CHATSWOOD
// DARLINGHURST
// BELLA VISTA Hills Sports Medicine
CHILDRENPodiatrists have specialist knowledge about the developmental changes that occur in the lower limbs from children through to adults. The hips, knees, legbones and feet undergo a great deal of change from birth to adulthood, and this change occurs at different times for different children. Most foot problems that occur in adults can occur in children. However, a very common comment with respect to childrens foot problems is that it is 'just a growing pain'. It is true that some pains that effect children are the consequence of changes due to growth but they should still be treated. Growth related pains can remain for years if intervention is not forthcoming and this can have major implications for younger clients as chronic pain when active can lead to a child becoming discouraged and avoiding regular exercise because, basically, it hurts. We diagnose and treat the following common podiatry complaints: Flat Feet (Low Arches)Flat feet is a common term to describe a foot that pronates or rolls in too much at the ankle and midfoot. The arch height in many of these feet is lower to the ground than what is considered average. Looking at these feet it is often apparent that a large bulging is present at the inside of the ankle joint. All feet pronate and flatten, they have to, as it is how the body naturally absorbs shock/pressures from the ground as you walk. However, if the foot flattens too much or at the wrong time during the natural walking cycle, this can be problematic. An important point is that a foot can appear to have a normal arch height but still pronate or flatten excessively. A podiatrist is trained to assess this. Flat / excessively pronated feet are associated with a number of lower limb overuse syndromes / pains including heel pain, ankle pain and shin pain. However, having a flat foot or a foot that pronates excessively is not a problem on its own, it is a combination of the flat foot and the activity level / type that may cause injury or pain. If you have a flat foot and you are suffering symptoms related to the flat foot, that is when treatment should be initiated in most individuals. Having said that, there are a category of clients who do display foot mechanics so extreme that we recommend treating a flat foot in the absence of symptoms, particularly if they choose activities that put them at greater risk such as running, football, netball etc. This judgement is made based on a thorough walking / running biomechanical assessment in conjunction with a clients own activity levels and types. Appropriate footwear and orthotics are very helpful at managing any negative effects of a flat foot. Both not only solve many acute injuries, but can also promote a lifetime of comfort when exercising while also reducing the chance of an injury reoccurring. FootwearCorrect footwear prescribed for an individual's activity and occupation is an important part of injury prevention. The following is considered based on a client’s requirement: Athletic FootwearThe appropriate athletic footwear is determined based on the following:
We provide the following solutions:
General FootwearThe following are features of ‘good footwear’:
We provide the following solutions:
Growing PainsSee Heel Pain below Heel Pain (Sever's Disease)Sever's disease is an irritation to the growth plate of the heel bone. It is a common complaint in active girls aged 9-12 and boys aged 11- 13. It is aggravated by tight muscles, poor footwear, poor foot function, and activity. It can be a cause of significant pain in younger patients however it responds very well to treatment. We provide the following solutions:
Ingrown Toenails (Onychocryptosis)An ingrown nail will occur when a portion of the nail forms a jagged edge (spicule) and begins to protrude into the surrounding tissue as the nail grows. Ingrown toenails are one of the most common reasons a client seeks the services of a podiatrist. They may occur as a result of poor nail cutting, direct trauma to the area, running in poorly fitted footwear or they may be due to a genetic predisposition which means the nails are too wide or too curled (involuted). Ingrown toenails should be treated as quickly as possible as infection often occurs. Whilst antibiotics may sometimes be required, antibiotics alone are generally not a long term solution for the problem. The nail spicule must be removed, as leaving it will not allow the wound to close and the area is likely to become infected or painful again. We provide the following solutions:
In-ToeingIn-toeing (Pigeon Toes) is a complaint when the toes point inward when walking. This is a common complaint in infants and young children due to the positioning of the hip, lower leg or foot. In most cases, the intoeing position decreases as infants and children grow. It can be the cause of some walking difficulties such as tripping or excessive leg fatigue. We provide the following solutions:
Out-toeingOut-toeing is a complaint when the toes rotate excessively outward when walking. This is a complaint secondary to the positioning of the hip, lower leg or foot. In many cases the condition does not prove to be a problem however leg muscle tiredness and avoidance of walking and standing may result. We provide the following solutions:
Plantar Warts (Verrucae Pedis)Verrucae pedis (plantar warts) are benign lesions that occur on the bottom of the foot in both children and adults. They are caused by the Human Papilloma Virus (HPV), which is one of the more common viruses and is the same virus that leads to warts on the hands and other areas. The virus is believed to be transported via water molecules and transmitted to others through tiny cuts and breaks in the skins surface. Walking barefoot in public amenities, locker rooms and swimming in public swimming pools are among the more common reasons people come in contact with the virus. They can be painful and feel like a rock under the foot when walking if they are on a pressure point of the foot. Their appearance is also quite unpleasant with a plantar wart having a cauliflowered appearance with tiny pigments throughout. The full extent of a plantar wart extends deep below the skins outer layer and explains why these lesions on the foot are more difficult to treat than a wart that appears on the hand. We provide the following solutions:
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