Tag Archives: Knees

Shin splints & metatarsalgia – a guest blog by Jeremy Ousey MSc MCPod

Do I have shin splints?

Frequently patients come into clinic complaining of conditions like shin splints and metatarsalgia.

These are two ‘diagnoses’ which are common labels used by many people, healthcare professionals, sports professionals and our friend Geena who works down the club and gets that exact same pain in her foot… We can all be guilty of it, but what do they mean and why is using these terms a problem?

Well… I’m sure we’ve all had that moment where we are laying in a dark room having maxed out on the pain killers we have in the cupboard and hoping that the clock quietens down with its ticking because it’s making that throbbing in our head feel even worse.

Then that thought comes into our head, “what is causing this pain??? Is it dehydration? Is it just a migraine? Maybe I ate something… and that is a stark reality, we can have pain in an area and not realise what’s causing it and while a migraine compared to an achy forefoot (metatarsalgia) is quite a contrast, we wouldn’t want the doctor treating our migraine like a hangover, and even less would we like him to treat our hangover like a migraine!

So why are shin splints, metatarsalgia and arthritis such a series of misnomers? Well, let’s break them down…

Shin splints

Shin splints is a term that gets used so interchangeably that it’s hard to know what people mean, but the commonly accepted diagnosis that it is linked to is “medial tibial stress syndrome”.

This being said, it can be used for multiple tendinopathies, exertional leg pain and even apophysitis (stress/injury to muscle/tendon attachment in children) such as that of Osgood-Schlatter’s.

Medial tibial stress syndrome is really a low grade stress reaction in the tibia that is typically the result of torsional (twisting) forces as the foot, ankle and leg make contact with the ground, ultimately causing a very low grade stress response (the precursor to a stress fracture).

So when its put like that, we’re dealing with a few different potential diagnoses… so if the diagnoses are different, surely the treatment has to be too? Let’s look at metatarsalgia…

Metatarsalgia

Metatarsalgia, when the word is broken down means “pain in the forefoot”. It doesn’t include toe pain, although the pain can radiate into the toes.

Metatarsalgia can be the result of inflamed joints, overloading of tendons, structural anomalies, arthritic changes or swollen, inflamed or trapped nerves. All of these things can cause foot pain, but the treatment for the specific condition should need to be different for each problem.

Arthritis

Arthritis is a highly generic term but in reality has a very specific meaning which varies on context.

There are various types of arthritis – osteoarthritis, rheumatoid arthritis, psoriatic arthritis etc, but quite often a diagnosis of arthritis may be made based off of an x-ray due to a narrowing of the joint spaces – which is actually typical in a huge proportion of the population who are “over a certain age”.

That said, the presence of arthritic changes do not necessarily mean that pain is guaranteed; in fact, there are a huge number of people walking or even running around whose knees are “bone on bone” with minimal or no pain. Equally there are a huge number of people who have joint pain but an x-ray examination shows no signs of that dreaded “wear and tear”.

There is a real paradigm shift going on within healthcare where we are concerned about the language we use and what that language means for our patients.

Equally, there is general misdiagnosis being made by those less experienced in diagnosing foot pain, and as a result I see many patients who go through life suffering with their feet for years until they get the correct diagnosis.

Always make sure that you get a diagnosis when you see a clinician and are not given a generic condition such as shin splints or metatarsalgia… 

About Jeremy Ousey MSc MCPod

Jeremy Ousey  is an HCPC registered Podiatrist and CASE qualified sonographer.

Having worked in podiatric surgical units, physiotherapy and multi-disciplinary practices, he takes a multi-faceted and patient-centred approach to care. With a bachelors in Podiatry, postgraduate degrees in podiatric sports medicine and medical ultrasound and a masters in the theory of podiatric surgery he allows evidence to guide his treatment plans.

Jeremy lectures on heel pain, extra-corporeal shockwave therapy, musculoskeletal examination, treatment of the foot and ankle including management of ankle sprains and verruca needling.

His interests are in the surgical management of skin lesions, nail surgery, musculoskeletal and biomechanical evaluation, acute and chronic sports injuries, tendinopathies, diagnostic ultrasound and surgical management of foot and ankle pathology

If you would like any more information or to book an appointment with Jeremy then please call Maidenhead Podiatry & Chiropractic Clinic on 01628 773588 or email info@maidenheadpodiatry.co.uk

Ever thought about visiting a Chiropractor and wonder what they do?

