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What is rehabilitation?

The term rehabilitation is used in a variety of different settings and contexts. It can be defined as the process of optimising physical and functional states following injury, illness or disease. Post-surgical rehabilitation is type of rehabilitation that aims to return the person to their pre-injury or pre-operative level of function. It not only involves physical interventions; education forms a fundamental aspect that is vital to success in achieving set goals.

Why is it important after foot surgery in Perth?

We know from documented research that changes in the body take place on a physiological level after a period of immobilisation. For example, the time period when wearing a post-operative shoe or moon boot, which is common after foot and ankle procedures. Immobilisation results in decreases in muscle strength, weakening in ligament insertion sites and changes to joints and cartilage quality, amongst other things.  The good news is, these changes can be reversed with an appropriately structured rehabilitation program through a qualified health practitioner.

What should I expect from my rehabilitation?

Everyone is different, so no two rehabilitation programs will be exactly the same. There are a number of key elements that should be considered by the health practitioner when designing your rehabilitation program.

Condition-specific – the interventions prescribed should be specific to the type of procedure you have had performed. For example, a program designed for someone who has had bunion surgery will be different from someone who has had plantar fascia surgery. The actual structures involved in these procedures, that being the bone, tendons, fascia and joints, are completely different, hence why rehabilitation needs to target the specific structures affected.

Patient-centred – Rehabilitation needs to consider the qualities, functional ability and goals of the person we are working with. For example, the needs of a 15 year old elite gymnast with a traumatic foot fracture will be different to that of an elderly female who has fallen and sustained a similar foot fracture.

Evidence-based – The evidence for certain interventions in constantly changing and evolving, and a forward-thinking practitioner will be aware of the current best-practice management in their specialist area. Research allows us to know which treatments work, and which don’t, plus those that require further study to really evaluate their outcome.

In conclusion, rehabilitation is vitally important following many types of foot surgery procedures, including bunion surgery, hammertoe surgery, heel pain surgery and many more. It should form a key part of your foot surgery journey and commitment will promote optimal functional ability and return to activity.

Our team at Perth Podiatric Surgery are able to assist patients in their rehabilitation after foot surgery in Perth. Feel free to book an appointment today by calling 08 9383 3851 or visit https://www.perthpodiatricsurgery.com/appointments/

The presence of heel pain in children can significantly limit their ability to participate comfortably in sport and exercise, and at times can cause children to stop playing sport for a period of time altogether. The most common cause of heel pain is a condition known as Sever’s disease, which occurs due to inflammation at the growth plate in the heel bone.

Treatment of Sever’s disease involves addressing a number of common issues that may be contributing to the problem, and is best assessed by an experienced podiatrist. Our experienced practitioners at Perth Podiatric Surgery in Perth, are here to help your children suffering with heel pain. Treatment is simple and non-invasive, and will get your kids back on the field as soon as possible. Book an appointment today by calling 08 9383 3851 or visit https://www.perthpodiatricsurgery.com/appointments/

Results after Heel Spur Removal Surgery in Perth

What is a Heel Spur?

A heel spur is a common complaint at Perth podiatry practices, and is often found incidentally when a patient’s foot is X-rayed for other purposes. Having a heel spur is not a sure predictor for pain in the heel, for example a person can have a heel spur and have no pain in their heel, or can have debilitating heel pain with no associated spur. In this blog we’ll explore why this occurs, what solutions are available for heel spurs and what to expect after heel spur surgery.

 

Heel spurs form when calcium deposits at areas where tendon attaches to bone, therefore spurs can form at both the posterior (back) of the heel and plantar (bottom) of the heel. Plantar heel spurs, which occur where a strong structure called the plantar fascia attaches to the heel bone, are more common than those that occur posteriorly at the attachment of the Achilles tendon.

 

Treatment for Heel Spur

There are many conservative treatment options available to treat heel pain relating to plantar fasciitis and heel spurs. Some treatments include specific footwear, orthotics, physical therapy, life-style modifications, non-steroidal anti-inflammatory medications and injections. Only a small percentage of people who experience heel pain have little or no benefit from conservative treatment options.

 

As a final option, surgery can be performed to partially release the plantar fascia, just distal to where it attaches at the heel bone, as well as to remove the bone spur if required. Plain X-ray imaging will clearly show whether a heel spur is present, however magnetic resonance imaging gives us further insight into whether the heel spur is chronically inflamed. This form of imaging may be recommended prior to considering surgical treatment.

