With the return of competitive sport after a year of very little, ‘Severs’ seems to be the buzzword around kids sport! What is Severs and how do we treat it?
As a result of the evolving COVID-19 we have revised our hours for the safety and health of both patients and our practitioners.
As a result of the evolving COVID-19 circumstances, we are adapting the way we provide podiatry for some of our current and new clients. We are still here for you, but for some clients this may be in a different way to before!
Ingrown toenails can be debilitating, footwear dictating and just downright painful. They occur when the nail edge pushes into and/or irritates the nail sulci, commonly resulting in infection and inflammation. It can also occur when a nail 'spike' is left behind from cutting the nail incorrectly.
Nicki has been using Footwork to manufacture custom orthotics for close to ten years now.
In the video below, Nicki discusses the benefits of working with Footwork to manufacture custom orthotics.
Footwork is a boutique Podiatric Laboratory specialising in custom orthotics utilising their own designed software.
Children are growing, and active children are often prone to growth-related injuries. Many of these can be prevented by having your child in the right type of shoe for their foot type and activity. So here’s a bit of information about different types of shoes!
Children spend much of their time in their school shoes, so they are just as important as sports shoes. If they are able to wear a sports shoe for school, then that is probably the best option for them – see below regarding runners and cross-trainers. If they are required to wear a black lace-up shoe, they need to have :
Depending on the type of activities they are participating in, children can wear either runners (designed for forward motion) or cross-trainers (designed for sports that involve change of direction). Most running and cross-training shoes have a ‘heel gradient’, which means that the heel of the shoe is higher than the toe of the shoe. The benefit of this gradient is to reduce the load through the calf, ankle and other structures in the foot. It is particularly important for children, as they are prone to pain in their heels if they wear a shoe that is too flat. If your child’s foot is pronated (heel rolling inwards and low arch) then they need a supportive shoe. These have a firmer material under the arch. If they have a normal or higher arched foot, then neutral/cushioned shoes are more appropriate.
Most traditional soccer boots are made without a heel gradient (flat from heel-toe). This can unfortunately increase the risk of injuries in junior players. Boots can be for firm ground or soft ground, however children should only wear firm ground boots, as they distribute pressure more evenly across the foot. There are boots available that do have a 10mm heel-toe gradient, which I recommend for children. These can either be a ‘grasscat’-style boot (more like a runner with lots of studs underneath), or a traditional style boot with a 10mm heel-toe gradient.
Please note this is a guide only. If you need specific advice regarding footwear for children please contact Podiatrist Nicki Quigley at Bayside Sports Podiatry, 13 South Concourse, Beaumaris – 9589 3777
A stress fracture is a partial or complete bone fracture, resulting from repeated low grade stress. There has normally been an increase in the amount or intensity of activity just before the foot gets sore. The pain is worse with activity, and is usually in a specific area of the foot where the fracture is present. It may settle with rest, or continue at a low level.
The most common areas of the foot that present with stress fractures are the metatarsal shafts (2nd, 3rd and 4th), the navicular bone, and the sesamoid bones (little bones that sit under the big toe joint).
Diagnosis is usually made by feeling the sore area, description of pain and description of the amount of training and the surfaces that this training has been on. Sometimes an X-ray, MRI or CT scan are needed if the diagnosis is uncertain, or if an athlete wants to continue training and needs specific details of their injury.
A rapid increase in training loads or intensity (too much too soon)
Navicular stress fractures are more common in sprinting and jumping sports
Hard surfaces such as concrete can increase the risk of stress fracture when combined with other factors
Depending on the location of the stress fracture, feet may either be over-pronated (rolled inwards, flattening of arch) or supinated (high arch, stiff foot type). Pronated feet often cause increased loading through the metatarsals and midfoot joints. Stiff ankles and high arched feet can have reduced shock absorption which can be a contributing factor.
Wearing the incorrect style of shoe for the activity, or footwear that does not have adequate support, can be a major contributing factor to the development of a stress fracture. The drop or gradient of the shoe (height at the back compared to the front) should be at 10mm for most activities.
Can be a factor in female athletes (‘the female triad’ – disordered eating, amenorrhea and osteoporosis).
Sometimes a cam walker needs to be worn for up to 8 weeks. Cross training is recommended, as long as there is no pain (swimming, pool running, cycling) to maintain fitness levels. Some stress fractures (particularly of the navicular and 5th metatarsal) need surgery.
This can detect a limb length discrepancy, over-pronation (rolling in of the ankle and flattening of the arch), muscle imbalance or weakness, and joint stiffness. Orthotics may need to be issued or the foot taped, to improve foot function. A footwear assessment also needs to be undertaken, and shoes updated if necessary. Sometimes, the patient may need to undertake gait retraining, which involves changing running technique through strengthening and repetition of improved technique.
