Ingrown toenails

What is an ingrown toenail?

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An ingrown toenail is a condition commonly treated by the podiatrists at Gold Coast Foot Centres. Ingrown toenails occur commonly, but not exclusively, in one or both sides of the big toe nail where the nail edge pushes into the surrounding skin.  This can cause pain and irritation to the skin, and can often lead to infection if left untreated.

 

What causes an ingrown toenail?

There are a few common causes for ingrown toenails:

-       Incorrect trimming technique

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-       Trauma to the toe (stubbing your toe)

-       Tight fitting shoes

-       Poor foot hygiene

-       Picking at toenails

-       Fungal infections

 

 

Signs and symptoms

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Common signs and symptoms of ingrown toenails include:

-       Pain around the edge of the nail

-       Redness and swelling around the nail

-       Clear/ yellow discharge

 

 

Treatment

Ingrown toenails are simple to treat if treated early. Once an ingrown toenail becomes red, swollen and infected it becomes a lot more difficult to treat. For this reason it is best to consult with one of our podiatrists as soon as you experience discomfort. It is not recommended that you treat your own nail if you suspect an ingrown toenail as incorrect trimming technique and unsterilized instruments can lead to further infection and pain.

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When the ingrown toenail is not too serious, our podiatrists can quickly and painlessly remove the offending nail spike. This simple procedure is completed in our clinics using a special instrument to trim the nail and will reduce your pain immediately.

For more severe or reoccurring ingrown toenail cases a safe and effective procedure can be completed in our clinics. This is called a partial nail avulsion and can provide a more permanent solution for ingrown toenails. Our podiatrists use local anesthetic so no pain is felt throughout the procedure.  Patients only require the rest of the day off work, and can return to work the next day.

For more information on how Gold Coast Foot Centres can help you with your ingrown toe nail, please contact one of our clinics.         

Gold Coast Kokoda Challenge Blister Prevention

With the 96 Km Kokoda Challenge on the Gold Coast coming up soon it is paramount that you get your blisters under control. The following is a guide on what blisters are and the best way to prevent them.

What causes blisters?

A simple test to start with. Place your right index finger on the back of your left hand. Keeping it stuck to same bit of skin, wobble your finger back and forth. This is shear. This is what causes blisters. Friction is what holds your index finger in the same position. It is the rubbing of the skin on the underlying structures, rather than on top of the skin that causes the blister. This rubbing causes tears in deeper layers of the skin called an intra-epidermal split, which fill with fluid within around 2 hours. Irritation on the surface of the skin then adds abrasion to the injury.

There are a number of factors that cause blisters including:

-          Skin type
-          High friction and pressure
-          Bone movement
-          Repetitiveness


Why on our feet?

Rather than just one event leading to an increase in blisters on your feet compared to anywhere else, there are a few aspects that combine to create a ‘perfect’ environment for blister formation. Firstly, the skin on the bottom of your feet is thicker and less mobile. Less mobile skin means an increased amount of shear. Secondly, the environment around your foot is hot and humid. This is due to a high density of sweat glands in your feet, combined with the fact that your feet are generally wrapped up in socks and shoes, trapping moisture. Thirdly, unlike anywhere else in the body, you experience high weight-bearing pressures through your feet. As mentioned above, increase pressure leads to increased blister formation. Lastly, the repetitive nature of trail walking/running creates recurring shear and pressure in the same area over and over again until a blister forms.


Prevention

Preventing blisters requires a multifactorial approach, and there is certainly no one size fits all method.

Shoes

Length: the length of the shoe should allow around a thumbs width in between the end of your longest toe and the end of the shoe. You should keep in mind that particularly during longer walks and runs that your foot will swell. Your foot may also slip forward in the shoe, especially during downhill periods, so allowing a small amount of room at the front of your shoe is paramount.

Width: When your foot is in your shoe with the laces done up comfortably, your foot should not be bulging over the sides of the shoe. Similarly, there should be no bunching of the upper of your shoe. You should be able to just pinch a small amount of the upper.

Ability to adjust: having the ability to loosen/tighten your shoes is very important. For this reason slip on shoes are not ideal. Shoes with laces are most appropriate.

-          Lock lacing is a lacing technique, which is particularly helping in prevent heel slippage. 