 

Surgery for Heel Spurs

Heel spur surgery can be performed in Perth as a day procedure and patients can weight-bear immediately afterwards in a special splinted sandal. This is generally worn for the first 2 weeks after surgery, after which time the patient can transition into a supportive sneaker style shoe. The procedure is performed through a key-hole incision, using X-rays intra-operatively to guide removal of the spur. The keyhole approach ensures minimisation of scar tissue and allows patients to recover faster from surgery with less overall pain. Patient’s undergoing heel spur surgery by our specialist in Perth, generally have minimal pain immediately afterwards and get back to normal activities within 2-6 weeks. Your post-operative recovery will also incorporate a range of stretching and strengthening exercises which are necessary to minimise long term stiffness and weakness.

 

For more information about heel spur surgery, visit https://www.perthpodiatricsurgery.com/ or call our friendly team on 08 9383 3851.

Cost of orthotics in Perth

Orthotics are devices worn inside the shoes to correct biomechanical abnormalities and relieve foot pain and fatigue. Orthotics in Perth can be ‘off the shelf’ which is a pre-made device with no special modifications to suit the individual. Custom made orthotics on the other hand are specially designed and custom made to suit the individual’s foot type and function, as well as relieve and re-distribute pressure from painful areas. Custom made orthotics in Perth are prescribed by podiatrists who are suitably trained and qualified in design and fitting of orthotics.

 

Custom made orthotics Perth

Perth Podiatric Surgery uses the latest technology in 3D orthotic scanning to ensure the best precision in the final fit of the orthotics. At your appointment, a 3D image of both feet is captured and a biomechanical examination is undertaken including analysis of your gait and range of motion examination. Custom modifications are then made to your images and final prescription is prepared. Orthotics take approximately 7 days to be manufactured, at which time you will return for a fitting appointment.

 

Orthotics in Perth can be made to suit a variety of different type of shoes, from sneakers to sandals. They are made from semi-rigid polypropylene which is durable in nature and will generally last several years. We recommend your orthotics are reviewed on a yearly basis to maintain optimum function. Sometimes small changes need be made to maintain proper correction. Top covers can also be easily replaced through our practice as required.

 

The total cost of orthotics at Perth Podiatric Surgery is $850 which includes your biomechanical examination, 3D digital scanning, manufacture of orthotics, fitting appointment and review appointment. Occasionally, minor modifications need to be made following the fitting of your orthotics which is also included if required. Rebates are available from your health insurance fund which can be claimed on the day via HICAPS.

 

To book an appointment to discuss your foot problem, please contact our friendly team on 9383 3851 or book online at https://www.perthpodiatricsurgery.com/appointments/

Podiatry for Children in Perth

Children’s foot problems are a common presentation in Perth podiatry clinics and can begin in the early years of life. Foot problems can range from acute sports injuries to more complex structural problems present from birth. When having your child’s feet assessed, it is important to see a specialist podiatrist with experience in paediatric foot problems who can accurately diagnose and treat their problem. Here we will discuss some common children’s foot problems treated in Perth.

 

Ingrown Toenails in Perth

Ingrown toenails are one of the most common children’s foot problems and can occur due to ill-fitting footwear, poor nail cutting technique, hygiene, or inherited nail shape. The edge of the nail pressing into the adjacent skin can cause pain, swelling and sometimes even infection. Ingrown toenails do sometimes require a procedure to treat them, however most can be treated and prevented with advice on nail cutting technique and clearing of the edge of the nail. Please click here for information on ingrown toenail surgery in Perth that we offer.

 

Plantar warts in Perth

Plantar warts are particularly common in children and occur due a virus called the Human Papilloma Virus (HPV). This causes a growth of tissue that is non-cancerous however can cause pain and discomfort. Plantar warts occur on the bottom of the foot and tend to cause more discomfort due to repeated pressure on the area when walking.  Warts can usually be resolved with treatment by a Podiatrist, however resistant infection sometimes requires surgical removal if the pain is affecting day-to-day life.

 

Heel Pain in Children

Heel pain can occur at any stage of life, however the cause of heel pain in children is different to the cause in adults. The most common cause of pain in children is a condition called Sever’s disease, whereby discomfort occurs around the area of the growth plate in the heel. Symptoms often ease with time, however several interventions such as stretching and strengthening, footwear modifications, orthotics and activity modifications can significantly reduce the frequency and intensity of pain in children.

 

Flat Feet in Children

Flat feet in children can not only cause pain in the feet and ankles, altered biomechanics can result in issues with the knees, hips and lower back. Flat feet should be assessed by an experienced podiatrist or podiatric surgeon in Perth and appropriate intervention discussed. This may differ depending on your child’s age, weight and activity level. Some children may need a prescription for specialised supportive footwear, others may require orthotic support or in extreme cases, rolling in of the foot or ‘pronation’ can be limited by placing a small implant into the hind foot. Please click here for information on hyprocure flatfoot correction in Perth that we offer.

