​Hallux Abducto Valgus is the fancy name for Bunions. Unfortunately, there is nothing fancy about bunions, neither the feel nor the look. A lot of people assume there is nothing that can be done to resolve a bunion other than letting a surgeon take a scalpel to it. Many other misconceptions regarding bunions include the cause, early signs and symptoms, treatment and prognosis.

Bunions can be begin to present in early childhood, early adulthood or later in life. It all depends on why. The ‘why’ is very important in determining the prognosis and appropriate treatment. Not everyone’s bunions are the same and not everyone will be or should be receiving the same treatment. 

There are lots of different causes of bunion, which is why whoever you consult with about them should always be taking a thorough history and assessment. They should know you and your lower limbs well. 

There are many different causes of bunions which can include, to name just a few common ones:

- Genetic predisposition
- Footwear
- Foot function and mechanics
- Foot posture
- Lower limb function
- Muscular imbalances

Conservative treatment options should ALWAYS be considered first. Bunions are commonly the presenting symptom of a cause that can be addressed without surgery. 

Here at Health Associates our Podiatrists can help identify the causative factors contributing to your bunions. Our Podiatrist Anneliese suggests cracking down on them early, as early prevention is key to either slowing down or stopping the progression of Hallux Abducto Valgus.
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Do your feet ache? Are your arches sore? Maybe the pain comes and goes or maybe it can last all day long.

Sore, painful feet is a very common problem for people of all ages. The source of your pain can be one or many things and getting to the root cause is critical for a speedy recovery.

When our feet suffer, it can impact our life in so many other ways. You may not be able to enjoy the activities you once enjoyed, you might lose confidence with what you can or can't do. Sometimes people delay getting their foot pain checked and attended too early. This can unfortunately lead to other consequences that could have been easily avoided. 

When you see a podiatrist at Health Associates they will effectively assess and diagnose what is causing your foot pain and provide you with the most effective way to relieve your pain and suffering.

From plantar fasciitis, bunions, corns, bursitis or heel spurs a podiatrist can help ensure you get the best advice and outcome possible. 

If you do have pain here are some tips to help you before your appointment with a podiatrist:

• Check your shoes - Do they fit well? How old are they? Do they have enough support?
• Apply ice - you may find temporary relief with the application of ice
• Massage - gently massage your feet or use a spiky ball. 
• Rest - put your feet up and have some rest

When you visit your podiatrist they will provide you with comprehensive and individualised options to get your feet feeling great.

At Health Associates we have some fantastic service offerings for our community including:

• Child/student discounts
• Senior/Concession discounts
• Bulk billed under a general practitioner EPC referral
• HCF - more for your feet programs
• Competitive pricing on custom orthotics with affordable payment plans

At Health Associates we believe that 'health is your greatest wealth' that is way our business is dedicated and committed to providing exceptional health services at affordable prices.

Experience the differences a podiatrist can do for you and your foot pain. Get your feet in great condition and step into life with ease and confidence. 

​For appointments call 9542 3330 or book online today.

The term “corn” is commonly used to describe what feels like a little stone in or under the foot and can look like barely anything at all! Or they man have a firm and dry appearance with a polished surface. They can also be found between the toes and be quite uncomfortable!

Corns are referred to as either Heloma Durum, Heloma Molle, Heloma Neurovasculare or Heloma Miliare by a Podiatrist.

Any type of corn is the result of excessive pressure to one focal point on the foot, for an extended period. Pressure can result from footwear, foot structure and/or foot mechanics. Depending on where the pressure is coming from, will determine the location of a corn. For example, if your new work shoes are just that tad too tight across your toes, you may find you’ve landed a “Buy one pair, get a corn between your toes free” in the process.

Heloma Durum is the most common type of “corn”. Otherwise known as “hard corns".