Socks

In the blister world, socks can either be a hindrance or your biggest ally. Moisture wicking socks are certainly the way to go, as higher moisture equates to higher friction. Cotton socks are most likely the worst socks you can wear due to their predisposition to trap moisture within. Acrylic and polyester fibres are most commonly used in moisture wicking socks, as they have the ability to move moisture away from your foot; although, the viability of this also depends on the breathability of your shoes. A nice breathable upper is most preferable. Waterproofing and Gortex lined shoes may reduce breathability. It may be difficult to find a happy medium in trail walking and running, as we want to do everything we can to keep moisture out of our shoes, but also want to allow moisture to escape. Having a couple of spare pairs of socks and even a spare pair of shoes for river crossings may be ideal. 

Some technical socks are also available in an anatomical fit, ie there is a left and right sock. This will improve the fit of your sock and reduce movement. In combination with this, socks with less seams or seamless will be most beneficial.

Wearing 2 pairs of socks has also been shown to reduce friction. The idea is to wear 2 pairs of socks that are slightly different from one another in their material. Similarly, toe socks may also prove beneficial, particularly if you have difficulties with blisters in between your toes.


Cushioning

It is thought that cushioning insoles may help with blisters on the plantar (bottom) surface of your foot by dispersing plantar pressures.

Cushioned insoles also have the ability to absorb shear, so your skin doesn’t undergo the same shearing strain. Having said this, there is limited research in the area.

Orthoses

Depending upon area of irritation, orthoses and padding can be added to shoes to alter mechanics to offload certain area For example, you may have a particularly supinated foot type and might be getting lateral forefoot blisters. In this case an orthotic / padding may be added to pronate the foot and offload the area in question. Another example may be that you have a rather prominent 1st metatarsal head, with a large amount of pressure going through this area. Once again, padding can be added to reduce the pressure under the 1st metatarsal head.


Skin

Your skin has an incredible ability to adapt to certain stressors. Over time your skin can become resistant to frictional forces and particular layers of the skin even become thicker. Adaptation occurs from spending more time in the shoes you plan on wearing and increased amount of training in the your particular activity, in this case trail walking/ running. Calluses are also the bodies natural response to prolonged pressure, although despite what you may think, do nothing to impede the formation of blisters.


Skin drying is another popular technique. Applicants like antiperspirants, and powders are commonly applied to reduce moisture on the foot. Antiperspirants attempt to prevent the skin from sweating, although at foot level are relatively ineffective. If there is any benefit from this technique, it is only very short term. Powders such as talcum powder are also thought to provide some relief by absorbing any access moisture. Frequent application is needed in this case, as too much as once can increase chances of blistering. Similar to antiperspirants, there is only a small amount of benefit from this practice. As previously discussed, moisture wicking socks are the best method for keeping your feet dry.

Lubricants can be hit and miss. Some can be helpful in the short term, while others such as moisturisers and less greasy lubricants can actually increase friction. Viscous, greasier lubricants do have the ability to reduce blisters, but only for around 60-90 mins after application, after this timeframe friction can increase. Targeted application is best, as excessive and unnecessary application can be messy and increase blistering by occluding the skin and not allowing it to breath. From this your skin can weaken (think of your skin if you’ve been in the bath too long) and be more susceptible to breakdown. Popular choice Vaseline is not ideal as it can attract grit and become messy.


Taping

 There has been very little research on taping to prevent blisters, although it is a widely practiced technique with mixed results. It certainly has the ability to prevent blistering if applied properly. The tape should stick on skin well with no creases that may cause irritation. It should also be applied at least at hour before the event to allow time for it to stick on the skin’s surface. Blister prevention patches can also be effective in reducing friction.


If you have any further questions or would like to book it to see one of our podiatrist at Gold Coast Foot Centres please visit our website www.goldcoastfootcentres.com and book in at your most convenient clinic.

Foot strike Pattern; is it one size fits all?

Is heel striking bad? Should I change to a forefoot striking pattern? I always get injured, should I consider changing how my foot lands? There is an enormous amount of information out there today regarding foot strike pattern; hopefully this article will provide some clarity.

 

What does the research say?

In summary, most of the literature written today basically suggests there is no advantage in regards to injury rate between forefoot, midfoot and rearfoot striking.

Most research suggests that the majority of us are heel strikers, with articles citing 87% (1) and 95% (2) of recreational runners land heel first, whereas around 89% of marathoners are heel strikers.

Studies have also shown little to no difference in injury rate, running economy and efficiency (3,4,5). One study looked at 202 Ultra marathoners. Over the course of the study, half of the participants got injured. Foot strike pattern was deemed not to be an indicative factor. Interestingly, the only related factors were age, being female and having a longer stride length.

