Month: July 2014

Pronation is the normal way the foot rolls-inward when you walk or run. For some people, the foot remains in a rigid position when they walk or run meaning that little or no pronation occurs. This is often referred to as a supinated or “high arched foot.” The supinated foot shock absorbs shock poorly, meaning that higher forces than normal occur at certain points in the foot and up through the lower limb. A supinated or high arched foot can predispose to injuries such as plantar fasciitis, achilles tendonitis, stress fractures, shin splints e.t.cetc. After completing a lower limb biomechanical assessment and detailed examination of your foot, we will discuss your treatment options. Treatment may include orthotics, stretching exercises and advice on footwear to prevent injury. If an orthotic is required, it is a different type of orthotic than that needed for a flat foot and this can be explained in greater detail at your appointment. Generally footwear that has extra shock absorbency or “bounce” suits the high arched foot best.
If you are making an appointment about a foot problem it is helpful if you bring in your shoes and sports footwear along with you to your first appointment.

The Achilles tendon connects the calf muscle to the heel bone. Thankfully, Achilles tendon rupture is not very common (estimated at 18 per 100,000 people). It is quite likely that a certain degree of degeneration is established within the achilles tendon in order for an achilles tendon rupture to occur.
When this degeneration is present within the tendon, achilles tendon rupture may occur with jumping, take off with running or a forced movement of the foot. Symptoms usually include feeling a “snap” at the back of the Achilles that is associated with pain and a sensation of having been kicked. In fact with an achilles tendon rupture patients often report looking behind them immediately after the injury to see “who kicked them!”

This is followed by a significant difficulty rising up onto the toes on the affected side and an inability to push off while walking.

Swelling and bruising are typically present. It is important to seek assessment by your chartered physiotherapist or doctor urgently if an Achilles tendon rupture is suspected.

If it is confirmed on examination, you will receive an urgent referral to an orthopaedic doctor who will discuss the best management option with you.

Early intervention is important to achieve a good outcome and return to sports and physical activity.

The Achilles tendon connects the calf muscle to the heel bone. Achilles tendonitis means inflammation of the Achilles tendon and this can progress to Achilles tendinopathy when tendon degeneration occurs, as a result of overuse.
Symptoms include pain in the region of the Achilles tendon that is often worse first thing in the morning, worsens with activity and/or is worse the day after exercise.

Achilles tendinopathy can develop for a variety of reasons which cause too much stress on the Achilles tendon including; increasing your training too quickly, tight calf muscles, biomechanical abnormalities (such as flat feet or high arched feet), lack of sufficient ankle movement, inappropriate footwear etc. At IONA Physiotherapy we will take a comprehensive history of your recent physical activity, along with carrying out a biomechanical assessment of your lower limbs.

Depending on the findings during your assessment, treatment may include manual therapy and massage, exercises, orthotics and advice on appropriate footwear and your training regime.

It is important that the reason for your Achilles tendinopathy is established so that it can be treated effectively and prevented from becoming a chronic condition. It is helpful if you bring in your shoes and sports footwear with you to your first appointment.

The term “shin splints” refers to an overuse injury that causes pain along the inner edge of the tibia (shin bone.) They typically develop after physical activity such as running, jumping, dancing etc.
It is caused by inflammation of the muscles, tendons and in severe cases even the bone itself (tibia).

Biomechanical abnormalities such as tight calf muscles, flat feet or high arched feet can all predispose towards shin splints. Tight calf muscles cause the muscles around front of the leg or shin to have to work harder (and create greater forces) to overcome the extra resistance created by the tight calf muscle. Other contributing factors include training error (e.g. too much too soon) and inappropriate foot wear.

At IONA Physiotherapy we will take a comprehensive history of your recent physical activity, along with carrying out a biomechanical assessment of your lower limbs. There are other causes of shin pain including stress fracture, compartment syndrome, referred pain etc., so a comprehensive musculoskeletal assessment is important.

Treatment for shin splints will depend on the findings in your individual assessment and may include manual therapy, massage, exercises, orthotics, advice on appropriate footwear and your training regime. It is helpful if you bring in your shoes and sports footwear with you to your first appointment.

The plantar fascia is a band of tissue that stretches from the heel to the toes to support the sole of the foot.
A variety of biomechanical abnormalities in the foot including those with “high arched” or “flat feet” can cause excess stress on the plantar fascia causing it to become inflamed. This is known as plantar fasciitis. Other biomechanical abnormalities such as a loss of ankle joint range of movement or a tight calf muscle can lead to plantar fasciitis. Inappropriate footwear such as foot wear with inadequate shock absorbency for those with a high arched foot or footwear with inadequate control for those with “flat feet” can be another contributing factor.

