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Sore feet? Plantar fasciitis relief!

Sore feet? Plantar fasciitis relief!

Plantar fasciitis is inflammation of the plantar fascia and is the most common cause of heel pain. The plantar fascia is the thick band of connective tissue under the foot that runs from the heel bone at the back of your foot to the toes at the front. It essentially acts like a sling to support the arch of your foot.

What causes Plantar Fasciitis?
There are a number of causes including:
Age as it is more common in middle-aged people due to ‘sagging’ of the arch of the foot, but can occur in younger people who put a lot of load through their feet.Weaknesses can occur in the muscles that support the arch of the foot, which causes the plantar fascia to take an increased load which can irritate
Poor bio-mechanics can contribute to plantar fasciitis i.e. having flat feet or high archesWeight gain or excess weight can put extra load on the plantar fascia, irritating .
the tissues; this can also occur from the weight gain during pregnancy
Repetitive loading i.e. high level sports or working on your feet
Poor support from footwear i.e. worn or ill-fitting shoes
Arthritic foot joints can irritate the plantar fascia
Diabetic people have an increased chance of suffering from plantar fasciitis

Signs and Symptoms of Plantar Fasciitis
Pain at the base of the foot near the heel with weight-bearing
More pain after getting out of bed, or after prolonged sitting
Heel pain will be worse with the first few steps and will gradually improve as you move more

Diagnosis
Generally your physiotherapist will be able to diagnose plantar fasciitis from your history, symptoms and a clinical examination.

Treatment
Calf stretches often give relief to sufferers – it is important to stretch both calf muscles, so stretch with a straight leg and also a bent leg. Hold each stretch for 30 secs and repeat twice. Try to do this at least morning and night every day.
Freeze some water in an old water bottle and roll the bottom of your foot up and down on this.
Taping can offer you some relief while you are doing your exercises to off-load the plantar fascia.
Strengthening is an important component of treatment for plantar fasciitis as it improves the ability of the foot and ankle muscles to support the arch of your foot hence off-loading the plantar fascia.

Book an appointment with one of our physiotherapists who can help you with ideas for strengthening exercises to help ease the pain caused by plantar fasciitis.

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Runner’s Knee: We can help!

Runner’s Knee: We can help!

At first it was just a niggle in your knee when you climbed stairs or were squatting. Then the pain and stiffness became more than a niggle and you began to feel it when walking, sitting and resting.

You may be hearing popping or cracking sounds in your knee, and notice that your knee “gives out” every now and again.

The knee is an amazing but complicated joint and knee pain is one of the most common reasons that people visit a physiotherapist.

Pain behind the kneecap is commonly called runner’s knee because it is often seen in athletes and people with an active lifestyle, although it can also be seen in everyone from the young adolescents during growth spurts to elderly people.

The medical term is patellofemoral pain syndrome. It is pain behind the kneecap where your patella (kneecap) slides along the groove in your femur (thighbone) beneath.

Pain and stiffness occurs when the kneecap does not slide smoothly and misaligns causing it to rub against your femur. Repeated mis-tracking causes pain, stiffness, and ultimately can cause damage to your kneecap joint surface.

Knee pain is most commonly noticed during activities that involve knee bending, jarring or weight bearing.

People most at risk are those whose sport or activity includes running, jumping or the need to land in a squatting position. Sports most commonly associated with knee pain include running, netball, volleyball, basketball, tennis, skiing and cycling. Many tradies such as tilers and carpet layers also have problems.

Causes of Runner’s Knee

Overuse – increased activity or increased duration and intensity of the activity
Changes in footwear or playing surfaces
Tight outer thigh muscles and weaker inner thigh muscles causing the kneecap to be pulled to one side
A twisting injury
Surgery
Excess weight
Flat feet and lack of arch support
Weak hip control muscles

First aid for Runner’s Knee

Generally, knee pain is gradual onset, which means it gradually increases in severity over time.

As with most injuries, the best initial first aid is rest, ice packs (15 minutes at a time every 2-3 hours), and taking anti-inflammatory painkillers such as ibuprofen.

You do not need a referral from a doctor to see a physiotherapist. If the pain is moderate, then you can seek treatment with your Physiotherapist immediately.

Physiotherapy Options

Physiotherapy is a proven treatment for runner’s knee. Your physiotherapist may initially tape or strap your kneecap to help pull it back into alignment and reduce pain.