 

To summarise, children’s foot problems in Perth can be just as complex as those occurring in the adult population, and assessment by an experienced practitioner is imperative to good clinical outcomes for your child.

 

Book An Appointment with our Specialist

Dr Andrew Knox has experience in dealing with both child and adult foot problems and can provide both surgical and non-surgical solutions to painful feet. To make an appointment, visit https://www.perthpodiatricsurgery.com/

 

Custom Made Orthotics for Heel Pain in Perth

Custom made orthotics are prescribed by Perth podiatrists every day for a number of different foot, ankle and lower limb problems. Podiatrists are university trained health professionals who assess, diagnose and treat all types of foot and ankle pain, as well as mechanical pain of the back, hips and knees as a result of altered foot mechanics.

 

What are custom made orthotics in Perth?

Most people have seen generic orthotics or shoe inserts which are often sold in pharmacies, sports stores and sometimes even supermarkets, however proper custom made orthotics are only prescribed by podiatrists. Orthotics are a pair of devices worn inside the shoes which can reduce pressure, provide cushioning, correct faulty foot mechanics and offload painful areas of the feet

 

How are orthotics in Perth made?

Making a custom pair of orthotics in Perth first requires a 3D digital scan of both feet using specialized equipment. A customized prescription is then completed by the podiatrist which takes into account how much correction is needed, the material, areas of cushioning and offloading and shape/fit depending on the type of footwear the orthotics will be worn in. Orthotics are extremely versatile essentially no two pairs will be the same!

 

How do orthotics help with heel pain in Perth?

Orthotics are often one of the first lines of treatment when fixing heel pain when biomechanical problems are involved. This is usually along with stretching and strengthening and footwear modifications. Orthotics work to correct malalignment of the foot, ankles and knees, thus reducing associated tension on areas of the heel. Orthotics also help to activate something called the ‘Windlass Mechanism’ which is an integral part of normal foot function.

 

What other foot problems in Perth can orthotics help with?

Orthotics can help with other foot problems such as Achilles tendonitis, Morton’s Neuroma, bursitis, foot ulcers and recurrent stress fractures. They can also help with other lower limb issues such as medial tibial stress syndrome (shin splints), patellofemoral pain syndrome, ilio-tibial band syndrome, Osgood Schlatter’s disease and mechanical pain of the hips and lower back.

 

If you have further questions regarding how custom made orthotics may improve your pain, please visit our website and ask away on our FAQ page https://www.perthpodiatricsurgery.com/frequently-asked-questions/

 

To book an appointment with Dr Andrew Knox, Podiatric Surgeon to discuss your issues relating to foot pain, please call 08 9383 3851 or book online at https://www.perthpodiatricsurgery.com/appointments/

 

 

 

Rehabilitation after Bunion Surgery Perth

Rehabilitation after bunion surgery in Perth constitutes a vital part of the recovery process, and usually follows a period of rest and restricted activity. Whether you have undergone a simple tendon release, or a more involved procedure such as an osteotomy (cut in the bone), rehabilitation will shorten your recovery time, reduce stiffness and swelling and get you back to activities of daily living as quickly as possible.

 

Post-operative rehabilitation involves a structured program prescribed by someone with appropriate knowledge and training in the area, such as a podiatrist, physiotherapist or your surgeon. Much of this can be performed at home, however regular checkups and guidance from your practitioner means exercises can be tailored to your current needs, progress and future goals. Below are some of the goals we focus on when rehabilitating patients after bunion surgery.

 

Joint movement after bunion surgery in Perth

Initially following bunion surgery in Perth, you will be required to wear a splinted sandal (post-operative shoe) to protect the area and limit motion through the joint. This is worn for 2-3 weeks depending on your individual needs. Following this period, is it normal for the joint to feel somewhat stiff to move, therefore physical therapy in the form of range of motion exercises is often the first stage of rehab. You will be shown how to safely move your big toe joint through its range of motion to loosen soft tissue structures.

 

Strengthening exercises after bunion surgery in Perth

Once you feel comfortable with manually moving the big toe joint, the use of a elastic band, known as a theraband, is used to apply resistance to the toe, allowing you to activate and strengthen the small tendons and ligaments that control motion. These muscles often become ‘lazy’ following surgery, however they begin to re-active fairly quickly once they are put under some tension.

