Foot pain

The warm weather has brought with it a seasonal spike in the amount of foot pain we are seeing in the clinic. We are featuring two of the more common types that we have seen this summer.

Tendonitis

“Itis” just means inflammation, so tendonitis is essentially an inflammation of the tendon. Tendons are essentially like elastic bands, and joint our muscles to the bone. We have lots of these in the foot and ankle, as there isn’t much room in the area for big muscles, and any of these tendons can get inflamed and painful. This type of pain is very bad first thing in the morning and often starts out just with this symptom, but as it gets worse it can become painful when you are on your feet, and throb when you are resting.

The important thing about managing tendonitis is that you catch it early and nip it in the bud. This is so important, as after about 2 weeks of tendonitis, the tendon starts to wear down, and more permanent changes happen to the structure of the tendon. This can leave you with a chronic problem, which, while treatable, requires a bit more expertise, time and effort to address.

Heel pain

The most common area for heel pain is shown in the picture above. This type of pain in the heel can often be caused by heel spurs, or a bruised heel. This sort of pain usually comes on gradually and for no obvious reason, and is typically worse in the morning, improves with exercise (only in the early stages), and is aggravated by standing and eventually walking.

Sometimes this can be caused by tightness in the plantar fascia, which is a soft tissue structure on the sole of our foot. This can get tight from exercising either excessively or with poor support for the foot, and this tightness can then pull on the heel and cause pain. It can also be caused by walking on shoes with too hard a heel, which can essentially bruise the bone.

Again, the important thing when treating heel pain is to settle it down quickly. We usually do this in the clinic by providing some form of small insert to take the pressure off the painful part of the heel. Taping the foot can often help it to feel better more quickly, as can ice massage of the area and loosening out any tightness that may have caused it.

So it is very important to catch it early and fix the problem. There are very often obvious explanations for why you got the pain, if this is the case it is important to eliminate the cause so that you don’t keep encouraging the tendon or heel to be inflamed.

Examples of causes of foot pain in summer-time are:

1. Walking or running on the beach -  this is great for working the leg and foot muscles, however if it is something that you are not used too, and you suddenly started doing alot of it, it can just prove to be a bit much for your feet.

2. Walking or being on your feet for long periods barefoot or in bad flip-flops – if you have flat feet, or feet that are used to cushioning and support, and then you suddenly throw away all of that support and spend long periods in poor or no support (either standing, just being active, or exercising), this again can overwork parts of the foot that are not used to it, and eventually cause those structures to start complaining. Likewise if you have a high arch and suddenly start going barefoot this can irritate the foot.

3. Getting out more! Nice weather encourages us to get outdoors, which is just fantastic. But again, if we go too hard too soon, and push our body beyond its limit and keep pushing it, the structures don’t get enough time to recover by the next exercise session, and they get overworked and damaged. So if you are taking up or resuming an activity, make sure you factor in recovery days, and try to build up gradually. Stretching tight muscles will help to keep things moving more smoothly. See examples of leg stretches here:

http://eastcoastphysio.ie/blog/stretches/

4. Weight gain over being overweight or obese puts more pressure on our feet.

How do I treat foot pain if I get it?

Catching and managing it early is key. If the pain is less than 2 weeks old:

1. Rest from whatever activity you think may have caused the problem.

2. Ice the area regularly (10 mins on, 10 mins off and repeat regularly).

3. Taking anti-inflammatory medication or gel can be beneficial (once there is no medical reason why you shouldn’t be taking it).

4. Stretch out tight muscles in the area.

5. Think about your footwear- generally trying to wear something with some arch support, good cushioning and a slight lift at the back of the shoe.

If all of the above doesn’t clear the pain within a week, you have the pain longer than that or it is severe, it is wisest to get it seen to, before longer term issues develop in the foot. We can assess the problem and advise a treatment plan to sort it out. The earlier it is managed correctly the quicker and more complete your recovery, so don’t take any chances. Also bear in mind that these are just 2 examples of foot pain, there are many other causes, so it is important to get assessed to ensure things are dealt with correctly.

 

 

 

 

10 Rules for minimising walking or running injury!

1. Get into the right shoe:

Poor biomechanics are the root of alot of running injuries. Chartered Physiotherapists can perform a detailed assessment to identify any such problems that can lead to injury, such as fallen or high foot arches. You will be advised of the best running shoe for your foot type – specialist sports shoe shops can also be of help. Make sure you are wearing a proper running or walking shoe.

2. Follow the 10% rule: never increase your mileage by more than 10% per week, and never increase both your speed and distance in the same week.

3. Warm-up: make sure to warm-up adequately before exercising. This prepares the body for training by increasing your heart rate, flexibility, and body temperature. A dynamic warm-up for running should include gentle jogging, stride outs and drills, and for walking, just build up the pace over the first 5-10 mins.

