of their heel pain.

Is your heel pain from sciatica?

A well-documented cause of heel pain that starts in the back is from sciatica. Sciatica refers to the compression of the sciatic nerve which starts in your lower back. Damage or irritation can radiate symptoms all the way down to the feet, through the hips, buttocks and legs. If you have sciatica, you may also notice tingling, numbness, burning around your heel. The pain may be dull or achy, or may shoot up the leg depending on the way you stand. You may also notice slower reflexes or muscle spasms.

Is your heel pain from problems in the spine?

While the sciatic nerve is a commonly affected nerve, other nerves and problems may also result in heel pain. These include:

A herniated disc in your lumbar spine: when the contents of one of your intervertebral discs leak or bulge
Degenerative disc disease: when the effects of ageing cause your intervertebral discs to narrow or shrink
Spondylolisthesis: when a vertebra slips over the one below it
Spinal stenosis: when the small bony openings of the spinal nerves narrow
Ankylosing spondylitis – an inflammatory arthritis that affects the spine and sacroiliac joints of the lower back. Can cause back pain, as well as referred pain down the legs

Is your heel pain from problems with your pelvis?

Moving a little further down the spine, there are three problems around the hip region that may also lead to heel pain. These include bursitis (inflammation of a fluid-filled ‘bursa’ sac on the side of the hip which can compress the nerves and affect the muscles in this area), sacroiliac joint dysfunction (when this hip joint doesn’t move in the way it should), and piriformis syndrome (piriformis muscle spasms in the pelvis impinges the sciatic nerve).

Heel pain may also occur from the compression of other nerves below the back, in the legs

You have a range of nerves travelling down the legs, and when they’re compressed, the effects may also radiate down the leg and to the heels. This includes compression of the peroneal nerve, sural nerve and the tibial nerve (known as tarsal tunnel syndrome). We know – the names are difficult to remember or understand. The most important thing to know is that heel pain isn’t always straightforward – and it isn’t always related to a problem in the heel itself. If your heel pain isn’t getting better, even if you’ve sought professional help from others, we highly encourage you to come in for a second opinion with our experienced podiatrists here at Perform Podiatry. We’ll complete a comprehensive assessment of your lower limbs to understand exactly what’s happening with your heel pain, what’s causing it, and why it hasn’t been getting better. We’ll then create a treatment plan to get you back to walking and living comfortably. Book your appointment with our team online here or call us on 09 523 2333

Get Your Feet Ski Ready: Pre-Ski Skin & Nail Care

With a great deal of uncertainty about where we can and can’t travel this winter, there’s one place that many families are excited about heading to – their snow trip! While there’s a lot of information out there on how to best prepare your body for the ski season to help minimise your risk of injury – today we’re sharing one secret weapon our patients are loving that’s helping them to not only move better on the slopes but look and feel great too: pre-ski medical pedicures.

How do medical pedicures help prepare feet for the slopes?

There are a few common pains that our patients experience from the slopes that medical pedicures can help improve or prevent altogether – and the difference can make or break your ski experience. These include:

Trimming and thinning toenails

Bruised, bleeding toenails are something that many skiers and snowboarders have experienced – and often it’s from something as simple as leaving their toenails that little bit too long so they spend the day pushing against the ends or tops of the boots if they’re thick. It seems simple – but given the number of changes nails undergo with age, they can become extremely tough to cut, difficult to reach, and seemingly impossible to thin. By safely and effectively trimming toenails, reducing their thickness and smoothing them during your medical pedicure, you can avoid this bleeding and bruising – and the pain that goes with it.

Removing corns

Corns are small, hard areas of callus that protrude into the foot and can feel like walking on small pebbles. They develop from areas of rubbing and friction in everyday life – often from shoes. They tend to appear on the heels, the ball of the foot, and around the toes. When paired with tight ski or snowboarding boots, corns can become incredibly painful, and further rubbing against the corns can quickly make them worse. We’re able to remove corns entirely, leaving you without any pain or problems in your boots.

Reducing callus and cracked heels

Much like corns, callus develops in response to rubbing and pressure, but in larger areas on the surface of the skin. Callus can take up a lot of extra space in properly fitted boots, quickly making them uncomfortable. When callus builds up thickly and dries out, cracks can form, often in the heels. This can become very painful for snowboarders that spend half their time on their heels. If the cracks are deep, they can also crack the healthy skin beneath, causing bleeding.