 

Proprioceptive exercises after bunion surgery in Perth

After bunion surgery, often your foot not only looks different, however the way it functions and responds to stimuli also changes. Pressures are distributed throughout the foot differently when there is a large bunion present, compared to when there is not. Therefore it is also important to re-train our brains to recognsze where different areas of the foot are in space when walking. This is particularly important for our balance and stability. Proprioception training involves a series of balance type exercises that may utilise unstable surfaces such as a bosu ball to re-gain important connections between the brain and the foot. This type of training is similar to what is undergone after many sports injuries such as ankle sprains.

 

Regain normal foot loading patterns and joint function

Finally, ensuring normal gait patterns are re-formed is vital before embarking on any type of physical exercise. Physiotherapists and podiatrists are trained in biomechanical gait analysis and can often make small adjustments to your gait patterns by working with you one on one. Changes to gait may have formed as a result of having foot pain or deformity for many months or years, or may have occurred as a result of wearing a post-operative shoe.

 

If you have further questions regarding bunion surgery or rehabilitation, please visit our website and ask away on our FAQ page https://www.perthpodiatricsurgery.com/frequently-asked-questions/

 

To book an appointment with Dr Andrew Knox, Podiatric Surgeon to discuss your issues relating to bunions or other foot pain, please call 08 9383 3851 or book online at https://www.perthpodiatricsurgery.com/appointments/

 

 

 

Foot Surgery in Perth for Hallux Rigidus

Hallux rigidus essentially means arthritis of the big toe joint which results in progressive pain and sometimes bony deformity. There are a number of different factors which may cause hallux rigidus including previous injury, osteoarthritis or inflammatory conditions such as rheumatoid arthritis, or foot deformity.

 

Signs and Symptoms of Hallux Rigidus in Perth

Most people with hallux rigidus present with pain upon movement of the big toe joint. It often starts becoming sore during strenuous exercise, then as the arthritis in the joint progresses can become sore from walking and pressure from footwear. Some people will develop bony lumps around the joint which can make wearing footwear difficult. Sometimes pain under the second toe can develop due to changes in foot mechanics resulting in overload pressure at the second toe.

 

Diagnosis of Hallux Rigidus in Perth

Investigation for big toe joint pain first starts with an X-ray to assess the joint and determine the level of arthritis present. The health of the joint can be graded on a scale from 0-4. The common signs of hallux Rigidus seen on x-ray include, narrowing of the joint space, extra bony growth around the joint and damage to cartilage. X-rays can be performed on site on your day of appointment at Perth Podiatric Surgery so treatment options can be made available to you straight away.

 

Foot Surgery in Perth for Hallux Rigidus

In the intial stages of the problem, a procedure can be performed to essentially ‘clean up’ the joint. This involves the removal of excess bone that is limiting motion. Depending on the joint quality, sometimes this procedure can be performed through a keyhole incision, meaning healing times are reduced. Please click here for information on the chilectomy procedure for hallux rigidus

 

In cases where arthritis has progressed significantly, the most effective way to reduce pain associated with the condition is to fuse the big toe joint (arthrodesis). This is done by first preparing the bone, then using a special surgical plate and screws to hold two ends of the bone together. The procedure permanently stiffens the big toe joint, preventing movement and therefore preventing any pain associated with movement.

 

If you have further questions regarding Hallux Rigidus surgery and it’s recovery, please visit our website and ask away on our FAQ page https://www.perthpodiatricsurgery.com/frequently-asked-questions/

To book an appointment with Dr Andrew Knox, Podiatric Surgeon to discuss your issues relating to Hallux Rigidus or other foot pain, please call 08 9383 3851 or book online at https://www.perthpodiatricsurgery.com/appointments/

 

Disclaimer: This blog is intended for general information purposes only. Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. 

HEEL PAIN IN PERTH

People with longstanding heel pain in Perth walk into our Perth Podiatry practice everyday frustrated by their lack of improvement despite spending extensive time and money on treatment. By listening closely to our patient’s history and carrying out a thorough physical examination, we’re helping people all over Perth get back to the activities they love.

 

A condition called plantar fasciitis is the most common cause of heel pain in Perth and can affect one or both feet. It is thought to be due to repetitive micro trauma at the region where the plantar fascia attaches into the heel bone. Most people experience pain during the first few steps in the morning, which worsens again after prolonged activity and upon rising from a seated position.

 

TREATMENT FOR HEEL PAIN IN PERTH

Research has shown that symptoms of heel pain resolve more quickly, when treatment for heel pain is started as soon as possible. The best place to start when first experiencing heel pain is with a trusted Perth Podiatrist who is experienced in treating heel pain in Perth. Your Perth Podiatrist will offer you a number of different treatments which may include changes to footwear, a stretching and strengthening regime, custom orthotics in Perth, manual therapies, shockwave therapy or night splints. They will tailor these treatments for heel pain in Perth to best address the cause of your onset of symptoms. For example, if you have flat feet and are standing and walking as part of your work, footwear changes and orthotics are likely the best place to start. Alternatively, if you have the onset of heel pain in Perth after starting a new exercise regime, footwear, training modifications and manual therapies may prove the best course of action.

