 In the first 6 years of life, our leg bones undergo a series of rotational changes. Sometimes it’s hard for both parents and the child to keep up! In toeing is a common pediatric podiatry concern, otherwise referred to as a ‘Pigeon-Toed’. Usually observed in a child’s first 2-3 years of walking and during early to middle primary school ages. It is seen mostly in children when they walk or run with one or both feet turning in. Although it is a gait variation, it is not typically considered abnormal. “Abnormal” depends on factors including age, lower limb function and if pain is involved. Most intoeing cases tend to present as asymptomatic (no symptoms), however some severe cases can cause issues with tripping, stability and balance. In toeing often comes from 1 of 3 places, the hip, leg or foot. Some common causes include: Metatarsus adductus * This is when the foot is curved inwards from the middle of the foot to the toes. * It can resemble a mild clubfoot deformity – but this is a separate problem. * If treatment is necessary, it normally involves casts or special corrective shoes between 6-9 months of age. Internal tibial torsion * This is when the tibia (shin bone) has an internal twist and turns inwards. * It is very common in infancy and childhood. * Tibial torsion normally improves in children with growth up to 12 years of age. Internal Femoral Anteversion (torsion) * This when the femur (thigh bone) turns inwards between the hip and knee joints. * It normally corrects in children by age 10. * Children with this condition often sit in the ‘W’ position, which should always be avoided Podiatry treatment options can vary from addressing posture abnormalities, stretching and strengthening to orthotics and gait plates. First and foremost a thorough assessment is always necessary to ensure appropriate treatment and the best possible outcome. Let’s take care of those little feet so they can grow into the big healthy feet they deserve to be!  Anneliese Ball
Podiatrist Anneliese is at Health Associates as a Podiatrist working Monday and fortnightly Saturday. She holds both a Bachelor of Psychology and Podiatry. As a podiatrist she combines her proficient knowledge of human mechanics and ability to connect and engage with her patients to deliver outstanding clinical outcomes and an exceptional customer experience. Anneliese loves health and fitness and enjoys encouraging her patients to maximise their health.
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 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. Anneliese Ball
Podiatrist Anneliese is at Health Associates as a Podiatrist working Monday and fortnightly Saturday. She holds both a Bachelor of Psychology and Podiatry. As a podiatrist she combines her proficient knowledge of human mechanics and ability to connect and engage with her patients to deliver outstanding clinical outcomes and an exceptional customer experience. Anneliese loves health and fitness and enjoys encouraging her patients to maximise their health.  The term arthritis is loosely used to refer to many different types of crippling pain associated with the joints. Many people do not know what arthritis is, what affect it actually has on the body, what type they even have or how to minimise the pain affecting daily activities. There are very important large and small joints in the lower limb and feet. Considering our legs and feet are what take the complete load of our body weight and not to mention all the extra forces that come with work, sports and exercise, they can be prone to degeneration and erosion as time goes on. The main types of arthritis contributing to chronic pain in the feet and legs include: Osteoarthritis is considered a mechanical degenerative arthritis. Osteoarthritis is due to excessive “wear and tear” on the joints as a result of repetitive and or increased forces. Osteoarthritis can affect any joint, but most commonly treated by Podiatrists are the knees, ankles and big toe joints. The big toe joint may have lost some or all of it range of motion, which is detrimental to the gait cycle and can cause many other issues, even with the back. It is important to address stiffness and lack of range of motion in any joint with the appropriate treatment to slow down the process of degeneration and its sequential negative impacts elsewhere. Rheumatoid Arthritis and, or Psoriatic Arthritis is an inflammatory, auto immune, systemic disease that can affect many organs. It is more common