Foot pain can be extremely debilitating, not to mention extremely inconvenient given the amount of time we all spend on our feet during the day.

Lately, with the warm weather and people spending plenty of time out and about being active, we’ve seen an increase in foot complaints and in particular, a high number of stress fracture injuries.

A stress fracture is a nasty injury; however, it is important to note that it differs from a regular fracture in many ways.

So here’s the big question:  How do you know when you have a stress fracture or are at risk of developing one?

As professional physiotherapists, we see a lot of nasty foot injuries and have extensive experience in picking the difference between stress fractures and standard fractures (as well as numerous other foot complaints).

A stress fracture is the result of repetitive stress imparted on a particular segment of bone, and is therefore classified as an overuse injury. It is not the result of acute trauma. Typical activities that can result in foot stress fractures include dancing, running and jumpingactivities. We have even seen foot stress fractures recently from excessive walking!

The single greatest contributing factor to a stress fracture is load – that is the volume of activity that you are doing and therefore the cumulative stress that you are putting on the bones in your feet.

Other factors that contribute to developing foot stress fractures include decreased strength and flexibility (especially in your calf and toe flexor muscles), reduced balance, poor biomechanics (including feet rolling in), foot anatomical variances including having a 2^nd toe longer than the 1^st (known as a Morton’s foot!) and inappropriate footwear. Believe it or not the surface on which you are exercising (too hard) can play a role as can low bone density, poor nutrition and even menstrual irregularities in females.

Combine any number of these risk factors together with a high load of running, walking, dancing or jumping activities and you place yourself at high risk of developing a stress fracture and spending a lengthy period of time away from these activities.

The reality is that stress fractures can occur in any of your bones in your body with repeated stress applied to them and they do! Due to the complicated biomechanics of the foot, and the fact that we spend large portions of the day on our feet transmitting our body weight through these tiny bones, it should come as no surprise to know that stress fractures are particularly common in the feet.

The most important role that we can play as physios is in the prevention of a foot stress fracture. This is achieved through noting the early signs of bone stress which include foot pain after activity (which may not be severe initially) which progressively worsens with activity and focal pain on palpation.

In most cases identifying what needs to be done to avoid a stress fracture of the foot is as simple as having a thorough discussion with the patient to ascertain activity load (and recent changes to this) and conducting an assessment of the lower limb biomechanics. This allows us to identify activity overload or biomechanical issues in the area, as these are the main contributors to injury and their identification is key to prevention.

Once it has been determined that you are at risk, our physios will take a number of steps in order to help you recover and prevent further injury. This will typically include:

• Altering activity load as appropriate,
• Gait/running/jumping analysis and intervening to make appropriate changes as required,
• Assessment and recommendation of appropriate footwear ,
• Personalised stretches, strengthening & stability exercises,
• Potential prescription of supportive orthotics,
• Soft tissue release techniques (e.g. massage, foam roller),
• Taping techniques to de-load the area at risk or to facilitate changes to biomechanics.

If a stress fracture is actually diagnosed in the foot, the aim of treatment is to facilitate optimal healing, reduce pain levels in the early stages and ultimately facilitate return to pre-injury activity, whilst minimising the risk or recurrence. Treatment may include the following (in addition to the things listed above):

• Immobilisation of the foot for a period of time (e.g. moon boot or cast),
• Rest from foot loading activities (e.g. running, jumping, dancing),
• Mobilising with crutches to eliminate/limit stress applied to the foot,
• Use of anti-inflammatory measures (e.g. medications & ice)
• Personalised plan to return to the loading activities that you desire!

Got a foot complaint?

No problem, we’ve got you covered.

Here’s what you need to do:

Simply call us at the practice on 8850 7770 and we will prioritise you as a matter of urgency.

Keep those feet happy!

Our team of expert physiotherapists have found over the years that whilst summer sports are in full swing, patients experiencing calf strains are at a peak.

Calf strains are very common among athletes, especially runners and those participating in sports that involve lots of explosive movements like tennis. This injury is caused by a combination of overuse and lack of strength, flexibility and general conditioning.

Suffering from a calf strain can cause you a lot of grief. You will feel a lot of sudden pain up the back of your leg (predominantly in the calf area), have difficulty standing on your toes and experience swelling and/or bruising of the calf muscles.

If you want to ensure that you don’t re-strain your calf, risking further (or repeat) damage, and want to be pain free again, it is highly recommended that you opt to get physiotherapy treatment to restore full function to the area.

What can you do for relief?

The best form of relief for the typical initial symptoms of a calf strain (sudden pain, pain rising on tiptoes, swelling and bruising) can be gained by utilising the RICE method – rest, applying ice and compression and keeping the affected area elevated.

In addition to this, physiotherapy treatment is required in order to restore full function to the area and to aide prevention of injury recurrence.

So, what are typical treatments for a calf strain?

Great question! Typical treatments can include manual therapy, strengthening and stretching exercises, footwear analysis, running technique analysis and a range of other options. After initial treatment and once the muscles have returned to full strength, a plan of progressive running and sport-specific exercises will be recommended to build condition and pave the way for return to active sports.

Can you tell who is at risk of developing a calf strain?

Whilst there is no crystal ball to tell who will sustain a calf strain, there are some factors that can indicate who is at risk. These include those having had previous calf and hamstring strains, especially if they were not completely rehabilitated. Many people sustaining calf strains report a feeling of tightness or lack of strength before sustaining the injury!