This usually starts with a jog/walk program, which slowly increases the amount of jogging time. This progresses up to a 15 minute jog pain-free before any increases in intensity can be added or any agility, depending on the sport. The overall training program will then need to be reviewed, to monitor loads long term.
A training program should always include different surfaces, different intensities, and even different footwear. Cross-training is vital to any training program (swimming, pool running, cycling, rowing).
If you need any advice regarding treatment or prevention of a foot stress fracture, see Podiatrist Nicki Quigley at Bayside Sports Podiatry - 9589 3777.
If you are having pain in your feet, legs, hips or back, you may require orthotics to improve your foot position and function during activity.
Orthotics are insoles that are issued by Podiatrist’s, and are worn in shoes to redistribute pressure, and reduce stress on certain structures in the foot and lower leg. They are used for both the treatment and prevention of injuries. They should only be issued after a full biomechanical assessment has been conducted, which looks at a person walking, running, the movement of their joints, strength in their muscles, and checking the wear pattern on their footwear. Orthotics are used in a variety of foot types (flat or high arched feet) and are worn by participants in a variety of sports. They can be fairly rigid, or very flexible/soft, depending on foot type, activities and footwear.
A higher arched foot needs a more flexible orthotic(a rigid orthotic under a high arched foot is very uncomfortable). A lower arched foot needs a slightly stiffer orthotic so it doesn’t compress too much when they walk on it, to ensure good support.
Heavier people need a stiffer material, or it just squashes underneath them and doesn’t give enough support.
Sports that require directional changes will need a more flexible orthotic. Some sports also require light-weight orthotics, or low bulk orthotics to fit into football boots and running spikes.
Harder training surfaces will need a more flexible orthotic to improve shock absorption.
Football / soccer boots, racing spikes and racing flats may require lower bulk orthotics for shoe fit. Most of the time, a full length cover is added to the top of the orthotic for comfort, but sometimes a smaller cover works better in spikes and flats. Ballet shoes are difficult to fit orthotics into, but sometimes a very low bulk pair can fit, although often dancers are just better off strapping their feet (a Podiatrist can show you how to do this).
Custom-made orthotics are generally more durable, and can be made specifically for a foot type. Off-the-shelf orthotics don’t fit every foot type. Some feet need increased tilt at the heel or more specific support, and others just don’t suit a generic device because their arches are too high or too low. Custom-made orthotics are more expensive, but they last longer. For short term injuries, where you may not be required to wear orthotics long term, off-the-shelf orthotics (if they are suitable for your foot) are perfect. They can be issued on the day of consultation, and once your injury has settled, they no longer need to be worn. I normally try to issue off-the-shelf orthotics for children with injuries or biomechanical concerns if appropriate, as their feet are growing rapidly and changing shape. Sometimes, athletes might prefer an off-the-shelf orthotic for their sports shoes, and a custom-made orthotic for their everyday shoes or vice-versa.
It will take you 1-2 weeks to adjust to wearing orthotics, although I normally give people 4 weeks to fully get used to wearing them, so they can run in them for a few weeks before I review them. They should be comfortable within one week of wearing them for daily activities, and you should be comfortably playing sport in them 2 weeks later. If this is not the case, then you should see your Podiatrist, as they may need a minor adjustment. Often stretching and strengthening exercises are given when orthotics are issued, and you should make sure you adhere to these, as orthotics are usually only part of your treatment plan.
Your Podiatrist will advise you how much you need to wear your orthotics. Some people just need to wear them for activity, others need to wear them for about 80% of the day or more. This will depend on the reason you were given orthotics (to settle an injury, to prevent the progression of a foot deformity such as a bunion, or to improve walking and running style).
Custom-made orthotics normally last an average of 5 years. During this time, the cover often needs replacement once or twice (depending on the amount and type of activity – some AFL players need several recovers in a season). Off-the-shelf orthotics usually last about 12 months.
You should have your orthotics reviewed by a Podiatrist every 1-2 years, to ensure they are still supporting your feet adequately. If you start to have any pain in your feet or legs or feel like the orthotics are not supporting you as well as they were, then have them checked earlier.
Bayside Sports Podiatry is now consulting at The Sports and Spinal Group in Beaumaris. Podiatrist Nicki Quigley is accepting appointments on Monday 9am-2pm, Tuesday 2-8pm and Saturday 8am-1pm.
Nicki Quigley has been practising as a Podiatrist since 2002. With her diverse knowledge of all sports, Nicki has treated Olympic track and field Athletes, international soccer players, AFL footballers from numerous clubs, national tennis players, national netballers, Victorian cricket players and NRL players.
Nicki looks forward to seeing you at our new Melbourne bayside location at 13 South Concourse Beaumaris.
We're excited with the launch of our new website which marks the start of a new era for Bayside Sports Podiatry. Our new website is currently undergoing the final stages of finalising more content and pages. The site should be complete in the next 2 weeks so we appreciate your patience. Stay tuned and we hope you'll visit us again soon..!