4. Cool- down: cool down properly after your run or after a long or fast walk. This should include some static stretching and foam rolling if possible. Stretches should be held for at least 20 seconds.

See stretches here: http://eastcoastphysio.ie/blog/stretches/

5. R&R: rest and recovery. Allow at least 1 rest day per week, if you don’t you risk overtraining syndrome. Difficulty sleeping, a higher resting heart rate, and darker urine are all signs of being burnt-out.

6. Listen to your body: don’t let niggles develop – anything not sorted out with a couple of days rest should be assessed.

7. Variation: vary running direction and running surface. Smooth, soft surfaces such as grass and trails are kinder than running on concrete. Running on the same side of the road can lead to strain if there is a camber in the road.

8. Get the foundation right: runners need a solid foundation, or good “core stability” to minimise strain on their back and legs. Pilates and strength training are good forms of this.

9. Roll it out: foam rolling is a good way of helping your muscles to recover. See our video on foam rolling here: https://www.youtube.com/watch?v=1hW9kAZu2HU

10. Be patient! Set realistic goals and work towards them gradually (see rule 2!).

 

Golf Stretches

Golf flexibility is important to avoid injury and to improve your performance.  Throughout the game of golf you use a variety of muscles and ensuring they are all flexible will enable the best swing.  Areas to highlight for flexibility in the majority of golfers are the shoulders, lower back and hamstrings. Flexibility exercises should be performed a few times weekly for the most benefit

#1: Side Stretch

Stand with your feet slightly apart, keeping your hips facing forward. Lift your left hand overhead and stretch it to the side over your head. Use your club to improved the stretch.  Hold the position for 10 seconds, release and repeat with your right arm.

#2: Rotation Lunge

Put your hands on golf club positioned at your side.  Take a big step forward with one foot into the lunge position. Extend your back knee. Hold for 10 seconds. Release and repeat other side

 #3: Hamstring Stretch

Lie flat on your back. Lift one leg into the air and hold the back of your thigh with your hands. Pull your leg towards you. The other leg should be flat on the ground. Hold for 10 seconds. Repeat, alternating legs.

#4: Cats up and down

Get onto your hands and knees. Keep your arms in line with your shoulders and your legs in line with your hips. Hollow and arch your back. Repeat 10-20 times.

#5: Back Flexion Stretch

On your hands and knees, push your bottom down to your ankles. Hold for 30 seconds. Repeat.

 

Any exercise holds an element of risk if undertaken without supervision. These exercises are recommendations only and are performed at your own risk. If you feel any discomfort or pain during exercise, stop immediately

 

Carpal Tunnel Syndrome

What is carpal tunnel syndrome?

It is compression of a nerve at your wrist, which can cause numbness, tingling and pain in your palm, thumb, and most of your fingertips (depicted in blue in the picture).


Causes include:
- poor wrist/arm positioning at a computer
- repetitive hand and wrist work (eg cooks, musicians, painters), especially in cold temperatures
- physical work involving vibration (such as driving motorbike, operating a drill)
- pregnancy, diabetes and being overweight are all linked to carpal tunnel syndrome, as are our genetics.
- women are at higher risk than men.
Symptoms generally start as mild, some can get better on their own, but others can get worse over time.

Prevention:

Anyone who does repetitive tasks should begin with a short warm-up period, take regular breaks, and avoid overexertion of the hand and finger muscles whenever possible.

1. Take multiple breaks:

  • Shake or stretch the limbs
  • Lean back in the chair
  • Gently squeeze the shoulder blades together
  • Stand up and walk around.

2. Good Posture, especially for typists and computer users.

  • sit back into the chair with the shoulders relaxed.
  • elbows should rest along the sides of the body, with wrists straight.
  • feet should be firmly on the floor or on a footrest.
  • typing materials and computer screen should be at eye level so that the neck does not bend over the work.

3. Good desk and chair.

Chairs should be adjustable for height, with a supportive backrest. Sit well into your chair to get the support out of it, and keep your chair close to the desk.

4. Keyboard and Mouse Tips.

  • Keep the hands and wrists in a relaxed position to avoid excessive force on the keyboard.
  • Use wrist rests, which fit under most keyboards, to help keep the wrists and fingers in a comfortable position.
  • Keep the computer mouse close to the keyboard and the user’s body, to reduce excessive strain.
  • Hold the mouse lightly, with the wrist and forearm relaxed. New mouse supports are also available that relieve stress on the hand and support the wrist.
If you think you may have carpal tunnel syndrome and it doesn’t go away with the above advice, best to get it assessed. Give us a call on 0404-49781 or email info@eastcoastphysio.ie.