So if you or someone you know is experiencing tight calves or has a calf strain, contact the clinic today to take the first step on the road to recovery so you can get back to pain free activity.

Knee pain is one of the most common injuries we see in our clinic. This is partly due to there being many different types of knee pain. Today we want to talk to you about the most common knee injury we treat here, it’s known as Patellofemoral Pain Syndrome.

Keep reading…

So, what is Patellofemoral Pain Syndrome and who is at risk?

Great question!

Patellofemoral Pain Syndrome is a term to describe the pain in and around your knee cap.

For some patients the source of pain can be hard to locate and even harder to describe. As clinicians we describe the pain as vague and diffuse in nature.

Almost everyone who is active is at risk of knee pain, including Patellofemoral Pain Syndrome, but there are certain groups that are more susceptible.

People who exercise or play sports, particularly those that involve sudden changes in movement or speed could be vulnerable to knee injuries. This is because when you run, jump, twist and turn, the extra force and impact is taken by the knee joint.

What leads to Patellofemoral Pain Syndrome?

Just like any injury, the exact causation can vary tremendously from one person to the next.

Some of the most common contributing factors include:
– Feet which roll inwards (pronate),
– Having a knee cap which sits towards the outside of the knee,
– Lower limb muscle tightness,
– Poor muscle function or weakness/imbalance (very common),
– External factors such as poor training routines or inadequate footwear (also very common and often missed in differential diagnosis to the untrained eye).

In many of the Patellofemoral Pain Syndrome cases that we treat, there is often a combination of several of the above contributing factors present.

What can you do to help combat this injury?

First of all, you will need to be assessed by an expert who sees Patellofemoral Pain Syndrome and successfully treats it often.

When you do present to your practitioner, it will really help in our differential diagnosis and subsequent management if you can keep a record of how your pain has been behaving up to that point.

Important aspects for you to note are:
– The specific location of your pain (although this is often difficult),
– What activities make your pain worse,
– A thorough history of when your pain started,
– Whether you are experiencing any clicking, or giving way of your knee,
– The presence of any swelling around the knee.

You should also always inform your therapist of any previous injuries you have suffered that may be affecting your present condition and future management.

The more accurate the information you are able to provide your physiotherapist, the easier it is to determine the best management plan for you so that you can make a successful recovery.

So if knee pain is preventing you for performing the activities you enjoy, or if you believe the way your body moves may be placing you at risk of developing knee pain in the future, please call our clinic for an initial consultation and we can get you on the road to recovery.

That’s all from us today.

Netball Australia has launched The KNEE Program, which is a warm-up program aimed to reduce lower limb injuries (specifically Anterior Cruciate Ligament injuries in the knee) in netballers.

Anterior Cruciate Ligament injuries account for roughly a quarter of all serious netball injuries and have a significant impact on the lives of the injured individual.

The majority of injuries sustained during netball occur when the player lands from being in the air. The KNEE Program “targets safe take off and landing technique with specific attention to the overhead position required of netballers.”

The KNEE Program stands for Knee injury prevention for Netballers to Enhance performance and Extend play. There are 3 variations of the program catering to all netballers – Junior, Recreational & Elite. The program can be found at www.knee.netball.com.au and has a host of resources to explain the program in detail including videos of the program components.

We strongly encourage netballers and coaches to commence using the program on a regular basis and that this contributes to an overall reduction in serious lower-limb netball injuries.

CAM boots, moon boots, fracture boots….they are all different names for the same thing.

A CAM boot is used to help immobilise the foot and/or ankle following injury/surgery to allow for healing to occur. They are useful in managing the following conditions:

• Foot/ankle fractures,
• Severe ankle sprains,
• Following foot/ankle surgery.

There are a range of different CAM boots available and the right boot depends on the specific injury. There are short boots, long boots, boots that allow some movement and boots that allow no movement at all.

Arrow Physiotherapy stocks a range of CAM boots and can fit the right boot for your injury. We will also ensure that you know how to put on/take off your boot and are able to mobilise safely whilst wearing it (some injuries will allow you to walk on the boot, whilst others require you to be non-weight bearing).

If you require a CAM boot, please phone us on 8850 7770 to make an appointment for a fitting.

A recent study by Janssen et al. (2014) published in the British Journal of Sports Medicine has demonstrated that ankle braces are better than neuromuscular training in the prevention of recurrent ankle sprains.

Neuromuscular training is the completion of strengthening and balance exercises to restore ankle strength, balance, reaction time and function. This form of training is an essential component of rehabilitation following an ankle sprain.

The above mentioned study showed that 27% of people undertaking the neuromuscular training re-sprained their ankle within 12 months. This compared to 15% of people who re-sprained their ankle wearing a brace.

This study does not take into account the severity of any ankle sprain and whether a brace or neuromuscular training has any impact on the severity of any potential re-injury. The study is also non-specific when it comes to what sport or exercise the participants were undertaking, co-existing injuries, age or gender.

The study does highlight that there is a role for bracing in the prevention of recurrent ankle sprains.

Ankle braces are commonly available although there are numerous varieties on the market. Many factors need to be considered when selecting an ankle brace including the material it is made of (rigid vs elastic, does is have supportive stays down the side?), the sport played, location of injury and durability.

To find out whether neuromuscular training or ankle bracing would be beneficial to your injury, consult your sports physiotherapist.