Massage and joint mobilisation techniques are also commonly used to reduce swelling and restore movement.

You will be prescribed exercises to stretch and strengthen muscles that may be contributing to the problem. These exercises will change as you heal and will gradually increase in intensity to match your recovery.

If you wish to continue exercising to maintain your fitness during your treatment, then explore swimming, deep-water running and low-impact gym equipment such as elliptical trainers.

Depending on your knee pain cause, you may also be advised to explore arch supports, orthotics or different footwear. You may also require postural or technique correction in your chosen sport to stop problems from recurring, as well as a strength and conditioning plan to get you back to full competitive fitness.

In our experience, over 90% of runner’s knee physiotherapy clients will be pain free within six weeks of starting treatment. However, for severely damaged joints or arthritic joints, surgery may be required.

Things to Remember

Runner’s knee or patellofemoral pain syndrome is a common cause of knee pain.

It is a gradual onset injury and is most commonly noticed during activities that involve knee bending, jarring or weight bearing.

Physiotherapy is a proven method to speed healing, and prevent recurrence of knee pain.

Future management may also involve assessment of your gait and posture during exercise, and prescription of arch support or custom made orthotics.

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Foot Pain: Plantar Fasciitis

Foot Pain: Plantar Fasciitis

Foot Pain OUCH!

You leap out of bed in the morning and you get stabbing pains in your heels or the arches of your feet. You hobble a few steps, and then hobble a few more until the pain reduces. Most of the day your feet feel OK …except when you tackle stairs or when you have been sitting for a while when the pain makes a reappearance.
Pain in your heel or the bottom of your foot is most commonly caused by Plantar Fasciitis. Your Plantar Fascia is the ligament that goes from the underneath of your heel to your toes. If you strain it, micro tears can form, which leads to swelling and sharp pain.
While most people experience the pain in their heel, some also get pain through to the arch of their foot. In about 70% of cases, the pain is in both feet, making walking a very painful experience.
You most commonly notice the pain first thing in the morning when you get out of bed and it reduces as your feet warm up with movement. It can reappear during the day after periods of rest or sitting, if you have been standing for a while, or when climbing stairs or ladders.
Plantar Fasciitis is more common in middle-aged people, although it can also affect younger people who use their feet a lot like joggers, dancers, or soldiers. That’s why it is also often called Joggers Heel.
Causes of Plantar Fasciitis
While the actual causes of plantar fasciitis are not known, there are risk factors that will increase the likelihood of you getting plantar fasciitis.

Overuse – excessive running, walking or dancing, or changing your training pattern so you dramatically increase hill running (for example).
Standing on hard surfaces
Flat feet or high foot arches (this is one time when average is better!)
Middle age
Being overweight
Tight Achilles tendons or calf muscles
Your feet roll in when you walk or run
Ill-fitting shoes, worn out or unsupportive footwear such as thongs/slides
Walking barefoot on hard surfaces
Pregnancy

First aid for Plantar Fasciitis

Generally, plantar fasciitis is gradual onset, which means it gradually increases in severity over time. If you ignore it and try to run through the pain, then the symptoms can get worse, ultimately leading to you changing your gait, limiting your activity or triggering the growth of heel spurs.
For initial symptoms, you need to rest, apply ice packs (15 minutes at a time every 2-3 hours), and take anti-inflammatory painkillers such as ibuprofen.
You don’t need a referral from a doctor to see a physiotherapist. If the pain is moderate then you can seek treatment with your Physiotherapist immediately as the sooner you begin treatment, the sooner you will experience relief.
Occasionally your plantar fascia can snap and you could hear a clicking or snapping sound, accompanied by swelling, intense pain and significant swelling. You need to see a doctor urgently if this occurs.
Physiotherapy & Treatment Options
Your physiotherapist will assess the extent of your injury, and will explore the causes of your injury.
Depending on your symptoms, you may have the soles of your feet taped or strapped to support your feet and reduce pain. You may also need to wear a plantar fasciitis brace or heel cups in the initial stages of healing.

Your physiotherapist will take you through a number of gentle stretching exercises for your feet, as well as exercises to address any tight Achilles tendons or calf muscles.
We will combine these with pain reduction techniques that you can do at home such as rolling your foot on a frozen water bottle or frozen golf ball to help ice your injury site.
Massage, joint mobilisation techniques, dry needling and ultrasound therapy will also be used to reduce swelling and restore movement.