Preventing itchy feet from Athlete’s foot

Ski boots create the perfect conditions for fungus to grow and thrive – they’re moist from the perspiration of your feet, enclosed and dark. These conditions can amp up your fungal infection and leave your feet feeling itchy and uncomfortable on the slopes. During your medical pedicure, we’ll provide you with information about your Athlete’s foot infection and team you with the right products to help manage it, so you can focus on your ski trip, not your itchy feet!

More than medical pedicures…

While medical pedicures are a favourite with our patients, there are more ways that we work with our patients to help them on the slopes, including:

Checking the size and fit of your ski boots
Making custom slimline orthotics for your ski boots
Conducting comprehensive biomechanical assessments to improve your comfort and performance and minimise your pain on the slopes

Read how we help with all of these here.

Ready to have the best season yet?

If you’re planning to hit the slopes, we recommend booking your medical pedicure within three or so weeks before you leave. To make your appointment, call us on 09 523 2333 or book online here.

I Think My Toe Is Broken. What Should I Do?

Excruciating pain in one of your toes? Wondering whether you’ve broken it – and if you have – whether you should go to the hospital or a doctor or a podiatrist and what they’ll do? Broken toes are more common than many people realise – and unfortunately, so is suspecting a broken toe, not doing anything about it, and then putting up with the consequences afterwards. While New Zealand tends to have a strong she’ll be right mentality, broken toes are not something that should be shrugged off in the hopes that the problem will just go away and be good as new. Here’s the inside scoop about broken toes and what they really mean for you.

What does a broken toe feel like?

Broken toes feel painful, swollen and may have some purple bruising from the bleeding beneath the skin. You may get some numbness or tingling, have marked redness or streaking around the toe, and your toe may look crooked or out of place. Try standing with weight and pressure on your forefoot and toes at least a few hours after the pain begins. Can you do so comfortably or are you unable to bear weight without significant pain on the toe? If it’s the latter, it very well could be broken. If it’s the former, don’t rule out the break just yet – some are more subtle than others!

How can toes become broken?

The most common ways people tend to break their toes are from stubbing it, dropping something on it, and during contact sports – particularly falls and tackles.

Should I see someone for my broken toe? Who?

Yes, you should. Every toe bone break is different – some are more severe than others, and there are special considerations based on which toe you’ve broken and what kind of a break it is, as well as your physical health and medical conditions. It’s important that your feet are also checked for circulation and nerve damage, skin injuries and any resultant wounds, as well as any injuries to any bones, joints, ligaments and tendons around the area. Often, breaks don’t happen on their own, and you’ll need to address any related problems too if you’re going to recover effectively. Your podiatrist should be the first port of call due to their comprehensive knowledge of the feet. They’ll be able to assess your toe against other causes of toe pain to get a clearer diagnosis. They can also refer you for an x-ray to confirm the break.

Can I treat my broken toe at home myself?

You can get some temporary pain relief at home by using ice to help reduce the swelling, keeping your foot elevated, removing any weight and pressure from the foot, changing to open-toed footwear, and using non-steroidal anti-inflammatories like nurofen. But you still need to see your podiatrist as quickly as possible. When broken toes aren’t allowed to heal properly or in the right position, this can have damaging consequences for you further down the line, from a prematurely arthritic joint to crooked toes, painful high-pressure areas or altered gait. At its worst, you may end up needing surgery – which may have been preventable. This is why it’s always best to get help early.

How are broken toes treated?

If you have a straightforward break where the bone is still well aligned, then your treatment may involve anything from ‘buddy taping’ the toe to act as a splint and then offloading the area, to using a moon boot for full immobilisation. You may need to change your footwear while your toe heals to give it adequate space and avoid harmful pressure. Here at Perform Podiatry, we understand that an effective treatment plan is far more complex than saying don’t walk on this foot for the next four to six weeks. Every treatment plan is made following a comprehensive assessment, and importantly, getting to know you, your work and life situation, and discussing which treatment options will be best for you under your circumstances.

Experienced podiatrists in Remuera, Auckland

If you have pain in your forefoot and you’re worried that you’ve broken a toe or sustained another injury, our experienced podiatry team is here to help. We’re located in the One Health building on Remuera Road, with x-ray services available within our building if needed. Book your appointment online here or call us on (09) 523 2333

Why Do My Feet Hurt In The Morning?