From the research we know that during ground contact, in a forefoot striking individual, there is a decrease in patella femoral joint loading (anterior knee), although an increase in ankle loading (6,7); this is the opposite for a rear foot striker. Prior to ground contact, we have also learned that in a forefoot striker, there is increased activity in the calves and decreased activity in the anterior shins during late swing phase. In contrast to this, rear foot strikers exhibit increased activity in the quadriceps and lateral hamstring during late swing phase (8).

It must be noted that most of the evidence available today is of medium level. There have been a couple of studies completed which are of low level evidence suggesting that a forefoot striking pattern reduces the rate of injury. As both were lower level studies, their clinical significance is somewhat irrelevant.

 

What are the implications for injury?

Force cannot just disappear, but rather be dispersed from one place to another. This principal can be applied in running. Move the force from one tissue, and it will be placed on another tissue. I think from a combination of the research available and clinical experience the following could be assumed, but not assured, about foot strike pattern and certain injuries.

-       More common in mid/forefoot strike pattern

o   Metatarsal stress fractures

o   Achilles tendon injury

o   Calf injury

o   Dorsal midfoot pain

o   Posterior tibial tendon problems

-       Heel strike pattern

o   Tibial stress fractures

o   Tibialis anterior injury

-       Less common in mid/forefoot

o   Patellar femoral pain

-       Less common in heel strike

o   Peroneal tendonitis

-       Not sure

o   Medial Tibial Stress Syndrome

o   Calcaneal stress fractures: Always thought of as a heel striker injury, although has seemingly become more prevalent in mid/forefoot. Perhaps this is not due to the impact force, but rather a pulling force from the achilles tendon?

o   Plantar heel pain

 

Foot strike pattern as a treatment tool

As mentioned, most of the research suggests that a forefoot strike pattern will lead to a decrease in anterior knee loading, and an increase to ankle loading. With this in mind it may make sense for a runner that is experiencing anterior knee pain, to very slowly and carefully transition to a midfoot or forefoot landing pattern. Research has also shown that reducing stride length by 10% can also be effective in reducing knee joint loads (9). Perhaps a combination of the two would be most effective in reducing knee loads? Having said that, the risk of developing ankle and forefoot issues must be considered, as a change in gait will lead to an increased load elsewhere.

What about a patient with an achilles tendinopathy? The opposite could be said for this patient, where a heel strike landing pattern might be most appropriate, as ankle loading is less in a heel striker. Delving further into the idea of loading, our current knowledge on tendinopathy is that they respond best to calculated and gradually increasing loads. In the case of an achilles tendinopathy, a heavy isometric calf raise strength program might be appropriate. Going by this thought process could we potentially gain the same results in a tightly monitored situation where someone transitions to a forefoot striking pattern, slowly and gradually increasing achilles loading.

I think that the take home message should be that not one size fits all. All of this is just food for thought, as there are not many concrete answers on the subject. All things must be weighed up with an appropriate health professional before making a decision. From a rehab perspective, the aim is to transfer from one tissue to another. With a sound knowledge of functional anatomy and running mechanics, we can make small and calculated alterations to gait to achieve a reduction in stress in a certain tissue.

I’ll leave you with this image from the Men’s 10km trials for the 2012 London Olympics. The image depicts the foot strike pattern of the participants who are among the most elite runners in the world. This perhaps tells us that the best way for your foot to land is however you please

Nelson Pollard
Podiatrist
Gold Coast Foot Centres

References

-       Characterization of Foot-Strike Patterns: Lack of an Association With Injuries or Performance in Soldiers: MAJ Bradley J. Warr; Rebecca E. Fellin; Shane G. Sauer; LTC Donald L. Goss; Peter N. Frykman; Joseph F. Seay

-       Is the rearfoot pattern the most frequently foot strike pattern among recreational shod distance runners? Matheus Oliveira de Almeida, Bruno Tirotti Saragiotto, Tiê Parma Yamato, Alexandre Dias Lopes

-       Is changing footstrike pattern beneficial to runner: Joseph Hamill and Allison H. Gruber

-       Foot strike pattern and injuries in Ultramarathoners

-       Characterization of Foot-Strike Patterns: Lack of an Association With Injuries or Performance in Soldiers: MAJ Bradley J. Warr; Rebecca E. Fellin; Shane G. Sauer; LTC Donald L. Goss; Peter N. Frykman; Joseph F. Seay

-       Patellofemoral Joint Stress during Running with Alterations in Foot Strike Pattern. Nathan Vannatta, C.; Kernozek, Thomas W.