For your footwear, we recommend you replace your joggers every 650km of use, and only wear shoes that support your feet while healing. Definitely no thongs or slides!
It also helps to put your shoes on first thing in the morning, before you take your first steps. Avoid barefoot walking on tiles or hard surfaces while you heal.
If the cause of your injury is your feet shape or foot pronation, you may need special orthotics. If this is indicated, we would conduct a walk/run assessment on you and have your technique analysed.

To maintain your fitness during your treatment, we recommend swimming and cycling. Don’t return to running until you have been pain free for at least one week, and then only run on soft surfaces until you rebuild your strength and stamina. If pain is felt at any time, then go back to swimming and cycling rather than running.
Unfortunately, Plantar Fasciitis is a long-term injury, and may take a number of months to fully heal even with the most aggressive treatments.

Things to Remember
Plantar Fasciitis is the most common cause of heel and arch pain, and is caused by micro tears to the plantar fascia.
It is a gradual onset injury and causes sharp pain when taking the first few steps in the morning or after rest.
Physiotherapy can treat plantar fasciitis, while reducing pain and increasing movement during healing.
Your physiotherapist may advise you of techniques for the improvement of your walk/running style, or provide you with solutions for arch support, to help prevent further reoccurrence.
Healing may take many months for full recovery.

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Knee Bracing helps with Osteoarthritis Pain

Knee Bracing helps with Osteoarthritis Pain

Wearing a knee brace has been shown to “significantly improve the pain and symptoms” of a type of osteoarthritis affecting the kneecap, according to a new study.

Arthritis Research UK-funded researchers at The University of Manchester claim their findings, presented at the Osteoarthritis Research Society International meeting in Philadelphia have enormous potential for treating this common joint condition effectively — as well as providing a simple and cheap alternative to painkillers.

Osteoarthritis of the knee affects around six million people in the UK and is increasing as the population ages and becomes more obese. Current treatments are limited to pain relief and joint replacement.

Osteoarthritis of the knee affecting the kneecap (patellofemoral osteoarthritis) accounts for about 20% of patients with knee pain. They typically experience pain that is made worse by going up and down stairs, kneeling, squatting and prolonged sitting.

“There’s a pressing need for non-surgical interventions for knee osteoarthritis, and little attention has been paid to treatments particularly aimed at the kneecap (the patellofemoral joint), a major source of knee pain,” explained Dr Michael Callaghan, research associate in rehabilitation science at the University of Manchester.

“We’ve shown that something as simple as a lightweight knee brace can dramatically improve the symptoms and function for people with this particular type of knee osteoarthritis.”
The research team conducted a randomised controlled trial of a lightweight lycra flexible knee brace fitted around the knee with a support strap for the kneecap. One hundred and 26 patients between the ages of 40 and 70 were treated over a 12-week period. All had suffered from arthritic knee pain for the previous three months.

They were randomly allocated to either immediate brace treatment or delayed treatment (i.e. after six weeks.) Both groups of patients eventually wore the brace for a period of 12 weeks and averaged roughly seven hours a day.
After six weeks of brace wearing there were significant improvements between the brace wearing group and the no treatment group in scores for pain, symptoms, knee stiffness, muscle strength and function. After 12 weeks there were significant improvements in these scores for all patients compared to when they started.

“Patients repeatedly told us that wearing the brace made their knee feel more secure, stable, and supported,” Dr Callaghan added. “Our theory is that these sensations gave the patient confidence to move the knee more normally and this helped in improving muscle strength, knee function and symptoms.”
Professor Alan Silman, medical director of Arthritis Research UK, which funded the trial, said: “Osteoarthritis of the knee is a painful disorder that affects millions of people in the UK, causing pain and reducing activities. We know that in patients with arthritis, the knee joint is frequently out of normal alignment, which might be an underlying cause of the problem, as well as making it worse.

“By using a simple brace, the researchers have been able not only to correct the alignment but achieve a very worthwhile benefit in terms of reducing pain and function. This approach is a real advance over relying on pain killers and has the potential to reduce the end for joint surgery and replacement, procedures often employed when the symptoms become uncontrollable.”

The ROAM (Research into Osteoarthritis in Manchester) project has run three trials at The University of Manchester and the University of Salford.

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