Heloma Durum’s are most commonly found on the sole of the foot and are a result of dysfunctional foot structure or foot biomechanics. If the foot isn’t working the way it’s meant to, the body (including the skin) will react in different ways.​

​Think of a corn as your bodies way of saying “Hey! Look at me! If you don’t start supporting my arch soon, this corn is going to be the least of your problems!”

If the cause of a corn is not addressed the corn will grow and increase in pain. The bigger the corn gets, the more it pushes on the healthy structures surrounding it. This is what makes you say
“OUCH” on every step! If a corn is not addressed, we find people also start walking in ways to avoid the pain, therefore putting pressure on other parts of the foot, even causing another corn. “Help! 

​It is important to investigate

  1.  Why is this corn hanging around?
  2.  What type of corn is it?
  3.  How can I remove it?
  4.  How can I make sure it doesn’t keep coming back?

HOT TIP: I do not recommend corn pads due to the skin surrounding the corn becoming inflamed, macerated and painful. Corn pads may or may not resolve the issue and they certainly don’t address the cause.

Luckily, there is a resolve for all types of corns, and the earlier you catch them the better. The best thing to do is talk it to your Podiatrist for a proper assessment. This may involve a full gait analysis, biomechanical and footwear assessment.

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​CATEGORIES OF LLD:

• Mild = 0-30mm
• Moderate = 30-60mm
• Severe = >60mm

SYMPTOMS OF A LEG LENGTH DISCREPANCY:

• Abnormal gait – limp or difficulty walking. This usually occurs when the discrepancy is greater than one centimetre.
• Pain in back, hip, knee or ankle.
• Scoliosis in lower spine
• Ankle deformities in one foot.
• Head or shoulder tilting to one side.
• Stress fractures in short leg (severe cases).

LEG LENGTH DISCREPANCY IS ASSOCIATED WITH MUSCULOSKELETAL DISORDERS INCLUDING:

• Lower back pain.
• Scoliosis.
• Hip pain.
• Knee pain.
• Arthritis of the hip and knee.
• Iliotibial band syndrome
• Tendinopathies of patella and achillies.
• Stress fracture
• Pronation and supination of the foot

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METHODS OF DIAGNOSING A LIMB LENGTH DISCREPANCY:

• History and physical examination.
• Gait analysis.
• Measuring the limb with a tape measure
• Diagnostic imaging such as an x-ray or CT-scan (most accurate method).

HOW CHIROPRACTORS CAN MANAGE YOUR LEG LENGTH DISCREPANCY:-

The type of medical management depends on the severity of the discrepancy, the type of discrepancy and if the patient is symptomatic. 

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• ​Mild and moderate SLLD can be treated with heel lifts up to 20mm but usually not more than 9mm. When the lift is more than 9mm some stability may be lost as it is a big correction for the patient, foot mechanics may also be altered. Heel lifts should be introduced gradually. A chiropractor can test biomechanically how much heel lift is needed, refer for custom orthotics and then re-test the bodies reaction and adaptation to the heel lift. In some cases, moderate may be dealt with surgically and severe case should be corrected surgically.

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• FLLD are usually caused by muscles in the hip and lower that have become chronically, involuntarily contracted. This is due to certain postures or movements that are constantly being repeated for long periods or a protective mechanism from an injury. The nervous system then adapts and causes these muscles to tighten leading to dysfunctional muscular patterns. Over a period of time this damages the physical structure of our bodies. A chiropractor can do the following for FLLD:

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1. Address the tight muscles around the hip and lower back that maybe rotating the hip making the appearance of one leg being longer than the other. These muscles include the adductors, glutes, erector spinae and quadratus lumborum.
2. ​​Make sure the sure joints of the foot, knee, hip and low back are moving properly.
3. Neuromuscular education to improve movement patterns and retrain the nervous system.
4. Stretches and mobility exercises.
5. Muscle strengthening.
6. Patient education – lifestyle factors, posture and ergonomics.
7. A heel lift is not used for FLLD as it can worsen the symptoms as muscular imbalances become more pronounced.​

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If you feel like you’re someone with a shorter leg or have any other musculoskeletal issues, please visit your local health care professional. If you are a local to health associates do not hesitate to ask or book in, we would be more than happy to help.