-       Forefoot strikers exhibit lower running-induced knee loading than rearfoot strikers Kulmala, Juha-Pekka; Avela, Janne; Pasanen, Kati; Parkkari, Jari

-       Differences in Muscle Activity between Natural Forefoot and Rearfoot Strikers during Running Jennifer R. Yong, Amy Silder, Scott L. Delp

-        The influence of minimalist footwear and stride length reduction on lower-extremity running mechanics and cumulative loading Colin R. Firminger, Brent W. Edwards

2017 Football Boot Review

It’s that time of year again where the AFL season is beginning to ramp up. With an abundance of football boot options available it can be tricky to decipher which ones are most suited to you. After trying on and testing a number of options, we’ve come up with our most favoured boots for the upcoming season. 

Before we get in to the boots themselves there are a couple of things to note. Firstly, everyone’s foot is made differently; different foot shapes, difference mechanics, different loading patterns, different injury concerns etc. For this reason, a boot that may be great for one person, may not be ideal for you, and the boot that may be best for you, may not even be on this list! Another important factor to consider is training load in football boots and variability. It would be ideal to complete running components of training in your runners, and the football specific tasks in your boots. This is potentially the best formula to reduce your chance of getting injured in the preseason

 

Asics -Lethal Tigreor 10 IT

-       10mm heel raise

-       Increased rearfoot cushioning

-       Good torsional rigidity and stability, with a firm heel counter

-       Kangaroo leather upper

-       Increased amount of studs

-       Removable sock liner

-       Orthotic friendly

The 10mm heel raise is particularly beneficial to those who may have achilles issues, as the elevation reduces load through the posterior musculature complex. Similarly, it may also be helpful for those with any anterior ankle impingement, as the heel pitch may ‘open up’ the anterior ankle.

A higher amount of studs may help reduce plantar pressures through certain areas, particularly around the 1st metatarsal phalangeal joint (MPJ or big toe joint).

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Asics -Lethal Legacy IT

-       Shares all of the characteristics of the Tigreor

-       Slightly wider and deeper, although less cushioned when compared to the Tigreor

-       Orthotic friendly

Being slightly deeper and wider than the Tigreor, the Legacy is a little more suitable for those who have a wider foot, and is also slightly more accommodative for orthotics, should you require them.

 

Asics -Lethal Ultimate IGS 12

-       10mm heel raise

-       Highly comfortable with full length cushioning

-       Good torsional rigidity and stability, with a firm heel counter

-       Grass cut type boot

-       Shorter and increased amount of studs

-       Wider fitting

-       Good preseason boot

-       Removable sock liner

-       Orthotic friendly

Due to the superior cushioning and shorter stud lengths, this boot is ideal as preseason boot. In addition, this boot is nice and wide for those with a wider foot.

 

Nike Tiempo Legend VI FG

-       Good width

-       Firm heel counter

-       Relatively good torsional rigidity and stability

-       Premium Kangaroo leather

-       Suitable for wet and dry grounds

-       Removable sock liner

-       Orthotic friendly

Not quite as wide as the aforementioned Legacy and Ultimate, although utilizes a soft leather upper which has the ability to stretch quite easily

 

New Balance Visaro 2.0 FG

-       Available in 2E width

-       Lightweight

-       Removable sock liner

-       Orthotic friendly

The predominant aspect I like about this boot is that it comes in a 2E fitting. Wide footy boots can be difficult to come across, so this is a great for those after a wider fitting boot.

 

Adidas Ace 17.1 Primeknit

-       Narrower fitting

-       Lightweight  

-       Available in Kargaroo Leather in the toebox

-       Removable sock liner

 

Puma King II FG

-       Good width and depth

-       Comfortable

-       Removable sock liner

-       Orthotic friendly

 

X Blades Legend Max

-       Has a removable 10mm heel wedge

-       Wide fitting

-       Removable sock liner

-       Orthotic friendly

Question mark over whether bladed cleats have the potential to cause metatarsal stress fractures and knee injury. Not all bladed boots created equal, not every foot is the same and not all surfaces are the same, for this reason the blades cannot be ruled out completely.  Another good option for those looking for a wider fitting boot

 