Sitting, the “creep”

Have you ever stood up and found it takes a minute or two before you can fully straighten?

This could be because of a phenomenon called “creep”. This is when our soft tissues, if not regularly moved, start to assume the shape that we are in.  It only takes 20 mins of being still in one position before this happens!

Unfortunately, modern life has us sitting a lot more than we should be. This has adverse effects on many aspects of our health, including our spinal health.

Creep is reversible with movement, but the longer it continues, the less reversible the changes in the soft tissues and joints become, and the harder it becomes to correct.

How you can help yourself:

- move regularly- whether this means standing up and moving around, simple shoulder movement, or sitting up good and straight and turning your head and your body from side to side. Do so every 20 minutes (it only takes a few seconds).

- try to reduce your sitting time in general- our spines need regular movement for good health.

- sit well – the more your slouch, the more your soft tissues and joints are put under strain.

- if you sit for most of the day, choose an exercise that straightens you out! Walking, swimming, running all involve upright postures and get the blood circulating around your body, including into your spine, which we need for our spinal health.

If your stiffness doesn’t clear up with the above advice, best to get yourself assessed so that we can give you advice best suited to your particular situation and body.

Shoulder pain

The most common type of shoulder pain that we see in the clinic is a shoulder impingement. This is essentially a general medical term for “pinching” of some of the structures in the shoulder, which is a busy and complex place, as you can see in the image below (first picture = arm by side, second picture = arm lifted, arrows show the “pinch” point).

With a shoulder impingement, the movement of the arm when it is lifted causes the bones in the shoulder to move closer together, which can pinch some of these structures in the shoulder, causing pain.

A common cause of this is posture- people who have slouched shoulders are more at risk of this, as slouching the shoulder brings the bones closer together, making it easier to pinch things in the shoulder when the arm is lifted.
Another cause is weakness in the upper back, shoulder and shoulder blade- if these muscles don’t work well, too much pressure is put on the shoulder, particularly in physical tasks such as gardening, housework, lifting, and overhead sports such as tennis.

Shoulder impingement is very treatable, but like anything, much slower to get better if it has been there a long time, so the quicker you address it, the best chance you have at a quick recovery.

What is a Chartered Physiotherapist?

In Ireland the title “Physiotherapist” is not protected by law, and so is not evidence of formal qualification in Physiotherapy. This can be confusing to the general public.

However “Chartered Physiotherapist” is a protected title, and requires a university degree in physiotherapy, and membership of the professional regulating body the Irish Society of Chartered Physiotherapists (ISCP). The terms “physical therapist” and “physiotherapist” are interchangeable internationally, but The World Confederation for Physical Therapy recognises the ISCP as the sole authoritative body for physical therapy in Ireland.

To become a Chartered Physiotherapist we must have a university degree in physiotherapy.  We are medically trained, and are recognised by the Department of Health.  Chartered Physiotherapists are regulated by the ISCP. We are a science and evidence based profession. In order to maintain our chartered status, we are required to perform continuing post-graduate education to keep our practise up to date with the best current practise.

It is important to ensure that your physiotherapist is a member of the ISCP. Chartered Physiotherapists are recognised and covered by VHI, Quinn Healthcare, Vivas and other health insurance schemes.

 

Tips for preventing aches and pains from Christmas shopping

It’s all about planning ahead!

1. Wear comfortable, well-fitting shoes.

2. Don’t overload individual shopping bags – spread the load over a few bags and between both hands. If you can bring your bags back to the car and start afresh halfway through even better.

3. Don’t put shopping bags too far into the back of your boot (you’ll have to bend excessively to get them out).

4. Where possible use a trolley instead of a basket.

5. Ask about delivery services.

6. If possible shop at quieter times to avoid standing in a queue.

7. Factor in breaks, where you can sit down and rest!

8. Shopping online can save you alot of physical hardship – If you are shopping online, remember that you could be on your smartphone, tablet or computer for a long time – make sure to sit well, stand up and stretch tall every 20 mins, roll your shoulders, shake your hands out.

9. Try not to do it all in one day – you’ll have too much to carry! (not always possible, I know).

And lets not forget some of the many benefits of shopping  local – less time stuck in traffic and supporting local business.

The downside of wearing high heels….

The down side of wearing high heels – some points taken from the diagram below include:

-          Knee joint pressures increase by up to 26%, and forefoot pressures by up to 76%.

-          The calf and Achilles tendon can tighten up, which can lead to a variety of problems, including foot and leg pain.

-          Pressure from the shoes can cause bunions and painful bumps at the back of the heel.

-          Joint pain and deformities can develop over time due to tight fitting toes and              pressure from the heel.

The bottom line is, while you don’t have to throw out your beautiful shoes, but choose to limit your time spent standing or walking in them.