Conditions

Plantar Fasciitis

Plantar fasciitis is a painful condition affecting the plantar surface (underside) of the heels where the plantar fascia attaches to the calcaneus (heel bone).  It is associated with a structural breakdown of the plantar fascia and is characterised by scarring and inflammation.  The most common causes of plantar fasciitis on the Gold Coast would be from overuse activities such as walking, running and playing sport.  Other factors include excessive pronation, leading a sedentary lifestyle, putting on weight, walking around on flat hard surfaces, barefeet walking and wearing the incorrect type of footwear.  Treatment involves treating the causes of the problem in the first place which usually involves a combination of Podiatry and Physiotherapy.  Podiatry will treat issues such excessive pronation, supporting and offloading the area with foot taping, managing footwear and starting off a home treatment plan. Physiotherapy will usually address soft tissue tightness, weakness, core strength and return to activity management.

Heel Spurs

Often mistaken for the cause of patient’s pain because of the often large, sharp appearance of the spur on an xray of the feet.  Pain is usually however associated with the condition called Plantar Fasciitis (see above) which is micro-tearing of the plantar fascia at the sight of the plantar heel.  The heel spur appearance is actually a result of the calcification of the repetitive tearing of the fascia at the sight of insertion into the heel.  The most common causes of Heel spurs and plantar fasciitis on the Gold Coast would be from overuse activities such as walking, running and playing sport.  Other factors include excessive pronation, leading a sedentary lifestyle, putting on weight, walking around on flat hard surfaces, bare feet walking and wearing the incorrect type of footwear.  Treatment involves treating the causes of the problem in the first place which usually involves a combination of Podiatry and Physiotherapy.  Podiatry will treat issues such excessive pronation, supporting and offloading the area with foot taping, managing footwear and starting off a home treatment plan. Physiotherapy will usually address soft tissue tightness, weakness, core strength and return to activity management.

Achilles Enthesitis

Inflammation of the site where the Achilles tendon attached into the calcaneus (back of heel).  This area where the tendon and bone meet is called the enthesopathic junction.  Common causes include tightness and weakness of the calf muscle and achilles tendon, wearing high heel shoes that shorten the calf and achilles, rapid increase in training load, change of training surfaces, inadequate stretching and rest in-between training sessions, poor foot biomechanics including excessive pronation and excessive supination, as well as being overweight and/or weight gain.  Treatment involves addressing calf and achilles tightness, strengthening the aforementioned, managing training load, home treatment of ice and anti-inflammatories, correcting foot biomechanics with the correct footwear and an orthotic device.

Sever’s disease

Sever’s disease also known as calcaneal apophysitis, is a common condition situated at the back of the heels in children usually aged between 9 and 13 years old.  Pain is due to the inflammation of the growth plate of the calcaneus (heel bone).  When the body is growing rapidly the soft tissue can lag behind in terms of lengthening and combined with other factors such as high activity load, hard sports surfaces, flat shoes including sports shoes such as football boots, weak calf muscles and poor foot mechanics, can lead to pain.  Treatment often involves releasing the tension through the calf and achilles by physical therapy, heel raises, home treatment including ice and anti-inflammatory get, strengthening of the calf muscles and core, addressing footwear suited to playing surfaces and foot biomechanics, orthotic therapy if required and activity modification.

Bursitis

Is an inflamed bursal sac.  A bursa is a sac of fluid that lubricates and reduces friction between two surfaces in the body.  Most commonly muscles and tendons as they glide over boney prominences however a bursa can exist in high pressure areas in the body such as in the feet.  From constant microtrauma caused from shoes or repetition activity for example, a bursa can form to protect or cushion that area.  If the microtrauma continues then the bursa can eventually become inflamed.

Conservative treatment can involve correcting footwear that accommodates foot shape, padding, orthotics, anti-inflammatories and ice.  If these are not successful then a cortisone or draining the bursa can be indicated.

Bunions

Hallux Abducto-Valgus

Claw toes

Morton’s Neuroma

Plantar Plate ruptures/injuries

Turf toe

Gout

Osteoarthritis

Metatarsalgia

Stress fractures of the metatarsals

Sesamoiditis

Tibialis posterior enthesopathy

Tibialis posterior dysfunction

Peroneal Brevis enthesopathy

Peroneal tendonitis

Achilles enthesopathy

Achilles tendonitis

Cuboid syndrome

Navicular stress fracture

Kohler’s disease

Os tibialis externa

Os trigonum

Os peroneum

Os navicularis

Sinus tarsi syndrome

Tarsal tunnel Syndrome

Tarsal coalitions

Lis franc injury

Shin Splints

Calf muscle myopathy

Peroneal muscle myopathy

Ingrown toe nails

Callouses

Heel fissures

Fungal nails