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.



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.



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

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


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

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


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. 

Ankle pain or pain in the hindfoot can have a significant effect on everyday activities resulting in pain when walking or exercising, difficulty carrying out duties at work and affecting the types of footwear that can be worn comfortably. There are a number of different causes of ankle pain, including acute injury, arthritis, biomechanics and foot structure. Here we will discuss common causes of ankle pain and how a suitably qualified ankle specialist can get you back to living pain-free.

Posterior Tibialis Tendon Dysfunction (PTTD)

The posterior tibial tendon runs on the inside of the ankle joint and has a pivotal role in supporting the arch of the foot. When there is a significant flattening of the arch of the foot, or rolling in, the posterior tibial tendon becomes overworked and strained, leading to pain and sometimes swelling and weakness on the inside of the ankle. Many conservative treatments are available for this condition and may include orthotic therapy, supportive footwear and strengthening. If conservative measures fail, a special implant known as the HyProCure implant can be inserted into the hind foot to permanently support the arch of the foot and prevent excessive strain on the tendon. For more detailed information about HyProCure surgery click here.


Fractures affecting the hind foot are common and can occur as a result of ankle sprains, jumping from heights or other traumatic events. Suspected fractures or events causing significant trauma to the foot require an X-ray to evaluate for different types of bony injury. Fractures where the bones remain in their usual position usually require a period of immobilisation for healing to occur. On the other hand, sometimes the two ends of bone come away from each other as a result of the force of injury, this is known as a displaced fracture. Displaced fractures usually need to be fixed via an open procedure where the two ends of the bone are brought back together and held with screws and a small plate. An ankle specialist will thoroughly review your injury and use appropriate imaging to determine whether ankle surgery may be necessary.

Ankle Impingement (Os Trigonum)

Painful impingement at the back of the ankle is often caused by a small accessory bone called an os trigonum. The presence of this accessory bone is congenital (present at birth), however, the onset of pain related to it is often triggered by an event such as an ankle sprain, or becomes painful in people involved in a sport such as dancing, netball, basketball etc. Treatment in the first instance usually involves rest, immobilisation, and anti-inflammatory medication, however ankle surgery to remove the accessory bone may be required if the pain doesn’t settle.

Haglund’s Deformity

Haglund’s deformity is a condition where a bony enlargement occurs at the back of the heel and can result in secondary irritation to the Achilles tendon at its attachment. The bump can be irritating in footwear, particularly shoes with a rigid heel counter. Opinion from an ankle specialist is helpful to determine whether surgery may be necessary to reduce the bony bump. This can sometimes be performed through a keyhole approach depending on the severity.

Perth Podiatric Surgery offers the latest surgical techniques including keyhole ankle surgery for a range of conditions. Book an appointment with our foot and ankle specialist online or speak to one of our friendly staff members by calling 08 9383 3851.

Navigating our complex health care system can be challenging and hence finding the right podiatric surgeon can be difficult. Here we discuss 5 things to look for in a foot surgeon to ensure a positive experience and the best results.

1. Excellent Communication

Having great communication with your podiatric surgeon is vital when considering upcoming foot surgery. Your surgeon should openly discuss your problem and the reasons for recommending foot surgery, as well as offering you alternative options, including conservative measures. Ask your surgeon open-ended questions about your diagnosis, proposed treatment and recovery expectations. They should make you feel comfortable and reassured and should be happy to answer as many questions as you need to be answered.

2. Background and Training

Research the qualifications of your surgeon and look at their previous appointments, or alternatively, ask your surgeon what their previous training and experience is in relation to your specific problem. Podiatric surgeons or foot specialists complete a Bachelor’s degree (or higher) in podiatric medicine and must be registered as a podiatrist with the Podiatry Board of Australia. Those who meet the eligibility criteria are then able to apply for entry into a surgical training course, taking 3 years of equivalent full-time study as a Podiatric Surgical Registrar. Upon completion, Podiatric Surgeons must be registered as a specialist with the Podiatry Board of Australia.

3. Experience in the newest procedures

Look for a surgeon who remains up-to-date with the most recent technology, and seeks to continue learning and improving their surgical skills and techniques. Surgeons who travel internationally to attend conferences and training courses gain vast experience in the latest techniques to improve outcomes for their patients. New techniques often mean reduced recovery times for patients, for example, see how minimally invasive foot surgery techniques are reducing recovery times for patients.

4. Reputation

A surgeon’s reputation in the community can tell a lot about the quality of foot surgeon they are. Online reviews provide honest feedback from real patients and can be valuable sources of information when choosing who is the right surgeon for you. It can also be helpful to ask friends and family, as often someone you know has had similar issues and may have consulted with someone in the past. Knowing a friend has had a positive experience with a foot surgeon can make the whole experience a lot less daunting.

