As the sportsman’s injury, plantar fasciitis makes sports headlines in the USA, UK podiatrist, Martine Abrahams sheds some light on this common, often debilitating condition

High profile athletes might create headlines, but this painful condition can affect us all.

The plantar tendon and its function:

Albert Pujols, player for Los Angeles Angels of Anaheim, the latest elite athlete left sitting on the bench, thanks to plantar fasciitis

The plantar tendon runs the length of the bottom of your foot, spanning the area from the base of the toes to the front of your heel. The two ends of the tendon attach at the base of the toes and at the front of the heel bone by means of fascia, a strong fibrous membrane. The plantar tendon keeps the arch of the foot from flattening completely when the foot bears weight, providing cushioning and shock absorption during walking, running or standing. This tendon also allows you to point your toes.

Albert Pujols, player for Los Angeles Angels of Anaheim, the latest elite athlete left sitting on the bench, thanks to plantar fasciitis.

What is Plantar Fasciitits?
When the plantar plantar fascititis 1fascia tissue is stressed, small tears can occur, which in turn, causes extreme pain during movement or even weight bearing – or any movement that creates a pull on the tendon.
Stressors can be varied in nature and include: regular exercise/sport, heel striking during striding, tight calves, inflexible Achilles tendon and wearing high heels.

 

 

Other common causes of plantar fasciitis include:

  • Wearing inflexible or worn out shoes
  • Very low or high arches
  • Being overweight
  • Spending long hours on your feet
  • Tight calf muscles or tight/stiff ankle muscles
  • Walking barefoot in soft sand for long distances
  • Those with natural flat feet (hyper-pronation) seem to suffer this condition more than others

Symptoms of Plantar Fasciitis:
Pain can be extreme and is often felt on the underside of the heel and more intense at the start of the day: “You almost want to pee in your bed rather than go to the bathroom,” Pujols told USA TODAY Sports. “It’s really painful in the morning.”

Treatment:
This condition can be difficult to treat and, perhaps most annoying for those who enjoy exercise, is that the main solution is rest, combined with physiotherapy, anti-inflammatory medications, corticosteroid injections and/or night splints to stretch the injured fascia.
As a short-term pain relief measure, you can roll the bottom of the foot back and forth over a tennis ball or cold bottle of water, to gently stretch out the tendon and disperse the fluid that pools there.

Stretching exercises can also help:

Orthotics can be worn to help support the foot arch:

Ultimately, prevention is probably better than cure where plantar fasciitis is concerned. Wear good shoes with adequate arch support; stretch the area well before and after exercise and regular foot massages will all help.

Prepare your feet properly for the marathon season warns leading London Podiatrist, Martine Abrahams

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Prepare your feet properly for the marathon season.  Things are finally hotting up – well, at least in the world of extreme running, if not the weather!

Take things slowly and prepare your feet gradually for the abuse that lies ahead.   They are going to take a pounding over the next few weeks and if you don’t prepare carefully, you could do some damage – most problems are reversible, but the symptoms could stop you competing.

  • Not many of us like it hear it BUT stretching before starting any exercise is vital to keep injuries at a minimum.
  • Choose the right type of footwear for the specific terrain – there are so many styles and brands of running shoes, all promising different things, it can be very confusing, try contacting your podiatrist for advise.
  • Ask a trainer to suggest the best way to build up your routine so all leg muscle groups are engaged slowly and completely warmed up before the long distances are tackled.
  • Here are some common injuries to look out for – and ideally prevent

Shin splints: Shin splints, which are painful and appear at the front and inside of the leg, are often caused by running on hard surfaces, over striding, muscle imbalance, or overuse. Shin splints can also be related to the shape and structure of your feet. Treatment includes rest, stretching, changing your running technique, and rebalancing foot mechanics with special show inserts. Physiotherapy can also be helpful. If you begin to feel this type of pain, slow down, take shorter strides, and see a podiatrist at your first opportunity.

