 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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 A rotator cuff injury is when there is a strain, tear or damage to the one or more of the rotator cuff muscles. It is one of the most common injured areas of the shoulder. The injury usually involves damage to the rotator cuff tendons (The part of the muscle that connect the muscles to bones). By the age of 50 approximately 10% of people will have a rotator cuff tear. A study by Yamamoto showed 20.7% of 1366 shoulders had full-thickness rotator cuff tears in the general population of a mountain village in japan. WHAT IS THE ROTATOR CUFF? The rotator cuff is a group of muscles that stabilise the shoulder joint, it does this by attaching the scapular (shoulder blade) to the humerus (upper arm bone). The rotator cuff also provides and helps guide movements of the shoulder. The rotator cuff is made up of 4 muscles (look at diagram for where they are):
Movements that the rotator cuff perform:
 SYMPTOMS
CAUSES
RISK FACTORS
TREATMENT
Treatment through chiropractic:
PREVENTION
If you have had a rotator cuff injury or shoulder discomfort, we recommend visiting your local health practitioner for an accurate diagnosis of your complaint with proper treatment and rehab plan. As mentioned above there are four muscles in the rotator cuff and making sure treatment is directed to the right area is vital. If you are local to the Loftus area, we are happy to help or answer any questions you may have. Written by Joshua Hallinan, Chiropractor Health Associates Working Tuesday (AM & PM), Wednesday & Friday (PM) References Minagawa, Hiroshi, et al. "Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: from mass-screening in one village." Journal of orthopaedics 10.1 (2013): 8-12. Yamamoto, Atsushi, et al. "Prevalence and risk factors of a rotator cuff tear in the general population." Journal of Shoulder and Elbow Surgery 19.1 (2010): 116-120. Jerosch, J., T. Muller, and W. H. Castro. "The incidence of rotator cuff rupture. An anatomic study." Acta Orthop Belg 57.2 (1991): 124-129. Ellenbecker, Todd S., and Ann Cools. "Rehabilitation of shoulder impingement syndrome and rotator cuff injuries: an evidence-based review." British journal of sports medicine44.5 (2010): 319-327. Lin, James C., Nancy Weintraub, and Dixie R. Aragaki. "Nonsurgical treatment for rotator cuff injury in the elderly." Journal of the American Medical Directors Association 9.9 (2008): 626-632.  Have you got pain on the outside of the hip? Perhaps you have been diagnosed with bursitis? Pain on the outside of the hips is an extremely common complaint coming into the clinic. The vast majority of people with lateral hip pain are women in their 40’s 50’s and 60’s. In the past this has often been called hip bursitis and treated with cortisone injections. Unfortunately this has mixed success due to the fact that tendons are often involved and cortisone injection has limited use for tendon injury. In fact 4% - 46% of people have bursitis visible on imaging and tendinopathy 18% to 50% of people. The technical terms that are often used include:
 We prefer the term GTPS as it more realistically encomasses the common causes of outer hip pain. Classic symptoms of GTPS include pain on the outside of the hip, especially at night when side sleeping and with the sore side down ALTHOUGH it quite often gets painful with the sore side up as well - due to the fact that the leg is hanging across the midline of the body essentially tractioning the outer hip muscles. Three things you can do right now to help relieve this problem. ✅✅✅Sleep with the sore side UP & place a pillow between your legs ✅✅✅  ❌❌❌Do NOT cross your legs when seated❌❌❌  ❌❌❌ Do NOT stand with all your weight posted onto one leg. ❌❌❌  Excessive loading of the gluteal tendon attachments to the top of the thigh bone along with direct compression (from side laying in bed) may be partly responsible for the development of lateral hip pain. As such, decreasing the repetitive loading on the muscles and tendons can help alleviate the symptoms in the SHORT term. Now GTPS can be particularly tricky to get better. In our experience one of the major challenges is doing too much too soon in the recovery process. Slow progressive exercises are the best way to a long term solution. If you would like further advice on the best progressive exercises for GTPS or other tendon issues we recommend consulting your local healthcare provider that has a special interest in tendon rehabilitation. If you are local to Health Associates we would be more than happy to help. Further Resources For a fantastic visual resource relating to any tendon problem click on the link below to view Jill Cooks - 10 Things NOT to do if you have lower limb tendon pain . Written by Christopher Bowles Chiropractor Working at Health Associates Monday, Thursday, Friday and Saturday  Credentials