 

PERTH FOOT SURGERY FOR HEEL PAIN

When symptoms fail to improve despite consistency with treatment prescribed by your Perth Podiatrist, it may be time to see someone who specialises in the surgery for heel pain in Perth. Usually, a course of 6 months of non-surgical care is an appropriate timeframe to then consider surgical management, however if symptoms are worsening or it is affecting your work and daily life, early referral to a Perth Podiatric Surgeon may be warranted.

 

Foot surgery in Perth for heel pain can be performed through a small portal incision at the heel area and sometimes a live X-ray machine is used to guide the Perth foot surgeon. Weight bearing is permitted immediately afterwards on the day of surgery, however should be limited to allow optimal healing. Local anaesthetic is used to keep the foot numb for several hours afterwards and often until the next day. The procedure can also be performed under general anaesthesia or with sedation if required. The majority of our patients undergoing surgery for heel pain in Perth experience very minimal discomfort afterwards, however all our patients are supplied with adequate pain relief in the event that there is some pain after surgery. Once the incision site has healed, patients undergo rehabilitation with trusted Perth podiatrists to work on strengthening, range of motion and other soft tissue modalities.

 

If you have further questions regarding Heel Pain surgery and it’s recovery, please
visit our website and ask away on our FAQ page
https://www.perthpodiatricsurgery.com/frequently-asked-questions/

To book an appointment with Dr Andrew Knox, Podiatric Surgeon to discuss your issues
relating to Morton’s Neuroma or other foot pain, please call 08 9383 3851 or book online at
https://www.perthpodiatricsurgery.com/appointments/

 

Disclaimer: This blog is intended for general information purposes only. Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. 

Morton’s Neuroma in Perth

Morton’s neuroma is a common issue affecting the digital nerve in the forefoot which
produces pain, numbness and/or shooting or tingling sensations. Morton’s neuroma surgery in Perth is aimed at decreasing pain associated with the condition through surgical removal of the damaged nerve.

The procedure takes approximately 20 minutes and is performed through a small
incision on the top of the foot. When considering surgical treatment for Morton’s
neuroma in Perth, it is important to understand what to expect during recovery. Below are some
common questions from our patients considering having surgery for Morton’s neuroma.

Can I walk after Morton’s neuroma surgery?

Our patients can weight bear immediately after surgery in a splinted post-operative shoe.
During the first week after surgery, we recommend only spending 5-10 minutes per hour on
your feet, with the rest of the time spent resting with your foot elevated.

Is Morton’s neuroma surgery painful?

A long acting local anaesthetic is used during the procedure which means the foot will be
numb often until the next day. Our patients report very minimal pain levels following
Morton’s neuroma surgery. You will be provided with adequate pain relief, however most
people find they only need to take it in the first couple of days after surgery.

How much activity can I do during my recovery?

You should cease all strenuous physical activity during your recovery until approval has been
given by your surgeon to recommence activity. During the first two weeks you are
permitted to walk only, after which time your progress will be assessed before allowing you
to gradually return to physical activity.

Time required off work after surgery for Morton’s neuroma?

People who work in a seated office job can generally return to work at 1-2 weeks post-
surgery, however those who have more physically demanding jobs may require 2-4 weeks
off work. Your job requirements will be discussed prior to undergoing surgery and you will
be given as estimate of time required off work.

Scarring after surgery for Morton’s neuroma

The incision for Morton’s neuroma surgery is only 1-2cm long, meaning you are left with
very minimal scarring. People who are at risk or have had previous keloid or hypertrophic
scarring can reduce their risk by notifying the surgeon beforehand, so that alternate suture
techniques can be implemented. It may also be recommended to you to use a silicone based
scar cream after surgery. Other options are also available to reduce painful or raised scars
should this rare problem arise.

If you have further questions regarding Morton’s Neuroma surgery and it’s recovery, please
visit our website and ask away on our FAQ page
https://www.perthpodiatricsurgery.com/frequently-asked-questions/

To book an appointment with Dr Andrew Knox, Podiatric Surgeon to discuss your issues
relating to Morton’s Neuroma or other foot pain, please call 08 9383 3851 or book online at
https://www.perthpodiatricsurgery.com/appointments/

 

Disclaimer: This blog is intended for general information purposes only. Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.