If you’ve been waking up with sore feet, heels or arches in the morning, this is for you. There’s a very specific kind of heel pain with the following three symptoms that you may relate to:

Pain at the bottom of the heel that radiates into the arch
Pain when standing up first thing in the morning, which tends to ease or go away as you take those first steps in the morning and stay walking
Pain in the heel or arch when you stand up after having a rest or sitting down during the day

The name of this heel pain is plantar fasciitis, and it’s the #1 most common cause of heel pain that we see here in Auckland. Today, our podiatrists have shared all about this heel pain, why it happens, and how you can get rid of it today.

Morning foot pain: Plantar fasciitis

We know – terms like plantar fasciitis can sound confusing, but this one isn’t. Simply put, you have a connective tissue at the bottom of your foot called a fascia. Because of its location, it’s called the plantar fascia, meaning the fascia at the sole of the foot. As there is some damage or inflammation to the tissue, it is called plantar fasciitis. What the plantar fascia actually is, is a thick band that runs from the bottom of your heel (where you’ll be feeling your pain) and spans out like a fan to connect into your toes. It supports your arch and works every time you take a step.

Why am I getting foot pain in the morning?

When this tissue is overloaded or strained, damage and pain occur. Specifically, the plantar fascia gets very small tears through its fibres. If the strain is high, it may even partially or completely tear. The reason behind the overloading and subsequent damage can vary greatly, and for our patients here in Auckland, tends to include:

Taking on more physical activity or training – like a fitness challenge or doing a very big day of physical activity like a hike
Foot biomechanics – the way the feet and legs function overloads the fascia when combined with other factors like a long day on the feet or poor footwear choices
Unsupportive footwear, especially ones that have a flat, firm base – this is often pronounced when you move from regularly wearing supportive shoes to wearing less supportive shoes
Hard surfaces – which affect many tradies at work
Specific activities that overuse the fascia like climbing stairs
Injury to the heel – like jumping down from a high surface, which injuries the fascia

I have been getting pain in the morning for a while. Will it last forever?

Absolutely not. Don’t worry – you will only continue to get pain while there is still damage to the fascia. Once we can help repair and heal the fascia, reducing the daily strain on it, the pain will also go and you can have your pain-free mornings back.

Will my morning foot pain go away on its own?

Not easily. The foot is a tricky area – unlike other parts of the body where you can immobilise it and just not use it for little while, you activate the fascia with every step you take, which may result in more damage occurring – or at least prevent it from getting better as it keeps getting irritated day after day. This is why plantar fasciitis should be professionally treated with the help of a podiatry team that have a strong focus on musculoskeletal injuries – like we do here.

How is plantar fasciitis heel pain treated?

Your treatment starts with a comprehensive assessment that looks at characteristics of your feet and legs, your gait, your injury and symptoms, evaluates the cause of the problem, and considers your lifestyle and goals. Here at Perform Podiatry, we don’t want you wasting time (and money) trying methods that aren’t effective. We focus on getting you the best clinical outcomes as fast as possible using evidence-based medicine, with superior long-term results. We start by alleviating your current painful symptoms and creating the right conditions for your fascia to heal. Next, we look at ways we can prevent your plantar fasciitis from returning in the future. Every treatment plan is different, but may include:

Custom foot orthotics – to support the arch and reduce tension off the plantar fascia so it can heal instead of continuing being strained with every step
Footwear check – to ensure your footwear isn’t contributing to your ongoing pain and inadvertently delaying your recovery
Strapping or bracing as needed
Strengthening weak muscles that may have contributed to the development of your heel pain
Stretching tight muscles – not only to help stretch the fascia to reduce pain (where appropriate) but to also stretch other muscle groups that may have contributed to your heel pain, which often happens with tight calf muscles
Dry needling – to release or activate trigger points to relieve pain or improve range of motion. This is usually done in the calf region

There are other causes of foot pain too

While plantar fasciitis is our #1 cause of morning foot pain, other conditions can create similar symptoms. This is why having a diagnosis is important – in our assessments we rule out other causes of heel pain like Abductor hallucis tendinopathy, fat pad syndrome and calcaneal stress fractures, to name a few. Once your diagnosis is confirmed, we will proceed with your care.

Proud to be trusted by thousands of people with foot pain every year

Our podiatry team here in Remuera is proud to be trusted by thousands with their foot and leg pain every year. If you’re waking up with foot pain, or it’s going all day, we’re here to help. Book your appointment online with us here or call us on 09 523 2333.

Medical Pedicure: The Safe, Feel-Good Foot Care Mums Love This Mother’s Day

Looking for a unique Mother’s Day gift in Auckland that your mum will truly appreciate?