5. Ask about hospital privileges

Surgeons go through an extensive accreditation process to be accepted to provide services in a hospital or day surgery. The hospital undergoes relevant background and training checks as well as referee checks by trusted surgeons in the community before appointing a surgeon with hospital accreditation. A trustworthy foot surgeon will have hospital privileges and should be able to provide you with options for where you have your surgery performed.

Book a consultation with our experienced and qualified foot surgeon, Dr Andrew Knox, or phone (08) 9383 3851.

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. 

A large proportion of us have experienced pain in one or both heels at some stage of our lives, but when the pain becomes more than just an ache in the morning and starts to affect activities of daily living, it’s time to see a qualified health professional. No one should have to suffer from ongoing heel pain, and that’s where podiatrists and podiatric surgeons use their knowledge and skill to get you back to doing the activities you love.

Heel Pain Explained

The most common cause of heel pain is a condition called plantar fasciitis which affects a strong band running from the heel to the toes on the bottom of the foot. People typically complain of an aching or stabbing sensation with tenderness to press at the bottom of the heel. There are a number of different factors which contribute to the development of plantar fasciitis including foot type, poor choice of footwear, activity and poor foot mechanics. Most people with plantar fasciitis experience pain when they first get up in the morning, which gradually eases with activity and pain when rising from a period of sitting or inactivity.

Treatment for common heel pain

Initial treatment for heel pain often involves a few simple changes to your lifestyle. In the first instance, stretching exercises of the calves and hamstrings can be helpful as well as ensuring you are wearing supportive footwear that fits properly and is suitable for your work and leisure activities. You may be required to temporarily cease a particular activity such as running until the inflammation is reduced. If symptoms persist, a proper biomechanical examination by a podiatrist or podiatric surgeon is essential to determine if your foot type is putting excessive load or strain on the plantar fascia. Orthotics to reduce this load may be recommended and can be worn in many different types of athletic and work footwear. For resistant heel pain, further treatment may be required including specialized imaging (MRI) to visualize the exact location and degree of severity.

What if nothing has worked…

Podiatric surgeons specialise in the surgical management of foot related pain and deformity and are highly skilled at diagnosing and treating complex problems with conservative measures and surgical techniques. Surgery for plantar fasciitis involves releasing one of the bands on the plantar fascia and can be done either via an open or keyhole surgery. The procedure is usually performed as a day surgery with minimal downtime postoperatively.

Top tips for understanding and resolving your heel pain:

  1. Seek an early opinion – early management leads to a better long-term outcome
  2. Ask questions – ensure you understand the cause of your heel pain and the steps you and your podiatrist or podiatric surgeon will take to resolve it, ask away!
  3. Don’t settle for long-term pain – see a podiatric surgeon for an opinion if conservative treatment hasn’t resolved your pain
  4. Finally, don’t give up! – seek a second opinion or discuss your options for surgery

Dr Andrew Knox of Perth Podiatric Surgery frequently performs surgery for chronic cases of plantar fasciitis in Perth. Book an appointment online to see Dr Andrew Knox or speak to one of our friendly staff members on 08 9383 3851.

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. 

Do you have problems finding footwear that fits and is comfortable? Do you have pain in your toes or under the ball of your foot? Do you have callouses or corns on your toes? If you answered yes to these questions, it is likely you have a common deformity known as a hammertoe, similarly known as a claw toe, or mallet toe.

What is a hammertoe?

A hammertoe is a deformity of any of the lesser toes, whereby the digit becomes contracted while an imbalance occurs in the tendons and ligaments that support the toe’s position. Hammertoes can be caused by trauma, ill-fitting footwear, foot structure and genetics and certain disease processes.

Do I need surgery for my hammertoe?

The decision to have surgery is always your own, however our patients often consider having surgery when:

  • There is the presence of a painful toe deformity or prominent joint
  • They have difficulty finding shoes that fit properly and don’t cause pain
  • There are painful corns or callouses as a direct result of the deformity
  • Other conservative treatments have failed e.g. footwear modifications, toe separators, routine podiatry care

hammertoe surgery xray

How does minimally invasive hammertoe surgery compare to traditional methods?

Dr Andrew Knox uses a state of the art implant called the Smart Toe II for hammer toe correction. This revolutionary system requires no k-wires to be used during the surgery, meaning patients can expect faster healing times, better cosmetic results and eliminates the risk of nasty pin tract infections. Patients will spend significantly less time in a post-operative shoe and can transition back to regular foot wear at 2 weeks post-surgery.

What does the recovery involve?

Patients who have minimally invasive hammertoe surgery using the Smart Toe II Implant can weight bear immediately post op in a splinted sandal. This is worn for 2 weeks then transition is made back to regular footwear. There is no need for removal of the implant as it remains permanently within the healed bone.