Have you ever thought about visiting a Chiropractor but wondered what they do?

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We took some time to speak to our Chiropractic team – Rebecca Rees (BSC) and Dr Lucy Steel (BSc, MSc, DC) to find out a bit more about what they do, how they could help you and about a typical days work, here is what they had to say:

How long have you been a Chiropractor?

Rebecca: I studied for my BSc in Chiropractic treatment at the Anglo European College of Chiropractic in 1994.  I have been practicing for the last 27 years.

Lucy: I studied for my BSc in Human Biology at Leeds University and my MSc and DC in Chiropractic at the University of Surrey in 2004.  I have been practicing for the last 17 years. I have a special interest Chiropractic during and following pregnancy.

What governing bodies are you a member of?

We are both registered members of the British Chiropractic Association (BCA) and the General Chiropractic Council (GCC).

What is Chiropractic?

Chiropractic is the treatment of spine and mechanical joint disorders. It is a common misconception that Chiropractors only treat backs. They can treat a wide variety of functional and mechanical disorders of any joints in the body.

What is a Chiropractic treatment?

Chiropractic treatment focuses on disorders of the musculoskeletal system and the nervous system and the effects of these disorders on general health. Treatment may involve – joint manipulation, soft tissue work, mechanical treatment such as Shockwave, RICE and rehabilitation advice.

What can a Chiropractor treat?

Our Chiropractors don’t just manage back pain but can also help with a wide range of conditions, head to toe, including –

  • Uncomplicated neck pain
  • Acute and chronic back pain
  • Osteo-arthritis (OA) and joint pain (as an addition to core OA treatments & exercise)
  • Leg pain
  • Prevention of migraine
  • Exercise guidance
  • Tension and inability to relax (through lifestyle advice)
  • Rehabilitation
  • Deep Tissue Massage
  • Muscle spasms and cramp
  • Headaches
  • Joint pain

Treatment is supported with individual advice and guidance about lifestyle, work and exercise to help manage a condition. You may be recommended massage, ice or heat treatment and specific exercises which you can safely do at home.

How do you treat these symptoms?

We help manage the discomfort through working on all the joints of the body, concentrating particularly on the spine/ spinal cord. We use their hands to make specific, gentle adjustments (the chiropractic term for manipulation) to improve mobility of joints, efficiency of the nervous system and release the body’s natural healing ability.

What could your clients expect on their first visit?

During your initial consultation we would explain about Chiropractic care and understand your personal situation through physical examination, observations and X-rays as needed. Our Chiropractors support the treatment they offer with individual guidance on lifestyle, work and exercise to help manage the condition.  We will agree a plan with our clients that best supports their ongoing treatment requirements.

Who could benefit from Chiropractic treatment?

People of all ages can benefit from chiropractic treatment, from a newly born baby to  over 100 years of age. Your consultation will be used to assess your requirements and the appropriateness of treatment. Following informed consent, your first visit will include treatment when assessed as appropriate.

Tell us one interesting thing about you?

Rebecca: My belief is that you are never too old to benefit from chiropractic treatment.

Lucy: My passion lies in the care of pregnant women, babies and children, most of my post-graduate training has been in these areas.

For more information or to find out more about how our Chiropractors can help or to book your appointment, please:

Call: 01628 779900

Email:  info@maidenheadpodiatry.co.uk

Visit:   maidenheadpodiatry.co.uk/treatments/chiropractic/

Need help with your feet or back – use our search bar.

Use our search bar the find what you are looking for

Many people visit our website for help or information on Podiatry or Chiropractic.

Both Podiatrists and Chiropractors offer a range of treatments and skills to benefit their patients but sometimes all you need is to be informed.

Below we describe what Podiatry and Chiropractic are and explain many of the treatments and services we offer but if you know what you are looking for then use the search bar in the top right hand corner of the screen.

A large part of what we provide for patients is help, advice and education and this website contains information on definition, diagnosis and treatment of a wide range of conditions and all can be accessed through the search bar.

It doesn’t matter if you are looking for something specific or just curious. Give it a go. Find what you are looking for in our education pages and previous blogs. Click on the search bar.

Podiatry

Podiatry is defined as the diagnosis and treatment of foot disorders; however, we assess, diagnose and treat from the knee down. We also treat warts on hands.

Chiropractic

Chiropractic is the management consists of a wide range of manipulative techniques designed to improve the function of joints, relieve pain and ease muscle spasm.