Our medical pedicures take care of mums feet – from her toenails to her corns and calluses, while giving her the assurance that her feet are being cared for by registered health professionals, safely and under strict hygiene and sterilisation protocols.

More than this, at every appointment, we discuss any concerns that mum may have about her feet, check for any warning signs or problems she may not have noticed, and explain why mum may be seeing the changes in her feet and legs that she is. Simply put, this is an all-inclusive service dedicated to optimising mums foot health – where she leaves our clinic feeling great on her feet.

Grab your gift voucher for mum today.

What does a medical pedicure include?

We use premium, sterilised and specialised tools to:

Trim toenails – regardless of how firm or thick
Reduce toenail thickness across the entire nail where needed
Remove or reduce areas of hard, dry skin (callus)
Remove or reduce cracks in the heels
Remove corns in the feet
Remove skin and dirt build-up beneath and down the sides of nail

We finish by smoothing the skin using a sanding tool, filing the nails, using an antiseptic spray, applying tea tree oil and finishing with a moisturiser. Bliss!

Why is a medical pedicure better than a pedicure at a nail salon?

88% of nail salons in New Zealand failed to meet adequate disinfection and sterilisation standards. By adequate, we mean quite simple – that they were taking appropriate measures to clean and sterilise both the premises of the salons and the tools they use so they don’t just get moved from person to person with a glass of water in between. This is absolutely shocking for us – as registered podiatrists, we maintain excellent, strict safety and hygiene protocols because your health and well-being matters. So failing to meet such simple cleaning practices to help prevent infections and other problems for your valued customers always baffles us.

Aside from giving mum the assurance that her foot care is a safe and premium service, another benefit is that she gets access to all our knowledge and equipment. If she has concerns or questions about her feet, or any pains or changes she’s recently experienced, she can discuss these with our podiatrist and get all the info she needs, learning what she should be doing at home to best care for and protect her feet. If mum wants to come back in the future, she can book in with her same podiatrist that will monitor her foot health and help keep her healthy, active, mobile and independent.

Before & after images

Here are a few before and after images from the results we get in-house.

The premium care your mum will love this Mother’s Day!

We’re proud to be one of Auckland’s leading and trusted podiatry teams, located in the One Health Building on Remuera Road. To book your appointment, call us on 09 523 2333 or book your appointment online.

The Top Four Pains In Runners – And How To Treat Them

We ask a lot of our bodies when we run. The force through our joints and our legs easily exceeds three times our body weight – so it’s not all too surprising that a large portion of our patients are either regular runners, or developed their symptoms when wanting to get into running. Today, we’re sharing the top four pains and problems we see and treat in runners, here in Auckland.

1. Shin Splints

Medically referred to as medial tibial stress syndrome, shin splints describe pain to the front and inside of the shins that often comes on during running and physical activity. The trick with shin splints in runners is that there are two other conditions that closely mirror the symptoms: a stress fracture to the shin bone (tibia), and compartment syndrome. Effectively treating shin splints means looking at the way the muscles that attach to the front of the shins are being used when running. Often, biomechanical factors and poor foot posture means these muscles are overused and strained – flat feet, or pronation, is often a contributing factor. We must check the runner’s shoes and how they are affecting their performance and the way the shins and the muscles are being used. It’s also important to check how a runner is warming up, recovering after running, and stretching. Tight muscles, joint limitations and improper muscle conditioning are also common culprits in the development of shin splints. To learn more about shin splints, click here.

2. Knee Pain

In any 12-month period, up to 70% of runners will sustain an injury from running – and 42% of these will be to the knee. There are two primary causes of knee pain we often see in runners – runner’s knee, medically referred to as patellofemoral pain syndrome, and iliotibial band syndrome. Runner’s knee is an overuse injury caused by the irregular movement (tracking) and rubbing of the patella over the femur, while the knee is bending and straightening. Instead of gliding smoothly through a groove at the thigh bone, the poor alignment of the knee means the patella can mistrack and instead rub against the bone itself. This causes irritation at the joint and damage to the underlying cartilage and bone. Iliotibial band syndrome is when the thick connective tissue called the iliotibial band (ITB) that runs down the outside of your thigh rubs against the outside of the knee joint, causing pain, swelling and damage to the tissue fibres. It’s common in runners as the rubbing tends to happen when you bend and straighten the knee repetitively – especially when you have a tight ITB. Treating knee pain in runners effectively must focus on not only relieving the pain and helping repair the existing damage, but also addressing the cause to help prevent it from happening again in the future. Often this involves using a combination of custom foot orthotics, ensuring adequate footwear use, a targeted strengthening and stretching program, and changes to the running technique based on findings from a video gait analysis.

