The navicular is the bone at the top of the arch on the inside of the foot. The navicular is the attachment point for the posterior tibial tendon, which supports the foot.
In approximately 10% of the population there is an accessory navicular, an extra navicular bone. Usually the accessory navicular is not large enough to cause symptoms.
The Achilles tendon is a strong, fibrous band of tissue that connects the calf muscle, comprised of separate muscles, to the calcaneous (heel bone). The two main muscles are the gastrocnemius, which crosses the knee joint, and the soleus, which does not cross the knee joint. Contraction of this muscle complex causes the foot to plantarflex (point downwards). This action allows for you to stand on tip-toe.
The gastroc-soleus muscle complex is vital in sprinting, jumping and climbing. As a result of the stresses experienced at this muscle complex several different conditions can occur including retrocalcaneal bursitis, Achilles tendinopathy and Achilles tendon rupture.
Adult-acquired flat foot is a relatively common problem. It is a progressive flattening of the medial (inside) arch of the foot in adults.
Pain is often associated with this condition in and around the arch of the foot. It often involves a series of pathological changes involving the complex network of tendon, bone and ligamentous structures in the foot, the main one being the tibialis posterior tendon.
A bunion is often described as a bump on the side of the big toe, however, there is much more to a bunion than a bump. The visible part of a bunion reflects bony changes beneath the skin’s surface.
Bunions, known as hallux abducto valgus (HAV), are a progressive disorder. They begin with a deviation of the big toe towards the second toe resulting in a positional and angular change of the bones, which over time results in the characteristic bunion bump.
Bunions usually appear in the later stages of life, however, children and teenagers may also experience this deformity.
Diabetes is a condition in which the amount of glucose (sugar) in the blood is too high because the body is unable to use it properly.
There are two common forms of diabetes:
Also known as insulin dependent diabetes usually affects children and young adults
Also known as non-insulin dependent diabetes and is by far the most common, usually affecting people over the age of 40 years
Malibu Podiatry, in accordance with recommendations outlined by the Health Department of Western Australia and the Federal Government, has set up initiatives in education, care and management for patients with diabetes. Examinations are performed on all at risk patients to reveal early indicators of circulatory and sensory impairment. Patients are categorised under the University of Texas diabetes foot risk classification system allowing easy identification of patients who may develop peripheral complications.
An annual assessment is performed on all diabetic patients that attendMalibu Podiatry and a concise report is forwarded to your doctor so that it can be reviewed and maintained with your medical records.
ESWT is a non-invasive adjunctive treatment for patients experiencing chronic heel pain such as plantar fasciopathy (heel spurs) or Achilles tendinopathy. Clinical trials have proven ESWT to be 80% effective in the treatment of heel pain.
In the podiatry setting ESWT has been found to be effective in the treatment of:
In most instances three (3) treatments spaced a week apart will be required to successfully treat the majority of patients. Some patients may require additional treatment if there is not sufficient energy given in three (3) visits.
Treatment with ESWT is very simple. The affected area of the body is positioned against the head of the ESWT machine and the converted shockwaves, or energy pulses, are then applied to the affected area. The number and strength of the pulses given depends on the patient and the area being treated, but a certain amount of energy needs to be delivered in order for the treatment to be effective.
Patients commonly describe a ‘flicking’ sensation during treatment. This is usually tolerable; however, pain levels can increase closer to bone. The intensity of the shockwaves may be altered if necessary to improve your comfort level.
Following treatment it is quite common for patients to experience an exacerbation of symptoms. Please avoid anti-inflammatory medication during the treatment interval, however, Paracetamol may be taken for pain relief. Some localised bruising may occur and ice applied to the area usually eases discomfort.
Depending on your diagnosed condition your Podiatrist may also recommend that one or more of the following are included into your treatment regime:
Foot orthoses are shoe inserts designed to support, align or improve the function of the foot. They are also often commonly referred to as orthotics.
There are many different kinds of orthoses. The orthoses recommended by your podiatrist are prescription devices, custom-made to suit your individual needs and biomechanics.
The first metatarsophalangeal joint (MPJ), commonly referred to as the big toe joint, is comprised of the first metatarsal bone and the hallux (big toe). Hallux limitus refers to a limitation of dorsiflexion (upward movement) of the big toe.
For the hallux to function normally there needs to be at least 70 degrees range of motion at this joint. Hallux limitus may be the result of injury to the joint or an inherited foot structure.
An ingrown toenail (onychocryptosis) occurs when part of the nail penetrates the surrounding skin causing pain and inflammation and sometimes infection.
There are a variety of different causes of ingrown toenails and may include:
Hammertoe, claw toe and mallet toe are common lesser toe deformities. The majority of toe deformities have a hereditary background that causes muscular imbalance in the foot, however, some may be the result of wearing constrictive footwear.
Each of the lesser toes have three bones and the hammer, mallet and claw deformities result in abnormal positioning of these bones and joints.
The most common neuroma in the foot is called a Morton’s neuroma, which occurs at the base of the third and fourth digits. Two nerves converge at the third and fourth metatarsophalangeal joints. Where the nerves join they are typically larger in diameter than those going to the other digits and are therefore more susceptible to compressive injury.
The resultant thickening or enlargement of the nerve is a result of irritation, trauma or excessive compression. This creates swelling of the nerve eventually leading to permanent nerve damage.
Nail surgery is a common procedure performed by your podiatrist to effectively treat an ingrown toenail. Surgery may be required when an ingrown toenail repeatedly gets infected or is continually painful.
A partial nail avulsion (PNA) is a minor nail procedure which aims to permanently treat ingrown toenails. The procedure is usually performed in the podiatrists’ rooms, takes approximately one hour and the patient is able to walk immediately afterwards.
Patello-femoral syndrome is a common overuse knee complaint resulting in discomfort under and around the patella (knee cap). Pain usually is aggravated by activity or following periods of sitting or lying down. Patello-femoral syndrome can occur in one or both knees.
The knee is a very complex structure and there is no specific cause of patello-femoral syndrome. Rather, a number of factors can contribute to the syndrome and may include one or more of the following:
Plantar fasciopathy is an overuse injury affecting the sole (plantar) aspect of the foot. Plantar fasciopathy is a condition involving inflammation of the plantar fascia, which is a thick band of tissue that connects the heel bone to the base of your toes. Plantar fasciopathy is one of the most common causes of heel pain and may commonly be referred to as ‘heel spur syndrome’.
Plantar warts are benign (non-cancerous) growths that occur on the plantar (bottom) surface of the foot. They are often painful and can occur at any age, however, they are more common in children and young adults.
Plantar warts are caused by the Human Papilloma Virus (HPV). The virus enters the body through tiny cuts or breaks in the skin. Normally the bodies’ immune system can fight the virus, however, in some cases it may take refuge in the skin resulting in plantar warts.
Severs disease is the most common cause of heel pain in young children between the ages of 10 and 13. The condition is more common in boys and is an inflammation of the growth plates of the calcaneus (heel bone) where the Achilles tendon attaches.
This condition is also referred to as calcaneal apophysitis.
Shin splints are an exercise related pain that commonly occur at either the front (antero-lateral) aspect of the leg or the back (postero-medial) aspect of the leg. Shin splints are an overuse injury resulting from repetitive activity on hard surfaces, running on tip toes and is also seen in people participating in sports involving a lot of jumping.
Shin splints are an inflammation of a thin layer of tissue that covers the bone known as periosteum and may be referred to as periostitis. Pain occurs where the muscles attach to the tibia.