If you have any concerns about football boots for the upcoming season, or any foot related queries, please see us at one of the Gold Coast Foot Centres Clinics


Nelson Pollard

PODIATRIST

Gold Coast Foot Centres

 

Plantar Heel Pain

This condition, commonly known as plantar fasciitis, or more recently plantar fasciosis, is one of the most common problems that we treat at Gold Coast Foot Centres.  Plantar fasciitis is an overuse injury involving the plantar fascia, a thick connective tissue on the bottom of the foot, originating at the heel and attaching at the metatarsal heads. Originally thought to be an inflammatory condition, recent research has suggested that it may be a non-inflammatory condition, hence the recent thought to change the term to plantar fasciosis. For the sake of this article, we will refer to the condition as plantar fasciitis.

Symptoms

There are a number of characterising symptoms which occur in people with plantar fasciitis including:

  • Pain is most severe after getting out of bed, or sitting for a prolonged period. Improvement of symptoms usually occurs after walking

  • Barefoot may exacerbate pain

  • Pain is generally unilateral, although can effect both feet

 

Risk Factors

As plantar fasciitis is an overuse injury in most cases, activities that increase load through the plantar fascia could increase the chance of developing heel pain.

  • Increase in activity levels

  • Increase in weight

  • Both ‘pronated’(flat feet), and ‘supinated’ (high arched feet) have been shown to be a contributing factor

  • Tight calf and Achilles, and poor footwear also may have implications in the development of this condition

Diagnosis

The diagnosis of plantar fasciitis can usually be done in a clinical setting. Pain can be palpated at the medial calcaneal tubercle and may be reproduced by stretching the plantar fascia by dorsiflexing the big toe. Dorsiflexion of the ankle may also be limited due to tightness in the calf and Achilles. Imaging is not generally required, although if confirmation of the diagnosis is needed, an ultrasound may be ordered.

Differential Diagnosis

  • Heel spurs – Despite common belief, almost all of the time, heel spurs do not cause pain and is not the cause of heel pain.

  • Plantar fascia tear or rupture – this is generally characterised by an incident with sudden onset of pain

  • Fat pad contusion – damage to the fatty pads in our heels can be the cause of heel pain

  • Fractures and stress fractures of the heel

  • Various types of arthritis

  • Bursitis

  • Nerve complications arising from the back, ankle and feet

  • Various systemic illnesses

Treatment

  • First line treatments include rest, ice, specific stretching and strengthening exercises, sports taping, activity reduction and NSAIDS such as ibuprofen

  • Footwear advice: The correct shoes can reduce load through the plantar fascia. Athletic shoes are ideal for this condition, as they provide cushioning to the heel, and usually have a heel height differential of around 1cm, which offloads the heel, achilles and calf. Going barefoot can exacerbate symptoms, therefore should be avoided if painful. An appropriate thong or open toed shoe may be a good option to help alleviate pain, especially for around the house. One such option we have been using in clinic with good success is the Telic thong, comprising  a contoured foot bed with superior shack attenuation.

  • Orthotic therapy: Ideally reducing the load through the plantar fascia can achieve a reduction in symptoms. A custom orthotic has the ability to do so and can be very helpful in reducing symptoms.

  • Manual therapy: Reducing the tightness in the calves can improve results. This can be achieved via massage, dry needling and foam rolling.

  • Other treatment options include extracorporeal shockwave therapy, corticosteroid injections and night stretching splints.

  • Surgery should be considered as a last option.

 

Please consult one of the podiatrists at Gold Coast Foot Centres for advice and treatment if you are experiencing any foot or lower limb related problems

 

Nelson Pollard

PODIATRIST

Gold Coast Foot Centres



 

Metatarsal Stress Fractures

Metatarsal stress fractures are said to be the second most common fracture site, behind the tibia, in the athletic population. Stress fractures of the 2nd, 3rd and 4th metatarsals make up around 90% of metatarsal stress fractures, with fractures of the 2nd being by far the most common. This is thought to be for several reasons such as:

-          The 2nd metatarsal is generally longer than the other metatarsals and sits higher on the    forefoot parabola, therefore does not share a common axis with any of the other              metatarsal heads

-          A pronated foot type is thought to be associated. As the foot pronates the 1st MTPJ is dorsiflexed, leaving the 2nd metatarsal head to be the predominant weight bearing structure

-          The 2nd metatarsal is also firmly anchored at its base. It is wedged between the medial and lateral cuneiforms, as well as being anchored down by the tarsometatarsal ligaments (short and long plantar ligaments and continuation of the tibialis posterior tendon). This is all said to lead to increased bending forces during activity.