in woman and usually comes on in your late thirties or early forties. Signs might be more evident when you are more stressed and your immune system is not coping. Many parts of the body can be affected including the skin, nails, vascular (circulation) and joints. Pitted or thickened toe nails, mild or severe joint deformity such a bunions, nodules on the feet such as the toes and or heels and joint swelling are all symptoms affecting the legs and feet that can be addressed by a Podiatrist. Gout, otherwise known as ‘the rich mans disease’ due to its association with high levels of Uric acid in the blood is achieved by a heavy diet rich in purine, e.g. red meat, fruit and alcohol etc. Gout can increase pressure and friction to the feet, causing secondary issues such as corns, callus and lesions. Gout can cause severe pain accompanied by red, hot, swollen joints.  Ankylosing Spondylitis is a systemic rheumatic disease where areas of the body become inflamed.  Dactylitis is inflammation of an entire digit and can be painful. Knowing which type of arthritis you have is crucial to being able to treat it effectively and appropriately. Not only can Podiatrists help identify issues resulting from your arthritis they can correctly treat it to reduce or eliminate discomfort, slow down the progression of the disease and help you get back to enjoying daily life. After a thorough physical examination involving a skin, nail and biomechanical assessment, Podiatrists can:
And much more.... Due to arthritis being a widespread condition affecting many parts of the body it is important that a multidisciplinary approach is employed. Your Podiatrist can always point you in the right direction to addressing other issues with the additional health professional you may not have considered. Podiatrists will leave you equipped with the right tools to take home in order to feel more confident and comfortable on your feet! Written by Anneliese Ball Podiatrist Health Associates  Anneliese Ball
Podiatrist Anneliese is at Health Associates as a Podiatrist working Monday and fortnightly Saturday. She holds both a Bachelor of Psychology and Podiatry. As a podiatrist she combines her proficient knowledge of human mechanics and ability to connect and engage with her patients to deliver outstanding clinical outcomes and an exceptional customer experience. Anneliese loves health and fitness and enjoys encouraging her patients to maximise their health.  If you swing your hips more than others, don’t like walking slow or hate standing in one position for too long because your body aches, you may have something uneven in the lower half of your body, this is known as leg length discrepancy (LLD). You might not know this but having unequal leg lengths is a common condition as it is estimated to affect 40-70% of the population and can occur in both children and adults. This should not come as much of surprise as we are all built differently, with different body types and structures. So, what is LLD and how can it be treated? THE TWO CLASSIFICATIONS OF LLD:
 CATEGORIES OF LLD:
SYMPTOMS OF A LEG LENGTH DISCREPANCY:
LEG LENGTH DISCREPANCY IS ASSOCIATED WITH MUSCULOSKELETAL DISORDERS INCLUDING:
METHODS OF DIAGNOSING A LIMB LENGTH DISCREPANCY:
 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.
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
 Joshua Hallinan Chiropractor Joshua is a very focused, dedicated and committed Practitioner. Growing up in Menai, he has been actively involved in AFL and Cricket and currently has a passion for Soccer and strength based training. He loves sport but more importantly, Joshua can see the major benefits of being active and moving regularly. Joshua's special interests are in sports injuries, musculoskeletal complaints and headaches. He enjoys helping relieve pain and alignments and supporting his patients to live optimally as well as instilling optimism and personal belief that moving well is important for a happy and health life. You know when you see Joshua you are in the hands of someone who continually strives to be ahead in his profession and will bring his expertise and skill to all of his patients. You'll find Josh has a friendly and enthusiastic personality, who is also very relaxed and down to earth to be with, leaving you feel comfortable and confident in his treatment and recommendations. Availability Tuesday 8am - 6pm Wednesday - 3pm - 7pm Friday - 3pm - 7pm  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! 