REFERENCES
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• Gurney, Burke. "Leg length discrepancy." Gait & posture 15.2 (2002): 195-206.

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• Bangerter, Christian, et al. "What are the biomechanical consequences of a structural leg length discrepancy on the adolescent spine during walking?." Gait & posture 68 (2019): 506-513.

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• Sekiya, Tatsuhiro, et al. "Evaluation of functional and structural leg length discrepancy in patients with adolescent idiopathic scoliosis using the EOS imaging system: a prospective comparative study." Scoliosis and spinal disorders 13.1 (2018): 7.

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• Mahmoud, Asmaa, et al. "Functional leg length discrepancy between theories and reliable instrumental assessment: a study about newly invented NPoS system." Muscles, ligaments and tendons journal 7.2 (2017): 293.

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• Knutson, Gary A. "Anatomic and functional leg-length inequality: a review and recommendation for clinical decision-making. Part I, anatomic leg-length inequality: prevalence, magnitude, effects and clinical significance." Chiropractic & osteopathy 13.1 (2005): 1-10.

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• Sabharwal, Sanjeev, and Ajay Kumar. "Methods for assessing leg length discrepancy." Clinical orthopaedics and related research 466.12 (2008): 2910-2922.

•  Leg Length Discrepancy Image - F.A. Davis Company, 2015

So you’ve reached that half way point. You find that flat spot with a killer view to sit down and enjoy. Getting that bag off your back feels so good and you know those goodies you packed for fuel are going to taste better than ever.

This view, the H2O and “aaaa-mazing” home made beef jerky your friend has supplied you with, promising no adverse affects, would all be perfect if you weren’t also wishing to find a new pair of feet at the bottom of that bag...

Whether you’re a competitive runner or humble walker on your own, with friends or with your family, here are some valuable HOT tips for hiking all year round!

• QUALITY GEAR: If you’re heading out for a HIKE rather than a walk, it is an absolute investment to gear yourself up with quality products. This doesn’t mean you need to go all out with a top of the range mini filtration system or most recent survival bracelet equipped with bottomless inventory! Invest in products that are going to take care of you so you don’t have to do it later.

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• NO NEW SHOES: Just a gentle reminder you should NEVER have to “break your shoes in”, let alone on a hike. If you have the right size and have been fit correctly, this shouldn’t be an issue. So just in case you haven’t discovered already the shoes were not fit correctly, don’t wear fresh shoes on a hike.

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• LACING: There are plenty of different ways to lace your shoes to accommodate different foot shapes.  Google can help with this research ;-)

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• SOCK(S): Merino wool and Bamboo are great materials for hiking socks. Thorlo and Bridegdale are brands highly recommended. Take into consideration the thickness of your socks, make sure they’re adequately dried and take more than one pair for those multi day hikes.

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•  ACTI-BLISS: You’ll find this blister prevention wool in many of our hiking shoes.

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•  MAGNESIUM POWDER: A heap of research shows that physical exercise depletes magnesium, leaving your energy metabolism efficiency impaired. So if you’re multi day hiking, you may benefit from supplementation. Consult with your GP if need be.

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• COMPEED BLISTER PACK: These can provide some really great relief for any sneaky blisters.

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• GORE-TEX: Moisture getting into your footwear is bad news! Gore-tex provides a waterproof lining keeping your feet dry and warm.

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• WALKING POLES: Depending how hardcore you’re going, and how uneven the terrain is, walking poles can really be the legs you need when you start to fatigue.  Kids are already great at this when they find a big stick to walk with;-)

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• GAITERS: Depending on the terrain and whether or not you’ve abandoned the beaten track, gaiters are a nice addition protecting your legs from branches, thorns, mud and even leeches and mosquitoes!