Minimalist shoes and shoes with a lower heel height differential have also shown to increase loading in the plantar forefoot. Although not confirmed, this increase in load through the forefoot may lead to increased incidence of metatarsal stress fractures.

 

Symptoms and Imaging

Stress fractures are a result of a cumulative load in the tissue which the tissue cannot tolerate and evolve in the following pathway:

-          Bone strain: this a dynamic response to stress in the bone. At this stage, there are generally minimal symptoms and changes are only visible on bone scan imaging

-          Stress reaction: There is local pain and tenderness. A stress reaction is not visible on plain          x-rays

-          Stress fracture. There local pain and tenderness with diffuse oedema. A stress fracture can usually be seen on an x-ray 2-3 weeks after the incidence.

As a stress fracture is a result of a cumulative load, rather than an acute occurrence, the onset of pain is gradual, made worse with activity and generally follows a period of increased activity or training intensity. Bone scans can be used as an aid in diagnosing metatarsal stress fractures due to their excellent sensitivity and specificity, although MRI is becoming more advocated due to its fantastic anatomical resolution

 

Treatment options

Treatment revolves around rest to allow the injured structure to heal. The use of a weight bearing CAM walker, or carbon splint to reduced metatarsal bending is sometimes used. Non-weight bearing x-training is encouraged. Usual training can be recommenced once the fracture site is pain free upon palpation. A monitored and graduated return to sport is required.

If you think you may potentially have a stress fracture, or any other concerns with your feet, please contact one of the Podiatrists at Gold Coast Foot Centres.

Pregnancy & Your Feet

Foot Pain During Pregnancy

During pregnancy, women can suffer from foot pain for various reasons. The most common which occur include general foot pain, plantar fascia pain, ingrown toe nails, corns and callous. These usually occur around the 2nd or 3rd trimester. This article discusses some of these problems, with some helpful tips to reduce any discomfort.

What causes foot pain during pregnancy?

Ligament laxity – During pregnancy there is an increase in the hormone relaxin. As the name suggests, relaxin causes relaxation of muscle and ligaments around the hip and pelvis to prepare for child birth. Although, it doesn’t only effect the hip and pelvis, but also other structures around the body including the feet. This ligament laxity can cause changes in the feet, particularly the arches. These changes may lead to increased load through certain muscles, joints and ligaments causing pain.

Increased fluid retention – While pregnant, there is an increase in the amount of blood and fluids produced by the body to cater for the baby’s needs. For this reason, women tend to experience fluid retention in their feet and ankles, manifesting in swelling. This can lead to increased pressure from tight fitting footwear, and problems associated with oedema.

Increased weight – With pregnancy comes weight gain, and as a result, increased loading through the feet and lower limb.

How to minimise pain during pregnancy

Footwear – Having the correct footwear can assist in the reduction of foot pain in a number of ways. Footwear should firstly have a method of loosening or tightening the shoes. This should ideally be laces, otherwise Velcro and buckle straps are okay. This decreases clawing of your toes and allows for loosening of the shoes as fluid retention increases. High heels should be avoided as they place greater strain on the forefoot, and are generally unstable. Shoes with a pointed toe should also not be worn as they increase the chance of ingrown toenails and corns. The ideal shoe during pregnancy is an athletic shoe, although this is not always appropriate.  

Exercise – More so during the end of the 2nd trimester and during the 3rd trimester largely weight bearing activities may need to be reduced or avoided. Activities such as swimming and pilates may be suitable. Swimming is a good option as it is non-weight bearing and can also act to reduce fluid retention. Pilates instructed by a qualified physiotherapist can be a good way to strengthen muscles around the pelvic girdle, which can reduce pelvic instability.   Always consult with your obstetrician regarding your exercise routine.

Minimising fluid retention – Legs should be elevated at the end of the day, and also after long periods of being on your feet. Calf and foot exercises can be effective in reducing fluid retention in the calf, ankles and feet, as well as the exercises mentioned above, supportive socks and stockings can also assist in this matter, although a GP should be consulted prior to purchasing these.

Additional – If foot pain is persistent you may require further assessment and intervention. This may be orthotics or taping to appropriately offload structures in your foot, or stretching and strengthening.    