 Anneliese Ball Podiatrist Anneliese is at Health Associates as a Podiatrist working Monday and fortnightly Saturday. She holds both a Bachelor of Psychology and Podiatry. As a podiatrist she combines her proficient knowledge of human mechanics and ability to connect and engage with her patients to deliver outstanding clinical outcomes and an exceptional customer experience. Anneliese loves health and fitness and enjoys encouraging her patients to maximise their health.  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:
Simple management plans that you can implement straight away include:
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 Joshua is a very focused, dedicated and committed Practitioner. Growing up in Menai, he has been actively involved in AFL and Cricket and currently has a passion for Soccer and strength based training. He loves sport but more importantly, Joshua can see the major benefits of being active and moving regularly. Joshua's special interests are in sports injuries, musculoskeletal complaints and headaches. He enjoys helping relieve pain and alignments and supporting his patients to live optimally as well as instilling optimism and personal belief that moving well is important for a happy and health life. You know when you see Joshua you are in the hands of someone who continually strives to be ahead in his profession and will bring his expertise and skill to all of his patients. You'll find Josh has a friendly and enthusiastic personality, who is also very relaxed and down to earth to be with, leaving you feel comfortable and confident in his treatment and recommendations. Availability Tuesday 8am - 6pm Wednesday - 3pm - 7pm Friday - 3pm - 7pm  Sciatica is a term that gets thrown around quite a bit as soon as someone complains of pain running down the leg. Sciatic nerve pain is when there is radiating pain that travels along the path of the sciatic nerve, this is from your lower spine through the buttock and down the back of the leg. In some cases, depending on where the nerve is affected, the pain can run all the way to the foot. It is typically one sided but in serious cases affect both legs. Sciatica pain is actually a symptom rather than a medical condition, illness, or disease and signals an underlying medical issue. The sciatic nerve is like a large river with many smaller rivers flowing into it, the small rivers are the nerve roots from the lower back and all come together to make the sciatic nerve around the hip region. The sciatic nerve is the longest and largest nerve in the body, about the width of a human finger. SYMPTOMS OF PATHOLOGY TO THE SCIATIC NERVE:
  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:
PREVENTION
GENERAL TREATMENT Most cases do not require surgery, but the type of therapy will depend on severity of the condition and include:
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:
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.  Joshua Hallinan Chiropractor Joshua is a very focused, dedicated and committed Practitioner. Growing up in Menai, he has been actively involved in AFL and Cricket and currently has a passion for Soccer and strength based training. He loves sport but more importantly, Joshua can see the major benefits of being active and moving regularly. Joshua's special interests are in sports injuries, musculoskeletal complaints and headaches. He enjoys helping relieve pain and alignments and supporting his patients to live optimally as well as instilling optimism and personal belief that moving well is important for a happy and health life. You know when you see Joshua you are in the hands of someone who continually strives to be ahead in his profession and will bring his expertise and skill to all of his patients. You'll find Josh has a friendly and enthusiastic personality, who is also very relaxed and down to earth to be with, leaving you feel comfortable and confident in his treatment and recommendations. Availability Tuesday 8am - 6pm Wednesday - 3pm - 7pm Friday - 3pm - 7pm  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.   Anneliese Ball Podiatrist Anneliese is at Health Associates as a podiatrist working Monday and fortnightly Saturday. She holds both a Bachelor of Psychology and Podiatry. As a podiatrist she combines her proficient knowledge of human mechanics and ability to connect and engage with her patients to deliver outstanding clinical outcomes and an exceptional customer experience. Anneliese loves health and fitness and enjoys encouraging her patients to maximise their health.  Scoliosis is a sideways curvature of the spine that is greater than 10° (Cobb angle), this is measured on an x-ray. It can occur at any age, but most often occurs in children and teenagers. The curve usually creates an “S” or “C” shape of the spine. The curve also causes the spinal vertebrae to rotate. In some cases, the scoliosis is stable, while others can increase over time. Mild scoliosis does not usually cause issues, but severe cases can be very problematic. CLASSIFICATION
