Structural Podiatry

Is about supporting and correcting the alignment of the lower limb. The foot is the foundation of the entire body so if it is out of alignment, the body cant work at its optimal capacity. This may take form as an injury or it may prevent you from participating and competing in your chosen sport at your full potential. Orthoses may be beneficial to you as they align the foot, keeping the rest of the lower limb and therefore the body in alignment.

Structural podiatry is the assessment and treatment of the alignment of the lower limb including the lower back and pelvis.

Paediatric condtions

 

flat feet knock-knees
intoeing bowed legs
out toeing Sever’s disease (heel pain)
abnormal walking patterns high arches

 

If your child has any of the above problems, it should be established what the cause is, and whether it is a part of normal development. If treatment is necessary, early intervention will yield the best result.

Adult Conditions

heel spurs (plantar fasciitis) metatarsalgia (inflammation under forefoot)
neuromas foot arthritis
knee osteoarthritis certain hip and low back problems

 

Management of the above conditions involves detailed assessment to establish the cause. Treatment will usually involve specific exercises and orthotics if deemed necessary.

Listed below are common sports & structural injuries, their causes and their treatment:

Lower Back Pain

Podiatrists are not back specialists and do not perform any ‘hands on’ back treatment, but in cases where abnormal or weak lower limb function contributes or aggravates lower back pain, a podiatrist can be a valuable team member in comprehensive approach to treatment.

Knee Pain

The knee is complex structure and there are numerous regions that can be damaged or inflamed. More common types seen are:

Runner’s knee (retro-patella chondralgia): Pain and swelling behind and around the kneecap due to malalignment and/or muscle imbalances in the foot, leg, pelvis or back or a combination of these areas. Treatment begins with assessing the exact cause of the inflammation, whether it be at the foot, leg, pelvic or spinal level. Long-term treatment usually consists of an exercise program, running shoe and training advice and orthotics if necessary.

Knee Osteoarthritis:
inflammation of the joint that is caused by cartilage damage that can progress to changes in joint size, shape, mobility and leg alignment. The original cause can be a genetic – structural malalignment, weakness of certain muscles or ligaments, cartilage defect; or developmental – injury, work related or secondary to an imbalance (ie. leg length inequality). Management involves thorough assessment of function and x-ray analysis. Treatment usually involves education and measures to avoid further damage, improving pelvic and foot strength and stability.

Leg Pain

Achilles tendonitis: Inflammation of the achilles tendon or its heel attachment is due to overuse and or lower limb imbalances. In most cases there is rapid and late activation of the calf muscles or overuse of the calf muscles due to inefficient core stability or foot hypermobility. Treatment involves addressing mechanical imbalances in the foot, leg and/or pelvis; training and running shoe advice and normal short-term protocol (eg. rest, ice, etc)

Shin splints (anterior, medial or lateral tibial/fibular stress syndrome):
Shin splints is a vague layman’s term that can encompass many injuries. In basic terms it is inflammation of the junction of bone and small muscle fibres in lower leg. It is due’, like achilles tendonitis, to overuse of specific muscles due to training errors or lower limb/pelvic imbalances. Treatment involves finding the cause of the overuse, which normally consists of a specific stretching/strengthening program, training and running shoe advice and orthotics if necessary.

Foot Pain

Heel spurs (plantar fasciitis): inflammation of the soft tissue that attaches to the bottom of the heel. Pain is experienced under the heel or arch and is usually worst first thing in the morning or walking following a period of rest. It is caused by abnormal function of the lower limb due to structural malalignment, muscular weakness or imbalance. Treatment involves rest, icing, strapping, stretching and massage, addressing abnormalities in leg and foot function using orthotics and stabilisation exercises.

Stress fractures:
Can occur in any bone in the foot but most commonly in the metatarsal bones( long bones between the high point of the arch to where the toes are attached to the foot). Stress fractures are caused by overloading of the bone due to training errors and biomechanical imbalances and weakness. Treatment essentially involves 4-6 weeks rest and correction of training errors and lower limb/foot function.

Metatarsalgia:
broad term that describes inflammation and pain under the central forefoot where the toes attach to the foot. Caused by abnormal leg and foot function that results in overloading of the metatarsal bones. Treatment involves improving foot function via orthotics and stabilisation exercises and padding to deflect excessive pressure off the metatarsals.

Neuromas:
inflammation of a nerve in the forefoot due to poor foot function and tight fitting footwear. Treatment is the same as metatarsalgia.