Master of Chiropractic Diploma Sports Chiropractic Registered Sports Trainer Active Release Technique Personal Trainer Functional Movement Screen Chris created Health Associates on the belief that movement is essential to living well. It is his personal mission to keep people active and moving for as long as possible. Recreational to elite, Chris will make sure that you are provided the best treatment possible and will help keep you in your sport. Chris is very empathetic to the pain and suffering of his patients. That is why he gives everything he can to ensure that they receive an accurate diagnosis and the most recent evidence based treatment plan.  Before performing any movement whether that would be a golf swing, throwing a punch in boxing, a 150kg back squat or even something as simple as going for a run/walk, we must make sure you know how align yourself in the best way possible to be able to get the most out of the movement, starting with the pelvis and importance of glute activation. When the pelvis is in neutral for you, you are able to properly activate the glutes. UNDERSTANDING THE PELVIS:
HOW TO FIND YOUR PELVIC NEUTRAL POSITION FOR MAXIMUM GLUTE ACTIVATION:
WHAT ARE THE ‘GLUTES’?
 CAUSES OF WEAK GLUTES?
WHY IS GLUTE ACTIVATION AND STRENGTH SO IMPORTANT?
GLUTE ACTIVATION EXERCISES:
GLUTE STRENGTH EXERCISES:
There is not one exercise that will build your glutes. You will need to perform a variety of glute exercises that target different parts of the glutes. You must include this new awareness of glute activation and pelvic position. Activation of glutes and core will ensure an increase in strength and decrease risk of injury when performing strengthening exercises.  Written by Joshua Hallinan, Chiropractor Health Associates Working Tuesday and Thursday References Mitchell B, Colson E, Chandramohan T Lumbopelvic mechanics British Journal of Sports Medicine 2003;37:279-280. Which Exercises Target the Gluteal Muscles While Minimizing Activation of the Tensor Fascia Lata? Electromyographic Assessment Using Fine-Wire Electrodes David M. Selkowitz, George J. Beneck, and Christopher M. Powers Journal of Orthopaedic & Sports Physical Therapy 2013 43:2, 54-64 Reiman, Michael P., Lori A. Bolgla, and Janice K. Loudon. "A literature review of studies evaluating gluteus maximus and gluteus medius activation during rehabilitation exercises." Physiotherapy theory and practice 28.4 (2012): 257-268. Cambridge, Edward DJ, et al. "Progressive hip rehabilitation: the effects of resistance band placement on gluteal activation during two common exercises." Clinical Biomechanics 27.7 (2012): 719-724. Boren, Kristen, et al. "Electromyographic analysis of gluteus medius and gluteus maximus during rehabilitation exercises." International journal of sports physical therapy 6.3 (2011): 206. Herrington, Lee. "Assessment of the degree of pelvic tilt within a normal asymptomatic population." Manual therapy 16.6 (2011): 646-648. Image 2 - http://www.ultimaterob.com/2013/05/30/glute-strength-and-activation/ Image 3 - https://moveu.com/blog/build-glute-strength/  Chiropractor
Bachelor of Chiropractic Science Masters in Chiropractic Joshua is a very focused, dedicated and committed practitioner. Joshua is committed to health and has achieved significant personal success in sport and through adopting a healthy lifestyle. Joshua is very ambitious and he is always setting himself personal targets to improve and be the best practitioner he can be. You know when you see Joshua that you are in the hands of someone who continually strives to be ahead in his profession and will bring that knowledge and skill to all of his patients. Joshua has a special interest in sports injuries, musculoskeletal complaints and headaches. He enjoys helping relieve pain and alignments and supporting his patients to live optimally. Josh has a great friendly and enthusiastic personality. His relaxing and down to earth approach leaves you feeling comfortable and confident in his treatment and recommendations. |
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