Symptoms of plantar fasciitis include pain under the heel and/or arch of the foot on weight bearing, which is often worse first thing in the morning. At IONA Physiotherapy, we will do a full biomechanical assessment to determine the cause of your plantar fasciitis.

Treatment may include manual therapy (e.g. if you have ankle joint restriction), massage (e.g. if your calf muscle is tight), taping, orthotics, exercises and advice on footwear.

If you are making an appointment about a foot problem it is helpful if you bring in your shoes and sports footwear along with you to your first appointment.

A bunion (also referred to as hallux valgus) is often described as a bump on the side of the base of the big toe.
The visible bump is caused by the big toe leaning in towards the second toe, changing the alignment of the joint at the base of the big toe, leading to a visible bump. This condition can be quite painful and make it difficult for shoes to fit. For those with an established bunion, it is important to seek footwear with extra room in the “toe box” area of the shoe to avoid compression of the foot at this spot.

Bunions are usually caused by a variety of biomechanical abnormalities of the foot and are a progressive condition. Poorly fitting footwear is often blamed, but bunions also occur in people whose culture it is not to use footwear. Development of bunions in those who always go barefoot demonstrates the biomechanical nature of the problem. At IONA Physiotherapy, a comprehensive biomechanical assessment will be carried out to determine the cause of your bunion.

Correction of this biomechanical problem with an orthotic can help slow the progression of the bunion and make your foot more comfortable to walk on but it will not get rid of the bunion if it has already started. Surgery is reserved for extreme cases.

This is a general term used to describe pain under the ball of the foot. This usually occurs due to excessive forces occurring through one or more of the metatarsals during walking and running. A comprehensive biomechanical assessment of your lower limb and foot will be carried out before discussing the best treatment option with you. Treatment may include taping, orthotics, advice on footwear and exercises.

If you are making an appointment about a foot problem it is helpful if you bring in the shoes and sports footwear along with you to your first appointment.

Pronation is the way the foot rolls inward when you walk or run. Sometimes this movement of pronation is excessive or too rapid (over pronation.) This is often referred to as “flat feet.”
Overpronation causes excess forces within the foot and further up the lower limb. This can be a contributing factor to developing lower limb injuries such as pain in the arches of the feet, metatarsalgia (pain in the ball of the feet), bunions, plantar fasciitis, Achilles tendonitis and even problems elsewhere in the leg such as shin splints or knee pain (patello-femoral knee pain). Flat feet are not just a cosmetic issue, they can cause pain and cause an inefficient push off during walking and running, slowing down your pace of movement. People with flat feet also often complain of a “tired” or “achey” feeling in their feet by the end of the day, this is particularly problematic for those who walk or stand a lot as part of their occupation.

At IONA Physiotherapy, you will receive a comprehensive lower limb biomechanical assessment and a detailed examination of your foot, both in static positions and during movement. Treatment may include taping, exercises, advice on footwear and orthotics if required.

If you are making an appointment about a foot problem, it is helpful if you bring in your shoes and sports footwear along with you to your first appointment.

Ankle fractures can occur with a twisting or rolling injury to the foot/ankle, a fall and in high impact trauma such as a car accident. The type of fracture .i.e whether it is a stable or unstable fracture will determine your management in hospital i.e. whether you are put in a cast or have surgery. Once your fracture is sufficiently healed, your orthopaedic surgeon will advise you to commence physiotherapy.

At Iona Physiotherapy, we will assess your gait (how you walk), your range of movement, muscle flexibility and strength and proprioception (joint position sense.) Based on your individual assessment, treatment may include manual therapy to restore movement and exercises to improve strength, flexibility, proprioception and function. It is crucial that you regain normal movement (as this can lead to other problems e.g. plantar fasciitis) in addition to normal strength and proprioception (to help prevent further twisting type injuries to the ankle.)

The carpus of the wrist is made up of 8 small bones and these bones are secured together by a complex set of ligaments. Over time, often due to repeated FOOSH in sport, these individual bones can become less securely connected to each other, leading to ligamentous instability. The most common carpal instability is Scapho-Lunate instability, which involves excessive movement between the scaphoid and the lunate bones.

This problem tends to develop slowly over time and can eventually lead to painful gripping, difficulty taking weight through the hand particularly with the wrist in extension (bent back) and painful clicking. Pain and slight swelling is usually noted over the middle of the back of the wrist.

It’s important to diagnose this problem as early as possible as it can lead to long-term wrist problems if it continues unabated. A detailed manual examination will lead to accurate diagnosis of this problem, often earlier than conventional imaging can. Treatment may involve manual therapy, activity advice, exercise and splinting.