Chiropractors don’t only treat backs and can help with any soft-tissue or structural issues.

What is Podiatry?

Podiatry like many health care professions has general practitioners and specialists.

A general practitioner will treat anything from corns to verrucas and from plantar fasciitis or heel pain to ingrown toenails. We are all licenced to use local anaesthetic, perform minor surgeries such as ingrown nail removal and dispense antibiotics, if and where appropriate.

We provide vascular assessment and diabetic screening as a matter of course when requested or required. We have Podiatrists with special interests in areas such as diabetic care and biomechanical assessment and gait analysisGait analysis includes being filmed on a treadmill followed where appropriate by prescription of custom moulded orthotics together with an integrated exercise and rehabilitation program.

Seven Podiatrists and two Chiropractors trained in using the latest treatment and cutting-edge technology for a range of common conditions.

Cutting edge technology

Shockwave, which is a percussive mechanical treatment for chronic, or long-term, soft tissue pain such as heel pain, Achilles pain, hip pain and of course plantar fasciitis although it can be used anywhere in the body. It is used by both Podiatrists and Chiropractors

We were one of the first clinics in the country to use Swift, a microwave generator for the treatment of verrucas. We also offer salicylic acid, freezing and needling.

We offer all general foot care too including fungal nails, athlete’s foot, splits, fissures and infections. We also provide foot care in nursing and care homes as well as a domiciliary/home visiting service.

Contact us

Hopefully you have found what you are looking for but just in case you haven’t, give us a call on 01628 773588 and let us educate you. To find us follow the map and directions or put SL6 5FH into your sat nav.

We have our own free car park directly outside the clinic. Our premises are disabled friendly with no door thresholds and easy access throughout the ground floor. Let us know if you have any special requirements.

If you would like more information or to make an appointment give us a call on 01628 773588, and speak to one of our friendly receptionists or arrange a call back from one of our Podiatrists or Chiropractors.

And, we will of course cut your toenails too.

Foot in vice

Why do I have pain in the arch and big toe?

What is the cause of my arch and big toe pain?

At Maidenhead Podiatry and Chiropractic Clinic, our Podiatrists are often asked about foot pain located in the inner long arch or inside of the foot. The pain often associated with pain in the large/big toe joint. It can also radiate up the leg.

When do I get the pain?

When exercising, the pain often doesn’t come on straight away, but can develop some time after starting. What can be happening, halfway through a round of golf or some miles into a walk, is that the small supporting muscles of the foot become fatigued. It may come on more rapidly with high impact exercise such as running. Inflammation may be involved meaning that the pain worsens the day following exertion.

Where do I get the pain?

Pain or discomfort can manifest along the inside of the foot or the inner longitudinal arch. It can also be associated with pain the base of the big toe and into the joint.

Because the discomfort of the foot is usually due to mechanical changes this can refer to compensation pain up the leg and into the knee, hip, or back.

Why do I get the pain?

If you ‘overpronate’ it causes medial or inward rotation of the lower leg, which can cause stress at the knee, misalignment of the hips, and resultant lower back pain. The degree of ‘pronation’ can vary from person to person and used to be known as ‘flat feet’ although the actual cause is more complex. As the muscle fatigue, this allows the arch to over-extend further stressing the support tissues and increasing discomfort.

Think of your feet as the ‘foundation’ for the rest of the body. Ensuring your feet are correctly aligned allows the rest of the kinetic chain or biomechanical relationship between the feet and the rest of the body to function efficiently. Big toe joint pain can be due to a number of reasons including inflammation, arthritis, and poorly fitting shoes.

What can I do about it?

What is most important with any foot pain is to ensure a correct diagnosis. This ensures targeted and appropriate treatment. This starts with a bio-mechanical assessment.

The assessment focuses on structure, alignment, strength, and starts with the foot. This includes pelvis, hips, knees, feet and their relationship, as pain in one area can result in or cause weakness or a structural problem somewhere else.

A biomechanical assessment is essential where there is a pain in the feet or lower limbs but no cause has so far been established. Sometimes simple recommendations on footwear can make a huge difference especially sports shoes. Simply tying shoelaces properly can dramatically increase the support offered to the foot by a shoe. There are many different ways to lace a shoe. For ideas and a bit of fun, click here for lacing ideas.