Where can I find out more?

To see how the Smart Toe II Implant works in animation format, click the link below.

If you believe you are suffering with a hammertoe, early consultation yields the best results. Book an appointment online or call 08 9383 3851 to speak with one of our friendly staff members.

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. 

Misalignment of the feet can not only result in foot pain and discomfort but a pain in areas such as the ankles, knees, hips and lower back. Unfortunately, often when problems arise in other parts of the body, pain relief is targeted at this area and little importance is given to identifying the underlying cause of misalignment.


The crucial joint in the foot that allows excessive collapse or rolling in is called the sinus tarsi which lies between the ankle and the heel bone. Misalignment occurs when there is a loss of stability and subsequent collapse of the sinus tarsi space.

Flat Foot X-ray

Flat feet are most commonly treated with arch support or orthotics, which are certainly beneficial for many people with issues related to misalignment, however, orthotics act as a supportive device and are not corrective in nature. We can compare orthotics for a person’s feet as similar to wearing glasses for the eyes. Although they are beneficial while being worn, when glasses are removed there is no longer any benefit, and the person will have just as much trouble seeing as they did beforehand. Similarly, orthotics will not correct the foot’s position or fix the problem of having flat feet.

HyProCure Foot Surgery Perth

So, what can be done for people who do not benefit from non-surgical treatment? Foot Surgery is a simple and effective solution to stabilise the hind foot using a special implant called HyProCure, that is about the same size as a paperclip. The implant is placed into the sinus tarsi which prevents the joint from collapsing during walking. The HyProCure implant still allows a normal joint range of motion and offers a long-term solution to misalignment of the feet with a removal rate of less than 10% found through extensive evidence-based research. The implant can be used in both adult and paediatric patients with most being able to weight bear on their feet the same day. The procedure can be reversed if required with the simple removal of the implant with no subsequent damage or impact on the foot’s structure or function.

Other procedures designed to address flat feet involve multiple screws being placed through the heel and midfoot bones with some joints of the foot requiring fusion. These procedures are irreversible and come with a long recovery process and much higher complication rates. Unfortunately for some patients, this is the only solution offered and many will continue to try non-surgical treatments with ongoing discomfort.

Dr Andrew Knox performs surgery for flat feet using HyProCure implantation in Perth, WA. Not everyone will be an ideal candidate for this procedure. Consultation is recommended to discuss your medical history and individual needs. Click here for more information on HyProCure.

Perth Podiatric Surgery offers the most up to date minimally invasive and traditional foot surgery techniques, including the HyProCure Solution. For a specialist consultation with Dr Andrew Knox call 9383 3851 or book online.

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. 

Our specialist Dr Andrew Knox is the premiere provider of keyhole bunion surgery in Perth, Western Australia. Since introducing this novel technique in January 2018, he has performed over 350 keyhole-based bunion surgery procedures achieving good deformity correction with a high patient satisfaction rate.

For detailed information on the keyhole bunion surgery procedure we perform, please see our Procedures Page.

A general overview about minimally invasive bunion surgery is provided below for the purposes of this blog post.

What is the difference between traditional bunion surgery and keyhole bunion surgery?

Traditional ‘open’ bunion surgery requires a 10-15cm incision to be made over the top of the big toe joint in order to access the metatarsal bone and perform the bunion correction. This causes significant disruption to the soft-tissue structures around the big toe joint which often leads to permanent joint stiffness, numbness and scar tissue formation.

In contrast, minimally invasive bunion surgery, referred to as ‘keyhole bunion surgery’, only requires three small 2mm incisions to be made around the big toe joint. It is most akin to laparoscopic surgery. Surgical instruments are then introduced into the metatarsal bone through the portals and the bunion correction is carried out using live x-ray guidance.

This highly specialised procedure is only performed by a small number of surgeons in Australia, and the outcomes we have observed at our practice over the past 2 years are so favourable that this technique has become our primary method of bunion correction.

What is the difference in recovery between traditional bunion surgery and keyhole bunion surgery?

Due to a significantly smaller incision, there is reduced trauma to the joint and less damage to soft tissue and surrounding structures with minimally invasive surgery as opposed to traditional techniques. Subsequently, pain and swelling following surgery have been found to be a lot less, allowing patients to get back to their normal activity faster. Since cuts are made to the bone and fixated, the bone still requires adequate healing time, however, this occurs while weight bearing in a post-operative shoe and patients can begin weight-bearing immediately after surgery. The absence of a long incision also means very minimal scarring following surgery, so this technique offers the best possible cosmetic appearance postoperatively.

An example of a recent patient who has had this procedure performed is demonstrated below:

Who is a suitable candidate for minimally invasive bunion surgery?