PREVALENCE + EPIDEMIOLOGY
CAUSES More than 65% of scoliosis cases are idiopathic (unknown cause) but it is generally believed to be multifactorial with genetics and environment being the main contributors. There are many other causes of scoliosis including:
 SYMPTOMS Symptoms will vary with each individual and may include:
ADOLESCENT VS ADULT
TREATMENT/MANAGEMENT
REFERENCES Negrini, S., et al. "SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord 13: 3." (2016). Schwab, Frank, et al. "Adult scoliosis: prevalence, SF-36, and nutritional parameters in an elderly volunteer population." Spine 30.9 (2005): 1082-1085. Weinstein, Stuart L., et al. "Adolescent idiopathic scoliosis." The Lancet 371.9623 (2008): 1527-1537. Konieczny, Markus Rafael, Hüsseyin Senyurt, and Rüdiger Krauspe. "Epidemiology of adolescent idiopathic scoliosis." Journal of children's orthopaedics 7.1 (2012): 3-9. Noshchenko, Andriy, et al. "Predictors of spine deformity progression in adolescent idiopathic scoliosis: A systematic review with meta-analysis." World journal of orthopedics 6.7 (2015): 537. Soucacos, Panayotis N., et al. "Risk factors for idiopathic scoliosis: review of a 6-year prospective study." Orthopedics23.8 (2000): 833-838.  Joshua Hallinan
Chiropractor Joshua is a very focused, dedicated and committed Practitioner. Growing up in Menai, he has been actively involved in AFL and Cricket and currently has a passion for Soccer and strength based training. He loves sport but more importantly, Joshua can see the major benefits of being active and moving regularly. Joshua's special interests are in sports injuries, musculoskeletal complaints and headaches. He enjoys helping relieve pain and alignments and supporting his patients to live optimally as well as instilling optimism and personal belief that moving well is important for a happy and health life. You know when you see Joshua you are in the hands of someone who continually strives to be ahead in his profession and will bring his expertise and skill to all of his patients. You'll find Josh has a friendly and enthusiastic personality, who is also very relaxed and down to earth to be with, leaving you feel comfortable and confident in his treatment and recommendations. Availability Tuesday 8am - 6pm Wednesday - 3pm - 7pm Friday - 3pm - 7pm  If you’ve experienced heel pain, you will know how inconvenient it was and how important your feet suddenly became! Feet functioning properly is surprisingly important when they begin to let us down! It's so easy to neglect your feet and take them for granted. Heel pain not only occurs in adults, but children commonly experience sore heels too. You’re going to hear about it from your kids, considering they’re using them all the time so it's so important to try and react to these signs and symptoms early if you can as it could possibly be more than just a blister or a splinter, these heel pains unfortunately, are the cries of some underlying issue demanding attention. Heel pain can be due to one or multiple different issues. It can involve any structure in the feet including:
Heel pain can occur in any area of the heel and can also radiate or refer pain to other areas. Signs can include things such as
Symptoms can include things such as
 Once we react and take action to signs and symptoms, it also allows us to become proactive in the face of possible re-occurrence or in any other issue/s that have have been bought to our attention. The most common pathologies causing heel pain include (not in order)
Less common pathologies can include
It is important to visit a podiatrist for proper assessment, diagnosis and management or referral. Even if it seems straight forward and self-explanatory about what may be going on with your child’s heel pain it is important to seek professional advice as your home treatment plan is likely to not be as effective. Also, understanding why this issue has popped up is just as important as treatment! Addressing signs and symptoms of heel pain, then consequently the underlying issue may also shine light on other issue/s that have gone unnoticed e.g. tight muscles; limited range of motion in joints, limb length difference etc. Addressing these can lead to a healthier, more comfortable and active life. It may help with sport performance and or just feeling more confident to get out and play! Written by Anneliese Ball, Podiatrist Health Associates Working Monday and every 2nd Saturday References
 Anneliese Ball Podiatrist Anneliese is at Health Associates as a podiatrist working Monday and fortnightly Saturday. She holds both a Bachelor of Psychology and Podiatry. As a podiatrist she combines her proficient knowledge of human mechanics and ability to connect and engage with her patients to deliver outstanding clinical outcomes and an exceptional customer experience. Anneliese loves health and fitness and enjoys encouraging her patients to maximise their health. |
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