3. Calf Pain

Your calves are very important when you run – working up to 25% harder than your quads when running. When you need to stop or quickly change direction, they’re the ones that help you do so safely without injury. They help to stabilise your knee and absorb a large amount of force when you run. Hence, runners with calf pain are a common occurrence. The most common cause we see for calf pain is overuse without the right preparation and conditioning, often combined with unaddressed tightness. Yep – we told you those super simple calf stretches could prevent injury! Treating calf pain involves addressing all the factors that are contributing to the overloading and strain, identified during the biomechanical assessment – which often includes a stretching program, strengthening, correcting any abnormal foot and leg biomechanics, and even looking at a little gait retraining to optimise performance and movement.

4. Heel Pain

When it comes to heel pain in runners, plantar fasciitis heel pain is a biggie. You’ll often hear of people referring to this pain as ‘heel spurs’ – though this is medically and physiologically incorrect. Plantar fasciitis heel pain is characterised by sharp, shooting and stabbing pain at the bottom and inside of the heel. It tends to be most painful when you stand after rest – especially after sleeping – before easing as you continue to walk. Treatment must be specific and effective in order to prevent the tissue damage from progressing to a more severe injury – like a tear in the plantar fascia tissue – or even a rupture. We have a proven treatment that we find to be very successful, which includes temporary strapping, the use of good running shoes if you’re not wearing some already, custom-prescribed foot orthotics that address all structural and biomechanical foot and leg issues, and a stretching and strengthening program.

So, what’s stopping you from running?

If you’ve got a pain or problem during or after running, whether we’ve mentioned it above or it’s something completely different or unusual, we’d love to help. Treating foot and leg pain is what we do! And we have the best technology, skills and experience to allow us to do it excellently. Book your appointment online by clicking here or call us on 09 523 2333

Fixing Curly Toes: Hammertoes, Claw Toes & Mallet Toes

So you’ve developed a hammertoe – or maybe you’ve noticed that your child’s toes are starting to curl. So what can you do about it? Should you do anything about it? What if there’s no pain – is it fine to leave them? Today, Auckland’s premier podiatry team, Perform Podiatry, talks about the causes and treatment of curly toes.

What are the different kinds of curly toes?

Hammertoes, claw toes and mallet toes are the three most common kinds of ‘curly toes’. These are medically known as clinodactyly, which translates to the ‘curvature of a digit’. The difference between the three lies in which joints the curvature is found and in which direction it is occurring. The lesser toes contain three joints – one at the ball of the foot and two within the toe. Here are the differences between the three conditions:

What causes these changes to the toe shape?

We have muscles and tendons running across the toes and attaching to the joints. When these muscles and tendons pull on the toe (which can happen from various causes), an imbalance occurs and the joint moves, curling the toe upwards or downwards. While these changes may be flexible at first, over time, the joints can become stiff and rigid. The causes of the imbalance may be:

- The length of your toes – a common place for a hammertoe is at the second toe, when the second toe is longer than the big toe
- Footwear – wearing tight or narrow shoes where your toes bump against the end of the shoes or are kept in a bent position can cause the toes to curl permanently
- Toe injuries – when your toes or feet are injured, curly toes are more likely to develop
- Poor foot posture or alignment
- Arthritis and other medical conditions – when you have medical conditions that affect the joints, the toes may be more likely to curl

Do curly toes cause pain?

While the changes to the joint shape and position do not typically cause pain, the resulting position of the toes can lead to painful complications. These include corns, callus, blisters, thickened nails or nail damage, metatarsalgia (forefoot pain), and difficulty fitting closed-toe shoes comfortably. This is a particular risk for those with diabetes or issues with circulation, as they are more likely to develop ulcers from areas of friction on the toes as a result of curled toe shape.

How are curly toes treated?

Curly toes fall into two distinct categories – those that are still flexible and may respond to treatment, and those that are stiff and will not respond to regular care. For those that are stiff, the goal is to keep your feet as comfortable as possible while reducing the risk of the complications we mentioned above. This can be done by wearing shoes with a wide toe box, using devices to offload the toes, and caring for any corns, calluses or other problems that arise. For curly toes that have recently developed and are still flexible, we have a range of toe props and other devices that can be worn to encourage the toes to straighten. The best device will depend on which toes and joints have been affected.

Is your goal to get back to straight toes and comfortable feet?