Pain in the large toe can be associated with this but can also be due to shoe pressure on the inner edge of the apex of the toe.

Buy shoes that have a square toe box to reduce this pressure.

What can we do about it?

Podiatrist Jeremy Ousey has a special interest in bio-mechanics There are numerous choices following a biomechanical assessment. The outcome of the assessment determines the appropriate treatment. If the mechanics of the foot are contributing to injury or pain, orthotics or custom made insoles are prescribed, moulded from a foam impression of the feet.

The orthotics are prescribed in conjunction with exercises and a carefully constructed rehabilitation plan. Footwear is also considered and recommendations made.

Topical treatments such as Shockwave can be very effective in the treatment of foot and lower limb pain.

If you would like more information or to make an appointment with Jeremy  Ousey call 01628 773588 or e-mail  info@maidenheadpodiatry.co.uk.

Why do I have foot pain?

Why do my feet hurt?

In a series of blogs this month we will look at the causes of foot pain. There are many reasons why anyone can experience different levels and types of foot pain.

Sharp or dull, bruised, or persistent, pain is a warning – don’t ignore it!

This list is not exhaustive but deals with some of the main reasons for calls to Maidenhead Podiatry and Chiropractic Clinic.

Ankle/heel pain

This is a very common condition and is often worse in the mornings getting out of bed, or after brief periods of sitting such as having a coffee. Plantar Fasciitis is widely known and there are numerous treatments available from stretching to insoles, from steroid injections to Shockwave Pain can also be caused by heels spurs, heel bursitis, Haglund’s deformity, and Achilles tendinopathy among others.

Arch and large toe pain

Pain is also often experienced along the inner arch of the foot and into the large toe joint although it can be in either of both. Arch pain can be due to changes in the strength and position of the foot and custom insoles following biomechanical assessment may be the best solution. This is common in runners and can be linked to over-pronation. Large toe joint pain can be due to ill-fitting footwear in the past and is often associated with enlargement of the joint and bunions. It can also be due to arthritic changes.

Localised, specific pain

This is where the pain is usually sharp and persistent, focused on a single point. Commonly found over a joint surface, between the toes or on the sole of the foot, the most common cause is corns. Corns are areas of callous with a hard central portion that focuses pressure on the underlying structures and can cause momentary eye-watering pain. Verrucas can also cause pain because they are rich in nerve tissue. This means that when they are compressed – they hurt! There are other possibilities including trauma, bruising, Morton’s neuroma, or a foreign body such as a piece of glass or an embedded hair.

Referred pain

Often pain in the foot or feet doesn’t have a local origin. Pain can often be referred from higher up a nerve but be experienced in the extremity. A common origin of referred pain in the lower back. Damage, degeneration, or repeat stress in the back can lead to the impingement or compressing of a nerve root leading to a reaction in the foot or lower leg.

Our Chiropractors or our Podiatrists will include this in their initial assessment as they form a treatment plan.

Ingrown nails

Anyone who has had an ingrown nail will know how painful they can be. This is where the nail grows painfully into the side of the toe, often made worse by shoes pressing. This can be caused by picking and tearing the nail, poor cutting – usually down the side, or simply be due to bad luck. Some toes are shaped in such a way as to make ingrown nails almost inevitable where others will never experience it. Ingrown nails vary in severity from constant soreness to infected and weeping.

Maidenhead Podiatry and Chiropractic Clinic offer a comprehensive ingrown nail treatment service, no matter the condition.

Compensation pain

Pain in the foot causes a person to walk differently or limp to take the load off the painful area. This is the body’s autonomic response to pain. This response is designed to protect the painful area. However, this in turn places increased stress on other structures that have to compensate for the change. In this way, a pain in the foot can cause pain elsewhere such as in the lower back, hip, and knee.

Other causes of pain

This list is not comprehensive and there are many other causes of foot pain. These include:

  • fracture
  • stress fracture-dislocation
  • soft tissue injuries
  • infection
  • skin infection
  • neuropathic changes

Remember, pain is a warning don’t ignore it!

Give us a call!

If you are experiencing foot pain and you would like more information give us a call on 01628 773588.

To make an appointment with one of our Podiatrists or Chiropractors, please give us a call on 01628 773588.

If you would like a comprehensive biomechanical assessment do give us a call on 01628 773588.

For more information visit www.maidenheadpodiatry.co.uk.

If you would like to know more about how we are risk assessing and managing our Covid-19 click here.