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• SKIN AND NAIL: Don’t head out with long and unruly nails. These can become super painful and cause further problems if they’re continuously hitting the end of your shoes. Any hard skin will also be uncomfortable and slow you down. Addressing both these after the hike is just as important as before.

​Headaches in short are a continuous pain around the head, face or neck, they can occur in any part of the head, on both sides of the head or in just one location. They are one of the most common medical complaints and can have a disabling effect on a day to day basis like quality of sleep, mood and overall function of the body. 

PRIMARY VS SECONDARY HEADACHES

Headaches are broadly categorised as either primary or secondary. A primary headache is when the headaches are not caused by another condition or disease. The two most common primary headaches are migraines and tension type headaches. A secondary headache is caused by problems elsewhere in the head or neck, or by a condition. The two most common secondary headaches are cervicogenic and medication overuse headaches. 

CONTRIBUTING FACTORS TO YOUR HEADACHE

Tension type headaches, migraines and cervicogenic headaches like many pain issues we are challenged with, are what we call 'multi-factorial'. We as Chiropractors, like the bio - psycho - social construct when approaching patient care and this encapsulates headaches we see in the clinic every week very well. But what does this actually mean?

Well in terms of headaches (and all pain) it means that lots of things contribute to the pain you are experiencing. One analogy could be the overflowing 'tea cup'.

If we think of your headaches as the overfilling of a tea cup (stick with me here) then everything in your life tipped into the tea cup could be a contributor.

Things such as: stress, dietary factors, sleep quality, exercise habits, hormones, genetics, medications, biomechanical skeletal factors and many more. Sometimes the triggers can be very hard to pin down because the thing that tips you over the edge can be different at different times and the last thing to make the cup overflow…… and then boof - headache.​

  DRUGS AND HEADACHES

There is significant dissatisfaction with headache drug outcomes and the side effects that come with taking these drugs and headaches are the third most common reason for why people seek help from chiropractors. We are a drug free alternative for headache sufferers.

HOW CAN WE HELP?

So how can chiropractic care actually help with headaches? 

Assessment of posture, muscle tone, functional movement patterns and how the spine and extremities are moving while taking into account work, hobbies and other daily activities are important factors for the possible causes of the headache. After this, appropriate treatment, lifestyle changes and patient education is needed. Treatment can include:

• Spinal manipulative therapy on areas of the spine that may be stiff or causing pain and 
• Muscle release techniques on muscles that may be contributing
• Lifestyle changes may be needed such as improved posture at work or during particular activities.
• Implementation of exercises and stretches to relax and strengthen muscles.
• Patient education explaining possible variables contributing to the headaches and ways to manage them. There are multiple contributing factors to the cause, pain intensity and frequency of headaches but if a factor such as postural related stress is decreased or removed this can have a positive outcome and possibly stop the headaches altogether. 

Simple management plans that you can implement straight away include:

• Alternating between standing and sitting desks.
• Taking regular breaks every 30 mins.
• Drink plenty of water.
• Making sure you’re in ideal posture while working or on the computer.
• Stretches for neck and shoulders.
• Screen is at eye level.
• Participating in regular exercise.

If you suffer from headaches on a regular basis or general neck pain, I highly recommend visiting a health professional. If you are local to the Loftus area, health associates would be more than happy to help you with these issues and take a holistic assessment and approach to taking control of your life.
​

Joshua Hallinan
Chiropractor
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Availability
Monday 8am - 6pm
Wednesday - 8am - 6pm
Saturday - 8am - 12pm

CAUSES

Sciatica is commonly cause by pressure or irritation from a disc herniation or disc bulge. The disc is pressing on one of the lumbar or sacral nerve roots. This is present in around 90% of cases and often occurs during heavy lifting. Other causes include:
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• Lumbar spine stenosis (Narrowing of the spinal canal where the nerve exits from the spinal cord).
• Spondylolisthesis (When a vertebra in spine slips forward over the one below).
• Degenerative disc disease (Loss of disc height, decreasing the space for the spinal cord and nerves).
• Pregnancy.
• Muscle spasm in low back or buttocks (piriformis muscle is a common site).