For further help and advice on foot care during pregnancy, please make an appointment to see one of the podiatrists at Gold Coast Foot Centres

 

Nelson Pollard

PODIATRIST
Gold Coast Foot Centres

 

Gold Coast Airport Marathon

Gold Coast Foot Centre tips for the upcoming Gold Coast Airport Marathon

Footwear

Make sure you have the right shoe for you. What does that mean? Sounds pretty straight forward doesn’t it… not at all! There are so many factors to consider, some of the more important being running shoe history, previous injuries, preference in feel of the shoe (softer or firmer) fit (wider, narrower, deep, shallow etc) and heel height, just to name a few. There’s no exact science to what the best shoe is, but rather what the best shoe for YOU is going to be. If you’re not sure where to start, get in touch with one of the podiatrists at Gold Coast Foot Centres www.goldcoastfootcentres.com  or a speciality running store who can point you in the right direction.

Generally speaking, I like to have at least 200kms in a pair of shoes before race day. This will ensure that you’ve had adequate time to appropriately wear in and adapt to the shoes. This minimises any adaptation issues such as blisters.

Another good tip during training is to have 2 pairs of runners that are slightly different from one another. There is an optimal amount of time for your shoes to ‘rest’ in between runs. Therefore, if your training plan calls for you to run on back-to-back days, then you may not be allowing appropriate rest, and might be shortening the lifespan of your shoes. Having 2 pairs of shoes you can swap between will minimise this factor. It is also thought that having 2 pairs of shoes, different from each other, can reduce injury risks. The reason for this being when you change between the 2 pairs, the stimuli from your feet is being slightly altered, as well as differed loading patterns and muscle timing. For example, your predominate training shoe may be a softer shoe with a 12mm heel height, and your secondary shoe used for interval training might be a firmer shoe with a 6-8mm heel height.

 

X-training, different terrains, altered intensity and distances

Similar to having 2 training shoes, incorporating x-training, different terrains and altered intensities and distances can be effective in reducing injury risks. If unsure how to best devise a training plan, consult a health professional or running coach.

 

Nutrition

Studies have shown that consuming carbohydrates during your run can boost performance. Generally speaking, if you perform more than 75 minutes of running, you can benefit from carbs during your run. Most research suggests around 30-60g of carbs per hour, after the first hour of running. There’s no exact amount which you should be consuming, but you can use common sense to tweak this to suit you. If you’re a heavier person your consumption might be at the higher end of the 30-60g scale. If you’re performing at a higher intensity you may also be at the higher end of the scale. Some people will also benefit from carbohydrate loading in the days leading up to the race.

Nutrition can be a highly personal thing. Something that may work for one person, may not for another individual. The key to it all is practicing what works for you, and fine tuning it through trial and error. Come race day you should know exactly what will allow your body to function most efficiently. For more specific information, please consult a dietician.

Footcare

Often runners find their toenails become black and bruised after long runs. This is due to repetitive micro trauma to your toenails. This can result from a number of factors; your nails may be too long, your shoes may be too small causing your toe to hit the end of your shoe or your shoes may be too big causing your toes to claw in order to hold the shoe on your foot. This can be avoided by ensuring your nails are appropriately trimmed and footwear is fitted correctly.  

Blistering can also be a large factor. Either caused by friction or pressure, blisters can be extremely painful and limiting. Strategies such as applying body lubricants, taping, having the right shoes for you and proper socks are all good strategies. There are particular socks on the market which are designed to wick moister away from your foot, decreasing the chance of blistering. Some are also anatomically fitted, having a left and right sock will improve the fit and decrease the chance of bunching or rubbing from your socks.

General maintenance and foot care can also be beneficial during training to reduce the build-up of callous, maintain your nails and monitor for things like blisters with regular podiatry visits.

Finally, enjoy your training and preparation and register through www.goldcoastmarathon.com.au 

Good Luck!!

For more information contact one of the Gold Coast Foot Centres Podiatrists, Ben Harcourt, Darren Gaffney or Nelson Pollard.

Nelson Pollard

PODIATRIST

Gold Coast Foot Centres

Multisports Magazine

Multisports Magazine is Australia’s #1 free Multisport and Triathlon Magazine!

Multisport Magazine is educational, inspiring and entertaining, connecting with the local athlete whether a professional, a weekend warrior or purely for social enjoyment.  

Click on the below link, it is a must have resource tool for anyone interested in multisport competition.

   http://multisportmagazine.com.au

Darren Gaffney

PODIATRIST

Gold Coast Foot Centres

AFL Pre Season

Start of the AFL season! Things to consider…

With the start of the AFL football season upon us, here are some things that we should be considering in regards to foot health.