Stress fractures: A stress fracture is a tiny or incomplete crack in a bone that is often caused by overuse. Stress fractures occur most frequently in the foot and ankle, so your podiatric physician is well trained to diagnose and treat this problem. Signs of a stress fracture are pain that increases with activity and decreases with rest, pain that increases over time or pain that persists even at rest. Often a stress fracture will result in swelling and a spot that feels tender to the touch.    Prompt diagnosis and treatment of a stress fracture can often prevent further injury. A podiatrist can determine your best treatment with x-ray and a physical examination. Many stress fractures can be treated with rest, ice and over-the-counter pain relievers. For most people, an appropriate period of rest will be sufficient for the bone to heal, but like all fractures, the bone can take up to 8 to 10 weeks to heal completely. In other cases, your podiatrist may need to immobilise the affected bone with a cast, cast boot, fracture shoe, or a splint. Surgical intervention may be suggested if other, more conservative treatments are not effective.

Blisters and nail problems: Runners often have blisters and nail problems but with a little maintenance and care, they can be avoided or minimised, so that they don’t limit your ability to keep up your training routine. Blisters are caused by skin friction. Don’t pop them. Apply moleskin or an adhesive bandage over a blister, and leave it on until it falls off naturally in the bath or shower. Keep your feet dry and always wear socks as a cushion between your feet and shoes. If a blister breaks spontaneously, wash the area, apply an antiseptic, and cover with a sterile bandage. Nails can become bruised or broken. Keep nails short to limit damage and if trauma occurs remove any loose pieces of nail by cutting with nail scissors and filing smooth with an emery board.

Ingrown nails are nails whose corners or sides dig painfully into the skin, often causing infection. They are frequently caused by improper nail trimming but also by shoe pressure, injury, or poor foot structure. Runners are particularly susceptible to nail problems, and long-distance runners often lose some of their toenails entirely while they are training. If an ingrown portion of the nail is painful or infected, your podiatrist can remove the affected portion to allow for healing. It is possible to permanently remove the offending portion of the nail to prevent occurrence. Soaking in warm salt water can relieve the discomfort of ingrowing toenails and prevent infection.

‘Locker room’ nail fungus – typically, fungal spores thrive in dark, damp, warm environments, and running shoes are perfect breeding grounds.  Look out for signs of Athlete’s Foot, itching under the arch or between the toes; little red spots over the sole of the foot; flaky skin particularly under the arch or around the heels; and moist, white macerated skin between the toes. Treat with over the counter topical anti-fungal cream. Athlete’s Foot can lead to nail fungal infections and vice versa…

Symptoms to look out for:

  • Thickened nails
  • Crumbly or brittle nails
  • Nail distorted in shape or separated
  • Nail with no lustre or shine
  • White, yellow or brown coloured nail

Conventional treatments include topical creams, and oral anti-fungal tablets, however a new laser treatment ‘Lunula Laser’ or ‘cold’ laser is revolutionising nail fungus treatments. Contact my office for more information https://staging.thelondonnaillaserclinic.co.uk

Marathon running can give you a real sense of achievement and an increased feeling of wellbeing – just remember to take care of the most vital component to a successful fun run – your feet!

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Chiropodist vs Podiatrist?

Image   Chiropodist vs Podiatrist?

I find clients are still a little confused about the perceived difference between the two terms, when in fact they are the same discipline.   Chiropody underwent a name change in 1993 and is now known as Podiatry.

The reason for this?  A Podiatrist is internationally recognised as a foot specialist, so it makes sense for all practitioners to be under the same name umbrella.

In my opinion it was a positive change, as the science of Podiatry is continually evolving.  Podiatrists diagnose, treat, and prevent diseases of the foot – but are also specialists of lower limb disorders.

The training of Podiatrists is constantly evolving, and is now an accepted medical based discipline.  An intense 4 year degree course, followed by post graduation continuing education enables Podiatrists to treat a vast array of foot and lower limb conditions.

Some Podiatrists choose to specialise in the area they find most rewarding whilst others practice general podiatry.  Some specialist areas:

Biomechanics – joint alignment

Orthotics – custom made insoles/shoes

Podopaediatrics – lower limb disorders in children

Surgery – an increasing amount of foot surgery is performed by specialist Podiatrists

Sports injuries – Podiatrists often work alongside physiotherapists

Personally, I am passionate about technological advances that have impacted on podiatry.  Laser science is the most dramatic, offering massive benefits to those suffering from nail infections of all kinds. The ‘cold’ Lunula Laser is revolutionising nail fungus treatment and, by using variable light energy, the procedure is both pain free and effective – a very exciting development!

No longer an enclave of the elderly, men and women of all ages consult Podiatrists for a variety of conditions.  As with most medical problems, prevention is better than cure so make sure you look after yourself – and your feet!