PREVENTION

• Maintain healthy weight.
• Exercise regularly to build strength.
• Low back stretches.
• Proper lifting techniques.
• Use good posture when sitting, standing and sleeping

GENERAL TREATMENT

Most cases do not require surgery, but the type of therapy will depend on severity of the condition and include:

• Rest.
• Medication (paracetamol, anti-inflammatory drugs).
• Physical therapy (chiropractic, physiotherapy or massage).
• Physical activity
• Lifestyle changes.

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How does chiropractic care help with sciatica?

Chiropractic treatment is used when the issue causing the sciatic nerve pain is musculoskeletal without serious pathology (disc issue, muscle spasm, mild forms of degeneration in the back or postural related, are some examples). The main goals are to de-load the back, take pressure off the irritated nerve and strengthen structures in the low back and gluteal region. Modalities used in chiropractic to treat the cause of sciatica include:

• Massage/trigger point therapy/fascial releases.
• Dry needling.
• Taping.
• Manipulation.
• Mobilisation.
• Education.
• Patient specific rehab.

If you have any issues regarding to low back pain or pain referral down the leg, I highly recommend visiting a health professional. If you are local to the Loftus area, health associates would be more than happy to help you with these issues. 


REFERENCES

Valat, Jean-Pierre, et al. "Sciatica." Best practice & research Clinical rheumatology 24.2 (2010): 241-252.

Koes, Bart W., M. W. Van Tulder, and W. C. Peul. "Diagnosis and treatment of sciatica." Bmj 334.7607 (2007): 1313-1317.

Vroomen, Patrick CAJ, et al. "Conservative treatment of sciatica: a systematic review." Clinical Spine Surgery 13.6 (2000): 463-469.

Ropper, Allan H., and Ross D. Zafonte. "Sciatica." New England Journal of Medicine 372.13 (2015): 1240-1248.
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​Callus build up on the feet can be uncomfortable, painful and unsightly. It is the symptom of a bigger problem and is just a part of a story our feet are trying to tell us.
 
There are usually internal and external factors contributing to this hard skin building up on our feet. Have you noticed it always returns in the same place?
 
Lots of questions to ponder.....like, why am I getting this hard skin coming back under the ball of my foot? Why are my heels building up dry skin and cracking around the back? Why do I get hard skin on the end of my toes or under the front of my foot?
 
As we become more active or less active, experience lifestyle or health changes, we may then notice the wear patterns on our shoes or feet also begin to change.

Foot function can be affected by muscle weakness or asymmetry, skeletal misalignment, footwear, activity and exercise type and many other internal or external factors.
 
The callus that builds is telling us where pressure peaks between our foot and the ground. Force and friction occur under and around our feet; when this becomes excessive and our body and feet cannot counteract it effectively, our body reacts in different ways. Our skin thickening and hardening is a defense mechanism and is one of the many reactions that can be experienced by us.

​For example, ONE cause of hard skin building up under the forefoot may be tight calves! Tight calves will reduce heel contact time and increase the time spent on the forefoot, and as a result, the pressure!
 
A callus is actually a cry for help! Your foot is not functioning the way it should be and the load of our body weight is not being distributed evenly.
 
So how do we correct this?
 
Removing the dry hard skin either at home or by a Podiatrist, sure does feels good! However, it will not be the best method in resolving the problem permanently.
 
By looking at the WHY you continue to build up this hard skin may actually be the same reason why you're also possibly getting heel pain, why the inside of your knee hurts or why your big toe joint has been throbbing the last couple of months after exercise.
 
If you are experiencing a build up of this hard skin it is definitely worth investigating why, instead of just removing the  callus every now and then.
 
Just like anything in life it is better to be Proactive rather than reactive! Put down the DIY hard skin removal kit and pop in for a proper assessment on why the callus or calluses are occurring.