The type of bunion surgery technique performed depends on the alignment of the bones making up the big toe joint and the severity of the problem. Not everyone will be an ideal candidate for minimally invasive surgery, however seeking an early opinion before the deformity worsens and becomes increasingly painful will give you the best chance of requiring only minimally invasive surgery as opposed to traditional techniques.

Where can I find a foot surgeon who performs minimally invasive bunion surgery in Perth?

Perth Podiatric Surgery is the premiere provider of keyhole bunion surgery in Western Australia. For a specialist consultation with foot surgeon Dr. Andrew Knox call (08) 9383 3851 or book online.

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. 

Bunion surgery is one of the most common foot surgeries performed at Perth Podiatric Surgery and involves correction of misalignment of the big toe joint. Surgery aims to relieve pain associated with the condition, prevent worsening of the deformity and allow a return to normal footwear.

There are many myths in the healthcare industry surrounding bunion surgery, however with the use of advanced surgical techniques, correct post-operative care and a skilled surgical team, complication rates remain low. Delays in presentation to a foot specialist most commonly occur due to embarrassment, anxiety about foot surgery or misinformation from other health practitioners. Patients sometimes present with the belief that they are ‘too old’ for bunion surgery, or it will be ‘too painful’ or ‘too risky’.

So let’s answer the question, who makes a good candidate for bunion surgery?

Put simply, bunion surgery is appropriate for anyone who experiences pain in the big toe joint, difficulty fitting into shoes or crowding of the toes. Most importantly, it is vital to seek early opinion from a specialist podiatric surgeon for the following reasons:

1 – More severe deformity means more complex surgery

We know that bunions are a progressive deformity that will worsen over time, resulting in the loss of cartilage and more severe arthritis within the joint. Once these changes have taken place, the joint becomes more difficult to salvage and requires more complex surgery to correct. With more complex foot surgery comes a longer recovery and subsequently greater risk.

2 – Conservative treatment could relieve your painful bunions

If detected in the early stages of the condition, sometimes conservative treatment is all that is needed to treat bunions and surgery can be avoided. Conservative treatment usually consists of footwear changes or modification, functional foot orthotics and anti-inflammatory medication.

3 – Podiatric surgeons are the most highly qualified health professionals to evaluate your bunions

Podiatric surgeons like Dr Knox undergo extensive medical and surgical training to qualify as specialists in their field and are recognised under The Australian Health Practitioners Regulation Agency. A podiatric surgeon will evaluate your bunions, as well as your medical, social and family history, and advise you on the best course of action to treat your bunions; whether that be surgical or non-surgical.

The takeaway message? Seek opinion early

If you or someone you know is suffering with painful bunions, don’t wait to begin treatment. Book in to see our specialist podiatric surgeon to discuss both surgical and non-surgical options to relieve your pain. Call 9383 3851 today or book online.

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. 

Ingrown toenails are one of the most common problems seen by foot surgeons in Perth, and they often present following extensive failed conservative treatment. At the first sign of an ingrown toenail, you may think your best port of call is your general practitioner or local podiatrist, however foot specialists, also known as podiatric surgeons, have extensive knowledge and training in diagnosing, treating and managing associated infection of ingrown toenails.

What is an Ingrown Toenail?

An ingrown toenail is a painful condition of the skin/nail most commonly affecting the big toes. They can be present with or without associated infection and can affect one or both of the big toes, and sometimes even the lesser toes. Ingrown toenails can occur at any stage of life as a result of many causes including; improper nail cutting technique, tight fitting footwear, trauma, anatomical factors such as thickening of the nail plate, pincer shaped toenail, and pressure from abutting toes caused by bunions, hammertoe deformities, or bony spurs underneath the toenail.

When is Surgery Necessary?

Surgery to treat ingrown toenails is indicated in patients where conservative podiatrist care proves unsatisfactory, or a recurrent problem is experienced. The aim of surgery is to correct the underlying nail deformity, reduce associated pain and
prevent further infection. There are two common nail surgery techniques performed by podiatric surgeons, both of which have been shown to have a high degree of success and a low recurrence rate. The procedure recommended to you by your foot surgeon will take into account the degree of nail deformity, and any associated excessive tissue growth in the nail sulcus.

What can I Expect Prior to Surgery?

Your foot surgeon will initially take a thorough medical history and details about your problem, before examining the nail and surrounding skin. In some cases your foot function and biomechanics will also need to be assessed as a potential cause of the nail problem. Treatment options will be discussed with you, including both conservative management if applicable, antibiotic therapy if infection is present, and possible surgical management. Your surgeon will then discuss the proposed procedure with you, including options of anaesthesia, pain medication if required and how to care for your toe/s after surgery.

If ingrown toenails are causing you pain, embarrassment or shoe fitting problems call 9383 3851 today to see Dr Andrew Knox, Specialist Podiatric Surgeon, or book online here.

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.