Then our experienced podiatrists here at Perform Podiatry are here to help. Book an appointment by calling 09 523 2333 or book online here.

Why Won’t My Achilles Tendon Stop Hurting?

A one-off pain at the back of your heel at your Achilles tendon that starts but then shortly subsides for good is one thing. Ongoing Achilles pains and problems that keep reappearing – or even worse, never truly go away – takes the problem to a whole new level of discomfort, frustration and pain. Ongoing Achilles pain can leave you unable to participate in sports, move efficiently at work, and even take your dog to the park. As Achilles pain is a common problem here in New Zealand, and ACC research shows that tendon injuries are on the rise, we’re filling you in on what’s going on when you have ongoing Achilles pain at the back of the heel, what’s causing it, and what you can do to prevent it from continuing to give you grief for years to come.

Why do I have Achilles pain at the back of my heel?

Your Achilles tendon is the largest and strongest cord-like tendon in your body. It connects the muscles at the back of your leg, your calves, to the back of the heel bone. More than that, it helps you to efficiently take each step, point your toes to the ground and push off as you run. Problems with the Achilles tendon falls under multiple names which describe different features of the injury process:

Tendinitis – this refers to the inflammation of a tendon, usually in the initial stages of overuse or injury
Tendinosis – this refers to a non-inflammatory degeneration of a tendon, usually after the initial inflammation has settled and the damaged tissue remains
Tendinopathy – this refers to the disease process of the tendon, and in the case of the Achilles tendon, typically describes chronic degeneration of the tendon

When you have ongoing Achilles problems that have lasted 3+ months, you’ll most likely have Achilles tendinopathy.

What causes Achilles pain and injuries?

Achilles pain most often starts when the tendon is overloaded and stressed or strained past the point that it can safely handle. This results in micro-tears and damage in the tendon. In severe cases, partial tears may develop in the tendon, which may then progress to a rupture. Common causes of overloading include:

Excessive running and jumping
Increasing training intensity and duration without adequate warm-up and preparation
Tight calf muscles
Abnormal foot biomechanics and poor foot posture that exacerbates the pull on the calves and Achilles tendon
Inadequate warm-ups and recovery techniques

Why won’t my Achilles injury get better?

If your Achilles pain won’t go away or stay gone, it’s a big sign to us that one or more of the causes of the overuse and stress are still present. You may try resting more and taking it easy on your feet, but if every time you walk your tight calf muscles and poor foot posture are straining the tendon, it will continue to incur damage and never truly get better. The only way to get rid of the pain for good – and keep it gone – is to understand all the factors that are contributing to the pain, and address them accordingly. This is one of our areas of expertise here at Perform Podiatry. We start with a comprehensive biomechanical assessment, and then put the right measures in place so that the tendon can heal appropriately without incurring additional damage.

What can you do at home to help prevent your Achilles pain from coming back?

There are a few things we recommend to reduce your likelihood of injuring your Achilles tendon:

Have a good warm-up and cool-down routine, focusing on effectively stretching your calves and Achilles
Retrain your gait if you know you have some biomechanical or alignment issues with your feet or legs. If you’re unsure about the biomechanics of your feet and legs, have it assessed by your podiatrist. If your feet and legs regularly feel sore and achy, it’s a good indication that this will be worthwhile for you
Don’t jump between low-intensity to high-intensity activity too quickly. If you’re just making the transition from casual to more strenuous exercise, ease into it. If it’s been a year since you were truly physically active, take it slow and don’t rush
Check your footwear. Our footwear serves an important function to support and stabilise our feet. Having your foot supported and contained inside the shoe, when it’s a good, strong shoe, limits the side-to-side motion of your foot and works to better control the steps taken, easing the strain on muscles and tissues including the Achilles tendon
Prioritise stretching and strengthening daily. This helps to optimise your lower limb health and thereby reduce future injury. Eccentric loading is a great strategy that strengthens tissues while lengthening them, helping you to absorb shock and better controlling the motion at your heel
Don’t ignore niggles or minor pain. This is perhaps one of the most important things you can do to prevent major problems developing. Many people will ignore minor niggles and aches in the hope they will resolve on their own. While this may be the case for some, for others, the injury will simply continue to worsen and then tendon will continue to degenerate until you have a much larger problem with a much larger recovery time.

Is pain holding you back?

If pain or injury is preventing you from enjoying your chosen activity, come in and see our podiatry team in Remuera – we’re here to help, and pain management and prevention is one of our specialities. Book your appointment online here or call us on 09 523 2333.