The right shoes

An imperative part of both pre-season and during the season is the right shoe.

Pre-season: Through-out this part of the year, players generally complete a larger amount of running compared to during the season. For this reason, we would recommend players wearing running shoes, rather than football boots, particularly when doing running and fitness based activities. In combination with wearing running shoes, there is also some benefit to having 2 different pairs of runners. This mixes up loading patterns and encourages longevity of your shoes which can potentially reduce your risk of injury. A good way to do this is to have a pair for shorter interval runs, and a pair for longer runs. Certain types of shoes will be better than others for these activities, if you have any queries about correct footwear please discuss with your Gold Coast Foot Centres podiatry team.

In-season: During the season your most prominent shoe will be your football boot. Choosing the right football boot can be determined by many factors.  These might include the shape of your foot, previous injuries, individual preference, playing position, whether you have orthotics or not and many other factors. Once again, depending on the amount you might be playing, having 2 different pairs can sometimes be beneficial, not only for injury reduction, but also to be prepared for differing conditions ie. Wet weather boots vs dry weather.   


Things to consider when buying football boots:
-              Always bring the socks you will be wearing during the game to try on
-              Consider whether you prefer moulded studs, blades and or screws, and which type and configuration will suit your position best.                       
-              Comfort, fit and function is more important than aesthetics and brands
-              Have you boots professionally fitted where possible and consult your Gold Coast Foot Centres podiatry team if your not sure.

Overuse injuries

There are a myriad of overuse injuries which can occur during the football season. Some of the more common overuse conditions treated at The Gold Coast Foot Centres include:
-              Medial Tibial Stress syndrome (Shin splints: pain around the area of the inside of the shin)
-              Severs (heel and Achilles pain in children)
-              Achilles pain
-              Sesamoid pain (pain under the big toe joint)
-              Plantar fasciitis (heel pain)

Other overuse injuries which you may experience include patellar femoral pain, patellar tendinitis (knee pain) and Iliotibial band syndrome (pain around the outside of your knee and upper leg).

Skin and nail conditions

Skin and nail conditions of the feet can be quite common and uncomfortable. Generally caused by the sudden initiation of activity, or the introduction of tight shoes and potentially wet environments, these are some of the common problems you may see:
-              Callous and corns (hard thick skin on the foot which can sometimes cause pain)
-              Ingrown toenails
-              Tinea (itchy and peeling skin between and toes and on the bottom of the foot)
-              Blisters

Prevention of these conditions can be done through good foot hygiene, changing out of wet socks as soon as possible, wearing well-fitting shoes and keeping nails properly trimmed.

 

If you find you are having any of the problems mentioned above, please arrange an appointment with one of our podiatrists, Ben Harcourt, Darren Gaffney or Nelson Pollard at The Gold Coast Foot Centres .
 

Nelson Pollard

PODIATRIST
Gold Coast Foot Centres
 

Sever's Disease or Calcaneal Apophysitis

Sever’s Disease

Also called calcaneal apophysitis, Sever’s is a traction apophysitis caused by excessive and repeated traction force from the Achilles on the calcaneus (heel bone). The calcaneus does not reach full maturity until around 12-13 years of age, and for this reason we most commonly see Sever’s in children from the ages of 7 to 14. This condition is also more commonly seen in boys.

Causes

The underlying source of this condition is tensile force on the insertion of the Achilles on the calcaneus. This can be exacerbated by a number of things:

  • Rapid growth of the tibia and fibula during growth spurts placing large force on the insertion

  • Tight calf muscles

  • Activities that involve repetitive running, jumping, hopping etc. For example most football codes, basketball, running and gymnastics

  • Shoes with tight heel counters

  • Foot and lower limb mechanics

Signs and Symptoms

  • Pain and tenderness around the posterior and plantar aspect of the heel, which is generally worse after activity or upon wearing shoes with a tight heel counter

  • There may be some swelling in the area

  • A limp or toe walking may be present

Treatment

  • Rest from aggravating activity

  • PRICE (pain control, rest, ice, compression and elevation)

  • Stretching program

  • Massage

  • Padding, strapping and heel raises

  • Optimisation of foot mechanics

  • If symptoms are persistent please contact one of our podiatrists for a specific treatment plan

 

 

Nelson Pollard

PODIATRIST

Gold Coast Foot Centres